2 Burst results for "Jonathan Winston"
"jonathan winston" Discussed on Here & Now
"The virus are experiencing kidney failure. Dr Jonathan Winston is a nephrologist and professor of medicine at Mount Sinai Health System in New York City. Dr Welcome thank you very much and Dr. What kind of increase? Have you actually been seeing patients needing dialysis during this pandemic? We're seeing an extraordinary number of critically. Ill patients in the Intensive Care Unit. Who developing what we call acute renal failure that means their kidneys. Were normal before they got sick and they shut down in the setting of the co- vid infection and usually in the setting of respiratory failure as well. Why is this happening? We don't know exactly why it's happening in terms of the exact underlying cause we do understand that patients who were critically. Ill develop kidney failure. Because they're not getting enough circulation or blood to the kidney whether there's something else going on the direct effects of the virus itself or microscopic blood clotting which has been described in other organs is yet to be settled but they are certainly critically ill patients and they're developing a sudden and severe form of kidney failure. Do you have enough dialysis machines and supplies to give dialysis to all of these people? We have enough dialysis machines but we have a relative lack of staff. These patients are virtually all housed in an intensive care unit and in order to do dialysis in intensive care unit. We need to set a specially trained technician to the intensive care unit to perform the treatment. Otherwise one person could take care of two three or four patients at one time if the patients were in a standard dialysis unit but in the ICU. The staffing ratio is much higher. Okay but we also understand that. You're having to reduce the amount of time. That people get dialysis so that you can treat more people. How exactly does that work? So when we're used to seeing about twenty patients in an intensive care unit. We're now seeing sixty plus patients. All of whom need urgent dialysis under the usual conditions. We dialyzers patients somewhere between three and a half to four and a half hours to efficiently. Remove the waste products during the treatment so in this setting with triple the number of patients and a difference in staff ratio. We just have to cut the treatment short so we can still treat the number of patients that need to be treated. I guess the next question with that is. Are there any long term consequences to receiving fewer hours of dialysis? Well certainly there a short-term problems. And they could be as dramatic as patients dying because their blood chemistries just aren't adequately cleared because of a sub optimal dialysis so our days are really spent triaging every patient every day to really assess how adequately they are getting treatment and how many treatments they really need. And it's a constant process of juggling of moving a machine from one to another of substituting reasonable medical therapy if a patient next door is in higher. Need for emergency dialysis. So it's something that we're used to in general but the intensity the severity the number of patients the pressure on the staff is a completely different. Does this impact in any other way regular patients who who aren't quite at the level of needing dialysis but they need to be seen for their kidney problems. Are you concerned that they are going to get the treatment? They need yes absolutely so now patients who are not infected who we've been able to manage for just so long may need treatment themselves. We're definitely seeing more people now without Cova who need help. But we're still trying to honor the appropriate stay at home recommendations so we still certainly think that if patients can stay at home they should but there are now. We're seeing more and more patients who just can't stay at home so that's creeping up on us so a lot of doctors. In a lot of different specialties anticipating that the consequences of completely focusing on Kovic which had to be done and has to be done is going to lead to downstream effects in non cove infected patients. Yeah what is it like for you and your staff to be in the middle of this pandemic knowing that it could go on for some time. It's it's hard to reflect wall. You're doing it Our staff especially nursing staff dialysis nurses and technicians. Have just done an exemplary job. And these are the type of situations I think where you just do. And you don't really think about it. I do think a lot of providers are stressed. They're anxious they're worried but they're all so proud to do what we trained to do and to do it well but right now we're just doing and doing what we were trained to do. And how we feel about it might be sorted out at another time. That's Dr Jonathan Winston. He's a nephrologist at the Mount Sinai Health System in New York City. Doctor Thank you so much for taking the time explaining all of this for us. Thank you for having me Mike. Many states Ohio has seen a record number of unemployment claims as a result of the virus. Today Governor Mike. Dewine is offering more details about how to reopen. The state's economy and workers will be watching closely as well as business owners in Cleveland. The owner of a hardwood flooring company talks about how her life has changed and what she misses in the age of covert nineteen. My name is Jesse Bennett. I am the owner of Cleveland Hardwood Restoration and we repair refinish restore install hardwood floors..
"jonathan winston" Discussed on Villains
"You run into like a bumper. Like you can't do. This can't go back. It John this one in particular feels so much video game. I feel like John wind at least for me. I was like one of my watching the first like forty five this one you're like more accustomed to what you're getting. So to your point like the rules of the John Mike university coming into focus, and you're like, okay. I know I know we're doing here. All right last one. This is my favorite one. This is going to be the one that I pick. The head of houseboy layer. Yeah. Yeah. Big different one. But this is this is at the end of the movie, John wicks almost last line. He was a whole speech. And then he ended the sim passing. Those eight words. Whence too. Tell them. Tell them all. Whoever comes whoever it is. Kill. Kill them. All I'll kill them off. And then he walks off. And then and then he doesn't walk off. Then he does thing REM mentioned earlier the guys like Jonathan Winston. And then he runs away. Okay. I have a bone to pack. It a really bothering with this line. Now, you decide. Okay. Central part, no fountain iconic. Although I didn't it wasn't water in it, which I thought was really interesting what no water in the fountain of that moment. The geography expert for all of this. No every place. It really bothers me that his name is Jonathan and he goes by John with an H because John with age a standalone name, if your name is Jonathan go by John. It's Jalen it really bothers me that he's J O H N, but his name is Jonathan but is his name John or they just call him that or just call back sometime not to be like funny informal. Exactly. Sean, I call him sometimes, Sean them, right? And I don't think that's his real name. Interesting. But don't you feel like Winston's a former guy does he does he crack jokes as you have running bit? He's funny. He's a funny guy. I know, but I don't know if he's a bit guy he could be funny without having been I think that this is definitely a bit to call him Jonathan wins. But certainly the obey. I love in chains hair. Is so good. I think an McShane is like one is just like a cult hero. Like just like to love you and McShane as to like identifies like some kind of nerd of some kind. I love him. He is he's really on the movie. Yes, he is. You do need to make a pick a different one. I think number six was Cassie Atlanta the bar, right? I like that a lot. But I also really liked how they got there. And I feel like right before they go. It's like they stop fighting and up the continental. And so they go to the bar and drink and John says to him Jin, isn't it? That's a good power power moved because he asserts that he like knows who he is your members him and all that. And I was like that's that's like kind of making clear that he's got the upper hand this. I think that that's seen when they BUSTER the window. I had no idea. It was going to happen. They're fighting for fucking forty five minutes straight across all Rome. Yes. And and then they BUSTER the window in you realize they're in the thing when the guy when Julius calls them, and then they stop and that to me was like another like, not only are they following the rules. But like that's a fucking really cool thing to do in a movie. Yeah. And then also their foreshadowing he's gonna break that rule later on as I know, I I really enjoyed it. I love this movie round. I I love the last line. I think that's like I'm just I wanted John with three immediately immediately immediate. I wanted to just hit next..