Pennsylvania is suing the USDA over cutting funding to a $1 billion food aid program for states
HARRISBURG, Pa. — Pennsylvania sued the U.S. Department of Agriculture on Wednesday, saying the agency, under President Donald Trump, had illegally cut off funding to it through a program designed to distribute more than $1 billion in aid to states to purchase food from farms for schools, child care centers, and food banks.
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Medscape
36 minutes ago
- Medscape
When Junior Residents Challenge Chief Attendings
Life as a medical student is far from easy. Every day, you grapple with a vast course load, erratic shifts during clinical rotations, stress, anxiety, and burnout. Yet, once you've reached the summit of that academic journey and are conferred with your medical degree, you start your residency, shiny new objects surrounded by much more experienced people. As a young resident or medical student, the mere idea of disagreeing with an attending physician in a position of power may raise hairs. After all, junior residents and students often look up to attendings, seeing them as versatile healers who can seemingly fix any ailment as they attend to the wards they lead. As a third-year medical student on call late at night, Suresh Mohan, MD, found himself in disagreement with a senior physician — the chief resident — over the treatment of a patient, which then escalated into an acute emergency. 'I quickly realized [about this senior physician] 'I think you're letting your ego get in the way of doing the right thing for the patient.' That was the first time I disagreed with the way that I watched this person manage something…I realized it was a very human emotion that got in the way of them doing the right thing,' said Mohan. Bleeding Trachea, Bold Dissent Mohan is now an otolaryngologist and surgeon at Yale Medicine, New Haven, Connecticut, with a specialty in reconstructive and cosmetic surgery for the face, head, and neck. But the experience he had as a third-year student still resonates with him. With few people around to help, Mohan found himself relatively alone. 'Sometimes, you're the only trainee in the hospital…the only doctor in the hospital that's responsible for all the patients that need ENT [ear, nose, and throat] care,' he said. While on call late that night, Mohan and his chief resident were called in on a consult for a patient's bleeding trachea after the patient had undergone a tracheotomy earlier that morning. During a tracheotomy, a surgical opening is made in the neck and a tube is inserted directly into the trachea. It is usually performed by an otolaryngologist. Bleeding from tracheotomies can range from minor oozing due to irritation or suction trauma to life-threatening hemorrhages if a major vessel is involved. Upon seeing the patient, the chief resident said there was nothing to worry about and they will continue to monitor the patient. An hour later, Mohan was called again, but his chief maintained that everything was fine. 'Of course, in the back of my head, I'm wondering if it's bleeding more,' said Mohan. Within the next few minutes, they were called two more times to see the patient, and yet his chief was adamant that no further action needed to be taken at that time. 'Eventually a code was called…we were rushing over there…and it turns out the trach was not fully in the airway,' Mohan said. 'The patient was having trouble breathing and causing more to happen from that…it escalated quickly into a much more acute emergent situation.' Mohan and the team started yelling for instruments, trying to get the trach tube back in place in the patient's trachea. Fortunately, they were able to secure the airway. One of Mohan's biggest takeaways from the experience: 'It doesn't matter if they call you three times, you still need to do the right thing.' Post-Bariatric Bleeding Incident As a third-year general surgery resident, Joshua Rarick, MD, found himself on call and alone at Covenant Hospital in Saginaw, Michigan. In the late evening during a 24-hour shift, a patient's vitals began to drop following a Roux-en-Y gastric bypass. Rarick had not personally performed the initial surgery, but as the resident on call, he had to respond to nurses messaging him with concerns about the patient's blood pressure dropping. 'To me, it looked like the patient was probably bleeding, so I had called the attending to update them,' he said. Rarick tried to temporize the bleeding, but his attending didn't agree. After a few hours of fluids, during which the patient would transiently respond, eventually the patient's vitals and pressure came back down because she was still bleeding. '[My attending] disagreed with my plan to go back to the OR [operating room], but eventually we had to go back to the OR because there was a bleeder that we needed to clip,' Rarick said. Rarick is now a fourth-year general surgery resident. He said these types of interactions aren't uncommon, and not all disagreements end with tempers flaring. 'Sometimes, attendings disagree with you, and they say, 'No, let's do this instead,' which is normal,' Rarick said. 'But that was one of the first times that there was an actual disagreement with what I thought the plan should be.' Advocating for Optimal Patient Care As a medical student or junior resident, if you truly feel a patient's case isn't being properly handled, don't be afraid to speak up in a conciliatory manner. 'There are many situations where seasoned attendings are so specialized, their knowledge in other areas of the field might be lacking or just not up to date,' said Mohan. 'So especially as residents who are on top of all the latest info, you have an opportunity to educate, but doing so in a way that's palatable is really important.' But what if an attending disagrees with a junior resident's or student's concerns, and the latter still feels strongly about the mishandling of a patient's case? In extreme cases where all other resources are exhausted, you'd want to contact a hospital ombudsman, clerkship director, site director, or even faculty mentor, said Mohan. 'If there's something egregious happening, and the resident or student doesn't feel comfortable approaching in a direct format, ombuds people are able to report a concern,' he said. Mohan listed an order of resources to consult before this, however. 'First, look it up to understand if your question is reasonable. Two, talk to a resident to try to get some more knowledge. Then, if you're still not feeling comfortable, and gently assuming that the attending is not receptive, I think finding other faculty mentors is probably the next place to go. And if you're really feeling lost, then contact an ombudsperson.'
