It’s a Tuesday evening when the bad news comes. Alyce LaGasse can barely hear her son over the phone. He is hoarse and struggling to breathe. He’s calling from a hospital in Salt Lake City, where he arrived in an ambulance.
Alyce had been thinking a lot about COVID-19 before this moment, and not just because she’s 70. She’s read those news stories about people dying alone, with no relatives allowed to hold their hand, or hold a proper funeral, and it makes her heart hurt. She feels for these families, contemplating the thought of not being there for the ones she loves. She’s a natural caregiver, always has been.
And now here’s Adam on the phone. Adam, her baby boy, even if he’s now 48. Adam, the sweetheart who never fails to look you in the eye and say, “How are you? What can I do for you today?” Adam, the vulnerable one, the paralegal living for years with diabetes, who just took the biggest leap of faith in his life a few months ago, when he left Oregon and moved to Utah because he finally met someone great.
It makes so little sense at first, because everything Alyce knows about COVID-19 suggests she should be at risk, in this condominium building filled mostly with older people; here in Portland, just 180 miles south of Kirkland, Washington, where the outbreak first erupted in the United States.
Not Adam. And now, suddenly, here she is, thinking about the nightmare of outliving one of her children.
At times, Adam has struggled a little to breathe out there in Midvale, about a half-hour drive outside Salt Lake City. Ever since he arrived in November, there would be times when he’d be huffing and puffing. But he’s not one to complain, Alyce knows, and he always just waves it away, saying it’s just the elevation.
This time is different. First, his fiancee, Wendy Higgins, takes him to an urgent care place, and they barely let him through the door. They pack him into an ambulance that takes him straight to the university medical center in Salt Lake.
The emergency room physicians tell Adam he has pneumonia in both lungs and congestive heart failure. They give him oxygen and order a test for the coronavirus.
When Alyce gets off the phone with Adam, she calls Wendy, who tells her that the emergency room wouldn’t let her in. She had waited in the parking lot for hours, unsure of what to do.
Now Wendy is home. She is coughing, too.
When Alyce hangs up from that call, she turns to her empty condo. “Alexa,” she says, “How many cases of coronavirus are there in Utah?” And the answer is just under 300. In New York, there are more than 15,000.
Her mind races. Here she is in Portland. Her daughter, Erica Schulte King, is in Minneapolis, and her grandchildren aren’t anywhere nearby.
“The idea that he is in this condition and I cannot see him is heart-wrenching,” she says. “Do I drive or fly to Salt Lake City and stay, waiting in a hotel?”
The following day, Adam’s test comes back positive, and he’s installed in the intensive care unit. He can’t speak or eat; he is struggling too hard to take in air. She waits for his texts.
She talks to the ICU nurse over the phone. “Does he have a shower?” she asks. Adam runs hot, she thinks. She’s certain a shower will help him feel better. And the nurse sounds like she almost chuckles. No showers in the ICU.
— — —
That first week reminds Alyce of Vietnam.
When her brother went off to war in the late 60s, the world around her in suburban New Jersey carried on as usual. Even as boys came home in body bags, many of her neighbors and friends and the other kids in school just didn’t seem to get it. To them, Vietnam was “over there.” She was certain some of them couldn’t even find the country on a map.
Alyce’s home looks out on an esplanade that runs along the bank of the Willamette River, and down below, she can see people out walking and jogging, some barely a foot apart. It’s the last week of March, days after the president declared a national emergency.
She goes cycling and walks around the city for exercise, and young people are panting after Frisbees in the park, sitting too close together.
“People are looking at the virus the same way: ‘It’s out there. It’s not going to happen to me,’ ” she thinks.
In Salt Lake City, Adam is alternating among an oxygen mask, a CPAP machine and a nasal cannula. The staffers throw the tools they have against a new foe, to support his fluid-filled lungs and get him air. When he starts coughing up blood, they add a tool to suction up the phlegm.
And on the other side of this surreal split screen, there are the jokes. Silly things that pop into Alyce’s Facebook feed or her email inbox, that she notices in the dark hours of the morning when she has just gotten off the phone with the night nurse to check on Adam’s condition. Stuff like: “I asked my wife to self-quarantine because I was tired of her cooking.”
