#I do enjoy talking to delirium patients and I’m pretty good at it

[andhumanslovedstories]

This shift has been so insanely long. I’m charge nurse for float pool tonight, which mostly consists of trying to figure out where all the people I’m responsible for actually are and then telling them to go be somewhere else. Sometimes I get to tell people they are getting more staff. Sometimes I get to tell people that I am here to kidnap their CNA. I feel like an omen. Periodically I handle an emergency, but usually it’s constant low level adjustment and recalibration and checking in and making sure people got breaks and asking newer nurses how they are doing and doing paperwork about all of that. It is not always a very busy job. Tonight? Oh Boy. It Was Busy.

At one point, I had to cover a break for someone who is sitting with a profoundly confused patient who kept forgetting he was in the hospital. It is obviously very scary to 1) have no idea where you are and then 2) learn that you are very sick, so we spent that hour teetering on the verge of an anxiety attack, while I reminded him again and again where he was and that his wife was coming in the morning and that he wasn’t doing anything wrong. At the end of the hour, I got up to leave, and he apologized to me for causing such a fuss. And I got to tell him, with complete honesty, that this was the easiest and most enjoyable hour of my 12 hour shift.

[joannasteez]

Hey lovely! Could I request a little something for Jax? It could be a headcanon or imagine, it’s up to you. But could it be about the reader is Angel and Ez’s little sister, and she’s in love with Jax?

𝐋𝐎𝐕𝐈𝐍𝐆 𝐘𝐎𝐔 {𝐇.𝐂}

𝐏𝐀𝐈𝐑𝐈𝐍𝐆: Jax Teller x Reyes!Reader

𝐍𝐎𝐓𝐄𝐒: The emotional direction wasn’t specified so I kind of just went with what came to me, by the way, This is my very first request!!, so hope whoever sent it in enjoys ❤️

𝐖𝐀𝐑𝐍𝐈𝐍𝐆: Angst. Fluff. I also suck at simplifying things so this is another long head canon, apologies if that sort of thing bothers you all lol.

Credits to the gif maker @tragertrap

Taglist: @my-rosegold-soul @appropriate-writers-name @est1887 @xladymacbethx @elektriknachosss @queenbeered @sesamepancakes @superhoeva @witching-hour @noz4a2 @nutterbu @withmyteeth

If you’d like to be tagged for Mayans MC fics ONLY let me know!!

☠︎

It amazed Felipe at times, scared him even, at how similar you looked to your mother Marisol. The spitting image of her; a younger, but slightly taller, reincarnation. But you were your fathers child through and through. The toothless yet warm endearing smile, the sharp intuitiveness, placid nature, and just through the black center of your eyes, enough experience to cover a few lifetimes. It’s what the Reyes men feared the most, that uncanny familial trait that forces you to bury such soul crushing pain, to turn cold to things that warrant warmth. Your father has it, your brothers as well, Ezekiel more than Angel, and so do you.

You had it now, that calm, collected demeanor, as the guys brought in a bleeding Jax Teller through the entry doors of the lodge. He was barely conscious, eyes dim, limbs heavy, and blood staining all along his color drained skin and the aged leather of his kutte. If you were anyone else you’d be alarmed, startled by the amount of blood and frantic men, but you were you, having seen too many things that resembled such a scene to let even a shudder pass through you.

“Get the kit, we need you to sew him up but he’s lost a lot of blood.”, Bishop says briskly, filled with worry, and your feet move faster than your mind can comprehend, snatching the kit laying near by and pacing to the bedroom where they have Jax. His head elevated by pillows, Both Ezekiel and Angel hot on your tail waiting for you to give them directions.

There’s a poorly wrapped cloth that lays against the wound, and just as you peel it back you pressurize the wound with a gauze. “I need gloves”, you say.

Angel’s a bit taken back, the President of the Sons original charter is on the precipice of death and you’re talking about gloves. “We don’t have time for that”.

“Just get the fucking gloves Angel”, you clip. Tone harsher than it’s meant to be, but he takes no offense and moves quick for the gloves before coming back.

You’re cleaning Jax’s skin once there on, wiping away all the blood that pours from him. A needle in your hand, eyes steady. “This is gonna hurt”.

Jax is sweating, teeth clenched at the piercing sting of the needle. “You sure you know what you’re doing?”

Did he really just ask you that? “I guess we’ll just have to find out”, you deadpan.

“Y/N”, Ezekiel warns.

The situation isn’t funny, a man’s life is on the line but still, you want to laugh at the audacity. “What?! He’s got a bullet in his abdomen and he’s worried about if I know what I’m doing”.

There’s silence now, a heaviness that settles to suffocate the whole lodge it seems. A dread of existential proportions that looms like a phantom in the waning rusted gold of the setting sun. The stillness is calming as you work, slipping the fine needle through his paling skin with a frightening ease that forces a worried look to Ezekiel’s face, Angel’s as well. Mayhem has consumed them all, men who laugh in the face of death everyday are doubling over, overwrought with fear, and here you are, unaware of the dark silhouette that threatens to form over Jax’s body, inching over the walls, creeping slowly as they tease whispers of death through the wispy blow of the wind.

Your brothers leave after while, called out by Bishop and Chibs who are talking over possible scenarios for revenge.

“Can you stay after this......... please?” It’s barely a whisper, and it’s drawled, but you hear the need in his voice.

It compels you to say “Okay”.

When you’re finished you wipe at Jax’s skin again, fingers trembling just the slightest as your mind catches up with your body, or is it the other way around? You’re not sure, but the two have surely had a crashing reunion and now you’re exhausted at such a fast build and fall of adrenaline. You’re thinking now, at the side of the bed, of deeply buried memories because the blood reminds you, it always does. All you see is Marisol, and your vision is blurred, eyes glistening with warm tears that comfort your skin, thumb shaking as you push the wetness away. She’s so lovely in your mind, a bright silhouette framing her and she’s so beautiful, so light and gentle. The aura of her, just from a thought, it makes her presence palpable again, till you remember she isn’t really there. Because it’s just a memory. A timeless mirage of sorts that ungrounds you from reality.

You breath, looking to the clock to find that it’s been three hours already. Three hours of you looking through your memories for your mother, Marisol. It’s purposeful, must be, why the need to think of her is so strong in this moment of all moments.

It’s infuriating, that you weren’t there, you couldn’t save her, but you were here now and you saved Jax. That counts for something right? It had to.

He’s awake again, and you’re not sure how but he is. Must be the force of his will that has his eyes opening, fighting against a sleep that feels too much like forever. “You alright?”

His eyes are a near lifeless blue but still they’ve got shine to them. “I should be asking you that, you’re the one that got shot”.

“Why the tears darlin’ ?”

You’re not up for a personal deep dive, never have been really. “Don’t know what you’re talking about”.

He smiled, noticing your reserved demeanor. “They we’re probably tears for me, I saw how worried you were earlier”, he jokes sarcastically.

You roll your eyes. “Why’d you want me to stay?”

“Didn’t want to die alone, if I did”.

You shake your head, fully convinced of otherwise. “You weren’t gonna die”.

He gives a weak smile. “I know that now since we’re talking, unless this is a dream, or some purgatory shit then I’m screwed”.

You chuckle at his dazed rambling and it makes his weak smile a little stronger as it spreads. Amusement looks good on you. Pretty. “There it is”, he says. Talking about your little smile.

There’s a stretch of silence, and it’s contemplative for Jax. Flashes of the incident from moments prior running through his mind. He’d just met Galindo for the first time, shook his hand, exchanging pleasantries. They’d talked business and at the end all parties seemed happy with the results, but it made him wary. How well everything was going, something somewhere was bound to go wrong, and yeah maybe he was a bit too pessimistic in the moment but it proved him right. The Sons and The Mayans were riding back to the lodge when the Lobos attacked and he can’t remember much after that, just feeling more than alive and then a little ways from death. His father calling him and then his mother, and he almost answered. He’s glad he didn’t.

“I’m sure you know as much as I do, you see a lot of shit when you live this life. Seen more guys than I can count take a bullet, and more times than none I’ve been the one to give it to them”. He’s quiet, contemplative. On the rise of something that resembles an epiphany. “After a while they just become faceless y’know, nameless, just kill #52 on someone’s list. That’s what it felt like, I was about to be on somebody’s fucking list and that shit is scary”. He turns to you then. “And then the next thing I know I’m in here, with your pretty ass standing over me saving my life. I thought I was in heaven”.

You roll your eyes, it’s delirium from the blood loss, making him say things he doesn’t mean. “Even with a bullet wound, flattery gets you no where Teller”.

“Tell me what does”.

———————————————————

𝐎𝐍𝐄 𝐘𝐄𝐀𝐑 & 𝐀 𝐌𝐎𝐍𝐓𝐇 𝐋𝐀𝐓𝐄𝐑

He’s warm under your skin, heartbeat a sweet song that pulses a quiet steady rhythm into your ears. It’s a comforting thing, soothing and mellow like the fiery cool blend of a setting summer sun.

You feel his hand, cool rings caressing the nape of your neck. “You awake baby?”

You move against him, to let him know that you are and a hand pulls gentle at your chin. “Let me see you darlin’ ”

Your body pulls up atop of his, bare chest moving along his and toward him so that you’re face to face, legs tangled together. His hands reach to caress your face, touch a gentle flame that burns to light your skin. It’s the first time you’ve seen him in the morning for weeks, the club stealing him away every moment it could, screwing around with the days you’d set aside to see each other. He grins, loving the dim set of your sleepy eyes. “Hi”.

“Hi”, you say. Tone rasped, sleepy.

There’s a glimmer in his stare, a dazzling sparkle that lives just over the grayish blue of his irises. You don’t identify it, what the warm glint means, for fear of being wrong, but somewhere inside, you know it’s love. It looks to pure to be anything else. He’s grinning again, all nostalgic like. “I was thinking just now, about that day when you patched me up. Best day of my life”.

You scoff. “You almost died”.

“But I got to meet you”.

You’re shaking your head at how lovey dovey he’s being. “Always with the flattery”.

“I’m serious, I fuckin’ love you. More than I ever thought I could”. He rolls you both over easy, his lean build on top surrounding you, fingers still caressing idly against your face and yours drawing along his tattooed back. He kisses you, patient and deep, as if to savor this moment. Staining his memory with the soft pliant flesh of your lips, the airy moan that resonates from your chest, and the lulling skim your nails give the gold of his hair. Forget the Irish and their guns, the Cartel and their H and everything that isn’t this. If he could, he’d stay with you here. Just like this. Forever.

He’s at your neck now, teasing you with tongue wet kisses and stingless nips, but something comes to mind. A wary thought that’s bugged you for a while. “When are we gonna tell my father about us. I want you to meet him”.

He looks to you, confused. “You don’t wanna tell your brothers first?”

“Ezekiel already knows. Found out the first time we met back up to see each other”. You’d thought you’d been sneaky enough that night, leaving after everyone fell asleep, but Ezekiel was always a couple steps ahead it seemed, following you out of Santo Padre a few hours to a bar where you’d met up with Jax. The conversation with him was easier than you expected, but still he was wary, and how couldn’t he be. You were his baby sister. He’d worry till his last breath. “... and I told Angel a couple of weeks ago. Couldn’t really get out of explaining how I had your rings laying around”. You couldn’t remember much of what that admission to him entailed, besides the look of disbelief he had, and then the screaming, and then eventually the forced calm of his expression when he realized that there was nothing he could do about it. It was still unbelievable to him, you weren’t that little girl anymore, no matter how much he wanted you to be.

You were grown, beyond capable of making your own decisions. But boy did it scare you having to tell Felipe.

“Whenever you want to tell him I’m ready”.

His sureness makes you smile, wide and bright, laying a kiss to his rosy lips. “I love you too Jackson”.

[sugar-petals]

SuperM as Subs

↪ A/N. UGH these guys have me fucking spiraling. very excited to bring you this, please indulge 👀

○ warnings ⚠️ 18+, dom/sub, kinks galore, gender-neutral dom!reader

3.5k words | bullet points | this is all over the place there is so much to say i—

⌈ ten

— motto: kitten has ‘ten’ in it, but so does intense.

wowza honey

best choke out you’ll find

the stamina, too, oh lord. ten can handle a lightning fast riding without blowing up in two minutes

all while you choke him

with a waist harness on and ankles bound

bondage looks so good on him; he’s flexible and enduring. imagine a hogtie... art. 

such a beautiful man.

literally, rope marks, imagine that

we need to talk about his pain threshold as well there

things that have other guys screaming are a mere tickle to him

i can’t emphasize enough how lucky you’ll be. this fella does not have to be trained much. experience? abundant. talent? more than vast. he knows precisely how far he can go with what kind of kink. that is invaluable.

and now, the most mind-blowing part. stress: he encourages you to take it all out on him. in his mind, that’s an extra treat and a promise he gets it raw how he loves it. 

your satisfaction is his fuel, as is seeing you unwind. 

the whole progression from heavy beginnings to breathless ends

the boy needs you to go, for the lack of a better word, buck-wild

so yes, ten is your number one (pun intended) address for all things messy. he asks you to hatefuck him, you spoil him with it.

the sheer masochism of him

are you kidding me

listen i’m not a fan of the sin concept but in this case... you can sin all you want with him

tl;dr: angry sex is his thing. strong emotions. guts will be rearranged.

about the elephant in the room: yeah, this guy can bust some extraterrestrial, dazzling, sexy as hell moves

that means one thing. contortionism. you can bend him into every position you desire and fuck him like that. he’s petite but don’t worry. your babe’s strong

in fact, you can sit on his face and get one ferocious rimming daily

things will get wet wetter wettest

surprise surprise vice versa he likes his own ass filled with plugs and vibrators

the type that buzzes him into a delirium while you slap him. with his neck turning red and those pretty almond eyes going wide. 

they do hold the universe. he’s just so enthralling.

btw. talking about toys. having a fleshlight ready to make him moan and ruin his orgasm is a veeery good idea.

chances are you will draw cute english or thai interjections from him

in return, you can call him your prince and kiss him all over for aftercare. he’s no different, thinking of you as someone figuratively and literally noble to him. he’s thankful you fulfill his greatest sexual dreams. it’s true, you’ll really worship each other.

he’ll do his little mona lisa smile and doze off in your lap...

sub!ten is just priceless okay

10/10

i need a moment

⌈ kai

— motto: local strip club found bankrupt.

oh mY GOD nini

he knows how it’s done

did he go to sub school or something

you’ll find him at the stove around 6:30 AM in his apron

making you breakfast pretty much butt naked otherwise

flustered and sexy butler kim right at your service

looking very sculpted

dancing a little, as usual, he’s getting into it

in other words, you’re sure to get those eggs fried well

now, besides his skimpy clothing and waiter allure

kai as a submissive is almost definite to be an epitome of organization. he’s just good at it. period. lube and protection are always in the house.

you do your part doing maintenance for toys and cracking the occasional whip but really i mean... as the great oh sehun once said... never don’t mind about a thing when jongin gets the chance to put something in order

so lean back — kai is a service sub. he’s the type who wants to break a sweat for you

and have that very visible because he doesn’t own clothes anyway. well, well.

something more about organization

fucking according to a schedule sounds about right

you have it all planned out with a special calendar book just for that purpose

but don’t believe he’ll be boring and hyper-structured beyond that

kai is the precise opposite of dull as a lover but that’s a huge duh

he has both the acute sense of bashful romance and strong erotic feelings that come with a regular eyebrow wiggle

he likes to provoke the wild animal in his partner

reckless abandon

kai is 100% guaranteed to make you let out the beast. he enjoys feeling you go all out and grip him, pin him. everything hands-on is good.

grinding and gyrating is always part of sex. hell, even floating and flying. fuck gravity.

you need a certain level of dexterity. and hey if you don’t, you will pick it up from him in a solid minute

what i’m trying to say is that it won’t happen that the two of you rub against each other in the sheets like two blocks of wood (even when going into aftercare!). it will be fluid, ever-moving, energetic right and left with the mattress creaking all over the damn place

sex with jongin is one thing for sure: fucking fast. he won’t mess up his tempo if you know what i mean. the two of you will be thrusting and moaning until complete fatigue sets in

he whines a lot i’m telling you

it’s the surefire way to know kai is into it, being genuinely vocal is one of his best qualities as a sub

besides handling any rough pace 

this guy will have you sneaking into his gym room and have a quickie on the next best workout bench

and lord knows what else. 

the bathroom is another destination. wet!kai, the yearning romeo, is an image you won’t forget

prepare to get your hands on all of that

he’s gonna melt right into ya

and that is sub!kai for you

⌈ taeyong

— motto: vanilla? hardly heard of her.

to use an nct pun: the options are— limitless.

and another: you’re signed up for a... long flight.

and you’re gonna be the: boss

who gives it to him

and i’m warning you

he’s shy about it but

taeyong is simply insatiable. take his kinky reputation at face value.

what doesn’t he do

the softest softcore (feathers to tease him) to the hardest hardcore (edge play, hallelujah), the whole spectrum without any efforts for transitions

so you guessed it, a normal bedroom really won’t do.

neither does a standard dom

but since you’re knee deep into taeyong — go figure, you’re reading this — news flash you likely aren’t one

plug in all of your toys and cameras for date night. he needs his good dose of lube-dripping fantasy, homemade with a bunch of latex thrown into the mix

yeah i know that will escalate quickly

he wears it well i’m telling you

and also greatly enjoys you donning it for friday evening

it will frustrate him to the max which is a sight to see indeed

no other sub in super m gets harder boners over latex. that’s how it is. he’s just so drawn to the material and how much authority it gives you in particular

noona/oppa kink incarnate

hell, even daddy/mommy

he calls you that when you are forehead to forehead and catching your breath

because man these orgasms are going to get you so high, bodies gently intertwined

and very, very drenched

not just skin-wise

so let me underline this

your dear taeyong, no matter how innocently he can blink at you, gets his daily nutrient intake from cum. 

what fancy-schmancy protein shake is he interested in other than yours like literally none

put him on a leash together with baekhyun and you have two salivating, ultra dirty boys

so ready to please and swallow everything up

taeyong is a handsome handful

you’ll be horny 24/7

or 23/7 maybe because aftercare

where we revert back to adorable yong. he clings to you a lot, you nuzzle him all the time, the affection is off the charts

he’s pouty and sweet, smiling to himself

holding him tight gives him a big sense of security. 

safe to say he wants everybody to know he belongs to you in terms of PDA, too

it’s not restricted to domestic intimacy and sexual aftermath

taeyong truly has the perfect ratio of freaky and soft

god worked hard on him

⌈ lucas

— motto: when bigger is better, things get wetter...

ready for take off are we 

yukhei is one flirty crackhead you’ll love it

teasing will go back and forth

there might even be play fights and wrestling involved. messing around on sofas and carpets, you know the deal. things won’t get too rowdy, he’s being his 6′ baby self and you don’t want to use your whole bag of tricks yet vice versa

lucas eventually lets you win anyways

and acts like he’s lethally injured ffs

he’s an aquarius don’t come for him they roll that way

in comes the patient-doctor roleplay. yep that’s how the story goes

and you sure as hell get to take care of um

luke’s big lightsaber

alright

it’s throbbing a bit too much and needs medicine

so think of yourself as a jedi master training your disciple.

read: edging the living soul out of him. 

rough handjobs are just perfect

as is going on a rodeo trip getting the guy to tame those bucking hips with a lil punishment here and there. and with punishment i mean tickling even when he is close to orgasm

uh-oh

wong yukhei is a cutie pie but he has just about a bucket of cum for you spilling all over the place

he might get a lil embarrassed about it, that’s the sweetest thing

cleaning it up will be his greatest pleasure

so

ready for subby lucas yet?

he’s juicy

so what else do we have... 

