#Fellowship in Family Medicine

[fellowshipprograms]

Family Medicine is a dynamic and diverse field that provides comprehensive care for individuals and families across all ages, genders, and health issues. While the foundational training in Family Medicine equips physicians with broad skills, pursuing a fellowship offers several significant benefits. Here, we delve into the advantages of undertaking a fellowship in Family Medicine.

[cerificatecoursegma]

Fellowship in Family Medicine after MBBS: Enhancing Medical Practice and Patient Care

The pursuit of a Fellowship in Family Medicine after completing a Bachelor of Medicine and Bachelor of Surgery (MBBS) is a commendable choice for medical professionals seeking to broaden their expertise and provide comprehensive healthcare to individuals and families across various stages of life. This specialized training equips physicians with advanced skills in diagnosing, treating, and managing a wide array of medical conditions, while emphasizing the importance of continuity of care and a holistic approach to medicine. In this comprehensive guide, we delve into the significance of pursuing a Fellowship in Family Medicine after MBBS, its curriculum, career prospects, and the impact it has on healthcare delivery.

Understanding the Role of Family Medicine:

Family medicine stands at the forefront of primary care, serving as the cornerstone of healthcare delivery in many countries. It encompasses a broad spectrum of medical disciplines, ranging from pediatrics to geriatrics, addressing acute and chronic illnesses, preventive care, mental health, and health promotion. Family physicians develop enduring relationships with patients and their families, offering personalized care that takes into account not only physical but also emotional and social factors influencing health and well-being.

Why Pursue a Fellowship in Family Medicine?

Comprehensive Training: A Fellowship in Family Medicine provides specialized training beyond the scope of general medical education, focusing on the unique needs of individuals across the lifespan.

Clinical Proficiency: Fellows gain hands-on experience in diverse clinical settings, honing their diagnostic and therapeutic skills under the guidance of seasoned family medicine practitioners.

Patient-Centered Care: Emphasizing a patient-centered approach, the fellowship equips physicians with communication and counseling skills essential for building trust and fostering collaborative relationships with patients and their families.

Continuity of Care: Family physicians are uniquely positioned to provide continuity of care, ensuring seamless coordination of healthcare services and facilitating better health outcomes for patients with complex medical needs.

Advocacy and Community Engagement: The fellowship fosters a commitment to advocacy and community engagement, empowering physicians to address social determinants of health and promote health equity within their communities.

Curriculum Overview:

The curriculum of a Fellowship in Family Medicine is designed to provide fellows with a comprehensive understanding of the principles and practices of family medicine. Core components of the curriculum may include:

Clinical Rotations: Fellows engage in rotations across various clinical specialties, including internal medicine, pediatrics, obstetrics and gynecology, psychiatry, and geriatrics, gaining exposure to diverse patient populations and medical conditions.

Didactic Sessions: Structured didactic sessions cover a wide range of topics, including evidence-based medicine, preventive care, chronic disease management, behavioral health, and practice management.

Procedural Training: Fellows receive training in procedural skills relevant to family medicine practice, such as minor surgery, joint injections, dermatologic procedures, and office-based gynecologic procedures.

Research and Scholarly Activity: The fellowship encourages fellows to engage in scholarly activities, including research projects, quality improvement initiatives, and presentations at conferences, fostering a culture of lifelong learning and professional development.

Precepted Continuity Clinic: Fellows participate in a precepted continuity clinic, where they assume primary responsibility for patient care under the supervision of experienced family medicine preceptors, allowing for longitudinal patient relationships and continuity of care experience.

Career Prospects:

Upon completion of a Fellowship in Family Medicine, physicians are well-equipped to pursue a variety of career paths, including:

Primary Care Practice: Many fellows choose to establish their own primary care practices or join existing practices, serving as primary care physicians in outpatient settings, community health centers, or academic medical centers.

Academic Medicine: Some fellows pursue careers in academic medicine, teaching medical students and residents, conducting research, and contributing to the advancement of family medicine as a discipline.

Hospital Medicine: Family physicians may also work as hospitalists, providing comprehensive medical care to hospitalized patients, coordinating with specialists, and managing transitions of care.

Public Health and Policy: Others may explore opportunities in public health and policy, advocating for policies that promote population health, addressing health disparities, and shaping healthcare delivery systems.

Global Health: With their broad training and adaptable skill set, family physicians are well-suited to work in global health settings, participating in medical missions, international health organizations, and disaster relief efforts.

Conclusion:

A Fellowship in Family Medicine after MBBS offers a unique opportunity for medical professionals to deepen their expertise, enhance patient care, and contribute to the advancement of primary care practice. By embracing the principles of family medicine and emphasizing continuity of care, holistic healthcare delivery, and advocacy, fellows play a pivotal role in addressing the evolving healthcare needs of individuals and communities worldwide. As champions of comprehensive, patient-centered care, family physicians stand poised to make a meaningful impact on the health and well-being of generations to come.

[medvantagesolution]

Family Medicine: Weaving Health Together, One Family at a Time

In the increasingly evolving world of health care, one thing that remains constant is family medicine and physicians dedication towards treating the whole person. Family medicine’s cornerstone is an ongoing, personal patient-physician relationship focusing on integrated and comprehensive care. That’s why doing a fellowship course in family medicine after MBBS is one of the best decision any healthcare professional can make.

Few of the key elements of Fellowship in Family Medicine course by Medvantage are – Family medicine is highly personal as a family physician follow patients overtime and the specialty are based on good communication principles and how well you empathize with the patients for example ordering fewer tests the only which are needed, ordering less expensive procedures. Family physicians provide one of the highest quality care and significantly improve morbidity. They also improve mortality substantially and do it at bare minimum cost because it starts with the patient, the patient is at center of what a family physician does. Good communication skills with the patient helps bring out all of their history and helps in treatment of the patient in the context of their values and what’s available to them.

So, after completing fellowship in family medicine, it helps physicians embrace the biopsychosocial model of healthcare. So, the bio, the patient has diabetes and heart failure. Psychological is when the patients have anxiety or generalized anxiety disorders due to a variety of trigger points for example, they might have recently lost their job or their kid isn’t doing well in school. Then the social is for example a patient is drinking more often which leads to poor control of diabetes and other metabolic disorders, that’s how it all ties up together. Every patient tie to these different domains and they are all highly interrelated. Family physicians put patient in context of relationships, e.g. a family physician doesn’t just see one member of the family, the mother, they also see the son, her husband, which helps get them a more complete picture of what’s going on in the family, what kind of area she lives in, so it puts patient in context of their human relationships and their relationship to society at a larger level.

After completing the fellowship in family medicine, the healthcare professional eligible to see patients in variety of spectrum of care such as nursing home, hospitals and clinics and others. It helps manage patients in the hospital setting as well, see them through the transition between the hospital, the outpatient setting and their home.

Conclusion

The family medicine course by Medvantage is highly efficient in the management of acute and chronic conditions. It helps in prevention screening, cancer screenings and immunizations by providing a holistic preventive approach.

[doctorweebmd]

afa;ldf;lakdflk;asdf urgh sorry i've been MIA i unexpectedly got super busy with the grant and my grand rounds and having to pick up shifts for people with emergencies/illnesses/moving PLUS my 'graduation' is tomorrow so i'm all over the place AHHHHH

[ppthsworstlapdog]

House Swapped au where you have

Dr Foreman, Dean of Medicine. First black person to act as such in PPTH’s history, and equally proud and defensive of it. No longer practicing neurology, but has a keen interest in mentoring med students and residents. Set up the Department of Diagnostic Medicine for Chase, and has a (not so) secret interest in participating, even if he thinks he shouldn’t. Often manages to get roped in somehow, anyhow. Not many at the hospital like him, although they do respect him.

Dr Cameron, department head of the E.R. Formerly an immunologist, after her husband’s death she prefers the fast paced environment, but is still available for immunology consults. Loves doing Clinic, is on the transplant board, one of the main routes through which diagnostics gets their cases, and involved in as much hospital business as she has time for. Her relationship with Dr Chase is tumultuous, in an on-again off-again are-they-together-or-not situationship. They’re friends, and sometimes lovers, but they’re too unstable to be long-term partners.

And Dr Chase, intensivist and surgeon turned crackpot diagnostician after a freak altercation with an intensive care patient left him reliant on a crutch (of course, with no House to diagnose him, a week of PT isn’t the solution). Although NOT addicted to Vicodin, he remains bitter/traumatized about the situation and refuses to interact with patients, often going to extreme lengths to avoid them. In a weird thing with Cameron, a brutal gossip and flirt, and mostly well-liked among the nurses, if not somewhat pitied (but only by the new ones). Bad at keeping fellows due to his less-than-stellar teaching style, but maybe this newest batch will be alright:

Dr Cuddy, an endocrinologist recently off of her residency. Has big goals and lofty ambitions, and will do anything to get there. Not the best diagnostic fellow, but she can handle her colleagues and is incredibly good at handling patients and their families. Is probably fooling around with one of the new hotshot hospital lawyers, but no one can prove it. Wants kids one day, but she’s more focused on her career right now.

Dr Wilson, once-divorced oncologist. A strange fellowship to end up in, but after his friend told him about the position decided to apply. Spends his weekends looking for his lost brother. Hoping the fellowship will offer him a chance to join the oncology department. Also good at dealing with patients, he’s the go-to for delivering bad news. Chronic flirt, but on good terms with all the nurses.

And Dr House, nephrologist and infectious disease specialist, who took the position in diagnostics because he was “getting bored” with his other specialities. Loud, abrasive, and boisterous, he’s Chase’s go-to for b&e and sniffing out patient lies. Is unfortunately the most stubborn, and will do anything to prove himself right, including getting assaulted on several occasions. Chase’s longest running employee, he met Wilson several years ago in New Orleans and convinced him to move to Princeton. Cuddy he met in med school, and they’ve kept in touch since.

[pinkthrone445]

-Abbott's house-

Pairing:Melissa Schemmenti x Reader

Gender:Fluff, funny, soft

Warnings:none(?) future smut

Summary:The district gives the school the idea of spending a month living together to strengthen bonds, you never thought that would change your relationship with some so much.

