For a whole year now I've been responding to WhatsApp messages with themed emojis instead of just simple thumbs up/smiley faces and not one person has commented on it.

@rowan.fyi @josswright.bsky.social

SO CLOSE

Tired: two-factor authentication Wired: n+1-factor authentication, where successfully authenticating on a new device just allows you to log in again, triggering another authentication request. Repeat ad infinitum

Ok Gemini, that's pretty good. IYKYK

@kurtstat.bsky.social has anyone ever used the phrase 'leftward shift of acuity in streaming' (and I'm slightly embarassed to be asking this.) My thought: if you thought of acuity of setting on the x-axis with home at the left and ED resus on the right, and patient numbers on the y-axis...

The Mandolorian is quite good, isn't it?

People in the NHS when someone uses the BCC (blind carbon copy) function in e-mails.

The most caustic effect of Brexit is the rise in the view that democracy is just about voting on things. (Ideally it's a complex interlocking system that relies on the rules and interplay between Parliament, government, courts and the press to try and maximise freedom and quality of life for all.)

Indicators of patient flow dysfunction mainly focus on either the hospital front door (e.g. breaches of the four-hour target) or the hospital back door (e.g. delayed transfers of care). But patient flow dysfunction manifests itself *everywhere* in a general hospital. 1/6

The important thing to understand about AI is that everything that everyone else creates using it is mindless slop that is heating up the planet but everything I create using it is like a cross between Oscar Wilde and Van Gogh and was 100% worth it.

TAKE MY MONEY DAMNIT @rowan.fyi

Great crisps? Or greatest crisps?

Pro-tip: I'll fill out a reference for anyone I've ever supervised but you have to remember unless you were the worlds most memorable person all I've got to go on is your electronic portfolio. So if there is no evidence in there you'll get some kind words but I can't do much else....

There is clearly a poo ninja that creeps around the house doing big poos in toilets when we're not watching because my 7 year old tells me it is not him.

www.bbc.co.uk/news/article... Don't understand this. 2 year degree which leads into semester 2 (not year 2) of a four year degree programme. So _longer_ then a standard medical degree.

I found that this album exists and the world is better because of it: en.wikipedia.org/wiki/Arnold_...

We didn't need really need a sequel @ericidle.bsky.social did we? www.bbc.co.uk/news/article...

What becomes painfully clearer with every day is that, regardless of any other merits or weakness he has, Keir Starmer is pretty crap at this whole 'politics' thing. www.bbc.co.uk/news/live/cz...

If you see this, repost a #vampire that is not Dracula. Desperately underrated.

Possibly true fact: in Orwell's 1984 the Ministry of Peace (Minipax) may have been inspired by the contradictory naming of UK and USA govt depts. At around the time the book came out the American Ministry of War had been renamed the National Millitary Establishment before later becoming the DOD.

@nickopotamus.co.uk Arc A770 in a Thinkstation p520. Great value or greatest value?

Always nice to check in on the pension and discover that one day I can hope to retire on #ERR/DIVIDEBY0--doesNOTcompute a year.

Hardest day of the week! Really should use a pen and paper.

I now have a t-shirt older then the FY1s. Specifically this t shirt (but mines is in worse condition.)

Untrue. Deadpool can also do this.

Are you using 0.9% NaCl or balanced salt solutions such as Lactated Ringer's or Plasmalyte to resuscitate your patients with DKA? This paper suggests that we should be using the latter. 🎩 tip to the authors. eddyjoemd.com/foamed

The (final?) judgement in the Dr Chris Day sequence/saga was published. It's something I've had quiet thoughts about for a long time. As always - if you really want to know read the primary sources yourself with an open mind. assets.publishing.service.gov.uk/media/68a44a...

Tips for new (and old) doctors: if you're diagnosing 'panic attack' in someone hasn't had a panic attack in their 80 years of life which have included giving birth to four children, surviving 2 heart attacks and bowel cancer think really hard about why they'd suddenly start having them now.

Is anyone using the DOAC score www.mdcalc.com/calc/10551/d... in stratifying bleeding risk?

Parkrun then Cluesbysam.com Can I go back to bed now?

If you write a guideline concerning two or more specialities and they both pass it without comment either: -you're a clinical governance genius -you've failed to predict the situations that will lead to arguments regarding the guideline in the real world

Yes I'm mildly obsessed by cluesbysam.com Yes, I only post these images when I've had a good game. Yes the puzzles are easier at the start of the week and get more difficult as the week goes on.

Sure I'm late to the party here but www.openevidence.com seems pretty good. That makes it 2x this week I've actually been impressed by AI applications in medicine....

I think this one was easier?

cluesbysam.com Still enjoying this site.

Look NEJM - what you think you are doing is presenting a case history and interesting image findings as a deep diagnostic challenge. What's actually happening is that you've shown me a picture of a funny shin and a CXR so obviously I'm going to diagnose sarcoid.

Social care, delayed discharge, death. What a sad coroner's case that sum up the systemic failure taking place across the NHS:

Worst financial mistakes of my life: -only taking out a 3 year mortgage instead of a 5 or 10 when interest rates were negligible -not moving my Universities pension into my NHS pension when I could -not mining a bitcoin or ten in 2009

cluesbysam.com Another perfect game but much slower today. Much screen staring!

www.youtube.com/watch?v=D6Ka.... Is there nothing the Doom music can't improve?

Perfect game!

has been working for the NHS for so long that all my passwords end in 25

I'm excited for a sequel. youtu.be/woxf23FphEw?...

Trying to come up with some form of wall mounted device that optimistically will enact cultural and behavioural change in the department.* Looking for ED wisdom to put on it. Got quite a few suggestions: *yes a poster. But let's be honest about both the goals and realistic chance of success.

I noticed Dr Aseem Malhotra was awarded a Global Health Award. doctoraseem.com/its-time-for... Just one or two slight issues...

Karol Sikora finally gains some insight. www.telegraph.co.uk/news/2025/07...

A Medical Reference To whom it may concern, I can confirm That of this Doctor I had no concern. If you truly require a discerning opinion I apologise for I have truly don't have one. However I can confirm, as requested, That they (probably) were never arrested.