So grateful to
@CQUni
for awarding me Alumnus of the Year for Industry Excellence and inviting me to give the Occasional Address at the Sydney Graduation Ceremony
A life highlight so far
(My talk is the first few minutes)
The hospital CEO just gave all the medical students his mobile number and email.
“If you’ve got a problem and you’ve tried the right people and solutions aren’t happening, call me.”
Woah
It is literally easier to buy illicit drugs than a Rapid Antigen Test in Sydney
I’m still just gobsmacked at how abysmal this entire public health policy failure is
A patient has clear fluid dripping from their nose and you want to know if it’s nasal secretions or CSF leak?
Check it with a glucometer
CSF has sugar in it,
rhinitis doesn’t
- Prof John Greene
Today was really inspiring
4 years ago I never would have believed that it was possible for someone like me to get published in the NEJM
yet just this morning they published a drug trial of 61 patients w/o control
Just goes to show
You CAN achieve anything!
Believe in yourself
Not sure why people think that a viral pandemic suddenly makes it ok to breach patient confidentiality
But here’s a gentle reminder that you can’t just post photos of your patients on a vent or their CT scan with their medical record number, admission date, and name on it.
I started as a St John Ambulance cadet when I was 14 and fell in love with healthcare
It ‘clicked’ like nothing else in the world did
I have loved EVERY single day of my journey as a Paramedic
And today I got into Med School
Thank you for your love and support twitter family 💚
If a UK anaesthetist goes on TV and spews anti vaccine rhetoric
And the GMC doesn’t suspend him immediately
Then I’m not sure I see the point of the GMC
@jamcfetridge
@timgill924
As a current zoom grad student
I barely get through a quarter of the assigned reading once every two weeks
And let me tell you
My ability to philosophise my way out of the gnosis of content has never been stronger than the current trend towards a hermeneutic confabulation
My
@uber
driver asked what I do
I said I was a healthcare student
She asked what I thought about vaccines
I told her they were the most important health invention in history and I would trade every hospital in the world for the ability to vaccinate our society
gave me 3 stars
Why don’t we routinely ask patients with chronic diseases who, by their own assessment, are doing ‘well’ to coach newly diagnosed patients, and then pay them, as a professional health service? because I’m almost certain this would work a lot better than the current ...nothing.
One day I'd really love to organise an all-female panel of 11 doctors or so to discuss vasectomies and erectile dysfunction.
I think it would be educational.
Putting together the scientific program for this exciting
#endometriosis
masterclass. We have an exceptional international faculty and places are limited to 15 delegates (9 left now). register here:
Endorse.
Please can we stop forcing people who don’t want to do research to do research?
It makes people hate research and it produces lots of bad research.
Everyone loses.
Like many students, I was told I needed to do research to “demonstrate dedication” to my chosen field. This is the dumbest thing. Read my personal statement. Read my letters of recommendation. If you’re not convinced of my dedication, I have no business getting an interview.
Emergency medicine gets a lot easier when you realise Delirium is brain AFib and Seizure is Brain polymorphic VT
Stroke is Brain Attack
Thunderclap headache is brain angina
Meningitis is brain IE/Pericarditis
If you introduce me to the patient with
“Hi, there’s a medical student here with us. He’s a male. Now you can say no if you like, is it ok if he watches?”
There is a 100% chance that I will not learn how to deliver a baby today.
#MedStudentDiary
It has taken almost 4 years of medical school and finally we had an Intensivist sit down and teach everyone the safe way to interpret ABGs:
1. PaO2 (P:F ratio etc)
2. PaCO2 (Ventilation etc)
3. bE, HCO3, then pH (Acid-Base)
4. Anion gap
Please teach this way
Just remembering the time in a simulation when a trainee first responder asked the bystander (an actor) to call them an ambulance
So the bystander
turns around
Catches my eye
Looks the trainee square in the face
Breathes
And with a deadpan face says
“You’re an ambulance”
When we as paramedics arrive on scene and there is a first responder who is a capable healthcare professional trying to give a very brief handover and we ignore and sideline them; that’s like when the Resus team leaders cuts us off mid-handover.
