What was it like to be an ER doctor at the beginning of COVID?

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ER Physician, filmmaker, popular speaker and travel company founder. Here how it all comes together [Show Summary]

Dr. Calvin Sun is an emergency room physician, known for his blog-turned-travel company. During the pandemic, his travel content quickly shifted to real-time COVID updates as he chronicled his experience as an emergency room doctor in Manhattan. He has gathered all of these experiences into his newly released book, The Monsoon Diaries: A Doctor’s Journey of Hope and Healing from the ER Frontlines to the Far Reaches of the World.

Interview with Dr. Calvin Sun, Founder and CEO, The Monsoon Diaries [Show Notes]

Welcome for the 493rd episode of Admissions Straight Talk, Accepted’s podcast. Thanks for joining me. Given the time of year, I’d like to highlight for today’s listeners a wonderful resource if and when you’re invited to a medical school interview, Accepted’s free download called The Ultimate Guide to Medical School Interview Success. In the guide, you learn how to prepare for interviews, including the difficult questions, how to make sure your body language matches your intent, and what is proper follow-up after your interview. Grab your free copy at accepted.com/ultimatemediv and enhance your chance of acceptance.

It’s really hard to summarize Dr. Calvin Sun’s bio, but I’ll try anyway. Calvin graduated from Columbia in 2008 and in 2014, he graduated from SUNY Downstate College of Medicine and then began his residency in emergency medicine at Montefiore and Jacobi Medical Centers. He also was the director of Resident Wellness at Jacobi.

In his non-existent spare time during medical school, he somehow managed to found and now runs The Monsoon Diaries, which he describes as a blog-turned-travel company. The Monsoon Diaries organizes flexible budget trips and has gone to over 128 countries in the past six years. He’s also a filmmaker, popular speaker and activist in the Asian American community emergency room physician, and, at one time at least, was a clinical assistant professor of Emergency Medicine.

Listeners, I invite you to listen to accepted.com/254 for the incredible story of how Calvin Sun became Dr. Sun, founded Monsoon Diaries, the travel company, and portrays his experience as an emergency room physician in Manhattan, the corona pandemic’s epicenter in 2020.

To start, I’d like to ask you how you came to write your just-released book, The Monsoon Diaries: A Doctor’s Journey of Hope and Healing from the ER Frontlines to the Far Reaches of the World. What’s the story behind the book? [3:12]

The story is my life in a nutshell, in a show-don’t-tell fashion. It can also be seen as a love letter of gratitude because it’s being released at the tail end of what we hope to be the worst or the end of the pandemic. I was approached by a literary agent two years ago. It was a totally cold approach in January 2021, and they asked if I’d be interested in writing a book. I think I had mentioned to you in our prior podcast, episode 254, that I have this habit of writing, which is what caused my Monsoon Diaries blog to turn into a community. I was writing live and blogging live on my travels while I was a full-time medical student. People started following along and it turned itself into a community.

During the pandemic, I did the same thing. We couldn’t travel during the pandemic. It was not ethical, so I worked all the time, and I blogged about it in the same way I would on a trip because it was all new territory and new frontiers. That’s the only thing I knew how to do to keep myself alive when I couldn’t travel. It was the next best thing. People followed along, one of whom was a literary agent who then wanted to turn it into a book so I said, “Sure.” One thing led to another, and two years later we now have a book published by Harper Collins in bookstores since September 27th.

What do you hope people take away from The Monsoon Diaries? [4:57]

There are a few avenues and it really depends on the reader. If you wanted to know what happened on the front lines of Covid from March to April all the way through a lockdown into the end of the summer of 2020, you could just see it as such a simple account day by day as if you were the fly on the wall or right next to me on my shoulder. What’s unique about the way we wrote this book was that everybody knows what a doctor does, but how do we think? That’s what I inject into this narrative when I talk about Covid. I talk about what was going through my head, and I use different fonts and stylistic creative licenses to go into my head and also the dueling voices that a doctor may struggle with when they’re facing something that’s so unknown.

