Joseph Bell MD, PhD

Neurosurgeon, neurointensivist, and neuroscientist @VCUNeuro. Trained @UCLANsgy @HarvardMITmdphd. Neurosurgery for movement d/o, epilepsy, pain, and trauma.

[Joseph Bell MD, PhD @josephsbell]

Oliver and I discuss neurosurgery residency @UCLANsgy, his unconventional techniques for posterior fossa decompression, and garbage trucks. Thanks to PD @m_bergsneider for helping show some of what makes our program so amazing.

[VCU Health @VCUHealth]

A brain tumor diagnosis can be life-changing, making access to advanced effective treatment especially important. Dr. Ryan Cleary, a neurosurgeon with VCU Health, shares what brachytherapy brain tumor surgery means for patients. https://t.co/xIARItaZ5O @VCUMassey @CBS6 🧠

[Dr. Ausaf Bari @ausaf]

https://t.co/EdSoYEvOKO

[Paul Sax @PaulSaxMD]

Hey look! @nejm moved my writing to a new spot.
Here's the first post, a rant about a particularly annoying requirement for those of us in work in hospitals
(link below)
1/3

[Dr. Jon Slotkin @slotkinjr]

As a neurosurgeon I care a lot about road safety.

By now you’ve probably seen @Waymo’s stunning safety results (like 91% fewer serious crashes). But they didn’t just publish data headlines. They released the raw CSV files and data dictionaries.
I did a much deeper analysis. A fascinating story emerges when you analyze how they’re achieving this.

This isn’t incremental improvement - it’s categorical. We’re looking at the potential elimination of traffic deaths as a leading cause of mortality.

The intersection breakthrough: Waymo has essentially solved intersection crashes, with 95% fewer injury incidents than human drivers in the same locations. That’s transforming the deadliest driving scenario.

The national math: If every US vehicle performed like Waymo, we’d prevent 33,000-39,000 deaths annually and save $0.9-1.25 trillion in societal costs. Even partial adoption at 27% would save ~10,000 lives per year. In terms of magnitude, this would be the equivalent of eliminating every pedestrian death nationally in a year.

The physics signature: Here’s what fascinates me: 47% of Waymo’s contacts involve less than 1 mph delta-V. They’re not just avoiding crashes; they’re converting unavoidable incidents into gentle bumps. It’s like having physics itself on your side.

We’re not talking about marginal safety gains. The data represents a fundamental shift from harm reduction to harm prevention.

The methodology matters: I used their dynamic geographic benchmarks (comparing like-for-like road conditions) and verified the findings hold across San Francisco, Phoenix, LA, and Austin. The safety advantage actually increases in more complex urban environments.

Link to raw data below….

Notes on my approach:

Analysis based on 96 million miles of Waymo Rider-Only (RO) data through June 2025, utilizing Waymo's dynamic geographic benchmarks to compare Waymo Driver performance against human drivers under similar road conditions and operational design domains.

The projections for national impact (deaths prevented, societal costs) involve several assumptions. Given Waymo's zero reported fatalities, the direct serious injury reductions were mapped to national fatality statistics using established NHTSA-derived ratios that correlate serious injury crash rates with fatality rates. This extrapolation assumes that Waymo's observed serious injury prevention capability would translate proportionally to fatality prevention. Societal cost savings are estimated by applying average per-fatality and per-injury economic costs (e.g., medical, lost productivity, quality of life) as published by NHTSA, scaling these national averages to the projected number of avoided fatalities and injuries based on Waymo's safety performance. These figures represent the potential annual impact if the Waymo Driver's safety profile were widely integrated into the national fleet.

@ethanteicher

[Pitt Neurosurgery @PittNeurosurg]

Spine surgeons—how do you clear recreational athletes after cervical spine surgery? Take our brief, anonymous global survey:  
https://t.co/UE8OgjAHYf
#spinesurgery #returntoplay #neurosurgery #orthopedics #sportsmedicine

[Nick Mark MD @nickmmark]

In honor of #MayThe4thBeWithYou let's consider the most difficult airways in the Star Wars universe:

1. Darth Vader
Species: human
Vader presents several challenges: Vent dependent at baseline, airway burns from Mustafar, limited neck mobility.
Discuss GOC before saving him

[Pete Buttigieg @PeteButtigieg]

I want politics to be about a better everyday life.

Here's what that can look like:

[Barack Obama @BarackObama]

Harvard has set an example for other higher-ed institutions – rejecting an unlawful and ham-handed attempt to stifle academic freedom, while taking concrete steps to make sure all students at Harvard can benefit from an environment of intellectual inquiry, rigorous debate and mutual respect. Let’s hope other institutions follow suit.

