Happy Study Time

  In live it’s not just about being right — it’s about knowing how wrong you’re allowed to be. 👻 The Ghost and the Exorcist (Type I Error — False Positive) 2:14 a.m: The ICU lights hummed softly. The telemetry monitor on Bed 5 showed a strange rhythm — some premature beats, maybe a wide QRS. Your heart sped up. “This could be VT… or something worse.” You called cardiology. Then the senior. Then the attending. Like calling an exorcist for a ghost in the monitor. But the patient? Sleeping. Peacefully. Stable vitals. The EKG you ordered (finally)? Perfectly normal. It was the student’s fault, of course. (I am the student) You saw something that wasn’t really there — and treated it like it was. That’s a Type I Error (α): a false positive. 🔥 The Rhythm We Ignored (Type II Error — False Negative) 2:14 a. m The next day: The monitor alarm kept beeping — softly at first, then louder. A few wide QRS complexes. A couple of dropped beats. “It's probably just artifact,” you thought. "I ...

After reading the latest Heart Failure (HF) guidelines, I had to acknowledge the massive difference from those of just five years ago. Here are a few key points I want to highlight before diving into vericiguat: HF is a syndrome. Mix everything HF results from an impairment in the function AND/OR structure of the heart, leading to elevated intracardiac pressure AND/OR inadequate cardiac output at rest AND/OR during exercise.  The number of times the guideline says "AND/OR" is truly impressive. HF can have preserved cardiac output (>50% EF), mildly reduced (40–49%), or reduced (The classic <40%). Then, of course, there are the stages: Stage A: Just risk factors—nothing too dramatic. Stage B (Pre-HF): Structural changes show up on echocardiography, but no symptoms yet. Stage C: Et voilà —breathlessness, ankle swelling, fatigue, JVP elevation, pulmonary crackles, peripheral edema. Maybe you’ll even catch the point of maximal impulse shift or, for the experts, the elusive S...

  I read an interesting article about the traits of great physicians. All the advice seemed recurrent: Be a detective  (👮 This is a detective...right?) Get healthy and relax 💆 Be a listener 👂 Find your passion 💓 Treat the whole patient 👴 Have empathy 👱 Pay attention to detail 👀 Develop resilience 💃 Take responsibility 👷 ... But the last piece of advice was different: Count your stars . Here, the author explains why it is so important to give value to the things that we currently don’t. He says that our stars are the ways we improve, save, and change the lives of our patients and their families for the better. So, I started to think about my stars. I’ve given something to my patients: respect, care, attention, knowledge, and love. And they have given me back these things, with even more rewards. I don’t know why we have nights  in our lives, but I know that those periods remind us that we have stars . 😌  Higgins JP. Ten Traits of Great Physicians! And Tips t...