Patient arrives. All staff know what will happen except for doctor in white coat 
This patient can’t move left side and has a facial droop. Doctor talks about possible stroke.
Most important thing: get her to the CT scanner. 2 types; the treatment that saves one, kills if other. Time is brain. #CyberMed2018
I’ve heard this short window called the magic hours. About 3? (If I recall) from stroke origin. #CyberMed2018
Golden hour
Hmm. While at CT & checking her blood work, another patient in. Chest pain. #CyberMed2018
2nd guy. Probable heart attack. Need some tests. EKG. #CyberMed2018
They need the Cath Lab (cardiac catheterization) right now #CyberMed2018
2nd patient headed to CathLab. Bringing back CT scan stroke patient to give (or not give) treatment to save or harm her. #CyberMed2018
Where are CT images??! CT scanner not working. Treatment matter on diagnosis; clot or not. Time matters. Time is brain. #CyberMed2018
With invasive procedures we shift to surgical dummy. She is vomiting now. We need images. Denial of service. #CyberMed2018
Placing in breathing tube. #CyberMed2018
Radiology rebooted. Bitcoin ransom request. No images from the unit. Contemplating next steps. Time is brain. #CyberMed2018
They didn’t admit the medicine & the window is closing/will close. Denial of service degraded patient care / prognosis #CyberMed2018
2nd patient: CathLab also ransomed. You can still give blood thinner. But cath is better. #CyberMed2018
Patient getting worse. Vomiting. Deadly dysrhythmia. Causing patient 2 to die. #CyberMed2018
Chest compressions. Ribs crack in people and this surgical dummy. Pushing a medicine to maybe bring back. Risky. #CyberMed2018
Cath lab called to move artificially pulsed #2 to helicopter patient to a nearby hospital (hoping they are not ransomed) #CyberMed2018
So. Stroke patient care degraded due to delay. Heart patient coded, then moved across town by helicopter 🚁 #CyberMed2018
In hot wash, doctor asked for new underwear. Expressed how every second brain is lost. Was shocked CT wasn’t coming back #CyberMed2018
Choice “flying blind” maybe kill w/ wrong treatment. Maybe save their brain function. Chose to not risk killing #CyberMed2018
Can’t fathom not having access to CathLab - discuss how many are running old Windows. #CyberMed2018
