James Lynch @JamesLynchGTC Twitter profile

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James Lynch

9 months

@hartgroup_org have produced this blogpost. It presents the concerns about midazolam as a false dichotomy and then fails to give both sides equal balance. It also falls foul of several conspiracist tropes. Lets take a look.

Balancing on an ethical knife edge

Two views of the Midazolam story

www.hartgroup.org

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James Lynch

@JamesLynchGTC

1 year

John Campbell @Johnincarlisle has stepped away from misinterpretting studies and turned his hand to NG163, the NICE Guideline for COVID (now replaced by NG191 on the MagicApp). As usual, he's wrong. Here's why: 🧵

Euthanasia in the pandemic?

COVID-19 rapid guideline: managing symptoms (including at the end of life) in the community https://web.archive.org/web/20200409054527/https://www.nice.org.u...

www.youtube.com

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James Lynch

@JamesLynchGTC

10 months

@dr_musgrave That must have been nice for you. It was fairly apparent on Intensive Care. The fact that we had over twice as many ventilated patients as normal. Many younger and less comorbid than normal. Half of whom are now discharged with complex sequelae under their GP.

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James Lynch

@JamesLynchGTC

9 months

Ivermectin apparently cures cancer now. Have I missed something?

DystopiaNow!

@scumbunker

9 months

@JamesLynchGTC @ladies4pd @ed_unwa Just wait till you find out how efficacious Ivermectin is on cancer. The whole theory and science on cancer is bunk, doctors don't even seem to know that glucose feeds tumours and tell patients they can eat whatever they want.

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James Lynch

@JamesLynchGTC

6 months

@TheDrJon She has form.

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James Lynch

@JamesLynchGTC

1 year

"What NICE have done is take that and transpose it into the COVID situation...when most people can get better from it" He seems to have forgotten that this is for patients who are "At the End of Life". Unsurprisingly most people who are at the end of life do not "get better".

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James Lynch

@JamesLynchGTC

1 year

Are we now clear? I'm clear Anna. You have shared calls for people to be hanged. Crystal clear

Anna de Buisseret

@AnnadeBuisseret

1 year

@JamesLynchGTC @TopPsychCoach @james_freeman__ @AshTFE @PBC174 @MrsLund1 @Skatingsindy Let’s be clear: I have NOT called for hangings! I’ve cited the case law from the Nuremberg trials of the Nazi doctors - some of whom were hanged when found guilty. That’s fact. That’s not me “calling for hangings”! Are we now clear?

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James Lynch

@JamesLynchGTC

3 years

@_Si93_ @kemz_1 @aaroneshh Pneumonia is a condition. It can be caused by a number of diseases, viruses, bacteria, fungi. In medicine we prefix it with lots of terms. Pneumococcal, legionella, PJP, nosocomial, ventilator-acquired, staph, and so on. COVID btw is real.

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James Lynch

@JamesLynchGTC

1 year

"This is a well tried, trusted treatment we use for terminal agitation" he correctly states but then goes on to suggest it is only used in "conditions such as cancer...incurable conditions" It isn't. Its an important part of palliative care regardless of primary illness. Eg. 👇

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James Lynch

@JamesLynchGTC

1 year

"Giving these two together, that stops people breathing" Well no. Not in these doses. It will as he says "depress respiration" but then it is being used to treat mod/sev BREATHLESSNESS with distress. So that's kind of the point.

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James Lynch

@JamesLynchGTC

1 year

@DrAseemMalhotra In the interests of balance will you be releasing statements from the vast majority of eminent Doctors who think your narrative review published in a journal you edit lacked basic integrity, that you're yet to provide evidence of risk, and lie about the deaths of young girls.

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James Lynch

@JamesLynchGTC

1 year

Continuing the acting (head down, lots of sighs, broken sentences) John claims that some of these deaths were caised by nurses and doctors "squirting drugs into people". He is calmly and deliberately accusing former colleagues of murder. But has provided NO evidence.

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James Lynch

@JamesLynchGTC

1 year

"The most concerning bit..." he goes on "Sedation and opioid use should not be witheld for fear of respiratory depression...its almost like saying respiratory depression is acceptable." 🤬 Its not only acceptable, its literally the aim of the guidance. TO REDUCE BREATHLESSNESS.

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James Lynch

@JamesLynchGTC

1 year

"Given a lot of those people had Acute Respiratory Distress Syndrome..." False. ARDS is clearly defined using the Berlin definition. It requires the presence of PEEP/CPAP. The majority of these patient's were on respiratory wards/care homes and did not have ARDS.

