ICU communication isn’t a vibe. It’s a system families can feel. Using ARMOR as a framework, this Tuesday Teaching Edition explains how huddles, daily goals, and structured rounds can create clarity, safety, and trust.
The cold didn’t bring snow. It brought clarity. Warmth is not just heat. Warmth is behavior: a hug, Persian tea, niche music, and a yellow dream world on a wall.
A story about heat, breath, and learning to stay present when the truth burns.
Notes from BOKA. Medicine, meaning, living. Bow ties, pipes, bookcases, and the quiet joy of thinking out our in internal medicine. Stay curious.
Sepsis doesn’t usually announce itself loudly at first. It holds itself together until it can’t.
I read my kids a Persian story about three dolls the other night. By week’s end, it had followed me into the ICU. Some moments ask for speed. Others ask for listening that stays. Notes from BOKA: Medicine, Meaning, Living.
INK+OXYGEN by Dr. Boka. A reflection on the quiet weight of responsibility in medicine, leadership, and daily life.
A Back to the Future theater night, a Hobonichi year review, and one simple plan to build 2026 with more attention, more reverence, and more oxygen.
A Christmas morning at the kitchen table—drawing with my kids, thinking about breathing rhythms in the ICU, and learning why showing up matters more than being productive.
After my first gallery exhibition in 2023, I quietly stopped drawing. Not because it went badly—but because it went well, and I lost the courage to be…
…Then came a very special moment: the Glue Stick Moment.
The First Real Paradigm Shift in COPD Care —
bicarbonate
In its pages, the rotund and perpetually sleepy character Joe the Fat Boy embodies what 20th-century clinicians first described as the “Pickwickian syndrome”: profound obesity, excessive daytime somnolence, and elevated CO2 (earlier known to be polycythemia).
criticalcare
“Levophed leave ‘em 💀?” “Fingers, nose, pen*s, toes”
CO2
A History, A Physiology, A Philosophy My apologies to this growing readership. After taking the summer of 2025 off from blogging, I’m back. I appreciate your patience 😀. Let’s try a new take today— I’ll attempt to weave history, physiology, evidence, controversy, and philosophy into a practical piece.
EvidenceBasedMedicine
The 65 mmHg MAP target in critical care medicine has deep historical roots—from Hippocrates’ humors to Poiseuille’s equations.
MedicalStudent
#MatchDay is here, Med Students!!
cough
In VCD, the inspiratory limb often appears flattened or coved due to paradoxical vocal fold closure during inspiration. This pattern is a key diagnostic clue that differentiates VCD from asthma, where the expiratory limb is predominantly affected.
cough
Have you ever wondered why coughs outlast colds? Studies shows that post-infectious cough persists in approximately 25% of patients with upper respiratory infections, sometimes for up to two months after the initial illness has resolved.
ILD
ILD Q and A
pulmonary
👁️ ➡️ 🧗♀️ ➡️ 🧠➡️ 🩸 Let’s talk about a drug you see prescribed for use in a few different scenarios: acetazolamide. Who made this and when? • Robin & Clapp at American Cyanamid • Attribution to them 1951 Why was it developed? • To treat glaucoma • First medically used in 1952 How does this drug treat glaucoma?
Hemodynamics
Okay. Now I know what you are thinking: does the title really combine sepsis and cardiogenic shock into a single term? SICS is an important concept, and the diagnostic criteria are a bid muddled for some. I for one don’t recall it being called SICS. It is basically a
It is a sophisticated display when the seasoned intensivist or veteran RT predicts the next arterial blood gas results after conjuring ventilator settings based on current ABG results. Although it may appear as magic to some and confusing to others, it is actually easy math. Learn this post for your
SepticShock
HOW does vasopressin work? • Released by pituitary ➡️ activates V1 receptors on vascular smooth muscle ➡️ increases phospholipase C causing calcium ion release ➡️ causing arterial vasoconstriction ➡️ thus raising blood pressure and SVR. • Promotes water retention via activation of V2 receptors (by adenyl cyclase). Hence ADH effect. • Lowers HR Name the trial that
