Rx for Pandemic Times: UCSD’s Dr. Rishi Deka Radiates Insights as Photographer

Rishi Deka has a doctorate in health services research and works as a postdoctoral scholar in the Department of Radiation Medicine and Applied Sciences at UCSD School of Medicine.

But when you ask him about the pandemic, this young academic in radiation oncology is as likely to prescribe art therapy.

Deka, a native San Diegan, won photojournalism awards for coverage of African-American civil rights in his time at his college paper — the Daily Utah Chronicle. He’s also a published poet.

“Art can enhance self-esteem and self-awareness, provide emotional resilience and reduce stress,” he says. “We need to realize that while it seems as if we occupy an increasingly polarized world, the reality is that there is no black and white. Everything is simply a shade of gray.”

His latest project evokes shades of human feelings. Deka recently shared images he made of what he calls the six basic emotions.

Times of San Diego: When and where did you take the six pictures? What equipment did you use?

Rishi Deka: I took the six photos during the first three weeks of California’s stay-at-home guidelines that were implemented on March 19. I was originally going to have an abstract photography art exhibition at the San Diego Public Library. However, this exhibition has been postponed due to the COVID-19 pandemic.

Thus during this time of stay-at-home, I have been inspired by my background in art and medicine to create with the natural lighting available at my home.

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The six basic emotions are surprise, fear, disgust, anger, sadness and happiness.

I used 16-35 mm and 70-200 mm lenses to create the photos. I focused on the interplay of light and dark, and I employed both long and short exposures. In some of the frames I intentionally rotated/panned the camera. This photo story has allowed me to visually reflect the tumultuous feelings we are all facing, and my hope is to provide alternative coverage of the COVID-19 pandemic.

How has the shutdown affected your radiation oncology work? Is your income cut?

The UCSD Department of Radiation Medicine and Applied Sciences is in the Altman Clinical and Translational Research Institute next to the Jacobs Medical Center. While I used to work both on campus and at home, all of the research and teaching I do now is remote. I am among the fortunate ones able to work remotely with no change in income.

Are you helping at any hospitals or clinics? If so, what’s your role?

All of the radiation oncology performed at UCSD is done at the Moores Cancer Center or the PET/CT Center. There are additional radiation clinics throughout San Diego in Encinitas, Chula Vista, 4S Ranch and Sorrento Valley. My physician colleagues who are currently treating prostate and gastrointestinal tumor patients have told me that their roles have not changed due to the COVID-19 pandemic.

However, prostate specific antigen (PSA) tests and prostate biopsies have slowed down and new diagnoses of prostate cancer have slightly declined. My colleagues do confirm that there may be a more dramatic change in their roles if the pandemic continues for a while.

Are you watching the work of local art photographers and photojournalists? Who most impresses you, and why? 

In terms of fine art and my general photography style, I love the strong contrast between light and dark. I employ the use of intense light and shadow to create riveting compositions that harken to the masters of the Renaissance – Caravaggio, Rembrandt and Leonardo da Vinci.

I also love the work of renowned artists from the Romantic, Impressionist, Expressionist, Abstract and Surreal eras – Caspar Friedrich, Claude Monet, Henri Matisse, Vincent van Gogh, Gustave Moreau, Wassily Kandinsky, Ivan Aivazovsky, Max Ernst and Zdzislaw Beksinski.

I enjoy browsing photojournalism work from AP, Getty, AFP, Reuters, UPI and Shutterstock Editorial. Some Southern California photojournalists whose work I admire include Sandy Huffaker, Sean Haffey, Ringo Chiu, Michael Blake and Tim Mosenfelder. Tim produces some very captivating compositions of prominent artists. In San Diego, I love Chad Kelco’s gothic black metal photos – my favorite music genre – and Alex Matthews’ wide-angle shots lush with vivid light.

With your background in epidemiology, how do you grade the efforts of San Diego Mayor Faulconer, county authorities and Gov. Newsom?

It is difficult for me to evaluate their overall performance since it is still a work in progress. I am pleased to see that California’s total number of infections/deaths is relatively low and that there has been a small but noticeable decrease in the incidence rate of COVID-19 over the past two weeks.

While the stay-at-home order has undoubtedly saved lives, many workers have abruptly become unemployed or seen their salary precipitously decline. We cannot let socioeconomic inequality – something that has been exacerbated by COVID-19 – intensify further in a state that has some of the highest levels of unemployment and homelessness in the nation. Thus we need to strike a balance between public health, economics and social unrest.

I believe this balance is what Gov. Newsom had in mind when he delineated the six steps for reopening the state on April 14. There are two aspects of his plan that I would like to further address. First is the ability to monitor and protect our communities through testing. However, it isn’t clear if widespread testing will become available in the coming weeks.

There are specific epidemiological measures that evaluate the accuracy of a diagnostic test – sensitivity, specificity, false positive and false negative. Sensitivity measures the proportion of people with COVID-19 who actually test positive for it while specificity measures the proportion of people without COVID-19 who test negative for it. How sensitive and specific will our COVID-19 tests be?

The second critical component of Newsom’s plan is the ability to reinstitute certain measures, such as the stay-at-home orders, if necessary. While I do think this is an astute idea in theory, I am irresolute on how it can be implemented in reality.

What will be the appropriate COVID-19 incidence rate and length of time that determines the reinstitution of stay-at-home? Will people be living under constant duress over an ever-looming stay-at-home order? Will we once again close all nonessential business or opt to keep some open?