Hi! This is an interactive story, if some thinks about something funny that one of the people of Abbott would be like to do, and you would like me to introduce it in the second part of the fic, you can leave it on the comments. I hope you like this part!

Abbott's shenanigans

There are a lot of things that influence the relationship we have with people, spending a lot of time together, going on vacation together, going on dates, being with someone when they're sick and taking care of them, having a fight or a problem that requires assistance, living together, and so on. It could change the relationship for the worse or strengthen the existing friendship, or sometimes even make love grow.

You and your Abbott classmates commonly spent a lot of time together at work, so you never thought that living with them would make much of a difference, but you were wrong and didn't know how much until Ava walked into the teacher's room accompanied by Janine to make an important announcement.

-"Please, if I can get your attention... I have an important statement, as the vacations arrives, Abbott will begin to do a month of interaction together to reinforce the fellowship and friendship between us so we can work better together as a team an as a family, you can say that you do not want to go, but keep in mind that it will be an all-paying month in a shared house, the groups will be 8 people per house, which if everyone says yes, this group will be a house shared by Melissa, Barbara, Jacob, Gregory, Ava, (Y/N), Mr. Johnson and I"-Commented a very excited Janine seeing everyone-"The house has 5 rooms, so some will have to share a room and others won't, we will fix that later depending on who says yes... It also has 1 private bathroom per room and a large one downstairs, it has a fully equipped kitchen, a dining room and living room with television, a terrace, a patio and a heated pool... The only thing you would have to bring is the clothes you would use, personal towel and any hygiene items you prefer besides personal medicines... You will also have money to go shopping, there will be group activities and you will have 2 days completely free to do whatever you want or go visit your family. If you want to be part of this, talk to me or Ava and we'll write you down, I hope you take advantage of the time the district decide to give us something for free..."Janine muttered the last part before leaving the teacher's room, leaving you all a little surprised with the news.

Immediately the murmurs and questions began

-"Gregory let's go together and share a room!" - Jacob murmured excitedly, grabbing his friend's arm

-"I don't know... I have my day to day planned even to what I eat, it would be a big change" - he replied without much conviction

-"Please! If we do this I'll have one more month to find a new apartment... Besides this will help me with my breakup...You know how sad I've been"-Jacob was using the pity card and Gregory knew it, but he loved him too much to say no...

-"Fine, but you better keep the room clean" - Gregory muttered under his breath, and Jacob jumped and danced happily

-"Are you going Barbs?" - Mel asked her friend she shrugged her shoulders

-"I have to ask Gerald first, but if I go, I want a room to myself so I can use my breathing machine... You?" - Barbara asked

-"I think maybe...I'm very bored alone, it will be a good distraction... You?"-Mel asked you this time while you were eating

-"I want to... I mean, paid vacation? Count me in, besides I don't have anything else to do"-You smiled looking at the redhead.

Little by little, everyone else got on board with the idea of spending the vacation together, so before you could think about it much more, you were already driving to the house where you would spend the next month of your life.

You were one of the first to arrive, even though there were already two cars in the driveway. You carefully unloaded your bags and walked inside the house, suddenly finding Ava and Janine talking and arguing.

-"Hello girls..."-You whispered trying to go unnoticed and not interrupt or get involved in the discussion

-"(Y/N)! Welcome!" - Janine yelled, walking away from the principal and getting closer to you-"All the rooms are assigned already... Yours is the one to the right in the second floor, you can settle in and when everyone arrives, we will handle you sheets with the schedule for the month, Okey? Enjoy" -The petite woman barely let you say hello before going back to her chat with Ava. You carefully brought your bags up and noticed that you had a shared room, although you still didn't know with whom.

After settling everything in, you felt more people arrive at the house and before you knew it, your roommate had walked through the door

-"Hello roommate" - Mel muttered, leaving her bags on her bed and smiling at you

-"Oh, hi Mel... I thought you will be sharing a room with Barb... I mean, sorry, from everyone that I could got, I'm happy it's you..." - You muttered a little embarrassed

-"Yeah... Barbara wanted a room to herself, but Ava and Mr. Johnson asked for it first, so Barbara was assigned with Janine, Gregory, and Jacob together and you and me together..."-The redhead began to unpack her bag as you looked at her

-"Do you want me to swap rooms with Barbara so you are together? It's not a hassle at all" - You responded, helping her with her stuff

-"Don't bother, Ava did this because she wants us to strengthen our bonds with people that we don't get together as much, so we are stuck together... Also, Ava did this arrangements because she wanted a whole room for herself"-she muttered, arranging her clothes on one of the furnitures

-"Okey... Do you want to set some ground rules or something? I don't wanna bother you"-You asked sitting on your bed looking at her

-"Just by saying that, I already like you a thousand times more... I just don't want the light on after 12 if possible and dry the bathroom thoroughly after a shower. I think that's it. You?" - she commented, turning to look at you and you shrugged your shoulders

-"I don't think so..."-You muttered before you pulled out one of your books and started reading while she sorted out her things.

The week began to pass normally, each one received their activity sheet, which included movie nights (each one would choose one movie per night), you had physical activities together, walks, reading nights, month game night, each one was assigned a place in the house to clean and other chores together. Everyone would have to cook or go shopping from time to time. Take some classes for school, etc.

It would be a busy and interactive month.

Your coexistence with Mel was going well, more than well, the fact that you didn't make her angry so far said a lot.

When the first movie night rolled around, Jacob chose the movie "It", which you tried to avoid because you didn't like horror movies and because you hated clowns, but Ava said it was a must-do activity so you had to stay, although the truth was that she wanted to laugh at how scared you were.

Before the movie started, you made popcorn for everyone and sat next to the redhead who was the only empty spot on the couch. Mel smiled at you and covered your legs with the blanket she had, sharing it with you.

At first you avoided watching the movie by looking at your phone, but Ava told you to turn it off so you no longer had any distractions, nervously, you started playing with your fingers but Mel noticed your fidgeting, carefully she took one of your hands with hers and intertwined her fingers with yours smiling at you

-"It's okay, it's just a movie, I'm here with you..."-she whispered close to your ear, making you blush. You never thought that sharing just a couple of days together would make the redhead more fond of you and want to take care of you.

The rest of the movie you saw it without letting go of her hand and shaking a little when the damn clown appeared, witch was all the time.

At the end of the movie you were one of the first to go to your room, as soon as you entered you lay down on your bed and started watching cartoons on your cell phone trying to get the face of the damn clown out of your memory. Mel carefully entered the room and stared at you tenderly, you looked like a small sacred child

-"Are you watching Bluey?" - she whispered, trying not to alarm you

-"Yes... I hate clowns and now I'm scared and I won't be able to sleep if I'm like this... Don't laugh at me please"-You muttered in shame and she shook her head

-"Never... I'll go take a shower, you can leave the lights on tonight if you want..."-She responded taking off her clothes in front of you, seeing her in her underwear made you forget your fears for a moment, it wasn't until the redhead walked through the bathroom door that you came back to reality and back to your cartoons.

After a few minutes, the room filled with the scent of flowers when the redhead came out of the bathroom, you followed her with your eyes waiting for her to go to her bed, but instead she stood in front of you

-"Move a little, give me a little of room, I'll sleep with you so you don't get bad dreams"-Mel suggested and you gave her space a little confused, thinking maybe she was joking. She carefully climbed onto your bed with her pajamas on and gently hugged you making you snuggle on her chest, consciously or unconsciously, this was making you feel safe and calmer.

Your heart began to beat more slowly and your head stopped thinking, her hands gently scratched the back of your neck and the beating of her heart over your ear made you breathe more calmly and steady, even the darkness and silence of the room provided a calm atmosphere now that she was by your side.

When Mel began to feel like you were falling asleep, she kissed your forehead gently

-"Good night hon, I'll take care of you..."-She whispered before you fell asleep completely.

Unable to believe it, you slept through the night without any nightmares, and when you woke up Melissa was still by your side sleeping and cuddling you. Not wanting to wake her, you tried to gently snuggle closer to her. You couldn't believe how good she smelled and how beautiful she looked while she sleeps. When you were about to snuggle up on her chest, her voice startled you

-"I'm already awake hon... Good morning" -she commented in a thick voice making you blush

-"I'm sorry...I...it's just that you're so warm that I wanted to get closer to you... Besides you smell so nice..."-You began to stutter from nerves that you had been caught in your attempt to be close to her-"I didn't want to disturb you, just feel your warmth..."-The redhead snuggled you with her arms putting you close to her chest making you shut up by being almost between her breasts

-"I said good morning... And you didn't answer" - She commented in a raspy voice

-"I... I'm sorry, good morning Mel" - You replied and closed your eyes taking a big breath to etch her perfume into your memory

-"Did I help? Did you have any nightmares?" - She asked and you shook your head with your eyes still closed-"Good... Do you want to go cook breakfast together?" - She asked again and after a few seconds of thinking, you nodded. Although you'd like to stay in that bed for as long as possible, if you said something, you might make her feel uncomfortable. Gathering all the strength in the world, you sat up on the bed and stretched out your arms under the watchful eye of the redhead.

After the two got ready, you went to the kitchen with the redhead to make breakfast. No one was up yet, so that gave more peace and quiet to cook. You and the redhead worked together like a well-oiled machine, it seemed like you had been cooking together for years as you saw how you helped and understood each other. The redhead put on Italian music and was surprised when you started singing, seeing you with different eyes than she did a few days ago.

At the time you didn't know it, but that month would be one of the most intense and crazy where your life would take a 180-degree turn, changing everything, especially your relationship with your coworker and roomie.

