KK, MD
@KK_medicine
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Your doctor when things go bump in the night…or day. Emergency medicine doctor 👩🏼⚕️ MD, MPH, MBA 🌈 🚑 operational and disaster medicine fellow
Level 1 Trauma Center, USA
Joined December 2018
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Yesterday, I did something very dangerous as a doctor and trainee — I stood up for my patients.
Not just that, I stood up to those who have power over me, and my career.
1/10
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Do you think the general public knows that the way you die from COVID is by suffocating to death?
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So, an an emergency medicine trainee, I’m sticking my neck out and publicly disagreeing with INACEP. Decreasing safe access to medical services WILL negatively impact our practice and our patients, and I personally don’t think that is a political stance.
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If this bill were to pass, we must acknowledge that EM physicians will likely be the primary providers for an increase in septic abortions, uterine hemorrhage, accidental toxicological overdose, and, on the other side, precipitous deliveries in the ED with neonatal resuscitation.
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Some EM docs prefer that we don’t involve ourselves in public health topics and stick strictly to the medicine, but I am of the opinion that EM docs are responsible for the public health and medical safety of the community they serve. It’s bigger than exam rooms and dispositions.
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We know from the CDC that there were an estimated 130,000 illegal abortions performed in 1972, which dropped to 17,000 by 1974 in the Roe era. We should anticipate similar, if not higher jumps in illegal aborts due to access to online materials and alternative at-home techniques.
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So here I am as an emergency medicine doctor in Indiana with my own personal views, to inform you of just some of the ways an abortion ban could impact emergency medicine doctors:
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I predict that any changes in patient volume stress our already struggling healthcare system. We saw this with COVID. The ED is a safety net, and putting more things into the net puts all of our patients in danger, not just the obstetric ones.
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Indiana American College of Emergency Physicians is taking a neutral stance on Indiana Senate Bill 1 (an abortion ban) and stood before our state Senators and the public without any opinion or recommendations on the bill, claiming “as it is written, it does not impact EM”
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Last week a travel ICU nurse asked how much I make as a resident, so I told her. She literally spit out her drink laughing. I can’t stop thinking about it.
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The INACEP Board members decided this would be our position statement independently, without polling the 600+ EM docs of Indiana.
Further, they did not give an EM physician expert opinion on how this bill could impact our practice, if implemented.
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Underwhelmed by our position, I sent an email to all 600 INACEP members through our chat forum to further clarify our stance. The response I got was varied and included “we shouldn’t be political, it is bad for membership” and “how it’s written doesn’t impact us”.
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I like giving presentations and educating learners, but this lecture is probably the most fun *I’ve* had creating content! Teaching 4th year non-EM students how to be doctors in the wild
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This month a nurse went directly to my attending without speaking to me and told my attending that I was being unprofessional with a patient and let me tell y’all — that HURT.
A thread 🧵 1/10
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Please stop being mean to healthcare workers in a pandemic. That’s all.
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MedTwitter has made me decide that a few years into my career I will consult procedural sedation at a low cost a couple hours a week to assist with IUD insertions. Not a joke, it matters.
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MY RECOMMENDATION TO INCOMING INTERNS: Before intern year I made a survival bag for my backpack so that I was prepared for some of intern year’s difficulties. Do it. It has proven to be SO USEFUL. Here are my recommendations to make your own little bag:
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What medical word would be a cute baby name if it didn’t mean what it does?
I’ll go first: Vicryl
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Today I was told that *two* M1s at my university are anti-vaxxers. It truly upsets me and breaks my heart that they were granted admission to the only public medical school in our state. I see this as a complete disservice to public health in Arkansas.
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What’s something that isn’t sexist, but ✨feels✨ sexist? I’ll go first...
Hospitals stocking “unisex” scrubs that rarely fit women, despite women making up >75% of the healthcare profession
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As a new doctor, I have very few practices I will stand by, but this is one — I would rather be too conversational in 100 rooms than make 1 teen girl feel confused about her body/care for the sake of seeming “professional”. Plain Languge is the hill I choose to die on. 9/10
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Let’s have frank discussions about how our bodies responded to a pandemic.
I gained 45 pounds in a little over a year. I ate my feelings, binged whatever food I wanted while working a stressful job, especially in the ICUs, and stopped exercising.
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Emergency Medicine Pro Trick:
if a patient comes in covered in dried 🩸blood🩸 that you want to clean up, cover the area in ultrasound gel for 5 minutes. The blood will wipe away and you don’t have to scrub 🤠
#MedStudentTwitter
#MedTwitter
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The most stressful part of a central line is putting on the dressing in a way that my nurse will be proud. Change my mind.
