#Medical Access Primary Care

[intersex-support]

Intersex Support Resources

Intersex 101: 

http://4intersex.org/#yourself

Intersex Organizations 

Intersex Organizations by Country 

Intersex Variations 

Intersex Variations Glossary by InterACT

Intersex History, Art, and Politics 

Compilation Post

Intersex Flag 

Morgan Carpenter on the Intersex Flag

Intersex Surgery 

“I Want to be Like Nature Made Me” Report from Human Rights Watch

Intersex Human Rights by Bauer et al, 2020

Legal Discrimination 

US Anti-trans bills also harm intersex Children by Human Rights Watch 

Intersex Legislative Toolkit by InterACT

Medical Records

InterACT Guide to accessing medical records

Intersex Health

Intersex affirming hospital policies from InterACT

Intersex affirming Primary Care from National LGBTQIA Health Education Center

Intersex and osteoporosis from Intersex Support Australia

Sexual Health 

Intersex Inclusive information for Sex Ed from Puberty Curriculum

Scarleteen Sex Ed

What Intersex People Want you to Know about Sex by Maddie Rose

I’m Intersex. Here’s How That Affects My Sex Life by Mark Hay

Intersex and Disability 

Liberating All Bodies: Intersex Justice and Disability Justice in Conversation

Intersex Mental Health 

Mental Health

Intersex Justice and the Care We Deserve: “I Want People to Feel at Home in Their Bodies Again” by Zena Sharman

A national study on the physical and mental health of intersex adults in the U.S. by Rosenwohl-Mack et al., 2020

Crisis lines that don’t call the cops: 

Trans Lifeline 

Thrive Lifeline

For Parents of Intersex Children 

Supporting your intersex Child by IGLYO

[chronicallycouchbound]

I feel like people often don’t talk about the experiences of disabled people who have caretakers because so much of the conversation is about us—not including us.

I receive in home care for 30 hours a week (+ 4 hours/week for respite). This is paid for by Medicaid (state insurance). Outside of paid hours, my primary caretakers care for me unpaid and assist me most of the time. I’m very rarely left alone due to my high support needs. Often, when I am left alone, I am completely bedridden or at minimum housebound. I have frequent emergency life threatening health problems, falls, and serious injuries even with support in place, and these things significantly increase when I’m on my own.

I’m extremely lucky that my paid caretakers are my partner, my sister (the only family member I have regular contact with, I’m estranged from the rest of my immediate family and most of my extended family) and my best friend.

I used to have agency staffing which was horrible for me and borderline traumatic. At several points, before doing the self directed care option (which allows me to choose my own staff, hire and train them myself and dictate hours for them), I opted to not have any staffing. I was regularly in the emergency room. I can’t drive, so I was having to walk and if I was lucky enough to be able to take the bus on occasion or get a ride from a Facebook acquaintance, they were few and far in between. I don’t have family support, and even my sister who is supportive wasn’t living in the state at the time and doesn’t have a car most of the time.

And before I could even choose which staffing option, even though medically it had been deemed essential for me to have in home care, even though my insurance covered it, I had to wait several years (I was 18 when I was approved) until I was 21 to qualify to start. The reason why: I was legally an “adult disabled child” because of my high support needs (which is funny because I STILL don’t have SSI at age 24) and thus legally unable to consent to my own care plan. I needed a blood relative to consent, and that same blood relative (who had to have proof of such!) couldn’t care for me. At the time, my sister was the only person who could’ve been my caregiver and also she is the only verifiable blood relative I have contact with for safety reasons, and my only relative on this side of the USA.

The first business day after my 21st birthday I immediately got things set up to get in home care.

This is out of date, I get assistance with more than just these highlighted ADL (activities of daily living) tasks now.

In short: my day-to-day life is entirely dependent on others.

And there’s power imbalances that exist between me and my caregivers, even with my current caregivers being amazing and anti-ableist. They will always exist. We talk about the power dynamics of me being dependent on them for my survival, and how heavy that weight can be for each of us.

Having caregivers often means that accessibility is extra difficult— I’ve been told straight up multiple times that I can’t have assistance from my caregivers to help me change in a changing room when we’re out shopping. That they can’t go into the bathroom with me, that they can’t help me get un/dressed during appointments, that they can’t come into spaces with me.

I’ve been denied access to psychiatric care because I can’t do my daily living tasks (ADLs- the highlighted items) independently. And when I’m in a hospital or emergency room, I can’t have my in home workers be paid to care for me, there’s an expectation that the nursing staff at the hospital will do it. Even though my caregivers were specifically trained to learn my body and needs for weeks and have been working with me for years. I have severe cPTSD and showering in front of a stranger is something I cannot do. I would rather fall or faint or get injured or just not shower than deal with that. But I’m expected to just let anyone have access to my body just because I’m physically disabled and need support.

When I faint/fall/get injured/have life threatening health issues arise while I’m not clothed, or when I’m otherwise vulnerable, I’m supposed to let strangers just touch me however they want to. I have to show them my chest (for my cardiac care) and let them poke and examine me. I can’t object without losing access to vital care.

I have agency. I have rights. I have autonomy. I deserve to be able to exercise these things.

[trans-axolotl]

(Described in alt text)

“I found out that I was intersex several years before I became more disabled by my other chronic illnesses, so my intersex identity felt more relevant to my life at first. When I was first diagnosed in 2015, I had an incredibly hard time trying to discover any information about intersex community. It took a lot of research in archives of primary sources just to find out that intersex people did have a powerful history of activism.

Embracing my disabled identity was a parallel process in so many ways. As a wheelchair user, it’s really important for me to define my own disabled identity outside of the medical system or ableist ideas from an inaccessible society. For me, one of the most important parts of my disabled identity is the powerful community we build to fight for justice. In both the intersex and the disabled communities, we get really good at caring for each other. When you're part of a community that's been excluded from accessing knowledge about your body, your health, and your needs, it’s meaningful when we can redistribute power from medical authority back into the hands of intersex and disabled people.

Even though there are many similarities and solidarity between the intersex and disabled communities, sometimes I still feel complicated about whether I want to consider my intersex variation a disability. “In an environment with so much pathologization through Disorders of Sex Development language, it can feel difficult to publicly talk about our intersex variations as disabilities. [Like many intersex people, I have felt] like we have to be the representative of every intersex person ever, rather than having the space to exist with a lot of complexities. For a while, I wondered if I would be betraying intersex activism if I also acknowledged the fact that part of the reason I was losing my mobility was because of my intersex variation.”

In an intersex and disabled future, I want us to have space to celebrate all parts of ourselves without feeling like we have to hide. Not only do we exist, we’re out here existing joyfully, and I want our intersex and disabled futures to reflect the power of our liberation. By Elliott L.”

-7 Disabled Intersex People Explain How They Embrace Their Identities, Teen Vogue, Courtney Felle

[prince-liest]

A little bit of celebratory light in the current political climate: I'm working with a local endocrinologist who is versed in gender-affirming care as well as my local LGBTQ+ resource organization to start a quarterly pride clinic that I'm going to run with and staff with the aforementioned endocrinologist. I don't know yet how successful it will be, but we're in a really under-served area and a lot of the local federally qualified health centers are pulling back their gender affirming care offerings due to the recent federal policies so that they can retain their funding, which after speaking to my residency program directer he seems to believe is unlikely to affect us. So I'm going to be working with our program attendings and this endocrinologist to help refer more queer and especially trans patients to myself and one of my seniors who is also really involved in LGBTQ+ health goals for gender-affirming care.

