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The words are familiar at first, a bedtime trope so dependable that it’s hard to imagine this ritual will ever change. Every evening, Elise Barrett helps her 2-year-old get ready for the night. Their apartment’s small, so he sleeps in the walk-in closet, and she climbs in with him, for a cuddle and a story before lights-out.

Now, he’s asleep, and she’s in the living room with her phone. She’s 34, a nurse supervisor at a cancer clinic in Seattle, and she’s tired. You can see it in the heavy way she blinks, in the darkness at the edges of her eyes. There are dishes to do, and she’s sweaty and feels like hot trash, but she hits the red button on her screen to record, and starts telling the same story she just told again. “Once upon a time,” she begins, “there was a little boy named Kepler.”

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They’d named him after the astronomer, who had lost some eyesight to smallpox and went on to trace the glittering paths of planets across the sky. They liked how he’d defied authority to sketch out his strange, clock-like vision of the cosmos; they liked how, even as he pored over formulas and diagrams, he’d written fiction, too.

For weeks now, she’s been eyeing the disastrous waves of coronavirus elsewhere, knowing that her city had been an early U.S. hotspot, and might soon be overwhelmed. She’d heard the Italian government had taken emergency measures to deploy thousands more health workers — reinforcement for those getting sick on the front lines. It sounded almost like medical conscription.

On nursing Facebook groups, she saw that swamped New York hospitals were desperate for anyone with any ICU experience at all. Sometimes, administrators threw in workers from other kinds of units, without much training. “How do I fix this?” one nurse wrote, frantically trying to debug life-sustaining equipment.

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Barrett had the sort of experience many didn’t. Before she’d switched over to oncology, in 2018, she’d spent nearly 10 years in the ICU. Ventilators, she knew, don’t run themselves; they need continual checking and fixing and alarm setting, a routine she’d gone through again and again. She knew you could put a patient face down to give stiff, swollen lungs more chance to expand, unencumbered by the weight of the heart. She knew you could gently roll the person’s head back and forth, to keep pressure sores from blistering on the skin.

She hoped it wouldn’t happen, but she suspected this crisis would require her know-how soon. Ministering to patients painfully caught between life and death is a strong tonic against denial, and she and her work friends are nothing if not matter-of-fact. They figured she’d be pulled back in. Sure enough, within a few weeks, she heard her workplace was forming a “float pool,” to shift nurses from other units into the ICU. The call would be voluntary at first, she imagined, and then become a request to which you couldn’t really say no. Even if she had a choice, and staying home meant leaving patients to die, she would have to go.

That wasn’t without risks. She’d read about the illness sweeping through Italian health care workers. She’d read about a young emergency doctor treating Covid-19 patients outside of Seattle, only to wind up in critical condition himself. She wondered when she’d next see Kepler if she went. She wouldn’t want to bring the virus home to him. Plus, she might not have all that much time. Even in non-pandemic years, the ICU pace could be brutal.

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A few Mondays ago, she was chatting with a nurse friend about what it might be like to go back in, now, amid this mess. “She and I have both done the thing where you sleep in your car between shifts, because you don’t have enough time to go home,” Barrett said. “She was like, ‘You’ve got a little kid … aren’t you worried he’s going to forget what you look like?’”

Gee, thanks, Barrett thought. What a thing to say.

Then she thought her friend was probably right.

She was already telling Kepler one story every evening, if he wasn’t too tired. Now, she tells each story twice: once in the warmth of his converted closet bedroom, a kind of fort to keep the news at bay, and then again when she’s emerged into the real world of obligations and worries and constant phone pings.

The plot usually revolves around Kepler as he explores the forest. He bargains with an orange and purple snake so it doesn’t devour his squirrel friends; he bops it on the nose so it doesn’t devour him. Sometimes Barrett becomes the snake, making slithery-whispery sounds with her tongue; sometimes she embodies Kepler, furrowing her brow, forging ahead no matter the risks.

Those videos, Barrett sends to her husband, in case she needs to miss bedtimes. But when he’s out, working as an aircraft mechanic on the night shift, she’s also started making other, less whimsical clips. These she entrusts to a friend, so as not to give her husband nightmares.

Some are about her wishes for herself, should she get infected and end up on a vent. She’s seen how hard it is for families — even those left with clear instructions — to make decisions when an ICU team is asking, should they let go, or should they try CPR again? The question can hit you with little warning. It can leave you sick with guilt, either way. She doesn’t want that for her husband. She wants him to hear her, in her own familiar voice, laying out exactly what to do, saying she doesn’t want things drawn out.

Other videos are for Kepler, when he’s 4 or 5, and starting to ask questions. There she is, in the same old red-rimmed glasses, explaining why she had to leave, that it wasn’t anything he did.

She hopes these videos will never be watched, that she’s making them for no reason, a library for no one but herself. She hopes she’ll be there, wearing old scrubs as pajamas, acting out a bedtime story before turning to the dishes left dirty in the sink. But she can’t help thinking about the emergency doctor out in the suburbs, just doing his everyday job when he fell sick. She wonders what he was able to say before a breathing tube blocked his speech. Then, she pushes the question away. She holds her phone steady, and smiles at the screen.

  • This clarifies why it is so very important for people, especially non-senior people, have the conversation with their loved ones about what their goals are as far as end of life decision making. Five Wishes and Honoring Choices have great resources for developing living wills and durable powers of attorney for health care — and for broaching the subject in the first place. Please, for the sake of those who care about you, do your living will now!

  • Difficult, but thank you. We need to know what our people on the front lines are dealing with, on personal levels, as this article makes painfully clear. I hope positive, loving thoughts really do get through. Stay healthy, happy, and helpful.

  • PLEASEPLEASEPLEASE have the “talk” with your loved ones about final wishes and make sure that the care teams knows them. This piece was heart wrenching and as one married to a battle hardened retired RN, it brought me to tears. It didn’t have to be this way…but here we are…Bless all the healthcare workers who are literally giving their lives to save humanity.

  • A beautiful heart, I pray that one day when her son is older and they celebrate a happy moment in their lives as a family, she is able to delete this heartwarming and heartbreaking video and thank God for a life well lived. May God protect and bless all of us, but especially our first responders in this pandemic.

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