1/10. Several clinical trials have shown that the mean nasal mucociliary clearance is negatively and significantly affected by cigarette smoking (PMIDs: 24669080, 3787531, 23615315,

I’m deeply saddened to learn that Dr Joseph Sonnabend, one of the most important figures in the history of AIDS, died yesterday. I spent time with him in 2018 for one of the last interviews he ever gave. Let me tell you about this man and what he did:

Sonnabend was one of the first doctors to raise the alarm. In 1979, while running a sexual health clinic in Greenwich Village, he wrote to the NY Health Dept to warn them of the symptoms he was seeing: low white blood cell counts, enlarged lymph nodes. He didn’t get a reply. 2/

So he kept speaking out. When a patient of his developed a very rare cancer – Kaposi’s Sarcoma – he linked up with a dermatologist at NYU who said that over a dozen gay men had it. Sonnabend knew there was something very wrong. He started working at the lab at NYU — for free. 3/

It was soon after this in 1981 that the New York Times famously reported “Rare Cancer Found In 41 Homosexuals”. The next decade would kill most of Sonnabend’s patients and friends — and all of his lovers. What Sonnabend did was to fight for every single of them. 4/

Want to know who was the first to publish advice to wear a condom? That was Sonnabend. In 1983 he co-authored the first safe sex leaflet to fight AIDS: “How To Have Sex In An Epidemic”. 5/

In medicine, reckoning with racism includes reappraising the very syntax we use every day. Proud to add my voice w/ @J_Ikeme and @RWGrantMD in this @JAMAInternMed pub addressing:

Does race/ethnicity belong in the first line of the patient

Some background: I’ve struggled with this question since early in medical school

Medical syntax is designed to communicate information in a predictable sequence with key elements prioritized to facilitate efficient communication and formation of an assessment and plan

2/

From preclinical lectures to Qbank questions to clerkship rotations, race/ethnicity was often prioritized in the same sentence as age + gender.

I grew accustomed to reading/hearing: a 70-year-old Black man w/ history of x, a 50-year-old Hispanic woman presented w/ y.

3/

However, when it came time for me to use race/ethnicity, there was always tension. Race/ethnicity are self/socially-ascribed identities that in clinical practice are almost always assumed by providers based on appearance. I was also concerned about the potential for bias

4/

I wondered how my own care would be impacted or not impacted by my ethnicity (Hispanic) – I have light skin so I’m not sure if my doctors would even identify me as such – but how would my care be different if I was presented as a 30-year-old Hispanic male?

5/

A week ago I voluntarily admitted myself to the hospital to get help bc I am losing weight as a result of increased food intolerances, secondary to my very severe #MECFS. A psychiatrist here decided that im mentally ill, 1/

purely on the basis that the medical workup was unable to explain my food intolerance. My psych eval only found mild anxiety and depression. 2/

They have put me on a 72hr psych hold while they work to get the county courts to commit me to a psych ward. This is a nightmare. They have taken away most of my belongings, put me in a new uniform, and are keeping me under 24/7 video surveillance. 3/

In the middle of the night last night when I sat up to use the urinal loud alarms sounded, as though I was trying to escape. I can’t even walk and hadn’t even left my bed. 4/

If they succeed in having me fully committed I will lose ability to communicate with the outside world except for an occasional phone call. I will lose all agency, and will very likely have treatments forced upon me. 5/

1/23 We haven't had a lot to celebrate during this pandemic. But achieving the milestone of offering vaccine to the over 70s, health and care workers and the most clinically vulnerable just before target date is a huge cause for celebration, given the scale of the achievement.

2/23 When Margaret Keenan got her first jab in Coventry on December 8th last year, who’d have thought that, by Valentine’s Day, we’d have vaccinated over fourteen million people across the UK in just ten short weeks? Amazing, extraordinary and truly, really, world class!

3/23 I’ve been struck by how much joy and relief has been brought to those doing the vaccinations and those receiving them. A GP told me yesterday that nothing had given him greater pleasure in his long career. And that the patient's relief was sometimes overwhelming.

4/23 It's vital to recognise the extraordinary contribution of the staff and volunteers who have made this happen. One of my close family had their jab yesterday and was in awe of the volunteer standing outside in the freezing cold for a four hour shift meeting and greeting.

5/23 What I wanted to share in this thread was the slightly untold story of some of the extraordinary challenges the NHS has had to overcome to deliver this target. Requiring superhuman effort from NHS leaders and staff, way beyond the call of duty. Five challenges set out below.

My uncle passed away from cancer when I was 16 years old.

I’ve since spent 100’s of hours researching how to avoid and fight cancer naturally.

Here’s what I found:

1) Boost your stem cells

Your body slowly regenerates using stem cells.

Foods that promote stem cell growth:

• Seafood & fatty fish
• Berries (black, blue, raspberry)
• Broccoli, cauliflower, brussels sprouts

More stem cells = lower chance of cancer

Fasting is also a viable option for increasing your stem cells.

You could do a 24 hour fast once a week.

Or go extreme like my business partner @taylinsimmonds

And fast for 4-7 days at a time.

I’ll stick with 24 hours tops ;)

2) Hack DNA repair for longevity

To amplify DNA repair:

• Sleep 7+ hours
• Exercise regularly
• Try intermittent fasting

Natural DNA repair prevents your cells from mutating.

Eat foods that amplify DNA repair:

• Greens
• Mangoes
• Greek yogurt

The best cancer cure is prevention.