Aditya Samitinjay, MD, MRCP

Democratizing medical knowledge to patients.
Ruthless Pragmatist. Dirk Kuyt is my hero. #YNWA

ST5 in Endocrinology and Diabetes

Views completely my own.

[Aditya Samitinjay, MD, MRCP @Samitinjay2]

Finally. . . Justice has come. #JFT96

[Rupert Lowe MP @RupertLowe10]

The arrested Sudanese man was an 'asylum seeker'.

He entered Britain in February 2023, immediately claiming asylum, according to the police.

Who was the immigration minister at the time? And then when the man was granted leave to remain in our country?

Reform's Robert Jenrick.

Who was Home Secretary?

Reform's Suella Braverman.

They were responsible for our borders.

They failed, in the most horrific way, with the most horrific consequences.

A Restore Britain Government will abolish the entire asylum system.

No more asylum seekers.

Anyone who entered our country illegally will be deported, regardless of current status.

Enough.

Restore Britain will not fail you.

[Eddie Gibbs @eddiegibbs]

🇧🇪 Football without Origi is nothing

Divock Origi retires at 31, and somehow that feels perfectly him. Early, unexpected, a little mysterious, with the last word belonging to nobody other than himself.

Let’s be honest, he never became the player his natural gifts suggested he might. He could disappear for weeks, sometimes months, and leave you wondering where all that speed, strength and serenity had gone.

And yet, look at the roll call.

Champions League winner. Premier League winner. Scorer in a European Cup final. Two goals against Barcelona on the maddest night Anfield has ever staged. Pickford, 96th minute, bedlam. Madrid, 87th minute, immortality.

His isn't a career to apologise for. It's a career most players would crawl over glass to own.

Origi was never a weekly certainty. He was something far rarer, a man for the thunderclap. When the match was dying, when logic had packed up and left, he would appear with that calm face and those cool feet, as if the pressure had mistaken him for someone else.

Liverpool have had far greater players. Plenty of them. Players with better numbers, longer peaks, more trophies, fuller bodies of work.

Few gave us moments quite so sharp, quite so absurd, quite so joyfully impossible.

So congratulations, Divock. On the trophies, on the memories, on knowing when your part was complete. Go make your fashion, build your work, carry your purpose.

Football without Origi is nothing, tongue in cheek, of course. Except for a few wild nights, it was absolutely true.

[Anglo Futurism Capital LP 🇬🇧🐿️ @RollingHedge]

Consider - a family of four stops being a net cost to the British state at around £105,000 in combined pre-tax income on two wages, or north of £130,000 on one, where the personal allowance taper above £100,000 pushes the effective marginal rate past 60%.

The median household earns circa £35,000. The gap does not close by itself. It gets filled by the state, which means most households are net recipients before anything has even gone wrong. When something does, a boiler, a job loss, a dental bill that got put off, there is nothing underneath. Bankruptcy implies six years without credit, private tenancy or regulated employment. That phase change is fast and irreversible.

The SME runs the same arithmetic from the cost side. National Insurance just went up and the threshold at which it fires dropped to £5,000. Electricity for anything with a physical process costs 4X the American equivalent. Compliance frameworks built for large incumbents with 50-person legal teams land very differently on a 12-person operation. AI tools help at the margin but the invoice arrives in dollars.

None of this shows up in the headline data, and there is a reason for that. The official poverty line is 60% of median income, a relative measure designed for a 1960s cost structure where housing was cheap and childcare was free. A relative measure cannot detect an absolute crisis.

If it were redrawn honestly it would classify most of the country as poor, which would require an explanation, which would require accountability. So it stays where it is. CPI is also massaged to hide the real cost of goods and services in moribund Britain. The real figure is at least 6-7% per my thinking.

The ONS, for what it is worth, has spent the last two years under formal review for the reliability of the very numbers it does report. Worth mentioning that too.

The signal is right there if you look in the right places. Credit card arrears are rising. Personal insolvencies are elevated. Corporate insolvencies are running at post-financial-crisis highs. Buy Now Pay Later adoption is a proxy for a cash flow crisis the official figures laughably refer to as ‘stability’. Should you choose to run the actual costs against the actual income of a representative household or small business - and any Govt dept (ok maybe not HMT lol) could in theory do this - you do not need the government’s data to see the problem. The stress test does the work the statistics are designed not to do.

