The First10EM wrap-up for Spring 2025

The First10EM monthly wrap up is a place for me to share updates about the website, about my academic life, and also interesting content, such as books, podcasts, and other FOAMed, that I have encountered in the prior month.

First, I have obviously been on a bit of a hiatus. I haven’t published anything since April, and I also took a pretty long break in January and February. I think that might be the new norm for a while. Parenting takes priority over this hobby, and right now parenting seems to take almost all of my hours, and if I am honest, I am not missing the daily grind of reading medical journals. I miss my regular chats with podcast co-host Casey Parker, but I don’t particularly miss wading through the endless morass of output from our relatively broken medical science industry. I am sure the regular rambling about research will return soon. There will definitely be overly long podcasts to record with my friends. However, for the short term, don’t expect weekly content.

My lack of output is going to make the next issue even worse: views on First10EM are way down over time. This started a long time ago, and I believe this is associated with my 2 withdrawals from Twitter – partial and then complete – but obviously I can’t be certain. Perhaps the quality has fallen off, or changed, or the audience has found better sources of medical education. (There is a degree to which people are using AI rather than the internet to answer questions, and that might also decrease traffic.)

I guess I raise this for a couple reasons. If I am correct that this is because of my withdrawal from Twitter (and I am definitely not going back to a platform owned by someone comfortable throwing around the Nazi salute), I could use your help in sharing the posts more widely around social media. You might assume that people have heard of First10EM after a decade, but it is still relatively niche, so if you enjoy the content, it would help a lot if you shared it. However, if I am incorrect about my Twitter conjecture, and you see other problems with the content being created, please let me know. The current numbers are still way higher than I would have dreamed of when starting this project, but I will be honest that seeing traffic drop by 66% is also a bit of a hit to my motivation.

What I am reading

The Family Experiment by John Marrs is a dystopian novel centered around a reality TV show following parents trying to raise babies in virtual reality, hoping to win enough money to actually be able to support a biological child. This book brought some awful characters and themes to life. I’m not sure I actually liked it, but I couldn’t put it down. It has some real Black Mirror vibes. I did not realize when I read it that it is the third book in a series, but that did not seem to matter at all for enjoyment of the novel. 

Range: Why Generalists Triumph in a Specialized World by David Epstein was recommended to me by a reader of First10EM as good outside the box parenting book. I am very happy for that recommendation, because the book was interesting, well written, and does lay out some thoughts that might be counter-intuitive to many (and reinforced some of my thoughts about parenting).

Moonbound is sort of scifi, sort of fantasy, but really just a good adventure novel. I have enjoyed everything by Robin Sloan (author of the better known Mr. Penumbra’s 24-Hour Bookstore), and I fully expect one of his novels to eventually crack my all time favourites list, but for now they are just all solidly good to great.

Everything is Tuberculosis is a very good nonfiction novel by one of my favourite authors/podcasters/YouTubers John Green. For those of us working in North American emergency departments, we are mostly working in a world of diminishing returns, where the answer is often “don’t do something, just stand there.” This is a great reminder that there is still so much good that medicine can do in the world, if we just collectively decided to spend our money and attention more wisely.

Paper Towns by John Green is a classic young adult novel. I couldn’t remember if I had read it, but after reading Everything is Tuberculosis I just felt like reading some more John Green. It might not be for everyone, and I didn’t regret the decision for a second.

The Ministry of Time by Kalaine Bradley was good but not great. I feel like that is what I write every time I read a novel about time travel, because the topics are always interesting, but it is very difficult to tackle time travel in a way that makes any sense.

Siddhartha by Hermann Hesse is a classic that I had never before found time to read. It is the story of a man on a quest for meaning and enlightenment, and there are definitely important insights within this beautifully written novel.

I have always meant to read more by Robert A Heinlein, but just haven’t found time. Have Space Suit Will Travel was a very enjoyable and insightful short sci-fi novel. Anyone who enjoys scifi will enjoy this book.

Sourdough by Robin Sloan seems to take place in the same somewhat magical San Francisco setting as Mr. Penumbra’s 24-Hour Bookstore, without directly overlapping the later. It is a very nice story with just a touch of magic, and is likely to be enjoyed by everyone who picks it up.

