#NHS surgeon

[nightmaretour]

From my interactions with a private clinic so far, I think I've figured out the REAL reason that NHS doctors almost universally do not give a fuck about their patients and will jump at any chance to be negligent.

The ones who give a fuck left, and I don't think I can find it in me to blame them. How could anyone who cares about their patients, who became a doctor or a nurse to actually help people, mentally withstand being forced to disregard their wellbeing at the command of some higher up who has never even stepped foot inside an NHS hospital before? Imagine you become a doctor, thinking you're going to save lives and alleviate suffering... only to be instructed to keep the treatments that could do so from your patients because they cost too much. Every single day.

Of course I really respect the few who chose to stay in public healthcare, but it doesn't surprise me one bit that the ones who stay are the ones who are only in it for power or status or money.

[recreationaldivorce]

man it is seriously depressing remembering how excited i was when i first got my bottom surgery referral multiple years ago now like things were finally looking up i was so excited to finally get surgery after waiting my entire life i was constantly browsing bottom surgery forums to read other ppls account of their recovery etc. i really couldnt wait to feel comfortable in my own skin and be able to have sex the way i wanted and be able to shower with the lights on and all that. and then that was all taken away from me. and all that imagining post-op life that made me so excited is so painful now bc i know it is so far off and possibly i'll never be able to have it bc the nhs can just arbitrarily take it away from me again on the whim of one doctor.

cant stop thinking about emigrating cause i know i would literally get bottom surgery faster if i moved to another country and went through their processes despite the fact that my initial gic referral was in 2017 lol. even if i got my bottom surgery referral today (realistically i won't be re-referred for like another decade p much, and no they won't let me keep my old place in the bottom surgery waiting list, i checked many times with gdnrss lol) it still might be faster to emigrate. i know that a friend of mine who was recommended for bottom surgery in 2019 recently had surgery (she's a trans woman, im aware the waiting times are an order of magnitude longer for masculinising bottom surgery bc of the nhs fucking up the st peters contract too) and like i definitely know foreign surgeons with wayy faster turnaround than that, although im not sure how quickly i could become a citizen to become eligible for those countries' healthcare systems. maybe i could take advantage of my british passport privileges idk how much easier that would make it. but anyway i've been on and off thinking about moving to cuba since i was 16 anyway for anti-imperialist reasons, and ofc they have free bottom surgery there. ive have stayed put bc i think there needs to be communists in the imperial core too to sabotage imperialist efforts to crush revolutions abroad if nothing else bc the british people are so impotent lol, but like damn if britain doesnt keep giving me reason after reason to leave this shitty place

[luv4kokafox]

Do No Harm - Henry Marsh

Rating : ★★★★ / ★★★★★

Do No Harm is one of those books that EVERYONE will tell you to read if you're considering entering the field of medicine or something close to that.

In reality, this book doesn't teach you anything about medicine itself (unless you're willing to look up every other word), but rather the ethics and mindset of a surgeon in theatre. Think of it as placing yourself in Marsh's shoes for a number of short stories within his life.

Would I recommend a read?

TL;DR : yes!! Though it doesn't act as a textbook, it is definitely a good read if you're interested.

The 'too-long' section:

To pick up this book, you have to be in the right mindset, at the right place, at the right time. Otherwise, you'll give the book a bad impression of a slow and boring read as soon as you start. I won't sit here and say that I understood every word written in this book - but if you are an aspiring surgeon or you take an interest in the brain / tumours, it can definitely help you in your future endeavours.

If not, the book does tend to give general explanations of words that aren't common, but there are a few instances where an acronym is thrown into the mix and I had no idea what was going on. Overall, it was a good read at times but a sleepy one at others.

If you're applying to universities or careers in medicine, and you're wondering if reading this book will give you an advantage, maybe. Only if you can write / speak about it in a sense that GIVES you that advantage. For example, showing that you've had an interest in science and medicine for a long amount of time, or you are passionate about the subject so much that you made extra time on the side just to read it. It is a very common book to be read and recommended, so keep this in mind. I would definitely not pass up the opportunity to get my hands on it if I were you.

