Howard Greller, MD

When the System Breaks Our Hearts and Blames Us At The Same Time Emergency physicians are blamed for wait times we didn't create, mourning a patient we couldn't save, and holding together a system that's collapsing around us.

This weekend has been hard.

I tried to put into words why.

open.substack.com/pub/feminemf...

Florida Decided There Were Too Many Children The state’s elimination of vaccine mandates is a courageous first step toward decluttering itself of any excess kids.

Florida Decided There Were Too Many Children

The problem with believing vaccines are dangerous is that by the time you realize you’re wrong, it’s too late and someone you love dies of a preventable disease.

Florida is about to find this out the hard way.

Kennedy’s attack on public health must be stopped The abrupt attempt to oust Dr. Susan Monarez, the CDC’s director just weeks after her Senate confirmation, is yet another glaring sign of Secretary Kennedy’s failed leadership and reckless mismanageme...

🚨It's almost 2am eastern, but the CDC debacle is still unfolding. Very important message from the American Public Health Association:

"We urge people across the nation to contact their representative and call for change to protect our health."

"RFK Jr. must be...

1/3

www.apha.org/news-and-med...

People talk about cuts to science, but they need to understand that what the Trump regime is doing is orders of magnitude worse. 👉All of science that the US government can touch is being replaced with pseudoscience.👈 Budgets diverted to grifters and quacks, reputations burned to sell snake oil.

🧵:

The roadmap for turning the NIH into an EBM slush fund and shutting down real science. Kulldorf, in the new public health blog ("journal") co-founded by Bhattacharya.

1: Fund based on who applies 🤔, rather than ideas

2: Give ECR grants. But only to "medical, dental and public health school".

Breaking News: Read three top CDC officials' resignation emails. The end of an era.

Enough is enough. The health of the country is in danger. Read our resignation letters: insidemedicine.substack.com/p/breaking-n...

The Day the CDC Died Updated COVID vaccines were approved, but too bad the CDC is no longer functional

COVID vaccines were approved today but it's a Pyrrhic victory for vaccines.

With the CDC stripped of leadership & capacity, we have no recourse for the outbreaks of preventable diseases that are coming. The CDC's death will kill people.
open.substack.com/pub/rasmusse...

5/ Bottom line: fentanyl still rules, but the “other stuff” — novel benzos, veterinary sedatives, synthetic cannabinoids — is the stealthy threat changing overdose care. Full report: npsdiscovery.org #DrugTrends

The Fentalog Study: A Subset of Nonfatal Suspected Opioid-Involved Overdoses with Toxicology Testing View substances detected in samples from patients experiencing a suspected opioid-involved overdose.

4/ Clinically, this underscores why standard opioid panels miss the mark. LC-QTOF-MS detected >1,200 substances, catching dangerous adulterants missed by routine screens. Treatment must anticipate multi-drug toxicity. #EmergencyMedicine
www.cdc.gov/overdose-pre...

3/ Public health takeaway: street drugs are increasingly poly-drug cocktails. Testing found opioids + stimulants + sedatives in the same patient; this complicates outreach, naloxone use, and treatment planning. #OverdosePrevention

Benzodiazepine Co‐Exposure Among Patients Presenting to the Emergency Department With a Confirmed Opioid Overdose Background Simultaneous exposure to both benzodiazepines and opioids can lead to synergistic respiratory depression, complicating overdose management. Our objective was to report on the detection of...

2/ A related Fentalog publication last week in AEM noted how lab-made benzos are reshaping #overdose risk. Our data back it up: bromazolam is showing up in multiple cities — often alongside #fentanyl onlinelibrary.wiley.com/doi/10.1111/...

1/ 🚨 New TOXIC Fentalog quarterly report on multi-city toxicology testing shows fentanyl & other synthetic drugs dominate suspected overdose cases in US ERs. Findings offer a near real-time look at the street drug market. #medsky #PublicHealth 🧵
www.cfsre.org/nps-discover...

