In this fascinating discussion, Matt Freedman, a pulmonary fellow at UVA, presents the complex case of an immunocompromised patient suffering from respiratory failure. Joining him are fellow doctors John Popovich, who discusses diagnostic strategies, and Tim Scialla, who offers insights on bronchoscopy and shock assessment. They delve into challenges of diagnosing ARDS in immunosuppressed patients, weighing the risks of steroids against potential infections, and the intricacies of shock evaluation using POCUS. Their expert commentary reveals the nuances of critical care management.