iiinova — where your digital self keeps evolving

Josh Trebach, MD @jtrebach.bsky.social · 22/09/2026

don’t make fun of neurologists until you walk a myelin their shoes

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Josh Trebach, MD @jtrebach.bsky.social · 06/09/2026

sadly this is not the worst cpr i have seen

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Josh Trebach, MD @jtrebach.bsky.social · 01/09/2026

didn’t think I needed to say this but epipens do not contain beta blockers and this home brew “allergy kit” is not a substitute for an actual epipen

Post that says: AN EMT taught me a secret many years ago.
An epipen is medicine that includes both types of beta blockers designed for rapid release.
You can make your own allergy kit at home.
Take Benadryl, and Pepcid AC with a glass of water that has had a small amount of Epson salt dissolved.
This cocktail works just as well as an epipen and costs almost nothing.

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Josh Trebach, MD @jtrebach.bsky.social · 24/08/2026

As an ER doctor I hate these e-bikes… Please wear a helmet Don’t drink alcohol and e-bike Don’t carry a baby while riding an e-bike Don’t e-bike after taking your blood thinners and reminiscing about your last hip fracture

Graph titled Estimated e-bike injuries treated in U.S. emergency rooms, 2020-2025
National estimates extrapolated from the CPSC NEISS hospital sample.

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Josh Trebach, MD @jtrebach.bsky.social · 17/07/2026

Reposting this thread now that people are studying for tox boards and other tests!!! Good luck :)

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Josh Trebach, MD @jtrebach.bsky.social · 26/06/2026

stop telling yourself you deserve a sensitive man you deserve a sensitive AND specific man

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Josh Trebach, MD @jtrebach.bsky.social · 14/06/2026

If the human body was an amusement park would the nephron or the semicircular canals be a better rollercoaster

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Josh Trebach, MD @jtrebach.bsky.social · 02/06/2026

friendly reminder that sometimes your patient isn’t “confused” or “altered” or “demented” they literally just need their hearing aids

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Josh Trebach, MD @jtrebach.bsky.social · 27/04/2026

currently in the phase of my life where all my shirts need texture

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Josh Trebach, MD @jtrebach.bsky.social · 21/04/2026

one time in med school I asked a doctor for feedback and he told me that I was stapling the patient lists together with the staple in the incorrect orientation and that a diagonal staple was not appropriate and it needed to be a horizontal staple so I laughed but he did not laugh

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Josh Trebach, MD @jtrebach.bsky.social · 08/04/2026

one time in med school we learned about a disease that gives you silver stools and I was like “woah I wonder what that looks like” so I googled it and idk what I was expecting

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Josh Trebach, MD @jtrebach.bsky.social · 20/03/2026

we joke in the ER that “chief complaints come in threes” so after two people came in after slipping/falling on ice i was like “okay who’s next” but a third never came in anyways i got off shift, walked to my car, and i

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Josh Trebach, MD @jtrebach.bsky.social · 03/03/2026

*be me in airport* me: person: hi Dr Trebach me: oh hey (who is this person? are they a patient? a student? why can’t I remember? Omg I’ve been thinking too long now it’s getting uncomfo—) person: u dropped this *hands me my hospital badge that says Dr Trebach*

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Josh Trebach, MD @jtrebach.bsky.social · 11/02/2026

it kind of sucks that you can randomly dislocate your jaw from yawning and then you have to go to the ER so we can pop it back into place

Skull drawing showing anterior dislocation of mandible

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Josh Trebach, MD @jtrebach.bsky.social · 23/01/2026

got a space heater and I was like “omg it’s so cute its saying hi to us!!” and my husband was like “no u doofus that is the power setting” 🙃

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Josh Trebach, MD @jtrebach.bsky.social · 17/01/2026

nothing will betray you faster than the front shirt pocket of hospital scrubs one lean forward and your pens and dignity end up on the floor

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Josh Trebach, MD @jtrebach.bsky.social · 09/01/2026

ER doc here. I’ve seen patients walk out during heart attacks and other life-threatening emergencies because no one could feed their pets at home. Imagine the lives saved if free emergency pet care existed.

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Josh Trebach, MD @jtrebach.bsky.social · 15/12/2025

Hi, medical toxicologist/ER doctor here 👋 here’s what you need to know about medetomidine in the illicit opioid supply

New York Times headline: A Powerful New Drug Is Creating a 'Withdrawal Crisis' in Philadelphia
Medetomidine, a veterinary sedative, mixed into fentanyl has sent thousands to hospitals, not only for overdose but for life-threatening withdrawal. It is spreading to other cities.

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Josh Trebach, MD @jtrebach.bsky.social · 07/11/2025

one time I was driving home and I saw a small crowd around someone who looked dead so I pulled my car over and checked for a pulse and then started cpr on the sidewalk and while I was doing cpr a bystander tried to STEAL MY CAR KEYS

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Josh Trebach, MD @jtrebach.bsky.social · 03/11/2025

nurse: doctor josh can you please tell my son that he shouldn’t eat too much candy me: ugh yeah one time I ate so much sour candy that my tongue started peeling it was soooo painful nurse: oh wow how old were you me: …….yesterday

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Josh Trebach, MD @jtrebach.bsky.social · 27/10/2025

one time in college I took an exam thinking “wow this is way harder than I expected” and the professor walked by and gasped because she’d given me (AND ONLY ME??) an exam from a different course. Every hard exam since I was like IS IT HAPPENING AGAIN? IT CAN’T HAPPEN TWICE RIGHT?