(besides that he sounds like harry styles is dubbing him and that voice is going to turn you on so hard)

if his dominant doesn’t have an ounce of a muscle and biting kink that’s, how to put it, a missed opportunity

just licking him and leaving marks everywhere just has to be the biggest feast in history. you have him parade around sleeveless just to see the hickeys on his arms. 

and you don’t have to be frugal. it has to scream mine mine mine. yes, xuxi has some arm sensitivity going on. he needs your mouth on him doing chaotic stuff that leaves his jaw hanging open. to the point of you eating your brunch off his chest and shoulders.

there i said it 

breakfast with yukhei is cancelled. it’s breakfast on yukhei

as for positions: things are usually more chill and standard. just how much missionary will there be, you’ll lose count. he’s good at it. lucas has the condensed passion of ten people, it will be more arousing than you’d think. it’s also a good pause to your usual activities, you both get a chance to um take a breath

if he feels cocky, wong brathei likes to lift you up during sex and here we go again with a staring contest... which ends with a bright smile and kissing 

what did you expect

always remember this one thing. in his big himbo brain only one thought floats around and that. is. his. love. for. you.

a whipped boy

he’s irreplaceable.

patient xuxi reports speedy recovery

⌈ mark

— motto: good boys go to heaven after debuting a couple times more

sirs and sirettes, mark lee.

what did you think the “m” in super m stands for? mario, man, massive, market, model?

nope

SuperMark is what keeps the planet spinning

now here it goes

let’s get one assumption out of the way first

you’d think he fucks how he talks but you’ll be surprised

everything’s slow slow slow

the pace is very casual for someone who raps and thinks that fast

mark is just too friggin’ cute

a blushy cupcake

innocent and always curious what you’re up to

just perfect for all sorts of gentle dominance

you can reassure him when he gets nervous which happens every now and then

and put him into soft sweaters and blankets when he feels cold

maybe even building a pillow fort and just caressing him ad nauseam literally for minutes on end.

tousling his hair would be adorable beyond belief

the same goes for giving him cheesy pet names

or feeding him sweets

you can bet chocolate is his favorite. 

but it’s not just all about pampering him

keen how he is you can expect a lot of gestures of attention from mark, like carefully selected presents and foot massages

there’s a real gentleman at your hands.

a gentlemark

he might have come up with that himself 

you bet there will be lots of humor involved mark just can’t do serious sex

his intellect is yeahhh... superhuman

as much as his heart is squishy for you.

it’s hard out there. this world is tough

but mark is a safe haven to return to and have wholesome hours in bed with

30% sex, 70% aftercare.

you think that’s impossible? look into his puppy eyes and tell me all you’ll do won’t be spooning

it’s an art form and mark is just too inviting not to do a brush stroke on the canvas. 

and after you’re done spooning things are back to more caressing

a smooch left, a smooch right

for the 30% he might need a bit of outside support because his inner perfectionist compels him

so he’ll text johnny at 4:30 in the morning with urgent questions

because his mind is racing and he promised to wake you up with a set of spicy stuff

sex veteran johnny will calmly explain it to mark but also keep it short and simple

because man how early can someone text you 

and mark appreciates a crisp how-to that he won’t forget

even when you are chest to chest feeling each other’s breath and his brain almost shuts down

at the end of the day...

you say hey canada lemme get my hands on those big thighs of yours and ding ding his pants are off. he responds so easily to guidance

and his dancing skill always helps to get groovy with you

so

bust down markiana

you’re that bitch and you know it

⌈ baekhyun

— motto: you and me, relax and ch...oking

leader on the streets 

screamer in the sheets

even the most peace-loving, noise-sensitive neighbors are going to dig the things that come out of his mouth as caused by you

just how good are his lungs

imagine him making audios for you. yes, god is real.

you just hit the lotto

the things his mouth can do 

byun baekhyun is a synonym of oral fixation when will merriam webster admit it

if there’s one person in super m who can nail the picture perfect drooling ahegao face without hesitation it’s him

he will pleasure you with his tongue so vigorously

that level of spit blowing will haunt you

and the slurpi—

THE NOISES. we can’t talk about the noises. nope, nope. the noises are not meant to be described to this world. 

you’ll suffer from incurable lust once you picture it

you know what his voice can cause

that would trigger a mass hysteria

anyway. moving on. 

baeks is the type to appreciate a mix of cheek-on-cheek cuddling and getting his brains banged out

you can toss him around, grab him by the hair, fuck him absolutely stupid

while also kissing his forehead and playing with the hair at the nape of his neck. as if he doesn’t want you enough already this will have baekhyun needy for so long

he’s the king of slutty behavior

and making both of you crack up with mid-sex jokes about who knows what, suho’s butt mole or something

he’s just too hilarious. on the other hand he likes being creative and concentrated

in his free time you’ll probably find him reading erotic stories, sketching sexy stuff (i.e., well, you) in a journal, or even a manual to the kamasutra. it gets him all hot and bothered to the point where he can’t stop being chatty about it.

baekhyun’s arousal always first manifests as a wave of words or texts 

your part of the equation is distilling the essence of said texts and getting to work on that perky body of his

and praise him plenty. baekhyun loves a lot of verbal affirmations and you’re glad to shower him with it.

kink-wise: he really has a gazillion ideas to try

costumes, gags, whips, pet play, sounding, collars, semi-clothed sex, cock rings, suspensions, you name it

as the cherry on top, a three- and fourway could be part of your routine for sure. 

that being said he might have a few dicks in him physically or mechanically because geez bacon loves fucking machines and dildos

he is 100% ready to embark on one hell of an anal odyssey

how much he can stretch out you can probably guess. and he’ll make jokes about it either way to turn you on

you’ll be certain to exhaust and stuff your lil’ darling to the brim but i’m telling you what you already know

he’s gonna be the happiest ahegao boy in the world

and throw peace signs when you take pictures of him fucked out

that’s byunbaek for you. one of a kind

a subby gem

⌈ taemin

— motto: 500 points to slytherin! 

this is what you’ve been waiting for i know I KNOW

red carpets out for the sensual sub king and nation’s p.r.e.t.t.y. boy

the international bombshell blonde

a bdsm luminary

DEITY

now, listen. 

some erotic feats are truly hard to execute

but there is always one guy who’s the exception 

and his name is lee taemin

no matter how unrealistic or complex your imagination of sex with him is

with this man, most of it can become real

effortlessly

because he’s a) an open-minded lover b) rich enough to rent ten dungeons — per hour and c) closest to perfection we as a human race have ever come 

taemin is a pro at bringing all kinds of your and his fantasies to life. that’s why it’s important that you sit down to talk about how your intimate encounters could look like every other week

primarily, as far as his taste is concerned

we’ve all heard about his tales of creepypasta romance

literally he’s been an idol for so long and still comes up with new baffling ideal type stories

so according to those

he wants to be run over by you and thinks that’s hot,,, but i say... we stick to flipping him over... like on a bed,,, no car involved

this pal is macabre you have to be an embodiment of the law to rein him in

police roleplay much. arrest this provocateur!

furthermore and on a lighter note

besides being jailed

lo and behold, chained up and decked out in lace, draped on a lip-shaped art sofa is how he feels the most in his element

add a mask and a corset 

just how glamorous is he

this guy has mastered all techniques of drawing you in with the most elaborate seduction. 

tremendous!

including dance: for your eyes only. 

prepare to have your loins set on fire.

because within the 4 walls of your home his every move will be pure danger loaded with sexuality. it would be even more of a public menace than he already is when performed in front of a crowd

keep those handcuffs ready officer

because it is your mission to stop that guy 

the more restraints the better

put five harnesses on him i don’t care as long as it contains him

and once that’s done

taemin likes to be stimulated and teased with you running silk fabric all over his body

he also enjoys you creating artistic pin-up-esque photography of him

with sultry eyes and puckered lips

and no worries. taemin will put his plump lips to good use elsewhere, too. all. over. the. place. servicing his dominant is an honor.

and those moans will be like a melody.

the literal only weak spot he has

is to kiss and tell. taemin gets carried away in conversation and feels pride when the topic switches to you. so... if you lick his earlobe and call him your slave, jongin knows the very next day and finds it very entertaining. 

taemin won’t deliberately spill the beans in a group chat but one-on-one with a close friend? he’s too excited not to talk about your chemistry and lets some juicy details slip if he can’t control himself.

taemin requires a dom/me who’s definitely not insecure and wants others to know who’s boss.

on the flipside, if you enjoy voyeurism? he is your man. it’s a matter of perspective entirely.

so to speak — even his weakness is a strength.

that’s all you need to understand about him

in sum: you got yourself quite an ace 

taem will press your number and you’ll have no sorrow in the world.

we truly are blessed by his existence

peace out

© submissive-bangtan 2017-2019. all rights reserved. do not repost.

[rohobi]

Pulse 03 | (m)

Kim Taehyung | Medical AU |  Smut | Angst | Trauma | Patient death | Medical Jargon | Medical Inaccuracies | Mature Content | Multi-fandom Medical Team |

COUNT: 8k Words  CHAPTER SUMMARY: ❝There are wounds that never show on the human body that are deeper and more hurtful than anything that bleeds.❞ LISTEN ▶ 

↳ INDEX → CHAPTER 4

↣ SEOUL HEARTS HOSPITAL | Dr. Kim Taehyung

Changing into a new pair of blue scrubs in the bathroom, Taehyung asks himself at which point did everything in his life go wrong. He was so tired. So fucking tired and so fucking unhappy and so fucking miserable. He’s been hiding it behind a smile, burying it deep within him.

A pain like no other. 

He scrubs his face with a cleanser he thinks belongs to Dr. Yoongi, hoping that it might make him feel grounded in something other than misery. But no matter how hard he scrubs, the feeling’s still there. 

Like scum.

Patting his face dry with a white face cloth, he takes a deep breath. It might as well tattoo itself across his face, nothing could take it away. Sadness made its home in his bones a long time ago and now he was living with the consequences of it.

The memories of a happy life he once had, grew into shards of glass over time, cutting him up in the inside. Why can’t he go back to that time? Why can’t he be that person he was? Why does he feel so damn guilty all the time when he was just trying to be a good son for a mother who’s on her way out? 

The wounds he sustained, ripped open at every reminder of you, are his worst enemy to date. He wonders if his mother’s aware that everytime he smiles, the ingenuity of pretending to be happy tastes like rotten fruit on his tongue.

He could never be happy again, as neurotic as that sounds, he doesn’t think he deserves to be. 

He hates himself.

Staring at his face in the mirror, he takes another deep breath as he stands up straight. He adjusts the lapels of his pristine white coat while brushing his teeth with his other hand. At least he enjoyed his job, the patients were usually older adults who reminded him of his grandmother, it was nice being around people who liked him. Lots of broken bones.

It was ironic, a doctor who could mend broken body parts for other people, lived uncomfortably with a broken heart.

One he broke himself.

One he could never mend on his own. Taehyung wondered if he would get any category one acute surgeries tonight. He loved the cases from ED. Traumatic neck of femur fractures -the greater trochanter fracture in particular were fun, he enjoyed being the specialist whenever he ran down. He loved the spinal injuries and the tibial fractures, knees and shoulders.

Bones. He loved them. It was the best distraction from life that he knew. Taehyung had always been really interested in Emergency Medicine but he could never do it, knowing it was your speciality and knowing you’d never want to see him again. 

He tried to respect that, he tried to respect the distance you wanted but sometimes, he just wants to know if you're okay. If you're happy. If you're loved. If you ever kept his child. If someone took up the space in your life that he used to. He's too afraid to act on those curiosities, to cowardly to come forth, too ashamed in himself for letting people control him, too ashamed for never standing up for himself, too afraid of the consequences his family offered if he did not follow their orders. He was a coward. Rinsing his mouth out, he frowns at himself in the mirror. This was the real him, the real Taehyung, the real person who never put up a pretence, someone who was unhappy and in pain every single day. But who else wasn't in pain. He adjusts the red, blue and green pens in his front coat pocket and wraps the bright red stethoscope from his pocket, around his neck. He turns the light off before closing the door behind him. Checking his pager, he clips it on to the waistband of his pants before pushing through the doors with his shoulder. Dr. Yoongi, Taehyung’s bestfriend, waits in the hallway for him with a coffee and an apricot danish for Taehyung. “Morning loser,” Yoongi says, handing him a bag and a coffee, “Got you a coffee that resembles your taste in woman.” "Morning? It's like 8pm," Taehyung smiles, sipping the bitter tasting beverage. “Yuck, Yoongi, my taste in women is not bitter.” Yoongi smiles. “You know, she called me last night, told me you hadn’t come home in a month, that true?” Sighing, he rolls his eyes. “I sent over the divorce papers, I’m only going back there if it’s to pick up those signed documents.” “Sounds about right,” Snorting, Yoongi wraps his arm around his shoulders. “You’ll finally be free from her? How do your parents feel about letting you loose?” “I haven’t told them yet,” Taehyung looks away from Yoongi, gesturing to start walking to work. “I’m pretty sure they’ll disown me. Anyway, enough of that, ready for a good night?” “Sure, we’ll talk about it later," Yoongi sips his own coffee. "I’m more than ready for a good shift actually. I've slept for 12 hours. Had to lecture the new guppies about social hierarchy yesterday, I swear they get loopy when they have rotations at Forest Lake. What are they putting in the water that makes them dumb?” “I don't know, whatever you’re drinking,” Biting into his pastry, Taehyung smiles wickedly at the blonde boy as he marches down the clean white hallway towards the Orthopaedic medical doctors office.

* * *

They stand in the office, preparing to do rounds on the ward. Taehyung’s looking at the list of patients he needs to visit experiencing post-operative delirium and constipation. He has students working with him tonight and Taehyung was fully prepared to dump his workload on them for “experience”.

Yoongi is signing discharge letters for patients leaving in the morning, writing prescriptions for pain relief and documenting orders for the morning nurses. The ward was quiet this evening, leaving a settled and peaceful evening for the nurses on shift but Taehyung wasn’t about to use the ‘q’ word in front of them.

“Shall we see our patients now?” Taehyung smiles, grouping up his 6 tired orienting medical students. “Why are you looking at me like that guys? Doctors rounds are fun and educational.”

“At this time?” One of his students snort laughs. “Not on this ward, it’s just old people-

-shut up Taemin,” a short girl says, she crosses her hands over here chest, rolling her eyes at the boy as she does. “You’re being disrespectful. Dr. Taehyung, please lets visit our patients. Quicker we can do this, quicker we can go home,” Younggi smiles up at him, “And I’d personally really love to see their progress.”

“Jesus Christ,” Yoongi curses under his breath. "Fucking brown noser."

The student ignores Yoongi as she stares back down at her black leather loathers.

“Every patient is your grandmother, try to think like that,” Hitting the top of Taemin’s head with his clipboard, Taehyung instructs a third student to push the trolley of patient files with them as all 6 students follow him down the ward hallway. Taehyung discards his coffee in the rubbish bin on the way. “Okay, because I know you all want to go home and sleep, let’s work in a team. Sound good?”

They all smile. Walking over to the trolley, he gives each of them a patient file. “What do you want us to do with these?”

“There’s six of you, pair up,” he says, watching them look at each other in confusion. “One of you will be assessing and the other will be scribing. You have two patients each, remember to switch.”

Taehyung folds his arms over his chest, they all look at him scared. “Oh come on, when my best friend in med school was in third year, below all of you, she was diagnosing aneurysms and scrubbing in on operations and you guys can barely talk to a patient without crawling in on yourselves. Get a grip, all of you.”

“But ...without you?” Taemin asks. “Can we do that?”

“I’ve worked with all six of you this month. Closely and together as a group. You’ve all grown so much and I believe that you all will make exceptional doctors. Believe in yourselves?” he says, watching them all smile, “So, look at the patient files for five minutes before going in, be polite and think before you speak. If you can't answer their questions, use your confidence and come and get me. I hope that doesn't actually happen though because you all should know the answers. Go on now.”

They all smile at him, clearly happy with the assignment.

“God, Taehyung,” Yoongi groans from behind him. “You still do that? You treat them like babies. That's why they get dumb.”

Taehyung rolls his eyes as he watches the students head off to their retrospective patients. He’d given them all stable patients who had questions regarding the postoperative process. Nothing they can’t answer but it was always a confidence booster for his students and he loved seeing them go home happy.

“Yoongi, this is why I am the educator on this ward and you’re an asshole,” Taehyung picks out the last couple of folders before walking into the 4 patient room, handing one to Yoongi.

Yoongi sanitises his hands, pulling out his favourite black pen before following him in into the cubical.

Yoongi watches Taehyung sweeten up to the old lady covered in a mountain of blankets as he reads over her notes. “It’s lovely to see you again Dr. Taehyung, how are you?” she smiles, gazing up at Taehyung like he was the sun and she was the moon. Yoongi watches his little hands rub up and down on her purple, green and pink crochet blanket on top of her. “I’m better now that I have seen you,” he winks and she laughs softly. “I’m here to talk to you about your bowels. The nurses tell me you haven’t moved your bowels since the operation three days ago.” “Ooh my dear, a lady never does number 2 and tells,” She widens her eyes at him. “But yes, I have not. Those wicked nurses have been trying to get me out of bed, I’m just too old for this, doctor. It hurts too much.” Taehyung sits on her bed, cupping her hands. “They’re doing that for you. Exercise is good for recovery, especially since you’ve had a hip replacement. Quicker you’re up, quicker you can go home and be with your kittens.” “Oh is it?” she opens her mouth in a little ‘o’ that makes Taehyung giggle. "My kittens, oh I miss them terribly so." “Do you usually take medication for your bowels?” he asks and she shakes her head. “How about we try some?” She frowns. “I’m not taking any more of your pills doctor. I'm quite content with my remedies but the nurses won't let me take my herbal remedies and rubbing crystals. What can I do?” “Some of your remedies can have a dangerous effect on the medication we give you here, that’s why you can’t take them,” Unwrapping his stethoscope from around his neck, he smiles softly. “What about kiwifruit?" "What about kiwifruit?" “Kiwicrush. It’s a little shot of kiwifruit that helps you move your bowels, it's like a natural remedy, I assure you that it tastes very good,” he informs her, she nods hesitantly. “I’m going to listen to your stomach now, my stethoscope is a bit cold so don't be surprised okay?" "Okay," She nods again. "I'll try the fruit doctor." "Good, Yoongi please make a note of that," Placing the diaphragm of his stethoscope on her abdomen, he listens for any present bowel sounds. Yoongi draws a little picture of abdomen in her files as he examines her, watching Taehyung’s face for an answer. Taehyung frowns, shaking his head for Yoongi. Yoongi then draws a cross through it. Yoongi writes the prescription in her drug chart for kiwicrush and signs her notes before closing them and slipping out of the cubical to tend to the last patient in the room for him. “Everything okay?” she asks, a worried expression drawn across her face. “You frowned, am I dying?” “Oh don’t be silly,” Clasping her hands again, he smiles tenderly. “It’s just that I am a bit worried about your bowels at the moment, and getting you up seems to be the best option right now. I’m going to ask the nurses to give you some pain relief before getting you up tomorrow morning, just so it’s a little easier for you and then, I’m going to ask you to give it your best shot. Mobilising will be very good for your stomach Maurine.” “You sound like the nurse,” She laughs, smacking the top of his warm hand. “I’ll try for you. So, please, call me mama. I’m too damn old to be called anything else.” Standing up, he lifts the blankets up to her shoulders, making sure her toes are covered the way he knows she likes. He turns off the overhead light, leaving a small night light on for her. “Alright mama, you have a pleasant sleep, okay? I’ll see you in the morning.” She hums her response as she turns her attention to the window beside her. She stares at the moon with a gaze he can only describe as suddenly haunting as the soft hues of light accentuate an unspoken fear drawn across her face, something Taehyung feels uncomfortable about. “What are you staring at mama?” he whispers, following her gaze out the window. "Are you okay?" "I am okay for now," Standing by the window, he presses his hand to the cold surface as he feels the wind brush against the surface underneath his palm. She laughs softly under her breath from behind him. “It’s a full moon. The wolves are out howling for blood. I’d be careful on such an auspicious night Dr. Taehyung, who knows what might happen.” He turns back to her. “It’s always an auspicious night when one is in a hospital mama, anything could happen here too.” Leaving her cubicle, he pushes the hand sanitiser on the wall into his palm, rubbing the dollop into his hands as he walks down the hallway. “You know, the other patients call her a witch,” Yoongi says, walking beside him with the trolley, patient file on top as he hurries with writing the last note. “Her notes say that she chants under her breath at people, gave me the shivers reading it but you seem close with her, so good for you. If you get hexed, let me know.” “You shouldn’t talk about people like that Yoongi,” Taehyung laughs, walking towards the nurses station. “You’ll be the one hexed. So, what was that patient's primary concern?”