[Joseph Bell MD, PhD @josephsbell]

This is how it’s done…

[Harvard University @Harvard]

“No government—regardless of which party is in power—should dictate what private universities can teach, whom they can admit and hire, and which areas of study and inquiry they can pursue.” - President Alan Garber https://t.co/6cQQpcJVTd

[Wanhe Li @xseedling]

Dear All, I believe that this thread will become one of my most important contributions to the fly field (I hope I will make other contributions)! Here, I introduce the Soy Milk Machine Fly Food Method, a.k.a., DeepCook!#Drosophila#NewPI

[Michael 英泉 Eisen @mbeisen]

So it’s going to spend 3 years crippled by insecurity, messing up everything it tries, contemplate quitting as it’s friends get rich and start families, before finally pulling it all together in a manic amphetamine fueled two month stretch and making an amazing discovery nobody reads because it’s paywalled?

[Sumner L Norman @SumnerLN]

🚀We’re hiring! @ForestNeurotech is looking for a Software Engineering Lead to build the core systems powering our ultrasound neurotech platform.

As a nonprofit FRO, we're advancing science for public good. If you’re excited about neurotech & impact let’s talk. 🌍🧠 Link below

[Cory Booker @CoryBooker]

From The Boss. He put it perfectly. Thank you Bruce Springsteen.

[Anthony DiGiorgio, DO, MHA @DrDiGiorgio]

Computerized physician order entry (CPOE) was imposed on us by bureaucrats who never practiced medicine. They insisted that forcing physicians to enter their own orders into the system would decrease errors, but this was never properly studied.

What's worse is that this system metastasized into an expectation that physicians must place every single order, no matter how trivial, into a slow and cumbersome computer system. For a "simple" order, the process of logging in, finding the patient chart, entering the order, completing the required checkboxes, and clicking "sign" can take 2-5 minutes. Ordering an MRI alone takes more than 50 clicks.

By contrast, a paper order could be as easy as writing "MRI brain" on a sheet and handing it to a nurse. Repeating this process for hundreds of orders a day chains physicians to computers, pulling them away from patient care.

Because CPOE is now the mandate, every small change in patient care requires a new order. Want the CT scan at a different facility? The physician must update the order. Medication needs to go through a feeding tube instead of by mouth? The physician must change the order. Need to adjust medication, advance the diet, or modify neuro-checks? More orders.

On top of that, "hard stops" prevent signing the order until every meaningless checkbox is complete, sometimes delaying life-saving care. This system, designed to reduce errors, ironically increases the burden on physicians and threatens patient care efficiency. It's time for @CMSGov to clarify CPOE for hospitals, taking steps to de-tether physicians from their computers.

@AJHolmgren @JPGK_MD @ReasObBob @sdixitmd @anish_koka

[Secretary Pete Buttigieg @SecretaryPete]

We're working on the future of America's passenger rail system—funding high-speed rail projects in the West and expanding service for communities across the country. Get your ticket to ride!

[dr. ashley juavinett @analog_ashley]

I strongly believe in transparency in PhD admissions, especially in the face of changing guidelines about how we select students.

So, @TaralynTan @VeronicaGMarti2 @Shitskichelle and I wrote this paper for @FUNfaculty to expose the hidden curriculum. 🔦

https://t.co/LuHCOfMm9g

[Randall Munroe @xkcd]

President Venn Diagram https://t.co/5qCm9YLtX5

[UCLA Health Neurosurgery 🧠 @UCLANsgy]

Congratulations to graduating Resident Dr. Sophie Peeters!

After graduation, Dr. Peeters will be heading to MD Anderson Cancer Center @MDAndersonNews to begin a Skull Base fellowship. We wish you the best of luck and we can’t wait to see all the good work you do!
#Neurosurgery

[UCLA Health Neurosurgery 🧠 @UCLANsgy]

Congratulations to graduating Resident Dr. Joseph Bell @josephsbell!

Dr. Bell will be joining us at UCLA as our new Neurocritical Care Fellow. We look forward to having you join us as a fellow!
#Neurosurgery

[derek guy @dieworkwear]

to people worried about looking like boring nerds:

1. you are boring nerd, hence your profession

2. you will look like a boring nerd in anything bc that's you

3. if you are cool, then you will still look cool in these clothes. see Glenn O'Brien, Duncan Hannah, Basquiat, etc.