iiinova — where your digital self keeps evolving

Robert Kirchoff, MD, FACP, FASAM @kirchoff.org · 27/05/2026

Modern GitHub is crushing it. Somehow they turned writing software into filling out compliance paperwork with anime profile pictures. The entire site has the energy of a workplace safety meeting with mandatory modules.

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Reposted by Robert Kirchoff, MD, FACP, FASAM

Katie Mack @astrokatie.com · 24/05/2026

In chemistry, a supersaturated solution is one where you've kept adding a solute to a liquid beyond where the liquid can dissolve everything. All it takes is a nucleation site / seed crystal for the solution to rapidly (sometimes violently) crystalize. Unrelatedly, the US has more guns than people.

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Robert Kirchoff, MD, FACP, FASAM @kirchoff.org · 23/05/2026

Great to see genuinely useful ecosystem work happen despite GitHub shitting all over everything. Literally turning every dev workflow into a KPI dashboard wrapped around Microsuck copilot upsells and BS engagement farming. Atleast pnpm still remembers software is supposed to solve problems Congrats

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Robert Kirchoff, MD, FACP, FASAM @kirchoff.org · 23/05/2026

“Would you like 14 security alerts, 9 AI suggestions, 3 workflow failures, and a notification about a stale issue from 2017?” “No.” “Perfect. We’ve enabled email notifications too.”

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Robert Kirchoff, MD, FACP, FASAM @kirchoff.org · 11/05/2026

Slightly increase a band Slight doubt

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Robert Kirchoff, MD, FACP, FASAM @kirchoff.org · 11/05/2026

What feelings does this symbol yield when you see it on a website / app? For me, it is the same feeling I have when interacting with multitiered phone menus, or clunky bloatware like office365 and SharePoint. I know I’m in for an annoying experience. #AI #chatgpt #LLM.

The AI symbols, indicating something is AI enabled.

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Reposted by Robert Kirchoff, MD, FACP, FASAM

BK. Titanji @boghuma.bsky.social · 21/04/2026

Warrior or not flu, anthrax, smallpox and meningitis can still prove lethal. All are vaccine preventable or attenuated significantly by vaccination. Only, Idiots will not understand these facts.

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Robert Kirchoff, MD, FACP, FASAM @kirchoff.org · 20/03/2026

As we just posted triple digit temps in Arizona today… in March.

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Reposted by Robert Kirchoff, MD, FACP, FASAM

Colette Delawalla, PhD @cdelawalla.bsky.social · 16/03/2026

Breast cancer mortality dropped 58% from 1975 to 2019. Localized, early detected breast cancer has a 99% 5 year survival rate. Modern mammogram tech was developed by NASA for telescopes. Last year, RFK Jr. cancelled 87 research grants on breast cancer. www.nytimes.com/2026/03/16/u...

nytimes.com

Susie Wiles, Trump’s White House Chief of Staff, Has Breast Cancer

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Robert Kirchoff, MD, FACP, FASAM @kirchoff.org · 11/03/2026

🍄 ➡️ 🚭 ? The future of addiction medicine is so much more than just receptor blockade and suppression of cravings…but rather attention to disruption of rigid neural loops, increasing neuroplasticity, and reprocessing of trauma and behavior in a therapeutic setting #addictionmed #medsky #psychedelics

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Robert Kirchoff, MD, FACP, FASAM @kirchoff.org · 27/02/2026

This is worth talking about. Great study and a potential game changer. #cdiff #IDsky #medsky

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Robert Kirchoff, MD, FACP, FASAM @kirchoff.org · 26/02/2026

My favorite podcast host speaking the truth yet again. I treat patients from Minneapolis every day. I hear their traumas, I hear their stories. I stand with you. This affects all of us.

