As a veteran photojournalist in Nashville, Tennessee, I was hired by USA Today newspaper to photograph a spina bifida corrective surgical procedure. It was to be performed on a twenty-one week old fetus in utero at Vanderbilt University Medical Center. At that time, in 1999, twenty-one weeks in utero was the earliest that the surgical team would consider for surgery. The worst possible outcome would be that the surgery would cause premature delivery, and no child born earlier than twenty-three weeks had survived.
The tension could be felt in the operating room as the surgery began. A typical C-section incision was made to access the uterus, which was then lifted out and laid at the junction of the mother’s thighs. The entire procedure would take place within the uterus, and no part of the child was to breach the surgical opening. During the procedure, the position of the fetus was adjusted by gently manipulating the outside of the uterus. The entire surgical procedure on the child was completed in 1 hour and thirteen minutes. When it was over, the surgical team breathed a sigh of relief, as did I.
A doctor asked me what speed of film I was using, out of the corner of my eye I saw the uterus shake, but no one’s hands were near it. It was shaking from within. Suddenly, an entire arm thrust out of the opening, then pulled back until just a little hand was showing. The doctor reached over and lifted the hand, which reacted and squeezed the doctor’s finger. As if testing for strength, the doctor shook the tiny fist. Samuel held firm. I took the picture! Wow! It happened so fast that the nurse standing next to me asked, “What happened?” “The child reached out,” I said. “Oh. They do that all the time,” she responded.
The surgical opening to the uterus was closed and the uterus was then put back into the mother and the C-section opening was closed.
It was ten days before I knew if the picture was even in focus. To ensure no digital manipulation of images before they see them, USA Today requires that film be submitted unprocessed. When the photo editor finally phoned me he said, “It’s the most incredible picture I’ve ever seen.”
I mainly freelanced for The Tennessean Newspaper in Nashville. They recommended me when USA Today called them needing someone to photograph the surgery.
I was honored to be shooting for USA Today and wanted to do the best job possible. I never imagined the child could possibly reach out during the surgery. But that is exactly what happened. As I write this nearly twelve years later I’m still in shock that Samuel reached out like he did. But I am also in shock as to what has become of the moment I captured.
USA Today and The Tennessean Newspaper both published the picture initially September 7th, 1999. With my cutline stating Samuel reached out on his own.
Several very prominent people at The Tennessean Newspaper said to me,”if that picture doesn’t win a Pulitzer Prize something is wrong.”
I called John Howser, Head of P.R. at Vanderbilt, seven days after the picture published in the Tennessean Newspaper, and in USA Today.
“You nailed it,” John said. “Look, I’m in the middle of something I don’t want to be in the middle of. Your picture is very good, but it has already been done.”
“What are you talking about, John?” I asked. He proceeded to tell me that Life Magazine planned and posed a very similar picture one month before I captured the picture of Samuel reaching out.
He said, “For their Millennium Issue, Life Magazine wanted to show how far medical science progressed in the twentieth century, in utero fetal surgery. It was intended to be the cover, December 1999. But they are not sure now.”
I asked John how old their baby was. “24 weeks,” he replied.
I said to John, “Surely Life Magazine would rather have the real thing rather than a posed picture.” John did not seem happy with me.
The next morning Susan called me from Dr. Bruner’s office and stated that Dr. Bruner would like to obtain a color slide of the picture for a presentation he was giving the following evening. I told her I would check with my lab and see if it was possible to rush the order. I called Susan back with the estimate of $145 to have the slide by tomorrow afternoon. “Let me speak with Dr. Bruner,” she responded. She came back to the phone and said, “he’s not going to pay anything.”
“I’m sorry I have offended Dr. Bruner,” I said.
Susan said, “not at all, I just found out you scooped Life Magazine.” I paused a minute and let that sink in. I then told her that I could not afford to pay for it myself, and said I was sorry.
I pondered the information I had and realized the position I was in. I knew about the Life Magazine picture, and story for their December 1999 issue. I knew their baby was 24 weeks and their picture was posed. After three days of pacing the floor trying to decide whether or not to use this inside information, I tried to call a photo editor at Life Magazine. No one returned my call. I decided to call Gamma Liason, a picture agency, and have them get in touch with Life Magazine for me.
When I called Gamma Liason I talked to Brian Felber. I tried to explain about my picture but he didn’t understand, so I told him to show this picture to Life Magazine and you won’t have to say anything. I sent him a small digital file of the picture to show Life Magazine. Mr. Felber called me back and said, “They do want to buy your picture. They want to buy it to kill it.” His exact words.
