The “Memorable Tweets” series is a monthly compilation of notable past tweets from the microblog version of On The Wards. The entries may provide some — albeit small — insight into my world as a clinical physician and scientist.

The comments are invariably true and may reflect real-life experiences. I have nevertheless made every effort to protect patient privacy. Most tweets are sufficiently obfuscated to avoid identification of any particular patient. If you feel a comment resembles your case, it is highly likely a mere coincidence. But if you’re a patient who is absolutely convinced that I was talking about you, and would prefer that I not, then contact me and we can discuss this.

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Earlier I wrote an article listing some challenges with medication reconciliation, one of which is the proper identification of home medications. I often encounter patients who may not recall the names or doses of the medications in their pillbox, but would identify them by their description: “I take the purple pill”. Interestingly, while physicians need detailed knowledge of various drugs to responsibly prescribe them, they typically do not know how they look like.

To confess, I myself rely on Epocrates on my iPhone to guesstimate patient’s descriptions of their own pills. Another good resource for pill identification is Pillbox, a website developed by the National Library of Medicine for the “rapid identification of unknown solid-dosage medications (tablets/capsules) based on physical characteristics and high-resolution images”. Through a Flash interface, the user can search for pill images based on imprint, shape, color, size, and scoring. There is also an option to just browse the 7287 pill images in the database. For each medication, Pillbox provides relevant external links about the drug, biological and physical data, toxicology, and drug effects on breastfeeding.
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Here is a flashback to some notable tweets from April of last year. The entries may provide some — albeit small — insight into my world as a clinical physician and scientist. The comments are invariably true and may reflect real-life experiences. I have nevertheless made every effort to protect patient privacy. Most tweets are sufficiently obfuscated to avoid identification of any particular patient.

• @grahamwalker @kevinmd The initial impetus for work-hour regulations stemmed from the Bell Commission. Read the recent IOM recommendations?
  9:55 AM Apr 1st from web in reply to grahamwalker

• @grahamwalker … though the recent IOM recommendations will not affect EM as much as Medicine or Surgery.
  9:58 AM Apr 1st from web

• There was already a nationwide shortage of oxycodone and now we have this (I don’t blame the FDA though) http://tinyurl.com/df7g47
  10:47 AM Apr 1st from web

• The polypill would be a great way to reduce _perceived_ polypharmacy, but it would be a headache for dose/drug titration http://bit.ly/fjdp4
  10:57 AM Apr 1st from web

• Just submitted a manuscript. Now awaiting the inevitable peer-review critiques or rejection.
  11:02 PM Apr 9th from Splitweet

• Intern pearl: call your consults early, especially if procedures are anticipated.
  6:25 PM Apr 20th from web

• Do night owls do better on 30-hour calls? http://bit.ly/P9fG0
  5:04 PM Apr 23rd from Splitweet

• The FUO (fever of unknown origin) can sometimes be frustrating or unsatisfying … until you discover the origin.
  2:03 AM Apr 26th from web

• Hospital now gearing up to prevent the local spread of the swine flu.
  1:20 PM Apr 26th from Splitweet

• Poking fun at Twitter and swine flu http://xkcd.com/574/
  3:54 PM Apr 27th from Splitweet

• Did a few procedures today: drew blood, aspirated synovial fluid, and did a central line. I spared someone an LP though.
  6:38 PM Apr 27th from Splitweet

• @kevinmd Banning free drug samples will harm indigent patients.
  7:36 PM Apr 27th from Splitweet in reply to kevinmd

• @DrOttematic Relax and enjoy. You won’t have much time for that once internship begins.
  7:52 PM Apr 27th from Splitweet in reply to DrOttematic

The “Memorable Tweets” series is a monthly compilation of notable past tweets from the microblog version of On The Wards. The entries may provide some — albeit small — insight into my world as a clinical physician and scientist.

The comments are invariably true and may reflect real-life experiences. I have nevertheless made every effort to protect patient privacy. Most tweets are sufficiently obfuscated to avoid identification of any particular patient. If you feel a comment resembles your case, it is highly likely a mere coincidence. But if you’re a patient who is absolutely convinced that I was talking about you, and would prefer that I not, then contact me and we can discuss this.

