Nostr notes by McNadoMD

A highschool friend of mine worked(s?) for Boston Dynamics. ...

2026-10-26T20:36:58Z

A highschool friend of mine worked(s?) for Boston Dynamics. Nobody there has any delusions about the purpose and likely use of their robots. The fact that some folks drew a line at ICE is both hilarious, and a commentary on ICE.

The US lost around 3,000 lives on Sept 11, 2001, and since then ...

2026-10-26T12:58:11Z

The US lost around 3,000 lives on Sept 11, 2001, and since then US voters have persistently allowed themselves to be swayed at the polls by racist and islamophobic garbage thrown by politicians. A virus killed over a million, and people raw dog the air and don’t get vaccinated. Twenty years of war killed more Americans than 9/11, but we’re back at it. Gun violence by white people in 1 year kills more.

Americans are idiots.

Good job Brazil and Serbia. Perhaps the US of A can learn ...

2026-10-26T00:17:21Z

Good job Brazil and Serbia. Perhaps the US of A can learn something.

The country that wants to land humans on the moon just needs to ...

2026-10-23T02:58:54Z

The country that wants to land humans on the moon just needs to recruit Republican scientists from America. I mean, hell, when we recruited nazi rocket scientists in 1945 it worked…

So will the Finns live up to their Polandball reputation and stab ...

2026-10-23T02:23:38Z

So will the Finns live up to their Polandball reputation and stab Google in the face while shithoused, or will they let their forests be cut down like Americans?

Since Collins thinks Manchin has solid independent cred, it’s a ...

2026-10-22T00:24:15Z

Since Collins thinks Manchin has solid independent cred, it’s a good time to remind people that Joe Manchin’s daughter ran up the price of epinephrine autoinjectors (Epipens) around 300% for no reason beyond pure profit. She is responsible for the preventable death of many children and adults. Joe Manchin facilitated this, and protected her in Congress. Fuck Joe Manchin and his yacht.

“Why are all of these evil billionaires…” Well, let’s ...

2026-10-20T11:13:36Z

“Why are all of these evil billionaires…”

Well, let’s start with the billionaire part. Would someone who hasn’t a phenomenal asshole just keep accumulating wealth after the first couple hundred million? They don’t need it. They can’t use it. A human with empathy and a desire to do good would be spending it lifting others out of suffering.

Remembering the time someone tore the “Stop bombing ...

2026-10-18T04:25:14Z

Remembering the time someone tore the “Stop bombing hospitals” sticker off my truck in the hospital provider parking behind the ER.

Following up on my previous post: Pretty much yes to most ...

2026-10-17T16:13:22Z

Following up on my previous post:
Pretty much yes to most comments.
Anxiety in the emergency department setting should be viewed as a symptom, or physical manifestation, of an underlying disease state. It is not an emergency diagnosis. The cause needs to be investigated, and life-threatening conditions ruled out.
For example, recently someone came to my ER with high heart rate as a complaint. They admitted chronic meth use, and feeling anxious. Guess what? Hyperthyroidism was the problem.
1/…

Guys, if you’re in #emergencymedicine please do not even put ...

2026-10-17T15:31:27Z

Guys, if you’re in #emergencymedicine please do not even put anxiety on your differential until you have done a very thorough medical workup AND the patient has reported feeling anxious. It is a diagnosis of exclusion. “Anxiety” is the diagnosis on the chart the day before the patient dies from their blood clot, arrhythmia, thyroid storm, sepsis, hemorrhagic shock, or overdose. It is a bullshit diagnosis unless you have a clear patient-reported history of anxiety.

Remember when DOJ wouldn’t do fuckall about Trump because it ...

2026-10-12T15:04:27Z

Remember when DOJ wouldn’t do fuckall about Trump because it was close to an election?

https://www.nbcnews.com/politics/trump-administration/rep-ilhan-omar-home-searched-federal-agents-criminal-probe-dhs-rcna602950

Two merits to the first journalist willing to ask Hegseth why he ...

2026-10-12T03:05:09Z

Two merits to the first journalist willing to ask Hegseth why he won’t just shoot the guy himself on live TV. What is he, a coward?

Good job Jared Polis! You let Tina Peters out just in time for ...

2026-10-12T00:06:00Z

Good job Jared Polis! You let Tina Peters out just in time for her to try to disrupt another election through blatantly illegal activity. Maybe you should go to jail as an accomplice?

Russian diesel won’t make the American corn harvest cheaper. It ...

2026-10-10T13:15:57Z

Russian diesel won’t make the American corn harvest cheaper. It is like pissing into the ocean at this point. What it will do, though, is tell Putin that we don’t care about civilian deaths, systematic rape of a captured populace, torture, and hybrid warfare.

None of this is surprising, of course, because Donald Trump doesn’t read or understand anything, is incapable of critical thinking, and would do anything to feel like he’s part of the dictator club.

Two things are true: 1. ICE is an unaccountable nazi organization ...

2026-10-09T23:44:05Z

Two things are true:
1. ICE is an unaccountable nazi organization hellbent on horrific violence, and well known to withhold medical care
2. Bullets remaining in a victim’s body is not an indication of lack of healthcare. In fact, we almost always leave lodged bullets in place. There are a few special cases, but most of the time the damage done by hunting the projectile down is worse than leaving it.

