Patients who took simvastatin in the 1994 4S trial had a 1 in 72,724 per-day chance of having their life saved by that medicine. youtu.be/ROM7DFmZo3Q

Legit! #writers #booksky #writingcommunity

Here's a short video to introduce you to the conceptual framework of Individual Daily Risk. You can convert a Kaplan Meier curve into an estimate of each patient's Daily Risk of Dying. Then you can calculate the Daily Probability of Being Saved by an effective medicine. youtu.be/HyI7Uk2l5AM

Learn to use a Kaplan Meier curve to calculate the daily risk or dying the patients faced. Then learn to calculate the Daily Probability of Being Saved. Much better than your dad’s NNT! a.co/d/4fDrHWw

Learn how to calculate the daily risk of dying and Daily Probability of Being Saved from any Kaplan Meier curve in any randomized controlled trial. a.co/d/5y3s2Pf

Do you know the equation to use to predict the next year after the right hand limit of a KM curve?

It’s crazy how many patients are on chronic oxygen therapy without a diagnosis

I don’t want my doctors to spend a lot of time writing a note in my chart. I want the to spend the time talking to me and writing my orders. I use the Golden Rule when taking care of patients.

Nearing the time I retired, I thought I was just about getting the hang of it, but then they kept discovering new stuff.

I’ve worked with hundred of residents and students through the years. If there is a problem, it’s never talent. It’s always lack of support, health, or inspiration. Every single one of them has the capacity to be a great doctor as long as we can figure out what’s missing.

My least favorite story: A visitor came to see [patient with disease of addiction] and now they are [asleep, altered, happy, snoring] and I think the visitor gave them some [drugs, alcohol, etc.]

Advocacy is not something you say. It is something you do.

I used to be happy to get the right answer right now today. Now I'm happy when I can see into the future. How my decisions are likely to play out with this particular patient and their particular disease. It's like having a super power!

I've changed my practice more in my PGY-20 years than I would have expected. I keep learning how the human body works!

Every sick person would love to hear their doctor say, “I’ve seen this before. I’ve done this before. I can help you.”

What so magical about this stuff anyway?

Most people expend most of their effort trying to maximize their suffering and minimize the personal growth that should result from it.

Patients and their families pay you to make unpopular decisions that are truly in the patient’s best interest. And be criticized for them. It is one of your sacred duties as a physician.

Effective medicines work because they lower your daily risk of dying.

As long as we are renaming stuff, can we make Pluto a planet again?

“Devastating” is not a characteristic of an event. “Devastated” is a response an individual person might have to a particular event. Other people will not feel devastated by that same event. Some may have entirely other emotional responses. Including: elation, indifference, ambivalence, etc.

Dumb old doctors get smarter as you get older just like your dumb old parents.

Dire predictions do not enhance your credibility. Even when you turn out to be correct.

As we head into 2025, I'll be sharing 25 MEDICAL HISTORY OBJECTS starting with... #1) 5,000-year-old prosthetic eye made of bitumen paste with lines radiating out from iris. Worn by a 6’ tall woman (possibly a priestess), found near the city of Zabol in Iran. The eye would have been painted gold.

Meet me at the gym tomorrow morning at 7am. I’ll be the older gentleman in the tight-fitting workout attire. Let’s do this thing*! *For two weeks

Soap and water and common sense are the best disinfectants. —William Osler

Last day of my 2024 New Year’s Resolution: Lose every argument. I told my wife I thought I was successful. She disagreed. I told her she was right and nothing more.

Original Article: Highly Pathogenic Avian Influenza A(H5N1) Virus Infections in Humans nej.md/3VU4R8I Editorial: The Emerging Threat of H5N1 to Human Health nej.md/4fKc42s Correspondence: Critical Illness in an Adolescent with Influenza A(H5N1) Virus Infection nej.md/4gR18Rt #IDsky #MedSky

It’s almost 2025 and I’m still waiting for my Staph aureus vaccine.

The differential diagnosis of a new fever should always include “that which festers beneath the bandage.” PS I told you not to check social media during meals.

You had me at “violaceous pustule.”

On a positive note I’ve managed to have call and nights spaced in such a way as to avoid every single holiday party.

What is the correct fluid restriction for a patient with SIADH due to metastatic adenocarcinoma of the lung with the following labs: serum Na 128, urine Na 80, urine K 43, urine osm 660 A. 2000 B. 1500 C. 1000 D. OMG! WTF are you doing! Let them drink!

For most sentient bipedal hominids, seeing a doctor or going to the emergency room is a last resort after all else has failed.

An order written in the hospital is an offer. A prescription is a suggestion.

Every doctor must learn this essential lesson: You cannot reduce your patient’s suffering by suffering more yourself. 1/

This is Gracie. She went for the most magical car ride last night. The whole world twinkled like it was excited to see her. 13/10

Periodic table colored by lickability. 😛

The world and its people have conspired to nurture, protect, and deliver you to this day, alive. Write them a thank you note before bed tonight.

Everything is ok.

This game is fun for about 30 seconds. That’s why I’m an internal medicine doctor.

I was diagnosed with lung cancer a year ago today. I expected the day to feel reaffirming, because I have made it a year and am doing great. But I think a fact of survivorship is that you’re always waiting for the other shoe to drop.

Advent Sci-Fact 22: Rats that drive are more resilient!🐀 Rats that were trained to drive small cars had hormones in their poop that suggest they’re more emotionally resilient! Some rats would continue to drive the cars, even when there was no reward. Paper: tinyurl.com/25vtahuz #SciComm 🧪🌍 #SciSky

It’s coming… 🎅🏼 @drsandman11.bsky.social @karijerge.bsky.social @brentweinberg.bsky.social

The Centers for Disease Control and Prevention (CDC) and the American Dental Association (ADA) endorse water fluoridation. The CDC has recognized water fluoridation as one of the ten great public health achievements of the 20th century.

I’ve decided I’m adding a line in my clinic notes underneath the Social History (which is no longer a litany of vices but more a what can I remember about this person’s life? section) for Pets. Because why the heck not?

In case nobody told you, once you hit 50, you become the person who brings candy and treats to every nurses’ station during the winter holidays. 🧁🍡🍫🍭🍬🍰🥧🥮

“Wound Man” is an illustration which first appeared in European surgical texts during the Middle Ages. It laid out schematically the various wounds a person might suffer in battle or in accidents, with accompanying text stating treatments. Tag yourself as a wound ahead of the holidays!