I’m still thinking about “quiet, piggy.” No president should be able to speak to a member of the press that way and remain president. That moment encapsulates how vile, misogynistic, and horrible that man is.

Today my patient asked me if my mom made sure I got off to school okay this morning.

Last night I dreamed I was attending in the ICU. A trainee was presenting tons of data to me. I asked, “but what did the patient say when you asked them why they came to the hospital?” In the dream, the trainee had to go ask them because they hadn’t yet. I usually dream about real stuff, and

#MustRead "Decreased bedside clinical skills lead to diagnostic error, poor clinical outcomes, increased health care costs, and physician burnout"

A physician at a hospital that I helped start a @3wishesprogram.bsky.social told me they lost a patient with a very strong Irish heritage. Per the family's request, his family was allowed to put a shot of Irish whiskey down his nasogastric tube as part of a final toast!

Coming off of a week of vacation and realizing that I need to change my mental and emotional relationship with work. It just feels all consuming, and the self induced pressure to be perfect and also efficient is wearing me out. How have you changed your mindset to make work more doable long term?

Hey so “underage girls” are…children. The word you’re looking for is children. They’re not like, women-in-waiting or women-lite or whatever. They’re children. I think some of you are very uncomfortable with what that means for you but it is still true.

Anyway a great way to radicalize people is for them to realize that you just abandoned their chance at being able to access and afford health care because you didn’t like waiting in line at the airport.

Watching the second half tonight which is much more crying than cackling.

Candle burning, cat purring, electric blanket on, gray sky outside with leaves falling, Psycho on the TV. Vacation mode activated.

Gotta be honest RFK jr. sprinting away from you is probably the very most he can support your health.

nobody needs a billion $$.

Introducing my 9yo to Fiddler on the Roof and he is CACKLING. He loves Tevye.

Fall evenings and hush puppies

Mamdani: "We can respond to oligarchy and authoritarianism with the strength it fears, not the appeasement it craves. After all, if anyone can show a nation betrayed by Donald Trump how to defeat him, it is the city that gave rise to him."

Rewatching Stranger Things and season 3 was so good. 😭

I am scheduled for venofer next month and if I feel like a new person after getting it I’m going to be mad that I waited a decade to do it.

Emilio Estevez is Martin Sheen’s son?! And Charlie Sheen’s brother?!

Just finished a consult weekend and I’m wondering what a consult service looks like in New Zealand @caulimovirus.bsky.social

The coal miners lost that 1921 battle, but they also laid the groundwork for future labor gains. The Battle of Blair Mountain became a rallying point for labor rights in Appalachia, catalyzing the United Mine Workers of America. The red bandana also stood for multi-ethnic class solidarity.

In this moment, coal miners turned their red bandanas into a symbol of solidarity — both to distinguish themselves from the enemy and to show that, across racial lines, coal miners were united along class interests For this reason, they were known as the "Redneck Army."

Known as the Battle of Blair Mountain, this was the largest labor uprising in US history and the largest armed uprising since the Civil War. For a month, 10,000 coal miners confronted some 3,000 company guards, state soldiers, and strikebreakers. Nearly a million rounds were shot.

Tensions ran high in the summer of 1921 when union-sympathizers Sid Hatfield and Ed Chambers were gunned down on the courthouse steps by company-hired gunman as part of a company-sponsored terror campaign. In response, 10,000 coal miners marched in Charleston, West Virginia.

"One intangible advantage of capillary refill time is that performing it brings the clinician back to the bedside to reassess the patient. This act may be itself the holy grail of early sepsis management." great piece on #sepsis

Feeling a little overwhelmed at all the things I need to be good at—diagnostic bronchs and lung cancer, other therapeutic pulm procedures, MICU, cardiac crit care, neuroICU, MCS, PH, complex ILD, CPETs, neuromusc resp failure, CF, pleural disease…3 years out of training and feel like I can’t keep up

Why do we have to make phones so freakin big

“That’s why I am for free schools, free universities, free health care, and free babysitting. Because our society could afford it.” In America, people think social democracy is some kind of communism. They think capitalism is freedom. It’s not. It’s only freedom to exploit people” -Stellen Skarsgård

“the president got mad at a television commercial so now your maple syrup is more expensive” is no way to run a country

Billy is by far the scariest character in all of Stranger Things.

Interviewing PCCM candidates and reviewing all these impressive CVs with so much scholarly activity and I can’t figure out why anybody let me into fellowship.

The main reason that I don’t have a bunch of kids.

Snuggle your babies, hug your kids, appreciate your partner, love your people, and be grateful for each day of health you’re fortunate enough to have.

Once a month I look through @accpchest.bsky.social, @atscritcare.bsky.social journals, and J of Resp Care. I save the articles that interest me in my cloud based folder system all divided by topic. This habit has been so helpful.

What’s your hospital’s culture re: ICU admission for intermediate risk PE? ICU for anyone with signs of RV dysfunction? ICU for massive only? Something in between? #EMIMCC

Discussing this article for our QI didactic on Monday. So good. journal.chestnet.org/action/showP...

we’re now several years deep into AI slop polluting the internet and still not one advocate of AI has been able to answer the very basic question of “why would anyone want to read something no one bothered to write?”

If you rank the songs on #ts12 in order of my favorite and in order of best bass lines they will be the exact same list.

Half way through and I am a FAN. #TS12

be kind and give your patients a REGULAR DIET caffeine-free diets ➡️ caffeine withdrawal sodium-restricted diets aren't evidence-based (use diuretics to balance volume) treat hyperglycemia with insulin (not by artificially restricting carbs) (renal diet for hyperkalemic renal failure = exception)

Based on didactic discussion today— Patient with h/o a-fib in septic shock with an otherwise normal heart. In AF, rate staying 120-150 day 1 of hospitalization. You’ve ruled out other badness and they’re otherwise responding appropriately to therapy. Do you slow them down or no? #EMIMCC

Slow Horses hittin a little close to home this season

One weekend I was covering pulm consults for three hospitals in two counties. I did a thora on a patient and as I was leaving the room, a hospitalist asked me if I could do the para, too because GI wouldn’t and he couldn’t.

If I’ve said it once, I’ve said it a thousand times: a paracentesis is an internal medicine procedure. As is a Pap smear/speculum exam.

Can’t we just have one day where everything isn’t stupid

Brb cringed to death

✅ first day of fall ✅ first day of vacation ✅ thunderstorm ✅ nap 😌

Watching The Sound of Music for the first time (long time Mary Poppins fan though) and Julie Andrews is literally perfect.

I stand by my claim that peak iPhone was the 2016 og iPhone SE. <4oz. Fits in the palm of my hand. I can reach all four corners with my thumb. With Touch ID I can have it already unlocked before it comes out of my pocket. At $399 I could buy several for the price of one iPhone 17.

Far as I can tell, Robert Redford was: * successful at everything he tried * genuinely intelligent & insightful * desired by women * envied by men * an absolute mensch to everyone he dealt with * a tireless, lifelong philanthropist ... and he died peacefully in his sleep. 10/10 life. No notes.

We haven’t had clouds or rain for weeks and all this sunshine is draining my life force.