Imagine being given a devastating diagnosis only to open Twitter to see the same attention-seeking MD reflecting on your specific case on the same day
This is a subtweet
Dear media, would you invite an oncologist to talk about how a little bit of smoking isn’t that bad for you, actually, and most people who smoke won’t die of lung cancer and we need to learn to live with secondhand smoke
One of my favourite stories ever is when I was giving my pager back at the end of residency
Clerk: sorry we can’t give you your deposit back as we don’t have a record of it
Me: best believe I kept receipts. *produces receipt for $50 that I’d been saving for 2 YEARS*
If you’re returning home after a
#wildfire
, remember that ash and dust can be harmful to your health. Wear protective clothing, such as long-sleeved shirts, long pants, goggles, and work gloves. Keep children away from debris.
Learn more:
#Maui
Great!!! Fantastic!!!!!! As an emergency doctor I’ve always asking why people don’t have MORE access to alcohol. Best use of $225 million I can think of.
I want to print this news story and post it by the wait time tracker in every emergency department in the province
BREAKING: The Ford government is spending $225 million to speed up the implementation of beer and wine in corner stores.
After Sept 5, all convenience stores province-wide will be able to sell beer and wine.
After Oct 31, all grocery stores will be able to opt-in.
#ONpoli
cw: MAiD
I realize this is a strong position and likely leaves me on an island. I do wonder if there are other MDs with similar views who have been too shy to speak up.
I believe MAiD in Canada is out of control and a moratorium is needed until it can be completely overhauled
Just learned that a major academic hospital in Toronto no longer able to have MRI staff in house overnight (!!!) Tell me more though about how things are getting back to normal
I was stalked by an unknown-to-me man while walking in downtown Hamilton today in broad daylight. He followed me for several blocks, through 2 malls, to the point where I sought refuge in a security office.
Police said “it’s not a crime to be a weirdo”
Controversial EM opinion: Clif bars are neither tasty nor filling nor healthy, you may as well have a Snickers, it has about the same nutritional content
*I have no conflicts of interest but I welcome them
How do you people see Olivia Chow looking like an absolute queen at Caribana and feel anything other than pure admiration???
If I have 10% of her energy level when I’m 67, nobody will be able to tell me *anything*
I can’t transfer a patient out because all the county ambulances are in EMS offload because we are completely bedblocked because I can’t transfer people out to free up a bed because there are no ambulances available because we are bedblocked
State of healthcare in Ontario, 2023
At least they are out in the open about why they would rather not talk about the elephant in the room.
"no outbreak declared due to 'negative connotations' "
As more hospitals drop mask mandates, the math literally isn’t adding up to me??? If as a hospital you mandated everyone to wear a new N95 every shift and the continuous use of N95s saved your employees an average of one sick day a year, you’d be coming out ahead
Reasons I have seen people approved for MAiD:
- poverty
- loneliness
- homelessness
- mental illness (note this is not permissible under current law as the sole reason for MAiD, but almost everyone with severe mental health conditions has physical illnesses too)
Walked home in tears after my dental hygienist said I “looked stressed” and terminated my appointment.
Stop fucking gaslighting women and writing off our valid concerns as anxiety, and start taking this deadly airborne pandemic virus seriously
1/n
Ofc I don’t think this was deliberate on their part or specifically targeting me - but I do think it’s interesting that institutions can lose records like this with no consequence to them
I believe the checks and balances the public believes are in place to prevent inappropriate use of MAiD are inadequate and from observing many real-life examples, I do not trust them to function in the way they are intended and promoted by MAiD proponents.
My god, imagine being a doctor in a province in which doctors are having to triage which patients are offered appropriate medical care because the system is collapsing, and deciding that advocating against airborne precautions for an airborne virus is a good use of your time
Disheartened by the elimination of public space in Ontario cities where people can simply exist. Just got asked told I can’t sit on a … wall … outside Union Station. Not a bench in sight. Nowhere to simply sit down and enjoy a sunny day
I believe that the public believes MAiD is used primarily or exclusively in cases of intractable suffering - eg terminal cancer patients with pain or nausea, which has not responded to many treatment attempts.
From what I have seen over the past year, this is not the case.
Doctors will know where I’m coming from: there are inclusion criteria that are easy to interpret to make your patient fit them, and criteria which are more rigorous and more closely scrutinized. I fully believe MAiD is the former
Individual: washing our hands after using the bathroom reduces transmission of Salmonella
Population: washing our hands may blunt but does not stop transmission of Salmonella
Most people with Salmonella have a very mild infection and we have good treatments for it now anyway
Contrary to what you might conclude based on the preceding tweets, I think there are situations where MAiD can be an appropriate way to relieve extraordinary suffering which has not responded to a robust trial of other methods.
I’m angry at this office, I’m angry at being gaslit, but I’m most of all angry at public health and IPAC as institutions for failing to acknowledge airborne spread and failing to mandate mitigation standards in healthcare settings.