Can the local economy ever get back to normal? What steps are needed to revive the local economy?

Not anytime soon. Extensive testing, contact tracing and isolation of COVID-19 positive individuals are necessary steps for a gradual opening and recovery of the economy. What we must avoid is a premature opening which is followed by another closure due to a resurgence of the pandemic. The timeline for the recovery will likely parallel that of the development of therapeutics and a vaccine.

A majority of San Diegans are employed by small businesses. Thus we need to focus our economic recovery on that segment. First, a higher proportion of our city budget should be redistributed to the San Diego Small Business Administration. This redistribution can occur by reallocating from general funds and enterprise funds. There must be some funding available from those two sources because San Diego is reducing public transportation services, closing beaches/parks/recreation and decreasing many public services.

Second, the SBA should increase the grant amount that is distributed to eligible businesses (currently ranges from $10,000-$20,000) and increase the number of businesses who receive these grants. Furthermore, the SBA should focus on providing relief to first-time business owners as well as to owners who work and reside in underserved neighborhoods of San Diego.

The city and state should also request additional assistance from the federal government to help buttress the SBA program. This could involve requesting funds from the federal government’s non-defense discretionary program. Finally, our city should strive to support freelancers, gig contractors and independent artists by making sure that they also are eligible for unemployment benefits.

If the incidence rate of COVID-19 cases flattens and preferably decreases through mid-May, then it would be judicious to start opening up our economy – small businesses – thereafter. At the same time, we need to make sure that all of our open businesses have the ability to safely and effectively employ social distancing. This should include limiting the number of people inside stores/restaurants, not serving patrons at bars, and making sure tables are at least six feet from one another.

Overall, we need to make sure that low-risk individuals (those who are younger than 65 or those without comorbidities) are able to work and consume relatively soon. Their ability to do so will help steer our city towards economic recovery.

At the same time, these low-risk individuals (and society) should practice smart social distancing in order to limit the spread of COVID-19 to high-risk individuals. If all goes well, then social distance guidelines should be reviewed in the summer.

What parts of San Diego culture do you miss most? What events have you attended — and expect to miss most? 

I miss the beach and the entertainment scene. I really love going to the beach and shooting colorful sunsets – particularly abstract photography that includes short and long exposures along with intentional camera blurring, panning, zooming, rotating, and shaking. While I still have the ability to shoot from a distance, I currently do not have the option to shoot at the beach itself. However, this does provide an opportunity for me to get even more creative with my work.

I also miss the entertainment scene as that is what comprises the bulk of my photography. I have been able to make strong connections with major entertainment venues, publicists, labels, and artists and to see that temporarily dissipate has been quite disconcerting. Events that I will miss this summer include not just the San Diego County fair but many performances that have been postponed to at least July.

Political and social observers expect major societal changes to grow out of the pandemic. What new ways of living do you expect in the future — if anything?

Foremost, I feel that this pandemic has exacerbated socioeconomic and racial inequality. Many low-income workers are now unemployed or work jobs (retail salespeople, cashiers, fast food workers, waiters/waitresses, and janitors/cleaners) in which work from home is implausible. Thus, low-income workers are more likely to contract COVID-19 compared to many high-income workers who are able to work remotely. In addition, the African-American community has suffered from higher rates of COVID-19 mortality compared to other ethnic groups in the nation. In order to attenuate these disparities, I foresee greater public support for the implementation of universal healthcare and perhaps, a basic income.

Much of our current health policy is focused on reducing COVID-19 cases in order to decrease demand on our healthcare system. However, long-term stay-at-home orders and social distancing could lead to an increased incidence of mental health illnesses – psychological stress, major depressive disorder, and generalized anxiety disorder. Mental health care is a pressing issue throughout the nation and is often overlooked and underserved.

We need to continue destigmatizing mental health care (through compassion, awareness, and education), and ensure that our healthcare system is equipped with enough mental healthcare providers to meet this burgeoning demand.

With so many activities being exclusively done online, I also feel that the COVID-19 pandemic could lead to a rapid rise in virtual classrooms, virtual medicine, virtual travel, virtual sports, virtual concerts, and virtual social interactions.

What role will art play in helping society recover from this ordeal?  How will you play a part?

Many people are suffering from stress, trepidation, anxiety, depression, loneliness and ennui during this pandemic. I feel that art can provide an invaluable psychological boost during such turbulent times.

We are all consuming copious amounts of art during this time period – movies, games, music, shows, literature, painting, photography – through our phones, computers, televisions and streaming services.

This is because art heals people. Art can enhance self-esteem and self-awareness, provide emotional resilience and reduce stress. I hope that my COVID-19 photo story and poetry can provide an alternative view compared to what currently dominates the mainstream news cycle.

I will also play a role through my work at UCSD. I seek to impact patient care in the African-American community, who bear a disproportionate burden of COVID-19, through my ongoing research related to health disparities.

What life goals do you have? Which do you see as attainable?

My near-term goal is to be happy and healthy. My long-term life goal is to continue progressing on my path towards Enlightenment. I feel that suffering stems from our attachment to states or ideas – be it a pandemic or a certain definition that we thrust upon ourselves. I constantly seek to break down all social/internal assumptions and free myself of attachment to any labels and categories. I will walk on this path of transcendent subjectivity until the day I cease to exist in this physical world.

Anything else readers should know about your hopes for yourself and society? 

I would like to leave readers with a poem titled “Permanent Impermanence”:

Life Eviscerated.
Sullied Heart.
Novel Restart.
Seraph Activated.
Plague Abated.