The doctor had such a severe case of COVID-19 in the earliest days of the pandemic that she shared her last wishes with her husband.

“There were nights when I didn’t think I’d wake up. My oxygen levels were dipping into the 70s,” recalled Dr. Kalindi Batra, who knew all too well that her oxygen saturation needed to get back in the 90s, or she might not make it.

She isolated herself in her room to protect her husband and their two children from the scary new virus.

“I wrote up my 5 Wishes and prepared for my death,” Batra recalled.

Back in March of 2020 when Batra became gravely ill with one of the first known COVID-19 cases among doctors in Colorado, she had to drive across town for a test and waited days before receiving confirmation that she did, indeed, have COVID-19.

At night, as she struggled to breathe, she consulted with her husband, Percy Salizar-Escobar, fellow doctors and her identical twin sister, Dutima Batra, who is also a family medicine doctor and cares for OB-GYN patients in California.

Kalindi Batra realized she needed supplemental oxygen and, in the midst of lockdowns, managed to buy an oxygen concentrator. The treatments likely saved her life.

But she went on to develop a terrible case of long COVID.

“I’m still short of breath. I have chronic cough, tinnitus, brain fog, headaches and pain. But I’ve worked through it.”

From the first days of her illness, Batra found solace, hope and healing through exercise, meditation and time spent with family and friends.

“I got a lot of fresh air. I walked even though I was so short of breath that I sounded like a smoker,” Batra recalled.

Bringing rays of hope to others

Amid her suffering, she focused on other people. Batra, whose first name means source of the river in Sanskrit, brought rays of hope to others. She anchored her primary care clinic, UCHealth Sterling Ranch in Littleton, while juggling parenting duties and remote learning for the kids. Later, she cared for her dad in the family’s Littleton home as he coped with advanced Parkinson’s.

Batra and her husband had been through a lot and were looking forward to rest and wonderful milestones in 2024. Their daughter was graduating from high school. Batra was eager to join her twin on one of their ambitious annual backpacking trips. All seemed well.

Then in April, seemingly out of nowhere, a large lump appeared in Batra’s right breast.

Her doctor brain – and her twin – told her she needed to get the lump checked out ASAP. It’s what she would have told her patients. But the human being in her simply couldn’t face another crisis immediately. So before focusing on the lump, Batra worked through her top priorities: celebrating their daughter Quilla’s graduation, organizing a family reunion, making arrangements to move her dad to her brother’s home and of course, taking care of her patients.

By early August, she made time for a mammogram.

The results were bad. And the outlook grew worse once Batra received her biopsy results.

She had triple negative breast cancer, an aggressive, fast-growing type that accounts for about 10 to 15% of breast cancers and doesn’t respond to typical therapies.

So far, it appears that the cancer has not spread.

“They say I’m at Stage 2B. There are some lesions on my ribs and sternum, but the doctors feel it has not metastasized,” Batra said.

Still, it’s been a shock for someone who’s been healthy all of her life to suddenly learn of this diagnosis. There is no family history of breast cancer.

“I breastfed both babies for years and have no significant risk factors. I feel SARS-CoV-2 (the virus that causes COVID-19) may have caused this cancer,” Batra said.

“Clinically we have all seen cancer cases rise during the pandemic.

“Scientists are currently studying how the M Protein on Covid-19 virus stimulates a complicated immune response that leads to proliferation of aggressive triple-negative breast cancer,” she said.

As Batra ponders why breast cancer struck her, she must focus on dealing with it.

“This is a really bad diagnosis,” said Batra, 50. “The truth is we don’t know how this is going to end.

“I’m focusing on survival stories, like the book, “438 Days: An Extraordinary True Story of Survival at Sea.” The take- home message is believing you will survive and more importantly, thrive.”

So far, the treatments have been torturous.

“Because it’s triple negative, we have to go the old-school way, there are fewer treatment options. The chemo basically kills healthy cells so it can kill the cancer,” Batra said.

“I’m trying to work through this with a lot of mind/body techniques,” she said.

She also has decided to open up about her cancer journey.