Looking back at the notes, Yoongi says. “Another patient needing laxatives. Typical for this ward. I don’t know why you don’t just prescribe laxatives post operatively anyway. Saves so much time.” Taehyung shrugs, leaning against the station. “I would if it were me doing it. It’s Dr. Minho. He thinks the best laxative is water and exercise.” Yoongi snorts. “He sounds out of touch with real patients.” “He’s a good doctor Yoongi.” “We’re all good doctors until we’re proven that we are not.” Settling in the nurses station, Yoongi starts nibbling at the cake the nurses left out, as Taehyung leans against the station. It was dark, the nurses had turned off the hallway lights so patients could settle to bed. The nurses station was empty as nurses eat their dinner in the fishbowl behind it. Their laughter flutters nicely out from their office into the long empty hallways. Taehyung’s ward was the only department in the hospital who did night doctors rounds. It was the only department in a rush to discharge people, shift them back home for recovery and it was good for student practice. “Dr Minho’s on tonight, floating between orthopaedics and urology by the way. You in ED tonight?” Taehyung asks, “I hear it’s been really busy down there.” “I’m the floater tonight,” Yoongi shakes his head. “We’ve got too many staff on down there. Too many damn know-it-all students too.” "Isn't that good though for the acuity?" he asks and Yoongi rolls his eyes. Looking over Taehyung’s shoulder, Yoongi sighs. "Speaking of the devils." The first lot of students walk towards Taehyung, file outstretched waiting for his signature to co-sign. “Younggi,” Taehyung says, reading over her exceptional penmanship. “Next time, just draw the lungs if you assess them. What is your plan? What do you want the nurses to do?” She smiles, looking at her partner. “Regular repositioning in bed, PRN asthma medications when symptomatic and lots of pillows for comfort.” "As if they aren't doing that already," Yoongi snorts behind Taehyung. "Your kids need to spend a week with the nurses, that'll make ‘em work." All the students arrive back and Taehyung reads through their notes, signing his name at the bottom. Congratulating them on their first lot of assessments. “Now, that is how we’ll do our night rounds from now on. In the morning however, it will be different. I will be assessing your assessment skills on morning ward rounds. One at a time, in front of all of us." They all groan. “Oh shut up, if you don’t like it, drop out,” Yoongi cackles, “You with the orange hair, put the folders back in the office and if you groan again, I’ll steal the muffin I saw in your backpack you had on earlier.”

Taemin, the boy with the orange hair, disappears to do so. "God," Taehyung says, yawning into the crook of his arm, "Why is it so settled tonight?" Yoongi laughs. "Trying to avoid the q word?"

"What's the q word?" a student asks. Know it all Younggi fills her in. "It means quiet, he's asking why it's so quiet tonight." Taehyung sinks against the station, dropping his head onto his hands, a loud groan falling from his lips as Yoongi leans up and smacks his head. "You didn't tell your stupid fucking kids not to say that word did you? Great." "Did I say something wrong Dr. Taehyung?" she asks, insecurity suddenly plaguing her usually confident demeanor. Taehyung stands up, turning to face her. "That word is a cursed word. We don't use it here."

"Oh. I'm sorry?" Re-emerging with his phone in his hand, Taehyung gasps loudly as Taemin walks towards him, face focused on his phone. He was 100% against students using phones on the ward at all times, often challenging them to stay engaged. “Taemin, you know the rules, I don't like phones on the ward- -you're gonna wanna hear this though. A code black has been triggered at Forest Lakes Hospital,” he looks up at the two senior doctors, suddenly pale faced. “My girlfriend’s a nurse there and she’s just texted me “FLH called a code black, it's not a drill, I am fine.” oh god.” "What's a code black?" one of the students asks much to the chagrin of the other students. "That some sort of medical emergency alarm bell?" Taehyung and Yoongi trade vacant looks. “What?” “It’s probably just a drill,” Yoongi says, picking his nails. “They always do them over there. They’re close to a military camp, lots of North Korean defectors get treated there. A code black is a bomb threat kids."  

Taemin looks up at Yoongi. “With all due respect, there is no way in hell that this is a drill. Look,” Turning his phone screen to Taehyung, a picture of ambulances rushing patients out, all wearing equally terrified facial expressions as they pile in the back of the trucks. “They’re evacuating people.”

“Are you sure you aren’t being pranked?” Younggi asks, hovering over his phone to check. Taehyung watches her double tap the picture, her face suddenly growing pale. 

“Doesn’t look like a prank does it?” Taemin whispers and they all watch her retreat back as she shakes her head. 

And then, all of their phones vibrate, pinging with texts, tweets and calls.

All 8 of them, pull out their phones.

Yoongi and Taehyung’s pagers go off. Ward phones start ringing. Grabbing his phone out of his coat pocket, Taehyung opens the first notification on the screen and the picture makes his heart stop; a wing of the hospital was on fire. A wing of your hospital was on fire. “Dr. Yoongi,” a nurse runs out, all the nurses following behind her. “Did you check your pager? Am I calling it in?” “Call it in please. Get your manager to remove all the patients in this ward. Orthopaedics is the mass casualty ward for this hospital kids. Whoever is the ward co-ordinator tonight in the nursing team, call all the other nurses, get them to come in immediately and cancel every single elective operation scheduled for tomorrow,” Yoongi says, reading his pager. "I want this ward cleared of patients within half an hour. I assume from the distance, patients will be arriving soon. So, let's do this quickly and properly according to your emergency protocol." “Why do we need to remove all the patients?” a student asks and Yoongi frowns at him. “Victims do better psychologically and physiologically where other victims are. Hence, why we need to get everyone out now and get the ward prepared for incoming patients.” “How many do you think we will get?” he asks again, his eyes widening in fear. Looking up to all the students and nurses pooling out from their office. Taehyung's hands suddenly begin to tremble by his side. “In this case, probably a lot.” “But you never know.” His heart begins to pound harshly against his ribs. Adrenaline surged down his body at the prospect of all those incoming patients; at the thought of you being in that building. “Text your families that you're okay.” Yoongi announces, pulling him out of his thoughts. Putting his pager in his pocket. Looking up to each and every nervous face in front of him, he grabs the department phone, immediately pressing the emergency number and holding it up to his ear. His hands are shaking but the only one who notices is Taehyung as a voice loudly screams into the receiver. Everyone in the room watches Yoongi's eyes widen and his head nod before hanging up again. "Fuck, it's real. All of you go, get ready. Remove these patients and clear this fucking ward right fucking now." "What about us?" Younggi asks, as the ward lights turn back on and nurses begin to frantically run around them. "What do we do?" “Text your families right now, none of you are going home tonight." ↣ FOREST LAKES HOSPITAL | Dr. Y/N The first blast hit the far west side of the hospital, where the VIP recovery ward was located, as you had run back into the dark and desolate, abandoned looking Emergency Department. You could smell the fire, you could even see it’s smoke boil up from the building in the northern windows of the ER. You ran harder. You were panting, completely solely running on adrenaline.

Your heart raced out of your skin as you looked in every room. In every bay. In every office. You were running completely on instinct and your instincts were telling you, someone was left behind. And you don’t leave people behind. No, not you. The force of the blast rumbled the entire floor, it was weak, a warning of what was yet to come and had you not been standing by an empty bed, it would have knocked you clean off your feet. Falling onto the white bed, plaster from the ceiling fell and the room seeped into darkness as the electricity completely cut out. No generator back up or anything provided you with a light to see in the dark either.

You coughed into your hand as you inhaled the plaster. 

“Hello, is anybody here?” you had screamed, coughing as you run through the hallway you’ve memorised by heart. “We don’t have much time, is anyone here?”

A voice muffled behind a door screams loud and clear out for you as they bang their fists on the hard wood. “PLEASE SOMEONE, I’M STILL IN HERE!” You were right. "HELP ME, I’M STILL HERE, OH GOD I’M STILL IN HERE, HELP ME PLEASE! DON’T LEAVE ME!” Running down another hall, you hear a terrified scream from behind the controlled drug room. Someone remained like you had thought, banging on the door for their dear life. The door shook from the sheer force of their desperation to get out but the lock made it impossible to break free. “I’m still here,” they sobbed, banging on the other side of the door, “Please save me.” You don’t think as you run towards it, punching in the code for the room and forcing the door open with all of your might. The doctor on the other side had tears down his face, falling straight into you. It was Jungkook. Idiot doctor and housemate, your Jungkook. "Y/N," he sobbed, looking completely broken. "I thought I was going to die." “Well, I’m glad you’re alive and all but we need to go, right now." He looked distraught and terrified, but of all, he looked relieved. Grabbing his hand, you run with every inch of strength you can muster out, of that goddamn building. He holds your hand tightly, practically dragging you as he runs faster, jumping over shattered glass and plaster. 

You hold images of Sunny in your mind as you pick your feet up. You hold the sound of her laughter and her cries, her singing, her screaming. You think of Taehyung, his smile, his embrace, his warmth. You think of a life you still think you can have. You think of punching Taehyung in the jaw when you see him next, you couldn’t die today knowing you haven’t. No, not today satan.

You run towards the clearing. And the automatic doors... ...they don't open. “What the fuck, why won’t they open?” you ask, waving your hand up to the monitor. “Fuck, I thought these would open in an emergency?” Jungkook bangs against the glass. Jimin and Seokjin look up, prompted by the loud banging. Ramming his shoulder into the glass, it doesn't budge. He throws everything close to him at the doors, again, it doesn't budge. They’re stuck. Irene holds back the boys from running over to help you. They had parked on the far end of the carpark to be safe as they waited. You both stare at the red lights of the ambulance in the night. “We need something heavy to smash it.” you say, “We’ll get out, don’t worry.” “How can I not fucking worry?” Jungkook shouts, throwing himself at the glass doors. “It’s just fucking glass, why won’t it break?” “It’s shatterproof material Jungkook.” Looking for an emergency button on the doors and falling short, “I’m going to find the emergency axe thing Jungkook, keep trying to pry it open okay?” 

You were certain that there was an emergency axe somewhere, you had seen it before and wondered if you'd ever need to use it and for what. Slipping on blood, you fall to the floor as the ground continues to shake beneath you. "Where is it, come on Y/N, think." Getting up again, you run to the hallway leading off to the operating theatres and that's where you find the axe, contained in a glass box, nailed to the wall by a fire extinguisher. Punching the glass, it's splinters piercing your knuckles, you grab the axe. You were certain that when this adrenaline stops fuelling your attempts to survive, everything is going to hurt. But you don't have time to think about that as you run back. Jungkook's running into the doors, kicking and screaming at it, continuously bruising his shoulder. “I’m not dying in this fucking building.” "Jungkook," you shout, he turns, eyes glinting in happiness at the sight of the axe. "I have no strength, you smash it." He takes it happily, immediately hacking at the door. "I need to get out." he chants, each time the axe hits the doors. "I'm not dying today." The axe cracks the glass but it doesn't shatter like you thought it would. He hits it again and again, only cracking it. “What the hell is this fucking thing made of?” "Jungkook," Turning to survey your area, you grab anything hard enough to throw through the glass. "Jungkook, move out of the way." "What?" He turns, watching you throw a vital signs machine straight into the cracked glass with a strength you didn’t think you had, shattering it completely. He watches in slow motion as the glass shatters and falls to the linoleum floor. He screams happily as he throws the axe into the reception to their left. He grabs your hand as you run over the ocean of glass pooling onto the sidewalk as you both run into the carpark. The ambulance was so close, yet so far away. The fresh air hits your lungs as you breath it in and then out. You were free. You would be okay too. 

Jungkook turns to you, smiling widely at you. “I’m free!”  "Kim Seokjin! Park Jimin!" you scream, running towards them, "Open the back doors!" But they never hear you, and that you are grateful for because what happens next would've definitely hurt him too. 

The second blast hit as you were running out of the building with Jeon Jungkook. The force of this blast, much bigger than the first, had thrown you in the air and onto the soft grass by the car park, metres away from the now swaying ambulance, winding you. Jungkook had fallen onto the hard concrete pavement of the carpark beside you, hands falling on shards of broken glass, blood dripping from his forehead. He screams in agony, feeling the bone of his arm break and tear through his skin on impact.   Black coloured smoke rushes out of the burning building, covering you and Jungkook in a cloak of silent darkness. It chokes you, filling your lungs with it’s painful toxin as you try to breathe. Jungkook looks at you, expression pleading, lips moving to form words you can’t understand. Everything is blurry and dark and deep and your falling into yourself as black spots fill your visual field. You can’t hear anything but a loud ringing in your ears, you can hear the faint scream of Jungkook at the back of your brain but you can't process what he's saying. He looks at you desperately, is he hurt? That's a stupid question. You know you should get up but you feel compressed, stuck to the ground, and you can’t breathe, feeling winded as though your lungs had lost their ability to take in oxygen. You try to get up, falling back to the ground. Were you hurt too? You look over to Jungkook again, watching him battle his demons, forcing himself to get up and to you. You watch as if it were in slow motion as Jungkook pulls himself up, rushing over to you as he cradles his left arm in his now dirty white coat. There’s a god awful whirlpool of horror in his brown eyes as he runs over to you, you may have saved him but he definitely earned it because he saves you right back. You pull yourself up as much as you can before his arm wraps around your waist, holding you up as you both run to the ambulance. You look back at the building, still standing with flames and smoke boiling out the windows. You knew it wouldn’t last long until it collapsed or forced to the ground by another and much larger explosion. You didn’t want to be here for that. Blood dripped from your ears and down the sides of your soot covered face, building materials you couldn’t identify laced through your hair, shards of glass embedded into the skin of your arms. You felt like you had been punched in every soft part of your body. Jungkook looked equally as dishevelled. Waving you both over, Jimin and Irene rush you both into the back as Seokjin revved the engine. Minutes pass of complete silence as you rush. Isn’t that weird, after something so huge, there was just silence? No piercing screams, no sirens, no pleas for help, just fire, fear and silence. Pulling themselves in first, Irene and Jimin sit opposite each other, strapping themselves in.   The third blast hit when you were trying to close the doors behind you. The blast wave hit the truck, pushing you into the back of the truck, shattering the windows, prompting Seokjin’s immediate acceleration as Jungkook toppled straight on top of you.  

The glass from the window narrowly missed the intubated patient on a stroller in the middle of the ambulance, but it cuts across Irene's cheek, something she'll probably need stitches for. She wails in agony, holding a hand against her cheek, immediately applying pressure to the wound as dark red blood dripped down her neck and onto her scrubs. 

Jungkook was afraid of letting you go, and for that, he saved you again. The doors slapped against the sides of the ambulance as Jin speed through the carpark and as far away from the hospital as he could. You wrap your arms around Jungkook’s waist tightly as he held onto anything that would keep you both in the ambulance as it sped away. His dead arm curled up painfully against your chest underneath him as Jin's abrupt driving makes you swing underneath him towards the other side of the truck causing shards of glass to tear through your coat as you do. You scream in agony, feeling the shards slice and embed into the flesh of your ass. It’s sweltering, a burning pain filling you by waves as it rolls over you, over and over again. You were hurt everywhere. 

"Are you okay Y/N?" Jimin shouts at you. You clasp onto Jungkook tighter, eyebrows flexed as pain tears through your body. “Hold onto him, we’ll get you out of here!” Jungkook sobs, wailing in pure agony. The sound breaks Jimin as he watches, the once strong Jungkook, completely break and fall apart.   "It's collapsing!" Irene shouts and you all look back to watch in horror as the sound of destruction echoes across the night sky. "The hospital. Our homes. You guys could've ...that was so close." she sobs loudly, feeling the horror of what could've been you two so deeply into her bones. “Drive faster,” Jimin screams, hitting the back of the front seat. Jungkook and Irene watch the orange flames burst from black clouds of smoke, as the hospital collapses from the emergency exit they just left, “Drive fucking faster Seokjin!” He presses his foot on the accelerator with sirens blasting and red lights flashing through the graphite night as he zips away. “I’m driving as fast as I fucking can!” Irene screams when he skids around a corner, her head hitting the wall hard as he drives straight through the car park entrance sign. The sound was like nothing she had ever heard before when she looks to her right, the once dark night now full of orange light as the fire boils and consumes her home away from home. It was haunting, something Irene would never forget. 

They had only just gotten away from the building in time when fire began to rain down onto the trees, there would no doubt be a forest fire too. Everyone would be working overtime tonight. “Irene, are you okay?” Jimin asked, watching her rub the back of her head. She pulls her hand back, fingers covered in blood. Grabbing one of the only packets of gauze from beside him, he clears his throat. “Hold these to your head and hold on tight to your chair okay? We’re going to be fine.” She pants, biting her bottom lip. “Are you sure?” Jimin looks at everyone in the ambulance, he doesn't think he should dignify that question with a response, you were all safe now. “Go, Seokjin! Get us out of here!” Jungkook yelled, as he sunk his head into the crevice of your neck. “Get us to the hospital!” How you both hadn’t died was a mystery. Irene and Jimin pull you both further in by the collars of your coats, dragging your glass covered bodies further into the ambulance when Jin drives over a bridge, forced to slow down. "Irene, grab Jungkook," Jimin says, watching her pull Jungkook up beside her, strapping him into the seat. Pulling you up, he forces you into the seat beside him as he sobs. "Y/N, I've got you. You're okay now, you're okay now." He holds you close, telling you something you can’t hear but he's crying and he's crying hard. He looks like a wreck. 

Holding your hands up to his checks, you wipe away his tears only to smear blood and soot across his face, he leans into your warmth. At least the sentiment was there. “Jimin, I have no idea what you are saying,” you think you shout, dropping your hands and leaning against him. The blood dripping down your right ear stains his green scrubs. “The barotrauma ...I think I have a ruptured eardrum in my right ear. Left feels like it’s resolving. I can only just hear you kind of.” He nods, red eyes sweep over yours. “I’m very glad you’re safe” he mouths and you smile softly up at him, glad you are too. Jimin hands you a bottle of water as he pulls out the first aid kit to attend to the cuts on your face. "Call Yoongi, tell him you're okay. I know he's probably worried." Jimin smiles, lips quivering. "I did, he was scared, still is I bet. The phone cut out during the second explosion, I'm just going to have to wait to see him at the hospital." "What? I can't hear you? Did you call him? yes or no?” Jimin nods, gesturing for you to drink the water. You looked worse for wear with your bloodied and blackened white coat; ripped, crimson stained scrubs; messy hair tied in a loose ponytail; and soot covered face but you were okay.    You were feeling okayish. Drinking the water, you sag against him. Jimin dabs your fingers, brushing his fingers over your pulse, completely thankful you still had one. You look out the ambulance window to see your hospital, the once tall white and green structure, up in flames. All those years of hardwork, patients you’ve saved, lives you’ve lost, friends you’ve made, memories you’ve cherished. All gone. Seemingly in the blink of an eye.

You suddenly want to cry. 

Today wasn’t a normal day at all. As you drink the last of your water, you feel your left ear pop and then you hear the unmistakable sound of the ambulances sirens and Irene shouting at Jungkook and Jimin shouting at Seokjin to update the hospital. You could hear and you wish you couldn't. Everything happened at a lightening speed, as though it all occurred within the single blink of your eyes. Seokjin pulls out the radio, bringing it to his lips as he speeds through the intersection, sirens blazing. “Seoul Hearts hospital, this is Ambulance 22 Kim Seokjin speaking. We are currently enroute to your facility with a 32 y/o male motor vehicle accident victim from Forest Lakes. Patient is unconscious, intubated and-

-yes, we came from Forest Lakes," he stops, listening attentively to the voice on the other end that you can't quite hear. "Mass casualties ...how many have you already got?" "32?!" he shouts, "We'll you're about to get three more- He then scoffs into the radio. “Don’t interrupt me. I have nurses Park Jimin and Bae Irene, Drs. Jeon Jungkook and Y/N who are injured- “Yes, I know the hospital has just blown up, I’m looking at it in my rearview mirror right now, we have two injured doctors in the back of the ambulance as well! Possible internal trauma, possible broken extremities,” he snaps, frustration ebbed into his voice, “We are unable to take current accurate vital signs of the patient and the doctors but our patient is unstable as hell. I'll update you if things change. See you in 5 minutes.”

He slams the radio back down. “Buckle up kids, we’re driving through the city now. Y/N,” Seokjin shouts from the front, “You good?” You nod, feeling your hearing fully come back in your left ear. “I think so?” "Good, you crazy fucking bitch, don’t you ever fucking do that again or I’ll cut your legs off." You're all staring out the back of the ambulance, watching the reactions of the public move out the way for Jin and gape at the very mangled up looking ambulance. It's almost a spiritual experience being in this position, having people responsibly move out of the way for you as you zip impossibly fast through red lights and traffic. "How's the patient doing?" you turn and ask Jimin, who had been watching you the entire time. His face pale. "What’s his vitals looking like?" "What?" Jimin shakes his head, forcing himself back into reality. "Um, I haven't checked. Hold on." You watch his heart monitor, the vital sign of life beat after beat after beat. You frown at a particular beat as it moves. "His hearts not looking too good," you point out. "It's not often but his hearts skipping a couple beats." "After everything, I would expect that too. We're just lucky he hasn't got a serious cardiac illness otherwise, he's fucked." Jimin says, shifting beside you. You watch him try to breathe. It was an insidious reminder of your responsibility to save this man. He was dangling by threads, he was so close to death. You look away from the numbers on his screen. You stare at your soot covered hands. That could’ve been you. “Seokjin,” you shout, “How far away are we from Seoul Hearts?” “A couple of minutes,” he shouts back at you, “You don’t need to shout at me you know!”