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James Lynch

@JamesLynchGTC

1 year

We aren't entirely clear why. Breathlessness may be driven by distress rather than purely hypoxia. The mechanics are complicated but we know in other settings, rapid shallow breathing doesn't lend itself to great gas exchange. So Campbells presumption is no more than that.

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James Lynch

@JamesLynchGTC

1 year

"How do you know they are at the end of life?" We know this isn't always easy and is often more intuitive than objective, but honestly. He's a nurse educator of decades. Surely he knows the basic signs and symptoms.

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James Lynch

@JamesLynchGTC

1 year

He starts by focussing on 6.5 shown in full below alongside the bits he has typed up (no idea why he keeps doing this). Specifically 6.5 is combined low dose opioids and benzodiazepines for people who are: -end of life AND -have mod/sev breathlessness AND -are distressed.

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James Lynch

@JamesLynchGTC

1 year

"If you give these drugs...you dont need me to spell out the consequences of that". But it isnt as simple as that. Often treating breathlessness has no/little impact on gas exchange. Anecdotally it sometimes improves it.

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James Lynch

@JamesLynchGTC

1 year

@IanCopeland5 @Johnincarlisle I'll take issue with the credentialism a little as a fellow nurse. It's not his qualifications that discredit him. It's the demonstrable bollocks he spouts.

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James Lynch

@JamesLynchGTC

6 months

@chrischirp I'm not sure how he thinks we ended up with a less comorbid, more independent ICU population than we do with typical viral pneumonias without Doctors making those decisions on a daily basis. And still, despite his protestations, ICU's were overwhelmed.

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James Lynch

@JamesLynchGTC

1 year

He's keen to use his "44 years in healthcare" here. "...something that goes against so many axioms" Palliative care is well established. Symptom control in disease is well established. That during his "44 years" John hasn't come across these axioms speaks volumes. About him.

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James Lynch

@JamesLynchGTC

1 year

There's a new ConWom article out about "How ventilators killed". As always with these conspiracies its based on nuggets of truths, presumptions, the opinion of non-experts and a scattering of lies. Here's why: *busy week-might not finish this one in a single go.

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James Lynch

@JamesLynchGTC

1 year

The last few minutes he, as many have before him demonstrates a correlation between palliative care drug use in the community...and people needing palliative care in the community. This is not evidence of anything except appropriate care.

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James Lynch

@JamesLynchGTC

1 year

And no, you don't need sophisticated, diagnostic testing facility to identify somebody at the end of life. You do for ARDS though. Which John seems to be diagnosing lots of people with, incorrectly.

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James Lynch

@JamesLynchGTC

1 year

"How many patients with COVID 19 were at the end of life?" he asks. Whilst you can argue "self fulfilling prophecy" here we know there were some 45,000 deaths involving COVID by June '20 in England. So certainly enough to warrant a plan of care that provides some symptom control.

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James Lynch

@JamesLynchGTC

1 year

He wants to take issue with the fact that existing care plans, advanced directives and DNRs should be taken into account when planning care. I have no idea why. They should always be taken into account when planning care for any illness. That's the point of them.

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James Lynch

@JamesLynchGTC

1 year

Right #77th #muttoncrew , Which one of you took on the Hitchens assignment? Please come forward to recieve your 🗿 medal (the highest honour bestowed) and immediate referral for psychological support.

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James Lynch

@JamesLynchGTC

1 year

He interestingly then points out that the guideline came in on 3rd April but tries to suggest the guidance could have been cause of all deaths thereafter. Why deaths would suddenly plummet 2 weeks after introducing a guideline that he believes is killing people isnt explained.

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James Lynch

@JamesLynchGTC

1 year

And after sincere condolences to anybody affected, thats it. An accusation of mass murder purely based on John's speculation that we can't identify when somebody is dying and the correlation between use of palliative care drugs and people needing palliative care.

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James Lynch

@JamesLynchGTC

1 year

He then makes a point about antibiotics saving thousands of lives. (As an aside this is quite suspicious of @jikkyleaks nonsense about azithromycin). Antibiotics are for bacterial infections. They should be used when secondary bacterial infection is suspected.

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James Lynch

@JamesLynchGTC

1 year

@DrAseemMalhotra @JosephFraiman

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James Lynch

@JamesLynchGTC

1 year

You'll note the sentence after he stops adresses this exact point and rather contradicts him.

