#FOUR DECISIONS TO MAKE

[gossip-girl-of-middleearth]

At the last fucking inning of the game, I get thrown a massive fucking curveball with less than 24 hours to decide, WHAT THE FUCK DO I CHOOSE???

[sensitiveheartless]

Chuuya Week Day 3: Found Family

(Or, Adam and the three messy teenagers he’s taken under his wing)

[casualavocados]

Chen Yi & Ai Di + the respect they command leading Yiyun Meng: North Hall

Chen Bowen as CHEN YI & Chiang Tien as AI DI KISEKI: DEAR TO ME (2023)

[philtatosbuck]

not to descendants post but it's crazy to me people are still looking at the core four like "you should have saved and liberated the entire isle within a month of being in auradon" girl what. how much power do people realistically think they had over auradon for them to do this without being evil about it (which y'all also hate)

[rushingheadlong]

You know something I don't think I've ever seen people talk about is how Freddie changed the lyrics for Big Spender.

Because in case you don't know, all original versions of the song are sung by women - and it is made very clear that they are singing to men:

The minute you walked in the joint I could see you were a man of distinction A real big spender [....] So let me get right to the point: I don't pop my cork for every man I see Hey, big spender Spend a little time with me

Probably not too surprising, then, that when Queen performed this song in 1974 Freddie had to do a bit of a gender-switch on it:

Though, it would probably be more accurate to say that Freddie made this song gender-neutral because he didn't change it to be about a woman. He eliminated the first use of "man" entirely and then sang "I don't pop my cork for everyone I see" (instead of "every man").

And honestly there's probably a whole dissertation you could write just about those changes alone, but what I really love is when Queen brought the song back in 1986 and Freddie changed the lyrics again:

Because yes he still dropped the first "man" but the "everyone" is changed and Freddie instead sang "every guy" with just the barest hint of a "-rl" sound at the end to give him plausible deniability if anyone asked about it.

So much of Freddie's music speaks to his experiences as a queer man but, because of the nature of the times in which he lived, he couldn't always be directly open about that fact. Most of his love songs are intentionally vague, and he sang about "somebody" or "you" to avoid having to use gendered terms as much as possible.

Freddie singing "I don't pop my cork for every GUYrl I see" wasn't just an adjustment to the original lyrics, it was a specific change from how Freddie had sang it before in order to make it more gay in a way that he could rarely be with his own music, and that is what I adore about this. It's such a little thing, but it gives such a unique insight into how Freddie balanced his sexuality and his stardom, and how the relationship between those two changed over the nearly 12 years between these performances.

[lsleofthelost]

eye contact

[skyloftian-nutcase]

Provider Discretion (LU in Healthcare)

(Lots of technical jargon in this one, lovelies, hope you don’t mind)

Something wasn’t right.

The patient herself was… okay. Mostly. She had called 911 because she’d had back pain that had just been getting worse, and she’d said she couldn’t even get around anymore.

Mo and Hyrule often exchanged a somewhat exasperated look when someone called an emergency line for something that had been an ongoing problem, but today this… was different. She just didn’t look well.

“I’m really sorry,” the patient apologized for the fourth time as Hyrule and Mo loaded the stretcher into the ambulance.

“It’s okay,” Hyrule quickly reassured her. His heart ached a little at how much this woman wanted to seem to shrink into oblivion. Even Mo, who, despite his big heart, often came across a little standoffish, had tried to make her smile multiple times. “This is what we’re here for.”

With a chief complaint of back pain, there wasn’t much to do outside of check vital signs. Mo could easily take this call. But Hyrule just… this felt wrong.

“Let’s get a 12-lead,” he said, already grabbing the cables for it while Mo got vitals. His partner didn’t argue, helping him place the leads in the right positions.

Vitals looked mostly fine. The patient’s blood pressure was high. She said she had a history of hypertension, so perhaps between that and her pain that would explain it. Though 180/98 did not make Hyrule particularly happy. But he couldn’t treat that.

The 12-lead showed normal sinus rhythm. Nothing wrong there. But something just didn’t feel right.

Grabbing the blood pressure cuff, Hyrule checked it again, but on the opposite side.

There was a discrepancy.