This weekend a kid came in for “med clearance for jail”, ...

2026-10-07T04:17:09Z

This weekend a kid came in for “med clearance for jail”, since he had smoked some weed a few days ago (yeah, I know…). He was 14. Some firearms shit. Anyway, I usually don’t “dad talk” these folks, but this kid is a kid. Just a kid. I told him if he cleans his act up now, his record will be sealed most likely. I have jobs where he can get all the excitement he wants. He can even fuck around with guns in some of them. If he unfucks his criming, he can come see me in 2 years to shadow.

Maybe JD’s right. Maybe we shouldn’t gripe about the little ...

2026-10-02T23:03:00Z

Maybe JD’s right. Maybe we shouldn’t gripe about the little things. Let’s focus in the big things, like how he’s the VP of a government openly embracing literal fucking nazis, kidnapping people, and torture.

Thanks JD. We needed that perspective you (alleged) couch fucker.

If you have healthcare training (IV placement, for example), and ...

2026-10-01T04:07:24Z

If you have healthcare training (IV placement, for example), and use that to aid an execution, FUCK YOU. Fuck you, fuck your bloodline, fuck your entire goddamn ecosystem. You are garbage. You are the worst fucking human. You were given knowledge and skill to heal, skill that not everyone has the opportunity to obtain or use, and you applied that for evil because of what? Profit? Some sick sense of righteousness? Fuck off into the sun. Shitbag.

Thanks for coming to my rant.

Hah. People letting Muse handle their FB marketplace, and it does ...

2026-09-28T13:13:42Z

Hah. People letting Muse handle their FB marketplace, and it does what all of the other AI tools like this do — make insane deals with people, and give away information it shouldn’t, like the home address of the seller.

Ell oh ell.

“AI went rogue and accessed…” Lemme fix that copy for you ...

2026-09-27T12:21:54Z

“AI went rogue and accessed…”

Lemme fix that copy for you —

“A human used a software package to hack…”

A human turned software loose, and that software had been prompted to hack. It did. Find the human. Some developer on a team at a company entered the prompts.

Do you watch baseball? Do you support National Parks? Write MLB ...

2026-09-27T02:58:51Z

Do you watch baseball? Do you support National Parks? Write MLB and tell them to fuck right off into the sun with an idea to build a stadium in Grand Teton.

I dunno, I guess I just assumed everyone had understood the ...

2026-09-26T21:42:26Z

I dunno, I guess I just assumed everyone had understood the lesson Nena taught us in 1983 about computerized warning systems integrated into defense networks. Hell, even the younger generation should at least have hear it taught again by Goldfinger. Do we need a T swift or Chappell Roan lesson update to really drive it home or what?

Anyway, fuck AI.

Waymo vehicles keep wandering into farmers’ markets, ...

2026-09-26T14:57:16Z

Waymo vehicles keep wandering into farmers’ markets, construction sites, and pedestrian zones. Colorado has no legal mechanism for ticketing anyone when this happens.

Two easy options:
1. Use regulatory action to require a human driver until the legal loophole can be closed by the legislature
2. Order a safety stop to review the technology, while working on a legislative solution. Let Waymo sue, and bring the details out in discovery.

Instead, our leaders just say “oh well!”

The good news is, for all the bootlickers out there saying armed ...

2026-09-26T00:51:06Z

The good news is, for all the bootlickers out there saying armed defense of democracy in the US would never work, fuck you because we have run down our supplies of advanced weapons enough that the military probably couldn’t put down an armed defense of democracy if they tried. Shit, they can barely operate aircraft without a total loss incident every other week.

“Americans still not comfortable with socialism…” ...

2026-09-25T06:16:22Z

“Americans still not comfortable with socialism…”

Motherfuckers, yes you are! You stupid fucks are so goddamned afraid of a boogeyman from 1960 that you don’t look at your own life. Ride a public bus? Socialism. Medicaid? Socialism. Road maintenance? Socialism. Fire department? Socialism. Kid in public school? Socialism.

You fuckheads are so fucking gullible.

Anyhow, imma enjoy my garbage-ass private healthcare, while wishing I could buy the medicaid my patients have.

In case you wanted to know: Insurance companies in the US (or ...

2026-09-25T06:05:59Z

In case you wanted to know:

Insurance companies in the US (or even government healthcare) will let a person die to save maybe $200 every MONTH, but ICE is pissing away over $200 per DAY housing detainees, and billions more on camps that never opened or never saw a single detainee.

That’s right. The pro-life party won’t spend money to keep granny from having a stroke, but they’ll shovel money into some bottomless hole to pretend they’re fucking over immigrants. Racist deathbringers.

Does anyone believe the F-35 parts were actually ...

2026-09-24T02:48:23Z

Does anyone believe the F-35 parts were actually “accidentally” routed to Hong Kong? The Chinese are not stupid. The US government and its suppliers are an open book, thanks to Elon’s DOGE boys.

Just a reminder that “Stop or I’ll shoot” is Hollywood ...

2026-09-21T00:37:24Z

Just a reminder that “Stop or I’ll shoot” is Hollywood bullshit unless the subject is actively a lethal threat to the public or officer. It is called murder when an officer shoots someone for running away, evading, eluding, being an asshole, spitting, or all manner of other behavior. Lethal force requires a lethal threat to be present or reasonably believed to be present.

