Daniel F. Pauly

Asking #medtwitter about the electronic health record (EHR) ... @EPICEMRparody @Cerner ... Given the choice, I would

@hvanspall I remember reading this back in 2007. Re-reading it now hurts all over again … as I know it does for you. Thank you for reminding us to be always on guard with our medical decision-making. It’s a matter of life and death.

The preventable #death of my dear dad & the disturbing #UnspokenCurriculum shaped me to - better listen to patients - pay attention to details - choose evidence over bravado - err on the side of caution - be truthful about mistakes - forgive #Lessons acpjournals.org/doi/abs/10.732…

He was a mentor But departing from evidence, he had my dad w new angina wait 4wks for CABG: Cath/IVUS had shown 70% LM, tight ostial LAD+LCx lesions, RCA occlusion My beloved dad died before CABG The ensuing silence left me w #lessons I carry everyday1/ acpjournals.org/doi/abs/10.732…

@cbrennansports Do you know why Bradie declined her spot? She has a lot of fans rooting for her!

Bradie Tennell was first alternate but she also has declined so Sarah Everhardt, 19, who trains with Ilia Malinin and is coached by his parents in the DC suburbs of Northern Virginia, will be replacing Liu.

Breaking: Olympic gold medalist Alysa Liu has opted out of the upcoming world championships in Prague. This is not an unusual decision considering how much time she is spending off the ice right now doing national media and TV shows and celebrating her Olympic triumph.

@NBCOlympics This headline has a problem. U.S. Figure Skating gives four medals per event. The fourth place recipient gets a pewter medal and stands on the podium. I believe Max has won the pewter medal twice before. So this is his first top-3 finish, not his first podium finish.

@HannaSorensen I graduated way back in 1990 … that duty doesn’t get any easier with time … which is probably a good thing

if you ever want to know if someone went to medical school just say “currant jelly” and see their reaction

What the hell kinda TV placement is this?!

Still have an opening for our Structural Heart Fellowship for 2025-26 at Carilion Clinic. High volume TAVR, LAAO, mitral and tricuspid interventions. >15 structural heart trials.

I wish he’d have put on a mask after the race to minimize exposing all the health care workers and volunteers who ran to help him. As we know, this virus is highly contagious and can still be deadly.

Holy Crap! 93-year-old billionaire, Dr. Ruth Gottesman, just donated $1 BILLION to a Bronx medical school, the Albert Einstein College of Medicine. Her instructions for the money? "The gift should be used to cover tuition for all students going forward." Her Husband passed away 2 years ago. “He left me, unbeknownst to me, a whole portfolio of Berkshire Hathaway stock,” The instructions were simple: “Do whatever you think is right with it,” she recalled. This is amazing!

@argulian Clinical history? What was the purported stress?

Answer: stress cardiomyopathy, mid-ventricular variant. Note symmetric akinesis of mid-segments with preserved motion of the base and apex. If confirmed in several views, this pattern of contractile dysfunction is quite unique for this condition.

A patient with chest pain. What is the diagnosis?

@AlanHawxbyMD This is what we are reduced to … and the people who mandate these unnecessary modules that waste our time then wonder why costs are high, access is limited, and efficiency suffers

Me, a surgeon who has surgically scrubbed his hands 4,000 times and washed his hands probably 15,000 times👏🏻🧼💦 My inbox:

🧵 On 6 December 1989 a man entered a mechanical engineering classroom at Montreal’s École Polytechnique with a semi automatic weapon. Separating women and men, he shot the women, screaming, “You are all feminists” 14 women were murdered. Today we remember their names and not his

Duke is hard at work seeking a new football coach. There is a feeling the search may bear fruit by week's end.

@BlueDevilNation Thanks for verbalizing the mood in Durham. As an alumnus, I’m not there so I appreciate hearing the mood there.

Yesterday was a day of therapy for Duke fans after waking up to pictures of Mike Elko stepping off a jet in Texas already in the fold. Naturally, a lot of emotions ensued, and for good reason. The coach who gave Duke much had a very tacky departure. It was so tacky that the fanbase felt zero love and was like a pawn in business. There was no note to Duke fans, no acceptable communication with players, and little if any remorse shown to many who supported him. Yesterday was the cold side of college athletics. Many expected Elko to leave, and nobody would blame him for what he felt best for himself and his family. But none thought it would be done in a way that stripped value away and left many devastated. Elko's departure was clunky at best and tacky at worst. It felt more calculated than it did a whim. As time passes, people will appreciate his two seasons here, but the way he left makes his positive comments in the past ring hollow in memory. As of right now, I still have not seen or heard one word from Elko on Duke or the fanbase he left. Many I have spoken to say it feels like they weren't good enough as a base and could not meet his expectations no matter the effort. Mike Elko is where he wants to be now. He had relationships in Texas, and the place made a clear impression on him. And for what it's worth, I think he will do well there. I still have yet to gather many details, but it is time to move on and not wallow in sorrow. The sad thing here is how this was handled. In the end, little thought was given to how things were left. And that is on Mike Elko, not the Duke fanbase.

@Morbidful Tragic … but should have been mathematically predictable … with knowledge of physics and engineering

In January 1999, a tragic accident occurred in Santa Fe, Argentina, when a bus plunged into a river, claiming the lives of ten passengers. During the recovery operation, a crane lifting the bus toppled into the river due to excessive weight. Miraculously, the crane operator managed to jump to safety just seconds before the incident.

@pione_co When you gotta’ go …

Go @DukeFOOTBALL!

Where do you see Mike Elko coaching next year?

@BrownJHM @LITFLblog Electrical alternans … occurs when heart swings in large pericardial effusion … clinical description indicates there is tamponade …

A middle aged male is brought to the hospital altered & hypotensive. Exam w/elevated JVP & muffled heart sounds. What is the noticeable ECG finding? @LITFLblog #medtwitter

@NotSoLilMD Well … I can’t think of any valid reason to no-show a virtual interview.

@DanielPauly9 Virtual. No in person interviews at my shop this year.

Two interview slots this week went unused due to a no call no show and a super last minute cancellation. There’s lots of people who would have loved to have those slots. Try to be considerate of your peers in this process. #PSA