CuriousWanderer @knucklemonk Twitter profile

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CuriousWanderer

11 months

One of my patients this morning is a homeless woman addicted to meth whom I’ve know for many years. She was at one point on the exam table, rocking and sobbing and repeating, “I just want to go home.” I just sat with her and gave her the space to come undone. There have been

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CuriousWanderer

@knucklemonk

7 months

From time to time, the last thing I do for a patient is sign their death certificate, and one of those times was this morning. He was such a sweetheart who had been dealt a bad hand in life. Hardly anyone knew he ever lived, and hardly anyone knew he died. But I knew him, and

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CuriousWanderer

@knucklemonk

7 months

@caseydanielee It’s a bit shocking that he doesn’t know that!

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CuriousWanderer

@knucklemonk

6 months

I saw a patient this afternoon who was clearly very depressed. After talking to her for a little while, she asked me, "Can you please give me something so I won't feel like crying all the time?" 💔

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CuriousWanderer

@knucklemonk

1 year

I just saw a patient of mine who brought me eggs from her own chickens. She asked me how I was doing, and I replied that I'm tired and very busy. She replied that of course, I am busy, because so many people loved me and I am a good doctor [sic]. I feel that hearing things like

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CuriousWanderer

@knucklemonk

1 year

I had another volatile patient today. She was switched to my schedule because the other provider was uncomfortable seeing her. The second I walked in the door, she was shouting threats of all sorts. She was floridly psychotic. Over the next ten minutes, I got her to settle down.

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CuriousWanderer

@knucklemonk

5 months

@DrEvans_Health Disturbing is a good word. ‘Cruel’ works, too. Finally, I would suggest ‘wrong.’ I work alongside people who have various sorts of health challenges, and they are dedicated and provide good care.

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CuriousWanderer

@knucklemonk

6 months

The other day, our dishwasher went on the fritz. I tried a few things, but I had to get to work. My youngest son took it upon himself to research the problem, cleaned out a filter, and stated that we had to keep it cut from power for about 2 days. Sure enough, when I restored

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CuriousWanderer

@knucklemonk

7 months

I wrote this post at a moment of sadness, feeling the need to express myself, as well as to try to honor my patient-- and so many others like him. I've been taken aback by the enormous response, and so moved by the many stories and sentiments you all have expressed. It clearly

CuriousWanderer

@knucklemonk

7 months

From time to time, the last thing I do for a patient is sign their death certificate, and one of those times was this morning. He was such a sweetheart who had been dealt a bad hand in life. Hardly anyone knew he ever lived, and hardly anyone knew he died. But I knew him, and

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CuriousWanderer

@knucklemonk

11 months

I pull up a patient’s chart, and one part of my brain says, “56 year old male… ah, and older gentleman,” and another part of my brain says, “Duuuuuuude. You’re 55.”

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CuriousWanderer

@knucklemonk

5 months

Well, maybe the world is on fire, but I gave a patient a neck injection today and I thought he was going to kiss me was so happy about the pain relief, another patient told me I was the best doctor he’d ever had, and with a little gentle coaxing I was able to get an overwhelmed

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CuriousWanderer

@knucklemonk

8 months

I saw a patient this morning who has a number of mental health challenges, crippling anxiety being among them. Hers is an all too common story: lots of abuse and trauma. Her new psychiatrist is hell-bent on tapering her off the Ativan she's been taking for years, and she's

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CuriousWanderer

@knucklemonk

2 months

I found out at the end of a tough day that one of my patients committed suicide. He was loved, but in the end, it wasn’t enough. 💔

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CuriousWanderer

@knucklemonk

1 year

I do not often comment directly on current affairs, as those who follow me know. But I have to get something off my chest. First of all, the man who "assaulted" the physician giving a presentation knew damn well that it would be captured on video and posted. He was very clearly

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@knucklemonk

1 year

A primary way in which I am rebelling against a healthcare system on fire is that I refuse to rush. I take my time, really talk to my patients, do what needs to get done. People have been very gracious about waiting because they know that they’re really going to be seen.

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@knucklemonk

1 year

The boys came home after two weeks at camp yesterday. It was a delightful profusion of duffel bags and loose ends, laughter, and breathless, animated tales of mischief and of quirky characters and the quirky things they did. The big surprise was that some other kids taught them

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CuriousWanderer

@knucklemonk

1 year

@JkkCalifornia I think the whole of civilization needs it!