The clinic itself is only going to be quarterly at this time (hopefully monthly in the future) due to the limitations of patient panel sizes and also residency scheduling, but we're hoping that we can also follow these patients in our actual primary clinic, since it will all be in the same building and part of the same system, and the endocrinologist has said she is willing to co-precept these patients (aka. have us forward her the notes and look over them to make sure the care plans are copacetic, as well as get curbsided by us when needed) when we work on hormone therapy in the primary care clinic. I think the main challenge is going to be 1) making sure we have the resources and access to a good multidisciplinary team (main points are mental health resources (gonna ask one of the psych program attendings, he is both openly queer and invested) and infectious disease specialist options that aren't going to result in bad experiences for the patients that we refer that way) and 2) making sure we have appropriate follow-up for patients, which I think on my end is just going to mean me telling our clinic coordinator, "Hey, if it's for this patient panel specifically, you can book me an extra patient per half-day for continuity."

We're also going to be doing internal-ish referral advertising through the LGBTQ+ org, as well as training through the organization and also just through research done by myself and my senior for our co-residents for things like cancer screening guidelines adjusted for risk factors we see in queer people (anal paps, three-site testing, when to screen for breast cancer in trans women, etc, etc). Waiting on my program director to talk to our clinic coordinator to see if there's any way for people to self-refer straight to the pride clinic (probably insurance-dependent) but otherwise it's just...happening.

I think my main wish is that I had more days to directly work with this endocrinology attending to pick her brain. She said she's game for any [redacted weekday] for the clinic once we get things going and I'm on my endocrinology rotation, but I'm mostly working with another endo and only see her twice this month due to her work schedule. She's a great teacher and next time I see her this month I'm going to see if she has time to give me a crash-course on HRT management that will help me synthesize the gender dysphoria treatment clinical practice guidelines I'm reading through from the Journal of Clinical Endocrinology and Metabolism. My PD actually specifically referred a trans patient to us to see that day because he knows I really want more experience with this (and, y'know, she's a great endo doc) so that will be the perfect opportunity.

Anyway! It's a great time to be working on offering more medical resources to LGBTQ patients.

[courtkossai]

sometimes can not help but look at what things other folks put in very public introduction posts , and just … ack ! stop that !

there is no need to detail trauma .

there is no need to detail triggers . ( please use tag filters first , and speak with friends privately for anything uncommon . )

there is no need to explain system origins .

there is no need to detail AGAB , trans status , and/or intersex status .

there is no need to detail race or ethnicity .

there is no need to detail full religious journey .

there is no need to detail everything about sexuality .

there is no need to detail disability or sensitive medical information - current diagnoses , suspect diagnoses , history with diagnoses , and so on .

there is no need to share exact age or position in school .

there is no need to explain that alias or nickname is not real name .

there is no need to share face in photography or video .

and so on , and so on .

sometimes might want to talk about things that implicate or expose certain details , but that still do not make necessary to say most things up front . there will be exceptions at times , especially for accessibility requirements or where specific identity is intentionally forefront of discussions , but many other things can actually be zip .

should also realistically be in habit to ask :

is this necessary to say ?

what would happen if someone from physical life find this page ?

what would happen if someone with cruel intentions find this page ?

is there enough here to figure out legal identity and/or place of residence ?

would this really benefit from public eye , or is private journal better ? always consider anything online to be in public eye , even if account seem to be unknown .

look . people who want to question and disbelieve , will do that regardless of how much proof . to explain and detail these points will never convince such people , and only give more ammunition to those who mean harm .

folks often like to say " nothing to hide " but in this world yes , there is plenty to hide . understand fully that folks want to find each other through commonality , but these also often happen to be identities with heavy marginalisation , identities that bigots seek out and target , identities under suspicion and harsh laws .

so please be careful with what information make way into primary public introduction , and public in general . friendship is great , but should not feel need to expose and doxx self just to find .

[globalnewscollective]

"Whereas health care for women should also adress the needs of men, families, and communities as they relate to women`s health care."

Who Owns Women’s Health? The Quiet Invasion of Male-Centered Policy

Imagine seeking healthcare tailored to your needs, only to be told that your care should also prioritize someone else. This is the reality women face as policymakers subtly reshape the language around women’s health. A recent example of this appears in the wording: “Whereas health care for women should also address the needs of men, families, and communities as they relate to women’s health care.”

At first glance, it might sound inclusive. But make no mistake—this is a deliberate shift that undermines women’s bodily autonomy. Instead of recognizing that women’s health deserves dedicated focus, it reframes it as something that must serve others. This is not just semantics; it’s a dangerous step toward erasing women’s self-determination over their own bodies.

The Consequences of Reframing Women’s Health

Medical Decisions No Longer Centered on Women – If women’s healthcare must account for men and families, it risks deprioritizing the specific needs of women. This could lead to funding cuts for reproductive health, fewer specialized services, and a system where women are not the primary focus of their own medical care.

A Trojan Horse for Restrictive Policies – Language like this paves the way for policies that justify male oversight in decisions about contraception, pregnancy, and abortion. If women’s health is framed as a "community" issue rather than an individual right, it becomes easier for lawmakers to impose restrictions under the guise of considering broader interests.

The Return of Male Authority Over Women’s Bodies – History has shown us what happens when men are allowed to dictate what women can and cannot do with their bodies. From forced pregnancies to restricted birth control access, societies that strip women of bodily autonomy ultimately deny them full personhood.

Who Benefits from This Shift?

This language change isn’t happening in isolation. It’s part of a broader trend where conservative policymakers seek to roll back women’s rights by making them seem less like rights at all. If women’s health is framed as something that must cater to men and families, it ceases to be about women’s individual agency. Instead, it becomes something that others—often men in positions of power—get to control.

The Bigger Danger: Women Losing Their Say

If men’s interests must be "addressed" in women’s healthcare, what happens when those interests conflict? Should a husband’s desire for more children outweigh a woman’s need for contraception? Should a father be able to veto his daughter’s decision to seek reproductive care? These are not hypotheticals—these are the real-world consequences when policies stop centering women in their own health discussions.

What Can We Do?

Call it out – Challenge these seemingly subtle shifts in language and expose their dangerous implications.

Push for policies that reaffirm women’s autonomy – Women’s healthcare must be about women, first and foremost. Period.

Refuse to let history repeat itself – We’ve fought too hard for bodily autonomy to let it be rewritten under the guise of "inclusivity."

Women’s health is not a community project. It is a fundamental right. And we cannot afford to let anyone redefine it as anything less.

[brucewaynehater101]

the empire starts noticing that their baby emperor will often be more than a little banged up when he comes to see them in person and they are very worried for their baby, competition to be the imperial physician is fierce but also very stressful for the ones with the position because humans aren't exactly new in space anymore but they're not precisely common either. The position of imperial chef and other positions that concern taking care of the emperor and the imperial consorts is even fiercer.

