iiinova — where your digital self keeps evolving

Lakshman Swamy (he/him) @laxswamy.bsky.social · 03/02/2026

a snippet about the ICU and rounding from my novel. A song that broke my heart and a poem that mended it. and a rant. hope you find something it. open.substack.com/pub/lswrites...

open.substack.com

Think Easy, Light, Smooth, and Fast

Tell me about despair, yours, and I will tell you mine.

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Lakshman Swamy (he/him) @laxswamy.bsky.social · 30/01/2026

My second post is about writing as healing, living infinitely in the moment, and this. open.substack.com/pub/lswrites...

Lady macduff in Macbeth just before she and her children are murdered by the state:

Whither should I fly?
I have done no harm. But I remember now
I am in this earthly world, where to do harm
Is often laudable, to do good sometime
Accounted dangerous folly. Why then, alas,
Do I put up that womanly defense
To say I have done no harm?

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Lakshman Swamy (he/him) @laxswamy.bsky.social · 30/01/2026

My second post is about writing as healing, living infinitely in the moment, and this. open.substack.com/pub/lswrites...

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Lakshman Swamy (he/him) @laxswamy.bsky.social · 30/01/2026

hi everyone I do not use bsky much but I am now on substack if you are interested! substack.com/@lswrites/p-...

substack.com

Identity is an eternal question mark

until you die.

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Lakshman Swamy (he/him) @laxswamy.bsky.social · 30/01/2026

hi everyone I do not use bsky much but I am now on substack if you are interested! substack.com/@lswrites/p-...

substack.com

Identity is an eternal question mark

until you die.

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Rana Awdish MD @ranaawdish.bsky.social · 21/10/2025

#CHEST2025 After Hours live storytelling event was 🔥🔥🔥 with baby gorillas and tales of being lost at sea and near drowning and break dancing! @chriscarrollmd.com @avrahamcoopermd.bsky.social @laxswamy.bsky.social

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Lakshman Swamy (he/him) @laxswamy.bsky.social · 20/06/2025

The corporate perception of imagination: it needs clarity and focus 🙃

"staying active is a powerful source of drive. It strengthens our bodies and lights up our minds - bringing clarity and focus to our imagination"

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Lakshman Swamy (he/him) @laxswamy.bsky.social · 17/06/2025

Sharing at my first ever workshop this week! #amwriting

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Alice Blanchard @alicebooks333.bsky.social · 11/06/2025

Try not to compare yourself to other authors. Writing's a long game, and other writers are looking at you wishing they could be where you are. So keep going, we're in this together. #5amwritersclub #amwriting #writerslife #WIP #poetry #wattpad #amreading #writingcommunity #writerscommunity

media.tenor.com

a group of people standing in a living room with pretty shows on the bottom right

ALT: a group of people standing in a living room with pretty shows on the bottom right

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Faye Rapoport DesPres @fayerd.bsky.social · 12/06/2025

Good morning, #5amwritersclub. I just received this link to my six-sentence story published today in Gooseberry Pie Literary Journal today. Enjoy (and remember: you don’t always have to write thousands of words). gooseberry-pie.com/survivors-ki... #microfiction #flash

gooseberry-pie.com

Survivors’ Kids At Carcassonne - Gooseberry Pie Lit Magazine

Photo by Mak on Unsplash by Faye Rapoport DesPres At Carcassonne we bought cheese and baguettes and stuffed them into our backpacks. We’d arrived overnight on a Paris train, weary from sleeping in a c...

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Carolyn Barber, MD @cbarbermd.bsky.social · 03/06/2025

He needed air. The price was $539. When OptumRx dropped coverage of his $66 inhaler, Cole couldn’t afford the new price. 5 days later, he died from a severe asthma attack—with no inhaler. He paid with his life. www.nbcnews.com/nightly-news... #MedSky #SciSky #PedsSky #PulmSky

nbcnews.com

22-year-old dies after being unable to afford asthma inhaler

In our new series “The Cost of Denial,” NBC News’ Anne Thompson reports on the young man who went to refill his asthma inhaler only to find it unaffordable because it was no longer covered by his insu...

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Dr. Annie Andrews @drannieandrews.com · 29/05/2025

This is going to be a different type of campaign. Because when you’re going after Medicaid and even ripping food away from hungry kids, all to cut taxes for donors and corporate lobbyists, we’re not pulling punches. I hope you’ll join us: secure.actblue.com/donate/loc_a...

secure.actblue.com

Elect Annie Andrews

Donate to send Annie to the Senate!