Sometimes she wants to shout at these people. Or shake them. Don’t they realize it could happen to them too?
That first week, Adam is still able to talk in short stretches, mostly through his oxygen mask. His voice sounds buzzy, raspy — partly because of the mask, and partly because of the dryness in his throat from all that air being pushed down.
So they text.
He sends some pictures of himself, wearing his oxygen mask, and Alyce thinks he looks awful. She’s always deleted texts as soon as she get them.
Now, she saves them, because she thinks it might be the last pictures she has of him alive.
And how did it come to this? Texting from the ICU, Adam mentions a young woman at work who had come into the office earlier in the month, despite having a fever. Erica, who is younger than Adam but fiercely protective of him, is irate when she hears this.
Adam sends photos of his doctors and nurses, whose faces he never sees. They come and go quickly, cloaked in gowns and masks that encompass everything, looking like astronauts in space helmets, “these 360 degree things covering their heads,” Alyce says.
“Adam’s room is not just a face mask — Adam’s room is a hazmat.”
Alyce thinks a lot about these doctors and nurses she has never met, but about how great they are, how selfless and attentive to her son’s precarious condition, but also how scared they must be, going in and out of Adam’s room, and the rooms of all the other COVID-19 patients in that hospital. They probably have husbands and wives at home who are terrified, too, she thinks. They’ll probably have PTSD when this is all over.
There’s a physician assistant named Jess who Alyce talks to almost every day on the phone. She doesn’t know her last name or what she looks like. She sounds young and she’s kind, so reassuring. She takes her time with Alyce, describes Adam’s condition in detail; how much oxygen he’s taking, how his lungs are looking.
Alyce tells Jess that she has the “hardest job on Earth” answering all these questions from worried loved ones, and Jess tells her that she doesn’t mind.
Then comes Day 5, and Alyce doesn’t hear a word from Adam. He doesn’t respond to texts, and he doesn’t call.
This is it, she thinks. She is going to have to bury her son, and she is swamped with fear.
When Alyce calls Erica in Minneapolis, she breaks down in tears for the first time.
“I’m scared,” she tells her daughter. What will they do with his body? she asks.
She fights to do her usual emotional road-mapping, anticipating whatever crises lie ahead and trying to plan for them.
She begs Jess to rank the severity of Adam’s current condition “on a scale of 1 to 10” when the physician assistant finally calls somewhere in that awful day. Jess says she can’t answer that question. She can tell her how many liters of oxygen he’s getting, and his heart rate, and his blood oxygen level, and whether he’s on a ventilator.
Alyce asks her if she’s also the one to call families when their son, daughter or parent dies, and Jess says, yes, she is.
Adam’s wedding was supposed to be April 11, and when the virus started its spread in March, he and Wendy realized they had to postpone it.
Alyce had tried to lighten their disappointment. “Don’t sweat it,” she said. “Katy Perry postponed hers!”
The two had met 22 years before through a friend and reconnected on Facebook. Soon, they were having hourslong conversations. She came to Portland. He visited Salt Lake. After a year of that, a “love story unfolding,” as Alyce saw it, Adam found a job in Utah. He got an apartment down the hall from Wendy, and courted her in a way consistent with her strict Mormon upbringing.
Now, Wendy has the virus and is sick at home, and Adam is fighting for his life.
“Wedding, no wedding,” Alyce thinks. “It doesn’t matter.”
— — —
On Day 6, it seems like Adam may have turned a corner. They gave him lime Jell-O this morning. He took off his oxygen mask to eat it and sounded so thrilled that, Erica jokes, he’s ready to buy Jell-O stock.
He tells Erica he thinks he’ll be around to annoy her a lot longer.
Jess tells Alyce that if Adam’s oxygen levels continue to improve, they’ll move him out of the ICU and onto the pulmonary service floor, and if that goes well, he can transition to a live-in facility, or even return home, for his slow recovery.
“I think I see the light at the end of the tunnel,” Alyce says.
She and Erica tell their relatives and Adam’s friends that the hospital has a program to print out greeting cards for patients from online submissions, and almost immediately the letters start pouring in; each printed beautifully on fine-quality paper cards.