Previously the empire more or less figured that this mysterious "earth" where their baby emperor makes his primary residence is fairly peaceful and a safe place for him to grow. However, stories finally reach the empire, which started very far from earth and very out of the way of any earth related gossip, about constant invasions that target earth and the general chaos that earth faces on a day to day basis. In hindsight for the empire it makes sense that their baby emperor is from such a dangerous world since he himself is very dangerous despite being so young and adorable. No wonder he's been able to handle their own broken infrastructure and the increasingly large responsibilities that they've put on his little shoulders. There is guilt and there is horror that babies are facing this and, again given their relative condition when they visit the empire in person, obviously they are not being properly cared for.

Finally a delegation from the great Red Bird Empire (robins are an earth species with no equivalent in the empire but there are lots of birds and the color red is known) goes to earth, they arrive in their finest discowing formal fashion to petition the protectors of earth to allow a small group of them to make a base on earth to assist their royal family who has taken refuge on the jl protected planet. They are not there to battle anyone or anything. They are there to make sure their emperor and his consorts are fed, have proper medical attention, and access to an appropriate wardrobe as befits their stations. They might also try to persuade their emperor and his consorts to visit the empire in person more often. While he does a fantastic job of governing from a distance (and at this point Tim has arranged things so he really barely does anything except when a new planet joins and each planet is basically self governing) they miss C4 actually being there.

JL internally freaking out a little because apparently they've had an alien prince? princess? king? goddess? emperor? a royal alien family? somewhere on earth for ages and there could have been a huge diplomatic incident if anything had happen to this royal family, like the family being crushed by a falling building during one of superman's fights, or hit by a tsunami, or earthquake, or even just a stupid speeding car. JL is under the impression that the imperial family on earth fled this empire at some point because of political upheaval and this is a group of imperial loyalists that's only just now gotten enough power to come keep a proper eye on the hidden royals. JL is now worried about alien assassins after the hidden imperial family. At least some part of the JL would like this imperial family to leave earth please.

Based on the delegations costumes, at least one member of the league suspects that the hidden prince of the empire is Dick. This is further supported when the imperial keeper of the wardrobe somehow finds out about Discowing and fawns over Nightwing and goes on about their impeccable fashion sense and how they are revolutionary in the field of haute couture.

Batman may have a small aneurysm when he learns that the alien delegation first thinks to set up in his city. Tim might also panic a little because no, that's too dangerous for them! And instead the Kents suddenly have new neighbors on the farm next door. The Kents are also now on the list of suspected royal family of alien empire even though Ma and Pa are definitely human. Somehow the JL absolutely misses Tim and his life partners visiting the alien delegation and none of the C4 is going to actually admit to anything if they can help it. The delegation is also perfectly happy to keep their mouths shut about the identity of their emperor because it amuses their emperor and also admittedly amuses them. The delegates are frequently rotated with other people who fill their various positions, they set up a schedule, so they can return to the empire and compete to maintain their position as imperial caretaker or end up losing their position to someone else or so they can renew their credentials or even just spend time with their families back in the empire.

Fudge. The choas, miscommunication, and both the delegation and C4 being on board with messing with the JL are precious. Essentially, it turns into various members pointing at each other in suspicion. "Are you the hidden royal family?"

In particular, what do Arthur, Diana, J'onn, and Starfire think about all of this?

I'm also glad the delegation decided to rotate the position on earth. It's like a seasonal job.

I wonder how Ma and Pa Kent feel about their new neighbors. Can they even eat pie?

I'm curious what type of systems Tim sets up for the worlds. It's groovy that he's set the worlds up to be essentially self-sufficient. He probably helps them establish connections, rules, trade routes, etc. for interplanetary trade outside of his empire, but otherwise has set up free healthcare, housing for all, welfare systems, etc.

[floral-ashes]

Gender self-determination as a medical right

Florence Ashley, CMAJ, vol. 196, E833–35 (2024)

Transgender people face many formal barriers to gender-affirming care, sometimes known as “gatekeeping.” Gender-affirming care refers to a wide range of medical interventions that patients pursue to affirm, actualize, or embody their sense of gender. Common forms of gender-affirming care include transition-related surgeries, hormone therapy, puberty blockers, and hair removal. Health care providers may refuse to offer gender-affirming care to transgender patients without an assessment of the person’s gender identity or dysphoria. Adolescents may, moreover, need to show that they have experienced gender dysphoria for several years before receiving care and may be denied care until they satisfy a strict age requirement.

I argue that physicians should rethink barriers to gender-affirming care in light of the principle of gender self-determination. By considering gender self-determination as a presumptive right, physicians are more likely to avoid unnecessary barriers to care. This presumption can be rebutted by showing that encroachments are adequately justified under standards detailed later in this article. Presumptive rights contrast with absolute rights, which cannot be rebutted or derogated from.

Being transgender is a matter of diversity, not pathology. When providers create barriers to gender-affirming care, they impair their patients’ ability to live out their sense of gender. Not every transgender person wishes to pursue gender-affirming interventions — it is a deeply personal choice — but many do. In Canada, 73% of transgender people want to or have pursued some form of gender-affirming care, and another 16% are unsure.2 Yet, only 26% of transgender people have received all the gender-affirming care they desire.

Medical autonomy and everyday autonomy

At the heart of medical ethics lies the principle of autonomy, according to which patients must be free to act “in accordance with a self-chosen plan.” Autonomy is the reason that patients have a right to refuse care, and it underpins health care providers’ duty to properly inform patients so that they can decide whether to accept a proposed treatment. Medical autonomy is, however, asymmetric. Whereas patients have the right to refuse an intervention, medical autonomy does not typically afford them the right to demand a specific intervention from their doctor. Nor does medical autonomy generally prevent providers from imposing discretionary restrictions and conditions on access to care.

Gender-affirming care, however, also engages the principle of gender self-determination, which is related to “everyday” autonomy: a person’s right to decide the shape of the life they want to live. Gender is a critical factor in how others refer to you, what facilities you use, whom you date, which peers you have, how others treat you, and which social norms are applied to you. Furthermore, a person’s primary and secondary sexual characteristics play a central role in social and sexual intercourse; bodily features influence whether others perceive you as a man, a woman, or nonbinary, or as trans- or cisgender; and having certain body parts also influences your ability to do many things, such as use urinals or have penetrative sex. If you do not feel like your body reflects your sense of gender, you may experience persistent discomfort in everyday life and struggle to flourish in your social or romantic life. Feeling misperceived may also cause you to withdraw from meaningful relationships and can be a source of substantial distress.

Gatekeeping gender-affirming care therefore imposes important limits on liberty, dictating critical aspects of transgender individuals’ social, interpersonal, and embodied life. The impact on transgender people of gatekeeping gender-affirming care extends far beyond the medical realm, permeating the deepest reaches and crevices of transgender people’s lives and defining their ability to live as themselves.

The principle of gender selfdetermination

Gender self-determination means that individuals have a right to define, express, and embody their gender identity as they see fit. It is one of the cornerstones of the Yogyakarta Principles, developed in 2006 by leading human rights experts, which state that

Each person’s self-defined … gender identity is integral to their personality and is one of the most basic aspects of self-determination, dignity and freedom. … No one shall be subjected to pressure to conceal, suppress or deny their … gender identity.

