monsoondiaries

[monsoondiaries]

A PSA on what "Plateau'ing" really means for us. (TLDR: things may seem calmer this week in the ER, but #dontfuckitup and #keepstayingthefuckhome) That things are "better" is a relative statement: You put sugar on poop, it's still poop -- Forgive me if I've developed some trust issues nowadays when people claim any "future projections." 1) "Plateau'ing" means if 100 new patients came in yesterday, another 100 patients comes in today (instead of 100 on day one, 120 on day two, 140 on day three, etc,). Think about that among ERs that were originally built to safely fit 30-40 patients at a time, and that having up to 100 patients a day consecutively could still mean patients can no longer fit inside an ER and go into cardiac arrest in the waiting rooms (which I actually had last weekend) 2) It takes about 7-12 days -- and sometimes up to 20 days -- for a COVID-19 patient (who was sick enough to be admitted to the hospital) to eventually recover. That means hospitals can keep getting fuller and fuller, even with a "plateau" of X patients coming to the ER everyday (of which an even higher than average % will still be admitted to the hospital due to COVID-19 being unusually associated with complications/sequelae such as embolic strokes and viral myocarditis) 3) What we need is a dip -- not a plateau -- that lasts long enough will allow us enough time to discharge enough patients (aka DECOMPRESS) from the ER and hospital, and accommodate the next wave of patients that come when we all break quarantine (whether it's because we have a false sense of confidence, when the weather gets better, etc.). Otherwise next month patients are not only going to die in the waiting room, but also on the street! 4) In other words, a cup pouring out at a steady plateau/rate will eventually run out of liquid, unless we slow the pour (aka a dip of patients coming to the ER) or we add to the cup (aka building new giant hospitals overnight, which still seems unlikely to happen). 5) "You can't pour from an empty cup." 6) #5 This applies to our mental health too -- I worry this is just the beginning: (This post continued below in my comments ⬇️👇🏼) (at New York, New York) https://www.instagram.com/p/B-4JPNcHD2s/?igshid=rearcm7lewj

[monsoondiaries]

*My PSA on COVID-19 testing*: Unless it’s a life or limb threatening emergency (aka you need ventilatory support), DO NOT GO TO, OR GET TESTED IN AN ER!!! What a week it’s been — I’ve worked the past 7 days in 6 different ERs in NYC. Every site has their own version of PPE, testing capabilities, IT workflow, screening rules, approach guidelines; signs all of us are still deriving some kind of meaningful order out of all this chaos. Outside field tents are also going up, entire corridors are being sealed, surge capacity has already been initiated at multiple sites. And since I can’t ignore the elephant in the room, I plan to cancel all travel with @monsoondiaries and not commit to any more trips until this shitshow blows over, hopefully by the summer. As per diem (having the flexibility to pick up shifts wherever I choose and when there is the greatest need in NYC), I‘ve been working more shifts than I expected to now that so many of my ER colleagues are already calling out sick or being furloughed due to exposure to COVID-19. The writing is on the wall. So where I’m doing my part in this pandemic, I urge that you to also do yours; we can still prevent a total collapse of our healthcare system if you can do one simple thing: unless you need ventilatory support, STAY AWAY FROM OUR EMERGENCY ROOMS. And please TELL EVERYONE that too. “But what about testing? Isn’t more testing better?” Ah but it doesn’t work as well when you come to the ER — Let’s say you had no symptoms (or at best mild symptoms from something else), or had some other non-life or limb threatening issue and you don’t have COVID-19 yet but came to the ER anyway. Or let’s say you came just for a screening or a work clearance. So we then swab you and send out a test, but during the time you got on the subway, registered at triage, waited to be seen or swabbed, or waited for discharge papers, you THEN got exposed to someone else who actually has COVID-19 — whether it was a sick patient shedding all that virus in the ER, a visitor, the guy sitting next to you on the bus, the work note you got that acts as a fomite, another worried well waiting for their test, or (continued in comments below) ... (at New York, New York) https://www.instagram.com/p/B9xCFdsHqaj/?igshid=yn84wa1i9abh

