iiinova — where your digital self keeps evolving

Alyssa Burgart, MD, MA (BurgartBioethix) @alyssaburgart.com · 04/10/2026

He’s named in the files many times related to Epstein’s urology appointments. Paduch is one of the physicians and academics in Epstein’s web.

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Alyssa Burgart, MD, MA (BurgartBioethix) @alyssaburgart.com · 03/10/2026

Institute for Safe Patient Care and Patient Empowerment to prevent sexual abuse at hospitals nationwide. Paduch is named in the Epstein files many times. Most of these are related to scheduling his own urology appointments, but not all. Medicine is complicit in clinical rape culture (CRC).

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Alyssa Burgart, MD, MA (BurgartBioethix) @alyssaburgart.com · 02/10/2026

Why do universities protect rapists? What happened at Cornell? What is Title IX? How does ketamine impact capacity to consent? @arghavansallesmd.medsky.social and I discuss Cornell and seven students being sued by survivor Jane Doe on our podcast, The Present Illness.

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Alyssa Burgart, MD, MA (BurgartBioethix) @alyssaburgart.com · 19/04/2026

The current order is on hold and the ACLU is fighting it. But at least 19 prisons have not complied and continue to deny gender affirming care to incarcerated people.

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Alyssa Burgart, MD, MA (BurgartBioethix) @alyssaburgart.com · 19/04/2026

While the government plans to make the rules, it will be prison doctors and nurses used as tools to deny patients their most basic right to access care. Just like using physicians to prevent access to abortion, the state uses physicians to prevent access to gender affirming care.

It is the professional obligation of health care workers to ensure that patients benefit from the therapies they are providing, that they are not harmed; that patients get to make decisions for themselves that are in their own best interest; and that all patients receive just access to care.

These are the four most basic principles of bioethics. This policy appears to violate every single one of them.

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Alyssa Burgart, MD, MA (BurgartBioethix) @alyssaburgart.com · 19/04/2026

Just like California prisons violated patients’ autonomy through forced, unconsented sterilization, the federal system aims to force patients to detransition.

Cal Matters headline: ‘I would have been a great mom’: California finally pays reparations to woman it sterilized (2024)

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Alyssa Burgart, MD, MA (BurgartBioethix) @alyssaburgart.com · 19/04/2026

They know what the result will be - the suffering, misery, and death of trans people. This plan violates the most basic tenants of bioethics.

Further, she noted that the administrative record included papers on data collection and studies related to trans suicide risk.

"It's strongly suggested that the BOP expects an increase in trans suicides, and rather than preventing these outcomes, it wants to sit by and collect the data," Vaca wrote.

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Alyssa Burgart, MD, MA (BurgartBioethix) @alyssaburgart.com · 19/04/2026

The Trump administration aims to withhold gender-affirming care for incarcerated transgender people. A rumor circulated that it was “medical experimentation,” but the government has no research question. @raesdeng.bsky.social @snopes.com

I suppose you could call it an experiment to see how many more trans people are profoundly harmed and perhaps killed in the prison system - Burgart said

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Alyssa Burgart, MD, MA (BurgartBioethix) @alyssaburgart.com · 30/01/2026

“Our expert ethical analysis does not support withholding gender-affirming care from minors.” As pediatric bioethicists, we wrote this analysis of the ethical shortcomings and flawed conclusions driving the two proposed bans on gender-affirming care. www.statnews.com/2026/01/30/g...

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Alyssa Burgart, MD, MA (BurgartBioethix) @alyssaburgart.com · 03/01/2026

questions about this condition that we don’t know yet. It will be much more difficult to find out in this environment. While the condition is likely rare, children should not suffer because of geopolitical attacks. A bombing in Caracas impacts pediatric health care in the US.