[vivalas-vega]

match // new perspectives universe // jake 'hangman' seresin x reader

heyooo - i'm back from the dead - it's been a while since we've seen these two and for this one we're going back in time !! this is kind of a rewrite of something that’s already happened in the main chapters 🤭 i haven't written jake and jupiter in what feels like forever so this feels rusty to me lol but hopefully you enjoy!

match // new perspectives universe // jake 'hangman' seresin x reader

add yourself to my taglist

part of my new perspectives series !! it will make a lot more sense if you're caught up on these two:

prologue - one - two - three - four - five - six - seven - eight - nine

word count: 4.8k

warnings: language, mention of alcohol, college/med school/residency inaccuracies (I didn't go to college and it shows lol any and all knowledge on any of this comes from tiktok or greys anatomy)

Sitting at your vanity (if you could even call a plastic set of drawers with a handheld mirror duct taped to the back a vanity) you briefly thought to yourself that you should be excited… and you were, for the most part. Today was one of those days that marked the start of a new chapter. You’d been lucky (or unlucky, depending on how you looked at it) to have had a few of these already… first opening your acceptance letter into college, then med school, and now you were getting ready to find out where you had been matched for residency.

The excitement and nerves you were feeling were subdued because really the only thing you could focus on was the fact that the only person you wanted here wasn’t… and you didn’t know where he was. He could have been on a ship halfway across the world or at a base a handful of hours away but in the end it didn’t really matter much… he wasn’t here, and that was just part of the deal. You knew what this was long before it got to this point, and that point was only accentuated by the floppy haired boy walking into your dorm just as you stood from your spot in front of the window to change.

“Well, don’t you just look darling,” he teased and on another day you might have laughed… struck a pose and had a witty comeback, something about ratty college tees and soffe shorts being on all the runways these days, but it wasn’t another day. It was today and your future was hinging on something written in an envelope waiting for you across campus and this boy wasn’t the one you wanted teasing you today. 

You undressed and stood with your back to him, a silent request for him to help zip your dress and he obliged just as quietly. There was an expiration date on you and Matt, this much you knew… but the way his fingers trailed down your arm and the lingering question he’d been asking all month told you he wasn’t on the same page. He had a vision for his life, one that very much included you and perhaps you felt a little guilty for continuing to keep him in your orbit but the more logical part of you reminded you that the vision you had for your life had been set in stone long before he showed up. He saw residency right here in California, with you by his side. He saw you switching your area of focus to general medicine, something less demanding to create room for starting a family, something you’d do within the next few years. You hadn’t had the heart yet to tell him that sounded like your own personal hell.

Your vision was Boston, in a cutthroat surgical residency program before moving on to whatever hospital offered the best fellowship for your chosen specialty… that was the one area of your life you’d yet to nail down. Most of your peers pursuing the surgical route knew what they wanted to focus on, some vying for cardio or neuro, others trauma or general but not you. That was the one thing you were leaving up to fate, deciding to instead let yourself make that decision a few years into residency… and if that fellowship happened to come along where the boy you missed more than anything was stationed? Well, you wouldn’t be one to complain. The vision didn’t include Matt, it never did. 

And so, as you turned to face him with a tight smile you wanted more than anything to tell him this was over, that it would be best to head into residency as individuals but then you saw that look on his face and you couldn’t do it right now… not right before finding out whether or not you were getting everything you’d spent the last eight years working towards (seven for you, but you wouldn’t point that out to him anymore than you already had). You’d wait until after, even if that meant walking into the ceremony with someone you had already decided you wouldn’t be seeing after today. 

“Hey, did you guys get settled okay?” you asked your parents as you set your bag down on the table and exchanged quick hugs. You’d already seen them this morning when they’d arrived and they’d decided to give you a little space to get ready. 

“Your mother has taken photos of about a dozen things at the hotel, taking notes for our upcoming remodel which… I was just informed of this morning,” your dad said and you laughed. Matt said his hellos before going off to find his own parents and you rolled your eyes at the look your dad fixed you with. “He’s still around?”

“Oh hush,” you replied. Your purse started ringing and you fished around lip gloss and old flashcards to find your phone, immediately feeling more settled at the voice on the other end.

“Hey you,” Jake said and you actually let out a sigh of relief. “How are you feeling?”

“Oh me? You know, cool as a cucumber. Not freaking out at all,” you answered with a small laugh and he just chuckled.

“Of course not, not like there’s anything big going on today.”

“Definitely not, just a normal day around here,” you said.

“I just wanted to call and tell you to breathe, because you forget to do that sometimes-”

“I do not-”

“Yes you do, and to remind you that no matter where you end up you’re going to be just fine.” 

“Thank you,” you said softly. “I know you can’t say where you are but I hope you’re flying safe today,” you added.

“Always do, sweetheart. I’ll call you tonight, yeah?” 

“You better.” you said with a smile as you hung up and put your phone on silent just as the announcer gave the two minute warning. You could practically feel the rising tension in the room, a mix of nervous excitement and pure dread. So many fates contained within tiny envelopes and as you picked yours up you found the whole notion of this rather silly. You felt bad for anyone who got news they didn’t want today, having to find out in a room full of people celebrating and you prayed to a god you weren’t sure you even believed in you wouldn’t be one of them. 

“I think I’m going to, uh…” you started, looking at your parents and then back at the envelope in your hand. “I’m going to just take a minute and open it myself, if that’s okay?” you asked hesitantly and they nodded.

“Whatever you want, honey,” your mom replied and you turned around as the announcer told everyone to open them. You took a deep breath, because you did forget to breathe in times of stress, and with shaking hands practically ripped the envelope apart to pull out a folded piece of paper… a piece of paper that you hoped contained two specific words. 

Massachusetts General. 

Your shaking hands persisted as you read and reread what was right in front of you. Massachusetts General. You blinked and read again, did it really say that? Massachusetts General. 

“Oh my god-” you started as you turned around to show your parents with the paper facing outwards but they were gone. Really they’d only stepped a few feet to the side but they, and everyone else in the room, may as well have disappeared because all you could focus on was him, standing right there in front of you in his dress whites looking so proud as he read the words in your hands that quickly fell to the floor in shock. “Jake?” you asked so quietly, your mind still not catching up but it didn’t matter, in an instant you were launching yourself at him and he caught you with ease as you wrapped around him.

“Hey you,” he repeated his words from just a few minutes ago on the phone and you let out a sound that was mixed with a laugh and a sob as you clung to him. “You did it, I knew you would.”

“What the hell are you doing here?” you asked as you pulled away slightly to look down at him and he just beamed up at you.

“You didn’t really think I’d miss this, did you?” he replied and you just smiled, but it was quickly wiped away as you heard someone clear their throat behind you and you didn’t need to look to know who it was as you slid down Jake’s body to the floor and turned to see Matt, who was looking at the pair of you skeptically.

“Jake’s here,” he said, trying to muster some kind of enthusiasm but it fell flat, “yay.” You stifled a chuckle as you looked at him expectantly, “I matched here, what about you?” You knew what was coming as you took the paper your dad held out for you and Matt nodded softly when he read it. “I thought we talked about staying here for residency?” You didn’t miss the way Jake scoffed behind you, clearly disgusted that that was the first thing out of his mouth.

“You talked about it, Matt… I was always clear about my goals.” you said firmly. “But this is what we’ve both been working for. Congratulations, really,” you said, wrapping him in a tight but quick hug. “Go, celebrate with your family. I’ll see you at the party later.” you finished, nudging him off and  when you turned around Jake was giving you the most unimpressed look.

“Don’t even, I will not be seeing him at the party later, if you must know.” 

“Is that so?” he asked with a smirk and you rolled your eyes as he chuckled.

“Congratulations, sweetheart,” your mom said, pulling you in for a hug.

“We’re so proud of you,” your dad added, pressing a kiss to the top of your head and you went to respond, to thank them for everything they’ve done for you but they didn’t give you the chance. “Go celebrate and spend time together, and have fun at the party tonight.” 

“What? No, you guys flew all this way… I thought we could go out for dinner-”

“Hush, you two have some catching up to do,” your mom replied. “Besides, I think whatever celebrations you get up to tonight are best kept from us,” she added with a knowing smile and you tried to fight your own. 

“We’ll do breakfast, just the four of us like old times… but we won’t wake you too early,” your dad said and you watched as Jake gave them hugs before they slipped away. 

When they left he turned to look at you, all pride and adoration, and you flushed under his gaze as you gave him a look that said what? “You fucking did it, Jupiter.”

“I fucking did it,” you replied, your laughter bright and uncontrollable as he lifted you from the ground and spun you around.

“How’d he take it?” Jake asked as you entered your dorm, and you chuckled as you took him in, sprawled out across your bed, one leg hanging off the side because he simply didn’t fit. 

“About as well as could be expected,” you said and he laughed as he sat up.

“So… not well at all?” He laughed again when you nodded. “Tell me about this party we’re going to.”

“It’s pretty standard, I expect things will go as they always do with a campus party… just a little more celebratory with a slight drinking to numb the pain vibe from some.”

He nodded, “all your friends got what they were hoping for?” 

“For the most part… a few didn’t get exactly what they wanted but that’s kind of how it goes… matching is about a little bit of hard work and a shit ton of luck.”

“So, I’m guessing dress whites aren’t the vibe for tonight?” he asked, watching as you discarded your jewelry onto your desk and you chuckled as you turned and walked towards him, stopping in between his legs.

“Not at all,” you said with a shake of your head and you laughed again as he pouted and rested his hands on the backs of your thighs. “But they were a nice touch, you look very official and handsome,” you added on, hoping to turn his frown upside down.

And you did, he looked up at you with that same look he’d given you in the event hall. “I know you know this, but I really am so fucking proud of you, J,” he said and you softly smiled, feeling crimson creep onto your cheeks and you quickly diverted, trying to break some of the intimacy of the moment by pulling the hat from his head and plopping it on your own.

“Well, you should be, cowboy,” you said, stepping back and grabbing two beers from the mini fridge that doubled as a nightstand, handing one to him and he looked at you expectantly as you both cracked them open. “Because your best friend got into the fucking brig,” you said as you clinked the cans together and he let out a few cheers before taking a generous gulp. 