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James Lynch

@JamesLynchGTC

3 years

@DelythHughes62 @KeithBurson @allisonpearson Oh give over. Yes we are normally busy this time of year but NOT LIKE THIS! Believe the nurses and doctors screaming it loud and clear. THIS IS NOT NORMAL! What has happened to this country? Why will people continue to promote journos regularly shown to be inept lie peddlers

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James Lynch

@JamesLynchGTC

2 years

A lot seems to be being made of midazolam again. So what is it and why was more of it used than normal, during COVID? Midazolam is a benzodiazepine with many uses. It is a procedural sedative (intravenous, small doses), anticonvulsant (various routes/doses).

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James Lynch

@JamesLynchGTC

1 year

He correctly points out NG163 was used (though regularly updated) until NG191 in Mar '21. We start with correlation between community use of palliative care drugs and people needing palliative care again. No surprise. No evidence of malfeasance.

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James Lynch

@JamesLynchGTC

1 year

"How many of these deaths were COVID?" He asks, particularly referencing the first and second wave. Well, given the table he shares is deaths by death certification (neatly cropped off), we know at least one Doctor in each case felt they were. They also corrwlated with cases.

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James Lynch

@JamesLynchGTC

1 year

Urgh. He's already posted a further 20minute video on this. Sorry, but more 🧵

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James Lynch

@JamesLynchGTC

1 year

He then makes the same point as here: About struggling to identify dying patients in diseases that most recover from. Most people recover from most illnesses. See flu, pneumonia, # hip. But we should still spot those who are dying and respond appropriately

James Lynch

@JamesLynchGTC

1 year

"How do you know they are at the end of life?" We know this isn't always easy and is often more intuitive than objective, but honestly. He's a nurse educator of decades. Surely he knows the basic signs and symptoms.

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James Lynch

@JamesLynchGTC

1 year

NG191 clearly points this out. As did existing guidelines. Most patients with COVID did not develop secondary bacterial infection. They don't have meaningful evidence of efficacy outside this.

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James Lynch

@JamesLynchGTC

1 year

"How many of these deaths were iatrogenic?" He asks before some marvellous acting but no actual evidence. "We know this happened in Sweden" he falsely claims. "Its fundamental you treat the underlying cause when you can and not simply suppress the symptoms" ...

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James Lynch

@JamesLynchGTC

1 year

"How many patients could have survived with antibiotics...and steroids" 1. As above antibiotics when indicated otherwise no evidence of impact on mortality. 2. There was no evidence of steroids in the first wave.

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James Lynch

@JamesLynchGTC

1 year

The next five minutes are literally a rehashing of the previous video. Almost word for word. The exception is the acknowledgement that morphine and midazolam dont have UK marketing authorisation for breathlessness. They dont. We use lots of drugs outside of their MA effectively.

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James Lynch

@JamesLynchGTC

1 year

He is correct, ofc. But when you don't actually have any treatments (March through June '20) all you can do is treat the often distressing symptoms. When "end of life" has been identified (which isn't easy, but far easier than he suggests) symptom control should be the priority.

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James Lynch

@JamesLynchGTC

2 years

@ianmcdermottLSO 8 cases of SEVERE COVID in placebo group. 1 in intervention group. 4 severe adverse events (which may not be anything to do with the vaccine). At a time of low prevalence. Underpowered. Basic maths shows that is false. And that data isnt "hidden". NEJM Jan 2021

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James Lynch

@JamesLynchGTC

1 year

Next, the BNF warning. This is good. A reminder to Nurses and Doctors to be cautious and use low doses. Note he shares the part that warns about "potentially fatal" side effects, not the part about warning patients so that they can seek attention themselves in the community.

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James Lynch

@JamesLynchGTC

3 years

@nicolawitch Yes, in the esteemed presence of David Icke, Gillian McKeith, Acruri, a real "meeting of minds" 👍

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James Lynch

@JamesLynchGTC

1 year

And then 5 minutes showing more correlation between palliative care drugs (midazolam, levomepromazine and haloperidol) use in the community and people requiring palliative care in the community. "There's real questions here for NICE" John states. But Ive not heard him ask any.

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James Lynch

@JamesLynchGTC

1 year

Finally, he quotes the foreward to NG163. "...are expected to take this guidance fully into account." Note where he stops. "If you go against the guidance and something goes wrong..." he tails off.

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James Lynch

@JamesLynchGTC

9 months

@Azeem_Majeed Non-medical clinicians tend to have a pay ceiling and tend to have plenty of experience working their way up from similarly pitiful pay. Everybody is getting paid poorly. Morale is rightly low. Falling for petty interdisciplinary conflict doesnt help.

