What happens when we have technology to support every organ, but no prescription to save your life?
It's my job to make sure no one dies too early. But do some die too late?
I explored this dilemma while writing Death Interrupted... it's fascinating.
Exciting news! After COVID kept us apart for months, I proposed to the love of my life the minute he got off the plane. Thanks
@United
for sneaking me to gate G3 to surprise him
@flySFO
. I couldn't be happier :)
Iโm so excited to see the cover of my new book, inspired by 17 yrs on ambulances & helicopters, then in the emergency room & now in intensive care. Death Interrupted explores the influence of modern technology on how we survive or die from critical illness. Preorder for Sept20.
To those inquisitive souls wondering how many people usually died in my ICU before COVID, the answer is zero. Zero people died in my COVID ICU before COVID, because we didn't have to open an extra ICU to treat patients with preventable lung disease.
I want a commitment from
@fordnation
@ONThealth
to fund desperately needed surge beds so patients donโt sleep on the ER floor; so elderly people donโt wait 22h in a wheelchair for a bed; so that I donโt have to discuss miscarriages in public hallways; so I can resuscitate people
48h later: no fever, no fatigue, no malaise. Iโve felt fine since I got my vax. My arm is still a bit sore at the injection site, but nothing compared to the heartache I have every time I go to work in the COVID ICU.
@StanfordCCM
@LakeridgeHealth
@UnityHealthTO
@STJOESHAMILTON
Iโm in rural Ontario trying to discharge someone needing home O2 to palliate. But they live on the other side of the Ottawa river in Quebec, and Iโm not licensed there. We need national licensure for healthcare professionals.
@CAEP_Docs
@CMA_Docs
@OntariosDoctors
@picardonhealth
Working in a COVID ICU has been one of the hardest things Iโve done in my 16 years as a clinician; so many unnecessary deaths. My gratitude to โฆ
@TheLancet
โฉ for letting me express an inner dialogue I had recently, through my lens as a brother.
Itโs official! Next June, Iโll complete my
@MacEmerg
residency and move to San Francisco to start an ICU fellowship
@StanfordMed
- with other exciting local opportunities in the works. Excited to start a new chapter in my life! Grateful to my mentors who encouraged me to apply.
Iโm sooo tired. Everyone I work with is just sooo tired. We are out of runway. All we can do on the front lines is show up and hope it ends soon. Please say something nice to a healthcare worker today. And just follow the rules for a little while longer.
@CAEP_Docs
#onpoli
When your book is placed next to โฆ
@DrJenGunter
โฉ you kinda freak out a little. Itโs out!!
#DeathInterrupted
delves into a modern dilemma: we have technology to support almost every organ, but when do we throw in the towel and allow death to come? We canโt all live forever.
Our biggest mistake all along has been to follow the virus instead of getting in front of it. We need to skate to where the puck is going to be, not to where is has been.
#COVID19
COVID cases are climbing again and Iโm so sick and tired of intubating people. My latest for โฆ
@GlobeDebate
โฉ At this point in the pandemic, itโs misinformation thatโs killing people โฆ
@SeemaMarwahaMD
โฉ โฆ
@StanfordMed
โฉ โฆ
@StanfordCCM
โฉ
Nine and a half months after intubating my first COVID patient I was vaccinated. The development of a vaccine this year is an achievement in human history. I canโt wait for COVID to go away, and today an end is in sight. โฆ
@StanfordMed
โฉ โฆ
@StanfordCCM
โฉ โฆ
@Stanford
โฉ
3 things I learned taking the last 2 weeks off from the ER and ICU to refresh:
1. It's hard to know you're experiencing burnout until you aren't experiencing burnout anymore
2. My partner suffers from my burnout as much as I do
3. Sacrificing fiction reading is short-sighted
My boyfriend made me pad Thai for my birthday because we had to cancel our trip to Thailand. He also turned the living room into an airplane, gave me a boarding card, and dressed like a flight attendant and sang a flight briefing al-la-
@RuPaulsDragRace
. Best J service everโค๏ธ
My boyfriend and I are on opposite shifts and I havenโt seen him in 4 days. I came home and found Doug dressed up for dinner and seafood pasta waiting for me (and him) in the fridge.
#CovidMicrowaving
#CovidCooking
#NoYouCantHaveHim
The moment when you get off a last minute Zoom video conference call and realize a) you didnโt do your hair today b) you havenโt shaved since Friday and c) youโre wearing your lace shirt usually reserved for gay clubs.
#workingfromhome
#ZoomFail
#OwnIt
So apparently, 2020 can actually get worse. Such sad news.
#RBG
was a champion for minority rights including
#LGBT
rights. A giant among giants, her impact is immeasurable.
I never expected people leading hospitals and health systems to come up to me and share stories from their lives which they relate to the themes and anecdotes in my book. It's truly humbling and speaks to the universality not only of death but of the modern struggles with it.
When will Canada start to take life threatening ER delays seriously?
