“…and if you’re going to faint, please make sure you fall backwards out of the operating theatre!”
It was a solitary moment of humour during two tough months. Delivered to me and my journalist colleague Louise Tickle by the theatre matron at the London Evelina Children’s Hospital moments before we were due to witness open heart surgery on 10-day old Finn Jones, the words were still ringing in my ears as the operation to save the baby’s life got underway.
Five hours later we emerged from theatre, the work of surgeon Conal Austin complete. The operation had been a success. Finn could look forward to a normal, healthy life, with a normal healthy heart. I left the hospital completely drained and exhausted, yet with a feeling of life-affirming exhilaration, knowing I had witnessed what in Biblical times would have been termed a miracle. A tiny life, brought back from the abyss by the knowledge, skill and tenacity of the surgeon and his team, supported by all those at the hospital.
This part of the assignment had not been planned: originally the commission was to document the work of the staff at the Evelina’s intensive care unit (ICU), focusing on the multi-layered, specialist care which goes on every day, every week, every year. The dedication of the staff, from senior consultants to cleaners, brings into relief just how many resources are required to care for premature and newborn babies with a multitude of complicated health needs who are brought into the unit I visited.
Then Louise and I met Philip and Kathryn Jones from Kent, bright and bubbly and still giddy with excitement at the arrival of their first baby, Finn. They were open and friendly and when we approached them about documenting their experiences of life in the ICU, they were supportive of the idea. Over the next few days we began to learn more about Finn’s condition and were confronted with a dilemma: Finn was scheduled to have a ‘heart switch’ operation to correct a major defect. While our assignment was originally meant to focus on the unit, suddenly the operation took centre stage as the defining event in this larger-than-life case study. It felt wrong to ignore it and to pick up the story again after surgery, when Finn would be back in intensive care.
A couple of days prior to the operation, Louise and I made the decision to approach Finn’s parents and the hospital, to enquire about being present for at least a short period of time either immediately before or after – or as a best case scenario during – surgery. Both Louise and I realised we would be asking Philip and Kathryn to place an enormous amount of trust in us – as virtual strangers – to be present at the crucial moment of this young life. After much consideration, understandably so given the nature of the request, consent was given just three hours before Finn was taken down to theatre from the ICU and put in the care of the anaesthetist. All of a sudden there were briefings about etiquette and behaviour around an operation, disinfection, getting changed into scrubs and preparing ourselves for something neither Louise nor I had ever experienced before and which we had no time to prepare for mentally. As someone whose squeamishness extends to diving behind a sofa if a hypodermic needle is produced on television, I did consider the consequences of getting close to open heart surgery. I knew, however, that my part in this operation was as a bystander, a witness and that everyone in that room was expected to do their job to the best of their ability, and that should include me. In the end, I suppose, some sort of adrenaline kicked in and the remarkable ability we have to carry on as normal took over as I quietly and unobtrusively as possible photographed the watchful precision of the surgical team as they went about their business in a calm and hushed environment. I concentrated entirely on photographing what was unfolding in the space around me, never stopping to consider the wider implications of what I was actually seeing. Occasionally, I would step back to the outer walls of the room, to draw breath, pause and reflect. But in those moments, I endeavoured to remain focused and not allow my mind to wander, especially to personal thoughts about my family, in particular my own healthy, happy children far way.
Those five hours seemed to pass simultaneously in an instant and yet last a lifetime. I had little comprehension of what occurred medically, but realised the enormity of what I was seeing and photographing and I hope the pictures convey a sense of what was achieved in that dark arc of concentration and skill. It was a privilege to be allowed such access to something so fundamental, and hiding behind my camera, I watched events unfold with a sense of humility. When it was over, my instinct was to taste the fresh, autumnal air outside the hospital and breath deeply and thankfully.
After the rarefied sense of achievement, the following few days proved to be black. Finn’s condition deteriorated due to falling blood pressure and word came through that his struggle for life wasn’t over. This news wrenched me back to the emotions of the operating theatre and made me question what I had seen: had I witnessed the beginning or end of a short life? Until we heard that Finn had miraculously started to pull through after several days of teetering on the brink, I looked deep into myself and sought answers to questions about the consequences of getting so close to a story.
Over the following month, Finn’s condition fluctuated but he eventually gained the weight and strength required to be allowed to go home with his parents for the first time. The final chapter for me and this story played out on a bleak, December day, illuminated by a visit to the Jones family house to take photographs of Philip, Kathryn and Finn together, all smiling and looking forward to a bright future thanks in no small part to the wonders of modern medicine and the people who deliver it.
(Colin McPherson and journalist Louise Tickle worked on commission for the Guardian Weekend Magazine between October and December 2013 documenting the work of the London Evelina Children’s Hospital. The article was published on 18th January 2014. The gallery of photographs accompanying this blog contains images from Finn’s operation which some of you might find distressing.)