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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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    1. Mark Hoofnagle‏ @MarkHoofnagle 25 Sep 2018

      So #NewAmsterdam is a new medical drama about “breaking all the rules” and “tearing up the bureaucracy.” Worth a live tweet a la #TheResident? Bets on “third leading cause of death” myth? Sex at work? Arrogance and bullying presented as competence?

      3 replies 4 retweets 31 likes
      Show this thread
      Mark Hoofnagle‏ @MarkHoofnagle 25 Sep 2018

      I’ll start at 10 EST/9 central. I promise to give it a fair shake. But at the same time these shows decry medical error they attack the entire notion of having systems - preferring charismatic rogues - which is the main mechanism for trying to mitigate individual fallibility.

      6:29 PM - 25 Sep 2018
      • 3 Retweets
      • 18 Likes
      • Chris 🇺🇸🏳️‍🌈 kfunk937 black traffic 🏴‍☠️🇪🇺 💙 a catherine scorned screamingmd 🏳️‍🌈Jenny🍭 Jennifer Rodriguez transplantrockstar §ⓐ℞Åℏ (hands washed, mask on)
      3 replies 3 retweets 18 likes
        1. New conversation
        2. Mark Hoofnagle‏ @MarkHoofnagle 25 Sep 2018

          The hospital is nick-named "the Dam", seems ominous. But yes, Oxygen for CO poisoning. So far so good. Apparently it's based on a book about Bellevue. By an actual doctor. Doing better than The Resident already.

          2 replies 0 retweets 13 likes
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        3. Mark Hoofnagle‏ @MarkHoofnagle 25 Sep 2018

          The director has apparently introduced himself by changing in the janitorial locker room (I think they would notice) and eavesdropping. Not exactly building trust. And the actors read lines like they think things are all one word defibventilatorACLS.

          1 reply 0 retweets 9 likes
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        4. Mark Hoofnagle‏ @MarkHoofnagle 25 Sep 2018

          One of the conceits is he isn't waiting to learn anything before he's deciding to run things his way. That's not a great sign for a leader. He's been here one hour and pissed off the janitorial staff and one of the more prestigious physicians.

          2 replies 0 retweets 9 likes
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        5. Mark Hoofnagle‏ @MarkHoofnagle 25 Sep 2018

          Here is one conceit they're stealing from #TheResident and I guess every other drama, he's trying to "win back" his lady. Vomit. Let's hope he's less rapey than Conrad and doesn't do it by cornering her in a call room.

          1 reply 0 retweets 9 likes
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        6. Mark Hoofnagle‏ @MarkHoofnagle 25 Sep 2018

          It is a little odd for a medical director to wear scrubs rather than a suit when he is introducing himself to the medical staff. He mentions he and his sister were born here but she died from a hospital acquired infection which was "totally preventable." Here we go.

          1 reply 0 retweets 8 likes
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        7. Mark Hoofnagle‏ @MarkHoofnagle 25 Sep 2018

          That's debatable. Now, he's asking for ideas...silence. And when he doesn't get an answer, he fires the entire cardiac surgery department for placing billing over care. Theoretically admirable but this is group punishment, scary, and extreme, how will you acquire new talent?

          2 replies 0 retweets 13 likes
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        8. Mark Hoofnagle‏ @MarkHoofnagle 25 Sep 2018

          If people can't trust the hospital isn't being run by a fickle lunatic, why would you trust them enough to come work there? It's not like it's a small deal to onboard new faculty, doctors and nurses. It also entails huge risks for the new employees. This is madness.

          1 reply 0 retweets 12 likes
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        9. Mark Hoofnagle‏ @MarkHoofnagle 25 Sep 2018

          He then says he will hire 50 new attendings because "untrained residents" will no longer run the hospital. Good luck with that, now that they've heard you just fired an entire department on your first day. This guy seems like a malignant monster. Run for the hills.

          2 replies 0 retweets 19 likes
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        10. Mark Hoofnagle‏ @MarkHoofnagle 25 Sep 2018

          He says, "let's be doctors again." By eliminating the waiting room. So triage is no longer part of medicine. Riiiight. This seems like the fantasy of a malignant narcissist that such a leader would be considered a good person. This is Trump medicine.

          1 reply 0 retweets 24 likes
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        11. Mark Hoofnagle‏ @MarkHoofnagle 25 Sep 2018

          Just say impossible things and expect that they'll just happen, without a plan, without study, without considering for a second the human costs of your actions. Now all I can see is Donald Trump, as a medical director, being presented as a "good guy."

          1 reply 0 retweets 12 likes
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        12. Mark Hoofnagle‏ @MarkHoofnagle 25 Sep 2018

          Oooh shock. It turns out that firing the entire cardiac surgery department struck an innocent person, and he immediately has to walk back a radical thoughtless action. He now tasks this person to build a new department that he just set fire to. Trumpian medical drama.

