Easier Days

I will never eat another apple pie. Never again. I wouldn’t have said that last year or any year before that. But now, the thought of an apple pie shatters me.

It started with a Facebook post from an ER doctor treating COVID patients. He wrote about baking his single use N95 mask in order to sterilize it before using that same mask again. And again. And again.

“It comes out warm and toasty and clean. It comes out safe. I set it on the windowsill to cool, like an apple pie from easier days,” he wrote.  

I sent that to Pip, who I knew didn’t have any time to check Facebook. “Yeah,” she wrote back. “We’re doing that too.”

That’s the thing about Pip. She never complains, never tells you how bad things really are. Until I asked her some pointed questions, I had no idea she was baking her only mask and wearing a garbage bag in place of a gown. She didn’t even have a face shield.

Pip and I have been best friends, practically sisters, since kindergarten. Her real name is Erin, but she had this fiery red hair she wore in pigtails back then which reminded me of my favorite childhood hero, Pippi Longstocking. She had the personality to match too. Pip was the one who’d gallop her pony headlong through a stream, while I would trot back and forth on the bank, studying the best approach to the safest crossing.  Pip was the one who’d run to the front of the classroom anytime they’d call for volunteers, while I’d hang back. And after graduating from college, Pip was the one who had moved to LA with no money and no plan, while I followed six months later, safely set up with a job and apartment.

So it came as no surprise that when coronavirus hit her hospital, that she was the first neonatal nurse to raise her hand and volunteer to work on the COVID ward.  She has these merry blue eyes and bubbling warmth that I’m sure brought some degree comfort to even the sickest of patients.  But for those of us closest to her – me, her mom and Noah, the new guy she’d started dating a few months earlier – it was like the COVID ward had swallowed her up from the moment she had her first shift.

That first week, I bombarded her with texts:

“How are you?”

“How are you holding up?”

“Is there anything I can do?”

“Do you have time for a call?”

“Hang in there!”

“I’m here for you if you need anything – anything at all.”

“I know you’re busy, but can you give me some sign you’re still alive?”

They either went unanswered or came back with that mustard-yellow thumbs up.

Her mom, who is essentially my second mom, and Noah were getting the same responses, so the three of us took to texting each other to share what little information we could glean from Pip’s hurried answers. 

By the third week we knew she was working seven days a week, which usually included two or three 24- hour shifts. We knew that she was very tired and didn’t have time to talk, except for a quick chat with her mom one night.  But we also knew she had a unrelenting sense of mission and felt very strongly that no one should die alone. She told Noah that she made every effort to be with her patients as they slipped away, lungs laboring until their very last breath. Typical Pip.

I wanted to drop food off at her apartment, figuring she didn’t have time to eat, but that was the first thing that prompted more than a two-word, one emoticon response.

“That’s so awesome of you, sweetie, but stay where you are. We’re in lockdown and you shouldn’t be risking exposure just to bring me some food. I’m fine,” she wrote.

“But when do you have time to shop? To cook?”

“They feed us here and I don’t really leave. I’m good.” She followed that with the thumbs up. Typical Pip.

And then there was mask-cooling-like-an-apple-pie moment I mentioned earlier.

“Yeah, we’re doing that too,” she wrote back after reading the FB post I sent her.

“WHAT???? You only have one mask?”

“Yeah, I wish we had more, but I sanitize it really well. Now I want an apple pie.” Laughing face emoticon.

“Do you have the other stuff you need?” I asked, decidedly not laughing.

“I’m ok.”

“Do you have a gown?”

“Garbage bag.”

“That’s outrageous! Can I find this stuff somewhere and send it to you?”

“Awww, sweetie. No, that stuff’s not anywhere these days.”

“Tell me you have a real face shield, gloves????”

“Gloves yes, face shield no.”

“PIP!!! That’s crazy! You’ve done way more than your fair share. Tell them you need a break.”

“Can’t. Gotta go. Don’t tell Mom.”

Typical Pip.

After that, Mrs. Barnhouse, Noah and I got used to not hearing from Pip. Week after week slipped by and we adjusted to the “All good”, “Fine”, smiley face and thumbs up. I hate that thumbs up.

So I was shocked late one Wednesday night, as I walked on my treadmill and binge-watched Season 3 of The Crown, to see Pip’s picture pop up on Facetime. I lunged for my phone.   

A stranger’s face greeted me. Though half-covered by her mask, I could see how gaunt she was. Dark circles that looked like bruises stretched from her eyes to her mask, made all the more garish by her sallow skin. Deep red marks and discolorations stood out all over her face like a map of the ways she had positioned her mask on her face, no doubt looking for some relief from the unrelenting tension of the elastic. Lines I’d never seen before were etched into her forehead. It was like she’d aged six years in the past six months. And she was crying. Not just silent tears crying, but really deep heaving sobs. I’d never seen her cry like that in all our time together. The fluorescent hospital light cut shadows across her face as she huddled into a corner of what I guessed was a break room.

“Sweetie! What’s wrong?” I asked.

She couldn’t even speak and I let her sob, helpless to comfort her. Then finally, “It was awful. It was so awful. But what could I do?”

“What was awful, Pip?” I asked, trying to sound as gentle as if I were coaxing a baby robin from its shell.

She took a breath and tried to steady herself.

