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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 30 Apr 2018

    #TheResident live tweeting starts a tiny bit late - tonight's episode "Rude Awakenings and the Raptor" After a shower/exercise montage, HODAD shows up and parks in the CEOs parking spot - why is getting him out of the OR a bad thing?pic.twitter.com/Hvd0PrEqY6

    6:24 PM - 30 Apr 2018
    • 2 Retweets
    • 11 Likes
    • ChopTart🏳️‍🌈🔪 Shannon Mitchel Ryan Kerzner LionstoneRxBetch 💧 Ian "Department of Diseasology" 🍩 Musgrave 🏳️‍🌈Jenny🍭 Tricia Pendergrast Liz "The Mask Goes Over Your Nose AND Mouth" Ditz Heightsmomma
    1 reply 2 retweets 11 likes
      1. New conversation
      2. Mark Hoofnagle‏ @MarkHoofnagle 30 Apr 2018

        First plotline - our intern is back in the ED, every patient has to have a complaint subject to mockery, this time a "broken weenie." Intern meets up with a resident catching his "second wind" after a brutal all-nighter, and he's clearly on speed.

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      3. Mark Hoofnagle‏ @MarkHoofnagle 30 Apr 2018

        Also, this is a universe without resident work hours, clearly.

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      4. Mark Hoofnagle‏ @MarkHoofnagle 30 Apr 2018

        Because our heroes practice good medicine, the patient is in so much pain he passes out. Speed resident rescue pages his buddy. I admit, I have used the rescue page.

        1 reply 1 retweet 3 likes
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      5. Mark Hoofnagle‏ @MarkHoofnagle 30 Apr 2018

        Okafor has joined Conrad in his creepy staring at a distance as he stares daggers at the CEO. Probably not a good career move. She's the only redeemable character, she tells him to fix his face. Yes, please fix your face Conrad, it's creepy.

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      6. Mark Hoofnagle‏ @MarkHoofnagle 30 Apr 2018

        Now they're standing outside the boardroom creepily staring at HODAD. Does Conrad ever not just creep on people?

        1 reply 1 retweet 2 likes
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      7. Mark Hoofnagle‏ @MarkHoofnagle 30 Apr 2018

        And for ultimate drama, speed resident falls through the skylight into the boardroom table. HODAD asks for a lac try. "I need that suture kit now" said no surgeon ever. And Conrad deploys a Foley into the neck, this actually works...sometimes.

        1 reply 1 retweet 4 likes
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      8. Mark Hoofnagle‏ @MarkHoofnagle 30 Apr 2018

        Usually not in compressible areas though, good for subclavian injuries and noncompressible spots, you can deploy it for some tamponade. These idiots are delaying a trauma for diagnostic stupidity. Even if he has a brain problem, you should stop life-threatening hemorrhage #1.

        1 reply 1 retweet 4 likes
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      9. Mark Hoofnagle‏ @MarkHoofnagle 30 Apr 2018

        It's an interesting clinical problem though, how much time to devote to scanning a head injury in the face of life threatening hemorrhage? Literally a question from my boards. If you have stable vitals you could consider a head scan. Not sure this is the case.

        1 reply 2 retweets 4 likes
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      10. Mark Hoofnagle‏ @MarkHoofnagle 30 Apr 2018

        Plotline #2, disgruntled NP Nic is now stalking Hunter at her coffee place, she says she has free time to focus all her attention on Hunter. Tells her she's uncovered her divorce. Time for a restraining order. That's kind of sic Nic.

        1 reply 1 retweet 2 likes
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      11. Mark Hoofnagle‏ @MarkHoofnagle 30 Apr 2018

        Is Conrad trying to cut the metal impalement with a bone saw? That's not going to work

        1 reply 1 retweet 4 likes
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      12. Mark Hoofnagle‏ @MarkHoofnagle 30 Apr 2018

        HODAD is rehearsing his "this is a tragedy but not our fault speech" even though he is the cause of the speed residents spiritual depantsment.

        1 reply 1 retweet 2 likes
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      13. Mark Hoofnagle‏ @MarkHoofnagle 30 Apr 2018

        They diagnose him with a subdural, and say if he went under anesthesia he would have herniated and died. Possibly a delay could have killed him, but still, life-threatening penetrating trauma! Get neurosurgery in the room while you work on the metal object impaling him.

        1 reply 1 retweet 3 likes
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      14. Mark Hoofnagle‏ @MarkHoofnagle 30 Apr 2018

        I would point out that the SAH isn't having a mass effect. They opt for an MRI. That's a bad idea. And let me guess, the impaled object will be ferromagnetic.

        1 reply 1 retweet 4 likes
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      15. Mark Hoofnagle‏ @MarkHoofnagle 30 Apr 2018

        HODAD is now talking about being a CEO and still operating. He can't seem to see this is a potentially graceful exit. Oh good, I misheard, they said get him to Neuro, not MRI. Thank goodness. Still, impalement! Need to do this in the OR.