He stayed by your side as you got ready together, only engaging in a few quarrels due to the lack of space that only got smaller when your roommate Katie showed up, and you couldn’t help your amusement as the two of them got on each other's last nerves. Their relationship was very akin to that of siblings, they’d scream at each other through the phone on facetimes when the other was pulling too much of your attention and on the rare visits Jake managed she’d spend the whole trip pouting about how no one else existed when he was here.

“Are we not going to this party together, Katie?” you said, interrupting her latest spiel about Jake’s evilness, as she put it, and she held her hands up in surrender as you laughed. She put on a good show but you knew she liked having Jake around, it meant she got to see more of her favorite version of you… party Jupiter. And party Jupiter was in full effect as you strolled down the street lined with fraternity houses. The parties you attended these days were typically on the other side of campus and not quite as rowdy, you couldn’t even remember the last time you’d been down here but it had been negotiated that the frats held parties for the med students this year, to give you all one more truly college party before everyone went their separate ways into a new journey of adulthood. 

“You’ve been here before, right?” you asked Jake as you watched him mix you a drink and he nodded.

“Mmhm, your third year of undergrad,” he answered and you snorted.

“Oh god, yeah,” you briefly reminisced on that party, one with no cause, and the shocked look on Jake’s face most of the night. As it turned out, you had actually been understating just how much Stanford kids like to party that day on the phone all those years ago. You mingled with Jake in tow, socializing with friends you hadn’t seen since the beginning of the year to due rotations and interviews across the country, and really emphasizing the fact that you wouldn’t see each other for a number of years after tonight in your drunken states much to Jake’s amusement.

You weren’t much of an emotional drunk but that didn’t seem to be the case tonight… Probably something about the finality of it all, going from college to med school didn’t seem like a huge transition for you because you stayed in the same place, but this was different. After graduation next week you’d be packing up and moving across the country, to somewhere that couldn’t be more different than where you were, and you would officially be a doctor. 

Jake watched as you let loose, cackling with friends about professors or that one time you stole a dozen mice because you couldn’t bear the thought of them being used for research (and you maintained that you’d been in the right each time it was brought up). The last time he’d come to visit you’d been so entrenched in your coursework he actually became worried, watching you study for hours on end from your bed as he realized this is what your life was. You’d always done a good job at completing everything before he arrived so you could focus on the fun but that visit just wasn’t the case… There were exams to prep for and applications to be sent out and interviews to be scheduled, and all he could do was half-heartedly read a book he’d plucked from your shelf about internal medicine and force you to come up for air every now and again.

But this time was completely different, there was nothing to worry about because you were done. You’d gotten to the end of your journey here at Stanford and were in that blissful reprieve period where there truly was nothing to fret over, and it simultaneously warmed Jake’s heart and broke it to see. On one hand, you were finally getting a true break after years of achingly hard work… but on the other that break would only last a few days before you went into a tizzy packing to move cross country and start your residency. He knew you were happy, and that you would be happy in Boston but he also knew things were only about to get harder, and that a few days of true relief weren’t enough.

Granted, this wasn’t how you felt, despite the fact that as you downed your drink and chatted with Katie about her upcoming move to Nashville you had no idea this was going through his head… you felt nothing but joy knowing that you got to spend the next few days with Jake before diving into your future. Residency is what you feel you’d waited your whole life for. You did the hard stuff, you laid the foundation and stuffed your nose in a book for years and now you were finally going to be able to do. 

“I think I might actually miss these parties,” you said as you sat down by the edge of the pool with a sigh, unclasping your heels and actually moaning in relief as you dipped your feet into the cool water and Jake chuckled beside you. 

“I find that shocking considering that after that one your third year you said you never wanted to set foot on this block again.”

“I’ve grown, things have changed,” you protested which coaxed another laugh from him. “God, I can’t believe I’m leaving this place soon. It almost feels like just yesterday I showed up here with nothing but a suitcase and a dream. And you! Mr. Top Gun graduate,” you added, nudging him playfully.

“Don’t let Coyote hear you, he’ll bust my chops even more than he already has.”

“I miss Coyote,” you said, leaning your head on his shoulder. “Are you going home for Christmas this year?” you asked and this took him slightly by surprise, considering it was spring and he didn’t expect you to be looking forward to anything other than residency.

“I don’t think so… the way it lines up I’d have to fly in on Christmas Eve and leave the day after… I think the short trips make my mom sadder than me not going home at all.”

“They do,” you said. “For my parents too. I don’t know why but they do. What do you think about me coming to you this year? If you’re on base.”

“I think that sounds perfect,” he replied, turning to press a kiss on the top of your head. “I’m sorry I can’t stay for graduation,” he said and you lifted your head to shake it, waving your hand dismissively.

“Truthfully I don’t care about graduation, it’s more for my parents and yours. This was the important one,” you replied, giving him a warm smile. “I still can’t believe you pulled off surprising me. How long have you known you’d be able to make it?”

“Since you first told me the day,” he answered and your eyes widened as you hit his chest.

“You asshole! You made me think you couldn’t come and this was your plan all along? I was really sad, you know.”

He let out a loud laugh, “yeah, I know. But it was worth it! The look on your face was priceless.”

“You’re unbelievable,” you muttered.

“Had to get you back for my tap out ceremony somehow,” he pointed out and you sighed, because he did have a point.

“That’s fair. Though, I could argue that it was a surprise for me as well, mine was not premeditated.” 

“To-mato to-mato,” he replied. “So, when do you make the big move?” 

“Well, tomorrow you’ll be helping me scout apartments, tough part is I’ll have to pick a place sight unseen so we’re going to have to be very thorough in our search and then hopefully I’ll be out there within three weeks… My program starts in four.”

“Unless a last minute deployment pops up, I think I can meet you out there… help you get settled and all that.”

“Really?” you asked, eyes wide and full of hope as you beamed up at him and he chuckled, knowing you were definitely drunk right now. “Seeing you twice in one month? I don’t think we’ve gotten that lucky since we were teenagers.” 

“Well, I don’t know about that,” he said with a suggestive raise of his eyebrows and you were startled by your own laugh, not expecting the turn in conversation. 

“That’s right, forgot I was talking to Hangman, eternal stud.” you joked. Briefly you thought joking about it should sting, and deep down maybe it did a little, but this was the first time it’s come up and the sting wasn’t the first thing you noticed.

“You haven’t done so bad for yourself either,” he said and you just gave him a deadpan glare.

“Really? You think Matt was making me feel lucky every time?” you asked and he went through the same range of emotions. He thought it should hurt, and it did somewhere deep down, but it wasn’t the first thing he noticed.

“He wasn’t? Then what was the point?” he exclaimed and you hid your face in embarrassment. 

“Oh, I don’t know! Truthfully it spiraled and I didn’t have time for anything else so…” you trailed off before letting out a groan. “Oh god, I’m a terrible person.”

“Now, how did we end up there?” he asked, brows furrowing in confusion at your statement.

“I knew all along I’d dump him right about now, how awful to not do it so much sooner.”

He shrugged, “maybe… but knowing you he did get lucky every time so don’t feel too bad. Broken heart or not he reached the mountaintop, good for him.”

“That’s a better, if not slightly twisted, way of looking at things.” you mused, resting your head on his shoulder again.

“Tired?” he asked and you nodded. “Don’t quite have the stamina of an undergrad anymore?”

“Shut up,” you said. “It’s been an emotional day.” 

“Wanna go home?” he asked and you nodded, allowing yourself to be pulled up and you awkwardly shook your leg over the pool to rid yourself of excess water, to which he just shook his head in amusement. 

You spent the walk back towards your dorm lost in conversation, giggling about nothing in particular and squealing when he picked you up and tossed you over his shoulder, “Jake! I’m too drunk, don’t make me hurl,” you laughed but he didn’t seem to care, carrying you like it was nothing until suddenly you were on the move again, sliding down to the ground with Jake’s firm hands on your waist to guide you. Your brows furrowed in confusion when you noticed you weren’t at your dorm but instead in front of a shiny car.

“I love Katie,” he started, but was cut off by the questioning look you gave him, “really, I do, but you didn’t really think I was crashing in your dorm, did you?” he asked and he did have a point… the last time he visited she was on rotation so he crammed himself onto her tiny bed and complained all the next day… there simply wasn’t anywhere for him to be this time around. “I have a hotel room a few blocks away, do you want to come stay with me? Or I can walk you back to your room,” he added the last part a little hurriedly and you chuckled, you thought you just caught a glimpse of a younger Jake… nervous and not wanting to overstep. 

“Are you kidding me?” you asked, gesturing towards the door and he was quick to open it for you, “a night away from that thing they call a bed sounds like heaven.”

“And here I thought you just wanted to spend more time with me,” he said after walking around and getting in the driver’s side.

“Well, that’s certainly part of it… just not the main part,” you teased and he shook his head as he navigated towards his hotel and you looked over at him in amusement when you entered the parking lot. “Very fancy, Mr. Seresin,” you said as he opened the door for you and he extended his hand which you gladly took.

“Shut up and come on,” he replied and you did as you were told. Following him through the hotel and to the elevator, where they opened to reveal a cozy and beautifully decorated rooftop bar and you just looked over at him, eyes wide and questioning. “Tonight was a goodbye to your college life, and I thought what better way to end it than here, welcoming in this next chapter?”

“Jake…” you started, the lingering alcohol in your system still present enough to have you feeling a little more emotional than usual. You sat at a cozy loveseat positioned in front of a firepit and thanked the waiter when he brought over your cocktails, gin and tonic for you and something whiskey based for Jake. 

“To you, Jupiter. You’ve worked so hard the past seven years, and you never once wavered when things got hard. You are nothing short of incredible, and being here with you right now, marking this occasion… it means a lot to me, and I’ll never stop being proud of you.” he said, and you felt your eyes well with tears that mirrored his own.

“Stop, you can’t cause then I’ll really lose it,” you warned, laughing softly as you wiped your cheeks. “Thank you… not just for saying that but for being you, and for being here. I was a wreck all morning and then I turned around and saw you and everything felt… settled. You being here means more than you know.” you said and you clinked your glasses together before taking a sip. “I’m really proud of us.” you said added a few moments of silence. “Do you remember the day we decided to break up?”

