Tyler Black, MD Profile picture
Dec 28, 2021 9 tweets 4 min read Read on X
The wonderful Messier Object M45 (The Seven Sisters, Pleiades). It's famous as the @Subaru_corp logo ("Subaru" is the Japanese name for this cluster!). It is the closest Messier Object to Earth! The bright stars lighten up the gas remanents of their formation.

#astrophotography
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I've revisited this object after a year of #astrophotography practice, and what a difference a year makes! The left is in Dec 2020 with my DSLR setup, on a tripod outside of Vancouver. The right is with my setup on my balcony in Downtown Vancouver.

[/2]
On top of being able to more of the nebula, we can see a lot more detail within the nebula; the striated gas is just stunning!

[/3]
Pleiades is an amazing object. It's "only" 450 light years away & is visible in most night skies (only the strongest light pollution hides it). It's earliest depiction is in 1600 BCE by the Unetice culture. Galileo was the 1st to see it through a telescope, & he sketched it here.
[/4]
Pleiades has made appearances in Homer's Iliad, the Bible, Sioux oral tradition, and the Qur'an. It's known as the "Makali'l" in Hawaiian, and are part of the Australian Indigenous traditional stories.

[/5]
The nine brightest stars are named after Greek Mythology's Pleione and Atlas and their Seven Daughters: Sterope, Merope, Electra, Maia, Taygeta, Celaeno, and Alcyone. I've labelled the stars here.

[/6]
@NASAHubble captured an amazing photo by zooming into Merope, and just to the top right you can see the light of the star. Underneath it, an amazing nebula lit up by Merope herself.

[/fin]

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More from @tylerblack32

May 5
RFK is no better at psychiatric medications than he is about vaccines.

RFK's "overmedicalization crisis" thread is a master class in using true-ish numbers to imply a false conclusion. Let's go through it. 🧵

/1
The core trick: he treats prescription prevalence as self-evidently bad. But high rates only signal a problem if the meds don't work, are given to people who don't need them, or cause net harm. He establishes none of this. He just gestures at numbers.

/2
The same rhetorical structure would indict insulin prescribing, or asthma inhalers. Prevalence is not pathology. The question is whether treatment matches need — and whether the alternative (untreated illness) is better or worse.

/3
Read 20 tweets
May 4
Disabled people should not live in poverty.

It makes no sense the way we treat our people with disabilities in Canada. Canada has the full apparatus to implement adjusted payments, yet we typically support disabled people WELL under the poverty line.

/1 Image
Canada has an official poverty line: the Market Basket Measure. It's regionally calibrated, methodologically sound, and updated by StatCan.



A single person on BC PWD receives ~$18.4k/year. The Vancouver MBM is ~$29k.

/2www150.statcan.gc.ca/t1/tbl1/en/tv.…
That's not a rounding error. It's a structural choice.

PWD recipients in Vancouver sit at roughly 47% of the poverty line and below the Deep Income Poverty threshold (75% of MBM), which is the level StatCan uses to flag the worst material deprivation in the country.

/3
Read 10 tweets
May 2
Quick thread: "How do SSRI's work" 🧵

I've had a few patients ask me how SSRI's work.

To be clear, my first answer is "well we know they are supposed to block serotonin reuptake, but it's not that simple and we don't really know."

But, if you want the best 2026 science...

/1Image
For a few particularly science-interested patients, I walk them through what we currently have for the 'best evidence' even though we're still not sure.

This is the "best story" I can tell about SSRI's right now.

(nb, this is NOT locked in, this is MY best synthesis)

/2
1) SSRIs BLOCK the Serotonin Transporter
The protein that pulls serotonin back into the neuron after its released is blocked. Serotonin lingers longer in the synapse, the gap where neurons signal each other.

This is very well established, & how SSRIs were designed.

/3Image
Read 15 tweets
May 2
The Ihben story is making the rounds. "Judge forced 18 vaccines, child got autism." It's being treated as a smoking gun. It is not a smoking gun. It is barely a story.

/1
Sourcing: one father, one advocacy org (CHD), one GiveSendGo. Records sealed. No filings. No named physicians. Every outlet repeating it cites the same Defender article. This is a closed loop, not corroboration.

/2
"18 vaccines in one day" is not a thing. That number counts antigens as doses to make the headline scream. Real catch-up schedules don't work this way and you can verify that in five minutes on the CDC site.

/3
Read 10 tweets
Apr 30
🧵Borderline Personality Disorder (BPD) 🧵

Ask any person who has been even suggested to have BPD; they will uniformly tell you that they have been told to try DBT (Dialectical Behavioural Therapy). Reflexively recommended. "Gold standard."

This is not science-supported.

/1Image
Quick history: Marsha Linehan developed DBT in the late 1980s, published the foundational manual in 1993. She drew on CBT, Zen Buddhism, and dialectical philosophy. Brilliant clinician, brilliant marketer. Her institute has trained tens of thousands of therapists worldwide.

/2 Image
That marketing machine is the reason DBT is "the BPD treatment." It is not the reason DBT works better than alternatives, because it does not.

The faint superiority signals in older trials evaporate once you adjust for allegiance bias (DBT researchers studying DBT).

/3
Read 16 tweets
Apr 30
The McCullough Foundation's @NicHulscher — who posts garbage medical misinformation — styles himself an "independent epidemiologist."

His entire career has been spent publishing with, and working for, McCullough. Image
No academic post, no health agency, no clinical role, no pre-Foundation experience. Hired straight out of his 2024 MPH by the senior author on nearly every paper bearing his name.

/2
He publishes almost exclusively with McCullough, overwhelmingly in predatory or fringe journals, and has already been retracted twice — plus an Expression of Concern — in a career that's barely two years old.

/3
Read 7 tweets

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