[monsoondiaries]

3 weeks ago I sat inside an empty train carriage meant to store iron ore instead of people, riding through the middle of the Sahara Desert and gazing up at an endless sky full of stars. I was crying. I think I waited my entire travel life for a night like this. After crossing over the 5km Mad Max-like post-apocalyptic “no-man’s land” from Western Sahara into Mauritania, we hopped on for a free ride from Nouadhibou on the legendary iron ore train, recently profiled on National Geographic Documentary Films as “the most extreme railway in the world.” 9 hours later and now in Choum, I agree with my travel companions that I will never ever do that again. And not because it wasn’t a positive experience. While rough, the moments on the train while looking up into oblivion has fundamentally affirmed life through a different lens for me forever; returning will never be the same. And I recommend to any true wanderluster to do this once — it was definitely a travel experience of a lifetime. Therefore I know a travel experience like this won't come around for a very very long time, if ever again. So this post is for all my fellow dreamers and hopelessly romantic imposters out there: When I started this journey a decade ago, I remember looking up to all these travel bloggers wishing I could have the courage to live their badass lives; now I’m now looking up to all these stars, wiping away tears while sitting on top of a legendary railway most badass travel bloggers have yet to do. Finally, the experience of riding on this train can compel one to really consider how temporary our times are on this spaceship called Earth: This is all we got. So I hope you arrive at a similar reckoning with yourself, along your fears and your demons sooner than later. And when you do, that will probably be your greatest adventure of them all. With that, here’s to our fears, and the courage that follows. 🤙 Onwards to the next step of this infinitely unfamiliar journey. Blogpost: https://monsoondiaries.com/2020/01/23/mauritania-railway/ (at Choûm, Adrar, Mauritania) https://www.instagram.com/p/B8b4u2NHUOK/?igshid=6x4w1nku5s0o

[monsoondiaries]

3 weeks ago I sat inside an empty train carriage meant to store iron ore instead of people, riding through the middle of the Sahara Desert and gazing up at an endless sky full of stars. I was crying. I think I waited my entire travel life for a night like this. After crossing over the 5km Mad Max-like post-apocalyptic “no-man’s land” from Western Sahara into Mauritania, we hopped on for a free ride from Nouadhibou on the legendary iron ore train, recently profiled on National Geographic Documentary Films as “the most extreme railway in the world.” 9 hours later and now in Choum, I agree with my travel companions that I will never ever do that again. And not because it wasn’t a positive experience. While rough, the moments on the train while looking up into oblivion has fundamentally affirmed life through a different lens for me forever; returning will never be the same. And I recommend to any true wanderluster to do this once — it was definitely a travel experience of a lifetime. Therefore I know a travel experience like this won't come around for a very very long time, if ever again. So this post is for all my fellow dreamers and hopelessly romantic imposters out there: When I started this journey a decade ago, I remember looking up to all these travel bloggers wishing I could have the courage to live their badass lives; now I’m now looking up to all these stars, wiping away tears while sitting on top of a legendary railway most badass travel bloggers have yet to do. Finally, the experience of riding on this train can compel one to really consider how temporary our times are on this spaceship called Earth: This is all we got. So I hope you arrive at a similar reckoning with yourself, along your fears and your demons sooner than later. And when you do, that will probably be your greatest adventure of them all. With that, here’s to our fears, and the courage that follows. 🤙 Onwards to the next step of this infinitely unfamiliar journey. Blogpost: https://monsoondiaries.com/2020/01/23/mauritania-railway/ (at Choûm, Adrar, Mauritania) https://www.instagram.com/p/B8b2nMRHKAg/?igshid=1ucfszn6lpnh4

[monsoondiaries]