The country has two stable positions: poor enough to qualify for the floor (the economy optimised for the bottom quintile that will soon be the bottom quarter or even third), or rich enough to ignore the costs. Everyone in between is being slowly cannibalised. That includes most people you know and most businesses you use. Which is why they are leaving and the businesses are folding.

IMF bailout ‘sounds’ far off. It’s not. I’d say it’s been a discounted risk for ages. I see this morning whilst reading the DT eating my breakfast that the excellent @LiamHalligan agrees.

My main hope is it isn’t some flaccid Fabian backdoor to rejoining the also moribund EU. Let alone the EZ (because: Stiglitz was right, and, throughout history currency unions always always die).

[GB News @GBNEWS]

‘The country hasn't been in such dire straits since the early 1960’s…’

Business and finance broadcaster Michael Wilson gives a bleak warning on the state of the UK’s finances.

[All Things Liverpool @ATLiverpool_]

@DivockOrigi Enjoy retirement, Divock ❤️

[Footybuzz @footybuzzHQ]

@DivockOrigi Divock Origi's Iconic goals for Liverpool

[Dr Jaison Philip. M.S., MCh @Jasonphilip8]

The world sees Praggnanandhaa as a chess prodigy. They see the trophies, the headlines, the victories over Magnus Carlsen,& the enigmatic smile across the board. They didn't see the journey of this Chennai star.

I saw a middle class Tamil family deciding that a child's dream was worth every sacrifice they could make. They don't see a father working tirelessly so that tournament fees could somehow be afforded. They don't see a mother travelling endlessly with her son, carrying home cooked food across continents because every rupee mattered. Yes, even food. They don't see the thousands of lonely hours spent staring at 64 squares while other kids watched Cable TV.

What makes his story remarkable is that he wasn't even the family's 1st chess prodigy. His sister, Vaishali, was already making waves. Many younger siblings would have lived in that shadow. Instead, he quietly built a light of his own.

By 12, he had become one of the youngest Grandmasters in history. But talent alone never explains greatness. Chess at the highest level, is never merely a test of intelligence. It is a test of resilience. Nezhmetdinov, Parimarjan Negi, Sultan Khan... They were all supremely talented. Yet never made it big.

Praggs had the doggedness, when the path was strewn with thorns & pebbles, the peak was not visible. A test of whether you can keep thinking when exhausted, keep believing after defeat,& keep improving when the world isn't watching.

Then came Magnus Carlsen. For most young players, facing Magnus is like standing at the foot of Everest. Praggnanandhaa climbed anyway. He beat him. Then beat him again. And again. What initially looked like an upset slowly became the arrival of a new force.

But perhaps the most extraordinary thing about him is his temperament. In an age that rewards noise, he remains quiet. Unassuming. In a world obsessed with self promotion, he lets his moves speak. He wins without arrogance. He loses without excuses. There is a rare dignity about Praggs.

Sometimes I think about the absurdity of it all. In a universe containing billions of stars and countless worlds, on one small planet, in one corner of Chennai, a boy sat before a chessboard,& dreamt the impossible. Not because success was guaranteed. It never is. Not because the odds were favourable. It never was. But because he loved the game, his family believed in him.

That, more than any rating or title, is what makes Praggnanandhaa special. His story is a reminder that greatness rarely arrives with fanfare. It is built quietly, one sacrifice, one setback, one ordinary day at a time, until suddenly the world looks up and calls it extraordinary. Jai Hind!

[Aditya Samitinjay, MD, MRCP @Samitinjay2]

@_amitbehere @DrDatta_AIIMS Haha bilkul sahi! I bark at my TV on occasion. I'm not exempt myself!

[Aditya Samitinjay, MD, MRCP @Samitinjay2]

@DrDatta_AIIMS @_amitbehere And nor has it changed after his message. Too much noise and easy to ignore.

[Aditya Samitinjay, MD, MRCP @Samitinjay2]

@DrDatta_AIIMS @_amitbehere Always remember, in such battles where the conversation does not progress forward and the Overton window regresses to the mean a.k.a it has now forced you to retort and use words like chu for very silly reasons - just give it a pass.