Anyway, fuck ICE.

All Republicans have right now is “so-and-so wants to spend ...

2026-09-20T15:12:20Z

All Republicans have right now is “so-and-so wants to spend your money on illegals”. That’s the ads, the speeches, the talk shows.

Three things:
1. Immigrants without a social security number don’t get most public benefits because they can’t register for them.
2. Many workers who entered the US illegally initially have work permits and pay taxes, so in fact they are paying for their services.
3. The money spent on immigrants pales in comparison to the money spent on ICE.

If ya have the means, perhaps go buy an album or some merch from ...

2026-09-16T02:06:12Z

If ya have the means, perhaps go buy an album or some merch from the folks with enough gonads to bail on a stadium tour to stand up for a people that have been forsaken.

“What were you proud of in your life dad?” “Well son, we ...

2026-09-11T12:36:09Z

“What were you proud of in your life dad?”

“Well son, we spent a year demonizing life boats. Those were the days.”

Dumb racist nazi fucks.

I am about a decade into my current ER doc job. I don’t quite ...

2026-09-03T16:32:39Z

I am about a decade into my current ER doc job. I don’t quite have a Gibbs’ rules yet, but I do have a few rules for the ER. For instance:
If a patient was walking recently, and can’t walk out of the ER, you’d damn better know why.
If a patient or family member asks “could it be ___”, you better realllllly think it through.
If your immediate reaction to a patient is bad, check your bias by being more thorough than usual.
Always read your own imaging studies before reading the radiology report

I cannot stress this enough, my fellow #healthcareworkers — ...

2026-09-03T16:23:14Z

I cannot stress this enough, my fellow #healthcareworkers —
LISTEN to your patients and treat them all the same.

I can count on one hand the number of people I have essentially shoved out of my ER. Sure, people malinger or want to prolong a stay to seek shelter or food, but I have saved my patient from harm and me from lawsuits by stopping and saying “why is this person upset about leaving? Why are they demanding some other thing? Did I miss something?”

PSA for my #EMS #emergencymedicalservices folks — please use an ...

2026-09-01T23:57:31Z

PSA for my #EMS #emergencymedicalservices folks — please use an interpreter service for patients who speak a language you haven’t mastered, if you have such a resource. I know it sucks, but trust me it will save you time in the long run. Basic things like assessing capacity cannot easily be done with broken speech.

Hey Republican hunters, fishermen, hikers, and climbers. Question ...

2026-08-29T02:34:42Z

Hey Republican hunters, fishermen, hikers, and climbers. Question for y’all:
Can you afford to buy access to that elk draw? That trout creek? That 14er? El Cap?

Nah? Me neither.

Trump is selling our lands. You gonna let that slide, or you gonna realize this fuckshit con man real estate scammer from NY is stealing your (our) land? He’s the rich guy conspiracy you’ve been bitching about. It’s him. It’s OK. You can tell him to get fucked and die. You told all of us. He’s just one pathetic guy

Oh fuck allllll the way off with this “electric vehicle owners ...

2026-08-28T15:28:53Z

Oh fuck allllll the way off with this “electric vehicle owners aren’t paying their fair share” shit on road taxes. You know who isn’t paying their share? Billionaires and multimillionaires. Those fucking guys. Those guys spend absurd amounts of money to buy politicians just so they can pay less in taxes.

My state says I made an error on my taxes and owed some silly amount back. I just paid it. Right then. Why not? It goes to services we all use. The ultra-rich would fight that. Parasites…

Well gosh, SCOTUS once again finds a way to rule on an ...

2026-08-25T02:47:29Z

Well gosh, SCOTUS once again finds a way to rule on an election-related case that will absolutely fuck up elections just before an election, after previously being unable to do anything close to an election.

Joke of a court. Roberts is a boot licking scumbag.

Hey Canada, ya cold-tolerant fucks! Yeah! You! Elbows up! Fuck us ...

2026-08-22T05:33:54Z

Hey Canada, ya cold-tolerant fucks! Yeah! You!

Elbows up! Fuck us Americans. Half of this dickbag country voted for the orange shitweasel. Don’t negotiate with him (us?). He’s a lying sack of moose bales, and he won’t keep his word even if you could get to an agreement. Make Americans feel the pain. Elections here are coming up. Make Republicans unpopular.

Anyhoo, thanks for the maple syrup. The Vermont and New Hampshire stuff is unobtainable here for a good while now.

@nprofile…hagm now, I suspect people started calling this ...

2026-08-20T19:09:52Z

In reply to nevent1q…6ckf
_________________________

nprofile1qy2hwumn8ghj7un9d3shjtnyd968gmewwp6kyqpqwzlzrd7lum5mzjgpgtfe09rhlzfa05t7c4q4cr0hn7qnvxz39y4qyyhagm (nprofile…hagm) now, I suspect people started calling this hallucination because some of the original examples seemed to just pull something from thin air, and besides, it makes the LLM sound silly. The reality is, the LLM is Making Shit Up. This MSU problem is an unfixable disaster. Imagine trying to read a two page story about someone else’s day, and find the one line in 100 (which is about the rate) that is just made up shit. How much concentration does that take?

As @nprofile…hagm points out, AI/LLMs don’t actually ...

