Transformational Leader: MSN, APRN, PMHNP; #STTI, @AmerPsychNurses. Tweets/opinions solely my own
Joined March 2012
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Wounded Healer retweeted
The great prostate cancer scam: when doctors betray and harm patients via @BertVorstman & @FreeRadicalRon8
howardwolinsky.substack.com/…
Wounded Healer retweeted
Ten million people have watched a comedian accidentally destroy the entire TED talk industry.
He filmed the talk once at TEDxNewYork in 2014 and openly admitted he had nothing to say.
Speaking coaches charge $5,000 to teach the exact tricks he used in 6 minutes to say nothing at all.
His name is Will Stephen. He is a comedian from Late Night with Seth Meyers who was invited to give a real TED talk and used it to prove the format is a costume anyone can wear.
Every TED speaker opens with a question, tells a personal story, cites a scientist, and shows a chart. Stephen did all four in six minutes with zero content.
His entire formula fits on a napkin.
Gesture with both hands. Ask the audience a question anyone can answer. Tell a mildly embarrassing story so they say aww. Point to a stranger on a slide and call them important. Flash a chart of random numbers. Wear glasses with no lenses. The audience will think you are brilliant.
That last trick alone has probably cost the public speaking coaching industry a hundred million dollars in sessions clients should have skipped.
"If you watched me on YouTube with the sound off, you would think I was a genius."
That is Will Stephen on the TED stage, three minutes into the talk he was paid to give. He wasn't lying.
Executives pay $15,000 for a keynote coach and still open with a joke the room never laughs at. Founders rehearse their pitch for weeks and still sound like Stephen at minute four, saying "wagga wah, gabba gabba" with authority.
The talk is free on YouTube. The method is written across every TED speaker's playbook for ten years.
Stephen still writes for Seth Meyers. Almost none of the ten million viewers have stopped nodding at empty slides since.
The formula is free. The willingness to actually say something before your next keynote, pitch, or townhall is the entire edge.
Wounded Healer retweeted
Storytime: Why you need a coach 👇
The year is 1993. I'm one of the top swimmers in my little region of Australia, about to head off to college in the "big smoke" of Sydney.
I'd been steadily improving through my high school years and had dreams of securing a partial scholarship at the Australian Institute of Sport.
I was excited about heading to Sydney for a lot of reasons, but at the top of the list was the fact that I'd be living just a short bike ride away from one of the top swim programs in the country, run by a guy named Doug Frost.
A couple of years later, Doug would start working with a young swimmer by the name of Ian Thorpe - the "Thorpedo" - who would go on to become a multiple Olympic champion, world record holder, and one of the greatest swimmers of all time.
Only one problem with my foolproof plan...
Doug knocked me back.
I was too old for his developmental squad and not quite good enough for his elite squad, which included several swimmers already on the national team.
No worries, I thought.
I'm a smart guy. I'm studying sports science. I've been doing this swimming thing for a while now...
I'll just coach myself!
I was in touch with the coaches at the A.I.S. at the time and told them about my plan...
"Bad idea!" they wrote back.
"You need to be part of a solid program. You're not going to be able to do it on your own."
What do they know? I thought.
I'm smart. I've got a pool. What more do I need?
Turns out, quite a lot.
I'd massively underestimated the difference in motivation that comes from having a coach and a squad expecting you to show up every day.
College life being what college life is - hell, LIFE being what life is - every so often, I'd start oversleeping and cutting workouts short.
I'd even miss sessions when I was especially tired or busy.
Things I wouldn't have even considered doing when I knew my coach was on deck expecting me.
And, here's the thing...
I was a VERY motivated athlete.
I had big goals. I loved swimming. I knew what I needed to do.
But, as it turned out, knowing what you need to do and actually doing it are two very different things!
Anyhow, long story short...
They were right. I was wrong.
And I learned a lesson that's stuck with me through 30 years of coaching.
Knowledge isn't enough.
You need accountability.
You need people who expect you to show up.
You need people around you who are in it with you, who care whether you succeed.
And, if you're truly serious about achieving your big goals...
You need a coach.
You need a squad.
Why A.I. will never replace high-performance coaching 👇
The year is 2030 and I am a 15-year-old up-and-coming athlete who has dreams of Olympic Gold. 🥇
Who do I turn to: the coachmaster-3000 or a real-life coaching squad with a proven pedigree?
The answer should be obvious; the reason a little less so.
By that stage, I suspect the coachmaster-3000 will be very knowledgeable. More knowledgeable than many coaches. And, I suspect that any human coach worth their salt will have a coachmaster-3000 in the office that they consult with. And yet, I'd bet the house that 99.9% of athletes winning Olympic Gold will have a real-life human in their corner. Why?
The main reason, in my opinion, doesn't come down to knowledge. It comes down to emotion. To human connection...
I really wanted to make my coach proud.
I never wanted to disappoint him.
I wanted to justify the belief he had in me.
Would I feel the same way when my sycophantic coachmaster-3000 told me that it believes in me? Would it carry the same level of motivation that pushes me through the tough days that are bound to show up in the years of training that high performance takes?
Nah.
