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MarkHoofnagle's profile
Mark Hoofnagle
Mark Hoofnagle
Mark Hoofnagle
@MarkHoofnagle

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Mark Hoofnagle

@MarkHoofnagle

Trauma/Critical Care/Acute Care Surgeon. MD/PhD. FACS. UVa/UMD/UPenn. Asst Professor of Surgery at Wash U. Blocking is curating.

St Louis, MO
surgery.wustl.edu/people/mark-ho…
Joined March 2012

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    Mark Hoofnagle‏ @MarkHoofnagle 24 Sep 2018

    It's 10 minutes until the new season of TV's worst medical conspiracy show #theresident on Fox. Season 2 episode 1 '00:42:30' - the hospital experiences a blackout, and for some reason has no emergency generators. Let me guess Conrad is going to endanger lives out of "heroism."pic.twitter.com/ujn42rA0L3

    4:53 PM - 24 Sep 2018 from St Louis, MO
    • 9 Retweets
    • 54 Likes
    • AME Brendan Hilbert, PhD Dr. Alexandra Zidenberg lisa thompson 💉Josh Rubin, MD 🩺 Jorge M. Escobar Traci 💙🐶💔🍀🐨 Christine Castater grace 🍊
    10 replies 9 retweets 54 likes
      1. New conversation
      2. Mark Hoofnagle‏ @MarkHoofnagle 24 Sep 2018

        The episode again seems to have begun with a proposition by Conrad to have sex with Nic at work. First fireable offense of the new season!

        3 replies 1 retweet 14 likes
        Show this thread
      3. Mark Hoofnagle‏ @MarkHoofnagle 24 Sep 2018

        Dr. Okefor goes to see her heart transplant boyfriend who she inappropriately performed surgery on last season. It's a good thing that went well. Dr "in the flesh" Austin is promising to perform heart surgery on a premature infant. Not a pediatric cardiac surgeon but hey.

        1 reply 0 retweets 12 likes
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      4. Mark Hoofnagle‏ @MarkHoofnagle 24 Sep 2018

        The idea that such a surgery on such a small infant is some kind of guaranteed success as Austin suggests is...inappropriate. Usually, if at all possible, you try to grow the baby unless it's an immediate life-threatening problem. Must be planning a Norwood procedure.

        1 reply 0 retweets 9 likes
        Show this thread
      5. Mark Hoofnagle‏ @MarkHoofnagle 24 Sep 2018

        Because there are no separations of specialties at all, apparently Conrad and the intern are now in the neonatal ICU, rather than say pediatricians or surgical residents. Then for some reason they just start examining the dad at bedside. Are there only 3 doctors in this hospital?

        1 reply 1 retweet 19 likes
        Show this thread
      6. Mark Hoofnagle‏ @MarkHoofnagle 24 Sep 2018

        Ok fair, hypoplastic left heart, that would be considered even in a very small infant. The Norwood, the first part of a staged series of operations that lets the right heart function as a "common ventricle" when the left heart is too underdeveloped. Has their consulting improved?

        2 replies 0 retweets 8 likes
        Show this thread
      7. Mark Hoofnagle‏ @MarkHoofnagle 24 Sep 2018

        Looks like not. Austin is planning to do this (when was he a pediatric cardiac surgeon again?) with a 2nd year resident rather than say, a fellow or another attending.

        1 reply 0 retweets 7 likes
        Show this thread
      8. Mark Hoofnagle‏ @MarkHoofnagle 24 Sep 2018

        Very realistic, the kid will not get off the phone long enough to make eye contact with Nic.

        1 reply 0 retweets 7 likes
        Show this thread
      9. Mark Hoofnagle‏ @MarkHoofnagle 24 Sep 2018

        And now the drama. Power loss, and apparently no emergency generators. Like, we've never thought of what if there's a thunderstorm?

        2 replies 0 retweets 9 likes
        Show this thread
      10. Mark Hoofnagle‏ @MarkHoofnagle 24 Sep 2018

        For some pointless reason there is no top drape on the baby surgery so we can see the infants face. And then, even though the chest is open, Austin asks for a scalpel. Can someone please tell them we use more than scalpels in surgery already?

        1 reply 0 retweets 9 likes
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      11. Mark Hoofnagle‏ @MarkHoofnagle 24 Sep 2018

        Ok commercial break is over and there still are no emergency generators on. Is this for real?

        1 reply 0 retweets 9 likes
        Show this thread
      12. Mark Hoofnagle‏ @MarkHoofnagle 24 Sep 2018

        After enough time for all the patients on ventilators to arrest generators click on. This is idiotic.

        1 reply 0 retweets 13 likes
        Show this thread
      13. Mark Hoofnagle‏ @MarkHoofnagle 24 Sep 2018

        Dr. Bell aka HODAD is overwhelmed by people asking him questions. Then a female doctor asks, "Mr. Bell, why is this happening?" He corrects her, rudely, to "Dr. Bell" because that's the real problem in medicine - female doctors not acknowledging the degree of the male CEO.

        1 reply 0 retweets 13 likes
        Show this thread
      14. Mark Hoofnagle‏ @MarkHoofnagle 24 Sep 2018

        His plan isn't terrible. It's more risky to treat this as only temporary, but he remains a better administrator than a surgeon.