Hyrule and Mo looked at each other, eyebrows pinching. Mo took a manual on the left. Hyrule took a manual on the right.

They still didn’t match.

Feeling dread fill him, Hyrule told Mo, “I’m taking this call. Let’s get going. We don’t need lights but… just drive expediently, ok?”

The transport was blessedly uneventful. But the discrepancy remained. Her blood pressure was high, but higher on one side than the other. Coupling that with back pain…

Her aorta. Hyrule was worried about her aorta. The biggest artery in this woman’s entire body could getting ready to tear apart.

When Hyrule texted Warriors later, he got his answer.

Dissection. They rushed her to the OR. You pointing out the BP difference really tipped off the doc. Good catch.

Mo whistled. “Good thing she didn’t rupture in our truck.”

Hyrule blew out a breath. He was just thankful he trusted his gut.

XXX

The dispatch information had been for diabetic emergency. Fire had gotten there first, which Aurora was thankful for since she and Dawn were coming from the hospital and therefore farther away than if they’d responded from the station.

When they arrived, the house was a nightmare. The street was so narrow that the ambulance and fire truck blocked the road entirely, the stairs were so narrow Aurora felt like she had to squeeze her arms in just to climb up them, and the turns were so sharp she wasn’t sure how any kind of equipment could get up there. The patient was lying on his bed, altered, and unable to move.

According to the patient’s friend, he’d heard him fall and came up to check on him. He knew he was a diabetic and figured his blood glucose had to be low. Fire had already checked it, saying it was over two hundred. As the firefighter paramedic gave information to Aurora, he said, “He could be acting like this because of his sugar. Could be a stroke. We’re not sure.”

Honestly, Aurora couldn’t see the patient all that well from her vantage point. Dawn had already walked in and started assessing, they’d handed a reeves stretcher to the firemen, and they were working on loading him on to it. The girl went downstairs to prep the stretcher for their arrival. Once they managed to get the patient into the ambulance, Aurora stared.

This man’s entire right side of his face was noticeably drooping. He was moving his head a little to the left, eyes somewhat moving, pupils equal. Aurora quickly asked him to look at her, to follow her finger. While he could stare at her, he couldn’t track at all, and his eyes wouldn’t move to the right. He blinked once while attempting, and was only able to blink his left eye.

Who the hell thought this could be his sugar??

Once Dawn got in the truck, they were quick to get vitals and a 12-lead. He was hypertensive, all other vitals fine.

“We need to stroke alert this,” Aurora immediately said.

“But he was last seen normal three hours ago,” Dawn said uncertainly. “Isn’t that outside the window? Or is the window four hours now?”

“I think it’s four,” Aurora answered. “And it doesn’t matter either way. This is absolutely a neuro issue. Drive us hot, okay?”

Dawn nodded, heading to the front. She drove to the hospital with the lights and sirens on, allowing them a faster transport time, while Aurora called it in to the hospital. As they progressed, she tried to get the patient to follow commands, but he couldn’t. He held up his right arm but couldn’t hold his left up at all, and he still didn’t really track any movement.

When they arrived at the hospital, they were placed in a major room, transferring him quickly to the hospital bed. Warriors was charge that night, working on coordinating all the help they’d need for this patient. The ED physician entered, looking the patient over, and then turned to Aurora, asking, “So what makes you think he’s having a stroke?”

Aurora stopped in mid motion, looking at him with the most enraged and bewildered expression. “I’m sorry, what?”

“Why do you think he’s having a stroke?” The doctor repeated.

“What makes you think he isn’t?!” Aurora snapped, completely mind blown that this was even a debate. “His face is drooping so low it’s hitting the earth’s fucking crust, he’s altered, not tracking movement, blinking with one eye, down on one side, is hypertensive, and you’re asking why I—do you even know what a stroke is??”

“Let’s just alert it,” Warriors said calmly as he walked into the room, clearly sensing that the paramedic was about to explode. “It’ll get us a CT to rule it out.”

Aurora was fuming, and she stormed out before she could hear a response. Dawn tried to gently check on her, only to be subjected to her ranting for the next hour.

Later, Warriors texted Hyrule, who relayed the message. “You were right.”

“OF FUCKING COURSE I WAS!”

