#On-Site Clinic Management

[101mobilemedicalsolutions]

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[jrueships]

guess whos not going in at all this week, actually

[izzy-b-hands]

Just submitted a new patient request to Anchor Health. Cross your fingers for me, so I can get set up w/a doc I can stick with who can handle my T and PCP stuff and maybe even mental health stuff? (their website let me mark all three as things I wanted them to provide care for at least)

and the poor local PP can get back to trying to help others without me taking up any more of their scarce resources and staff

[arinrowan]

It is hard to focus on being sad and anxious when you have gotten to pet 7 (seven) new cats in one day in exchange for baked goods, 5 (five) which were long hair, and 3 (three) which were MAINE COONS.

[reverse-mccarthyism]

hhmmhphm

[hectorresearch]

[dermatology-cro]

[market-insider]

Strategic Insights into the Clinical Trial Investigative Site Network Market

The global clinical trial investigative site network market size is expected to reach USD 12.5 billion by 2030. Growing investments in pharmaceutical R&D, increasing demand for new therapies and complications associated with site management of clinical trials are some of the major factors driving the growth of the industry. There has been a consistent rise the clinical trials in the last 5 years. For instance, according to ClinicalTrials.gov, over 262,298 trials were registered in 2018, whereas as of September 2022, over 399,518 trials were registered. The clinical trials are expected to grow even further as the funding for research improves.

Gain deeper insights on the market and receive your free copy with TOC now @: Clinical Trial Investigative Site Network Market Report

This is expected to propel the growth of the industry post-pandemic. There is a growing focus on reducing the cost associated with clinical research. Hiring a clinical trial investigative site network supports the regulatory function, improves the enrollment of participants, assists in data management, and quality assurance. It increases process compliance, reduces process issues with each trial, and helps with faster trial initiations, and shorter trial timelines. These factors are supporting the demand for clinical investigative site networks. The governments are actively trying to improve R&D by providing tax deductions. For instance, in January 2022, the Indian government stated that it is providing a weighted average tax deduction of up to 200% in R&D.

Such initiatives are expected to improve the R&D activities on drugs and thus support industry growth. According to the IQVIA, report on oncology trends, clinical trials for cancer have been increasing for the last 10 years. For instance, in 2011, 1,242 trials were registered for cancer, and as of 2021, 2,335 trials were registered for cancer. The number of clinical trials for cancer is expected to rise even further owing to the growing prevalence of the disease. This is expected to improve the demand for clinical investigative site networks for cancer clinical trials post-pandemic.

[101mobilemedicalsolutions]

Role of Mobile X-Ray Services - 101 Mobile Medical Solutions

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[ccrpsorg]

Introduction to Clinical Trial Training

The field of clinical research has seen a significant rise in demand over recent years, with the evolving landscape of the pharmaceutical and biotechnology industries playing a significant role. A clinical research associate (CRA) is a crucial part of the clinical trial process, as they are responsible for overseeing the well-being of subjects and ensuring that the study complies with regulatory requirements. With the clinical research market set to experience growth, it's essential to have a thorough understanding of clinical research training, encompassing its components, course options, and benefits.

I. Clinical Research Training: Background and Importance

Before diving into the specifics of clinical research training, it's necessary to understand what clinical research is and its importance in the field of medicine. Clinical research refers to the systematic study of potential new drugs, medical devices, and techniques to establish their safety and efficacy before they can be approved for use by regulatory authorities. In simple terms, clinical research aims to ensure that new treatments and therapies are both safe and effective for human use, protecting the public from potentially harmful side effects or complications.

Clinical research, thus, plays a key role in the process of bringing novel medical treatments to market. It is a multifaceted process that requires a range of skill sets, from data analysis to ethics and compliance. Clinical research associates (CRAs) are responsible for managing clinical trials and ensuring that they adhere to relevant laws and ethical guidelines. As such, clinical research training equips potential CRAs with the necessary skills to excel in their roles and contribute to the safe development of new therapies and medical products.

II. Components of Clinical Research Training

Clinical research training typically comprises several essential components, each designed to provide a comprehensive understanding of the clinical research process. Some of the critical elements of clinical research training include the following:

1. Basic Principles of Clinical Research: An overview of the fundamentals of clinical research, including the phases of clinical trials and the importance of randomization, blinding, and placebo controls.

2. Good Clinical Practice (GCP): A thorough understanding of GCP guidelines set by regulatory authorities like the International Council for Harmonisation (ICH) and the Food and Drug Administration (FDA) to ensure the safety, integrity, and quality of clinical trials.

3. Protocol Development: Training in the design and development of clinical trial protocols, with an emphasis on creating study objectives, inclusion/exclusion criteria, and the types of assessments required.

4. Ethics in Clinical Research: In-depth exploration of ethical considerations in clinical research, including informed consent, institutional review board (IRB) approval, and data protection.

5. Regulatory Compliance: Gaining a comprehensive understanding of the role of various regulatory authorities in the clinical research process, and ensuring compliance with relevant regulations.

6. Data Management and Biostatistics: Knowledge of essential data management techniques, including data collection and validation, data quality control, and the application of biostatistics in clinical research.

7. Clinical Trial Management: Training on the roles and responsibilities of the clinical trial team and best practices in trial management, including site selection, patient recruitment, and study closeout.

8. Safety Reporting and Pharmacovigilance: An understanding of safety reporting requirements and the importance of pharmacovigilance in maintaining patient safety throughout the clinical trial.

III. Clinical Research Training: Course Options and Certifications

Numerous clinical research training programs are available for those wishing to enter or advance within the clinical research field. These programs typically cater to diverse educational backgrounds and levels of expertise, ensuring that all prospective CRAs have access to the necessary training. Courses generally range from short-duration workshops to comprehensive diploma or degree programs.