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Reposted by Robert Kirchoff, MD, FACP, FASAM

REBEL EM @rebel-em.bsky.social · 24/02/2026

🚨 New on REBEL EM! 💨💉 Nebulized TXA for Hemoptysis ⚡ 72% stopped bleeding in 30 min (vs 51% w IV) 📉 Fewer procedures: 25% vs 48% BAE 🌬️ Easy, cheap, non-invasive ✅ Bottom Line: Neb TXA is safe, accessible & effective—but needs more validation. 👉 wp.me/pdrP8b-5om #EMIMCC #FOAMed #MedSky

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Robert Kirchoff, MD, FACP, FASAM @kirchoff.org · 26/02/2026

A few of us were just talking about effecting change in this current climate where nothing matters and everything is what is fed to you. some things were brought to my attention that I didn’t know.It changed my behavior.Does that make @tipperofcows.bsky.social an INFLUENCIAL HERO? I think it does.

you.so

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Robert Kirchoff, MD, FACP, FASAM @kirchoff.org · 26/02/2026

Reskeeting this so that friends in my slack group will see it twice. Some of the most important content @notwes.bsky.social has posted. As my drill sergeants always said to us: “It’s too damn easy to do the right thing”

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Robert Kirchoff, MD, FACP, FASAM @kirchoff.org · 12/02/2026

Check out our team’s latest article in Current Opinion in Toxicology here! 🌿 🔬 💊 👨‍⚕️ Romero, PM, Heard, KJ, Oblizajek, NR, Qadeer, A, Kirchoff, RW, and Leung, MCK. (2026). Cannabis Hyperemesis Syndrome: Pharmacological and Toxicological Perspectives. (In press)

sciencedirect.com

Cannabis Hyperemesis Syndrome: Pharmacological and Toxicological Perspectives

Cannabis hyperemesis syndrome (CHS) is a disorder of gut-brain interaction with symptoms of nausea, severe episodic vomiting, and abdominal pain. The …

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Robert Kirchoff, MD, FACP, FASAM @kirchoff.org · 04/02/2026

🎙️ It was a pleasure to be a guest on the Mayo Clinic Health Matters podcast discussing nicotine dependence. We covered addiction neurobiology, withdrawal physiology, and evidence-based pharmacologic and behavioral strategies that improve cessation outcomes. ▶️ youtu.be/r_o0f8F70ag

youtu.be

Breaking Up with Nicotine: How to Kick a Nicotine Dependency

YouTube video by Mayo Clinic

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Reposted by Robert Kirchoff, MD, FACP, FASAM

Memento (spooky) Morty 🌙 @mementomorty.bsky.social · 31/01/2026

This is life support, by the way. Those medications are keeping the patient alive and if stopped for only a moment would likely result in death. The nurse manages all of that.

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Robert Kirchoff, MD, FACP, FASAM @kirchoff.org · 31/01/2026

No one is going to save you. Certainly not 911. It’s over. The saddest days are ahead. 😕

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Robert Kirchoff, MD, FACP, FASAM @kirchoff.org · 29/11/2025

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Robert Kirchoff, MD, FACP, FASAM @kirchoff.org · 27/11/2025

Wishing everyone a very anti-MAGA thanksgiving. May your holidays be filled with tolerance, peace, and a complete absence of xenophobia.

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Robert Kirchoff, MD, FACP, FASAM @kirchoff.org · 12/11/2025

Encouraging news: COVID-era telehealth rules for addiction meds are likely extended again. Not yet official, but reassuring that these vital services will remain in place for those who need them most. Barriers to treatment are steep—telehealth bridges the gap.

statnews.com

Covid-era rules for addiction medication, Ritalin are extended again

For a fourth time, the government avoids making permanent policy on telehealth prescriptions of controlled medications for addiction and ADHD.

