I am done giving this doctor or team grace. I started with "We are tremendously grateful for all you are doing." He seemed irritated to speak to us. Literally I asked, "What is the likelihood our mom will die on current support, in the next 24 hours, so we can plan travel?"

He hammered us with how severe this was and that was. Yes, that is why I am asking the question. "We are asking you to be a thought partner so we can make responsible decisions as the family." I had had pre-conversations with doctor friends to understand the numbers and prognosis

He said "It would be illegal for me to tell you that she won't die, then she dies." Yes, that is why I said LIKELIHOOD - critical care docs deal in likelihoods. It so frustrating to be on this side and not get a fraction of the standard that I have been held to and hold myself to

Then I made the error of saying, "I'm a pediatrician, I literally do this work on family-centered, compassionate care." to which the charge nurse answered, "It is not the work we do. We keep people alive." End of life care IS your job. Planning IS your job. It's not just numbers

Compassion is not only a pediatric thing while critical care/end of life can proudly lack it. I've had more end of life conversations than I want to remember. My mom is not numbers. She is a human being. I am modulating my voice, complimenting you, leveraging my network.

Dear #MedTwitter please, please, if you are a licensed medical professional and/or in school to be, do NOT delete your tweets or comply with anyone telling you to do so. It will harm you far more than leaving them up and explaining. Nothing is ever deleted. Can be used in court.

When I was at Harvard Med School and at an esteemed children's hospital, a case against an esteemed professor, that NO lawyer would touch cuz this was someone who had WRITTEN the textbooks and trained every expert, was won ..based on "a document was deleted" - creating suspicion

"Sunlight is the best disinfectant" you will hear me say OVER and OVER - wins & losses *should* be on data/standards but unfortunately wins & losses are in the court of public opinion. So be reliable, credible, and trustworthy. Transparency is one way to achieve that reputation.

The tweets I delete typically have a typo or the link did not populate the image as I wanted and I *immediately* repost THE SAME tweet, corrected. That way if anyone with "dark web" capacity were to try to "find dirt", ain't none. What you see is what you get.

I have been around the block enuf times, been a public servant w/ strict COI & scrutiny of my every word, & have been "in the room" when we have been deciding billions of dollars of state funding in Medicaid

You can decide whether you trust my