6/n
In case you’re wondering what sparked this thread:
“Two of the [12 Indigenous women who experienced miscarriages of justice] in the report are asking for medical assistance in dying because they believe they will never get justice.”
I think there are actually many physicians who are very concerned about the current state of affairs with MAiD who have not spoken up due to the sensitivity of the topic and not wishing to cause offence or harm to patients.
This void is happily occupied by proponents of MAiD
There are of course many interventions in medicine which are discontinued in practice/drugs that are pulled from the market despite evidence of benefit to some patients, due to overriding concerns about danger to society. I sincerely believe this is where we’re at with MAiD
cw: assisted death, eugenics, Holocaust
I've seen few MDs in my immediate vicinity speaking about
#BillC7
, the bill to expand access to MAiD to individuals who's death is not imminently foreseeable.
I was hoping to stay out of the debate, but I don't think I can anymore.
1/14
I believe this is one example where refraining from commentary is an endorsement of the status quo, and I think there are many physicians who are as horrified as I am. So let’s speak up.
Anyway, disability justice isn’t my area of expertise, and I invite readers of my tweets to take the time to carefully consider the viewpoints of people with lived experiences of disability, and its intersections with racism, sexism, homophobia, transphobia, poverty, and others.
@usr9988
@drsandypants
Obviously not every patient can wear an N95 and they shouldn’t have to. Sometimes the condition that brings them in eg respiratory distress precludes mask use. Plenty of very young + very old can’t wear. Onus is on hospitals to keep patients safe to the best of their ability.
No, he didn’t assault me, but he followed me for blocks, walking <2 feet from my face.
What would have happened if it wasn’t in the middle of the day, with people around, and if I wasn’t with a male friend who knew where to go?
@SocialObGyne
The security office staff were actually great! I am going to write a letter of appreciation to them. It was the police who didn’t take it seriously. I have written to the local councillor who is also on the Police Services Board
I’m DONE witnessing the carnage and destruction COVID-19 is causing in Ontario as a result of
@fordnation
failure to implement equitable public health measures. Step up or step aside.
Join me and other
#HealthWorkersFightBack
Act here:
#onpoli
An emergency department is closing for five days - FIVE DAYS - due to a COVID outbreak, then will only be open 12 hours a day.
Anyone want to ask the COVID minimizing ID docs if this is what we should expect as the new normal as we ‘learn to live with COVID’? I’m serious.
Not feeling great? Your appointment can wait. If you or your child are coming to one of our clinics but are feeling sick, please call & rebook your appointment for when you are well. Thanks for helping keep our patients and staff safe & healthy.
You know what folks? If the people in charge were as “stressed” as those of us who understand the gravity of the situation, and had the courage to act on it, soon we wouldn’t be in this mess
But instead we get promises of a provincial hug day, best summer ever, etc.
8/n
In tandem with speaking up, it’s imperative to listen to diverse perspectives of people affected by MAiD - and this of course includes those who wish to retain access to it in the context of their own life circumstances.
Just got my updated COVID booster at Walgreens in the US. Don’t have insurance, didn’t get charged. FYI for Canadians who may not be keen to wait another month
I’m grateful to people like
@DFisman
@jmcrookston
@DavidElfstrom
@kprather88
and many others who have been sounding the alarm re: airborne spread of COVID for well over a year now, mostly to fall on unreceptive ears.
Good luck to us all, we’re sure af going to need it.
9/9
Crying in my office after finding out HCW in my community aren’t expected to get the vaccine until the end of FEBRUARY. I’m a doctor working in a rural northern Ontario ED that is precariously staffed on a good day.
You can keep your vaccine selfies, southern Ontario.
Finally, for my fellow MDs: we don't talk nearly enough about how we uphold ableism as doctors. This has gotta change.
I find this a really tough and upsetting topic to grapple with.
We need to be gentle with ourselves as we learn and strive to do better.
14/14
Controversial opinion: proof of vaccination and recent negative COVID test result are not interchangeable & should not be treated as such, thank you for coming to my TED talk
Y’all the rooms didn’t even have DOORS separating patients. The air is literally a soup of all the other patients’ exhaled breath and I’m supposed to not be stressed about this????
4/n
Spent a shift seeing patients almost entirely in the hallway. Constantly dodging obstacles. Insufficient space, inadequate privacy. Most other EDs experiencing the same or worse. I truly don’t know how we dig ourselves out of this hole as a country
There was not an N95 in sight. Maybe a third of the staff were wearing cloth masks and the rest surgical. When I sat down in my chair I was perhaps 3m away from another patient - with not even a door separating us. Loud music played on the speakers.
2/n
Oh I forgot to mention - crucial information - I got my temperature screened at the door which has 100% sensitivity/specificity for COVID as we all know
10/9
I was told I “looked stressed”. When I expressed how uncomfortable I was to be 3m away from another unmasked patient while I had my cleaning, I was told “that’s life”. And when I disagreed, I was told I shouldn’t have my appointment today
3/n
Gentle reminder to people age 21-70, in possession of a cervix, who have ever been sexually active: if you haven’t had a Pap test “since the pandemic” you are probably overdue!