Do any of you want this life? Because it’s not as pretty as you think. If so, then say goodbye to your former life and those who stood by you, who felt they gave you everything only to feel betrayed when you walk away. To say “so long” to even those who have known you for so long. If so, then you and I may be cut from separate pieces of the same cloth, filled with wonder looking over fences and leave familiarity behind, while embracing hurt and challenges and willing to question your own purpose on this earth for crossing these borders... And with these experiences you will soon reckon with the stark reality that we and time past mean nothing among the vast seemingly endless stretches of this world. And yet, that is everything — ...Happy 10 years. 10 years of Accidents. Mistakes. Serendipities. 10 years since I accidentally lost a bet over roundtrip fare to Egypt, which changed my life forever. 10 years of never slowing down and never looking back since. 10 years of Momentum. Discipline. Spontaneity. 10 years would see me to 185 countries & territories — 70 of them more than once — and over a thousand strangers that have travelled with me because of a small quirky travel blog that I had first started just to let my mom know I was okay. 10 years since accidentally fostering an environment for a bafflingly interconnected international community that to this day has become family. 10 years of traveling both far and together. 10 years of Serendipity. Synchronicity. Disbelief. Magic. 10 years since I lost another bet, applied to and then barely graduated from medical school. 10 years would mean $200,000 in student debt, countless exams, and never expecting to make it out either alive or sane, never knowing what the next step would be. 10 years engaging in a war of attrition, countless small victories and countless more failures. Breakdowns. 10 years of becoming a medical student, class president, a resident, a doctor, an attending, a medical captain, chief physician, and clinical professor. 10 years of imposter syndrome. Cognitive dissonance. Learned helplessness. Endless, boundless doubt. And yet: Privilege. Gratitude. ...(Continued in comments) ⬇️ https://www.instagram.com/p/B6wOMQTn0g5/?igshid=fiuqlt5oa2xb

[monsoondiaries]

I have returned after one week off the grid in Yemen 🇾🇪 with @youngpioneer, most of it on Socotra Island: a UNESCO World Heritage Site and home to countless endemic species and described as “the most alien-looking place on Earth.” It is the least developed destination I ever have had the privilege of exploring for an entire week — it has been a whole week of daily camping on beaches and in caves, with either squat toilets or holes in the sand, a morning stranded by a freak flash flood in a canyon, and even an afternoon transversing a massive gorgeous lagoon where we hunted for live sea urchin and puffer fish for dinner. I thought I had seen it all, but Yemen has proven me wrong yet again. And I haven’t even gotten to why we had come to Socotra Island in the first place: the one of a kind alien-like vegetation, flora and fauna, not least of which are the Dragon Blood and Bottle Trees, which grow nowhere else on Earth. As I end one trip in Yemen and begin another monsoon today — my 10 year anniversary trip to Egypt 🇪🇬 (the one that started it all back in 2010) with 20 monsooners (get ready y’all!!) — I look back reinforced in the resolve not taking for granted everything I have had on my travels so far and of course, all that we enjoy back home. Thanks Yemen 🇾🇪 https://monsoondiaries.com/2019/11/19/socotra/ . . . . . . #yemen #socotra #socotraisland #love #beautifuldestinations #instatravel #instapassport #mytravelgram #travelgram #travelingram #monsoondiaries #doyoutravel #bbctravel #guardiantravelsnaps #natgeo #natgeotravelpic #lonelyplanet #livetravelchannel #theglobewanderer #nature #lagoon #wonderful_places #sunset #travelawesome #wanderfolk #places_wow #passionpassport #travelblogger #travelphotography #sunsetporn (at Socotra Island جزيرة سقطرى) https://www.instagram.com/p/B5YrZaTnEJh/?igshid=tllb5qkl82v3

[monsoondiaries]

Swipe ➡️ for more! These specific species of Baobab trees are unique only to Madagascar’s ecosystem, where these millennia old trees look like they’ve been uprooted and have been growing upside down ever since. Madagascar 🇲🇬 Looking forward to continue then tree fetish with the unique Dragon Blood trees of Socotra Island in Yemen 🇾🇪 tomorrow! monsoondiaries.com . . . . . #madagascar #baobabs #beautifulnature #visitmadagascar #baobabtree #baobab #sunsets #naturenerd #roamtheearth #sunset #sunsetlover #sunrise #sunrisephotography #monsoondiaries #beautifuldestinations #doyoutravel #bbctravel #travelphotography #instatravel #natgeotravel #doyoutravel #livetravelchannel #wonderful_places #naturephotography #nature #places_wow #travelblogger #travelgram #sunrise_sunsets #wanderlust (at Avenue of the Baobabs) https://www.instagram.com/p/B5EHmf5Hin8/?igshid=1xj0vdo8ys6b9