“Vividly,” he chuckled and you couldn’t help but laugh too.

“God, we were so young, with such big dreams… and going into it all so devastated… I wish we could go back and tell them it wouldn’t be for nothing, that we made it.” 

“We did make it didn’t we?” he asked and you nodded, a smile creeping onto your face. He reached out to tuck a strand of hair behind your ear and you didn’t know if it was the weighty realization that seven years ago you broke each other’s hearts to pursue the dreams you’d just achieved or the alcohol or just the fact that you simply wanted to but you leaned forward and let your lips brush against his. Soft and questioning but he pressed forward and captured you in a searing kiss. Years of pent up emotion and love spilling out, and you smiled when he chased your lips as you pulled away. 

You didn’t need to say anything, didn’t need to acknowledge any of it. You both knew it didn’t change anything, you both might have made it but only to the next stepping stone… it still wasn’t the time. You kissed him once more before scooting closer and resting your head on his shoulder, his arm wrapping around your waist as you just enjoyed the moment for what it was. A celebration of what was to come.

taglist: @mamaskillerqueen @clancycucumber230 @the-romanian-is-bae @alldaysdreamers @zzsloth @emma8895eb @novagreen04 @classyunknownlover @olliepig @purplevortexx @mayhemmanaged @ohgodnotagainn @smoothdogsgirl @swiftsgirlfriend @memoriesat30 @the-fandom-ness @midnightmagpiemama @shanimallina87 @tiredqueen73 @charles11700 @thegodessc @angelbabyange @failuretothrivestuff @wildxwidow @sp1rit-realm @grxcieluvr @alluringshawn @amatswimming @camilaricci @pinkpantheris @taytaylala12 @starcatcher48 @buck-nasty @misshoneypaper @waklman @4evinlovewithfictionalmen @devil-angel-winchester @callsignspirit @cruelmissdior @underaveragefangirl @camilaricci @nolita-fairytale @dempy @aviatorobsessed @pono-pura-vida @binnieslove @nik2blog @abaker74 @halstead-severide-fan @percysaidnever @memeorydotcom @eli2447 @dumb-fawkin-bitch @toobouquet @a-v-a123 @rae-you-gotta-be-kidding-me @86laura11 @justenoughmadnesss @yoonbutterfly (if your name is struck through it means I couldn't tag you - so sorry!)

[passingnights]

Ame is a child when she first wonders through Grandmother Wren’s cottage. She wakes to the stomps of a fierce rooster, the smell of juk, the chorus of small sounds that builds the cottage.

Ame is a child when she falls in love with magic, the scent of it, the purity and the heart that lives at the core of it. Magic, the ability to connect with the earth, to provide for the animals and the trees, for the Spirits and honour their works. To help humans with sickness and mending.

The humanity in magic, the spinning of life to vow service to all that breathes on Umora.

Yet Ame is still a child as other children scowl at her, throw piercing gazes and words, “you’re a witch!” and see nothing but body, a little girl disconnected from the flesh of their own, a witch, nothing but a witch, an orphan, a stranger, a child. All but human.

But Ame had never thought herself anything other than human.

Ame, a child that never was, never could be, and forever will be.

She is a child when she is given to Grandmother Wren. Unwanted, strange child. She is a child when she is othered by the other children. Witch and apprentice, and still a child.

Ame never experiences childhood. She knows the wonders of magic and medicine, of healing and earth. But she never experiences the wonders of friendship, of connections in childhood. Ame never experiences the wonders of playing make belief, the warm hug after a heated argument, the small secrets shared in childhood.

But Ame is a child when finds more to her little family. A wizard, a witch and a wild one. Each child with a deep and profound sadness etched into the core of their beings and yet all too young to form the words to it.

Ame is still a child when she waves goodbye to her best and most True Friend. Tears wet her cheeks and the summer falls to her feet in a sweet breeze and a distant memory unforgotten. Ame is a child when she whispers her final goodnight to her brother, her True Friend, without and fully knowing so. She wakes up to the smell of moss and nothing but moss. She finds the cottage all too quiet.

Ame gains more than childhood during one summer and looses more than it when it is over. She finds fellowship and family in two True Friends. A secret and bond in childhood that cannot be simply broken. A thread that stretches across over water and mountains that no matter how far they are, they know they have a piece of themselves, of a simpler yet complicated summer in childhood somewhere across the lands. A small shard of childhood, of their true humanities stuck in memory of the scent of honey and magic and fur, a time long ago.

[twistie-tara]

Dear Supporter,

I hope this message finds you and your family in good health. My name is Rakan Zaqout from Gaza.🍉 I am reaching out to seek your urgent help in spreading the word about our fundraising campaign. I lost both my home and my school, my parents lost their jobs too, due to the ongoing genocide in Gaza and we are facing catastrophic living conditions.💔

I kindly ask you to visit our campaign. Your support, whether through donating or sharing, will help us reach more people who can make a difference. Thank you for your continued support for the Palestinian cause. Your dedication brings us closer to freedom.🕊

Please note, our campaign has been verified by 90-ghost and aces-and-angels.☑

Please help out Rakan Zaqout and his family!

Rakan Zaqout is the child of Eman and Mahmoud Zaqout, and the brother of Seba Zaqout. Him and his family’s house and life has been destroyed by the IDF, and they’ve been forced to flee to a displacement camp with the lack of food, water and medicine.. These basic human necessities are also becoming highly unaffordable in Gaza.

Before the bombings, Eman Zaqout used to work at Al-Shifa Hospital and Turkish Palestinian Friendship Hospital, as a Biotechnology Specialist. She poured her heart into her work, to provide for her family..

But, it was all ruined by the IDF…

(their homes were destroyed too…)

Eman Zaqout is one out of the 22 women who has been awarded with OWSD-PhD fellowship to pursue her PhD in Malaysia.. However, due to the occupation, she is forced to stay in captivity in Gaza, wasting away..

Please go and support Eman, Rakan, Mahmoud and Seba in helping them reach their goal of $40,000 (currently at $25,199 CAD)!!

[fellowshipprograms]

Family medicine is a rewarding specialty that allows you to build long-term relationships with patients and provide comprehensive care across all ages. But did you know there’s a way to further specialize in this field? A Fellowship in Family Medicine program can equip you with advanced skills and knowledge to become an even more effective primary care physician.

[cerificatecoursegma]

Advancing Healthcare: Fellowship in Family Medicine for MBBS Graduates

Introduction:

In the dynamic landscape of healthcare, the role of family physicians is becoming increasingly vital. With a holistic approach to patient care and a focus on preventive medicine, family medicine practitioners play a crucial role in addressing the diverse healthcare needs of individuals and communities. For MBBS graduates seeking to specialize in this field, a Fellowship in Family Medicine offers comprehensive training and invaluable experience. This article delves into the significance of pursuing a Fellowship in Family Medicine after MBBS and explores the opportunities it presents for doctors aiming to excel in primary care.

Understanding Family Medicine Fellowship:

A Fellowship in Family Medicine is designed to equip medical professionals with specialized knowledge and skills required to deliver comprehensive healthcare services to individuals and families across all age groups. It encompasses various aspects of primary care, including diagnosis, treatment, preventive care, and patient education. Through a structured curriculum and hands-on clinical experience, fellows gain proficiency in managing a wide range of medical conditions, promoting health and wellness, and fostering long-term patient-doctor relationships.

Why Pursue a Fellowship in Family Medicine after MBBS?

Comprehensive Training: Unlike the broad curriculum of MBBS, a Fellowship in Family Medicine offers focused training specifically tailored to the needs of primary care physicians. Fellows delve deeper into areas such as chronic disease management, behavioral health, geriatrics, pediatrics, and preventive medicine, enhancing their proficiency in providing holistic patient care.

Specialized Expertise: Family medicine fellows develop expertise in managing complex medical cases within the context of family dynamics and community health. They learn to address the unique healthcare needs of diverse populations, including underserved communities, rural areas, and culturally diverse groups.

Career Advancement: Completion of a Fellowship in Family Medicine enhances career prospects for doctors by opening doors to a wide range of opportunities. Whether pursuing a career in clinical practice, academia, research, or healthcare administration, specialized training in family medicine provides a solid foundation for professional growth and advancement.

Patient-Centered Care: Family medicine emphasizes a patient-centered approach, focusing on building trust, communication, and continuity of care. Fellows develop skills in empathetic listening, shared decision-making, and cultural competency, enabling them to forge meaningful connections with patients and address their individual healthcare needs effectively.

Impact on Community Health: Family physicians play a pivotal role in promoting public health initiatives and addressing healthcare disparities within communities. By participating in community outreach programs, preventive screenings, and health education initiatives, fellows contribute to improving the overall health and well-being of the populations they serve.

Flexible Practice Settings: One of the key advantages of specializing in family medicine is the flexibility it offers in practice settings. Whether working in private clinics, hospitals, community health centers, or academic institutions, family physicians have the opportunity to tailor their practice to suit their interests and lifestyle preferences.

Continuous Learning and Development: Medicine is a constantly evolving field, and family medicine fellows are encouraged to embrace lifelong learning and professional development. Participation in conferences, workshops, and continuing medical education programs ensures that fellows stay abreast of the latest advancements in primary care and healthcare delivery.

Conclusion:

In conclusion, a Fellowship in Family Medicine holds immense value for MBBS graduates aspiring to excel in primary care. By providing specialized training, fostering patient-centered care, and offering opportunities for career advancement, it equips doctors with the skills and expertise needed to make a meaningful impact on individual health outcomes and community well-being. As the demand for primary care physicians continues to grow, investing in specialized training in family medicine not only benefits doctors but also contributes to the overall improvement of healthcare delivery systems worldwide.