The principle of gender self-determination can be derived from and is supported by many long-recognized rights, including the right to free speech, equality,  privacy, identity, and dignity, and to live and act with integrity. As explained by Loukēs G. Loukaidēs, later of the European Court of Human Rights: “For [someone] to be able to function freely, in the full sense of the term, [they] must have the possibility of self-definition and self-determination: the right to be [oneself].” Gender self-determination is implicitly and explicitly recognized by multiple international actors, including the European Court of Human Rights and the Inter-American Court of Human Rights.

Gender self-determination as a medical right

The principle of gender self-determination shapes the ethical obligations of health care providers. Given the impact of gender-affirming care on people’s ability to express, embody, and live out their gender in everyday life, a presumptive right to gender-affirming care for transgender people would seem essential to supporting the principle of gender self-determination. Transgender patients are, in this sense, in a special situation that expands the traditional scope of medical autonomy, a reasoning perhaps best expressed in the decision of the European Court of Human Rights in Van Kück v. Germany, which explained that “the burden placed on a person to prove the medical necessity of treatment, including irreversible surgery, in the field of one of the most intimate private-life matters, appears disproportionate.”

Medical care often constrains everyday liberty, but there are differences of kind and degree when it comes to gender-affirming care. Gender-affirming care is a way for the person to shape themselves from a gendered perspective, not a means of treating an underlying pathology. If transgender existence is understood, as it should be, in terms of diversity rather than pathology, gender self-determination comes to the fore as a medical right, and approaches to gender-affirming care rooted in a conventional diagnostic-and-cure model seem out of place. Gender-affirming care can be considered along similar lines as abortion, which is also desired for its own sake and often framed as a right.

Reconsidering barriers to gender-affirming health care

Gender self-determination is a presumptive right, meaning that it can be outweighed by other considerations. The burden of justifying barriers to care should fall on the health care providers who erect them and not on those seeking care to affirm their gender. A barrier to gender-affirming care would be justified if there were clear and compelling evidence that it prevents harms of sufficiently great magnitude to unambiguously outweigh the barrier’s negative impacts on gender self-determination and well-being. The harm that barriers seek to prevent must be sufficiently serious to outweigh individuals’ autonomy in defining the most fundamental aspects of their personal identity, bearing in mind also that impairing one’s ability to live out one’s sense of gender is psychologically and socially harmful. It is important to remember that autonomy includes the right to make bad decisions for oneself. The freedom to make only good decisions would be meaningless.

For illustrative purposes, I wish to briefly touch on 2 common barriers to gender-affirming care: the requirement that adolescents prove several years of gender incongruence and rigid age requirements. The requirement that adolescents experience “several years of persistent gender diversity/incongruence” before initiating hormone therapy or surgery is not grounded in evidence that immediate access to gender-affirming interventions, without waiting several years, is associated with regret or negative mental health outcomes. Similarly, the use of rigid age requirements for certain interventions lacks empirical evidence and does not take into consideration differences in youths’ cognitive and emotional maturation. Contemporary understandings of autonomy recognize its gradual development and heterogeneity across the population, an understanding that is recognized in Canadian law under the mature minor doctrine. In the words of the Convention on the Rights of the Child, youths’ views must be “given due weight in accordance with the age and maturity of the child.” This calls for an individualized approach that is incompatible with rigid age lines. In the future, providers should also consider whether there is sufficient evidence justifying requirements for transgender adolescents and adults to prove their gender identity or dysphoria before offering care.

Conclusion

In this article, I have argued that providers of gender-affirming care have an ethical duty to respect the gender self-determination of patients and accordingly bear the burden of justifying the barriers they erect on access to gender-affirming care. Health care providers working with transgender communities should carefully examine their gatekeeping practices to ascertain whether they are justified by clear and compelling evidence and abandon those that cannot meet this justificatory threshold.

[bethammfetameen]

TF2 SELF INSERT OC!!!!!!!!! (the radiator)

[Unnamed] was once employed at ANSTO, where her growing obsession with the radioactive properties of Australium certainly raised eyebrows. Passionate, but not exactly “genius,” she was eventually gently let go after pushing too hard for unapproved research. RED (or BLU depending lol) offered her something ANSTO never would: that being full access to Australium, a lab of her own, and no ethical oversight!!! Yay!! Now serving as the team’s Radiation Support Unit, shes given extremely minimal protective gear because Mann. Co does not care at all about their mercanaries dawg. She really gets to live her dream life too, aside from the killing people thing. Constant exposure to radioactive materials is her dream life! Thanks to some experimentation of Australium with Medic, her tolerance for radiation is higher than that of most people. Soon enough, she may glow in the dark lmao. She uses her customized primary weapon—the Irradiator, bulit by her good friend Engineer (😍), a weapon where--when pointed at an enemy for a certain period of time--shoots concentrated neutrons until it kills them. By the time they see the weapon being pointed at them like that, it's too late. Similar to how Sniper works, Radiator gets to work best when people are still. Here's basically how it goes down:

(Other weapons coming soon probs)

[goddessxdivine]

The Pitt - Episode 8

•the show does a good job of showing humanity both at its worst, and through it efforts of being better. it does a really good job of showing the shortcomings of the US healthcare system as well

•i literally cried so bad when that little girl died from drowning. then her little sister saying that she was only in the pool to save her and drawing her that get well card … yeah i lost it. this show focusing on things that happen in everyday life (not just shocking discoveries of medical anomalies) really makes the impact feel even more real. it’s not uncommon to hear the story of a child accidentally drowning even if the pool was fenced and that news is always devastating

•so glad Ginger’s daughter didn’t abandon her. that would’ve been so sad. but her accidentally falling asleep being why she didn’t pick up further proves the point that primary caregivers need support and that needs to be more easily accessible. if they hadn’t gone to the hospital and interacted with Dr. King they might’ve never known of other options

•Dr. Santos … girl! after last week’s episode where we’re given a bit more of her background, i can understand her “sharp around the edges. trust my gut”nature. however, the thing with the vial and bringing it up it to Dr. Garcia just isn’t smart. there’s a hierarchy and seniority in almost every field so being basically at the bottom of the totem pole and accusing someone above you of using hospital drugs is something to do with much caution. yet you’re telling me this girl who is headstrong and self-assured in her smartness thought the smart thing to do, as an intern, was accuse her superior of drug abuse to her other superior? it’d be different if she’d been observing him long enough to have substantial evidence. but it’s been one shift and the issue with the vial could be attributed to her having an off day before people suspect Langdon (who doesn’t seem like it) to be functional addict

•Dr. Collins miscarrying then having a case where a 6 year old died from accidental drowning and doing the honor walk for the 18 year old accidental overdose omg she’s had such a day! she was miscarrying in real time and still had to do her job, women go through so much. I’m curious to see how that affects the rest of her shift. Nurse Dana is the only one at work who knew about her pregnancy and now Dr. Robby suspects too so it’ll be interesting to see those interactions. plus it seems like basically a confirmation that Robby wasn’t the father of Collins’ baby. however, he obviously cares about her more personally because of their history so it’d be nice to see a comforting moment between them.

