iiinova — where your digital self keeps evolving

In the section on Variola another similarity with our time— due largely to low uptake of vaccination (which then meant injecting cow lymph) in the 1870s, Montreal suffered severe smallpox outbreak in 1885…

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How did they treat typhoid fever then? Besides hydrotherapy (using cool water to lower the fever—which in case series appeared to lower mortality by 7-8%), 8 shots of good whiskey per day- less so is “hoisting the teetotaler by his own petard.” There’s otherwise instructions for good nursing care.

Alcohol is not necessary in all cases, but may be given when the weakness is marked, the fever high, and the pulse failing. In young healthy adults without nervous symptoms and without very high fever, it is not required; but when the heart-beat is feeble and the first sound becomes obscure, if there are a muttering delirium, subsultus tendinum, and a dry tongue, brandy or whisky should be freely given. In such a case from eight to twelve ounces of good whisky in the twenty-four hours is a moderate amount. It would be too much like hoisting the teetotaler with his own petard to attribute the high rate of mortality from Typhoid fever at the London Temperance Hospital — 15 to 16 per cent during the past twenty years— to failure to employ alcohol.

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Also: stop calling it typho-malarial fever 😤 (this is at least the third time it’s come up in the first chapter)… sounds a bit like reading @pulmcrit.bsky.social commentary on the sepsis guidelines. Nor are all prolonged febrile illnesses in the pre-antibiotic era treated the same.

There is no such disease as typho-malarial fever—that is, a separate and distinct malady… there is now no excuse whatever for the continued use by practitioners of the term typho-malarial fever, and still less for the falsification of vital statistics by death certificates signed with this diagnosis. The principle is bad and the practice is worse, since it gives a false sense of security, and may prevent proper measures of prophylaxis.

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Short answer: no, not really. But is weirdly riveting and I have observations to share. It’s amazing how much they learned just from anatomy and basic pathology. Theres a throw away sentence that Chiari suspected the gallbladder as a reservoir of typhoid—well before the famous case of Typhoid Mary.

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Mayor Zohran Kwame Mamdani @mayor.nyc.gov · 09/05/2026

On a lark started reading Osler’s textbook from 1899. One of my mentors had his quote “listen to your patient, he’s telling you the diagnosis” framed in her office (shout out Darlene)… took me until being an attending to really appreciate that one. I guess I wondered if maybe more wisdom in there?

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Let’s go Liberty!

Mayor Mamdani poses with Ellie the Elephant at tonight’s New York Liberty basketball game.

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Will Preston @willpreston.bsky.social · 03/05/2026

Types this and saw it wasn’t accepted so moved to a nearby game within the same app (wordle)

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Will Preston @willpreston.bsky.social · 24/04/2026

If y’all aren’t watching Jamie Ding’s run on jeopardy you’re missing out. Today’s ep better than the Super Bowl.

Will Preston @willpreston.bsky.social · 13/04/2026

He finds out the bosses health bars by catfishing them and I just think it’s dishonorable

Will Preston @willpreston.bsky.social · 04/04/2026

Maybe there should just be no healthcare

Brad Lander @bradlander.bsky.social · 23/03/2026

Reposted by Will Preston

ICE agents have become synonymous with terror, not safety. Trump’s goal in deploying them into our airports is to push ICE’s menacing presence into more & more places. Organizing & public pressure pushed them out of Minneapolis. So we’ll have to get louder in saying it here: Abolish ICE.

nydailynews.com

ICE agents patrol JFK airport amid growing lines

Small groups of ICE agents walked through JFK terminals as huge crowds lined up at security checkpoints during the morning rush hour.

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Will Preston @willpreston.bsky.social · 09/03/2026

Maybe that’s why none of the LRs are particularly high? Agree not perfect but presumably does reflect that pulmonary congestion does more often than not go with systemic. Need to see how they defined tho.

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Will Preston @willpreston.bsky.social · 07/03/2026

You think he’s not alive? Look at how anxious he looks.

I googled furby and used the first image

Will Preston @willpreston.bsky.social · 06/03/2026

For nephrologists— in this range soc for primary team is give a lil fluid and see what happens

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Will Preston @willpreston.bsky.social · 06/03/2026

A lack of controlling for multiplicity hasn’t stopped many from recommending less sensible interventions before (…ie entresto for women w/ HFpEF from the negative PARAGON-HF despite being more costly and more AEs). Is there any reason not to use 12 meq/day limit in those >70 with moderate hypoNa?