“I need to share this story with other people. I don’t know why, but there’s a calling there,” Batra said.

“I want to be vulnerable. Maybe it will help others. The world of cancer is very complex.”

As Batra copes with this grueling, unwanted journey, she’s trying to focus on beauty and blessings.

“Life is not guaranteed,” Batra said. “No matter what the outcome is, I feel truly grateful. My 50 years on this planet have been truly marvelous. I am one of those people who has lived each day to the fullest.”

And she’s trying to absorb lessons about what it’s like to be the patient rather than the doctor.

“I’m scared but blessed for this opportunity to become a better doctor, a better mom, a better wife, a better human.”

A childhood full of travel, a life dedicated to others

Batra is fierce and determined but also exudes warmth and empathy – the perfect blend of traits for a beloved primary care doctor.

She grew up as a daring child of immigrants in Alaska. Her mom came from Canada, her dad from India. The family embraced the wild, natural beauty around them.

“We lived in the mountains in the Chugach Range, about 45 minutes from Anchorage. It was beautiful. I love the mountains and the water.”

Batra is one of four siblings. She and her twin have an older brother and sister.

The family traveled every year to India to see relatives there, but traced their roots to far-flung places around the world.

“Our ancestry isn’t exactly from India. It’s Pakistani, Punjabi, East African, Afghani and Irani. There was a lot of migration. My mom is French, Irish and Scottish. I’m a true zebra,” Batra said with a proud grin.

International travel at young ages forged a sense of mission in Batra and her siblings.

“The three of us landed in medicine because of the things we had seen. We saw people in challenging circumstances and realized that we could provide help,” she said.

Batra, her twin and their brother are all family medicine doctors. Their other sister is an artist, and their mom was a teacher and counselor.

The entire family embraced the pioneering spirit in Alaska.

“My dad is an engineer. He put up the first data telephone lines in the Alaskan bush. We used to go out with him in little Cessnas and travel to native villages above the Arctic Circle.”

Their family dog was a rescued pup that their dad found in a small Indigenous village.

“Supposedly, she was half wolf, half husky. She never barked, but she’d howl at the moon,” Batra said.

‘I’m a warrior’

These days, as Batra copes with mounting chemo side effects – including extreme exhaustion, loss of her hair, joint pain, unrelenting tinnitus in both ears, headaches and frequent, random nose bleeds — she’s tapping into two sources of strength: her DNA and lessons learned on challenging mountain expeditions.

First, the DNA.

Afghani people are known for thriving in harsh, mountainous terrain, and they’ve endured countless invasions, which have molded incredibly resilient people.

Batra is embracing that survival mentality.

“I am a warrior,” she says. “Afghans are known for being very strong men and women, and I’m telling you now, ‘Cancer is not going to get me.’ I’ve told everybody this. I feel strongly about this.”

Batra also is summoning deep wells of strength that she has relied on many times during challenging backpacking trips.

It was through one of those adventures that she met her future husband.

Love in the Andes

Back when Batra was in medical school, she did her final rotation at a remote clinic in the Peruvian Amazon, Yanamono Medical Clinic.

Classmates who worked at the clinic before her told Batra to be on the lookout for two wonderful locals: the librarian, Nancy, and an expedition guide named Percy Salizar-Escobar.

Raised in a small Inca village in the Peruvian mountains 3,444 feet above sea level and a native speaker of the Indigenous language called Quechua, Salizar-Escobar frequently brought his tour guests to the Amazon clinic so they could support the work doctors were doing there.

Batra never happened to cross paths with Percy at the clinic.

But after finishing her rotation, she met up with her sister. The twins planned to hike the legendary Inca Trail to Machu Picchu. Before starting their trip, Batra decided to try to find Salizar-Escobar and seek his advice. The sisters went looking for Percy at a fancy travel agency in Cusco. They received a cold shoulder at the agency that seemed to serve only wealthy celebrities. But a co-worker overheard their conversation, offered to help and walked the twins 10 minutes away to find Salizar-Escobar.