•SEASON 2 CONFIRMED!!! I’m so happy to see where they’ll go from here. personally I don’t think the current format of each episode being one hour of one shift is sustainable, at least not for (main) character growth. but idk what that would look like if they shift the format. watching the show feels like im spending the day shadowing doctors and i appreciate the show not overdramatizing the lives of the doctors like greys anatomy would. but id like to see ~some~ more of their personal lives. no shade to grey’s, i watched it for a long time but this show feels like it’s meant to be different from the rest of the medical dramas that have been airing in the last 20 years

•can’t believe we’re more than halfway through s1 already. hopefully it airs yearly cause a two year wait might drive me insane

[arinzeture]

Michael Jordan has opened a third clinic in Wilmington, NC, to support uninsured and underinsured residents. The Novant Health Michael Jordan Family Medical Clinic was funded by his $10 million donation, providing primary care services such as health screenings, preventive care, and behavioral health support. This donation also helped establish two other medical clinics in New Hanover County. The first clinic, located at 15th and Greenfield streets, began operations in April 2024, and the second is near Princess Place Drive and North 30th Street.

Continuing his commitment to his community, Jordan partnered with Novant Health to open the third clinic on May 7, 2024, at 1423 Greenfield Street. The goal of this clinic is to offer essential care to uninsured and underinsured individuals. These efforts are part of Jordan’s broader mission to improve healthcare access and equity, ensuring that quality healthcare is available to all residents, regardless of their insurance status.

[manonamora-if]

From the Itch page:

Palestinians are being persecuted from their homes in an ongoing genocide. Due to the armed actions of Israel, they lack access to essentials such as food, water, electricity and medical care. 

In response to this crisis, all proceeds from the Palestinian Relief indie bundle will be donated to the PCRF (Palestine Children's Relief Fund). PCRF describes itself as "the primary humanitarian organization in Palestine, delivering crucial and life-saving medical relief where it is needed most". By donating to the PCRF, Palestinians will have better access to medical relief, food and water. 

Want more TTRPGs? You can donate $15 to TTRPGs for Palestine.

Not sure where to start with the bundle? Check out randombundlegame.com or Dominic's list.

Contact

For further queries: email: gamedevsforpalestine@gmail.com | twitter: @vgforpalestine

[sayruq]

I am Dr. Mahmoud Al Tibi, a 27-year-old Palestinian general practitioner currently residing in Argentina. My family consists of 15 members, may God protect them: My father, Mamdouh. My mother, Manal. My brothers: Mohammed (with his wife Hadeel and their son Mamdouh), Ahmed (with his wife Lakaa and their children Mamdouh and Manal), Mustafa, Abdullah, and Yassin. My sisters: Sahar and Heba. Allow me to briefly recount our story. Before October 7th, my family—consisting of my parents, five young brothers, two sisters, and myself—lived in a warm, loving home. Our lives were filled with joy and love until the devastation of war struck. I vividly remember October 6th, a day before the war on Gaza began. It was a day of celebration as we gathered to virtually celebrate my younger brother Mustafa’s graduation from pharmacy school. Little did we know, those pictures captured by my sister Sahar would be the last images of our warm home. The war left nothing but rubble and memories, shattering our once-happy life For the past five months, my family has endured unimaginable suffering in makeshift tents, where the threat of death looms large. I implore you, out of sheer humanity, to contribute whatever you can to save my family. I am left with no option but to seek your support in ending this nightmare. Our needs: Exiting Gaza to safety requires funds beyond my means—$6,000 to $7,000 per person. Your assistance will not only save my family but also restore warmth and hope to their lives. Utilizing Your Donations: Ensuring Safety, Medical Care, and Education Evacuation to Safety: The primary goal is to relocate my family to a safer location outside of Gaza. The funds will cover the expenses associated with transportation, documentation, and any fees required for leaving the region. This includes ensuring safe passage for my parents, my brother Mustafa, and my brother Yassin. Medical Treatment: A portion of the donations will be allocated towards providing necessary medical treatment for my mother, father, and brothers Mustafa and Yassin. This includes access to healthcare services, medications, and any required medical procedures to address their health needs and ensure their well-being. Educational Support: Another priority is to support the education of my brothers Mustafa and Yassin. The funds will be used to cover the costs associated with continuing their education in a safe and stable environment. This includes tuition fees, school supplies, and any other educational expenses necessary for their continued learning and development. By contributing to our cause, donors will directly support our family's journey to safety and provide crucial resources for the medical treatment and education of our loved ones. Your donations will have a meaningful impact on their lives, helping them access the care they need and pursue their educational goals in a more secure environment. We are deeply grateful for your generosity and support during this challenging time.

[m1nsur0]

[JTTW OC: 智平] Character Profile

Name: 阮智平 (Ruan Zhi Ping)

Age (JTTW): 1471

Height: 7’1” (215CM)

Pronouns: He/Him

Unflinching and unwavering in all ways, the Violet Dragon is not ever referred to as “pleasant” to endure, however it is preconception welcomed if it abstracts him to the follies of the living.

“Trying to turn him from his planned path is akin to throwing brittle knifes to a cliff face.” - Wujing

“The strangest man around, that’s for sure. Ya ever meet a doctor that wants you to come to him through death’s door?” - Bajie

“Abrasive, but all good pieces of sandpaper must be so.” - Sanzang

“More stoney faced than Ol’ Sun! Nothing The Great Sage can’t crack open.” - Wukong

SUMMARY: (a bit of a long one i would say)

-Born the eldest child of the Dragon [REDACTED].

-Left his home as a ward under the tutelage of Divine Knowledge at the age of 8, and began his own career in academics before reaching adulthood.

-Spends 400 years in isolation between painted realms and isolated corners of the primary realms, the only signs of his life are routinely submitted papers and documents regarding his innovations and social critiques.

-Gets unwillingly found by the Heaven’s Dog, and swears an accord to His Divinty to avoid a change in lifestyle.

-Emerges to his native lands briefly after reported Yaoguai disturbances in the Seas, and commits the minimum of social requirements to younger relatives before returning to isolation for another 200 years.

-After reaching undeniable renown of his works, he agrees to spend one year every century in mortal plains. Towards both placating his kin and making unwanted ties to other realms for research efficiency.

-Around age 800, his lack of care for social nuances lands him in hot water with the Jade Empress. Both hands are whipped on her command, to ensure consequences on his ability to write and study- the only thing of importance to him.

-Another century of isolation, however this time in his original bedchambers from his home at his parent’s residency. Not a single paper is released by the scholar, and he is as much of a ghost in his home as ever before.

-The joint efforts of Wenchang and Erlang prompt Zhiping to agree to meeting with them outside of politics, and he takes the long walk across the lands to meet them.

-On the walk, finds the first sprig of amusement in 500 years from a crash figure trapped under a mountain.

-Erlang and Wenchang pass on the Emperor’s “pardons of his actions” regarding The Court, and is ushered to Yao Wang and Guanyin to heal any internal injuries in his hand. After this comes a deal struck to expand Zhiping’s access to Heaven’s archives and scholars in apologies.

-The dragon scholar delves even further into his research, invigorated, and is not seen in person for another 300 years. Any work regarding outside beings having express magic pathways to avoid physical encounters.

