racism, if we're being honest.

Excellent read from @iwashyna.bsky.social voices.nejm.org/doi/full/10.... I still struggle with this, as a PGY29 #MedSky

Thank you, Dr @thanh-neville.bsky.social Happy to share with other clinicians 🩺 via @nejm.org voices.nejm.org/doi/full/10....

Loved this beautiful piece by @iwashyna.bsky.social , on mentoring. And listening. Waiting. Trusting. Teaching. And Learning. And. And. And. “We discussed when process matters, when outcomes matter, and how to distinguish ‘not what I would have done’ from ‘not acceptable’.” 🛟🧪

I truly believe that strong arts and culture builds strong communities.

I also wanted to make sure you all know about our big fundraiser next week. Things like this event help keep our work going.

Maryland’s air quality remains unhealthy as wildfire smoke thins and severe storms roll in

This was a nice note to get: “Precisely because of your @nejm.org paper, I prevented myself from jumping in for a new fever in our mechanically ventilated patient and was so proud when the intern walked through his thinking and got to exactly the right plan”

When journalists asked me "where we will see the effects of DOGE on outcomes?" one of my responses was "during crises...as long as media connect the dots." Well, dots connected: www.wired.com/story/cdc-cy...

A proletariat that has in certain institutions recently organized (or not so recently in the case of @umich.edu house officers) and are finding their voice

I am a climate scientist and, same.

I am not a climate scientist but when I was a kid the number of times we couldn’t go outside because of Canadian wildfire smoke was zero times

The central tension physicians at all levels of training (including attendings) have to face: Control in the pursuit of excellence? Or entrustment to allow for learners to demonstrate their skills even if management is not optimal? Timely as I reflect on this past year and set goals for this year

This is awesome. Very relevant to us in Blighty too #medsky

1) nice IG reel on new headache guidelines incl ONBs (www.instagram.com/p/Da5stn4t_xb/) 2) i posted a response about ONBs 3) one of my former residents replied cc @iwashyna.bsky.social

”The intern will also — almost incidentally — help save the lives of nearly a dozen people. But those saves will mostly feel undramatic, often experienced as nothing more than the absence of disasters in a room.”

Thanks for sharing, this is one of those essays that gave me neck strain from nodding along so much throughout recent story: busy shift with a solid team, including a new senior resident in the ED, a few patients/families who are very reasonably frustrated by their wait times for upstair beds…

As I start fresh with new interns in primary care clinic this month, this lovely column from NEJM columnist @iwashyna.bsky.social was really touching voices.nejm.org/doi/full/10....

taking care of patients is an immense privilege– and so is training residents, which gives us medical educators the amazing opportunity to watch (and hopefully help) them grow @iwashyna.bsky.social in @nejm.org

there's so much in this essay by @iwashyna.bsky.social in @nejm.org that resonates helping and watching residents learn and grow and go through the same struggle I do as faculty – balancing today's patient care with residents' learning so they can better care for countless patients in the future

My daughter just texted me about my new (and 1st) @nejm.org #Voices column: ‘From my pre med friend: “it’s things like that, that make me rly excited to go into this profession”’ And I am going to be smiling all day I would love your thoughts voices.nejm.org/doi/full/10....

Working with July house staff means “living with the inherent contradictions in their role. Interns and residents are at once learners … and also degreed doctors. Our learners are also … semi-proletarianized workers in a capitalist machine that … will manage them as one more cost to be minimized”

Are pulse oximeters risking Black patients' lives? Episode 4 of the Intention to Treat podcast explores the story of the pulse oximeter and the deadly consequences when a critical medical test doesn’t work on dark skin. Listen on Apple or wherever you get your podcasts. 🎧 https://nej.md/ITTs2e4

Cat not love heat wave (She is in front of a fan)

This is cool

Ugh, looking out the window and knowing there are gonna be some BAD acute exacerbations of asthma and COPD coming in

Corruption is bad

Sarina Sahetya is an incredibly effective clinical teacher @hopkinspccm.bsky.social #MICU

I'm always here for library porn

I had a cyclospora infection in 2022 before it got trendy

Has there been a spike in acute kidney injury in the last year or two? Any contemporary epi? It feels like I am seeing new BUNs >150 a lot all of a sudden

lol/sob

Writing headlines is hard. You have to compress an article into a phrase or two. And you have to fit an exact and usually inconvenient line space. Two images below: What the NYT is running on line. (h/t @jaywillis.net for calling this one out.) And what would fit exactly the same space, by me.

it is extremely funny that these guys are the same kind of people who always sneer at "cafeteria Catholics" for picking and choosing what teachings to follow, and it really did blow my mind to realize they think of the Archbishop of Canterbury as a schismatic Catholic in the year of our Lord 2026

I do rather feel that they are attempting to set themselves up as sovereign citizens of Catholicism which, like, we already have they're called Protestants you can break away from the Catholic Church and do whatever you want, buddy. be the Henry VIII you wish to see in the world

It is simply accurate to call this regime segregationist.

An incredible euphemism here for “the government is doing illegal discrimination”

Segregation is bad

"More than half of those fired or removed by Mr. Hegseth from promotion lists have been female or Black."

Two updates to the Michigan 💩 map: - the state provided updated county-level data three days sooner than expected - the mapmaker has now made an interactive version on maps.com that you can explore & embed: www.maps.com/produce-para...

In my @newrepublic.com debut, I argue that Dems' good faith efforts to spare voters from the worst of HR1/OBBBA may backfire by obscuring for voters how reckless a law it was. This will demand that Dems effectively communicate & take victory laps over burden reduction newrepublic.com/article/2125...

We have a few here - criticalcarereviews.com/conditions/t... Hyperactivity (might need to copy and paste the entire link)

this link should work - criticalcarereviews.com/conditions/t...

View of the Baltimore Basilica (1821) from the second floor of the Baltimore Enoch Pratt Library (1933.)

Feel like this is a pattern in public comments now. Overwhelming public opposition, but Trump administration will move ahead anyway (See also, Schedule F). This does not mean public comments are not important - far from it, it creates a case for overturning the rules in court.

Great resources linked in Sarah's thread. I found this two-page "take action flyer" from @elizabethginexi.bsky.social especially helpful for pulling together comments — due today — quickly: drive.google.com/file/d/1ppq4...

“We have launched a frankly enormous campaign educating the public and scientists on what is included in this rule,” said @cdelawalla.bsky.social , CEO of @standupforscience.net Up for Science, a group she founded last year amid the Trump administration’s disruption of science."

I submitted my comment on the proposed OMB rule. Sharing here to the extent it’s useful. Today is the last day to comment. If you have not yet commented, please do! substack.com/@jennanorton...

Hey #NeuroICU friends (and maybe @criticalcarereviews.com ): Can you suggest a good review on contemporary understanding of “neurostorming” in the brain injured patient and prudent strategies for distinguishing it from all the other causes of hemodynamic variability in the chronic inpatient?