My grandma passed away peacefully today with her children in the room after raising 3 kids, 8 grandkids, 3 great grandkids, working as an army intel officer, a hotelier, jeweller, cheese & wine seller, and moving her family from Jerusalem to Vancouver, and then Sydney in the 70’s
Channukah Miracle
Grandma has an NSTEMI with Trop of 63,000.
(yes sixty three thousand you didn't read that incorrectly)
and shes .... fine?
like her EF is 50%
Her BP is normal
shes.... shes fine.
shes going home soon 😂
Keeps telling me about the time she was in the army
The year is 2021
Medical school lectures are delivered entirely over TikTok
All NHS healthcare workers eat a donut on fridays as a symbol of protest/solidarity
Nobody remembers why
Canada has built a wall around America
The Pound is benchmarked against the cost of an N95 Mask
I don't have anything to promote really.
This isn't my idea.
But I guess if you could all do a bit more to support all women in your local communities that'd be rad.
Lecturer asked diff between VBG and ABG in a scenario
I answered that VBG would suffice and was practically equivalent
Lecturer said that the VBG was always a waste of time and ABG was more accurate
And I said ok, nodded, breathed.
😌
Really channeling that inner peace 🙏🏼
“They chose me to be head of the medical school here because I’m someone at the later end of their career who loves what they do just as much as when I began it.
I’m not a workaholic,
I’m a workaphile.
I take that passion home with me to my kids who are my greatest achievements”
The solution they came up with as a group:
Always render assistance in an emergency but refuse to fill out any paperwork when asked by airline staff. Give them your work address and bill the airline at a private consulting rate for all time taken to complete forms/ paperwork.
Had an Interesting chat with a bunch of ED, ICU and crit care consultants this week.
They’d all responded to in flight emergencies on
@Qantas
flights
Went out of their way to help.
When they missed their connection / gave up seat etc to help
Qantas left them out to dry
One day you’re going to hurt a patient by mistake
It will happen no matter how hard you fortify yourself with knowledge
and nothing you’ve experienced will prepare you for it
If you’re lucky it will hurt you more than it hurts them
you will need good mentors to help you heal
Open to all HCPs.
1. What's one thing you wish they'd told you during your training/education for your role?
2. What's one thing you need to experience on the job, that can never be taught in training?
Midwife to patient: “by the way, I just want to remind you that you’re in control and if at any point you’re uncomfortable with anyone in the room, including me or any of the doctors, you can ask that person to step outside and nobody will be offended ok?”
Awesome midwife the other day
“Hello my dear. I’d like to introduce you to Aidan. He’s training to become a doctor and he is part of our team today. If it’s ok, he is going to be helping me with your delivery.”
I say hello to patient, we meet etc
1/2
Me last year:
my body is a temple and I am free of the constraints of relying upon caffeine
Me 3 months into Med school, speaking to barista:
Hey John, I’ll have my usual
#MedSchoolDiary
@michaelharriot
White people don’t ever tend think about this question because we assume ourselves to be the default monocultural
Which is why most will struggle to answer it
Boyfriend and I are sitting on the sofa
(that feels really nice to write)
I am calculating LRs from the Sn/SP in a paper, he is writing grant proposal.
The Mandalorian is on pause while the kettle boils.
Life is good.
Have a wonderful week y'all
💙
TikTok videos by
@DGlaucomflecken
are one of the highlights of my week.
They make me happy.
He possesses an unrivalled talent for tasteful self-effacing comedy that capture ‘the little moments’ of medicine.
He is, in short, a living treasure
As a paramedic
I’ve saved more lives by referring young men to see caring GPs in their area for mental health care plans
than basically any other intervention I can think of
I’m on my psychiatry rotation at the moment
And Paramedics of Twitter
I just want you to know that everyone reads the patient care record you’ve written as well as repeats what is said during ambulance handover to ED.
