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In this scene, the surgeons have asked the scrub nurse to add a hand, to help hold while placing a port in the chest. It illustrates the need for tight teamwork in the OR. The scene was lit with a single overhead light from the surgeon's forehead giving a dramatic vignette (the vignette is even more severe in the room, as that is all the light to see anything when the photo was taken). The steel particularly picks up the highlight of the light in black and white.
This was shot with my second body, a Canon 30D using the Canon EF 50mm f1.4. Exposure: ISO 200, f4.5 1/2500 sec exposure. Note the exposure date was changed for confidentiality. Initially RAW processed in Apple Aperture and finished in Adobe Photoshop CS6.