Dr Janaway Profile picture
May 6, 2021 23 tweets 8 min read Read on X
Medical specialties as Pokemon, a thread. Yep. Another one of these.

..gotta catch em all...

#MedTwitter
1) Allergy/Immunology - Vileplume

An expert on poisons and dangerous dust, these creatures are ones to go to on anything red, itchy, and a little bit feverish.

Strengths: sedation, immune suppression
Weaknesses: sedation, immune suppression, microbiologists
2) Anesthetics - Drowzee

This wild beast excels at knocking out its enemies. Often found sleepy itself, it relies on caffeine and datix to stay awake

Strengths: sleep power, cannulation
Weaknesses: consciousness, conversation, nephrology
3) Critical care/ICU - Mewtwo

Rare and mistakenly feared, this one is an expert in control. Don't be fooled by its hard demeanour and side-eye, it's listening to everything. Is it the machine?

Strengths: peep, vasopressors
Weaknesses: powercuts, government resource allocation
4) Dermatology - Persian

This preening beauty is often found strutting majestically around watering holes. It may be distracting, but don't make any rash judgements, it's queen for a reason.

Strengths: precision, salve attack
Weaknesses: fire types, immunology lite, starbucks
5) Radiology - Porygon

Created by computers and always plugged in, this expert leads in reading others. With super x-ray powers, it can spot an enemy a mile off. Hunt at night only.

Strengths: x-ray, clinical correlation
Weaknesses: sunlight, contrast medium, babadook
6) Emergency Medicine - Mankey

Fierce, unpredictable, and always ready for the next challenge, it's all about the first interaction. Get it done, in and out. A key player.

Strengths: agility, a keen eye
Weaknesses: Saturday night, 4-hour limits, psych liaison
7) Palliative Care - Chansey

Nurturing, reliable, and empathic, these are the carers and the steady hand when times get tough. Experts in soothing and sense, and always there if you need them.

Strengths: being bloody awesome
Weaknesses: undervalued
8) Geriatrics - Omanyte

Hardy, patient, and methodical, they may move slow but they leave a mark. Resilient under pressure, this quiet lot are experts in the mystical ways. Not fans of opiates.

Strengths: social assessment, care packages
Weaknesses: polypharmacy, constipation
9) Cardiology - Arcanine

Intimidating but understandably so, these powerful beasts spring into action when the chips are down. With a keen sense of smell, they can spot a raised troponin a mile off.

Strengths: dual antiplatelets, OP follow-up
Weaknesses: nephrology, ink leaks
10) Endocrinology - Parasect

Another creature rarely seen in the light of day, it's often found clinging to mess sofas. The large mushroom on its back contains insulin. Oddly into urine.

Strengths: hba1c, gp follow up
Weaknesses: fructose, underfilled sample bottles, lithium
11) Gastroenterology - Arbok

Watch out for this one, just as likely to take a bite as shove something down your gullet. An expert in all things gripey, and never found alone.

Strengths: speed, surprise, omeprazole
Weaknesses: post-take, anti-platelets, chunderdragon
12) Haematology - Golbat

Often found hanging upside down, these blood-suckers are obsessed with your precious life force. One bite is never enough. Pretty damn good at dealing with poison.

Strengths: accuracy, rouleaux formation
Weaknesses: rhesus positivity, garlic, the spleen
13) Infectious disease - Koffing

This one is all things creepy crawly, spluttery poorly. King of the coughs and prince of the pus, often found lurking in the dingy and smelly. But right now, heroes.

Strengths: tazocin, mandatory IC training
Weaknesses: tazocin, dave from ortho
14) Respiratory - Ninetales

With its myriad appendages, it is ready for anything, and struts like it owns the place. Clever, and resourceful with super-breath, vulnerable to poison types.

Strengths: oxygen blast, salbutamol nebs
Weaknesses: smoking, fluid overload
15) Nephrology - Alakazam

By far the most intelligent beastie, this one scares the crap out of cardiology. Never worried about a bit of dry nephron, these are the guardians of the glomerulus.

Strengths: intelligence, banana guards
Weaknesses: cardiologists, gentamicin
16) Paediatrics - Mr (or miss) Mime

Great with the young and always ready to make you smile, but don't be fooled by their chirpy demeanour, these are badasses. Always have colds tho. Sometimes find it hard to let go!

Strengths: calpol, friendliness
Weaknesses: parents, ouchies
17) Neurology - Farfetch'd

A curious and intelligent foe, this one glides in and out but little holds its interest. Obsessed with tests and tendon hammers, it usually just ends up giving steroids anyway

Strengths: computed tomography, IVIg
Weaknesses: lead, ticks, psych
18) Public health - Articuno

Soaring above and watching all of us, this has the power to freeze disease in its tracks. When its not being filmed, it spends it time taking care of us all.