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Dr. Annie Andrews @drannieandrews.com · 29/05/2025

I'm Dr. Annie Andrews. I’m a pediatrician, not a politician. But either way I know how to handle people who are full of sh*t. Today I am announcing my campaign for US Senate to replace Lindsey Graham. Share this if you're with me. www.youtube.com/watch?v=J8wM...

youtube.com

Annie Andrews Launch Video: "Unafraid"

YouTube video by Annie Andrews

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Ed @notdred.bsky.social · 28/05/2025

I’m not trapped in rounds with you, you’re trapped in rounds with me

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Emily Moin @emilymoin.com · 27/05/2025

If you ask medical intensivists which types of admissions scare us the most, I would guess the most common answer would be pregnant patients (followed by status asthmaticus, which is a separate conversation). Pursuing any policy that increases risk of severe disease in pregnant people is insane.

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Critical Care Reviews @criticalcarereviews.com · 25/05/2025

In memory of professor Rinaldo Bellomo: A giant of intensive care medicine CCR Journal Watch - tracking the critical care literature daily doi.org/10.1016/j.ccrj.2025.100110

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josh farkas 💊 @pulmcrit.bsky.social · 17/05/2025

You intubate a patient smoothly with roc & ketamine After connection with the vent: - oxygen saturation is 98% - etCO2 tracing & values are normal - breath sounds are symmetric the vent starts alarming for a 60% air leak you ascultate the neck & cannot hear a leak what is happening? #1/2 #EMIMCC

media.tenor.com

a man in a tie is standing in front of a sign that says `` what is going on ? ''

ALT: a man in a tie is standing in front of a sign that says `` what is going on ? ''

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Lakshman Swamy (he/him) @laxswamy.bsky.social · 13/05/2025

My friend (icu nurse) and his wife wrote this for the globe. They were finalists for the Pulitzer for the series! apps.bostonglobe.com/opinion/grap...

apps.bostonglobe.com

True stories from an ICU: Was it right to keep her alive?

An ICU nurse explores the impact of end-of-life care in an illustrated opinion piece.

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Don De Tina @donnyd.bsky.social · 13/05/2025

A more artistic expression of moral injury, I have never seen.

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mothman the wanderer @gnostichippie.bsky.social · 13/05/2025

this is a lovely little comic about how icu nursing can (will?) require you to violate your own ethics

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Lakshman Swamy (he/him) @laxswamy.bsky.social · 13/05/2025

My friend (icu nurse) and his wife wrote this for the globe. They were finalists for the Pulitzer for the series! apps.bostonglobe.com/opinion/grap...

apps.bostonglobe.com

True stories from an ICU: Was it right to keep her alive?

An ICU nurse explores the impact of end-of-life care in an illustrated opinion piece.

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Deanna Behrens, MD | PedsICU @deannamarie208.bsky.social · 29/04/2025

I also think phrasing matters. When we hit certain milestones, we do sometimes get a party, but happens after a hitting a goal, and the perception is not that we are doing it for a party. If they asked me to do QI to get a party, it would not be an incentive

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Deanna Behrens, MD | PedsICU @deannamarie208.bsky.social · 29/04/2025

The other problem with any kind of party is that only a minority of people in the unit are on when it happens. And would need to make sure to cover both day and night shifts.

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Deanna Behrens, MD | PedsICU @deannamarie208.bsky.social · 29/04/2025

Interesting! I have not had this happen, but I do not think that would be a motivation for me. I would feel a little offended by a gift card, but I cannot articulate why. We do sometimes get pizza parties, but it's not linked to efficiency Not aware of any literature, though!

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Lakshman Swamy (he/him) @laxswamy.bsky.social · 29/04/2025

Getting a gift card or pizza party as a reward for clinical efficiency can feel cheap and devalue the intrinsic motivation. Have you experienced this? anyone aware of any literature on the topic? @iwashyna.bsky.social @deannamarie208.bsky.social @nursekelsey.bsky.social or others?

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Lakshman Swamy (he/him) @laxswamy.bsky.social · 24/04/2025

The little things.

Dead birds are little things.
On the sidewalk, or in the park
You pass them without pause
As a child, though,
Dead bird? the world stopped turning.
Maybe you asked
Can we save it, mom?
Brought broken wings home
And your parents-
They gave it life!
Gave it flight and freedom
Gave it the breath of God
The lies of parents are little things too.

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Kevin Hearne @kevinhearne.bsky.social · 23/04/2025

I’m not on it but Kimberly checks the neighbourhood Facebook page once a week and gives me the tea. This week: Somebody is mad that someone picked up their dog’s deuce, bagged it, and put it in their trash can which was out for collection. This was, apparently, very close to an act of war

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Lakshman Swamy (he/him) @laxswamy.bsky.social · 23/04/2025

The last days always seem to come without warning. Without consent.