-Guanyin enlists Zhiping to round off the group of pilgrims under a deal. Zhiping makes it clear that he cares not for buddhahood as the pre-established reward to other contract members, and accepts the task once his proposal is the one defining his involvement.

-Spends the years until the journey more social than normal, knowing that the environment he will have to endure

-Joins with the Tang Monk before reaching The Monkey King, is notably silent in comparison to the others in the group. Not one for small talk or “unnecessary” words.

-Ends up as the group’s healer due to his medical and surgical education, however is known to allow any other party member to suffer physical pains for a safe extra moment if they pushed his buttons recently.

-Despite being one of the group’s dragons, he never interacts with one other than Bai Long Ma- with plausible and pragmatic excuses to leave before meeting any other dragons in passing.

-About 2 years into the Journey, takes in an injured wolf pup, which then stays along for the ride from that point on after regaining it’s health. It takes a few years for Sanzang to settle with the predator.

-Zhiping is “closest” (as much as he can be) with Wujing due to their shared stable personalites, and an odd affection to Bai Long Ma that the group can’t seem to figure out as to why.

-Wukong and Zhiping have the first shift in their allyship after when Zhiping is almost entirely focused on the affects of Samadhi fire, in which the monkey feels something change in him after being on the receiving end of genuine care for the first time in centuries.

-Wukong becomes a bit of a step father to the group’s grown wolf, honing it’s protective and hunting skills. Most Definitely Not to work his stead once the journey fractured the group post-completion. He picks the dog up like he’s still a puppy.

-Zhiping breaks off from the group briefly at the Xiliang Kingdom due to his academic work, after many whines from the horse and dog. Reminding them that he is not bound to this task like the rest of them, and he knows that they’ll manage until they rejoin.

-He reunited with them later, now dealing with a cold-furred-shoulder from the monkey king.

-The golden circlet becomes his next area of research, both in neutrality of how the spell works, and how to possibly alleviate Wukong of the pain in unjust casting. The universe is against him completing that work until the scriptures are delivered- it renders the end goal void. But he keeps the project on the back burner regardless.

-Wukong and Zhiping enter a rocky exclusivity, born of Wukong’s paranoia of separation and possessive nature.

-Sanzang is confronted by Zhiping about his illogical use of the tightening spell, after an explosive argument, Sanzang says a comment out of bounds. The wolf scars the monk in retaliation, and Zhiping departs the group a second time with said canine. But not before placing soothing salves in the luggage Wujing carries.

-Seasons pass, and whilst the group can function on their own, Wukong works to convince Zhiping back with Guanyin’s additional effort, he then comes back after providing Wukong with a plan to outsmart Meifa Guo’s King.

-Zhiping remains with the group from then on, closer to the non-humans as ever before, but warning Sanzang that there’s no circlet or Guanyin to prevent him from being eaten by a dragon should he get too bold.

-The amount of wedding traps the pilgrims have encountered at this point prompts Wukong to make a veiled comment about the two of them after the run in with the Jade Rabbit.

-Tripitaka attains Buddhahood, The Journey Completes

-Wukong refuses anything beyond the removal of the circlet, Zhiping collects his agreed rewards. Their relationship stays strong as Zhiping takes Bai Long Ma and the Wolf, as the Dragon returns to a small island in view of Huaguoshan to complete his studies based on the Journey.

-The Monkey King is the only one he allows to enter the Island, and always makes comment on how not even the Divinity was allowed entrance to any of Zhiping’s domains.

-Throughout continued courtship, Wukong Learns that Zhiping has been inspired to start an academy from his enjoyment of educating the pilgrims from time to time. And the Monkey King decides he is the only one capable of funding such a project. It becomes a part of his betrothal gift to ensure it’s perfect.

-The academy is first open to only 3 monkeys from Huagoshan for a few decades, with no more than 4 at any given enrolment. Wukong declares himself a permanent student of Zhiping, and so only 3 others set foot on academy groups at most.

-Zhiping eventually expels his betrothed for his habit of never doing the assigned work, and only listening to the lectures that focus on botany or weapon masonry. Anything else is Wukong trying to distract the dragon to end work early.

-Nezha is not accepted as a student, despite his repeat attempt at entrance.

-Zhiping limits the academy to two students once he becomes King Consort, substituting it with public lectures beyond the regular medicinal ones to to anyone on Huaguoshan.

VISUAL DESIGN:

“His clothes are thin and fold neatly, they are as considerate of my weary bones as he is.” - Wujing

“Bah! Too Floaty, Too Floaty! It would do better for him to dress in a way that would not make others confuse him with a Lady” - Bajie

“Very delicate, for a Dragon.” - Sanzang

“Oh, very soft… very soft…. I would know most of all.” - Wukong

Zhiping dresses in old fashioned Deep Style clothes, light in colour and light in weight. shifting through Winter Blues, Spring Purples, Summer Pinks and Autumn Oranges.

Even on the journey, his clothes remain ideal for desk work, knowing that his skills in long-range combat and Wukong’s reliability means he has no need to change his wardrobe’s Function.

Once Wukong attaches himself to Zhiping, the outer layer of his hanfu is repurposed as a loose garment for the monkey- both as a signal of their connection and the monkey’s urge to playfully steal from his companion.

He bears no weapons on his person, only writing equipment in deep pockets and in his sleeves, his bow and arrow are stored in dimensional magic spaces that work towards efficiency in drawing a shot. This allows him to make the group look less intimidating due to how feeble he presents himself- before Wukong shatters the illusion.

Standing at 7’1”, he is only a few inches shy of Wujing and “Two Bajies Tall” (as the group says), his dragonic tail also stretches two meters from back to tip. However with how heavily it is armoured with thick scales it is seen as a blunt weapon more than a 5th appendage.

Both Horns and Tails are hidden in all but few specific scenarios. Either when he is alone in isolation or around a group he knows won’t press into his ancestry or kin’s identity. They are slightly more blue-toned than his hair and eyes, and glimmer like mother of pearl under the light. To Wukong’s disappointment, they are not shown within his reach, due to his habits of pulling and pinching.

STATS:

Physical Traits:

A classic glass-canon in fights, beyond his title as the “Feeble Scholar” Zhiping boasts highly specialised utility of his mind and body. His nature as a dragon offsets this fragility through lifestyle, and allows him a comfortable zone of sustainability before taking advantage of his innate speed to avoid conflicts that take away from time he could put towards research.

Too young to properly learn the sword and spear before leaving home to Wenchang’s abode, any combat skills in his youth were cultivated through observation of Heaven’s soldiers- and later a trade off with Erlang. This stuck to gaining skills in archery and knife throwing, preferring to stick to long range.

[Endurance: 2]

-Due to his lifestyle being limited to his desk and labs, the dragon does not refine his form beyond what is necessary to complete tasks related to his research. His skin is soft and unweathered from any hard labour, and if he grasps and scrolls to fast he is likely to gain a paper cut.

[Strength: 6]

-Unwillingly to spend time away from studies, and heavy lifting is done via magic manipulation- never by hand. It doesn’t help that said magic can reduce the tension needed to fire arrows. Slightly below average for a dragon, but left to dwindle without upkeep.

