WORKING LIVES: In the first in an occasional series featuring people in unusual NHS jobs, Barbara Millar meets Kathy McFall, medical illustration manager, who has a passion for shooting patients - with her camera

The only time Kathy McFall felt queasy was watching fluid being drawn from the shoulder of an elderly patient who was clearly in pain: 'I can do blood, guts, specimens, whatever, and it doesn't affect me at all, ' she says.

Ms McFall is medical illustration manager at Gartnavel General Hospital, part of North Glasgow University Hospitals trust.

She loves medical illustration but believes its value is not always appreciated by the NHS. 'It is a fundamental diagnostic aid to understanding the pathology of disease and suffering, ' she says. 'But too often the profession has had to rely on the enthusiasm of dedicated individuals in order to progress. '

This may soon change. In February, junior health minister Lord Hunt announced a new strategy for the healthcare science professions, which include medical illustration. Medical illustrators, of whom there are some 2,000 in the NHS, will be renamed as healthcare scientists in medical illustration. The barriers to state registration may finally be removed.

Ms McFall, now 31, did a degree in photographic and electronic imaging sciences at the former Central London Polytechnic, qualifying in 1992.

She then studied for an MSc in medical illustration at the University Hospital of Wales in Cardiff, a course which combined academic study with paid, practical experience.

Only 15 months into the course, Ms McFall was head-hunted by Westway Graphics, based at Hammersmith Hospital, London.

'This was the first outfit of its kind, an entirely commercial business operating within the hospital, ' she explains. 'It was so different to Cardiff, where the emphasis was on education, and you had twoweek deadlines to turn things around. At Westway I was thrust into a business: two-hour deadlines had to be met. '

After a year with Westway she accepted a promotion to join the medical illustration department at the Victoria Hospital, Kirkcaldy, Fife.

She took up her present post in 1995, completing her MSc the following year.

Ms McFall is involved in photographing patients in operating theatres, clinics and in the studio. 'We often take serial photographs, such as changes in a skin cancer over time, or pre- and post-operative photos of a patient undergoing rhinoplasty. '

Medical illustrators also do video work, recording endoscopies, bronchoscopies or surgical procedures. There is also video-conferencing - transmitting live surgery from various theatres to other parts of the hospital, or overseas if necessary.

The technology changes all the time. Digital photography, which dispenses with film processing, means patients can be photographed before they go into the theatre and, a couple of hours later, the image will be in their notes and available to the surgeon. Urgent clinical photography takes precedence over all other departmental activities.

Ms McFall did a course in anatomy and physiology as part of her MSc. The recently introduced BSc course in medical illustration includes anatomy and physiology at the same level as for nursing.

Although she enjoys her work, she is not sure whether she will stay in the profession forever. Pay, based on medical technical officer scales, is not particularly attractive, and trust mergers mean there are now fewer top jobs.

She recently became one of only nine fellows of the Institute of Medical Illustrators. She also edits the Journal of Audiovisual Media in Medicine, the first woman editor in its 50-year history.

'The job's biggest satisfaction is still the patient contact, 'Ms McFall says. 'Even if I was head of a department of 30 people, I would still want to have a camera in my hand. '