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One Year with COVID-19 – A Seasoned Pulmonologist and Photographer Looks Through a New Lens

john hansen flaschen

Last spring, John Hansen-Flaschen, MD, a professor of Medicine and Pulmonary, Allergy, and Critical Care in the Perelman School of Medicine and the founding director of Penn’s Paul Harron Lung Center, watched it all unfold on his screen. Working from his computer, the former chief of Pulmonary, Allergy, and Critical Care collaborated with Penn clinicians, administrators, and researchers to assess the changing state of the COVID-19 pandemic, discuss findings from the bedside, review research and data, and create efficient plans to bring the latest treatments to patients.
While Hansen-Flaschen remained home due to his age and semi-retired status, his peers who were caring for the most severely ill hospitalized COVID patients met over video, too, from wherever they happened to be: a corner of the hospital, their office, their home, and some even from hotel rooms where they were temporarily living to keep from accidentally bringing the virus home to their families or to be closer to the hospital should they need to quickly return to the Intensive Care Unit (ICU).

A passionate photographer, Hansen-Flaschen set his camera on a tripod directly over his shoulder and captured his colleagues working together at that moment in time where medical experts and the world tried to make sense of the new pandemic. One year later, Hansen-Flaschen explains the photos he took — that he later turned into a photo essay — and what those images say about medicine, coping and collaboration in a crisis, and the ways we connect with colleagues across the world today.

Can you take us back to a year ago? What was it like dealing with the first surge of the pandemic?

The first surge was a humungous event, particularly for doctors and hospitals. It came upon us in a week. It was a tsunami. There were warnings of it, and all of the sudden, it was upon us. We stopped everything we were doing and dug into something that was very much unknown. People were innovating and putting things together on the fly. And then, on top of that, we had to teleconference several times a day. Before that, remote meetings had been a very occasional thing, meeting with people in other parts of the world a couple times a year. So there was an adjustment to the state of the world but also to constant video conferencing, and I think these photos show the first few weeks of the crudeness of this adaptation.

covid photographer

What encouraged you to photograph the video meetings?

I was a recently retired clinician who had worked at Penn for over 35 years. When the staff put schedules together to handle all the possible influxes of COVID patients, I wasn’t called back in because of my age. I’m 70. I felt kind of left out. I was always someone on the front lines, going over the hill to fight new battles. And here I was left out. But I was invited to participate in the back-room story, the teleconference meetings where we were struggling together to make sense of the science that was coming out, to make our schedules, to figure out how we would deal with certain medical situations, whether this medicine or that medicine worked.

I was in those conferences several times a day in my home office where I have two computer monitors set up. We had these very, very structured meetings over video conference, and I continued to feel left out because I was not joining them in person and not doing patient care like them. But then I started to reflect on what I was really seeing on my screen. Behind my colleagues were their kitchens, a hotel room where they were staying, maybe a kid’s head would poke up in the shot. Some people were unshaven and appeared exhausted. And on top of that, they were not behaving like they normally did when we would meet in conference rooms.

Do you think being on the computer versus in person stripped down some of those walls we all put up when we’re around others, or do you think it was the stress of the situation? Maybe both?

Yes, both! If you go to a meeting after being in the ICU, you take off your ICU clothes, you walk through the hallway, and you sort of shift gears from being a doctor to being a conference-room person. But here were some people video conferencing, calling in from a small corner of the ICU. They could be interrupted at any time, and sometimes they were for urgent business. Some had marks on their face from masks or face shields. So there was no separation between hands-on clinical work and participating in meetings.

covid photographer

Why did you shoot with an actual camera instead of just taking screenshots?

I wanted to convey to the audience that I was sitting in front of a monitor. And I really liked that I photographed exactly what I was seeing. It included the screen and the monitor, and I thought that was a better depiction of my experience. That actually made it a technically challenging project. I had to experiment with various focuses and shutter speeds so that I captured the moment but you didn’t end up with pixelated shots that caught the screen refreshing.

Taking pictures of pictures is pretty “meta.” Does that mean anything to you?

It does reflect the feeling of being removed from each other a bit and me being removed from my peers. It emphasizes the distance between us that we successfully overcame.

Do you think of your colleagues any differently now that you’ve had this intimate and vulnerable glimpse of them?

Seeing their homes can give you some insight into their personalities or seeing them unshaven or less “groomed” can make you see them in a more human or personal light. But the main experience I had here was how professional, how capable, how highly-able to communicate these people were. So now, in the early days in crisis mode, everything’s on the line. There’s no small talk. There’s no joking around. There’s no trivia here. It’s all business. Bang, bang, bang. No wasting time; it’s right into the business. I saw my colleagues demonstrate the kind of communication you expect from air-traffic controllers or communications with astronauts in outer space, or with the military on the battlefield. And I was very impressed.

covid photographer

How do you think your photos compare to other photos of frontline workers and medical experts that we’ve seen this year?

There are hundreds and hundreds of photographs of people in PPE protective gear standing in an ICU with their goggles and face shields. And I guess that’s foreign to most people. But the ICU was my second home for 35 years. I essentially lived there.

All the photos of the ICU I’ve seen have been of a stressful, sad place. What I like about these videoconferencing photos is that they are images of those same people in a more personal environment where you have to think twice to realize, “This is an ICU doctor.” It’s a much more personal view.

Well, other people are familiar seeing health care professionals in some sort of medical attire or scrubs at least, too. So even to people who aren’t in the medical profession, seeing someone in street clothes or in these personal environments who is a medical professional is still unique. Your photos humanize them.

Yes, the people in my shots are still being clinicians in those moments, in those back-room meetings. And those meetings and that collaboration are what made us excel. We combed through research and data from Penn and those of others around the world. Most of us here at Penn are part clinical and part research. We have a lot of doctors to cover our ICUs and were able to appoint a lot of people, with research expertise, to the behind-the-scenes work, at least some of the time. All of that work behind the scenes, done when we don’t “look” like doctors, was key to helping people recover successfully.

What’s different now versus the beginning of this pandemic? What does it mean looking back on this time now?

We have come so far. We are better able to treat people with mild to severe COVID symptoms. We have vaccines that will protect people from this coronavirus. We have more research on which to base standards of care. We’re more used to conducting personal and professional business on videoconferences and have proof that it is an effective tool.

Our virtual meetings are different now, too. We “ready” ourselves for the camera, prepare our backgrounds, and I think that luxury of not having to jump right in, without concern for appearances or comfort or niceties, is symbolic. Thankfully, we have a better handle on the situations in front of us. We have confidence. We are now lucky enough to be able to worry a little over the shallow things like fixing our hair.


View Hansen-Flaschen’s Photo Essay Here.

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