Listen. I am definitely a worrier and a contingency planner. It is what makes me well suited to a career in anesthesia. But, for those who refused to consider worrying or “living in fear” of covid citing its “low mortality rate” I would like to present a few things to consider:
1. Mortality is only one aspect of suffering. Morbidity is vast and infinite. Pay attention to both to properly consider the risks you are willing to take for yourself and others.
2. When hospitals and resources are stretched to their limits, quality and availability of care decreases.
3. When healthcare workers are sick, burned out, or morally depleted; availability, safety, and quality of care decreases.
4. When ICUs are overwhelmed with covid, there is less ability to care for patients needing cardiac, transplant, neuro, or other major surgery. There is less room to have the misfortune of getting critically ill.
5. Given the above, the risk with other things having a “higher mortality rate” than covid 19 will increase.
6. This pandemic is making us globally sick whether you believe in covid or not. You can’t will it away. It doesn’t go away when you close your eyes. Don’t open them too late.
7. Being a good citizen and good neighbor sometimes requires belief, listening, and sacrifice. Reading this may not matter to you, but if it does... that may matter to a whole lot of other people. Psssst: Helping feels good.

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More from @AlexAndersonMD

10 Apr
Breaking down the 2-3% COVID-19 mortality rate:
I am a million years old and yes I took a pic of my computer but this is a helpful graphic. I am also not an infectious disease doctor or a critical care doctor or an internal medicine doctor or an ER Doctor or an epidemiologist.
I put breathing tubes in and make the air go in and out and make the blood go around. But I love people. I love helping. I love science. I am trying to keep up and learn and adapt with everyone here.
This is helpful information for understanding why it is important for EVERYONE to socially distance if possible, and to look out for those who can’t or who are struggling
Read 10 tweets
26 Mar
Dear Medicine,

I turned to you when I was young and too scared and hated myself too much to do anything else. I signed up for surrender. I signed up to be told what to do. I needed to be something to escape being me.
But something happened. Slowly. You made me find myself during the process of becoming a doctor. You made me find my humanity. You made me connect and love, and that tricked me into loving life.
People talk about what a career medicine has taken from their lives. I have had a different experience. Being a doctor saved me. It got me out of my head. Helping other people made me want to exist. A career in medicine gave me a life. Purpose. Meaning.
Read 11 tweets
19 Mar
Today a colleague made the point of using the word “update” instead of “change” regarding covid19 practices in our department. This was such an elegant narrative shift to show just how fluid and uncharted this situation is.
I’ve noticed denial/minimalizing turned to annoyance turned to fear turned to ANGER as the constant “changes” to practice caused perception of chaos, lack of leadership, and lack of transparency.
Shifting to the word “updates” gives some space for things to evolve and shows how fluid the situation is, even to top levels of leadership. Unity was restored. I can’t overstate how important transparency with this rapidly evolving preparation is for the team dynamic.
Read 9 tweets
2 Nov 19
So tonight our two year old woke up with sudden stridor. He was screaming and gasping for air. Red not blue. He was dry heaving and throwing up. I wanted suction, positive pressure, racemic epi, steroids.
I am a hospital based physician. I am used to having support and equipment to diagnose and treat things. I am a mom. It’s that moment when you realize that you are just a parent within the walls of your home, without all your tools.
Respiratory. Distress. Both present. I wrestled with calling 911, waiting, or just going into the ER. I just kept thinking “Don’t lose the airway. You have nothing”. I wondered what I would tell a friend to do if their child woke up unable to breathe. I dialed.
Read 16 tweets
25 Jul 19
Neuromuscular Blocking Drugs:

I am a proud neuromuscular blocker monitoring and reversal nerd. I LOVE talking about this stuff. If you get a hoot out of my emojis, then you are just as nerdy! Jump in and comment! This barely scratches the surface.
The stats on postoperative residual neuromuscular blockade (PRNB) are alarming; current literature puts incidence from 20-40%. PRNB leads to increased morbidity, particularly pulmonary complications.
(Bulka. Anesthesiology; 125:647-55)
How is this happening? Let’s discuss barriers to proper monitoring and reversal of nondepolarizing neuromuscular blocking drugs.
Read 20 tweets

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