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Tyler Black, MD Profile picture
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8 Jul, 4 tweets, 1 min read
Except that these published/preliminary findings do NOT show the impact of loss of in-person school. They cannot, because they were not designed to do so. They show that during a worldwide pandemic that killed hundreds of thousands, kids suffered too.
BC, which has had in-person schooling since September, experienced similar patterns and there has been NO correlation between "returning to school" and anything other than "increased stress on kids."

School is an additional stress. Let's all work to make that stress minimal.
And keeping with the archaic belief system out of Sick Kids pediatricians, they continue to slam "media use" in kids as some kind of boogieman. The science world is leaving them behind.
I abso-effing-lutely guarantee that two of the co-authors of this study are:
"Anti-Ttechnology bias" and
"Moral Panic on covid and kids MH".

Poor AT and MP just always go uncredited.

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More from @tylerblack32

Tyler Black, MD Profile picture
9 Jul
REFLECTIVE LISTENING Mini🧵
=-=-=-=-=-=-=-=-=-=-=
Quick #meded / #psychtwitter teaching

"We need to listen to our patients," right? But *HOW* we listen matters! Many annoyingly *parrot*, which makes the person feel UNHEARD.

This is called "reflecting" and it is ANNOYING AF.
/1
"I feel angry."
"It sounds like you feel angry."

"My wife left me."
"So you're telling me your wife left you."

It's really really really annoying.

/2
There are good and easy modifications that REQUIRE THOUGHT AND EFFORT but both demonstrate to the patient that you've heard them, but also advance the conversation and allow the patient to think/reframe what they are saying.

Let's look at the statement.

/3 "Will you please just leave me alone? Nobody can help m
Read 9 tweets
Tyler Black, MD Profile picture
3 Jul
Not only is this imposter (he is not currently a health care employee, I'm told) unfunny and a horrible representative, he's just plain wrong. Medical students spend 2 full years working in hospitals learning from supervisors prior to becoming interns.
Plus, there is NO evidence of a "july" effect. This video is precisely the type of myth that an awful, uneducated, stigmatizing asshole would spout.

Interns (graduated medical students in the first year) are carefully supervised by junior residents, senior residents, and staff physicians, as they SUPERVISE medical students and teach them. They are highly skilled, conscientous, and hard-working.
Read 5 tweets
Tyler Black, MD Profile picture
18 Jun
I love my #dslr camera - though phones are amazingly convenient and that means a lot in photography, nothing beats physics and light-gathering.

Quick comparison.

I was standing, looking at this building. There is a window washer 150m away.

.../
/2

There he is. Here, I'm using my phone camera's natural "5x zoom" lens
/3

Lets use the Samsung-marketed "superzoom!" I can.. well... I can see him.

The phone is doing what it can with its tiny sensor and algorithms. But see that bucket? let's pull out my DSLR.
Read 6 tweets
Tyler Black, MD Profile picture
17 Jun
So Monica Gandhi and Kyle Hunter made a few mistakes in their piece on kids and the pandemic, specifically in suicidology. With additional context, a lot of their points about MH and the pandemic specifically melt away. I'll enumerate them.

/1
First, she claims that there was an increase of 24% child suicides in california (by rate it's 24-27%) in 2020. She points to data for 2019, 2018, 2017 to show that this is an anomaly.

/2
In fact, this is true. However, some additional context (or, had she consulted a suicidologist) sort of undermine this argument. The suicide rate has increased by 24% or more 4 times prior to 2020 in the past 20 years, and does so with a regular frequency.

excel data, CDC

/3
Read 16 tweets
Tyler Black, MD Profile picture
11 Jun
Thread:

The CDC made a large mistake in their recent publication. It took data from "nonsuicidal self injury" and "suicide attempts" and combined them to create a metric "suspected suicide attempts."

This is stigmatizing and wrong. I will explain why.

Non-suicidal self injury is a phenomenon that happens in adolescence at a high rate. About 12 to 20% of adolescents and young adults engage in non-suicidal self-injury yearly.

It is **not** suicidal. It differs from suicide in many ways.

/2
Non-suicidal self-injury (NSSI):
* Is recruited for therapeutic purpose
* usually involves superficial injuries that do not threaten life
* usually provides relief (as reported by those who do it)
* When we ask kids, they are clear. "IT MAKES ME FEEL BETTER*

/3
Read 6 tweets
Tyler Black, MD Profile picture
11 Jun
Hey CDC if your article is about suicide attempts why did you present data about nonsuicidal self harm?

Shocked to see the CDC make such an elementary mistake in its titles and headlines, and it was a great opportunity to separate the two **very different** phenomena.
Nonsuicidal self harm is a coping mechanism. It's intent is to feel better, not die. It's a sign of distress and ineffective/failing coping mechanisms and usually people with it are suffering but want to live. It's very common in adolescence. (10 to 22% depending on survey).
Suicide attempts are gestures or actions intentionally taken with the purpose to die. They are signs of hopelessness and overwhelming distress, and represent a much smaller group of kids. By survey, about 6 to 8%, by ER presentation about 2%.
Read 5 tweets

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