As Kimberly Tusi was taken off a ventilator and began her long, slow recovery from COVID-19, she couldn’t have known that in the same Billings hospital her husband, her brother and her father were fighting the same disease.
It wasn't until after the 54-year-old recovered that she learned her younger brother had died, and later, her father, too.
They were the first and second, and as of Friday the only, deaths from COVID-19 in Yellowstone County. In all of Montana, 16 have died from the disease as of Saturday. More than 265,000 have died worldwide.
Bruce “J.R.” Spotted Bear Jr., age 52, died April 17.
His father, Bruce Spotted Bear Sr., 77, died April 28. Bruce Sr. died alone, not knowing his son had passed 11 days before.
Kimberly didn't get to say goodbye.
Her husband, Tafuna, recovered quickly from the disease. While making J.R.'s final arrangements, he tried to keep the news of her brother’s death from her, fearing she may relapse.
“I was scared if she found out, and her heart broke, she’d go under,” Tafuna said. “I didn’t think she’d come out of it.”
Tafuna Tusi is a native of Samoa and a Methodist. He said he sought God’s guidance in how and when to tell his wife of 32 years about the loss.
He recalls thinking, “If my wife gets mad at me forever, I’m OK — as long as she’s alive.”
It was one of Kimberly’s co-workers who inadvertently broke the news when she texted her condolences.
By then, Kimberly was well enough to take it in.
“I was OK and understood,” she said. "I know how hard it was for them to tell me."
'We prayed a lot'
J.R. cared for his dad Bruce Sr. on a ranch they shared near Pryor.
In late March, J.R. waved through the front window of their house to his cousin Renee Hawley and told her he loved her.
She was dropping off his favorite sodas, Grape Shasta and Pepsi. It was the last time she would see him.
The next day, Saturday, March 28, J.R. texted Hawley saying he was heading to the Billings Clinic emergency room.
Hawley had spent her high school years living with the Spotted Bear family and considers J.R. and Kimberly her siblings.
Kimberly, who lives in the Billings Heights with her husband, was admitted earlier the same day to the same hospital. She had told her husband she couldn’t breathe and was having trouble smelling or tasting anything. He drove her to the ER.
When Kimberly arrived at the hospital, she was given an oxygen mask and taken into the Intensive Care Unit where she was put on a ventilator. Kimberly, a diabetic, said she was intubated and heavily sedated and doesn’t remember the next two weeks.
On April 6, her 50-year-old husband started having trouble breathing, and checked himself into Billings Clinic. He was put on oxygen and developed pneumonia, although he was never sick enough to need a ventilator.
Just three days later, the Tusis' daughter, Sonya Goes Ahead, raced to the ranch to get Bruce Sr. to the hospital.
Goes Ahead had just finished basic training at Fort Jackson, South Carolina, and had been looking forward to visiting her grandfather. She had talked with him on the phone, but the rushed trip to the hospital was their only chance to reunite.
Typically, Bruce Sr. hated hospitals and had to be dragged to doctor appointments. But, he was feeling alarmed enough that day to call for help.
Before he was sedated, he gave Goes Ahead a list of chores to do around the ranch. The horses needed tending.
Bruce Sr. was well known for his way with horses, and he raised racing horses on the ranch after retiring from 30 years of driving buses for St. Charles Mission School and Pryor public schools. He was the one who taught Goes Ahead how to work with horses.
During the next few weeks, Goes Ahead made daily phone calls to check on her family’s recovery.
“It was really stressful,” she said. “At one point they were all in the ICU, and there isn’t anything we could’ve done. We prayed a lot.”
Beating the ventilator
Bruce Sr. and J.R., along with Kimberly, were all put on ventilators, not a good sign for COVID-19 patients.
According to preliminary data, survival rates are low for coronavirus patients put on ventilators, a device that pushes air in and out of failing lungs.
In New York City, one of the hottest spots in the country for the novel coronavirus, about 80% of ventilated patients have died, according to the Associated Press. No one is certain yet why the death rate is so high. It’s possible the ventilators cause more trauma to the lungs, or that many patients are too sick to survive anyway.
Kimberly beat the odds, after two weeks on a ventilator. She later told her husband that while she was under she prayed to God she could have more time with her family. She and her husband have raised five sons and two daughters and have four granddaughters.