XXX

Legend wasn’t particularly a fan of working triage.

There were aspects of it that were exciting - he was the one to make first contact with patients who didn’t come in via ambulance, and he determined their acuity. But there was also a public relations aspect to it, a patience dealing with impatient people, a kindness and sympathy for those who were genuinely hurting or needing help but had to wait anyway. It was understandable, but public relations… was not Legend’s forte.

There was a reason he was put in triage, though.

It wasn’t always obvious, what was wrong with someone. But there were times when a patient just didn’t look right. Legend saw the man limp over, listened to him as he explained that he had some leg pain that had been going on for the last few days, how he thought maybe he’d strained a muscle but the pain hadn’t improved.

There were always signs to look out for. Little things, cues that something was off. The man looked resigned, reluctant; he clearly had been talked in to coming to the hospital, and he commented that his wife insisted on it. Legend saw the clothes he wore, heard the accent he spoke with, saw his muscles, and pieced together that he was probably a farmer.

Farmers never came to the hospital.

“We’ll get you back as soon as we can,” he finally said after completing his assessment. Usually, this patient would be low on the acuity scale—a muscle spasm or strain was not nearly as important as a heart attack, pneumonia, sepsis, strokes, traumas—but Legend made him a yellow rather than a green. Just to be sure.

That higher acuity score got him a room far faster. That faster room made a doctor assess him and notice that his left leg was bigger than his right. That doctor made sure he got an ultrasound of his leg, found clots in his leg. She also learned the man was short of breath sometimes, which his wife insisted was new, and got a CT scan.

Legend glanced at his chart later to see him being admitted. Confused and curious, he did some digging.

The man had a pulmonary embolism.

Huffing with a small smile of satisfaction, Legend closed out of the chart as another patient approached.

XXX

Time had to admit, he did not spend as much time assessing his patients as he should. His hours were stolen away in the OR, unpredictable and chaotic as his line of work was. So sometimes he didn’t get to round, sometimes he didn’t have a chance to walk in and chat with the patients and the nurses and the licensed independent providers who took charge of their care.

Today he was glad he did.

The patient was actually calm and pleasant, had little complaint of anything except for some lower back pain. In the world of uncomfortable hospital beds, it wasn’t a huge surprise.

But Time saw something. Some staining, bruising, around the patient’s groin. He peeked around their gown, turned them a little, and saw it.

Their groin was purple. He asked the nurse, who said they were told this had been baseline for a day or two, and that the independent providers over them had acknowledged the finding and moved on.

Time walked into the doc box where the providers were. “I want a CT abdomen for room 3. She’s got some bruising that’s concerning. Her H&H has been down trending steadily.”

“Her JP drains haven’t put out much,” the physician assistant noted, looking over the patient’s chart.

“She might have a retroperitoneal bleed,” Time pointed out. “Let’s just be sure.”

Years of education and even more years of experience had taught the trauma surgeon well. The war was especially humbling and educational. So when he got a text from the PA that the patient did indeed have a retroperitoneal, he wasn’t surprised. But he was disappointed that he had to be the one to notice it.

Sometimes, he supposed, it took the leader to point out the problem.

XXX

Four… didn’t like this.

Report had been bad enough. The day shift nurse spoke of how the patient had been previously septic and was recuperating well before her pressor demand had gone up during the day. She looked… not great. She was so edematous they were constantly changing the sheets underneath her arms because her body was leaking fluid from every inch of itself - they had dumped fluids into her over the last few days just to maintain her blood pressure. She was on a lasix drip to get her lot o pee off the fluid as best as possible, and her kidney function was… decent, but not great.

As Four assessed her, the clenching his chest only worsened. She was alert, oriented, a little miserable but trying to be in good spirits, bless her. She was peeing a decent amount, her pulses were present despite the swelling, her lung sounds were a little coarse but overall mostly clear. Her abdomen was soft and non-tender, her pupils were equal and reactive, and she didn’t have much complaint of pain aside from being sick of laying in bed, which Four could understand.

But still. This just… didn’t look great.

As the night progressed, the woman’s pressor need climbed. Four continued to increase epinephrine, increase norepinephrine. He tried not to increase the vasopressin too much as it had such a profound effect on vasoconstriction that it could cause necrosis. Also, the woman had a history of heart failure and had a pretty weak heart.