“I can’t hear anything well,” you say, pointing to your ear and the dried blood around it. “I think the blast burst my right eardrum.” Irene laughs suddenly, smacking her thigh. “I hate to laugh but consider yourself lucky it was just that. When you ran back in, I didn’t think we’d see you again. Jimin ...he-” “I thought I lost you,” Jimin interrupts, not wanting to relive those moments of his life. “You’re stupid but you’re incredibly brave saving Jungkook like that. How did you even know he was in there?” “I had a feeling someone was still in there, that’s just it,” you nod, looking over to Jungkook. The boy looked frightened as hell. “He would’ve saved me too, that’s for sure.” Jungkook stays silent, eyes wide as he tenses his jaw. You watch him cradle his arm, was he hurt? Jimin looks at him, shaking his head. “She saved your life Jungkook, you could’ve died back there. Why do you consistently and constantly go against your superiors instructions? What is wrong with you- -I got locked in the drug room!” he shouts back at Jimin, “It locked behind me when Namjoon asked me to clear it, she only found me because I was screaming for my fucking life. You think I don’t already know that I could’ve died back there, I know okay! I know it very well. I called my parents while I was holding a vial of fucking ketamine, I apologised for being a shit, I told them that I was locked in a room and that I was going to die. You think I wanted to hear my mother cry?” “Jungkook,” Jimin musters, unsure what to say, “I’m sorry, I- “-I was going to swallow it, you know. With the first sign of fire, I was going to kill myself. My girlfriend ...all I could tell her was that I was sorry that I loved her… I could’ve died back there, I could’ve seriously died back there.” Jimin crosses his arms over his chest. "But you didn't because she ran back- -and saved my life." Jungkook finishes. “Oh shut up both of you,” Irene shouts, “Pick up your damn phone and tell your family, you didn’t die already. Who knows what they’re doing thinking you’re dead. Hell, if I loved you, I would be driving out here right now to try and get you out.” “Seokjin,” You ignore their discussion as you gaze back at your patient. “Are we close?” “I’m driving as fast as I can with my sirens on, Y/N,” he shouts back clearly agitated, “Just focus on monitoring your patient. And Jimin, shut up and please Irene, fucking deal with Jungkook’s arm instead of pissing him off. It looks bent as fuck from the rear-view mirror. The kid is obviously hurt psychologically and physically, stop being assholes and be compassionate.” “You’re hurt?” Irene gasps, her voice now dripping in sympathy. Her bloodied fingers reach out for him. He lets her tender touch explore the mangled arm from underneath his coat. “It’s broken. How did this happen?” You snort. “Besides the hospital blowing up and the waves that were emitted from the explosion travelling at a supersonic velocity straight through us, throwing us in the air with all that glass and onto hard concrete and debris?” “I fell on it,” he says, watching Irene open up the bag on the floor. She nods her head. “You hurt anywhere else?” He shakes his head, letting her dab the wounds on his face with saline and gauze. It’s quiet again as she works his wounds, there’s not much she can do with his arm trapped in his coat like that, he’s just going to have to wait. Irene hands Jungkook her phone to call his family before finishing up on his wounds.  Jungkook dabs her cheek with some gauze. Everyone was hurt in different ways but they were alive. 

The ambulance grows silent when Jungkook sends the group text to his parents and to his girlfriend. 

Jimin fusses over your knuckles, his mind on fire with residual grief and anger over your stupidity and bravery.  But you were okay. For now.

* * *  

Jungkook stares at the face of your patient.

He filters through the faces he knows, the patient’s he’s treated before leaning forward to look at his wrist band. “Oh it’s this guy, oh man, didn't think he'd come back,” he says, looking up at his cardiac monitor carefully, scrutinising every wave of his heart beats, “Y/N, are you aware that your patient has a past cardiac history?”

“Yes, angina pectoris,” You nod your head, pointing to his monitor as Jimin cleans your arms, “Are you worried about those PVC’s (heart skipping a beat) too? He's post motor vehicle accident, fucked himself up pretty bad. He needs surgery pretty much as soon as we get to Seoul Hearts.”

“Angina?” He frowns, prompting Irene to swap places with him beside the head of the patient. “He doesn’t have Angina, I have a photographic memory, I would’ve remembered that. He had an acute myocardial infarction a couple weeks ago and he hasn't been compliant with his medication-

-what!” you shout, interrupting him, commanding the attention of the truck as you dart your eyes into his. “This patient's had a heart attack before? That wasn’t in his medical files at all when he came in. That’s pretty fucking important information. Jimin,” you turn to the boy. “Did you get a history from the family?”

Jimin shakes his head. “Didn’t have time with the code. They still don't even know he's a patient.”

“I can see Seoul Hearts Hospital now, we’re about 2 minutes away.” Jin says, but you’re heart is racing hard against your ribs now. It’s like a dose of adrenaline and you suddenly feel so awake.

“If what I am thinking has happened, this patient probably crashed his car because he had chest pain. Irene,” your voice is shaky, everyone in the ambulance detects the urgency in your voice. You forget about the bomb. “Did you get any cardiac biomarkers from the bloods you took?”

“The ones that detect heart muscle death?” Her eyes widen as she tries to remember, clearly put on the spot as everyone looks at her. “Oh my god. I think so, like almost ...almost immediately but Dr. Namjoon came in before I got to ...I didn’t have time to check exactly.”

“What were they, do you remember? It’s okay, take your time. It’s important to remember which ones there were.”

She closes her eyes and Jungkook resets the vital monitor to get an accurate reading. “He’s hypotensive with ventricular dysrhythmia,” he says, printing the ECG out. He grabs the pen from his pocket as he reads the rhythm carefully. “Was it troponins T and I Irene? Do you remember a T?” She opens her eyes, pursing her lips at him. “I think it might’ve been but I don’t remember- -Y/N, his heart rate is 165, blood pressure is 80/40. I think he’s in cardiogenic shock,” Jimin cuts in. “Vitals are crashing.” "Good timing." you slap yourself. 

“Fuck the bloods. Holy fuck,” Jungkook circles a portion of the rhythm, spotting an ST-elevation in the electrocardiogram (heart attack), holding it up to you as Seokjin drives. “He’s having a fucking heart attack right now Y/N.” “What do we do?” Irene asks. You look back at his cardiac monitor seeing it clear as day now that the patient's heart rhythm goes from erratic to nothing. "HES ARRESTING," Jimin shouts, pulling you out of your gaze. "He’s going into cardiac arrest Seokjin!!“ “This can’t be fucking happening right now. Jimin, we need the defibrillator he needs defibrillation immediately. We need an epi?! Wheres the adrenaline?” You shout, unsure if you could jump straight onto the patient with the door open like that. It looked dangerous. “The ambulance isn’t stocked, there isn’t one in here,” Seokjin shouts from the front, “You’re going to have to do chest compressions until we get there but fuck, it could be dangerous for you with the door open so be careful.” “I’ve got this,” You close your eyes. "I can save him." “Jimin, ambu bag, right now. Get on the resps." Without hesitation, you get out of your seat as Jin turns, to straddle the patient. Holding your arms straight, you press the heel of your palm on his lower sternum, compressing it in a steady rhythm with your interlocked hands, one on the other. You hear a couple cracks almost immediately. "Irene, are you sure we don’t have any adrenaline in that bag?” She tips the back out onto the seat looking for a little vial, it all flies out the ambulance anyway. “There’s no medication in here, so no we don’t.” Jimin gently squeezes the ambu bag twice. "We're nearly at the hospital, I can see it out the window now." “Beginning ...30 compressions to 2 breaths. Jimin watch me closely," you say, feeling your own heart rip through your ribcage. "Seokjin radio report change in status.”  “Will do,” he shouts, pulling down the radio to call it in. “Hi, this is Seokjin, incoming ambulance from Forest Lakes we have a cardiac arrest in progress in the back of our truck, prepare for defibrillation on arrival in less than a minute.”  “25, 26, 27, 28, 29, 30. Resps!” Perspiration drips down your dirty face as you pause your chest compressions, turning to the two to the left of you. “Irene and Jungkook prepare to wheel me out of this ambulance and in to that fucking Emergency Department. No one is dying on my watch, not if I can help it.”

Jungkook and Irene look at each other as the ambulance comes to a halt outside the Emergency Department at Seoul Hearts Hospital. Turning off the engine, Jin runs around the truck, pulling down the ramp and grabbing the end of the stroller.

You can ear the screams of agony inside the Emergency Department from here as doctors rush in bright yellow aprons, blue gloves and white face masks towards your truck. 

“Let’s go, get out Irene and Jungkook,” Seokjin yells, pulling the stroller towards him and down the ramp with Jimin shuttling beside it. “Let’s move team! Keep doing compressions Y/N and hold on tight.” 

[wingsy-keeper-of-songs]

Schultz and Nora? Kisses where one person is sitting in the other’s lap

This turned into a monster, Nonny. I hope you enjoy it! Kisses all around, folks! :D

Nora kicked the door open because her hands were full, andbecause there wasn’t any conceivable way she would be able to open it with herteeth, now was there. She set her things down on a dusty-looking end tablenearest the window before turning to look at her patient. Dr. Schultz hadfinally done it as far as she was concerned. He’d finally gone and sassed thewrong person and wound up getting shot for it. He was extremely lucky to havesurvived this long, and it was mostly thanks to the town’s doctor and Nora’sfrantic cart driving. He was propped up by a few pillows and had a book restingon his chest. His spectacles gleamed in the sunlight streaming through theblinds. Nora rolled up her sleeves, tied back her hair, and washed her handsbefore turning to him.

             “Feelingbetter, are we?” She asked as he flipped a page. He glanced over his spectaclesat her.

             “Muchbetter than I have been, thank you for asking.” He said with a rueful smile andone that she absolutely did not return. As far as Nora was concerned, she wasstill angry with him. His stubbornness nearly got the two of them killed.

             “Good,”she said with a curt nod. “Dr. Jules is busy with other patients, so I supposeit falls to me to take care of that wound of yours.” Schultz looked taken abackby this and he put his book down, removed his glasses and put both on thenightstand, wincing as he did so.

             “I don’tsuppose you would mind us waiting for the good doctor, would you?” He proposed.Nora lifted an eyebrow at him and he was fairly certain he might lose thisargument. Nora only looked at him like that when she was close to furious withhim and he suspected she was still cross about what had gone down at theLouisiana plantation.

             “I canhandle blood. It got all over my dress when you were shot, you know.” Norareplied as she pushed the end table closer to the bed. She wet a few towelsbefore looking over at him. “You’ll need to pull that shirt back, or I can doit for you if it hurts too much.” Schultz did not look pleased about this. Hedidn’t want Nora doing something she wouldn’t feel comfortable with. Wincing,he slowly slid his suspenders from his shoulders and started working on thebuttons of his shirt. Nora rolled her eyes and swatted his hands away. “Here,I’ll do it. We’d be here all bloody day if you kept that up.” Schultz let hishands fall to his sides and focused on something other than a pretty womanunbuttoning his shirt. Of course, he couldn’t help his gaze wandering to herevery so often, but he made sure to look away when she’d pulled back. Shecarefully unwound the old bandages around his waist and squeezed water from thetowels. Her hands were so small compared to his and Dr. Jules, and Schultzfound this frame of reference terribly fascinating. Of course, that was alsoprobably the delirium talking. Nora’s hands were gentle as she carefullycleaned the area around his stitches and the wound itself. It hurt like a shit,but Schultz was determined to hold back his wince.

             “I’msorry,” he said softly. She didn’t look up from her work.

             “Begpardon?” She asked, turning to get another towel. He grasped her wrist beforeshe could, and she looked over at him finally.

             “I’msorry,” he repeated. “About what happened.” Nora stared at him for a goodminute before turning back to get the towel.

             “You are,are you?” She said, mostly to the end table rather than to him. Schultz nodded.

             “I am. Ididn’t think it would escalate as far as it did. I put us in danger and becauseof that, I’m sorry.” Nora looked back over at him. He seemed sincere, and hedidn’t have any reason to lie to her. She shrugged.

             “Well, inany case, I’m just glad you’re still alive.” She said honestly. “You’re reallymy only friend at the moment.” That sounded a lot lonelier than she intended itto. There was no pity in his eyes when he gazed at her, only understanding. Shesaid nothing more as she returned to tending to him. The wound was ugly and itwould most likely scar, deep as it was. The bullet had ruptured his spleen and hehad been in serious danger of bleeding out. Had it not been for Nora’s franticcart ride through East Jesus Nowhere, he would have died. Nora didn’t know whatshe’d do with herself if she lost him due to sheer stubbornness and pride. Thatwas part of the reason why she was so upset with him. She cleaned him up asbest she could and gathered the clean bandages together. “Can you sit up alittle more? I need to bind you up again.” She said, gesturing towards him.Schultz nodded and sat up as best as he could without tearing his stitches.Nora reached around his waist and started bandaging him up again, missing thelook on her patient’s face as he watched her. As soon as she’d finished and wasabout to pin the bandages back in place, he very gently lifted her chin. Shecouldn’t describe the look in his eyes, but it was something akin to gratitudeand an emotion she couldn’t quite decipher. She found herself liking how darkhis eyes were, how gently they looked at her. His eyes left hers and flickereddownwards, hooding slightly. She wondered why her breathing was getting shallowand her heart was pounding in her chest. She hated not knowing what he wasthinking. It would honestly save her a lot of trouble if she did.

             “Nora…”he spoke softly and leaned so close that their breath mingled. She remainedstill. Her name sounded pretty when he said it. It was probably due to theaccent.

             “Yes?”She asked, voice just as soft and wondering where the hell this had come from. Hebit his lip and slowly released it, keeping his eyes downcast. She wonderedwhat he was looking at until he finally gave into whatever it was going throughhis head and kissed her. Nora was surprised, but she didn’t push him away. Shetentatively kissed him back, just a little bit unsure of just what it was theywere doing (she knew damn well what, but it was the why that stumped her) untilhe pulled back to study her. She said nothing, and found that her anger wasslowly ebbing away. She offered him a shy smile, which was quite unlike her. Hetook a deep breath and leaned back, looking as if he may have regretted whathad passed between them.

             “Nora, I…”he started, but she silenced him with a finger and leaned in to kiss him again.She situated herself in his lap, careful not to disturb his injury. Whatever trepidationshe had before were gone now as he kissed her back, his hand gently falling fromher chin to the back of her neck. He carefully pulled her closer to him andthen broke their kiss with a hiss of pain. “Damn,” he swore softly and thenlooked back to her. She tucked her hair back and avoided his gaze, partlyembarrassed by what had passed between them.

             “I, ah, Ishould get going.” She said softly. She removed herself from his lap andstarted for the door. “We’ll be leaving as soon as you’re able to move withouttearing anything,” she continued, officious and business-like. Or at least, shecertainly hoped so. “I’ll be right outside if you need me.” She said as shetook the bowl of water, the old bandages, and the soiled towels with her. Hewatched her go and unbeknownst to either of them, both of them sighed deeply.Nora’s heart was still thrumming in her chest and she made a mental note totalk to Dr. Jules about it later. Schultz, in the meantime, lay back andconsidered himself to be very lucky once again.

[in-mutual-weirdness]

Elsewhere University: Wayward

AN: First attempt at writing a thing in a long while. I have a weakness for fae stories and urban magic-y kind of scenarios, and @charminglyantiquated‘s universe here caught me hook, line, and sinker. Still, didn’t think I’d write anything for it, until the library scene popped into my head while I was procrastinating. Hope you enjoy what it’s turned into.

----------

When you were younger, your parents had impressed upon you the importance of going into the sciences.

“Be practical,” they said. “We have three sets of tuition to pay for. You can't waste time on art or philosophy. Love is all fine and noble, sure, but debt is not.”

Your original reaction had been a slowly growing resentment. Now, you're glad for it. You wouldn't touch humanities with a 10 foot pole now.

Oh sure, you're no automaton. You can appreciate people with an eye for theory, ink-stained fingers, or the aptitude for composition. A good portion of your friend group chose to study and create beautiful things. You love hearing about what they do, seeing the way their eyes light up and their words run away from them in sheer enthusiasm. But interspersed between their conversations about theater or lit class readings, you heard...other things. “Weird and inexplicable” didn't even begin to cover it. You finally put the pieces together in the spring of freshman year, after Sydney disappeared and everybody gathered to drink in memory and mourning.

It spooked the hell out of you. No two ways about it. Elsewhere University had a reputation for weirdness, for sure. You'd be lying if you said that hadn't swayed you in favor of attending in the first place. But this went past weird. “Weird” wasn't going to get you killed or kidnapped. The only thing keeping you from just transferring straight away was the impossibility of trying to explain it to your parents. And your grades weren't exactly gonna convince any other admissions office to let you in. Nowhere comparable, anyway.

So you coped in the ways you knew how. Reading all the guides you could get your hands on. Finding source folklore. Your choice of major had already stacked the cards in your favor. And while you still hung out with your arty friends, by sophomore year you'd found another group. A group more shielded from the weirdness. Where things could be normal and nobody thought to ask doppelganger questions or carry old screws in all their pockets. Except that one engineer lady, but far as you could tell, that was just a personal quirk.

And then school brought the hammer down on you.

You knew that college was gonna get tougher. But knowing didn't mean you were prepared. Those grades that had kept you from transferring came back to bite you. That creeping unease from Sydney hadn't gone away, and it was showing up in your work habits and shattered focus. You'd talked to the student health services people about it, and gotten nowhere. Scholarship money was on the line. The second round of exams was coming. And linear algebra was the first one.

You’d done your best to stay away from Elsewhere’s weirdness. But that didn’t mean you weren’t aware. You remembered what your humanities friends had told you. There were things you could do, loopholes you could exploit. Options, options, always options. If you were brave enough to take them.

And so here you are, venturing into the lower floors of the library.

You didn’t know many specifics going in, but you did know where to look. The bio majors Facebook page didn’t explicitly mention their library base camps, but the “Spelunkers Club” did, and had drafted a map to boot. The printout is sitting in your backpack, right now, sandwiched between notebooks. You’d wondered about their ability to diagram a non-Real, inconsistent space, but the solution made you laugh in shocked delight once you saw. While the shape of the shelves would change every six days or so, even a fae-touched library was militant about the Dewey decimal system. You spot the Fashion books (746.92) and make a right, nodding at a dude you recognize from your Psych class. He gives a weak thumbs up in response. Not somebody you'd expect to come here, but the psych lecture is the morning after the exam. If any of you vanish, it'll get reported quickly.

You move off a ways, finding a row of empty carrels against the wall. All identical, save one, whose lone desk light throws shadows around the walls. The rest of the row has their lights off, but you can hear the ambient shuffle of papers anyway. Best avoid those chairs, then. You pull out your ramen packs, selecting the saltiest variety (verified with a taste test, once. And never again.) The remaining 2/3 of the packets you scatter about the table, and stash back into your pockets. Should work.

You crack open your textbook and a bag of chips, and get started.

Time passes. The sound of your pages joins the general rustling. The clatter of laptop keys cuts through intermittently. You pull out your phone to google a definition and glance at the clock--apparently it thinks you’re in Dubai. Well, at least there’s proof that the time dilation here is actually a thing. Or just that it screws with your electronics. You make decent progress through some of the practice problems, but stall whenever you hit the theorems. That's algebra for you. A lot of numbers and graphs and definitions that use letters like they're words you should understand. You don't. Which is why you're even in this part of the library right now.

It takes you a while before you realize that no letters make sense anymore. You're still thinking in English- at least, you're pretty sure it's still English. But now even the chapter headings in your textbook look merely like shapes. It might just be delirium. That's the reasonable conclusion. You’d downed your second can of Red Bull just trying to keep your eyes functioning. But...

On impulse, you try to write your uni name. (Not your real name, you're not stupid. Just panicky.) Descartes. Cogito ergo sum, and all that. It comes out successfully, but it's entirely due to memory. Making the individual letters takes as much effort as if you were writing them backward, every curve meticulously plotted and traced.

Your circle is undisturbed, thankfully. But the shuffle of pages has stopped. Wind howls from beyond the walls, and the shelves creak like old floorboards. For a moment you wonder about the psych kid. It's a moment too long. You see something move out of the corner of your eye, when you look back toward where he was.

Don't move. Nothing’s there.

Except the Red Bulls are doing a number on your system, and even though you were never the wordy sort you'd still like your language back, thanks, and even if you wanted to leave your suddenly too-small circle and brave your way back to the campus proper, that exam would still be there.

The memory of your GPA curdles your fear into anger. “I thought we were the kind of people you'd leave alone,” you snap, turning to yell over your shoulder. Your voice climbs an octave as you start to rant in earnest. “What's the deal? I'm a STEM major. Doing math. Algebra. You don't even like algebra.”

“Mayhaps,” comes a voice from behind the shelves. “Numbers and Logic are mortal things, it’s true. But you are not a number. You just work with them.”

