Will Preston

@willpreston.bsky.social

Hospitalist in Bronx NY Interests include clinical epidemiology and med ed. Shasta connoisseur.

Lots of pearls in the gram negatives update - presumed ESBL for E ecoli and K pneumo when ceftriaxone MIC >4ug/ml - Added Hafnia alvei as significant Amp-C producer - More evidence for avoiding Zosyn for the Amp-C bugs

2026 AMR Guidance

This updated IDSA AMR Guidance document provides treatment suggestions for infections caused by extended-spectrum β-lactamase–producing Enterobacterales (ESBL-E), AmpC β-lactamase–producing Enterobact...

idsociety.org

sailor in 1806: - work all day (climb the rigging, holystone the ship, stand watch) - salted pork - ration of watered rum - sing - gamble - tell stories sailor in 2026: - work all day (computer) - whatever is on the menu - scroll phone - gym - shower - no grog

A $3 @mta.info subway fare and some good Q train timing can buy you one hell of a view of the July 4th fireworks and the Brooklyn Bridge light show! Huge shoutout to the train operator for slow rolling over the Manhattan Bridge and the conductor for announcing it.

How to dx cerebro-spinal fever in 1899: “the most reliable method is Quincke's lumbar puncture, which is easily performed and free from danger. The puncture should be made between the second and third or the third and fourth lumbar vertebræ with an ordinary exploratory or "antitoxine" needle…

On a lark started reading Osler’s textbook from 1899. One of my mentors had his quote “listen to your patient, he’s telling you the diagnosis” framed in her office (shout out Darlene)… took me until being an attending to really appreciate that one. I guess I wondered if maybe more wisdom in there?

ICE agents have become synonymous with terror, not safety. Trump’s goal in deploying them into our airports is to push ICE’s menacing presence into more & more places. Organizing & public pressure pushed them out of Minneapolis. So we’ll have to get louder in saying it here: Abolish ICE.

ICE agents patrol JFK airport amid growing lines

Small groups of ICE agents walked through JFK terminals as huge crowds lined up at security checkpoints during the morning rush hour.

nydailynews.com

Last year I got a MKSAP question wrong about PE management - vignette was a high risk patient likely needing intervention but without shock and I chose LMWH instead of UFH. I emailed the editor to complain and argue for my answer but they shut me down. Just want to say now completely vindicated.

Management diagram from new AHA/ACC PE guideline recommending LMWH for the situation in the post

ICE must be abolished. It has become a lawless, rogue agency. Federal law enforcement agencies must follow the law, if they're going to have any credibility enforcing it. We are demanding justice for Renee Good and the prosecution of ICE agent Jonathan Ross for her murder.

Making a fan edit of The Pitt that accurately reflects how I spend my day. The 2-3 min scene in the first ep of the ED team rounding plays on a loop for 10 hours and to fill the other 2 hours I’m looking for B roll of someone standing in a supply closet unable to find what they’re looking for.