Hearing of *non clinical* staff working in research divisions of UHN who have received the vaccine is pretty demoralizing when you’re a family/EM doc who’s gotten shrugs after asking when it might be your term 😭
I hadn’t been to the dentist since Feb 2020. I was so looking forward to this. I told multiple friends how excited I was to finally do this thing I’ve been putting off. This office had a very high rating on Google.
And I was essentially told to leave for being hysterical
7/n
Just one example: Roger Foley, a man living with cerebellar ataxia in Ontario, was denied home care that would enable him to live independently in the community, and was offered MAiD instead
8/14
I thought adulthood would be staying up late with my friends and going on adventures and instead it's googling how to hang curtain rods and researching space heaters and paying for winter tires, I feel scammed
Hard not to feel a sense of pride (and maybe shed a few tears) witnessing the massive (but fast-moving) crowd of people lined up to get their vaccines at Scotiabank arena today
Love us, Toronto 💖
WOW … the government of Alberta is planning to take some hospitals away from the public health system and turn them over to a Catholic health authority … to prevent rural ER closures??
Not a serious place
Will transferring Alberta’s hospitals to new management improve healthcare and stop ER closures? One province’s ‘strange’ plan detailed by
@seeingread
- Airdrie News
They did have an “air purifier” in each room but could not tell me if it contained a HEPA filter and I had no way of discerning whether it was doing anything other than blow air around.
5/n
I don’t believe Ontarians are aware that in the midst of emergency department crises across the nation, our EDs are having their physician hours *reduced*.
Fewer physicians will lead to wait times being even longer than they are now
I... let me get this straight... golf courses & marinas are opening but parks remain closed. Cool. Cool cool cool. Ontario you may as well say fresh air is just for rich ppl
I am always amazed at how much faith people have that wearing a parachute WILL reduce the risk of falling to one’s death. Like …no one even questions that.
Even though we have no RCTs
I am always amazed at how much faith people have that higher filtration of particles WILL reduce risk of infection.
Like …no one even questions that.
But there’s a LOT of data pre COVID where N95 masks weren’t clearly better. Why? “As used”…
1/
When I started hearing disabled activists on here talk about how
#BillC7
would pressure disabled people into ending their lives, I was horrified because deep down I knew they were right.
There is precedent for this
7/14
I didn't have a lightbulb moment per se. But the seeds were planted in my brain and I started noticing how my peers and staff spoke about disabled patients.
And I learned more about power in society and who is written off and who gets given the benefit of the doubt
5/14
As a recently graduated family doctor (2020) I wish to say in no uncertain terms that the
@CFPC_e
's plan to lengthen training by a year will worsen the exodus of people from family medicine, as so many have been saying
1/n
First solo overnight shift in a busy rural ED. (2 hours to get a CBC back because you have to drive it to a nearby hospital rural) Can’t say I’m not nervous but also thrilled I get to do this job.
Anyone, anything, any time. Let’s do this!!!!!!!
I’m sure grateful for the ID and PH docs in 1972 Yugoslavia who didn’t say:
- we need to learn how to live with smallpox
- smallpox won’t end, but this outbreak will
- we’ll get through this with no solid policy, just kindness & vibes
Not a critical care doc but a significant proportion of patients I have admitted to critical care got there as a result of societal failures - poverty, racism, colonialism. Often with substances as a mediator. Laughable to think vegetables and bike lanes will solve that
I still find this all really difficult & upsetting to grapple with.
Like, it is very difficult to accept that you're part of a system that is actively harmful to vulnerable individuals on the daily, but it's reality
6/14
We think we’ve struck a good balance in our approach to school streets in
#Tirana
. This project was fast, inexpensive, it works, and it is loved. Twelve more like this in 2023, on track for every school in the city by 2027.
@Qendra_M
@punetorettirane
@CityOfTirana
I'm not an expert on ableism in medicine or MAiD or
#BillC7
.
I do believe that removing safeguards currently in place (not perfect btw) will have horrifying consequences for disabled people.
I will now share some resources that shaped my understanding of this issue
9/14
@Kidsdoc1Rick
What the heck??? It used to be a ‘hack’ to tell the hospital you had a history of MRSA so you’d get a private room free of charge due to isolation requirements. This seems backwards
I’m actually so livid at this framing, I don’t even have words. This is not something to celebrate. This is not cause for relief. The fact this was ever a possibility in the first place is disgraceful.
I don’t get it. Suppose as an institution you didn’t care about protecting patients from respiratory illness or your workforce from acute or long COVID, or about doing the right thing generally, wouldn’t you at least care about the cold hard cash??
I like how the onus is placed on parents and children to keep “patients and staff safe and healthy” instead of the actual hospital, which arguably had one job