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Was writing a progress note on a patient; initially wrote “she was complaining of fatigue”— I changed this to “she was fatigued”; language matters.

Writing patients “complain” has a negative effect on the way we see them subconsciously.
@bmj_latest blogs.bmj.com/bmj/2018/08/29…
2/ As a follow-up, I wrote about how patients in today's medical system become inherently dehumanized. Because, we function in a system that forces us to see people as patients, rather than one that reminds us that patients are in fact people. @bmj_latest

blogs.bmj.com/bmj/2019/10/16…
3/ In the middle of the pandemic in Boston, while I was taking care of #covid19 patients in our hospital's emergency room, I remember feeling frustrated. As a doctor at the bedside- unable to stop what was unfolding.

"Alone with our patients"
@bmj_latest
blogs.bmj.com/bmj/2020/04/29…
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Abraar Karan
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1/ Actually ask yourself- if you were recently out with others (and maybe already felt guilty about it); then got sick w/ #covid19; would you easily/readily let everyone know?

Or would you feel scared/ashamed/rationalize why its best to just stay home and keep it quiet.
2/ For those who have done contact tracing work/research around #covid19 (I am currently)-- there are major barriers related to *trust*.

People who are getting infected & were socializing w/ others are afraid to speak up for fear of being reprimanded/stigmatized socially
3/ Honestly, I think many people-- including myself-- would feel some level of guilt/shame bc of how awful #covid19 is. No one would intentionally get sick/infect others.

We are all trying to be safe but also balance life's others needs (socializing *is* one of them).
Read 10 tweets
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Abraar Karan
@AbraarKaran
1/ An interesting piece- & you know that I have been invested in the idea of more/better masks for some time. But, in places where the epidemic spread is beyond control, we need targeted lockdowns. Everything else is a pipe dream or false "silver bullet".

npr.org/sections/healt…
2/ Targeted lockdowns at a county level will allow for a quick stop to community transmission in the places that need it now.

This lockdown time should be used to set up response systems- testing/tracing/isolating/masking/surveillance + bolstering healthcare capacity.
3/ Lockdowns have consequences- we know what these are.

People need to be provided with $ protections; vulnerable will need extra outreach.

Other health emergencies need to be detected and brought to the hospital.

Isolation *options* outside the home are important.
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Abraar Karan
@AbraarKaran
Masks work at stopping #covid19 spread, significantly.

How we get enough people to actually wear a mask, and wear it at the most important, risky times is turning out to be a very complicated behavioral problem in the absence of a mandate.
I'll add-- a mask mandate is not a golden ticket here, esp bc of home transmission.

Getting more people to mask while outdoors is not where the $ is at (IMO), although it plays a role in some circumstances

Needs to be indoors, inc work, transport, and for some, right at home.
When I visited family briefly (no medical conditions but in their 50s), I masked indoors at home almost the entire time except while sleeping in a separate room.

That is despite having no known sick contacts, no close #covid19 patient care in the past few weeks, no symptoms, etc
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