Deadeye Dick is quite different than other novels I have ready by Kurt Vonnegut, but with the same sense of humor. I am still not sure how I feel about it. I mean, it is definitely a good novel, but perhaps I wasn’t expecting it to be quite so dark?

Interesting media

This is actually somewhat embarrassing. I usually consider myself curious and somewhat insightful, but it never even struck me as strange that sand dries out when you step on it. I just assumed I was squeezing out the water. I was incredibly wrong, and the truth is so much weirder. Apparently some substance can increase in volume when you squeeze them??

Some things seem so obvious, until someone raises the question. For example, it is obviously harder to run on an inclined treadmill, right? But wait, you aren’t actually going up against gravity, so obviously it isn’t harder? Now I am confused, but I am left with an even bigger problem: how the heck do I test how much energy it takes me to run on a treadmill? I am not up to such challenges, but thankfully Steve Mould is:

Well I’ve spent a large part of my career complaining about ATLS and the ABC approach to trauma. This episode of Radiolab goes over the history of the course, which I think most of us know, but provides a nice reminder that ATLS was born out of the right mindset, for its many issues. (I think the ethos that drove ATLS is very similar to the ethos of FOAMed: recognize a gap, scour every resource possible to find an answer, and try to share that information widely.) There is also a brief cameo from FOAMed hero Reuben Strayer, so this episode has it all. 

Using science to cook better brownies:

My Favourite FOAMed this month

Cliff Reid: What it takes to be at the cutting edge

Considering how rarely I have made a de novo diagnosis of an eating disorder in the emergency department, the statistics raised in this episode of EM Cases are incredibly concerning. For most of us, this podcast will be one of the highest yield FOAMed publications in memory. 

Ok, I am willing to admit I have never heard of a gastropericardial fistula: https://www.aliem.com/saem-clinical-images-series-short-of-breath-and-short-on-time/

Another great video from Cliff Reid goes into excruciating and important detail on hyperangulated video laryngoscopy:

I have spent an obscene amount of time watching prior videos specifically about hyperangulated video laryngoscopy, attended many airway courses, and played with these devices for hundreds of hours in the sim lab, and I still came out of this 13 minute video with multiple pearls that might change my practice. 

I was incredibly pleased to see blog posts on P Cubed Presentations again. (Perhaps the blog had been active all along, and I just missed posts, but there seems to have been a recent flurry of activity. Ross Fisher was one of my major sources when learning how to present. Whether you are interested in speaking at conferences or really just any kind of medical education, I think this is a blog that you want to follow. 

The FOAMed universe has felt both saturated and stagnant for a while, so I am excited to see the niche of emergency and critical care nursing covered by EMCrit. I am not sure how I feel about a podcast targeted at nurses being hidden behind a paywall (perhaps it is different in other countries, but nurses I work with get no support for this kind of education). That being said, based on my recent reflections on the sustainability of FOAMed, I certainly understand the decision. Either way, I am very excited to see what the one-to-one podcast becomes.

I am honestly not sure why I enjoyed this post from “In the pipeline” so much. There is so much about pharmaceutical chemistry that I don’t think about at all, but has such important impacts on the human body. This won’t make you a better emergency doctor, but it might serve as a reminder of the tremendous impact that we have on human bodies when we put chemicals into them, and why it is so hard to have a net benefit effect when altering human homeostasis.

Not sure if this is the first time an actor has come out of Hollywood and into FOAMed, but this was a pretty crazy episode of the SGEM

Quotes or Thoughts

“We do not learn from experience…we learn from reflecting on experience.” ― John Dewey

“Don’t aim at success. The more you aim at it and make it a target, the more you are going to miss it. For success, like happiness, cannot be pursued; it must ensue.” – Viktor Fraknl in Man’s Search for Meaning

“Don’t waste your time chasing butterflies. Mend your garden, and the butterflies will come.” – Mario Quintana

“We are all ready to be savage in some cause. The difference between a good man and a bad one is the choice of the cause.” – William James

“The hero of a David Lodge novel says that you don’t know, when you make love for the last time, that you are making love for the last time. Voting is like that.” from On Tyranny: Twenty Lessons from the Twentieth Century by Timothy Snyder