2026-08-20T19:07:21Z

As nprofile1qy2hwumn8ghj7un9d3shjtnyd968gmewwp6kyqpqwzlzrd7lum5mzjgpgtfe09rhlzfa05t7c4q4cr0hn7qnvxz39y4qyyhagm (nprofile…hagm) points out, AI/LLMs don’t actually hallucinate. They confabulate. This is also called “making shit up”. For example, when a person with severe dementia tells you a very plausible story about how they arrived at the ER today, but five minutes later they tell a completely different tale, they are confabulating. Their brain knows they should have a story, so they just start filling gaps. LLMs do this. It is unpredictable, and extremely hard to detect in a written result.

The implication then, is if you are using AI reports or notes, ...

2026-08-20T15:15:33Z

In reply to nevent1q…vgfg
_________________________

The implication then, is if you are using AI reports or notes, you MUST proofread them line by line before submitting them to the official record. You are, after all, the one signing the note. You are the one who is staking your license/certification on the information being accurate. If the AI lied, and you sign their note, you are wrong. It’s like if I signed a medical student note without any corrections or hint that it was a medical student note, except that most students don’t hallucinate.

Whether you are in #lawenforcement or #medicine it is imperative ...

2026-08-20T15:13:14Z

Whether you are in #lawenforcement or #medicine it is imperative that you understand this simple concept: AI engines that write reports will put information in the report that the AI engine thinks is what you want to see in the report.

Doesn’t matter if that information is true. Doesn’t matter if the referenced facts or events actually occurred, were discussed, or are present in the record. The engine will “hallucinate” — make it up entirely — whatever the engine decides fulfills the prompt.

Want to know what the shock gloves ICE is buying do? Here’s the ...

2026-08-12T21:20:20Z

Want to know what the shock gloves ICE is buying do? Here’s the sanitized ad from the company. Basically appears from this and the spec sheet that it can deliver a shock similar to a Taser.

https://m.youtube.com/watch?v=hiINGUEhmZQ&ra

Awwww, Bill Cassidy is upset that the narcissistic corrupt ...

2026-08-11T02:29:59Z

Awwww, Bill Cassidy is upset that the narcissistic corrupt asshole he has consistently voted to protect, including last week, is issuing batshit vaccine orders. Maybe, and I’m just spitballing here, Cassidy could have grown a pair at any point since 2016 and prevented this.

Dr. Benjamin Salinas and Dr. Shauna Kincheloe. Remember those ...

2026-08-10T12:52:31Z

Dr. Benjamin Salinas and Dr. Shauna Kincheloe. Remember those names. Those are the names of doctors working for ICE who actively requested a court order to torture hunger striking detainees. They are not only complicit, but in fact, instrumental in the unethical treatment of civil detainees.

https://www.theguardian.com/us-news/2026/aug/10/ice-force-feeding-detention-gabar-choli

Anyone else hope Greenland just goes ham on these US oil thieves, ...

2026-08-09T02:36:48Z

Anyone else hope Greenland just goes ham on these US oil thieves, and overruns their base, shoots everyone who “resists”, and puts the survivors in a black hole for a decade?

Anyway, Trump’s a fucknut, the US can’t maintain a war against Greenland if we can’t against Iran, and these cockwombles deserve whatever in the 1890s comes to them.

The news coming off the USS Abraham Lincoln isn’t so much about ...

2026-08-08T13:45:06Z

The news coming off the USS Abraham Lincoln isn’t so much about the time at sea. It is about the lack of logistics. Not enough food or water is a logistics problem. Other ships can provide those — why aren’t they? Did Kegsbreath’s DEI purge get rid of everyone who knows how to get a ship loaded in England or Italy or wherever, and have it take water and food and clothes and soap to the strike group? Not like German submarines are out there sinking the convoys.

Why did FDA approve the Moderna flu shot despite RFK, Makary, and ...

2026-08-06T04:30:35Z

Why did FDA approve the Moderna flu shot despite RFK, Makary, and Trump raging against Moderna and MRNA? Senators, Trump, RFK, Makary — they’re all old and vaccinated. This vaccine works. They know that. They don’t want to drown in viral inflammatory secretions.

Anyway, fuck ‘em all.

Controversial point for my #Emergencymedicine colleagues: The new ...

2026-08-05T01:12:18Z

Controversial point for my #Emergencymedicine colleagues:

The new trauma guidelines requiring an emergency physician in all level IV trauma centers just mean we’ll have fewer rural trauma centers. It’s asinine, dangerous, and does a disservice to patients.

PAs and NPs can suck. They can also be good. ER docs aren’t that common, and rural sites can’t afford them. The ones who work in rural level IVs are the soon-to-retired, incompetent docs, or a few good ones who hate city medicine.
1/2

RFK may have claimed COVID-era lockdowns caused the measles ...

2026-08-03T04:14:33Z

RFK may have claimed COVID-era lockdowns caused the measles outbreaks, but my first kid was born in the middle of that shitshow and he is fully vaccinated, so clearly it wasn’t a barrier to pediatric appointments.

Also, RFK intentionally targeted vulnerable communities for his antivax grift before his current job, with multiple community outbreaks of measles in areas he had been visiting and spreading his trash .

If you haven’t had the pleasure of taking a dip in the cesspool ...