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Hot take: Stop kicking nursing or medical students out of Code Blues
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Yesterday in resident peer support counseling I remarked, “the last thing dozens of people with COVID saw before they ultimately died was me, upside down, in goggles, 2 masks, & a gown as I prepared to intubate them” and wow. I never paused to reflect on how profoundly sad it is.
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In medicine, we act as gatekeepers to medical understanding by using language with patients that is indigestible. It is a system build to exclude patients by using nonsense jargon that is intended to intimidate and make them complacent in their care. 6/10
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I take USMLE Step 3 in a couple days and I just want to know, who thought a SEVENTEEN HOUR TEST was a good idea?
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Lastly, it really hurt that a nurse my age went to my attending with her concerns rather than addressing it with me. I hope I can work on being more approachable so that if anyone in the healthcare team feels uncomfortable, we can talk peer-to-peer for better feedback 💚 10/10
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I have newly diagnosed so many late stage cancers in the ED this year I cannot even begin to count.
COVID deaths aren’t the only deaths happening because of this pandemic and what it has done to healthcare.
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Major kudos to the multiple bystanders photographed holding excellent pressure over gunshot wounds at the Sunset Park Subway shooting. Brief refresher for laypeople when someone has suffered a gunshot wound and you want to help:
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In my note will I use “pull out game”? Absolutely not. But when talking to a teenage girl, I want medicine to be focused on her, her comfort, and her understanding of her body. “Pre-ejaculatory withdrawal” just isn’t the same. 7/10
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new residency milestone: sent my medical student home early so he didn’t have to sit and watch me type 😎💪🏼🤠
#medstudenttwitter
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Any other healthcare professionals out there still never been tested for COVID, or just me? 👀
#MedTwitter
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Passed EM boards! Officially certified in Emergency Medicine by the American Board of Emergency Medicine!
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Tylenol, ibuprofen, travel toothbrush + paste, a pair of socks, phone charger, face wipes, deodorant, extra contacts/glasses, hair ties, a spork, Tums, tampons, rewetting eye drops
Extras: multi-port charger to let patients borrow, trauma shears, your must have makeup item 💅🏼
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My first year of residency starts this week. Taking the advice of a thread, I made my
#backtoschool
bag to live in my backpack so I can survive long days intern year. Thank you
#medtwitter
for the advice!
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I just walked around the ED showing off this textbook blood sample!
Diagnosis?
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While on the phone with a hospitalist known to be very snarky, he cut me off & asked “What year are you??”
I replied “Sir, If you have to ask, you already know the answer. I know I’m disappointing you. I’m disappointing me too, but here we are 🤷🏼♀️😊”
I think he smiled 😅
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I’m sad and a bit ashamed it got that this point, but that was then, and this is now, already 14lbs down.
I’m just saying it’s okay if you’re like me and focused on your survival and stress rather than fitness and health for a little bit 💚 It’ll be okay.
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Sometimes, that means I have to toe the line of professionalism, use street terms mixed with medical terms for patient understanding. Sometimes, I will accidentally cross the line. 8/10
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One of the most badass emergency medicine doctors to ever walk this planet just wrote me a very, very nice evaluation.
Once I stop crying from fangirling / happiness, I think I’m going to print it to look back on when the days are hard.
Faculty — your words matter!
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Lastly lastly, please forgive all of the typos along the way. I will be eternally mortified by them but I am so appreciative of y’all’s feedback on this thread 💚 11/10
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Due to the interest, YES, I will post this online in some format after I give it, receive feedback, and do some edits in response to feedback. Probably posting early April :) Will add it to this thread when it is available!
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EM doc: *sees, treats, and DCs 99 patients with specialist complaints without consult*
Also EM doc: *consults on 1 patient with unclear history*
Our consultants: this tweet.
Friendly reminder to specialists that you have no idea how many people we see without consulting you.
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On day 167 of residency emergency medicine residency, the inevitable happened — I got shot in the face with an abscess 🤠😎
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Just had to show a vaccine card to get in to a bar and I’m going to be honest, that was so dang cool 😎
#VaccinesWork
#vaccinated
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Reason the ICU almost broke me today: Someone ate my Thai red curry I was saving for lunch.
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Downtown Indianapolis has ONE 24 hour pharmacy to accommodate three level 1 trauma centers with over 250,000 annual ED visits.
Thank you to the employees of the CVS Pharmacy on 16th and Meridian for keeping this city safe and allowing great patient care. The ED appreciates you!
