iiinova — where your digital self keeps evolving

Ed Miles @brisgasdoc.themiles.es · 01/10/2026

“I have told everyone I am a traitor by mistake!” #traitors #traitorsuk #celebritytraitors

Richard E Grant and Paul McGann soaking wet in the rain during a scene from Withnail & I. The quote is, “We have gone on holiday by mistake!”

Ed Miles @brisgasdoc.themiles.es · 16/07/2026

I’ll let you know when I’ve solved it for a distraught 12yr old. All I have to offer so far is that I think it gets marginally less distressing with each passing international campaign. Sad to watch their cynicism build with each one, though.

Jackson Lamb (from Slow Horses): “It’s not the hope that kills you. It’s knowing it’s the hope that kills you, that kills you.”

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Ed Miles @brisgasdoc.themiles.es · 12/07/2026

Great news. Our boy Milo disappears for 7-10d at a time, several times a year. The first 10-15 times it happened we were distraught, out searching etc. Now we’ve worked out that he will come home just as soon as one of us voices a genuine concern that he might actually be dead this time.

Milo the cat, demonstrating a coquettish “what, you missed *me*” vibe after being missing for almost a fortnight.

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Ed Miles @brisgasdoc.themiles.es · 02/09/2025

It says, “2:00 PM THE PRESIDENT makes an announcement.” It doesn’t say Donald Trump.

Kyle Cheney posting a screen shot of the White House posting that at 2:00 PM today the president will make an announcement.

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Ed Miles @brisgasdoc.themiles.es · 16/08/2025

Whilst we are on the subject of seagulls, I thought I’d share this wonderful @globalportraitproj.bsky.social original. It hangs with pride of place over my desk at home. Watercolour on anaesthetic chart. By far and away the best work of art I will ever own.

An original watercolour painting of seagulls diving into an ocean, painted by an anaesthetist colleague of mine on one of our anaesthetic charts.

The seagulls are painted over the area of the chart where the blood pressure is normally recorded. On an anaesthetic chart the arrows indicating the blood pressure are sometimes referred to as “seagulls”.

The ocean into which the seagulls are diving is painted over the portion of the chart where the fluids given to the patient are documented.

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Ed Miles @brisgasdoc.themiles.es · 08/08/2025

New DIY achievement unlocked. As a true professional, I followed the NHS Digital Lock SOP and wrote the code on the window frame next to the gate.

A newly fitted digital gate lock. Don’t worry about the terrible broken wood around it 😳

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Ed Miles @brisgasdoc.themiles.es · 27/07/2025

Makes it appear in this list…

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Ed Miles @brisgasdoc.themiles.es · 25/07/2025

Zuck has shut off my dopamine supply at source. Gave an option to have a temporary ban reviewed, when I clicked it I was immediately told the result of my review was that I was banned. Feels like an automated system gone rogue. Genuinely no clue what I could have done otherwise. #FreeTheWhatsAppOne

A screen shot of WhatsApp telling me I have received a permanent ban with no recourse for a review.

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Ed Miles @brisgasdoc.themiles.es · 15/05/2025

Thanks for posting, @robjimfleming.bsky.social - I am sad not to be there this year. When the scientific update comes, please can you confirm if epidurals still work and whether 2.5mL remains an acceptable spinal dose? #OAA25ASM

A complicated equation to calculate the dose (in millilitres) of 0.5% Heavy Bupivacaine for spinal anaesthesia in obstetrics. The formula sums 0.2 times the weight in kilograms, 0.3 times the height in centimetres, and the square root of the mother’s parity. It then subtracts the foetal gestational age in weeks divided by 25. The total is multiplied by zero with 2.5 added to the result.

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Ed Miles @brisgasdoc.themiles.es · 28/04/2025

Since when was Danny Baker a cardinal? #Conclave

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Ed Miles @brisgasdoc.themiles.es · 21/04/2025

It’s the “Truss Effect” all over again.

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Ed Miles @brisgasdoc.themiles.es · 20/04/2025

It’s hard to pinpoint where it all went wrong…

A cartoon showing a large group of men facing a small group of women. The men are saying: “So ladies, thanks for being the first to witness the resurrection and we’ll take it from here.”

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Ed Miles @brisgasdoc.themiles.es · 18/04/2025

Yep, absolutely no confusion here whatsoever.

A screenshot from a Supreme Court ruling that there isn’t any confusion about PAs being doctors that incorrectly names the Royal College of Physicians (doctors) the Royal College of Physicians Associates (not doctors).

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Ed Miles @brisgasdoc.themiles.es · 16/03/2025

Bit late, but I liked this one…

A bottle of Caesar salad dressing with a knife in it and a message saying “Happy Ides of March”

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Ed Miles @brisgasdoc.themiles.es · 25/01/2025

Quite literally for the love of God, it’s all there in the book your orange antichrist is peddling. “And who is my neighbour?” I think Jesus quite famously gave a good answer to this, although Speaker Johnson will no doubt consider it too woke to mention. Luke 10:24-37.

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Ed Miles @brisgasdoc.themiles.es · 21/12/2024

Note to our American cousins, this manoeuvre is referred to a “Doing a Truss” and will inevitably be frowned upon by the left-wing blob known as “The Fed” and “Wall Street”. Have your lettuces at the ready, lads…

A highlighted paragraph from an article in The Guardian (21st December 2024) which reads: “Democrats decried the new bill as a cover for a tax cut to benefit wealthy backers such as Musk, while creating trillions of dollars in additional debt for the US. Several Republicans also rebelled, outraged by the proposed lifting of government borrowing limits.”

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Ed Miles @brisgasdoc.themiles.es · 18/12/2024

Have a read of “17 pencils and an FRCA” anaesthetists.org/Portals/0/PD... Whilst it can definitely feel it, you are not alone. I can guarantee that in your current department you will have consultant colleagues who deferred success on one or more occasion during their exam journey.

An image of an article in Anaesthesia News titled: “17 pencils and an FRCA”.
The article is about a colleague who took multiple attempts to pass professional postgraduate exams in anaesthesia.

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Ed Miles @brisgasdoc.themiles.es · 21/11/2024

Congratulations to my #oneNBT colleagues who, I am reliably informed, have just won the #HSJ “Towards Net Zero” award. Couldn’t be more proud of the work they are doing in building a sustainable organisation.

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Ed Miles @brisgasdoc.themiles.es · 20/11/2024

Kicking off our joint Severn/Peninsula Foundation Schools meeting, #OrthoPriority from Yeovil - a professional game to support development of prioritisation skills for junior T&O resident doctors.

A colleague presenting OrthoPriority - a professional game to help junior residents develop their prioritisation skills.

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Ed Miles @brisgasdoc.themiles.es · 18/11/2024

Another reason why standalone #DepthOfAnaesthesia monitoring is superior to the modules purchased to augment standard monitoring. Until they can show me the DSA, the modules simply are not worth it from a clinician-reassurance, nor burst-suppression-avoidance, point of view.

A digital spectral array representation of a processed EEG monitor demonstrating specific high frequency bands (consistent with interference) superimposed on a pattern consistent with anaesthesia.

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Ed Miles @brisgasdoc.themiles.es · 16/11/2024

Settling in for an evening with @xkcd.com at The Forum in Bath. Packed house, should be a good night.

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Ed Miles @brisgasdoc.themiles.es · 09/09/2023

Will this one do? It’s a neighbourhood cat we think is called Adolf 😬

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