Eyewitness to a death

January 14, 2008

For news photographers covering accidents, natural disasters, war and conflict is all part of the job. In some parts of the world sudden death is an everyday event. 

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.

phone

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.

arrival

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.

coffee

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.

team

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.

overhead

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.

ohd

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. 

organs

The team carries on working intently. Blood flow into the organs is interrupted to flood the organs with a special liquid. 

 bag

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.

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.

tired 

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.

donor

10 comments

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Very impressive coverage, just because of the fact that you tell everything by showing nothing. I can imagine it’s a tough job covering such a story, but it’s nice and clean. Great job!

Posted by ralpje | Report as abusive

I feel as though I’m at a loss for words.
Moving account.
But to take you back, you said you would try to answer certain questions you asked which I feel were left unanswered. I agree with you that it’s 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?”
So at what stage do you stop? Do you help or continue shooting? When is it deemed intrusive?

Posted by Diana Ngila | Report as abusive

with this blog you made a nice memorial to this woman, who gave her life for other people who still had a chance

Very well done. This article was not only informative, but showed a sense of emotion that went perfectly with the story.

Posted by Joe Gavic | Report as abusive

I would like to take the opportunity to answer Diana Ngila’s questions in public, because they are crucial ones when you touch this point of coverage in news business.
Honestly I can’t give you an universal answer, when I stop to shoot pictures, because it depends on the circumstances and the environment, but I can tell you from my experiences that I stop shooting immediately when it’s time to save a life, help injured people without any exception, or when continuing to take pictures might endangered people.
It is always a balancing act on the spot. Often eye contact to the persons in such situations can help a lot to open a way of personal communication. But there were situations where a camera was to intrusive and I didn’t shoot pictures. These pictures are still just in my memory only.

Posted by Fabrizio Bensch | Report as abusive

Thanks :-)
I also believe there’s no universal answer to that question Fabrizio. It means different things to different people but what’s important to me is to follow one’s heart. If it helps you sleep better at night, go ahead by all means…if not, don’t do it.

When it comes to covering something like war, I always wonder, is there a line to be drawn? I mean, not even war can change what people feel. So even then, you still weigh your options? And in following your heart, you use your brain too.

Why? “No picture is worth your life.”
Yeah, that’s what editors and others will say but no herograms come when you take a picture while 10miles away…the closer, the tighter, the better, the higher your chances of getting that award-winning shot and those herograms. What happens then? Ignore those comments/orders given to to you by the executives to cover themselves and go in or…?? What do you say to that?

Posted by Diana Ngila | Report as abusive

Fabrizio Bensch recognizes that the donor was alive at or soon after 3.30 a.m. At that time she was “motionless”, perhaps because she had been paralysed with drugs, but with her vital functions still present.
He describes her as dead, after some period of surgery, when the vital signs have disappeared following the order “we can switch off” at 5.42 a.m. What was switched off, presumably, was the mechanical ventilator, as well as the monitors displaying the heartbeat and blood pressure.
He feels he witnessed the donor’s death – in the operating theatre – at some time after her heart finally stopped beating (not necessarily co-terminous with the cessation of the monitor’s beeping). I think most people would agree with him.
The inescapable conclusion is that the donor was operated upon for the removal of her organs while still alive.

Posted by David Evans | Report as abusive

Your piece shows above all that the donor was alive during this procedure. Her body was mutilated and robbed. A rape victim photographed during an attack would have amounted to exactly the same process that you have photographed here.

Those who comment on how moving this is should really look at this again. Take off your blinders. The proof is there if you would accept that you are only blocking it out hoping you will get an organ one day. The consumer mentality sure is revolting!

Posted by sue grieves | Report as abusive

This piece is not without its artistic side. There is an unspoken aspect to it which occurred to me after reading it and responding the first time round.

I would like to ask the photographer if his reservations mentioned at the beginning imply that he–after the fact–wished he had saved this poor woman. She was one of his subjects who needed help but he kept taking pictures.

He says “it is not until hours later that I realise I had unconsciously registered that moment [of her death].” Is the photographer saying he realizes the woman was murdered? It’s probably important to clarify because there is much ignorance to dispel. More people will be butchered like this if the facts of organ harvesting isn’t made crystal clear. It’s not as if no one really knows because these surgeons are sure acting as though THEY do.

http://www.themarca.com

Posted by sue grieves | Report as abusive

[...] there thinking for a while after I finished it. I think it will make you stop and take notice also. Eyewitness to a death – Reuters PhotographersTechnorati Tags: photojournalism, reuters, organ [...]

hello !
i read alot about organ donor!!
i aske alot about the kidneys and i see alot of pepole suffer !
i wish can help ; because i want to do something nice in my life ..i would like to give one of my kidney my blood is a+ contact me at my email fay.souici@hotmail.com or my number phone 00213 6 69 61 44 37
good blees you

Posted by fay | Report as abusive