Jack Iwashyna
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iwashyna.bsky.social
Jack Iwashyna
@iwashyna.bsky.social
8K followers 1.6K following 5.9K posts
I work at Johns Hopkins to help patients + their loved ones heal from critical illness. I mentor clinicians and other scholars to become exceptional scientists.

Democracy is a Social Determinant of Health (#SDoH). Preserve it

Also #ICU #Baltimore
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iwashyna.bsky.social
Yanov:

“repeated in all of Russia's major crises: in the 1680s, before Peter I; in the 1780s, before Paul; in the 1820s, before Nicholas I; and so on, to this very day, when it is repeating itself before our eyes…
Book text: Faced with this challenge, the moderate “centrist" segment of the establishment, instead of joining forces with the "left" spokesmen of the reforms, chose to sacrifice them. At this price the moderates apparently hoped to save what it was still possible to save. They were mistaken. With the extermination of the "left," the entire reformist process came to a halt. This resulted in political stagnation, which in turn led to a "revolution from above." Thus, this chain of events turned out to be a chain of fateful mis-takes, in which every segment of the then Russian establishment was destined to lose, and eventually to perish. The moderates succeeded the "left-wingers" as victims of the Oprichnina, and the "right-wing-ers" succeeded the moderates. Civil society was conquered by the state and virtually destroyed. What is even more mysterious about this chain of mistakes is that it has—in different ways and in different circumstances-been repeated in all of Russia's major crises: in the 1680s, before Peter I; in the 1780s, before Paul; in the 1820s, before Nicholas I; and so on, to this very day, when it is repeating itself before our eyes. Once again, the powerful "right-wingers" have broken the rules of the game and stopped the process of reform. Once again, the "centrists" have betrayed the spokesmen of this reform. Once again, the nation has entered the zone of political stagnation, setting the stage for a restoration of the ancien régime.
December 1, 2025 at 2:16 AM
iwashyna.bsky.social
And we are up

Happy holidays to all
Christmas tree dresses and lit, in front of a dark window
November 30, 2025 at 11:53 PM
iwashyna.bsky.social
Ready for ornaments
Fully lit 9 ft tree, warm white lights
November 30, 2025 at 7:47 PM
iwashyna.bsky.social
This may be the softest Frazier Fir I have ever strung lights on
More lights, tree getting bushier 2/3 of way up with lights
November 30, 2025 at 6:24 PM
iwashyna.bsky.social
In process
Lower quarter of a Christmas tree with lights on
November 30, 2025 at 6:09 PM
iwashyna.bsky.social
"There is nothing so American as our national parks. The fundamental idea is that the country belongs to the people...for the enrichment of the lives of all of us."
PRESIDENT FRANKLIN D. ROOSEVELT
Above quote A pueblos poster
November 28, 2025 at 4:01 PM
iwashyna.bsky.social
And Dorothy Waugh reminding us what democratic government can do
Gorgeous poster calling the Grand Canyon “a free government service”
November 28, 2025 at 3:55 PM
iwashyna.bsky.social
The Marshall Plan alternative
Some Marshall plan posters, caption in next Caption: FAME=CAOS, PANE=ORDINE (HUNGER=CHAOS, BREAD=ORDER). c. 1947 Designer Unknown Fondazione Massimo e Sonia Cirulli Collection, Bologna • This poster presents a strict dichotomy between Italian life under the fascist regime and under the Marshall Plan. On the left, totalitarianism leads to starving children, while on the right, food and order have brought a flourishing democracy. The central and lower text translates as: "freedom to choose the life of tomorrow. This is why America has already sent aid to Italy in the sum of 1,140 billion lire." • Following the fall of Italy in 1943, a civil war broke out as Mussolinis remnant government, occupying German forces, invading Allied armies, and Communist-leaning partisans battled for control of the country. With the war's end in 1945, an Italian Republic-the modern nation of Italy-was established, and political parties now began to jockey for power. • The largest and most successful of these was the American-backed Christían Democratic Party, promoted in this poster and nicknamed "The White Whale" due to its huge membership and official color. In opposition to its primary rival, the Communist Party, it became in many ways the voice of American interests in Italy, under pressure from the U.S. President Harry Truman it formed a broad coalition that, with support from the American government and the Catholic Church, won local elections in 1948 and went on to control the nation for the next 40 years,
November 28, 2025 at 3:50 PM
iwashyna.bsky.social
“YOU MUST ALWAYS BE DOING THINGS AND OBVIOUSLY SUCCEEDING.

THE HARD PART IS TO KEEP PEOPLE ALWAYS AT THE WINDOW BECAUSE OF THE SPECTACLE YOU PUT ON FOR THEM.

AND YOU MUST DO THIS FOR YEARS.”

-BENITO MUSSOLINI
Above quote over image of planes and an imperial eagle
November 28, 2025 at 3:45 PM
iwashyna.bsky.social
“FASCISM SHOULD MORE APPROPRIATELY BE CALLED CORPORATISM BECAUSE IT IS A MERGER OF STATE AND CORPORATE POWER.”
-BENITO MUSSOLINI

At Poster House
A Fiat poster with above quote
November 28, 2025 at 3:42 PM
iwashyna.bsky.social
Here’s a wider shot

A = Empire State

B = One Vanderbilt ( onevanderbilt.com )

C = mystery building behind Chrysler
New York City skyline from NYU hospital w 3 buildings labeled
November 28, 2025 at 1:37 AM
iwashyna.bsky.social
What is this building behind the Chrysler Tower called?
Chrysler building at night, with cool new blocky tower behind
November 28, 2025 at 1:22 AM
iwashyna.bsky.social
Nice
New York skyline w sunset on Chrysler building
November 26, 2025 at 9:29 PM
iwashyna.bsky.social
Political stagnation as pathway to despotism