“And other things,” you reply. You strain your eyes into the dark, frozen in your half turn, but the shelves reveal nothing. Whatever’s out there doesn’t sound like it wants to approach. Probably. Your brain is racing, just barely outpacing your heart. “What do you--is there something you desire from me?”

“Presumptuous.” There’s a cicada-like buzz behind the voice. It makes you picture some kind of massive chitin-plated thing waiting just out of view.

“I meant no presuming. Uh.” Your tongue ties itself in knots to avoid the word “sorry.” It’s surprisingly hard to come up with less dangerous words. “Tell me where I went wrong and I shall try to avoid repeat offense?”

The hum continues. It's starting to sound like laughter. Your spine shivers like a loosened spring. “I want nothing of yours, pupa. What use could I have for it?”

You're pretty sure that question is rhetorical, and if it wasn't, any answer you could give would only endanger yourself. “Then if that’s so, we may move on with our lives. I’m sure you have your own stuff to- to attend to.” You try to muster up enough courage to turn back to your desk.

“I don’t understand. My current business is talking to you.” The thing- the Visitor’s legs skitter about around the shelves, its voice circling around. It better not be getting closer. “You’re proving a rather difficult conversation partner. Most im-po-lite.”

“I did not come here expecting conversation,” you say, uneasily. God, you want out. You shouldn’t have said anything to begin with. You never know who’s listening. “I came here to study, nothing more. That’s where my lack of grace comes from, uh, good fellow.”

“Odd, that you should stroll right into somebody’s front parlor and not be prepared for conversation.”

That can’t be right. That can’t be. The map- You turn the chair fully around and reach over to your backpack, before pulling back at the last minute. Can you even show that to a fae? Is that allowed? You wrack your brain for details, and keep coming up blank. Meanwhile, your Visitor- or Host, perhaps, as the case may be now- waits patiently beyond. “I was told that this was neutral ground where I could complete my work undisturbed,” you say, finally. Your hands rest on your lap now, fingers aching from where you gripped the swivel chair armrests. “I was told that this was public ground.”

“Misinformed trespass is still trespass, hatchling.” Their tone of voice doesn't change, but something in the cadence of it makes your hand stray toward your ramen packs. “You've wandered across my threshold and barred the door. Surely even you know what that means.”

Deep breaths. Deep breaths. You raise your hands in a placating gesture. “I understand. I will-” Die? Get Taken? Tell the Spelunkers that their map is a piece of shit and they need better cartographers? “I will leave and remove the salt circle. I will find where the actual neutral zones are and leave your domain alone and not trespass on it again. And...”

And? Your brain insists that something is missing, but by now all you want to do is flee and never come back. “And yeah. Does that sound reasonable to you?”

There's a different sort of clicking now. It sounds like pincers. You swallow back the lump of shuddering fear and wait for their answer. The entire section of the library is quiet except for that awful sound. “Usually there are reparations for an offense such as this. But...” Oh God oh god what does it want now. “I see that you've already lost something. That would normally go to the offended party. But I have no use for your words. Go then, pupa.”

It’s already started to skitter away when you’ve finished processing what it said. “Wait!” You even reach out toward the shelves, almost tripping out your chair onto the salt circle. Your legs are practically wobbly enough to wriggle out of your own jeans. “My- the words! English. Do you have my words?”

“They say external ears are better for hearing. I think they're mistaken.” You don't have time for its coy amusement, but it has even less time for overt demands and careless students. You grit your teeth and wait. “I have no need of your words. But I know how to get them back. I could retrieve them for you, even. But, that would be a favor.” You catch a glimpse of something between a gap in the shelves and you look hurriedly away. There's only leather spines and library labels. There's nothing else worth looking at over there. “And I don't give those out readily, even to those who haven't offended me. That is my offer. You know what to do, pupa.”

Trade nothing you cannot afford to lose. But you've already lost- You screw your eyes shut and count to ten, in half-remembered high school Italian. Uno, due, tre... You get to “cinque” before you switch into Spanish by accident. Right. A peace offering. You look at your desk, at your backpack, glance down at your pockets.

Only one option stands out to you.

You pick up the map and throw it out at the room with a flick of the wrist. “Here,” you say, as it drifts down just outside of the yellow-y line of flavor powder. “A map. Designed by the best cartographers of my age.” In a manner of speaking. “Knowledge for knowledge. Use it to secure the borders of your domain.” You reach for your notebook, and while you can't read what it says, you recognize the formatting of the list. “Here is a copy, in my own writing. It is as a contract. Take it as confidence that I will learn and know the borders here, and not cross them, ever.”

There's a rush of movement and suddenly something with more legs than you can really perceive lunges out from behind the shelves. You can't help the scream of terror. (Nor the stream of pee either. Caffeine, what a diuretic.) The sheer speed of it blows your hair back, as if you were standing on a subway platform by an oncoming train. When it’s passed back into the shadows, you look down at your feet. The circle hasn’t moved at all.

“Do not let anybody say I am not fair,” it says. “I always give back equal to what is given in turn. You can have your letters back. I grant you 24 hours of grace period inside this building. That should be more than enough to settle whatever affairs you need to in here. Good morrow, pupa.” It slinks back into the library, the click of its legs blurring together like the sound of pouring sand. Once more, the only sound is from the phantom students on either side of you.

You collapse back into your chair, barely able to move. Thankfully, whatever that fae did seems to have worked. You can read your notes, and even the textbook again. The adrenaline rush of it all has thrown everything into sharp relief. You write with abandon, blasting through proofs and problems alike with new vigor. When you finally leave and walk back out into the late evening sun, you stumble back to bed and nearly sleep through your alarm. But the exam, after that ordeal, feels like a doctor’s visit. Longer than you wanted and a bit uncomfortable, sure. But nothing worse than that.

Psych dude doesn’t show up the next lecture, but you do see him during the break. Probably just came in late. You do that too, you know the feeling.

It isn’t until that weekend, when the exam comes back with a grade better than you could reasonably expect, that you get antsy.

When a about a row’s worth of people don’t show up to your systems biology midterm the week after, you upgrade to worry.

You really wish you could say that you contacted the Spelunkers Club before their page got shut down.  (Part 2?)

[dontbeallupinmyfriesdawg]

Drabble request: The year is 1915 and front-line soldier Enzo st John is wounded. With no chance of saving him, a special blonde angel of a nurse called Rebekah talks to him all night about everything they can think of. The fall in love in a single night. Refusing to let him die, the nurse turns him into a vampire. Before Klaus can find and kill him, she leaves Enzo, never to be seen again. Until of course, Enzo and Caroline show up in NOLA.

A/N: Written due to having this prompt knocking around my head for a while; as a response to this ^ prompt and also based off of this gifset by @fiercerebekah . 

I’d be remiss if I didn’t thank @austennerdita2533  who basically spent ages beta’ing this and made it 100x better than it was.

Includes Klaroline + Carenzo brotp.

1915

9:30 pm

Rebekah smoothed down her apron, nodding at a group of nurses standing together by the stairs. As she considered the last few weeks of her life, she allowed herself to be proud of the control she’d managed to exercise. Everywhere she turned, she was surrounded by copious amounts of blood. Blood in bags. Blood on sheets. Blood flecked against white walls. Blood spurting from limbs. Blood coating the muddied uniforms of wounded soldiers, the smell of it overpowering and pungent.

Still, despite this, Rebekah had managed to control her urges; rationing herself to three blood bags a day (breakfast, lunch, and dinner respectively) and requesting to be transferred out of the emergency ward, thus decreasing the amount of gushing wounds she’d have to see on a regular basis.

Never had she dreamed that tending to the injured and sick in the midst of such a gruesome war would give her such fulfilment. It felt good, knowing that after centuries of taking lives, she could restore some balance by saving a few.

Of course, Niklaus had disapproved strongly, just as he had disapproved of Marcel’s decision to join the soldiers in the trenches. But since - for once - he wasn’t physically stopping her (i.e: twisting a dagger into her chest cavity) Rebekah resolved to ignore Klaus’ taunts about her foolhardy, sentimental heart and follow it anyway.

It had been a particularly gruelling day. A fleet of fifteen men was rushed into her ward after an explosion went off in one of the battlegrounds. This meant it was all hands on deck to try and undo some of the carnage. Rebekah stifled a yawn as she headed back to her regular ward, the squeaking of her nurse’s shoes echoing through the corridor as she went. When she arrived, she paused momentarily to scan the row of beds, looking for one that didn’t have a nurse stationed by it.

Her eyes landed on a dark-haired man in the far corner of the room. He was what one might describe as roguishly handsome and as Rebekah came closer, she noticed a slight shadow of stubble on his cheeks. A bandage was wound tight around his left arm.

As a woman who’d always been able to appreciate beauty when she saw it, she couldn’t help but stare at the man as he slept - unprofessional though it was. She jumped in surprise as he began to stir, his eyes–rich, brown, and unfocused–meeting hers through hooded lids.

“Are you an angel?” he rasped, his accent distinctly British.

Rebekah smiled sweetly and shook her head, blonde curls bouncing underneath her nurse’s cap.

“Far from it.”

“You certainly look like one,” he murmured with a smirk, his eyes having yet to settle completely on her.

“I’m sure you say that to all the nurses,” Rebekah replied with an unimpressed scoff.

“Only if they’re as delightful as you.”

Despite his disoriented state, the soldier managed to shoot Rebekah a wink which earned him nothing but an eye roll.

“You can’t blame a man for trying,” he grinned. “A beautiful nurse standing over my bedside is quite the breath of fresh air after some of the things I’ve seen.”

Seeing the momentary flicker of distress in his eyes, Rebekah’s heart softened.

“That’s over now,” she said comfortingly,  allowing her hand to rest gently over his. “You’re safe here.”

“Careful, love,” the man hummed, lifting Rebekah’s hand and placing a kiss against her knuckles “One touch and I could skyrocket into fever delirium.”

Ignoring his laughter, she wrenched her arm free of his grip before he could finish his sentence.

“Name?” she demanded, picking up her clipboard.

“Whatever you’d like it to be a sweetheart.”

Rebekah huffed and searched until she located the brown folder that held all the patient documents.

“Lorenzo St John,” she read out loud.

He stuck out his hand.

“Enzo. Pleased and honoured to meet your acquaintance, George-”

Due to Rebekah unceremoniously shoving a thermometer into his mouth, glaring as if she dared him to remove it, his eyes widened and he fell silent. He lay still, obedient until she took it out herself to examine it.

“Well it appears you have a temperature,” she mused, scribbling something on her clipboard.

“Told you. Just one touch was all it took.”

“I’ll be back,” she said, ignoring him. “Try to get some rest.”

“I didn’t catch yours, gorgeous,” he called after her.

Rebekah turned and frowned. “My what?”

“Your name.”

“Nurse,” she replied curtly before turning on her heel and exiting the room. Enzo’s hearty laugh echoed down the corridor after her.

9:45 pm

“Hello, gorgeous.”

Rebekah skirted around the neighbouring bed and scowled, “Are you going to stop calling me that?”

“Depends,” he shrugged. “Are you going to tell me your name? Nurse.”

“No.”

“Might I enquire as to why?”

“Because it’s none of your business,” Rebekah answered, flashing him a saccharine smile.

While Enzo pouted rather comically, she pretended to check the time on her pocket watch.

“Hot date, sweetheart?” He smirked. “In that case, don’t let me hold you up.”

“Very funny,” Rebekah tutted.

“I do my best.” He shrugged, flashing her a lazy smile. “So, I have a proposition for you…”

“I’ll save you some time. No.”

“I’ll guess your name and if I guess correctly, you have to tell me.”

“No.”

“Excellent!” he continued unfazed. “Now, let me see, your name is… Claire?”

Rebekah scoffed.

“Really? I was sure I was right, you do strike me as a Claire.”

He frowned pensively and started at the stubble on his cheeks.

“Alright… er, let’s see Louise? Emily? Cassandra? Julie? Joanne? Amanda?”

Rebekah’s face remained impassive.

“Tatiana? Elizabeth?… Elena?”

“Hmph, hardly,” she said. For some reason or another, Rebekah had always detested that name. Elena. Yuck.

“Will you at least give me a clue?”

“No.”

“You’re a tough cookie to break,” Enzo said smiling wryly. “Luckily, I enjoy a challenge.”

Rebekah glared and almost retorted with some choice words of her own, but stopped herself when her Matron, Genevieve, appeared at the end of the corridor.

“Sister Rebekah!” she called.

“Yes, Matron?” she answered stiffly, allowing her eyes to flutter shut.

“When you’ve finished treating your patient, please come and find me in my office. I want to have a briefing session before the shift is over.”

“Yes, Matron.”

Genevieve gave her a tight smile before tottering back down the hall.

“Ah, Rebekah,” she heard Enzo hum, the syllables of her name gliding across his tongue. “How did I not guess that? A beautiful name for a beautiful woman.”

Rebekah shot him an irritated glance as she picked up her clipboard, but for the briefest of moments, her lip quirked upward.

“At some point, or at some time,” she said, “you’re going to run out of pretty words to say.”

Enzo smiled. As he did, Rebekah noticed for the first time the way his dimples cut into his cheeks. Rather unfair, she thought, for such a handsome man to be such a pain in the arse.

“Don’t tell me it’s not working?”

“Not in the slightest,” she answered with her nose lifted in the air, although her voice had lost the sharp edge to it.

10:05 pm

“Hello again.”

“Lorenzo,” Rebekah replied casually. “How many nurses have you flirted with since I left?”

“Not a single one. I’m a very loyal man, you see,” he winked.

Rebekah pressed her palm to his forehead. “You appear to be stable… physically anyhow,” she added, causing Enzo to chuckle.

A short silence followed as she made up the empty bed beside him. Once she finished, she turned to arrange the pillows more comfortably behind his head.

There was a short silence as Rebekah began making the now empty bed beside him. When she’d finished that, she turned and began arranging the pillows behind his head. Enzo propped himself up on his elbows and regarded her seriously.

Rebekah frowned, feeling self-conscious under his penetrating gaze. “What?”

“I’m curious about something….” Rebekah arched an eyebrow but didn’t interrupt. “What is someone as heavenly as you doing cleaning up sick and changing bedpans? I mean,” Enzo continued, swallowing a laugh, “it’s hardly the most glamorous job, sweetheart. Doesn’t all the blood turn your stomach?”

“Being a nurse is a lot more glamorous than it looks.”

“Oh, really? Perhaps I’ve missed something in my assessment?”

“Mhmm, the blood isn’t so bad. I’ve…learnt to cope with it,” Rebekah said. “Bedpan duty is for the new recruits and as the for the sick, if I’m lucky, most of the time the patient manages to aim the vomit in the other direction. And if not, I always keep an umbrella handy,” she shrugged.

Enzo’s eyes lit up as a stream of raucous laughter escaped him, gleeful that Rebekah had chosen to engage with him. His laughter was so infectious, Rebekah couldn’t help but join him. However, the mirth soon died down as a cough racked through his chest, sending him panting and heaving for breath as his fingers gripped the side of his bed for support.

“Okay, okay, easy now,” Rebekah offered soothingly. “It’s going to be alright I promise.” Placing a hand behind his head, she eased him back down onto the pillows.

The violent sputtering continued for several more minutes and attracted the attention of several other nurses, one of which took initiative and fetched Enzo a glass of water. Disgruntled, his face twisted as Rebekah brought the glass to his lips and encouraged him to take a sip.

“I don’t sup-suppose you have any gin, do you?” Enzo wheezed, a half-hearted grin sliding across his lips.

“Hush,” Rebekah said. “I need to take your temperature again.”

“S’what usually works for me…”

While he sipped from the glass, Rebekah shook her head and sighed, displeased. “You’re temperature’s gone up again.”

“I told you,” he coughed, “you have that effect on me.”

Cocking her head to the side, she examined the marked paleness of his features and the shallowness of his breathing and noted how different, how ill, he looked now compared to their first encounter. Despite the physical toll the coughing had taken on him, the exhaustion, Enzo still wore that familiar roguish grin.

“By the way,” his eyes roamed her form appreciatively, “that uniform you’re wearing? It’s the stuff dreams are made of.”

“Dirty bastard,” Rebekah chided. “You’ve been spending too much time in the trenches with the rest of those potty-mouthed troops and have forgotten how to speak to a lady.”

“You could be right.” He sunk down onto the mattress. “Or perhaps I’m just inept at expressing myself properly?”

“For example, what I wanted to say,” he said, “is that you’re lovely….and the prospect of seeing you every half hour or so is the only thing that makes me want to keep going.” He curled himself beneath his blanket. “The only thing.”

Breath hitched in her throat at the sincerity of his words, but before Rebekah could respond, he released a low sigh and allowed his eyes to flutter shut. Before long, the gentle rumble resounded from his chest and a melodic snore filled the room.

10:26 pm

“Tell me something you’ve never told anyone else.” Enzo prodded as Rebekah changed the bandage on his wrist.

Rebekah considered him with a coy smile as she changed the bandage on his wrist. “I’m a vampire.��

“Now who’s the comedian, gorgeous?” Enzo said with a chuckle.

Rebekah continued with her work dutifully until she felt Enzo’s eyes burning holes into her forehead in anticipation of her answer.

“Why don’t you go first?” she sighed.

“Mmm, well… let’s see. When I was young, I once stole an entire bag of toffees from the shelf in a store. Right out from under the shopkeeper’s nose.”

“Is that it?”

“What do you mean is that it? That’s a secret I’d intended to carry to my grave!” Enzo protested, a hint of humour evident on his face.

Rebekah rolled her eyes.

“You’re not in a confessional with a priest! I don’t want to hear about your childhood mischief, so either volunteer something real or forget it. I’m not taking this game seriously if you won’t.”

Enzo fell silent for a moment. His expression pensive.

“Alright,” he said at last, “here’s something real for you.”

Rebekah lifted her head and met his eyes, showing him he had her full attention.

“It terrifies me.”

“What does?”

“Death, dying. The finality of being gone I can deal with (I mean, it’s not like many people would notice if I went missing, anyway), but it’s the pain that gets me. It’s knowing, beyond a doubt, that this is about to be it,” he explained. “That everything you’ve done up until that moment–that final, ticking moment of your life–is set in stone.”

“It’s the realisation that you’re out of time. That you have no more chances left to undo any of the mistakes you’ve made along the way, no threads left to start over. Or to begin anew. What I truly fear,” he said, his tongue passing over his bottom lip, “is at the end of it all, at the end of my life…all I’ll have is nothing. I’ll have nothing and be nothing but useless and insignificant–a prime nobody. I’m afraid I’ll be a nobody who died in a pointless war.”

Enzo rubbed a hand across his chin. He avoided eye contact.

“But, uh, you aren’t supposed to admit any of that, right? That isn’t brave. That isn’t…” He laughed, but it came out hollow and weak. “That isn’t what men do, is it?”

Rebekah leant toward him slowly, then cupped his face in both hands. “What if you had the chance to start over? What if you were given an opportunity to live a life that wasn’t being wasted?” she asked.

Enzo studied her, his gaze steady and sharp. “I’d snatch it,” he answered huskily, “I’d grab it with both hands and never let it go.”

A short nurse, flustered and covered in blood, appeared at the end of the hall at that moment and halted their conversation.

“Sister!” she gasped at Rebekah. “You’re needed.”

11:50 pm

Taking the familiar route back down the hall, Rebekah checked her pocket watch again, only then realising how long she’d been gone.  When with Enzo it was as if she didn’t feel time, it was so easy for Rebekah to forget the war going on around her.

With another emergency, all the nurses in the division were on-call to treat the hordes of wounded soldiers trickling in from the newest battle. Rebekah let out a sigh of exhaustion (which was more emotional than physical). She spotted Edith, a tall, willowy nurse who had been stationed on her ward for the past few weeks down the way. Edith was attractive and blonde like Rebekah, except her hair was more of a white-ish/silvery colour and she wore it in looser curls.

Edith was also a bit of a gossip and everyone knew it. Which, ironically, was part of the reason Rebekah liked her so much.

“Hey there! I’ve been meaning to catch up with you lately, It’s such a shame that we run into each other for the first time in days during all this chaos,” she said as she gestured behind her.

“It is a pity, isn’t it?” Rebekah answered, allowing herself to be pulled into the small talk. “War is such an unfortunate thing,”

“Speaking of unfortunate, I am so sorry about your patient, Becks,” she drawled in her New York twang. “Ain’t it a shame? It’s always the handsome one’s.”

“What?” Rooted to the spot, her voice cracked. “What do you mean?”,

“Oh, you haven’t heard yet? He took a nasty turn while you were gone, pretty awful chest infection he’s got there. Matron doesn’t think he’ll live through the night.”

By the Edith finished speaking, Rebekah was already zipping down the corridor towards her ward, cursing the fact that she hadn’t had time to compel the chatty girl and vamp-speed to Enzo’s bedside.