>60min offload delay; >35h for inpt bed
Atrocious to leave the elderly in hallways
UK NHS: declare critical incident!
Canada: just another dayโฆ
@CAEP_Docs
@CMA_Docs
@OntariosDoctors
@picardonhealth
Wow, โฆ
@mattgallowaycbc
โฉ got deep into the dilemma of how we die when technology has failed to save us. Honoured to chat with him. ~~ Why one doctor says modern medicine has disrupted our relationship with death | The Current with Matt Galloway
Dr Greenwood has been my family doctor for 34 years. Today I wished him a happy retirement and thanked him. We joked about the current state of medicine, but he said itโs as fascinating now as it was when he started. A great role model and an inspiring doc.
Itโs a honour to have
@Radiolab
share the story of my Dad. Next week will be bitter sweet as Fernando and I celebrate our one year anniversary. His surgeon
@Sunnybrook
put him in a taxi w NG to come officiate our wedding hours before palliative surgery.
Oh dear.
@CBCNews
please call me or anyone else on the front lines before giving Richard Schabas any more airtime. This is not an overreaction.
@CAEP_Docs
emergency doctors are bracing for an unprecedented surge in demand over the next months. Moves to
#ShutItDown
were justified.
Nailed it,
@picardonhealth
โฉ explains why more beds wonโt cut it: โ a bed is not just a bed; it requires a highly skilled team... 13 months into the pandemic, finding health workers who are still standing is an ever-growing challenge.โ
My friend is going to work in the ER tonight. Weโre all scared, but we also have work to do. โฆ
@MacEmerg
โฉ is gonna
#FightTheVirus
and win. โฆ
@HHS_staff
โฉ โฆ
@STJOESHAMILTON
โฉ have strong and brave health care workers who canโt stay home. Please, stay home for them.
Sometimes, it's hard for me to know if you're having an emergency.
@AnthemBCBS
policy asks you to determine if you're having an emergency before coming to the ER. If I can't figure it out with all my resources, how should you? END the games.
@EmergencyDocs
@ACEPNow
@CAEP_Docs
An insurer's cost-reduction policy may make 9 out of 10 ED patient weigh the chance of having an emergency against possible coverage denial.
#JNOVA50
cc:
@mdaware
#CovidCooking
day 4. When you come home from an ICU night shift and your boyfriend made you eggs Benedict with real peameal! :)
(I was so hungry I ate half of it before I remembered to snap a pic). Also, no you canโt have him, heโs mine.
If you're rude to colleagues, you're hurting patients.
Diagnostic performance significantly lower in team exposed to rudeness 2.65 vs 3.18, p0.005; Procedural performance significantly lower in team exposed to rudeness 2.77 vs 3.26, p0.008
@MacEmerg
Listening to this gives me chills. Thanks to
@latifnasser
and the
@Radiolab
team for the care they took in telling my dadโs story.
Itโs a privilege to save lives with critical care technology and itโs a privilege to provide palliative support when that technology fails to help
My birthday trip to Sri Lanka and Madagascar got cancelled due to the pandemic, but I woke up on my birthday to learn I had adopted a slow loris (Sri Lanka) and a lemur (Madagascar)! Best. Boyfriend. Ever.
7 hours of studying in a coffee shop; I think Iโm ready for my elective โฆ
@UHN
โฉ ICU. Excited to get some ECMO and lung/liver transplant experience :)
In addition to being an emergency med. resident at
@McMasterU
and a qualified helicopter paramedic,
@BlairBigham
is also a medical journalist. He is also a
#CMAAwards2018
Young Leaders (residents) recipient - Read his story:
New health podcast! Join us every other Monday for the latest on Canadaโs health care successes and failures, inspired by the pages of โฆ
@CMAJ
โฉ. On Apple Podcasts, Spotify, or wherever you get your podcasts. โฆWith the fabulous
@Drmojolaomole
โฉ.
Launching next week!
โI think itโs incredibly irresponsible and very cruel,โ Ford gov to cut $1-billion in funding to Toronto Public Health over 10 yrs. This is the definition of madness. Public health PREVENTS acute care costs by orders of magnitude. โฆ
@OntariosDoctors
โฉ
Celebrating a rainy first anniversary at the
@TorontoZoo
with our ring bearer, the goat named Easter Bunny (heโs staying warm in his little house). Thinking of how magical our wedding was 365 days ago.
I wrote this in the midst of working in a COVID ICU where families were banned from visiting their loved ones as they died. Iโm not sure the right way to balance safety and humanity but I donโt think we did a good job via
@JAMA_current
part of
@JAMANetwork
@meganranney
@DylanRJCollins
Once I was transporting a bleeding patient to a trauma center by helicopter. My pilot said he needed to do a fuel stop. I asked if we could stretch it to the helipad and he said โI fly on fuel, not hopeโ.
Equity argument falls flat: Fall exams don't help pregnant candidates, candidates with job commitments, candidates sprinkled all over the world for fellowships. Equity and fairness required an exam before June 30.
