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Arghavan Salles, MD, PhD Profile picture
Arghavan Salles, MD, PhD
@arghavan_salles
media contributor | DEI researcher/consultant | speaker | surgeon | feminist | yogini | words at places | views mine | she/her
4 subscribers
Sep 26 • 13 tweets • 3 min read
I’m seeing a lot of med student match posts, so I might as well share what I wish I’d considered when I was a student.

1. One of things I loved about general surgery was that we were the ones people called when they didn’t know what else to do. This felt very badass. What + …I didn’t consider was that being needed means being available. When you do a month or two of general surgery call as a medical student, it’s impossible to extrapolate how that will feel month after month, year after year. It is exhausting and can be demoralizing +
May 28 • 18 tweets • 4 min read
I signed up for the "n0n-w0ke" impl!cit b!as training. Follow along if interested!

It looks like Part 1 is about 42 mins or so and starts with an overview. Notice there are no references for the bold assertions on the right. Screenshot of a slide that says "Key points: Part 1 -Requirements for Michigan implicit bias training -"Implicit bias" defined -The Implicit Association Test 9IAT): what does the evidence say? -"Health equity" and "equitable access to care" -How Critical Race Theory (CRT) relates to implicit bias in healthcare a box on the right says, "Did you know? Politicized healthcare means more discrimination, less personalized care, and less innovation that saves lives." Lol off to a great start as they say "Do No Harm" was established to "restore merit to healthcare," a phrase that is problematic for many reasons, including the implication that healthcare was ever meritocratic (it was not).
Apr 9 • 4 tweets • 2 min read
The problem isn’t false accusations. It’s that men refuse to acknowledge rape. “They [rapists] had absolutely no sense of themselves as rapists and were only too happy to talk about their sexual behaviors.”

Based on a study of rapists, as described in Missoula by Jon Krakauer.🧵 The participants in the study had no qualms about being research subjects, Lisak told me, "because they share this common idea that a rapist is a guy in a ski mask, wielding a knife, who drags women into the bushes. But these undetected rapists don't wear masks or wield knives or drag women into the bushes. So they had absolutely no sense of themselves as rapists and were only too happy to talk about their sexual behaviors." Most of the student rapists interviewed by Lisak were regarded by their peers as nice guys who would never rape anyone, and regarded themselves the same way. They are too entitled and self-centered to see the harm they cause. The serial rapist hidden in plain sight among us, isak explained, "harbor all the usual myths and misconceptions about rape. Adi. tionally, we now have data showing they are more narcissistic than average. So they are caught up in their own worldview. They lack the ability to see what they do from the perspective of their vic-tims. It's not like they've spent any time thinking about what it would be like to be passed out and wake up to someone raping you. It's not like they've ever asked themselves, 'How would I feel if I fell asleep, someone climbed on top of me, and penetrated me wit...
Dec 16, 2023 • 5 tweets • 2 min read
The pandemic has been so badly bungled that people don’t know if they have Covid, don’t care if they have Covid, don’t know when to test for Covid…what are we doing here??

My mom just tested positive for Covid and wouldn’t have known if I hadn’t told her to test again… Photo of a positive Covid test and a text message that says “positive” …She had tested the first day of symptoms and was negative. I told her to test again, and bam, positive.

A family friend got Covid around Thanksgiving. I told her she should keep testing even after she feels better bc of rebound and how long some people stay positive…
Aug 25, 2023 • 11 tweets • 3 min read
We don’t talk enough about coercion in healthcare. I just had a procedure I did not want to have because I was forced to do so in order to move forward with IVF. I stated multiple times I would accept the risk of foregoing the procedure. (The risk, as far as I can tell, is… …perhaps slightly lower success rate for implantation.) I invoked shared-decision making and bodily autonomy to no avail. I was reassured, in the classic paternalistic medicine way, that this was in my best interests.

