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The diary of an emergency room physician

By Dr. Calvin D. Sun

This issue was written by Dr. Calvin D Sun. He is based in New York City and worked as an Emergency Physician and Clinical Assistant Professor in Emergency Medicine at emergency rooms all over the city during the COVID-19 pandemic.

I land at Newark Liberty International Airport at 5:00 p.m. on March 7, 2020. “Welcome Home!” is the only sign I see.

I’ve spent the past two weeks traveling through a region still recovering from a brutal and inhumane civil war, yet at least some part of me feels that returning home may be the greater danger.

I am an Emergency Room physician, but I don’t work for just one hospital. I’m a per diem doctor by choice. Per diem shifts enable me to keep up a rigorous (some, wrongly, would snide as “ridiculous”) pace of international travel while also practicing emergency medicine: the rapid diagnosis, treatment, and disposition of people likely having one of, if not the worst day of their lives. During the early months of Covid, I worked in seven Emergency Rooms across four of the five New York City boroughs.

During many of a late night after a shift, I would sit shell-shocked in front of a screen, phone or a monitor, mindlessly scrolling for information that had not yet existed. Spending months on the uncharted waters of the first pandemic of our generation, we struggled with how this was not something anyone could easily Google or Wikipedia their way out of. Whatever little we knew about this virus on the frontline was already more than anything you could find online.

I wrote not for you, but for me. I wrote by habit.

Or, if the worst were to happen, I wrote for whomever would be left to pick up the pieces and try to make sense of it all. Every moment put to virtual paper was confirmation, an affirmation to myself, that I was still alive.

This happened. These moments, captured on a break by hasty thumbs or recalled in my apartment after a death-washed double shift, happened. I lived them. I lived through them. I live to write this.

I write to live this.
I have a right to live.
Now that these moments are memory, and we look together on what we survived and toward whatever comes next, I think I was writing for
us all along.

Here are a collection of moments excerpted from my upcoming book, The Monsoon Diaries: A Doctor’s Journey of Hope and Healing from the ER Frontlines to the Far Reaches of the World.

Cover of The Monsoon Diaries book

March 9, 2020

My second day back from Angola, I arrive for a 4:00 p.m. shift with my now one day-old N95 in hand. Parked outside the ER is a Medical Evacuation Transportation Unit fire truck. I’ve never seen one and half hope, even while knowing better, that it’s for something other than coronavirus.

Inside I glance at the electronic board and see:

exposure

exposure

exposure

exposure

exposure

exposure

exposure

Seven patients, all asymptomatic, had come in at once, all here to be tested for the virus. But nothing has changed in twenty-four hours: We still have no tests. We swab them for existing viral panels as quickly as possible and take an extra sample each to send over to the Department of Health, still hoping someone there will have more answers.

I’ve always thought that one of our main jobs as healthcare workers is to guide our patients through the dense nebula of sickness and health, helping them better understand what they’re experiencing when no one else can. We never have all the answers, but we usually have enough.

Not today.

March 28, 2020

Two more deliveries on my second day off, from two different college friends. The first, from Daniel, contains two boxes of 3M bunny suits: two weeks’ worth of head-to-toe protection. The second is a full-face P100 that looks like an old-timey underwater dive mask, with a note from Paula:

“Stay safe and see you after this is all over!” I wish them both virtual hugs from afar.

Although this P100 fits a bit small on me, I already have a couple of colleagues in mind who will sing hallelujah on their COVID shifts, especially if it comes time to intubate.

Victoria, a med student friend, then stops by with a bag of Lavazza coffee to exchange for some N95s. It’s like any typical drug deal, only with no drugs or money.

Throughout the day I get three personal texts meant for the larger HCP community who are following me on social media, so I post on my accounts to help people make badly needed living arrangements:

Text message screenshot

This is what supporting the frontline looks like. My friends are knocking my socks off. Thank God for high-quality humans.

May 17, 2020

Armed with fresh infection statistics (still dropping), first- hand experience of yesterday’s mass outdoor gathering, and still-unused N95s, I plot my farthest walk yet.

The nightly 7:00 p.m. applause for shift-changing health- care workers is my sendoff, down 3rd Avenue into Midtown, for a quiet pause at the Kobra firefighter mural on 49th Street. Soon I reach a Grand Central Terminal worthy of a postapocalyptic movie: The promenade remains utterly abandoned, even as flashing timetables assure me the empty trains are running on schedule. Fifteen minutes later I stand at the world’s empty crossroads, Times Square, like Tom Cruise in the opening scene of Vanilla Sky. A bicyclist careens by, breaking my reverie, as tight household knots spill out of cross streets for the golden hour. I return to my old post- college neighborhood—the stretch of 7th Avenue that feels like the middle child between its two better known siblings of Times Square and Columbus Circle and the very place where I had made and lost a wager to two friends that would lead me to Egypt for the first time. I stay here for a minute to recall the story.

The night begins to set in, so I turn east down Central Park South to 5th Avenue and then home.

If I synchronize my pace with the traffic lights, I can walk without stopping. A tailwind off the East River luckily keeps me company. And so I stride through my life forward and in reverse: They say you can find solace after a loss simply by ambling the streets of New York. I solve by walking.

I continue to seek comfort in the known, even knowing enough how I have struggled against this pandemic. And yet I now want the freedom of an unknown so fiercely, want fate to finally hand over the reins of my life. Now I realize they’ve been in my hands all along; how will I know what to do with them?

My heart long with longing, I struggle to catch a full breath. I walk down these familiar streets choking on the relief knowing that I am still alive.

Taken from The Monsoon Diaries: A Doctor’s Journey of Hope and Healing from the ER Frontlines to the Far Reaches of the World by Dr. Calvin Sun. Copyright © 2022 by Calvin Sun. Used by permission of Harper Horizon.

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