Áine Yore, MD 🏳️⚧️🇮🇪
@AineYoreMD
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chaotic neutral woman. “trans influencer” as cited in Forbes. my transition ends when I kill god.
Amon Sûl
Joined September 2008
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My 38 week pregnant unvaccinated patient w Covid: requests Monoclonal antibodies
Me: sorry they’re no longer available bc they don’t work against omicron
Her eyes get wide with real fear for the first time.
I hate this so much
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@benryanwriter
@Esqueer_
Is this meant to be exculpatory?
“Hey I was *going* to contribute to the rising tide of anti-trans healthcare legislation but I got fired before it could be published.” Isn’t really an exoneration
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I finally FINALLY finally got to have this delightful exchange w a patient recently:
Me: your Covid test came back positive, which means you do have the coronavirus
Pt: no, I don’t think so
Me: …?
Pt: I don’t believe in Covid
Me: you may not, but Covid believes in you!
Pt: …
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Hey everybody I have a bit of a personal announcement so if I could have your attention for a moment that would be great, thanks.
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Idk why we rate heart murmurs on a six point scale. There are only really three:
1. I think I hear a murmur but maybe I’m imagining it
2. Hey! I can hear this one!
3. Whoa that’s loud.
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Me: did you get your covid vaccine?
Pt: no.
Me: why not?
Pt: Well, I've got asthma and heart problems so I just thought it was too risky. better to be safe, you know?
Me: (screams wordlessly)
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@DGlaucomflecken
I don’t ultrasound the eye: when I call an ophtho consult I describe what I imagine I would have seen on my eye exam if I had done one (which I did not because it’s hard/the equipment was broken/eyes are gross)
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My pronouns, as the kids say, are she/her. I have also chosen a name more in alignment with my gender: Áine (pronounced “Anya” not “Annie”). Yes, I had to choose an oddly spelled Irish name, sorry, it's in my bylaws. I’d be grateful if y’all were to use it.
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pt post arrest from anaphylaxis (wasps). CPR + epi x 2 rounds by EMS. ROSC, not intubated, awake and 100% fine. epi gtt quickly weaned to off.
ICU Doc: no need for ICU, send to floor
Hospitalist: um, he arrested, we're not taking him on floor
Patient: I think imma just go home
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IMPRESSION: No finger fracture. Accompanying dinosaur incompletely imaged, no fracture noted, clinical correlation recommended.
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I’d like to emphasize that this is a positive change for me and that I am really happy about it. I will miss having pockets, though.
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HOLY SHIT I JUST GOT A SARS-COV2 PCR RESULT IN 2 HOURS
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I am once again begging PCPs, urgent cares and fire stations to stop telling asymptomatic patients w uncontrolled HTN that they need to come to the ER right away for immediate control of their BP.
Thank You.
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I’m so happy that my friend
@DGlaucomflecken
has become TikTok famous for his ophthalmology related joy-filled videos. But it’s a bummer he hasn’t found a sponsor to support his charitable activities. Maybe
@Visine
would be a good fit? Let’s get this trending and make it happen!
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Do you like big dogs, medium dogs, or small dogs?
Please take 30 seconds to answer this 3 question survey for my son's AP Stats class.
Thanks!
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One of the fun things about being an ER doc is there is no lower limit to how dumb I can pretend to be that a specialist won't believe it at least for a moment.
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Remember when the entire world got together and every single person on the planet got a vaccine and we eradicated smallpox?
That was weird.
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Nine years ago this month my wife was diagnosed with breast cancer. Seven years ago today she was diagnosed with metastatic breast cancer. She’s still here and doing great on chemo. Mind boggling how much that has changed our lives.
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I have lived with gender dysphoria for my entire life. My strategy of “ignoring it and hoping it would go away” has proven ineffective. Fortunately, there is an effective treatment for this: gender transition. I have been engaged in this process for some time now.
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As far as I can tell Infectious Disease docs are wizards. I had to consult one today for an adult w a fever wo a source (not going into details bc they’re complicated/boring)
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I mean … yeah? Why is this even a headline? My medical history, sexuality, religion … as long as I’m fit to practice, patients have no right to my private details.
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There’s a metaphor in this photo, somewhere. If only I could decipher it.
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Welp, that’s pretty much what I had to say today. Awkward and weird but hey. So. (whistles tunelessly) How about those Seahawks? And Fuck the Packers, amIright?
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@choo_ek
I’m going to get harassed for saying this but every woman should know how to handle a lightsaber and command the rebel armies against the sith. It’s part of being and incredible nurturer and caregiver.
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@hankgreen
@jrgmarwood
@pr3cipitation
ER doc. I see this all the time. It’s *not* dangerous. Pls let people know. People will be scared seeing yr initial tweet. It’s usually an drug or plant compound causing it. Scopolamine patches are notorious. But in any case almost always benign.