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@knucklemonk

5 months

My father had his first date last night since my mother died a little over a year ago. New life can begin at 80. ♥️

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@knucklemonk

7 months

@srbinca @jethrostudio Beautifully said. 🙏

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@knucklemonk

1 year

Many years ago, when I was going through yet another wave of depression, I sent an email to my mother, pining about my life. Her response was brief: "Love, When you were born, your bowl of life was filled with light. You have everything you need. Love, Mom" One can only get

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CuriousWanderer

@knucklemonk

1 year

My mother had an immense capacity for love, compassion, and non-judgment. And. When she was in labor with me back in June of 1968, and the doctors were not going to let my father be with her in the delivery room, she sternly informed them that either they relent, or she was

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@knucklemonk

6 months

I can remember the moment the Noonday Demon of depression first visited me. I was lying on our family room couch the summer I turned twelve. All of a sudden, everything just felt wrong. I felt profoundly disquieted, frightened, lost, and bewildered. Not knowing what else to do,

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CuriousWanderer

@knucklemonk

6 months

It was one of those appointments. She's been struggling and struggling in life and with drugs. Missed appointments and positive urine drug screens. Today, she was disconsolate, sobbing, and at the end of her rope. My heart just broke, and the tears stung my eyes, too, which only

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CuriousWanderer

@knucklemonk

1 year

A chronic pain patient was sobbing in my office today. Chronic pain isn’t a crime, nor is it always “all in their head.” Treat it. With compassion.

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CuriousWanderer

@knucklemonk

6 months

There has been a rash of resignations at our clinics of late, both nurses and providers. Turnover has become a more significant problem nationwide since the pandemic began for a number of fairly straightforward reasons, and one of the main ones is this: we are being asked to do

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CuriousWanderer

@knucklemonk

6 months

I had a challenging but satisfying day. My patients had all the things, including metastatic breast cancer, Lupus, severe depression, combat PTSD, and neuropathy refractory to just about every treatment. Through it all, I bore witness to the courage of ordinary lives.

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CuriousWanderer

@knucklemonk

6 months

Good morning! Free virtual hugs today. Sending you all love and well wishes. ❤️🙏🫂

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CuriousWanderer

@knucklemonk

7 months

@georgiagirlsara 🙏

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@knucklemonk

15 days

I found out yesterday afternoon that my brother had be hospitalized for passing out and shortness of breath. It turns out he had extensive pulmonary emboli (blood clots in the lungs). I had a Facetime session with him and the pulmonary critical care physician, who was kind enough

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CuriousWanderer

@knucklemonk

5 months

Of Men and Bears I'm sure many of you know of the recent X poll asking women to choose between a man or a bear if they had to encounter one of the two while alone in the woods. Many women in my circle chose the bear in all sincerity. Sadly and predictably, men mocked women over

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CuriousWanderer

@knucklemonk

1 year

I’m turning 55 on Sunday. My staff decorated my office a bit, and bought me this cake. They jokingly were calling it my 100th birthday. I’m quite a bit older than they are, so I get it… 😂

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CuriousWanderer

@knucklemonk

1 year

@KallMeMayBee @ask_aubry Just wow.😞

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CuriousWanderer

@knucklemonk

1 year

Today was both busy, and intense. I saw a patient who was utterly disconsolate; her suffering filled the room. There were moments where she sat in silence and could not even speak. Another woman was homeless and struggling with permanent brain damage following a vicious assault

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CuriousWanderer

@knucklemonk

1 year

Those of you who have followed me for a while may recall that my clinic has been short a clinician since January. As a result, I immediately inherited an additional 500 patients, for a total of 1,700, a high percentage of whom are very complex. I’ve enjoyed the challenge, but

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CuriousWanderer

@knucklemonk

1 year

@TheRealTechRN @ask_aubry They wouldn’t find a clue even if they searched for it.