“I had a patient who was dying,” she started.

“I’m so sorry” I said. “That must’ve been awful --“

“She was the seventh today,” she interrupted. 

“Oh.”

“I knew she didn’t have much time left and I called her family on the tablet so that they could say good-bye.” She spoke with a flatness at that point which told me she had gone through this process many times. “I told them she’d been fighting like hell for two weeks, but was declining quickly.”

She took another breath and paused before continuing.

“I could see a little light in her eye and she tried to smile when she saw them on the screen. They were crying and praying for her. My mask was getting wet from my tears. I kept looking at the time because they were only allotted five minutes, but I couldn’t stop them. I just couldn’t. This was the last time they’d ever speak to each other.” Tears started sliding down her face again. “Five minutes went to 10 and then to 15. The other nurse was waving at the door because another patient needed the tablet. At 20 minutes, I had to tell them ‘I’m so sorry but I have to end this call because I’ve let it go on 15 minutes too long.' I just started bawling. I promised I would be with her when she passed.”

“Oh sweetie – I’m so sorry. Did they understand?”

“They said they did, but how could they? Even I couldn’t understand how I could do that to them.”

“But, Pip, you didn’t do anything wrong.”

She started sobbing again and rubbed her forehead furiously as though she were trying to scrape the skin right off.

“I didn’t do anything wrong. They didn’t do anything wrong. But it all feels so wrong. None of this makes any sense. We try and we try and we try to save these patients. And when we can’t, we at least try to ease their suffering. But they suffer anyway and they die anyway and I feel so helpless.”

The last word trailed into a pool of hiccupy tears.

“Some recover. I’m sure you’ve saved so many lives," I said.

“Not nearly enough. God, it’s hard not to put yourself in the shoes of every patient you see.”

“Pip?”

“Yeah?”

“Will you think about taking some time off?” She looked at her watch and jumped up, brisk and professional again.

“Can’t – gotta go. Thanks, sweetie.”

A few hours later, I texted her: “How are you doing?”

Thumbs up.

****

It’s been three weeks and three days since that last conversation.

Pip is gone.

I write the words. I say the words. But I still can’t believe the words.

Four days after we spoke, Pip sent her mom, Noah and me a group text: “Tested positive. Quarantining.”

After that, we spoke everyday. Sometimes three or four times a day. She made no mention of the earlier incident that had devastated her so completely. Instead, she seemed like the old Pip. Smiling, laughing, staying positive and talking about all the trips we’d take and all the crazy adventures we’d have when she was better. The silliness came between labored breaths and scary coughs and an ongoing fever, but Pip assured us this was normal and that she just had to tough it out. We believed her. After all, she was the nurse. She was young, fit and healthy, save for the stress of the past several months. Her mom, Noah and I besieged her with food deliveries, books, magazines, flowers and clothes and, for a moment, it felt like everything would be fine.

But we could feel her fading. Her speech slowed, her voice became thinner, and she didn’t have the energy to Facetime or text, so we would just speak on the phone. We all tried to convince her to go the hospital but she wouldn’t.

“Not enough beds,” she mumbled to her mom. “I’ll be fine.”

The next day, I called her.

“Come on, Pip. Call the hospital. They’ll fix you right up and then we can go hiking or ride or go to the beach,” I told her, trying to keep the fear out of my voice.

She didn’t say anything. Just those rasping breaths.

And then, so soft I could hardly hear her: “Remember the apple pie?” 

“Huh? What are you talking about?”

“The story about the pie and …. baking the mask.”  

“Oh, right. What about it?”

“It was funny.”

She wasn’t making any goddam sense. Low oxygen affecting the brain. I’d read about that. My stomach clenched.

“It wasn’t really funny, Pip. It was sad. And terrible. You should’ve had proper equipment.”

Her voice sounded like a cloud drifting away.

“Maybe I didn’t bake long enough.”

“What?”

“The mask ….maybe that’s how I got this….didn’t bake the pie.”

I called her mother who called her supervisor who sent an ambulance for her.  They put her on a ventilator but her blood pressure kept dropping. They put her on three different meds to raise it, but nothing helped.  Even after Mrs. Barnhouse called me – barely able to get the words out - to tell me Pip wouldn’t make it, I couldn’t believe it. I wouldn’t believe it. I still don't believe it. This was Pip. And Pip powered through everything with a grin and wave of her hand that made magic happen.

She died at 9:23 pm on Monday night after a last conversation with her mother over the tablet and with two of the other nurses by her side.

I am sitting on the couch in my apartment staring at the wall. Empty. My thoughts make no sense to me. There are a million things to think about, a million things to be angry about, a million things to cry about. And yet all I can hear are Pip’s final words to me in that breathy, dreamy voice. What was it about the mask-and-apple-pie that stuck with her so strongly? I’d learned so much more about Pip over those past eight months than I’d ever known over the past 25 years. I tried to put myself in her head and see what she saw in the mask-and-apple-pie story. But all I can see is her mask, steaming and safe, on the counter. A battered mask that should have been tossed after the first use. A single mask that should have been one of thousands given to her and the other nurses. A mask that should have been fresh and new and complemented by an endless supply of gowns and face shields and goggles and gloves.   A mask cooling on the windowsill like an apple pie from easier days.