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Robert Kirchoff, MD, FACP, FASAM @kirchoff.org · 27/10/2025

This one took a while to get accepted, but we are excited to take this off the project dashboard. Congrats all! #pocus #research #academicmedicine

mdpi.com

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Robert Kirchoff, MD, FACP, FASAM @kirchoff.org · 13/06/2025

It’s almost as though non-scientists /cognitively deficient conspiracy theorists shouldn’t be making decisions that impact public health. 🤷🏽 #medsky

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Robert Kirchoff, MD, FACP, FASAM @kirchoff.org · 06/03/2025

Outcomes: Patient stays home —>??? Patient brings positive at-home test to ED —> ED orders D-Dimer Patient brings negative at-home test to ED —> ED orders D-dimer Patient presents to ED with no at-home test —> ED orders D-dimer <pre-test probability has entered the chat> #medsky

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Robert Kirchoff, MD, FACP, FASAM @kirchoff.org · 05/03/2025

Webdesigners and DBA’s: if you are going to authenticate using an email address as username, don’t make the field case sensitive.

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Reposted by Robert Kirchoff, MD, FACP, FASAM

Sam Wang @samwang.bsky.social · 03/03/2025

Note: obviously I'm kidding about the collapse. That has already happened. Normal work at NIH to review grants is nearly completely blocked. And $1 billion has been blocked from going out the door. My work, and thousands of projects like it around the nation, are about to grind to a halt.

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Reposted by Robert Kirchoff, MD, FACP, FASAM

Peter Gleick @petergleick.bsky.social · 04/03/2025

Dear universities, scientists, lawyers, farmers, workers, artists, doctors... Being silent won't protect you.

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Reposted by Robert Kirchoff, MD, FACP, FASAM

Elinne Becket, PhD @bielleogy.bsky.social · 03/03/2025

Friendly reminder: if you are waiting on something from a US-based scientist/reviewer/editor, please realize that we're barely making it through each day putting out non-stop fires and trying not to collapse into tears. We're trying our best, but things will take longer right now. Give grace.

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Robert Kirchoff, MD, FACP, FASAM @kirchoff.org · 04/03/2025

My disrupted sleek-wake cycle allowed me to stumble upon this…#90sky (if that tag isn’t a thing it should be)

died-of-dysentery.com

You Have Died of Dysentery: The Oregon Trail Game

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Reposted by Robert Kirchoff, MD, FACP, FASAM

Dr. Jack Brown @drjackbrown.bsky.social · 04/03/2025

Volodymyr Zelenskyy is the Leader of the Free World.

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Reposted by Robert Kirchoff, MD, FACP, FASAM

Nephrology Journal Club @nephjc.bsky.social · 26/02/2025

Hypertension is rises, and HyperAldo is back on #NephJC! #NephJCld MRAs be stopped for "safety," or are we overthinking it? 🤔 Are we following guidelines or just adding complexity? 🔥 #NephMadness is around the corner—let’s revisit 2019 data! #NephJC

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Robert Kirchoff, MD, FACP, FASAM @kirchoff.org · 28/02/2025

The sharply dressed men of the Republican Party. Definitely well positioned to be giving advice on professional attire. 👍

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Robert Kirchoff, MD, FACP, FASAM @kirchoff.org · 28/02/2025

A friendly reminder: This could have been avoided

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Robert Kirchoff, MD, FACP, FASAM @kirchoff.org · 28/02/2025

For the seventh consecutive year, Newsweek has ranked Mayo Clinic as the No. 1 hospital in its annual “World’s Best Hospitals” list.

newsnetwork.mayoclinic.org

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Robert Kirchoff, MD, FACP, FASAM @kirchoff.org · 26/02/2025

Post-call delirium makes this ever funnier. #medsky

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Robert Kirchoff, MD, FACP, FASAM @kirchoff.org · 25/02/2025

Even with all the chaos and new policy driven threats to public health, antibiotic stewardship remains critically important and actionable by all prescribers of antimicrobial medications. #medsky #IDsky

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Reposted by Robert Kirchoff, MD, FACP, FASAM

The Liberator 🦋 @drnancysp.bsky.social · 25/02/2025

💯

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