Dr. Daniel O. Bral

@emresidents @ChristianKasia3 @miguel_reyesMD @aluc333 Woooohoooo!!

We're highlighting EM Resident articles that captured attention in 2025. Check out these featured articles at emra.org/top10-2025: 🔹Post-Intubation Sedation in the ED 🔸How to Manage MDMA Toxicity @ChristianKasia3 @DrBral @miguel_reyesMD @aluc333 #EMResident #MedEd #EMBound

It’s worth pointing out two things here. 1. When surgeries go longer than expected, that’s often when high quality anesthesia care is needed most. 2. Private insurance companies turn larger profits by covering fewer services, no matter how critical. asahq.org/about-asa/news…

MOCA Minute ✅ @AbaPhysicians twas fun. Def can wait a year before doing that again. 😂

This is true depravity. Don’t look away. Look at these images. This mirrors the Nazi atrocities to the “others” of society-not just the Jews-also gays/queers, gypsies, disabled, Jehovah’s Witnesses, dissenters. In a diff country, this could have been anyone else. Never Forget.

Hey @Verizon/@VerizonSupport … SOS! What’s the deal?!!

@RJSzczerba @subatomicdoc

Calvin? Calvin, sweetheart?" In the darkness Calvin heard the sound of Susie, his wife of fifty-three years. Calvin struggled to open his eyes. God, he was so tired and it took so much strength. Slowly, light replaced the darkness, and soon vision followed. At the foot of his bed stood his wife. Calvin wet his dry lips and spoke hoarsely, "Did... did you.... find him?" "Yes dear," Susie said smiling sadly, "He was in the attic." Susie reached into her big purse and brought out a soft, old, orange tiger doll. Calvin could not help but laugh. It had been so long. Too long. "I washed him for you," Susie said, her voice cracking a little as she laid the stuffed tiger next to her husband. "Thank you, Susie." Calvin said. A few moments passed as Calvin just laid on his hospital bed, his head turned to the side, staring at the old toy with nostalgia. "Dear," Calvin said finally. "Would you mind leaving me alone with Hobbes for a while? I would like to catch up with him." "All right," Susie said. "I'll get something to eat in the cafeteria. I'll be back soon." Susie kissed her huband on the forehead and turned to leave. With sudden but gentle strength Calvin stopped her. Lovingly he pulled his wife in and gave her a passionate kiss on the lips. "I love you," he said. "And I love you," said Susie. Susie turned and left. Calvin saw tears streaming from her face as she went out the door. Calvin then turned to face his oldest and dearest friend. "Hello Hobbes. It's been a long time hasn't it old pal?" Hobbes was no longer a stuffed doll but the big furry old tiger Calvin had always remembered. "It sure has, Calvin." said Hobbes. "You... haven't changed a bit." Calvin smiled. "You've changed a lot." Hobbes said sadly. Calvin laughed, "Really? I haven't noticed at all." There was a long pause. The sound of a clock ticking away the seconds rang throughout the sterile hospital room. "So... you married Susie Derkins." Hobbes said, finally smiling. "I knew you always like her." "Shut up!" Calvin said, his smile bigger than ever. "Tell me everything I missed. I'd love to hear what you've been up to!" Hobbes said, excited. And so Calvin told him everything. He told him about how he and Susie fell in love in high school and had married after graduating from college, about his three kids and four grandkids, how he turned Spaceman Spiff into one of the most popular sci-fi novels of the decade, and so on. After he told Hobbes all this there was another pregnant pause. "You know... I visited you in the attic a bunch of times." Calvin said. "I know." "But I couldn't see you. All I saw was a stuffed animal." Calvin voice was breaking and tears of regret started welling up in his eyes. "You grew up old buddy." said Hobbes. Calvin broke down and sobbed, hugging his best friend. "I'm so sorry! I'm so sorry I broke my promise! I promised I wouldn't grow up and that we'd be together forever!!" Hobbes stroke the Calvin's hair, or what little was left of it. "But you didn't." "What do you mean?" "We were always together... in our dreams." "We were?" "We were." "Hobbes?" "Yeah, old buddy?" "I'm so glad I got to see you like this... one last time..." "Me too, Calvin. Me too." "Sweetheart?" Susie voice came from outside the door. "Yes dear?" Calvin replied. "Can I come in?" Susie asked. "Just a minute." Calvin turned to face Hobbes one last time. "Goodbye Hobbes. Thanks... for everything..." "No, thank you Calvin." Hobbes said. Calvin turned back to the door and said, "You can come in now." Susie came in and said, "Look who's come to visit you." Calvin's children and grandchildren followed Susie into Calvin's room. The youngest grandchild ran past the rest of them and hugged Calvin in a hard, excited hug. "Grandpa!!" screamed the child in delight. "Francis!" cried Calvin's daughter, "Be gentle with your grandfather." Calvin's daughter turned to her dad. "I'm sorry, Daddy. Francis never seems to behave these days. He just runs around making a mess and coming up with strange stories." Calvin laughed and said, "Well now! That sound just like me when I was his age." Calvin and his family chatted some more until a nurse said, "Sorry, but visiting hours are almost up." Calvin's beloved family said good bye and promised to visit tommorrow. As they turned to leave Calvin said, "Francis. Come here for a second." Francis came over to his grandfather's side, "What is it Gramps?" Calvin reached over to the stuffed tiger on his bedside and and held him out shakily to his grandson, who looked exactly as he did so many years ago. "This is Hobbes. He was my best friend when I was your age. I want you to have him." "He's just a stuffed tiger." Francis said, eyebrows raised. Calvin laughed, "Well, let me tell you a secret." Francis leaned closer to Clavin. Calvin whispered, "If you catch him in a tiger trap using a tuna sandwich as bait he will turn into a real tiger." Francis gasped in delighted awe. Calvin continued, "Not only that he will be your best friend forever." "Wow! Thanks grandpa!" Francis said, hugging his grandpa tightly again. "Francis! We need to go now!" Calvin's daughter called. "Okay!" Francis shouted back. "Take good care of him." Calvin said. "I will." Francis said before running off after the rest of the family. Calvin laid on his back and stared at the ceiling. The time to go was close. He could feel it in his soul. Calvin tried to remember a quote he read in a book once. It said something about death being the next great adventure or something like that. He eyelids grew heavy and his breathing slowed. As he went deeper into his final sleep he heard Hobbes, as if he was right next to him at his bedside. "I'll take care of him, Calvin..." Calvin took his first step toward one more adventure and breathed his last with a grin on his face ! #calvinandhobbes #comics #virals #Hobbies #billwatterson