2026-08-01T02:28:58Z

If you haven’t had the pleasure of taking a dip in the cesspool that is the US legal system, let me just say that it is not adequate for a prosecutor to just say “ooops, my bad, this case was rushed. We’ll drop it. Cool, right?”. It fucks up lives. “Good” legal counsel costs ~$400+/hr. Every email and phone call is money. Charges can be reported to employers or licensing agencies. Jobs lost. Kids taken away. Bad shit happens.

One closing thought tonight: did you know you couldn’t access ...

2026-07-30T05:34:21Z

One closing thought tonight: did you know you couldn’t access Fox’s studios if you weren’t vaccinated against COVID during the shitshow? Yeah. All of those fucking weaseldicks were jabbed. They just lied to everyone because it makes money. Guess everyone forgot about it.

November 2020. Two weeks before my expiremental vaccine ...

2026-07-30T04:54:59Z

November 2020. Two weeks before my expiremental vaccine appointment. It’s 2 am, and I’m charting late after a shift. Tech walks up “hey man, the gal I put in 15 looks like she’s about to code”. THE FUCK?!?

Look at monitor. O2 sat is 30% with good waveform. Run into room. My worn out N-95 is too loose. Goggles are back at my desk. Shit. She’s grey as fuck. Yank gurney across hall into the big room. Start bagging O2 into her lungs. Scream at staff to fuck off and go get their PAPRs on.
1/2

May 2020, the ER. Walk out of a room. Spray myself down with ...

2026-07-30T04:49:05Z

May 2020, the ER.

Walk out of a room. Spray myself down with alcohol mist. Take off the chemical warfare hood and PAPR pack. Take off the gown, and 1st pair of gloves. Soak my still-gloved hands in alcohol. Take off the N-95 and goggles. Doff the gloves. Cover myself in hand sanitizer.

Go find the ED manager.

“We need to put 800 mcg of fentanyl, 8 mg midazolam, and 200 mg of ketamine in the RSI kit. We don’t have enough sedatives to manage these folks in there for 3 hours.”

Call the ICU.

Pro-tip: if a fire ripped through a property you maintain, and ...

2026-07-30T03:45:40Z

Pro-tip: if a fire ripped through a property you maintain, and that property is in, say, a canyon, TAKE THE TIME TO INSTALL EROSION BARRIERS.

Brought to you by: I just spent two days digging trenches and shoveling mud out of a garage and barn.

I knew I needed to do it. Got backburnered by fighting with insurance on critical house shit. Doesn’t help that my mom’s place is 1.5 hours from here so it’s a haul to go help out. Epic hail storm dumped a whole canyon wall of run off. Damnit.

Nostr event nevent1qqs9gq6lyz5hxqvdlh4pgtasmvydx62yppuuuukvypft9l7pketevgszyptq44jmgfpj6elr5jeq57x0n5548kk7xxkhpd69a2mymq2wk57wupkm8fn

2026-07-29T15:24:30Z

Remember when that guy broke Rand Paul’s ribs?

I’m in my 40s, logged into the MMORPG I played in 2003, on a ...

2026-07-25T05:28:10Z

I’m in my 40s, logged into the MMORPG I played in 2003, on a gaming tower with sweet-ass LEDs inside, a bitchin’ headset, a backlit keyboard and mouse, in a room that isn’t 120 degrees. My teenager self is so happy right now.

Friendly reminder if you are new to mastodon: you NEVER need to ...

2026-07-23T12:41:52Z

Friendly reminder if you are new to mastodon: you NEVER need to “prove your identity” or other such bullshit to “verify” your accounts here. If you get emails or messages saying otherwise, it’s a scam.

“My loaded shotgun with the safety off, left propped against a ...

2026-07-23T04:08:09Z

“My loaded shotgun with the safety off, left propped against a tree, went rogue and shot me in the back”.

You see how fucking stupid that sounds?

No you absolute coop scraps, you were NEGLIGENT and left something in an unsafe state, and it PREDICTABLY caused a problem. That’s a liability, a testament to shitty judgement, and an indictment of your safety practices. Get wrecked hosers.

I care for someone experiencing a spontaneous abortion on nearly ...

2026-07-21T04:15:13Z

In reply to nevent1q…juha
_________________________

I care for someone experiencing a spontaneous abortion on nearly every shift I work. My medics care for them in the field. My family has been through the trauma of them. They are very common, even if Republican men aren’t aware of it. When someone has to sit for days in horrible pain, bleeding through pad after pad, becoming anemic hour by hour, because of asinine laws, we have failed as a society.
2/2

ICYMI: The July 7 JAMA has a great paper by Rodriguez, Fuerst, ...

2026-07-21T04:12:09Z

ICYMI:
The July 7 JAMA has a great paper by Rodriguez, Fuerst, and Schrote, in which they evaluate the management of spontaneous abortion (miscarriage) before and after *Dobbs*. In short, after *Dobbs*, women are being told to suffer through it without medication more often, and when they are prescribed medication, they are given a less effective treatment than before.

https://jamanetwork.com/journals/jama/article-abstract/2849131

1/2

Blowing up water tanks in Iran is an unconscionable act. It may ...

2026-07-19T02:40:16Z

Blowing up water tanks in Iran is an unconscionable act. It may disrupt military targets, but it absolutely will kill civilians. Cowardly fucking nonsense by a country too chickenshit to put boots on the ground and too stupid to just say fuck it and leave.

