When I took on leadership of the #CHIP clinic @DanaFarber @DanaFarberNews, I was #bookedandbusy lots of #CHIP & #CCUS had been diagnosed since we rolled out our clinical NGS panel in 2014/15. But the uncertainty (the “indeterminate potential”) was disquieting. Imagine someone hands you a grenade & says: don’t worry most don't explode. But some do. But most explosions don't kill you. But some do. We don’t know which grenade you have. Oh, and you must hold it forever

That's a hematologists diagnosing CHIP/CCUS, precursors to #MDS & #AML

Happy about the AMA choosing to no longer lump Middle Eastern people in as white.

Understand calls for similar from the US census.

Wonder if people understand the function of category “white” in the US has been to define “non-Black”

It’s why “white” is such a mishmash. First principle for maintenance of economic & political order and thus preservation of power is anti-Blackness. Looking for the root of cultural oppression and erasure? There it is.

If the Senate votes to convict I’ll be surprised as hell.

You want to know what you have to do to dismantle white supremacy? You have to denounce and condemn it. You have to punish people for the violence done in its name. A white president summoned a mob of mostly white people with flags bearing his name to violently siege the central symbol of our democracy. They were permitted to erect a gallows in plain sight. They were permitted to go home & they are mostly charged with misdeameanors

Think about the Black women you know that are killing it in academia - prolific writers, orators, researchers, excellent educators, commanding administrators.

Know they are often creating this beauty from the ashes & scraps they were given...all while watching their backs. Know that every single day a colleague, fellow admin or even a student undercuts, undermines or sabotages their work & their voice. Know that they deal with this on top of micro-aggressions & gaslighting

One of the most common Oncology e-consults I get is a post-menopausal woman with sweats, no lymphadenopathy, a completely normal CBC, RBC indices, & diff where the concerned primary is asking about the utility of a bone marrow biopsy to evaluate for an occult heme malignancy. In first year of fellowship, one time on Heme consults, on my weekend off, the team gave ATRA & did a marrow on a patient with nary a circulating blast or promyelocyte (but gorgeous babesia rings) on the peripheral smear.

He did not in fact have occult APML, just Babesiosis.

Saw this paper on floating on the TL and decided to take a break from death by R™️

A lot to unpack...but we’re in the middle of a pancetta so I’m gonna leave most of it in the bag 🧵

nejm.org/doi/metrics/10… I almost quit after the section on “Racial Categorizations in the United States” b/c it oversimplifies & inaccurately recounts the history of census racial designations.

(No “Black” or “Native” in the 8/2/1790 census, btw. Indigenous ppl were first counted in the 1860 census)

https://twitter.com/lachelle_dawn/status/1268287563086925825

Can’t get over Dr. Susan Moore’s death.

It’s on my mind heavy. Being sick is bad enough - fatigue, pain, shortness of breath. I imagine that to be a member of the majority caste in this country is to be able to just be sick. To be able to focus energy on getting well and maybe (because medical capitalism) how to pay.

Morning geriatrics/gerontology thoughts

On #failuretothrive

Last night while researching frailty scores, I vividly remembered being paged at 2am by the paging operator to call a patients family member while I was working in the ICU (back in the day when I did such things 😅) Things were calm - and I figured a patient family member paging in the middle of the night was probably important - so I called:

“Is this Dr. Weeks?”

“Yes”

“you may not remember me, but I’m ___ you took care of my dad a few months ago and I wanted to talk about his paperwork.”

If you need grounding this AM - here’s Ancestor Toni Morrison’s lecture from Portland State, Black Studies Center, May 1975

It’s a classic I revisit often.

Incidentally, her voice is one of the calming voice I’ve ever heard speaking truth to power.

m.soundcloud.com/portland-state… The whole thing is brilliant but these are a few most brilliant excerpts:

“Who are these people who know our sperm count and but they don’t know our names?”

Looking at researchers who study racial health inequities but don’t know anything about actual communities you study 👀

I try to be thoughtful about what I write/say because words matter. I don’t always get it right, but this is a hill I am willing to die on.

*clears throat*

🗣 We don’t need to fix Black people’s mistrust. We need to fix medicine’s lack of trustworthiness.
#COVID19 #CovidVaccine It isn’t enough to “remember Tuskegee.” The Tuskegee Syphilis Study ran from 1932- 1972. There’s segregation and disregard for humanity happening in the here and now.

Up thinking about this because I had a similar conversation with my mom re: “Black folks aren’t prioritized for anything beneficial any other time”

Where I land is here - I hold no false belief that American Medicine all of a sudden is absolved of a racist past (or present).

https://twitter.com/ActsofFaithblog/status/1334004483668504576

Transparency involves being honest abt who/what you are.

So it’s probably less benevolence driving the consideration to prioritize minorities & more interest convergence. Minorities r disproportionately impacted by the virus & are a large portion of essential low wage workforce

An observation re: language, media information distribution & #COVIDー19 vaccinations.

I took a Lyft to work this morning because I was running late.

My Lyft driver was an older Black man who after asking if I was a doctor he asked me about the #COVIDー19 vaccine: “I heard on the news that they *targeting* Black people to get the vaccine first. Why *target* us?”

He emphasized targeting/target.

Dear America (the non-racist half):
As a trauma survivor I wanted to remind us that we don’t owe kindness, grace, conversation, understanding or respect to abusers. It is not our job to rebuild bridges others burnt.

Saving the souls of abusers is not the victim’s responsibility It is not to us to placate the half of the country that hates all that isn’t white, cis, male, hetero, protestant, English speaking and able-bodied.

Our primary responsibility is to ourselves - securing our health, safety & freedom.

Random reflections from this week. Brain dump 🧵

#electionday was a clinic day. I don’t typically discuss politics w/ patients. But on Tuesday, everyone wanted to discuss the election. Palpable anxiety. Leukemia patients should not also be burdened by the threat of fascism. 1/n I had 6 unread text messages by 7:30am Tuesday morning. One was from a friend in Benin who said (loosely translated) “I hope your election goes well for the world.”

Fanning the flames of racism and legitimizing white supremacy has been bad for the world. 2/n