dr_cois
@drcois.bsky.social
Emergency Physician | Climate change advocate | Human Centered Design | Dad of 2 | 🇦🇺 in 🇺🇸
In a world of health related misinformation we can actually simplify and get 90% of the way to good health.
> Eat mostly plants
> Exercise (doesn’t matter what type) most if not all days of the week for about 60mins
> 🚭
> Work on building social connections
> Eat mostly plants
> Exercise (doesn’t matter what type) most if not all days of the week for about 60mins
> 🚭
> Work on building social connections
August 4, 2025 at 8:34 PM
In a world of health related misinformation we can actually simplify and get 90% of the way to good health.
> Eat mostly plants
> Exercise (doesn’t matter what type) most if not all days of the week for about 60mins
> 🚭
> Work on building social connections
> Eat mostly plants
> Exercise (doesn’t matter what type) most if not all days of the week for about 60mins
> 🚭
> Work on building social connections
20 month old. Previously well.
> Croup and hypoxia from COVID.
> Vaccines work and are important.
Tell me again why having an antivaxxer at the head of hhsgov is a good idea?
> Croup and hypoxia from COVID.
> Vaccines work and are important.
Tell me again why having an antivaxxer at the head of hhsgov is a good idea?
July 28, 2025 at 9:13 PM
20 month old. Previously well.
> Croup and hypoxia from COVID.
> Vaccines work and are important.
Tell me again why having an antivaxxer at the head of hhsgov is a good idea?
> Croup and hypoxia from COVID.
> Vaccines work and are important.
Tell me again why having an antivaxxer at the head of hhsgov is a good idea?
Post night shift sleep starts before the shift…
Pre night shift routine:
> Hard workout
> 20min sauna
> Cold plunge (wakes me up!)
> Try to avoid snacks on shift
> Don’t eat within 4 hrs of bedtime
What do you do?
Pre night shift routine:
> Hard workout
> 20min sauna
> Cold plunge (wakes me up!)
> Try to avoid snacks on shift
> Don’t eat within 4 hrs of bedtime
What do you do?
July 25, 2025 at 5:42 AM
Post night shift sleep starts before the shift…
Pre night shift routine:
> Hard workout
> 20min sauna
> Cold plunge (wakes me up!)
> Try to avoid snacks on shift
> Don’t eat within 4 hrs of bedtime
What do you do?
Pre night shift routine:
> Hard workout
> 20min sauna
> Cold plunge (wakes me up!)
> Try to avoid snacks on shift
> Don’t eat within 4 hrs of bedtime
What do you do?
So we can understand how cruel and idiotic the #USAID cuts from the current administration, here are some high points from a recent @thelancet.com analysis:
> In the last 21 years USAID interventions prevented:
- 91 million deaths in all-ages
- 30 million deaths in children less than 5yo
1/n
> In the last 21 years USAID interventions prevented:
- 91 million deaths in all-ages
- 30 million deaths in children less than 5yo
1/n
July 20, 2025 at 3:53 AM
So we can understand how cruel and idiotic the #USAID cuts from the current administration, here are some high points from a recent @thelancet.com analysis:
> In the last 21 years USAID interventions prevented:
- 91 million deaths in all-ages
- 30 million deaths in children less than 5yo
1/n
> In the last 21 years USAID interventions prevented:
- 91 million deaths in all-ages
- 30 million deaths in children less than 5yo
1/n
There's something that happens in America…
> A patient has a provider/therapist managing a chronic medical or psychiatric condition - it's stable
> January comes around, and their insurer no longer covers that provider.
> A patient has a provider/therapist managing a chronic medical or psychiatric condition - it's stable
> January comes around, and their insurer no longer covers that provider.
May 12, 2025 at 9:44 PM
There's something that happens in America…
> A patient has a provider/therapist managing a chronic medical or psychiatric condition - it's stable
> January comes around, and their insurer no longer covers that provider.
> A patient has a provider/therapist managing a chronic medical or psychiatric condition - it's stable
> January comes around, and their insurer no longer covers that provider.
I had 70 something year old patient.
No HTN, diabetes, non smoker.
Exercises daily, not overweight.
Non-HDL cholesterol 181, LDLc 124. She knew it was elevated but wasn’t on meds.
Had a NSTEMI - 2 vessel disease requiring stents.
Don’t ignore cholesterol, it is all you need to have an MI.
No HTN, diabetes, non smoker.
Exercises daily, not overweight.
Non-HDL cholesterol 181, LDLc 124. She knew it was elevated but wasn’t on meds.
Had a NSTEMI - 2 vessel disease requiring stents.
Don’t ignore cholesterol, it is all you need to have an MI.
April 13, 2025 at 10:29 AM
I had 70 something year old patient.
