Shadows and Light: A Physician’s Lens on COVID by Heather Patterson, MD

Editor’s note: this review previously appeared on the Atlantic Books Today website as part of our ongoing cooperation with them.

When I picked up this book, I could feel it. Something was not quite right – this book does not behave as any other book. Yes, it has covers, pages, pictures and binding – but something, something is so very different.

Shadows and Light: A Physician’s Lens on COVID by Heather Patterson, MD, beautifully formatted by Goose Lane Editions, is a solid, intimate book, filled with the author’s view of the COVID pandemic. Dr. Patterson is the author and the photographer. She is also an emergency physician, working in the Emergency Department of one of Canada’s busiest hospitals. This gives Patterson a first-row seat working on the front line of the COVID pandemic. A talented photographer and dedicated physician, we stand witness as we read this book and visit her black and white images in a world that most of us never see.  Patterson takes us through the locked doors of the hospitals in Calgary, and we see what’s behind them through her camera’s lens.   Her world is one of co-workers, patients, unusual equipment, attire, and language – but mostly it’s a world of life and death.

“After almost a decade, the impact of continual exposure to some of life’s toughest moments, coupled with high-stakes decision-making, caught up with me.  I was left with an unfortunately common problem – emotional exhaustion and cynicism. Burnout.”

Heather Patterson, MD

Shadows and Light is a book with real people on every page.  After an introduction, Patterson lets us meet her young children, and her husband, fellow ER doctor, Kip. She then gives us an honest look into her life as a mother, wife, and working woman. She brings us from her home to work, and we enter a totally different community with high-stress activity 24 hours a day. It is at this point in the book we realize that as a physician, Patterson is suffering. This happens to be BEFORE the onslaught of COVID-19. “After almost a decade, the impact of continual exposure to some of life’s toughest moments, coupled with high-stakes decision-making, caught up with me.  I was left with an unfortunately common problem – emotional exhaustion and cynicism. Burnout.”  Patterson notes statistics, which are astounding – the burnout rate is high among American and Canadian physicians and a jaw-dropping 86% among emergency physicians. At her husband’s suggestion, Patterson pursued blending her love of photography with her hospital job.  “COVID’s arrival in Calgary was simultaneous to the development of this project. At the request of AHS (Alberta Health Services), I agreed to expand the scope … providing a comprehensive picture of our pandemic response. I realized that this could act as a historic record to show how the pandemic was affecting front-line workers and citizens and generate empathy.” This marrying of her two passions rejuvenated Patterson.

Armed, as Patterson says, with ‘my camera instead of my stethoscope’, she invites readers into her work at the Emergency Department, as COVID is beginning its second wave, in November 2020.  At this point, the worldwide population is not certain what we are dealing with. I remember being glued to the television awaiting updates. Many businesses and schools were being ordered to close. People had to now remain at home, isolated. The hospitals however are never closed. The staff are expected to come into work every day, not knowing what they may be facing with this highly contagious illness, spreading quickly. In Shadows and Light, we see the photographs of the hospital staff, clothed from head to toe in personal protective equipment (PPE) and everything that entails – face shields, goggles, face masks, gloves, head, body and shoe coverings, and over pants. Hand sanitizers dot counters everywhere, along with signs with reminders to distance and mask.  

As I read this book and stare into the images held within, I develop an intimate connection. These are pictures of real people – the physicians, cleaning staff, nurses, kitchen staff, technologists, aids, clerical staff, and pharmacy – everyone within this extensive community of hospital healthcare workers. I am in awe of how these dedicated people come to work every day, supporting all of us with their examples of generosity, compassion, endless reassurance, and spirit. Who among us laypeople could fathom their fear and exhaustion? The care they have to take when returning to their own families, likely contagious and most certainly spent? How are these people able to put one foot in front of another, day after day, night after night, for long hours of uncertainty, sickness and death, every single day? Remember, the physicians and staff not only deal with COVID, but all illnesses, conditions, and accidents, as they occur. Babies are still being ushered into the world, car crashes and heart attacks happen, diabetes becomes unmanageable, transplant and cancer patients are compromised with a common cold, never mind the effects of a pandemic wreaking havoc on every aspect of our lives.

The patients we meet in Shadows and Light have one thing in common – a look of hope that they will be helped, that they will be saved. Their faces reflect the gratitude that they are not alone and busy, oddly-clothed strangers take the time to offer care, a handhold, and kind words of encouragement. “Since David’s COVID test had come back negative, his wife and daughter were able to be at his bedside before intubation. The beeping of monitors kept urging us to hurry, but still, the pace of the room slowed. These moments need time. Patients need time to understand. Families need time. So, we waited, together… ‘Lead with your heart,’ Erica Foulds tells, as we sit for the evening at the bedside of a dying woman. She has been volunteering with the No One Dies Alone program twice a week for the past two years, bringing companionship through touch, talking, singing, and reading poetry… At least three of four patients each week had a volunteer at their bedside during the last seventy-two hours of their life.”

From the touching picture on the cover of Shadows and Light to the pictures inside the book and the author’s words which accompany the images, I felt an energy, I could almost hear a humming. For me as a reader, this book offered a cathartic feeling. The book infuses an overwhelming sense of compassion for the hospital staff and the patients. Patterson gives her reader a bold inside look, a visual accounting, of what these brave people have gone through at a time of extreme uncertainty and fear, snapshots of a lengthy pandemic. Our eyes were all turned to physicians and hospital staff for answers, for help, for comfort. They bravely walked up to the plate and gave us their all, everything they had to give; they did not hold back anything, and so often at their own expense.

Pick up a copy of Shadows and Light: A Physician’s Lens on COVID by Heather Patterson, MD and discover the dedication, generosity, and empathic grace that these people shared with us all, daily. The photography and words are a stunning journey into the life of the hospital workers and the patients they treat.  When I held Shadows and Light in my hands, I know now what I felt, and what I suspect you too will feel – the steady, low thumping of its compassionate heartbeat.

Full disclosure: My son, a geriatrician, worked in a hospital throughout this pandemic. He was with his patients and co-workers for long, endless periods.  He worried continually about work, his patients, and what he was bringing home, literally and emotionally, to his wife and young son. Thank you to all the physicians and hospital staff, and their families. Your work continues – and I am grateful.


Heather Patterson is an emergency physician at Foothills Medical Centre and Alberta Children’s Hospital in Calgary. Her photographs of the pandemic have been featured in Macleans and the Calgary Herald and on CBC, CityNews, Global News, and CTV.

  • Publisher ‏ : ‎ Goose Lane Editions (Sept. 6 2022)
  • Language ‏ : ‎ English
  • Hardcover ‏ : ‎ 176 pages
  • ISBN-10 ‏ : ‎ 1773102745
  • ISBN-13 ‏ : ‎ 978-1773102740

Managing Editor

TMR’s Managing Editor Carrie Stanton has a BA in Political Science from the University of Calgary. She is the author of The Jewel and Beast Bot, and picture books, Emmie and the Fierce Dragon and The Gardener. Carrie loves to write stories that grow wings and transport readers everywhere.  She reads and enjoys stories from every genre.

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