That hearkens back to the imposter syndrome a medical student or resident may struggle with. They may ask, “Am I ready for what’s facing me right now? This is something that’s so unknown. Lives are depending on these hands and my training even though I don’t feel completely ready for it.” That was how I felt during the pandemic and the book really gets into that. Those of you who are in training right now can probably identify with that.

However, I don’t want this to be seen as just a Covid book because I don’t write just about Covid. Covid is a vehicle to tell a wider story about grief and loss and deriving resilience from things that already happened rather than searching for things externally. For those of you who like books and not necessarily need to know what happened during Covid, I know it’s a hard topic to read about, this book is for you as well. In fact, that’s what I want to write this book for. Covid is just a vehicle to tell a bigger story about resilience.

There are two thirds of the book where I also write about other topics. One-third is my father’s death and how I navigated that. I share the lessons I learned from my father’s death at a young age before I decided to go to medical school. Those are lessons I needed to rely on to navigate through a pandemic while seeing so much death in front of me and so many other people losing their loved ones.

The other third is about my travels. It’s not exactly a negative thing like Covid or my father’s death, but it’s an adventure. It’s something new. It was full of stress and those of you who are familiar with my prior episode on this podcast, it was not something I signed up for but ended up loving it and the irony is now I run trips for other people who already love travel more than I ever did when I first signed up. The lessons from that are to be comfortable with being uncomfortable and being okay with not really knowing yourself but still embracing that side of you. That’s a lesson you can harness and use for future obstacles which for me was the pandemic.

I want listeners to know that this can be applied to whatever you’re going through. When you go through your next challenge, you can rely on this book and know you’re not alone.

Can I ask you how that connects with gratitude? [8:40]

The very moment here right now, the words that we’re speaking right now, this connection that we’re having, whether it’s you asking the questions or you listening to my answers, those are investments into the future. The best thing you can do to invest in your future is give all you can in the present moment. That’s gratitude, knowing that every passing minute you have on this planet is an opportunity for gratitude. You are only able to realize that when you also see that you’re here because of all the things that got you to where you are right now, and those are the things that happened in the past. That includes all the terrible things, challenges, and things that you thought would never change.

What I want the reader to understand is that there are plenty of things that have happened in our past lives, whether it’s the loss of a loved one, a rejection, the loss of a job, or something traumatic, these discrete events will never change. You think at the time it’s going to stay with you for the rest of your life. It will. But what’s remarkable, and something I want the reader to appreciate from showing not telling is that our attitudes to these events can change and evolve as long as we are brave and courageous enough to be willing to revisit these events over and over. It’s so powerful to sit with the feelings, label them, and let them pass through, rather than trying to ignore them to move on. Revisit it, honor it, and go through the process of grief in a brave sense, to create those brave spaces so that it finally can leave you and let go in a more holistic, organic way. That way, when you think of them again, your attitudes to that event that once had tormented you are now somewhat of a comfortable friend that guide you to overcome challenges in the present and the future. By doing that, you’re investing in the future right now.

In reading the book, it seemed like you felt first responders and healthcare workers were almost sacrificed during the pandemic. They were not given enough PPE, they didn’t have the right equipment. Do you think the healthcare system is any better prepared for a pandemic or some kind of horrible mass casualty event than it was in 2020? [11:22]

Absolutely not. We didn’t learn a thing.

I think we may have a few more sources of PPE, but that’s a bandaid on the fundamental root cause of a healthcare system that was bound to collapse. If you ask me, the healthcare system did collapse. We had to ration care in a developed country. There were ambulances that refused to pick up cardiac arrest cases because there were just too many. That means if you had a heart attack or you dropped dead, you would be put on the line and they may not take you if they couldn’t get your pulse in the field to take you to a hospital where we could probably save you because the hospitals were full.

It was understandable at the time but I don’t think the structures are in place to create a sustainable change so that if this were to happen again, we wouldn’t repeat the same mistakes because we have been repeating them. Monkeypox was a temporary scare recently, but when it first exploded in the past couple of months, people couldn’t find a way to get access to care or understand how to test or even get a vaccine that’s more than 30 or 40 years old.

