A raw portrait of a hospital

October 22, 2021
A team of six nurses surround a COVID patient who lies face down on a bed, covered in drypads
A team of nurses, patient care technicians and a respiratory therapist prepares to turn over a COVID patient after being on his stomach for 24 hours. This technique, known as "proning," helps a patient's lungs oxygenate better. Photos by Alan Hawes

As a photojournalist for more than 20 years, Alan Hawes saw life up close. NFL playoff games from the sidelines. Bruce Springsteen from the front row. Standing on the deck of a barge as the Civil War submarine the H.L. Hunley was lifted from the bottom of the Atlantic Ocean.

But through all these exhilarating experiences, what stuck with him the most – what left a tack-sharp image in his mind, long after the photo was snapped and published – were the smaller, more intimate moments.

Headshot of nurse Alan Hawes who took all the photos 
Alan Hawes, R.N.

“One of my life goals was to make an impact on the world through my career. And for a long time, I felt like I was doing that with photojournalism,” Hawes says. But one day, after a particularly emotional assignment at a hospital, he began to doubt his convictions.

“I saw these life-changing things happening in front of me,” the Chicago native explains, before briefly pausing to take a small step back in thought. “As a photographer, you’re an observer – and it’s an important job, being that messenger – but seeing those people work, the way they cared for the patients, the difference they could make, I felt like it was time to be a participant.” 

And just like that, Hawes enrolled in a human physiology night course. It was really hard – and humbling for a father of two who was experiencing a bit of professional uncertainty – but he managed to get an A. 

“I know this sounds weird, but I felt like I had a gift for understanding how the human body works,” he says. That led to another class. And another. “Then I was in it,” he says, with a wry smile. For almost two years, he continued to work as a newspaper photographer during the day and take nursing classes at night. 

Eventually, his side passion became his central one. 

A nurse in full PPE peeks out the window of a isolation room containing a COVID positive patient 
Respiratory therapist Miriah Blevins – looking for assistance – peers out the window of the room of a COVID patient. The wearing of personal protective equipment makes simple tasks much more complicated and often requires the help of others outside the sealed rooms.

Developing a talent

When Hawes was 12 years old, his father gave him a camera – a real one, one of those really nice SLRs with a big fancy lens – as a middle school graduation present. It wasn’t completely out of the blue. This was the same kid who used to always save up his money to buy film for the family’s Polaroid. 

Once he had his hands on a legitimate camera, he was in business. And so he began to learn all the little nuances of exposure, shutter speed, aperture. That curiosity led him to serve as a photographer for his high school yearbook. Over the next several years, he developed a deep passion for the craft. During one assignment, he met a firefighter who introduced him to the art of listening to a police scanner. It was the window into the community, he told Hawes. That’s where the good stuff was, he said.

A man who would eventually die from COVID is surrounded by nurses, one of which is holding his hand 
"Don't suffer like me, get the vaccine immediately. It's not only protecting yourself, it's protecting people like me." Those were the words of Joel Croxton, who was fully vaccinated but the virus took his life September 14 due to his weakened immune system. Here, he prays with a hospital chaplain via an iPad held by his nurse Jessie Ramirez (left). His wife Sandra Croxton and son Mark Croxton hold his hands.

“I immediately bought one of my own, thinking if I had a scanner and a camera, I could take pictures of what was going on and then sell them to the local paper,” Hawes says. And, as simple as that, it worked. 

After a while, the Chicago Sun-Times and the Associated Press would buy just about anything he shot. His reputation landed him a full-time job with a newspaper in Greenville and ultimately with the Post and Courier in Charleston. 

His camera became a part of him – like an appendage. 

Over the next two decades, Hawes would carry that appendage with him to document emotionally charged and poignant moments. The confederate flag coming down from the S.C. Statehouse. A man whose motorcycle careened over the side of the James Island connector left covered in so much plough mud, you could only see the whites of his eyes. Two Citadel football players sitting inside an ice freezer, the kind you see in front of gas stations, doing whatever it took to escape the blazing summer heat. 

He snapped tens of thousands of images over the years; a surprisingly high number of them were so good that they won regional and national press awards, some gaining international accolades. Those images would appear in newspapers across the country and giant magazines like Sports Illustrated, and they would earn him the reputation as one of the best photographers in the business. But ultimately, all of that wasn’t enough for Hawes. And as difficult as it was to leave behind a career he loved, he was convinced his calling was elsewhere.

Finding a higher resolution

In 2011, Hawes accepted his first job as a registered nurse at Summerville Medical Center. Two years later, he came to MUSC Health and has been here since. During his eight-plus years at the teaching hospital, he has worked in critical care, on the rapid response team (they are first on the scene in the hospital when there is concern for a deteriorating patient) and most recently, with some of the most serious COVID-positive patients in the hospital’s medical intensive care unit (MICU)

Two nurses who just called a patient's spouse to let them know he was about to die are consoling each other as they cry 
After completing a phone call to a patient's wife, telling her she needs to come to the hospital because her husband is dying, MICU nurse Andrea Crain cries at the nurse's station as patient care technician Kelly Burchette comforts her. "Everybody is dying and it just makes me so sad," she said.

