iiinova — where your digital self keeps evolving

Mark Shrime, MD, PhD @markshrime.bsky.social · 11/02/2026

Feels like the democrats telling a democratic senator to tell the democrats to tell Congress that someone needs to resign is the perfect example of how we don’t have a real opposition party

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Mark Shrime, MD, PhD @markshrime.bsky.social · 11/02/2026

I want to live in a world where a million mentions of a pedophile offends people way more than some music in Spanish

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Mark Shrime, MD, PhD @markshrime.bsky.social · 05/02/2026

This is an Anti-Zionist Pro-Palestine Anti-ICE Pro-immigrant Pro-LGBTQ+ Pro-women Pro-choice Account

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Mark Shrime, MD, PhD @markshrime.bsky.social · 19/06/2025

Paulo Freire wrote, ‘it is in the interest of the oppressor to weaken the oppressed’. And it is our imperative to counteract that weakening. To counteract recrudescent hegemony, we need science that serves human liberation. Read my editorial in BMJ Global Health here ↓ gh.bmj.com/content/10/6...

gh.bmj.com

The academy, a battleground for justice: a call for prioritarian scholarship

Knowledge, like any cultural product, is never produced in a vacuum.

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Mark Shrime, MD, PhD @markshrime.bsky.social · 23/03/2025

→ Finally, the effects of climate change disproportionately fall on vulnerable populations. Global health’s focus on ‘health over there’ must also reckon with its role in furthering this crisis. Read more: gh.bmj.com/content/10/3...

gh.bmj.com

Advancing global health in an unprecedented (and unpredictable) era

When BMJ Global Health launched 9 years ago, it positioned itself as a forum to address a fundamental, paternalistic information asymmetry in global health. To quote Dr. Seye Abimbola’s launch editori...

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Mark Shrime, MD, PhD @markshrime.bsky.social · 23/03/2025

→ When current AI systems are literally incapable of generating images of a Black African doctor caring for a white child, we must acknowledge, address and combat AI's potential to perpetuate systemic racism.

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Mark Shrime, MD, PhD @markshrime.bsky.social · 23/03/2025

→ The traditional global health focus on infectious disease, nutritional support, primary care, and maternal/child health has had the unintended consequence of deprioritising corridors of healthcare that many of us—who live in the Global North—take for granted. It's time for that change.

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Mark Shrime, MD, PhD @markshrime.bsky.social · 23/03/2025

My introductory editorial for BMJ Global Health is out (link at the bottom of this thread): Among our priorities: → The notion that global health is about health that happens ‘over there’ must end.

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Mark Shrime, MD, PhD @markshrime.bsky.social · 26/01/2025

Thank you! Glad to have you on board!

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Mark Shrime, MD, PhD @markshrime.bsky.social · 26/01/2025

Last thing. Healthcare is a deeply exhausting profession. If you’re a provider (or you know one) who’s burning out, stagnating, or stuck, I’ve launched a new program It uses decision science to help people figure out what they need to do for their next chapter Quick video here: solvingforwhy.co

solvingforwhy.co

Solving for Why Coaching | FREE Training

Healthcare providers: your burnout ends here

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Mark Shrime, MD, PhD @markshrime.bsky.social · 26/01/2025

Anyway. Today’s 4:30 post was more serious than usual. If you liked it, please repost! And follow for more thoughts on health, global health, NYC, and occasionally faith AND…I write weekly posts about decision science (it’s what my PhD is in). I do this on my mailing list. home.markshrime.com ↓

home.markshrime.com

Mark G. Shrime, MD, MPH, PhD

Harvard-trained surgeon and decision scientist helping healthcare leaders overcome burnout, make confident career decisions, and find purpose through executive coaching.

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Mark Shrime, MD, PhD @markshrime.bsky.social · 26/01/2025

You know. The disease that killed Emily Brontë. And Doc Holiday. That one That’s the direction things are going. Isolationism WILL undermine your own right to health ↓

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Mark Shrime, MD, PhD @markshrime.bsky.social · 26/01/2025

5. Even if you’re of the America First bent, withdrawing from the WHO is an outright terrrrible idea. Why? It puts our own national security at risk I mean, the US is seeing its biggest documented outbreak of freaking tuberculosis ever right now ↓

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Mark Shrime, MD, PhD @markshrime.bsky.social · 26/01/2025

Health, as defined by these international agreements, is “complete physical, mental, and social wellbeing, and not just the absence of disease” This…this is what we have a right to. This is what we deserve Not capitalistic health insurance ↓

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Mark Shrime, MD, PhD @markshrime.bsky.social · 26/01/2025

4. HEALTH INSURANCE IS NOT HEALTH If I could scream this louder, I would. Health insurance is not health. Our inalienable human right to health isn’t a right to paying a yearly $10,000 fee to massive corporations just for the privilege of staying alive ↓

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Mark Shrime, MD, PhD @markshrime.bsky.social · 26/01/2025

Because we’ve signed onto—and ratified—a bunch of other treaties that commit us to it Here they are: ↓ mckinneylaw.iu.edu/practice/law...

