Brett Biebelberg, MD
@bbiebelberg.bsky.social
IM PGY1 @ Penn, researching sepsis @MGH/BWH, gun violence prevention advocate, EMT, via Harvard. 🗣evidence-based medicine, QI, public health, humanity in medicine.
Career changer & proponent of physician leadership.
#medsky #emimcc #pccm 🫀🫁
Career changer & proponent of physician leadership.
#medsky #emimcc #pccm 🫀🫁
7) The people you work with matter. On night float blocks, there really isn’t much time outside the hospital for anything besides eating and sleeping. You invariably lose contact with friends and family. My night co-residents became my friends and support system.
November 23, 2025 at 5:16 PM
7) The people you work with matter. On night float blocks, there really isn’t much time outside the hospital for anything besides eating and sleeping. You invariably lose contact with friends and family. My night co-residents became my friends and support system.
Me hyping myself up to try, again, to place an ultrasound–guided IV
September 28, 2025 at 4:32 PM
Me hyping myself up to try, again, to place an ultrasound–guided IV
This is intern year except every 2 weeks you go back to rolling a wooden box filled with patients you know nothing about, subspecialty services you have no experience in, new attending and senior resident preferences, and
bathrooms you don’t know the codes for 😀
bathrooms you don’t know the codes for 😀
September 15, 2025 at 10:36 PM
This is intern year except every 2 weeks you go back to rolling a wooden box filled with patients you know nothing about, subspecialty services you have no experience in, new attending and senior resident preferences, and
bathrooms you don’t know the codes for 😀
bathrooms you don’t know the codes for 😀
4/ THC wasn't immediately known to be the cause.
Emergency services initially tested the restaurant and the homes of several customers for carbon monoxide but found no leaks
Instead, one of the pizzeria patrons who went to the ED had a UDS collected which was positive for THC
Emergency services initially tested the restaurant and the homes of several customers for carbon monoxide but found no leaks
Instead, one of the pizzeria patrons who went to the ED had a UDS collected which was positive for THC
August 1, 2025 at 6:08 PM
4/ THC wasn't immediately known to be the cause.
Emergency services initially tested the restaurant and the homes of several customers for carbon monoxide but found no leaks
Instead, one of the pizzeria patrons who went to the ED had a UDS collected which was positive for THC
Emergency services initially tested the restaurant and the homes of several customers for carbon monoxide but found no leaks
Instead, one of the pizzeria patrons who went to the ED had a UDS collected which was positive for THC
3/ The owner of the pizzeria told officials they'd run out of cooking oil and grabbed what they thought was canola oil from the shared commercial kitchen
In fact, they had grabbed hemp-derived THC-infused cooking oil
They didn't know 'D9' was short for Δ9-tetrahydrocannabinol
In fact, they had grabbed hemp-derived THC-infused cooking oil
They didn't know 'D9' was short for Δ9-tetrahydrocannabinol
August 1, 2025 at 6:08 PM
3/ The owner of the pizzeria told officials they'd run out of cooking oil and grabbed what they thought was canola oil from the shared commercial kitchen
In fact, they had grabbed hemp-derived THC-infused cooking oil
They didn't know 'D9' was short for Δ9-tetrahydrocannabinol
In fact, they had grabbed hemp-derived THC-infused cooking oil
They didn't know 'D9' was short for Δ9-tetrahydrocannabinol
1/ Last October, 85 people ages 1-91 developed dizziness, drowsiness, anxiety, and/or memory distortion. Some went to the ED. They'd all recently eaten at a Wisconsin pizzeria.
Local public health officials investigated. As reported in last week's CDC MMWR, they found
Local public health officials investigated. As reported in last week's CDC MMWR, they found
August 1, 2025 at 6:08 PM
1/ Last October, 85 people ages 1-91 developed dizziness, drowsiness, anxiety, and/or memory distortion. Some went to the ED. They'd all recently eaten at a Wisconsin pizzeria.
Local public health officials investigated. As reported in last week's CDC MMWR, they found
Local public health officials investigated. As reported in last week's CDC MMWR, they found
First week of residency down.
June 27, 2025 at 10:59 PM
First week of residency down.
Takeaways from @nejm.org acute abdomen review:
➡️ Don’t withhold analgesia
➡️ CT angio abd/pelv w/ IV contrast is usually ideal image; ultrasound for others but high performance variability
➡️ Consult surgery ASAP
➡️ Beware of cognitive bias
www.nejm.org/doi/full/10....
#medsky
➡️ Don’t withhold analgesia
➡️ CT angio abd/pelv w/ IV contrast is usually ideal image; ultrasound for others but high performance variability
➡️ Consult surgery ASAP
➡️ Beware of cognitive bias
www.nejm.org/doi/full/10....
#medsky
April 20, 2025 at 4:48 PM
Takeaways from @nejm.org acute abdomen review:
➡️ Don’t withhold analgesia
➡️ CT angio abd/pelv w/ IV contrast is usually ideal image; ultrasound for others but high performance variability
➡️ Consult surgery ASAP
➡️ Beware of cognitive bias
www.nejm.org/doi/full/10....
#medsky
➡️ Don’t withhold analgesia
➡️ CT angio abd/pelv w/ IV contrast is usually ideal image; ultrasound for others but high performance variability
➡️ Consult surgery ASAP
➡️ Beware of cognitive bias
www.nejm.org/doi/full/10....
