Shashank Nuguru

Pulmonologist/ Intensivist @WellstarHealth / Bibliophile/Aspiring storyteller/ History and Mythology Enthusiast

[Mike Pesca @pescami]

Ordinary Abundance. This is the greatest thing I've read in weeks. No kidding. This should win a Pulitzer in a category not yet invented. https://t.co/iqnoACNt6z

[Peter Girnus 🦅 @gothburz]

Last quarter I rolled out Microsoft Copilot to 4,000 employees.

$30 per seat per month.

$1.4 million annually.

I called it "digital transformation."

The board loved that phrase.

They approved it in eleven minutes.

No one asked what it would actually do.

Including me.

I told everyone it would "10x productivity."

That's not a real number.

But it sounds like one.

HR asked how we'd measure the 10x.

I said we'd "leverage analytics dashboards."

They stopped asking.

Three months later I checked the usage reports.

47 people had opened it.

12 had used it more than once.

One of them was me.

I used it to summarize an email I could have read in 30 seconds.

It took 45 seconds.

Plus the time it took to fix the hallucinations.

But I called it a "pilot success."

Success means the pilot didn't visibly fail.

The CFO asked about ROI.

I showed him a graph.

The graph went up and to the right.

It measured "AI enablement."

I made that metric up.

He nodded approvingly.

We're "AI-enabled" now.

I don't know what that means.

But it's in our investor deck.

A senior developer asked why we didn't use Claude or ChatGPT.

I said we needed "enterprise-grade security."

He asked what that meant.

I said "compliance."

He asked which compliance.

I said "all of them."

He looked skeptical.

I scheduled him for a "career development conversation."

He stopped asking questions.

Microsoft sent a case study team.

They wanted to feature us as a success story.

I told them we "saved 40,000 hours."

I calculated that number by multiplying employees by a number I made up.

They didn't verify it.

They never do.

Now we're on Microsoft's website.

"Global enterprise achieves 40,000 hours of productivity gains with Copilot."

The CEO shared it on LinkedIn.

He got 3,000 likes.

He's never used Copilot.

None of the executives have.

We have an exemption.

"Strategic focus requires minimal digital distraction."

I wrote that policy.

The licenses renew next month.

I'm requesting an expansion.

5,000 more seats.

We haven't used the first 4,000.

But this time we'll "drive adoption."

Adoption means mandatory training.

Training means a 45-minute webinar no one watches.

But completion will be tracked.

Completion is a metric.

Metrics go in dashboards.

Dashboards go in board presentations.

Board presentations get me promoted.

I'll be SVP by Q3.

I still don't know what Copilot does.

But I know what it's for.

It's for showing we're "investing in AI."

Investment means spending.

Spending means commitment.

Commitment means we're serious about the future.

The future is whatever I say it is.

As long as the graph goes up and to the right.

[Bharat Tiwari @BharatTiwari]

This rumination by Dr @ShashiTharoor on the death of his friend David Malone is like a chapter of the Bhagwat Geeta that was never published. Read it to understand the relationship of life with the importance of death.
https://t.co/8ysqJcys3m

[ANI @ANI]

#WATCH | New York | On India defeating Pakistan to lift the #AsiaCupFinal trophy, a fan of the Indian Cricket Team says, "...India won the final match and we are very happy...We all should enjoy this moment"

[NephroPOCUS @NephroP]

Using a two-hand model to illustrate the spatial relationships between cardiac structures for #POCUS #anatomy.
#FOAMed #Nephpearls
Courtesy 🔗 Xue, et al. BMC Med Educ 23, 101 (2023).

[Nick Mark MD @nickmmark]

It's that wonderful time of year when new residents are joining the ICU team!

Here are a few of my favorite @CritCareTime infographics to help you understand key concepts:
⚡️Undifferentiated shock
💉 Vasopressors
😮‍💨 The physiologically difficult airway &
🧪 Metabolic acidosis

[Samuel Hume @DrSamuelBHume]

Progress in medicine is incremental but relentless

Here are this week's highlights: 🧵

[CHEST @accpchest]

A new infographic from the CHEST Critical Care Network describes the conditions for patient-ventilator synchrony, what happens in early cycle dyssynchrony, and causes of early cycle dyssynchrony. Learn more: https://t.co/U5HsVbymO7
#CHESTCritCare #MedEd

[CHEST @accpchest]

A #CHESTReview presents an algorithmic approach for differentiating between various causes of pulmonary nodules & masses in individuals without #HIV who are #immunocompromised, providing a valuable tool for clinical practice. Read more: https://t.co/4wuoTWGSqD
#MedTwitter #MedEd

[CHEST @accpchest]

Management of #Asthma and #COPD Exacerbations in Adults in the #ICU

Read the full research in the March issue of #journal_CHESTCritCare: https://t.co/43HK0lR9Zb
#MedTwitter

[CHEST @accpchest]

A new #CHESTReview explores a proposed algorithmic approach to the identification and management of patients with interstitial lung abnormalities. Read more in the March issue of the journal CHEST®: https://t.co/HvynphRbMl
#MedEd #MedTwitter

[Ross Prager @ross_prager]

(1/x) Non-invasive ventilation (BIPAP/CPAP) is one of the few interventions that consistently demonstrates improvement in patient important outcomes... but only if done correctly.

A 🧵on avoiding the 6 biggest NIV mistakes

[IMCrit @IM_Crit_]

ICU Pharmacology Secrets:

Dexmedetomidine (D) (Precedex in 🇺🇸) is one of my favorite ICU drugs. It is a highly selective α-2 adrenoreceptor agonist, w sedative/analgesic/ anxiolytic properties & minimal resp depression. Its main side effects are hypotension & bradycardia

[Dr. AK 🇮🇳 @docakx]

A🧵

[Beyond the Cosmic Veil @ClassicalAegis]

Michelangelo was more than just an artist.

The painter of the Sistine Chapel was a mystic.

But most don't realize he encoded into it esoteric secrets about the nature of God.

Read this, and you'll never see him or the Sistine Chapel the same way again... 🧵

[Oren Gottfried, MD @OGdukeneurosurg]

Critical care 1 pager: second page

[AI @WTAI27]

@KnowledgeArchiv Here is the image in high resolution.

[Nick Mark MD @nickmmark]

My approach to detecting pneumothorax using POCUS. @CritCareTime

[Avraham Z. Cooper, MD 🩺 @AvrahamCooperMD]

Complete and absolute atelectasis

C/o @Paintothal @grepmeded

[Oren Gottfried, MD @OGdukeneurosurg]

How to place a chest tube