What motivated you to be so active on social media during the pandemic? [13:04]

It was just habit. It’s like brushing your teeth. You know that brushing your teeth is good for you, but there are some nights you come home late after socializing with friends and the bed looks very tempting and you just want to skip one night. But you know, there is a part of you that will stop that temptation and make you somehow go through the motions of brushing your teeth, changing out of your clothes into your pajamas, and going to bed normally, even though your brain is saying it doesn’t want to do this. These habits compel you to do things when your will falters. They’re so powerful. There’s nothing bigger than the small things.

I had a habit of writing during medical school and writing during my travels during medical school to show others that I was able to do it. I was able to travel to 60 countries during medical school, 70 during residency, and I’ve been to 50 more since. I’ve been to about 200 countries and territories in the last ten to twelve years. I didn’t start traveling until I was 23 and didn’t start medical school until I was 25. These are all habits that add up over time.

I also had a habit when I’d go on a trip to write about it, and put it on social media so that other people could be inspired and also live their lives knowing that they could do it too or even reach out to me and ask for me to take them along on my trips, which I’ve been happy to do. By the time Covid came around, it was the adventure I didn’t sign up for. I didn’t want it and wish it never happened, but you can’t change that. We just talked about that. But my attitude towards Covid, as much as I hate the pandemic and hated what it did to me, my family, my loved ones, and my patients, my attitude towards it is one of active acceptance. Before, it was resignation, despair, and despondency, but now its active acceptance. It happened and I can’t change it but my attitude towards it changed in that it inspired me to keep writing when I wasn’t traveling. That’s something I wasn’t used to.

I was posting often about the things I was learning like new things about the virus as it unfolded in patients, how it presented itself, and even the big picture of how patient flow was ebbing and flowing during the different phases of the pandemic. Those things gave people a good understanding of why it was important to stay home at the time. There’s a tornado outside, let me tell you what the tornado looks like. I’m the one inside the tornado. You don’t need to step outside to confirm that, stay inside and stay safe. But once the tornadoes were over, I posted about how the tornado was over, the sun was shining, it was June and people could go outside again. These are things that I was learning that also resonated with the people that were reading. We were able to guide each other. It wasn’t just me, it was also the responses I got from my community to guide each other where there were from because I couldn’t be everywhere. I wish I could. But people that were around the world were telling me what they were seeing. I was posting that too, to get to where we are today where we can now rebuild and look forward.

As you mention in your book, you had impact sharing with colleagues techniques that seemed to be working. Could you share a few more of the impacts that you had with your social media posting? [17:48]

It was so shocking to me how common sense was not being utilized by public health authorities. Public health authorities did not take the initiative to warn people that emergency rooms were the most dangerous places to be in the beginning of a pandemic. They did so after the fact, which I was very appreciative of, but that was a month in. I didn’t start seeing commercials for that until three to four weeks in. Maybe it’s a production value thing, but it’s very easy just to go on the air and just say it, which I did the first week because I was in the emergency room and it just was like World War Z where Brad Pitt can tell from all the people it takes seven seconds from a bite to turn to a zombie. That’s very easy to notice but someone actually took the time to pay attention, and he somehow did.

In the first week, I was seeing patients coming to the emergency room asking for a test that did not exist. I quickly realized they were coming to the best place for a disease to manifest which was the emergency room. If you have no symptoms and you’re coming to a place that you think is the only place that would have tests for something that you may have when you have no symptoms, you might leave with a party favor you may not have wanted. And then you’re giving it to other people in the emergency room who are there for different reasons and now have it, so you’re harming other people. But then as a disease spreader even further beyond the emergency room in the second week, then I thought about the people who may have caught it on the subways or on the bus or on their way to the emergency room, or maybe they never had it and then they got tested and on their way out, somebody coughs in their face and then they get it.

That’s what I saw in the first week. It really stood out to me. So I just wrote about it and I was surprised. I was considered one of the fewer people to have talked about in the first week. It wasn’t until the third or fourth week that I think people caught onto why the emergency room was a dangerous place to get tests and that’s why stay home became a hashtag.

Are you glad you went into emergency medicine? [21:47]

Absolutely. Yeah.

I get to speak here with you. If I didn’t choose emergency medicine, I don’t know if I would be here on the podcast with you on my second episode.