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James Lynch

@JamesLynchGTC

2 years

@DBurnettLiberty @nuclearquizics @whykeepitup @SeamusMacSuibh1 @lucycdoyle @ellethejambo @metpoliceuk Holy shit. This is the best yet. 🤣🤣🤣 Somebody want to tell him his body has mRNA in it right now?

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James Lynch

@JamesLynchGTC

1 year

@thereal_truther @DiedSuddenly_ @drcole12 I presume @FloridaMedCtr and @pbhnPG know Dr Erik Beyer's work with them has veen hijacked by antivaxxers.

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James Lynch

@JamesLynchGTC

1 year

@StarkNakedBrief "Incurable conditions drugs" what are you harping on about? End of life care is for anybody at end of life, regardless of cause. And all of the drugs mentioned are used for all sorts of things outside this population. Campbell is talking rubbish as usual.

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James Lynch

@JamesLynchGTC

1 year

But NICE guidance is based on: 1. Empirical evidence. 2. Where this is lacking, expert opinion. And, as the paragraph says shortly after he ended it, should be taken into account alongside an individuals needs.

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James Lynch

@JamesLynchGTC

5 months

I'll be working the next few nights. Our Junior Doctors won't be. It will be difficult. Patients won't receive the usual standard of care. But I fully support the #DoctorStrikes The strikes are a window into our future if Govt and NHS do not start to value our Doctors.

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James Lynch

@JamesLynchGTC

3 years

I thought #WrongAgainIvor was all about debate? Apparently not. Oh well, I got my badge. Do I get into a special club now @WrongAgainIvor @dr_barrett @_johnbye @jneill ?

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James Lynch

@JamesLynchGTC

1 year

"EBM should be based on empirical evidence, expert opinion and patient preferences" he summises. "It seems to me these last two have completely flown out the window..." with aggressive hand clapping.

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James Lynch

@JamesLynchGTC

1 year

@ABridgen No. France has finished advocating an autumn booster...in spring. As has just about every northern hemisphere country.

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James Lynch

@JamesLynchGTC

2 years

Utterly draining couple of days at work. Not in terms of volume (that festive gift is still to come). In terms of challenging discussions with very, very unwell people and/or their loved ones. Misinformation IS killing people.

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James Lynch

@JamesLynchGTC

8 months

@KateShemirani "5 to 7 times the dose" 🙄 Please could you have the basic courtesy of actually proving this claim you keep repeating. Just once.

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James Lynch

@JamesLynchGTC

1 year

@juneslater17 One is so well respected in his field he gets to interview the greatest players whoever graced the game. The other hangs about with...Right Said Fred.

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James Lynch

@JamesLynchGTC

5 months

@IsabelOakeshott No she didn't. She admitted there wasn't a robust evidence base (wrongly as there was by that time). The only way she said it would make it worse is if people developed a false sense of security. Accurate and responsible journalism might have helped avoid that.

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James Lynch

@JamesLynchGTC

3 years

Great thread. I'd add to David's description of patients on the ward the ICNARC dataset. It isn't a competition, but on ICU we care for the patients some people would have you believe don't exist. For context we have 6 current "hot" wards. 1/n

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James Lynch

@JamesLynchGTC

3 years

@Adam_Stratford_ Zzzz Also 5 year average. Hospital bed occupancy doesnt necessarily mean quiet/capacity if there are an extra 2000 ventilated patients.

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James Lynch

@JamesLynchGTC

1 year

@LD_Sceptics People needing palliative care skyrocketted to more than twice their usual levels during the first COVID wave. Those speculating without having first checked this obvious explanation need to ask themselves why they find it easier to believe healthcare workers murder people.

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James Lynch

@JamesLynchGTC

3 years

@ClareCraigPath Whats your conclusion? My 17 ICU COVID patients are just a figment of my imagination?

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James Lynch

@JamesLynchGTC

1 year

@naomirwolf You...retweeted this:

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James Lynch

@JamesLynchGTC

2 years

FFS The responses to this range from misinformed to just vile. The midazolam theory remains one of the stupidest and sickest of the last 2 years.

Paul

@Paul29256859

2 years

Thought of the day.. The real scandal of the first lockdown was not partygate which the media knew about but sat on it for 18 months, but midazolam which the 4th estate seems to have conveniently forgotten about.. wonder why 🤔

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James Lynch

@JamesLynchGTC

3 years

@DarrenPlymouth Ahhh, an outbreak of a new variant of idiocy. Great. What freedoms are we fighting for this week? You realise you could all just meet in a pub rather than Trafalgar Square. I wouldnt recommend it, terrible for transmission, but its legal.

