ER Doctor In Los Angeles Captures The Toll Of COVID-19 With His Camera
RACHEL MARTIN, HOST:
There is some good news to report out of California. Coronavirus cases there are finally trending downwards.
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GAVIN NEWSOM: One month ago today, on January 16, we reported 40,600 cases of COVID-19. Today, 5,600 cases - two weeks, 39% reduction in the number of people hospitalized, 32% reduction in the number of people in our ICUs.
MARTIN: That's California Governor Gavin Newsom yesterday at the opening of a new mass vaccination site in Los Angeles. The decline in cases is welcome relief for Los Angeles County hospitals. Just last month, this was the grim figure - one person in LA County was dying of COVID-19 every six minutes.
It's been difficult to convey the chaos and trauma happening in these hospitals. Journalists and photographers have had a hard time getting access to these COVID units because of health concerns. Those who have are able to show us the suffering unfolding there. But when the photographer is a doctor taking pictures of his colleagues and patients in his ER, the photos carry a different level of intimacy and power.
SCOTT KOBNER: Every day off that I had or sometimes after shifts, I would stick around or come in to do this kind of work to try to really be in a totally different role, one that had nothing to do with the medical care that was being provided, but in a position where I could use my knowledge and experience to help others kind of see the world through my own experience.
MARTIN: This is Dr. Scott Kobner. He's the chief emergency room resident at the Los Angeles County-USC Medical Center. He's also an amateur photographer. When the pandemic began, Dr. Kobner decided to start taking pictures of what was happening in his hospital. The photos appeared this week in the LA Times.
KOBNER: I knew during that time it would be really important to document this part of history and all the changes and experiences that we had just in our small corner of the world, if not just for our own knowledge and reflection after the event, but then as the time moved on and I realized that some of this work might be more important to share with a larger audience and give people a sense of what was really going on.
MARTIN: Let's just try to convey what these pictures show. Right? We have to use words on the radio, but we'll make sure to post some of your photos online. But can we talk about just a couple of these? We should say they're all black-and-white. They're really stark, intimate photographs of doctors, nurses and patients. One that struck me - a box of Polaroid photos attached to a wall in the COVID unit. Can you tell us about that?
KOBNER: The idea was to take Polaroid self-portraits that we could then attach to our gowns or somewhere on our bodies while we were providing this care so that patients could see what we looked like and so that they knew the faces of the people who were taking care of them. Then for us, it became so common to just see people by their eyes. And then as patients came back in again, they became more comfortable with it. The practice kind of wore off. And then eventually outside - in this room where we would put on all this equipment, this glass box where all these pictures were kept just kind of hung there as a reminder of all these faces - of the people that we used to be before this all really took off.
There's also a photo of doctors surrounding a COVID patient who looks to be older. And your post on Instagram about this photo reads as follows - quote, "It's a sacred honor to be with human beings during their most vulnerable, especially their last moments on Earth." Is that what was happening in this moment in this photo?
KOBNER: Yeah. That's been the hardest part, I think, about all of this pandemic, from at least the emergency department perspective and certainly, like, my friends and colleagues who work in ICUs or in medicine wards - because whenever we have some of these really important and deep conversations in the emergency department about placing somebody on a ventilator or about performing a therapy that might make them unconscious for a period of time, it's always with the hope in our mind that this is going to be a temporary thing and, you know, you may really get better, especially people who came in walking and talking and you're able to really engage with.
And to have day after day after day conversations where you can't really give people a good number as to their chances of successfully coming off of a ventilator or surviving this illness but telling them, the next best treatment that we have for you is to put you to sleep and put you on this machine. And so these moments right here may be the last time that you get to speak to your family, may be the last time that you remember being awake is just so continually heartbreaking. And it's such a burden to carry for so many people.
And normally, the most profound and, I think, important thing that we do in health care is to just be with other human beings during those moments - the moment where we tell somebody that they have a cancer, the moment where we tell them that their cousin was in a bad car accident. Thankfully, a lot of those times, the really deep ones, the ones that kind of really hit you night after night, where you're lying on your bed and looking at the ceiling, don't happen every single day. And during this whole time, it has been that every single day, every single shift. And so it's really both brought to the greatest light kind of the sacred nature and the true, deep privilege that we have in what we do to be with other people during these moments, but also the human cost of that.
MARTIN: Has taking these pictures - has that been its own form of catharsis for you?
KOBNER: I think in some ways, yes, but in other ways, no. I think it's been very cathartic to hear feedback from people from all walks of life across the world about some of these pictures on Instagram or, you know, from the LA Times publication because it's just - it's both heartbreaking and also so supporting to know that there are other people going through the exact same thing and facing the exact same challenges. But a lot of times now, looking back on this work, I just see the entire development of the events playing out and how hard every step of the way this - OK, it's going to get better, like, next week or, all right, you know, hopefully this winter won't be as bad - and just kind of looking back and knowing that that was truly, like, a false hope and having to still have had that experience.
MARTIN: Is there one photo that evokes something particular for you when you look back on it now?
KOBNER: I think the one that's still the most powerful to me is a photo of one of my best friends and colleagues, Dr. Molly Grassini. And there's a portrait I took of her, and it's in the middle of a chaos of an unexpected cardiac arrest, where a patient came in and was really young and, you know, died on the way to coming to the hospital. And this was kind of early in the first surge. And the team had scrambled to get on all of their PPE and to try to take care of this man and resuscitate him. And it's a portrait of her just looking out onto the monitor. And it's just - her eyes are really the only thing that's visible about her face. And there's just such a sense of deep hope for the monitor to show, you know, a sustainable heartbeat, some sign of life.
And to just see her in that moment and to know that exact feeling of fear and vulnerability and hope all entwined together through her has really been something I think about a lot because it's just - I think, really, the pinnacle of what this whole experience has been for me has been, you know, seeing the people that I get to work with every single day in such a new light and seeing the other side of what I do in such a new light.
MARTIN: Have you thought about what you want people who aren't in hospitals right now to take away from them?
KOBNER: Yeah. I think the best part about photography is that there's an undeniable narrative authority to it. You know, when you see a photograph, you know that this was a documentation of a snapshot in time, and it wasn't a reimagining of something. It wasn't a drawing or a painting where, you know, many details could be - or had to be remembered or changed. And, you know, I think that in the society that we live in now in 2020 to 2021, the essence of truth has been hard to pin down for a lot of people, and there's so much misinformation. And what's allowed a lot of that misinformation and fear and conspiracy theory on some level to flourish about medicine is the absence, I think, of that narrative authority that something like photography can provide.
And there's many reasons why that part of the conversation has been more absent from the side of medical professionals. But it's my hope that sharing these images and for people who are outside of medicine can really understand what's going on and to understand why they see people in scrubs riding the bus home from a 12-hour shift just look like they are the most exhausted people they've ever seen or, you know, why their significant other is having a really hard time relating to them because after shift after shift at the hospital, something seems missing - or people who live in communities where they've been fortunate to not be as affected by this pandemic and might not believe that it's really a problem for people in this country and around the world to change that belief and to prepare and to continue to live in communities that haven't been affected by taking important measures like social distancing and vaccination to ensure their health and safety.
MARTIN: Dr. Scott Kobner, chief resident at the Los Angeles County-USC Medical Center's emergency department and photographer.
Dr. Kobner, thank you so much.
KOBNER: Thank you for the opportunity.
MARTIN: And you can see some of Dr. Kobner's photos for yourself at npr.org.
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