The outcome wouldn't have changed before...

[LinaHua @Linahuaa]

Why are English football managers the bottom of the barrel?

They haven't won a single Premier League title in their own country since 1992.

They haven't won a single championsleague.

They haven't revolutionised anything- unlike German managers with gegenpressing, Spaniards with tiki taka, Dutch with total football, Italians with their OG haramball...

The answer is:
England was a snobby society and only absolute bellends engage intellectually with football.
That's why their pundits are also trash.
Only thoughts they ever manage to muster are like: "you gotta want it more, mate"

In Spain, German and Italy it's much more normalised for high society and intellectuals to unironically philosophize about football.

[Aditya Samitinjay, MD, MRCP @Samitinjay2]

@RollingHedge The largest, most corrupt and above all incompetent cesspit is the NHS. What a fall from grace.

The first two characteristics large bloatware and corruption are from the latter - extreme incompetence.

[Andrew Branca Show @TheBrancaShow]

The medical profession kills hundreds of thousands of patients every year through sheer incompetence.

You're damn fucking right I'll question your judgment.

If an airline had your record they'd be obliterated in lawsuits.

[Aditya Samitinjay, MD, MRCP @Samitinjay2]

@TumulStocks @RedDevilae1323 Blimey! Quite an ignorant take. If anything we need more data centres. Here's an incredibly long winded but spot on answer for why

https://t.co/6IX5I6fIol

Europe is busy with dumbfuckery and is blissfully unaware of what AI is going to do and capture.

[Dr Sudhir Kumar MD DM @hyderabaddoctor]

If you are planning a trip to Sikkim, this post could be helpful. Bookmark this for future reference.
We visited Sikkim in the first week of May 2026, covering Gangtok, Nathu la and Lachung (North Sikkim). Our group had six people, including my parents in their 70s.
(1/n)

[Sir Jeremy Hunt MP @Jeremy_Hunt]

Here are the top 20:
1. DEBT: Bring down debt with a new fiscal rule saying that, outside emergencies, public spending will not grow faster than the economy.

2. WELFARE #1: Remove mild/moderate anxiety, depression and musculoskeletal conditions as criteria for claiming benefit and replace it with a guarantee of rapid NHS treatment as happens in Denmark.

3. WELFARE #2: Cap the DWP benefits budget just as defence and NHS budgets are capped. Otherwise the DWP has little incentive to find savings or stop abuse.

4. WELFARE #3: Devolve administration of the welfare system to elected mayors allowing them to keep a proportion of any savings made.

5. WELFARE #4: Require face-to-face benefit assessments with no telephone applications except in exceptional circumstances.

6. WELFARE #5: Replace the triple lock with a guarantee the state pension will always match inflation.

[James Noake @DrJN_SportsMed]

'A silent disability’

At the time of writing, it’s about 8 months since I ‘walked’ out of the Cleveland Clinic into bright sunshine, on crutches, fearful and unable to stand upright

I’ve recently accepted that I have a mild form of PTSD after my 6 weeks as an in-patient – an abstract clinical nightmare world, heavily medicated – an environment in which I’ve spent 20 years of my career, patrolling with confidence and empathetic dissociation

Then suddenly I find myself on the other side of the fence, in a sterile cubicle and bed - separated from my family and close friends, battling suicidal levels of pain due to disciitis and radiculitis – all the while bacteria feasting on my vertebrae, lying on the floor of the toilet crying and begging for help, the patient in the bed opposite swearing at the staff to assist me - banging my head against the radiator

And yet there is no effective help to be offered

“You aren’t due your next Oromorph for another 2 hours”
“Would you like to try an ice pack?”

