In my living room are two bags filled to the brim with used N95 masks. Since March 2020, I’ve worn out every N95 I’ve been given to its fullest, taken it home, and saved it in my stash. The reason I keep them has transformed: from existing as a “just in case” measure of self-protection, to preserving the memories I have tucked away from a year that my mind has actively tried to forget. 

I shaved off my beard meticulously before wearing my first N95, knowing that any straggling hair could break the seal of this life saving respirator. The blue straps around my head were tight and left dark indentations, marks that brought comradery with the healthcare workers around the world showing the physical strain of personal protective equipment (PPE). The mask was the only thing that separated me from the patients. One slip and I could share their fate. Between patients I would place the mask in a brown paper lunch bag with my name scribbled on it in Sharpie and pin it up to the wall in my unit, the way a proud mom would post a certificate of achievement at home. I wore the same mask for two weeks, too scared to let it go. Upon its retirement, I took it home. 

I soon learnt that it was my responsibility to seek a new mask when mine was “soiled.” But what did soiled mean? Did a scent from bad breath count? Or a slight leak of air on the bottom with big breaths? Each time I was offered a new mask I’d be filled with guilt. Was my mask really soiled beyond use? Could the mask I was taking have been used to save someone else’s life? Which other doctor or nurse may be left vulnerable from my actions? Ultimately, when masks were offered I’d accept, but I wouldn’t seek them out myself. And unless my mask truly was deformed, I’d hold onto whatever new ones I was given, just in case. Having a clean mask on backup felt like an insurance policy during a game of survival.

As the weeks passed, I started to feel more comfortable in my self-imposed mask rationing. I would tie the elastic band on the back of the mask to make it tighter rather than using a new one I was saving “just in case.” I would lock my unused N95 up at night, scared it wouldn’t be there the next morning. My masks beyond repair would go into my stash at home as backup. I was acutely aware that these masks were in unusable condition, but to throw them away seemed like letting go of a lifeline. The hoarding behavior felt normal. 

A year later, my collection has grown out of control. I now wear a new mask whenever I’d like, and intellectually feel confident that my work can provide me with the resources I need to stay safe during patient care.

Yet I still can’t throw my old masks away. 

In the pile is the mask I wore while performing CPR on a patient for two hours with only two other doctors, only to ultimately have the patient in his 40s pass from covid-19. Another mask I wore while holding hands silently with a patient for 45 minutes before he was intubated. There’s the mask that had protected me from the virus that killed three of my patients in 24 hours. The mask I used to facetime the families of patients who were dying so that they could say goodbye. The mask that muffled my voice as it cracked in distress. The mask that felt suffocating when screaming into an abyss for people to understand the necessity of social distancing. The mask that made my eyes the only facial expression that could show my distress. The mask that shielded me as I declared patients dead who I had never had the pleasure of truly knowing. 

It’s been a year since I met my first patient ailing from covid-19, and though we have better treatment options and a vaccine, the emotional trauma of covid-19 persists. Just last night I wore an N95 while telling a patient she needed to be intubated, before helping her call her family to say goodbye just in case. 

My N95 collection is a tangible display of my lived experiences from the past year. A representation of the hours of care I provided, and the wear and tear of the devastation on my personhood. The difficulty of sharing the heartbreaking news, of guiding patients and their families through the horrors of covid, of seeing the same pathology wreak havoc on patients over and over again. 

The masks are my vigil—a reassurance that the lives of my patients will not be forgotten. 

Eric Kutscher is an internal medicine physician in New York City with a passion for addressing health disparities. Twitter @ekutscher

Competing interests: none declared.