In 1980, 21% of NIH-funded principal investigators were under age 35. By 2015, this proportion was 3%. The dramatic ageing of independent scientists is bad because old people are simply worse at science than young people. Latest meta-scientific deep-dive from me 🧵 ⬇️

I hereby propose that we rebrand b.c. from ‘before Christ’ to ‘before ChatGPT’

My grandpa’s name was Dan Singh. His father, Katha Singh, came to America from India decades ago to seek a better life. He became a raisin farmer in California. My grandpa eventually took over the family business and also worked as a truck driver. This post is racist and demeaning to anyone with the last name Singh.

A terrific choice to lead @nyulangone through its next chapter. @SVRaoMD is unique — peerless in many ways — and will do great things and bring the program to new heights.

Not a great question. Verapamil-sensitive VT (or Belhassen's VT) is a clinical entity referring to a re-entrant fascicular VT with part of the circuit that is sensitive to calcium channel blockade. While verapamil isn't the right choice in poly VT, there are instances where it is the right drug.

Congrats to @gregorymmarcus and his team. Greg is unique in cardiovascular science: time after time, Greg does the studies that are hard but sound, challenge dogma, and others aren’t able or willing to do.

Honored and humbled to announce my clinical practice article on aortic stenosis for the @NEJM

These are rational choices in academic medicine when RVUs pay the way. The real disparity is that clinician scientists can only do science if they can afford to — independent wealth, high spousal income, or self sacrifice. The system must change.

Causal inference should be taught in every high school in America.

Often, trial results are taken as gospel when in fact, they are blunt instruments designed to detect high signal over short time periods. While obs studies often overestimate, a negative RCT doesn’t always translate to evidence of absence. There can still be absence of evidence.

Nico Williams made sure Lamine Yamal’s little brother had his own World Cup final. 🥹⚽❤️

One of the challenges of #medtwitter is that the teaching is sometimes wrong. This is a great example of artifact, but the teaching thread calls this torsades. Not only can the QRS be seen marching through, but the pulse ox has a bar that shows a pulse corresponding to each QRS. While intentions may be good, accuracy matters.

can't even en passant without offsides anymore

Imagine if the EP community got together and did the same, replacing “HF” with “AF”. All hell would break loose. Less is more.

One challenge in healthcare is the Lake Wobegon effect. Everyone wants to believe that their center is above average. That may be true for a given center, but it's not true for all. Master clinicians are scarce. AI can be an equalizer, raising the median and reducing variation.

It was two in the morning, the hour when even the bravest samurai retires to his bedroll, yet here, a fortress of light beckoned me from the darkness. Every castle I have ever known has fallen. Fire, siege, taxes. Eight hundred years of my family learning one lesson: nothing stays open forever. This house has never closed. Not for storms. Not for holidays. Not for the hour when even the moon looks tired. I asked the waitress when they lock the doors. "We don't have locks, hon." No locks. I own walls, moats, and a sword older than this country, and I have never once said anything that powerful. Inside, a cook was scraping the grill at 2 a.m. with the calm of a man guarding something. I asked if he was the night watch. "I'm Darnell." A trucker two stools down raised his coffee. "Place stayed open during the hurricane," he said. "FEMA's got a whole index about it." An index. The government of this nation measures disasters by whether THIS HOUSE is still standing. In Japan, we measured a clan's strength by its castle. Same thing. Theirs serves waffles. I ordered. I ate. I confess what happened next. I did not want to leave. The night outside was large. The booth was warm. I am a grown warrior, and I sat in a yellow fortress at 3 a.m. feeling protected by hash browns. A castle does not promise to stand forever. It simply leaves the lights on. I drive past at night now. Just to check. The lights are always on. Sentries of the griddle — I see you. Hold the line.

Identifying the limitations of traditional arrhythmia monitoring is key to reducing time to diagnosis and improving patient experience. Join Dr Emma Svennberg, Dr Isaac Whitman and Dr Joseph Mills for a live webinar exploring the clinical, operational and economic value of 14-day ambulatory ECG monitoring. 📅 Wednesday 24 June 2026 🕕 18:00 BST | 19:00 CEST Register now: ow.ly/SRXE50Z9g8U This webinar is supported by iRhythm.

I won't pay $4,000 for a ticket to see my Knicks play in the NBA Finals for the first time in 27 years, but for some reason I routinely pay three times that much for open access to papers that I wrote myself

Today, I learned that Dr. Eugene Braunwald and Eugene Kleiner (of @kleinerperkins) are first cousins and grew up in Brooklyn a block from each other. Both fled Vienna with their families during the Nazi occupation. Tom Lee from @BrighamWomens has written a beautiful biography.