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Mark Shrime, MD, PhD @markshrime.bsky.social · 26/01/2025

3. It also means that, even though 2.0 has set our withdrawal from the WHO in motion last week, nothing changes about the US’s commitment to the human right to health And not just because of the “unalienable” stuff. ↓

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Mark Shrime, MD, PhD @markshrime.bsky.social · 26/01/2025

This means—crucially, given this last week—they aren’t given to us by a country or a law…and they can’t be taken away Health, again, is one of those rights ↓

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Mark Shrime, MD, PhD @markshrime.bsky.social · 26/01/2025

2. Human rights, to borrow the words of the US Declaration of Independence, are “unalienable.” They’re inherent to us, simply because we’re human. ↓

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Mark Shrime, MD, PhD @markshrime.bsky.social · 26/01/2025

As a human being, you have a right to health. Your neighbor, your children, your uncle, your boss, your employees…we all have a right to health But what’s that mean? ↓

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Mark Shrime, MD, PhD @markshrime.bsky.social · 26/01/2025

1. Health is a human right This isn’t my opinion. It’s codified into about a dozen international human rights instruments. The constitution of the WHO says it best: “the highest attainable standard of health is one of the fundamental right of every human being” ↓

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Mark Shrime, MD, PhD @markshrime.bsky.social · 26/01/2025

Since you all seemed to like the 4:30-on-a-Sunday-morning posts: I’ve been a doctor for 24 years, and I’ve worked in global health for 17 of those. Here are five things I’ve learned, in view of *gestures broadly* this last week Don’t hate me for number 4 ↓

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Mark Shrime, MD, PhD @markshrime.bsky.social · 23/01/2025

Thanks, Helen! Really appreciate it! Sadly, I left Ireland and RCSI back in 2022. Firmly re-ensconced in NYC these days!

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Mark Shrime, MD, PhD @markshrime.bsky.social · 22/01/2025

Since İCĘ can now raid hospitals… Any lawyers in the crowd have a good resource for what healthcare providers are required to do during a raid? What remains protected health information, and what are we obligated to disclose about our patients? Asking for a friend

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Mark Shrime, MD, PhD @markshrime.bsky.social · 20/01/2025

5. The arc of the moral universe is long. But it bends toward justice. In the next four, eight, twelve years, be justice. Not the retributive justice of those in power. Instead, be the justice that brings down structures of dominance. We can do this. Even if the arc is long. #inauguration

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Mark Shrime, MD, PhD @markshrime.bsky.social · 20/01/2025

When the crowd went to stone the woman caught in adultery in John 8, they were doing EXACTLY what their scripture told them they were supposed to do. They were in the right. They were SUPPOSED to kill her, according to their understanding of scripture Jesus still stopped them. ↓

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Mark Shrime, MD, PhD @markshrime.bsky.social · 20/01/2025

4. They were convinced they were right. Don't be surprised to hear your religious siblings tell you that they're right, that they're following the Bible, that they're doing God's will. Don't be surprised to hear sermons against those dirty people at the margins. ↓

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Mark Shrime, MD, PhD @markshrime.bsky.social · 20/01/2025

3. They chose Barabbas Speaking of (insurrectionist) similarities... ↓

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Mark Shrime, MD, PhD @markshrime.bsky.social · 20/01/2025

The similarity could not be more stark. No idea what direction these next four years will go, but we can't forget that, at least for a little bit, Jesus's message did NOT win ↓

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Mark Shrime, MD, PhD @markshrime.bsky.social · 20/01/2025

2. And they killed him for it. I'm SO desperate to sugarcoat this. To pretend violence won't happen this time around. But the fact is, Jesus was put to actual death by the political powers of his day, at the EXPLICIT request of the religious powers of his day. ↓

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Mark Shrime, MD, PhD @markshrime.bsky.social · 20/01/2025

1. This isn't the first time, nor the last time, that religion is used to oppress those at the margins. Heck, that was literally Jesus's message ↓

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Mark Shrime, MD, PhD @markshrime.bsky.social · 20/01/2025

Today's a hard one. For so many of us (brown, Black, LGBTQIA+, trans, poly, disabled, women, undocumented, incarcerated, you name it...) today is rough. Today marks the consummation of an unholy union between religion and political power. 5 thoughts, from growing up in the Evangelical church. ↓