• I won’t have a day off for over 2 weeks, but am at least enjoying my time on service.
  12:05 PM Mar 1st from web

• Enjoying my first day off in >2 weeks … or catching up on the pile of work screaming for my attention?
  11:03 AM Mar 7th from TwitterMail

• @grahamwalker Unless NAC makes any difference or any meaningful hepatic recovery occurs, It’s a sloooow death. Not a good method of suicide.
  7:37 AM Mar 9th from web in reply to grahamwalker

• @dagarton @smeets Except for the inability to remove polyps, that’s why CT colonography will eventually become a popular screening modality.
  10:50 AM Mar 11th from web in reply to dagarton

• @serious_skeptic Point well taken. [Practically] nothing is devoid of risk.
  4:27 PM Mar 11th from web in reply to serious_skeptic

• It has been a very busy weekend: I had to unfortunately send a few of my patients to the ICU … one intubated and others on pressors.
  6:32 PM Mar 17th from web

• Tertiary / quaternary care hospitals can have very sick patients.
  6:35 PM Mar 17th from web

• On the brighter side, two of my patients finally got new organs this week!
  6:37 PM Mar 17th from web

• Congratulations to everyone who participated in Match Day 2009!
  6:20 PM Mar 19th from TwitterMail

• I enjoy chatting with my patients. It’s unfortunate that a heavy workload and paperwork burden can often create artificial time constraints.
  3:30 PM Mar 24th from web

• In some places, health care can often feel like saving patients from themselves.
  3:31 PM Mar 24th from web

• Oh, I may be chronically sleep-deprived and look grumpy in the morning, but I LOVE my job!
  3:32 PM Mar 24th from web

• @Berci Interesting article. This is yet another reason I need to invest in an XBox 360 or PS3.
  1:58 PM Mar 31st from web in reply to Berci

The “Memorable Tweets” series is a monthly compilation of notable past tweets from the microblog version of On The Wards. The entries may provide some — albeit small — insight into my world as a clinical physician and scientist.

The comments are invariably true and may reflect real-life experiences. I have nevertheless made every effort to protect patient privacy. Most tweets are sufficiently obfuscated to avoid identification of any particular patient. If you feel a comment resembles your case, it is highly likely a mere coincidence. But if you’re a patient who is absolutely convinced that I was talking about you, and would prefer that I not, then contact me and we can discuss this.

• The new UCLA medical center by I.M. Pei is gorgeous! I hear the marble is imported. Of course, this all happened before the recession.
  5:03 PM Feb 1st from web

• There are very sick people in the hospital right now: 3 codes and 4 intubations in 3 hours.
  5:28 PM Feb 2nd from web

• I have encountered 4 cases of FUO (fever of unknown origin) in the past 2 weeks. The Infectious Diseases service is perplexed as well.
  7:23 PM Feb 4th from web

• Your team can sometimes make or break your experience.
  5:04 AM Feb 8th from TwitterMail

• … but in the patient’s best interest, we have to learn to get along with the team.
  5:05 AM Feb 8th from TwitterMail

• I appreciate the hard work of those in the Kitchen services, but my first experience with hospital food (for patients) was not too pleasant.
  12:06 PM Feb 16th from web

• Spent half a day tracking down relatives for a comatose patient. I even had to request police assistance.
  7:52 AM Feb 22nd from web

• Hospital near 100% capacity. Patients via EMS now being diverted elsewhere.
  9:38 PM Feb 22nd from TwitterMail

• It’s not a good sign when the family plans the funeral while the patient is still alive … intubated/sedated, yes, but not terminal.
  8:31 AM Feb 24th from web

• It’s not a good sign when the code team rushes by me, while I’m waiting for the elevator … and I reach ground floor before they do.
  8:32 AM Feb 24th from web

• Did you know that the rate of chest compressions in CPR = beats in “Staying Alive” or “Another One Bites The Dust”?
  8:45 AM Feb 25th from web

• I wouldn’t sing the second song though during CPR … at least not aloud.
  8:46 AM Feb 25th from web

• Obesity hypoventilation syndrome seems to be a common trend lately. Had another tubed/trached patient too large to fit in the CT scanner.
  12:34 PM Feb 26th from web

• @Juan_Negro That’s right … we’ve got the McDonald’s generation to treat.
  1:21 PM Feb 26th from web in reply to jonathandblack