The smile behind the mask
MD student Hui (Harriet) Yan first realised the importance of the human touch in medicine when she was volunteering in the ICU waiting room in the McGill University Health Centre's Royal Victoria Hospital.
“I wasn’t doing technical things or patient care. I was speaking with families who were scared, anxious and confused,” said Ms. Yan, then a master’s student in neuroscience at McGill University. “My role as a volunteer was to be a friendly human face, someone they could talk to. So I saw how important that face-to-face human connection is.”
The arrival of the COVID-19 pandemic in 2020 not only shut Ms. Yan and her fellow volunteers in the ICU Bridge Program out of the hospital, it also forced the workers on the unit to cover their faces with masks and shields.
Searching for a way to remain involved in the hospital despite the pandemic, the ICU Bridge Program team came across an article about PPE portraits—photographs of themselves that health care workers could wear to show patients, and colleagues, the face behind the mask. The idea, which originated during the 2014–2016 Ebola crisis in Africa, was the brainchild of American photographer Mary Beth Heffernan.
“The ‘otherworldly’ appearance of the personal protective equipment contributes to patients’ isolation and fear of Ebola virus disease, while its frightening effects diminish clinicians’ ability to establish trust and emotionally connect with patients,” Ms. Heffernan noted on her website. “Wearable headshots can lessen the frightening appearance of PPE by personalizing the health care provider–patient encounter, thereby reduce patient stress.”
Reaching out to some ICU nurses they knew, Ms. Yan and her fellow members of the ICU Bridge Program executive team offered to create PPE portraits for them. Soon, the initiative had spread from nurses to doctors, respiratory therapists, occupational therapists and housekeeping staff.
“Once they started wearing the portraits around the ICU, their colleagues started noticing and asking to get theirs done, too,” Ms. Yan said. “They had so many positive things to say, not only about their interactions with patients, but also with their colleagues.”
Articles in the Journal of Pain and Symptom Management and the Journal of General Internal Medicine reported on initiatives in American hospitals, where health care providers found a benefit to wearing PPE portraits. One commented: “It makes it feel less like a disaster zone.”
In the fall of 2020, Ms. Yan began her medical studies at the University of Ottawa Faculty of Medicine. By that time, she had become an executive member of PPE Portraits Canada, a volunteer organization that branched out from Montreal’s ICU Bridge Program and that is dedicated to creating the portraits for Canadian health care workers.
She reached out to her fellow uOttawa MD students via social media, asking for volunteers to help get the initiative started in Ottawa. Second-year MD student Jason Tran joined the cause.
“I’m very interested in the arts,” he said. “This [initiative] looked like something in the arts and humanities, and that’s something we need more of in medicine.”
For the two students, the greatest challenge to getting the project started in Ottawa has been logistics: promoting the initiative, distributing the portraits to different hospital sites, and finding grants to cover the costs of printing and distribution.
So far, they have received 81 requests for PPE portraits—mostly from upper-year MD students and residents—and delivered 66.
“As important as PPE is, it takes some of that [human connection] away,” Ms. Yan said. “For me, being able to see someone’s friendly smile and remember there’s a human face behind that mask is really important.”