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Personal Statement

The Last Line of Defense

A visual narrative of the pandemic by an ICU physician

The Covid-19 pandemic has created a healthcare crisis almost as invisible as the virus itself. “The Last Line of Defense” is a collection of images that highlight some of the experiences of healthcare providers as they care for their most vulnerable patients during the Covid-19 pandemic. It offers a glimpse into a world inaccessible to the general public due to the highly infectious nature of Covid-19 and the need to protect patient confidentiality.


My desire for this ongoing project is to place within a visual perspective the more than 630,000 who have lost their lives in the United States alone. For every patient who dies, there are many more who are permanently disabled, develop posttraumatic stress disorder, lose limbs, experience a decline in cognitive function, suffer from loss of physical strength, and more. We don’t adequately discuss the financial burden and anguish that family members face. They cannot visit their loved ones through the days or weeks spent in the hospital. As a culture, we cannot collectively grieve their loss.


Work overload, emotional and moral injury, together with fear of contracting the disease and spreading it to their families, impact healthcare providers immeasurably. Some have already dropped out of the workforce, stretching an already short-staffed industry even thinner.

The pandemic firmly established the difficulty in separating reality from fiction, biases, anecdotes, misinformation, conspiracy theories and downright lies, easily spread over social media. The decisions people make based on this confusing bundle of messages directly influence the number of the patients coming to the ICU. The combination of my role in taking care of critically ill patients and my passion for photography makes me uniquely poised to contrast the world of misinformation to the tragic reality occurring daily within the healthcare setting.


I have recreated as conceptual images, either on site or outside the healthcare setting, some of the events that my colleagues and I have witnessed. Individually, the images cannot offer a full picture of the problem’s scale, but collectively they begin to give shape to a novel infectious disease that destroys lives from behind the curtains of ICU rooms.


Vaccination programs have knocked a huge dent in this deadly pandemic in the US, reducing the daily death rate from thousands to hundreds, but not enough to prevent the emergence of more infectious variants of the virus, resulting in the recent surge in hospitalizations and deaths.


I hope that these photographs and their corresponding essays will spark empathy with the tragedies that have been unfolding in hospitals; that they will help challenge the logic behind vaccine hesitancy; and that they will generate a measured but noticeable visceral jolt in attitudes towards dealing with the pandemic. Convincing more individuals to get vaccinated and wear masks in the appropriate settings saves lives, reduces the likelihood of creating a more deadly mutant virus and steers us closer to a normal life.

– Javid Kamali

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