No HTN, diabetes, non smoker.
Exercises daily, not overweight.
Non-HDL cholesterol 181, LDLc 124. She knew it was elevated but wasn’t on meds.
Had a NSTEMI - 2 vessel disease requiring stents.
Don’t ignore cholesterol, it is all you need to have an MI.
No HTN, diabetes, non smoker.
Exercises daily, not overweight.
Non-HDL cholesterol 181, LDLc 124. She knew it was elevated but wasn’t on meds.
Had a NSTEMI - 2 vessel disease requiring stents.
Don’t ignore cholesterol, it is all you need to have an MI.
Home | Substack
Discover and discuss great writing with the world’s smartest readers on Substack.
substack.com
February 16, 2025 at 9:35 PM
It happened again…
> Caring for a child that has incomplete vaccination status
> Had a discussion about getting back on track and vaccinated with parents
> They want to catch up now
> Reasons for not getting vaccinated, hearing BS on social media
Keep talking to your patients. Not all is lost…
> Caring for a child that has incomplete vaccination status
> Had a discussion about getting back on track and vaccinated with parents
> They want to catch up now
> Reasons for not getting vaccinated, hearing BS on social media
Keep talking to your patients. Not all is lost…
February 9, 2025 at 6:55 PM
It happened again…
> Caring for a child that has incomplete vaccination status
> Had a discussion about getting back on track and vaccinated with parents
> They want to catch up now
> Reasons for not getting vaccinated, hearing BS on social media
Keep talking to your patients. Not all is lost…
> Caring for a child that has incomplete vaccination status
> Had a discussion about getting back on track and vaccinated with parents
> They want to catch up now
> Reasons for not getting vaccinated, hearing BS on social media
Keep talking to your patients. Not all is lost…
Inbox | Substack
open.substack.com
February 1, 2025 at 12:10 AM
Reposted by dr_cois
Wow. Caroline Kennedy breaks her silence on RFK Jr in a message to Senators: “We grew up together. It’s no surprise that he keeps birds of prey as pets because Bobby himself is a predator. He enjoyed showing off by putting baby chickens & mice in a blender to feed to his hawks.”
January 28, 2025 at 7:22 PM
Wow. Caroline Kennedy breaks her silence on RFK Jr in a message to Senators: “We grew up together. It’s no surprise that he keeps birds of prey as pets because Bobby himself is a predator. He enjoyed showing off by putting baby chickens & mice in a blender to feed to his hawks.”
After all of this malarky on outlawing DEI policies, I decided to write something down about it.
TLDR; I absolutely support it, our teams will be better as a result both for the patient and for the organisation.
open.substack.com/pub/drcois/p...
#DEI
TLDR; I absolutely support it, our teams will be better as a result both for the patient and for the organisation.
open.substack.com/pub/drcois/p...
#DEI
Inbox | Substack
open.substack.com
January 26, 2025 at 10:55 PM
After all of this malarky on outlawing DEI policies, I decided to write something down about it.
TLDR; I absolutely support it, our teams will be better as a result both for the patient and for the organisation.
open.substack.com/pub/drcois/p...
#DEI
TLDR; I absolutely support it, our teams will be better as a result both for the patient and for the organisation.
open.substack.com/pub/drcois/p...
#DEI
The Whitehouse website is a nightmare fuel reading at the moment.
www.whitehouse.gov/presidential...
www.whitehouse.gov/presidential...
Defending Women From Gender Ideology Extremism And Restoring Biological Truth To The Federal Government – The White House
By the authority vested in me as President by the Constitution and the laws of the United States of America, including section 7301 of title 5, United
www.whitehouse.gov
January 24, 2025 at 3:31 AM
The Whitehouse website is a nightmare fuel reading at the moment.
www.whitehouse.gov/presidential...
www.whitehouse.gov/presidential...
Doctor here… ✋🏻
All I want for the next four years is for health and science to be left to the scientists and healthcare professionals.
Grifters and antivaxxers need to step aside. We got real work to do…
#publichealth
All I want for the next four years is for health and science to be left to the scientists and healthcare professionals.
Grifters and antivaxxers need to step aside. We got real work to do…
#publichealth
January 23, 2025 at 7:15 PM
Doctor here… ✋🏻
All I want for the next four years is for health and science to be left to the scientists and healthcare professionals.
Grifters and antivaxxers need to step aside. We got real work to do…
#publichealth
All I want for the next four years is for health and science to be left to the scientists and healthcare professionals.
