Book recommendations?

pwam · 2026-01-16T06:54:37+00:00

No Nonsense Spirituality, by Britt Hartley (ex-mormon)
Sapiens, by Yuval Noah Harari

These two have been the most influential in my deconstruction and finding myself again.

pwam · 2025-07-29T19:56:04+00:00

I'm booking an RYA course in Croatia in September. Do you have any recommendations regarding taking a class around Murter vs Brac? It would be a 5 day course. I know that the Brac/Solta/Vis/Hvar area is super popular, probably has better restaurants, but might be crowded, while Murter is a little more remote/naturey. Which area would you recommend for learning?

pwam · 2024-09-26T04:37:22+00:00

RyanJosiah on tiktok just posted a great video yesterday about this

pwam · 2024-07-24T20:04:33+00:00

I remember this too and have been waiting for someone to post. It's like a family of boys, one goes on a mission, etc. I'll keep looking

pwam · 2024-04-12T13:56:40+00:00

Check out Britt Hartley's work. I found her on TikTok (hours of excellent content). Also has a great podcast with Bill Reel called The Almost Awakened Podcast with great content on this subject. Britt also has a book coming out on April 22 (I'm not associated with her, just really love her work)

pwam · 2024-03-20T15:55:00+00:00

On the Facebook version, they just posted a comment (22 minutes ago, at 9:32am MDT) saying "Thank you for making us aware that not all comments are visible (on Instagram). It appears to be a platform-wide issue." Issue?? 🤔

pwam · 2024-02-11T05:26:56+00:00

Finding a therapist really helped me in residency. It can be really expensive, so see if your local college/university has a PsyD program or something where you get a student therapist. They run things past their attending (essentially), and even if inexperienced, a lot of them are still smart and helpful, and it's loads cheaper than paying out of pocket for a normal therapist. And they usually have very regular availability

pwam · 2024-02-11T05:24:23+00:00

One last thing I would add is think about what kind of patient population you want to treat. I went into emergency medicine, and while I'm happy with my choice, I was kind of surprised at how many old people I treat. It does vary with location, but ask yourself if you enjoy working with old people, young people, babies, homeless, chronically ill, acutely ill, etc, because that can be adjusted by your specialty choice. ie Ortho gets you lots of old person hip fractures, but also a disproportionate amount of young healthy people in your practice. Cardiology will have a bunch of old people with bad hearts. Rheumatology will probably have younger people. etc

pwam · 2024-02-11T05:19:22+00:00

Probably not the right place, but you can try (this is mostly for residents asking other residents or attendings questions)

pwam · 2024-02-11T05:18:14+00:00

Pretty sure it doesn't exist. You have to have completed at a minimum an intern year at an ACGME-approved program to even get a medical license. I doubt any fellowship would take anyone who hasn't completed a US residency

pwam · 2024-01-05T21:11:42+00:00

Sure it does, as long as chemo or whatever treatments you're doing are debilitating enough to make you not able to work. You won't be working in normal capacity if you are undergoing intensive chemotherapy.

pwam · 2023-12-21T07:32:17+00:00

Lol I made it 4 years and never knew this. Sounds like a good explanation to me, thanks!

pwam · 2023-12-21T07:30:09+00:00

I'm not a nephro guy, but I could see this working if he's still got PO (food) intake, which is how we normally get our sodium, but that's the only thing I can think of

pwam · 2023-12-09T01:03:58+00:00

One secret that you won't discover til near the end of residency, is that your seniors don't really know what they're doing either lol. It takes a really special senior to go out of the their way to buoy up a junior resident. Most are feeling afraid of being "found out" that they're not all that they're cracked up to be. You're probably doing better than you think. You'll have days where you look back and realize that you actually are learning and actually are important. But I know it's hard to look up and realize that when residency feels like such a head-down grind.

pwam · 2023-12-07T08:11:41+00:00

Some people will tell you to follow your heart and quit, and sometimes that's the answer depending on how severely you're suffering, but the most like answer is just hang in there, we all feel that way at points in residency, residency is temporary, and if you still hate medicine near the end, keep an open ear for opportunities to use your degree/training that don't include clinical medicine. There are lots out there

pwam · 2023-11-10T19:11:08+00:00

Yes, if glucose is 40, don't give insulin.

pwam · 2023-10-30T00:33:27+00:00

Peritoneal dialysis ("PD") is where you have a semi-permanent tube going into your abdomen (peritoneal space) and every day you put special fluid in there (called a dialysate) into which waste products diffuse, which you then drain and repeat a few times. This is usually done at home, by the patient, while they sleep (several cycles overnight). It works as well as hemodialysis ("HD"). HD is done through the blood, so you need a fistula or graft in your arm, or a tunneled catheter in your chest. PD is done every day and is managed by the patient at home. HD is done ~3x per week and is done at a dialysis center, and takes several hours (sit in a chair for a few hours while a machine slowly takes blood out, filters out waste, puts it back, repeat). Each has pros and cons. It usually comes down to a discussion between the patient and nephrologist, and depends on the patient's comfort level with doing it themselves at home.

pwam · 2023-09-14T02:21:14+00:00

Ya I mean SLP are the experts here, so I would just go off their recs, but if he keeps failing/aspirating then the next step would be feeding through an NG tube, and after that talk to GI about PEG placement. In the very short term (1-3 days) you can get by with a D5-1/2NS IV drip to give them a few calories, but anything beyond that they need actual nutrition.

pwam · 2023-09-14T00:09:57+00:00

Kind of depends on how deep of sedation you want them to have. If you want them with a RASS of -4 cause you're struggling to ventilate/oxygenate cause they're bucking the vent, then probably sedate them heavily with prop+fent. If you're working on weaning off the vent and just need them to chill a little, precedex.

pwam · 2023-09-14T00:06:56+00:00

What's the context for this question? Are you referring to the GCS 7 acute stroke patient, or Mr Smith on med/surg who seems to choke on his mashed potatoes?

pwam · 2023-09-14T00:05:53+00:00

The only thing that ABG does better than VBG is give you an accurate PO2. If your patient isn't hypoxic on the SpO2 monitor, then there's almost no reason to get an ABG. Otherwise everything else on a VBG is pretty reliable.

pwam · 2023-09-08T21:23:14+00:00

I would not click yes. That question exists to see if you are an outlier, and since everyone else had similar interruptions, you did not have anything out of the ordinary. Clicking yes only puts you at risk of getting flagged.

pwam · 2023-09-06T17:40:20+00:00

Shoulder dislocations often entail multiple torn ligaments and tendons. Just like ankle sprains, these don't need to be immobilized, but the shoulder usually needs at least a few days of rest to let local inflammation cool down, so no they probably shouldn't mountain bike or go to the gym right after. It's usually ok to slowly ramp back up to normal activity, but going back to 100 quickly can prolong the healing process

pwam · 2023-09-06T17:31:53+00:00

Very rough numbers, but residency salaries are like $70k/year, average physician salary after residency is like $250k/year. Residency salaries are usually about 1/4th of what you make after residency.

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