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Was using this phrase the most professionalism I’ve ever exuded? Absolutely not. Would I say that to just any mom and daughter? Definitely not. I read the situation and deemed the level of conversation to be appropriate to be more casual, considering the chief complaint. 4/10
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More importantly, I want to break down WHY we think talking about “pull out game”, “cum” or other colloquial terms are unprofessional. 5/10
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47.8% of my emergency medicine residency intern class is badass women. This is what that 47.8% looks like 👀
#MedTwitter
#DisasterDay
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I have been a doctor for 387 days and today was my first day wearing a long white coat.
I hated it.
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Brand new attending here — Stop calling medical students “kids”. They are not children, and frequently have had full professional lives before medical school. Anyone who refers to grown adults as “kids” gives those “kids” the vibe that you’re trying to put them in their place.
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Just to clarify as this is blowing up — we were just chatting as colleagues about vacations and going out to eat when the topic came up. She didn’t mean it with any malice and I didn’t take it that way. It was just a funny realization moment for us both 😌
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It cost zero dollars and zero cents to tell your team you appreciate them
and their work.
Today I told someone they were doing a great job and they started crying with relief.
Let’s appreciate each other more. It’s free. 💚
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Today I gave a brief presentation on why we should be doing ALL (yes, I mean all) chest tubes ultrasound-guided.
I learned a lot making the presentation, so here’s a thread 🧵 to review it for my
#embound
,
#MedStudentTwitter
, and
#MedTwitter
friends 1/17
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Big news! I am delighted to announce that in July I will be joining the team at The University of Tennessee Health Science Center as an attending physician at Regional One Health, Memphis’s only Level 1 trauma center and the safety net hospital for the community
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I have spent my entire adult life in the South. Every morning I wake up to temperatures that are lower than my age, I contemplate Midwestern existence.
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- Larger wounds can be packed by stuffing socks, shirts, or any fabric material tightly into the wound
- Wounds to the chest or head need professional medical attention if they are survivable. Direct EMS to those people.
- Check out Stop the Bleed for excellent training!
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- Get yourself to a safe place before helping others!
- Hold pressure directly over the area until bleeding stops
- Don’t check if the bleeding has stopped. Don’t let go.
- Don’t use shirts or belts as tourniquet. They are VERY hard to get tight enough. Direct pressure is better
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Ecstatic to announce that I have accepted the operational and disaster medicine fellowship position at Carolina’s Medical Center — I’m going to be a disaster doc!
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Unpopular opinion: Don’t go in to
🚨Emergency Medicine🚨
if you don’t ALSO enjoy the “boring” stuff, the “social” stuff, & the “primary care” stuff 🤓 It’s all part of this specialty in 2020 and it is what makes our role in the community unique 💚
#MedTwitter
#MedStudentTwitter
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@ITooMD
Nothing raises your spirits when you’re hungry and desperate quite like a granola bar that’s been in your backpack for 6 months
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Last night I realized I hit an emergency medicine milestone I’m really proud of — I can’t remember the last time I looked at the top of an EKG for the computer interpretation before making my own. Seems insignificant, but I’m proud of my growth 🥺
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Residency is hard, so here are my tips and tricks for wellness: Dog(s)
That’s all.
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I was denied to med school the first time. I said screw ‘em, got my MBA, worked full-time in healthcare, & published 5 peer-reviewed articles that year. Now I’m at one of the best programs in the country 🤠 let’s normalize not getting in & realize we are still worth investing in
I’ve never publically stated that I was accepted off the alternate list for medical school. Prior to acceptance I was told I should treat it as a rejection. Also told by faculty at my COM that I should have attended a different undergrad to increase my chances of acceptance.
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For HIPAA sake, I won’t use any details other that teen girl with concern for pregnancy. I love these visits and they are truly my ED 🥖 and 🧈. When chatting and developing rapport, I use a line from a certain Cardi B and Meg The Stallion song, referencing “pull out game”. 2/10
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I agree that all parents should be afforded the option of plastic surgeon closures for their child’s complex lacerations, BUT I just wish y’all could to listen on speakerphone to hear how that phone call to the consultant goes. It is very different than these replies.
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This year I will be taking on an attending physician role in the emergency department at a teaching hospital and am conflicted on whether to wear a white coat. Thoughts? (And please don’t bring up cleanliness when I know y’all aren’t washing those patagonia jackets daily) 1/
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We all chuckled, the history and physical continues, all is well and at the end of the ED visit, the teen’s mom asks if I can be her PCP, which unfortunately, I told her I cannot. 3/10
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So excited to see all of these
#MedGradWishList
posts from the
#EMBound
#MedStudentTwitter
and
#MedTwitter
community. As a current emergency medicine resident, here is a thread of items I recommend adding to your wishlist as a soon-to-be doctor:
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Who is out here is still telling women that “there’s no chance you could get pregnant”?