I still find it hugely triggering to return to the hospital for yet more interval imaging – hoping that my staph aureus devoured L4/5 segment is finally nearing natural bony fusion

Whilst in the MRI machine again today, I passed the tedious hour by doing rough mental calculations -

In the last 12 months:

1000 hours lying in a hospital bed slipping in and out of false sleep, picking up where I left off in familiar nightmares

20 hours of MRIs, CTs, biopsies and X-rays – fighting desperately to keep still, despite my legs being 'on fire' – rolling off the machine bed like an invalid

42 hours of intravenous antibiotics via my PICC line (I can still see the small scar from this, a tiny medical tattoo lest I ever forget the journey passed)

I went into hospital at 105kg – I left at 83kg

As the patient, you don’t recognise the changes as they are insidious – the mirror deceives you – but to others its stark. It’s been upsetting to hear friends confide that they found it harrowing seeing me after my discharge

“You looked 60 years old mate”

“I didn’t recognise you – I called my sister after I saw you to talk about it and cried over the phone”

“I didn’t know what to say”

And then, function improves, but at a glacial pace – when I first returned to work at limited hours, I had to stop several times walking up Threadneedle Street to the clinic from Bank tube, sat embarrassed on the pavement, waiting for the heaviness in my pelvis and legs to subside

“You alright mate?”

Now I can undertake low level exercise. I have days when I appear ‘normal’ to colleagues. The bilateral foot drop is subtle and, with focus, I can tame it. But I still trip if I’m not paying attention. It is variably wearing and upsetting.

And, so, it seems to those around me that I have recovered. But I haven’t – not fully. Physically nor mentally.

I still have daily pain and it can be exhausting. They can’t see my feet that feel ice cold, ache, swell - insensate. They don’t belong to me.

I’m an inch shorter than this time last year. My posture has changed - I feel & fight it constantly – slouching is my constant aesthetic nemesis.

I can't look at myself in the mirror. I can’t lie flat on my back because of the kyphotic deformity. Simple things. I can’t have a bath.

I used to play off 5 in golf, I was a sub 12 second 100m sprinter - now my daughters have to help me put my socks on in the morning

Once you’ve left hospital, the battle isn’t over – there is the task of arduous self-directed withdrawal from the heavy-duty opioid and benzodiazepine medication, which never seemed to do anything anyway

Hello ‘Trainspotting’

Now I just take ibuprofen occasionally

The mornings are the worst – waking up to the familiar rat gnawing on my shins. I kick and lash out at it to get it off, half asleep, imagining it to be under the duvet, but it’s not there

I’ve worked out that the longer I stay in bed, the worse my symptoms are into the day – so I flop inelegantly out of bed onto the floor at 5am, stare at the ceiling for 10 minutes and try and find some peace listening to the birds outside, cursing my lot

I have a silent disability

On the Tube I cast my eye over the posters that remind commuters that not all ‘disabilities are visible’ ��� a rueful smile

And wrestling with the uncertainty:

Is this as good as I’m going to get?

Will I be like this for the rest of my life?

Do I have any other options and at what further cost?

If it’s a struggle now, how will I cope in 20 years time?

How will I support my family?

And in darker moments - what did I do to deserve this?

It sounds bleak – and it is – but there are some positives to grasp hold of:

A different perspective on life – prioritise health, family, friends, interests…. not work

A different level of empathy – I can truly acknowledge a patient’s suffering based my own lived experience – this has made me a more rounded, compassionate doctor

I can share tested, real world management strategies

All the clothes that were too small for me that I insisted on keeping, much to my wife’s irritation, now fit me again – a whole new wardrobe at no cost!

I’ll admit I’ve had some tearful conversations with patients when trying to discuss this and share my experiences – but despite my reticence, the feedback has universally been that they felt closer and more trusting of me having seen I’m a ‘human being’, not a clinical robot.

And so we push on. What other choice do I have?

Riding a wave of support from closer friends and family.

I will get there.

[Monty burns @Montyburnout123]

@DrLKVaughan The dishonesty is what it is, but is there any evidence that attendance at regional training days is of any value? Certainly wasn’t when I was a reg.
Most teaching seems to occur so that TPDs can assure the GMC that there has been teaching, rather than any learning has occurred.

[Irfan Ahmad @Irfuu_]

@LFC Arne Slot with lovely words to Mohamed Salah and Andy Robertson.

[Liverpool FC @LFC]

Liverpool FC can confirm Arne Slot is to depart his role as head coach with immediate effect and that the process to appoint a successor is under way.

He leaves with a Premier League title to his name and our deepest gratitude and appreciation.