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|| News Item: Posted 2006-12-19

A Dark Room
By Yana Paskova

Photo by Yana Paskova

Photo by Yana Paskova

The thirty-five-year old "Pharaoh," as he prefers to be called, slams a Bulgarian coin on his forehead as he says, "Money controls everything. Money is why I am here. Money is why I will never get out. We have no voice here; only money speaks."
Over 5,000 miles divided my grandfather and my home in Chicago when a stroke crippled him to a hospital bed in Vidin, Bulgaria. Uninvited, my imagination flooded the gaps in my grandmother's description of her two-week care for him. She said she brought him clothes, bed sheets, water, food, and even medication the hospital's thinning funds could not afford; what I pictured was two old people in a country of nearly eight million who had never viewed a hospital as a place of healing.

Months later, when my other grandfather spent a few precarious nights in the same hospital (for a stroke as well,) I was far closer-since I was actually in Bulgaria visiting my family as the summer of 2005 expired. I could touch the decade-old hospital mattress, as well as dig my fingers into the crumbling walls, feel the mosquitoes descend above my hair, see a hungry desperation in the patients' eyes.

While Bulgarians undoubtedly dealt with this reality to a numbing degree, I felt the Western media was relatively unfamiliar with the struggles of what used to be the Eastern Bloc-countries that were just learning how to speak of the ills of its people and formerly communist-run institutions. Bulgaria had not endured recent wartime atrocities such as that of its neighbor, former Yugoslavia, but its citizens were certainly suffocating under more silent killers- such as hospitals that decayed in a political system that tried, with mixed success, to live up to new European Union standards for Bulgaria's accession on Jan. 1, 2006. For example, if Bulgaria did not fight any corruption, fraud and money laundering that drained funds designated to its health institutions, the country would lose EU monetary grants that could rejuvenate them.

A few days later, when I returned to the States to begin my last year of college, I discovered I lacked the verbal capacity to describe the hospital to my American friends. This was odd, considering I'd spent half of my college career on journalistic and creative writing. But for the first time I believed pictures could tell this story better than words, or perhaps that I couldn't tell it without images, and wanted others to see what I had-maybe because of the passion one felt when entering their first year of professional shooting, as I had; maybe because I'd always heard nightmarish stories of what happened if you were unfortunate enough to fall ill in Bulgaria, but had emigrated as a twelve-year-old, before anyone let my eyes record its realities; maybe because despite growing up in a family of doctors, I'd only witnessed the more sanitary side of any medical staff's heroics of working in an environment that disarmed them from tools needed to heal their patients.

This hospital's financial maladies did not allow it provide its psychiatry wing with enough of the basic services necessary for patients' recovery. This means: 1. Inconsistent medical treatment; 2. No security personnel, cameras, or locked, insulated rooms for unstable residents; 3. Lacking mental stimulation for its patients; 4. Minimal treatment for leaking ceilings, bursting bathroom pipes, and rodent and flea invasion.

As usual, I split the next summer between the States and Bulgaria, but for the first time, I wanted to divide my time in Bulgaria between my family and the hospital. I confess intimidation surged throughout me as I introduced my intentions to the chief psychiatrist-the one responsible for granting me permission to shoot on its premises. He granted it after I explained I wanted to tell the hospital's story in an effort to help it; I thought it would benefit from informing others outside Bulgaria of what its citizens faced when they fell ill-by a possible combination of outside funding to a country that lacked it and pressure on the government to slowly create a more functional health care system. I didn't think my essay would accomplish all that, but I hoped it would initiate the dialogue that would.

But first, I had to start a conversation with the patients themselves, and make sure they understood and agreed with what I wanted to do. And so, I spent almost my entire first day of "shooting" actually speaking with the patients. First, I introduced myself. Then, I told them I wanted to photograph and write about their life at the hospital, and try to publish the pictures abroad in hopes of improving their life. It sounded like the ordinary way to obtain permission, although it was anything but; these were not people used to media attention, so I wanted to repeat my query even after most patients had given consent to be photographed, and approached hospital staff to confirm the individual patients were lucid and medicated enough to understand me.

