Nurse: “Hey, Anesthesia? Are you the resident?”
Me: “No, I’m Dr. Sheikh, the attending. How can I help you?”
The tone of conversation shifted rapidly. But it doesn’t have to be this way if we choose to speak respectfully to everyone, not just the ones “in charge”.
#MedTwitter
Can we stop assuming unmarried, childless women have tons of free time? We also have lives (and our mental health) to maintain outside our full time jobs 🤦🏽♀️
I have not been active on this account lately as I have been preoccupied with *life* ☺️. Most notably, I got married to a wonderful man who I am lucky to call my husband.
I also resigned from my position as an academic obstetric anesthesiologist in New York City to be closer to
My family celebrated the marriage of my brother Mujtaba to his wife Maria over the long weekend.
It was a traditional Pakistani American wedding with events over 3 days (more below).
Pakistani weddings are beautiful & full of customs dating back to pre-partition India. 🧵
🧿
The biggest scam in American healthcare (and a huge contributor to physician burnout) is that people who don’t regularly practice medicine are the ones making rules on how to practice medicine. Make it make sense.
To the person who thinks only surgeons save lives, I sincerely hope you never suffer from a traumatic accident, obstetric hemorrhage, or anaphylaxis. Even the best surgeon can’t save your life without a skilled anesthesiologist (they all know it, only few will admit it). ✌🏽
@colleenmfarrell
It took me years to develop a voice as a resident. It takes a lot of strength to speak up when you are:
1) young
2) female
3) trainee
4) when your employer has already threatened termination for speaking up
Thank you for the truth. Future generations depend on us for it.
The great Dr Ahmad Muhanna, Medical Director of Al Awda hospital arrested yesturday by the Israeli army and taken to an unknown location.
We worked together in the 2nd Intifada, the 2012 and 2021 wars, the Great Marches of Return in 2018 .
An outstanding anaesthetist.
One of the best pieces of advice I received as an anesthesia trainee: “a few extra minutes in the OR is worth avoiding an emergent reintubation in the PACU.”
Do not ever allow yourself to be rushed by surgeons/proceduralists if patient safety is compromised.
It is incredibly fulfilling to teach residents/fellows and watch them grow which is why I plan to return to academia someday. But for now, I am ready to explore who I am beyond “Dr. Maria.” ♥️
Something I wish senior attendings would say to junior attendings: it’s okay to not excel at everything — research, clinical work, etc. It’s okay to simply enjoy being a good clinician.
Demanding perfection in every arena is a recipe for physician burnout.
walk away from that career.
For the foreseeable future, I will be working as a private practice obstetric anesthesiologist so I am not exactly “walking away”, but taking a much-needed break from the demands of a full-time academic career.
@meenaharris
Knee on the neck compressing the airway... is murder. This should have NEVER happened. Thanks to smartphones and social media, the perpetrators will be held accountable, and hopefully put a stop to police brutality for good.
#JusticeForGeorgeFloyd
@MaaloufMD
I am bewildered by how people can read / hear something and believe it without question, despite there being no published evidence. When I chose to become a doctor I didn’t expect that we would be fighting a pandemic of misinformation. Makes our jobs so much harder.
As a HCW I’ve spent many holidays away from family. I had a particularly rough call last night & was thinking about the extravagant meal I would order for tonight. On my walk home I saw several people hard at work, away from their families. Tonight we support them, NYC style.
personal life in favor of tackling the next academic challenge. I know other physicians can identify with this gradual transformation of self-identity. The problem with associating our identities with our careers is that it can be incredibly destabilizing once we take a break, or
“You’re fear mongering!” — said the conspiracy theorist in the safety of his own home, as the doctor intubated and coded her own colleague.
— 2020 America
my husband and family in Texas.
For the last 15+ years starting from undergraduate “pre-med” studies through medical school, residency, fellowship & academic practice - I slowly & gradually became less of the “Maria” I knew myself to be and more “Dr. Maria” who put aside her
The fact that this is resonating with so many people shows that the problem persists. A trainee (he/she/they) is deserving of respect (assuming they are respectful to you) as they will someday “grow up” and be the attending everyone believes is deserving of respect.
@tystiklorius
“Selfishness is why Americans will never see the end of this pandemic.” — wise words from a hardworking, NYC 🚕 driver who came from a country where mask-wearing is simply about protecting others. No drama, just everyone doing their part to prevent disease & move on with society.
