1/🧵 Letter to Young Scientists

Are there professional trends in academia that are robbing scientists of joy & vocational success?

When #scientists burnout, it robs pts of answers to their problems & increasing their suffering.

Let’s discuss…
 
#AcademicTwitter
2/ The goal of science is to determine the truth about question no one knows the answer to…so that we can make things better for others.

I thought I'd share a few thoughts about discernment and the scientific process that I learned while graying 💫
 
#ScienceTwitter
3/ Discovery in medicine, for example, is not a job. It is not work.

It is creating art. It's painting.

And when we are being artistic, most of us enjoy diving all the way in & immersing ourselves without undo distraction.
 
#MedTwitter
4/ We want to experience the full emotional and intellectual benefits of music, painting, cooking, exercise.

The same is true with #science.
5/ There is something immensely beautiful about developing a question, figuring out how best to answer it, pursuing the data, cleaning & analyzing the data, and then allowing ourselves to relish in the moment while we seek to understand & learn.
 
@nataliexdean @EpiEllie
6/ I have found that I cheat myself of the joy of the scientific process by letting social media overly interrupt my thought process while ✍🏻 and by being a slave to emails & other things that stutter my progress & stunt my growth in seeking wholeness.
 
#medicalstudenttwitter
7/ To approach writing as a chore can achieve publication…

BUT it won’t produce a beautifully woven quilt.

It takes uninterrupted chunks of time (days), attention, & personal investment to get in the zone. This allows synthesis of brush strokes in each corner of the canvas.
8/ 📝 Creating “less” of a manuscript than it deserved to be deprives the reader and the patient.

They are presented with somewhat of a “hidden research paper” rather than something they should be joyously plunging into and gloriously digesting.
9/ We, as writers, want our readers to enjoying each section…the abstract, introduction, methods, results, discussion and especially the Tables and Figure legends.

All of it must be woven into a cloak that they can wear, enjoy & share with others.
10/ For 3 decades I have found tremendous joy in discovery as a physician scientist. It has been a gift beyond measure to serve others.

In writing hundreds of papers, I have never once been bored or thought the process tedious. Rather, it’s mesmerizing & endlessly stimulating.
11/ Even under the burden of Covid & the chaos of our clinical circumstances, we designed investigations, some of which have already provided life-saving new therapies (baricitinib) as others unfold (cognitive & physical burdens of #LongCovid)

We need YOU, the next generation!
12/ So if you want to be a healer - whether by touch, words, math, imaging, analytics - and you imagine striving to reduce human suffering, then medicine and the path of academic inquiry may be for you.

There’s so much more, but I will stop & wish you well on your journey.🔥
13/ ADDED THOUGHTS…

I shared these final thoughts w our @CIBScenter team this week.

We are here to affect the lives of people we’ll NEVER meet. We do that by learning from the lives of people we DO meet. We may never know our success or failure in these endeavors…
14/ One barometer is how well we reach medical teams and scientists globally through our peer-reviewed publications. And that means, we have to try REALLY hard to write amazing papers. But the paper is only an end-product of the TONS of work that came beforehand…
15/fin
Our #research process starts w a question, study design, then enrollment, conduct, data collection, data cleaning & analysis, etc, THEN writing.  All of you play a key role in these steps…
 
Let’s keep going…there are lives at stake. And YOU are making a difference.

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More from @WesElyMD

4 Jan
1/🧵🎥 A young mom suffering #COVID. Her husband is scared.

We need to prevent serious long-term complications. Her new normal will likely include PTSD, Dementia, Depression & severe physical disability. (shown w Perm)

Not so “mild” ➡️ Do you want this?

#vaccinate
#LongCOVID
2/ what you need to know about ICUs, #PICS and #LongCOVID prevention:

I wrote this @thedailybeast piece👇 to help empower you as patients & families. It’ll tell you what you need to know & ask your team for amid the chaos and confusion.

There’s more…

bit.ly/3DhC6Xe
3/ This patient on 100% O2 and high-dose propofol & fentanyl did not need both agents. When able, we try to avoid prop & benzos. We stopped Prop, continued Fentanyl & added dexmedetomidine because it’s shorter acting & won’t build up so much in her brain.

This is the #A2Fbundle.
Read 7 tweets
4 Jan
1/🧵 You test positive for #COVID.

Should you take the COVID Pill?
 
