Professor of Emergency Medicine at UCSF · founder of ALiEM · AI tinkererdirects AI systems(the words "AI tinkerer" are crossed out in red pen and corrected to "directs AI systems")
the old site really did call me a "tinkerer." corrected, June 2026.
I spent 25 years becoming a professor of emergency medicine. Then I learned to build. I don't write code. I direct it, the way an attending directs a resuscitation: clear intent, constant verification, no pretending to know things I don't. These days I'm building AI systems for academic clinicians and writing down what I learn, mistakes included.
Flowsheet· career vitals · checked October 2026
Active problems
October 30, 2026 · AI 201
I have Codex, OpenAI's version of Claude Code, review what Claude Code builds and writes: as an editor, an adversarial reviewer, and a skeptic. How to set it up, why a role beats "are you sure?", and why a person still makes the final call.
An API lets a program use an online tool like PubMed, Kit, or Tally without opening its website. Here are three I use, what they cost, and the downsides.
Three Mac shortcuts I use every day with Claude Code: a screenshot straight to your clipboard, a hotkey for dictation, and copying a file's path.
A .env file is a small hidden text file on your computer that holds your passwords and keys. Claude Code only ever needs each one's name. The real value stays in the file.
Claude Code printed my WordPress app password in our chat while fixing an upload error. Why that counts as a leak, why changing your WordPress password doesn't stop it, and what to do instead.
An app password is a second password to your WordPress account that lets a tool like Claude Code work as you. What it is, why it's worth having, and how to make one.
Two systems in daily use, three IRB-approved studies in progress.
| System | Status | What it is |
|---|---|---|
| Faculty Promotion Letter Automation | In daily use | n8n workflow that curates faculty documents and generates first-draft promotion letters with transparent audit trails and flags for human review. Currently in use by UCSF EM promotion committee. |
| PAIA: Executive AI Assistant | In daily use | Personal AI assistant built with Claude's Agent SDK featuring memory, journaling, board of directors advisory sessions, CRM, YouTube video analyzer, and growing skill library. |
| Base Hospital Radio Call Analysis | IRB-approved QI · in progress | AI-powered transcription and QI analysis of base hospital radio calls between paramedics and physicians. |
| California Poison Center Call Analysis | IRB-approved QI · in progress | Using AI to transcribe and analyze poison center calls for quality improvement insights. |
| SF EMS Medical Record QI Analysis | IRB-approved QI · in progress | AI-driven quality improvement analysis of San Francisco EMS Agency patient care records. |
Tricks of the Trade in Emergency Medicine - 50 clinical tricks from 38 experts, 100+ photos, expert authors, real-world tips. Buy a copy or read about it.