Grifters and antivaxxers need to step aside. We got real work to do…
#publichealth
My first sub stack!!
https://open.substack.com/pub/drcois/p/rfk-will-be-a-disaster?r=2yh5r&utm_campaign=post&utm_medium=web&showWelcomeOnShare=true
https://open.substack.com/pub/drcois/p/rfk-will-be-a-disaster?r=2yh5r&utm_campaign=post&utm_medium=web&showWelcomeOnShare=true
January 23, 2025 at 4:47 PM
Where the IMGs working in the US at?
My EM path.
> 4yrs undergrad (Exercise Science)
> 7yrs S&C coaching
> 4yrs medical school (Perth 🇦🇺)
> 5yrs working as a RMO/reg and advanced diplomate in OBGYN (Perth 🇦🇺)
> 3yrs EM residency (OR 🇺🇸)
> 2nd yr as Assistant Prof EM
Wild but rewarding journey!
My EM path.
> 4yrs undergrad (Exercise Science)
> 7yrs S&C coaching
> 4yrs medical school (Perth 🇦🇺)
> 5yrs working as a RMO/reg and advanced diplomate in OBGYN (Perth 🇦🇺)
> 3yrs EM residency (OR 🇺🇸)
> 2nd yr as Assistant Prof EM
Wild but rewarding journey!
January 19, 2025 at 3:22 AM
Where the IMGs working in the US at?
My EM path.
> 4yrs undergrad (Exercise Science)
> 7yrs S&C coaching
> 4yrs medical school (Perth 🇦🇺)
> 5yrs working as a RMO/reg and advanced diplomate in OBGYN (Perth 🇦🇺)
> 3yrs EM residency (OR 🇺🇸)
> 2nd yr as Assistant Prof EM
Wild but rewarding journey!
My EM path.
> 4yrs undergrad (Exercise Science)
> 7yrs S&C coaching
> 4yrs medical school (Perth 🇦🇺)
> 5yrs working as a RMO/reg and advanced diplomate in OBGYN (Perth 🇦🇺)
> 3yrs EM residency (OR 🇺🇸)
> 2nd yr as Assistant Prof EM
Wild but rewarding journey!
You know how we won’t just ban fossil fuels becuase it would put people out of work.
> We just banned #tiktok, and people rely on it for their income
> I haven’t seen a plan to help retrain tiktok creators so they aren’t out of work
Why is this not a scandal?
> We just banned #tiktok, and people rely on it for their income
> I haven’t seen a plan to help retrain tiktok creators so they aren’t out of work
Why is this not a scandal?
January 19, 2025 at 2:03 AM
You know how we won’t just ban fossil fuels becuase it would put people out of work.
> We just banned #tiktok, and people rely on it for their income
> I haven’t seen a plan to help retrain tiktok creators so they aren’t out of work
Why is this not a scandal?
> We just banned #tiktok, and people rely on it for their income
> I haven’t seen a plan to help retrain tiktok creators so they aren’t out of work
Why is this not a scandal?
I had an elderly patient who lived off his social security.
> Around $24,000 per YEAR
> He ate most meals for free at the seniors centre
> His younger sister paid his phone bill
He was worried about his electrolytes because he heard a podcaster tell him the importance of getting enough salt.
> Around $24,000 per YEAR
> He ate most meals for free at the seniors centre
> His younger sister paid his phone bill
He was worried about his electrolytes because he heard a podcaster tell him the importance of getting enough salt.
January 17, 2025 at 11:42 PM
I had an elderly patient who lived off his social security.
> Around $24,000 per YEAR
> He ate most meals for free at the seniors centre
> His younger sister paid his phone bill
He was worried about his electrolytes because he heard a podcaster tell him the importance of getting enough salt.
> Around $24,000 per YEAR
> He ate most meals for free at the seniors centre
> His younger sister paid his phone bill
He was worried about his electrolytes because he heard a podcaster tell him the importance of getting enough salt.
When I have a patient with a STEMI…
> Commonly they tell me they overconsume #seedoils and they regret not having enough saturated fat in their diet.
> …
> Joking…
Was this post stupid enough for me to be a wellness grifter now?
> Commonly they tell me they overconsume #seedoils and they regret not having enough saturated fat in their diet.
> …
> Joking…
Was this post stupid enough for me to be a wellness grifter now?
January 17, 2025 at 10:58 PM
When I have a patient with a STEMI…
> Commonly they tell me they overconsume #seedoils and they regret not having enough saturated fat in their diet.
> …
> Joking…
Was this post stupid enough for me to be a wellness grifter now?
> Commonly they tell me they overconsume #seedoils and they regret not having enough saturated fat in their diet.
> …
> Joking…
Was this post stupid enough for me to be a wellness grifter now?