The Last Days
May your last days be filled
with bitter antiseptic
invading every pore, every orifice
clinging to long nose hairs
stinging eyes. Ears ringing
shrill beeps and alarms
reminding you too often
of machines prolonging your misery.
May you drown in the hazy gloom
punctuated only by needles
Sharp and sudden!
Without warning
Without consent.
Your bowel and bladder
no longer yours to command.
May you lay in your waste for hours
being noticed is a fading memory.
With hollow bones and leaden limbs,
hard plastic in the softest places
pink and chafing, bleeding and burning
May wilting flowers never be replaced.
May your loved ones pour their warmth
on photographs, so far from your heart.

These are the blessings we shower on our American parents.
LS

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Jack Iwashyna @iwashyna.bsky.social · 21/04/2025

Good day to have principles

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josh farkas 💊 @pulmcrit.bsky.social · 20/04/2025

folks using prolonged ketamine gtts for pain: do you trial a bolus 1st to see how the patient responds? (& then follow with an infusion if effective) or just start the infusion & gradually titrate to effect? I think there are some interesting practice pattern differences in ED vs ICU vs anes

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Lakshman Swamy (he/him) @laxswamy.bsky.social · 19/04/2025

I don't share my writing for notoriety. It is the drive to share a thin slice of who I really am, a chance to be seen, and hopefully, to resonate so someone else feels less alone.

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Lakshman Swamy (he/him) @laxswamy.bsky.social · 11/04/2025

I have been in that room, and the other one too. But I am no savior.

Savior
I have been in that room
Pinned limbs against bed frame
I have found what I needed
Hidden under skin and sinew

I have driven the blade
I have pushed in, hard,
Against resistance
Slicked your hair with blood.

I have heard the cries
Of panic and pain
Of horror and hate
But I have never listened.

I have done these things
To the drugged and delirious
To women and men
To the elderly, to their children

I have stood,
Coldly commanding
A legion of rib breakers
While their tears fell.

And then I left that room
To tell mothers and brothers,
Their children, their lovers
That what I did was not enough.

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Avraham Cooper @avrahamcoopermd.bsky.social · 18/04/2025

This is such a good album and a monumental achievement!!!

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Avraham Cooper @avrahamcoopermd.bsky.social · 18/04/2025

15/SUMMARY Salt in wounds causes pain by multiple probable mechanisms. These include: 🧂Increasing local osmolarity, which stimulates osmo-sensitive TRPV nociceptive neurons (the same neurons through which capsaicin signals) 🧂Osmotic stress leading to cellular injury/death

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Avraham Cooper @avrahamcoopermd.bsky.social · 18/04/2025

1/THREAD As the old idiom goes, one deliberately causes additional pain by "pouring/rubbing salt in an open wound". But this is also literally true. Physiologically, why would it hurt so much to have salt poured into a wound?

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Jack Iwashyna @iwashyna.bsky.social · 18/04/2025

Chest is a superb scientific journal to which I regular submit some of my best science. This letter is an obvious travesty I hope @accpchest.bsky.social treats it as the travesty it is

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the corghoul from cowboy beBOO! 👻 @realqrampage.fightins.online · 11/04/2025

this was amazing! I cried, she cried, there was so much love and excitement about helping patients like me, and it was just so beautiful to see the good parts of this industry 🥹 there are good people out there working really hard to improve care for patients with rare diseases

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Lakshman Swamy (he/him) @laxswamy.bsky.social · 11/04/2025

Someone asked me "hows work" and this was my response and this is why i need to stop talking to people 😆

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Lakshman Swamy (he/him) @laxswamy.bsky.social · 11/04/2025

I have been in that room, and the other one too. But I am no savior.

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Shematologist, MD @shematologist.medsky.social · 10/04/2025

PSA: Your period should not 🩸last longer than 7 days 🩸interfere with your life 🩸happen more than monthly 🩸require product changes more than every 2 hours 🩸have clots larger than a quarter 🩸cause debilitating pain 🩸require double product coverage 🩸make you anemic

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Marceline Leiman is Racing Dinos @marcelineleiman.bsky.social · 10/04/2025

I’ve been getting a bunch of new follows so—Welcome new friends! ✨ Here’s a fast track to follow a whole mess of incredible women making #Boardgame and #TTRPG games for you to love! If you want increased gender diversity in our tiny hobby world, support us with a follow! go.bsky.app/71p7ixo

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Mike @empiricgame.bsky.social · 03/04/2025

📌

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Lakshman Swamy (he/him) @laxswamy.bsky.social · 03/04/2025

You should read this... It is really good. I know bc we wrote it 😘

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