Sandy Simons MD
@ERGoddessMD
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Mom, Wife, ER Doc, 20x Marathoner, @EMNews columnist, Physician wellness advocate. Figuring out how to stay true to my own voice amidst life's cacophony.
Joined August 2012
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Pinned Tweet
I will never ever complain about my car smelling like stinky football gear. Because one day it won’t and I will miss these times.
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If you want to know how it’s going in the ER, last night I saw more patients than I’ve ever seen in a single night shift in my entire career. And I’ve been out of residency since 2005, working only night shifts since 2006.
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My patient punched the charge nurse in the face. While my patient got hauled off to jail, the charge nurse went right back to work with his bloody nose like it was just part of the job.
Let that sink in. This is not okay. The pendulum in medicine has swung too far.
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Grabbed a warm blanket to take to a patient & my well-meaning scribe said, “Let me do that. You didn’t go to med school to deliver blankets.”
I went to med school to improve the lives of other human beings. Sometimes a small gesture of kindness does that better than any pill.
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The funniest part about preparing to do a live CNN interview from my home office was trying to convince my teenage sons not to video-bomb the segment while yelling “FLATTEN THE CURVE, BITCHES!”
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There’s a relatively young surgeon in town who just said “F this shit” &walked away from medicine entirely. More &more experienced docs (the ones we want caring for patients) will leave medicine to protect their mental health. What’s happening in healthcare is toxic to our souls.
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I am exhausted from trying to be a therapist, social worker, and primary care doc while simultaneously running my ED. It feels like once people get on a stretcher, we’re expected to fix all things in their life, very few of which have to do with medical emergencies.
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“Told a patient ‘I’m gonna send you upstairs.’ I couldn’t figure out why the patient appeared so fearful. Until I realized I was working in a single floor hospital.”
-ER Doc quote of the year
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Today we bought a 10 acre lot in the country. Because we’re done peopling.
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I just got in bed with a glass of whiskey and a plate of bacon.
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They also never mention how becoming a physician costs you your 20s.
How many times do we hear, “I could’ve been a doctor.” Lots of people could have, but the ones who actually did are the ones who sacrificed and studied while others their age were having fun in their 20s.
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I am sooooooo in love. I found my person. Through years of dating, I never settled. And I got my happy ending.
#LoveWins
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“Told a patient ‘I’m gonna send you upstairs.’ I couldn’t figure out why the patient appeared so fearful. Until I realized I was working in a single floor hospital.”
-ER Doc quote of the week
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Covid-19 is causing a mental health crisis. I am seeing more and more people with incapacitating anxiety, depression, and psychosomatic complaints. Do not underestimate the psychological effects of this pandemic.
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The scary part of this pandemic is that our health depends on the common sense of others.
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WE GOT A PUPPY!!!!!!!
Twitter, meet Whiskey the corgi.
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“We stayed at work for you. You stay at home for us.”
Love,
your ER team in Richmond
#GirlPower
💪🏻
#COVID
ー19
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An MS1 just tweeted that my tweet “is not an okay attitude for an ER doc.”
How can an MS1 even fathom what it’s like to have worked 15 years post residency in the ER trenches? And presume to know what attitudes are okay for folks who have?
#YouHaveNoIdea
I am exhausted from trying to be a therapist, social worker, and primary care doc while simultaneously running my ED. It feels like once people get on a stretcher, we’re expected to fix all things in their life, very few of which have to do with medical emergencies.
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When an experienced nurse says "something isn't right," you better listen.
#tipsfornewdocs
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Patient satisfaction. Time metrics. Ridiculous charting requirements with cumbersome inefficient EHRs. Inadequate staffing.
The healthcare industry is showing doctors and nurses his much we DON’T matter. We are treated like expendable laborers.
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Women in medicine, would you rather be liked or be respected? And why does it so often feel like we can’t have both?
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For patients well enough to quarantine at home, running tests will not only fail to change management but also overwhelm EDs and clinics.
YOU DON’T NEED A TEST RESULT TO STAY HOME.
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The cardiologist I consulted last night just sent me a personal text to let me know how my patient did. We need more consultants like this.
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People have been asking to see the ring, so here it is.
I am unbelievably grateful.
Ladies and gentlemen, this officially concludes
#docdates
.
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Treating med students and residents with humanity would be more effective than forcing them to major in humanities. The problem is not with the students.
Consider a modest proposal: that all students applying for admission to med school major in the humanities with an optional minor in biology and science. No premed majors need apply; the science training will come after acceptance.
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A pt called me “nurse” while we discussed her diagnose & made joint decisions about her plan. I was in a white coat with a badge & had introduced myself as doctor.
