medic.cafe

Molossoidea @molossoidea

Wenn ich einem Geschäft eine Mail schreibe - wieso rufen sie dann zurück?

Molossoidea @molossoidea

Learning, you learn, is not really a process of expanding your mind, but of watching it shrink against all there is to know.

Escape into meaning - Evan Puschak

Mikka @mikka

Oh, and it's the 5th already?

That means it's the start of Hygge. And that means 25 days of no complaining, no negativity. Positivity, acclaim, and creation. I'm the biggest moaner 11 months out of the year, so this is my short break from all the things that need fixin' and a view towards all the things that are great and I am thankful, happy, and content with and about.

Mikka @mikka
Mad rants of a night shifter Show More

The ICU is more or less full. Telemetry works (not always guaranteed), and my two nurses are old hats and very comfortable people to be around.

Had to extubate one of my patients early (we'd aimed for Monday morning) last night, and he's doing pretty well, with good oxygen saturation and his lungs sounding much better now. Three cheers for antibiotics, a big booooh for all those overprescribed and OTC antibiotics that led to MRSA, VRE, and others.

So I am hopeful. We might have an OK night, unless one of the drunk drivers in the ER below have to come up. I have two beds I can use, but then we won't be able to accommodate in-house moves tomorrow morning or whatever else comes up tonight.

Not so fun fact: it's not the SARS-CoV-2 patients that overfill us. It's the "hold my beer and watch this" ones. The joys of being a holiday island.

Mikka @mikka
Mikka @mikka

medic.cafe users may notice a changed light theme. This is intentional, but not finished. We're working on it, but we wanted you to have a first look at some of the changes in the design that will, carrying forward, be used to add the things we really want to add, such as an input box that is more conducive to writing and less to flaming/sloganeering.

Mikka @mikka

cbirt.net/a-new-machine-learni

A New Machine Learning Algorithm Classifies Sinonasal Tumors Based on DNA Methylation

Mikka @mikka

"Nurse"

There is a lot of gendered role stereotyping in who is being called a nurse and who a physician by patients. Women are more likely to be addressed as nurse than men, male nurses have to explain that, no, they are not physicians but something better called a Nurse.

On the other hand, I am being called a nurse a lot. It happens even after intense workups that are, generally, left to physicians. Not that the line does not blur in my part of medicine, nurses do initial workups, get vitals, perform an initial diagnostic pathway, and then hand the results to a physician who, in concert with the nurse, decides on therapeutic or stabilizing measures.

So I did some experimenting with a number of male and female physician colleagues. It turns out that, almost more than gender, patient-provider interactions made a huge difference. Being present, taking time, being gentle in contact (physical and psychological), explaining things, and doing small things that are typically thought to be "not doctor" work (cleaning up behind oneself, arranging a slipped pillow or changing the incline of the bed's head portion), led to either gender being called a nurse much more often than acting the opposite.

In employing the stereotype content model (which suffers somewhat from its association with scientific fraud Amy "powerposing" Cuddy), nurses are seen as warm and less competent, while physicians are considered cold and competent.

Showing competence in one's work isn't just about "doing things right." Nurses are much better at invasive procedures that are largely performed on all patients, such as getting blood samples, setting IV, applying ECG leads, and make it look effortless. Effortless looks are, however, strongly associated with a perception of simplicity.

This opened a second can of worms, however.

Female physicians who acted cold and competent were perceived as "bitchy" or "having a bad day" while simultaneously being perceived as physicians more often. This might be explained by precisely the stereotype, that females can't be physicians and that females are warmer and less competent. Acting "male" in this stereotype opens a cognitive dissonance that is mentally explained by "bitchiness" rather than "maleness."

Interestingly enough, female patients were more likely to exhibit those confusions, from misplacing providers based on their perceived warmness to experiencing male cold physicians as "bossy" and female cold physicians as "bitchy."

The paper on this will (hopefully) be out in Q1, Q2 the latest, of 2023.