Now, this isn't to say that A.I. won't make a big splash in low-performance coaching. If you don't really want to make that commitment to a human, if you want to fool yourself that knowledge is the limiter, A.I. will be there. And there's always a market for self-deception.
But real coaching, coaching that takes athletes to their full potential, that requires a living, breathing, feeling, human. That requires a coach.
Always has. Always will.
Wounded Healer retweeted
One problem with medical school admissions is that interviews can reward confidence over character.
I know many incredibly kind, soft-spoken, humble doctors who struggled to get in because they sucked at interviewing.
Wounded Healer retweeted
While everyone is different, to give a little additional context, I looked at average sleep duration across all athletes that I have coached in my database, and the average was...
8hrs 54mins per night.
When training at high (human-appropriate) levels, your body needs its rest!
Wounded Healer retweeted
Every day that I work in the hospital, I am reminded of how life-saving it is to have a great advocate at your bedside.
Dedicated family members are frequently the first ones to raise a red flag when something is wrong.
Hospitals are busy places.
If you love your family member, I’d highly recommend being next to them every hour you are allowed to visit if they are acutely unwell in a hospital. Rotate with other family members if necessary.
Don’t forget this. You’ll thank me later
Wounded Healer retweeted
Sometimes what looks like a man “growing out of ADHD” might actually be his wife quietly taking over the planning, remembering, and organizing for both of them.
Wounded Healer retweeted
When a surgeon tells you you don’t need surgery…
It takes longer to explain to someone why they don’t need an operation than it takes to explain the risks of the operation you’re trying to help them avoid.
Wounded Healer retweeted
#SNL should take notes from these folks on how to do satire. They never miss and sometimes ,like this one, are brilliant
Wounded Healer retweeted
Treating insomnia with CBT-I reduced the severity of suicidal thoughts by 23%.
Another reminder of just how important sleep is for mental health.
Wounded Healer retweeted
Two nurses, one of them still in training, were responsible for 16 emergency room patients, including a baby with RSV who needed to be transferred.
Molly Murray, a physician assistant in emergency medicine, says that was her last shift. She says the baby, in all likelihood, should have been one-to-one, and that administration said, “Well, technically there are two of you, so this seems like a fair staffing ratio.” She says it wasn’t, because one of the two was still in training.
What else she says the nurses were juggling on the same shift:
Patients asking for medications, water, and discharge paperwork, some of them yelling at the nurses.
Two ICU holds, one of them a GI bleed.
Consultants to talk to, orders to carry out, and blood products to pick up.
Hours of documentation after the shift was over.
What does your unit get when the nurses call administration for help?
Listen to the full conversation on The Podcast by KevinMD. Link in the replies.
Search "The Podcast by KevinMD" wherever you listen to podcasts.
#EmergencyMedicine #ThePodcastbyKevinMD
ALT Dark red card with white text: On her last emergency room shift, a physician assistant watched two nurses, one of them in training, care for sixteen patients, including a sick baby needing a transfer. The baby, in all likelihood, needed a nurse one-to-one, but administration said: "Well, technically there are two of you, so this seems like a fair staffing ratio." The Podcast by KevinMD.
Wounded Healer retweeted
Behind the Science: In the devastating condition known as amyotrophic lateral sclerosis (ALS), or Lou Gehrig’s disease, the motor neurons degenerate and die. Stanford Medicine’s Aaron Gitler and team are searching for answers. med.stanford.edu/news/insigh…
Wounded Healer retweeted
“Substance use disorders can involve periods of remission and recurrence — as is the case with heart disease, diabetes, and other chronic illnesses. But lasting recovery is possible, and science continues to deliver new tools to help more people achieve it.”
Dr. Nora Volkow serves as director of NIH’s National Institute on Drug Abuse.
Read her new editorial on the state of addiction science via the USA Today. ➡️ bit.ly/4jtdFix
ALT Image features a person in front of laboratory glassware. Text reads: 'Nora D. Volkow, M.D., Director, National Institute on Drug Abuse. The science driving the next generation of addiction treatment.' Logos for U.S. Department of Health and Human Services and NIH are included.
Wounded Healer retweeted
Interesting
We have known about #WPW and accessory pathways as a common cause of SVT for >100 years and have effective procedures to address them, but we still have NO IDEA why some patients are born with these extra slivers of muscle that electrically connect atria to ventricles. Medicinal use of lithium in pregnant women leads to heightened risk of a particular form of congenital heart disease associated with these pathways. Might variable levels of lithium in drinking water affect the chance a growing fetus will be born with such a pathway? @jclinicalinvest @UCSF @UCSFHospitals @stopafib @DrDave01 @KnowYourPulse
JCI - Elevated lithium levels in drinking water are associated with higher prevalence of Wolff-Parkinson-White diagnoses jci.org/articles/view/205020
Wounded Healer retweeted
Her descending aorta, normally about 2 centimeters, was down to 4 millimeters. The first physician to listen to her abdomen in four years of symptoms was in an ER.
Victoria Rundus, MD, a board-certified pediatrician in middle Tennessee, tells it from the patient side. Her symptoms started in late 2021 with back pain, neck pain, and stiffness. Then came malaise, tachycardia, dizziness, a burning sensation in her back when she stood up, and colicky abdominal pain.