When she finally reached him, her heart sank in her stomach. His face was drawn, his eyes were rimmed in blueish black dark circles, his cheeks were gaunt, and large beads of sweat ran down his forehead as he shivered beneath the bed linen. He was worse than she’d expected. How long had she been gone? An hour? Maybe two? No more than that, surely.

He forced his quivering limbs to still as she approached, attempting to look composed. Rebekah drew up the blanket and tucked it under his chin, then swiped cold compresses across his forehead in an effort to lower his fever. But she knew it was fruitless. Although she hadn’t been a nurse for long, she knew a dying man when she saw one.

“This is it, isn’t it?” he asked, blinking back moisture from the corner of his eyes.

“Hush. You’re going to be fine. I’ll have this temperature down by the morning,” she promised, the lie in her voice discernible.

“I can tell you don’t like games. Neither do I,” he sighed, his eyes hardening, “so give it to me straight, alright? You’re honest. You always have been with me, that’s what I like about you.”

“There’s a chance–”

He held up his hand, interrupting her. “Come on, gorgeous, I’m a big boy. I can handle it. Now tell me the truth,” he said, “I’m dying, aren’t I?”

Rebekah bowed her head in an effort to avoid his gaze, surprising herself when a large tear dropped from her eyelashes and slid down her cheek.

“Now, now, none of that,” Enzo said, reaching up to catch it on his pinky finger and swiping it away. “Those of us who are still young, gorgeous, and living, have no reason to cry.”

Rebekah let out a laugh despite herself, choking on the hot tears that’d suddenly lodged in her throat.

He grabbed her hand. The action was tender and comforting, similar to how she had calmed him only hours- though it felt longer- ago. “Tell me your thing,” he insisted.

“What–what thing?” she half-hiccuped.

“Tell me the one thing you’ve never told anyone else, not a single soul…what is it? I want to know.”

Before Rebekah could reply, Enzo launched into another coughing fit. Loud hacks and wheezes jerked his upper body and tiny spurts of blood flew out of his throat, causing him to gurgle and choke. Unable to catch his breath.

“Easy! Easy!” Rebekah implored.

“Tell. Me.”

“Okay, okay. I- uh…”

“There has to be s-something,” he gritted out.

Before she knew what she was doing or what she was saying, she blurted, “I’m afraid.

His forehead crinkled in concern, in confusion? It was difficult to tell.

“I’m terrified of ending up alone. I’m constantly surrounded by people and voices and bodies, so many tasks and responsibilities that I’m rarely granted two seconds for myself….and yet…and yet, I’m so desperately, hopelessly lonely. And I’ve felt this way for such a long, long time…but maybe this is what I deserve?”

“Stop.”

“God, you can’t begin to imagine all of the horrible things I’ve done,” Rebekah continued, not hearing him, “so maybe this is my penance. Maybe…maybe my punishment is to be alone forever?”

“Stop it. No pity parties, remember?” Enzo said, his voice resolved yet imploring. “You deserve the world, gorgeous, and if I had the strength to lift myself out of this bed without help right now, I’d sure as hell find a way to give it to you.”

At the end of his speech, Enzo lurched forward again. His entire chest constricted as harsh coughs split through him like a saw and robbed him of speech. And of breath. Rebekah’s mind whirled with thoughts as she eased him back down onto the bed.

She shouldn’t.

No, it was crazy. Risky. Impulsive.

Niklaus would be sure to find him–kill him–as soon as he discovered the truth of what she’d done. But what was the alternative? What other choice did she have?

“Gorgeous?”

“Listen to me,” Rebekah said in a low voice. She leant over his bedside and peered into his face, “You have a choice, alright? It doesn’t have to end this way, you…you don’t have to die.”

“What do you–” As spidery, ink-coloured veins crawled beneath her eyes and her sharp fangs punctured the delicate skin on her wrist, Enzo gasped and recoiled in horror. “What’s going on? Who…what are you?” he stuttered.

“Shhh! We don’t have much time,” Rebekah hissed. “Or rather, you don’t.”

She extended her bleeding wrist to him, but he gaped. Staring at it with a mixture of confusion and alarm.

“You have a choice: either die of a chest infection in this tiny hospital bed as another number, as just another soldier fighting for Queen and Country or Uncle Sam or whoever; or, you can live,” she said. “If you choose it, if you accept, I can heal you right here, right now with my blood…and you can leave this place. You can go anywhere, do anything you want…”

“For the sake of argument,” Enzo interrupted, rubbing a hand across his eyes as if trying to wipe away a feverish hallucination, “let’s say I believe you. Let’s say I think you are capable of healing me with your magic, cure-all blood…but then what?”

“Where would I go, what would I do? Forgive the cynicism, sweetheart, but I’m poor as dirt and the military have my paycheck in reserve, so dying seems like the most viable option for me under the circumstances, wouldn’t you agree?” he said.

“There is a third option.”

“Tell me.”

Rebekah winced as she forced the words from her mouth, “You can live forever. Like me, you can be strong and ageless and–”

“A vampire. I could be a vampire,” Enzo murmured, realisation and understanding now dawning over him.

“You can feel and experience all that the world has to offer, drowning your senses in everything you never thought you’d see. Hear. Taste.”

Enzo’s head spun and spun with possibilities, the room tilting and blurring his vision in cloudy pink as Rebekah hovered above him like a kaleidoscope and tore into her wrist again with teeth.

“There isn’t any time!” she exclaimed. “Take it. Take the blood or die.”

“I want it to be over,” he replied.

Rebekah’s hurt sunk. She wasn’t sure what response she’d been expecting, but it wasn’t that one.

“I–I can’t live this way anymore.” He sounded tired. His voice grew weaker and weaker, and pretty soon it would fade out altogether. “I don’t want this life.”

She withdrew her hand and nodded, “I understand.”

“Let me rephrase that,” he breathed, “I don’t want to just survive anymore. I want, I want to live.”

Rebekah’s eyes widened. “Are you saying–?”

“How bad does blood taste exactly?” Enzo asked as his eyes fluttered shut.

“Oh, God! Oh, God! Lorenzo…drink!” Rebekah pleaded desperately, shoving her wrist into his mouth and propping him up in her arms. “Come on, you handsome bloody idiot! Drink.”

Just as she considered all to be lost, she felt Enzo’s head stir ever so slightly against her chest.

He drank. And drank. Slowly at first, and then with urgency. As he did, colour restored to his face and his lungs cleared. It felt as if a weight had been lifted from his chest. That being said, a little nagging voice inside Enzo’s head craved more–and despite his better judgment–he latched hard and clung tightly onto Rebekah’s promise of forever.

“What happens now?” he asked.

“Now, you start the rest of your life; now, you get your freedom. Try not to waste it,” Rebekah whispered. Her voice was the last thing he heard before the world went black.

Present Day. New Orleans, Louisiana.

“That has to be the most bizarre story I have ever heard!” Caroline exclaimed.

She removed her hands from the steering wheel for the billionth time to gesture dramatically and Enzo winced. He adamantly regretted his decision to let her drive the rest of the way to New Orleans.

“No backseat driving.”

“I wouldn’t have to backseat drive if you were capable of actual driving,” he shot back, jetting backwards when Caroline’s balled fist landed hard against his chest.

“Seriously!? How is it that every vampire I manage to befriend has a mysterious past with an evil blonde Original who hates me? Ugh!”

“That’s a little harsh, love.”

“To hell it is!” Caroline bristled. “You have your version of Rebekah: the floating angel who saved you; and I have mine: the evil blood slut who tried to ruin my life.”

“And yet, here you are,” Enzo hummed, “going off in the same direction as I am in search for her equally (if not more) diabolical older brother.”

She stiffened.

“I have my… reasons for going to New Orleans to find Klaus. I told you it’s-”

“Complicated,” he nodded, “right. It’s fine, Caroline, you don’t need to explain the intricate, complexities of love to me. All I’m saying is let’s dial down the judgement a tad shall we?” he suggested.

Caroline flashed him a sheepish look before proceeding to run a stop sign. The fifth one so far. Enzo sighed softly, deciding not to mention it in the hopes that they wouldn’t be stopped again. He’d already compelled four officers away on this road trip, but he was growing peckish and a fifth one wouldn’t be so lucky to get away untasted.

A long, peaceful silence fell between them for a while and Enzo took the opportunity to gaze out the window and marvel at the scenery (fleeting, though, for Caroline was going at least 60 mph) while he reflected on the words he’d been rehearsing to say to Rebekah for decades now.

You saved my life. For that, I can never repay you.

“Aren’t you scared?” Caroline asked, abruptly breaking the silence and pulling Enzo from his thoughts.

“I know what you told me about your big, bad hybrid friend, and a lesser man than me might be intimidated.” He flexed his muscles playfully, which earned him an eye roll. “But something tells me I can take him,” he said.

Caroline gave him an unimpressed huff and shook her head.

“The issue of whether or not Klaus will allow you to keep your head did cross my mind, but that’s not what I was talking about. It’s only that–” She paused. Bit her bottom lip. “Are you sure you want to do this?” she asked.

“I mean, after everything you told me, what if we get there and…”

She trailed off, either unable or unwilling to finish her sentence.

“What if I get there and she wants nothing to do with me?” he said for her. “What if she doesn’t remember that I exist or if I’ve concocted some crazy, unrealistic fantasy of her in my head? What if she’s in love with someone else? Or, what if the moment our eyes meet again she regrets turning me and rips my heart from my chest? What if after all this time I learn that the whole vampire thing was nothing but a big, fat lie and she’s actually aged horribly and–”

“Enzo,” Caroline scolded, wanting him to be serious.

He sighed.

“These are all questions I’ve gone over in my head about a million times, Caroline.”

She flashed him a quizzical look as they continued to speed down the highway, “If you know all of this, then why risk it?”

“That’s the thing about hope,” he said with a laugh. “It can trick you into all sorts of hilarious, unrealistic scenarios.”

Caroline still looks unconvinced, so he continued.

“When I was a child, my parents kicked me out and sent me to the workhouse as soon as I could walk. I was poor and didn’t have many friends. I joined the army to become something, to be a part of something bigger than myself, to feel as if I was doing something worthwhile with my life…but all I got for my efforts was a broken hand, a bullet to my ribcage, and a deadly cold from being drenched to the bone. I was alone and insignificant and dying.”

“You know me as I am now, Caroline,” he continued, shaking his head. “But when I was lying in that hospital bed all those years ago, I had nothing. Nothing at all. Rebekah showed me that there was something out there beyond poverty, beyond the slow descent into alcoholism that other soldiers like me would slide into after the war. She gave me a life.”

“And I’m better now because of it,” he said. “Stronger. Smarter.”

“Yeah, but now you’re also a blood-sucking monster who feeds off innocent human flesh,” Caroline pointed out.

He shrugged. “Pot and Kettle, love.”

“The difference with me is that I didn’t ask to be turned; it was out of my control entirely! You, on the other hand–” Caroline chanced him a sideways glance, not quite disapproving but perhaps a little questioning; judgmental, “–you practically sold your soul to the devil gift-wrapped!” she said.

“My, you really do have a flair for the dramatics, don’t you?” Enzo chuckled.

“I’m only looking out for you.” Her voice was soft, her expression concerned. “I don’t to see you get hurt, that’s all.

“And I appreciate that, but here’s the thing,” Enzo explained, “it’s been nearly 140 years. That’s 113 I wouldn’t have had if Rebekah had never intervened.”

“I don’t want to date her, Caroline–” he paused, hope and resolve flickering in his eyes “–I want to thank her.”

New Orleans, The French Quarter.

The place was everything and nothing like Caroline had expected. They’d picked a good time to come to the city, for Mardi Gras was fast approaching and the French Quarter boomed with music and bright colours as tourists roamed the streets in search of excitement.

If their source was to be believed, they drew close to the Mikaelson mansion. Caroline felt the bile rise in her stomach as she and Enzo continued to progress through the streets, knowing all the things he’d said in the car rang true for her, too. 

What if this was a mistake and Klaus didn’t want to see her? Or what if he’d long forgotten the promise he’d made to her those years ago?

She shot her friend a look, curious to see if he shared any of her apprehension, but his expression was tranquil. Annoyingly so. Then again, looks could be deceiving.

A few twists and turns later and they stood outside a grandiose residence tucked away at the end of a long stretch of road.

Typical Klaus, Caroline thought. Of course he wouldn’t live in a house of normal proportions. Figures.

“Are you ready for this?” Enzo asked.

“About as ready as I’ll ever be,” she said.

The Mikaelson Mansion, The French Quarter

Unsurprisingly, Klaus apprehended them as soon as their feet crossed the threshold. He pounced on Enzo, who crossed into his line of vision first, and pressed him against the wall in a choke hold demanding to know why he was trespassing on his property. Caroline fought an eye roll. She cleared her throat, making her presence known.

“Caroline?”

“Hello Klaus,” she replied nonchalantly despite the tightness in her chest. “I should’ve known the next time I saw you you’d attempt to murder yet another one of my friends.”

Snapping out of his blind rage, he released his grip on Enzo’s neck, allowing him to collapse onto the ground with a loud thud. He stalked towards Caroline as if in a disbelieving trance.

“To be fair, sweetheart,” he smirked, “you always did have the most unfortunate taste in friends.”

The sight of him before her stirred feelings in the pit of her stomach. Feelings that, on previous occasions, she would have shoved down or away in stubborn denial–but she was done with all that now. She’d had a long time to think about what she wanted.

Shaking herself from her thoughts, she realised that both Klaus and Enzo stared at her…waiting. Waiting for her to say something. Anything.

The courage Caroline had mustered during the drive slowly began to evaporate. Smiling nervously, she gestured at Enzo, “I did tell him that he should probably wait in the car,” she said.

Enzo glared, still rubbing his bruised neck, as Klaus flashed before her with an intensity in his expression that made her shiver. “Why have you come?” he asked in a whisper.

“Is there….is there somewhere we can talk?”

This trip had seemed so much better in theory. But in practice, it was terrifying. For, standing before her was Klaus: the living representation of everything she’d never allowed herself to have. Expectant yet curious, he looked conflicted as he considered the accompanying male by her side. (Most likely pondering the reason for his trespassing)

“Enzo’s with me.” He stiffened at this. She shook her head, reading his mind, and continued, “No, not with me, with me. He’s here because…well…it’s actually a pretty long and complicated story but–”

“You wouldn’t happen to know where I can find Rebekah, would you?” Enzo cut in, having found the strength - or the courage - to rise to his feet.

Klaus’ expression darkened. “What could you possibly want with my sister?”

“Like the lady said,” he answered, “it’s complicated.”

Klaus growled at his insolence. Caroline fretted as he advanced, racking her brains in an effort to find a solution to diffuse the situation before it escalated into more murderous directions.

“Niklaus,” a voice drifted from the staircase, “I heard voices, what is–”

Rebekah, clad in eight-inch heels, khaki shorts, and a white chiffon blouse, halted in the middle of the stairs. Gaping. “Lorenzo?”

Silence lingered for what felt like hours and the air thickened with tension, with things that had been left unsaid for far too long.

“Hello Gorgeous,” he said at last.

Caroline felt the interjection ready to burst from Klaus’ lips as he glared venomously between the couple, so she tugged the sleeve of his Henley and fixed him with wide, puppy dog eyes (a distractionary tactic she’d always found to be useful). “Klaus,” she purred as she dragged him from the room, “how about that talk now, hm?”

Once alone, an eerie muteness stretched out between Rebekah and Enzo as they faced one another. It was Rebekah who first cut into the soundlessness, she face the colour of a sheet.

“What are you doing here?” she asked sounding breathless like the wind had been knocked out of her.

“Now isn’t that the question.” He expelled a shaky, humourless laugh and took a cautious step forward, afraid that moving too fast would spook her.

“It’s funny,” he said, “I’ve spent over a century attempting to figure out what I wanted to say to you, but seeing you here, in front of me now I…”

“How did you find me?”

“The wonders of technology. Word of mouth.” He gestured vaguely. “Does it matter?”

Rebekah circled him, all the all the while maintaining a safe distance between them. “It’s been over a century. Why now? Why track me down now, out of the blue like this?” she asked.

“Funny thing about vampirism,” he quipped, “it comes with certain complications. Most of which you failed to warn me about.”

“So this is revenge? You’re holding a grudge against me for saving your life?” Her gaze narrowed. “I think you’ve conveniently forgotten about the choice I gave you, Lorenzo.”

Enzo took another calculated step towards Rebekah, this time causing her to quail in response.

“You mistake me, sweetheart. I am not here for revenge,” he said, “I am here to thank you.”

She smiled ever so slightly. “I appreciate that.”

“If you hadn’t found me, I would have died. You gave me back purpose and I came here to let you know how much that meant to me, how much you mean to me. After all this time.”

“Well, I certainly hope you took my advice and haven’t wasted what was given to you?” she countered, her breathing normalising.

He grinned. “Not a single second have I wasted.”

Tenuously, Rebekah edged toward him until her palm ghosted over his cheek. Although she smiled, her eyes were tinged with sadness.

“You haven’t changed,” she whispered.

She lingered for a moment and then took a step back as if realising her mistake. “You shouldn’t have come.”

“I beg your pardon?” Enzo blinked.

“I said, you shouldn’t have come. This was a mistake! You–you finding me was a mistake.”

“I don’t understand–”

“You should leave,” she interjected. “You should go, Lorenzo. You should leave now”

Without any further explanation, Rebekah flashed away, leaving Enzo alone in the foyer.

Klaus sighed impatiently. Caroline had her ear pressed up against the door and one eye squinted shut in concentration.

“Sweetheart, I thought the entire object of you and I coming up here was to discuss your sudden appearance in my city?”

“Oh, grow up Klaus,” Caroline said with a scoff. “I only came here to give those two some privacy while I eavesdropped.”

Klaus muttered something about shenanigans going on under his roof until she shushed him with a frantic wave of the hand.

“What is going on down there!?”

“If the the sound of my sister’s expensive Louboutins shuffling up the stairs is anything to go by, I’d say the conversation is over,” he mused with disinterest.

Caroline’s eyes widened. She wrenched open the door just as Rebekah moved down the hall and said, “What the hell happened?”

“That’s hardly any of your business.”

Rebekah attempted to sidestep her, but found her path blocked.

“Where’s Enzo?”

She shrugged. “Gone I assume.”

“Gone?” Caroline gaped.

“My goodness, don’t tell me you really are as stupid as you look! Yes, gone.”

“Why!? What did you say to him?”

Rebekah sighed as she manoeuvred past her, “Lorenzo came here looking for someone who doesn’t exist anymore. I did him a favour.”

“You’re a coward.” Caroline hurled the word like an arrow at her back, stopping Rebekah in her tracks.

“What did you just bloody say to me?!” she accused, her voice growing shrill.

“Don’t you remember all the time and energy you spent trying to rip Stefan and Elena apart in Mystic Falls so you could have him all to yourself? Or how you spent an entire year stealing my life in order to live out some contrived high school experience you never had? Or what about when you put all of our lives in danger because you wanted the cure-all for yourself?”

“All of this you did in the name of happiness, right? And where did it get you?” Caroline asked, her gaze sharp and her words biting. “Where?”

“Enzo’s a good guy,” she continued. “He’s a good guy who’s been pining for you for over a century. You’d be lucky to have a guy like him in your life, okay? Damn lucky.”

“You want to know why you’re a coward, Rebekah?” Caroline took a step forward and peered straight and hard into her face. “You’re a coward because a chance at real happiness stood right in front of you and you let him waltz right out of your life. You let him walk away.”

“You know nothing about me, Caroline Forbes! Nothing about us!” Rebekah seethed.

Caroline squared her shoulders and raised her chin defiantly. “Maybe I know more than you think,”

5:15 pm, Somewhere in the French Quarter.

He’d been wandering the streets of New Orleans for about an hour now. Of course, it was only after travelling four blocks that he’d remembered that he left the car keys with Caroline. He was stuck.

Typical.

Taking a kick at a bottle lying near his feet, Enzo cursed himself for being so stupid. Of course, Rebekah wanted nothing to do with him! What’d he expect? He was nothing but a poor soldier lying on his deathbed who she’d taken pity on in a moment of weakness. He was nothing to her. She was a vampire, vampires did not feel; they did not love.

No matter, Mardi Gras would drown his sorrows with its booze and tourists–both to be drunk.

“Lorenzo?”

His name sounded faint on those lips. The voice calling him was painfully familiar (a sound that had haunted his thoughts for over a hundred years now) and yet, he ignored it. He pretended he didn’t hear it. He was deaf.

“Lorenzo!” the voice called again. “Please, I know it’s you. I know you can hear me.”