I am a 43-year-old physician. If my doctor doesn’t think…
Jul 19, 2023 • 10 tweets • 2 min read
Did you know up to 200 women at Yale’s fertility center were forced to undergo egg retrievals without narcotics? These procedures are typically done under heavy sedation, but these women were awake enough to talk; one even told them she was alert enough to drive. These women… …were in pain, and they were brushed off. A nurse in the clinic had swapped out fentanyl for saline in hundreds of syringes. So for FIVE MONTHS women had these horrific experiences. They told their doctors, but nothing was done. One of the women recalls her doctor saying…
Jul 18, 2023 • 7 tweets • 2 min read
We all know women make less money than men. Did you know people are compensated less for performing procedures on female patients than if performing similar procedures on male pts? We’ve know this in the US, where compensation is based on RVUs which are determined by a group of… …almost exclusively men.

A recent study found the same thing in Canada, where compensation is totally different!

Urologists and ob/gyn surgeons created a list of procedures performed for female patients and identified analogous procedures performed on male patients…
Jul 12, 2023 • 11 tweets • 3 min read
Seemingly “natural” homogeneous gatherings like this are a result of the systematic exclusion of marginalized people and further perpetuate the marginalization.

Here are my favorite tweets pointing out this absurdity.
Jul 9, 2023 • 6 tweets • 2 min read
I don’t know if y’all have been following what’s been going on with the men this week, but here are some tips:

1. Whether you’re a famous celebrity or an unknown baby daddy, you have no right to tell a woman what to wear. She is not your property. Your discomfort… …is your problem, not hers.

2. If you are pretending to be a women’s advocate, don’t talk down to women and blame them for making the best of bad situations. And if you do do that, don’t come out with two fauxpologies. Either be truly sorry, or consider the jig may be up.

3…
Jun 28, 2023 • 13 tweets • 3 min read
Since AirBnB is trending, here’s my story from a recent stay in Milan. When I checked in, the host left me standing on the street with my bags for about 20 mins. Not ideal, but what happened next is the real issue. When he showed up, he did not apologize for keeping me… …waiting. I tried to explain that there was an opportunity for better communication to avoid this situation. That made him really angry. So the entire time he showed me around, he alternated berating me/defending his position with banal…
Nov 18, 2022 • 4 tweets • 1 min read
How much do y’all think this costs? At a normal grocery store (Safeway). Photo of groceries on a conveyer belt, including pasta, two Most of these guesses are wildly off, sadly. Inflation 😥
Nov 12, 2022 • 6 tweets • 2 min read
As the walls of Twitter come crumbling down around us, I need you all to know that this community has really saved me. You have been through all the ups and downs with me, and I literally would not be where I am without you. Some ways twitter has been instrumental for me: 🧵 1. All the research I’m doing on fertility/family planning/abortion was made possible by collaborations born on twitter. After I wrote the piece in my pinned tweet, I connected with so many others who had similar experiences. Ultimately @AMWADoctors took up the cause, and…
Sep 3, 2022 • 4 tweets • 2 min read
This is why we should have been investing in ventilation two years ago. After 2.5 hours in a theater, the CO2 level is super high (3355).

I wore an N95, as I always do indoors. But many in the audience were not wearing any masks 😟 Image Btw this image shows one way to interpret these data (via @ModelAyshaMirza)

And here’s one explainer from the Imperial College in London (related to classrooms): imperial.ac.uk/news/233154/cu… Graphic showing risk of Cov...
Jan 22, 2022 • 18 tweets • 15 min read
MY FIRST BYLINE IN THE WASHINGTON POST, Y'ALL!!!!!!

A thread

Many of you have seen the study by @WallisCJD and @propelresearch et al which found female patients were 32% more likely to die if cared for by male, rather than female, surgeons.

washingtonpost.com/outlook/2022/0… It's fascinating to me that in all the media coverage of this excellent research, few picked up on another key finding: male patients were also more likely to die if cared for by male, rather than female, surgeons. So, really, all patients did better with female surgeons.

