This X-ray teaching file was from an infant with a condition of the gut known as necrotising entero-colitis. A complication occurs in which gas escapes from the gut into the portal vein and flows to the liver. This could be seen on the original X-ray – of which little more than the outline persists in my picture. When I was newly qualified this complication was almost universally fatal, but with better understanding of the condition and improvements in the care of sick neonates most now survive.
The file has been associated with a picture of a country lane bounded by pine and eucalyptus trees in bright sunshine with deep shadow, and it takes on a rather sinister aspect. For that reason you can see lines of fire shooting out towards you symbolising progress from a blurry distant time when survival was difficult to a more hopeful present.