iiinova — where your digital self keeps evolving

Dr Dave Triska @davetriska.bsky.social · 23/05/2026

📝 The Drag We call it rebirth. A new person, a fresh start. But what if nobody asked for the new person? And what if the drag has no top, no badge, no end? A dusty bike. A mouldy tent. A wet hillside, twenty years ago. 👇👇👇👇 open.substack.com/pub/davetris...

open.substack.com

The Drag

The wall hook

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Dr Dave Triska @davetriska.bsky.social · 05/05/2026

📒The Lull What if hope wasn't the thing that kept you safe? What if hope was the thing that left the door open for the shadow to walk back in? A chair. A tremor. Damage with no marks. 👇👇👇👇 open.substack.com/pub/davetris...

open.substack.com

The Lull

I am sat in a chair, alone.

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Dr Dave Triska @davetriska.bsky.social · 04/05/2026

📝 The Bunker In month six in Kandahar we stopped flinching at incoming rounds. In a consulting room in February we stopped flinching at sixty-four week waits. The threshold moved. Nobody agreed to move it. 👇👇👇👇 davetriska.substack.com/p/the-bunker...

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Dr Dave Triska @davetriska.bsky.social · 25/04/2026

Fantastic experience at the Charlie and The Chocolate Factory afternoon tea. One Aldwych in London.

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Dr Dave Triska @davetriska.bsky.social · 22/04/2026

Big steps again with Rose 🌹 the rescue eating for the first time with her sister Molly

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Dr Dave Triska @davetriska.bsky.social · 18/04/2026

Saturday night is all about Mind Enterprises and Campari 🇪🇺 music.apple.com/gb/album/tut...

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Dr Dave Triska @davetriska.bsky.social · 17/04/2026

📒I cried in a treatment room recently. Nothing bad was happening. That was the thing. New piece. The Visitor's Chair. 👇👇👇👇 open.substack.com/pub/davetris...

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Dr Dave Triska @davetriska.bsky.social · 16/04/2026

📝 The Fog What if the delusion wasn’t that you were failing? What if it was believing you were ever at the wheel? One drive home. One windscreen clearing. 👇👇👇👇 open.substack.com/pub/davetris...

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Dr Dave Triska @davetriska.bsky.social · 14/04/2026

6 months after we rescued her, Rose 🌹 finally chose to eat inside with Mrs T there - never been with us like that before. Bittersweet for me after months of inching her bowl millimeters closer to the house, but awesome. She keeps coming back and staring at the door - badly wants to be inside🥹

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Dr Dave Triska @davetriska.bsky.social · 13/04/2026

11:39. Just really tired. External services emailing problems across that they could solve themselves because we're the path of least resistance. 629 tasks. 24 staff. 249 minutes. One practice. One Monday morning. This is general practice. This is what we do. Every single day.

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Dr Dave Triska @davetriska.bsky.social · 13/04/2026

It doesn't count prescriptions, documents, results, medication reviews. Or the 999-level emergency that came through the online triage form at 10:10, caught in a 30-second lull because someone was watching carefully.

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Dr Dave Triska @davetriska.bsky.social · 13/04/2026

10:48. The national GP Partners group was discussing workload. One practice reported 228 requests per 22,000 patients. We had 150. The metric only counts requests.

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Dr Dave Triska @davetriska.bsky.social · 13/04/2026

10:25. The inbox had slowed. The room was quiet. I could see a bird outside the window. The waiting room was empty. My head was not. Home visit out in the field. Dispensary flow. Referral that needs more than a yes. None of it in any data field. All of it here.

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Dr Dave Triska @davetriska.bsky.social · 13/04/2026

Somewhere around 09:30 I made a tea. Left the bag in - no time to wait for it to brew. Sat back down to six new appointment requests. The mug went cold on the desk.

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Dr Dave Triska @davetriska.bsky.social · 13/04/2026

09:05. My colleague left triage. For the next three hours, I was the only GP managing acute demand for 11,500 patients. I noticed this. There was no time to do anything about noticing it.

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Dr Dave Triska @davetriska.bsky.social · 13/04/2026

At no point this morning was there a queue in our waiting room. Every patient arrived to an appointment. Some people have complained we don't look busy enough. A packed waiting room isn't a sign a practice is working hard. It's a sign demand is outstripping management.

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Dr Dave Triska @davetriska.bsky.social · 13/04/2026

08:06. The Monday flurry. Sore ears, sore throats, coughs. "Just send them to the pharmacist." We do. Except someone has to own the clinical decision first - the safety netting, the judgement call, the assessment of whether this cough is viral or the start of something

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Dr Dave Triska @davetriska.bsky.social · 13/04/2026

By 08:01 - one minute after we opened - we were at 154 tasks. The number that appears in NHS workload reports, the one practices get compared on, is the request count. The difference is the unrecorded workload nobody talks about.

