Just Published! 😎 BIG THANKS to the 80 authors who contributed to the 1st hard cover book geared for the surgical PA @NeilFlochMD @rbarbosa91 @farkomd @JBMatthews @LilianaBordei @wchrisfox @SWexner @ScottRSteeleMD @MN_GIMD @SeanLangenfeld @pferrada1 @pakotze @AASPASurgeryPA

Congratulations to ACS Fellows Drs. Paula Ferrada, Jeremy Goodman, and Jacqueline Saito, who were recognized by @BeckersHR among 145 patient safety experts helping ensure patients receive safe, effective care. brnw.ch/21x3f35

You have noticed it. ChatGPT feels dumber than it used to. Your prompts that worked six months ago produce worse results now. The writing sounds flatter. The ideas sound safer. The internet itself feels like it is shrinking. Every article reads the same. Every email sounds the same. Every answer sounds like it was written by the same voice. You thought it was you. It is not you. Researchers at Oxford and Cambridge published a paper in Nature proving what is happening. They call it Model Collapse. Here is the mechanism in one sentence. AI trained on AI-generated data gets dumber every generation until it forgets what real human data looked like. The internet is filling with AI-generated content. Blog posts. Articles. Reviews. Comments. Social media. AI companies scrape the internet to train the next generation of models. Which means the next generation of AI is being trained on the output of the current generation. Each cycle loses information. Not randomly. It loses the rarest, most unusual, most creative parts first. The researchers call these the "tails of the distribution." The weird ideas. The unexpected perspectives. The things that made the internet feel human. Those disappear first. What remains is the average. The safe. The expected. The bland. Then the next generation trains on that. And loses more. And the next generation trains on that. And loses more. The researchers proved this is not a slow decline. Major degradation happens within just a few iterations. Even when some of the original human data is preserved. They tested it on large language models. On image generators. On statistical models. The pattern was the same every time. The output converges toward a narrow, flattened version of reality that looks nothing like the original data. The lead researcher put it plainly. "Large language models are like fire. A useful tool. But one that pollutes the environment." The pollution is invisible. You cannot see which sentence on the internet was written by a human and which was written by AI. Neither can the AI that is about to train on it. And once the tails are gone, they do not come back. The damage is irreversible. This is not a prediction anymore. It is a diagnosis. The internet you grew up on was built by humans writing things no algorithm would have written. Strange, personal, imperfect, alive. That internet is being diluted. One generation of AI at a time. And the models trained on what remains are learning a smaller and smaller version of the world. Model Collapse is not a technical problem. It is a cultural one. The thing that made the internet worth reading is the thing that disappears first.

Management of 1-2 cm rectal neuroendocrine tumors @JournalofGISurg @MaherAK @zbayat_md pubmed.ncbi.nlm.nih.gov/4214…

Fresh off the presses - 8th edition of Mulholland & Greenfield! With @UMichSurgery faculty @Doctor_Chigo on the cover! Always exciting to sign new copies for our incoming interns! My apologies on the color scheme to coeditor @timpawlik

#Cholecystectomy for acute gallbladder disease showed similar bile duct injury rates with robotic-assisted vs laparoscopic methods, but robotic-assisted use was linked to more major complications & longer hospital stays. 📽️ Watch the video & learn more: ja.ma/4am41ZZ

STEVE JOBS GOT FIRED FROM APPLE… Then he walked straight into MIT and dropped the most raw, unfiltered 60-minute business masterclass ever recorded. Zero PR bullshit. Zero image to protect. Just pure, brutal honesty from the man who built Apple once — and was about to rebuild it even bigger. Stop scrolling. Watch this tonight instead of Netflix. Bookmark it. Come back to it. This is how legends think. 🔥

just a 23 year old and her 67 year old bestie

That is not a guy singing a song. That is a guy pouring his soul into a song. RIP Mark. Talk Talk - It's My Life (Live at Montreux 1986)

Some days work is insane- it takes everything you have to get through the day. Other days, there is space to work on research or attend to things like resident evaluations, recertification, charting, and the 10K tiny things to maintain practice. The OR days are always the best. Choosing to become a #ThoracicSurgeon was one of my best decisions ever.

🔬 Fascinating to see #ILookLikeASurgeon become the subject of scholarly study more than a decade later. 🙏 I'm grateful to @DrKathyHughes @KickAsana @susieQP8, and the thousands of @womensurgeons around the world who gave life to this movement. What began as a simple hashtag became a community, a conversation, and for many, a reminder that they belong. 💙 ✨ It's a powerful reminder that words—and the communities that gather around them—can have a longer reach than we ever imagine. 🌍

Strong work Ron. 👍

Every month that you neglect your physical health while early in your career, you incur a debt that you will repay later on, when you should be in the prime of your career. I’ve learned this now but I wish I could have explained this to my 30-year-old self.

Today, our team continues to push the boundaries of aortic care with Drs. Parodi, Bozso, & Frederick. ✅ First in the USA to offer the Artivion NEXUS Total Arch Device after FDA approval ✅ Expanding one of the nation’s leading aortic programs ✅ Training the next generation

PHOEBE BRIDGERS HAS ANNOUNCED THE LOST TOUR 2026 “i’m going on tour no phones”

Book is now out 😎 Great resource for surgical and surgical-adjacent APP’s… Some time ago, @SamAtallahMD asked me to simply walk into Mordor…oops I mean, write the chapter on knot tying. There are 51 chapters in total, covering many different parts of surgery. 📖💪

It’s an honor to have written the chapter on Metabolic Bariatric Surgery for this textbook.

Today's trainees pale in comparison Dr Harrington, a fellow at WashU, thought ITP was due to a blood factor that caused destruction of platelets To test hypothesis he took 500 cc 🩸 from a pt with ITP, injected it into himself, ended up hospitalized with severe thrombocytopenia

Stool analysis of a patient with acute diarrhea showing “smiling face” organisms. What’s the diagnosis?

Great work @SamAtallahMD and team

🧵regarding the 'figure-of-eight' suture. I did a similar one 3 yr ago, but the students and interns are new. We'll go over the surgical application of the 'figure-of-eight' stitch, some technical pointers, and compare it to a similar stitch (the' horizontal mattress'). (1/ )