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James Lynch

@JamesLynchGTC

2 years

Urgh @MaajidNawaz has been at it again. Another 90 minute smooth looking rant of "if's", "could's" and "allegations" (baseless ones he keeps giving a platform to). I've got better things to do but-a thread (this might take a while).

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James Lynch

@JamesLynchGTC

3 months

@EmergMedDr The thalodomide comparison is quite the unnecessary and distateful take.

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James Lynch

@JamesLynchGTC

3 years

@Lyndonx @JamesMelville You werent saying that when it was 1000 per day...context.

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James Lynch

@JamesLynchGTC

9 months

@scumbunker @ladies4pd @ed_unwa You do tend to need glucose to survive, cancer diagnosis or not. It cures cancer now!? Clearly Im out of the conspiracist loop.

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James Lynch

@JamesLynchGTC

5 months

@davidicke We didnt. Midazolam was used as a palliative care drug and an ICU sedative. Palliatively its indications and dose, as per NG163, reflected most existing guidance. Nothing changed during COVID except the volume of people meeting those indications.

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James Lynch

@JamesLynchGTC

19 days

How on Earth is Bridgen able to spout this rubbish in Parliament. As much as it's fun to see him adressing an empty room I do think it would be much more damaging if somebody such as @drlukeevans actually corrected this 💩 in the room.

James Lynch

@JamesLynchGTC

19 days

@ABridgen Hi @ABridgen , I'm amazed you were allowed to spout such guff in Parliament. Beyond the obvious nonsense about PCR in your tweet, now kindly corrected by a Community note, let's take a look at what you actually said.

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James Lynch

@JamesLynchGTC

2 months

@OlooneyJohn As a funeral director you have spent 4 years spreading misinformation about COVID and vaccines. Its gained you a growing following and may well have been a factor in some deaths. If you do the same for cancer you will cost lives.

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James Lynch

@JamesLynchGTC

3 years

This account has made my day

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James Lynch

@JamesLynchGTC

7 months

@Dr_Done_ @BritSocGastro This PA is highly specialised. I see nothing wrong with the description provided. Clinics-nurse led for years. Paracentesis-a skill that non-medics can develop and master. Endoscopy-see above. Working within that scope, acknowledging both highly specialist expertise and...

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James Lynch

@JamesLynchGTC

1 year

The second sentence of the article is false (good start). In fact, most patients ventilated in wave 1 of COVID in the UK survived, as demonstrated by @ICNARC dataset. The third sentence is a false assertion the rest of the article attempts but fails to evidence.

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James Lynch

@JamesLynchGTC

5 months

@TheRustler83 Again, well done. Your forensic analysis shows that use of a palliative care drug correlates with people needing palliative care. Genius. 🫡

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James Lynch

@JamesLynchGTC

1 year

@ABridgen Andrew, They knew about it. We knew about it. Just about everybody except for you and PV knew about it in late 2021. Which is odd because its rare. But you wrongly say its common and yet seem to have realised it exists far later than everybody else.

SARS-CoV-2 vaccination and myocarditis or myopericarditis: population based cohort study

Objective To investigate the association between SARS-CoV-2 vaccination and myocarditis or myopericarditis. Design Population based cohort study. Setting Denmark. Participants 4 931 775 individuals...

www.bmj.com

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James Lynch

@JamesLynchGTC

3 years

@piersmorgan The vaccines wont STOP you from catching it. They will greatly reduce your chances of needing oxygen, a ventilator or a mortician though.

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James Lynch

@JamesLynchGTC

2 years

@MaajidNawaz 's recent (third) episode of @TheRadicalShow dedicated entirely to the subject of midazolam is abhorrent. Its been viewed 10k times. I'll go through some of the flaws in it. A 🧵of 🧵's.

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James Lynch

@JamesLynchGTC

4 months

Great article on PA's in the Guardian. The only 2 downsides to the article are that: -it reflects how PA's can be used effectively and several of the quotations within might be taken as gaslighting concerns when they aren't. -if the bottlenecks in JD...

‘I’m not a doctor’: the role physician associates play within NHS

Plans to increase their number in England to plug workforce gaps have been criticised – but their work is valued by hospital colleagues

www.theguardian.com

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James Lynch

@JamesLynchGTC

11 months

@BillSauer3 "Spike in the nervous system" 🤣🤣🤣 Seems legit Bill.