Your assessment from scene matters hugely
TXA - not much benefit
REBOA - causes harm
Vasopressors - safe peripherally
Fluids first vs vasopressors first in septic shock - not much difference
A glorious day for critical care research
#CCR23
Only just discovered a old medical drama called House and I'm as addicted as I was for Grey's 😱counting this as productive preparation for entering clinical years (Y3) :)
Mad to think it started when I was 4 years old lol no wonder I hadn't heard of it😂
#MedTwitter
#MedSchoolDiary
Nothing healthy is going to come of putting 100 odd high achievers with esteem issues into small room 5 days a week with the weight of a 250+ year old culture of elitism and social seperatism.
This literally feels like hogwarts.
Dysfunctional and strange
Well actually
More doctors are dicks than other health professionals
we are taught through the hidden curriculum that we are superior in knowledge and that by virtue of our harder work studying, we are owed deference, and must protect patients from harm by the lesser professions
Over the years I’ve met some amazing people who made me feel lazy at how little I was able to “do” at any one time.
What was their secret?
Their spouse basically organised their entire life and did thousands of hours of unpaid labour to help them.
If the patient can read your tweet and identify themselves from your story then it is not sufficiently anonymised.
Please do not prioritise the willingness to share a touching moment you have experienced over the right of our patients to confidentiality
#ShareAStoryInOneTweet
“It is a tragedy to be born a man and to die a doctor.
This [medicine] should not define the totality of your life otherwise you will be very impoverished and very boring at the end.”
- A/Prof John Dearin
I have friends who are Doctors and can’t get back to australia to start WORK in frontline essential medical roles but they let Katie Hopkins the racist potty mouth back for some TV stunt ?!
Katie Hopkins published a video where she explains how she’s deliberately exposing our quarantine hotel workers to risk—by not wearing a mask and not waiting 30 seconds to open the door.
Throw the book at her Australia. She’s taken the video down now but it’s archived.
It's pride month.
A reminder that nobody one day decides to just 'be gay' and 'come out'
There is a lengthy process by which J.K Rowling must appoint you and then you receive a letter by owl.
Its Sirius business .
i'll see myself out...
I got a bit teary eyed reading this
Positive feedback like this is so powerful
and so rarely given
Being new is hugely daunting
Today is dedicated to this awesome med reg
A little bit emotional seeing this today
As a Aussie paramedic, rego is an especially big deal
Seeing my name on the list makes it finally feel real
It’s taken 10 years of falling down and getting back up again thanks to the help and love of so many of you
Thank you 💙🫶
Shoutout to the lovely guy I went on a date with last night for majoring in linguistics and still not feeling the need to correct my grammar even once.
That’s a level of self restraint we should all aspire to.
The new
@jemsconnect
@EMSTODAY
advisory board at their first meeting. A fabulous group of EMS heavy hitters. Proud to work with them to move JEMS and EMS Today into the future!
First day of GP Rotation done ✅
Absolutely loved it.
my biggest takeaway:
I think an 8hr shift in General Practice is harder than an 8hr shift in ED or Prehospital care.
Certainly more mentally taxing.
#MedSchoolDiary
One of the most pernicious things we can do to a person is label them as a
“Difficult Patient”
It’s a label that will never scrub off
It WILL mean they receive poorer care
If I ever absolutely lose it
Like
Go on a rampage through a store throwing clothes left right and centre, bags of flour on the floor. etc
Just know
It is because entire generations of medical students and doctors are taught that the trigger for intubation is a GCS <8
EM Answer: push it in a strain the wine when you pour it out.
ICU Answer: Use a 22g spinal needle and 20mL syringe with extension set to pressurise the bottle, forcing the cork out.
Anaesthesia Answer: Apply a flame gently below the cork and Boyles Law will pop the cork out.
Why are medical schools globally obsessed with teaching students about some syndromes?