Photo by Yana Paskova

Photo by Yana Paskova

P.P. ignites a cigarette in the ward's bathroom, although the entire building is officially a non-smoking zone, and says, "Sometimes I look out of that window and think about what my life could've been."
I only shot on seven sporadic days, a few hours each day. The chief of psychiatry and I had agreed I mostly pick his working days (or those of his substitute.) And so, I could not always choose the time of day, or the actual day of my visits. There were times I wanted to catch the beautiful morning light or the slant of the sunset rays through the windows, but simply could not be there. I experimented with my 580EX flash, but the green- and yellow-colored walls cast a sickly hue over my images. A lot more damning to my desire to "write with light" were the completely un-bouncable (is this even a term?) cathedral-tall ceilings adorned with miniscule, flickering lights. Nonetheless, I tried to use my flash only when I thought absolutely no setting would salvage the image.

Soon I wished to use it even less-not only because I meant to be unobtrusive, but also because it detracted from the rooms' natural gloom I tried to convey in my photos. The flash hits-and-misses and abysmal illumination forced me to claw myself to rare pockets of natural light. I managed to time my visits to a sunset when the golden light streamed through the entire length of the soaring windows-though it mostly hit the hallway. But the patients spent a lot of time there, sitting on couches, leaning on walls, smoking. I realized this was a more important story-telling moment than I'd initially considered. The doctors confirmed this when they told me the greatest hurdle in their patients' healing was the lack of funds to create social activities and distractions from the routine inside their four-walled residences.

There used to be a pay-per-view TV, but paying to watch it became a problem for the financially incapable, which describes most of the patients there. This leaves many patients unable to advance their mental development. As the head psychiatrist explained, one of the greatest problems was that patients had no way of developing their communication skills. "They don't have much to do," he said. "They sit out and grab some coffee and a cigarette, but that's about it. And being psychologically ill, a deficiency they need to overcome is the one with their social communication."

It wasn't only scarce light that paused my shooting. One evening when I strolled into the building, the patients surrounded me and exclaimed, "Ohh, you should have been here. This morning, a heroin addict entered the hospital, and then immediately escaped." (The term "escaped" might be a bit inaccurate, as the doors to the hospital were only locked at night, there were no safety bars on the windows, or any video-monitored, keyed, padded rooms for more active patients. In short, patients could walk around town almost unrestricted. This is one renovation for which doctors really worked to gain funds.) As the evening progressed, muffled screaming suddenly reached my ears. A nurse ran toward it and helped a middle-aged woman carry a young, skinny man inside a room. His eyes were closed, his mouth agape and scabs and tattoos marked his skin. While I itched to shoot the moments as they passed me by, a sense of deep intrusiveness overcame me, and I let my camera hang by my side. The woman, who I later discovered was this heroin-addict's mother, did not know me. I felt that her eyes, blinded with terror and pain, would not process what I was doing. And so, I waited. Half an hour passed before she noticed me standing on the side, and asked, "Little girl, what are you doing in a place like this?"

Photo by Yana Paskova

Photo by Yana Paskova

Obsessive compulsive and schizophrenic I. A. spirals down the stairs and toward the door leading out of the ward. After sitting on a couch in the hallway for hours, she gets up to seek distractions in the courtyard.
I told her what I was doing there and why-and she then actually asked me to shoot, to record her story: "Look at this place! Talk about this, please. Everything about it is horrible, except for the personnel. They try their best, but how can they help my son heal without any money?"