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Alyssa Burgart, MD, MA (BurgartBioethix) @alyssaburgart.com · 03/01/2026

severe neurological injury/death due to a single anesthesia exposure. How do we screen families when everyone is scared that ICE is going to abduct them? What family will feel safe sharing their Venezuelan ancestry while our president is determined to destabilize Venezuela? There are so many

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Alyssa Burgart, MD, MA (BurgartBioethix) @alyssaburgart.com · 03/01/2026

The attack on Venezuela is a disaster for so many reasons. As an anesthesiologist, it further complicates screening children for a devastating mitochondrial disorder. Recent reports indicate at least 25 children and young adults of Venezuelan maternal ancestry have suffered

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Alyssa Burgart, MD, MA (BurgartBioethix) @alyssaburgart.com · 09/09/2025

I'm stoked to get to chat with the incomparable Mary Roach (@maryroach.bsky.social) about her new book Replaceable You: Adventures in Human Anatomy! [link in 🧵]

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Alyssa Burgart, MD, MA (BurgartBioethix) @alyssaburgart.com · 05/09/2025

Got to meet @glaucomflecken.bsky.social today at the Big Ideas in Medicine conference. I made him laugh, so I’ll be an insufferable unicorn all day. 🦄 🌈

Me and Dr Glaucomenfleken, Will Flannery

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Alyssa Burgart, MD, MA (BurgartBioethix) @alyssaburgart.com · 31/08/2025

You can feel free to watch the video: x.com/JSweetLI/sta...

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Alyssa Burgart, MD, MA (BurgartBioethix) @alyssaburgart.com · 10/08/2025

Don’t confuse individual perceptions of goodness with collective good.

The human being who would not harm you on an individual, face-to-face basis, who is charitable, civic minded, loving, and devout,
will wound or kill you from behind the corporate veil.
-Morton Mintz

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Alyssa Burgart, MD, MA (BurgartBioethix) @alyssaburgart.com · 05/08/2025

develop anxiety disorders, panic attacks, and PTSD related specifically to the risk of enduring another shock.

ICDs have two parts: the ICD generator box and the electrical leads. The device sits under the skin on the left or right side of the chest, and the leads are inserted in the atrium and ventricle to both sense what the heart is doing, and to automatically deliver electrical impulses in response. Image source: Heart Foundation

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Alyssa Burgart, MD, MA (BurgartBioethix) @alyssaburgart.com · 05/08/2025

Nashville General Hospital says it never agreed to turn off 69-year-old Byron Brown’s defibrillator to facilitate his death by lethal injection. The state plans to kill Brown tomorrow, August 5 at 10am, regardless of his cardiac device.

The court stated that delaying the execution due to an inability to get Brown’s device deactivated amounts to a “stay of execution” that they didn’t have the authority to authorize. The irony of this argument, when Brown was sentenced to death in 1988, is not lost on me.

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Alyssa Burgart, MD, MA (BurgartBioethix) @alyssaburgart.com · 01/08/2025

About 280,000 kindergarteners attended school without documented MMR vaccine series completion during the 2023-2024 school year These numbers are not just statistics; they are a roadmap to future outbreaks.

Idaho leads in both medical and non-medical exemptions

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Alyssa Burgart, MD, MA (BurgartBioethix) @alyssaburgart.com · 01/08/2025

Conscientious objection claims relate to low vaccination rates - the Texas-driven measles outbreak provides a case study in how anti-vax propaganda fuels “deeply held beliefs” and loosened vaccine regulations.

Since 1971, Texas has allowed both medical and religious exemptions. In 2003, the Texas Legislature passed a provision allowing for a conscientious exemption to vaccination. All parents must do to exempt a child from vaccination and still attend public school is submit a simple affidavit to the Department of Health.

Graph showing significant rise in vaccine exemptions granted in Texas per year and by child grade.

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Alyssa Burgart, MD, MA (BurgartBioethix) @alyssaburgart.com · 31/07/2025

For anyone who thinks high school literature isn’t useful, I just impressed my entire family by getting a geography trivia question solely based on loving Jean Rhys’ Wide Sargasso Sea.

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Alyssa Burgart, MD, MA (BurgartBioethix) @alyssaburgart.com · 19/07/2025

I wrote this letter as a first year medical student, 19 years ago. I’ve cared for many patients that have died since then, but this letter was never quite where I needed it to be. What advice would you give to a young healthcare worker about bearing witness to death? I hope I was kind to myself.

An envelope says “open when first patient dies”

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Alyssa Burgart, MD, MA (BurgartBioethix) @alyssaburgart.com · 13/07/2025

Know your patients’ rights. Know your rights. Know what’s right. Do no harm. Protect your patients.

ICE and CPB agents should be treated like any other hospital visitor - with restricted access.

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Alyssa Burgart, MD, MA (BurgartBioethix) @alyssaburgart.com · 10/07/2025

This is the core of moral resilience - to choose to have hope in the face of hopelessness. To choose to help despite the sense of helplessness. This is the kind of faith I feel I need every day. The faith to believe there is capacity for change.