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Josh Trebach, MD @jtrebach.bsky.social · 22/10/2025

people named barb are so lucky because they can be like “my name is short for phenobarbital” and no one can argue with them

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Josh Trebach, MD @jtrebach.bsky.social · 18/10/2025

didn’t think this needed to be said but please don’t put urine in your eyes

Social media post where someone is describing putting urine in their eyes and then having their eyes get red and have pus

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Josh Trebach, MD @jtrebach.bsky.social · 16/10/2025

when I was a resident, a mysterious ER nurse used to leave a cookie on my desk after I did a good job with a sick patient. Years later, no cookies appear…but after every resuscitation I still crave one….a Pavlovian echo of a kindness that never quite left me 🍪

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Josh Trebach, MD @jtrebach.bsky.social · 02/10/2025

*be me in med school* me: ok remember these 3 words—book, cat, potato. I’ll ask again in 5 min to test your memory patient: ok *5min later* patient: book, cat…uhhh…what was the third one? me: ……. patient: did u forget too me: …………yeah

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Josh Trebach, MD @jtrebach.bsky.social · 01/10/2025

just Bucket (orange) and Pebble (grey) being gamer kitties

Orange cat and grey cat on top of Simpsons arcade cabinet

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Josh Trebach, MD @jtrebach.bsky.social · 21/09/2025

*me working in pediatrics ER* kid: do u play video games kid’s dad: he’s a doctor of course he doesn’t play video games me:

Marge looking concerned and then Marge covering her mouth while smiling

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Josh Trebach, MD @jtrebach.bsky.social · 20/09/2025

thank goodness for this useless infographic now we know the cure for cancer is “minerals”

“You’re not sick your body is starving” infographic that lists a bunch of diseases and things your body is “lacking”

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Josh Trebach, MD @jtrebach.bsky.social · 16/09/2025

chew your food please or it will get stuck in your esophagus and then you will have to go to the ER and yes the culprit almost always is steak

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Josh Trebach, MD @jtrebach.bsky.social · 08/09/2025

got a new kitten from the shelter and we named her Pebble and I was worried that our adult cat Bucket would be upset but it has been less than 2 weeks and I woke up this morning to this 🥰

Orange cat (Bucket) cuddling with dilute tortie (Pebble)

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Josh Trebach, MD @jtrebach.bsky.social · 04/09/2025

if you post a video on social media making fun of your patients body fluids you deserve to be fired and never see patients again

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Josh Trebach, MD @jtrebach.bsky.social · 02/09/2025

not sure what is more impressive—an IV placed in the forehead, or the fact that it was documented as “IV-head”

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Josh Trebach, MD @jtrebach.bsky.social · 26/08/2025

fun fact: this is chocolate agar and it’s used to grow gonorrhea less fun fact: it does not contain chocolate medical fact: a 3yo child ate a culture dish of chocolate agar in his moms car (she was a microbiology lab tech) and the kid got throat gonorrhea :(

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Josh Trebach, MD @jtrebach.bsky.social · 23/08/2025

accidentally said fresh frozen pizza instead of fresh frozen plasma I think I need some pizza

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Josh Trebach, MD @jtrebach.bsky.social · 21/08/2025

its time I come forward with the truth: I love the watery powdered eggs that hotels have at their free continental breakfast AND I AM NOT ASHAMED

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Josh Trebach, MD @jtrebach.bsky.social · 13/08/2025

in honor of National Left-Handed Day, here is an exchange I had with a surgeon when I was in medical school *in operating room* surgeon: hold this tool in your right hand me: i’m left handed actually surgeon: no you’re not me: oh ok my bad

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Josh Trebach, MD @jtrebach.bsky.social · 07/08/2025

👋 medical toxicologist here and I am begging people to not take this gas station “wellness” drink want to know why?? 🧵

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Josh Trebach, MD @jtrebach.bsky.social · 31/07/2025

Which antibiotic is most likely to make a huge bid at an auction? Macrobid!!!!

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Josh Trebach, MD @jtrebach.bsky.social · 28/07/2025

rolled my ankle in my hospital clogs and saw my life flash before my eyes

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Josh Trebach, MD @jtrebach.bsky.social · 23/07/2025

do NOT google image “carbuncle” expecting to see the cute fox creature from final fantasy unless you want to learn what a carbuncle actually is

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Josh Trebach, MD @jtrebach.bsky.social · 14/07/2025

*me in med school* doctor: welcome to your first shift in the ER! me: yay doctor: make sure you wear a lanyard that emergency releases when pulled or someone could strangle you with it! me: wait wha— doctor: ok let’s go see our first patient!

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Josh Trebach, MD @jtrebach.bsky.social · 03/07/2025

Saw Les Mis the other day. Honestly it reminds me of the emergency department bc everyone is either bleeding or singing or desperately trying to do their job.

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Josh Trebach, MD @jtrebach.bsky.social · 27/06/2025

do I hate that this exists or do I hate that I would try it

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Josh Trebach, MD @jtrebach.bsky.social · 27/06/2025

labubu this labubu that…its giving labubonic plague and im terrified i might catch it

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Josh Trebach, MD @jtrebach.bsky.social · 26/06/2025

i’m not interested in your beer menu JUST 👏 SHOW 👏 ME 👏 THE 👏FRIES

Gay man wearing black shirt with red flowers seeking attention

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Josh Trebach, MD @jtrebach.bsky.social · 24/06/2025

went for a run and saw a gorgeous red flower among a bunch of dandelions so I ran closer and it was just a fire hydrant nature really is beautiful sometimes 🥰

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Josh Trebach, MD @jtrebach.bsky.social · 18/06/2025

Peckingham Palace (my bird feeder with a camera in it) caught this diva having a little snack!!!!! what should I name her

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