Someone needs to take the big red "war" button away from fascist grandpa.

Writing Tip o' the Day: Sight and sound are the biggies, but there is no sense more closely linked to memory than smell. A well-described, vivid scent will instantly immerse your reader in the scene. Don't ignore this description. #WritingCommunity #amwriting #amediting

Good guy Bernie Sanders standing up for physicians in training. 💙

Hey, guess what guys Guys Guys, Donald Trump is not a physician, and neither is RFK Jr. As an actual physician, I do not recommend taking medical advice from a fascist charlatan and his worm-ridden conspiracy theorist Gumby. #medsky #autism #saveourscience #choosedatanotlore

Important topic. I have thoughts. First, even if we call it "AI Delusional Disorder," delusions are a feature of psychosis, and delusional disorder is a psychotic disorder, so I would indeed categorize it as a psychosis. (1/5) #medsky #psychsky

WGA Statement on ABC’s Decision to Pull Jimmy Kimmel Live!

Fun with the old OMT skillz: I may be a psychiatrist, but I can still crunch it Kirksville-style. #medsky #DO #osteopathy #osteopath

This weekend I was reminded that even some very intelligent, thoughtful people are unaware of the AI/data center/energy use problem. Such a massive issue, easily missed in the deluge of other disconcerting events.

Cascadia's first national department, perhaps? SoCal doesn't fit the whole bioregional piece of the movement, but hey, I think we could make some exceptions. #Cascadia #SaveOurScience #Medsky

Experiencing satisfying story craft is one of life's great pleasures. Dexter: Resurrection Episode 9 was *the stuff,* y'all. Not perfect. Ridiculous and unrealistic, sure. And yet...so delicious.

Living the smallish town PNW life: your favorite bagel shop knows your name and order, and the bagelrista decides to go to the back to grab a bagel so fresh it's still warm. ❤️ Savoring the little joys.

Things like this have me feeling like some kind of luddite. Can we, you know...not use AI in our EHR? Maybe run some proper research and see if it *actually* improves patient and clinician outcomes before we shove it down everyone's throats? No? Move fast/break things? Got it, got it. #medsky

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GLP1 medications are life-saving and life-changing breakthroughs. They aren't for everyone, but they are remarkable. No one should forget that public funding largely paid for the science which created these drugs - only so corporations could then price gouge us for them.

Get real. Trump is against electronic voting. He's against mail-in voting. Donald Trump is against voting. It's that simple.

Ended up involuntarily renting a Tesla for the weekend. Infused with Muskian arrogance, it seems to believe it knows how to operate even minor aspects of itself (like the vents and windows) better than I would. I do not like it. I do, however, like charging up on Musk's dime. #silverlinings

When the management company of one of your professional medical organizations emails out a rundown of Trump's "trade deals and tariffs," one can't help but feel like this is some kind of fascist kowtowing. Never received any emails from medical orgs about Biden's economic policies. 🤔 Sus. #medsky

Slightly diminish a band: Arrows Inaction

Challenge: post your last photo taken in DC to show what a hell-hole it is. #FreeDC

The beauty of a roselle hibiscus blossom and the bee who loves her 🐝♥️ #PNW #gardening #beesky #oregon

Say it with me, say it loud: People with mental illnesses are more likely to be victims of violence than perpetrators. As a physician, I have no magic elixir to cure criminality. Violence is multifactorial. It is societal. Don't buy the "mental health will fix this" nonsense. #medsky

Hot weather ahead for us this weekend in Oregon, but just today I stepped outside and tasted a hint of Autumn in the morning breeze. Oh, how I look forward to hoodie season.

Cosmic Rule of Writing: you'll inevitably get into your best flow the minute life requires you to go do something else. Every. Single. Time. #WritingCommunity #Writesky #Amwriting #WasWriting #Sigh

Appreciating beauty in the small things. #gardening #PNW #oregon

I grew up on these streets.