I suspect you’d do something else really interesting, Calvin [22:04]

I hope I would. Emergency medicine, as I said in the last episode with you was the closest thing to bartending I could think of. And I loved bartending. I still love it.

I served a few drinks to a friend last night for the first time in months. I haven’t made a drink in months, and she loved it. It brought me so much joy. It’s just like someone coming to the emergency room. They don’t know what they have and most of the time we may not get it, but we at least do something that makes them feel better. It’s fulfilling because you get immediate results. Sure, people who criticize emergency medicine say, “Well, you never follow up. You never actually find out what they really have and you don’t know if it takes years for them to get better.”

But I like small victories. I like saying there’s nothing bigger than the smallest of things. I need the small victories. I need to go home every night knowing that I made a difference and I feel fulfilled. Does it come from a sense of insecurity? The need for validation for my childhood? Hey, guess what? That’s in my book too. I write about that.

The best of something is always the worst of something. A big con of emergency medicine is that it’s very fast-paced. You may never figure out what that person has, but at least you’ll get a little bit of a sense of gratification with the small victories you get with your immediate life-saving maneuvers or techniques or the tests that you do. The results you get are much more expedient. So they may not know what they have, but they can go home with reassurance knowing what they don’t have and that also adds up. The con is you never know what they really have but you’ve got to keep moving. It may feel like a hedonistic treadmill. I explore that in my book.

Yeah. I write in my book how emergency medicine is like time travel. If you are a big sci-fi geek nerd and you love time travel movies, emergency medicine is just that. You are controlling time. Imagine somebody gets stabbed and they’re bleeding out and they only have an hour left to live. If emergency medicine didn’t exist, they would’ve died in the whole scheme of humanity by natural selection. But we now live in a world where emergency medicine does exist and we can take that hour that you have left and because we’re there, we get to turn that hour into six hours because we just gave you blood and stopped the bleeding. We look for other sources of trauma. We give you medicine to feel better. We stabilize your vital signs with medicine so that you don’t exsanguinate and hemorrhage all over. We stopped the bleed by finding the source and even sutured it. Then we called down our colleagues from upstairs who are busy in the middle of their elective surgeries or their patients that they’ve known for years to perform the surgery. We may not to be the ones to take the bullet out or open the chest up because we’ve got to keep seeing new patients. But we created six hours so that you can go to the operating room in a more stable state and the surgeons can get you back to 100%.

Maybe somebody only has five days, and I turn that into two weeks. And then weeks become months and months become years, and then you get to live again. That’s time travel. It’s time manipulation.

Being an emergency room doctor must be extraordinarily gratifying. [26:34]

It’s easy to forget but I’m so grateful. It’s conversations like these that we are having that make me grateful because unfortunately, a con is that in emergency medicine you don’t have the time to think about these things. Most of my colleagues don’t have the time to take a deep breath because they’re so busy trying to do time manipulation. They’re not even realizing they’re manipulating time and doing all these amazing things. Not everyone is going to write a book, but when I stop to just write in general or have conversations like this one, it allows me to channel gratitude in a more holistic sense.

What should M3s, M4s, or even pre-meds thinking of emergency medicine know about the field that they may not be thinking about? [27:28]

I believe that emergency medicine is going to change by the time they apply in about two to three years because of the pandemic. Are you going to be working for a hospital system or a physician group? That’s always a moving target. No one can really predict for sure. But the ultimate bottom line is that there will always be emergencies and there’ll always be payment for your expertise in emergencies. Job security in the long run is going to be just fine. In the immediate sense, it’s going to be a little nerve-racking, but you can say the same for every single medical specialty. You can say that for every single job out there.

If you’re scared of what you are hearing about emergency medicine, you might as well just move to a deserted island and hunt or harvest coconuts because no job is secure post-pandemic in an economy recovery during what looks like to be the next World War 3. Hopefully not.

You don’t know but you can rely on the fact that at least with emergency medicine, since that’s the question, there will always be emergencies and there will always be people who need you during emergencies. You will learn a skill that is forever investible and will pay back dividends. It’s a great investment whether it’s for job security, which is great in my experience, or for your loved ones and for yourself. And it helps you understand the chaotic world that is around you. These skills that you learn in emergency medicine transcend just your job. It applies to everything else and how you see the world and derives an order to this otherwise chaotic place in the universe.

