Al Green

NHS Acute Physician trying to keep his wife & 3 sons happy. likes skiing, squash, diagnostic efficiency and tea breaks.

[shey⁴ @lan4luvr]

this was so brilliantly explained and i think some of you should watch it for a better understanding as to what happened yesterday

[Jeff Pappone 🇨🇦 @jpappone]

Anyone defending VER on the Lap 64 contact needs to watch this angle.

#AustrianGP #F1

[CALL TO ACTIVISM @CalltoActivism]

A British writer penned the best description of Donald Trump I’ve ever read:

“Why do some British people not like Donald Trump?”

A few things spring to mind. Trump lacks certain qualities which the British traditionally esteem. For instance, he has no class, no charm, no coolness, no credibility, no compassion, no wit, no warmth, no wisdom, no subtlety, no sensitivity, no self-awareness, no humility, no honour and no grace – all qualities, funnily enough, with which his predecessor Mr. Obama was generously blessed. So for us, the stark contrast does rather throw Trump’s limitations into embarrassingly sharp relief.

Plus, we like a laugh. And while Trump may be laughable, he has never once said anything wry, witty or even faintly amusing – not once, ever. I don’t say that rhetorically, I mean it quite literally: not once, not ever. And that fact is particularly disturbing to the British sensibility – for us, to lack humour is almost inhuman. But with Trump, it’s a fact. He doesn’t even seem to understand what a joke is – his idea of a joke is a crass comment, an illiterate insult, a casual act of cruelty.

Trump is a troll. And like all trolls, he is never funny and he never laughs; he only crows or jeers. And scarily, he doesn’t just talk in crude, witless insults – he actually thinks in them. His mind is a simple bot-like algorithm of petty prejudices and knee-jerk nastiness.

There is never any under-layer of irony, complexity, nuance or depth. It’s all surface. Some Americans might see this as refreshingly upfront. Well, we don’t. We see it as having no inner world, no soul. And in Britain we traditionally side with David, not Goliath. All our heroes are plucky underdogs: Robin Hood, Dick Whittington, Oliver Twist. Trump is neither plucky, nor an underdog. He is the exact opposite of that. He’s not even a spoiled rich-boy, or a greedy fat-cat. He’s more a fat white slug. A Jabba the Hutt of privilege.

And worse, he is that most unforgivable of all things to the British: a bully. That is, except when he is among bullies; then he suddenly transforms into a snivelling sidekick instead. There are unspoken rules to this stuff – the Queensberry rules of basic decency – and he breaks them all. He punches downwards – which a gentleman should, would, could never do – and every blow he aims is below the belt. He particularly likes to kick the vulnerable or voiceless – and he kicks them when they are down.

So the fact that a significant minority – perhaps a third – of Americans look at what he does, listen to what he says, and then think ‘Yeah, he seems like my kind of guy’ is a matter of some confusion and no little distress to British people, given that:

• Americans are supposed to be nicer than us, and mostly are.

• You don’t need a particularly keen eye for detail to spot a few flaws in the man.

This last point is what especially confuses and dismays British people, and many other people too; his faults seem pretty bloody hard to miss. After all, it’s impossible to read a single tweet, or hear him speak a sentence or two, without staring deep into the abyss. He turns being artless into an art form; he is a Picasso of pettiness; a Shakespeare of shit. His faults are fractal: even his flaws have flaws, and so on ad infinitum.

God knows there have always been stupid people in the world, and plenty of nasty people too. But rarely has stupidity been so nasty, or nastiness so stupid. He makes Nixon look trustworthy and George W look smart. In fact, if Frankenstein decided to make a monster assembled entirely from human flaws – he would make a Trump.

And a remorseful Doctor Frankenstein would clutch out big clumpfuls of hair and scream in anguish: ‘My God… what… have… I… created?' If being a twat was a TV show, Trump would be the boxed set.”

-Nate White

[Alexander Burnett @alex4peneast]

This burden on younger people is one of the reasons (i think) for the current unhappiness within the junior doctor community: Sky high interest rates for huge debts that we can’t get out of.

This manifests itself in unhappiness, strike action and longer waiting lists.

[Manoj Wickramasinghe @manoj-w.bsky.social @Manoj_Wickram]

Echo is one of the more skilled ultrasound exams you can do. Having learnt it and now teaching it, I see the same mistakes being made over and over again. I have put together thread on beginner mistakes in echo. #tweetorial #POCUS #FUSIC #askpocus

[Mark Toshner @mark_toshner]

If you want to understand why doctors strikes will not end any time soon and why this is a disaster, take the temp of doctors from contemporary surveys 🧵

[Rob Galloway @DrRobgalloway]

I have just finished another set of incredibly difficult weekend nights as the A&E consultant incharge.

Some thoughts:

The NHS no longer provides unscheduled care - we provide treatment. Care is with dignity - that's impossible for our patients in corridors.

The model of acute care is not working or sustainable. We need a completely different approach - with long term investment in prevention and community care

111 need to change risk thresholds as far too many come to a&e when they don't need to.