Corinair @Corinair

Auf was ich am frühen Morgen gar nicht klar komme sind NEUE Dekubiti am Patienten, welche am Vortag noch nicht da waren!

Mikka @mikka

Dear fellow fediverse netizen.

If you find yourself more than once every six months needing a "thread" kind of function, meaning you want to write more than the standard 500 chars your instance gives you, please do yourself, us, and the fediverse at large a favor and find an instance that does not use those outdated, arbitrary, and artificial character restrictions.

The fediverse was built, largely, to transport all manners of media. The "Note" type can, technically, do much more than 500 chars, but should not ever have line breaks. That's what "Article" is for. Now, someone (cough, cough) thought it'd be cute to look like the Birdsite and used an impulsive limit to 500 chars while going against the standard and using the Note type.

That bell can't be unrung. But the moronic character limits can. Many instances give you more than 500 chars, use them. Threads in the fediverse don't work well. The Birdsite, historically an SMS service, thus the 140 chars, at least displays such threads in a somewhat legible manner. Many instances on the fediverse won't. Even if the very same mind that cursed one instance software with that idiotic 500 char limitation, would implement something to that effect, nine out of ten instance softwares won't.

Just write more. Find a place that does not infantilize you down to a guppy brain caveman conversation. Or, well, stay with those short grunts. But don't thread. Please.

Mikka @mikka
Mikka @mikka

medic.cafe will be a little(!) slower for a few hours while we clean up the database and media storage.

Mikka @mikka

It is remarkable and baffling how many people noticed that I'd deleted my Instagram account. Today's Zoom call was about a part of antiviral policy I am neither very familiar with nor actively involved in, and yet someone at the end of it, a person I'd met maybe once before, told me they missed me on Instagram.

I took the opportunity to tell them about the Fediverse, Flickr and Tumblr as soon to join, why not to go onto large Instances, the coolness of , and more. That took a whole 'nother 30 minutes and now we have a scheduled call to discuss academia and science communication in a changing federated landscape.

Would be amazing to get the CDC and WHO and other stewards here. We'll see if that happens.

Mikka @mikka

I finally managed to move the old version of my user on this instance to the new one. That was one hacky bullshit and I do not ever recommend anyone try it, lest they incur the wrath of one shitty code monster after another and hose their instance.

If you received a second follow request or follow notice, I deeply apologize. But at least my old statuses from 2018 and beyond should be coming in with the next DB maintenance.

Corinair @Corinair

Heute . Viel Zeit heute und Wunsch einer jungen Patientin erfüllt. Würde sie doch so an zuhause und ihre Kinder erinnern.

Molossoidea @molossoidea

"Mami Mami. MAMI."
"Jetzt chills mal."
🤣🤣🤣

Mikka @mikka

Ich bin ja voll dafür, dass eine Steuer auf die Anzahl der Räder, die man zur Fortbewegung nutzt, erlassen wird. Sagen wir mal 3-5% des Bruttoeinkommens pro Rad und Monat. Für den kommerziellen Verkehr machen wirs 7%.

Von dem Geld finanzieren wir den kostenlosen ÖPNV und Fernverkehr, kostenlose Bus- und Bahnreisen.

Molossoidea @molossoidea

Mich nimmts schwer wunder wer im anderen Pikettzimmer so laut schnarcht. Aber immerhin weiss ich jetzt, dass die Wände nicht so dünn sind wie ich meinte.

Mikka @mikka

1:30am ... you know which sound I love more in the world than any other? The "be wheee beee" our AED make every night at 2am to signal recalibration and self test.

2am means I've been here for six hours and have another six to go. It also means that my ERT gets quieter soon, and that it's another two and a half hours until we can smell the kitchen across from us starting to bake bread. It means it's time for another can of coffee to be made. And time for the celebratory mid-shift smoke.

Yeah, I love that sound.

Mikka @mikka

Winter in . Temperatures sometimes dip into the teens, but the main feature of winter here are rain and (finally) clouds in the sky. We also have some of the greatest thunderstorms I ever witnessed, with maybe Texas coming close.