“I was ready to not be able to climb for the rest of my life”: Jessie Tan, MD, Finds New Perspective

Sacramento Emergency Medicine Doctor, Jessie Tan, finds a new perspective on life and climbing after facing unexpected challenges during the height of the pandemic: He was suicidal six out of seven days a week. If the air temperature went above 72 degrees, his body flared with hives and the sensation of being burned alive. “I was ready to not be able to climb for the rest of my life,” Jessie said. 

The following is about the evolution of his climbing path, a bout with severe depression, and a reoccurring struggle with an acute case of cholinergic urticaria. Moreover, our conversation explores Jessie’s insight into the seperate reality of the Emergency Department, while also dissecting a few building blocks behind trad climbing in Yosemite Valley. These two worlds may seem unrelated, however, the skills required to thrive in emergency medicine and on a big wall are more intertwined than one might expect. 

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On most weeknights, I would routinely see him in the bouldering gym, after a long night shift, hiking shirtless on a fully-inclined treadmill with a large haul bag stuffed to the brim; two 70-meter ropes, a full rack, water, and food inside. He was looking straight-ahead with a deadpan stare. The tattoos on either side of his ribcage–Curious George with a crash pad and the Monk on Fire–moved up and down with each stride while Jessie hardly broke a sweat.In 2018, Jessie Tan, an already well-versed Valley trad climber, was the first person I met in Sacramento that was willing to go out on a limb and take me up my first ever multi-pitch in Yosemite–the north face of the Rostrum. I took my first lead fall on the third pitch, a 20-foot lob onto a finger sized cam. “That’s how you get better at trad!” Jessie yelled up to me, beaming with his usual irrepressible smile, diamond studded ears, and a pink tie-dyed Yoda T-shirt with cut off sleeves, as I dangled in the air hundreds of feet above the ground, pale faced and terrified, questioning why I had even come in the first place. He lowered me to the belay ledge and we shared a cheese-stick before he casually blasted us off to the summit in a few hours.

“Why are you doing that?” I asked him, genuinely curious about his tactics. “So my legs don’t get fucking tired when I get to the base of the crag,” he quipped, throwing his head backwards and releasing his signature deep-belly laugh, eyes momentarily disappearing beneath his fully scrunched face. He loved to train.   

During the height of the pandemic last March, I called to check in. He seemed fine. After a year of silence, he left me a voicemail.

“Yo Dave. Winding down and thinking about my day. Awesome seeing you today, really nice. Hope you and Madison and Meagan are doing well. It’s been too long. I know you probably didn’t think too much of it then, but I wanted to say thank you for calling me and reaching out to me last year. It means a lot. I went through some crazy health and emotional shit and I might not be around if it weren’t for a few people reaching out and Parita [wife] helping me.”

I was shocked. As a friend, I knew it was time to talk and given my own experience with debilitating depression, I needed to know why. 

 

Humble Beginnings

Following his first trip to Yosemite Valley, Jessie knew exactly what he wanted to do with his life: free as many big walls as possible in one of the most coveted climbing destinations on Earth. 

His first outdoor climbing experience was at Grand Ledge, a 30-foot top rope area, that he would regularly traverse for a couple hours before his morning classes at Michigan State. Jessie eventually linked up with one of his friends from Planet Rock, Doug McGraw, an accomplished trad climber, and went from climbing 5.8 to 5.11 trad in a single weekend at the Red River Gorge–a place they would go on the weekend despite a 12-hour round trip drive. Previously a Jiu Jitsu fighter who lived to eat as much as possible and get swole, everything changed the day he tried climbing at the Detroit YMCA and started going to the local indoor climbing gym, Planet Rock, in Pontiac, Michigan. “This is what I need to be doing,” he realized. 

As their partnership fortified, the two inevitably set their sights on Free Rider. Every year during his residency at a level 1 trauma center in downtown Detroit–known to be one of the roughest Emergency Departments in the country–Jessie would take one week off for his family and devote the other three to climbing in the Valley. 

Jessie planned meticulously for these trips: months of training, obsessing, and counting down the seconds until blastoff. To prepare, they would dial in rope systems, like building anchors, rappelling, and hauling, in the stairwell of his high-rise apartment complex or in the trees of a friend’s backyard. To increase his crack climbing proficiency, Jessie lapped the 30-foot wooden finger, hand, and fist cracks at Planet Rock; sometimes climbing up to 4,000-feet a session. 