There needs to be alternative pathways to get care overnight for those who don't have accidents or emergencies. A&E shouldn't be anything and everything

Staff are broke - supporting staff is just as vital as looking after patients

This government have totally decimated our the NHS. They are the ones who should be apologising to our patients not our staff.

Hundreds are dying each week because of lack of hospital capacity and corridor care in a&e, yet it's not on the news and no public uproar. As staff and patients we have accepted the unacceptable.

Everyone needs to know the reality of what is happening - so that politicians offer a different solution and patients get the care they deserve. Sadly most of the public have no idea of what is genuinely going on.

And finally, a post night fry up is the best antidote for the stresses of the weekend. Goodnight!

[Dr Tony Goldstone @goldstone_tony]

If you haven't seen my updated pay thread (latest data released 4/1/24 incl. DDRB 23/24) pls have a read

Because THIS👇is why doctors are striking. HUGE real terms to pay in the NHS- the whole economy, not so much. Have a read/RT & educate yourself on the FACTS #payrestoration

[Sean Ninan @sean9n]

12 CPD points for £80? (virtual) and £120 in person. Too good to turn down! Come and learn about frailty, delirium, dementia, falls, polypharmacy and more in the wonderful city of Leeds. https://t.co/Es3x1DVOfz

[Alison Moore @alijanemoore also on Bluesky @AliJaneMoore]

supervision has a very high level of risk. I don’t have any answers to these issues but they need to be discussed and resolved before expansion of the role takes place 6/6

[Dr Tony Goldstone @goldstone_tony]

1/ NEW & IMPORTANT: So we need to talk about NHS pay. NEW shocking [post DDRB] data just in 4/1/24 👇 (SPOILER: Not "fair & reasonable")

We need to fix pay/retention to fix waiting lists- increasingly clear next GE will won/lost on NHS

Please read whole 🧵 & share widely/RT

[Core EM @Core_EM]

Dizziness is a notoriously tricky chief complaint to work up in the ED. Let’s review one of the most up to date guidelines on how to approach it.

🧵 1/8 #MedEd

[Journal of Brown Hospital Medicine @BrownJHM]

Diagnosis? #medEd (Medinaz Academy)

[Raja Adnan Ahmed @drraja_]

UK Training Competition Ratios
Round 1 Aug 2023 - CT1/ST1 level

I have arranged the competition from most to least competitive speciality.

Psychiatry is ranked 8th most popular among 15

The least competitive is Paediatrics followed by IMT and GP.

https://t.co/hubZ5cf4BY

[Darshan H Brahmbhatt @Doctor_Darshan]

Wow! Frail patients with AF do worse if switched from warfarin to a DOAC #ESCCongress FRAIL-AF study shows increased clinically relevant bleeding with DOAC reports Linda Joosten & discussant @IsabelleVGelder

[Historic Vids @historyinmemes]

This is Mary Mallon, also known as Typhoid Mary, photographed after being institutionalized on North Brother Island in New York in 1909. She is the first recorded asymptomatic carrier of typhoid, a bacterial infection that is spread by consuming food or water contaminated with the feces of an infected person.

Mallon worked as a cook in New York City from 1900 to 1907. During this time, she infected 51 people. One family hired a typhoid researcher named George Soper, who believed Mallon was the cause of the outbreaks. He finally located her and informed her that she might unknowingly be spreading the disease. When he asked if he could collect her urine and stool samples, Mallon refused, despite Soper offering her royalties for a book.

In 1907, Mallon was forcibly quarantined at a hospital on North Brother Island in New York, situated on the East River between the Bronx and Rikers Island. In 1910, she was released on the condition that she change her occupation.

After her release, Mallon worked as a laundress, which paid less than cooking. She continued in this occupation for several years until she decided to change her name to Mary Brown and return to cooking. In 1915, she caused a massive outbreak at Sloane Hospital for Women, infecting 25 people and causing two deaths. Authorities apprehended her, and she was imprisoned for the remainder of her life.

[videos that boost your mental health @cheerfulclips]

Staff At Nursing Home Invents Games to Keep Residents Engaged https://t.co/hyvwI6Hxcx

[Simon Fleming 🛠 @OrthopodReg]

Oh goodie.

Apparently have to have a tetanus (DTP) and a flu shot before I work at the Kid’s Hospital.

Bilateral arm ouch before two days of operating

Joy.

#MedTwitter #orthotwitter #Fellowship

[Simon Carley @EMManchester]

Please visit @stemlyns to read about Max and the reasons why we need the AMAX4 algorithm in anaphylaxis/asthma. I promise you'll learn from this tragic story. Thank you Ben and Tamara.

Joining @DFTBubbles @LITFLblog to get the learning out there.

https://t.co/UYBer26nih

[Emily Fridenmaker @emily_fri]

I recently gave a COPD boot camp lecture and wanted to share some of the high points. 🫁

#tipsfornewdoctors