The Photographer’s Intent: Understanding the Narratives We Amplify

In the article “Capturing Racial Pathology: American Medical Photography in the Era of Jim Crow” (p. 75), Stephen Kenny analyzes the photographic work of elite White surgeon Rudolf Matas. The images, published in the 1890s, were “produced and assembled in parallel with the making, publication, dissemination, reception and use of Matas’s racialized medical research, in particular his influential 1896 pamphlet on ‘The Surgical Peculiarities of the American Negro’” (p. 76). Kenny includes three images to support the argument that the images were made, published, and disseminated in parallel with Mata’s racialized medical research and the term he coined: “racial pathology.”¹

After reviewing the piece, Alfredo Morabia, AJPH editor in chief, asked me to consider the following questions: What do these pictures tell you as image editor? You look at so many images; what was your first reaction when you saw these? What do they tell you?

I approached the images from the vantage point of professional image editor but with a layperson’s interest, my work being visual communication generally rather than public health specifically. Although I had some specific reactions to each individual image, the bulk of my reaction was directed to the images as a set. My response felt visceral: the longer I studied the images, the more I wanted to look away.

Image context is critical. On the literal surface, there is the subject, what a viewer sees. But there is a subtle layering of messages within photographs. This is the story told by the photographer. It involves context, composition, and purpose. On a deeper level, there is message, mission, and integrity. All of this is perceived by the viewer, can dictate feelings, and can direct actions.

On the surface, the Matas photos appear flat. The stiff subjects give an initial impression of clinical objectivity, but very little medical information is explained or revealed. Despite being typical of the period, as diagnostic tools these photos are lacking. Lengthy examination reveals a more troubling story. There is no intimacy between photographer and subject or between photographer and viewer. The distance feels purposeful. The subjects are in positions that emphasize “peculiar conditions,” thus supporting Matas’s theory of racial difference. All the subjects are all test subjects. I feel like a voyeur. These are images that I am not supposed to see.

On another level, the Matas photos challenge my current cultural definition of decency while simultaneously upholding cultural messages I have been taught about brown-skinned people: specifically, brown-skinned people can be viewed as pieces or parts. Although I am seeing these specific images for the first time in the context of this specific article, they feel familiar. I am used to seeing these images and others like them. They are a typical, historical representation of brown bodies. Visually, these themes appear repeatedly in history books, comics, illustrations, advertisements, television, and movies.

Disengaging with the Matas photos, I am left with a single clear thought: I distrust this photographer.

THE PHOTOGRAPHER’S INTENT

The 2015 World Press photo contest was labeled “tumultuous” by writers of the New York Times LensBlog after a number of images were disqualified because of manipulation and excessive digital editing. One large prize was “revoked amid allegations of staging and misleading captioning.”

Photographer and contributor Donald Weber wrote at length about the intent of the photographer—specifically that the most important consideration for photography is how the photographer has decided to engage the viewer. According to Weber, viewers must look beyond the photographs to the photographer’s intent. Weber warns, “Photographs lie, photographers do not.”¹ Similarly, other contributors supported the idea that the intent of the photographer is paramount to the integrity of the photograph and the story it depicts. There is an ethical line in photography where images cease to depict reality, but rather uphold systems of belief.

In light of these ethical considerations, the work of Matas is deeply problematic. As Michele McNally, director of photography and an assistant managing editor at the New York Times, observed, “There are many societies where photographers work without accepted ethical guidelines, but with a long history of producing propaganda disguised as ‘news.’”¹ And the problem with propaganda lies in its purpose, which includes information, ideas, or rumors deliberately spread widely to help or harm a person, group, movement, institution, nation; the deliberate spreading of such information and rumors; and the particular doctrines or principles propagated by an organization or movement.

CAN A LENS CONDITION RACIAL BEHAVIOR?

Sarah Lewis, assistant professor at Harvard University, explores the relationship between racism and the camera. Her work examines how the construction of public pictures limits and enlarges our notion of who counts in American society.² In a 2019 essay for the New York Times, she asks, Why does inclusive representation matter so much? For this answer, she considers her grandfather, who was expelled as a high school student for asking why his school history books did not include images of African Americans (he later became a photographer).³

According to Lewis, the example of young children gazing up at Michelle Obama’s portrait by Amy Sherald at the National Portrait Gallery and images from former White House photographer Pete Souza of Barack Obama with young African American children make it clear: “You can’t become what you can’t accurately see.”² Matas created images that dictate both the way a subject sees himself and how the subject is seen, viewed, and treated by others. His work perpetuated prevailing thoughts about racism while simultaneously creating a new paradigm: racial pathology.

One might admit that today inclusive representation matters. But did it matter, even during the time when Matas created his images? To that end Lewis offers the following:

Frederick Douglass knew it long ago: Being seen accurately by the camera was a key to representational justice. He became the most photographed American man in the 19th century as a way to create a corrective image about race and American life.²

ANTIRACIST ACTION

At its core, public health is antiracist work. Practitioners, workers, and writers in the field know that ignoring the impact of racism on racialized health disparities enables the perpetuation of these inequities. “As public health researchers, students, and practitioners, we have a similar responsibility to directly confront, analyze, and dismantle racism.”^3(pe28)

From my image editor’s perspective, it is imperative that photos published in the journal accurately depict their subjects and be created by photographers sharing a transparent truth with their viewers. Images must engage truthfully and challenge respectfully, adding to rather than directing narrative. The cover of the October 2019 issue of AJPH—Racial Biases and Health Disparities 400 Years Since Jamestown—showcased the work of visual narrator Texas Isaiah—artist, African American, transman. Texas Isaiah looks through a lens that matches his subject matter with empathetic eyes. Honoring voices rather than dictating narrative is crucial for public health antiracist work.