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Will Preston @willpreston.bsky.social · 04/03/2026

Last year I got a MKSAP question wrong about PE management - vignette was a high risk patient likely needing intervention but without shock and I chose LMWH instead of UFH. I emailed the editor to complain and argue for my answer but they shut me down. Just want to say now completely vindicated.

Management diagram from new AHA/ACC PE guideline recommending LMWH for the situation in the post

Will Preston @willpreston.bsky.social · 04/03/2026

Correct ! The largest organ of the body.

Will Preston @willpreston.bsky.social · 04/03/2026

True daily Ken, periorbital… WAIT😭

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Ken Jennings @kenjennings.bsky.social · 19/02/2026

Hemingway was once bet that he couldn’t write the world’s happiest short story in just 5 words. He replied,

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Letters of Note @lettersofnote.com · 12/02/2026

Happy birthday to one of my favourite haters, Charles Darwin

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NYSNA @nynurses.bsky.social · 09/02/2026

BREAKING: ~10,500 NYSNA nurses at Montefiore, Mount Sinai, & Mount Sinai Morningside/West reached tentative agreements late Sun/early Mon. Nurses won: enforceable safe staffing, maintain their health benefits, workplace violence protections, and more! www.nysna.org/press/victor...

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Will Preston @willpreston.bsky.social · 22/01/2026

No action in EHR for 5 plus seconds excluded as idle time but surely nobody needed to stop and think about all those questions they didn’t get to ask Beyond parody lol

NYSNA @nynurses.bsky.social · 15/01/2026

Reposted by Will Preston

Want to help out NYC's nurse heroes on the picket line? Check out four ways you can support nurses preparing to strike!

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Brad Lander @bradlander.bsky.social · 15/01/2026

ICE must be abolished. It has become a lawless, rogue agency. Federal law enforcement agencies must follow the law, if they're going to have any credibility enforcing it. We are demanding justice for Renee Good and the prosecution of ICE agent Jonathan Ross for her murder.

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Will Preston @willpreston.bsky.social · 13/01/2026

It’s January 12th and already this year I’ve spent 30 hours on the NYC subway AMA

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Jane @jane.meangirls.online · 09/01/2026

in a way Patrick O’Brien’s Captain Jack Aubrey was the first mecha pilot and his ship the first Gundam

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Will Preston @willpreston.bsky.social · 08/01/2026

Making a fan edit of The Pitt that accurately reflects how I spend my day. The 2-3 min scene in the first ep of the ED team rounding plays on a loop for 10 hours and to fill the other 2 hours I’m looking for B roll of someone standing in a supply closet unable to find what they’re looking for.

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Sam @postmalort.bsky.social · 02/01/2026

It’s too late, I have already portrayed myself as Chortling Bernie and you as Seething Eric Adams

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Will Preston @willpreston.bsky.social · 01/01/2026

New trend for 2026: referring to them as hyperaquaremia and hypoaquaremia

Will Preston @willpreston.bsky.social · 22/12/2025

I know a lot of people out there may have friends or family at CBS, call them now and ask them to de-Bari our segment

m.youtube.com

Tim And Eric on getting Rango'd at Sundance

YouTube video by Eric M

Will Preston @willpreston.bsky.social · 05/12/2025

Things we published things we do for no reason about for no reason

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josh farkas 💊 @pulmcrit.bsky.social · 28/11/2025

updated the acute liver failure chapter biggest change is increasing support for early CRRT to remove NH3 (to reduce elevated intracranial pressure) now rec'd for clinically overt encephalopathy (Grade 2-4) if admitting to ICU for ALF & encephalopathy, just dialyze emcrit.org/ibcc/alf/ #EMIMCC

article: https://pubmed.ncbi.nlm.nih.gov/37377263/

IBCC chapter about acute liver failure: https://emcrit.org/ibcc/alf/

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Will Preston @willpreston.bsky.social · 26/11/2025

Immensely enjoying the Beatles Anthology 4 released last week but disappointed to see no Maxwell’s Silver Hammer (Take 3,057)