At first, the relationship between Batra and Salizar-Escobar was all business. He was busy preparing to lead a trip to the Galapagos Islands. Still, he took time to talk to the women. He wasn’t thrilled with the bare-bones Inca Trail expedition they had booked. So, he lent them some good sleeping bags, which proved essential.

Their journey to Machu Picchu was tough but spectacular.

“It’s grueling. There’s a lot of elevation gain, a lot of ups and downs. The trails are narrow and steep. There’s a lot of stair stepping. You have to be sure footed,” Batra recalled.

Their tents leaked every night, but thanks to Salizar-Escobar, the sisters stayed cozy in their sleeping bags.

After finishing the trip, the Batras returned the borrowed gear to Salizar-Escobar, who spontaneously invited them to dinner.

“There was no mention that we were going to meet the entire family,” Batra said.

The youngest of eight children, Salizar-Escobar was hosting a giant family gathering on the eve of his niece’s wedding the next day.

The women had a wonderful time.

“There was dancing and entertainment. It was a beautiful night.”

Batra had no romantic intentions when she first sought Salizar-Escobar’s help. She had heard he was married and had children. She just wanted advice from a pro who loved mountains as much as she did. But it turned out that he was single and living with his mom and dad. He’d been far too busy catering to tourists through his Kay Pacha Excursions Tour Company to settle down.

After the party, the sisters were heading to Bolivia to do another tough mountain route: a 7-day trip called the Illampu Circuit.

They invited Salizar-Escobar to join them.

“That’s when the trouble started,” Salizar-Escobar said with a laugh as he supported his wife during a recent chemo treatment at the UCHealth Cancer Center at Highlands Ranch.

The trip was fabulous, and the sparks started flying.

“We were in nature. We shared a tent and we bathed in the river,” Batra said.

After the Bolivian adventure, she decided to delay her return to the U.S. Instead, she headed back to Peru with Salizar-Escobar.

“My mom couldn’t believe it,” he said. “Her prayers had been answered.”

A wedding at Machu Picchu and lessons from steep climbs

The couple met in 2003 and married two years later at Machu Picchu.

A group of 12 friends and family members — including Batra’s dad — did the full hike to the spectacular, sacred site. Porters took great care of the wedding party, cooking delicious meals and playing music every night of the journey.

Once at Machu Picchu, the couple enjoyed a simple ceremony full of meaning. The bride wore her mother’s wedding sari while the groom led a ritual offering to his ancestors and to bless the spirit of the mountains.

Their love story is still full of mutual admiration and kindness.

As Salizar-Escobar tends to his wife now, he’s leaning into his heritage. His mom was a healer who provided people with herbal medicines and served as a midwife in her area. As a child, he sometimes accompanied her as she cared for sick people and assisted with home births high in the Andes.

“She would be walking with her little lantern,” he recalled. “In exchange for her help, people would come and work on our farm, helping us harvest coffee and cacao.”

These days, Salizar-Escobar starts each day by making his wife a nutritious green juice. It’s full of healthy ingredients from spinach to kale, to ginger and chayote squash.

Cancer has killed Batra’s appetite, and chemo makes everything taste metallic. But she dutifully drinks her husband’s concoction each day.

During a recent chemo appointment, the couple forgot Batra’s favorite blanket, so Salizar-Escobar ran home to get it.

“He’s a very generous, thoughtful human being,” said Batra.

Salizar-Escobar, 56, in turn, said his wife is extraordinary.

“She doesn’t think of herself,” he said. “She’s still seeing patients and is giving them hope. I have to remind her to take care of herself and to listen to her doctors.”

The two come from very different worlds but are wonderfully compatible.

As he likes to say, “She’s from Alaska, and I’m from heaven.”

The small town where Salizar-Escobar was raised is called Quillabamba, which means land of the moon in Quecha.

Their daughter, Quilla, is named for the Quechua word for the moon, while their son, Inti, 13, is named for the sun, “our treasures.”

An unwanted expedition: ‘I have to keep putting one foot forward’

So far, dealing with cancer is a lot like climbing a tough mountain, both Batra and Salizar-Escobar said.

