“Memory” from FB: The time I could not breathe despite 6 puffs of albuterol.
Severe asthma attack.

#blackqueens - thank you for always being there. Of all the women in the world, if I had to choose one at my side, I pick a #blackqueen every time. You all are the real deal. Image
That year ended up a patient in ED twice cuz
-I was working a lot of 12-hour night shifts in the ED
-working as many hours as uncompensated/volunteer for ACA policy work including flying to D.C. often
-dancing non-stop in between

This is how I look w/peak flow ~200 (red) btw ImageImageImageImage
The #DrSusanMoore story really makes me think. I had a #blackqueen nurse friend who worked at the hospital & who knew that I don’t look sick when I am about to collapse. She was not caring for me, rather able to come visit me after she completed her own 12-hour shift.
❤️💪🏿❤️💪🏿❤️
Studies like this? Constructed wrong, tbh

#Healthcare is delivered in a team

As doctor much of what I respond to is filtered through what other team members report to me (MD aware)

Who is the information gatekeeper for me?

Nurses often drive #quality

jamanetwork.com/journals/jamai…
As a doctor, am the person held accountable for productivity on patient volume and with malpractice liability - easy to be distracted from keeping the patient at the center and human.

Bedside nurses ARE the patient advocate then.

They have held me accountable as a doctor.
Why the blaming statement about #DrSusanMoore suggesting she “intimidated” nurses by being “knowledgeable” when she herself could not herself breathe, really struck me.

When I was a patient, & could not breathe but “looked well”, I had a nurse as a visitor. I am also not Black. Image
It was a white male physician friend who told me, when I was just going to stay home despite seeing retractions on myself after 6 puffs of albuterol & get steroids called in, that it could be a PE.

Oh, yeah, that adult stuff.

Why was *I* believed?

vox.com/identities/201…
Who was it that spoke for me when my peak flow was ~200 & I could not speak easily in complete sentences? Who was it that stepped up, allowed me to be the “good” or not “intimidating” patient as judged by other clinicians? (& why are we judging patients?) northshorern.com/bad-patients-t…
Read this thread from @TamorahLewisMD on how it plays out. A lot of us don’t want to acknowledge what we do through implicit bias or simply scarcity of resources.

It’s not always race alone that determines who we like or dislike but that plays a part in how we prioritize people.
So, the 1st picture is after I was treated. I was better able to breathe. Luckily, my oxygen level was not low. But anybody who works in emergency medicine/medicine knows that things like asthma can quickly change.

This is what it looked like outside then.

Also, ED was empty. ImageImageImage

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More from @usnehal

2 Jan
Well that is lovely.
Welcome 2021.

I should just disable the news notifications. I have no need to know about homicides being up. And yes, I am, aware, domestic violence is a big killer. People home with their “loved ones” = danger, maybe death. ImageImage
Again, I prefer pumas to humans many a day.

Conservatives try to fear monger & tell you it is some “other” (typically another race) who is the murderer & rapist.

Nope, danger is greatest from those you trust the most with access. Pediatricians know this. americanbar.org/groups/public_…
I have become extremely discerning regarding abuses of power particularly in faculty given this long history that is extensive across multiple elite boarding schools where reputation mattered more than protecting children including my own boarding school. I had no idea of it then ImageImageImageImage
Read 15 tweets
1 Jan
OMG. This is SO me.

I really truly do NOT know how people just sit on the beach. I literally have said exactly that SO many times.

Like how? Why? Are you all okay? Are you in a coma? Who just sits still and does nothing!?!? Sounds like torture.

m.tiktok.com/v/691213491165…
But I am not annoying to travel with... because I travel alone. 😉😂

I go off being Ms. Energizer Bunny all over the place without any slowpokes holding me back. For difficult terrain or activities, I book a tour or hire a guide.

Did someone say kayak?

*This* is vacation: ImageImageImageImage
Also, it important to mix it up. Must salsa on glaciers and on mountains. Yes, true, on occasion it gets tricky, salsa-ing in hiking boots on loose rock. But it only makes it more interesting. A challenge.

(I am also okay with salsa-ing on beaches - better than sitting about.) ImageImage
Read 9 tweets
1 Jan
The inaugural episode of the Vision to Value podcast by Nehal Group LLC - just under the wire before midnight. #MedTwitter #leadership #pandemic

Listen to "Episode 1: Vision to Value for Chief Medical Officers" by Vision to Value. ⚓ (Nehal Group)

anchor.fm/umbereen-s-neh…
I'd promised myself I would do this in 2020
Big thank you:
@Ned_Arick who taught me Anchor
@becker_sbecker whose short <15 minute format I used as a model
@Ackermanjay who invited my first #podcast
@ACHEConnect for more podcast practice
To listen: nehalgroup.com/news
Ended up trying out two different audio editing programs, finding free (non copyrighted) transition then intro/outro music (went a bit down a rabbit hole). But for inviting Mark at 6p, recording at 7p, learning to edit and editing and uploading by 11p, I feel pretty accomplished.
Read 5 tweets
31 Dec 20
People get #MedTwitter mixed up with the doctors’ lounge or M&M or narrative medicine. It is not. #SoMe patient details sharing has gotten folks disciplined. Plus, even narrative medicine can cross into appropriating someone else’s experience.
Folks don’t realize HIPAA is not limited to name, initials, age, DOB, etc. If a patient might recognize you and the story you are telling and/or a coworker can go to your schedule and see a list patient diagnosed and put 2+2 together, that has been used to discipline clinicians.
There is also a really bad trend on #MedTwitter driven by both seasoned and entry level faculty (latter likely replicating/perpetuating things taught by mentors) of lazy teaching using screenshots and real life examples, identifiable, without consent, of lay people or peers.
Read 5 tweets
31 Dec 20
Mad respect.

The same people who signal visibly certain values, do not act in that way in such situations.

Recall hearing advice on how to survive academic politics, "When you see dead bodies floating in the river, don't jump in." People look away.
I repost this tweet by @DrOmolara often as it is so true. There are occasional private messages. Mostly there is silence in such situations. Personally, I have found Black women, who often have the least support, step up. Others stay silent.

Leadership is not getting a title, reaching x number of publications. Is your ability to create a vision for something that does not exist & to have the courage to go for it despite risks. It is often WOC, specifically Black women, who with that courage.

info.kpmg.us/news-perspecti…
Read 6 tweets
30 Dec 20
Believe women

The gf was taken to a #mentalhealth facility

The man she was afraid of, the future TN suicide bomber, was assumed to not be a threat enough to get a warrant

Hers *could* have been a normal response to living with someone violent

apnews.com/article/ap-top…
There is no way of knowing w/out additional details

But as long as

-we do not believe women

-we do not see fear of a “regular guy” as valid enough to investigate (like if he had been Black, brown, or Muslim)

-we are soft on domestic violence

then: we will fail on prevention
Not uncommon for men who have difficulty dating (socially awkward? short?) or experience social rejection

to date women who need some kind of financial security from them but may have troubled lives, have own #mentalhealth issues

Few women call for help

usatoday.com/story/news/nat…
Read 28 tweets

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