[cardiachospitalwellsunmedicity]

Wellsun Medicity is a 200 bedded multi super-speciality hospital. It has well equipped modular operation theatres, interventional Cath lab, intensive care unit and in-patient rooms ranging from economy to luxury.

[sinsofsinister]

on all levels except physical i am violently shaking this goddamned surgeon to get him to respond to me like mr mellington please i need to know if you're accepting new patients and if you accept referrals for top surgery from my clinic so i can know if i should continue with plan a or plan b

[jackoshadows]

Ex-NHS surgeon Nizam Mamode broke down as he told the international development committee what he witnessed when working as a surgeon in Gaza.

Q: You believe it was deliberate targeting of civilians? A: Absolutely no question in my mind and I and it's been uh it's been the experience of so many healthcare workers who've documented it time and time and time again um but my personal experience and those of my colleagues was this was clearly persistent deliberate targeting of civilians and I've worked in a number of conflict zones um in different parts of the world I was there at the time of the Rwandan genocide um I've never seen anything on this scale ever and that was also the view of all the experienced colleagues that I worked with um one of the surgeons in my team had been to Ukraine five times and said this is 10 times worse normally in a conflict Zone you would have a front line have fighting going on between um two sets of forces and you might get some civilians injured in in that um in that exchange there doesn't seem to be a front line there just seems to be 1.4 million people trapped they can't leave and having bombs dropped on them on a daily basis and then drones coming in and shooting them and um and there's plenty of evidence um out there uh from from Israeli soldiers that that's what's going on but we saw it you know we saw the results of it

Dr. Mamode talks about how they are running out of supplies to operate and how they used the last of their shunts - device used to bypass artery in the neck to supply blood to the brain - on a three year old shot deliberately in the neck by an IDF drone. The 3 year old died 4 days later from infection because they don't have the medicines either.

Please donate:

[littlesmartart]

DRAWTOBER #1 - A Respectable Young Man by @out-there-tmblr

"He's finishing his residency this year," Aunt Mai says, with a conspiring glance at her neighbour, Mrs Yueng. "He's studying to become an orthopaedic surgeon." "And he's very handsome," Mrs Yueng adds, pulling out her phone. She turns it on and hands it over. The phone background shows a young man in dark green scrubs, smiling toothily at the camera. He has a lean face with kind eyes; Xichen can imagine that would be a comforting face in a hospital. "Very handsome. That's what I said when I saw his photo," Aunt Mai says. "I said he's very handsome, almost as handsome as my nephew who's still single, despite graduating law school second in his class. It's such a shame." Xichen smiles and nods and tries not to crumble under the avalanche of family pressure. *** Lan Xichen is in love with his very close friend, Meng Yao, who is currently working and studying and trying to gain his father's respect, and doesn't have time to date anyone. Lan Xichen is devoted and waiting, but all of his friends and family keep trying to set him up with much nicer, more respectable young men.

welcome to drawtober 2024! kicking it off is a delightful little modern AU with And They Were Roomates! xiyao. whilst endless will they/won't they angsting and pining can be fun, I have to say that I do appreciate the trope that I've seen a few times with xiyao where they both know, it's just not the right time, so they love each other in silence 🥲 thankfully a meddling NHS nips that one in the bud and the second chapter is full of a lot of VERY fun xiyao dynamics! a good fun sweet read for the first day of october

[edandstede]

https://www.justgiving.com/crowdfunding/quills-top-surgery

it’s my 28th birthday in march and i’m crowdfunding for my top surgery! going private is the only option thanks to 4-5 year waiting lists for NHS consultations in the UK, and i haven’t even been referred to a GIC as of now. of course i’ll be putting my own funds towards the costs but at an average cost of £5,000-£8,000 it would take me years to save - a position myself and many other trans people are in, which breaks my heart. i wish trans healthcare was better than this.

i am so unhappy as i am. i want to get married in a few years in a body that feels like my own. i want to be happy with how my clothes fit. i want to not wear a binder every day, especially as a chronic asthmatic. i want to not feel depressed and uncomfortable and sick to my stomach about my chest. i just want to live, instead of feeling like my life is stuck on hold. i want to go into my 30s as a new man.

i’ll keep my justgiving page and my tumblr updated as i go forwards with consultations, finding a surgeon, gender dysphoria referrals and all that jazz! i currently have an appointment to get my dysphoria diagnosis and we'll go from there!

if you can’t donate, i appreciate you regardless, and just sharing this will help enormously. thank you so very much! ⭐️❤️✨

[ghost-of-a-dream-girl]

as a doctor, where in the hospital staff would you place each of the bg3 companions? what would fit their characters the most?