Do you ever feel like like it’s too much? Did you ever feel like that during the pandemic? [30:06]

I wrote a memoir that required a year of decompression after a pandemic. I needed to decompress after a pandemic of very, very tough shifts that were happening daily. The work life balance was skewed during the pandemic. I usually recharge through travel. That is the way I fill my cup. A lot of people go to the gym, do yoga, hang out with friends, go to Vegas, go on a ski trip, etc. For me it was leaving on a Friday and coming back on a Sunday on an international trip, looking for the cheapest flights, hacking fairs, and then bringing people along to make it sustainable. I think that it paid off dividends. It was an investment and I’m so grateful to have had those experiences and adventures. During a pandemic when I couldn’t travel, I was able to relive those experiences through my photos and my blog posts. Those are the things that were getting me by.

However, ultimately I wasn’t actually traveling, so I lost my source for decompression. This ultimate decompression and having a lockdown didn’t help. I couldn’t hang out with friends or socialize with loved ones. That does build up over time. I spent the last year writing this book which was a really good excuse to work fewer shifts. I’m actually happy that happened. I don’t miss it as much as I thought I would because I already had a lifetime’s worth of it during the pandemic.

Normally ER doctors work about ten to eleven shifts per month. That’s full-time, which is great. That means you have 20 days off as “weekends” without having to use vacation time. During the pandemic, I worked about 35 shifts during the first month and a half. The shifts were twelve to sixteen hours. Sometimes I’d do four hours in one place and eight hours in another place. I would do two shifts in two different places in a single day. I wrote about that in the book and I just felt like I was going crazy.

But at least I was per diem. I am a per diem doctor by choice, which means I get to choose different hospitals to work in. I think that got me by because I had not only my travel blog to read from to feel like I was traveling again to decompress, but I also was working different sites a lot, which for me was a source of decompression, not the other way around.

A lot of people think that’s stressful because they learn different systems. But I got to meet new friends and catch up with people that missed me from the last shift which sometimes was a month ago. Every site was new. I had different food options to order from and new neighborhoods to be in. To me, that’s where I derive some satisfaction. Some people may feel that’s too much, but I liked it.

The other thing is that I was choosing to go in. Being per diem means you get to choose whatever shifts you want. So the autonomy of knowing I came in not because some scheduler told me to go in, but because I chose to go in was very helpful. That was only so much until the pandemic really almost broke all of us. I’m taking a step back, not because I’ve burnt out, but because I don’t want to burn out. I’m still working a lot, but I’m not working as intensely as I used to before the pandemic. I know what my limits are and I don’t want to ever meet those limits again. I don’t need to go back to the pandemic again if I don’t have to. At that point it becomes sadomasochism and you can’t pour from an empty cup and help other people when you become masochistic.

What are some of the trips you have planned now that the world is opening up again and travel is becoming safe? [35:38]

I just finished a trip a few weeks ago to the Faroe Islands. It was nine of us. It’s pretty much Iceland on steroids without the tourists. It’s a set of islands between Iceland and Scotland, and it’s beautiful. Few people know about it, and it’s so easy to get to. There are no tourists there so you feel like you have it all to yourself. It’s a quick flight from Copenhagen, Denmark or Reykjavik, Iceland.

I’m grounded for the book as the publisher would like me to stick around for any opportunities to do book signings or book tours. I have a trip coming up in November to the Galapagos and one in December to Senegal, Gambia, Guinea-Bissau, West Africa. That’s an open invite for anyone who’s interested. And then for next year, February will be Burkina Faso, March will be South Sudan into maybe South Korea, May will be East Africa, July maybe Greek Island hopping and Belgium, and August is Papua New Guinea.

Can you share a favorite trip or the most beautiful place you’ve visited? [37:53]

How can you choose favorites among children? I can do superlatives.