When I started the Moral Injury Clinic last year, I knew in my soul and in my bones that there was value in the work of learning about and exploring moral harms in real time, not just for myself, but for other people, aiming to make sense of the pain we experience related to our moral lives.

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Alyssa Burgart, MD, MA (BurgartBioethix) @alyssaburgart.com · 07/07/2025

Season 2 of The Retrievals drops on July 10. Back in 2023, I analyzed each episode in Season 1 - about untreated pain during egg retrievals for fertility care. Before then, catch up at poppiesandpropofol.com for my analysis of all 5 episodes from season 1.

Doctors are sadists who like to play god and watch lesser people scream. - Allison Janney in Juno 2007

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Alyssa Burgart, MD, MA (BurgartBioethix) @alyssaburgart.com · 14/06/2025

The Minnesota assassin had a hit list of abortion providers and activists. This is why I hammer HCWs about home security & digital privacy - esp those in abortion, vaccination, and trans care. Check out the comments for my free guide to understanding and reducing your risk of doxxing.

Hit list was found in shooting suspect’s car with nearly 70 different targets, including abortion providers and lawmakers, officials say

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Alyssa Burgart, MD, MA (BurgartBioethix) @alyssaburgart.com · 30/05/2025

Today, Dr Jenn Conti and I wrote about Adriana Smith’s brain death diagnosis and how Georgia’s anti-abortion law treats women as little more than fetal incubators. Having a uterus shouldn’t mean you get treated less human. www.usnews.com/opinion/arti...

Georgia Shouldn’t Be Allowed to Force a Brain-Dead Woman's Body to Incubate a Fetus

Why abortion bans violate medical ethics.

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Alyssa Burgart, MD, MA (BurgartBioethix) @alyssaburgart.com · 26/05/2025

The pain of an unethical situation is not all in your head. Moral distress and moral injury show up in our bodies and behaviors. 💔

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Alyssa Burgart, MD, MA (BurgartBioethix) @alyssaburgart.com · 12/05/2025

I highly recommend reading the full medical board report on both David Geier (practicing without a license) and his dad - Mark Geier (physician whose license was revoked). The elder Geier died shortly before the younger Grier’s selection. Links to both ⤵️ www.poppiesandpropofol.com/p/dr-christi...

So, during the largest measles outbreak in recent history, RFK Jr tapped a discredited anti-vaccine figure to study this already disproven link. David Geier — who lacks a medical degree and was previously sanctioned for practicing medicine without a license — is reportedly leading the effort. Geier and his father, Mark Geier3 (whose medical license was revoked in several states due to harming patients with dangerous autism “treatments”), have long promoted debunked claims that thimerosal, a vaccine preservative, causes autism.

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Alyssa Burgart, MD, MA (BurgartBioethix) @alyssaburgart.com · 11/05/2025

Laying in a hammock with Sierra, reading about polio and the dawn of modern intensive care.

Foreground - Sierra the Chihuahua. Background - The Autumn Ghost by Hannah Wunsch

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Alyssa Burgart, MD, MA (BurgartBioethix) @alyssaburgart.com · 13/03/2025

Thrilled to be back in Los Angeles for the Ethics of Caring conference. The theme: Everyday Ethics Rooted in Trust Investing in trust & trustworthiness in healthcare has never been more important. Looking forward to learning & growing with these fabulous professionals. #ethics #bioethics #NNEC

Picture of my ethics of caring name badge

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Alyssa Burgart, MD, MA (BurgartBioethix) @alyssaburgart.com · 06/02/2025

We do not have the kind of patterned seasonality as with flu and RSV (winter peaks).

CDC graph: showing COVID is not limited to winter seasonality like other common respiratory illnesses. https://www.cdc.gov/ncird/whats-new/covid-19-can-surge-throughout-the-year.html

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Alyssa Burgart, MD, MA (BurgartBioethix) @alyssaburgart.com · 29/01/2025

And yet Dr Greg Murphy appears to be a full time congressperson…

Screenshot of a post from “congressman Greg Murphy, MD” : #1 reason for MD shortage is med schools admitting students who aren’t going to practice. Only 60% of med students today plan on practicing clinical medicine. Med schools need to focus on admitting students who want to take care of patients, not just get their MD”

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Alyssa Burgart, MD, MA (BurgartBioethix) @alyssaburgart.com · 28/01/2025

There is no justice in indiscriminately rounding up people solely on mere suspicion of an immigration violation. 1000s of citizens unlawfully deported since 2002. Stories below are a sampling from Trump's first presidency. This is not justice. www.latimes.com/archives/sto...