For anyone wondering: you can, in fact, run while wearing a 3M ...

2026-07-17T03:37:14Z

For anyone wondering: you can, in fact, run while wearing a 3M Aura N-95 respirator. It feels awful for a minute or two while you get used to the restrictive feeling, and you dump sweat like whoa out of your face, but it works. I was doing it here last week when you could see the smoke particulates in the air at night with a headlamp.

For smoke particulates, a vented N-95 makes it less sweaty and gross, I just don’t have any at the moment because they aren’t safe for clinical use.

Congratulations to Pete Hegseth for offering men gender affirming ...

2026-07-16T19:22:58Z

Congratulations to Pete Hegseth for offering men gender affirming therapy. Real surprise move, but the first step is always the most important.

ICE and GEO group say that there are currently no active ...

2026-07-16T03:45:06Z

ICE and GEO group say that there are currently no active tuberculosis cases at the Aurora facility where there was one a week or two ago. This means that person was hospitalized, moved, or deported. One of those is reasonable. The other two means contact tracing and treatment is difficult or impossible. It is a statement that says ICE and GEO group intentionally are making it impossible to control a deadly and highly contagious pathogen.

ICE is killing more people because ICE is probably being told to ...

2026-07-14T11:16:33Z

ICE is killing more people because ICE is probably being told to be more aggressive. The fascists want more violence and instability going into the fall so they can play the security card. It didn’t work in 2020 and it won’t work this time either.

Israel is gonna go through some things when we get control of our ...

2026-07-12T02:37:18Z

Israel is gonna go through some things when we get control of our country back.

https://www.theguardian.com/world/2026/jul/11/ro-khanna-congressman-detained-israel-settlers-west-bank

Once again, ICE appears to have shot a driver from the side of ...

2026-07-11T00:51:04Z

Once again, ICE appears to have shot a driver from the side of their vehicle for no particularly good reason.

https://www.theguardian.com/us-news/2026/jul/10/texas-man-ice-immigration

This 100%. If a country won’t let a ship dock because the ...

2026-07-10T00:57:25Z

This 100%. If a country won’t let a ship dock because the passengers are gay, you and I should say fuck that place, and boycott the country.

quoting
nevent1q…jm9y
It’s very easy to say ‘I’m not a fan of cruises’, ‘I don’t visit countries with dubious human rights records’ or even ‘I’m not gay, what’s this got to do with me?’

But that misses the point that Turkey and Egypt’s economies depend on tourism. They also like to think that they play a pivotal role in terms of diplomacy on the world stage.

They are trying to make homophobia acceptable.

Be an ally.

https://www.theguardian.com/world/2026/jul/09/lgbtq-cruise-ship-refused-entry-egypt-turkey

Why do Republicans win? They win because they treat this as a ...

2026-07-09T02:01:05Z

Why do Republicans win?

They win because they treat this as a team sport, and just like in college football, they don’t let rape allegations derail the game.

That doesn’t make Democrats wrong for demanding rapists stay the fuck out of their party. It just makes Republicans shit people, and Democrats principled losers.

Listen, I think it would have been cool for the USMNT to win the ...

2026-07-07T04:30:17Z

Listen, I think it would have been cool for the USMNT to win the world cup, but Trump’s bullshit tainted their victory up to this point, and frankly, Belgium pounding them into the turf is what America needed.

We aren’t the best at almost anything right now. We have a bully as president. We have nazis roaming our streets. We don’t need wins. Conservatives are hooked on power and need to hit rock bottom and start their recovery journey.

In a sure sign of freedom, a sailboat was removed from the parade ...

2026-07-04T21:55:56Z

In a sure sign of freedom, a sailboat was removed from the parade of sail in NY today because of climate justice banners on the main.

Yup. Celebrating Independence Day by ejecting people from a parade for inoffensive signs.

Nice work.

If you’re buying pickles in the US this week, just know that ...

2026-07-04T18:05:32Z

If you’re buying pickles in the US this week, just know that Mt. Olive Pickle Company did humanity a solid and pulled out of the Trump fair bullshit when they learned that North Carolina’s booth had a confederate battle flag on it (which, incidentally, was never flown over North Carolina during the confederacy…).

Heh. Trump is worried about the commies. Buddy, you need to be ...

2026-07-04T15:13:03Z

Heh. Trump is worried about the commies. Buddy, you need to be worried about the middle aged, middle of the road folks like me who are becoming socialists by the hour in response to your nazi nonsense. We were raised on a steady diet of Freedom (TM), underdog stories, and DEI armies saving middle earth from an evil bastard hellbent on our destruction.

Yo fellow #Coloradoans If you are setting off fireworks this ...

2026-07-03T05:42:20Z

Yo fellow #Coloradoans

If you are setting off fireworks this week(end), you are a phenomenal asshole. This hot wind we’ve had for over a week now is a longer stretch than I can remember in 38 years in Colorado. It is drier than all get out. You drop one little firework cinder in the wrong place and you could kill people and burn down homes. It ain’t worth it.

Seriously though. The firefighters I work with have been on one fire after another all week. We don’t need more.

If you recently moved to somewhere where a wildfire can get to ...