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Dr Dave Triska @davetriska.bsky.social · 13/04/2026

7:40. I've just walked in. The doors don't open for another twenty minutes. 113 tasks are already done. Prescriptions processed, documents reviewed, results filed. The pharmacies and dispensaries are waiting on those scripts. The day started before I arrived.

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Dr Dave Triska @davetriska.bsky.social · 13/04/2026

🧵A Monday morning in general practice. One small rural GP surgery in Surrey. Real numbers from a real working day. Here's what happened between 07:30 and noon.

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Dr Dave Triska @davetriska.bsky.social · 12/04/2026

A little bit of sibling rivalry today (the good kind). Rose is figuring out if it’s worth venturing from her den to compete with our tiny pug for some liver treats. Getting better by the day

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Dr Dave Triska @davetriska.bsky.social · 12/04/2026

There’s a meditation program on Meta called Tripp which is absolutely lovely. Just putting yourself somewhere serene and calm is quite wonderful.

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Dr Dave Triska @davetriska.bsky.social · 12/04/2026

📝 The Heaviness You carry it for long enough and you forget you’re leaning. You call it love. You call it coping. You don’t know what you look like underneath. One hallway. Twenty heartbeats. The moment the weight came off. 👇👇👇 👇 open.substack.com/pub/davetris...

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Reposted by Dr Dave Triska

Zack Polanski @zackpolanski.bsky.social · 11/04/2026

Yesterday the Green Party WON in Margate. Today I campaigned with teams in Hackney, Southwark, Lewisham and Newham - ready to do it too! All so fired up and ready to win on May 7th. Let's go! 💚🚀 Join.greenparty.org.uk (📸 - Aldoshoots)

Zack with some of the candidates in Southwark

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Reposted by Dr Dave Triska

Dr Steve Taylor @drstevetaylor.bsky.social · 11/04/2026

What nobody sees In the old model - the one I trained in, the one they dismantled - these threads would have sat in the same building. The man’s script, the son’s behaviour, the wife’s exhaustion You’d have pulled the threads. I don’t have threads. I have encounters A must read

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Reposted by Dr Dave Triska

Huw Willliams @huwpenylan.bsky.social · 11/04/2026

This is very good. I’ve sat with families just like this for about 10 years now - and have really only just started to feel the benefits of that continuity I can now bring to the room. Takes time

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Dr Jo Maher NHS GP @drjomaher.bsky.social · 11/04/2026

….’That’s what continuity is. Not a policy word. Not a contractual metric. Not a slide on a presentation about neighbourhood health. It’s the thing that lets you see the whole cloth when everyone else is looking at individual threads.’ Brilliant writing by @davetriska.bsky.social thank you 🙏🏽

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Reposted by Dr Dave Triska

Sarah M @sarah-owl.bsky.social · 11/04/2026

This is so powerful and reflects what continuity with a GP means. It rings true as both a doctor (not my specialty but we have more depth of input than many specialties which gives some of these moments) but even more so as a patient in a practice with good continuity and compassionate care

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Dr Dave Triska @davetriska.bsky.social · 11/04/2026

Ah! Thanks must have messed the copy paste up

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Dr Dave Triska @davetriska.bsky.social · 11/04/2026

📝 The Transaction Who will hold the threads of a community in 5 years? A companion piece to What You Can’t Measure (link below, read first) 👇👇👇👇 open.substack.com/pub/davetris...

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Dr Steve Taylor @drstevetaylor.bsky.social · 11/04/2026

This is where medicine moves from a mere matter of measurement & data to an art There is nuance, understanding, empathy, knowledge, kindness, compassion, being inquisitive This cannot be replaced & needs to be saved #TeamGP

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Dr Dave Triska @davetriska.bsky.social · 10/04/2026

📝 What you can’t measure What happens when a GP sees something others couldn’t reach? What if the instrument wasn’t training - it was years of knowing a community? Who measures what matters? One room. One family. One conversation. 👇👇👇👇 open.substack.com/pub/davetriska…

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Dr Steve Taylor @drstevetaylor.bsky.social · 09/04/2026

‘Not the NHS Again!’ A new podcast series released every Friday. This week ‘The GP employment crisis’ with GPs Dr Sarah Jacques, Dr Neena Jha and Dr Steve Taylor youtu.be/bT08Zoj7F3A?...