Hahah oh this is great

Gonna keep this to doctors but let’s do different specialties

Ok so starting off strong: I think Karlach has big emergency medicine energy. She’s running the ED with an energy that nobody else can match, but especially that resus/trauma bay! Doesn’t shy away from the scary, gets stuck in. You know they don’t need security there to restrain the agitated when she’s on shift- all you need is Karlach and some ket.

Next I think Gale has the same aura as a senior ICM registrar (intensive care medicine resident). Probably dual training in renal or respiratory, likely has a PhD on the side. He has intensity when it matters but is an utter nerd. Likely the type who doesn’t like odd numbers on the vent settings. Precise, a little OCD, but fucking magical.

Wyll has to be a medical registrar (internal medicine senior resident). Probs in something acute like acute medicine or resp/gastro. Able to deal with vast quantities of shit and still put on a smile, graceful, caring, and properly holistic in the way he views patients. Quietly competent as the hells. Sacrifices himself for the good of the hospital.

Shadowheart is a tricky one. It would be too obvious to lean into the goth girl vibes and say pathology or whatever but actually I don’t think that fits. I think Shadowheart is an anaesthetist (anaesthesiologist to u Americans). Very very competent and always there exactly when you need her to save everyone else’s asses, but keen to retire to theatres after the fun is over and just crack on with a case by herself. Able to gossip like a pro. Likes taking the lead with her own problem solving. Would be catty as hell about her list overrunning or the surgeons doing something silly. probably overly reliant on caffeine.

Astarion. Cardiothoracics. Probably specifically cardiac surgery. No mortal human can stand for 12 hrs and perform like that. Also the most (justifiably) egotistical surgeons around. Would be bitching about his colleagues across the drapes with Shadowheart. Has had 200yrs to practice his techniques so the ego is probably really well placed. Those rogue hands were meant for complex cardiac surgery but that hair was made for the drama of it too. Easy access to blood products. Would do 30% NHS lists and 70% private practice to fund his lifestyle. Best dressed in the hospital.

Lae’zel is that really strange surgical registrar (general surgical senior resident) that you’re never quite sure if she’s joking or not when she makes threats toward you. Obviously very competent. Makes other surgeons cry but particularly the men. Has > 300 publications in major medical journals. Probably pioneered a revolutionary new technique that she came up with one rainy Saturday. Can get an appendix out in 5 mins max.

There is only one woman for trauma and orthopaedics and that is of course Minthara. A woman who dominates what is well known to be the most male dominated field in medicine. Lowest complication rate in the country. Every single one of her male juniors is terrified of her and for good reason. Will operate on things other surgeons would be too scared to touch. Complex poly-trauma patient with ‘unsurvivable’ injuries? Watch them walk out of hospital 3 months later.

Honourable mentions:

Durge- you know what, it’s so tempting to put Durge as a surgeon or even a pathologist (people who do autopsies), but that’s just too obvious. I think the murdering would be kept on the side. One thing Durge would love though is blood and carnage, maybe even a little high octane drama. For that reason- obstetrics. A little poetry to a killer bringing new life into the world too.

Jaheira - that incredible Professor who only works part time clinically now but when she does everyone is reminded of how brilliant she is. Gives me the energy of a ‘seen it all’ medical consultant (internal medicine attending).

Minsc- he should be ortho. Everyone thinks it- he has big Ortho lad energy. But he’s not. Minsc is a paediatrician!!!! It shocks everyone when they first meet him, this massive guy with a hamster on his shoulder. The kids love Boo. He’d be obsessed with Prof Jaheira too.

Halsin- can see him as a psychiatry professor actually. Probs does dabble in a little of the cooler types of therapies on the side (and tries them for himself) eg LSD for PTSD. Mixes medicine with non medical therapies. Very soothing to listen to.

Withers- palliative care consultant that should have retired millennia ago.