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Mark Shrime, MD, PhD @markshrime.bsky.social · 19/01/2025

I write weekly posts about decision science (it’s what my PhD is in) and using its tools to make better decisions in your life I do that on my mailing list, and all I want for Christmas is for you to sign up! home.markshrime.com

home.markshrime.com

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Mark Shrime, MD, PhD @markshrime.bsky.social · 19/01/2025

If you liked this thread, please share the top skeet! And follow for more content on medicine, surgery, global health, NYC, and (occasionally) faith And also ↓

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Mark Shrime, MD, PhD @markshrime.bsky.social · 19/01/2025

We can help arrange resources (shout out to all the social workers!), because we’d rather hear your crazy weekend party stories the next time you’re in, than never hear them again ↓

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Mark Shrime, MD, PhD @markshrime.bsky.social · 19/01/2025

5. We DO care if you're alone, or if you’re unsafe at home. Tell us if you don't have someone to drive you home. Tell us if you don’t have someone to check on you. Tell us if you *do* have someone at home but they’re not safe We’re not just here to cut and sew. ↓

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Mark Shrime, MD, PhD @markshrime.bsky.social · 19/01/2025

4. In that vein, we DO care about the illicit substance you just took We are mandated reporters for child abuse We are not mandated reporters for drug use. So, if you’ve just pumped a bunch of ketamine through your body, let us know so we can treat you right ↓

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Mark Shrime, MD, PhD @markshrime.bsky.social · 19/01/2025

We also do care if you’re using it INSTEAD of (and not as a complement to) the other things. I said it last week—one of the saddest patients I ever had was someone who decided to treat her cancer with lavender oils Chat, they did not work ↓

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Mark Shrime, MD, PhD @markshrime.bsky.social · 19/01/2025

3. We don't care if you’re using home remedies or complementary medicine. We do care that you tell us though. That ginkgo supplement you’re taking? It can act as a blood thinner, and I want to know that if I’m going to take you to the OR. ↓

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Mark Shrime, MD, PhD @markshrime.bsky.social · 19/01/2025

And we’ll do everything in our power—not that we have much of it—to make sure that ambulance bill is covered ↓

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Mark Shrime, MD, PhD @markshrime.bsky.social · 19/01/2025

2. We don't care if you called an ambulance "for nothing" Medical care is hard af to get in this country. If you're having chest pain and you’re worried it's a heart attack, get thee to an ER. Not a single person is going to judge you if it ends up being heartburn. ↓

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Mark Shrime, MD, PhD @markshrime.bsky.social · 19/01/2025

1.5 (Side note…if you do enjoy that sort of play, make sure the object is flanged at the end. Much harder for it to slip in that way) ↓

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Mark Shrime, MD, PhD @markshrime.bsky.social · 19/01/2025

1. We don't care what you were doing when you got that object stuck You and I both know you didn’t “slip and fall” onto that light bulb Honestly, we’ve seen it all… just tell us what happened so we can start fixing it ↓

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Mark Shrime, MD, PhD @markshrime.bsky.social · 19/01/2025

Since you all seemed to like last week’s 4:30-on-a-Sunday-morning Medthreads post… I’ve been a doctor for 24 years. Here are three more things we don’t care about (and two things we absolutely DO care about) when you come to the ER Trust me on number 4… ↓

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Mark Shrime, MD, PhD @markshrime.bsky.social · 14/01/2025

And if you liked that post, please share it! Plus, if you want early access to my weekly decision-science posts, like this one, as well as discounts on decsion-making courses, join my mailing list! home.markshrime.com

home.markshrime.com

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Mark Shrime, MD, PhD @markshrime.bsky.social · 14/01/2025

Want to know more? Check out this week's DecisionTuesday post www.markshrime.com/blog/pro-con-lists-suck ↓

markshrime.com

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Mark Shrime, MD, PhD @markshrime.bsky.social · 14/01/2025

Well, the obvious. Hernia instruments just aren't fit for purpose when you're doing a pediatric tonsillectomy. They work—very poorly. And here's the thing. For two VERY good reasons, pro-con lists are the hernia instruments of the decision-making world. ↓

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Mark Shrime, MD, PhD @markshrime.bsky.social · 14/01/2025

About a decade ago, I had to take out a young girl's tonsils using surgical instruments designed for repairing hernias in grown men. Did the tonsils come out? Yes. Was it a bloody mess? Also yes. Why? ↓

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Mark Shrime, MD, PhD @markshrime.bsky.social · 14/01/2025

STOP using pro-con lists to make big decisions! They're keeping you trapped Let me tell you a story ↓

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