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after careful consideration I have decided that, yes, I am ok with "food" being a fundamental human right.
You see, I am a doctor, and I learned in medical school that you do need food to live.
How long until someone runs on the platform of
#FoodStampsForAll
?
If healthcare is a right, is food as well?
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I’m under no illusions that this will be an easy path. I am blessed to have a loving and supportive family, including my wife, our kids, as well as many supportive friends and in the workplace. I hope that I can count on the same level of support from each of you.
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Had a patient come in w an unexpected devastating illness. Too young. Family totally unprepared. It would have been so easy to tube, line, norepi and off the the unit. But it was clearly not survivable.
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The most powerful force in the universe is an ICU charge nurse intent on enforcing an arbitrary policy.
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I don’t like death and dying. But other than saving lives, facilitating “good” deaths is sometimes the most meaningful thing we do in the ER.
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So anyway. Infectious disease doctors are wizards. There’s no other explanation
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If you want to support me the only thing I need from you is your love and acceptance and maybe your compassion. If you want to support me more tangibly, well, I’m grateful but there are people who need help more than I do.
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Been waiting the whole pandemic to use this line in context, tbh
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All respect to engineers but this and similar techniques are well described in Emergency Medicine literature for many years
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Gave both my boys & son
#1
’s GF narcan kits as they went off to college this year.
The GF called me and told me she’d USED her kit yesterday appropriately and a great save!
I’m so freaking happy, and so proud of her, too!
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The idea of getting Covid now has a feeling of grim inevitability. And I hate it.
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If you have questions I’m open to (respectful, appropriate) DMs. Yes, I’m out at work. Yes, that’s complicated. No, I’m not going to go into detail about any medical treatments. No, I won’t be offended if you inadvertently get my pronouns/name wrong, as long as you’re trying.
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Inconceivable!
Without saying the name, what's a movie that is instantly recognizable based on one quote?
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While I’m cognizant of the significance of the moment, trust me, this was a step that I chose for my own well-being, not as a political statement or symbol. I’m also not transitioning to compete in women’s sports.
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I’m in a good place: mentally, family, socially, career, financially. I may call on y’all for support when there’s a hard day but I’m genuinely happy about living more authentically.
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Melania carries a $50,000 purse so maybe you should just sit this one out, ok?
While Americans are struggling to pay more than EVER for the holidays, Kamala Harris is out buying a $375 pot.
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@hankgreen
@jrgmarwood
@pr3cipitation
It’s called “atraumatic anisocoria.” You can even get it after mild head or blunt eye trauma! It’s always fair to get it checked out. We are happy to see you in the ER. But the notion that it indicates increased intracranial pressure is false. With one major caveat…
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The Trevor project provides resources for LGBTQ kids in crisis. If you’re moved to give something you can do so here:
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I had a chance to say something unkind and I chose to say nothing.
Please clap.
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ME: (Admitting a patient w a random Covid complication)
Hospitalist: Is he taking a diuretic?
ME: Good Question. IDK. Let me check the med list here in the ol' EMR...
MED LIST:
Hydroxychoroquine
Ivermectin
ME: (Screams wordlessly)
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I’m very aware that this comes at a unique moment in politics/society. Trans people have never been more accepted, and yet have never been more the target of hateful political attacks.
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@ShannonOMac
well, speaking as someone who has paid off all her school loans and wouldn't personally benefit from this:
hell yes cancel that debt baby
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@RuralEDPA
“Professional” attire standards are tools used against women and other marginalized groups. Scrubs are fine.
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@hankgreen
@jrgmarwood
@pr3cipitation
If (and this is an important if) you have had a severe brain injury and are in a coma, and also if you then blow a pupil, then yes, your brain is smooshing its way out of your skull and you will likely die.
But if you’re *not* in a coma? You’re fine.
Pls let people know
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Today was the first day in 20 years of working in the ER where I got to my car after work and just wanted to cry. (I’m ok)
The next couple of months are going to be really bad.
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In 25 years I’ve never seen the ER this bad. The whole system is at the breaking point.
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we really need a blood test that is like the hemoglobin A1C but for alcohol
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Covid +
pH 6.9
Gluc 1100
A-a gradient 600
K 7.2
Cr 4.0
HCO3 4
That’s it. That’s the tweet.
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And if politics is more your game, then I am very here for you. The Republican party wants to erase LGBTQ people from existing. the Victory Fund supports LGBTQ candidates for public office:
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Well the part where 600,000 people died was pretty rough.
Gwyneth Paltrow broke down and ate bread during quarantine. What was your lowest point?
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Cleaning up the remnants of someone’s digital life might be the most depressing thing I’ve ever had to do. Deactivating phone lines, cancelling the Amazon and Hulu and Venmo accounts, memorializing the social media, credit cards. Subscriptions, etc.