On April 11, Kimberly and her husband Tafuna were released from the hospital after twice testing negative for COVID-19. Kimberly was sent to Advanced Care Hospital of Montana in Billings to recover. Tafuna was sent home.
A week later, J.R. died.
Mourning during a pandemic
As the family planned for J.R.’s funeral, they still hoped for Bruce Sr.’s recovery.
On April 28, at 1 p.m., those gathered for J.R.'s small funeral on the family ranch didn't know that Bruce Sr. had died just three hours earlier.
Tafuna and Kimberly Tusi waited until later that night, after J.R.’s funeral, to tell everyone.
At the funeral, Goes Ahead recalls thinking that even though her grandfather was in the ICU, he could still survive.
“I didn’t want to be too sad,” she said. “Then I found out that he did pass away that day. All of my emotions compounded.”
Kimberly was still recovering at Advanced Care Hospital and couldn’t attend the funeral. Truthfully, she was relieved she didn't attend, she said.
“I’m not ready to see my brother put in the ground,” she said last Friday. She still hadn’t read his obituary, either.
J.R.'s small funeral was closed-casket, and those who attended wore face masks.
“Everybody looked lost,” recalled his cousin, Renee Hawley. “… It just seemed unreal.”
After J.R.’s funeral, Hawley returned to her apartment in Billings to contemplate the second death in her family in less than two weeks.
May 2, a fresh grave was dug next to J.R. Spotted Bear's grave.
Bruce Sr.’s funeral was a blend of Tafuna’s cultural tradition and his wife’s tradition. Kimberly, her brother and their father, are enrolled members of the Mandan, Hidatsa and Arikara Nation in North Dakota.
A Samoan priest honored the service, which was conducted in English and in the Apsaalooke language.
There were no hugs or handshakes as family members tried to respect social distancing. There was no reception afterwards.
“We’re a family that loves to give hugs,” Kimberly said. “That was really hard not to give hugs. That hurts me because that’s how we are. I don’t get kisses anymore."
How Kimberly became infected with COVID-19 remains a mystery. She had been working for the Bureau of Indian Affairs from home and said she was “doing everything right.”
She limited herself to essential trips. She socially distanced. She wiped down groceries and washed her hands.
Still, there’s guilt.
One distant relative has blamed her and her husband for the deaths in the family.
“I’m here, and they’re not,” Kimberly said.
The fact that she was hospitalized first doesn't mean she was the source of infection within the family.
COVID-19 symptoms can take up to 14 days to appear, and severity varies from person to person. Some people can be contagious without experiencing symptoms, according to the Centers for Disease Control and Prevention.
Health officials have said there is evidence of community spread in Yellowstone County, meaning the source of the patients' infections is unknown.
As Montana slowly reopens its economy, Kimberly urges people to consider those who are more vulnerable to the disease, like her 77-year-old father, her brother with kidney disease or herself, a diabetic.
“This virus, it just attacks who it wants,” Kimberly said. Post-recovery she's going to donate her plasma, which should contain antibodies that others can use against the virus.
A visit that would be the last
The day before Kimberly and J.R. were hospitalized, he came to visit her at her Heights home.
It was a ritual for the close siblings. He’d finish his shift at the West End Shipton’s Big R and spend a few hours with her before heading back to the ranch in Pryor.
J.R. and his father were more alike than not. Hawley would tease them by calling them “Sanford and Son.”
Kimberly jokes that her father was a "tightwad,” although it was more out of self-sufficiency than lack of generosity. He didn’t like paying for things he could do himself.
During the annual Crow Fair, or during rodeos, Bruce Sr. was quick to donate his time and horse trailers, or anything else the community needed, Kimberly said.
J.R. inherited that generosity. He would gift a belt he had beaded, or a handmade quilt, or often he'd simply cook for his family, sometimes using his mom's recipes.
Had Bruce Sr. recovered from COVID-19, Kimberly isn't sure he would have survived the loss of his son. Bruce Sr.'s wife, Myrna, died in 2014.
It'll be tough for Kimberly to survive the losses, too. At 54 years old, she's now the last of her immediate family.
But given the chance, she didn't want to watch her dad die. The doctors had offered her the opportunity to FaceTime with him before he died. She said no.
"I didn't want to remember him like that," she said.
She may have made a different choice with her brother.
Kimberly doesn't blame Tafuna for keeping the news of J.R.'s death from her. But as it is, she doesn't remember the last words they said to each other.
“I wish I could’ve said goodbye,” she said.