During Doug and Jessie’s first foray up Free Rider, they ran out of water. Due to the fact that their “shit was too heavy” and they were “too slow hauling,” it took them 14 hours to get to where they had previously stashed water in the Alcove. Doug led the Monster Offwidth pitch that evening, which was a big deal for him at the time–as it is for anyone that climbs it–got to the top and yelled down to Jessie, “Tan, I just flashed the Monster!” When Jessie arrived at the anchor after jugging the line, he sarcastically replied, “That’s great Doug,” just completely shattered from the day. Jessie said he’s never been that thirsty in his entire life. It crushed him. Jessie called Parita the next morning from the Alcove, in tears, about to quit. She reminded him that “he wanted this” and that he should keep going. 

He never quit. After six days and five nights on the 3,000-foot granite wall, they pulled the lip at the top.  When I asked him why he didn’t just bail, he told me that “quitting is too final” and that going up just “a little bit more” always feels better than going down and being done. 

For years after that, he cut his teeth on classics like the Rostrum (all free), Half Dome (French free), and the Nose (French free). In 2013, he left his family in Michigan and moved to Sacramento to realize a dream of being able to climb year round in the Sierra, Tahoe, and most importantly, to be just three hours away from Yosemite. 

 

At The Peak

On April 5th, 2018, after four months of effort, a combined nine sessions and 22 attempts, Jessie sent, placing all gear on lead. “I will cherish this day forever. It has all added up to this, all the falls, the scared days, the days of progress, pushing myself in the gym, the core workouts, the initial idea, and the hunger.”

“Just have fun and enjoy it. These kinds of  moments only happen every so often in climbing,” Jessie’s belayer told him right before he set off. “It was exactly what I needed to hear,” Jessie wrote in his journal to remember the day. “I could hear Parita in my head saying ‘Do it, just do it’. My Yoda by proxy. Me and Ryan fist bump. I took my sensei breaths, said my mantra, my last words in my head were ‘have fun’. I smiled and started climbing. I did each move perfectly. I flowed automatically, dialed. The undercling traverse, the laybacks, my rests, I got it all back. I remember being in the handjam rest and looking rightward into the wall and feeling happy. I stepped up my left foot onto the high dark diorite foot chip like I was taking over the world.”Five years later, Jessie found himself roping up underneath the famous Grand Illusion (5.13b/c)–first climbed by Tony Yaniro on pre-placed gear in 1979 and repeated by Wolfgang Gullich, Todd Skinner, Hidetaka Suzuki, Tommy Caldwell, and Beth Rodden, among others. This hallowed line is one that Jessie had been dreaming about for years while toiling through medical school, endlessly scrolling Mountain Project on study breaks and in the middle of the night while in the call room during residency ICU rotations. 

The following year, he also climbed his hardest projects up in Donner, CA, including Taste the Pain (5.13c), Pump Lust (5.13b), and a V10 in Tahoe. He leveled up. Unexpectedly though, after one of the best performance years of his life, he lost motivation to climb. 

After forcing himself to climb for several months–going out, but not genuinely wanting to be there–he stopped altogether and found himself lost in the grips of severe depression for reasons unknown.  

 

The Lowest of Lows

When I pulled up to his house in the early evening, I felt nervous, wondering what had happened, what he would tell me. Did the pandemic destroy him? Or was it something else?

Being so close to the American River, the air felt cool despite the seemingly inescapable heat of the Sacramento summer; a city that feels like the inside of an oven set to broil that someone forgot to turn off. Jessie was crouched down next to a creek freeing worms from the clutches of a water filter. He walked up to me, flashed his usual larger than life smile, and gave me a big hug.

He led me slowly along a path that he walks regularly around his house, stopping to point out and appreciate each tree along the way. Oak. Pine. Redwood. Japanese Maples. Even some fruit trees—Persimmon, Lemon, and Pomegranate. I followed him carefully as frogs trilled and chirped overhead, lulling us along with a strange melody as we sauntered through their territory. “Hey man! Perfect timing. Good to see you. Come walk with me, I gotta show you these trees, they’re pretty amazing,” he says. 