Rebekah sighed with relief as Enzo finally stopped and turned, but her gut wrenched when she saw the expression on his face.

“Come to make sure you’d gotten rid of me, I see?” Don’t worry, gorgeous,” he said, his tone hard, “I’m leaving. I just need to make sure Caroline’s okay first.”

Rebekah shoved down the burning questions that sprang to mind about Caroline and her relation to Enzo to explain herself instead.

“I came to apologise,” she blurted with an exhale of breath. “How I behaved…I–I shouldn’t have treated you like that. It was rude, and I’m sorry.”

“Was there anything else?” he replied cooly.

“Yes, actually.” Rebekah paused, looking away. “I’m sorry, Lorenzo, but I’m afraid I don’t understand?”

“What do you mean?”

“You came all this way to find me…why?”

“I told you why ” Enzo answered.

“Just to thank me?”

He inhaled deeply.

“Do you remember what you told me all those decades ago? Your deepest confession?” he asked. “You told me what you feared most was that you’d end up on your own, all alone. Is that still true?”

Rebekah shifted uncomfortably, “Eternity is a long time,” she sighed.

“It is, isn’t it?”

“Tell me something–” he slid his hands into his jean pockets “–why did you come after me?”

“I–I didn’t want things to end this way, I suppose. I didn’t want you to walk away and hate me,” Rebekah answered bashfully.

Without either of them realising it, they had drifted nearer. Close enough to touch.

“I could never hate you, gorgeous.”

Rebekah felt a familiar surge of affection brewing in her chest.

“Look,” she started, “I’m not the angel you think I am I–”

“I’m certain of it,” Enzo cut in with a smirk.

Rebekah smiled demurely. “You really haven’t changed at all, have you?”

He gazed at her fondly for a moment.

“Look, I’m not saying we should find a chapel and get hitched. I’m saying…” He paused and gazed at her fondly for a moment. “I’m saying, maybe get to know me? Take some time to see the man that I’ve become?” he suggested.

“And then, after that, if you still can’t stand me you’re perfectly within your rights to run for the hills.”

“That’s a reasonable request I suppose,” she nodded, reining in her amusement. “But you need to stop looking at me like that if we decide to go steady.”

“Looking at you like what?” Enzo asked pretending to be aghast.

“Like. That.” Rebekah insisted, removing what little space there was between them to wrap her arms around his neck.

“Can’t help it,” he murmured. “You’re still the most beautiful thing my eyes have ever seen.”

Without wasting any more time, Rebekah closed the gap between them entirely by brushing her lips against his in a slow, tender kiss that left him lightheaded. Enzo planned to savour this moment, the one that he’d dreamt of for a large portion of his life, but his ardour got the better of him as he pulled Rebekah harder against him and wrapped his strong arms around her.

“You should consider yourself lucky. I don’t wear down a perfectly good pair of heels on these streets searching for just anyone,” she said when they drew back.

“Oh trust me,” Enzo beamed, “I consider myself the luckiest man in the world.”

Fin.

[oovitus]

Ask a Doc: Caring for Older Adults

In our Ask a Doc series, we sit down with physicians and other clinical experts across Highmark’s health plan networks, including at Allegheny Health Network (AHN), for a chat on an important health topic. In this post, AHN’s Dr. Lyn Weinberg discusses her work with older adults.

We’re getting older in the U.S. The nation’s median age rose from 28 in 1975 to 37.9 in 2016, and the number of people 65 or older grew from 35 million in 2000 to 49.2 million in 2016.

As our population continues to age, it’s vital that health care systems adapt to meet the needs of older patients. To start, Dr. Lyn Weinberg of Allegheny Health Network (AHN) stresses that preconceived notions of what aging looks like must be discarded.

“Older adults are heterogeneous,” she says. “I see 85-year-olds who are in great shape and working or volunteering in their spare time. I also see 85-year-olds who are in hospice. One treatment might work well for one patient, but not for the other. It’s so important to treat each patient personally and individualize their care.”

Dr. Weinberg was recently named the new Division Director for Geriatrics at AHN. In her position, she’ll work to operationalize and standardize geriatric care across the network while also continuing to practice.

During our conversation at the cafeteria of West Penn Hospital, Dr. Weinberg discussed her work with AHN, how she approaches geriatric care, and her vision for geriatric care delivery.

The Next Generation of Care

Nikki Buccina (NB): Being a younger doctor, what’s it like to provide cross-generational care?

Dr. Lyn Weinberg, Division Director for Geriatrics at Allegheny Health Network

Dr. Lyn Weinberg (LW): I get a lot of comments about how young I look, but it’s in good faith. There’s a special bond between younger and older generations. I had my first baby at the beginning of last year and I could see that it definitely brightened my patients’ days to share that with me. I had patients bring me gifts, knit things for me — it made that connection even closer.

NB: Are health care providers who specialize in geriatric care in high demand?

LW: I would say geriatricians are in high demand, but there may never be enough geriatricians to meet that demand. In my role, I like to focus on educating clinical trainees and other primary care doctors on quality geriatric care, because it’s going to be delivered by almost all health care providers.

I believe that as a geriatrician, it’s also my responsibility to be an educator. I want to help all health care providers better understand care delivery for older adults and the nuances within that — it’s why I’m so passionate about incorporating geriatrics education into residency training. We have a very robust geriatric curriculum for our resident trainees here at AHN and I’ve gone through a formal fellowship as part of my training.

NB: Can you talk more about what a fellowship in geriatric medicine entails?

LW: A fellowship in geriatric medicine is a year of training beyond internal medicine. It focuses on issues that affect older adults, and the curriculum that falls outside of typical medical training, dipping more into the psychosocial area.

In particular, it looks at how to navigate an older adult through the health care system and place a focus on available resources as well as issues that affect older adults like low vision, hearing or even urinary incontinence. I know it’s not very glamorous. But it’s important.

Another important part of this training focuses on how to best manage polypharmacy in older adults. One way to define polypharmacy is any patient who is taking more than four medications, which is pretty much everybody in geriatric populations. It can be a major factor in health-related complications, so in a training program someone may cover how to ask questions in practice like “how can we cut this down?” or “is there something we should be using instead?”

Lastly, providers learn more about the best methods to manage end-of-life issues and dementia.

Caring for Older Patients

NB: What drew you to working with older adults?

LW: I just have a soft spot for older adults; I don’t know what else to say. I love the complexity of care in older adults. There are standardized guidelines in medicine about how to take care of heart attacks, hypertension, you name it, but many of those guidelines came out of research and studies which didn’t include real-world geriatric patients. So, when I’m working with older patients, it’s really about individualizing their care and going one step beyond the guidelines.

I also enjoy working with families to meet end-of-life goals for the patient, and the way caring for older adults relies heavily on multidisciplinary teams. It’s not just what I think, it’s also the professional opinions of therapists, social workers, pharmacists and more.

NB: What is your perspective of palliative and end-of-life care?

LW: The word palliative in medicine means to relieve suffering, and that should be part of practice �� I don’t know if we necessarily need to send someone to a different doctor. As for end of life, I find it rewarding to work alongside a patient and their family to make sure the patient dies with dignity. If they have goals to die at home without pain, it’s crucial that we do everything we can to meet those goals.

I have had to personally change the way I think about palliative and end-of-life care because I have my own idea on what a good death looks like, but that’s not the same for everybody. There are some patients who need to feel that they’ve tried every aggressive measure at the expense of what I would consider to be a good quality of life. Over the last five years, I’ve learned to meet people where they are and support them through whatever they decide for themselves.

NB: You were instrumental in standing up the HELP program at AHN. Can you tell us more about why you thought it was important to implement this national program and where you’re going with it?

LW: Throughout my residency, fellowship and beyond, I saw some of the hazards of hospitalization for the elderly. When they are admitted, the process is normally that they’re put to bed, restricted from walking (which stems from a fear that they will fall), and they can quickly become deconditioned. Especially when you take into account the new faces, new sounds and alarms, interrupted sleep patterns and even different medications, all of this can cause older adults to become extremely disoriented, which can cause delirium, or acute confusion.

Personally, I think that’s just heartbreaking. Someone comes to the hospital to get better, but there’s this risk with older adults that they may leave better on paper but with more disability than when they came into the hospital.

The HELP program is great because it focuses on the prevention of delirium and acute confusion in older adults. It’s a common-sense approach. We have volunteers who help seniors stay awake during the day so they can sleep better at night, give them a newspaper so they can read the date, have conversations with them — it’s a strategic approach to keep their minds active and engaged throughout their stay. It’s just good care.

We started HELP here at West Penn, and we also introduced it at Allegheny General Hospital (AGH) in June. It’s been going extremely well — we’ve already seen 160 patients at AGH, and at West Penn we’ve seen more than 2,000 patients since its launch in May 2016.

NB: What program or initiative, outside of HELP, are you excited about in terms of AHN’s care for seniors?

LW: We have a formalized program with the trauma surgeons at AGH. When patients who are 75 years or older are admitted to the hospital for trauma service, they are also now seen by one of our geriatric practitioners who will then follow them throughout their entire stay.

The majority of trauma-related admittance for older adults is caused by falling. The trauma surgeons are amazing at managing the injury, but always appreciate further guidance on managing the cause of the older adult’s fall.

Our geriatric practitioners are able to talk to the patient about their health goals, or if the situation is severe enough, their end-of-life goals. This has been an extremely successful program and we’re hoping to introduce it at Forbes Hospital in the near future.

Improving Care for an Aging Population

NB: Is there ageism in the U.S. health care system?

LW: It’s huge. Ageism can be found mostly at the hospital level, especially if the patient develops delirium. To take just one example, if a patient is a little confused one day during his or her stay, some doctors may quickly jump to dementia. If a chronic condition like dementia is on your chart — it doesn’t just go away.

So a year later, I may see that same patient who has dementia written all over the chart and they’re completely fine, but if dementia is on the chart, the patient might not be a candidate for certain treatments or surgeries because of that.

It’s important that clinicians take their time with older adults and be patient. It can be difficult, especially when working with a patient who may have low hearing or other challenges, but it’s important to ensure the highest quality of care.

NB: Is there an area where providers could focus more when it comes to improving care for older adults?

LW: I hope to guide other providers to keep the big picture in mind. Older adults have a lot of different medical issues going on and some of them see a variety of specialists. I think clinicians have the best intentions but can sometimes solely focus on their “organ system” or area of specialty, and then a patient’s care can quickly become fragmented.

We need to ensure that with geriatric patients we’re focusing on the person, and we’re looking at the whole person and the whole picture. It’s a rewarding thing to work with these patients and their families in this season of their lives and to look beyond just the medical aspects of their care, but also care for their psychosocial needs as well.

Ask a Doc: Caring for Older Adults published first on https://storeseapharmacy.tumblr.com

[oovitus]

Ask a Doc: Caring for Older Adults

In our Ask a Doc series, we sit down with physicians and other clinical experts across Highmark’s health plan networks, including at Allegheny Health Network (AHN), for a chat on an important health topic. In this post, AHN’s Dr. Lyn Weinberg discusses her work with older adults.

We’re getting older in the U.S. The nation’s median age rose from 28 in 1975 to 37.9 in 2016, and the number of people 65 or older grew from 35 million in 2000 to 49.2 million in 2016.

As our population continues to age, it’s vital that health care systems adapt to meet the needs of older patients. To start, Dr. Lyn Weinberg of Allegheny Health Network (AHN) stresses that preconceived notions of what aging looks like must be discarded.

“Older adults are heterogeneous,” she says. “I see 85-year-olds who are in great shape and working or volunteering in their spare time. I also see 85-year-olds who are in hospice. One treatment might work well for one patient, but not for the other. It’s so important to treat each patient personally and individualize their care.”

Dr. Weinberg was recently named the new Division Director for Geriatrics at AHN. In her position, she’ll work to operationalize and standardize geriatric care across the network while also continuing to practice.

During our conversation at the cafeteria of West Penn Hospital, Dr. Weinberg discussed her work with AHN, how she approaches geriatric care, and her vision for geriatric care delivery.

The Next Generation of Care

Nikki Buccina (NB): Being a younger doctor, what’s it like to provide cross-generational care?

Dr. Lyn Weinberg, Division Director for Geriatrics at Allegheny Health Network

Dr. Lyn Weinberg (LW): I get a lot of comments about how young I look, but it’s in good faith. There’s a special bond between younger and older generations. I had my first baby at the beginning of last year and I could see that it definitely brightened my patients’ days to share that with me. I had patients bring me gifts, knit things for me — it made that connection even closer.

NB: Are health care providers who specialize in geriatric care in high demand?

LW: I would say geriatricians are in high demand, but there may never be enough geriatricians to meet that demand. In my role, I like to focus on educating clinical trainees and other primary care doctors on quality geriatric care, because it’s going to be delivered by almost all health care providers.

I believe that as a geriatrician, it’s also my responsibility to be an educator. I want to help all health care providers better understand care delivery for older adults and the nuances within that — it’s why I’m so passionate about incorporating geriatrics education into residency training. We have a very robust geriatric curriculum for our resident trainees here at AHN and I’ve gone through a formal fellowship as part of my training.

NB: Can you talk more about what a fellowship in geriatric medicine entails?

LW: A fellowship in geriatric medicine is a year of training beyond internal medicine. It focuses on issues that affect older adults, and the curriculum that falls outside of typical medical training, dipping more into the psychosocial area.

In particular, it looks at how to navigate an older adult through the health care system and place a focus on available resources as well as issues that affect older adults like low vision, hearing or even urinary incontinence. I know it’s not very glamorous. But it’s important.

Another important part of this training focuses on how to best manage polypharmacy in older adults. One way to define polypharmacy is any patient who is taking more than four medications, which is pretty much everybody in geriatric populations. It can be a major factor in health-related complications, so in a training program someone may cover how to ask questions in practice like “how can we cut this down?” or “is there something we should be using instead?”

Lastly, providers learn more about the best methods to manage end-of-life issues and dementia.

Caring for Older Patients

NB: What drew you to working with older adults?

LW: I just have a soft spot for older adults; I don’t know what else to say. I love the complexity of care in older adults. There are standardized guidelines in medicine about how to take care of heart attacks, hypertension, you name it, but many of those guidelines came out of research and studies which didn’t include real-world geriatric patients. So, when I’m working with older patients, it’s really about individualizing their care and going one step beyond the guidelines.

I also enjoy working with families to meet end-of-life goals for the patient, and the way caring for older adults relies heavily on multidisciplinary teams. It’s not just what I think, it’s also the professional opinions of therapists, social workers, pharmacists and more.

NB: What is your perspective of palliative and end-of-life care?

LW: The word palliative in medicine means to relieve suffering, and that should be part of practice — I don’t know if we necessarily need to send someone to a different doctor. As for end of life, I find it rewarding to work alongside a patient and their family to make sure the patient dies with dignity. If they have goals to die at home without pain, it’s crucial that we do everything we can to meet those goals.

I have had to personally change the way I think about palliative and end-of-life care because I have my own idea on what a good death looks like, but that’s not the same for everybody. There are some patients who need to feel that they’ve tried every aggressive measure at the expense of what I would consider to be a good quality of life. Over the last five years, I’ve learned to meet people where they are and support them through whatever they decide for themselves.

NB: You were instrumental in standing up the HELP program at AHN. Can you tell us more about why you thought it was important to implement this national program and where you’re going with it?

LW: Throughout my residency, fellowship and beyond, I saw some of the hazards of hospitalization for the elderly. When they are admitted, the process is normally that they’re put to bed, restricted from walking (which stems from a fear that they will fall), and they can quickly become deconditioned. Especially when you take into account the new faces, new sounds and alarms, interrupted sleep patterns and even different medications, all of this can cause older adults to become extremely disoriented, which can cause delirium, or acute confusion.

Personally, I think that’s just heartbreaking. Someone comes to the hospital to get better, but there’s this risk with older adults that they may leave better on paper but with more disability than when they came into the hospital.

The HELP program is great because it focuses on the prevention of delirium and acute confusion in older adults. It’s a common-sense approach. We have volunteers who help seniors stay awake during the day so they can sleep better at night, give them a newspaper so they can read the date, have conversations with them — it’s a strategic approach to keep their minds active and engaged throughout their stay. It’s just good care.

We started HELP here at West Penn, and we also introduced it at Allegheny General Hospital (AGH) in June. It’s been going extremely well — we’ve already seen 160 patients at AGH, and at West Penn we’ve seen more than 2,000 patients since its launch in May 2016.

NB: What program or initiative, outside of HELP, are you excited about in terms of AHN’s care for seniors?

LW: We have a formalized program with the trauma surgeons at AGH. When patients who are 75 years or older are admitted to the hospital for trauma service, they are also now seen by one of our geriatric practitioners who will then follow them throughout their entire stay.

The majority of trauma-related admittance for older adults is caused by falling. The trauma surgeons are amazing at managing the injury, but always appreciate further guidance on managing the cause of the older adult’s fall.

Our geriatric practitioners are able to talk to the patient about their health goals, or if the situation is severe enough, their end-of-life goals. This has been an extremely successful program and we’re hoping to introduce it at Forbes Hospital in the near future.

Improving Care for an Aging Population

NB: Is there ageism in the U.S. health care system?

LW: It’s huge. Ageism can be found mostly at the hospital level, especially if the patient develops delirium. To take just one example, if a patient is a little confused one day during his or her stay, some doctors may quickly jump to dementia. If a chronic condition like dementia is on your chart — it doesn’t just go away.

So a year later, I may see that same patient who has dementia written all over the chart and they’re completely fine, but if dementia is on the chart, the patient might not be a candidate for certain treatments or surgeries because of that.

It’s important that clinicians take their time with older adults and be patient. It can be difficult, especially when working with a patient who may have low hearing or other challenges, but it’s important to ensure the highest quality of care.

NB: Is there an area where providers could focus more when it comes to improving care for older adults?

LW: I hope to guide other providers to keep the big picture in mind. Older adults have a lot of different medical issues going on and some of them see a variety of specialists. I think clinicians have the best intentions but can sometimes solely focus on their “organ system” or area of specialty, and then a patient’s care can quickly become fragmented.

We need to ensure that with geriatric patients we’re focusing on the person, and we’re looking at the whole person and the whole picture. It’s a rewarding thing to work with these patients and their families in this season of their lives and to look beyond just the medical aspects of their care, but also care for their psychosocial needs as well.

Ask a Doc: Caring for Older Adults published first on

[oovitus]

Ask a Doc: Caring for Older Adults

In our Ask a Doc series, we sit down with physicians and other clinical experts across Highmark’s health plan networks, including at Allegheny Health Network (AHN), for a chat on an important health topic. In this post, AHN’s Dr. Lyn Weinberg discusses her work with older adults.

We’re getting older in the U.S. The nation’s median age rose from 28 in 1975 to 37.9 in 2016, and the number of people 65 or older grew from 35 million in 2000 to 49.2 million in 2016.

As our population continues to age, it’s vital that health care systems adapt to meet the needs of older patients. To start, Dr. Lyn Weinberg of Allegheny Health Network (AHN) stresses that preconceived notions of what aging looks like must be discarded.

“Older adults are heterogeneous,” she says. “I see 85-year-olds who are in great shape and working or volunteering in their spare time. I also see 85-year-olds who are in hospice. One treatment might work well for one patient, but not for the other. It’s so important to treat each patient personally and individualize their care.”

Dr. Weinberg was recently named the new Division Director for Geriatrics at AHN. In her position, she’ll work to operationalize and standardize geriatric care across the network while also continuing to practice.

During our conversation at the cafeteria of West Penn Hospital, Dr. Weinberg discussed her work with AHN, how she approaches geriatric care, and her vision for geriatric care delivery.

The Next Generation of Care

Nikki Buccina (NB): Being a younger doctor, what’s it like to provide cross-generational care?

Dr. Lyn Weinberg, Division Director for Geriatrics at Allegheny Health Network

Dr. Lyn Weinberg (LW): I get a lot of comments about how young I look, but it’s in good faith. There’s a special bond between younger and older generations. I had my first baby at the beginning of last year and I could see that it definitely brightened my patients’ days to share that with me. I had patients bring me gifts, knit things for me — it made that connection even closer.

NB: Are health care providers who specialize in geriatric care in high demand?

LW: I would say geriatricians are in high demand, but there may never be enough geriatricians to meet that demand. In my role, I like to focus on educating clinical trainees and other primary care doctors on quality geriatric care, because it’s going to be delivered by almost all health care providers.

I believe that as a geriatrician, it’s also my responsibility to be an educator. I want to help all health care providers better understand care delivery for older adults and the nuances within that — it’s why I’m so passionate about incorporating geriatrics education into residency training. We have a very robust geriatric curriculum for our resident trainees here at AHN and I’ve gone through a formal fellowship as part of my training.

NB: Can you talk more about what a fellowship in geriatric medicine entails?