“Bad choice of words, there isn’t enough money in the world that would allow that to happen,” I said. I told Brian to tell Life Magazine that if they did not use my picture I would find an agent to aggressively market my picture, and the story about in utero fetal surgery would be old news by the time their December issue could hit the streets.
Brian negotiated with Life Magazine for rights to my picture for the next four days. The second day of negotiations, I was talking to Brian on the phone, and I told him that I knew the baby in the Life Magazine picture was 24 weeks, and Samuel was 21 weeks, the youngest even considered for the surgery. I could hear a woman scream on another line when Brian told her that. He must have had a phone at each ear.
I asked Brian who I was negotiating with? “Vivette Porges, a photo editor at Life Magazine,” he responded. I knew when Brian asked me,”They want to know what speed of film the picture is on?” They were actually considering using the picture.
Around lunchtime on the fourth day Brian called and said, “Negotiations went on late into the night, and were very heated at times. But Life Magazine decided to pass on your picture.”
Now it was a race to have my picture published before the December Issue of Life Magazine could come out. It was nearing the third week in September 1999. I listened to the advice of a man I respect very much and hired Marcel Saba to represent the picture for me. He was owner of Saba Press, a very reputable New York picture agency.
Marcel Saba worked quickly. A four page layout of my pictures from the surgery were first published in the French magazine called VSD, September-October issue, 1999. By mid November, the picture and story were in syndication and newspapers and magazines across Europe had published them.
The story about the groundbreaking fetal surgery was old news and Life Magazine buried their story,”Born Twice” in the last few pages of the December 1999 issue.
Then it happened. The January 9th, 2000 article by Bill Snyder for The Tennessean Newspaper titled, “Photo of fetal surgery still stirs emotion.”
Dr. Joseph P. Bruner stated, “Depending on your political point of view, this is either Samuel Armas reaching out of the uterus and touching the finger of a fellow human, or it’s me pulling his hand out of the uterus … which is what I did.”
In his interview with Bill Snyder, Dr. Bruner said, “I took the hand out and posed the picture for the photographer.”
In an article, May 2, 2000, by Robert Davis for USA Today titled, “Hand of a fetus touched the world.” Dr. Bruner made these comments:
“It has become an urban legend,” says Bruner, the Vanderbilt University surgeon who fixed the spina bifida lesion on Samuel. Many people he hears from wonder whether it’s a fake.
“One person said the photo had been reviewed by a team of medical experts and they had determined that it was a hoax,” Bruner says with a laugh. More commonly, people want to know how the photo came to be.
Some opponents of abortion have claimed that the baby reached through the womb and grabbed the doctor’s hand. “Not true,” Bruner says. “Samuel and his mother, Julie, were under anesthesia and could not move.”
“The baby did not reach out,” Bruner says. “The baby was anesthetized. The baby was not aware of what was going on.”
The popularity of the picture and story, through emails, propelled their publication in the June 9th, 2003 issue of Newsweek, four years after the picture was taken. That issue of Newsweek was displayed, to show the picture of Samuel reaching out, during the Partial Birth Abortion debates on the floor of the U.S. Senate, and the House of Representatives.
September 25th, 2003, Samuel, his parents, and I testified before a Senate Committee about the surgery and the impact of the picture. Samuel actually answered questions from Senator Sam Brownback.
I went on to freelance for eight years after the picture.
Please study the three frames that were taken in sequence in the slide show. These frames were taken at 1/60th of a sec. as fast as my Canon 1N motor drive could shoot. The motion blur in the third frame explains what is happening. Watch Dr. Bruner’s fingers, compare the first two frames to the third frame. The doctor’s fingers are blurred because he is shaking them up and down in the third frame. The motion blur on Samuel’s hand transfers to the upper part of his wrist as he grasps the doctor’s finger. Samuel squeezed so tight, he stopped the action in the photograph. He is the reason the picture is in focus.
Notice in the third frame, the right side of the surgical opening. The edges are smooth. Now notice above Samuel’s hand. You can see the surgical edge was damaged as Samuel thrust his hand out.
Anesthetizing a child in utero is the most experimental aspect of this procedure.
Someone please, ask Dr. Joseph P. Bruner if he truly did pose the picture that caused him to lose the cover of Life Magazine?
– Michael Clancy