Eyewitness to a death
How we photograph scenes of death and injury is a tough call. We have to make decisions about how close we can get to the victims. If we are not working then perhaps we are just in the way and may even be making matters worse. At what stage do we stop shooting pictures to help somebody who is hurt? What if it is a colleague?
It is a balancing act and anyone who has ever covered a funeral will recognise that tangible point beyond which the presence of cameras becomes intrusive and hurtful for the bereaved.
Is it different if our exposure to death is not unexpected? What happens when it is anticipated, even meticulously planned?
I have an idea to try and document the process involved in obtaining human donor organs for transplant. I approach staff at one of Berlin’s biggest hospitals, the accident hospital Berlin-Marzahn and then wait several weeks for the call to come. It comes on a Friday afternoon. A surgeon rings to say that a female patient of around 50 years has suffered brain trauma and is clinically dead. Her family have agreed to donate her organs for transplant and he has just called-in the specialist “explantation” team who are enroute to the hospital to begin the exhaustive checks to decide which organs would be applicable as donor organs.
Four hours later at 9pm I call the anaesthetist to try and find out when the operation will begin, he doesn’t know but says the decision will be made in the next six to twelve hours and that he’ll ring me when he does.
At 1.30 as I go to bed my mobile phone rings. The surgeons of the operating team are ready and the operation is fixed for 4 am.
A nurse from the intensive care unit meets me at the hospital. The anaesthetist is continually on the phone, coordinating flights and transport vehicles for the organs. The liver, both kidneys and the spleen are available as donor organs via the Eurotransplant International Foundation which is responsible for the mediation and allocation of organ donation procedures in Austria, Belgium, Croatia, Germany, Luxemburg, the Netherlands and Slovenia.
At 3.30 I am standing in the intensive care unit which is completely silent apart from the occasional noise from monitoring equipment. The motionless donor is brought to the unit in an elevator. I change into sterile blue scrubs, mask and cap and go into the theatre. Instruments are being laid out on special tables, everything made ready. Then the intensive care nurses and I sit and drink coffee while we wait for the surgeons.
The surgeons, on call 24 hours a day, come from all over the city. They change their clothes and scrub-up. Everyone is very calm, concentrated, nobody speaks much. The donor is brought in on a trolley and the operation begins.
She has been kept “alive” for days by artificial respiration. The surgeon isolates the abdominal wall and I take pictures. I have to keep a distance while taking pictures during the operation because of the risk of infection.
With a remote controlled camera I can photograph directly from above over the operation field. The only sounds are the surgeons giving each other instruction and the life-support machines with their flashing lights and the beeping heartbeat monitor.
The liver, kidneys and spleen are ready for removal. Then there is a moment of silence. It is 5.42 am as the surgeons looks over to the anaesthetist, “we can switch off”. The rhythmic beeping stops, there are no vital signs, the female donor is dead. It is not until hours later that I realise I had unconsciously registered that moment.
The team carries on working intently. Blood flow into the organs is interrupted to flood the organs with a special liquid.
Then first the liver is detached followed by the two kidneys and the spleen. The operation site is continuously cooled with iced water and the organs are transferred into cooling bowls. Surgeons clean off the fat before packing the organs into plastic bags surrounded by a chilling liquid which are then placed into cool boxes.
More than four hours after the procedure began the anaesthetist carries the cool boxes to to a waiting ambulance which rushes the organs to the airport.
The surgical team are exhausted but satisfied that through their efforts a dead woman and her family may have, by the gift of her organs, given others a second chance.