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@knucklemonk

1 year

Yesterday I had to de-escalate a very troubled young man. He was right in my face, screaming at me and calling me a colorful list of names as his caregiver sat helplessly in the corner of the exam room. The teen had flipped when I said something that he thought meant I was going

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@knucklemonk

7 months

I have a healthy dose of Ferdinand the Bull in me. I am content to spend my days in the fields of flowers, watching the world go by. I have never gotten over the delightful shock of being alive. On a nighttime fishing trip, I caught nothing, so engrossed I was in staring up at

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@knucklemonk

5 months

Last night, a dear friend called me to tell me that his son had just been diagnosed with a serious heart condition that will require surgery. It came as a complete shock, an incidental finding at a well-child exam, and the full extent of the problem revealed by an echocardiogram

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CuriousWanderer

@knucklemonk

1 year

Just saw a new patient, a hospital nurse who has been traumatized by all too common reasons over the last few years. She could not stop crying. If you’re a healthcare professional who is struggling with trauma and burnout, please get help. You deserve it, you need it. 🫂

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CuriousWanderer

@knucklemonk

1 year

I just got my medical loan forgiveness letter, so it’s officially official and I still can’t believe it….

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@knucklemonk

1 year

This morning I saw a patient who came in with acute fentanyl withdrawal. They are very young, and it took very little time for their life to unravel once they used for the first time. Towards the end of the appointment, they said to me, "You're the best provider I've ever met.

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CuriousWanderer

@knucklemonk

1 year

@RogueBumbleBee @ask_aubry I would be sad too if that was my attitude towards sex.

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CuriousWanderer

@knucklemonk

11 months

It’s not easy seeing your Jewish wife upset, scared, angry, and questioning her decision to bring children— our children— into this difficult world.

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CuriousWanderer

@knucklemonk

11 months

@LizMurrell81 I'm a nurse practitioner, and thank you!🙏

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CuriousWanderer

@knucklemonk

6 months

@starrylamp She will.

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CuriousWanderer

@knucklemonk

7 months

@DHCalifornicus 🙏❤️

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CuriousWanderer

@knucklemonk

1 year

As of today, my medical loans have been discharged. I found out during a particularly intense day during a particularly intense week. I've felt a weird mix of elation, relief, disbelief, and the need to remain intensely focused on doing the job those loans made possible. I've

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CuriousWanderer

@knucklemonk

11 months

@KrehbielAuthor And I feel it is significant.

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CuriousWanderer

@knucklemonk

7 months

Good morning, friends. I'm on vacation for the next week and a half, and as always, it's much needed. Like many in the medical profession, I struggle with burnout. It's a significant dilemma for me because the work is so deeply meaningful, and I also love the people I work with.

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CuriousWanderer

@knucklemonk

6 months

Oof. Being there for a patient whose life is in ruins while my own heart is broken is a special kind of hard. 😢

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CuriousWanderer

@knucklemonk

10 months

I’m full, but there are cookies. You see my dilemma.

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CuriousWanderer

@knucklemonk

6 months

Today is not, strictly speaking, a holiday for me. I grew up celebrating the Christian holidays, but my parents did not raise us in any particular tradition. My father, who considers himself a lifelong "recovering Catholic," is largely hostile toward organized religion. My mother

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CuriousWanderer

@knucklemonk

1 year

A patient who struggles with substance abuse resurfaced today. Life has been hitting her from all sides of late, so today’s agenda was limited to letting her cry and vent. She showed up. That’s a win. For all of you who struggle with substance abuse, please never give up on

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CuriousWanderer

@knucklemonk

8 months

@Sixxwitch1 One of the first things I learned in my course of study in statistics is that descriptive statistics reveal the properties of a population and do not say anything about an individual case per se. It is ironic that in a statistics driven age, this seems to have largely been

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CuriousWanderer

@knucklemonk

1 year

@ShannonDingle I’m so sorry you went through that. 🙏🫂

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@knucklemonk

1 year

I started life with a heavy dose of abuse and cruelty, from my father, and from my peers. I knew what it felt like to have no safe haven (at least, not reliably). To be told over and over again that there was something wrong with me, that I was unlikeable and weird and got beaten

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CuriousWanderer

@knucklemonk

7 months

@JanTeegarden I love that passage. Beautiful.

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@knucklemonk

1 year

I remember one of my first real crushes, a girl named Rochelle, in seventh grade. I taped a card to her locker door in which I confessed how I felt. There was a school dance that night, and I worked up the courage to ask her to dance with me that night all day. I was at the

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CuriousWanderer

@knucklemonk

1 year

Oof. I'm feeling run down lately. It's been seven months of being short a doc in our clinic, and I still have a huge patient panel, and I came back from vacation to a mess exactly because we're short, and there was limited capacity to cover for me. In other words, there's no end

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CuriousWanderer

@knucklemonk

6 months

I’m in quite the funk. And I’m just going to let it rip until it passes.