        1 reply 1 retweet 3 likes
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      16. Mark Hoofnagle‏ @MarkHoofnagle 30 Apr 2018

        I would suggest that in the absence of midline shift or ventricular effacement, the deadly hemorrhage might be a more serious priority. Or at least, try doing two things at once?

        1 reply 1 retweet 3 likes
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      17. Mark Hoofnagle‏ @MarkHoofnagle 30 Apr 2018

        Uggh, HODAD told Okafor to "smile". Every dude in this show is a creep.

        1 reply 2 retweets 6 likes
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      18. Mark Hoofnagle‏ @MarkHoofnagle 30 Apr 2018

        Okafor gives a tour to the new recruit, and in another example of how every man is horrible, he asks her an opinion of a female doc who has "man hips". Okafor plays along. Everybody in this show is terrible.

        1 reply 1 retweet 4 likes
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      19. Mark Hoofnagle‏ @MarkHoofnagle 30 Apr 2018

        Nic continues to pursue her investigation of Hunter like a crazy person, yelling at someone at the medical board and telling him "he sucks". That seems normal.

        2 replies 1 retweet 3 likes
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      20. Mark Hoofnagle‏ @MarkHoofnagle 30 Apr 2018

        Okafor lures the recruit into the room of the guy with the broken penis, who he then harangues and says "I have a tee time". They abuse him until he admits how he broke his penis on an elliptical machine. This serves no medical purpose but to humiliate the patient.

        1 reply 1 retweet 5 likes
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      21. Mark Hoofnagle‏ @MarkHoofnagle 30 Apr 2018

        Gotta say, at every opportunity, they manage to make all of these characters despicable. The new recruit is a CT surgeon, why is he even interested in a urologic case?

        1 reply 1 retweet 4 likes
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      22. Mark Hoofnagle‏ @MarkHoofnagle 30 Apr 2018

        He justifies this behavior in an absurd rant that he needs to figure out how to prevent him from engaging his fetish because "next time he'll die". Well, maybe, but more likely, they are again using patient humiliation and shaming for drama in a way that is unprofessional.

        1 reply 2 retweets 6 likes
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      23. Mark Hoofnagle‏ @MarkHoofnagle 30 Apr 2018

        More likely than not, the broken penis is enough of an object lesson that he needs safer sex play. Nic is now being counter-stalked by someone obviously in Hunter's employ. They really are elevating Hunter to comic book villain in this episode.

        1 reply 1 retweet 3 likes
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      24. Mark Hoofnagle‏ @MarkHoofnagle 30 Apr 2018

        The new recruit is observing the impalement surgery now. They suggest putting him on bypass. New recruit says, "I guess that's how trauma surgeons think" and "you wouldn't need a bypass if you knew how to do heart surgery like me" I would kick him all the way out of my OR.

        1 reply 1 retweet 2 likes
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      25. Mark Hoofnagle‏ @MarkHoofnagle 30 Apr 2018

        Why does this show insist on the inane conceit that to be good at something you also have to be awful, abusive, rude, crude, sexist, and unprofessional?

        1 reply 1 retweet 6 likes
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      26. Mark Hoofnagle‏ @MarkHoofnagle 30 Apr 2018

        Okafor says "theoretically, if you move fast enough you don't need bypass". Practically, trauma is unpredictable, you have no idea what to expect. Theoretically, if you had x-ray vision you'd know exactly how a random object has penetrated this guy's vasculature. But you don't

        1 reply 1 retweet 4 likes
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      27. Mark Hoofnagle‏ @MarkHoofnagle 30 Apr 2018

        Now the recruit is going to scrub. Unprivileged. He attacks the nurse for helping him, asks scrub if "English not your first language". This guy is such a monster he should not only not be recruited, he should be reprimanded never to enter this hospital again.

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      28. Mark Hoofnagle‏ @MarkHoofnagle 30 Apr 2018

        Is this guy even licensed in the state? The surgeon steps aside and allows the yelling madman to take over. He yanks out the object, the patient immediately tries to die. Much thrashing occurs and bleeding magically stopped. He would have bled so fast you'd see nothing.

        1 reply 1 retweet 4 likes
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      29. Mark Hoofnagle‏ @MarkHoofnagle 30 Apr 2018

        This is the stupidest part of the stupidest show on medicine I've ever seen. And it's worse than stupid. It's malignant. It sells this BS idea that you have to be a bastard to people, or that you have a right to be a bastard to people if you are skilled or smart.

        2 replies 1 retweet 8 likes
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      30. Mark Hoofnagle‏ @MarkHoofnagle 30 Apr 2018

        The recruit/psychopath/asshole diagnoses a gastric bypass by stretch marks on his abdomen, says obesity was the cause of the patients LVH. A better diagnostic would be the laparoscopic scars, otherwise, he might have just lost some weight.

        1 reply 1 retweet 2 likes
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      31. Mark Hoofnagle‏ @MarkHoofnagle 30 Apr 2018

        Ok the psychopath's name is Austin. Introduces himself as "AJ Austin in the flesh." Get this guy away from your hospital. Nothing he can do is worth having a malignant madman terrorizing your patients and staff.

        1 reply 1 retweet 3 likes
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      32. Show replies

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