Esther Choo, MD MPH Profile picture
account represents my views only, not those of any org | she/her/hers | #DoctorsLog | #BWMtakeover
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7 Jul 20
Dear Women on Twitter:

Please check your Lists.

A Thread
Lists are a way for bad players to do efficient, coordinated harassment. Particularly if you notice an uptick in the volume of trolling, check your lists as one way of interrupting the process.
1. Go to your own home page. See that option below “Profile”? Click on that.
Read 9 tweets
19 Jun 20
Every guided run I complete starts with a reminder to slow down. The start of your run should be your slowest. As you go further into your run, your pace will naturally start to pick up.

This is about running. And this is not about running. - CN
In an effort to put out statements on #BLM and anti racism, #MedEd has sped ALL the way up and I am asking everyone to slow down.

Notice how I didn’t say stop.

I said slow down.
Black people have been doing this work for a while. It requires care and due diligence. Don’t just throw a program together and not think critically. That’s how you end up with cultural competency training that tells you a filter that lets you smile to break chains is ok 🥴
Read 7 tweets
19 Jun 20
How did one of the most monumental moments in #MedEd history drastically decrease the number of Black doctors? Let’s look at the impact of the Flexner report and medical school demographics. #BWMTakeover - CN
Before 1865, many Black doctors received their medical education abroad while a few Black students were admitted to schools in the East (like Harvard, Yale and Penn).

Dr. David J Peck was the first Black student to graduate from a school up north (Rush Med School).
Of note, there were about 54,000 doctors in the country in the late 1860s. Only 300 of them are women, and only one of those women is Black - Dr. Rebecca Lee Crumpler #BWMTakeover Image
Read 15 tweets
19 Jun 20
Medicine continually fails to account for the historical racism and gender-based violence Black women have experienced.

A THREAD.
The Mothers of American Gynecology are known as Anarcha, Lucy, and Betsey + the 11 other unnamed enslaved Black women who suffered at the hands of Dr. J Marion Sims.
White supremacy is Dr. J Marion Sims, the father of modern gynecology, being framed as a hero in the media, despite his history of performing experimental surgeries on enslaved Black women. #SayHerName
Read 18 tweets
18 Jun 20
Recently, @NNkinsi + other phenomenal @UWMedicine students, staff, and faculty fought for the removal of race when calculating the estimated glomerular filtration rate. 🧵
Yesterday, @NEJM published a piece on “Use of Race Correction in Clinical Algorithms” that featured no Black authors.
nejm.org/doi/full/10.10…
@NNkinsi states:
I think the frustration about the NEJM piece was simply because none of these ideas or complaints are new. Black scholars, students, doctors have noted them for some time now before it was politically safe to do so and were villified for it. It's frustrating...
Read 10 tweets
15 Jun 20
Good morning! This week this Twitter account will be run by four Black women in medicine I hugely admire #BWMTakeover They are...
Dr. Christle Nwora (@ChristleNwora), who is starting her med-peds residency at @JohnsHopkins

Dr. Monique Hedmann (@Dr_Mo_1111), who is about to start her family medicine residency at @HarborUCLA
Lash Nolen (@LashNolen), @harvardmed ('23) Class President

Alexis Umoye (@UmoyeAlexis), who is starting medical school at @UCDavisMed in the Academic Research Careers for Medical Doctors program
Read 4 tweets
11 Jun 20
Robin D'Angelo: "I'm confident to say the following: if you are white, and you have not devoted years of sustained study, struggle, and focus on this topic, your opinions are necessarily limited, superficial and uninformed."
"Wow, how can I say that?... Maybe you've been to Costa Rica." {laughter} "I can say it because nothing in dominant culture gives us the information we would need to have an informed opinion on arguably the most complex, nuanced social dilemma for the last several hundred years."
Please watch the whole thing (intro is very interesting, but Dr. D'Angelo starts at 7:05, and the sound gets fixed pretty quickly):
Read 6 tweets
10 Jun 20
IMPORTANT COMMENTARY ALERT: "Stolen Breaths" in @nejm, by @RRHDr, @RheaBoydMD, and Eduardo Medina is both powerful commentary and practical advice, nejm.org/doi/full/10.10… #BlackLivesMatter
Their 5 practices for health systems to dismantle structural racism:

1. Divest from racial health inequities: "Racial health inequities are not signs of a system malfunction: they are the by-product of health care systems functioning as intended."
2. Desegregate the healthcare workforce: "The health care workforce is predominantly white at essentially every level... This lack of diversity must be understood as a form of racial exclusion4 that affects the economic mobility and thus the health of nonwhite groups"
Read 7 tweets
8 Jun 20
To academic institutions about to launch new initiatives around racial equity, please do not expect the work to happen via (even more) free labor from Black faculty.