Jessie seemed like a shell of his old self. Like he had been through some kind of war, hiding somewhere, dormant. 

He led me inside his house. I stopped in his living room and stared up at a 5-foot-wide, 3-foot-tall topo of Yosemite big walls looming overhead with post-it notes on either side: “Number One Goal: Have Fun!” and “Keep Going”.

“I had this weird loss of interest in climbing. I just didn’t want to do it anymore. It was unexplainable. I completely lost my desire. It was crazy,” he says to me while I admire El Capitan. “My whole life circulated around climbing. I was always just on to the next goal. But every time I went out, it just felt like I was forcing myself to climb. There was a profound emptiness. Part of me was removed and gone.” 

The onset of this depression, perhaps many years in the making, seemed to be a combination of several factors: work stress, not sleeping enough, eating poorly, straining to hold uneasiness inside, and a possible side-effect from an asthma medication called Singulair. People don’t always know why they suffer, but they do nonetheless. I couldn’t help but think about how his job may have affected him even though he shrugs it off. “It sucks telling people their mother or father or daughter or son died, old or young, it’s heart wrenching, people die even if you do everything right. Then you move on to care for the other 16 people on your list.”

Because the emergency department is both the front door to the hospital healthcare system and the safety net when all else fails, medical professionals, much like endurance athletes, are conditioned to clock long hours and ignore fatigue and the emotional toll of their work. 

Whether or not this was a contributing factor to Jessie’s suffering is unknown, but for many in the profession, that day-in-day-out stress can lead to crippling depression. It is one reason doctors are far more likely than the general population to die by suicide. According to a review of 10 years of literature on the subject presented at the American Psychiatric Association annual meeting in May 2021, an estimated 300 to 400 doctors kill themselves each year (Kaiser Health News). 

“I understand wanting to kill yourself, the desperation to stop all the suffering and torture,” Jessie says, something he witnesses at work daily. But just like when he wanted to fold in the Alcove and retreat back to Earth, the idea of quitting just doesn’t sit right with him. “It’s too final.”

So he just kept going, one day at a time.

 

Heat Bump Takeover

As the world began to shut down amidst the ramping pandemic, countries sealed their borders, schools closed, employees went home, people started wearing masks and social distancing. While most of us got a reprieve from life, a time to pause for free, Jessie dug in even deeper and hit his next obstacle. He developed an acute case of cholinergic urticaria. 

“Anything that increased my body temperature, exertion, being in the sun, spicy food, laughing too hard, certain stress, I would break out into hives,” he says. “It felt like my body was being lit on fire and the only thing I could do was leave whatever I was doing and take a cold shower or be in air conditioning.”

Working and fighting COVID-19 became the least of his problems. Dealing with the pandemic was just a “normal part of life in the background,” he says. “When you are doing the same thing everyday, every week, it just becomes routine.” 

Learning to manage the hives was a different story.  Jessie began to prepare himself for the worst. “If I can’t take the garbage out or walk from my car to work without being unbearably uncomfortable, how am I going to be able to exert in any way?” he thought.

 

Life Inside the ER

We went back outside onto his porch and sat down at the dinner table. 

Jessie worked the night shift on the 4th of July the night before and it reminded me of something he wrote on his Instagram a few months prior:

“I would describe a shift as a mix of preparation, anticipation, high intensity, chaos, beeping, screaming, overhead pages, phone calls, text messages, always being handed ekgs, codes, smells, fluids, cutting, injecting, suturing, venting, shocking, consult talks, family talks, emotions, breathing, refocus, finding patients, teaching, communication, finding nurses, getting behind, catching up, typing, clicking, teamwork, efficiency, focus, sprinkle a little bit of low intensity and peace at the beginning and end and add a pandemic on top. Then flowing, making all the right decisions for everybody while all that is going on.” 

I asked him about some of his most memorable moments thus far as an ER doc. He started telling me about the time he double-shocked someone back to life. 

It was 4am at the end of one of his night shifts when a young male walked in, turned grey, and went into cardiac arrest. After an hour of CPR and shocking the patient 13 times, Jessie remembered something that he had learned in residency: sometimes if one defibrillator isn’t helping you connect the patient to two defibrillators because you have nothing to lose. Jessie went rogue, hooked up two defibrillators to the man’s chest, charged each machine at the same time, and shocked him twice more. This was happening while other patients continued to flow into the ER.