Volo- ophthalmology. 👁️

—

[tieflingkisser]

Israeli drones shooting children in Gaza deliberately 'day after day', UK surgeon tells MPs

Nizam Mamode, a retired NHS doctor who recently returned after working at Nasser Hospital, said he had 'never seen anything on this scale ever'

In harrowing testimony to British MPs on Tuesday, Nizam Mamode said of all the conflicts he had worked in, including the genocide in Rwanda, he and other experienced colleagues in Gaza had "never seen anything on this scale ever". He said at least once or twice daily, there were "mass casualty incidents," meaning that 10 to 20 people were killed and up to 40 seriously injured. He estimated that at least 60 percent of the people treated at these times were women and children. "Drones would come down and pick off civilians, children," Mamode told members of the International Development Committee in a hearing focused on the humanitarian situation in Gaza.  "This is not an occasional thing. This was day after day after day operating on children who would say, 'I was lying on the ground after a bomb dropped and this quadcopter came down and hovered over me and shot me'."

[...]

The 62-year-old surgeon broke down three times during his testimony as he provided detailed accounts of his patients, including an 8-year-old girl who he said was bleeding to death during surgery one Saturday evening. "I asked for a swab and they said, 'No more swabs'," he said, momentarily unable to speak. Mamode said lack of medical supplies as a result of Israel not allowing aid into Gaza included sterile gloves, drapes and pain killers, but also basic items like soap and shampoo, leading to unhygienic conditions.

[...]

He and his colleagues were particularly disturbed by a pattern of wounds - three to four shots on the left and right side of the chest and also in the groin area - caused by drones. "That we thought was prima facie evidence of an autonomous drone or semi-autonomous drone because a human operator would not be able to fire with the degree of accuracy that quickly," Mamode said. But he also said the pellets fired by most drones were also more destructive than bullets which would pierce a body straight through. Instead, the pellets were bouncing around inside bodies.

[maaarine]

My PMDD hell: why I went abroad to have my ovaries removed (Sarah Gillespie, The Times, Nov 27 2024)

"For six years, from my late twenties, I have lived with a condition called premenstrual dysphoric disorder, or PMDD.

Due to a genetic quirk, I have a brain sensitivity that makes my body intolerant to its own hormonal changes.

Instead of becoming moody and irritable, as with PMS, I become catatonic and racked with pain.

Dysphoria blooms in my brain, making me depressed and paranoid. I binge on carbohydrates, needing 3,000 calories a day just to function.

This happens for 7-14 days every month, during the latter half of my menstrual cycle, as hormone levels plummet.

On the third day of my period, the fog lifts and I feel normal again. But relief is soon replaced by dread as I survey the destruction.

There are relationships to repair, overdue bills to pay and excess pounds to lose.

It is the life of Sisyphus: every month, I roll the boulder up the mountain only for it to roll down again. (…)

PMDD is surprisingly common and, according to World Health Organisation data, affects 5.5 per cent of women of child-bearing age — about 824,000 women in the UK.

Of these, more than a third have attempted suicide. Yet hardly anyone’s heard of it.

No one knows the cause, either, though scientists generally agree that it’s genetic — hence why psychological therapies can’t fully fix it.

It was only in 2019 that the WHO added PMDD to its international classification of diseases and related health problems (ICD-11), legitimising it as a medical diagnosis (though there are still medical professionals who dispute its existence). (…)

After diagnosis, women with PMDD are put onto a ladder of treatments ranked from least to most invasive.

But as the body ages and hormones become more erratic, PMDD gets progressively worse.

So even when I found a rung on the ladder that worked, I never got to rest there for long.

First, there were lifestyle changes: diet, weight training, high-intensity interval training (HIIT).

Then supplements: chasteberry, evening primrose, magnesium, calcium, L-tryptophan, vitamin B6. Then antidepressants: fluoxetine, sertraline, citalopram.

Then contraceptives: Evra, Yasmin, Eloine. Finally, there was HRT: Utrogestan, Estradot, Estraderm.

I climbed that ladder for five years. Only HIIT and fluoxetine worked, for about nine months each; the rest worked for two months, if at all. (…)

After all this, only one rung was left on the ladder — one with a 96 per cent satisfaction rate, the closest thing to a cure.

