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Zachary D Levy MD ๐Ÿ‡ฒ๐Ÿ‡ฆ ๐Ÿ‡จ๐Ÿ‡ฎ
@ZLevyMD
emergency medicine / critical care / telestroke puzzles for @nytimes @wsj @latimes @AndrewsMcMeel "Views are my own."
NYCx
Joined May 2015
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    Backstory on today's puzzle. Thanks to @DebAmlen for letting me share. (spoilers)
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    We are now a monolith. We started with a medical ICU, surgical ICU, cardiac ICU, neurosurgical ICU, and a cardiothoracic ICU, plus a dozen mixed specialty floors. Every floor and unit is becoming a COVID unit. There is no more specialization โ€” weโ€™re all treating one thing.
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    "aaaaand here's when we decided a big in-person celebration in Times Square was still a good idea", i said amongst the smoldering remains of Manhattan
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    once upon a time, all health insurance in this country was not-for-profit, everyone was charged the same, and no one was denied coverage because of age, sickness, or preexisting conditions. that sounds like a fairy tale, but it's just straight-up history. why can't we go back?
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    So in between fighting cancer and continuing to serve on the court, #RBG solved my #NYTXW puzzle with her granddaughter and sent me an autographed copy! @NYTimesWordplay
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    Replying to @choo_ek and @NEJM
    We intubated nine patients today alone and the outbreak is barely in full swing. Vent beds are not a bottomless resource.
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    Sobering @NEJM COVID reccโ€™s: โ€œWe believe that removing a patient from a ventilator or an ICU bed to provide it to others in need is also justifiable.. the decision to withdraw a scarce resource to save others is not an act of killing and does not require the patientโ€™s consent.โ€
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    An hour into my shift and already pronounced two patients โ€” including a 33-year-old with no medical history who had a fever x 1 week. They are both likely COVID deaths, though who knows if they get tested post-mortem and join the โ€œofficialโ€ stats. The curve does not feel flat.
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    Replying to @ZLevyMD
    And @realDonaldTrump is out here talking about opening up Outback Steakhouse again ASAP.
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    "No longer were there individual destinies; only a collective destiny, made of plague and emotions shared by all." Camus and #COVID19 -- a thread. 1/x
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    Replying to @acweyand
    itโ€™s a horrible, painful, life-limiting disease, and i teach the residents to ask them what works for their pain, then smile and nod and give it to them as often as necessary
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    Replying to @ercowboy
    Exactly the same. Day 7. Hypoxic, no distress. Fine, then intubated. Underwhelming x-rays, terrible CTs. Don doff don doff don doff. Hands cracked and stinging. Groundhog day.
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    On the heels of that disquieting @NEJM article โ€” some hospitals now considering blanket DNR orders for #Covid patients. wapo.st/2Jepkzl
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    Replying to @ZLevyMD
    "What we learn in time of pestilence: that there are more things to admire in men than to despise." 6/x