#WomenInMedicine
: It’s a great thing to “have it all” by age 30 - a career + marriage + children on the way.
You know what is *also* okay? Being financially independent, career-minded, having 100% control over your life, & delaying marriage until you’ve found the right person.
“Can everyone in the OR please lower their voices, except the Anesthesia team?” — OB resident.
👆🏼the best way to collaborate with & support your Anesthesiology colleagues during a chaotic stat C-section when seconds mean everything for mom and baby.
#OBAnes
#OBGYN
@DGlaucomflecken
I will never forget the pregnant patient gasping for air in the room across my call room who said she didn’t get the vaccine because her husband would file for divorce. 😞
@choo_ek
The one thing physicians & scientists will never forget long after the pandemic has ended: the baseless attack on scientific principles. Shameful.
@coffeeandscrubs
Reminds me of a time right before graduating residency — attending sent me on a 15min break during a ♥️ surgery take-back. Put my head down at 3:30am &woke up 45 min later😱 she had taken pt to ICU
Didn’t yell & just said “I figured you fell asleep.” I’ve never been so relieved.
What is something you absolutely love about your specialty?
For me: when we call for help (unexpected difficult airway, massive bleed, ♥️ arrest) — you KNOW your colleagues will show up to help save the patient, or save you (with emotional support).
#Anesthesiology
#MedTwitter
Attending physicians of
#MedTwitter
: what is one thing you miss about being a resident? One thing you don’t miss?
I’ll start ➡️
I miss the safety net of being able to rely on someone with more expertise when performing difficult procedures.
Don’t miss: logging duty hours.
@bschapiroMD
The narrative of mask-wearing being about “control” is something I will never understand. We wear masks in the OR to prevent surgical site infection. If we are willing to protect patients from ourselves, why won’t they do the same for us/others?
There is nothing more dangerous for patient care than:
— an overconfident trainee
— any health professional attempting to practice beyond the scope of their knowledge/training
When you don’t know what you don’t know, safety is compromised.
#SupervisedIsBest
Dear non-anesthesia personnel,
If you would like to get a better view of the surgery, please ask before coming to the head of the bed, i.e. “anesthesia space”. It may not look like it but we may be at a critical point & need access to the patient.
Otherwise we usually say yes😉
In case you were wondering what the Omicron situation is in
#NYC
, COVID(+) pregnant patients are outnumbering COVID(-) in Labor & Delivery. This is the worst wave I have seen in the pregnant population since the start of the pandemic.
🤰🏽🤰🏻🤰🏼
Please 🙏🏽 get vaccinated (+booster)
Very excited to share my 1st peer-reviewed publication in
@IARS_Journals
.
In our small case series, we found SCPB to be highly effective at reducing discomfort associated with large-bore central line placement in awake pregnant women with placenta accreta or advanced ♥️ disease.
I didn’t match to my desired specialty but found a different path that ultimately led me back to taking care of women. I ♥️ what I do, even after insanely busy weeks like this one.
Luna 🐱 and I are rooting for you — We’ll be looking through
#medgradwishlist
today!
#MatchWeek
@alextatem
No this would never happen to males. Some of my most difficult interactions as a resident were with senior female nurse who refuse to take orders from a younger female doc. Often these are the same types who — when asked to do a task — will be 1st to say “that’s not my job.”
Absolutely ♥️ the concept of
#medgradwishlist
for attendings (or anyone!) looking to help 2021 graduates 🎓 — especially underrepresented minorities — as they embark on their journey to residency & beyond. Sometimes
#MedTwitter
can be a wonderful place.
“I am an anesthesiologist because I care. If anything, I care more than I knew I was capable of. I care about learning because my lack of knowledge can have life and death consequences.”
@ASALifeline
@ASRA_Society
@SOAPHQ
Patients undergoing surgery should be empowered to ask if there is a physician trained in Anesthesiology available on the premises. If the answer is no, best to look elsewhere. If/when things go wrong, you need a physician (MD/DO) with the appropriate education and experience.
This is not good news for the residents of Watertown, WI. Watertown Regional Medical Center(courtesy of the private equity-backed, contract medical group Envision) removed all of its anesthesiologists for a 100% CRNA model. In a nutshell, they replaced physicians with nurses.
