WesElyMD Profile picture
Oct 24 16 tweets 6 min read
1/🧵 Should Doctors be involved in Lethal Injection?

📍We take an oath to heal
📍Yet Prisons hire Docs to end life
📍I wrote this Op-Ed to challenge the system
📍I’d love your thoughts

(next tweet has a screenshot to bypass paywall)

@GovBillLee

bit.ly/3eZdX1Q
2/ There is a pervasive myth that #lethalinjection is a medical procedure, but this couldn’t be more wrong.

This was a falsehood created by someone with no scientific training.

Suffocation…imagine you’re suffocating…feeling like you’re being buried alive…

@SteveCooperEsq
3/ The force you’d exert to breathe would suck water into air sacks of your lungs.

This is what’s seen at autopsy in the lungs of 77% of prisoners after execution by lethal injection.

Pulmonary Edema. Drowning in water.

bit.ly/3SA2BPj
4/ Lethal injection was touted in 1977 as involving “no pain, no spasms, no smells or sound – just sleep then death”.

This was a falsehood created by someone with no scientific training.

The state of Tennessee halted executions this year to investigate.

bit.ly/3TLsixy
5/ Impersonation

Regardless of what any of us feel about the death penalty, we should all oppose use of medicines in executions—a practice that impersonates a complicated medical procedure in a poorly monitored setting.
6/ This too often results in botched executions (~8%) and simultaneously imposes psychological harm for the healthcare professionals and others involved.

bit.ly/3TyKKK4
7/ The drugs listed in different state’s lethal injection protocols, and the quantities used in an execution, are based upon experimentation and speculation—not the art and practice of medicine.

bit.ly/3FdWZY6
8/ A string of horrific scenes in execution chambers, in Tennessee, Alabama, and other states, have made clear that condemned prisoners often experience agonizing deaths.

bit.ly/3StA6Dc
9/ Medical communities and pharmaceutical companies have never wanted a role in lethal injection.

Over 30 healthcare associations including the AMA have uniformly stated that it fundamentally violates our core commitment to preserve life.

bit.ly/3FaezMM
10/ The burden placed on those involved in performing executions is immense.

Correctional staff are charged with carrying out an execution by lethal injection for which they are medically ill-equipped.
11/ Just last month, Joe James Jr was repeatedly cut with a scalpel as Alabama Department of Corrections staff tried to establish an IV line for three hours—the longest lethal injection execution in American history.

bit.ly/3MXocQJ
12/ In Arizona and in Oklahoma, struggling staff when things went awry froze, uncertain whether to resuscitate him or find some other way to kill him.

bit.ly/3sqxQSC
13/ When I graduated from medical school, I took an oath of primum non nocere (first, do no harm), and I would be breaking my oath to you or anyone else if I ever intentionally used medications to harm someone.

bit.ly/3TteW9m
14/ Poll - Medical personnel in this role…
 
🔸Do you think your doctor should be involved in the act of lethal injection?
15/fin
My Thoughts:
📌 Regardless of one’s opinion about capital punishment, lethal injection is a flawed construct
📌 More tinkering will not fix it
📌 It is wrong for those in the medical profession to be involved
📌 It’s forced impersonation
📌 We must be left out of it
It’s about intent. Intent to heal vs intent to harm. @eji_org see thread and thanks for your advocacy

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More from @WesElyMD

Oct 20
1/🧵What do ICU survivors tell me about PICS…(post intensive care syndrome)⁉️

Former ICU patient: “I’m angry. I’m furious because the doctors who injured me aren’t willing to help me recover.”

Is this fair?

I think so.

Why?

Read on…(perm to share)
2/ I just got off the phone w a patient who has had PICS for 12 years since nearly dying in the ICU. His story is included in #EDDB…he granted permission to share some thoughts today that I think are eye opening…in terms of how poorly we’re doing w Chronic Disease management
3/ people who never had PTSD before critical illness, leave with inexplicable experiences of road rage, rejecting their spouse, acting in ways that are so foreign to them that they don’t recognize themselves.

They also have tremendous problems with lack of self worth because…
Read 7 tweets
Sep 13
1/🧵 Land Mines in Long COVID - @BostonGlobe

Alex was training for 2024 Olympic Trials 🥇

That dream exploded 💣
 
New #LongCOVID science
📌Viral reservoirs at 1 year
📌Cardiac edema at 1 year
📌Dementia at 2 years
📌Hijacked mitochondria

ScreenShot👇
bit.ly/3U77u4r
2/ It’s one thing to concede that Long COVID exists as a societal problem for those w vulnerabilities like advanced age, pre-existing health conditions, or nearly dying in ICU.

