a snippet about the ICU and rounding from my novel. A song that broke my heart and a poem that mended it. and a rant. hope you find something it. open.substack.com/pub/lswrites...

My second post is about writing as healing, living infinitely in the moment, and this. open.substack.com/pub/lswrites...

My second post is about writing as healing, living infinitely in the moment, and this. open.substack.com/pub/lswrites...

hi everyone I do not use bsky much but I am now on substack if you are interested! substack.com/@lswrites/p-...

hi everyone I do not use bsky much but I am now on substack if you are interested! substack.com/@lswrites/p-...

#CHEST2025 After Hours live storytelling event was 🔥🔥🔥 with baby gorillas and tales of being lost at sea and near drowning and break dancing! @chriscarrollmd.com @avrahamcoopermd.bsky.social @laxswamy.bsky.social

The corporate perception of imagination: it needs clarity and focus 🙃

Sharing at my first ever workshop this week! #amwriting

Try not to compare yourself to other authors. Writing's a long game, and other writers are looking at you wishing they could be where you are. So keep going, we're in this together. #5amwritersclub #amwriting #writerslife #WIP #poetry #wattpad #amreading #writingcommunity #writerscommunity

Good morning, #5amwritersclub. I just received this link to my six-sentence story published today in Gooseberry Pie Literary Journal today. Enjoy (and remember: you don’t always have to write thousands of words). gooseberry-pie.com/survivors-ki... #microfiction #flash

He needed air. The price was $539. When OptumRx dropped coverage of his $66 inhaler, Cole couldn’t afford the new price. 5 days later, he died from a severe asthma attack—with no inhaler. He paid with his life. www.nbcnews.com/nightly-news... #MedSky #SciSky #PedsSky #PulmSky

This is going to be a different type of campaign. Because when you’re going after Medicaid and even ripping food away from hungry kids, all to cut taxes for donors and corporate lobbyists, we’re not pulling punches. I hope you’ll join us: secure.actblue.com/donate/loc_a...

I'm Dr. Annie Andrews. I’m a pediatrician, not a politician. But either way I know how to handle people who are full of sh*t. Today I am announcing my campaign for US Senate to replace Lindsey Graham. Share this if you're with me. www.youtube.com/watch?v=J8wM...

I’m not trapped in rounds with you, you’re trapped in rounds with me

If you ask medical intensivists which types of admissions scare us the most, I would guess the most common answer would be pregnant patients (followed by status asthmaticus, which is a separate conversation). Pursuing any policy that increases risk of severe disease in pregnant people is insane.

In memory of professor Rinaldo Bellomo: A giant of intensive care medicine CCR Journal Watch - tracking the critical care literature daily https://doi.org/10.1016/j.ccrj.2025.100110

I'm at NTI if anyone is here!

You intubate a patient smoothly with roc & ketamine After connection with the vent: - oxygen saturation is 98% - etCO2 tracing & values are normal - breath sounds are symmetric the vent starts alarming for a 60% air leak you ascultate the neck & cannot hear a leak what is happening? #1/2 #EMIMCC

My friend (icu nurse) and his wife wrote this for the globe. They were finalists for the Pulitzer for the series! apps.bostonglobe.com/opinion/grap...

A more artistic expression of moral injury, I have never seen.

this is a lovely little comic about how icu nursing can (will?) require you to violate your own ethics

My friend (icu nurse) and his wife wrote this for the globe. They were finalists for the Pulitzer for the series! apps.bostonglobe.com/opinion/grap...

I also think phrasing matters. When we hit certain milestones, we do sometimes get a party, but happens after a hitting a goal, and the perception is not that we are doing it for a party. If they asked me to do QI to get a party, it would not be an incentive

The other problem with any kind of party is that only a minority of people in the unit are on when it happens. And would need to make sure to cover both day and night shifts.

Interesting! I have not had this happen, but I do not think that would be a motivation for me. I would feel a little offended by a gift card, but I cannot articulate why. We do sometimes get pizza parties, but it's not linked to efficiency Not aware of any literature, though!

What, are you too good for a crisp $5 gift card to Dunkin?

Getting a gift card or pizza party as a reward for clinical efficiency can feel cheap and devalue the intrinsic motivation. Have you experienced this? anyone aware of any literature on the topic? @iwashyna.bsky.social @deannamarie208.bsky.social @nursekelsey.bsky.social or others?

Added @yessir-icanbougie.bsky.social @matdesgro.bsky.social @lferrantemd.bsky.social @intensivemd.bsky.social @aboyle.bsky.social @alaurx.bsky.social!

A classic www.sfu.ca/~palys/Miner...

The little things.

I’m not on it but Kimberly checks the neighbourhood Facebook page once a week and gives me the tea. This week: Somebody is mad that someone picked up their dog’s deuce, bagged it, and put it in their trash can which was out for collection. This was, apparently, very close to an act of war

The last days always seem to come without warning. Without consent.

Good day to have principles

folks using prolonged ketamine gtts for pain: do you trial a bolus 1st to see how the patient responds? (& then follow with an infusion if effective) or just start the infusion & gradually titrate to effect? I think there are some interesting practice pattern differences in ED vs ICU vs anes

I don't share my writing for notoriety. It is the drive to share a thin slice of who I really am, a chance to be seen, and hopefully, to resonate so someone else feels less alone.

I have been in that room, and the other one too. But I am no savior.

Check it out! youtu.be/GouSHrHNNhg?...

This is such a good album and a monumental achievement!!!

15/SUMMARY Salt in wounds causes pain by multiple probable mechanisms. These include: 🧂Increasing local osmolarity, which stimulates osmo-sensitive TRPV nociceptive neurons (the same neurons through which capsaicin signals) 🧂Osmotic stress leading to cellular injury/death

1/THREAD As the old idiom goes, one deliberately causes additional pain by "pouring/rubbing salt in an open wound". But this is also literally true. Physiologically, why would it hurt so much to have salt poured into a wound?

Chest is a superb scientific journal to which I regular submit some of my best science. This letter is an obvious travesty I hope @accpchest.bsky.social treats it as the travesty it is

Check it out, new album just dropped 🤩 open.spotify.com/album/5orTSx...

this was amazing! I cried, she cried, there was so much love and excitement about helping patients like me, and it was just so beautiful to see the good parts of this industry 🥹 there are good people out there working really hard to improve care for patients with rare diseases

Someone asked me "hows work" and this was my response and this is why i need to stop talking to people 😆

I have been in that room, and the other one too. But I am no savior.

PSA: Your period should not 🩸last longer than 7 days 🩸interfere with your life 🩸happen more than monthly 🩸require product changes more than every 2 hours 🩸have clots larger than a quarter 🩸cause debilitating pain 🩸require double product coverage 🩸make you anemic

I’ve been getting a bunch of new follows so—Welcome new friends! ✨ Here’s a fast track to follow a whole mess of incredible women making #Boardgame and #TTRPG games for you to love! If you want increased gender diversity in our tiny hobby world, support us with a follow! go.bsky.app/71p7ixo

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You should read this... It is really good. I know bc we wrote it 😘