Four eventually went to the resident in charge of the patient for the night. “Hey. Can we maybe give 11 some albumin? She has plenty of fluid to give, but clearly it isn’t in her vasculature - she’s peeing ok but her pressure isn’t tolerating it. I feel like it could help.”

The resident shuffled on his feet uncertainly. “The surgeon really wants to make sure we can get this fluid off. I’d rather keep her negative and not give her more fluid, you know?”

“Yeah, I get that,” Four greed before continuing, “But albumin is only 250mL, and if it helps suck in the fluid that’s third spacing, it’ll still help. We’re dumping fluid in her through the pressors anyway.”

The resident continued to waffle, before the night attending asked, “She’s on vaso, right?”

“Yes.”

“Just go up on that.”

Four stared a moment longer, starting to doubt himself. He hadn’t been a nurse for long, and if an attending physician was saying this, then… it had to be true, right?

Sighing, he went back to the room and did as he was told. The patient’s blood pressure improved well enough, and the night progressed fine.

The next night was not as fine. At rounds, Four suggested that perhaps she should be lined for CRRT, a continuous dialysis that would allow for Four to control how much fluid they were pulling and would likely be better for the patient to tolerate. The night doctors shrugged, saying they’d mention it to the day team.

Again, the woman’s blood pressure was tanking. Again, Four had to increase pressors. Vaso had been turned down and was told to be left alone because the woman’s systemic vascular resistance was so high the attending was worried about her heart. (Four couldn’t help but feel a little bitter about it, because he knew that was going to happen)

This time, though, she went into atrial fibrillation as well. As Four called the resident and attending into the room, they deliberated the matter, muttering, “Maybe we should line her for CRRT.”

Four blinked. Stared. Was he… losing his mind?? Was he invisible? He’d suggested this earlier!

Ultimately, Four had managed to keep the patient stable enough so that it wasn’t needed. Ultimately, the shift ended uneventfully.

But when Four came back for his third night, he could hear the woman’s breathing from the door, he could hear how she was drowning in fluid because she couldn’t tolerate losing fluid but had too much for her lungs and heart to handle. The day team had lined her for CRRT, but her pressors were almost maxed out at their dosage, and she was so hypotensive that the renal nurse who had set up the machine was hesitant to start it up, saying it would further bottom out her pressure.

Tonight was different, though. Tonight, the provider in charge of making decisions and orders was a nurse practitioner, someone who was used to this unit. She walked in, saw the issues Four had seen, and she walked right back out, making a call.

Four struggled to keep the patient alive long enough for the ECMO team to arrive as the patient fell apart. He felt frustration boil his blood as he had to hand off her care after fighting for her, had to watch as the CV ICU nurse came in to take over while surgeons put large cannulas into the patient’s body to redirect blood flow around her heart so she could still perfuse her organs. He watched as they wheeled her out of the trauma ICU to go to the cardiac ICU where she would remain while on such extreme support, and he threw his pen on the desk, burying his face in his hands, fuming.

They should have listened to him.

[1esor2]

Happy birthday to me, I made y’all some memes!

More accurately they’re text posts but that didn’t rhyme.

[phoenixtakaramono]

There are only two episodes left in The Boys S4, but having seen the leaks and with what we got, I have some opinions.

My conspiracy theory is that they got too many cooks in the kitchen (writers in the writer’s room)—plus the writer’s strike and pandemic happening during this time—and it’s starting to make sense how they dropped the ball with this season.

[dinitride-art]

“Mike wheeler’s armpit of a basement”

“I’ve seen Mike’s room look worse than this”

“I was being a total self pitying idiot”

“Why am I the bad guy”

“One day she’s going to realize that I’m just some random nerd”

“At least Lois Lane is an ace reporter for the Daily Planet”

“I’ve been bullied my whole life”

“Mike’s always whining about it”

“And yet you still have a C in Spanish”

“You can’t even write it Mike”

“You made it super clear that you’re not interested in anything I have to say”

“-and if I said that thing then maybe she’d want me there with her, wherever she is”

“The bad government dudes are after your super-girlfriend right? Right?! Okay, so, maybe the cops can help us find out where she is because they’re gonna kill her, man. And if they kill her, there gonna kill us!”