[Magic: 10]

-Due to both the wide field of Magic studies, and interwoven nature of it with earthly science, Zhiping quickly gained great abilities in it under Wenchang in Heaven whilst still a child. Gaining skills in conventional and sealed branches of magic due to sneaking into Xuanwu’s archives when his classes had finished for the day.

[Speed: 9]

-Born of the Seas, His body is built to manoeuvre water that offers far more resistance than air, and such finds anything above the water’s edge to offer no push back. His thin stature is aerodynamic and sleek, however the lack of muscles means he can only sprint in ways similar to a cheetah before he needs to halt.

[Constitution: 6]

-His body is naturally suited to ward off illness and fatigue, however his habits of using himself as a test subject for various pellets and spells has worn down various aspects of his body. His stomach can no longer handle eating more than once a week, and his hands still feel phantom pains. Walking the wolf does help build up stamina again, though.

Social Traits:

Blunt and uncaring for comfort in his words, the Violet Dragon has often found himself at the end of outcries from his harsh comments. It takes years for the best natured people to understand his sheer truthfulness and neutral intent. It has worked equally in his favour and against regarding goals. But he would rather lose his senses before he gains baseless placation in his encounters.

The path of erudition is where every step of his treads, no action or words are made if they do not move him in the right direction.

[Athleticism: 4]

-Briefly trained in proper etiquette by his kin and given a structured life until his departure to isolation, Zhiping has experience in courtly dance and basic performance arts. More graceful than strictly powerful, he can perform feats of entertainment and water-based traversal. However lacks the ability to measure up to other dragons in regards to endurance travel or weight lifting.

[Charisma: 0]

-Not inviting both subconsciously and by curated personality, Zhiping bolsters no way to prompt endearment and prefers using his bristly nature to nip any outside fondness in the bud. Any bonds forged with him are this tempered through years of putting up with harsh environment and even harsher comments. He has only every failed in inheriting courtly manners.

[Willpower: 5]

-Swings like a metronome between hyper focus and callous disregard for any topic depending on how it aligns with his scholarly pursuits. Topics can be hotly pursued and suddenly dropped when reevaluated to not hold any further academic value. It means that any he decides to pursue is hunted relentlessly, in a very specific scope of interest.

[Intelligence: 18/10]

-Undeniably the foundation of his being and soul, his mind overpowers every other part of him. Able to grasp any unfamiliar field of study to the highest degree within one day cycle. However with how long he has lived there are few topics left for him to discover anew. His intelligence does not stop at traditional means, with excellent abilities to decide his emotional and psychological state- and more importantly others. Possess such mastery over his emotions that many think he possesses none.

[Self-control: 6]

-He can easily coordinate his desires to what is pragmatically ideal to the moment, shutting off what is unnecessary or irrelevant to the task at hand. But also possesses no desire to temper the intensity of his studies towards compile knowledge. Dragons do have a nature to hoard.

[Creativity: 7]

-Study of the world is to study the arts and mind. There are infinite topics of interest regarding the creative arts, and creativeness in methods of conduct are often the only way to achieve results in contexts of tight parameters. When he is rarely not researching, Zhiping can be found illustrating his notes or tuning his Ruan.

Black Myth: Zhiping

Following the Mortal Death of Wukong, Zhiping’s efforts have continued on focusing on sustaining the lives of Huaguoshan’s inhabitants, ushering them to his academy under intense protective magic wards to avoid any more of Heaven’s Soldiers reaching them.

Some monkeys of Wukong’s mountain follow immediately, some stay with the healers he has instructed until this moment. Some flee the mountain. Zhiping states that the Mountain itself will attract the ire of Heaven and that the Academy can provide solace, that it would be forever open to any of Wukong’s denizens.

Quest 1: Medicinal Brews

Required: [Rescue Shen Monkey] [Gain access to Shen Monkey’s services] [Defeat the Whiteclad Noble] [Defeat Elder Jinchi] [Defeat Rat Royals] [Obtain: Loong Scales]

Speak to Shen Monkey, if [Loong Scales] are in possession, completing all new dialogue alluding to a healer who solved his chronic wounds will end in receiving [Ziluolan Pellets]

(Ziluolan Pellets: If added to a flask originating from a monkey, will create immunity to DOT effects- but will not remove the build up of Four Banes.)

Quest 2: Western Waters

Required: [Defeat Kang Jin-Star] [Defeat Cyan Loong WHILST having Ziluolan Pellets in brew effect] [Defeat Cyan Loong wearing Loong armour OR wielding a Loong Staff][Possess at least 4 Loong Pearls] [Talk With Bajie near Kang Jin Loong body]

After Bajie finishes his monologue, having all mentioned pre-requisites achieved will provide additional dialogue on Wukong and his involvement with Dragons. Allow for this extra dialogue to finish to have Bajie pass on the [Broken Arrow Tip Curio]

(Broken Arrow Tip: Takes up two equip slots. Allows [Pierce] to be applied to all damage. [Pierce] will reduce enemies DEF by 25% when headshots are landed. Can stack with multiple of the same Curio.)

Following Western Waters being completed, speaking to Chen Loong will start a cutscene related to Zhiping and the barrier towards his Academy grounds. The Destined One having a birthright allowing access to this island will make Chen Loong as to go there to ask the Dragon of that domain for a list of seeds. Receive [Seeds and Saplings List]

[This opens up the Sprawling Roots Quest]

Following Western Waters being completed, speaking to Xu Dog will open dialogue on the academic papers released on celestial pellets he has near his furnace. Complete this dialogue to be asked to take his noted questions to the paper’s Author. Receive [After-Lecture Questions]

[This opens up the Loong Road to Perfection Quest]

Quest 4: Familiar Seas

Required: [Defeat All Four Loong Bosses] [Defeat Yellow Loong with Ziluolan Pellets in Brew] [Defeat Yellow Loong with Broken Arrow Tip Curio Equipped] [Apply Pierce in Thrust Stance at least once during fight with Yellow Loong]

If the boss fight is completed with all above tasks, Yellow Loong will relinquish the rune needed to open a pathway through the Academy Ward.

Quest 5: Painted Realms, Painted Fogs.

Required: [Possess the reward rune from Yellow Loong] [Unlock Somersault Cloud]

After unlocking the ability to fly around Huagoshan, finding Bajie staring westward on a platform in the open-map will start a cutscene of him complaining about an odd fog cloud beyond the waters. He will end the cutscene muttering about Wukong’s Dragon. Flying towards the Fog will prompt a cutscene where the unlocking rune will dispel the illusioned cloud, and open up the Secret Area: Yinshi Academy.

Progress through the path to Yinshi until you encounter a Dragon Wrapped Gate.

Possessing the [Loong Scales] and at least 4 Loong Pearls will awaken the Dragon from slumber, and initiate the boss fight with [White Dragon, Son of Ao Run]

Fighting the White Dragon will end with a cutscene at 25% health, where a wolf will unavoidably interrupt any attack the Destined One is making, and will take the equipped weapon with it as it runs down the path towards the academy.

Drinking from the Gourd whilst the [Ziluolan Pellets] are in brew will end the boss fight early, and the player will retain their equipped weapon. A wolf will grab the attention of the player and guide them down towards the academy.