What about nationally ranked D-1 long-distance runners⁉️

Paywall so read 🧵
bit.ly/3U77u4r
3/ Alex Schell is 21 & based his life decisions on making the 2024 Olympic trials.
 
“Not only can I not run due to #LongCOVID, I’ve also lost everything I hoped for. Who I envisioned myself to be is a past idea. It’s a monumental loss.” (story w perm)
 
What causes LongCOVID?
Read 22 tweets
Sep 12
1/🧵🎥 How do “Dominoes of life” fall in critical illness⁉️

A pt arrives awake & talking but vomiting. In just 8 hrs he nearly dies of sepsis 🤯

Lung & kidney failure, heart attack, coma.

How can this happen & can we save him?

This🧵can help us understand the “arc of illness”
2/ His disease is Ascending Cholangitis

A gall stone lands in his common bile duct

📍Pain & vomiting
📍He’s admitted to the ICU
📍GI performs an ERCP to place a stent, bypass the stone, drain pus & control the source of sepsis
📍Add fluids & antibiotics
📍But he gets worse
Why?
3/ We bypassed the septic source (stone) & drain the pus, but dominoes were already falling.

Bacteria had gotten into his blood.

Too much inflammation & capillary blood clotting occurred, just like in COVID.

What happens when “cellular” dominoes start to fall uncontrollably?
Read 11 tweets
Sep 6
1/🧵 Beauty in the Now…

While normally Greg doesn’t #worry, in this case, he succumbed to fear of change.

He was screaming and Crying in Fear - see tweet below.

How did he get through it?
What did he teach me?

#NothingDownAboutIt #DownRightPerfect #UpSyndrome #Tribe321
2/ Greg held his head in his hands and trembled with worry.

We were disrupting his usual Saturday of watching “I Love Lucy.”

Think Rain Man type of dependence on routine &
that’s Greg.

So when Kim and I took him to the mountains, it totally messed him up.

What happened?

#T21
3/ At first Greg got angry with us for taking him on this trip.

I mean, REALLY angry.

And we know that #ANGER is just one letter away from #DANGER.

He was heading in a dangerous path of rejecting something that could be healing & good in his life.

#TheLuckyFew #FindYourTribe
Read 7 tweets
Aug 30
1/🧵 Paxlovid in Omicron⁉️
 
🔸Large study of 4k treated pts vs. 105k not on Pax
🔸Robust 80% ⬇️ in death prevention in elderly
🔸Hospitalization 70% lower if >65 y/o
🔸No help in young?

Why will I keep using in young & old patients?

Read next tweet…
 
bit.ly/3PRbbId
2/ This retrospective observational cohort in @NEJM only showed statistical benefit in patients 65 & older.

Does that mean Paxlovid does not work in the young during #omicron times?

I don’t think so.

Here are reasons why I will keep using the drug in young patients as well…
3/ Subgroup analysis of studies are mainly meant for hypothesis generation.

Usually in clinical trials there are not qualitative differences in how a medication works by age cut off.

There can be, but it’s unusual.

Original Paxlovid data showed efficacy across age.
Read 5 tweets
Aug 25
1/🧵 The Haunting Brain Science of Long COVID 🧠

@washingtonpost Aug 25

📍Brain shrinking
📍Corona ghosts
📍Autoimmunity
📍Clinical clusters

“The good news is that in some pts #LongCovid #BrainFog may not be permanent.”

Link👇 but paywall so see 🧵

wapo.st/3wvPBlF
2/ Mild Covid is biologically dangerous long after initial viral infection.

81 mild COVID pts:

Study revealed:
✔️Astrocytes (🧠 support cells for neurons) get infected
✔️Neurotransmitters are altered
✔️Neurons die indirectly
✔️Then we lose brain power

bit.ly/3pcqbFV
3/ Epidemiology💥

Long COVID is tightening its grip on society.
 
We’re still losing >600 people a day to death from COVID in US alone

Over 100,000 new infections per day (Johns Hopkins data).
 
This is an epic global 🌍#PublicHealth catastrophe.

wb.md/3SKjGrh
Read 28 tweets

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