A class at my kids’ school put up little statements about the good they want to do in the world and I was over the moon about this one - then I learned they meant to say “teach people in jail” which is also good!

My 9 y/o cried when Jamie lost this week. We loved watching him!

I took my work email off my phone last week for vacation. I’m experimenting with leaving it off, since most emails require me to be at a computer to deal with anyways. So far I like not having to know about things before I can actually take care of them.

Herbs and strawberries (with a photobomb from coral honeysuckle climbing up the trellis), and the prettiest little copper garden markers ready and waiting for their flower friends to go in the dirt. 🌱

Pretty baptisia

I’m not catholic, but JD Vance thinking that it’s a good idea to Catholicsplain truth and theology to the Pope is WILD.

New neighbors moving in 🐦

I listened to @weeklyshowpodcast.bsky.social today and they referred to crypto as Beanie Babies for Bros and Mary Kay for Men and it was so on point.

Really enjoying watching Vance fumble literally every play he attempts.

They’re here!

When I get really, truly exhausted—like, think I can’t go on living like this exhausted—I recharge by watching documentaries. Tonight I was so wore out I thought I wasn’t going to make it to tomorrow so I watched the Led Zeppelin doc on Netflix and it was SO good.

I definitely cried.

🍓

This is not uncommon and is why you should have a dang good reason to be using a heparin drip on your patient (vs lovenox, or just DVT ppx if full a/c is actually not indicated).

I'm a data scientist @ourworldindata.org and I need help from a botanist or someone local to Kyoto, Japan! 🌸 We present one of the world’s longest climate records: 1,200 years of peak cherry blossom dates in Kyoto. The researcher who maintained it, Prof. Yasuyuki Aono, sadly passed away last year.

Violet picking and garden therapy. 😌

Does 7 on/7 off (12hr shifts) feel sustainable for the rest of your life for those who do it? I do a stretch of 7 12s about once a month (rest is clinic or shorter consult shifts) and I’m so wore out afterwards.

"what can I do to avoid using chatgpt then?" YOUR BRAIN YOUR BRAIN IT CAME FREE WITH YOUR MEAT SUIT WHEN IT WAS CREATED YOUR. BRAIN.

I love love loved Project Hail Mary. It felt very faithful to the most important parts of the book. I can’t wait to buy it and watch it all the time as my new favorite comfort movie.

Before the Challenger exploded, engineers tried to tell their bosses that the o-ring that failed would do exactly that. Their bosses decided their NASA contract - aka the money - was more important than safety and gave the go ahead anyway. I think about that a lot lately.

An update

There are deer frolicking and literally chasing turkeys around in our yard right now.

Our log so far this spring. The tufted titmouse is our favorite, but the cowbirds have our favorite call. The boys think it sounds like a robot but I hear a rock plopping into water.

I have had a very long few weeks, with lots of work. Today it was cool and rainy and I got to unplug, start about a hundred seeds, thin out all my growing seedlings, and visit all my perennials as they’re waking up. Here’s a couple of my little apple trees. 😌

“Those who serve in the front lines of rescue must learn —and teach others— to slow down, evaluate with a clear clinical eye, and determine whether the carnage they are creating in the hope of victory is destroying any possibility of achieving the good they are attempting to do.”

When I was a resident I always felt like the sepsis police were out to get us. Did you check a lactate, did you see the sepsis alert, did you document why you didn’t do 30ml/kg, etc. Now though I feel like it’s the CLABSI police.

WV is a small, so it’s common that I’ll have mutual friends with patients and see things about them shared online when they’re sick, or have passed. At least twice recently I’ve seen outpourings of praise for what wonderful people they were. It’s a good reminder of the humanity of our patients.

In general I don't like protocol or algorithm driven care. This feels like many patients will unnecessarily get PA catheters which are not without complications.

Our hospital is doing a new initiative where if you suspect someone has shock and it could be cardiogenic, you call a shock call and the swan must be placed within 90 minutes. If a candidate for MCS by the numbers, you escalate to cardiology and CTS. Do you guys do this at your hospitals?

Today I learned that Mercury’s day is longer than its year. 🤯

Seeds feel like magic. Something so small grows into a tree?!

I know sitting and working in the unit is a popular strategy for ultimate availability, but I do my best doctoring when I can have some time by myself to think.

Today’s organ donation question—would you have qualms giving premortem heparin for a DCD? What about if there’s a head bleed, or GIB, etc?

We moved our fellows from 4 week blocks to 2 week blocks (which I loved as a fellow). The residents now frequently mention that 4 weeks of ICU is too much. Is this the case elsewhere too? I have only ever seen 4 week blocks for residents and have always accepted that as usual.

The sun is nervous As a kite That can’t quite keep Its own string tight. Some days are fair, And some are raw. The timid earth Decides to thaw. From March, by John Updike

Re: organ donation. Is there literature on what percentage of patients who start the process of DCD progress to death within the allotted time frame?

This little guy and his lady are back for the third year building their nest in our birdhouses and they make me so happy. Our indoor cats love supervising the nest build, too.

"This miserable political moment will end when especially Christian politicians forsake cruelty for compassion and realize that we shall know Christians in politics not by their stridency and ideology, but by their integrity and love, inc. their love for, as Talarico put it, “all of our neighbors.'”

I think @davidfrenchjag.bsky.social and I would disagree on many lower-level policies, but I completely agree with his point that having Christian politicians espouse actual Christian values is sorely what the US needs now as a way out of our division. www.nytimes.com/2026/03/08/o...

Things are starting to wake up 🌱

I think we are making PE more complicated than it needs to be.

Last night we went to visit my new niece. Today I got to sit in a few hours of faculty development on teaching. This evening I started two trays of seeds while my kid played on the swingset and my husband baked focaccia and the cats meowed through the screen at the birds.

Fresh blog: STRATIFY trial for PE Peripheral tPA infusion is EQUALLY EFFECTIVE as compared to ultrasound-assisted thrombolysis Catheter-directed thrombolysis for PE is dead We can get the same benefits with peripheral tPA infusions (w/o procedural costs & complications)... #1/2 #EMIMCC

Given the literature on vent mechanics and cuff leaks as poor extubation success predictors for allcomers, should routine measurement of these things be built into pre-extubation workflows for RTs? Or should they be optional, and done only when requested/felt to be necessary? #emimcc

My two brothers have had 3 babies in under a year. We just had to postpone the first birthday party for his sister’s birth. I am swimming in bay nieces and nephews and it’s the best thing ever.

PERT activation worksheet 😁 trying to design a one-page sheet to collect info & guide the process this is what I've got so far, please provide constructive feedback #EMIMCC

I got this in preparation for Sturgill Simpson’s physical only album release and I am so happy. We used to record ourselves on tape at my grandma’s and this one records, too.

WV governor announced a data center coming to the eastern panhandle. It will sit on 540 acres and create…125 jobs. 0.23 jobs created per acre by this monstrosity. Not to mention how bad it is for the environment, the economy, and literally for our brains and souls as humans. So sad to see this.

Why do I have to pretend that I'm going to print something in order to save it as a PDF. Why do I have to engage in a little ruse.

This one hits hard.