“Once I made it to the ICU, I knew I was in the right place,” he says. And when the world changed forever in March of 2020, not so surprisingly, Hawes was one of the first to jump into action in the COVID unit. 

“I knew I was going into the belly of the beast in that unit, but that’s what I like to do,” he says. Just like all those years ago when he’d carefully keep an ear to the police scanner, looking for the action and then heading toward the trouble when most people would be headed in the opposite direction, he leaned into the heat and didn’t back off. 

“It was super exciting but terrifying. But that was where the news was. I will always have that news bug in me. To experience up close what the rest of the world doesn’t normally get to. I had a front-row seat.”

Only this time, it was with a terrifying and largely unknown virus, not Tom Petty or the Green Bay Packers. 

Depth of field

Somewhere along the line, Hawes had the idea to marry his two passions. After talking with hospital leadership, he got the green light to bring his camera into the units, something that is particularly tricky in the new world of patient privacy laws. But with the right permissions and everybody on board, it was something that could be carefully navigated. 

Hawes wanted people to see what he and his colleagues saw on a daily basis. He wanted them to see the compassion. The struggle. The reality. 

A COVID-positive woman lies in her hospital bed while clutching an iPad showing her little baby boy 
Tala'Shea Foster holds an iPad as she visits with her newborn son Ta'myus Coffey via Facetime, while she was recovering from COVID at MUSC. Ta'myus was born via emergency cesarian section because Foster's COVID was so severe. She spent weeks near death on a ventilator in the ICU, eventually ending up with a temporary tracheostomy and a healthy baby boy who she hadn't held yet. She said she didn't know the vaccine was available to pregnant women.

“Honestly, as I was walking toward the building on the first day in the COVID unit, I knew how good a story this would be to cover as a photographer,” he says. Pride in his team coupled with frustration surrounding all the vaccine-related misinformation were the main reasons he wanted to do it. What “it” was, he wasn’t sure at the time, but he knew that through photographs – something not even the best writers can compete with when the pictures are really good – there was an opportunity to tell a powerful visual story. One that lets the general public peek inside a place that rarely pulls back the sliding blue drapes – and for good reason. After all, there is no more private, intimate or vulnerable environment than inside a hospital. 

For the next several weeks, whether he was on the schedule or not, Hawes would grab his camera and head into the hospital. At first, he explains, his colleagues were a bit leery of him. But he wasn’t just a guy with a camera. He was one of them. Slowly, they began to let down their guards, and eventually, they forgot he was even there. 

What he witnessed was humanity at its absolute best … and worst.

Steven Lavendar's COVID was so severe at one point that he needed a tracheostomy and a ventilator to breathe. At his side during that time was his fiance' Mary Moore, who kept a daily diary of his stay in the hospital. 
Steven Lavendar's COVID was so severe at one point that he needed a tracheostomy and a ventilator to breathe. At his side during that time was his fiancee Mary Moore, who kept a daily diary of his stay in the hospital.

A man dying slowly from COVID. Another with seemingly the same fate who miraculously made a turn for the better. A woman with the illness giving a pep talk to three other COVID-positive patients, passionately declaring how they were going to beat this. And along the way, there were a few smiles. And a lot of tears. 

“I am really proud of my team, and I wanted people to see how hard they work, how much they care,” Hawes says. “But truly, I just wanted people to know that the people in here, these ones that are really sick, a lot of them are just regular people who weren’t vaccinated. And they’re dying because of it.” 

During his time on the COVID unit, Hawes has seen miracles, families estranged over vaccine disagreements, laughter, tears. But the hardest thing he and his colleagues have had to do is facilitate a goodbye with no loved ones in the room – something no one should ever have to experience.

“You’re standing there, holding an iPad so a dying patient’s family can say goodbye. And the patient isn’t even conscious,” he says. “As a nurse, it’s such a helpless feeling. You need to be there, but on some level, you feel like you shouldn’t – their family should be the ones there. But this virus robs us of so many things. It’s heartbreaking. Hardest thing I’ve ever had to do in my career. I wouldn’t wish it on anybody.”

Which is why he wanted to show the world his photos. Because it matters. What will become of them – an installation in a local art gallery possibly – he’s not sure. But what he does know is that this was an opportunity to use all the skills available to him. 

“I will never stop seeing the world as a photographer,” Hawes says. “That guy is still in there, but these days, my heart is on the other side of the camera.”

And though he might not admit it, it proves that through both of his careers, he is able to impact the world.

MUSC Health Covid Unit