Images are increasingly used in health research as a complement to discursive methods, to elicit more and different types of knowledge and experience from participants. The use of image-based research, such as drawing and photography, then, holds promises for understanding health in new ways. However, such promises fall short when researchers and audiences treat images as realist representations of participants’ lives. Images are never clear representations of an objective reality- this is not their value either during or after research. In this photo essay, we show and discuss how we countered image positivism in the PHRAME study, Photographing Health by Rural Adolescents in the Midwest. The photos shown in this essay take viewers into our interviews in PHRAME and then out to our modes of audience engagement. Throughout, play served as a critical orientation and form of listening. We show this, first, through glimpses into our interviews, where we engaged in play that transformed meanings of photos taken by the young people. Then we show how we engaged public health, academic audiences, and popular audiences of the young people’s photos in play where audiences were invited to co-produce meaning through interactive activities, rather than reading to extract meaning from the photos. In conclusion, we suggest that play as a mode of research and exchange holds transformative potential, taking health research beyond the image positivism that has constrained the methodology to expand visions of what health is and might be.