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James B. Ray

@rxpalli8r

Palliative care pharmacist teaching goal-concordant pharmacotherapy in serious illness | fortunate husband | appreciative Band Dad https://pharmacy.uiowa.edu/people/james-ray

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01.08.2023
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Latest posts by James B. Ray @rxpalli8r

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In cases you were wondering . . . this is a photo that annoyed Pete Hegseth so much because he thought it was "unflattering" so he got the photographer barred. I encourage all of you to use it as often as possible.

12.03.2026 01:05 πŸ‘ 4358 πŸ” 2228 πŸ’¬ 447 πŸ“Œ 231
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The idea that America isn’t for everyone who wants to be an American is something that makes my blood boil. Posting a photo of yourself as a Congressman smiling next to these words is wicked. It’s antithetical to the concept of America.

11.03.2026 03:34 πŸ‘ 6423 πŸ” 1143 πŸ’¬ 67 πŸ“Œ 381
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Lindsey’s diplomacy working wonders in UAE.

09.03.2026 12:13 πŸ‘ 19721 πŸ” 6755 πŸ’¬ 805 πŸ“Œ 436

It’s looking increasingly likely that Kristi Noem and Lewandowski funneled almost 200 million in government money to a company that is run by her friend and that nobody can give an address for.

Oh, and it was 8 days old when it was awarded the contract.

04.03.2026 19:03 πŸ‘ 23839 πŸ” 9405 πŸ’¬ 1245 πŸ“Œ 613
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GeriPal Pubcrawl is Back in San Diego for the 2026 AAHPM-HPNA Annual Assembly We haven’t lost that loving feeling. The GeriPal pub-crawl is back, and this time we are bringing it to San Diego during the AAHPM-HPNA Annual Assembly. The Pub CrawlΒ starts at 8 pm on Thursday, March...

Join us at the GeriPal Pub Crawl The GeriPal pub crawl in San Diego during the Annual Assembly of #hospice and #palliativecare. We start at 8pm on Thursday night, March 5th.

Details are on the link below:

geripal.org/geripal-pubc...

18.02.2026 03:28 πŸ‘ 5 πŸ” 4 πŸ’¬ 0 πŸ“Œ 0

Check the spelling on Pete’s last name

25.02.2026 01:28 πŸ‘ 0 πŸ” 0 πŸ’¬ 0 πŸ“Œ 0

The reason we're here is that tens of millions of people will punch a hole in a wall if they hear someone used food stamps to buy soda but they're fine if the right-wing podcaster turned fbi director uses his taxpayer funded private jet to go party whenever he feels like it bsky.app/profile/thed...

22.02.2026 23:01 πŸ‘ 18515 πŸ” 6558 πŸ’¬ 431 πŸ“Œ 174
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β€˜Don’t go to the US – not with Trump in charge’: the UK tourist with a valid visa detained by ICE for six weeks Karen Newton was in America on the trip of a lifetime when she was shackled, transported and held for weeks on end. With tourism to the US under increasing strain, she says, β€˜If it can happen to me, i...

A retired British primary school administrator with a British passport and a valid visa was shackled, chained and detained for six weeks by ICE

www.theguardian.com/us-news/2026...

21.02.2026 06:54 πŸ‘ 7236 πŸ” 4210 πŸ’¬ 249 πŸ“Œ 632
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Kash Patel heads to Milan for the Olympics β€” on the FBI jet The FBI director has plans to watch the U.S. men’s hockey team vie for gold, sources tell MS NOW.

Breaking MS NOW:

FBI Director Kash Patel flew today on the FBI's Gulfstream jet bound for a trip to the winter Olympics in Italy to watch one of his favorite sports: men's ice hockey.

Patel's trip to Milan is likely to cost as much as $75,000. www.ms.now/news/kash-pa...

19.02.2026 23:40 πŸ‘ 3030 πŸ” 1496 πŸ’¬ 392 πŸ“Œ 247
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The cover-up just never ends. Rest in peace, Ruben Ray Martinez.

20.02.2026 03:40 πŸ‘ 19167 πŸ” 9014 πŸ’¬ 505 πŸ“Œ 391

a government for, by and of degenerates

19.02.2026 22:11 πŸ‘ 7281 πŸ” 1516 πŸ’¬ 164 πŸ“Œ 47
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The FBI interviewed one of Jeffrey Epstein’s victims four times over her allegation that Donald Trump assaulted her when she was underageβ€”but most accusations against the president appear to have been removed from the government’s documents.
trib.al/t8cm1D1

19.02.2026 20:52 πŸ‘ 1776 πŸ” 1100 πŸ’¬ 176 πŸ“Œ 78

UK: Prince Andrew arrested.

South Korea: Former President Yoon sentenced for life.

Brazil: Former President Bolsonaro serving a 27-year sentence.

USA: President Trump demands $10 billion payout from taxpayers.

19.02.2026 13:08 πŸ‘ 15149 πŸ” 5670 πŸ’¬ 206 πŸ“Œ 272

I would use the Tramadol analogy - unreliable analgesia (care) and multiple potential adverse effects (missed psychosocial assessments, poor transitions of care, increased caregiver burden).

11.02.2026 14:19 πŸ‘ 0 πŸ” 0 πŸ’¬ 1 πŸ“Œ 0

Training students and residents, I was able to point out that this type of physician behavior was NOT the way an interprofessional team cares for patients with serious illness.