I politely said, “It’s doctor”
Her sister scoffed & mocked me with, “Look at you with ‘DOCTOR’.”
#MedicineIn2019
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"No one wants to know the blood, gore, trauma, pain we deal with, but if we make one mistake we're on the front page of the paper."
#smaccUS
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While most people are sleeping, ER nurses are getting peed on, swung at, &vomited on. So be forgiving if their charts aren’t perfect or they haven’t met every metric. Take my word for it— they’re not sitting on their butts eating bonbons; they’re busy dodging piss, punches, &puke
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While most people are sleeping, ER nurses are getting peed on, swung at, &vomited on. So be forgiving if their charts aren’t perfect or they haven’t met every metric. Take my word for it— they’re not sitting on their butts eating bonbons; they’re busy dodging piss, punches, &puke
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As we face a possible implosion of our healthcare system, we should suspend HCAPS and press ganey so we can put all our effort into saving asses, not kissing them.
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Today I am feeling demoralized and scared. One would think a pandemic would make people realize that physicians aren’t replaceable widgets. One would think.
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Everybody, please, STOP PUNCHING GLASS.
Sincerely,
Your friendly ER docs
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If you are hesitant about the
#CovidVaccine
, like I was, that’s understandable. Here are some things I found reassuring that you might like to know.
1. The development of this vaccine was prioritized more so than rushed.
1/
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The real horror of finding my 13yo with a thumb tack through his earlobe was not that he was trying to pierce his own ear but that nothing, neither earlobe nor semi-sharp instrument, had been sterilized.
#WaysToPissOffDoctorMom
And they’ve only been out of school 1 day so far...
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Why are hospital systems making gentle requests instead of orders re:
#Covid19
-“We hope you’ll cooperate ¬ have visitors” instead of “NO VISITORS.”
-“Please consider not scheduling elective surgery” instead of “NO ELECTIVE SURGERIES.”
Now is not the time for asking nicely.
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Men,
How often have you been advised to watch your tone or you won’t be taken seriously when you’re complaining and advocating for yourself in a situation that clearly warrants complaining and advocating for yourself?
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No, Dragon dictation, I did not say “angry otitis.” I said “PANCREATITIS.”
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Shame on the culture of medicine for not valuing and taking care of the caretakers.
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@Parkerlawyer
“Guys, my bill just went from $22 to $84.” —a Diplomatic statement of fact that puts the ball in their court. Then hopefully they do the right thing.
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“I’m so excited about the rare Friday the 13th full moon happening this weekend,” said no ER doc ever.
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DOCTORS ARE BEING GAGGED.
From a friend, who consented to being quoted anonymously:
“I was explicitly told not to comment on the fact that our salaries are being cut, our 401K are not being contributed to, and our lack of PPE. I expect that many others are being told the same.”
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I got my first pair of glasses. My son says I look old. I say I look wise ...and fabulous AF.
It’s not about the glasses, or the clothes, or the hair; It’s about what’s underneath them.
#SelfLove
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I asked my sons if they'll walk me down the aisle, one on each arm.
They said yes.
Then my littlest added, "But you should know- I look damn good in a suit, so I'll probably show you up and steal the spotlight. You've been warned."
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I’m having a hard time understanding: What exactly is so high-stake about putting a harmless piece of cloth over one’s face when out in public? Why are are people irrationally irate, to the point of toddler-like tantrums, over such a minor nuisance?
1/thread
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CMS is planning to reduce Medicare reimbursement by 8% for ER docs, hospitalists, and anesthesiologists starting January 1. That’s a fucked up decision by legislators who are safe and comfortable while we are manning the front lines of the pandemic.
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He did it! After 2 written exams for a total of 100 questions and 4 buzzer rounds yesterday, my son made it through to the National History Bee finals this morning. Go Cole!!
#ProudMomMoment
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Apparently I need 43,000 more followers for a “strong social media platform.” Editors say a good social media presence is 50k to 100k.
I’ll take my 7,000 followers and the good experiences I’ve had with all of you. I may not have quantity but I have quality.
#HarvardWriters2018
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Where are the other Gen X physicians on twitter who matched 19 years ago (or longer)?
My feed here is filled with Gen Y and Gen Z. As much as I appreciate seeing their perspective, I crave interaction with other people who have actually been an attending for a decade or so.
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The tendency to imply that doctors and nurses aren’t compassionate enough, aren’t doing enough, or aren’t resilient enough is demoralizing. When the canary in the coal-mine dies, the right answer is not to question the canary’s resilience.
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My boyfriend tends to be a little bit of an ER cowboy, which under normal circumstances I find very sexy, but now it just stresses me out.