ICE held an American man in custody for 1,273 days. He’s not the only one who had to prove his citizenship

$The wrongful arrests account for a small fraction of the more than 100,000 arrests ICE makes each year, and it’s unclear whether the Trump administration’s aggressive push to increase deportations will lead to more mistakes. But the detentions of U.S. citizens amount to an unsettling type of collateral damage in the government’s effort to remove undocumented or unwanted immigrants. The errors reveal flaws in the way ICE identifies people for deportation, including its reliance on databases that are incomplete and plagued by mistakes. The wrongful arrests also highlight a presumption that pervades U.S. immigration agencies and courts that those born outside the United States are not here legally unless electronic records show otherwise. And when mistakes are not quickly remedied, citizens are forced into an immigration court system where they must fight to prove they should not be removed from the country, often without the help of an attorney.$

Federal policies require ICE agents to “carefully and expeditiously” investigate any claim of U.S. citizenship. But throughout his detention, Carrillo said, ICE officers either ignored or scoffed at his repeated claims. When his son rushed to the downtown booking facility with his father’s passport and citizenship certificate, ICE officers refused to consider the documents, he said.

After he was moved to a privately run immigration detention center 85 miles outside Los Angeles in the Mojave Desert, Carrillo’s hope that ICE would quickly remedy its mistake gave way to a sense of despair.

“Inmates were telling me, ‘You’re not going to see a judge for weeks. In here, you don’t have any rights,’ ” he said. “I started getting real scared: How long was I going to be in here? How could this be happening?”

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Alyssa Burgart, MD, MA (BurgartBioethix) @alyssaburgart.com · 27/01/2025

The majority of studies have been done in military and healthcare space. Many other professions have not been explicitly studied. Also data not collected similarly across studies makes comparisons challenging. Below is an excerpt from healthcare. link.springer.com/article/10.1...

Some evidence suggested that the risk of functionally-impairing moral injury was higher among women (versus men), younger (versus older) HCWs, nurses (versus physicians), those who worked more versus fewer hours, and providers with less experience [13]. Also, the risk of severe moral injury symptoms was lower among individuals who identified as religious/spiritual versus those who did not [14]. The impact of COVID-19 on these prevalence rates is unclear due to the paucity of prevalence estimates for HCW PMIE exposure and moral injury prior to COVID-19. Demonstrating the pandemic’s influence, rates of annual PMIE exposure in HCWs responding to the COVID-19 pandemic decreased from 56% in 2020 to 36% in 2022, when COVID-19 related hospitalizations, deaths, and shortages had declined [15].

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Alyssa Burgart, MD, MA (BurgartBioethix) @alyssaburgart.com · 07/01/2025

Parent were surprised because this nurse was well liked by many families. Their favorite nurse. Always a good reminder that likable is not equivalent with competent, compassionate, or caring. You can like someone who betrays you. You can like someone who breaks your baby’s legs when you’re away.

$“Twelve fractures on a baby?” Hackey said. “I couldn’t even fathom it. I looked at that father and we hugged and cried together.” Hackey said he was shocked to learn of Strotman’s arrest, saying he remembered her as a kind nurse and had no concerns at the time about her care. He said he spoke with other victims’ families who had shown him photos they had taken with Strotman and text messages referring to her as their favorite nurse. (WaPo)$

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Alyssa Burgart, MD, MA (BurgartBioethix) @alyssaburgart.com · 07/01/2025

A white Virginia NICU nurse, Erin Strotman, seriously injured at least 7 infants over more than a year. According to source at DailyMail, majority of these babies were Black. An injured patient’s grandmother, a former NICU nurse, reported a 2023 incident to Child Protective Services.

