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

Over the past year, I have noticed a surge in the number of medical colleagues using the Apple iPhone. I can no longer recall how many times I have seen students, residents, fellows, and attendings pulling the device out of their white coat pockets. This is not surprising, considering that Apple has had phenomenal success with the product. The company sold over a million units within 3 days of launching its latest iPhone 3G S model.

Besides its phone, web surfing, e-mail, and personal information management (PIM) functions, the iPhone has become a veritable tool for medical reference and calculations. Ye olden days of the Palm Tungstens or Treos as the must-have tool for students and residents are no more.

As an interesting side project, I decided to create a Squidoo page on iPhone medical apps. This will serve as a growing catalog of useful medical applications for the iPhone. If your favorite app is missing, do not hesitate to leave me a message.

Financial Disclosure: No, I do not own Apple or related stocks, but maybe I should.

The advent of the Internet and Web 2.0 (for what it’s worth) has stimulated a movement for open information sharing and has heralded the migration from subscription-based paper publications to their more accessible–and free–digital counterparts. Notable by-products of this change include sites such as Wikipedia, NCBI Bookshelf, and the Johns Hopkins OpenCourseWare. Traditional academic journals have also begun to embrace this culture of open exchange, with a rapidly growing list of open access peer-reviewed publications on the Internet. Some journals opt to make their archived articles freely available a certain period after publication.
Read more … »

The “Memorable Tweets” series will include a monthly compilation of notable past tweets from the microblog version of On The Wards. Since this is the first post of the series, we will go back to January 2009, when I made my first foray into the world of microblogging.

• I purposely left my laptop at home during a business trip 2 days ago (i.e., no Internet access). I will bring it for my trip today.
  7:29 AM Jan 29th from web

• I need to find a way to repay this growing sleep debt.
  12:48 PM Jan 28th from web

• Sometimes a simple “cold” virus can wreak havoc in an immunocompromised patient.
  9:08 AM Jan 28th from web

• Critical care medicine is fascinating, while physically, emotionally, and intellectually demanding. That has been my night in the ICU.
  3:53 AM Jan 25th from web

• This week has been unusually active. In the past 4 days, I responded to 3 codes [blue] (2 as a passer-by) in the clinic and hospital.
  5:43 PM Jan 24th from web

• Primum non nocere: I cancelled a paracentesis today. Although the procedure would have helped the pt, the risks far outweighed the benefits.
  11:25 AM Jan 22nd from web

• It hurts when a patient dies. One of mine, with whom I have grown fond, passed away yesterday. I pronounced another one today.
  6:12 PM Jan 19th from web

• Welcome to the microblog version of the blog. http://www.onthewards.com
  4:43 PM Jan 18th from web