I’ve reached a new level of nagging in our relationship:
“Are you wearing a mask with every patient?”
#PPEnagging
#WhenERDocsDate
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As of today, I’ve officially lost 30 pounds over the last year. I feel fabulous!
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At dinner before my boyfriend’s night shift.
Me- Just please have a low threshold for wearing your N95 mask, okay?
Him- But it’s uncomfortable.
Me- You know what’s uncomfortable? An endotracheal tube.
#WhenERDocsDate
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When a physician reaches the point of rocking the boat, complaining, or challenging authority, it’s because we care. We do choose our battles, so if we feel strongly enough to take the risk of speaking out, it’s worth paying attention.
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I care. I do. I think I’m compassionate and I try very hard to do right by people. But I come home with serious compassion fatigue because it is impossible to be everything to everyone. Why is it no longer good enough to just rule out medical emergencies?
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Today is one of my all time favorite days on twitter. I found 199 other Gen X
#medtwitter
folks and made a Gen X
#medtwitter
list!
If you are a Gen Xer in medicine, let me know so I can add you!
#OldIsAwesome
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“After this shift I’m going to get my butt into the gym and do a workout.” ~me going to work
“After that shift I’m going to get my butt into bed and do wine.” ~me leaving work
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The nurses were chanting “GO MAMA GO!” this morning to my patient who doesn’t want to swallow her medicine. I think I heard a “CHUG! CHUG!” in there too. ❤️
ER nurses are the best.
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“So what’s new?”
“Mom, there was a walk out today.”
“Did you walk out, Cole?”
“Yes” *proud smile*
“Did you walk out, Graham?”
“Yes” *proud smile*
Those are my boys.
#NationalStudentWalkout
*proud mom smile*
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I forgot all about eggs and butter and pushed my grocery cart straight to the checkout area, because I heard “CRASH CART AISLE 10!!!”
False alarm. Apparently it does not mean the same thing at Kroger.
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Normally when you’re driving down the road and a song you like comes on you start doing something like air guitar, air drums, or head banging.
Today ‘Staying Alive’ came on and my boyfriend started doing air CPR.
#WhenERDocsDate
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So my kids have no virtual school today. Because of snow. 🤦🏼♀️
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BF: What color did you get on your nails today?
Me: It’s like a sparkly melena.
#WhenERDocsDate
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Not a water breed? A tube with legs unsuited for swimming, you say? Pfffft. Don’t ever tell me I can’t do something!
#corgitude
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Are we beloved heroes or replaceable widgets? I can’t keep up.
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What are some good medical pet names?
P.S. I think we’re getting a puppy!!!
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“The Doctor Came to Save Lives. The Co-op Board Told Him to Get Lost.”
This is not just any doctor. This is the airway guru of emergency medicine. Essentially Superman flew in and was told he’s not welcome.
TREAT DOCTORS BETTER.
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It is beyond stressful to have to worry whether what I say or write outside of work will get me fired. I have learned to live with a level of censorship, to the detriment of my own wellness. It is soul crushing.
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I used to be a pretty good bassoonist before med school. Today I heard the bassoon solo in Tchaikovsky’s Capriccio Italian and felt nostalgic, wishing I could play it myself again. We give up many pieces of ourselves for medicine.
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BF saw a 20yo with pericarditis of unknown etiology despite prior workup. BF (a) via smart history taking figured out he took minoxidil for a thick beard before it started & (b) knew off the top of his head that it has a black box warning for pericarditis.
#MysterySolved
#Swoon
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What do you say to comfort a doc who tells you, “I’m a little messed up. The guy who came in coding was the same guy I discharged 3 hrs earlier”?
#Devastating
#Guilt
Like all EPs, he’ll go right back for the next shift as if nothing happened.
Words just don’t seem adequate.
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I'm a doc. If I need a stethoscope I borrow one from one of the amazing nurses I work with.
#Respect
#NursesRock
http://t.co/D8c1OXejg8
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In the last month I discovered a cut-your-own sunflower field, slid down Virginia’s best natural rockslide, lost 7 lbs, took my oldest to get his learner’s permit, bought a timeshare, read The Overstory (which is now my fav book), & put my corgi on a diet.
#ImBackBitches
💃🏼
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To all working moms dealing with guilt this December— guilt about working too much, about not being available when your kid gets the winter sniffles, about not having decorations up or not being home to cook dinner— it’s okay not to do it all. Leave stuff undone. You’re allowed.
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I guess I just need some yoga to find my inner zen? Bullshit. This attitude toward physician burnout is victim blaming.
