Dr Evil Profile picture
5 Oct, 12 tweets, 3 min read
I’m going to tell a story from the ER. It’s probably my only meaningful interaction with a journalist. I was taking care of an 60’ish female, I honestly don’t remember the chief complaint, but it was probably chest pain. =>
Then I met the daughter. A journalist. She had questions. Evaluating chest pain is rarely simple, and when it is, the patient is usually dying. This patient was not dying. With a wrinkle here or there patients over the age of 25 who have chest pain will get =>
An EKG and Chest Xray rather quickly. Oxygen is standard. 2 liters. Lab draw. Aspirin by mouth. Vital sign abnormalities are addressed, and after the EKG is some variant of “non specific changes” and the patient’s pain is relieved =>
You wait for labs. Here’s where the daughter came in. This was a large ER with a large main hallway. This gal got me in the hallway. I was polite and answered the questions. It became clear to me rather quickly though, that the conversation was devolving=>
The daughter had. Question for every answer, and in spite of me telling her that we did not have an exact diagnosis at the moment, might get one in 30m or so, but more likely would have to admit her mom for further study she was in some kind of vapor-lock of the brain=>
“We don’t know yet” and “sometimes the diagnosis is not immediately apparent” got a response of “why?” And it seemed she stepped a bit closer to me. After a bit of this and after saying for the 4th or 5th time that her mother was one of my many patients I was finally=>
Able to break away. Hadn’t thought about that in years but tonight we have all these journos (and some activist-type MD-journos) all chiming in happily with their 1000yd diagnoses and infantile sleuthing of the mysterious “dexamethasone” and “2 liters of oxygen” and =>
Opining on the Secret Service and all@manner of idiocy. The lady journo in the ER was trying to look out for her mom, I get that. She hindered her mom’s care a bit by being a journalist. Look folks, whatever disease you are thinking if there’s PROBABLY not a lab test for it =>
Even specific tests like COVID PCR have significant false positive and negative rates. Diagnosing a patient, to me, is often like looking at a landscape. Sometimes not. If someone is having an MI or a stroke the hard part becomes getting the treatment =>
And interventions done ASAP and without mistakes. The. The phone calls. But with most other cases you have to really pull a whole bunch of stuff together INCLUDING “gestalt”. It’s not easy. It doesn’t lend itself to the journalism technique of pressing the subject =>
On their answers. “I don’t know yet” really means I do t know yet. These journos having #journams so@much remind me of that gal. There’s no immediate answer so they speculate. Then some utter hack MD gets on Twitter and gives them ammo and it’s off to the races. =>
If you believe that the Docs at WRMC are anything less than excellent and that we can’t trust them then, and I mean this sincerely. F right off. Trump looks good. I’m glad. //

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More from @MD_STAT

4 Oct
Cue the following insane Tweets:
1. OMG this was a hoax! Trump never had COVID!
2. OMG that’s not Trump, it’s a body-double!
3. Add your own...
Yaaaaas!
Read 4 tweets
11 Jun
@molratty So interesting to see this dynamic change over the past few decades. I was a history major and when I learned about the civil war it was presented as a incredibly complex conflict, with roots in slavery, but roots as well extending back to pre-revolutionary days. Also on the =>
@molratty industrial north growing and driving the need for expanded crop production in the agrarian south such as, of course, cotton. Also, I learned of the struggle many officers had in choosing sides and many choosing to fight for the south. But now, 150 years removed, it's =>
@molratty all of a sudden so clear that it was war caused singly by slavery. There may be momentous events with a single cause but I can't name one. I think there are other drivers here.
Read 8 tweets
26 Oct 19
@JoeSilverman7 Part of this stems from medicine “mission creep”, part from mandated data-gathering that is used for “studies” (shitty data as should be obvious here), and part from Doctors surrendering their profession. =>
@JoeSilverman7 “Mission creep” is a military term that means trying to go above and beyond your mission. This often has disastrous consequences. A classic example would be a pilot tasked with taking out two targets on a mission but seeing a third, destroying it, and going “bingo” fuel =>
@JoeSilverman7 Running out of gas. Crashing. Medicine is REALLY hard to do well. Focusing on the patient in front of you completely, making good diagnostic decisions, and instituting prompt treatment is critical, especially in the ER. It is NOT and exaggeration to say that doing this =>
Read 14 tweets

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