@AgnesSolberg
@fuzzymittens
Putting her in prison for the medical error does not make the healthcare system safer for patients. The whole case is tragic and awful for all parties involved. 😔
“I’m sorry I haven’t been productive, the world has been up in flames & I am working through processing the grief I haven’t allowed myself to feel from the last 6 months.”
Can we normalize saying this, especially now?
@haithamahmedmd
@Cleavon_MD
So easy to criticize when one has no experience on the COVID frontlines. Someday all these people will realize doctors were never the enemy.
@tomfolanmd
In my anecdotal experience, residents who trained internationally had way less entitlement and much more respect and appreciation for medical education. Isn’t that what makes the best doctors (and human beings)?
There is a special place in my ♥️ for surgeons who respect “Anesthesia time” & offer to help in any way they can by:
- Keeping noise levels to a minimum during induction of anesthesia
- Handing us ETT/Tegaderm/tape
- Holding mask/cricoid pressure
- Being patient during emergence
As a women's anesthesiologist, I will continue to provide safe anesthesia care for abortions in NYC. Our hospitals anticipate a significant ⬆️ in patients.
Anesthesiologists: tubal ligations/surgical contraception should be prioritized for those w/undesired fertility.
#RoeVWade
@NidaQadirMD
I’ve noticed people telling HCWs— particularly females (myself included) — to “stop being negative”. The desire to return to normalcy and “be positive” is collective denial of the seriousness of the pandemic.
Appreciate your honesty & hope you stay strong 💙
@DBelardoMD
Someone told me I should be "more positive". Sorry we cannot post about puppies and makeup tutorials when our colleagues are literally dying on the frontlines from lack of PPE meanwhile some folks are out & about ignoring public health advisories.
🚹 MD to RN: “Go get me the _______.”
*RN completes task*
🚺 MD to RN: “Can you please go get _______? Thank you.”
🚺 MD to RN: “Can you please go get _______?”
🚺 MD to RN (3rd time, now with raised, assertive voice): “Go get me the ______.”
RN: “🚺 MDs are bossy.”
🙄
@yashar
And this is why the country needs to shut down. To deal with the massive surge of hospitalized cases. THESE PEOPLE MATTER. AND SO DO THE
#HealthCareWorkers
TAKING CARE OF THEM!
#GetUsPPE
@Brenbash
As someone who has showed up to work every single day of the pandemic, (& dreams of going to the
#MetGala
someday) — I 100% support this. Slay.
Circulating RN asked for music to be turned down as I was getting ready to put a patient to sleep. “Dr. Sheikh likes it quiet during induction.” She has known me for one day.
⬆️ that’s how you support your Anesthesiology colleagues 🥹
We talk about choosing a good surgeon, but it is equally as important to choose a skilled anesthesiologist. When things go wrong in surgery (or childbirth), everyone often turns to the anesthesiologist to make it right. Patients deserve the highest level of physician-led care.
@LynneIlike
Agree with your points. I don’t think it was a matter of disrespect either. However, I am drawing attention to the fact that we [female physicians] are often shown less respect than our male counterparts and we [anesthesia providers] deserve to be called by our names.
My family started a life in America 24 years ago here in New York. We didn’t have much money back then but my parents always made ends meet for their 3 kids who could not fathom their struggle. And now here I am — in beautiful Manhattan. That, my friends, is the American dream ✨
I have presented case reports/“mini” research projects at meetings since 2016. After 7 years of hard work, sweat & tears I am honored to receive recognition for a project that is deeply meaningful to me. Infinitely grateful for the mentorship at
@Stanford_obanes
🙏🏽
#POCUS
#OBAnes
That feeling when you see healthy, young people wearing N95 masks in public places, when you and your colleagues at the frontline are forced to conserve and reuse yours... DONATE THOSE MASKS PLEASE LAST TIME I CHECKED THE PUBLIC WASN'T PLANNING TO INTUBATE ANY TRACHEAS
#GetUsPPE
As someone who has gotten involved in various research projects since med school for the sake of “having a publication” — many of which were inconclusive — I am excited to share that a manuscript from fellowship has finally been accepted for publication (my 1st!) ☺️
There is so much more to being an anesthesiologist than “putting patients to sleep.” As an OB anesthesiologist, I take pride in being able to provide the highest level of care to women during their most stressful moments. Happy Physician Anesthesiologist Week.
#PhysAnesWk21
Why has there been no media coverage of this?
