Pulmonary and critical care medicine fellow, ethicist, math enthusiast via @MGHMedicine @PennMEHP @AmherstCollege Es könnte auch anders sein (Tweets my own)
Jun 25, 2022 • 18 tweets • 3 min read
Feeling very life-affirmed to get to spend my last twelve hours of residency on the rapid response team while eight new interns experience their first call night.
We'll see how affirmed I feel at 7 AM.
Jan 8, 2022 • 6 tweets • 1 min read
How is it that when an elderly patient has COVID and altered mental status the COVID is "incidental" but when an elderly patient has altered mental status and 10-20 WBC/hpf the diagnosis is UTI?
The diagnostic hubris will continue until morale improves, apparently.
Oct 26, 2021 • 11 tweets • 4 min read
The healthcare system in the US is in a slow motion death spiral. Healthcare workers are leaving because of the moral injury of providing substandard care, which is an inevitability in an overwhelmed system. 1/ npr.org/2021/10/26/104…
Everywhere you look there are think pieces unpacking the problem. A bottleneck at nursing schools that can't expand class sizes because of a shortage of instructors. Higher acuity patients presenting to the ED because of delayed preventive care during the pandemic. 2/
Sep 7, 2021 • 16 tweets • 6 min read
It verges on journalistic malpractice to not say what Idaho's actual crisis standards of care are, since I guarantee the cited examples were already happening. I have only several other important tasks to do today, so I'll read them now... washingtonpost.com/nation/2021/09…
Considerations, that's good
Apr 13, 2021 • 6 tweets • 3 min read
I always hesitate to amplify something I disagree with, but this flavor of messaging is extremely counterproductive. We're talking about cerebral venous sinus thrombosis specifically; claiming an apples-to-apples comparison to less serious VTE like DVT only erodes public trust.
Does the incidence of CSVT after J&J vaccine still seem much, much lower than the incidence of CSVT in women taking OCPs? Yes: 1 in 1,000,000 vs 1 in ~37,000. ncbi.nlm.nih.gov/pmc/articles/P…
Feb 11, 2021 • 5 tweets • 1 min read
A brief 🧵 about RECOVERY: In addition to lots of people on the internet, the authors themselves make this claim in the preprint... but it is not true—and it's not a matter of opinion, it's quite clearly false. 1/
If we were concerned with whether toci's effect were neutral or beneficial it might be a fair claim; but we are concerned with whether toci helps *or harms*. 2/
Apr 19, 2019 • 5 tweets • 2 min read
I'm reviewing the history of how care for patients with ESRD came to be a Medicare entitlement. Many people have heard the story in broad strokes concerning "God panels," rationing of dialysis machines, etc journalofethics.ama-assn.org/article/god-pa… ...
In 1971, Shep Glazer testified before the House Ways and Means Committee in favor of the legislation. As a 43 year old with ESRD, he gave stirring and memorable testimony...
