Today I talked to a patient who is doing SO well a few months after I met them in ("oh! you're the one who always brought me candy!"), and another patient brought me the most hilarious/sweet gift. yes it's 1:30am on Thanksgiving and I am writing notes, but I am grateful for my job!

Why oh why is MassHealth so obsessed with restricting access to monoproduct burpenorphine? I truly do not understand.

You know, sometimes I really regret letting the hospital suck up my energy and attention until 8pm, and sometimes I’m like “well, it’s better than reading the absurd news of the day”

1. A landmark study was just published in The Journal of Pediatrics. It found a 68% reduction in suicidality for trans youth getting HRT. It also found only 7 of more than 400 stopped taking HRT... and of those that did, 4 still identified as gender-diverse. Transgender care saves lives.

Not the worst thing about this of course, but the idea that medieval Europe judicially executed 2% of the population is ludicrous. Even at the highest peaks you get nowhere close to 1 in every 50 people. That's wartime massacres territory.

Its hard to keep up with the bad news

An extraordinary, beautiful, and heartbreaking piece by writer & environmentalist Tatiana Schlossberg (Caroline Kennedy’s daughter). My prayers go out to her and her family. www.newyorker.com/culture/the-...

these are some messed up times

Your periodic reminder that there’s nothing magical about meth for causing dental decay! Stimulants of all varieties dry out the mouth, and *that* causes tooth decay. Lots of other meds do this, too. If a med makes your mouth dry, it can mess with your teeth. To avoid drug-related dental issues:

Kelly: "I never expected after serving 25 years in the Navy flying combat missions over Iraq and Kuwait, flying the Space Shuttle, that now I've got to worry about my personal safety and that of my wife, Gabby Giffords, who was already nearly assassinated, because of something the president said."

If you receive an illegal order, you have a duty to disobey. This isn’t controversial. A President calling for the execution of anyone who reminds service members of this oath is showing us why the duty to disobey illegal orders is so important in the first place.

hive mind, I need help! Lawrence just passed an anti-camping ordinance that has stricter rules within 1000ft of a school. is there a GIS program or similar resource that would make it easy to map this?

Things I’ve learned at #AMERSA25: - I love AMERSA folks and especially our MA contingent even more than I thought - lots about LAI Bupe - lots about 42cfr part 2 - I need a new contacts prescription - I absolutely cannot read slides that everyone else can 😂🧐

Things I’ve learnedthis conference

I cannot

🤔 I’m no housing expert but this seems unlikely

we used to really look at people who were taking 100mg, 130mg, 150mg, 180mg of methadone who missed one week of dosing and tell them: "you've lost your tolerance you need to start back at 30mg" I mean I'm sure there are still places that do this now BUT IT IS SO BAD

well so far I my flight to #AMERSA26 hasn't been canceled so 🤞

i strolled to my local baseball field, and it was lovely to see a touch of aurura despite the city lights and houses, and to see a true splash of color with camera on 10sec exposure, but woooooowwww it is COLD and wintry all of a sudden and makes sense that all my neighbors weren't out there w me

Totally. If people are open to setting cutting back goals, I'll basically give them as homework and follow up. Sometimes they meet their goal, sometimes they don't but brush it off, and sometimes it's the start of a deeper conversation.

this tracks

the ACA is FAR from perfect and not what I *wanted* or *want* but it is obvious that leaning further away from regulation and patient rights, and more towards capitalism will be... worse

Tonight was a very bad night.

Following up on this. This remains a ‘cave is minutes or hours away’ situation. If you want to impact how this plays out you need to contact senators literally now. I want to add additional points of context. What I’m relaying is what I’ve picked up from highly reliable sources.

The amount of effort this administration is putting into making sure lower income folks don’t have food is really…. Extraordinary

Rosalind Franklin appreciation post. 🧬

1. If not for Republicans we could have had a public option - 2. Where exactly can one purchase one’s own “much better health care” without insurance?!?!

Massachusetts governor says she'll fully fund SNAP benefits in November.

Seriously? Why have three branches of the government?

Air traffic controllers are resigning due to the stress inflicted by the government shutdown, a union president warned

"World's first potential trillionaire has killed 600,000 people, including 400,000 children" is the only headline that anyone should ever read about Elon Musk

One trillion dollars is an absurd amount of money for one human to have. I am a very privileged person (I’m no orthopedic surgeon or investment banker, but I’m a doctor!) and it would take me more than 4 million years to earn that much money!

I had not heard about “6, 7” before last week, and now I have seen it on every form of social media, talked about it with coworkers, and had a 20 minute discussion about it with my 8 yo nibling 😂 (“you need to move your hands like this”)

One analytical model shows that, as of November 5th, the dismantling of U.S.A.I.D. has already caused the deaths of 600,000 people, two-thirds of them children. https://newyorkermag.visitlink.me/jUzNSc

Mamdani: "New York will remain a city of immigrants, a city built by immigrants, powered by immigrants, and as of tonight, led by an immigrant."

survived involuntary urgent care shift. horray!

For the record: - SNAP benefits did not increase “many fold” during Biden’s term - disaster aid during, INFLATION contributed to ⬆️ SNAP costs - we spend $100 billion/year (equivalent to 1.5 months of military spending) to help feed 1 in 8 Americans… seems like a good deal

Proud Bowdoin grad & Bowdoin YDSA alum here 🙂 #goUbears #forthecommongood #mayormamdani

This is the president of the United States taking a break from gold-and-marble interior renovations to say he’ll defy a court order to feed hungry Americans. Nero would be proud.

🙋 "Home, please"

Trump still has not followed a court order to release SNAP funds for millions of people. Meanwhile, he hosted a "Great Gatsby" themed party at Mar-a-Lago this weekend. And he posted seven times about renovating a White House bathroom with marble and gold. Priorities.

Saying it again: "So what you’re telling us is you need less evidence to kill somebody than you do to hold them."

I think he genuinely thinks this is what asylum seeker means

logged in on Sunday night to catch up on charting (as one does) (#primarycarelife) and there were bad news in there for a patient I was worried about, and now I feel like being sad and going to sleep instead of charting 😞

I want to be an independent woman but I really wish I were tall enough to change ceiling lights without climbing to the top rung of the ladder 🫣 no me gusta

I can get to Hitler in three.

Sunset tomorrow will be at 4:37pm 😭 If it weren’t for the absurd darkness, and also my body’s inability to maintain warmth even when my house is 70°, winter would be much more enjoyable …

Today is four years since I have had alcohol Things weren't out of control, but I didn't like my drinking I was a "gray area" drinker (internal struggle, no external consequences) I envy those with a healthy relationship with EtOH But I'm glad I quit www.medpagetoday.com/opinion/seco...

We have progressed from data collection to data analysis.

Halloween adventures on the mobile health unit: EMS dude: “where’s the doc?” Me: “um that’s me, I’m the doc, I’m …… just a giraffe today” 😂🫣