[monsoondiaries]

Swipe ➡️ for more! I grew up witnessing generations of Mac/Apple wallpapers, never expecting that one day I would be taking photos of them in person myself one day. Greenland 🇬🇱 monsoondiaries.com . . . . . #greenland #greenlandscape #beautifulnature #visitgreenland #fjords #greenlandpioneer #grønland #naturenerd #roamtheearth #geologyrocks #icebergs #earthscience #icebergrightahead #monsoondiaries #beautifuldestinations #doyoutravel #bbctravel #travelphotography #instatravel #natgeotravel #doyoutravel #livetravelchannel #wonderful_places #naturephotography #nature #places_wow #travelblogger #travelgram #oceanwideexpeditions #wanderlust (at Greenland) https://www.instagram.com/p/B5C5REQn1iu/?igshid=12p62je7gej22

[monsoondiaries]

Where we go, few dare to tread. Greenland 🇬🇱 monsoondiaries.com . . . . . #greenland #greenlandscape #beautifulnature #visitgreenland #fjords #greenlandpioneer #grønland #naturenerd #roamtheearth #geologyrocks #sunset #earthscience #hikingadventures #monsoondiaries #beautifuldestinations #doyoutravel #bbctravel #travelphotography #hiking #natgeotravel #doyoutravel #livetravelchannel #wonderful_places #naturephotography #nature #places_wow #travelblogger #travelgram #guardiantravelsnaps #wanderlust (at Greenland) https://www.instagram.com/p/B4prYNzHAZU/?igshid=1phnr5tq6ql7n

[monsoondiaries]

We come here for the northern lights and vanilla skies. monsoondiaries.com . . . . . #greenland #greenlandscape #beautifulnature #visitgreenland #fjords #greenlandpioneer #grønland #naturenerd #roamtheearth #geologyrocks #icebergs #earthscience #icebergrightahead #monsoondiaries #beautifuldestinations #doyoutravel #bbctravel #travelphotography #instatravel #natgeotravel #doyoutravel #livetravelchannel #wonderful_places #naturephotography #sunset #sunrise #travelblogger #travelgram #guardiantravelsnaps #sunriseporn (at Greenland) https://www.instagram.com/p/B4fLn7fnPzz/?igshid=8anwulnlxovv

[monsoondiaries]

Arctic sunrise. monsoondiaries.com . . . . . #greenland #greenlandscape #beautifulnature #visitgreenland #fjords #greenlandpioneer #grønland #naturenerd #roamtheearth #geologyrocks #icebergs #earthscience #icebergrightahead #monsoondiaries #beautifuldestinations #doyoutravel #bbctravel #travelphotography #instatravel #natgeotravel #doyoutravel #livetravelchannel #wonderful_places #naturephotography #sunset #sunrise #travelblogger #travelgram #guardiantravelsnaps #sunriseporn (at Greenland) https://www.instagram.com/p/B4a7xJ-HLfj/?igshid=q0nudnwpps0w

[monsoondiaries]

Sleeping under the arctic sun. monsoondiaries.com . . . . . #greenland #greenlandscape #beautifulnature #visitgreenland #fjords #greenlandpioneer #grønland #naturenerd #roamtheearth #geologyrocks #icebergs #earthscience #icebergrightahead #monsoondiaries #beautifuldestinations #doyoutravel #bbctravel #travelphotography #instatravel #natgeotravel #doyoutravel #livetravelchannel #wonderful_places #naturephotography #sunset #sunrise #travelblogger #travelgram #guardiantravelsnaps #sunriseporn (at Greenland) https://www.instagram.com/p/B4XTe6xnO1T/?igshid=vpguv0aj2718

[monsoondiaries]