LW: A fellowship in geriatric medicine is a year of training beyond internal medicine. It focuses on issues that affect older adults, and the curriculum that falls outside of typical medical training, dipping more into the psychosocial area.

In particular, it looks at how to navigate an older adult through the health care system and place a focus on available resources as well as issues that affect older adults like low vision, hearing or even urinary incontinence. I know it’s not very glamorous. But it’s important.

Another important part of this training focuses on how to best manage polypharmacy in older adults. One way to define polypharmacy is any patient who is taking more than four medications, which is pretty much everybody in geriatric populations. It can be a major factor in health-related complications, so in a training program someone may cover how to ask questions in practice like “how can we cut this down?” or “is there something we should be using instead?”

Lastly, providers learn more about the best methods to manage end-of-life issues and dementia.

Caring for Older Patients

NB: What drew you to working with older adults?

LW: I just have a soft spot for older adults; I don’t know what else to say. I love the complexity of care in older adults. There are standardized guidelines in medicine about how to take care of heart attacks, hypertension, you name it, but many of those guidelines came out of research and studies which didn’t include real-world geriatric patients. So, when I’m working with older patients, it’s really about individualizing their care and going one step beyond the guidelines.

I also enjoy working with families to meet end-of-life goals for the patient, and the way caring for older adults relies heavily on multidisciplinary teams. It’s not just what I think, it’s also the professional opinions of therapists, social workers, pharmacists and more.

NB: What is your perspective of palliative and end-of-life care?

LW: The word palliative in medicine means to relieve suffering, and that should be part of practice — I don’t know if we necessarily need to send someone to a different doctor. As for end of life, I find it rewarding to work alongside a patient and their family to make sure the patient dies with dignity. If they have goals to die at home without pain, it’s crucial that we do everything we can to meet those goals.

I have had to personally change the way I think about palliative and end-of-life care because I have my own idea on what a good death looks like, but that’s not the same for everybody. There are some patients who need to feel that they’ve tried every aggressive measure at the expense of what I would consider to be a good quality of life. Over the last five years, I’ve learned to meet people where they are and support them through whatever they decide for themselves.

NB: You were instrumental in standing up the HELP program at AHN. Can you tell us more about why you thought it was important to implement this national program and where you’re going with it?

LW: Throughout my residency, fellowship and beyond, I saw some of the hazards of hospitalization for the elderly. When they are admitted, the process is normally that they’re put to bed, restricted from walking (which stems from a fear that they will fall), and they can quickly become deconditioned. Especially when you take into account the new faces, new sounds and alarms, interrupted sleep patterns and even different medications, all of this can cause older adults to become extremely disoriented, which can cause delirium, or acute confusion.

Personally, I think that’s just heartbreaking. Someone comes to the hospital to get better, but there’s this risk with older adults that they may leave better on paper but with more disability than when they came into the hospital.

The HELP program is great because it focuses on the prevention of delirium and acute confusion in older adults. It’s a common-sense approach. We have volunteers who help seniors stay awake during the day so they can sleep better at night, give them a newspaper so they can read the date, have conversations with them — it’s a strategic approach to keep their minds active and engaged throughout their stay. It’s just good care.

We started HELP here at West Penn, and we also introduced it at Allegheny General Hospital (AGH) in June. It’s been going extremely well — we’ve already seen 160 patients at AGH, and at West Penn we’ve seen more than 2,000 patients since its launch in May 2016.

NB: What program or initiative, outside of HELP, are you excited about in terms of AHN’s care for seniors?

LW: We have a formalized program with the trauma surgeons at AGH. When patients who are 75 years or older are admitted to the hospital for trauma service, they are also now seen by one of our geriatric practitioners who will then follow them throughout their entire stay.

The majority of trauma-related admittance for older adults is caused by falling. The trauma surgeons are amazing at managing the injury, but always appreciate further guidance on managing the cause of the older adult’s fall.

Our geriatric practitioners are able to talk to the patient about their health goals, or if the situation is severe enough, their end-of-life goals. This has been an extremely successful program and we’re hoping to introduce it at Forbes Hospital in the near future.

Improving Care for an Aging Population

NB: Is there ageism in the U.S. health care system?

LW: It’s huge. Ageism can be found mostly at the hospital level, especially if the patient develops delirium. To take just one example, if a patient is a little confused one day during his or her stay, some doctors may quickly jump to dementia. If a chronic condition like dementia is on your chart — it doesn’t just go away.

So a year later, I may see that same patient who has dementia written all over the chart and they’re completely fine, but if dementia is on the chart, the patient might not be a candidate for certain treatments or surgeries because of that.

It’s important that clinicians take their time with older adults and be patient. It can be difficult, especially when working with a patient who may have low hearing or other challenges, but it’s important to ensure the highest quality of care.

NB: Is there an area where providers could focus more when it comes to improving care for older adults?

LW: I hope to guide other providers to keep the big picture in mind. Older adults have a lot of different medical issues going on and some of them see a variety of specialists. I think clinicians have the best intentions but can sometimes solely focus on their “organ system” or area of specialty, and then a patient’s care can quickly become fragmented.

We need to ensure that with geriatric patients we’re focusing on the person, and we’re looking at the whole person and the whole picture. It’s a rewarding thing to work with these patients and their families in this season of their lives and to look beyond just the medical aspects of their care, but also care for their psychosocial needs as well.

Ask a Doc: Caring for Older Adults published first on https://storeseapharmacy.tumblr.com

[oovitus]

Ask a Doc: Caring for Older Adults

In our Ask a Doc series, we sit down with physicians and other clinical experts across Highmark’s health plan networks, including at Allegheny Health Network (AHN), for a chat on an important health topic. In this post, AHN’s Dr. Lyn Weinberg discusses her work with older adults.

We’re getting older in the U.S. The nation’s median age rose from 28 in 1975 to 37.9 in 2016, and the number of people 65 or older grew from 35 million in 2000 to 49.2 million in 2016.

As our population continues to age, it’s vital that health care systems adapt to meet the needs of older patients. To start, Dr. Lyn Weinberg of Allegheny Health Network (AHN) stresses that preconceived notions of what aging looks like must be discarded.

“Older adults are heterogeneous,” she says. “I see 85-year-olds who are in great shape and working or volunteering in their spare time. I also see 85-year-olds who are in hospice. One treatment might work well for one patient, but not for the other. It’s so important to treat each patient personally and individualize their care.”

Dr. Weinberg was recently named the new Division Director for Geriatrics at AHN. In her position, she’ll work to operationalize and standardize geriatric care across the network while also continuing to practice.

During our conversation at the cafeteria of West Penn Hospital, Dr. Weinberg discussed her work with AHN, how she approaches geriatric care, and her vision for geriatric care delivery.

The Next Generation of Care

Nikki Buccina (NB): Being a younger doctor, what’s it like to provide cross-generational care?

Dr. Lyn Weinberg, Division Director for Geriatrics at Allegheny Health Network

Dr. Lyn Weinberg (LW): I get a lot of comments about how young I look, but it’s in good faith. There’s a special bond between younger and older generations. I had my first baby at the beginning of last year and I could see that it definitely brightened my patients’ days to share that with me. I had patients bring me gifts, knit things for me — it made that connection even closer.

NB: Are health care providers who specialize in geriatric care in high demand?

LW: I would say geriatricians are in high demand, but there may never be enough geriatricians to meet that demand. In my role, I like to focus on educating clinical trainees and other primary care doctors on quality geriatric care, because it’s going to be delivered by almost all health care providers.

I believe that as a geriatrician, it’s also my responsibility to be an educator. I want to help all health care providers better understand care delivery for older adults and the nuances within that — it’s why I’m so passionate about incorporating geriatrics education into residency training. We have a very robust geriatric curriculum for our resident trainees here at AHN and I’ve gone through a formal fellowship as part of my training.

NB: Can you talk more about what a fellowship in geriatric medicine entails?

LW: A fellowship in geriatric medicine is a year of training beyond internal medicine. It focuses on issues that affect older adults, and the curriculum that falls outside of typical medical training, dipping more into the psychosocial area.

In particular, it looks at how to navigate an older adult through the health care system and place a focus on available resources as well as issues that affect older adults like low vision, hearing or even urinary incontinence. I know it’s not very glamorous. But it’s important.

Another important part of this training focuses on how to best manage polypharmacy in older adults. One way to define polypharmacy is any patient who is taking more than four medications, which is pretty much everybody in geriatric populations. It can be a major factor in health-related complications, so in a training program someone may cover how to ask questions in practice like “how can we cut this down?” or “is there something we should be using instead?”

Lastly, providers learn more about the best methods to manage end-of-life issues and dementia.

Caring for Older Patients

NB: What drew you to working with older adults?

LW: I just have a soft spot for older adults; I don’t know what else to say. I love the complexity of care in older adults. There are standardized guidelines in medicine about how to take care of heart attacks, hypertension, you name it, but many of those guidelines came out of research and studies which didn’t include real-world geriatric patients. So, when I’m working with older patients, it’s really about individualizing their care and going one step beyond the guidelines.

I also enjoy working with families to meet end-of-life goals for the patient, and the way caring for older adults relies heavily on multidisciplinary teams. It’s not just what I think, it’s also the professional opinions of therapists, social workers, pharmacists and more.

NB: What is your perspective of palliative and end-of-life care?

LW: The word palliative in medicine means to relieve suffering, and that should be part of practice — I don’t know if we necessarily need to send someone to a different doctor. As for end of life, I find it rewarding to work alongside a patient and their family to make sure the patient dies with dignity. If they have goals to die at home without pain, it’s crucial that we do everything we can to meet those goals.

I have had to personally change the way I think about palliative and end-of-life care because I have my own idea on what a good death looks like, but that’s not the same for everybody. There are some patients who need to feel that they’ve tried every aggressive measure at the expense of what I would consider to be a good quality of life. Over the last five years, I’ve learned to meet people where they are and support them through whatever they decide for themselves.

NB: You were instrumental in standing up the HELP program at AHN. Can you tell us more about why you thought it was important to implement this national program and where you’re going with it?

LW: Throughout my residency, fellowship and beyond, I saw some of the hazards of hospitalization for the elderly. When they are admitted, the process is normally that they’re put to bed, restricted from walking (which stems from a fear that they will fall), and they can quickly become deconditioned. Especially when you take into account the new faces, new sounds and alarms, interrupted sleep patterns and even different medications, all of this can cause older adults to become extremely disoriented, which can cause delirium, or acute confusion.

Personally, I think that’s just heartbreaking. Someone comes to the hospital to get better, but there’s this risk with older adults that they may leave better on paper but with more disability than when they came into the hospital.

The HELP program is great because it focuses on the prevention of delirium and acute confusion in older adults. It’s a common-sense approach. We have volunteers who help seniors stay awake during the day so they can sleep better at night, give them a newspaper so they can read the date, have conversations with them — it’s a strategic approach to keep their minds active and engaged throughout their stay. It’s just good care.

We started HELP here at West Penn, and we also introduced it at Allegheny General Hospital (AGH) in June. It’s been going extremely well — we’ve already seen 160 patients at AGH, and at West Penn we’ve seen more than 2,000 patients since its launch in May 2016.

NB: What program or initiative, outside of HELP, are you excited about in terms of AHN’s care for seniors?

LW: We have a formalized program with the trauma surgeons at AGH. When patients who are 75 years or older are admitted to the hospital for trauma service, they are also now seen by one of our geriatric practitioners who will then follow them throughout their entire stay.

The majority of trauma-related admittance for older adults is caused by falling. The trauma surgeons are amazing at managing the injury, but always appreciate further guidance on managing the cause of the older adult’s fall.

Our geriatric practitioners are able to talk to the patient about their health goals, or if the situation is severe enough, their end-of-life goals. This has been an extremely successful program and we’re hoping to introduce it at Forbes Hospital in the near future.

Improving Care for an Aging Population

NB: Is there ageism in the U.S. health care system?

LW: It’s huge. Ageism can be found mostly at the hospital level, especially if the patient develops delirium. To take just one example, if a patient is a little confused one day during his or her stay, some doctors may quickly jump to dementia. If a chronic condition like dementia is on your chart — it doesn’t just go away.

So a year later, I may see that same patient who has dementia written all over the chart and they’re completely fine, but if dementia is on the chart, the patient might not be a candidate for certain treatments or surgeries because of that.

It’s important that clinicians take their time with older adults and be patient. It can be difficult, especially when working with a patient who may have low hearing or other challenges, but it’s important to ensure the highest quality of care.

NB: Is there an area where providers could focus more when it comes to improving care for older adults?

LW: I hope to guide other providers to keep the big picture in mind. Older adults have a lot of different medical issues going on and some of them see a variety of specialists. I think clinicians have the best intentions but can sometimes solely focus on their “organ system” or area of specialty, and then a patient’s care can quickly become fragmented.

We need to ensure that with geriatric patients we’re focusing on the person, and we’re looking at the whole person and the whole picture. It’s a rewarding thing to work with these patients and their families in this season of their lives and to look beyond just the medical aspects of their care, but also care for their psychosocial needs as well.

Ask a Doc: Caring for Older Adults published first on https://storeseapharmacy.tumblr.com

[oovitus]

Ask a Doc: Caring for Older Adults

In our Ask a Doc series, we sit down with physicians and other clinical experts across Highmark’s health plan networks, including at Allegheny Health Network (AHN), for a chat on an important health topic. In this post, AHN’s Dr. Lyn Weinberg discusses her work with older adults.

We’re getting older in the U.S. The nation’s median age rose from 28 in 1975 to 37.9 in 2016, and the number of people 65 or older grew from 35 million in 2000 to 49.2 million in 2016.

As our population continues to age, it’s vital that health care systems adapt to meet the needs of older patients. To start, Dr. Lyn Weinberg of Allegheny Health Network (AHN) stresses that preconceived notions of what aging looks like must be discarded.

“Older adults are heterogeneous,” she says. “I see 85-year-olds who are in great shape and working or volunteering in their spare time. I also see 85-year-olds who are in hospice. One treatment might work well for one patient, but not for the other. It’s so important to treat each patient personally and individualize their care.”

Dr. Weinberg was recently named the new Division Director for Geriatrics at AHN. In her position, she’ll work to operationalize and standardize geriatric care across the network while also continuing to practice.

During our conversation at the cafeteria of West Penn Hospital, Dr. Weinberg discussed her work with AHN, how she approaches geriatric care, and her vision for geriatric care delivery.

The Next Generation of Care

Nikki Buccina (NB): Being a younger doctor, what’s it like to provide cross-generational care?

Dr. Lyn Weinberg, Division Director for Geriatrics at Allegheny Health Network

Dr. Lyn Weinberg (LW): I get a lot of comments about how young I look, but it’s in good faith. There’s a special bond between younger and older generations. I had my first baby at the beginning of last year and I could see that it definitely brightened my patients’ days to share that with me. I had patients bring me gifts, knit things for me — it made that connection even closer.

NB: Are health care providers who specialize in geriatric care in high demand?

LW: I would say geriatricians are in high demand, but there may never be enough geriatricians to meet that demand. In my role, I like to focus on educating clinical trainees and other primary care doctors on quality geriatric care, because it’s going to be delivered by almost all health care providers.

I believe that as a geriatrician, it’s also my responsibility to be an educator. I want to help all health care providers better understand care delivery for older adults and the nuances within that — it’s why I’m so passionate about incorporating geriatrics education into residency training. We have a very robust geriatric curriculum for our resident trainees here at AHN and I’ve gone through a formal fellowship as part of my training.

NB: Can you talk more about what a fellowship in geriatric medicine entails?

LW: A fellowship in geriatric medicine is a year of training beyond internal medicine. It focuses on issues that affect older adults, and the curriculum that falls outside of typical medical training, dipping more into the psychosocial area.

In particular, it looks at how to navigate an older adult through the health care system and place a focus on available resources as well as issues that affect older adults like low vision, hearing or even urinary incontinence. I know it’s not very glamorous. But it’s important.

Another important part of this training focuses on how to best manage polypharmacy in older adults. One way to define polypharmacy is any patient who is taking more than four medications, which is pretty much everybody in geriatric populations. It can be a major factor in health-related complications, so in a training program someone may cover how to ask questions in practice like “how can we cut this down?” or “is there something we should be using instead?”

Lastly, providers learn more about the best methods to manage end-of-life issues and dementia.

Caring for Older Patients

NB: What drew you to working with older adults?

LW: I just have a soft spot for older adults; I don’t know what else to say. I love the complexity of care in older adults. There are standardized guidelines in medicine about how to take care of heart attacks, hypertension, you name it, but many of those guidelines came out of research and studies which didn’t include real-world geriatric patients. So, when I’m working with older patients, it’s really about individualizing their care and going one step beyond the guidelines.

I also enjoy working with families to meet end-of-life goals for the patient, and the way caring for older adults relies heavily on multidisciplinary teams. It’s not just what I think, it’s also the professional opinions of therapists, social workers, pharmacists and more.

NB: What is your perspective of palliative and end-of-life care?

LW: The word palliative in medicine means to relieve suffering, and that should be part of practice — I don’t know if we necessarily need to send someone to a different doctor. As for end of life, I find it rewarding to work alongside a patient and their family to make sure the patient dies with dignity. If they have goals to die at home without pain, it’s crucial that we do everything we can to meet those goals.

I have had to personally change the way I think about palliative and end-of-life care because I have my own idea on what a good death looks like, but that’s not the same for everybody. There are some patients who need to feel that they’ve tried every aggressive measure at the expense of what I would consider to be a good quality of life. Over the last five years, I’ve learned to meet people where they are and support them through whatever they decide for themselves.

NB: You were instrumental in standing up the HELP program at AHN. Can you tell us more about why you thought it was important to implement this national program and where you’re going with it?

LW: Throughout my residency, fellowship and beyond, I saw some of the hazards of hospitalization for the elderly. When they are admitted, the process is normally that they’re put to bed, restricted from walking (which stems from a fear that they will fall), and they can quickly become deconditioned. Especially when you take into account the new faces, new sounds and alarms, interrupted sleep patterns and even different medications, all of this can cause older adults to become extremely disoriented, which can cause delirium, or acute confusion.

Personally, I think that’s just heartbreaking. Someone comes to the hospital to get better, but there’s this risk with older adults that they may leave better on paper but with more disability than when they came into the hospital.

The HELP program is great because it focuses on the prevention of delirium and acute confusion in older adults. It’s a common-sense approach. We have volunteers who help seniors stay awake during the day so they can sleep better at night, give them a newspaper so they can read the date, have conversations with them — it’s a strategic approach to keep their minds active and engaged throughout their stay. It’s just good care.

We started HELP here at West Penn, and we also introduced it at Allegheny General Hospital (AGH) in June. It’s been going extremely well — we’ve already seen 160 patients at AGH, and at West Penn we’ve seen more than 2,000 patients since its launch in May 2016.

NB: What program or initiative, outside of HELP, are you excited about in terms of AHN’s care for seniors?

LW: We have a formalized program with the trauma surgeons at AGH. When patients who are 75 years or older are admitted to the hospital for trauma service, they are also now seen by one of our geriatric practitioners who will then follow them throughout their entire stay.

The majority of trauma-related admittance for older adults is caused by falling. The trauma surgeons are amazing at managing the injury, but always appreciate further guidance on managing the cause of the older adult’s fall.

Our geriatric practitioners are able to talk to the patient about their health goals, or if the situation is severe enough, their end-of-life goals. This has been an extremely successful program and we’re hoping to introduce it at Forbes Hospital in the near future.

Improving Care for an Aging Population

NB: Is there ageism in the U.S. health care system?

LW: It’s huge. Ageism can be found mostly at the hospital level, especially if the patient develops delirium. To take just one example, if a patient is a little confused one day during his or her stay, some doctors may quickly jump to dementia. If a chronic condition like dementia is on your chart — it doesn’t just go away.

So a year later, I may see that same patient who has dementia written all over the chart and they’re completely fine, but if dementia is on the chart, the patient might not be a candidate for certain treatments or surgeries because of that.

It’s important that clinicians take their time with older adults and be patient. It can be difficult, especially when working with a patient who may have low hearing or other challenges, but it’s important to ensure the highest quality of care.

NB: Is there an area where providers could focus more when it comes to improving care for older adults?

LW: I hope to guide other providers to keep the big picture in mind. Older adults have a lot of different medical issues going on and some of them see a variety of specialists. I think clinicians have the best intentions but can sometimes solely focus on their “organ system” or area of specialty, and then a patient’s care can quickly become fragmented.

We need to ensure that with geriatric patients we’re focusing on the person, and we’re looking at the whole person and the whole picture. It’s a rewarding thing to work with these patients and their families in this season of their lives and to look beyond just the medical aspects of their care, but also care for their psychosocial needs as well.

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