In order to survive difficult journeys, he always has urged clients to take their time and stick to their own pace.

Especially at high elevation, climbers can get very sick if they try to hike too fast without adjusting to decreased oxygen levels. They’re much less likely to make it to their destination if they climb slowly and steadily, not pushing to keep up with others who can go faster.

Batra has leaned into the “slow and steady” mantra throughout her ordeals with both long COVID and cancer.

“I’ve always been short of breath. Elevation is hard on me, and it’s a lot harder now. I have to go at my own pace, and I like the word ‘pivot.’ I’ve pivoted a lot,” Batra said.

Cancer is sending her on a new, unwanted expedition.

“You really have to be in the present as you take each step and focus on what’s important. It’s just like hiking. I have to keep putting one foot forward.”

Triple negative breast cancer requires a difficult chemotherapy regimen

Among breast cancer patients, those with triple negative cancer have to deal with the toughest treatments and side effects.

“It’s one of the rare ones, and it tends to be more aggressive,” said Dr. Radhika Acharya, Batra’s cancer specialist at UCHealth Highlands Ranch Hospital.

“The cancer cells grow independently of estrogen, so we don’t have good targets to treat it,” Acharya said.

As a result, the chemotherapy regimen is long and difficult.

There has been good news in recent years. Doctors have learned that adding immunotherapy treatments to the traditional chemotherapy medications improves outcomes for patients with triple negative breast cancer.

“That’s translating into higher cure rates,” Acharya said.

But the added immunotherapy brings its own set of challenging side effects on top of the already difficult traditional chemotherapy.

“It’s a regimen of four chemotherapy and immunotherapy medications combined. You do that for six months, then you have surgery and based on your surgical outcomes, we decide how to proceed,” Acharya said.

The side effects are very challenging.

“Nothing comes for free,” Acharya said. “We love immunotherapy, but the big drawback of immunotherapy is the way it can over-heighten the immune system. It can have life-threatening impacts. The body can attack itself. It can attack the liver and the colon, so we have to be on the lookout for that.”

She and her colleagues keep a close eye on how patients are doing to prevent adverse effects.

“The patients are well protected and monitored. We pride ourselves on catching any problems early and on being on top of patient care,” Acharya said.

But they can’t prevent the tough side effects.

She said Batra is an amazing person who’s doing as well as possible despite having received a very difficult diagnosis.

“She exudes a really wonderful energy. She’s very real and open, and that helps us give her really good care. She’s not afraid to say anything or tell us how she feels. She’s not apologetic, and I find that so refreshing.

“If someone is really open, you get to know them well, and you can tailor their care, which results in higher success rates.

“She will do well because of her good support system and her openness and willingness to receive information. She has great ideas too,” Acharya said.

Batra is taking full advantage of the array of services that the Highlands Ranch Cancer Center offers, including counseling to cope with a frightening diagnosis.

Acharya also encourages patients to stay as physically active as possible throughout chemo treatments.

“We offer all kinds of tips to keep exercising during chemo. We don’t recommend that people train for a marathon. But walking, doing yoga and strength training all have been proven to decrease treatment-related fatigue and to reduce the toxicity (of the treatments). Exercise may also improve outcomes,” Acharya said.

Batra knows well that physical activity helps her through hard times. So, she’s heeding her doctor’s advice, and despite overwhelming exhaustion, she’s trying to keep getting as much exercise as possible.

Along with hiking, Batra loves swimming. She’s been trying to do one-hour sessions, swimming at least a mile as often as possible.

“Water is very therapeutic, very healing. I find peace in the pool. And it helps me regulate my breathing and calm my nerves,” Batra said.

Identical twins: Inseparable as kids, tackling challenges as adults

Along with her medical team, Batra’s husband, children and family are doing all they can to support her.

Her twin, Dutima, plans to spend as much time in Colorado as she can during Kalindi’s treatments.

The two have always been close — literally inseparable as children.

They had separate beds but regularly slept curled up around one another, just as they had nestled together in the womb.

As adults, they’ve deliberately carved out time to do special trips together every year, much like their challenging expeditions in South America.