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The font abuse in the title shot gave me a stroke.
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She passed peacefully in the ED a few hours later, surrounded by her family. The patient only has one chance for a peaceful death with dignity. I gave her that chance (or at least didn’t take it from her).
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(And by “good” I mean “as pain-free as possible and consistent with the patient’s wishes and values”)
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The eternal ER dilemma: I have three people I need to page. I page the first one, no callback yet. Should I go ahead and page the second, thereby guaranteeing they will both callback at the same time? Or just stay in "no callback" hell for a while longer.
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@Ranting_Trans
Dustin Hoffman cried when he was filming Tootsie and he realized that the makeup artists weren’t able to make him conventionally pretty.
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if the emergency physician can identify the appendix on the CT scan, this is pathognomonic of appendicitis.
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Remember like a hundred years ago when The NY Times got Trump’s tax returns?
That was Monday.
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@benryanwriter
@Esqueer_
The publishing outlet is less important than the implied content in your solicitation. Searching for doctors with “misgivings” about gender affirming care is a pretty clear expression of editorial bias and that’s what we’re objecting to.
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The minimum wage for tipped workers in the US is $2.13/hour. It hasn’t been updated since 1992.
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I don’t feel like thinking today. Everyone gets a CT
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Took the time to sit with the family, help them process, grieve, and do the right thing for the patient: comfort focused care. That’s harder than doing a central line.
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Never good when you are driving to work and your 13-year-old daughter sends you this message.
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I think I love “righteous angry” Glauc even more than I love “silly funny” Glauc
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whoa. Thread
1) A stranger than fiction Roman ring mystery thread: this enigmatic Roman gold ring was found in a ploughed field near Silchester in 1785. The square bezel has a portrait of the pagan goddess Venus, inscribed backwards SUNEV for use as a signet ring by the owner. Curiously...
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64 patients in the ED at 0700. 48 are admitted/waiting for bed or admitted/boarding.
gonna be a day
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Churches are more dangerous for kids than drag shows part one million
North Carolina evangelical pastor & founder of a christian non-profit, Larry Wilkins, has been arrested for raping children.
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Nurse rushes a patient back in a wheelchair, slumped over unresponsive, blue. “Fentanyl OD!”
We get them to a bed, I start bagging, sensors applied. Starting to get color.
Me: what’s the sat?
Nurse: 69
Me: (choking on my tongue to prevent myself from saying “nice.”)
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My son is now learning the importance of clean data fields when dealing with an unexpectedly large dataset.
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My coworker: so, how’s your wife?
Me: … you … you don’t read your email very much, do you?
(awkward)
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@cyron
@fujikoketamine
I didn’t choose to be trans either but I did choose to transition and to make myself who I am and will be. I feel proud in claiming that agency. I think that’s what OP is referring to? (Not saying your perspective is wrong or invalid; just sharing mine!)
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“Just drunk” remains the most dangerous phrase in the ER.
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Omg just saw a kid w bronchiolitis. Literally the first case of bronchiolitis I’ve seen in a year.
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Why yes it is in fact possible to have sixty (60) admitted patients boarding in the ED.
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@gretchemaben
“Patient is tweeting and therefore in no acute distress. Transfer to floor.”
Hugs and get better.
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I regret to inform you all that recent events have radicalized me in the service of (checks notes) human rights.
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When I first heard of ED-Palliative Care fellowships, I thought it was the dumbest idea I’d ever heard.
Now I often feel like palliation - both providing it and recognizing who needs it - is the most important service I provide.
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Me: hi cardiology? I’ve got a STEMI in the ED. Pls come fix
New Cardiologist: are you sure it’s a STEMI? Can you send me a photo of the ECG?
Me: 🤨
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Hard to imagine it’s been a year already. 💔❤️🩹
My wife, Liza, died today. We were married almost 26 years ago. Our anniversary is two weeks from today. We have four amazing kids and she leaves behind a massive community of friends and loved ones.
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THIS IS EXACTLY THE OPPOSITE OF WHAT WILL HAPPEN YOU HYPOCRITICAL DIRTBAG
SEN. SUSAN COLLINS: "The one silver lining that I hope will come from this is that more women will press charges now, when they are assaulted," the Maine Republican tells
@FaceTheNation
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I was about halfway through my presentation before he said “I know exactly what she has but I’m going to let you finish before I ask you a couple of questions.” Which absolutely gave me med school panic flashbacks.
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I realize that there's nothing at all surprising about an extremely frail 96-year old woman dying. It is pretty wild that just yesterday (2 days?) she was apparently ambulatory and well enough to greet the new PM, and then passed away in a matter of hours (?). So sudden.
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Coolest veteran story I recall. An old dude w an atraumatic swollen knee. Needed it drained. Said that every couple of years it just swole up for no reason. Looked pretty benign so I went to tap it.
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