          1 reply 0 retweets 12 likes
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        13. Mark Hoofnagle‏ @MarkHoofnagle 25 Sep 2018

          Now for pointless drama, a patient shows up with possible Ebola. Because during outbreaks we allow diaphoretic, febrile people onto planes and clear customs no problem... You can have drama short of hemorrhagic fever you know.

          1 reply 0 retweets 7 likes
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        14. Mark Hoofnagle‏ @MarkHoofnagle 25 Sep 2018

          My wife has bailed. Too stupid to tolerate. Too reminiscent of Trump. Apparently they had BSL IV level ebola isolation just ready to go. Good for them.

          2 replies 0 retweets 14 likes
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        15. Mark Hoofnagle‏ @MarkHoofnagle 25 Sep 2018

          I like the neurologist who keeps losing his glasses on his head and talks to people. They are true diagnosticians, and time with the patient is a sign of strength. Then they switch to a pt yelling in Russian. The medical director seems determined to micromanage each interaction.

          1 reply 0 retweets 6 likes
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        16. Mark Hoofnagle‏ @MarkHoofnagle 25 Sep 2018

          He convinces the patient not to leave AMA, and scares him with "rectal bleeding" as a possible consequence of ignoring CO poisoning while waving a folder of restaurant menus. Good to see lying to patients as a strategy coming from the top.

          1 reply 0 retweets 10 likes
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        17. Mark Hoofnagle‏ @MarkHoofnagle 25 Sep 2018

          It's amazing in this time of malignant narcissists ruining the country that people are craving for malignant narcissists to ruin medicine.

          3 replies 0 retweets 13 likes
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        18. Mark Hoofnagle‏ @MarkHoofnagle 25 Sep 2018

          Something, something reverse racism....

          2 replies 0 retweets 4 likes
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        19. Mark Hoofnagle‏ @MarkHoofnagle 25 Sep 2018

          Now the medical director is micromanaging a psych patient. Seems like if it's that important to her just let her keep the damn book. I agree one of the most frustrating aspects of psychiatric care is the total absence of mental health parity and lack of outpatient services.

          1 reply 0 retweets 5 likes
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        20. Mark Hoofnagle‏ @MarkHoofnagle 25 Sep 2018

          Because there wasn't enough drama the ebola patient now is suspected ISIS terrorist. The medical director is now interfering with the investigation because he knows better than the counterterrorism investigators after hearing the patient's story. Because no one lies.

          1 reply 0 retweets 11 likes
          Show this thread
        21. Mark Hoofnagle‏ @MarkHoofnagle 25 Sep 2018

          The neurologist schools medical director on the value of listening. A characteristic he doesn't exercise himself but seems to see as valuable in others.

          2 replies 0 retweets 9 likes
          Show this thread
        22. Mark Hoofnagle‏ @MarkHoofnagle 25 Sep 2018

          Ebola kid is vomiting blood. Dr. Bloom runs in without proper gear despite the kid vomiting blood all over. Medical director shows up to micromanage the code. The most unbelievable aspect of this drama is that he has such perfect situational awareness.

          1 reply 0 retweets 8 likes
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        23. Mark Hoofnagle‏ @MarkHoofnagle 25 Sep 2018

          Maybe this is a flaw of modern medical dramas. We can't be trusted to follow more than one character or specialty. Everything has to revolve around a single tyrannical white man who will set everything right.

          1 reply 1 retweet 12 likes
          Show this thread
        24. Mark Hoofnagle‏ @MarkHoofnagle 25 Sep 2018

          Now his wife has shown up with possible placenta previa, apparently unknown (were they not keeping up with prenatal screenings?)

          1 reply 0 retweets 7 likes
          Show this thread
        25. Mark Hoofnagle‏ @MarkHoofnagle 25 Sep 2018

          Good thing he didn't fire the entire OB department on a whim.

          1 reply 0 retweets 13 likes
          Show this thread
        26. Mark Hoofnagle‏ @MarkHoofnagle 25 Sep 2018

          White female doctor can't get over the black doctor isn't interested in dating white women. This is the biggest tragedy for white people, that for one second we experience what it's like to be denied what we want, as folks of other races routinely are, based on our race.

          2 replies 0 retweets 5 likes
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        27. Mark Hoofnagle‏ @MarkHoofnagle 25 Sep 2018

          So this #NewAmsterdam show is pretty terrible. Why do Americans crave strongmen and dictators? The savior, once again, a rule-breaking, impulsive white dude who makes wild promises without plans, is presented as a *good* thing. I think we've had enough of that for a lifetime.

          1 reply 2 retweets 32 likes
          Show this thread
        28. End of conversation

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