It worked. The patient’s heart regained a normal rhythm for a moment, but he was still unstable. Jessie had to make another decision: administer a “clot buster” drug, otherwise known as a tissue plasminogen activator or tPA, that could save the patient with the risk of bleeding to death. Jessie chose tPA and saved his patient who walked out of the hospital weeks later.

“When it’s a high risk situation and you need to do all the right things at the right time, that’s when I do really well,” he says. “I don’t like to be doing that all the time. But when I’m there, I perform. There is a satisfaction that comes with being right, seeing the direction something was going and having made the right call. It’s about calculated risk and commitment to a plan.”

Keeping patients healthy relies on more than just one person. Teamwork is key. Everyone in the ER is important “whether it’s people checking patients in, the nurses making rounds, the techs, ekgs, supplies. Everyone goes hard,” he says. “You have to keep doing tasks to stay afloat and try to be ahead of the flow of patients coming. You always have to be anticipating what’s next. “

At the end of the day, one must always be cultivating and sharpening instincts, pattern recognition, and decision making skills under pressure to succeed as a doctor. This nonstop need for evolution is what drives Jessie. 

“I feel like I’m in such a different place when I am doing something that I have trained and prepared my entire life to do,” he says.  “I really enjoy finding something that fits me or that I like doing and just crafting that, honing in and improving every aspect of it that I can. When I am able to do that, and call on those skills, years of crafting those skills, years of training skills, if I’m in a scenario where I need all that, those are some of the best moments of my life.”

 

Insights into the Trad Game

In fact, Jessie protects himself from the emotional and mental loads of work with the all encompassing world of climbing and maintains his balance in both realms with his fastidious attention to the details.Preparing. Nurturing. Revising. These tendencies embedded in Jessie’s DNA are the same traits that propel him up the wall. 

“I exist in a plane of this universe where if it involves calculated risk and decision making and discipline, I do really well there,” he says. “There comes confidence from what I’ve been through before combined with accumulated skill and experience. I feel like I’m at my best when tied to a rope climbing thousands of feet above the ground or running around an Emergency Department doing what I’ve trained my entire life to do.”

In Jessie’s opinion, climbing can be broken down into three main pillars, excluding soloing for the sake of this discussion. You’ve got bouldering, sport, and trad climbing. With bouldering, a climber can focus “100 percent on physical power,” not having to be fully committed unless the problem is a dangerous highball. 

With sport climbing, a climber can focus solely on performance as well, whether it be a short thugfest or a long endurance challenge, generally without the worry of mortal injury or serious bodily harm in case of a mistake or bad fall. Each discipline serves as a fundamental pillar to the structure of his trad game.  

With trad climbing “I am 100 percent on mentally and emotionally and that’s why I love it. I like to be in that zone,” he says, referring to what some call the “sharp end,” navigating new terrain and questing above gear. “It’s a zone that has to be trained and entered regularly because if you don’t enter that zone regularly it’s scary and foreign and uncomfortable.”

In order to safely function within that zone, a climber must “know their gear, know how to place the gear, and how to protect different kinds of terrain.” After all, the point of protecting yourself is to remain healthy and come back to climb another day. 

Consequently, pushing the boundaries of one’s personal trad game hinges upon having the ability to make “an honest assessment of your current skill set,” he says. You can’t fake it. There is no lying your way through a route. “When you see people get into trouble, go up something that maybe they shouldn’t, their thoughts of what they think they’re ready for are not quite consistent with what they are getting themselves into.”

Just like running an Emergency Department and completing Grand Illusion, the two represent an “accumulation of so many things coming together to make one thing happen,” and skipping steps along the way to force some preconceived outcome can lead to undesirable consequences. “Things can get real, real fast,” Jessie reminds me, as I know all too well.  

Ultimately, one of the best ways to develop trad skills is to “find a mentor and gain exposure.” Jessie reached a point in his climbing where he knew that if he wanted to get better, he couldn’t climb with Doug [his original Michigan partner] because he had to “grow in my own way.” So he spent a year climbing multi-pitch with other people, equal or more experienced. In time, he became a solid leader as he pushed his comfort zone more regularly without Doug as a backup. 