I just want to talk.
Because…they keep getting pregnant.
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My emergency medicine residency program match more women than men for the first time ever. Emergency medicine is changing and women are driving the change. Congrats everyone!
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Today in EM residency I:
✅ broke car windows, lights, and bumpers
✅ used a reciprocating saw to turn a car into a convertible
✅ used the “jaws of life” to take a car door off
✅ took a sledgehammer to a car, just for funzies
EMS and fire friends — y’all are rockstars! 🚑🚒🚨
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🚨 Y’all! 🚨 MATCH DAY RESULTS ARE IN!! 💚 I am going to be an
#EmergencyMedicine
resident at Indiana University in Indianapolis, IN (
@IUSMEmergMed
) 🥳🤩
#MatchDay2020
#MedTwitterMatchDay
#MedStudentTwitter
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I have officially decided — I am applying for a Disaster Medicine fellowship this year!
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Cut deodorant wipes and mouth wash, added chargers and a spork
My first year of residency starts this week. Taking the advice of a thread, I made my
#backtoschool
bag to live in my backpack so I can survive long days intern year. Thank you
#medtwitter
for the advice!
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Match 2022 applicants — you did it! You’ve made it halfway through the virtual interview season. Congrats! Zoom interviews are hard, but I’m here with a pep talk to keep you motivated and looking like the stars you are even though the luster of interviewing may have died.
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Now add a little bit of ✨spice✨
Happy to work at a place that doesn’t have hair color policies 🤗
#medtwitter
#EMBound
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What if we cared about how much our patients are being charged for seeking emergent medical care as much as we cared about the marketing missteps of a *scrubs company*?
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I stopped at s farmer’s market on my way home from my shift yesterday. Someone at a stall asked me where I worked. A group of people started clapping for me. COVID was the theme of my shift so I nearly cried just seeing that people realize how bad it is and how hard we are trying
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Always remember to restock when you use the last of something and don’t be afraid to add and edit! 🤠 what else would
#medtwitter
recommend?
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When we say our residency is a like a family, I mean 3 of my co-resident’s husbands are going out tonight together without any of us and I’m DDing them on the way to my shift 😅🥳
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I take the emergency medicine oral board exam tomorrow and it could possibly be my last board exam for…forever? 🥹
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My parents couldn’t be with me for Match Day but my dad still got dressed up 😭😭
#MedTwitterMatchDay
#MatchDay2020
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It happened. It finally happened. It is Day 11 in the ICU. I left work and... couldn’t find my car in the garage. Zero recollection of what level or which row. I am now officially a
#resident
. ☹️
#MedTwitter
#embound
#MedStudentTwitter
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@dr_mary24
Next time I work with her I’m going to try to bring it up in a neutral manner. I would love the feedback but I don’t want to make her feel overly confronted and make matters worse for my perceived professionalism
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@MelindaHamerMD
Dr. Hamer, all respect, your article has absolutely nothing to do with my point or thread that discusses illegal abortions, patient volumes, and downstream effects of bans. I never mentioned ectopics.
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And that’s my job entirely. Every time I call a consultant I am fiercely advocating for the interest of my patient to a consultant who is already spread thin. Making a blanket statement that “EM Bros” have too much ego ignores the hours of advocating we do daily. That sucks 🤷🏼♀️
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And with my final [death] note, I’ve now finished what has been and may forever be the hardest month of my medical training — goodbye COVID medical ICU ✨
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Patients have slowly learned that surgeons listen to music while in the OR, but do they know that everyone else does too? Emergency medicine, inpatient teams, etc. Healthcare runs on Spotify
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@PenPaperPlanner
Absolutely. Things in your cervix with an OB/GYN? I’m here to support you and their services
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In medical school we were taught about
#TheGenderUnicorn
during our OBGYN rotation. This graphic has been one of the best things I was taught about. Here is why... 1/n
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OPINION: when talking about changing your name upon marriage, the quip:
“my husband didn’t go to med school, I did! 😏” is insulting to doctors who decided for themselves and their family that they wanted to change their name. 🤷🏼♀️
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Me: posts a pic on Facebook with a message discussing the importance of
#COVID19
vaccination 💉
My redneck Arkansas family:
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A very mild inconvenience, clearly, but when working 80 hour weeks, this is the stuff that gets you teary eyed. Residency is hard, y’all 🤠🤪
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