Portrait Project Reveals the Faces Behind Health Care Workers’ Protective Gear

Doctors and nurses are attaching smiling photos of themselves to the outside of their protective gear to maintain connections with patients

Health care workers
Health care workers at Stanford and the University of Massachusetts who have placed smiling portraits of themselves on the outside of their protective gear Cati Brown-Johnson, Stanford Medical School and UMASS Palliative Care via the PPE Portrait Project

Despite experiencing a surge in COVID-19 patients, hospitals have become a rather lonely place. Those taken ill with SARS-CoV-2, the new coronavirus, must be walled off from others as much as possible to avoid spreading the infection. And the few health care workers who visit to administer care must do so garbed in layers of personal protective equipment (PPE) that cover most parts of their bodies, including their faces, anonymizing these individuals as masked, expressionless staff in space suits.

Frustrated by this lack of face-to-face interaction, Cati Brown-Johnson, a researcher at Stanford University who has studied the role of compassion in medicine, devised a way to reintroduce the aesthetic of kindness into patient care: by pasting pictures of doctors’ and nurses’ smiling faces onto the outside of their clothing.

Brown-Johnson’s idea is new for COVID-19, but not for infectious disease overall. Occidental College artist Mary Beth Heffernan was the first to cook up the idea, developing a similar project while observing health workers donning protective gear during the 2014 Ebola outbreak. As Heffernan explained to Laura C. Mallonee of Hyperallergic in 2015, she asked herself, “Wouldn’t they be less frightening if the person on the inside was pictured on the outside?”

Thus was born the PPE Portrait Project, which Brown-Johnson, with Heffernan’s assistance, has now adapted for Stanford University’s response to the ongoing pandemic, according to a press release.

In a recent trial, Brown-Johnson snapped photos of 13 health care workers at a COVID-19 testing site on Stanford’s campus. Per Hyperallergic’s Elisa Wouk Alimo, each individual received the same prompt Heffernan used in 2014: “[S]mile [as you wish] the patient could see.” Per the press release, the images were then affixed onto the workers’ protective gowns at heart level, “because your care is coming from your heart.”

Anna Chico, one of the nurses in the trial, says that the simple addition of a photo has already buoyed spirits among health workers and patients alike.

“When they drove up to me, I would introduce myself and point to my picture saying, ‘This is me under all this,’” she explains. “One patient actually said, ‘I love your picture.’ ... It enhanced my interaction with my patients, as they were able to see me and not just a full suit of PPE.”

The perks probably go beyond just patients, too. Back in 2014, when Heffernan first rolled out the project, doctors said it put them in higher spirits as well, making them feel as if they were “working with people, with my team, instead of inanimate objects,” according to Hyperallergic.

The humanizing trend is quickly gaining traction across the state and nationwide, with physicians at Scripps Mercy Hospital San Diego, UMass Memorial Health Care, the University of Southern California’s Keck School of Medicine and other health care centers following suit.

The benefits of the practice are particularly intriguing in conjunction with recent evidence that human connection can shore up the body’s immune defenses, as Sarah Kaplan reported for the Washington Post last month. With that sentiment in mind, Heffernan thinks there is a chance that some version of the PPE Portrait Project may someday become a medical mainstay.

“It is my hope that after seeing the benefits of using PPE Portraits,” she says, “that clinicians will continue their use beyond the COVID-19 pandemic.”

Get the latest stories in your inbox every weekday.