Mount Sinai Receives $3.8 Million Grant to Study New Synthetic Drugs and Opioid Overdoses in Emergency Departments to Prevent Deaths

1/
Exciting news: Our team has been awarded a NIDA R01 grant to fund "Fentalog II", a continuation of our groundbreaking collaboration to detect novel fentanyl analogue overdoses in EDs across ten major hospitals over five years. #syntheticopioids
#Medsky 🧵
www.mountsinai.org/about/newsro...

LeVar Burton delivered this testimony in 1995 urging Congress not to cut funding for public broadcasting.

His words remain true 30 years later, as Senate Republicans advance a bill that would slash funding for PBS and NPR.

Tell your senators to oppose these cuts: (202) 224-3121.

As a new group of young doctors enters the #ER during July, our seasoned Emergency Medicine physicians, @askdrbilly.bsky.social and Dr. Howard Greller explain what it means for your #summer ER visit on @nyudocs.bsky.social SiriusXM ch. 110 - Thursdays 8-10am East.☀️

The first time Charlie Chaplin used his voice in a film, he wielded it to forcefully condemn the rising forces of fascism around the globe.

Will we listen to his words today?

The July issue of @journalmedtox.bsky.social is out now! ACMT members login via the ACMT member portal (or your academic institution) for unrestricted access.
@ziadkazzi.bsky.social @toxicologist12.bsky.social @heshiegreshie.bsky.social

These people disgust me. They hate us all. This is a game to them. They are pathologically antisocial and selfish. They deserve as much contempt as we can give. They have nothing but smug, selfish contempt for us, and they will smirk to each other as they kill children and enrich themselves doing so

A refrigerator truck filled with body bags

A refrigerator truck being loaded with multiple, stacked carts of body bags

What an unserious person. I will never be able to unsee the people suffocating in their own bodies because the virus melted their lungs. Whole families showing up together at the brink of death. Myself & my colleagues putting on garbage bags & months-old N95 to resuscitate them in hospital driveways

Martin Kulldorff & @MartinKu...•9/10/23 S.•• "One of the most disturbing images of the Covid-19 pandemic was when a teacher .. forced a mask on a crying toddler .. In some ways, the U.S. government.. treated all of us like toddlers, compelling us to endure draconian Covid measures" - @HRaleighspeaks

RFK Jr’s ACIP pick, Martin Kulldorff, said one of the most disturbing images from the pandemic was a toddler crying about having to wear a mask. I see toddlers cry about everything all the time, and I found it far more disturbing to see refrigerator trucks full of body bags outside of the hospitals…

SORRY. Sorry.
Have we seen this *incredible* news video coming out of Queensland? Wait for the witness/witnesses statement

Heads up guys, making cracks about alcoholism, addiction, and recovery programs isn't the chill win some folks seem to think it is. People are going through hell out there.✌️

Calm down, folks, it was just an attempted assassination of a Jewish Democratic governor and his family on the first night of Passover, it’s not like somebody spray painted a dick on a Cybertruck.

I love it when you find an author you love and they have the grace to have published several books so you're not going to run out of their work any time soon. Thank you authors 🙏

Kurt Vonnegut tells his wife he's going out to buy an envelope: "Oh, she says, well, you're not a poor man. You know, why don't you go online and buy a hundred envelopes and put them in the closet? And so I pretend not to hear her. And go out to get an envelope because I'm going to have a hell of a good time in the process of buying one envelope. I meet a lot of people. And see some great looking babies. And a fire engine goes by. And I give them the thumbs up. And I'll ask a woman what kind of dog that is. And, and I don't know. The moral of the story is — we're here on Earth to fart around And, of course, the computers will do us out of that. And what the computer people don't realize, or they don't care, is we're dancing animals. You know, we love to move around. And it's like we're not supposed to dance at all anymore."

Kurt Vonnegut man

Yes a shutdown would have consequences.

And a Republican President, Republican House, and Republican Senate would be responsible.

They have acted in a unilateral and unprecedented way.

Democrats cannot cave. They must fight back.

KEEP CALLING. PEEL OFF ALL DEM SENATORS YOU CAN.

☎️: (202) 224-3121

Tell them to vote NO on Cloture and NO on CR. Vote is pushed to after 1:15ish for now. Situation is fluid.

The only public YES votes are Schumer and Fetterman. They need 7-8 total. KEEP CALLING.

Call retiring Senators too!