In recent years — even as Kalindi was coping with long COVID — the sisters did a challenging 60-mile NOLS trip in Wyoming’s craggy Wind River mountains.

They also did Colorado’s legendary Four Pass Loop in the Maroon Bells-Snowmass Wilderness Area.

“I’ve encouraged her to step out of her comfort zone,” Dutima said of Kalindi.

“We intentionally carve out space to be together. We can turn off our phones and connect. We grew up very close. People describe us as mirror opposites. She’s more of an extrovert, the really social person. I’m more introverted, but we share many similar interests,” Dutima said.

Watching her twin go through both long COVID and cancer has been heart wrenching.

Dutima has been so sad to see her sister suffer. She’s doing as much as she can to support her sister, and there have been some funny twin moments when the women seemed to read each other’s minds.

For example, once, soon after Kalindi learned she had triple-negative breast cancer, the sisters were chatting on the phone when both realized they had just stumbled across the same study that found breast cancer was more common among people who had also dealt with long COVID.

Doctors have been learning much more in recent years about the connections between infectious diseases and cancer.

“There are many viruses that are causational for cancer,” Dutima said.

As the impacts of COVID-19 continue to reverberate, researchers will no doubt continue to document impacts.

Along with having occasional twin mind melds, the Batras literally sometimes feel each other’s pain.

Dutima was lucky to escape an early case of COVID-19 and so far, hasn’t had to deal with long COVID like Kalindi has. Dutima also is perfectly healthy now but on occasion feels sick for no apparent reason.

“Sometimes, even if we’re not talking about side effects, I’ll get nauseous,” Dutima said.

As she supports her sister as much as she can, she’s in awe of the network of support Kalindi has fostered.

“All of us were shocked and scared when she got this diagnosis, but she has created a really strong community of friends and neighbors who are helping her every step of the way.”

‘Each person handles cancer differently’

One of those friends is Mary Beth Graff, who herself is a cancer survivor and has known Kalindi for 15 years.

“She’s like a sister to me,” Graff said, recalling how kind Batra was when she was diagnosed with ovarian cancer in 2012.

“She was so supportive. She’s such a good listener. It was really challenging. My kids were only 6 and 8. I always tell her that I want to show up for her in the same way she did for me,” Graff said.

So, she’s been taking her friend on fun, distracting outings like walks and a recent trip to a sunflower festival.

Each person handles cancer differently, Graff said.

She has encouraged Batra to let others help her.

Especially for a doctor who is used to being the healer, it can be tough to be the person who needs healing.

“I’ve encouraged her to let the light in and let the love in. She has spent all of her life doing that for other people,” Graff said.

“Some people want privacy and flowers. Kalindi needs a balance of time alone and time with family and friends,” she said.

Sometimes you’re angry about your diagnosis. Sometimes you’re scared. Sometimes you need to seek out a friend and simply cry.

“I bought her a grief journal. It’s helpful to check in every day and ask yourself, ‘What am I feeling? What do I need?’”

A tough climb, but we’re going to make it

Living through chemotherapy is really difficult.

Batra is the kind of person who wants to tackle tough challenges and be done with them quickly.

“I want to beat this and move on,” she said.

Especially since she has fought so hard to regain her strength after long COVID pummeled her, Batra gets teary as a health setback is betraying her again.

“This has been life changing. It’s the biggest pivot I’ve ever experienced in my life, particularly when you feel so strong and when I’ve worked so hard to condition my body to get my strength back.”

“And now, here we go again,” Batra said.

Still, she has no choice. She must surrender to cancer. And she can’t speed up this journey.

For inspiration, Batra has been reading survival books about people who have been stuck at sea for weeks on end or those who have endured tough wilderness challenges.

Other remarkable survivors will inspire her.

“I think we can learn a lot from these stories,” Batra said.

Standing by his wife’s side, Salizar-Escobar is at the ready 24/7 to help his wife navigate the toughest stretches of her journey.

“We’re climbing right now,” Salizar-Escobar said. “It takes physical and mental strength. It’s a big climb, but we’re going to make it.”