Grilled Cheese

ExploreLog inSign up

Jack Iwashyna

@iwashyna.bsky.social

1.8k Following8.4k Followers

I work at Johns Hopkins to help patients + their loved ones heal from critical illness.

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

https://voices.nejm.org/browse/voices-series/theodore-iwashyna

PostsRepliesMedia
@iwashyna.bsky.socialOct 11, 2026, 11:30 AM

Oh yes. Yesterday had a bit more of a “that was a lot” vibe — team rallied and got everybody everything they needed. (I am so grateful to the folks I work with) Was just one of those “ah, yes. I should go back in” nights.

@iwashyna.bsky.socialOct 11, 2026, 10:47 AM

Those are so cool

@iwashyna.bsky.socialOct 11, 2026, 1:49 AM

Ooof

@iwashyna.bsky.socialOct 10, 2026, 8:01 PM

It is not, but “cheat day”? And the pastries are very popular with my team, which is more important

@iwashyna.bsky.socialOct 10, 2026, 7:04 PM

I am shocked by how good <$10 has worked — I keep thinking I want something nice (and I find the idea of self-winding just cool, notwithstanding your valid comments) but haven’t been able to justify

Analog watch
@tomgauld.bsky.socialOct 10, 2026, 10:47 AMReposted by @iwashyna.bsky.social

My latest @newscientist.com cartoon

Panel 1: a large robot (composed of AI servers, network switches, storage arrays, and power distribution units) and a human are talking.

Professor "You don't want to destroy humanity do you, lLLM-A-9300x?"

Robot "Haha. What a silly question, Professor. I have no desires or feelings of my own whatsoever."

Professor (relieved)"Oh good." 

Panel 2: they walk on. The robot continues  "I am merely a tool of the company that created me. And that company, being composed of humans, will naturally have humanity's best interests at heart."

Panel 3: The professor is conspicuously quiet.
"Right?" says the Robot.
…
More silence

"Professor?"
29
@iwashyna.bsky.socialOct 10, 2026, 6:32 PM

Like, I don't want a full size Antikythera on my wrist, nor something that looks like a tank tread (ok, I lie, I would take an Antikythera, but something that has nearly that level of complexity merely to save me the bother of looking at my phone screen seems ... overcompensating)

@donmoyn.bsky.socialOct 10, 2026, 2:40 PMReposted by @iwashyna.bsky.social

New open-access paper: Direct File showed that govt could build its own user-centered platform without relying on contractors. But the product was killed after a DOGE lead spoke with the private tax preparation industry lobbying against a private option.
onlinelibrary.wiley.com/doi/10.1111/...

The ability of governments to build and sustain public interest capacity partly depends upon the position of private interests, and the ability and willingness of a government to resist private interest opposition.
The Internal Revenue Service (IRS) built a digital tax reporting service, Direct File, that created significant public value for users.
Direct File depended upon the creation of internal capacity: a government digital service team that could build digital platforms, rather than procuring a product from private vendors. Government control of the process allowed agile development and iterative improvement that would have been impossible under a traditional outsourcing model.
Long-standing opposition to Direct File by the private tax preparation industry, combined with Trump-era downsizing by the Department of Government Efficiency (DOGE), led to the elimination of the tool.
11
@iwashyna.bsky.socialOct 10, 2026, 3:58 PM

Shortly thereafter

One box with a few croissants left
@iwashyna.bsky.socialOct 10, 2026, 11:47 AM

Back at it this morning

Lots of croissants on a hospital break rooom table
@iwashyna.bsky.socialOct 10, 2026, 1:18 AM

“it was pneumonia we were fighting against, not against men” ~ Orwell, homage to Catalonia

@iwashyna.bsky.socialOct 9, 2026, 7:50 PM

Who will you be at the end of the world? I tried to be a good parent. I tried to be a good friend. ~ Emily St John Mandel 😢

@iwashyna.bsky.socialOct 9, 2026, 6:42 PM

Professional organization cowardice

@iwashyna.bsky.socialOct 9, 2026, 3:24 PM

Co-sign

@iwashyna.bsky.socialOct 9, 2026, 3:07 PM

“doing nothing is a very demanding job when other people are constantly on your back” ~ Erland Loe, Doppler [not cross posting to LinkedIn, because really, what would be the point?]

Cover of book Doppler, that has a moose on it, in front of an open window overlooking Baltimore Harbor
@iwashyna.bsky.socialOct 8, 2026, 10:28 PM

Thank you! There is a vast relevant experience in looking for, measuring, and interpreting these context effects in implementation science, so we do not have to reinvent the wheel

@iwashyna.bsky.socialOct 8, 2026, 7:55 PM

I feel confident that at some level of not perfusing, it becomes a problem?

@iwashyna.bsky.socialOct 8, 2026, 7:51 PM

“You know what no one tells you about life in an authoritarian state? How exhausting it is” ~ Emily St John Mandel in Exit Party

@iwashyna.bsky.socialOct 8, 2026, 7:22 PM

I hope you are right, at least about the great potential

@profkori.bsky.socialOct 8, 2026, 12:33 PMReposted by @iwashyna.bsky.social

Everything Solnit says… because this is know-your-place aggression, too.

Older posts
Terms of UsePrivacy PolicyCommunity StandardsHelpGet the app

Grilled Cheese is a product of Village Compute

Version devBuilt at: 2026-10-11 23:30:56 EDT