This last-resort treatment is a bilateral salpingo oophorectomy: the surgical removal of both ovaries and fallopian tubes.

Upon their removal, all hormone fluctuations would stop, my hormone levels would drop to almost zero and I would enter menopause.

I would need to take hormone replacement therapy (HRT) until my fifties or risk the early onset of osteoporosis, heart disease and dementia. It would also make me infertile. (…)

Getting approved for surgery on the NHS requires a trial period in a reversible “chemical” menopause: monthly injections that would shut down my ovaries, end my suffering and “prove” that I had PMDD.

That was the idea, anyway. Instead, the injections threw my hormones into chaos, resulting in a PMDD episode that lasted for 11 months.

Deprived of even the monthly breaks in my symptoms, I languished in bed.

My attention shattered; I spent countless days scrolling my phone. I gulped down painkillers and sleeping pills like Skittles.

My finances were collapsing. I gained more than two stone in weight.

“It should be working by now,” the gynaecologist said after three months. “Have you tried eating more vegetables?”

The next gynaecologist was no better. “If it hasn’t worked, that suggests it’s not PMDD,” she said. “I should probably refer you to a psychiatrist.”

After months of my pleading, she agreed to write to the surgeon. But her letter was an act of sabotage.

“Sarah has diagnosed herself with PMDD,” she wrote, ignoring my GP’s diagnosis.

“She is on many help groups and accessing a lot of support from other PMDD sufferers online.” In other words: “This hypochondriac is spending too much time on the internet.”

Yes, I was on the internet, but I wasn’t talking to help groups any more.

Instead I’d been digging into scientific papers to find studies on chemical menopause.

Eventually, I found one — a meta-analysis of five clinical trials published in the Journal of Clinical Psychiatry.

It stated that chemical menopause treats PMDD in “upwards of 70 per cent” of cases — but not 100 per cent, as the NHS doctors had said.

The International Association for Premenstrual Disorders (IAPMD) backs this up.

On its page on chemical menopause it says, “In rare cases [chemical menopause] does not fully suppress the cycle and there are breakthrough symptoms… If this was the case, you may still respond well to surgical menopause.”

Two months later, I was in Lithuania. Feeling desperate and unable to afford the £10,000 it would cost for private surgery in the UK, I had googled “gynaecology surgery Europe”.

This led me to Nordclinic in Kaunas, which treats about 2,000 British patients annually.

I sent my medical records to the surgeon, who agreed to perform the surgery. (…)

Though it’s early days, I still can’t believe how well I feel. My future unfurls before me without interruption.

I have so much time: time to write, to see friends and family, to travel, go on dates, paint and sing and read and run.

Time to cook, as I can now handle knives without fear. Time to sit and do nothing and burst out laughing from sheer wonder — for life without PMDD is so, so wonderful and I will forever be grateful for it.

That said, I still need to reckon with all the time taken from me over the past six years.

My trust in our healthcare system is broken and will probably never be restored.

I need to kick away the crutches — food, phone, pills, alcohol — that have held me up and rediscover better ways to cope.

But this time, I don’t need to keep starting again and again and again every month.

Yes, the scars are still red and raw. But by next summer, they’ll be gone."

[brf-rumortrackinganon]

Yeah I live in the UK and my mum is a consultant surgeon in obstetrics and I remember asking her about the two epidurals, the umbilical cord wraparound, misuse of gas and then the ASAP return to home and she said right away that it would never happen - NHS or private sector - both abide by strict guidelines and especially so in obstetrics and paediatrics (of all ages) and my mum said that the only time any new mum would be allowed home after such a traumatic birth would be if they hadn’t actually birthed the child & that the child was born to a surrogate - and my mum says that a lot of private sector hospitals are being used for surrogacy pregnancies nowadays but also what Harry said in Spare & what else has been said, my mum says The Portland would be medically negligent and sued nonstop for such bad practices & care

the only time any new mum would be allowed home after such a traumatic birth would be if they hadn’t actually birthed the child & that the child was born to a surrogate -

the odds are stacking up...

[jomiddlemarch]

Let the more loving one be me

Rupert knew himself to be a cad, a bounder and a rake, singularly devoted to his own desires and unashamed of it, but he hadn’t known he was stupid.