She can tell that the letters brighten Adam’s mood. She can hear it in his voice over the phone.
In Portland, Alyce has continued to wake in the predawn hours every morning. It gives her a chance to call the night nurse in Utah to get an update before things get hectic. She catches up on the news and the turbulent markets and her work, providing Mac tech support.
She divorced Adam and Erica’s father when they were preschoolers and raised them alone in Connecticut. Their father died of cancer in 2011.
“I don’t have family support except for my kids,” is one way Alyce describes their closeness. And now they are all horribly apart.
When the hospital social worker reaches out, for the second time in two weeks, Alyce is stunned and grateful.
“I’m calling for you. How are you?” the social worker, whose name is Elizabeth, says. And just the thought of someone asking her how she is doing makes Alyce feel a thousand times better.
At her condominium building, Alyce hosts a socially distanced happy hour for her neighbors in the 4H Club. She sets up chairs, spaced 10 feet apart along the hallway, and carefully wipes down each one with a Clorox wipe. She puts a table out, too, with an orchid on it — a nice touch. And then they all sit there and sip their wine, each clutching the glass through a wipe, and they talk to each other from a safe distance. It feels nice.
She signs up for some free online classes and meets with her ukulele group over Zoom to practice. She thinks about how Americans’ social lives have contracted, and yet in some ways the practice of social distancing “gives us the opportunity to just be.” She contacts friends to gather up old computers and tablets to send to high school students who don’t have any, and donates blood — “just because it’s one of those things to do — I can do that.”
Adam, meanwhile, is worried about his job. So Alyce is, too. He sends her a text message about his communications with the law firm he has worked at for only a few months. He’s not getting paid while he’s out, and the doctors say it will be weeks before he can work again.
On the morning news, health officials are advising Americans to start wearing masks in public. When Alyce heads out for a long bike ride on a nice day, the other riders are now wearing them.
Better late than never, Alyce thinks, although now it’s early April, and more people are dying of the virus every day.
After nine days in the ICU, Adam is moved to the pulmonary floor.
Alyce is so thrilled that she writes a letter to the hospital. “Somehow, after a week, the medical team did what I perceive as ‘saved his life,’ ” she tells them.
The hospital discharges Adam on a Sunday, 12 days after his admission. The people who took care of him now wheel him downstairs to the street, where Wendy is waiting in her car to drive him home.
Adam and Wendy are so ecstatic that they entertain the idea of going through with the wedding on April 11 anyway. No intimate family gathering in Wendy’s mother’s backyard in scenic, southern Utah — but a sort of drive-by wedding, in which a local bishop administers the ceremony to just the two of them, through the window of his parked car.
The notion fades in a few days. There are so many other uncertainties, like whether Adam’s health insurance plan will cover all of his medical expenses, which so far are coming in at nearly $140,000, starting with the $2,400 bill for that first 14-mile ambulance ride to the hospital.
The doctors tell Adam his recovery could take weeks, and the available science on the vulnerability vs. immunity of survivors is even less clear.
By early May, Adam is in his third week back at work, from home, his computer and two monitors on a table next to his bed. Adam is still dependent on oxygen during the day and a CPAP machine at night. His insurance is going to cover all his costs.
Wendy is still coughing, but she’s back at work, too, from home.
One day Adam has a “virtual appointment” with a pulmonologist, and his ever-protective mother wonders how that works; how can they take his blood pressure through a screen?
Once again, she contemplates driving out there. Now that he is recovering it should be safe, she thinks. But it might not be. Would it be worth going, worth the risk of spending the night somewhere along the way and potentially being exposed to the virus in some hotel?
“And then I get there, and am I 100 percent positive that their immunity is enough that they’re not contagious?” she wonders.
Is it worth going all that way just to be able to look at him through a window, just to see his face? She knows that Erica will say it again: “No, Mom, you’re the risk group!”
Then again, maybe it would be worth it. “You can read your kids,” she thinks. She’d be able to look at his face and tell something from it; tell how bad he really feels, how far he still has to go.
Alyce resolves to wait a little longer.
“This is uncharted territory,” she decides. But they’ll get there.