Every student I speak to has had a disproportionate amount of time spent on
Horner’s syndrome
and Grave’s disease
for example
The amount of lecture time =\= population frequency
Meeting boyfriends mum in 20 minutes for the first time at a breakfast spot
We decided to go out for ‘just a few drinks’ last night
I cannot emphasise enough how terrible this decision was in retrospect
Pray for me
Hey Guys
Really exciting news
By the grace of god I’ve been accepted into interventional cardiology training at Glenfield Hospital in the UK as a medical student
So humbled and excited for this amazing opportunity.
🙏🏼💚☺️🙌
#Goals
#OneTeam
#Development
American EMS conferences are cool because one minute someone is saying reasonable stuff and all, and the next minute sheriff Joe from whosawhatsit county is talking about how his special ops tactical paramedic team for a city of 15,000 people use IV clonidine for analgesia in ACS
Opioid analgesia does not prevent the assessment of abdominal pain
Pacemakers & LBBB do not prevent the assessment of the ischaemic changes on ECG
Nerve blocks do not prevent the assessment of ischaemic pain from compartment syndrome
Twitter doesn’t prevent reading the paper
Dear Premiere
@ChrisMinnsMP
I’m a paramedic who works at music festivals
In fact
I’ve probably personally treated 1/4 of all the severe MDMA related medical emergencies at festivals in NSW since 2017
The reason most young people have died is not due to quantity of ingestion
"The truth is, that there's no safe quantity to take of these illegal substances" |
#nswpol
@NSWLabor
@ChrisMinnsMP
NSW Premier Chris Minns has ruled out any hasty changes to the state government's stance on pill testing as Australians get ready for a summer of festivals.…
Medical school is pathogenic for mental illness
I’ve never felt so unhealthily stressed for as long as I can remember
Classmates all around me are developing GAD and depression/ adjustment disorders.
Please excuse my language when I say this is truly F***ed
#MedSchoolDiary
End of an incredible week with an incredible group of clinicians. Our inaugural Senior Paramedic induction comes to an end with input from all areas of the Trust. Great feedback from those in attendance and sets
@WelshAmbulance
on the next step on its clinical journey.
My lecturer is a no-show
There are 100+ grad students on this recorded zoom.
We’ve started blasting hits from the ‘90s for everyone.
And just for a moment, everything was right with the world.
‘The depressed and anxious brain is like a puppy
You gotta tire it out with walks and reward all the good behaviours (no matter how small) otherwise it will tear everything to shreds and poo on your floor.
And even when it does, acknowledge the poo, clean it up, and then love it’
3. Stop the statins over 80
4. The lowest mortality BP in the very elderly is 160-180 systolic
5. You can destroy very carefully orchestrated plans by community care teams
6. Don’t urine dip >65yo’s
7. Smelly urine is not indicative of UTI
-
@DrLindaDykes
#18IAEM
One consultant called up the Qantas Chief Medical Officer
“I gave up my seat, you held me for hours w/out aircon to speak to police & airport doctor, missed my connection. I’d at least expect a refund on the seat”
Told by CMO “I don’t care. It’s your Hippocratic oath to help”
I end up speaking to paramedic friends and collages every few months about doing medicine. Is it worth it? What’s the process like?
“Should I do it?”
And my answer is essentially these three things I’ve discovered and learned from others
1/ 🧵
Picture this
You’re a young consultant
thriving on the success of a smoothly run cardiac arrest
You turn to twitter to jubilantly express your enthusiasm and...
Your sister, a registrar, announces to the world your childhood misunderstanding of household fluid dynamics
🔥😭
There is an anaesthetic consultant who has had me in theatres with him twice in the last week.
He’s spent hours teaching me, watchfully allowing me to learn, has drawn out entire context-sensitive half time graphs of various drugs with me.
He has made feel valued as a student
there's a moment that happens when you notice the scars on the inside of a patient's arm, and they notice you noticing, and your next action is one of gentle reassurance, and you can literally feel the worry melt away,
because they were so scared of what your response would be