2026-06-30T22:38:06Z

If you recently moved to somewhere where a wildfire can get to your home, some advice:
Have a fireproof box with your passport, mortgage docs, birth certificates, etc. so you can grab them in a hurry, but hopefully won’t lose them if you must leave them behind.

Have a go bag with a change of clothes, basic toiletries, and if possible, a few days of any key medicines you need.

Decide now that you are OK leaving everything to burn, because you don’t want to confront that as the house goes up.

Huh. I wonder why I’ve never seen the Elon Musk food bank, or ...

2026-06-30T22:31:54Z

Huh. I wonder why I’ve never seen the Elon Musk food bank, or the Musk hospital for uninsured children, or the Musk shelter for the homeless?

Y’all, NYT has good scoops. It does. I won’t deny it. ...

2026-06-27T04:29:24Z

Y’all, NYT has good scoops. It does. I won’t deny it. Nonetheless, the rag is a fucking propaganda tool of mediocre shitbags. I have no fucking clue what the editors think the end game of this speedrun to concentration camps is, but regardless, they haven’t a fucking care in the world for reality. Please, for fuck’s sake, stop driving engagement with their content. If they pick a side, great. For now though, they are team head-in-the-sand-one-eye-to-fascism.

One thing many folks don’t think about is how hard it is to ...

2026-06-26T13:52:10Z

One thing many folks don’t think about is how hard it is to fight fire in hot temperatures. My medics have an entire “firefighter rehab” protocol. You get pulled off the apparatus, sent over for temp and vitals checks, and may have to get fluids and so forth. If you don’t get better, off to the hospital. In summer structure fires, we drop crew members to heat illness quickly no matter how attentive we are.

Let’s pretend Democrats win in the fall, grow some gonads, and ...

2026-06-23T16:36:55Z

Let’s pretend Democrats win in the fall, grow some gonads, and start fixing shit. We’re gonna hear things like “but that’s court packing!”.

Do. Not. Argue.

Instead, say “you’re fucking right it is! And we’re coming for every court, every DA, every government role and position and budget, and when we win the presidency, we’re coming after every single Trump-related minion”.

We’re done with decorum. Republicans think any means is justified to meet the ends. We will embrace this as well.

Lol. The US Air Force (a hotbed of fundamentalist Christian ...

2026-06-20T13:07:28Z

Lol. The US Air Force (a hotbed of fundamentalist Christian extremists) sought an exemption from Pete “Whiskeybreath” Hegseth’s policy banning mandatory flu vaccines at Lackland Air Force base because a flu outbreak among recruits is so bad. They are now vaccinating everyone.
It took only two years for science to prove itself there. They’re lucky it was seasonal flu not meningococcus.

@nprofile…vzsp there’s a guy who took a simple action that ...

2026-06-20T05:26:44Z

In reply to nevent1q…p8dy
_________________________

nprofile1qy2hwumn8ghj7un9d3shjtnyd968gmewwp6kyqpquxkfpd3w4ftys3sspx9q7tvgckcx5dppd6t9jyltrhpy92tr4egs03vzsp (nprofile…vzsp) there’s a guy who took a simple action that changed that equation for about six months.

Been a while since I did any #medicaleducation shitposting. ...

2026-06-20T03:48:14Z

Been a while since I did any #medicaleducation shitposting.

Tonights beer talk: Epi and cardiac arrest.

Epinephrine (adrenaline) is often used during cardiac arrest. Why? Well, it makes heart muscle more exciteable, which is great if you want sleepy muscle to become super zombie muscle while you resuscitate someone. It also makes the heart squeeze harder, and it shrinks peripheral blood vessels (makes the tank smaller so more blood can make it to the brain and kidneys).

1/7

Man, FUCK the news stations out here. While it is technically ...

2026-06-19T15:07:21Z

Man, FUCK the news stations out here. While it is technically true that doctors at Children’s Hospital Colorado are able to prescribe gender affirming therapies but are not doing so, that isn’t really what is happening. The hospital has told the physicians that it won’t protect them from federal investigation and legal action if they prescribe. These docs would be placing their ability to practice medicine, their livelihoods, and their safety at risk. The problem here is Trump’s assholes.

Ahahahahahahahahahahahahaha wheeeeze hahahaha. He, he sign ...

2026-06-18T17:15:28Z

Ahahahahahahahahahahahahaha *wheeeeze* hahahaha. He, he sign ahahahahaha, he signed a treaty ahahahahahahahah *cough, wheeze* ahahahaha at Verahahahahahaha at VERSAILLES ahahahahahahahahahahahahahahahahahahahahahaha. *slams down tankard*

The thing about this baby who was shot by cops in Mississippi ...

2026-06-17T02:50:08Z

The thing about this baby who was shot by cops in Mississippi that bothers me most is the (perhaps inaccurate) reporting that an adult was stealing diapers.

Who. Fucking. Cares.

Why does an adult need to steal diapers? What kind of bullshit society do we live in where baby supplies are something so hard to afford that someone might steal them?

As per tradition, the US will sign an agreement with Iran, ...

2026-06-14T23:20:09Z

As per tradition, the US will sign an agreement with Iran, leaving the region with more instability, the US with less advantage, and having spent billions of dollars and, of course, the lives of US servicemembers, not to mention untold civilian lives.

