Valentine’s Day Special: A Love Letter to the Heart
A Valentine’s note that skips the pink hearts and goes straight to the real one: the four-chambered muscle that keeps you in the game. VO2 max, rowing, breathing, and the quiet work of maintenance.
Latest
No Snow & Keep Your Lines Light
A snow day that wasn't, a 0.2 mm pencil, and what Crucial Conversations gets right about drawing: keep your lines light until you know where the structure is.
Have You Ever Wondered…the Medicine & Science of Losing Your Temper?
This Teaching Edition explores what happens in the brain and body when anger takes over the nervous system, how to bring it back online as a physician, parent, and human.
Have You Ever Wondered…Why “We Talked About It” Isn’t Communication?
ICU communication isn’t a vibe. It’s a system families can feel. Using ARMOR as a framework, this Tuesday Teaching Edition explains how huddles, daily goals, and structured rounds can create clarity, safety, and trust.
Polar Vortex, Persian Jazz, and Yellow Dream Worlds
The cold didn’t bring snow. It brought clarity. Warmth is not just heat. Warmth is behavior: a hug, Persian tea, niche music, and a yellow dream world on a wall.
Learning to Breathe While the Truth Burns
A story about heat, breath, and learning to stay present when the truth burns.
Bow ties & Pipes
Notes from BOKA. Medicine, meaning, living. Bow ties, pipes, bookcases, and the quiet joy of thinking out our in internal medicine. Stay curious.
Have You Ever Wondered Why Sepsis Patients Crash So Quickly?
Sepsis doesn’t usually announce itself loudly at first. It holds itself together until it can’t.
Three Dolls
I read my kids a Persian story about three dolls the other night. By week’s end, it had followed me into the ICU. Some moments ask for speed. Others ask for listening that stays. Notes from BOKA: Medicine, Meaning, Living.
The Quiet Weight We Carry
INK+OXYGEN by Dr. Boka. A reflection on the quiet weight of responsibility in medicine, leadership, and daily life.
Where We’re Going, We Need More Time
A Back to the Future theater night, a Hobonichi year review, and one simple plan to build 2026 with more attention, more reverence, and more oxygen.
INK+OXYGEN #2: Showing Up
A Christmas morning at the kitchen table—drawing with my kids, thinking about breathing rhythms in the ICU, and learning why showing up matters more than being productive.
ink
INK+OXYGEN #1: Adler
After my first gallery exhibition in 2023, I quietly stopped drawing. Not because it went badly—but because it went well, and I lost the courage to be…
gratitude
🦃 5 Years of Planners & the Slow Discovery of Gratitude: A Thanksgiving Letter
…Then came a very special moment: the Glue Stick Moment.
COPD
🧬 Dupilumab: Biologics in COPD
The First Real Paradigm Shift in COPD Care —
bicarbonate
Pickwickian Legacy: Obesity Hypoventilation Syndrome (Past to Present)
In its pages, the rotund and perpetually sleepy character Joe the Fat Boy embodies what 20th-century clinicians first described as the “Pickwickian syndrome”: profound obesity, excessive daytime somnolence, and elevated CO2 (earlier known to be polycythemia).
criticalcare
“Quad-Strength” Levophed: What It Really Means — And When It Matters
“Levophed leave ‘em 💀?” “Fingers, nose, pen*s, toes”
CO2
Have you ever wondered: WHY do we reach for Sodium Bicarbonate in the ICU?
A History, A Physiology, A Philosophy My apologies to this growing readership. After taking the summer of 2025 off from blogging, I’m back. I appreciate your patience 😀. Let’s try a new take today— I’ll attempt to weave history, physiology, evidence, controversy, and philosophy into a practical piece.
EvidenceBasedMedicine
Have you ever wondered: WHY a MAP of 65 mmHg?
The 65 mmHg MAP target in critical care medicine has deep historical roots—from Hippocrates’ humors to Poiseuille’s equations.
MedicalStudent
Match Day 2025: Finding Meaning Beyond the Algorithm
#MatchDay is here, Med Students!!
cough
Article of the Week: Vocal Cord Dysfunction
In VCD, the inspiratory limb often appears flattened or coved due to paradoxical vocal fold closure during inspiration. This pattern is a key diagnostic clue that differentiates VCD from asthma, where the expiratory limb is predominantly affected.
cough
The Lingering Cough
Have you ever wondered why coughs outlast colds? Studies shows that post-infectious cough persists in approximately 25% of patients with upper respiratory infections, sometimes for up to two months after the initial illness has resolved.
ILD
ILD Differentials
ILD Q and A
pulmonary
Diddling with Diamox (acetazolamide): Mountains to Medicine
👁️ ➡️ 🧗♀️ ➡️ 🧠➡️ 🩸 Let’s talk about a drug you see prescribed for use in a few different scenarios: acetazolamide. Who made this and when? • Robin & Clapp at American Cyanamid • Attribution to them 1951 Why was it developed? • To treat glaucoma • First medically used in 1952 How does this drug treat glaucoma?