An orthopedist and later a rheumatologist saw her. She was diagnosed with fibromyalgia, which she did not accept. Fibromyalgia is a real condition, she says, and those patients deserve good medical care. But she feels that diagnosis sometimes closes the door to everything else.
Then an ER physician listened to her abdomen and discovered a bruit, and sent her on. She was later diagnosed with Takayasu’s arteritis, an autoimmune inflammatory condition of the large vessels.
On the diagnosis itself, Rundus says labs are not typically helpful, and her CRP and sed rate were normal. It is usually found by CT scan, PET scan, or CT angiogram. She learned in medical school that it mostly affects Asian women in their 20s and 30s, and she fit neither demographic. She also had claudication and did not recognize it, because ankylosing spondylitis already limited how far she could walk.
"I wonder how long I had the bruit and no one had listened." She is careful about where she puts the blame: "It’s not that there are bad physicians out there. We are all victims of this diagnostic bias."
Her take-home for clinicians: "Although we usually do see horses, we have to always keep an open mind to those zebras."
Of the ER physician who finally listened, she says she appreciates the time she took "to not only listen to what I was saying, but also literally listen to me."
What is one symptom a patient mentioned in passing that changed your next question?
Listen to the full conversation on The Podcast by KevinMD. Link in the replies.
Search "The Podcast by KevinMD" wherever you listen to podcasts.
#DiagnosticBias #ThePodcastbyKevinMD
ALT Putty card with black text: The first doctor to listen to her abdomen in four years worked in an ER. Her aorta was down to four millimeters. "Not only listen to what I was saying, but also literally listen to me." The Podcast by KevinMD.
Wounded Healer retweeted
Jackson Burke, son of former major leaguer Chris Burke, and junior shortstop for CAL, commits to Louisville. He’s the sixth-ranked player in the state of Kentucky.
He also throws the football to a really good UofL receiver commit from CAL.
Thank you Coach Mac and the staff for believing in me and giving me this opportunity!! I’m excited to announce my Commitment to the University of Louisville🛑⚪️ @LouisvilleBSB
@CAL_Baseball_ @AaronBeard24 @patrigsby @DHicks09 @ChrisBurke02 @CamronHahn @JamieTessoff @jefffloyd11
Wounded Healer retweeted
A flight’s medical kit held epinephrine only at the strength used for cardiac arrest, in a device the doctor who answered the call had never used.
Samara Friedman, MD, a pediatric orthopedic surgeon in private practice, was on a long flight when the call came: is there a doctor on board?
A 20-year-old college student had eaten the meal, found nuts in it, and could not find her auto-injectors. A nurse had already given her an allergy pill. When that did not help, the nurse said, "Maybe it’s a panic attack. Why don’t you sit down, relax, and see how things go?"
Dr. Friedman took a history. The student’s throat was itchy, her nose was running, her pulse was fast. No hives and no wheezing, and nobody could say yet whether it was anaphylaxis.
Her reasoning is worth saving. If it was anaphylaxis and went untreated, the ramifications could be disastrous. If it was a panic attack, the cost was a painful shot with minor side effects. With limited resources on an airplane, she says the right call was unquestionably to give the epinephrine.
The flight kit did have epinephrine, but not in an auto-injector and not at a concentration meant for anaphylaxis. It was the cardiac arrest kind, in a device she was completely unfamiliar with. "I had to MacGyver this epinephrine." She got it into a needle and syringe and converted the dose herself. The injection came out to about 10 times the volume of an auto-injector, because the concentration was 10 times more dilute. Within minutes the itchy throat and runny nose resolved and her pulse returned to normal.
Her point is the system, not the rescue. In a flight of 300 or 400 people, she says, there are at least three or four who cannot eat the food. She says an airline could afford auto-injectors: "They probably prefer not to, and they just push that off to you, the doctors that have to deal with it when the issue arises."
As an orthopedic surgeon she uses maybe three or four medications in her practice, and she says she would not have known the proper anaphylaxis dose offhand without a personal reason to know it. An auto-injector, she says, could be used by a flight attendant, a paramedic, or a nurse.
What should an airline medical kit hold so that anyone on board can use it?
Listen to the full conversation on The Podcast by KevinMD. Link in the replies.
Search "The Podcast by KevinMD" wherever you listen to podcasts.
#FoodAllergy #ThePodcastbyKevinMD
ALT Pale green card with black text: A college student ate her airline meal, found nuts in it, and was told maybe it was a panic attack. The flight kit had no auto-injector. "I had to MacGyver this epinephrine." The Podcast by KevinMD.
Wounded Healer retweeted
Amen:
“The EP community at-large, and other relevant stakeholders, have to be the arbiters of whether the right questions are being asked and whether the right studies are being done. This is why it is critical to ensure that we refocus training programs with this goal in mind.”
Cardiac Electrophysiology at a Crossroads: Building on Dr. Josephson's 20 years of observations. Is EP science, procedure or both? What is the future of EP science?
authors.elsevier.com/a/1nzSl…
#EPeeps #CardioX @ACCinTouch @HRSonline