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James Lynch

@JamesLynchGTC

4 months

@david_r_morgan No. The NHS, procured more of a common palliative care drug and ICU sedative. During a pandemic. They published guidance mirroring widely used guidance available at the time suggesting appropriate doses and indications. You hadn't heard of midazolam before 2020. It shows.

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James Lynch

@JamesLynchGTC

3 years

@KeithBurson @allisonpearson Oh come on Keith. Maybe, just maybe believe the bloody nurses and doctors going through it. Never believe the govt, but also ignore journos spouting claims repeatedly shown to be fake. Go to the source.

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James Lynch

@JamesLynchGTC

2 years

@carlheneghan @MailOnline "Could" is doing some heavy lifting there Prof. Your "study" appears to show nothing more than the fact that statisticians will respond to FOI requests in the terms requested, no matter how 🦇💩 crazy they are. You were responsible for at least one of the definitions.

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James Lynch

@JamesLynchGTC

1 year

@paula_hannaford @MattHancock Well Paula, you explain it by: -inaccurate sums on your part. -doubling of the ICU population as well as their lower age and increased size (huge doses here). - doubling of the volume of people needing palliative care. So no. No murder.

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James Lynch

@JamesLynchGTC

1 year

@ABridgen The truth is that NG163 largely mirrors existing palliative care guidelines. Symptom control using low dose opiates and benzodiazepines isnt a new and the doses are well established. The issue here is grifting, misinformation peddlers who've conned grieving relatives.

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James Lynch

@JamesLynchGTC

5 months

If you are currently using your own interpretation of this image to critique a PA's interpretation of the actual chest X-Ray, you've either got a serious arrogance issue or need re-training on CXR interpretation.

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James Lynch

@JamesLynchGTC

5 months

@armyemdoc I'm one of those Europeans. But I've seen ICUs in Baltimore and Boston. You have difficult airway trolleys. They are a thing in the US. I wouldnt be surprised if its where the UK pinched the idea from. Keep your mucky knife for your morning bagels. FONA kit is in Drawer Four.

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James Lynch

@JamesLynchGTC

1 year

@CKellyUAP Midazolam injection in the community is used almost exclusively for palliative care. Well done. Youve just demonstrated correlation between people needing palliative care and people being given palliative care. Quite why an Aus Politician is invested in UK community prescribing?

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James Lynch

@JamesLynchGTC

3 years

@ClareCraigPath The percentage positivity rate is static, not falling despite increased testing. Therefore they arent testing too much yet. Your own data doesnt support your conclusion.

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James Lynch

@JamesLynchGTC

2 years

And to relatives, I'd say I'm very sorry for your loss. The last 21 months have been awful for those with relatives in hospital or care homes. But, if you have serious concerns about midazolam please discuss with the hospital, not with an Icke, Deevoy, Arcuri, McKeith...

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James Lynch

@JamesLynchGTC

3 years

@RealJoelSmalley Sorry, the percentage of all COViD deaths? You mean after we started vaccinating those at high risk the unvaccinated began to make up a higher proportion of deaths? That doesnt seem to be "unusual", more "entirely predictable".

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James Lynch

@JamesLynchGTC

4 years

@SpeedyShev @andrewiconnell Much like 6th March. Forgive me for forgetting but can you remember what Italy was like by the end of March?

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James Lynch

@JamesLynchGTC

1 year

@ABridgen Hmmm...they all seem to say the exact same thing. And youve not provided any evidence. You do realise people recieving midazolam shortly before death is not uncommon and often entirely appropriate.

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James Lynch

@JamesLynchGTC

1 year

@TerrEstLibre @Johnincarlisle Strong evidence based rebuttal. Thanks. 👍

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James Lynch

@JamesLynchGTC

1 year

@DuttyMonkey_ And an appeal to authority is an odd choice from somebody who argued about midazolam use, using an Icke documentary to an ACCP.

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James Lynch

@JamesLynchGTC

11 months

@DrAseemMalhotra If you're going to slag off other healthcare professionals as "bots" for demanding evidence of your claims, you should reply with some evidence rather than an unrelated opinion piece. It amazes me how little you think of your followers that you presume they'll blindly follow.

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James Lynch

@JamesLynchGTC

3 years

@RossGrant17 @carlheneghan Ross mate. Take a deep breath. Ask yourself why anybody would do that- they wouldnt Ask yourself "does this sound really mental?"-it does And then maybe seek some help- youre in waay deep.

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