I am done giving this doctor or team grace. I started with "We are tremendously grateful for all you are doing." He seemed irritated to speak to us. Literally I asked, "What is the likelihood our mom will die on current support, in the next 24 hours, so we can plan travel?"

He hammered us with how severe this was and that was. Yes, that is why I am asking the question. "We are asking you to be a thought partner so we can make responsible decisions as the family." I had had pre-conversations with doctor friends to understand the numbers and prognosis
He said "It would be illegal for me to tell you that she won't die, then she dies." Yes, that is why I said LIKELIHOOD - critical care docs deal in likelihoods. It so frustrating to be on this side and not get a fraction of the standard that I have been held to and hold myself to
Then I made the error of saying, "I'm a pediatrician, I literally do this work on family-centered, compassionate care." to which the charge nurse answered, "It is not the work we do. We keep people alive." End of life care IS your job. Planning IS your job. It's not just numbers
Compassion is not only a pediatric thing while critical care/end of life can proudly lack it. I've had more end of life conversations than I want to remember. My mom is not numbers. She is a human being. I am modulating my voice, complimenting you, leveraging my network.
My sister in NJ and I are literally trying NOT to be another critical care patient in a car pile up. This is something an ICU doctor and team should respect. I'm not saying do aromatherapy or music therapy. https://t.co/Oeyyibw6kH
My mom was awake and alert last night. We asked to speak to her. No, she has no cell phone. There is a way. You can bring your spectralink in.

I know busy. I did 22 admissions one night while doing crosscover. I want to say "burnout" but this sounds like culture.
Thing is you can't win. In a hospital with the iPads and all the resources, there is a higher likelihood of racism/bias. I do NOT think there is any racism here. I think that places that are staffed by minoritized and see minoritized patients often lack resources and compassion.
He seemed to be having a different conversation. And threw in so many things like "if she had a cardiac arrest we should not resuscitate" then my sister asked, "so you would resuscitate?" He said, no she is full code we are legally required to. It was haphazard and hard to follow
I finally got the information that was needed. >50% or <50% chance of her dying in 24 hours. Do I need to rush to get on a flight today? No, she is not "crashing and burning" - uff, my mother is not a bombed aircraft. Tell me in those numbers you love. >/< 50%?
I'll get through this. When on the other side, I am going to follow up with this hospital. This is just not okay

This team is actually making their own jobs harder. All my doctor friend conversations result in a pragmatic realism, not anxiety. I am trying to make safe decisions
But you know how this could go. The average family, including doctor family, might be internally arguing, getting conflicting opinions, and then rather than us de-escalating the clinicians to communicate with us, they would be dealing with fights.
So, I'll get the data from nurses and then I'll keep interpreting it with my trusted doctor-friend-advisors. I am not going to go into that vortex of stress again by asking for information that is given in ways that are anti-communication.
Thing with critical care is numbers do tell the story. FiO2, PEEP, vent settings, P/F ratio, vitals, pressors, etc, etc. I am grateful I have these external resources. My family is able to manage ourselves despite uncertainty and align, share the work, manage.

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Wow, Morgan McSweeney again, Rachel Riley, SFFN, Center for Countering Digital Hate, Imran Ahmed, JLM, BoD, Angela Eagle, Tracy-Ann Oberman, Lisa Nandy, Steve Reed, Jon Cruddas, Trevor Chinn, Martin Taylor, Lord Ian Austin and Mark Lewis. #LabourLeaks #StarmerOut 24 tweet🧵

Morgan McSweeney, Keir Starmer’s chief of staff, launched the organisation that now runs SFFN.
The CEO Imran Ahmed worked closely with a number of Labour figures involved in the campaign to remove Jeremy as leader.

Rachel Riley is listed as patron.
https://t.co/nGY5QrwBD0


SFFN claims that it has been “a project of the Center For Countering Digital Hate” since 4 May 2020. The relationship between the two organisations, however, appears to date back far longer. And crucially, CCDH is linked to a number of figures on the Labour right. #LabourLeaks

Center for Countering Digital Hate registered at Companies House on 19 Oct 2018, the organisation’s only director was Morgan McSweeney – Labour leader Keir Starmer’s chief of staff. McSweeney was also the campaign manager for Liz Kendall’s leadership bid. #LabourLeaks #StarmerOut

Sir Keir - along with his chief of staff, Morgan McSweeney - held his first meeting with the Jewish Labour Movement (JLM). Deliberately used the “anti-Semitism” crisis as a pretext to vilify and then expel a leading pro-Corbyn activist in Brighton and Hove
There is some valuable analysis in this report, but on the defense front this report is deeply flawed. There are other sections of value in report but, candidly, I don't think it helps us think through critical question of Taiwan defense issues in clear & well-grounded way. 1/


Normally as it might seem churlish to be so critical, but @cfr is so high-profile & the co-authors so distinguished I think it’s key to be clear. If not, people - including in Beijing - could get the wrong idea & this report could do real harm if influential on defense issues. 2/

BLUF: The defense discussion in this report does not engage at the depth needed to add to this critical debate. Accordingly conclusions in report are ill-founded - & in key parts harmful/misleading, esp that US shldnt be prepared defend Taiwan directly (alongside own efforts). 3/

The root of the problem is that report doesn't engage w the real debate on TWN defense issues or, frankly, the facts as knowable in public. Perhaps the most direct proof of this: The citations. There is nothing in the citations to @DeptofDefense China Military Power Report...4/

Nor to vast majority of leading informed sources on this like Ochmanek, the @RANDCorporation Scorecard, @CNAS, etc. This is esp salient b/c co-authors by their own admission have v little insight into contemporary military issues. & both last served in govt in Bush 43. 5/

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I'll begin with the ancient history ... and it goes way back. Because modern humans - and before that, the ancestors of humans - almost certainly originated in Ethiopia. 🇪🇹 (sub-thread):


The first likely historical reference to Ethiopia is ancient Egyptian records of trade expeditions to the "Land of Punt" in search of gold, ebony, ivory, incense, and wild animals, starting in c 2500 BC 🇪🇹


Ethiopians themselves believe that the Queen of Sheba, who visited Israel's King Solomon in the Bible (c 950 BC), came from Ethiopia (not Yemen, as others believe). Here she is meeting Solomon in a stain-glassed window in Addis Ababa's Holy Trinity Church. 🇪🇹


References to the Queen of Sheba are everywhere in Ethiopia. The national airline's frequent flier miles are even called "ShebaMiles". 🇪🇹