Like tested veterans for whom warfare is not the dusty stuff of history books, they are on the front lines of the medical battle of their lives. They have seen things they never want to see again.
Now Casey Hertello and Katlyn Campbell, friends, colleagues, and 30-something nurses who are treating COVID patients at Boston Medical Center, are watching the numbers.
And they’re worried. And frightened.
"In the past week, we’ve been getting more nervous because we’re seeing that in the community the numbers are going up,'' Hertello told me.
"Now, we’re seeing them in the hospital, too. We’re getting a few more here. It’s scary. I just don’t want to go back to where we were in March and April.''
She turned to the woman she has known since they started work on the same day in March 2013 — a friend, a trusted colleague, an intensive care unit sister.
"Yeah. I just don’t want to get to the point where we’re overwhelmed and that’s all we’re doing for months on end again,'' Campbell said.
“Through the summer, I kept on hearing about people getting COVID — people I knew. But we didn’t see it in the hospital. It seemed like more mild cases. I was optimistic. Maybe the strains are weakening. But now we’re seeing people sicker and having to be hospitalized.”
Like a bad old black-and-white melodrama in which the monster twitches and refuses to die, the creature is stirring again.
Hospitalizations for COVID-19 are climbing — albeit slightly — at hospitals around Boston. In Massachusetts, confirmed COVID cases jumped by 968 to 144,895 on Friday.
That trend is producing the highest number of new cases in almost five months.
Last Friday BMC reported 24 patients with COVID. Earlier this month, on Oct. 7, that number was 8. That increase mirrors a disturbing national trend.
I first met Casey Hertello and Katlyn Campbell in April when I was attracted to their efforts to connect patients to their families by taping up hundreds of images of loved ones who, for safety reasons, could not visit in person.
That seems like a lifetime ago now.
The pandemic has raged on. It has rearranged our lives, driven us from our workplaces, and has taken center stage in a national election that is now just days away from its stormy conclusion.
In Boston, the positivity rate rose to 5.7 percent at mid-month. That’s up from 4.4 percent the week before that. Bad numbers. An echo of last spring.
"There were days, especially in April, where you just dreaded coming to work because it weighed on you so much,'’ Campbell said. "And then it did lighten up.''
It got better. Until it didn’t.
They know the signs. Rapid, shallow breathing. Inability to catch a breath. High heart rate. High fevers.
These two nurses who, quite literally, can finish each other’s sentences have seen too much of it. And now, they’re seeing it again.
"We take care of sick patients on a normal basis and I feel like we have a pretty good handle on things and know what to do in certain situations,'' Hertello said. “But with COVID, it’s like . . .”
"You didn’t get a break,'' Campbell told her.
"Yeah, it was non-stop,'' Hertello concluded.
For these nurses, nothing about this is academic, grist for political candidates, or for headlines about social distancing, or empty restaurants, or nearly vacant office towers.
And don’t tell them that it’s all going to float away some day like a bad dream.
"Some people would be just going out, acting normal as if things weren’t happening,'' Campbell said. "It’s just frustrating. You hear about COVID deniers. And that’s just so frustrating being on this side of it and then seeing people kind of downplaying it
"Everyone that I know personally who had had COVID has done OK. But we’ve seen the side of it that is very not OK. So it’s very hard.''
For Hertello, the disease came too close and may have breached her efforts to defeat it.
She tested negative in April after she displayed symptoms of the disease. But then she experienced backaches and a headache. A slight cough and a low-grade fever. She lost her sense of smell and of taste.
"It was just a mild case, thank God,'' she said.
They have stopped predicting when normalcy will return. Or what it will look like when it does.
The pandemic has taught them lessons that they don’t — and really can’t — teach you in nursing school.
"You get more comfortable with how to speak with the families,'' Campbell said. "That’s something you learn in your career as you encounter death more. What do you do to comfort them? Sometimes it’s just silence. You just kind of feel it out. But, definitely, I was far more uncomfortable at the beginning of my career 10 years ago than I would be now.
"But it’s never less emotional.''
How could it be? Few of us have jobs that take us so close to something so profound. And something so profoundly sad.
Like being in the room when a husband and his wife say their final goodbyes.
"How do you know what to say?'' asked Campbell. "So much runs through your mind.
"The husband was not yet intubated but he said, ‘I want to talk to my wife for the last time because I know I’m not going to be alive off the ventilator.’ He was right. And we were frantically trying to get his wife on Facetime and she wasn’t answering.
"And he was decompensating very quickly. And they wanted to intubate him right away. But I’m like, ‘No. We need to get her.’ I’m calling the daughter to try to get her mother because I could feel it. And I knew how important that conversation was going to be. And, finally getting her on there, they just kept saying: ‘I love you. I love you. I love you. I wish I could be with you.’
"It’s very hard.''
A deeply personal piece of the pandemic.
All now part of Casey Hertello’s and Katlyn Campbell’s daily work.
It’s the kind of work that makes this part of their still-young careers something they will always carry with them.
Thomas Farragher is a Globe columnist. He can reached at firstname.lastname@example.org.