Alastair McAlpine, MD Profile picture
Paeds infectious diseases MD. Runner. Metal music reviewer🤘. Ice-cream enthusiast. Dislikes pseudoscience. Views ≠ my employer 🏳️‍⚧️🏳️‍🌈 He/Him
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Oct 2, 2018 6 tweets 2 min read
According to all available sleep research:
If you’re getting
7-9h sleep/d: 👌
6-7h sleep/d: 😔
<6h sleep/d: 😰
<4h sleep/d: 😭

Most Americans get +/- 6h per night. Down 20% from 50 years ago. If you missed a night’s sleep, you’re the equivalent of someone with a 0.1% blood-alcohol level (the legal limit for driving in SA is 0.05%). In other words, you’re drunk.

And it takes approximately 5-7 days of good sleep to make up for 1 missed night.
Sep 21, 2018 9 tweets 2 min read
If there is a more nefarious concept than the ‘resilient physician’, I ain’t heard it. (Thread)

Instead of improving a system that is brutal, unkind and dehumanizing, the powers that be are basically saying, ‘Harden the fuck up... by doing some yoga and stuff.’ /1 These are people, remember, who worked hard in school, slaved away for years at university, missed out large chunks of their 20s and 30s working incredibly long hours in tough conditions.

They are resilient!
Sep 16, 2018 5 tweets 2 min read
All right, folks*, hide the kids away... time to talk metal! 🤘🤘🤘

*My 5 metalhead followers It’s been a killer year for melodeath (Amorphis, Omnium Gatherum). This one from Shylmagoghnar (what a ridiculous name) is just epic. And beautiful.
Aug 25, 2018 5 tweets 1 min read
This whole John McCain ‘giving up’ treatment for his cancer is terrible language. (Thread)

(a) He is simply shifting the goals of care from curative to a palliative. While a cure may no longer be an option, this mode of medicine is just as active, sometimes more so.
(b) Someone who decides to stop fighting a futile battle against an invasive cancer isn’t ‘giving up’ - that implies weakness.

Accepting the truth, when that truth is terrible, is not weak.
Sometimes it’s the strongest thing we can do.

Jul 20, 2018 11 tweets 2 min read
In light of the fact that I had to come to Vancouver to find a book by Ngugi wa Thiong’o (yes, Sea Point library, I’m looking at you), I’m going to be highlighting some great African books I’ve read (by authors of ALL races).

Thread /1 ‘Chaka the Zulu’ (sic) by Thomas Mofolo. A rich and interesting fictional recreation of the life of the great warrior and leader.

Jun 21, 2018 4 tweets 2 min read
In principle, healthcare should not be a for-profit enterprise because that corrupts best practice. Doctors’ decisions should not be influenced by how much money a decision will make them, but by benefit to their patients. /1 Having said that, the #NHI that Motsoaledi is proposing will be a complete disaster. The SA govt can’t deliver my mail on time, or keep the lights on; they can’t be trusted with my healthcare. /2
Apr 24, 2018 10 tweets 2 min read
Part of the challenge of paediatric palliative care is weighing up the desires of parents (keep the child alive at all costs) vs. the rights of the child (a life free of unnecessary suffering).

Thread /1

#Palliativecare Usually, with proper counseling, the doctors and parents of a seriously ill kid can reach a consensus on what path to take, in the best interests of the child.

But occasionally, there is a breakdown

Feb 1, 2018 13 tweets 2 min read
For an assignment, I asked some of my terminal paediatric palliative care patients what they had enjoyed in life, and what gave it meaning. Kids can be so wise, y'know. Here are some of the responses (Thread). First:
NONE said they wished they'd watched more TV
NONE said they should've spent more time on Face Book
NONE said they enjoyed fighting with others
NONE enjoyed hospital