Paul Williams
@paulnwilliams.bsky.social
Internist, Curbsider
Pinned
Paul Williams
@paulnwilliams.bsky.social
· Jul 25
*How to round with Paul Williams*
Tips for medical students, interns, and the curious - a thread
Just in case this might be helpful. Your mileage may vary with other attendings, who may violently disagree with these. (1/16)
Tips for medical students, interns, and the curious - a thread
Just in case this might be helpful. Your mileage may vary with other attendings, who may violently disagree with these. (1/16)
Shout out to my dictation software for transcribing “Alpha Zosyn,” perhaps the manliest of the antimicrobials
November 28, 2025 at 4:13 PM
Shout out to my dictation software for transcribing “Alpha Zosyn,” perhaps the manliest of the antimicrobials
Feels like a snow day in clinic today
November 28, 2025 at 2:55 PM
Feels like a snow day in clinic today
Probably good, in case you're wondering
New in the November 27, 2025, issue of NEJM:
Early Discontinuation of Aspirin after PCI (TARGET-FIRST trial) nej.md/3UKJxS7
Early Withdrawal of Aspirin after PCI (NEO-MINDSET trial) nej.md/3VeTJT8
#MedSky
Early Discontinuation of Aspirin after PCI (TARGET-FIRST trial) nej.md/3UKJxS7
Early Withdrawal of Aspirin after PCI (NEO-MINDSET trial) nej.md/3VeTJT8
#MedSky
November 28, 2025 at 12:50 AM
Probably good, in case you're wondering
Ah, Thanksgiving. A magical time where you must decide if you’re going to become a shrill, east coast liberal stereotype or simply disassociate over mashed potatoes when a story about Ariana Grande being too skinny takes a surprising and unsettling turn.
November 27, 2025 at 10:19 PM
Ah, Thanksgiving. A magical time where you must decide if you’re going to become a shrill, east coast liberal stereotype or simply disassociate over mashed potatoes when a story about Ariana Grande being too skinny takes a surprising and unsettling turn.
Congrats to the authors on this excellent study and even better trial name
jamanetwork.com/journals/jam...
jamanetwork.com/journals/jam...
Caffeinated Coffee Consumption or Abstinence to Reduce Atrial Fibrillation
This clinical trial compares the effect of caffeinated coffee consumption vs abstinence from coffee and caffeine on recurrent atrial fibrillation.
jamanetwork.com
November 26, 2025 at 6:09 PM
Congrats to the authors on this excellent study and even better trial name
jamanetwork.com/journals/jam...
jamanetwork.com/journals/jam...
In general, I like the writing in @theguardian.com, but this paragraph about the Beatles made me gag three different times. “Songwriting aside????”
November 26, 2025 at 11:37 AM
In general, I like the writing in @theguardian.com, but this paragraph about the Beatles made me gag three different times. “Songwriting aside????”
I will absolutely not be lectured on civility by this administration
November 26, 2025 at 11:18 AM
I will absolutely not be lectured on civility by this administration
Every. Single. Tuesday.
November 25, 2025 at 1:09 PM
Every. Single. Tuesday.
Reposted by Paul Williams
maybe i am going insane
November 24, 2025 at 6:49 PM
maybe i am going insane
Trying to live my life in such a way that people bring me zucchini bread unprompted
November 25, 2025 at 3:07 AM
Trying to live my life in such a way that people bring me zucchini bread unprompted
Thinking about this, and probably worth noting statins don’t completely prevent heart attacks and blood pressure control doesn’t completely prevent strokes. Might be time to reframe our discussion around vaccinations.
Some vaccines like COVID and flu don’t stop completely stop infection.
But they do reduce the risk of getting infected and greatly reduce severe illness risk.
They are still worth getting.
Since they are not 100% effective it’s also wise to add another layer of protection by wearing a mask.
But they do reduce the risk of getting infected and greatly reduce severe illness risk.
They are still worth getting.
Since they are not 100% effective it’s also wise to add another layer of protection by wearing a mask.
November 24, 2025 at 3:17 AM
Thinking about this, and probably worth noting statins don’t completely prevent heart attacks and blood pressure control doesn’t completely prevent strokes. Might be time to reframe our discussion around vaccinations.
I mostly hate running in the dark, but I do like that my head lamp lets me do a little deer spotting
November 23, 2025 at 12:01 AM
I mostly hate running in the dark, but I do like that my head lamp lets me do a little deer spotting
Reposted by Paul Williams
*mechanic wipes his hands on a rag*
Well, there’s your trouble
*points to a lifetime of crippling depression and anxiety*
Well, there’s your trouble
*points to a lifetime of crippling depression and anxiety*
November 22, 2025 at 4:01 PM
*mechanic wipes his hands on a rag*
Well, there’s your trouble
*points to a lifetime of crippling depression and anxiety*
Well, there’s your trouble
*points to a lifetime of crippling depression and anxiety*
Reposted by Paul Williams
i don’t care about your typos. not one bit. only mine. ONLY MINE ARE WRONG AND BAD
November 22, 2025 at 6:03 PM
i don’t care about your typos. not one bit. only mine. ONLY MINE ARE WRONG AND BAD
Reposted by Paul Williams
We gotta bring back shame in a big way
November 22, 2025 at 6:37 PM
We gotta bring back shame in a big way
The blessing and the curse of my aura is that my vibe on public transportation is very much that I would prefer no one sit next to me, which works on everyone but absolute mouth-breathing lunatics who are completely immune to social cues
November 22, 2025 at 5:39 PM
The blessing and the curse of my aura is that my vibe on public transportation is very much that I would prefer no one sit next to me, which works on everyone but absolute mouth-breathing lunatics who are completely immune to social cues
This is the exact correct take. If I thought they were smarter, I’d say this is some 4D chess to sow left-leaning distrust of Mamdani.