“Oh, no, no, no, no- it’s a shitty knock off, yeah”

“Who’s that twig with her?”

“That doesn’t mean he’s wrong. I mean, if that guy would’ve lived one more second- one more second- th- we could know where she is. Wh-why didn’t he just say the number? I-I should’ve explained myself, cuz then maybe, Eleven would’ve taken me with her and things would be different but I-I didn’t know what to say”

“And I feel like maybe I-I was worrying too much about El, and I don’t know, maybe I feel like I lost you or something”

“Y’know the last few days, I’ve had to think about the last talk we had. You know, before the cops and the whole word went to shit and everything? I- I guess- I just- I- I dunno- I guess I just wanted to- to say-”

“But… but what if after all of this is over… sh-she doesn’t need me anymore?”

“No I… it’s so stupid, given everything that’s going on. It’s just… I… I don’t know. I just”

“I, love you.”

Mike’s flopping on the floor like a miserable and suffocating fish out of water season. His friends make fun of him. Eddie made fun of his clothes. Karen told Dustin he’s welcome at the Wheeler’s anytime which implies that Mike isn’t really talking to his friends outside of school. Dustin and Mike didn’t know when Lucas’ basketball game was, which implies that they haven’t really been talking to Lucas a lot. Mike did call the Byers but wasn’t able to get through. El and Will are have been in Lenora for months and Mike hasn’t really been able to talk to either of them. El’s been lying to him in her letters and writing and signing letters is a reminder that he’s avoiding writing the word love. Everyone’s telling him that he’s doing something wrong. This kids going through it.

[theminecraftbee]

sometimes I scroll through a tag on ao3 and look at all the fics and am like. man. do you know how many of these would have been banned on ff.net. do the kids these days know how good they have it,

[im-still-watching-anime]

kakashi: sorry kids gotta go, i’ve got a date with gai

naruto: but you guys just went on a date for lunch

kakashi: yeah honestly you guys just seem to be in a particularly devious mood and i’ve determined my chances of getting in trouble by association are lower with him today

[3hobbitsinatrenchcoat]

I've had a few hours of sleep and some time to process and I have A LOT of emotions about Ashton right now.

Like. The thing I keep circling back to is everyone EVERYONE is afraid, Ashton included. But Ash pours their fear into rage and fuel, clings to the hope that their actions will keep others alive for just a little longer.

Last time they didn't get to chose their fate, this time they did. They poured all their rage and pain into hope that it would keep them alive long enough without involving and risking their family.

It wasn't selfless. It was selfish in many ways. A determined grab for control of fate, a chance to BE something, protection for someone they love who was uncertain of the path ahead.

Is it selfish to protect your friends? Ultimately yes.

And when it failed? When their one constant, their rage, failed them? Their friends strode into danger anyway. Ashton did everything they could to keep them away. Because they would stop them. Because they would get hurt trying.

Ashton took the fall, again.

But this time they didn't wake up alone.

[nicohischier]

hey gang should i drop another $160 on kpop albums after i already spent $120 earlier today haha is this a smart financial decision haha. ha.

[blvckentropy]

Alright ladies after a day of getting acquainted, the boys have divided the girls into their appropriate groups. #TeamAdam or #BlueTeam all have blue wrist corsages. And #TeamRichie or #RedTeam have red. Just to make it nice and even.

Eliminations will be chosen with a twist. Since we're dealing with a small group, sims that participate in woohoo with the opposite team brother 3 times will result in automatic elimination. The first two days will be spent in the shed.

Now taking in consideration of possible "love triangles" and the game being unpredictable, flirting will be free game, but a slight deduction to your romance bar depending on your current team. Solo dates will be determined by highest romance bar (with the exception of some games here and there) from each team for the day. Group dates/gathering will be random.

However, by the end of week 1, each individual will have their chance of swapping teams before finalizing and moving on with the competition. This is a ONE and done opportunity.

Thanks again for our beautiful contestants:

@riverofjazzsims

@foxsimthings

@invisiblequeen

@havenroyals

......................................................................................................................

Hopefully we start seeing some romance happening because atm it's dry like desert 💀