The PPE Portrait Project is being used at the UMASS Memorial Medical Center. Above, Michaela Essam Agbesi, RN, MSN, ACNP-BC, UMASS Palliative Care, April, 2020 (image courtesy UMASS Palliative Care)

LOS ANGELES — When a patient has a highly contagious virus like COVID-19, doctors and nurses must take the necessary precautions and wear protective gear from head to toe, exposing just a sliver for their eyes. From the perspective of the patient, it can be a highly lonely experience to not really see anyone for days, to not even recognize the medical staff helping you.

Back in 2014, during the Ebola outbreak, the Los Angeles-based artist and Occidental College professor Mary Beth Heffernan came up with a seemingly simple, yet ingenious solution to help patients feel more connected to their providers. With camera in hand, she went to Ebola Treatment Units in Liberia and took warm, friendly portraits of the medical staff and attached the photos to their suits, over their hearts — “to convey that the care is offered from the heart,” Heffernan explained over email. “Before taking the photo,” she said, “I asked the healthcare worker to offer the smile that they wished the patient could see.” Not only did patients report feeling more cared for, but healthcare workers also found the work environment more tolerable; as one doctor put it, “It makes it feel more like I am working with people, with my team, instead of inanimate objects.”

Heffernan sharing PPE Portrait with Augustine Bindi, Hygienist. ELWA 2 Ebola Treatment Unit (2015) (photo by Marc Campos)

It’s no surprise that Heffernan’s PPE Portrait Project (PPE stands for “personal protective equipment”) is making a comeback during the COVID-19 pandemic. While the artist has generally been the one to pitch hospitals, physicians and medical researchers are now contacting her, like Cati Brown-Johnson, a research scientist at Stanford, who asked to bring the project to the medical school’s Express Care center. Heffernan eagerly obliged and sent the project’s guidelines outlining how to take the portraits. She recommends “plain backgrounds and diffuse lighting,” and encourages all subjects to look “directly into the lens,” to make the patients feel like the healthcare worker is “directly engaging with them.” She also advises against “traditional glamour expressions, selfie overhead, or portrait poses like the 3/4 view.”

Ben Smith, Hygienist, photographing Reginald M. Poindo, PA, ELWA 2 Ebola Treatment Unit, Liberia (2015) (photo by Marc Campos)

Brown-Johnson and Heffernan have been in communication daily, “sometimes multiple times a day,” to evaluate the project’s roll-out and reception. “One patient actually said, ‘I love your picture,’” said one of the Stanford RN nurses, Anna Chico, who is trying out the portraits. “It enhanced my interaction with my patients, as they were able to see me and not just a full suit of PPE.”

Heffernan was also approached by Jennifer Reidy, the Chief of the Division of Palliative Care at UMass, where the project was urgently implemented by printing out healthcare workers’ UMass profile pictures (they plan to follow Heffernan’s photo guidelines eventually). “We’re looking for ways to humanize our connections with patients and each other during this pandemic, including things like video technology, PPE Portraits and everyday acts of kindness,” Dr. Reidy is quoted saying in the hospital’s newsletter.

Jennifer Reidy, MD, Chief, UMASS Palliative Care (image courtesy UMASS Palliative Care)

The Keck School of Medicine of USC is likewise in the process of adopting the PPE Portrait Project and Heffernan expects to work with more hospitals in the greater Los Angeles area, including the Providence Saint Joseph Medical Center in Burbank. The Gold Foundation, which has previously funded the PPE Portrait Project, is also seeking to bring it to hospitals in New York City and New Jersey, where populations are particularly hard-hit.

The artist’s goal is to give each hospital the tools to independently run the project. “It is my hope that after seeing the benefits of using PPE Portraits, that clinicians will continue their use beyond the COVID-19 pandemic,” she said, such as for cancer and transplant patients who see healthcare workers in masks. 

Throughout her career, Heffernan has reflected on representations and expressions of the human body, from ghostly cyanotypes of skeletal forms to  photos documenting the tattoos on the bodies of US marines memorializing fallen comrades. The PPE Portrait Project, straightforward in its aesthetic, may not obviously look like an artwork at first. Rather, its artfulness lies in what can’t be seen but is palpably experienced by those hidden beneath and separated by all the layers of protective gear.

Elisa Wouk Almino is a senior editor at Hyperallergic. She is based in Los Angeles. Follow her on Twitter and Instagram.