[bearsinpotatosacks]

I'm thinking that TOS Bones was either a surgeon (based on how he's shown doing surgery in a few episodes like Journey to Babel) or was a country doctor (which he says often) but was the type from such a rural town that he just knows everything. Need a vet? Dr McCoy. Need a paediatrician? Dr McCoy. Need literally anything but a GP/family medic? Well it's Dr McCoy or death buddy because it's a rural town and the nearest hospital is too far away even in the future. Just got the vibes that this is a rural mountain town, also this explains his accent because people from Georgia, or at least Atlanta, don't tend to have southern accents like Bones does. So either Bones had to adapt to Starfleet life or, because he's shown to not know Academy culture, he went through a sort of training program like OCS in the Navy (yes I'm using my Top Gun knowledge) which caught him up on other types of medicine necessary for the job.

For AOS Bones I don't think he was either of these, because I don't remember him talking about being a country doctor or seeing him in any particular surgical scenarios. What I can see him as is an A&E/ER doctor. He mentions doing emergency c-sections on pregnant gorn, and from what ER has taught me, being an ER resident while having a daughter and working wife can kill your marriage (Bones and Mark Greene's stories are kinda similar like that with their meeting wife early on, both having intense jobs and becoming bitter with her eventually cheating). Also, this would mean he was more accustomed to Starfleet life and instead of retraining in the Academy perhaps did a fellowship in Xenomedicine considering how much more diverse the AOS crew is than the TOS crew

[the-ace-with-spades]

I have the urge to write a seven-season-long medical drama, so here is a concept for Top Gun Hospital AU with ER hate-to-love hangster AU that no one asked for.

as a warning: this is a bit incohesive and silly

All the aviators are doctors and all the WSOs are nurses. With the exception of Bradley (but there’s an explanation for it).

Mav — cardiothoracic surgeon; Ice — former neurosurgeon and Chief of Surgery, current Head of Patient and Medical Services (so, entirely admin). I imagine they have the same kind of relationship as House and Cuddy in this, including Ice keeping an entire legal team for Mav’s unconventional practice methods. They've met during med school and had been rivals up until they both finished general surgery residency. Slider is an OR nurse turned anesthesia nurse. Goose was an ER nurse and met Mav during his rotation as a med student and died after an incident in the ER during Mav’s residency (that was the moment he switched from emergency medicine to surgery).

Phoenix — emergency, but she managed the impossible (like Mav) and switched from obgyn residency after the first year (only chose obgyn in the first place because of her mom, a renowned obgyn in Oregon), she's still really passionate about the obgyn field but didn't enjoy the work enough to do it for the rest of her life; Javy — general surgery; Payback — emergency with sub-spec in pediatrics; Friz — respiratory medicine; Omaha — oncology; Yale — ortho surgery.

Bob — a former OBGYN nurse, left because of a toxic work environment, working in the ER six months now, Phoenix's favorite nurse now, duh; Fanboy — started in peds oncology, had to switch because it was too hard on him mentally and is now peds emergency; Halo — started as a palliative care nurse, switched to oncology after a few years; Harvard — OR nurse, switched from general team to ortho

Hangman is the new trauma surgeon starting in their ER. Born and raised on a ranch, was expected to take over the ranch but never wanted to. Thankfully, he had too perfect grades to not send him to college — his parents wanted him to be a vet, which obviously didn’t happen, so he could stay close to the family business. He moved to California for his MD. He has terrible bedside manners with patients and patients’ family, but is surprisingly decent with kids, has lost respect for nurses sometime during his first residency year, and had a terrible case of Ego hit him during his trauma surg fellowship.

Now, about Rooster:

Bradley got into a pre-med program, Mav (who had set up Bradley’s college fund) said he’s not going to pay for it since he doesn’t want Bradley to be a doctor (long hours, lack of work-life balance, burnout, high stress, etc. It was more complicated because Mav still has the Goose trauma). So they had the fallout, Bradley moved out and deferred college to find a way to pay for it and, wanting to gather hospital experience, started working as a CNA in Peds ICU at a children’s hospital which accidentally was having a new CNA intake at the time. He liked it, actually loved it, and started hesitating whether he should continue with pre-med and be like Mav or go for nursing, like his dad. Year after, he got an offer from the hospital that said hey, we’ll fund some of your BSN as long as you work for us while you study and then work for us for another four years after getting your license. So he became a nurse, got certified as peds nurse after working two years in PICU and after another three, switched to the Pediatric Rapid Response Team, where he stayed for another two years before getting a spot as a senior nurse in adult/peds ER in a different hospital.

His relation to Mav and Ice only came to light a few months after the hiring process, as Bradley didn’t even know they worked there when he applied and it’s still a hash-hash topic in the ER. He’s been in the ER for almost three years now and has become an unofficial second-in-command as one of the few with substantial experience.

I imagine he’s definitely one the best nurses you could have as a patient — he’s honest but in an empathetic way, he’s worked in the most demanding environments with the most complex patients (ICU and RRT), he’s skilled and experienced in most procedures. Because he is one of the few male nurses, he’s the one dealing with inappropriate patients, aggressive patients, patients that need restraint, frequent flyers, etc. and he genuinely doesn’t mind — he is the perfect mix of calm and firm that makes him very reliable in most difficult situations. He is absolutely most reassuring and guiding with new stuff, be it new nurses or med students that don’t know what’s happening, and he doesn’t judge. It does help, too, that he was partially raised by two very cocksure surgeons and therefore knows how to deal with doctors that turned a bit too arrogant.

Before I go to the hangster part of this shit, I want y’all to know it all started because I found this Rooster-coded scrubs:

I imagine that he buys most of his scrubs since the work-issued scrubs don’t fit well on men (most unisex ones are very much just female fit stamped with unisex label) and peds nurses can have lots of cute ones so the kids feel less nervous around them

Also, this is a warning that yes, Bradley is trans in this scenario, too, because I said so. It's relevant to a few scenes, I think?? and there's tw for transphobic OC

Now, a bunch of scenarios I can see for this AU:

On the first day at his new workplace, Jake makes a reputation for himself. He confuses Nat, in her hospital-issued scrubs and with her doctor tag clearly on display, for a nurse and literally talks over her in front of a patient. Same thing happens with Billy because he’s Filipino and there is a large number of Filipino nurses everywhere and he’s stereotyping. Then he makes another patient’s parents agitated. This is when he meets Bradley — he takes over to talk to the parents and calm them down before it can escalate, basically shushing Jake out of the room. Jake doesn’t clock he’s a nurse at first — he’s a big, very fit, very well-built, very handsome dude with a questionable mustache who looks comical in a pastel pink scrub top with a teddy bear pattern and a matching headband on his forehead, but also the sheer shock of how different to all the nurses he looks gives Jake a pause  — so he doesn’t say anything even if it pisses him off a nurse just forced him out of the room.

*

It starts innocently with Bradley though — Bradley comes up and asks, “Jake, can you put the narcotics order into the system for Lily?” and Jake scoffs and corrects, “Doctor,” tapping his full tag with Dr. Jacob Seresin.

Bradley, as the nurse’s tag says, raises an eyebrow and says, “Doctor Jake, can you put the narcotics order for Lily?”  Natasha, standing behind him, snorts. Jake doesn’t even have the time to tell him off because he’s already gone when his brain processes.

*

Natasha drops off a patient on him — a taxi driver who had a stroke while driving and had been in a car accident, that had been thrombolysed but might need emergency surgery because of a suspected GI bleed. He’s stable, so they're going to check if he can be admitted to neurosurg and wait for his turn there or if Jake will need to take over before that.

Bradley hands him a tablet the minute he walks into the room.

“What’s that?”

“Results,” he supplies before going back to setting up an oxygen cylinder at the bottom of the bed.

“I didn’t order that,” he notes. The blood and urine panels are what he would order with suspected operable GI bleed but he’s barely looked at the patient’s case before he walked in there.

“I did,” Bradley tells him as he switches the oxygen from the wall socket to the tank supply. “Faster this way.”

“No,” Jake says, blood boiling. “You do exactly what I tell you to do and only that.”

Natasha raises her eyebrows, high on her forehead. Bradley doesn’t hesitate — waves on Bob from behind the glass wall and they both grab each side of the bed.

“I supposed you want to put the CT order yourself then,” Bradley says as Bob takes the small back monitor and attaches it to the frame. He steps on the bed brake and rolls out the bed, straight into Jake and Nat, fast enough that he moves out of the way on instinct. “Better do it fast because it’s free now and I’m going.” *

“Did you see that? Who the heck does he think he is?” Jake asks Nat.

“Better put that CT scan order,” is all Natasha replies as she walks away.

*

It’s Reuben’s patient, an eleven years old boy with blunt trauma, and Jake makes a verbal order to Bradshaw, who is the boy’s nurse. “I understand but I think that—” and Jake goes, “If I want your opinion, I’ll ask for it.”

The whole room gets quiet and everyone looks to him — Reuben, Mickey, and the technician are wide-eyed.

Bradley just says, “Alright,” in a perfectly leveled voice and leaves the room.

 Mickey is not making eye contact as he quips under his nose, on his way out of the room, “You do realize he basically runs this ER, right? You’re making your life a lot harder.”

*

Jake orders IV fluids for one of his patients which is also in Rooster’s section that day and he bleeps the order info to Rooster. Fifteen minutes later he sees that it hasn’t been filled and is like, hah, I knew there is a reason I hate that guy. Finds him when he passes Jake in the corridor and is like, “I want you to start the IV for room 7. Now,” and Rooster  just tells him, “No, do it yourself or find someone else.” 

They have a little back and forth as Jake follows him down the corridor which ends with another, “No.”

There’s still no charge nurse in the ER (she’s on medical leave that will most likely end with her leaving employment, from what Jake gathers) so he makes a datix and the ER nurse manager (Warlock) following up is apprehensive because obviously, he knows Bradley, and hears about what actually happened — Bradley was getting an igel for a toddler from the peds side and deemed it more important than starting a bag of saline to bust someone's blood pressure.

Jake feels like an idiot.

*

Jake and Reuben are charting next to each other and Reuben gets bleeped his patient’s lab results. Jake, who is also waiting for lab results, complains about how he sent a pod to the lab before Reuben. Reuben just gives him a look and says, “Yeah, that’s because I asked Bradley to put my request in.”