Sprinkling subtle Star Trek references in my notes today, because sometimes you just need to uplift your own spirits amidst the humdrum of documentation. #medsky

Asha's generosity is never optional. #WIPSnips #WritingCommunity #WriteSky #SFF

If they make another Star Trek movie, can we have James Gunn direct it? Not because of his directorial skills; I just think it’s about time a narrative included Gunn’s Chekov.

Let's talk risk. Every conversation I have with a patient, pregnant or not, is a risk/benefit discussion. Is the medication- or procedure-induced risk greater than the benefit, or is the risk of disease-caused morbidity and mortality so great that it's worth making an intervention? (1/3)

In the midst of uncertainty and world plight, nature continues to do beautiful things.

The optimist in me would love to see recent events as some kind of gift. The Republicans have definitively outed themselves as the party of pedophile apologists. In a sane world, that could lead to something wild like a veto-proof Blue majority after the midterms. My internal optimist is so cute.

Often reminded of quotes from "Illusions" during times of change and adventure.

One of those days that started with a prolonged legal conundrum and ended with some of the most severe character pathology I've seen in my entire career. 10 notes to go, but hey, it's still light outside. #medsky #psychsky #thisisfine

The US senate just declared war on the American public. A bill that destroys Medicaid while cutting taxes for the wealthiest at a time when we already have record income and wealth inequality is societal suicide.

As a physician, I have a duty to warn against harm to others. Watching the "big beautiful bill" ramrodded through congress is like watching them ram planes full of vulnerable people right into the ground. These irresponsible medicaid funding cuts will kill people. Full stop. #savemedicaid #medsky

Ah, the delicious moment where you finally finish eking out that all-important transition scene and can move on to the next leg of the story. Feels so good. #AmWriting #WritingCommunity #WriteSky

I'd love to see the evidence base for clicking through endless hospital "learning" modules. Do they improve outcomes and adherence? Does anyone come away knowing anything after? I'm going with a null hypothesis here. #medsky

Still looks more dignified when Dukat is the one saying it.

On June 5, 1865, Black Union soldiers of the 25th Army Corps arrived in Galveston, spreading the news of freedom to the enslaved. On June 19, Gen. Granger issued Gen. Order 3, enforcing emancipation in Texas. 62 days until Slavery Remembrance Day. #HappyJuneteenth #CountdowntoSRD

(What is common knowledge in your field, but shocks outsiders?) Electroconvulsive therapy (ECT) is a highly-effective, life-saving treatment we still use today. ECT would save even more lives if not for sensational portrayals in media - it's really quite anticlimactic to witness. #medsky

Oregon showing up for #NoKings day. No surprises here, but you love to see it.

Doing my nails and makeup in preparation for a fun little community dance show, and then oh, look at that, Senator Padilla handcuffed on the floor. Struggling to find words, but one that comes to mind is 'fascism.'

Various joys in my personal life starkly contrast with the whole "country-sliding-toward-martial-law" situation. That is one hell of a dialectic to hold.

With personalities like theirs, there was no way everyone was going to walk away looking like friends. About time, really.

Me: carefully choosing low-VOC paint in a hue I think the bees will like, positionining and leveling the hive just so, preparing sugar syrup tea with mushroom extract to support their health... Bees: we like a box #beekeeping #Layens #beekeepher #beesky

QRP with your pride flags 🏳️‍🌈

1. If you think you won't pay for this/ it won't impact you b/c you have private insurance, you're wrong. 2. This is going to impact the most vulnerable of the U.S. pop and if you think that's OK, you're wrong. 3. This is taking food away from children. CHILDREN. What is wrong with these people.

In the Star Trek Voyager episode, "Critical Care," a society rations their healthcare only to the 'deserving.' Enraged by the system, The Doctor revokes an administrator's medical privileges, forcing him to be restricted to a lower "allocation" of care. I'm with The Doctor on this one.

Bees streaming to and from hives in the morning light like glittering gold magick. #beesky #beekeeping