Both Boss endings will reward the player with [4x Celestial Ribbon]

Once the Destined one reaches Yinshi’s front door, A cutscene will start showing The Violet Dragon healing an elderly monkey.

There are no other fights in this map, and the Destined one cannot draw any weapon or cast spells once this point has been reached.

Quest 6: Violet Scales, Violent Tales.

Required: Complete [Painted Realms, Painted Fog] [Have Broken Arrow Tip Equipped]

The Violet Dragon will not speak, nor pay the Destined One any attention unless they walk directly into his line of sight after he moves to his open desk.

The Dragon will reach for the broken arrow tip, [This will remove it from the player’s inventory permanently] and will traverse the room to hand the Destined one the [Pristine Arrow Head Curio]

Leave the area via fast travel or Somersault Cloud to reset Yinshi Academy, then return to The Violet Dragon. This will prompt dialogue, asking if the Destined One knows the NPC’s name.

Exhaust this Dialogue to receive [Amethyst Abacus Necklace]

Zhiping will provide access to the reward chests deeper in Yinshi, and if given excess materials, will upgrade medicines beyond Xu Dog’s formulas.

(Pristine Arrow Head: Takes up two equip slots. Allows for the [Shatter] effect to be applied to enemies. [Shatter] will apply 2% DEF reduction with each hit onto the enemy, stacking up to 20 times as long as the wearer is not hit. Stacks reset upon taking damage.)

(Amethyst Abacus: Takes up one equip slot. Wearing this curio will allow the user to summon Langgou, highly affective against some bosses.)

After this Quest, Zhiping will move on schedule around the map.

Sprawling Roots: Talk to Zhiping whilst he is in the Gardens, and with [Seeds and Saplings List] in inventory will end with gaining the [Seed Pouch] to give to Chen Loong.

Loong Road to Perfection: Talking to Zhiping whilst he is in the Lecture Halls, and with [After-Lecture Questions] in inventory will end with gaining the [Refined Fomula] to give to Xu Dog.

After all mentioned Quests are completed, The Destined One can now:

-In Yinshi Academy, use the equipped weapon to throw near Langgou, Zhiping’s Wolf, to play fetch. (If the Jingu Bang is equipped, you will have to play a game of tug with Langgou.)

Collect rare plants from the Academy Gardens, however taking more than 5 per visit will result in Zhiping removing the Destined One from the secret area for the day.

Listen to Zhiping’s tales of the Journey in the Archives.

Pat the White Dragon, Son of Ao Run as you pass through the Gate.

Using the [Amethyst Abacus] in Painted Mount Mei will take Xiaotian Quan’s aggro from the Destined One during Region’s Boss fight.

[macgyvermedical]

Med school teaches a lot about handling various conditions with all kinds of medication and equipment etc. but so little on what to do when there isn't access to any ( in the middle of the highway in a movie bus/car with a first aid box consisting of a few band-aids. Or in the middle of a forest or a remote lake or beach.)

So what can we do in these situations when people look at you (as a known healthcare professional).

Eg: a case of anaphylaxis and no epi-pen, case of ureteric colic due to a kidney stone. Or something very acute.

There are a couple of ways to look at this. The first is from a first aid sense, the second from a broader medical sense.

The first aid sense:

One of the best things you can do is take a Wilderness First Aid course or get your Wilderness EMT. I know it seems like you'll be learning a lot you already know, but I promise- first aid (and particularly wilderness first aid) is so so different than the kind of medicine you learn in med school. These courses teach you to make decisions in contexts where you're thinking about safety of a group, how and when to go for help, and what basic things you can do about the most common illnesses and injuries in a wilderness or remote setting. Mostly, it gives you permission to improvise in a way that med school doesn't.

The broader medical sense:

This one is tougher to fit in a tumblr post, because I've been studying this my whole life and honestly I know there's still so much to learn. Think of low-resource medicine as an entire medical specialty. You could fill an entire residency program with the information you would need to provide high quality medical care in low-resource environments.

In order to improvise, you need a lot of knowledge about the subject area. You need to know how bodies work, and you need to know how and why they break. Med school is great for this.

You also need to know how to figure out how a body has broken. Hopefully, you got a class or two about physical exam skills. This is a great jumping off point. A lot of these skills were perfected in the 1930s-1970s, so getting a physical exam (AKA physical diagnosis) textbook from this era will give you a much deeper dive into how to figure out how a body has broken without a CT scan or a lab test.

Then you're just going to need to amass knowledge. One of the best ways to do this is to, as you encounter medical problems in your patients, ask yourself: "What did we do before we had the current treatment for [illness or injury]?". Talk to older doctors and ask them what treating __________ was like when they were going through residency. People love to talk about this stuff. If you can find someone who was in residency in the 1960s or 1970s, you're in for a real treat.

I would also highly recommend you find textbooks like Improvised Medicine by Kenneth V Iserson (designed for doctors) or Where There Is No Doctor by David Werner (designed for lay people who need primary care). Also, because a lot of low-resource care is nursing care, I recommend Barron's The Complete Guide to Home Nursing by Diana Hastings. All of these are available on Internet Archive if you want to sample them before you buy.

[cy-cyborg]

I've seen my new GP twice now, and omg I didn't realise how bad things were with my previous one until now. Like I knew it was bad, but having someone who actually listens and cares to contrast to makes the shitty treatment stand out so much more. Some of the highlights:

My memory isn't great, so my partner wrote out a full report of what had been happening with a list of symptoms and a timeline of the most recent events, as well as printed versions of whatever tests results we could get before we arrived. Id summerised it at the top because every doctor id been to never reads what i give them, even when its from other doctors, but he read all of it, and asked clarifying questions as he did to make sure we were on the same page.

He actually read what little bits of my medical history had access to (while I've never seen this doctor before, I attended this clinic as a child, which was when most of the stuff associated with my primary disability was happening, so he could see that) and agreed that there is almost certainly something chronic going on that he will gladly investigate once the immediate issue is dealt with.

The fact I was autistic came up at some point, and I explained that I'm not formally diagnosed. My current psychologist and one other has done all the testing they can and they were both very confident I am autistic, but we can't get the formal diagnosis without a review from a neuropsyc because of something in my history, and I don't have the money to do that. My autistic traits are in my medical files but they're incorrectly attributed to something else. He was incredibly understanding of that and told me not to stress about the diagnosis (unless i want to, in which case he said hed support me from his end if he can) and asked if I could get something from my psychologist to explain how this might effect my treatment (not noticing symptoms, not being able to articulate problems consistently etc) so he knows what additional support I might need in the clinic.

He admitted to not knowing things, and told me how he was going to go about fixing that gap in his knowledge before my next appointment. For example, He admitted to never having a trans patient before, but that he's going to do some research on his own time to learn what he needs to do to be a better Dr for me.

He asked me to get some scans from a previous hospital stay, and picked up that I was hesitant. mum was with me and explained my auditory processing issues and how it makes communicating via phone hard. he told me not to stress and said he can get the receptionist to do it with my concent.

A lot of these aren't big things, but they make the world of difference when you have a complex medical history and its so refreshing just to feel heard after all this