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@knucklemonk

3 months

I've been thinking more about my mother recently. She died about a year and a half ago, and yet she still dwells at the core of my being. She was the kind of person who preached little and practiced a lot. She was love incarnate. She devoted her life to the mental well-being of

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CuriousWanderer

@knucklemonk

8 months

Yesterday, a nurse sent me a note saying that one of my patients had called in just to tell us that the medication I had prescribed was working and that I was a lifesaver. For all of the hard stuff we deal with in medicine, the rewards are wonderful and really hard to beat.

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CuriousWanderer

@knucklemonk

2 months

Well, this is shaping up to be quite a week. Complex patients, so many of them. My last patient today discovered her parents in their bedroom, shot to death in an apparent suicide pact. She was completely disconsolate. I don't think I've seen many people in my life in such an

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CuriousWanderer

@knucklemonk

9 months

I had a rough go of it the past few days, as a number of factors combined to sink me into significant depression. Those are the times when those who really love you show up, and show up they did for me. It’s been a wake-up call that I really need to make some changes in my

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CuriousWanderer

@knucklemonk

1 year

@fuzzymittens @djwiththejd Agreed. Wantonly cruel and insensitive.

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CuriousWanderer

@knucklemonk

9 months

"Isn't it nice just to be here?" my father said to me after a few moments of silence between us. He didn't just mean the bench on which we sat, overlooking the sea; he meant life, being in this world. This from a man who had survived an abusive childhood, the Vietnam War, and

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CuriousWanderer

@knucklemonk

6 months

Last night, my oldest son was very proud of his girlfriend. She placed second in the 800m run, and promptly puked on the track when she finished. “That’s sigma!” He exclaimed, followed by, “What an athlete!” She’s fine, and I think quite happy with her performance. I found it so

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CuriousWanderer

@knucklemonk

1 year

Someone from admin came to check in on me this morning; they have all been concerned by the load I am carrying while we remain short a provider. I started to get surprisingly emotional, and she extended my upcoming vacation. I wish all of you could work in the kind of environment

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CuriousWanderer

@knucklemonk

5 months

My in-laws arrived last night from the San Francisco Bay Area. They are here for the week, Mother's Day weekend, and to watch their grandsons participate in a track meet this evening. As in-laws go, they are about the best one could ask for-- sweet, kind, generous, and fun.

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CuriousWanderer

@knucklemonk

10 months

Grief for me includes not wanting to be separated from the ones I love. Crawling out of bed this morning to go to work was hard. It's also been an intense year where I've had to care for too many patients because we were short on providers. I bumped into a colleague the other day

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CuriousWanderer

@knucklemonk

8 months

On paper, I practice family medicine, but to a significant degree, I am a counselor, a safe place for people to come undone. For some of these people, there is not much more I can do, but for everyone, I invite them to unload the feelings that get pushed down as they try to just

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CuriousWanderer

@knucklemonk

7 months

@Bevin802 One of my favorite things is to wonder about the stories of people I pass by on the street or who are in the car next to me. It's one of the kid games I played that I never outgrew. There is a book about the history of life on Earth entitled "The Immense Journey," and it might

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CuriousWanderer

@knucklemonk

5 months

I’m getting the impression— and correct me if I’m wrong— that folks are a bit overwhelmed by the state of the world right now. There’s not much I can do about that, but I am going to offer free virtual hugs. Take care of your hearts, my loves. ❤️🫂🙏

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CuriousWanderer

@knucklemonk

1 year

@FishieJAM I knew where it was coming from; the kid has been through hell. It was my job to be the cooler head, not his.

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CuriousWanderer

@knucklemonk

1 year

This morning, I awoke heartsick for my fellow human beings as war emerges yet again. It was difficult for me to feel ready for another very busy day in the clinic. My first patient of the morning was a jovial veteran who was coming in for a routine follow-up. I reassured him

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CuriousWanderer

@knucklemonk

1 year

I'm one of those guys: White, male, heterosexual, cis, from a Protestant, northwestern European background. I'm Ivy League educated. I'm the 1%. But I'll tell you this: all I see are fellow human beings. Not greater or lesser, more or less worthy. I don't just believe in

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CuriousWanderer

@knucklemonk

1 year

@CherylharrisRD We need to create an epidemic of calm.