        1 reply 0 retweets 5 likes
        Show this thread
      15. Mark Hoofnagle‏ @MarkHoofnagle 24 Sep 2018

        Now back to AJ Austin - who keeps referring to himself in the third person - thinks he's breaking the rules by not aborting an open heart surgery that would result in patient death. More fake drama. And he remains inappropriate, referring to staff as "nurse whatsyourname."

        1 reply 0 retweets 7 likes
        Show this thread
      16. Mark Hoofnagle‏ @MarkHoofnagle 24 Sep 2018

        And out of pure pettiness I'd like to point out he's not using a pediatric Yankauer suction.

        1 reply 0 retweets 12 likes
        Show this thread
      17. Mark Hoofnagle‏ @MarkHoofnagle 24 Sep 2018

        HODAD even seems to pull the trigger on evacuation at the proper time. He turned in the crooked oncologist, he seems to be maintaining in an emergency, why is he still being lit like the villain? This is a healthy career progression.

        1 reply 0 retweets 6 likes
        Show this thread
      18. Mark Hoofnagle‏ @MarkHoofnagle 24 Sep 2018

        AJ Austin is having his second year resident suture in a shunt in a Norwood procedure. He harasses her calling her princess and insisting on calling her boyfriend mid-case to mock her for feeling uncomfortable doing an incredibly complex task above her level. Can we fire him?

        1 reply 0 retweets 8 likes
        Show this thread
      19. Mark Hoofnagle‏ @MarkHoofnagle 24 Sep 2018

        In a new order of magnitude of skullduggery they are suggesting the doctors are triaging patient based on their billing cost to the hospital rather than acuity.

        1 reply 0 retweets 4 likes
        Show this thread
      20. Mark Hoofnagle‏ @MarkHoofnagle 24 Sep 2018

        Oooh. New level of drama - the blackout is being caused by "pirates." I have to wonder about the plausibility of being able to strike a single institution on a power grid - like hospital computers are responsible for running the hospital power grid? Waah?

        2 replies 0 retweets 5 likes
        Show this thread
      21. Mark Hoofnagle‏ @MarkHoofnagle 24 Sep 2018

        Hospital have been known to be cyber-attacked, but usually the attacks are on the computer frameworks rather than the power-grid, which I can't imagine how that could be plausible. Not an IT guy, but pretty sure our computers and the power company's are separate.

        2 replies 0 retweets 6 likes
        Show this thread
      22. Mark Hoofnagle‏ @MarkHoofnagle 24 Sep 2018

        Now a trauma has appeared and Conrad is going to do a thoracotomy. On a patient who still has a pulse. I can't even.

        1 reply 1 retweet 6 likes
        Show this thread
      23. Mark Hoofnagle‏ @MarkHoofnagle 24 Sep 2018

        He then builds an OR by making a tent with lights from a firetruck shining in it. Because reflected headlights are adequate for OR lights. A better move would be just finding the surgeon a headlamp. Or getting the *spotlight* from an emergency vehicle. But I'm not a writer...

        1 reply 0 retweets 9 likes
        Show this thread
      24. Mark Hoofnagle‏ @MarkHoofnagle 24 Sep 2018

        Trauma surgeon operating in the dark. Someone get the poor man a headlight that isn't on a car.

        1 reply 0 retweets 3 likes
        Show this thread
      25. Mark Hoofnagle‏ @MarkHoofnagle 24 Sep 2018

        Now dad of Norwood baby is passed out on stairs, and the intern shoulder-carries him upstairs to the ICU. Impressive. But we do have stretchers for that.

        1 reply 0 retweets 5 likes
        Show this thread
      26. Mark Hoofnagle‏ @MarkHoofnagle 24 Sep 2018

        Preemie Norwood baby needs to have the pump run off power. For some completely not-suspicious reason, AJ Austin (in the flesh) knew precisely how long the generators would last to a second.

        1 reply 0 retweets 4 likes
        Show this thread
      27. Mark Hoofnagle‏ @MarkHoofnagle 24 Sep 2018

        In an amazing act of doctoring the intern diagnoses not a stroke in the 30 year old dad but an allergic reaction. My hero.

        1 reply 0 retweets 5 likes
        Show this thread
      28. Mark Hoofnagle‏ @MarkHoofnagle 24 Sep 2018

        They're trying to suggest a kid with a cell-phone is running the hack, but for some reason, despite being so savvy as to bring down a hospital with a cell-phone, needed to be physically present in a hospital bed to perform the hack.

        1 reply 0 retweets 4 likes
        Show this thread
      29. Mark Hoofnagle‏ @MarkHoofnagle 24 Sep 2018

        This is a break from tradition. Not since the first episode in which they showed they didn't understand how doors work have we seen a plot point turn on something so stupid *and* non medical.

        1 reply 1 retweet 7 likes
        Show this thread
      30. Mark Hoofnagle‏ @MarkHoofnagle 24 Sep 2018

        But then we knew their computers were a sieve when they suggested a patient could hack the video cameras recording his own surgery last year. They apparently have set the password of all their computers to "password."

        1 reply 0 retweets 3 likes
        Show this thread
      31. Mark Hoofnagle‏ @MarkHoofnagle 24 Sep 2018

        Nic and Conrad then aid and abet this felon by helping them negotiate with HODAD for her hospital bills to go away. Postop from a Norwood the baby is immediately extubated and crying. That's...improbable.

        2 replies 0 retweets 6 likes
        Show this thread
      32. Show replies

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