If this is really first priority work, support it. Pay for their time, provide admin support, give it a title.
I am CRINGING at the outcry for new task forces, committees, panels, listening sessions, reading lists that stop short of specifying resources to be dedicated to this work. We all have a need for major, sustained work - I do appreciate the places that acknowledge this ...
... but it will be terrible if the endpoint is that inequities are exacerbated because our Black colleagues get mired in that work and derailed from their own personal professional goals. You can see that it would be extremely messed up.
Read 6 tweets
2 Jun 20
I am a Christian. This person does not represent Christ. There is not a shred of evidence of prayerful word or deed, nor that he has a clue what is in the book he waves around for drama. Note the words of Rev. Mariann Budde, Bishop of the Episcopal Diocese of Washington, DC:
“Let me be clear. The president just used a Bible, the most sacred text of the Judeo-Christian tradition, and one of the churches of my diocese without permission as a backdrop for a message antithetical to the teachings of Jesus and everything that our churches stand for.
"I am outraged. The president did not pray when he came to St. John’s, nor … did he acknowledge the agony of our country right now, and, in particular, that of the people of color in our nation...
Read 5 tweets
28 May 20
"In unjust times, it's essential to double down on what matters: our institutions, our relationships, facts, and evidence" - @mclemoremr giving me chills with her speech to 2020 grads: #HealthSTEMencement
Now @PublicHealth President Lisa Carlson:
1. Build your community
2. Pause when needed
3. There's no blueprint for the future; embrace tenets of public health, honor your values, the path will emerge
4. It's not all about work
5. Know why you go to work in the morning
6. Be kind
From @mindofandre:
1. Invest in yourselves - be in it for the long haul
2. People matter - cultivate relationships
3. Your voice matters
Read 8 tweets
26 May 20
I keep thinking how in the ER when someone rolls in gasping "I can't breathe, I can't breathe" we all jump to our feet and run to assess and help them. It's #1 and 2 of our "ABC's" - Airway, Breathing, Circulation - that comes before any other concern.
"I can't breathe" is the last thing people push out before they are too breathless to say a single word. It's said with a gasp. It has a certain cadence and intonation. "I can't breathe" sets my heart racing like almost no other patient utterance, because I've seen what follows.
"I can't breathe" from a person in distress makes us reach for the oxygen, the non-rebreather, the oral airway, the bag valve mask. Eyeball the crash cart, the boogie. Be ready to needle, to crich. Page X-ray, page RT. Every fiber of your being is focused on securing that airway.
Read 6 tweets
26 May 20
I’m so in love with @sarahcpr’s Trump presser re-enactments, I treated myself to her book. I’d been familiar with individual panels from it, but the whole thing is a treat (excerpts follow)
“How to Talk Like a Man But Still Be Seen as a Woman” hits so close to home I’m laughing a very grim laughter
I mean...
Read 11 tweets
24 May 20
The number one question asked these days is, "What's going to happen now that cities / states are reopening?" The tough thing is that "re-opening" means so many things. A few thoughts.
Reopening is heterogeneous, as are new case rates in the states: nytimes.com/interactive/20… There will be a complex interaction between reopening and case rate in determining what happens next.
What states declare and what actually happens is complicated. Even in states where officials have "opened," individuals and communities may or may not engage, depending on many factors, including what they see as responsible safety measures by businesses allowed to open.
Read 8 tweets
21 May 20
Well THIS is interesting. The University of South Carolina is asking its medical students to formally waive liability for exposure to COVID-19. The other option is to opt out & do non-clinical rotations... but they risk not graduating in time.
"We are definitely not requiring you to do these clinical rotations. Unless you want to graduate and start paying off your loans or something. In that case, you are required to do them."
Who has the luxury of extending their education indefinitely? Who will have to suck it up and sign to make sure they can enter the workforce ASAP?

Also, how many students have the agency to report a site for not allowing them adequate PPE? You want a good grade, right?
Read 4 tweets
9 May 20
I may not have known Alison Roman from a hole in the wall but if you told me that there is a white woman viciously tearing down a non-white woman for being successful - in particular, financially successful - yes, I know that woman.
For Asian women (since that was her target), there is this overtone that they should be subservient and in a supporting role. Did they not get the societal message (hello Hollywood, thanks for reinforcing) that they are meant to be a side character only?
That’s why it makes *perfect* sense for her to go after @chrissyteigen. People are like “why would you bite the hand that feeds you?” - because it RANKLES for some that an Asian woman would be in the role of sponsor.
Read 5 tweets
7 May 20
We don’t have enough tests to guide decision making. We probably won’t get there.

We don’t have enough PPE to adhere to best infection control practices enough to make all workers feel safe. We probably won’t get there

Medications will have modest effect and disappoint you.
Vaccines will come but not as fast as we’d like them to. Distribution will be puzzling and inequitable.

Social reopening will be unsatisfying because it will be gradual with lots of pull backs and will have fewer hugs than we need.
We are not anywhere sufficiently ready to feed and house people in the coming months.

Health and economic inequities of all kinds are deepening and will continue to do so for years, unless we all work very hard to ensure they don’t. (For the most part, we won’t.)
Read 4 tweets
7 May 20
Picking up the convo with some additional questions #academics #promotion
You should absolutely document canceled abstracts and invited talks and mark "canceled due to COVID." These are signals of your hard work, accomplishments, and recognition
Here's an example from my CV - I may not be able to go and actually present, but it was a meaningful acceptance for me & my team and I thought merited some "credit."
Read 5 tweets
6 May 20
Tomorrow I’ll finish Year 2 on my medical school’s promotion & tenure committee. With the caveat that it’s a little different at each place, I’m happy to take questions about the process for the next 30 minutes or so.
So many people fear that if their first job isn’t academic, they’ll be shut out. If you can’t get the academic job, take what you can but keep developing your interest areas - that can feed into future academic work
We review people’s accomplishments and make the decision to promote people to the next academic tank or not
Read 15 tweets
4 May 20
Imagine the impact on the economy a competent, anticipatory, and science-based approach to the pandemic would’ve had.
Pissed at extended stay-at-home? It’s the back up coping strategy for the lack of testing, tracing, isolation, and PPE. Be angry at the root cause.
We (health care professionals, epidemiologists, virologists, public health experts etc) are angry too, you know, at these measures that we’ve had to resort to. It’s beyond infuriating to watch preventable disease and death, and to have to go to plan B and C to staunch it all.
Read 3 tweets