Triage Emergency nurses (L to R) Jane Hoang, Gelsey Hines, and Laurie Metcalf spot each other as they put on personal protective equipment (PPE). Small things, such as a mask not covering a nose or hair peeking out of a bonnet, can be caught and corrected. (Photo by Dr. Dawn Lim)
It’s a gesture of support. A visual chronicle. A time capsule of sorts for these extraordinary times.
For the past few weeks, Dr. Dawn Lim has filled her downtime and off days between shifts as a UHN Emergency physician by returning to work with her camera to photograph her colleagues on the frontlines of the COVID-19 pandemic.
Her motivation goes back two decades – before she cared for patients herself, balanced professional demands with keeping her young family safe, or monitored a grandmother in long-term care.
“Several of my colleagues worked during SARS,” Dr. Lim says of severe acute respiratory syndrome, a viral, respiratory illness caused by a coronavirus, which was deemed a global threat in 2003.
“One of them told me that after the crisis was over, no one was interested in knowing how the team felt. In many ways, their story was forgotten.
“We often forget that healthcare providers need care and support like everyone else. I wanted to capture the essence of a hospital coming into its own strength so that our story is not forgotten.”
Emergency physician Dr. Kasia Stefanski, acting as the “runner doctor,” clutches a baby monitor to communicate with the Emergency Medicine Team of nurses, doctors and respiratory therapists at the patient’s bedside. They are conducting a Protected Code Blue, which signifies the patient’s unknown COVID-19 status and that it’s an emergency intubation – inserting a breathing tube. (Photo by Dr. Dawn Lim)
Over the past few weeks, Dr. Dawn Lim, seen here standing on a stool to get a better angle, used her off days and time after shifts in the UHN Emergency Departments to photograph the battle against COVID-19 in the EDs, Intensive Care Units (ICUs) and General Internal Medicine (GIM) units at Toronto General Hospital and Toronto Western Hospital. (Photo by UHN)
Over the course of three weeks of photography, Dr. Lim captured a series of poignant portraits: Environmental Services workers cleaning and disinfecting a room after the treatment of a COVID-19 suspected patient; a team responding to a Code Delta, the term for a patient with the coronavirus who must have a breathing tube inserted; medical staff rushing a COVID-positive patient to the intensive care unit. (ICU)
The images are dramatic and courageous; haunting and illuminating.
Upon reflection, Dr. Lim says two things that struck her over the course of the project were how the COVID-19 story has evolved over time and the effect it is having on her and her colleagues.
“At first, I saw a lot of tension while our team waited for the surge to appear,” she says. “It was as if the hospital was holding its breath. There was a lot of practising and preparation behind the scenes.
“Then, as sick patients started to arrive, I saw bursts of activity. A lot of work goes into each resuscitation from the pre-hospital staff to the actual protected codes, to the debriefs, and to the massive cleanup that occurs afterwards.
“Each sick patient revives and drains the department at the same time.”
Patients with suspected COVID-19 are put under droplet and contact precautions to reduce the risk of spreading infection. Mohammed Haque of UHN Environmental Services works tirelessly to clean and disinfect a room for the next patient. (Photo by Dr. Dawn Lim)
As both a frontline worker and, through this photo project, a chronicler of the times, Dr. Lim has a unique perspective. She knows firsthand the anxiety her and her colleagues feel for their own safety.
They are no strangers to caring for and treating people with illness and disease. But with COVID-19, there is the added stress of protecting themselves from getting the virus and infecting their loved ones, something driven home by the experience of healthcare workers in China, Italy and New York.
“Safety is high on everyone’s minds,” Dr. Lim says. “I know many of us have a lot of questions and sometimes the answers just aren’t there yet.
“We are used to dealing with unknowns, but COVID is an exercise in vulnerability and loss of control that is beyond anything we’ve ever experienced.”
To help quell that anxiety, Dr. Lim works hard at maintaining a calm homelife with her husband, a cardiologist, and their two children – a four-year-old boy and 15-month-old daughter.
“I have the same routine each time [before an ED shift],” she says. “I eat a huge meal in case I have to skip lunch or dinner. Then, I give my husband and children a kiss before I leave.
“I always turn back and watch them wave to me from the window. My son makes a little heart sign with his thumb and index finger to remind me to be brave. After that, I can handle anything.”
Dr. Lim says she hopes her photos serve an educational purpose, showing members of the public as well as those on TeamUHN what’s actually happening on the frontlines of the pandemic.
And, she wants the project to be a tribute to colleagues while helping everyone in the healing process.
“People have been extremely welcoming and enthusiastic about me documenting their efforts,” she says. “I think they understand this is my way of saying ‘thank you, you matter, keep up the great work.”
Dr. Dawn Lim, pictured here in 2018 as part of a UHN News photo project on a day in the life of the UHN Emergency Departments, says with this COVID-19 work, “I wanted to capture the essence of a hospital coming into its own strength so that our story is not forgotten.” (Photo by UHN)