2/
Jan 21, 2022 • 8 tweets • 3 min read
It's easy to forget how little we knew back in April 2020.

We didn't know how the virus spread (on surfaces? in droplets? as an aerosol?) or how to treat it, and we definitely didn't have vaccines.

There was confusion about masks. Should we wear them in public? 🧵 Selfie wearing scrubs, N95, faceshield, scrub cap If so, what kind? What we knew for sure was that people were dying in numbers we had not seen before in our lifetimes. I flew to New York City on a near-empty flight, upgraded to first class because I was going to volunteer my time as a physician. People valued doctors then.

2 Photo from inside empty plane
Dec 9, 2021 • 19 tweets • 9 min read
This manuscript was a heavy lift from inception (trying to understand the negative experiences of women surgeons) to the conduct of the study and then analyzing transcripts and writing the manuscript. There's a lot to unpack. Ready? Here we go! 🧵

journals.sagepub.com/doi/abs/10.117… Screengrab of title and authors: "Unpacking the status First, what'd we do? We interviewed 45 surgeons (16 men) about their working relationships with nurses. What we found was significant evidence of the ways women surgeons regulate themselves AND the way they work to satisfy what they perceive to be nurses' expectations.

2/ We interviewed 45 surgeons (29 women; 16 men) about their ex
Nov 9, 2021 • 7 tweets • 2 min read
It wasn't until my fourth year of residency that I scrubbed with another Persian surgeon. As we bantered in Farsi, I was surprised at my own glee, at the way this simple thing, speaking in our native language, made me feel more at home.

That feeling didn't last long. 🧵

1/ We were shut down, told we were being disrespectful and that it was inappropriate to speak in another language. From a patient safety lens, mind you, there was nothing urgent happening in the operation. No one was missing out on "critical" information by not...

2/
Sep 7, 2021 • 17 tweets • 8 min read
My point-by-point response to Dr. Klotz, who did us all a favor by putting his biased thinking out in the open.

Dear Dr. Klotz,

Thank you for demonstrating the challenging attitudes faced by women in medicine. Here are the flaws I see in your arguments.

1/ A letter to the editor by Dr. Klotz in reply to an article t #1. Perhaps instead of “ideological” lens you mean the authors have some kind of agenda? That agenda seems to be helping women have the same access to opportunities as do men.

2/ A letter to the editor by Dr. Klotz in reply to an article t
Aug 26, 2021 • 7 tweets • 4 min read
It's not every day your piece is front and center on the @TheLancet homepage!!

I was delighted to work with @reshmajagsi on this commentary covering what institutions should do to reverse the damage the pandemic has done to women's careers. 🧵

thelancet.com/action/showPdf…

1/ Screenshot of The Lancet ho... We have four major recommendations. "First, institutions must intentionally implement best practices to recruit, select, retain, and promote women..."

This would include criterion-based evaluations and transparency regarding roles and compensation.

2/ Screenshot of first page of...Screenshot of second page o...
Aug 21, 2021 • 24 tweets • 13 min read
“We care more about the crazy, insane members of Times Up Healthcare???”

This is what Roberta Kaplan apparently thought of us a few months ago when we stood up for survivors and ultimately resigned. A long 🧵explaining the news..

1/ Many of us resigned bc the organization clearly did not, despite its purported mission, prioritize survivors.

This piece, by @jodikantor, @arya_sundaram, @melenar, & @caranyt, is the latest in a series of articles about TU after the Cuomo debacle.


2/
Aug 2, 2021 • 12 tweets • 4 min read
Lately I've kept quiet on here about covid. There are amazing doctors and scientists tirelessly sharing the latest studies and policies, and my daily work is related more to bias and harassment than it is patient care. So I have been leaving that work to others.

1/ But I have been spending time with some amazing colleagues who are trying to educate the public over on Clubhouse. What I've seen in the last six months there has me concerned.

I'm not trying to be alarmist, but with infections rising across the country, I'm a bit down.

2/