thicc notary public

@medmalreviewer Considering median hospital LOS was 3.5 days, curious what 7-day and 30-day mortality was attributed to since thromboembolic events didn’t seem major/different …. would be important difference if death was due to ICU sequelae vs. bleed vs. fall from ladder vs bacteremia

@medmalreviewer Hard to make a sweeping generalization when lack of blinding makes selection bias so easy - pts perceived as “sicker” always get “more aggressive” treatments. Documenting when anticoagulation was resumed could help understand re-bleeding rates.

Interesting paper on PCC vs. FFP vs. VitK reversal for GI bleeding on warfarin. If you've followed my newsletter for any length of time, you know the most common med mal cases we see are anticoagulation-related.

@elonmusk @Yuchenj_UW What’s even more insane is that ~15-20 years ago our Canadian family friend was granted an exceptional ability green card as an artist who paints shitty nudes … still salty about it

@Yuchenj_UW This is insane 🤦‍♂️ I was denied an exceptional ability green card after selling my first Internet company, Zip2, for over $300M in cash within 4 years of finishing my undergrad, and where I was the founder, chairman & CTO! They only gave it to me after PayPal.

USCIS just denied my US green card application. claiming my work lacks impact "beyond that of Apple, Inc." -- even though they acknowledge that I am the Apple CTO. WTF? I have NEVER worked at Apple! I got my cs PhD, cofounded an AI startup, and raised $20M. Yet, after waiting an entire year, I'm rejected with this absurd reasoning. I really hope DOGE, with @elonmusk, @sriramk, and @DavidSacks, can fix the system and accelerate high-skilled immigration. High-skilled immigrants are America's secret weapon. It should be merit-based -- not left to some USCIS officer carelessly reviewing documents and copy-pasting rejection reasons!

@RoofTopKrn I was born in the former Soviet Union and my Russian grade 5 math books were what was being taught in American high school.

@Cloudwatch199 As a Canadian Citizen clinical pharmacist on a TN visa waiting for H1B approval who has lived in the US for ~10 years, discourse disparaging the H1B pathway is disheartening. I went to school in the US, happily pay taxes and contribute to a need in the hospital/healthcare system

(1/x) Here are the top things I think of when a patient with sepsis is worsening despite 'appropriate therapy'. (note: it rarely is that the bug developed resistance..) A 🧵 #medtwitter #foamed

@GilbertPharmD 🙋‍♀️ was a circumstance driven decision and I’m lucky to be thriving but still invariably encourage completion of a PGY2 to those who ask

Be obsessed with improving yourself.

being a good partner is somewhat linked to simply being a good person, if you are selfish, stingy, a liar, deceptive, manipulative, all of these flaws will color an interpersonal relationship, and it’s fine to fly solo; work on yourself before traumatising people

@JamesWilsonDO1 @DrToddLee @wwrighID @ABsteward @IdVilchez @nmoore07 These are great discussions to have with your ID pharmacist 🤓

@DrToddLee @wwrighID @ABsteward @IdVilchez @nmoore07 I agree entirely; tx BCx over UCx if you only are able to tx one of them. But how do you explain the difference in SUSC?

#IDTwitter #MedTwitter #MedEd When you have disparate UCx to BCx organism susceptibilities, you treat the BCx ones. But how do you explain your very obvious source having that disparity? @wwrighID @DrToddLee @ABsteward @IdVilchez @nmoore07

@kirtipatelmd The fact that people are finding things to criticize here is absolutely astounding

Ridiculous. I don’t discharge patients for reasonable requests like this, or being “rude” or having a bad day. The last patient I discharged called me a “cunt” and “sand n*gger” (points for creativity)! So yeah, forgive me for showing myself compassion & telling her to please go.

@RIDICULO_pathy @PitterPatterPTA @Rebekah_Bernard Love the appreciation! Even I personally feel uncomfortable (as a pharmacist) being called doctor because it causes too much patient confusion in a system that is already difficult to navigate. I don't feel the need to ascertain my value with the title.

@robdeedo Perhaps because the average $35/month copay is modest when most other healthcare costs are subsidized by the provincial government

Disappointing that removing $$ barrier in low-income older adults in Canada had little impact on outcomes. Given the relative price gouging that occurs in the US, wonder if the results would be different here. ahajournals.org/doi/epdf/10.11…

women of the world unlearn your my-nose-is-ugly complex

@PulmCrit @GilbertPharmD Everyone on twitter colloquially call treatments/studies trash lol. Calling this 1 tweet some kind of disservice to women/women who publish is such a reach; if this is what we’re choosing to criticize in an effort to uplift&empower it sounds like a co-opted view of allyship imo

@GilbertPharmD Brian, I call out lots of people & papers on this bird app. I criticised that paper because it has poor methodology & may encourage overutilization of central lines. The gender of the authors is not why I didn’t like it (and someting I just now noticed).

I think it's fine to just shut the fuck up on issues you don't know enough about

I wish we would stop fetishizing forgiveness and pay a little more attention to the healing power of incandescent rage

Want to know where the lie that you need 8 glasses of water a day originated? And about how your body regulates fluids via the wonder of homeostasis? Check out this episode of Body Stuff from @TEDTalks and @transmitterpods where I interview @kidney_boy m.youtube.com/watch?v=C07RyM…

@morelandln_ @NeonatalPharmD “Gender differences in the measurement of pharmacists’ job satisfaction” by Manuel j Carvajal, Ioana Papovici & Patrick C Hardigan from Nova Southeastern University, published in Human Resources for Health 🙄

@NeonatalPharmD Oh this makes me 😤 do you have a source I’m curious to look more into this literature.

So women complain but men have concerns? Got it. #whoreviewedthis #academictwitter #wordsmatter