Terribly, terrifyingly stupid. 

Because being a witless imbecile was the only way he’d ended up sitting in the waiting room of a hospital which could serve as prime evidence of NHS budgetary woes, the plastic chair doing its best to shove him off, the air redolent of antiseptic and very old, very cheap coffee, both scents an improvement over the remainder of Taggie’s vomit on his cuffs, the acrid bite of his own sweat. 

He'd been so bloody stupid—and now she was suffering for it.

It hadn’t seemed like she’d been injured at all in the crash. He wouldn’t even have called it a crash, hadn’t, at first, when the doctor, a middle-aged woman with the coloring of a field mouse, had asked him what happened, how he came to be rushing in to A&E with Taggie cradled in his arms like a pre-Raphaelite maiden fished out of a weedy lake. She’d wrecked her car, but it was already a wreck and how Declan let her drive it was a mystery, and she’d gotten out and come to him entirely sensible, if breathless. He’d held her in his arms and she’d been whole, her trembling soothed by his hand stroking her hair, down the length of her spine. She’d seemed shaken up but that was all and he’d seen her look worse. 

Until she’d cried out, gotten sick all over herself, and fainted. Until she hadn’t woken up when he’d called out her name several times, increasingly loudly, and then pulled over, nearly into a hedgerow, and had tried to wake her with a hand at her shoulder and then her cheek. She’d been desperately pale, her chestnut curls dark against her face, slumped over and for a moment, he hadn’t known what to do, everything blank.

Then he’d put his foot on the gas and broken every traffic law that existed in Great Britain.

They’d taken her from him as if something like this happened every day, which for an A&E department was probably the case, and he tried to be reassured by the general lack of interest engendered by an MP arriving with a unconscious woman in his arms, but they were all British and thus expected to be minimally excited by anything except sport and he hadn’t liked the way Dr. Field-Mouse had pursed her lips and then asked whether he’d noticed Taggie was bleeding.

He hadn’t and he’d thought that was good, but Field-Mouse, who had none of the charisma of a Harley Street surgeon, shook her head a little and paused before saying We’ll get her sorted out shortly, you might have a seat. She pointedly left off sir and it occurred to him she must be a Labour voter who loathed aristocrats and he blurted out she’s Irish, she’s only twenty, as if that would ensure better care.

Dr. Field-Mouse only said, “Have a seat,” again without the sir or any particular kindliness.

Rupert sat.

For two hours. Staring at his hands, at the signet ring on his finger, his stained cuffs. He tried to think of something distracting or consoling, but nothing helped, nothing worked. When he closed his eyes, he saw Taggie’s face, a dozen different times, how he’d shocked her, disgusted her, disappointed her. How she’d trusted him when he’d held her after the crash, how she’d looked at him in the bluebell wood. She had the most expressive eyes of any woman he’d ever known and he’d hurt her so many times already, sometimes with glee, and still she’d stumbled into his embrace, seeking comfort, Taggie who took care of everyone else in the O’Hara household. He was piss-poor at comforting anyone, at his best with dumb animals, and yet she wanted him to hold her, to tell her everything would be all right.

Would Taggie be all right? Christ, it was enough to drive him to prayer, dissolute sinner that he was. Stupid, when he didn’t believe in God and no God worth His salt would ever believe in Rupert Campbell-Black.

“Sir, your wife is stable, you can sit with her,” an orderly said.

“Not my wife,” he replied and the assessing look on the orderly’s face made Rupert barrel on. “Not my daughter, bloody hell, not mine—”

“Perhaps you’d rather ring someone then. Someone she’d want with her when she wakes up. She’s in 206, down the hall to the right,” the orderly said.

“I’ll sit with her,” Rupert said. He’d have to call Declan but he couldn’t bear to just yet, to explain what had happened, to hear the man begin to roar and then stop himself, to be cursed and rightly so, to brace for Maud’s tragedy queen entrance. He’d sit with Taggie first, for a little while, when it might be the last time they were alone. “206. Thanks.”