#medsky
Wellness will be when I don't have to do a module on how to use hand sanitizer
April 19, 2025 at 5:38 PM
Wellness will be when I don't have to do a module on how to use hand sanitizer
I'm thrilled to have matched in internal medicine at Penn! @pennmedicine.bsky.social
Endlessly grateful for my family, friends, and mentors on whose shoulders I stand.
#Match2025
Endlessly grateful for my family, friends, and mentors on whose shoulders I stand.
#Match2025
March 21, 2025 at 7:24 PM
I'm thrilled to have matched in internal medicine at Penn! @pennmedicine.bsky.social
Endlessly grateful for my family, friends, and mentors on whose shoulders I stand.
#Match2025
Endlessly grateful for my family, friends, and mentors on whose shoulders I stand.
#Match2025
March 17, 2025 at 2:15 PM
When the recipe calls for 2 cloves of garlic
#docswhocook
#docswhocook
March 16, 2025 at 11:31 PM
When the recipe calls for 2 cloves of garlic
#docswhocook
#docswhocook
Little Prayer
by Danez Smith
As seen on the subway, illuminated by rays of sunset
by Danez Smith
As seen on the subway, illuminated by rays of sunset
March 15, 2025 at 8:04 PM
Little Prayer
by Danez Smith
As seen on the subway, illuminated by rays of sunset
by Danez Smith
As seen on the subway, illuminated by rays of sunset
UpToDate, feeling pressure to remain relevant in the face of popular new generative AI tools like OpenEvidence, leans into AI-powered search, but stops short of rolling out any gen AI tools of its own.
March 14, 2025 at 12:03 AM
UpToDate, feeling pressure to remain relevant in the face of popular new generative AI tools like OpenEvidence, leans into AI-powered search, but stops short of rolling out any gen AI tools of its own.
Listen to Cher
March 5, 2025 at 2:34 PM
Listen to Cher
Do you decompress after leaving the hospital before you get home?
March 1, 2025 at 6:03 PM
Do you decompress after leaving the hospital before you get home?
My neighbor, Lee Aaron Adler, was a father and computer engineer at Cantor Fitzgerald on the 103rd floor of One World Trade. He was also a member of the board of trustees of our synagogue. He died.
Knock it off.
www.nj.com/lives_rememb...
Knock it off.
www.nj.com/lives_rememb...
February 11, 2025 at 2:09 AM
My neighbor, Lee Aaron Adler, was a father and computer engineer at Cantor Fitzgerald on the 103rd floor of One World Trade. He was also a member of the board of trustees of our synagogue. He died.
Knock it off.
www.nj.com/lives_rememb...
Knock it off.
www.nj.com/lives_rememb...
Over on Elon Musk's Twitter, people are being banned for criticizing the openly racist 20-somethings working for DOGE, but Kanye West is on another unfettered and unchecked antisemitic rant
February 8, 2025 at 7:32 PM
Over on Elon Musk's Twitter, people are being banned for criticizing the openly racist 20-somethings working for DOGE, but Kanye West is on another unfettered and unchecked antisemitic rant
1/ Cautionary tale about the blindly-accepted "you can't give contrast to a patient with an AKI" dogma still permeating medicine
Consensus guidelines from ACR & NKF clearly state risk of contrast-induced kidney injury in pts w/ impaired renal fxn has been overstated d/t confounding
#medsky #emimcc
Consensus guidelines from ACR & NKF clearly state risk of contrast-induced kidney injury in pts w/ impaired renal fxn has been overstated d/t confounding
#medsky #emimcc
February 8, 2025 at 5:15 PM
One of the biggest things I’ve learned about academic writing (and writing in general, really)
It’s better to write a shitty first draft than to write nothing at all
#medsky
It’s better to write a shitty first draft than to write nothing at all
#medsky
February 6, 2025 at 2:19 PM
One of the biggest things I’ve learned about academic writing (and writing in general, really)
It’s better to write a shitty first draft than to write nothing at all
#medsky
It’s better to write a shitty first draft than to write nothing at all
#medsky
To the ship!
January 27, 2025 at 12:13 AM
To the ship!
Thanks Jesús. Good point. In this case the authors of the original article excluded patients who tested positive for viral illness and focused their analysis on bacterial cultures. But perhaps some with neg bacterial cxs were never tested for resp viruses media.springernature.com/full/springe...
January 25, 2025 at 2:03 PM
Thanks Jesús. Good point. In this case the authors of the original article excluded patients who tested positive for viral illness and focused their analysis on bacterial cultures. But perhaps some with neg bacterial cxs were never tested for resp viruses media.springernature.com/full/springe...
"Culture-negative sepsis" is associated with higher rates of pulmonary infection & respiratory failure
Why? In a Critical Care letter, I share two hypotheses:
1) Limited ability to detect bugs localized to the lungs
2) Lack of infection (ergo, lack of sepsis) to begin with
#medsky #idsky #emimcc
Why? In a Critical Care letter, I share two hypotheses:
1) Limited ability to detect bugs localized to the lungs
2) Lack of infection (ergo, lack of sepsis) to begin with
#medsky #idsky #emimcc
January 24, 2025 at 9:53 PM
What is the AMA doing about this?
January 23, 2025 at 7:02 PM
What is the AMA doing about this?