New Cannabis Based Menu for Chao Phraya Hospital patients (service being rolled out to other hospitals too)
"This cannabis special menu is bringing different parts of the cannabis plant to use with leaves to cook as ingredients in food" #cannabis #Thailand

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/

We’ve done menstruation, let’s talk about the menopause! Because only women however they present can have the menopause although men who have had treatments for prostate cancer can have symptoms mimicking the menopause. There’s nothing scary about

the menopause. It’s a perfectly natural function of the body but it’s tied up with a thousand stereotypes of women, ageism and ‘old women are frightening’. True, old women are often very frightening to young men because look! A woman who doesn’t give a rat’s

arse what you think of her now all her mating hormones have gone and with it your charm as a potential mate. Now you’re just another annoying lad. That’s gotta hurt. Menopause means Wisdom, like it or not and it’s not always nice or cosy. Old women

are encouraged to refer to themselves as ‘young at heart’ and ‘as young as you feel’ and other such crap and told to ‘never give in to age’ which is ludicrous. Cosmetic surgery is now a thing but I can tell you what the surgeons and marketing

men won’t - it does not make you look young. You’re just an old woman who looks like at best, she’s had a great holiday and at worst like she was was trapped in a wind tunnel. Old is good. Old is meritorious. Old is survival. Old means you didn’t die young

Okay, let's start this hypersomnia thread!

[note - I am not looking for unsolicited advice.]

Idiopathic hypersomnia or narcolepsy (not the same, but similar) is very hard to describe to people.

When I say "I slept 10 hours last night and I'm still tired" I'm not bragging. 1/16

For me, the accommodations I need are about time. My body doesn't care what I want to do - when I want to wake up or be asleep. My body wants to wake up at 10-11am, and go to sleep at 3am, always.

Just a one hour shift in my sleep schedule can screw me up for days. 2/16

When I tell people that I'd really "prefer it" if we could meet at 10am or later, it's because getting up before that has consequences for me. Big consequences. Most people won't see them. Sometimes I still give in and say it's fine. It ruins 2-3 of my days, sometimes more. 3/16

Let me explain. When I am required to wake up at 9am, esp. in covid times working from home, my body pays me back for it later.

I'm going to show you ways this happens. I can usually withstand 1 day of waking up early, with some consequences, but 2 days in a row kills me. 4/16

Let's say this graph represents Day 1, the first time I am required to get up early. The y-axis is my level of Sleepiness. Any symptom listed higher up includes that symptom + every other symptom below it. Getting up that early means I can't listen or concentrate all day. 5/16

I do want to talk a bit about connections, conflicts and information during a pandemic. Since @fordnation insinuated I have COI which I don't, let's take a look at a single instance where @fordnation and Hospital for Sick Children are both making interesting decisions.

Both share a powerful supporter in Peter Gilgan, who has been a great supporter of Sickkids

But his company, Mattamy Homes, has also substantially bankrolled Ontario Proud, which I have reason to believe pushed the Postmedia hit on my reputation.

Sickkids and Mattamy have very close ties. Here is Mary Federau, a longtime Sickkids exec who has moved to Mattamy but remains involved with the Sickkids foundation:

Mary's bio is too modest. It looks as though it has been scrubbed a bit over the last 72 hours. Here's the google cache from Jan 25: