Medlife Crisis (Rohin) Profile picture
Dr Rohin Francis. Cambridge-trained cardiologist working at the Essex CTC & doing a PhD @UCL I make scienceful YouTube videos & bad jokes Dad, doctor, dork
Rockyang MD Profile picture 1 added to My Authors
1 Jun
Next procedure cancelled so sitting in the staff room with 2 nurses watching day 6 of #BlackLivesMatter protests in the US. Yesterday a huge protest in London & many other cities. The nurses felt protestors shouldn't use violence & were wrong to go near the White House. I said >
"what other options do they have?" But as I said it, I knew how tone deaf it is for me to saying that as both of the nurses are black and I'm not. You've heard the difference about non-racism vs anti-racism, I've been thinking about it a lot recently.
Being able to talk to others honestly & hearing their views is important, otherwise it's easy to never change your mindset, safe in the knowledge you are a 'good guy'. You don't hate black people! You're not like these racists. But we all have things to learn.
Read 12 tweets
27 Mar
Important update from @ICNARC - analysis of the first 775 patients admitted to critical care in the UK with COVID-19

Average age only 60 (remember this will be skewed, but pretty similar to typical admission with non-COVID viral pneumonia - R column)…
Compared to typical viral pneumonia admissions to ICU, COVID patients:

Are in previously better shape (90% fully independent)
Have fewer pre-existing co-morbidities
Are *much* more likely to be mechanically ventilated
Mostly men (70%), broadly similar to typical viral pneumonia admissions (thin lines)
Read 7 tweets
5 Nov 19
A little tidbit for non-cardiologists who might not've heard of the Smoker's Paradox. WHY INCOMPLETE DATA CAN MISLEAD!

Yrs ago it was observed that although smokers had more heart attacks (MIs), they actually did *better* after having had one, compared to a non-smoker. wtf?
Can you think of any reason why this might be the case?
Forest plot showing adjusted odds ratio for death in smokers following MI. Towards the left & not crossing midline = favouring the Smoker's Paradox.
Read 9 tweets
27 Sep 19
I thought #BlackHistoryMonth (Europe) would be a great opportunity to make a video about 2 cardiac surgery stories that I love. Behind the blockbusting first Tetralogy operation & the first heart transplant were black men working in deeply racist times.
Followers/readers of @FredWuMD & @thomasngmorris will know these well. Hamilton Naki left school at 14 and worked as a gardener in Cape Town but ended up performing heart & liver transplants on dogs and is credited with devising the heterotopic heart transplant
Vivien Thomas saw the Great Depression dash his hopes of medical school so took a job as Alfred Blalock's lab assistant and proved himself a gifted and innovative surgeon, instrumental in achieving the first successful operation for 'Blue Baby Syndrome'
Read 5 tweets
25 May 19
You've probably seen this viral Hillary Step pic taken by ex Gurkha & SBS speed climber @nimsdai. 10 people have died this yr on Everest, 20 including other peaks.

Everyone you see is in the death zone >8000m. Every minute spent queueing brings death closer, waits up to 2 hrs.
For a recent influx of new followers (welcome!), I made a video about what makes the Sherpa such amazing climbers. They are superhuman. At the end I mention the conditions they face & how you can help
A great Twitter account to follow if you're interested
Read 10 tweets
13 Feb 19
Please remember to vote - it takes 20 seconds

I have never told anyone how to vote, it's your choice. Respectful difference in opinion is always healthy. So it's disappointing @OurDutyOfCare feels it has to resort to attempting to guilt people with inflammatory accusations.
The RCP is polling its members about their views on assisted dying. Instead of recognising this as a sensible approach, @OurDutyOfCare implies the @theRCN doesn't care if people take their lives, because their stance is neutral.
Every point here is wrong.

I am my brother's legal guardian. He has severe learning disabilities. No matter what happens I would never ever advocate assisted dying for someone like him. AD is and always will be for fully competent adults. This is pure scaremongering.
Read 5 tweets
5 Feb 19
I urge all RCP members to vote in this poll on assisted dying - only this way will the result be representative. Please read the text the RCP has published. I'm not going to tell anyone how to vote but want to highlight a few key points:
The main question concerns the RCP's stance, it is not a binary for or against; there is the option already taken by the @theRCN which is to be neutral on the topic. I believe this will allow sensible and honest debate.
This is not a poll about euthanasia. Assisted dying is for

1. Patients with less than 6 months' life expectancy due to terminal illness (ie not the disabled as is often scaremongered)
2. Who are assessed to have mental capacity (ie not those with psychiatric disease for example)
Read 5 tweets
31 Dec 18
What are the craziest medical signs?

My favourite has always been uraemic frost.
Oh just remembered one which is a finals favourite & figured only exists in books until I saw it in St George's ED yrs ago: Lipaemia Retinalis.

Hypertriglyceridaemia causes vessels to look whiteish on fundoscopy. Pt already known to have FH but never had fundoscopy - new finding
Read 2 tweets
7 Nov 18
Talking with @reepRN and @nsivcd about #Takotsubo cardiomyopathy made me go hunting for an old gif. Clearing out my hard drive so here is an old school gif firesale. Everything must go!
Read 6 tweets
6 Oct 18
Shall I eat these fancy hospital biscuits?

[science thread]
Important vote 🍪🍪🍪
The packet tells me that each biscuit has 300kJ = kilo joules
Or 72kcal = kilo calories, ie 72,000 calories

But the box says "72 calories per biscuit"

So what's that about?
Read 20 tweets
2 Jul 18
You've probably all seen this epic meme. It got me thinking - why *IS* the human body asymmetrical? Why do almost all of us adopt the same asymmetry? [SCIENCE THREAD!]
An object is chiral if it is distinct from its mirror image, derived from Greek for hand as they are the archetypal chiral objects (ie L is not the same as R) 👈🏽👉🏽

Humans are obviously chiral. Hearts left, livers right, colons clockwise etc. We're not absolutely sure why.
Strictly speaking we're not chiral in morphological classification terms - we're pseudobilateral. Snails are chiral - their shells turn in one direction.

Spherical - volvox
Radial - sea anemone
Chiral - snail
Bilateral - planaria
Pseudobilateral - most vertebrates
Read 18 tweets
29 Jun 18
The NHS was created 70 years ago. My aunt & uncle were born a few years later but like so many immigrants, dedicated their lives to the National Health Service. It is exactly 10 years since they died. This is a thread about immigrants and the NHS. Are they overloading it?
I did something very unusual recently - I enjoyed a copy of the Daily Mail. Well, 1 page entitled 'NHS heroes'. This is my uncle in 2000. Have you ever read a better description of how valued a traditional family doctor is?

He & his wife (my maternal aunt) were GPs from India.
Their story is not exceptional. They arrived in the 80s as junior doctors and worked in under-served & deprived areas. Thousands of doctors from India & Pakistan started arriving in the 60s, at the request of - surprisingly - Enoch Powell (then Health minister)
Read 24 tweets