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@knucklemonk

1 year

A present from a grateful patient. 🩷

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@knucklemonk

8 months

I miss my mum. Full stop. 😥

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@knucklemonk

5 months

For the last year and a half, my presence on X has intentionally been either anodyne or supportive, as a salve and an antidote to the hatred, vitriol, and negativity that has been all too common on this platform. It was perfectly sincere, just only revealing a part of my full

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@knucklemonk

6 months

@RealSoliliqui Yep! It also makes you less apt to believe stupid things. That’s priceless these days. 😉

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@knucklemonk

7 months

@perfectrose2011 That sounds like a lovely idea. Thank you.🙏

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@knucklemonk

7 months

New haircut. I think I like it.

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@knucklemonk

1 year

There’s an old story about a Buddhist monk who lived and worked in a leper colony. One day a much younger monk arrived to study with him. The senior monk took him to one of his patients, whose arms were badly ravaged by the disease. The senior monk began redressing his wounds,

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CuriousWanderer

@knucklemonk

10 months

I can tell that the first anniversary of my mother’s death— which is also my youngest son’s 13th birthday— is approaching. My soul has been feeling heavy lately. Mornings are the hardest; it takes a few hours for the fog of grief to burn off. But even then, I’m far from my usual

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@knucklemonk

2 months

I’m taking a break from X. I love you all and wish you well. Keeping being awesome. 🙏♥️

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@knucklemonk

1 year

Yesterday, as I was waiting outside a café for a friend, a man, disheveled, agitated, cursing to himself, approached me. He had an energy drink in one hand and a cigarette in the other. He asked me for a light, and when I told him I did not have one, he became enraged. He was

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@knucklemonk

4 months

@caseydanielee I’m so sorry, Casey. I see this sort of thing happening to my patients at the ED’s all too often. I would’ve handled your case differently, especially to rule out infection. I hope things get sorted and you can find relief. 🙏♥️🫂

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@knucklemonk

4 months

A mesmerizing animation of Jupiter's Great Red Spot using Voyager 1 and Hubble images.

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@knucklemonk

1 year

One of the best decisions of my life was to change my career into medicine at the age of 40. Healthcare is fraught, taking care of others, especially the most vulnerable among us, is very challenging to day the least. But I accept the messiness of human life, and find great

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@knucklemonk

5 months

Good morning. It's #TealTuesday , and I'm wearing this teal jacket in support of women everywhere who suffer from Premenstrual Dysphoric Disorder #PMDD (PMDD), which is a severe form of Premenstrual Syndrome affecting about 2% of menstruating women. It can include profound

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@knucklemonk

1 year

@acweyand Oof. Not okay.

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@knucklemonk

2 months

I’m the one who needs a hug today. 😪

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@knucklemonk

10 months

Today is my youngest son’s 13th birthday, and the first anniversary of my mother’s death. Yesterday was a somber day for me, while today feels lighter, as though I took some time to touch the cool, heavy Earth from which we all arise and pass away, to reaching upwards towards the

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@knucklemonk

10 months

The first day back to the clinic can often be a bit rough, as I struggle to catch up and see patients packed in due to my absence, but today was particularly tough. A patient of mine is on a downward mental health spiral and repeatedly threatened me, my family, and my staff with

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@knucklemonk

1 year

This morning, I recalled something I loved to do on the weekends while living in San Francisco. Early in the morning, while my girlfriend was still sleeping, I would hop on my motorcycle and head over the Golden Gate into the Marin Headlands, a magical place of steep hills, fog,

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CuriousWanderer

@knucklemonk

7 months

My mother died more than a year ago now, but Alzheimer's being what it is, she was gone long before that. Yet still I have memories of her, her vibrance, something funny she said or did, random vignettes from ordinary life, and they seem so present, so vivid, such that for a

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@knucklemonk

11 months

Last night, my brother and his wife attended an interfaith service at a synagogue near their home. He was amazed at the number of religions represented, and the service was moving. At a time when so many people are giving in to outrage, judgment, and righteousness, there are

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@knucklemonk

10 months

Merry Christmas in the specific sense for those who celebrate. In the more universal sense, I wish for each of you that your lives be blessed with unconditional love, compassion, forgiveness, rebirth and renewal, wisdom, peace, health, and flourishing. And when life's inevitable

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@knucklemonk

1 year

@MiceInSpace I’m sorry to hear you and your wife have struggled with health issues for so long. I’ve gotten a lot of feedback over the years that I make people feel comfortable and at ease. I work hard on self-care so that I can remain empathetic despite the significant pressures of medicine.

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