(more Yanov)
Book page: in this late part of the third cycle, the system enters an age of political stagnation, accompanied by economic and spiritual decline. And this is a clear signal that a new cataclysm, a new restoration of the ancien régime is at the door. The drama which England experienced only once, at the end of the Middle Ages (in 1660-89), which France experienced for an even briefer time (1815-30), Russia has been experiencing all the way through its tortuous history. One might say that it is developing through and by historic cataclysms. And for this reason, perhaps, it is even now, at the end of the twentieth century, still a medieval political system—an autocracy, as it was under Ivan the Terrible at the end of the sixteenth. Let me try to describe the mechanism of these repeated restora-tions, as I see it. The removal of the liberal wing of the opposition by no means signifies the elimination of the opposition as such. It is precisely the increased conservatism of pseudoabsolutist regimes, precisely their obvious inability to solve the vital problems of the country which catalyzes and brings to the surface the dual nature of the op-position. The annihilation of the left "Europeanist" wing means, in reality, not a victory but a defeat for the "gray consensus" of the ruling center. For, by routing the left, they activate the right, transtorm-ing it into a real political force. The rigid phase of the system has, chameleonlike, variously adopted the coloring of Westernism, as under Peter; of Russification, as under Alexander III; of open tyranny, as under Paul; of ideological isola-tionism, as under Nicholas I; and of Gulag-style industrialization, as under Stalin; but its essence does not change. What it aims at is the elimination (or the greatest possible reduction given the historical context) of the latent limitations on power, and removal from political circulation (often by the method of simple physical annihilation) of both the gray centrist elite and its li…
November 26, 2025 at 8:20 PM
iwashyna.bsky.social
Good god, am I going to have to spout my 💩 about how stupid “all male panels”, or “manels” are? Again?

Don’t start this crap at academic conferences again, boys
Slide with 80’s hasselhoff and my “no manel” email pledge
November 26, 2025 at 1:13 AM
iwashyna.bsky.social
So drill bits *can* be labeled clearly… and goodness bless whoever made this
Clearly labeled 17/64 drill bits Completely illegible drill bits … like 99% of the bits I own and inherited from my dad look like this. There is almost some stealth technology on them that makes them impossible to see clearly
November 23, 2025 at 3:46 PM
iwashyna.bsky.social
Yes, please!

Maybe a 4 ft square #quilt?

Something with green and red on white? Like a wreath or a tree on a snowy background? Evergreen forest in snow? Horse in wheat field?

To go on the wall in a little cabin in central PA woods that has a great fireplace already…
A shaggy brown doodle wearing an orange safety vest in front of a fireplace
November 22, 2025 at 5:03 PM
iwashyna.bsky.social
#MomentOfSven
Very floofy tuxedo cat with his head on my leg
November 22, 2025 at 3:05 PM
iwashyna.bsky.social
For the final substantive class of the Johns Hopkins first year seminar “Death and Daring in the Modern ICU”, we talked about how universities and the National Institutes of Health have partnered to be the greatest engine of innovation and discovery the world has ever known
Agenda, on chalk board, including: - Labruto - Owen-smith on universities as sources, anchors, and hubs -recombination and the garbage can model - productivity of NIH - grant life cycles - grant types - direct v indirect costs
November 20, 2025 at 3:42 AM
iwashyna.bsky.social
Great talk by Nancy Kass on ethics of comparative effectiveness research

#PERLHS @bsph-hpm.bsky.social
Slide saying: Consideration #2: Impact of Participation on "Meaningful Patient Decisions" • Respect for autonomy requires considering which decisions are meaningful for patients • Two components of whether participation restricts a meaningful patient decision: • Is it usually a "patient decision*? Is (or should) patient input ordinarily sought? Vs. being an operational decision or a routine clinically assumed decision? • Is it a meaningful choice or decision for patients? • Does the research limit or remove from patients a decision about which they might likely have important preferences, based on values, logistics, prionties, etc.
November 19, 2025 at 3:36 PM
iwashyna.bsky.social
… The kinds of simple rules I suggested earlier represent what organizational theorist James March called "superstitious learning"

They are akin to arguing that because many successful Silicon Valley firms were founded in garages, economic growth is a simple matter of building more garages.

…
Cover of Research Universities and the Public Good Page with the above quote underlined
November 18, 2025 at 12:27 AM
iwashyna.bsky.social
Blockblast’s recent grade inflation really devalues the experience
Block blast app boisterous celebration scheme
November 17, 2025 at 1:35 AM
iwashyna.bsky.social
Over on LinkedIn I was just reflecting on one of my favorite social media, which @bnallamo.bsky.social called "On Exactitude in Science, in reverse"
tweet saying: A Borges story about a guy who gets Al to summarize all the world's information for him, and then summarize the summary, until the Al has the whole world summarized into a single word. He sits alone at his desk, staring at the word, repeating it endlessly, certain he is experiencing everything 14 de julio de 2025,
November 10, 2025 at 5:12 PM
iwashyna.bsky.social
Firstly, do no (net) harm.

~ (adapted from) Hippocrates

Reading Hunink et al (2014) this morning…
Textbook page with same quote
November 10, 2025 at 1:52 PM
iwashyna.bsky.social
It is always fascinating teaching in the same seminar room as Prof @yipingong.bsky.social

My agenda for Week 11 of Death & Daring in the Modern ICU using @victorerikray.bsky.social and @hauschildt.bsky.social was surprisingly well paired with her on Viktor Frankl
Her elegant cursive "each man is questioned by life, and he can only answer to life by answering for his life" My scrawl on clinical teaching on code status, structures shaping possible choices, Ray on Structural Racism and Racialized Organizations, and Hauschildt's power applications to the ICU
November 6, 2025 at 3:50 PM