Contemplating the nature of Greenland 🇬🇱, it may be difficult to appreciate the impact of climate change here with all this ice, but realize these icebergs are all fresh pieces that have recently separated from their parent glaciers and are now heading out to warmer and open sea...it was once all ice here not too long ago. monsoondiaries.com . . . . . #greenland #greenlandscape #beautifulnature #visitgreenland #fjords #greenlandpioneer #grønland #naturenerd #roamtheearth #geologyrocks #icebergs #earthscience #icebergrightahead #monsoondiaries #beautifuldestinations #doyoutravel #bbctravel #travelphotography #instatravel #natgeotravel #doyoutravel #livetravelchannel #wonderful_places #naturephotography #naturephotography #placestotravel #travelblogger #travelgram #guardiantravelsnaps #wanderlusts (at Greenland) https://www.instagram.com/p/B4U0sQ-n_iO/?igshid=19ok56t5bvsip

[monsoondiaries]

Cathedrals on the Sea. Greenland 🇬🇱. monsoondiaries.com . . . . . #greenland #greenlandscape #beautifulnature #visitgreenland #fjords #greenlandpioneer #grønland #naturenerd #roamtheearth #geologyrocks #icebergs #earthscience #icebergrightahead #monsoondiaries #beautifuldestinations #doyoutravel #bbctravel #travelphotography #instatravel #natgeotravel #doyoutravel #livetravelchannel #wonderful_places #naturephotography #nature #places_wow #travelblogger #travelgram #oceanwideexpeditions #wanderlust (at Greenland) https://www.instagram.com/p/B4SM9XoHWrD/?igshid=n8mxfh0pf6ms

[monsoondiaries]

Take me to your leader. monsoondiaries.com . . . . . #greenland #greenlandscape #beautifulnature #visitgreenland #fjords #greenlandpioneer #grønland #naturenerd #roamtheearth #geologyrocks #icebergs #earthscience #icebergrightahead #monsoondiaries #beautifuldestinations #doyoutravel #bbctravel #travelphotography #instatravel #natgeotravel #doyoutravel #livetravelchannel #wonderful_places #naturephotography #nature #places_wow #travelblogger #travelgram #guardiantravelsnaps #wanderlust (at Greenland) https://www.instagram.com/p/B4PoDU1HriO/?igshid=4htywkyvommb

[monsoondiaries]

After the arctic chill of Greenland 🇬🇱, we’re now changing courses gearing up for upcoming travel to the arid climates of Yemen 🇾🇪 and Egypt 🇪🇬! 17 monsooners are joining us, and we just opened spots for more. monsoondiaries.com . . . . . #greenland #greenlandscape #beautifulnature #visitgreenland #fjords #greenlandpioneer #grønland #naturenerd #roamtheearth #geologyrocks #icebergs #earthscience #icebergrightahead #monsoondiaries #beautifuldestinations #doyoutravel #bbctravel #travelphotography #instatravel #natgeotravel #doyoutravel #livetravelchannel #wonderful_places #naturephotography #nature #places_wow #travelblogger #travelgram #guardiantravelsnaps #wanderlust (at Greenland) https://www.instagram.com/p/B4M9CtKnEWm/?igshid=125vxwpwjvqgp

[monsoondiaries]

People ask how big can icebergs get? This big. After the arctic chill of Greenland 🇬🇱, we’re now changing courses gearing up for upcoming travel to the arid climates of Yemen 🇾🇪 and Egypt 🇪🇬! 17 monsooners are joining us, and we just opened spots for more. monsoondiaries.com . . . . . #greenland #greenlandscape #beautifulnature #visitgreenland #fjords #greenlandpioneer #grønland #naturenerd #roamtheearth #geologyrocks #icebergs #earthscience #icebergrightahead #monsoondiaries #beautifuldestinations #doyoutravel #bbctravel #travelphotography #instatravel #natgeotraveller #doyoutravel #lonelyplanet #wonderful_places #naturephotography #nature #places_wow #travelblogger #travelling #guardiantravelsnaps #wanderlusting (at Greenland) https://www.instagram.com/p/B4KN7ZpnKck/?igshid=1hi5tig71u4ew