11.02.2026 14:19 πŸ‘ 0 πŸ” 0 πŸ’¬ 1 πŸ“Œ 0

This behavior robs the patient and family of valuable input and care from the team. Often, escalating doses of medications for symptom control when what was needed was the skill of the social worker, chaplain, or music therapist.

11.02.2026 14:19 πŸ‘ 0 πŸ” 0 πŸ’¬ 1 πŸ“Œ 0

Thank you for this thoughtful discussion! I have worked with physicians who had a "savior complex." They were the only ones who knew how to care for the patient. Unsolicited recs that help patient care were often viewed as an annoyance or an affront to their skill.

11.02.2026 14:19 πŸ‘ 0 πŸ” 1 πŸ’¬ 1 πŸ“Œ 0

This is just insane. It’s only a matter of time before DHS kills another innocent person here.

(clip via MPR and @davidjbier.bsky.social on X)

31.01.2026 18:13 πŸ‘ 29293 πŸ” 13267 πŸ’¬ 1767 πŸ“Œ 1199
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πŸ’― Every. Fucking. Word.

22.01.2026 23:32 πŸ‘ 5016 πŸ” 2282 πŸ’¬ 171 πŸ“Œ 235
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McGovern: Well, he said a lot of crazy shit today. I think it’s time to take the keys away from grandpa. He doesn’t seem like he’s all there.

21.01.2026 18:59 πŸ‘ 32747 πŸ” 9546 πŸ’¬ 875 πŸ“Œ 589

The man with the nuclear codes wants to annex a key ally…and he can’t even remember which one it is. It’s time to take away the car keys.

21.01.2026 23:42 πŸ‘ 1611 πŸ” 376 πŸ’¬ 78 πŸ“Œ 14

This seems so incredibly short sighted, since the note created by a pharmacist could be reviewed and co-signed by a physician and be billable. This would increase team capacity. MedStar, OSU, U of Kentucky, John Hopkins, VA system all examples of success but somehow not seen as benchmarks.

19.01.2026 18:33 πŸ‘ 0 πŸ” 0 πŸ’¬ 0 πŸ“Œ 0

Same. Worse, no interest in discussing what quantitative or qualitative metrics matter. Offloading billable providers by doing routine symptom management so they can engage in complex GOC convos, challenging family meetings, or new complex ICU care consults doesn't seem to move the needle.

19.01.2026 18:33 πŸ‘ 1 πŸ” 0 πŸ’¬ 1 πŸ“Œ 0
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ICYMI β€” In negative degrees weather they took a LEGAL naturalized citizen out in his underwear, after trashing his house.

They released him an hour later.

The cruelty is the point. (From @thejfreakinc.bsky.social )

19.01.2026 16:06 πŸ‘ 6474 πŸ” 3414 πŸ’¬ 458 πŸ“Œ 297

Seems that cost savings/cost avoidance carry little weight in the C-suite anymore. These activities alone can justify a pharmacist's/social worker's salary (reducing medication misadventures, earlier discharges, ToC coordination, etc). Spent a decade trying to demonstrate value without success.

19.01.2026 17:51 πŸ‘ 2 πŸ” 0 πŸ’¬ 0 πŸ“Œ 0

Non-protesting dad just trying to hustle his kids, as young as 6mo, out of the neighborhood. ICE threw a flash-bang INTO HIS car, all 6 kids in the hospital now.

If anyone wondered how things turn against occupying armies there's a case study playing out in front of you.

15.01.2026 04:27 πŸ‘ 17828 πŸ” 8367 πŸ’¬ 302 πŸ“Œ 490

It's horrific but also this is pretty much a regular arrest. That's how violent arrests are. I am glad people can see it and be horrified -- that's what police are out there doing every day, legally. Every 3 seconds basically.

14.01.2026 22:09 πŸ‘ 1372 πŸ” 494 πŸ’¬ 9 πŸ“Œ 0
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β€˜I was flooded with fear’: Minnesotans describe their encounters with ICE, being detained From an Uber driver to a school drop off, MPR News spoke with Minnesotans who were stopped or detained by U.S. Immigration and Customs Enforcement agents.

She says ICE agents mocked her: β€œThe ICE agent who had pepper sprayed into the vents of my car said β€˜you guys gotta stop obstructing us, that’s why that lesbian bβ€”β€” is dead,’ verbatim, speaking of Renee Good. Which filled me with absolute rage and shock..."
www.mprnews.org/episode/2026...

14.01.2026 15:42 πŸ‘ 6831 πŸ” 3398 πŸ’¬ 183 πŸ“Œ 224
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Donate to TJ Sabula is a patriot!!, organized by Sean Williams ***UPDATE 2*** I am in direct contact with TJ and we are discussing the donation beneficiary a… Sean Williams needs your support for TJ Sabula is a patriot!!

The GOFUNDME is now up for TJ Sabula, the man Ford suspended for calling Trump a β€œPedo protector”.

It’s already over $120k.

If you can’t donate please SHARE!

www.gofundme.com/f/tj-sabula-...

14.01.2026 12:41 πŸ‘ 1468 πŸ” 786 πŸ’¬ 81 πŸ“Œ 56

Christ on a bike! Demented weirdo with command codes.

13.01.2026 23:15 πŸ‘ 0 πŸ” 0 πŸ’¬ 0 πŸ“Œ 0