1/🧵What is Testimonial Injustice in medicine? It’s Silencing pts…

@crageshri tells her story & it’s brave & important. In #COVID, I have silenced pts by giving too much sedation to ventilated pts. I was wrong.

At every opportunity, I must amplify my pts’ voices!

#A2Fbundle
2/ Dr. Rageshri writes:
Testimonial injustice can occur when a person’s voice or knowledge is discounted or dismissed due to bias from the listener about their social identity…
3/ It’s a type of silencing called “testimonial smothering”. This is a form of self-censoring, where silence or withholding testimony is preferable to the psychological trauma of being dismissed and disbelieved.
4/ A way of responding to such a disclosure is by saying, “I believe you”. If we’re more ready to say this in every area of health care, along w “I hear you”, we may begin to hear our patients’ true testimonies, a crucial step to healing.

Thx @crageshri. I’ll try to do my part.
There is a lot of testimonial injustice in #Covid. Especially in disbelieving and dismissing our #LongCovid patients. They should NOT have to prove they have an illness. Again, we should start by saying, “I see you. I believe you.”

@Dr2NisreenAlwan @LongCovidSOS @long_covid

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More from @WesElyMD

13 Sep
1/🧵🎥 REFLECTION on Fear & Love – what connects 9/11 & #COVID19?
 
On #Sept11, 2,996 died. 412 were 1st responders running INTO danger.

WIKI: bit.ly/3AiqZN2

WHY did they do this? Listen to my patient Col. Correa👇

HINT: it was NOT religion, politics, or patriotism.
2/ When someone around us needs help, the only universally unifying response is #LOVE.

Wells of love (see pics 👇) must be what we drawn on to achieve success in serving others, whether on 9/11 or in this #Pandemic.
 
Pics by Robert Mecea & @marklennihan
3/🎥 I cared for 9/11 hero Colonel Victor Correa as he died in our @VA hospital years later. His story is told in #EveryDeepDrawnBreath. He carried men out of the Pentagon saving lives. Watch more of his testimonial…
Read 9 tweets
10 Sep
1/🧵🎥 Tennessee has highest #COVID19 case rate IN THE WORLD 🌎‼️

1/3rd are KIDS, & we haven’t even peaked!

Dr. Jeff Balser, @VUMChealth President & CEO, explains our dire situation. Despite 375M doses of #Vaccine is US alone, we have ~50% overall #Vaxxed & need YOUR help.
2/ This surge is different. The children are disproportionately affected – 1 in 3 new cases. Overall, and this is hard to believe, but we are at our ALL TIME HIGH in admissions. Image
3/ 🎥 Except for immunocompromised patients, almost all in hospital are #unvaxxed. We are re-deploying OR personnel to the ICU and having to curb care for non-COVID pts. It’s just not fair to them. Not getting vaxxed means more suffering for everyone.
Read 5 tweets
1 Sep
1/🧵💥 NEW COVID THERAPY SAVES LIVES

Adding baricitinib to steroids will save 1,000s of hospitalized #COVID pts. Our @LancetRespirMed COV-Barrier study is FREE.

I explain👇why it’s such a great #Pandemic discovery story: a new way to ⬇️ COVID19 deaths.

bit.ly/3DE8Co8
2/ Early in COVID, computers predicted “Berry” (for Bari-citinib), an FDA-approved medication for rheumatoid arthritis, could be repurposed to stop SARS-CoV-2 from killing us. Now we proved it! Why did the computers think it would work?

bit.ly/3t244CR
3/ Bari has antiviral mechanism but mainly we thought it would work by interfering with the intense inflammation the virus 🦠 causes, which is what leads to so much lung, heart, blood vessel, & brain damage (#delirium).

bit.ly/3jsgCjN
Read 15 tweets
1 Sep
1/🧵 EVIL & the #AntiVaxx Movement:
 
By no means do I think the #Unvaxxed patients filling our ICUs to capacity are evil. NO. But I do think there is evil involved in the misinformation leading many good, caring people to that decision. And I listen to each. Please hear me out.
2/ Philosophers define evil as “a deprivation of the rationality that proper human action requires individually and as a member of society.” In that sense, we can discuss choosing not to be vaccinated and “cooperation with evil.”
3/ Thus far, “cooperation with evil” has been used as an argument by some in the #antivaxx culture as a reason NOT to get #Vaccinated. The main argument is that Pfizer and Moderna were safety texted w the HEK-293 fetal cell line.
Read 6 tweets
31 Aug
1/🧵 “Live every day like you have a terminal illness.”

The most important thing I learned @ISICEM, after 3 ✈️ & 4,400 miles to Belgium for this huge meeting of #COVID ICU doctors, had nothing to do w science.

The iconic @JRandallCurtis1 taught me…(pic & story shared w perm) Image
2/ My friend of 25 years opened his lecture on End-of-Life with, “I have a disclosure of sorts. I’ve been diagnosed with ALS (Amyotrophic Lateral Sclerosis, aka Lou Gehrig’s disease), so this will probably be the last time I lecture at this meeting.”

Then he asked us to PAUSE. Image
3/ Talk about a Frame Shift.

I already knew, but it all hit me like a thunderbolt⚡️. The Father of ICU EOL #PalliativeCare research & former president of @atscommunity had just told us all that he has a fatal illness, and we could hear it in his speech pattern.
Read 12 tweets
31 Aug
1/🧵 The main question I wake up wanting to answer every day as a physician in the #COVID “I see you!” is this:

“How can I help people recover fully so that their dignity is upheld…so that the unique pricelessness…(read on)

Podcast: bit.ly/3gLnCa0

#ListenDNA
2/ of every human being who comes into my care is such that they feel fully human, fully respected, and that they don’t think they lost part of themselves in the process of critical illness.”

Yet #LongCovid pts are telling me they’ve lost themselves.
3/ my colleague #delirium neuro @doctorShawniqua is haunted by this too. She’s trying to find out what exactly happens to the neurons & synapses in the brain of critical illness survivors so that we can manage people more safely during and after illness.
Read 4 tweets

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