And Jake is like, “What does he have to do with anything?”

Reuben looks at him like he’s dumb and says, “He has more sway with the lab,” and walks away with his tablet.

*

Javy is doing a consult for Nat and stops to chat to Jake (they know each other from residency days) and Bradley comes by and says, “Maggie’s becoming hypotensive again,” and Javy observes as Jake looks at the nurse that came, gives him a very long, very detailed look and licks his lips.

He manages to think Oh before Jake asks, “Maggie?”

The nurse looks seconds from rolling his eyes. “Mrs. Lawrence? Room 5?” 

“That's Margaret.”

“She prefers Maggie.”

And it goes on, with Jake standing there rigid, puffing up his chest and cocking his hip out. “Did you start the fluids?”

“Finshed already.”

“Start another bag.”

The nurse looks unimpressed and instead of confirming says, slowly, like he’s talking to a child, “Her fluid balance is positive. She’s usually on pressors.” Jake’s face gets red and he goes, “Then put an order for her.”

It’s kind of funny to observe and to be fair, the nurse does give Jake a minute to go over what he said, leaning his elbow on the counter, eyebrows raised, before he points out, in that damn slow, unimpressed tone, “I can't put orders for things like pressors."

He hands Jake the closest tablet and starts walking away.

Jake calls after him. "What, you're not even going to draft it for me?"

He doesn't even turn around and Javy is silently shaking from the laughter he's holding in, "I thought I wasn't allowed to do that, doctor."

*

Mav comes down to the ER to talk to Rooster on a slower day — about how they’re about to sponsor a new CRNA for the cardiothoracic surg unit and maybe he could put a good word for their development team for Bradley and yada yada.

It happens like that: Mav comes down, Bradley is charting next to the monitors station, Jake is going over a scan on the opposite side when The Dr. Mitchell himself comes down and stops next to Bradley. He gives Bradley and his pink Paw Patrol scrubs a look and clears his throat a couple of times before Bradley raises his gaze toward him, turning away a second later and ignoring him again.

Jake is freaking out — this is The Dr. Mitchell and one of the reasons Jake wanted to work in this exact hospital, along with the rumored to-be-announced cardiothoracic surg fellowship under Dr. Mitchell he had his eyes on. He’s been thinking about how to make contact with Dr. Mitchell since he started in the ER and here he is, telling unresponsive Bradshaw, “I heard you’re looking to go back for your Master’s in the near future.” Bradshaw doesn’t say anything and Dr. Mitchell adds, “We have a CRNA development spot for—” and Bradley tells him, not turning away from the screen, “I’m not an OR nurse,” and then taps his card on the computer’s reader to log out and walks away.

Dr. Mitchell is a fucking legend, a VIP of this hospital, so Jake just stands there, contemplating how the heck Bradshaw could do that and hears him mumbling under his breath, “Really slick, Mav,” and jumps on the opportunity to say, “I’ll be talking to his supervisor about this, his attitude is unacceptable, Dr. Mitchell.”

And Dr. Mitchell turns to him, raises an eyebrow and asks, “Excuse me?” 

“The nurse you were talking to. He might be senior in here but his attitude’s been horrible and I’ll personally step in. This won’t happen again.”

Dr. Mitchell gives him a look before slowly saying, “I suggest you mind your own business, Dr. Seresin,” and walks away.

Nat is silently laughing a few feet away and Jake asks her what’s so funny. His heart dead-ass stops when she says, “You do know Dr. Mitchell is Bradley’s dad, right? They might not be on the best of terms but that’s still his son.” And Jake has the urge to bang his head on the keyboard in front of him. 

* 

TW for transphobia.

There’s a new nurse practitioner to be (graduated, about to get her cert) that's rumored to be a candidate for the charge nurse position. Izzy. She’s quite young for that, younger than Bradley for sure, must have barely worked in the clinical area before going for her Master’s. Jake doesn’t know if it’s on purpose but the nurse manager and Bradley keep on putting her in his section.

She’s—well, she’s a bit too in his face. She agrees with everything Jake says and doesn’t roll his eyes at him, which is boring, and she’s, for an NP, not that knowledgeable. She doesn’t argue with him, which is a change, and Jake starts to hate it after about five hours. Her voice is saccharine sweet, she keeps on standing a bit too close to him at all times, and she’s decent with patients, but she keeps on asking him about the smallest of things.

Jake’s section is less busy, usually, since he deals primarily with trauma in the ER, but she never bounces off to help others when she is free, like Bradley did. She’s clinging to his section, a little bit, and he doesn’t get why. It’s not like he is any nicer to her than to Bradley or any other nurse.

She is busy taking bloods and Bradley finds him when he has a second alone, finally, and enlightens him about why.

“If you don’t believe me, you can just ask any other nurse. Everyone noticed.”

“If you really think that then why do you keep putting her in my sections?”

“I don’t. She’s senior as an NP, she’s taken over allocation from me now.”

Jake’s mind only focuses on one detail. “You were allocating yourself to my sections?”

“Only because no one wants to work with you and because I’m actually certified in trauma.” That makes sense. It’s not like Bradley would work with him voluntarily. “Look, all I’m saying, you watch out — you fool around with her and then reject her and she’s going to HR. I know the type.”

“The type?”

“You know, the girl that thought she’ll become a nurse, snag a rich doctor and never work again? Well, it’s not always women, there are guys who do that too, but in this case, she’s very much the type.”

“And you think she’s trying to—snag me?”

“She’s certainly not going after the residents that are getting paid twelve bucks an hour or Reuben who is married,” he points out. Which, again, fair, even if he didn’t know Reuben is married prior to this strange conversation.

Jake stares at him, processing, until he blurts out, “I’m gay.”

“Then you’ve got nothing to worry about,” Bradley says after a second, eyes barely noticeably a bit wider, before he walks away.

“Was he bothering you, doctor?”

She calls him doctor, always, and it honestly makes him grit his teeth. Now even more. He’s got a bad feeling about it.

It gets confirmed later when Jake is taking care of a six-year-old girl who had fallen down the stairs. She’s dehydrated and Izzy’s just tried to put a cannula on her three times before Jake told her to grab the bedside ultrasound and not make the girl cry even more.

Bradley passes by the room and Jake’s learned that he can’t leave a distressed child alone, so he comes in and gets the parents and the girl relaxed. He’s about to go in and tell him to leave it alone until Izzy brings the ultrasound when Nat grabs him by the arm and tells him, “He was in a Rapid Response Team, I’m pretty sure he can put a cannula in blind. Just let him do it.”

And he does let him. Watches, expecting the girl to burst into tears at any moment but she never does. Bradley’s literally been in the room for less than ten minutes and it’s all back to calmness.

Izzy comes back with the ultrasound. It should not have taken her so long to grab it. “What is he doing there? That's my patient.”

"He said he can put the IV line without the ultrasound.” Well, Nat said so. Jake can’t believe he’s saying but, “He’s a peds nurse, he’ll be fine.”

“I’m sure the girl's parents wouldn’t want him anywhere near her.”

This sets alarm bells in Jake’s head. “What do you mean?”

"People like him shouldn't be around kids," she says, to his horror. She leans in, way closer than needed, and conspiringly whispers, "Dr. Seresin, haven't you known that he is, you know, a she in disguise?"

He’s dumbstruck. "I'm sorry?"

"He's actually a woman, just pretending to be a man because he's mentally—You're the doctor, I'm sure you know better than I how the brains of people like them work. He shouldn't be around that girl, is what I'm saying. I certainly wouldn't like him around my child, if I had one."

Jake didn’t know this about Bradley but he understands what she means, even with how awful she is about it. This, however, should not be a piece of information thrown around in public if Bradley didn't wish to disclose it, and certainly not in such a manner. "And how do you know that, exactly?"

"Nurses share a locker room, it's not hard to notice how she, you know, mutilated herself."

Jake doesn’t say anything out loud but mentally he is preparing datix report in his head. He catches the ER’s nurse manager before he goes home, too, because that’s some shit he doesn’t stand for. He might be an asshole but he’s not a bigot.

Next time he comes to work, Bradley is back in his section and Izzy is no longer employed.

“Thanks,” Bradley says, when they’re at the station, next to each other, in a relatively slow moment. “If I went on my own, we’d have a weeks-long investigation that would probably end with her or me moving to a different unit.”

“She said this shit to your face?”

“Kept calling me she in front of patients,” Bradley admits after a moment. “I think most of them thought they misheard but—I knew.”

“Well, good riddance then.”

Bradley snorts, but he’s looking down at the tablet in his hands, smiling, and wow, the apples of his cheeks are so round and his eyes so bright and Jake can't breathe for a second.

---

(there might be a second part coming because I meant seven-season-long medical drama literally-- including Jake realizing he's an idiot, Mavdad drama, Jake having his hands inside Bradley (in the literal, surgical sense) and jealousy that could rival the McDreamy/Dr. Grey drama)

[biblically-accurate-pirates]

tips for writing law as a surgeon in a modern AU

the US medical system, and especially medical training, is a mess of incomprehensible rules and timelines. surgery training ESPECIALLY. and accurate information can be weirdly hard to find! so without further ado, here's a list of random factoids that i thought would be vaguely useful to have in one place

Some basic terms: 

Attending: boss doctor, fully trained and certified. Often intimidating. 

Resident: worker doctor, still finishing training. They usually do the majority of the actual work in surgeries, especially as they advance. 

Intern: first-year resident. Their schedule is slightly different because every intern in every specialty has to meet a few requirements. They’re also limited in what medications they prescribe until they take a big test (usually at the end of the year).  

Junior resident: first 2 years of training. They do more of the paperwork (writing notes, calling other doctors, admitting patients) and floor work (changing wound dressings, seeing new patients, checking on old patients if there’s an issue)

Senior resident: 3+ years of training. They check on the juniors to make sure they’re doing everything right, and generally do more operating and interacting with the attendings. 