“Why some physicians aren't burned out:
1-They’ve found a niche that they’re passionate about
2-They’re calm
3-They’re well-rounded”
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Mr. Potato Head will now be known as simply Potato Head?
People were upset by the title prefixing a plastic toy based on a vegetable?
Get. A. Grip.
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He was another ER doc my same age, also working in Richmond, also with 2 kids. While I was suffering with my own depression in silence, I learned that he killed himself. It was a wake up call that I needed to reach out. We must make our mental health a priority.
#DocsTalkSuicide
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I still drive home after some shifts worrying about the patients I saw. I am 16 years out of residency and my give-a-damn is still going strong.
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In the ER we are seeing a lot more mental health complaints and somatic symptoms related to anxiety. People are stressed. Be kind.
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After getting my ass kicked overnight, I was at my computer working hard to dispo my patients. Someone told my boss that I could’ve seen the pt that came in at 6:50am instead of leaving it for the day doc b/c “She was just sitting there twirling her hair.”
This article resonates.
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Shift work is hell. The sleep deprivation, the opposite schedule from family &friends, & the need to be on when our circadian rhythm has other ideas are underrated threats to our wellness. No amount of self-kindness or reframing makes up for nightshift’s physical &mental effects.
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3 year old patient with abdominal pain:
Her- I eat all the things.
Me- Me too, girl. I LOVE to eat!
Her- Does your belly hurt too?
😍
#CutenessOverload
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Guess what y’all?!?!
My boyfriend and I have decided to move in together. This is monumental!!
#NewChapter
#Excited
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Too exhausted from 14 years of nothing but night shifts, trying to balance motherhood and medicine, to make more than 1 tweet about National Women Physicians’ Day.
Props to all the women balancing full time clinical work with being moms, daughters, wives, & everything else.
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We never got around to sending Christmas cards this year. I think Quaratine cards are in order. Not joking. I’m totally doing this.
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My sons know I’m going to a conference next month at Harvard for physician writers. Driving to school I was telling them what I’m excited about learning.
My 10-yr-old piped up from the back seat, “Wait, You’re not teaching it??”
God I love that kid.
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“What’s the difference between snow women and snow men?
Snowballs.”
~me at the nurses’ station at 2:30am on Christmas morning.
Merry Christmas Everyone!!
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“Cough & congestion for 1 week. Decided to be seen b/c the coronavirus is going around.” No shortness of breath. Stable vitals.
This is what our ERs are filling up with.
#COVID19
WE MUST DO A BETTER JOB OF EDUCATING THE PUBLIC. The ER, now more than ever, is for emergencies.
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I loved looking at these pictures. Wedding pictures are some of the best pictures out there. Anyone else want to show off their wedding pics and make us all smile? I wanna see more!
#HappyMoments
My suggestion when you marry one... 5 inch heels and stand on something so the photographer can get you both in the same frame 🤣
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I have perpetual memory block about perianal vs perirectal abscess. Every time I have to look up which goes to the OR & which gets drained in the ED. I thought up a way to keep them straight:
PeriAnal= “A-okay” to drain in the ED
PeriRectal= “Ruh-roh”—better call a surgeon
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Is it because I’m a woman or because of a diminishing respect for physicians in today’s healthcare culture? Or both?
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I deleted a tweet about feeling blue. It’s a valid feeling that we all have sometimes. But I didn’t want to show that side of myself, b/c of the stigma.
But then I thought about it & I’m 100% sure others have days like this. It’s just that we all go around pretending we’re ok.
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Forgetting a dose of antidepressant affects the mood of someone with depression just like forgetting a dose of antihypertensive or insulin affects the blood pressure or blood sugar of someone with hypertension or diabetes
Mental health illness isn’t a choice. It’s brain chemistry
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This thanksgiving I’m thankful for those working to keep our stores, restaurants,roadways, public transportation, public utilities, fire stations, police stations, & hospitals running so the rest of us can enjoy the day.
Working holidays is a wonderful act of service.
Thank you.
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Going to pick up my 14yo after his last day of school & I have Alice Cooper’s ‘School’s Out’ queued up so when he gets in the car I can blast “SCHOOOOOL’S OUT FOR SUMMER!”
Not sure if I’m a cool mom, or a dorky mom who think she’s cool, but I don’t care b/c it’s summer, Bitches!
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I guess this officially makes me an “award winning writer.” I like the sound of that!
#WomenInMedicine
💪🏻
Join us in congratulating
@ERGoddessMD
for receiving a Grand Award for Writing in the APEX 2018 Awards for her Emergency Medicine News article, “Enough!” about how administration and employers tried to censor her and other EPs:
#womeninmedicine
#womeninEM
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