This morning I am sitting at work in numb silence. What happened in my neighborhood last night was painful and unacceptable, and 100% preventable.

A thread.
The choice to see the Governor's words as an attack on religious freedom led many to argue that the treatment of our neighborhoods and zip codes was based on "picking on" the Jews, "anti-semitism," "reminiscient of the Holocaust."
The alt choice would have been to unite the community with safe public health behaviors.

Two rules: wear masks, avoid crowds. That’s all.

It is no secret that from May-Sept my community failed to follow these rules.

Many felt the disease had run its course in our streets.
But signs of an uptick in September still did not induce a change in behaviors, until threats to shut us down led to widespread mask wearing in the public arena.
Let me rephrase this: the neighborhood masked up by Yom Kippur due to threats of school, shul, and business shutdowns: NOT in response to rising cases and threats to their loved ones health.

And the meager leadership we have encouraged this logic.
Now with our cases rising and the Gov taking a strong stance, our leadership fomented theories on persecution, antisemitism, freedom of religion, and more.

The culmination of all of these inappropriate responses? Shameful protests, injuries, rampant chillul Hashem.
We live in a country and state whose health department officials provided us guidance on having safe Yomim Tovim, from how to conduct Yom Kippur davening to how to Sukkah hop safely. How lucky are we? How grateful should we be, to be given bespoke pandemic guidance?
Our leadership - political, religious, askanim - had ONE chance to back up the rules: to endorse their community members to take the rules seriously, make a Kiddush Hashem, keep their loved ones safe.

They failed, and instead, stoked a fire that shames us all.
I am crying today, as we all should be. We are in the news, acting shameful, yet feeling righteous about it.

And we cannot even do teshuva for it for another whole year.
Now that you’re all here, feel free to review my Patreon account, where you can support my underserved cancer patients who cannot afford copays, OTC medications, or taxis to their appointments.…

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More from @MarcusBlimi

25 Sep
Make no mistake, what is about to happen in the ultra-Orthodox communities in Brooklyn will be catastrophic. School closures, business closures, synagogue closures and fines to everyone will rock the community and pain them - WITHOUT FIXING THE PROBLEM.
I am all for punitive responses and mandates and fines, but only after an effective, community-centered approach towards education and participation. This has not happened. This hasn’t even pretended to happen.
Instead, clueless methods to improve mask wearing and social distancing were implemented - 2 days ago - and now there are threads to attack the community from all sides by early next week. 3/
Read 5 tweets
15 Sep
"So, the first thing we're going to do is give you 1.5mg of dilaudid in your IV line to get you out of this immediate pain crisis. I already entered the order," I told the patient, crouched at her bedside and holding her hand. She closed her eyes briefly and nodded.
I took her call button and whacked it. We gazed at each other and the unit assistant blared out a "Can I help you?" to which I replied "Yes can we get pain meds please?"
I placed the button back in her hand. "I also placed a consult for our palliative pain team - they will help us get your pain under control with medication. They'll get all the right medications ordered in the right doses so that we keep you comfortable around the clock."
Read 6 tweets
30 Aug
We got into the car, and with my Bluetooth connected, were assaulted with Christian gospel music.

My husband raised an eyebrow at me. He’s used to my rambling taste in music but this was new.

I grinned. “That was for my patient.”
Miss Mary came in every two weeks for chemotherapy for pancreatic cancer. 77 years old, she rarely complained, but I did catch her wincing a few weeks ago. After a lot of probing it appeared she had a lot of pain which didn’t respond to Tylenol or ibuprofen.

I prescribed 5mg
of oxycodone for her, and she had reported that it worked well and she only took it during severe pain attacks.

But then she came in for chemo and the pains arrived. She didn’t have her oxycodone with her and we don’t have it in the clinic.

I gave her Tylenol and hot packs.
Read 6 tweets
26 Aug
At 7pm I slung my bag over my shoulder and wheeled around to the door, ready to sign my patients over to the team of physicians on night duty, my 12 hours of managing complex care completed.

Then the intern’s pager went off: “Patient in room 1032 expired. Family distraught.”
I glanced at the intern. His resident left and he looked alarmed.

“Do you need help?” I asked tiredly.

“What do I have to do?”

“Console the family, pronounce his death, call the organ donation network, write a death note, and enter into the NYC Vital Statistics records.”
Blank stare.

I set my my bag down. “Come. This is what you do when your patient dies.”

We entered the patient’s room. The widow was surrounded by 3 nurses and 5 family members around her. A basin in her lap, a nephew fanning her, a son holding a cup of water.
Read 7 tweets
27 Jul
She walked into the clinic, looking gorgeous and fit. New there, I wasn’t sure if she was an employee or patient, until she settled into the infusion chair.

Sleek top knot, glistening sunglasses, artful makeup, she looked glamorous and well, a year shy of her 50th birthday.
I pulled up a chair and introduced myself.

“Hi! I’m new to the clinic and I’m making sure to meet everyone so I can be familiar with all of the patients.”

She smiled through her mask. “I’ve been treated here for 4 years, the staff is wonderful. They’re my family.”
I smiled back as I mentally calculated her illness beginning at age 45. Not having had a chance to review her chart, I asked her what she’s being treated for at our clinic.

“MBC,” she replied calmly.

My heart sank.
Read 5 tweets
22 Jul
A Life and Death in 7 days

Friday: He walks in to the ER, tall, tanned, thick silver hair. A French accent, loping gait, and an easy smile, he could be mistaken for a Hollywood actor. But he is here with new lung cancer, new confusion and a calcium
level which needs to be corrected before his treatment. A CT-scan of the brain also confirms bleeding metastases - tumors which migrated north from his lungs. I settle him in his room as he flirts with me and his nurse.
Saturday: His calcium trends down but his confusion is ramping up - he needs a 1:1 nurse to keep him safe, keep his IV line in, keep him from falling. I prescribe sedatives, anxiolytics, benzodiazepines. I bring more teams aboard, take recommendations, tweak medications.
Read 9 tweets

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