Chief resident: resident on their last year of training/just out of training. In many specialties there’s only one, but usually, every 5th year surgical resident is a chief. Treated as attendings in many cases, they also build the schedule for the other residents. 

Fellow: fully certified doctors doing additional training in a sub-specialty. Common surgical fellowships are trauma/critical care surgery, colorectal surgery, surgical oncology, and cardiothoracic surgery. 

Service: a team of doctors from one specialty who admit, operate on, and follow up with patients for one specific problem. 

On service/off service: “on service” residents are working on the team within their own specialty (a surgical resident who’s working on the general surgery team this month). Off-service residents are on a team outside of their primary specialty (an anesthesiology resident on the general surgery team). Anesthesiology, urology, plastic surgery, transitional year, and sometimes family medicine residents have to rotate through surgical teams. These residents pretty much never operate and only handle paperwork and floor work.  

Please, for the love of god, forget everything you saw on Grey’s Anatomy

I’m begging you. It’s so inaccurate.

Scrubs is decent tbh  

Dating patients is a HUGE no-no, especially for surgeons. Surgeons and psychiatrists are the two specialties where it is a top-tier ethical violation to ever date anyone who has ever been your patient. With other specialties (especially in rural areas) it’s generally okay, though still a little frowned upon, to date someone who’s a former patient, but you also can’t ditch someone as a patient just to date them. 

Also: surgeons deal with poop so much more than you can imagine. Would you, a normal person, ever want to date someone who wakes you up at 5am to ask you very seriously if you’ve pooped yet, press super hard on your still healing incisions, and leave? No. You would not. 

Surgical training is long AF. in the US you need to get through a bachelor’s degree (3-5 years), a MD/DO degree (minimum 4 years, often longer), general surgery training (minimum 5 years, up to 7 pretty regularly if people do research), and maybe fellowship (about 2 years). That’s a minimum of 12 years of training, after graduating high school at 18 years old. If you’re writing law as an attending (boss doctor) he’d need to be at least 30 years old, and if you’re writing him as a specialist he’d need to be 32. 

Attending schedules vs resident schedules: 

Residents work around 80 hours a week, often more. They switch services every month, and work all over the hospital. The work year starts in July and ends in june. Residents get either new years or christmas off, never both. residents have to get an average of one day off every week, and having both weekend days off is called a “golden weekend”. Also, most surgeries are at seven AM, so residents get to the hospital around 4:30/5am to see patients, write notes, and get ready for the surgeries. 

Attendings have more control over their schedule. Surgeons still work over 40 hours a week, more if they’re on a busy inpatient service. Generally, when they’re not covering the inpatient service, they’ll have 3-4 days a week of operating, a day of clinic, and a day of administrative work or research if they’re doing other projects. Attendants also take calls, which is when they supervise residents and do emergency surgeries for 24 hours straight. If they’re lucky they don’t actually spend the full 24 hours awake and working, but they’re rarely lucky. On some services, (especially trauma) there is Q3 or Q4 call, which means the surgeons work 24+ hours every 3 or 4 days. It’s brutal. 

What certain specialties actually do:

This is very Law specific and one of my pet peeves. “Heart surgeons”, who are cardiothoracic surgeons, are kinda boring imho and don’t fit the law's vibe. (all cardiothoracic people will, of course, disagree with me). They do some very cool, very intense open-heart surgeries, but they also do pretty much everything inside the chest cavity. So that means things like repairing a hernia in someone’s esophagus, or messing with the diaphragm. But that’s all pretty controlled surgery and they’re very limited in what else they can do. 

Trauma surgeons, on the other hand, are “emergency room surgeons”. They’re the ones who handle all of the super serious surgical injuries that come into the emergency department. They’re the ones who will fix someone if they have a gunshot wound and are bleeding out, or stabilize someone who was hit by a truck and broke all of their bones, or will open up someone’s chest cavity and use their hands to physically squeeze a heart to make it start beating again. They’re wild. They’re also usually chronically sleep deprived and have a thick veneer of “i give no fucks”. Very law.

anyway WOW that got long but i hope this was helpful to someone!!!

[son-of-drogo]

Samfro AU of the day: Frodo stays in Minas Tirith for a year while he recovers from the quest

-Frodo shows a lot more signs of illness in this scenario and Aragorn suggests that he should stay while they research the best ways to care for him.

-Sam is with him until when they get the news of the Scouring and he has to go and help with repairing the damage done by the ruffians.

-He comes back as quickly as he can in the spring and finds Frodo gravely ill.

-Sam nurses Frodo back to health and in the interim Aragorn finds a remedy in the Minas Tirith libraries.

-Frodo starts getting better and stronger thanks to the new medicine and Sam's care.

-during this time, Frodo and Sam realize that they love each other and decide to get married.

-They decide to get married ASAP and are wed in a small ceremony while Frodo is still bedridden.

-Merry and Pippin were annoyed about not being present but they came to their second wedding at Rivendell.

-around May, Frodo is finally strong enough to travel and while he's sad to leave the other members of the Fellowship, he's very ready to go home.

-Merry and Pippin are waiting for them when they get to Rivendell.

-they get married again in front of Merry, Pippin, Bilbo, and Elrond's household.

-They leave just after Frodo and Bilbo's birthday, promising to meet Bilbo the next year when he was on the way to the Havens.

-Frodo does fall ill on Oct 6th, but it's easier than the previous anniversary. They spend a few days at the Prancing Pony, till Frodo gets better, then they move on to the Shire.

-When they reach the Shire, they are both surprised and delighted at the progress Sam's forestry work has made.

-Sam sees the sapling where the Party Tree was and weeps.

-Bag End is almost fully restored by the time Frodo finally comes home.

-after Frodo settles in, he and Sam announce their marriage.

-with mixed results. The people closest to Frodo and Sam are overjoyed for them, but a lot of Frodo's relatives are not happy about him "marrying below his station".

-they go to the Havens the next September to see Bilbo off.

-Bilbo was sad that Frodo wasn't coming with him, but he was so happy that Frodo was well.

-Epilogue involves Frodo, Sam, and their two adopted daughters, Primula and Eleanor, to Lake Evandim to spend time with Aragorn, Arwen, and family.

[justinspoliticalcorner]

Abby Vesoulis at Mother Jones:

Dr. Leilah Zahedi-Spung spent four years in medical school, four years in an OB-GYN residency, and three years in a maternal-fetal medicine fellowship learning how to care for high-risk pregnant patients. In her decade-plus of medical training, she learned that in some cases, the only rational and responsible option for medical intervention is an emergency abortion. In July 2021 she moved to Chattanooga, Tennessee, and discovered she was the sole provider in her area trained to perform second-trimester dilatation and evacuation abortions for patients who needed them to survive.

But in 2022, the Supreme Court delivered its Dobbs v. Jackson Women’s Health Organization decision, and Tennessee’s trigger ban—written in preparation for the possibility that the Supreme Court would overturn Roe—went into effect a month later. Suddenly, providing an abortion in Tennessee became an immediate Class C felony punishable by up to 15 years in prison. There were no exceptions, even when an abortion was necessary to save a life or prevent serious bodily harm. Only after being arrested could a physician provide something called an “affirmative defense” to fight the charges. (Eight months after the trigger law took effect, the GOP governor signed a bill allowing abortions in limited medical emergencies.)

Given her unique work, which also includes genetic testing and live deliveries, Zahedi-Spung felt as if she wore a bull’s-eye on her back. She hired a criminal defense attorney—just in case—and immediately began looking for a maternal-fetal medicine position out of state. She didn’t want to leave Tennessee at all, she says, but her goal was “to not go to jail.”  Relocating for work isn’t a novel concept, but in the age of unfettered abortion restrictions, there has been an exodus of OB-GYNs from abortion-banned states, and dwindling interest among future OB-GYNs to settle in those states. The result is worsening health outcomes for the vulnerable patients and moms who remain. 

“As more clinicians leave those states, as more maternity care deserts happen, we will see poorer outcomes,” says Dr. Stella Dantas, an OB-GYN in Oregon and the president-elect of the American College of Obstetricians and Gynecologists. “And I do think we will see more maternal mortality just by the sheer fact that we won’t have providers even trained to take care of some of these obstetric emergencies.” Indeed, 64 percent of practicing OB-GYNs who responded to a KFF (formerly the Kaiser Family Foundation) survey said the Dobbs ruling has worsened maternal mortality.  In the before times, a high-risk obstetrics patient might consider having an abortion to nearly eliminate their potential maternal health risks, or even just seek more frequent monitoring to decrease them. But what happens when there are fewer clinicians left to treat sicker pregnant patients—and higher numbers of them—as birth rates rise in abortion-banned states? Data from states tell the story.

Even before outright abortion bans, the states that eventually restricted the medical procedure had higher rates of pregnancy-related deaths, sicker patient populations, and less access to maternal and preventative health care, according to data from KFF and Surgo Ventures, a nonprofit that researches health and social issues.

[...]

The care deserts will disproportionately affect low-income people and people of color. In her new maternal-fetal health role in Colorado, Zahedi-Spung says many of her dilatation and evacuation patients travel to her from Texas, Oklahoma, and Idaho because of unworkable abortion laws there. Given the current reproductive health care landscape, they are the lucky ones. She fears others in abortion-restricted states lack the resources to travel.

“We know that privileged people will always have access to abortion. We know that they will always have access to health care,” says Monica Simpson, the executive director of Sister Song, one of the oldest reproductive justice organizations in the country. For everyone else, Simpson says, “thousands of people are falling through the cracks.” Further, the states restricting abortion are also less likely to have social support benefits to help moms and children. For example, 10 of the 13 states that rejected federal funds for low-income kids to get summer food assistance have banned abortion, either beyond six weeks or at conception. “Those same people who are anti-choice are the ones who want to cut welfare,” says Zahedi-Spung. “They’re the same ones who don’t want to provide food stamps. They’re the same ones who don’t want to expand birth control options.” 

The Dobbs ruling in 2022 has led to an increased rate in maternal mortality, particularly in states that have strict abortion bans.