The new administration will correct this wrong…
Oh wait. They are a bunch of white billionaires…
https://www.statnews.com/2025/01/09/medical-school-black-hispanic-enrollment-drops-after-supreme-court-affirmative-action-ruling/
Oh wait. They are a bunch of white billionaires…
https://www.statnews.com/2025/01/09/medical-school-black-hispanic-enrollment-drops-after-supreme-court-affirmative-action-ruling/
Black and Hispanic medical student enrollment falls after Supreme Court ruling
Enrollment of Black and Hispanic students in medical schools dropped precipitously last year after the Supreme Court banned the consideration of race in admissions.
www.statnews.com
January 16, 2025 at 3:23 AM
The new administration will correct this wrong…
Oh wait. They are a bunch of white billionaires…
https://www.statnews.com/2025/01/09/medical-school-black-hispanic-enrollment-drops-after-supreme-court-affirmative-action-ruling/
Oh wait. They are a bunch of white billionaires…
https://www.statnews.com/2025/01/09/medical-school-black-hispanic-enrollment-drops-after-supreme-court-affirmative-action-ruling/
Doctors just push pills on people…
> Couldn’t be farther from the truth
> Most guidelines inc diet, exercise, weight loss, sleep BEFORE medications
> A cornerstone of medical education is to make these decisions WITH the patient
So please wellness grifters - stop making this false dichotomy
> Couldn’t be farther from the truth
> Most guidelines inc diet, exercise, weight loss, sleep BEFORE medications
> A cornerstone of medical education is to make these decisions WITH the patient
So please wellness grifters - stop making this false dichotomy
January 14, 2025 at 5:54 AM
Doctors just push pills on people…
> Couldn’t be farther from the truth
> Most guidelines inc diet, exercise, weight loss, sleep BEFORE medications
> A cornerstone of medical education is to make these decisions WITH the patient
So please wellness grifters - stop making this false dichotomy
> Couldn’t be farther from the truth
> Most guidelines inc diet, exercise, weight loss, sleep BEFORE medications
> A cornerstone of medical education is to make these decisions WITH the patient
So please wellness grifters - stop making this false dichotomy
Typical for an ER doc walking room to room…
> Receive thanks from worried parents for reassuring them about their sick child
> Get chastised by a patient for not prescribing them opiate pain medications without an indication
1/2
> Receive thanks from worried parents for reassuring them about their sick child
> Get chastised by a patient for not prescribing them opiate pain medications without an indication
1/2
January 11, 2025 at 10:41 PM
Typical for an ER doc walking room to room…
> Receive thanks from worried parents for reassuring them about their sick child
> Get chastised by a patient for not prescribing them opiate pain medications without an indication
1/2
> Receive thanks from worried parents for reassuring them about their sick child
> Get chastised by a patient for not prescribing them opiate pain medications without an indication
1/2
Last night I discussed vaccination with a 9mo child’s mother who had not been vaccinated.
> She wanted to catch him up on all his vaccines.
> She was initially hesitant but had been misinformed by psychopaths that vaccines cause autism.
She wanted all of them done in the ED right then.
🥹
1/3
> She wanted to catch him up on all his vaccines.
> She was initially hesitant but had been misinformed by psychopaths that vaccines cause autism.
She wanted all of them done in the ED right then.
🥹
1/3
January 10, 2025 at 6:44 PM
Last night I discussed vaccination with a 9mo child’s mother who had not been vaccinated.
> She wanted to catch him up on all his vaccines.
> She was initially hesitant but had been misinformed by psychopaths that vaccines cause autism.
She wanted all of them done in the ED right then.
🥹
1/3
> She wanted to catch him up on all his vaccines.
> She was initially hesitant but had been misinformed by psychopaths that vaccines cause autism.
She wanted all of them done in the ED right then.
🥹
1/3
January 9, 2025 at 4:24 PM
Need some help…
> I want to know what is wrong with healthcare in the US.
> I’ve been collecting some excellent resources - but need more.
> As a stakeholder I want to hear from you.
What’s wrong with healthcare in the US?
I’ll go first - we have seeded control to insurance companies.
> I want to know what is wrong with healthcare in the US.
> I’ve been collecting some excellent resources - but need more.
> As a stakeholder I want to hear from you.
What’s wrong with healthcare in the US?
I’ll go first - we have seeded control to insurance companies.
January 9, 2025 at 4:18 PM
Need some help…
> I want to know what is wrong with healthcare in the US.
> I’ve been collecting some excellent resources - but need more.
> As a stakeholder I want to hear from you.
What’s wrong with healthcare in the US?
I’ll go first - we have seeded control to insurance companies.
> I want to know what is wrong with healthcare in the US.
> I’ve been collecting some excellent resources - but need more.
> As a stakeholder I want to hear from you.
What’s wrong with healthcare in the US?
I’ll go first - we have seeded control to insurance companies.