#ExamFail
. This special meeting is an echo chamber from March 2020
Thanks
@BlairBigham
for volunteering to speak on behalf of residents at the
@Royal_College
special meeting. You raise a great point - no resident representative bodies as part of the discussion (RDoc or PHOs).
@ResidentDoctors
Every 9 minutes, someone in Ontario visits an ER for dental pain. Yet dental care isnโt covered under Medicare. One in five people avoids dentists because they canโt afford it. Hasan Sheikh calls
@CAEP_Docs
to action
#caep18
@AndreaHorwath
@Kathleen_Wynne
@fordnation
Happening now: Ontario Health Minister
@celliottability
and Premier
@fordnation
say โUrgent and immediate action must be takenโฆ to save livesโ and then defer lockdown till Dec 26. Negligent. This will cost lives. We need to shut it down now; ICU beds critically low.
#ontpoli
We're so pleased that one of our new LED sky ceilings has been installed in intensive care, thanks to
@lhchcharity
. Hopefully this small change will help to make a big difference to the experience of our patients and families while they receive care and treatment at LHCH.
Wellness isnโt about add-ons to make a bad system tolerable. Wellness requires seismic shifts in the system so that nothing needs to be added on. We all want to care for patients, but thatโs only part of my job. Find a way to get rid of the other part.
Thanks! Great to meet you in person! So excited to join
@StanfordMed
and canโt wait to meet more of the
@StanfordEMED
team :). Week
#1
has been awesome.
The One and Only
@BlairBigham
is now in the building (The New Stanford Hospital). Congratulations on starting an outstanding critical care training program!
@grandpawrinkles
Prior to COVID, we didn't have a COVID ICU, so I guess I'd say zero. Two weeks ago in an equally sized non-covid ICU we had one death.
Someone should tell self-important anti-gun doctors to stay in their lane. Half of the articles in Annals of Internal Medicine are pushing for gun control. Most upsetting, however, the medical community seems to have consulted NO ONE but themselves.
Thanks for making
#DeathInterrupted
a best seller for a second year!!
Need something that arrives next day for stocking stuffers or last minute gifts? Consider sparking an important conversation on life at the end.
A patient in the wrong place: Fernando Valencia's dadโs remarkable recovery after a severe subarachnoid hemorrhage was met with frustrating health system failures. Read the new
#PatientPortrait
by
@SeemaMarwahaMD
:
#cdnhealth
I woke up this morning 99.9% human and 0.01% virus mRNA. I have never felt sexier.
But for so many people this vaccine didnโt come fast enough. They soffocated to death, alone, afraid, because the world failed to control spread of COVID. Please do your part. Get the vax.
I wish I could say I understand
@Royal_College
decision to postpone exams 6 months. I don't at all and am absolutely devastated. My entire life has been shredded to pieces. I'm also going to be jobless for 6 months now as no way I can start a practice while having to study.
Tips on saying โnoโ so you can stay sane. My darkest months have been those where too many yeses coalesced into an unmanageable workload. Stress comes from perceived reputational risk and fear of letting others down. Anticipated workload is hard to predict; timelines often shift.
#Burnout
is a big problem in medicine, but what are concrete solutions? We suggest 3 for residency: (1) Integration of
#wellness
into existing curricula, (2) Formalize time to share vulnerability, (3) Learn to say no!
#meded
@CJEMonline
@ResidentDoctors
Great perspective, very relevant to residents! Many mentors
@MacEmerg
(and elsewhere!) that have influenced me beyond words. The 5 types of mentors you need in your life via
@TEDTalks
Emergency room chaos is about more than dignity and compassion for the ill. Overcrowding is proven to be deadly.
@CAEP_Docs
have been advocating for decades to ensure ER teams have space and resources to care for sick Canadians.
Thrilled to be sharing what I've learned over the years as a paramedic, ER doc and intensivist about the end of life
@UofTSurgery
Balfour Lecture
@agotoronto
Nov 29.
Second shot! So grateful to be vaccinated. Lots of great questions came pouring in after my first dose... hereโs answers to two of the most common around the safety of mRNA vaccines.
#covid19
#vaccination
Brilliant essay on how antiquated death certificates fail to speak for the dead to protect the living, by not capturing the true reasons disease leads to death. By
@Bondzi23
in
@TorontoStar
Whatโs more Canadian than universal access to healthcare? My latest for
@globeandmail
All Canadians deserve access to precious emergency care /via
@globe
@Kevin_Getz
Ontario is looking for additional experienced health care providers to help provincial efforts to prevent and control the spread of COVID-19. Learn more at:
Canada's health and science journalists have saved more lives than doctors in the last two weeks by articuling important information about social distancing and reducing fear and panic. Kudos to you all! We know you're working overtime and we appreciate it.
#scicomm
#COVID19
has shown many the true value of good journalism. Many outlets, like
@globeandmail
, have removed their paywalls so everyone can stay up to date. But news costs money to produce. Please subscribe to local, regional, national outlets.