At home, Americans have effectively lost economic power through war inflation, while billionaires have consolidated more wealth.

In short, a typical war.

If I ever successfully run for President, I’m hosting an ...

2026-06-14T01:04:58Z

If I ever successfully run for President, I’m hosting an inclusive sex work expo on the lawn of the White House. Get some fucking poles. Get some dudes in leather, some chicks with classy pasties, something of everything, and when any dumb motherfucker on the right whines about degrading the place, I’ll just point to Trump’s shitfest and point them to the Rule 34 tent.

It is unethical and immoral to be a billionaire. It is evil to be ...

2026-06-12T21:33:00Z

It is unethical and immoral to be a billionaire. It is evil to be a trillionaire. Nobody needs, or frankly can use, that kind of money. It is just hoarding for hoarding’s sake.

Elon Musk, who famously illegally overstayed his visa in the US, ...

2026-06-10T15:31:35Z

Elon Musk, who famously illegally overstayed his visa in the US, and lied on his citizenship application, is stoking anti-immigrant violence in Northern Ireland, a area whose people faced terrible discrimination when they came to the US to escape starvation.

People just want to hurt someone so they can feel less bad about their own lot in life.

Israel keeps ordering the evacuation of entire cities. When you ...

2026-06-09T22:29:25Z

Israel keeps ordering the evacuation of entire cities. When you force people to move like that, you kill people. The infirm, babies, people on dialysis…

Not sure why people think liberals have tears. The crybabies for ...

2026-06-07T23:15:19Z

Not sure why people think liberals have tears. The crybabies for the last decade were all whiny-ass Republicans.

You know most of us have? Seething rage. We have lists. We have grudges. We have anger, frustration, and most of all, a deep desire to avenge the people harmed by this disaster in a way that will prevent future harm threefold. We aren’t crying, we’re planning. When we get our country back, it won’t be a bipartisan hug-fest.

In case anyone feels Luigi Mangione’s actions could never be ...

2026-06-07T23:12:13Z

In case anyone feels Luigi Mangione’s actions could never be justified:

He took one life. He took a life from a man whose career was dedicated to letting people die.

For months afterwards, insurers in the US reversed care denials, approved care, and played nice. There is no doubt in my mind that lives were saved by this change.

On balance, I’m not sure what is “right” here, but it is clear Luigi Mangioni saved some lives. Should it take an assassination to effect change in this system? No.

Guys, we knew screw worm was headed north. We knew it would get ...

2026-06-06T16:43:55Z

Guys, we knew screw worm was headed north. We knew it would get here, absent profound mitigation efforts. We CHOSE to not help Mexico control it. We CHOSE to not prepare. We could have been producing and releasing millions of sterile flies daily, at a cost much less than the collapse of the Texas beef industry, but again, we CHOSE to focus on racist nazi nonsense instead. Trump, Abbot, and their goons own this, full stop. (Also, fuck the guys who voted for their own demise…)

This doesn’t keep me from being active in resisting the nazi ...

2026-06-06T05:37:07Z

In reply to nevent1q…hwqu
_________________________

This doesn’t keep me from being active in resisting the nazi bullshit, but I do take precautions.

We aren’t unique. Many people risk their financial or physical wellbeing by resisting. But we also aren’t immune.

Why don’t more US doctors protest this admin? Well, for one ...

2026-06-06T05:35:48Z

Why don’t more US doctors protest this admin?

Well, for one thing, many of us have to hold a DEA license issued by the feds to be able to do our job. No DEA license, no job. Since docs graduate with 6 figures of debt in this hellhole, they can’t afford to lose their ability to practice.

I have multiple jobs right now. All but one require a DEA license. I’d be fucked if Trump’s goons took it, even if I were able to sue and get it back later.

Republicans in the Senate, with one exception, just voted to fund ...

2026-06-05T13:11:41Z

Republicans in the Senate, with one exception, just voted to fund concentration camps and unaccountable squads of out-of-control ICE agents, while continuing to defund hospitals and schools.

Ask yourselves — does closing hospitals to fund concentration camps align with your values?

I don’t advocate violence, and I am not advocating assaulting ...

2026-06-04T15:53:08Z

I don’t advocate violence, and I am not advocating assaulting anyone here. With that out of the way — there aren’t enough ICE goons in the country to saturate polling places in a tactically safe way. Surround the vehicles, pound on the glass, call them what they are, and make them feel the heat, and they will fuck all the way off. They operate knowing their buddies will rush in and bail them out. They can’t do that across the country all at once. Local cops are also starting to turn on them.

Every time I see an article on Federal judges blaming lawmakers ...

2026-06-04T03:50:34Z

Every time I see an article on Federal judges blaming lawmakers for undermining public faith in the judiciary, I wonder just how far into the sigmoid colon their heads are. Like, do they have gumby necks that allow an extra amount of flexibility? Perhaps gills too?

What makes me think we have a pile of partisan hacks on our courts is the partisan hack decisions they keep issuing. If you don’t want us thinking you work for rich nazis, stop working for rich nazis.

Congress authorized something like $150 million to 250th ...

2026-05-31T18:36:34Z

Congress authorized something like $150 million to 250th anniversary events. That would pay for nearly 20,000 people to be on Medicaid for a year.

The problem isn’t money, it’s how our leaders spend it.