Yahoo
36 minutes ago
- Yahoo
Dozens of anti-ICE protesters busted at Trump Tower after lobby takeover: ‘Bring them home!'
About two dozen anti-ICE protesters swarmed the lobby of Trump Tower in Manhattan Monday, and were busted after refusing to leave. The mostly grey-haired crowd sat together on the ground, chanting, 'Bring them back! Bring them home!' as NYPD cops descended on the Fifth Avenue skyscraper around 1 p.m. The group called for the release of inmates from the notorious hellhole prison CECOT in El Salvador – where migrants deported from the US, and even 'dangerous' American citizens convicted of heinous crimes are held in overcrowded cells. 'We are demanding that the administration bring back everyone from CECOT to the United States, release them ICE custody, return them to their homes and families and allow them their day in court,' demanded a woman leading the protest. The NYPD confirmed that the protesters were given multiple orders to disperse from the lobby, but refused to comply. An audio recording with the message, 'This is the New York City Police Department. You are occupying these premises unlawfully and without permission. I am ordering you to leave these premises now. If you refuse to leave, you may be subject to arrest,' played before police began placing the crew in zip-tie handcuffs. Sources say 24 demonstrators were rounded up by the NYPD. Charges were not immediately filed.
Yahoo
36 minutes ago
- Yahoo
Nearly two dozen arrested outside Manhattan ICE facility after protests erupt into chaos
Nearly two dozen people were busted as protests erupted Wednesday night after ICE arrested multiple migrants at a Lower Manhattan courthouse hours earlier, cops said. Twenty-three people were taken into custody as activists rallied outside the U.S. Immigration Court on Varick Street near West Houston Street, according to police. Eighteen were released with summonses, and the status of the five others was not immediately known. The arrested demonstrators were attempting to block the path of the two vans that Immigration and Customs Enforcement agents were using to transport the detained migrants, Hell Gate reported. The crowd also clashed with authorities over the barricades set up to keep them back, according to CBS New York. The protesters were outraged after two dozen masked, plainclothes officers gathered Wednesday afternoon in the lobby of 26 Federal Plaza, where they corralled at least six migrants as well as a Queens pastor who tried to intervene, according to a report in The City. The six men and one woman were spotted as agents carted them — some in handcuffs — back into an elevator they had just come out of, the outlet reported. ICE spokesperson Marie Ferguson told The City that the operation was in line with the Trump administration's push for 'expedited removal' of those who had illegally entered the country over the last two years under the Biden administration. 'ICE is now following the law and placing these illegal aliens in expedited removal, as they always should have been,' Ferguson said. 'If they have a valid credible fear claim, they will continue in immigration proceedings, but if no valid claim is found, aliens will be subject to a swift deportation.' But a member of the crowd gathered on Varick Street told CBS he was astonished by the scene. 'I've never seen anything like this,' said the man, who only provided his first name, Ben. 'I've been working here for a couple years and I've never seen this many agents, let alone agents dressed in plain clothes, wearing masks, pulling people out of line. It's totally out of the ordinary.' Meanwhile on Thursday, at the City Council's Fiscal Year 2026 executive budget hearing, NYPD Commissioner Jessica Tisch said the NYPD prohibited by city law 'to participate or assist in civil immigration enforcement, and we do not.' 'We have been very clear and consistent on this, and our officers understand that this is a red line we cannot cross,' the top cop said. 'At the same time, we will continue to target criminals, regardless of their immigration status.' 'Some have asked whether we should reconsider our cooperation with federal agencies on criminal investigations in light of their work with ICE,' Tisch added. 'The short, straight answer to this is no. Working with our federal partners on criminal matters is crucial to the safety of our city.'