The most beautiful places are Greenland, Antarctica, Namibia. The most fun place is Cuba. The most magical place is New Zealand. The region I find myself going back to over and over again is South Asia like Pakistan, India, Bangladesh, Sri Lanka, and Nepal. The most fascinatingly, weird and interesting place is North Korea, Myanmar, and Turkmenistan. I went in 2010 before all this went down. The most underrated and surprising place is Slovenia. The best food is in Iran, Spain, and Japan. The most convenient but still adventurous, like the opposite extremes where I could turn my brain off because it’s so easy is Japan.

How long are most of your trips? [39:36]

However long that you want them to be. Really it’s ad hoc and we prorate the cost for however long you’re there. It’s usually about a week. Our longer trips are about two to three weeks. Our shortest trips are sometimes a 24 to 48 hours. We leave on Friday, come back on Sunday.

Everybody is welcome on our trips. We just had a yacht week trip last year in September in Sardinia and Corsica. It was essentially spring break for adults or Burning Man on water. We’ve had two people above their 60s join us. We’ve had families with kids but they left the kids behind and had tons of fun. Emotion knows no age limits, and we don’t have any age limit for people to join. We’re happy to have you. We have a lot of mother/daughter combos come join us. We haven’t had any father/sons for some reason. The more the merrier.

Is there anything you would’ve liked me to ask you? [40:57]

Please go out there and pick up a copy of my book, The Monsoon Diaries. I really do not want this to be seen as a Covid only book if those of you are reluctant to buy for that reason, because it’s really a book about what you can do with your life when you have no idea what you’re doing. It’s about being comfortable with the uncomfortable and working through the crossroads of life. Stasis, sitting with your feelings, is very valuable. Life keeps moving and in order to be comfortable with that motion, you need to be comfortable to take a breath.

A lot of times the answer is not knowing. When that happens, you can feel very lonely. My story is for people who may need reassurance to know that they’re not alone. I am only here now because I felt comfortable with staying with the uncomfortable. It’s still uncomfortable, don’t get me wrong. I just had to embrace it rather than look away from it and still go through the motions of applying and doing my best. I surrounded myself with so many people who believed in me more than I ever did and allowed me to realize that the goal is not what matters. What you become doesn’t really matter so much as the journey and what you learned on the way to get there.

Had I not traveled, had I just embraced medical school and just applied for it, had my dad still been alive, I still would’ve been a doctor. I still would probably be on this podcast talking to you, but we wouldn’t be talking about a book or my travels. I would just talk about the nuts and bolts of how to apply to medical school. Things that we’ve talked about in the beginning podcast. Everybody knows what a doctor does. You don’t need that. You can learn about it in a textbook.

It’s not so much what you become, it’s how you become it. It’s about how you think and what the thought process is. Even embracing the dilemmas that happen to you illustrate the kind of person you are. As we go through life, our changing attitudes to discrete things is what I think defines a person. I kind of liken that to a rollercoaster. We don’t need to know what the rollercoaster is. I don’t need to know there are three loops, five drops, a G force here, and a lift. Just enjoy the rollercoaster.

It may not feel comfortable, especially if it’s your first rollercoaster, but you know that one day you’ll look back and say, “Wow, I’m glad I went on that.” Just trust the process. No matter how uncomfortable you are, wherever you are in your process, I hope this book provides some kind of solace and familiarity to know that you’re not alone. I’m right there with you being a fly on your wall, sitting next to your shoulder, going through what you’re going through and knowing that you will get to where you need to be. You just don’t need to know what it looks like. Just invest all you can in the present.

Where can listeners find you online and learn more about The Monsoon Diaries, both the book and the travel community? [49:54]

My website is MonsoonDiaries.com. You can also follow me on social media, my Instagram, Facebook, and Twitter handles are all Monsoon Diaries. I am responsive to messages. I read everything, and I look forward to hearing your feedback and hopefully my story and my book out there touches someone and motivates them to live their best life no matter how dark of a space they’re in. I’m right there with you. I have been there with you, and I’m happy to help you navigate and guide you through that space to a better tomorrow.

Related links:

The Monsoon Diaries, the travel company and web site
The Monsoon Diaries, A Doctor’s Journey of Hope and Healing from the ER Frontlines to the Far Reaches of the World, the book.
The Ultimate Guide to Medical School Interview Success, a free guide
Accepted’s Med School Admissions Consulting Services

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