 

A Separate Reality 

As we wrapped up dinner, I couldn’t help but ask him what I had been wondering all along, a lingering question I had about a paragraph he had posted a few months back:

“The suffering that we see in the ER each shift is unquantifiable, this year more than ever. Hoping this vaccine gets rolled out to all on the frontline and in the community asap. Thankful for scientists. Excited about moving a step forward towards seeing my parents and family with less worry about spreading covid and killing them. It is confusing to me that people would risk killing their family and unknown virus long term effects rather than take precautions. If they could only see what I see on a normal day. It is confusing to me that the chance of eradication exists like humans did with smallpox, tetanus, and polio and likely most will not take the vaccine. I am curious how past generations and ancestors who passed away from modern preventable conditions would react to their descendants’ decisions today. This is a step forward. Do not get fatigued. This is the way.”

Health care workers have been working around the clock during the pandemic to save lives while risking their own. Now that there is a solution, many still neglect irrefutable evidence, data, and science that support vaccine efficacy and instead proudly vilify imminent ways of eradication. 

How does he compartmentalize anger and frustration from those unwilling to lay bare their humanity in the face of a global crisis?  How does this not crush him on a daily basis?

“It’s a thing putting COVID patients on oxygen and ventilators all day and coming home and hearing about people who don’t believe it. An older version of myself might have been angry, bitter, burnt out, but these days, I don’t have the luxury to expend extra energy on things that will drain me, take away from my sleep, or stress me,” he says, reminding me that we all have only so much mental and emotional energy per day and the obstacles he has encountered over the past year have helped him redefine his optimal functioning state of being. “When all this other political stuff is going on and policies are being made, people believing this or that, it’s so interesting because no one really understands the problems in society the way ER doctors witness it. Many people don’t understand or know what’s happening on the front lines.” 

But it’s all part of a “complex problem,” one that surpasses the outlying issues of this pandemic. 

“Being in the ER, you get to see a side of society that nobody else sees on a daily basis. I see the end effect of all the problems in society through what comes into the ER.” Illness does not discriminate. “It seems all random, those who are sick or dying, but I treat everyone with respect and give them my 100 percent” he says, despite the fact that some people treat health care workers poorly. “It’s a thing that happens that isn’t really talked about. People can be really mean. People are in pain. People are angry. People are tired. Its displacement from what they are experiencing, trauma, socio-economic stress.”

Despite this unseen side of the healthcare system that Jessie shoulders on a daily basis, he has been able to surpass the incumbent detritus of his domain. 

 

Ace of Spades

In many ways, he has revamped his lifestyle. 

These days, he gives himself more time to sleep. Eat better. Talk with a therapist regularly. Paint with Parita. Not to mention, continue a regular course of biologic shots every few weeks from an allergy and immunology specialist for the hives. “My doc told me to try stopping the Singulair. I did and two or three weeks later I woke up happy again and wanted to climb. It was instant, like the clouds cleared as the hives took full effect.”  All that said, Jessie is gradually getting back to normal, sessioning in the rock gym, regaining his strengths, and reacclimating his body to physical stress.

Thankfully, his depression and cholinergic urticaria have faded, but the mental and emotional strength he has gained from having his health unexpectedly stripped away has not. He enjoys the simpler, slower moments now. If something is bothering him, he just says it.

“I cried the first time I was able to get back on the treadmill,” he says. “I was ready to quit climbing and move on. I have a new appreciation for just being able to be in the sun. Every rep, every step, I’m thankful to be able to do it. It’s given me a whole new perspective.” He still has climbing goals, but he “doesn’t put expectations or deadlines” on them, but they are there, always guiding him. 

We got up from the table and went back inside his house for some fresh fruit and water. He walked over to the cupboard in his kitchen and pulled out a 250 dollar golden bottle of champagne that he bought with his first paycheck as an ER doc called Ace of Spades.

On the back of the bottle, there are two words written in black nail polish: Free Rider. 

“I don’t care if I never open this bottle,” he says, looking at me side-eyed over his shoulder. “I’d rather never open it and keep trying then to give up. I’ve got time. I’m on my path, moving towards it.”

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