#ZinatHossain
, a Bangladeshi woman, was killed last week. New York's women of color are terrified every time we take the subway. We MUST make NYC safer for everyone.
@NYCTSubway
@ericadamsfornyc
@GovKathyHochul
Delaying an elective, non-emergent case for 15 minutes so my resident or nurse anesthetist can eat/drink/use the restroom/pump ➡️ a hill I will always die on.
@colleenmfarrell
We often tie our identities to our career as medical school/residency/fellowship take up so much of our time. 6 months into my 1st job as an attending, I’ve been having these same thoughts & am making active effort to become “Maria” again, beyond the “Dr. Maria.” It isn’t easy.
@CatDocMD
These days it seems some wake up in the morning & decide, “today is the day I will start giving out unproven/harmful medical advice without consequence because I am not held to the same standard as a qualified physician.”
Patients should be encouraged to ask for credentials.
@anya_steezia
Appreciate you acknowledging it. If only more men stood up for me & my female colleagues when we were spoken to in a condescending manner. Let's make positive changes for the next generation.
#heforshe
Tranexamic acid is not warranted in the prophylaxis of
#postpartumhemorrhage
as it does not prevent morbidity and can ⬆️ risk of VTE.
‼️ It should be stored carefully & kept far away from spinal & epidural kits due to >50% mortality if injected neuraxially
#SOAPAM2022
#OBAnes
If you want to support women in the workplace, a good starting point is learning to listen and not interrupt / talk over her.
#GiveHerAReasonToStay
#WomenInMedicineMonth
👩🏽⚕️👩🏼⚕️👩🏾⚕️👩🏻⚕️
“Of those who contracted COVID-19 at work, most did so while eating in a break room without wearing a mask.”
I know we are all burned out, but we can’t let our guard down.
900+ Mayo Clinic workers diagnosed with COVID-19 in past 2 weeks
@relatableafmd
Some of the most terrifying moments in residency were weekend 24’s in the CVICU at night (attending & intern gone home). You’re not alone, you have super skilled ICU nurses who’ve got your back and you will come out of this as an extremely competent physician. Good luck!!
Most often, the people rushing you are the ones who won’t be able to help you if you get into trouble. And they will look to you to fix it. Patient safety is first, ALWAYS.
Children are being blown to pieces in schools. Meanwhile, some folk are upset that Stanford’s incoming surgery class is mostly female. This is the world we live in.
@DebVasalech
@DrFrankGabrin
So incredibly sorry for your loss. Absolutely heartbreaking that doctors and other healthcare workers have to risk their lives because of a poor government response in providing appropriate PPE.
A physician friend from Spain once told me, “we don’t make as much money as Americans, but we are happy.”
I think about it all the time.
#MedTwitter
#Academia
#WorkLifeBalance
People are quick to press the “patient shaming” button, but can we talk about how rampant doctor shaming is? We aren’t always the enemy, and often work very hard to assure patient concerns are addressed and that they are satisfied. Ultimately we want to do what is safest for you.
@yazjazyaz
F) explain to the patient that there is concern for hemorrhagic shock & death if bleeding is not controlled and ask her how she would like to proceed.
She can choose to involve the husband/partner, but assuming she has decision-making capacity, her wishes should be respected.
@JAFERDIAN
💯 — very easy to label the physicians who by education and training ARE the leaders of the team as “condescending” or “disparaging” or “egocentric”. Nope, we are just stating the facts so everyone’s loved ones know the true role of the person in the white coat.
You see, spinals & epidurals take away the sharp pain during a C-section, but it’s normal to feel pressure & pulling sensations especially when they’re getting the baby out.
While I have your ear, there’s no such thing as a “walking epidural.”
#OBAnes
Just to clarify: this isn’t an attack on surgical colleagues or other specialties. It is in response to an attack on anesthesiologists. We didn’t go into it for the glory, but if you attack one of our own we won’t remain silent.
Surgeons & anesthesiologists are complementary ☯️
A thoughtful & well-written piece on acknowledging one’s unconscious bias. It’s time to set aside the internalized misogyny and start listening to your female colleagues. — From one of the best mentors I’ve had in my career.
@Stanford_obanes
@AutismDrMom
Correct answer should be your first choice B - decreased work hours so the physician can have more time for sleep and exercise. And then won’t need to waste their precious time on useless “resiliency” modules, getting more burned out in the process.