It wasn’t far and the walk took forever. She was lying quietly in a narrow bed, a blanket that had once been some pastel faded into a dull cream pulled up to her breasts, her eyes closed, for all the world like some fairy princess waiting to be woken with a kiss. He might have leaned over and grazed her lips with his, save that Dr. Field-Mouse was standing next to the bed.

“Her scans look fine, no evidence of bleeding in the brain or in her abdomen. She’s very likely badly concussed and we’ll want to keep her for observation, but she ought to be coming around,” Field-Mouse said. She nodded towards the chair next to the bed and he sat.

“I’ll feel better if she regains consciousness soon. You might try talking to her a wee bit, see whether she’ll wake up to a familiar voice.”

“What should I say?” he asked. Few people who knew him would have believed him ever at a loss for words, but Taggie, lying so still, so vulnerable, left him stricken, speechless. Field-Mouse held his gaze and something softened in her.

“Whatever you think she’d like to hear should do well enough,” she said and left the room.

Rupert reached over, took Taggie’s hand in his and squeezed it lightly.

“Taggie darling, angel, it’s Rupert, please open your eyes. You were right, right about everything—”

“What everything?” she mumbled, eyes still closed, and shifted her hand so that their fingers were laced together. He laughed, a choking sound, and then she did open her eyes. The mixture of skepticism and tender concern felled him. Tears filled his eyes, spilled over.

“Ssshh, s’okay,” she said.

“You’re hurt. I’m meant to be looking after you,” he said, his voice rough. When was the last time he’d cried? Maybe when he’d had to have Trajan put down after the stallion broke his right foreleg. Rupert had been fourteen.

“You’re holding my hand, that’s enough,” she said.

“It bloody well isn’t, but it’s something,” he said. “I haven’t rung your parents yet—”

“Later, I can’t, Da and my mother—in a little while,” she said.

Rupert nodded. He’d told her she was right about everything. He’d wait to call. 

[flowercrowncrip]

My post op appointment went well! The incisions have closed well and are looking healthy. My nipple grafts are attached and have blood flow. Unfortunately the mirror wasn’t at wheelchair height so I didn’t get a proper look but my surgeon showed me on my phone which wasn’t quite as good of a look but I could see enough to know that it looks really good.

After I got my dressings off my surgeon put micropore over my long incision scar (my incisions meet in the centre of my chest to make one long scar) and I got square dressings for my nipple grafts. Because I use a chest harness in my wheelchair I’ll have to keep dressings over my nipples until all the scabs have fallen away which could be a couple of months off. (Usually the dressings only need to stay on for about 24 hours)

My surgeon was really good with all his recommendations. He fully explained his reasons for each and let me know what the consequences might be if I didn’t follow each one: which ones were cosmetic, about avoiding infection, speeding up healing etc. He also told me which recommendations were based on research and which were based on more anecdotal evidence. He gave me the information to make my own decisions in a way that wasn’t rushed, patronising or performative.

We talked for quite a bit about my post op binder. I was really hoping he’d just say I didn’t need to wear it any more but there’s still a bit of fluid under the skin on one side and he felt I needed to wear it 12 hrs a day for another two weeks.

I was concerned because I’ve had some skin breakdown because of it already and was worried about that becoming worse/ infected (because the binder is gross and has to be washed by hand at a low temperature and my skin is delicate).

He was really good at neutrally explaining how the compression vest works and what would happen if I didn’t wear it (potential for further fluid build up and my skin becoming stretched) He also let me know if I chose to wear it that I could wear it over my pyjama t shirt to protect my skin without affecting how well it works.

In the end I’m following his advice but he was probably the best doctor I’ve met at describing the reasons behind a recommendation without putting on unnecessary pressure to blindly follow it.

Overall he’s been a fantastic surgeon who is clearly very skilled in the operating theatre as well as being absolutely amazing at listening and explaining things and making me feel comfortable as well. I’ve had too many bad experiences to ever trust any doctor again, but I completely trust him which I never thought could happen.

For anyone wondering I had surgery on the NHS with the Manchester team and my surgeon was Nick Hobbs. Although you don’t get to chose which member of the team does your surgery, I would recommend the whole team – they have clearly worked very hard to get amazing technique and create the best culture I’ve ever found from a group of doctors. The only downside is the NHS waiting times (I don’t think any of them have a private practice).