But really, this is just the vibe he responds to, and that the grotesque sycophants in his orbit desire but could never achieve.
But really, this is just the vibe he responds to, and that the grotesque sycophants in his orbit desire but could never achieve.
my jaw is on the floor and yet im completely unsurprised. trump’s only political conviction is that he loves a handsome winner
A reporter asks if Mamdani stands by calling Trump a fascist. Mamdani starts to give a delicate answer.
Trump (smiles, pats Mamdani's arm): "That's OK, you can just say yes. It's easier. I don't mind."
Trump (smiles, pats Mamdani's arm): "That's OK, you can just say yes. It's easier. I don't mind."
November 22, 2025 at 12:31 AM
This is the exact correct take. If I thought they were smarter, I’d say this is some 4D chess to sow left-leaning distrust of Mamdani.
But really, this is just the vibe he responds to, and that the grotesque sycophants in his orbit desire but could never achieve.
But really, this is just the vibe he responds to, and that the grotesque sycophants in his orbit desire but could never achieve.
One of my residents told me that they once heard me say: "I'm sorry, I had a hard time hearing you because I was still speaking," which is a great reminder that role-modeling is an important part of this job.
November 21, 2025 at 11:32 PM
One of my residents told me that they once heard me say: "I'm sorry, I had a hard time hearing you because I was still speaking," which is a great reminder that role-modeling is an important part of this job.
Super excited for a future in which AI does the tedious work of diagnosis and disease management so I can focus on the things that REALLY matter, like scrolling through impenetrable insurance formularies and completing paperwork no one actually looks at.
November 21, 2025 at 3:07 PM
Super excited for a future in which AI does the tedious work of diagnosis and disease management so I can focus on the things that REALLY matter, like scrolling through impenetrable insurance formularies and completing paperwork no one actually looks at.
I'm so old that I remember using the CDC website to look up credible medical information
November 21, 2025 at 11:22 AM
I'm so old that I remember using the CDC website to look up credible medical information
Sometimes I do miss Twitter
www.theguardian.com/technology/2...
www.theguardian.com/technology/2...
Elon Musk’s Grok AI tells users he is fitter than LeBron James and smarter than da Vinci
Users noted that in a raft of now-deleted posts, the chatbot would frequently rank Musk top in any given field
www.theguardian.com
November 21, 2025 at 11:22 AM
Sometimes I do miss Twitter
www.theguardian.com/technology/2...
www.theguardian.com/technology/2...
Reposted by Paul Williams
Can’t believe the whole country has to suffer through the return of Dickensian childhood diseases because the worst, most ignorant attention-demanders decided other people’s expertise makes them feel bad
November 20, 2025 at 4:19 AM
Can’t believe the whole country has to suffer through the return of Dickensian childhood diseases because the worst, most ignorant attention-demanders decided other people’s expertise makes them feel bad
Today, a patient said to me: “You don’t LOOK like a perfectionist.“
Merciless. Flawless victory. Fatality.
Merciless. Flawless victory. Fatality.
November 19, 2025 at 11:25 PM
Today, a patient said to me: “You don’t LOOK like a perfectionist.“
Merciless. Flawless victory. Fatality.
Merciless. Flawless victory. Fatality.
Yes, but if you push back, you run the risk of losing access to all of this high quality, factual information
I mean, look, I'm not a reporter, so who am I to talk?
But on a day where the president both just called a woman reporter "Piggy" and is celebrating someone who had people bone saw apart one of my colleagues, I might just be a little ready to defend my colleagues and profession.
But that's just me
But on a day where the president both just called a woman reporter "Piggy" and is celebrating someone who had people bone saw apart one of my colleagues, I might just be a little ready to defend my colleagues and profession.
But that's just me
November 19, 2025 at 12:15 PM
Yes, but if you push back, you run the risk of losing access to all of this high quality, factual information
Loosely following the "piggy" discourse, and it took about 12 milliseconds for someone to comment "Well actually, pigs are very clean and fastidious animals" and I cannot for the life of me imagine what you'd get out of typing something like that
November 19, 2025 at 12:12 PM
Loosely following the "piggy" discourse, and it took about 12 milliseconds for someone to comment "Well actually, pigs are very clean and fastidious animals" and I cannot for the life of me imagine what you'd get out of typing something like that