I didn’t know there were 20,000 ways to spell entitled. 🤦🏽‍♂️

Make sure to talk to your surgeon and anesthesiologist about Ozempic and when surgery might be safest for you.

Hi, ER Doc here. RT if you’ve ever done CPR on someone and they survived. Trying to prove something.

@mattyfred_ Selfie/Tik Tok light.

Hey medtwitter does anybody know what this thing is? Keep seeing them in hospital rooms….

@olsonplanner Public loan forgiveness denied.

In 5 words or less, ruin a financial plan.

@gina_linganna @brandi_bottiger Just watched part 1 of CVP. Great video!

If people are interested in resident level cardiac anesthesia education, check out my YouTube channel. I go through basic echo views, CVP tracings, and an interesting case of TOF. All videos are very short !! They will also be more coming soon!! @intotheether431?si=WWTTvEaVaI-3-hxA" target="_blank" rel="nofollow noopener">youtube.com/@intotheether4…

Friends, Valentin (Eli) Ghnassia, 23, was a lone soldier from France. He was on the frontlines in Kibbutz Be'eri and fought the Hamas terrorists for eight hours, saving countless lives. Valentin is being laid to rest at 12 noon today at Mt. Herzl in Jerusalem. Please go.

My father lived his whole life with the hope that there might be a peaceful two-state solution. He spent his last years making YouTube videos on the topic and telling anyone who would listen about his family’s olive groves in Gaza. I am actually kind of relieved that he left this earth before he had to watch Hamas slaughter his dream on video, for all the world to see. Hamas has ensured that there will be no more Palestine, and no more hope for an independent state.

Hamas has stated that it is going to start executing hostages - civilians, young children, helpless men and women. These are crimes on every level - religious and legal. The barbarism you are witnessing is a repetition of ISIS. Anyone sympathetic to Hamas is supporting terrorism. The “Palestinian Cause” has been exposed for what it truly is: a genocidal agenda to ethnically cleanse whoever they disagree with, Jews, Christians, including 15 Muslims so far. We must all unite against the fanatic supporters of Hamas and Hezbollah in the West.

I am an "American Jew" but now more than ever "American" is the complement to my core as a Jew. When I weep, when I bleed, when I hurt...Im Jewish. I also recognize the hurt, pain, and loss that many innocent Palestinian families are feeling as well. #Israel_under_attack

@jtrebach Think to myself… wow what a fungi

you walk into the hotel lobby and see me taking a selfie in a mushroom shirt what do you do???

I’ll be happy when I become a resident, it’ll make all this studying worth it I’ll be happy when I am an attending… that will solve my burnout It’ll be happy when I buy a house… or car… or… This is called an arrival fallacy, and it’s a big problem for a lot of doctors 1/