Dr Marise Gomes thought she was making a short trip home from her adopted New York to celebrate carnival with her family in Brazil.
But more than a year later, she is still in her home country, fighting on the front line of the coronavirus pandemic.
Racing to keep up with the crush of patients at a sports complex turned field hospital in the suburbs of Sao Paulo, Gomes looks far from the carefree spirit of carnival.
The parking lot quickly fills with ambulances carrying patients struggling to breathe, young and old alike.
"It's caught us by surprise. Our patients now tend to be young, with no pre-existing conditions. The disease hits them hard and a lot of them die," said Gomes.
A 53-year-old surgeon who sports tattoos and a nose ring, Gomes had rarely returned home since moving to the United States 15 years ago.
The glittery allure of carnival brought her back in February 2020, joined by her husband, Jack, an American lawyer.
But no sooner had the confetti landed than Covid-19 started engulfing Brazil.
Gomes was due to fly back to New York, but decided to stay, sensing her country was in for a rough time, she said.
"I thought I could be more useful here," she said.
Classmates from medical school helped her get the job at the Santo Andre field hospital, not far from her hometown, Sao Bernardo do Campo.
As Brazilian President Jair Bolsonaro downplayed the virus and refused to impose social distancing measures, Covid-19 exploded.
Soon, Brazil's health system was buckling under the strain. Gomes lost two uncles to the disease.
By June, Brazil had the second-highest Covid-19 death toll in the world -- after her adopted home, the United States.
"People would say to me, 'What are you doing here? You should go back there.' As if there were some perfect 'there,'" she said.
- 'A lot of pain' -
Gomes had imagined spending time with her family, but ended up doing everything she could to avoid contact, fearing she could infect them -- particularly her mother.
"It's hard returning home and feeling kind of rejected because you might be contaminated from working at the hospital," she said.
She has since been vaccinated, allowing her to breathe easier.
But her voice cracks when she talks about her sister, a fellow health worker who took her own life in November, aged 47.
She had struggled with depression for years, and it grew to be too much, said Gomes.
"It's a lot of pain all at once," she said.
"But at the same time, I've seen so many people whose pain is so much greater than mine."
She said she was frustrated to see many of her compatriots ignore face masks and social distancing guidelines and even flood to underground parties.
"I see no difference in people's behavior. People don't seem to understand the magnitude of this," she said.
"The CAT scans we're seeing are terrible. Young people who are 22, 23, 25 years old. It's scary. I'm afraid, afraid for the population."
She hopes to return to New York soon to pick up the life she left behind.
In the meantime, she and her colleagues keep up their struggle against a surge of severe cases that caused a record 66,500 deaths in Brazil last month -- more than double the previous record, in July 2020.
"I'm giving it everything I've got," she said.