Two free options available soon from stores like Walmart:
1. Paxlovid + Ritonavir
2. Molnupiravir

Who takes them?
Vaxxed or Unvaxxed?
Whats the deal?

Read this new thread to accompany data I posted👇
2/ Once available, people should take eg Paxlovid (2x daily for 5 days regimen) if they

1. are symptomatic
2. have 1 risk factor for progression to severe disease or 60 years and older
3. do not have severe liver and kidney disease.

bit.ly/3Jc0Nsp
3/ That’s who was studied. The Paxlovid study is not out yet so I’m waiting to read the list of risk factors but it’s stuff like obesity, immunosuppression, diabetes, asthma & hypertension.

Will this drug benefit people at less risk? Probably but we don’t know yet definitively.
Read 8 tweets
3 Jan
1/🧵 Brain + Body damage in #COVID & Critical Illness
 
Sepsis -bacterial, viral, fungal- can cause rapid-onset #dementia. Finishing this test should be easy at her age but Millions of brain cells are damaged!

Protect yourself & others: #Vaxx + #Mask

H/T @trishla_17 for helping
2/ Our brain depends on a delicate balance of blood flow, nutrients & oxygen. When someone gets critically ill w #Covid or from other causes, that balance is dramatically disrupted. Small blood clots, dropping oxygen levels cause 🧠 damage.

bit.ly/36K5F65
3/ It’s odd to me that people don’t see severe COVID as a form of VIRAL SEPSIS. Sepsis is when infection of any kind causes your organs to begin to fail – lungs, brain, heart, kidneys.  It’s EXACTLY what we see day-in day-out in the COVID ICU.
 
bit.ly/3eM8pUx
Read 6 tweets
25 Dec 21
1/🧵 Christmas Reflection on Gratitude

My patient today - IN THE ICU on Christmas - said:

“I’m sorry for complaining, Doctor. I realize that if I have time to complain, I have time to say ‘thank you’ too.”

WHOA!
 
I will be w my patients today & throughout the Holidays…
2/ …many of these people are suffering #COVID lung failure that might end their lives. For them & for me, it brings into perspective what matters.

In the picture above (1st tweet), we are with a recovering pt, letting her see the 🌞.

It’s for #Hope & a vision of her future
3/🎥 “It’s a Wonderful Life”

We watched this classic last night and it helped me think of how we all must be in community to lift one another up during these hard times…see ending clip here ☺️

…this message never gets old!
Read 7 tweets
23 Dec 21
1/🧵 Molnupiravir & Paxlovid are BOTH approved for EAU (emergency use) as pills for #Covid to reduce hospitalization and/or death if taken EARLY (w/in 5 days).

This ⬆️ our need for Rapid Tests!

Primary prevention is #Vaxx. 🤛

A few thoughts…

FDA - bit.ly/3ElTef1 Image
2/ Which drug? When? Why?

Both drugs reduce likelihood of you being hospitalized if you take them early. The actual scientific publication of Pfizer’s #Paxlovid is not out yet, so I’m waiting to read peer-review data before firm stance.

But...

bit.ly/3Jc0Nsp
3/ Molnupiravir - 👇 @NEJM paper & conclusion.

You might think the story is clear. But it’s not.

1st half of study period yielded strong results but 2nd half did not…see 1 & 2.

Only 3% difference, so 1 improvement for every 33 pts treated.

bit.ly/3FEJ377 Image
Read 9 tweets
23 Nov 21
1/🧵🎥 COVID & Thanksgiving Safety: 🍁

Use of Rapid Antigen Testing❓

I’m getting lots of QUESTIONS about eating Tgiving turkey w people who are not #Vaxxed. A very safe thing to do is have people cleared by a rapid Ag test.

Watch 2 min👇: @michaelmina_lab & I’ll unpack…
2/ It’s NOT a brain biopsy like PCR. More like picking your nose. 😂

Legit Rapid Ag tests you get commercially at a drugstore or online will tell you: AM I INFECTIOUS?

Am I shedding COVID virions in a quantity that places others at risk.

I’m NOT endorsing any one test here. Image
3/ PCR is the most sensitive way to detect COVID globally. @US_FDA & @CDCgov say so and that’s technically accurate. But (1) PCR takes too long & is not practical for YOUR purposes (outdated by the time you’re w mom). (2) PCR will stay positive way longer than you are infectious!
Read 8 tweets

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