A doctor overheard her and said whenever the country could not provide funds for medication, it came out of doctors' salaries or the patients' dwindling pensions. He questioned how Bulgaria's health care institutions would then handle the new EU standards: "How are we going to join the EU like this? People won't have the money to pursue the kind of educational guidelines the EU will impose or bring their hospitals up to code. These standards work in wealthier countries only. How can we pay to live up to them when we have doctors and professors driving taxis at night so they can make ends meet? This is a societal problem on a grand scale. There isn't any structure in Bulgaria to help the mentally ill. What we really need is a strong Social Service system."

The mother nodded, and continued to talk. She said her son's drug habit had buried her economic status under substandard poverty, and since she could not pay for the out of town drug center, she brought him here.

"Money for his treatment? Well, where can I get this money? I've been fired from almost every job I've taken because I've told them about my son. I've also told them I need the money but I won't steal from them, because that would be a sin. But I still won't hide what is happening to him, because that would also be a sin. I believe everyone has a path. God exists--he must. You can't heal until you believe. And my son will heal this time. This will be the time he heals."

Her son awoke the next day, sober but angst-ridden, and I spoke with him about the project. He was accepting of it and even said he wanted to stay in the hospital to heal. Sadly, the next day personnel told me he'd walked out, never to return.

The rest of the patients also let me into their rooms and their minds. I explained I not only wished to get to know them and talk with them, but also photograph the routines they'd follow if I were not there. I honestly was not sure whether that would be possible. However, most of them warmed up so quickly to our interaction, to puzzling together their life for me, to going about their daily life around me, and to occasionally advising me on what to shoot: "Show everyone the walls! Look how they're peeling here," or "Come with me if you want to see how the ceiling leaks on us when we are in the bathroom," or "My mattress has fleas; they bite so much, I can hardly sleep at night."

Photo by Yana Paskova

Photo by Yana Paskova

Mentally ill patients stare at the world outside a general hospital's psychiatry ward in Vidin, Bulgaria, in August of 2006.
I will admit an encounter with the latter bothered (I stopped short of using a terrible pun here) me quite a lot, as those who know me could tell you I am openly bug-o-phobic. But my fear of the blood-sucking creatures did not compare to the anvil-heavy feeling I carried in my stomach as I continued speaking with the people to whom I gradually grew closer. There were times when I distinguished between the weary faces of doctors and patients only because the former wore medical garb, and that shocked me. I wondered if their expressions masked hopes that the hospital and the minds inside it would heal. The patients enjoyed telling me about their lives, feeling as if others would hear and care about them. I was happy to be the potential conduit for that, but also began to feel I had somehow gotten lucky.

I first sensed this while talking with a younger patient who used to work in Greece with his wife. His mother had suffered long years of manic depression in this very hospital, and one day, the same fears and delusions forced him into this hospital.

As he dragged a puff from his cigarette, his eyes wandered to the yard beyond the window, and he murmured, "You are living your life, so enjoy it. You have places to go, things to do. We go nowhere; do nothing. Sometimes I look out of that window and think about what my life could've been. I could've lived; I could've traveled. But then this happened."

Another patient (who called himself the "Pharaoh") told me, "Don't forget that you have your mind, and you don't need anything else." I suppose it would've sounded prosaic when uttered by anyone with sound health, but the words came from a man confined to other people's care for life.

On my last day, I printed each doctor and patient a photograph. Many had never before possessed one. As I watched patients tape the pictures above their beds, I leaned against the peeling wall in solitude with my thoughts. I had slowly realized that while this experience taught me much about photography (using an environment with little activity and light,) and about interacting with my subjects (listening to what they wanted you to tell, and respecting what they didn't,) my greatest lesson was one in motivation-in my personal and professional life, both of which I would try to take for granted less than before. When the patients and doctors asked me to return in 2007, I wanted to tell them all this, but I again lacked words; so I just promised I would. Instead, as gratitude, I hoped my images would shed light on the worth of each of their lives.

(Yana Paskova is a writer and photographer based in Chicago, IL. She is a recent graduate of University of Wisconsin-Madison. This is here first article for the Sports Shooter Newsletter. To see more of here work, check her member page: and her personal websites: and .)

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