gratitude
Where We’re Going, We Need More Time
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.
EvidenceBasedMedicine
art
INK+OXYGEN #2: Showing Up
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.
COPD
🧬 Dupilumab: Biologics in COPD
The First Real Paradigm Shift in COPD Care —
bicarbonate
Pickwickian Legacy: Obesity Hypoventilation Syndrome (Past to Present)
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
“Quad-Strength” Levophed: What It Really Means — And When It Matters
“Levophed leave ‘em 💀?” “Fingers, nose, pen*s, toes”
CO2
Have you ever wondered: WHY do we reach for Sodium Bicarbonate in the ICU?
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
Have you ever wondered: WHY a MAP of 65 mmHg?
The 65 mmHg MAP target in critical care medicine has deep historical roots—from Hippocrates’ humors to Poiseuille’s equations.
MedicalStudent
Match Day 2025: Finding Meaning Beyond the Algorithm
#MatchDay is here, Med Students!!
cough
The Lingering 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.
Hemodynamics
Article of the Week: Sepsis-Induced Cardiogenic Shock (SICS)
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
MedEd
Jan 21-22 Assignments
1. Find the studies which showed MAP of 65 mmHg to be the hemodynamic threshold for perfusion. 2. Are there any conditions in which a MAP goal of 70 mmHg should be targeted? 3. Name the recent study where MAP 60-65 mmHg was explored. Would it change your management? 4.