Henrico County Police announced Friday that Erin Elizabeth Ann Strotman, 26, was arrested in connection with an incident that occurred in November. Police said in a news release that they have reopened all of the cases reporting mysteriously injured babies at the hospital from 2023 and 2024. Officers are combing through hundreds of hours of surveillance footage from the hospital, according to the release, trying to piece together what happened to at least seven babies. (WaPo)

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Alyssa Burgart, MD, MA (BurgartBioethix) @alyssaburgart.com · 07/01/2025

I’ve been speaking about the benefits of trauma-informed care for years - benefits to patients, families and clinicians. The speaking requests are steadily increasing. Feels like a good sign that clinicians are interested in reducing the harms of care that we were trained to tolerate/accept.

Trauma informed care as ethical practice. Trauma informed care practices help HCWs provide better, safer care - especially to patients who have experienced traumatic life events. A commitment to reducing the harms of healthcare also protects clinicians from moral injury.

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Alyssa Burgart, MD, MA (BurgartBioethix) @alyssaburgart.com · 04/01/2025

I’m one of the few people wearing a mask at the airport. It’s wild how this has become such an anomaly, yet people keep wondering why so many people are sick…

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Alyssa Burgart, MD, MA (BurgartBioethix) @alyssaburgart.com · 16/12/2024

My son desperately wanted his favorite old hat fixed. I was on call, so I did it in the most Anesthesia way possible. Tell me about the creative ways you’ve used work-specific tools and tricks. 🧵🪡🧢

My son’s dirty blue and white hat, with a damaged part held together with a tiny bulldog clip. My hand is holding a clamp with a curved surgical needle and thread

Me in my blue scrubs, sewing the hat using surgical needle and thread

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Alyssa Burgart, MD, MA (BurgartBioethix) @alyssaburgart.com · 08/12/2024

“She wants to eat food!” My pal @writingelizabeth.bsky.social on her family’s experience with United Healthcare. Caring for a kid with cancer should be the hardest thing - not dealing with insurance. Thank you @rabcarian.bsky.social at the LA Times for interviewing her. 🙏

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Alyssa Burgart, MD, MA (BurgartBioethix) @alyssaburgart.com · 06/12/2024

Im sad my friend is leaving this job, but so grateful to have supported her along the way. She’s taught me so much! ❤️

Hi Alyssa
I hope you are well. I wanted to let you know that accepted a position with [other hospital].
I appreciate you, the doors you opened and the constant example of what I fucking baddie looks like. From the bottom of my heart thank you.

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Alyssa Burgart, MD, MA (BurgartBioethix) @alyssaburgart.com · 28/11/2024

As you head into festival holiday meals and family gatherings, I hope you can be prepared to avoid high conflict when possible. (11/11)

Thanksgiving table food on white plates on a wooden table. One person is cutting up pumpkin pie, and another is holding a glass.

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Alyssa Burgart, MD, MA (BurgartBioethix) @alyssaburgart.com · 28/11/2024

I am obsessed with learning about navigating everyday conflict. So, I devoured Amanda Ripley's book High Conflict. I walked away with 5 timeless principles for reducing high conflict. Here are the golden takeaways: (1/10)

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Alyssa Burgart, MD, MA (BurgartBioethix) @alyssaburgart.com · 24/11/2024

Don’t like branded bandaids from the pharmacy? Decorate with corgi butts. Go forth my friends. You have the power.

Two kids’ arms with two red bandaids each, all four bandages decorated with cartoon corgi stickers

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Alyssa Burgart, MD, MA (BurgartBioethix) @alyssaburgart.com · 23/11/2024

Loved it there. Got to go back for a few days last summer. Lets me all nostalgic for being nearly off grid for months at a time.

Tooth of Time rock formation in Cimarron, NM

Interesting morning insects on a sunny flower at Philmont Scout ranch

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Alyssa Burgart, MD, MA (BurgartBioethix) @alyssaburgart.com · 16/11/2024

Bluesky Bioethics starter pack - small but mighty. Let me know who I should add. go.bsky.app/J8YLDZ7

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Alyssa Burgart, MD, MA (BurgartBioethix) @alyssaburgart.com · 12/11/2024

HR 6408 aims to target and strip the tax-exempt status of non-profit organizations advocating by labeling them terrorist organizations. Today, HR 6408 is up for a vote Please send a message to your representatives (resist not makes it easy) resist.bot/petitions/PC...

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Alyssa Burgart, MD, MA (BurgartBioethix) @alyssaburgart.com · 20/09/2023

We rescued Sierra Sopaipilla - our little chihuahua-rat terrier-angel ❤️

The cutest sweetest little white dog with giant ears and a black nose. Sitting on a pile of dog beds.

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