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
November 4, 2026 · AI 101
You downloaded the Claude app on your Mac. Now what? Pick a plan, set your privacy, learn the desktop app's layout, install Git, and connect GitHub. No coding background needed.
Git saves versions of your files each time you commit, on your computer. GitHub keeps a free, private copy online, so your other computer can pull the same work.
The context window is the AI's working memory: everything it can hold in mind at once. Like ours, it can get overloaded. How I check, and when I start a fresh session.
Markdown is plain text with a few symbols for structure: # for a heading, ** for bold. AI chats format their replies in it, and it's an easy way to hand notes to an AI.
AI doesn't read words. It reads tokens, small chunks of text. Two reasons a beginner should care: how much the AI can hold at once, and what API use costs.
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.
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.