Strengths: omnipotence, next slide please
Weaknesses: government contracts, naomi wolf
19) General Practice - Ditto

The ultimate adapter, this one can deal with any challenge and assimilate it quickly. Although seemingly not an expert in anything, its an expert in everything! The real MVP.

Strengths: knowledge
Weaknesses: paperwork, 'gp to kindly..', back pain
20) Psychiatry - Slowpoke

Okay, it usually takes a few hours to turn up and longer to have a chat, but don't be fooled, this one isn't just a dopey grin. Master of mental states, and reassurer of registrars.

Strengths: zen, empathy
Weaknesses: szasz enthusiasts, projection
i spent too much time on this. thank god I'm in psychiatry.
Yall looking for rheumatology its just inner derm.

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More from @drjanaway

Oct 6
A good opportunity to answer a complex question. Thread 1/x
Firstly, "mental illness" is not a comprehensive label, it refers to a wide number of different illnesses of different natures, severity and risk, from severe and enduring psychotic disorders to brief adjustment reactions.
So maybe we can start by defining those conditions where "cure" is not really applicable in the longer term sense, more "manage".. I.e schizophrenia, bipolar, recurrent severe depression, dementia.
Read 13 tweets
May 6
The major issue with the "all mental illness" is an extent of human experience is that it ignores that "adaptation" relies on physiological mechanisms. These mechanisms break. Psychosis may have an adaptive role (in theory) but it is more likely a failure of a process.
The question of what defines an illness is of a metaphysical philosophy and pracitical ontology (thats all science can be.) The decision about what we define as intolerable and must treat is majorly ethical, and thus social (unless you feel morality is an apriori construct.)
In such a way the category of a "mental illness" is not dissimiliar to any "physical illness" aside from the social element by which we labor under a special misapprehension of "personhood" or "soul." It is of a physical nature as all cognition and experience is.
Read 8 tweets
Jan 27
Lets put this to bed now

1) Trauma is factorial to an extent in all mental illness, causal or as a result or both. The major conscillient explanation is susceptibility to atypical responses.

2) The presence of antecedent trauma is not always the cause of mental illness.
3) Restructing early experiences from a subjective viewpoint can always suggest a traumatic cause. Especially when the observer relies on therapy as their intervention.
4) The presence of a traumatic cause does not negate the concept of illness, it simply shifts the aetiology toward an individuistic view, whilst maintaining the same symptomology.
Read 12 tweets
Oct 21, 2023
We cannot parse any ideology that perceives the killing of innocents as justified in its ambition. Ideologies are often just a way to hide human motivations of greed and power behind lofty concepts of 'right' and 'holiness.' Challenging this is not blasphemy, but humanity.
I would say this of any ideology, any religion, any cult, and any politic, all are man-made and reflect decisions made over years by individuals toward their own ends, even if these aspirations are socially tolerable or 'good', they are man-made, man-acted and man-responsible.
Frankly, I am tired of those who claim a higher power or wrote to justify their atrocities, who hide behind books and mantras, who dodge responsibility by claiming victimhood, who enable violence by making enemies not of dictate, but competition for resource.
Read 9 tweets
Apr 13, 2023
My payslip as an ST5 junior doctor (registrar with 7 years NHS experience) w/adjustment for 80% less than full time.

£24.46 p/h basic rate

After all deductions £2850 per month,
£712.50 a week, or £21 hr (this includes accounting for enhanced rate on nights/weekends, additions) Image
£24 is more than average, but so is the work, training, and responsibility. I am asking for a 35% increase in this pay to reflect the amount I would have earned 15 years ago. The work has gotten harder, but the pay reduced in real terms.
This is not about 'who deserves what' (although it has raised alot of discussion about it,) it is about whether its reasonable to do the same or more work for such an amount less than my predecessors (who by the way, have had even higher reductions since)
Read 15 tweets
Apr 11, 2023
TLDR: Midazolam is a commonly used palliative (end-of-life) drug that can help with agitation and anxiety. Its use increasing during covid, where a lot of people sadly lost their lives in a horrible way, is easily explained by its indications of use. No conspiracy here.
Dying of covid is a horrible way to go. I have used midazolam with patients at the end of life, dying in all manners of ways. Recognising that switching care to palliation is a hugely valuable, if not easy, decision to make. It makes passing less horrifying for people.
I did not use it during covid, as I was not involved with managing the those in acute medical settings. But I can speak of using it alongside and under seniors whilst working in oncology. Infact, my first patient ever, and several afterwards.
Read 6 tweets

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