One popular and widely recognized accreditation is the Clinical Research Associate (CRA) Certification. Obtaining this certification demonstrates a commitment to excellence and professionalism in clinical research. Several organizations offer clinical research associate certification online, making it an easily accessible option for many individuals.

In conclusion, clinical research training is essential for anyone wishing to pursue a career in clinical research. It equips learners with the skills and knowledge necessary to conduct and manage clinical trials, ensuring public safety and helping to bring life-enhancing treatments to market. With various course options available, including the Clinical Research Associate Certification Online, gaining the required qualifications is more accessible than ever before.

[indorivclinical]

Be ready to contact Indoriv Clinical, the leading clinical trial site management organization. We offer biobanking in India too. Explore our blog section.

[23victoria]

𝔤𝔬𝔩𝔡𝔢𝔫 𝔣𝔞𝔫𝔱𝔞𝔰𝔶

*☾⋆･ﾟ pairings: 𝔠𝔥𝔞𝔯𝔩𝔢𝔰 𝔩𝔢𝔠𝔩𝔢𝔯𝔠 + 𝔠𝔞𝔯𝔩𝔬𝔰 𝔰𝔞𝔦𝔫𝔷 x 𝔣𝔢𝔪!𝔯𝔢𝔞𝔡𝔢𝔯

word count:11𝓀

*☾⋆･ﾟ synopsis: paying for sex was a first, but after all, who could blame you? it had been too long, and you deserved to have a little fun too. besides, it was just a straightforward transaction—money for pleasure. what could possibly go wrong? 𝔠𝓌!☠︎ pornstar, escort, pet names, praise kink, rough sex, fingering, oral (f & m), body worship, overstimulation, size kink, belly bulge, dacryphilia, voyeurism/exhibitionism, creampie, face sitting, double penetration, threesome, wax play, blindfolded, anal play/sex, throat fucking, nipple play, begging, aftercare

authors note: i am so sorry is this is complete shit, i struggled with this so much and….yea, i hope it’s good and again i’m sorry likes, asks, and reblogs are appreciated! i hope you enjoy :)

𝔴𝔞𝔫𝔫𝔞 𝔟𝔢 𝔞𝔭𝔞𝔯𝔱 𝔬𝔣 𝔪𝔶 𝔱𝔞𝔤𝔩𝔦𝔰𝔱?! CLICK HERE!

*☾⋆･ﾟ f1 MASTERLIST. KINKThe TOBER MASTERLIST.

The plush carpet muffled your footsteps as you paced the length of the suite, the glass of wine in your hand barely touched. You weren’t here for the wine, after all. The cool rim of the glass pressed against your lip was a distraction, a flimsy attempt to calm the anxiety swirling in your chest. Your reflection caught in the mirror, and you almost rolled your eyes. Dressed in the black lingerie you’d splurged on for the occasion, you looked... ridiculous. Sexy, sure, but ridiculous. Who pays $6k for sex? Apparently, you do.

You snorted, shaking your head at yourself. God, what the hell am I doing here?

The reasoning had seemed airtight at the time. Two years of celibacy after that disaster with your ex—who, naturally, had managed to ruin not just your relationship but your self-esteem too. He'd cheated, and when he left, he took a piece of you with him. Trust, confidence, maybe even desire. All of it was locked away in the aftermath of his betrayal. But you were a grown woman, an adult who could make her own decisions.

I could fuck anyone I want to, right? You thought, half-defending yourself, half-mocking the idea. Right. Except I haven’t. The lingering anxiety had kept you paralyzed, unable to even flirt, let alone let someone close again. So, you made an impulsive choice, one that had you sitting in a five-star hotel, waiting for a stranger.

Not just any stranger, though. The best. That's what the website had promised, and you had researched thoroughly—more than you cared to admit. Every review, every service listed, the options detailed right down to the type of man you could request. It all felt clinical, safe. A transaction.

That’s all this is. A simple transaction. You repeated it like a mantra, hoping the words would settle the knot in your stomach.

But the number—$6,000—echoed louder in your mind. Six grand for sex. You winced, taking another slow sip of wine, trying to justify it again.

He was supposed to be the best, though. The reviews had gushed, the site had practically bragged about how this guy was the epitome of everything you could want: good-looking, professional, discreet. For what they charged, he better be.

But that didn’t stop the anxiety from clawing at your chest. What if you got too stuck in your head? What if, after all of this buildup, the wine and the lingerie and the research, you chickened out? You’d waste his time, your time, and a small fortune on top of it. $6,000. Jesus.

You laughed at the absurdity of it. Of course, I’d make a stupid decision like this.

But the laughter faded quickly, leaving you standing alone in the middle of the suite, your skin buzzing with nerves. What if this doesn’t even help? What if it makes things worse? You pushed the thoughts away, though they clung to the edges of your mind like a fog you couldn’t quite shake off.

The sound of a knock at the door yanked you from your spiraling thoughts. Your heart lurched. You hesitated for a moment before setting your wine glass on the table. With one last glance at yourself in the mirror, you crossed the room and opened the door.

And there he was.

For a split second, your mind went completely blank. Standing in front of you was, hands down, the hottest man you’d ever seen in person. He was just a couple of inches taller than you, with a lean but muscular build that suggested he worked out without being overly bulky. His shirt hugged his chest in all the right ways, and his dark hair was styled effortlessly. You blinked, mouth slightly open, as you tried to take him in.

“Bonsoir,” he greeted, his voice a low rumble laced with the softest French accent. “My companion should be here any moment. Sorry, he’s running late.”

You blinked again, still processing. Fuck. That accent. You were barely listening to what he was saying, too distracted by the smoothness of his voice, the way the words rolled off his tongue with an effortless charm that made your stomach flip. Lord. This man alone was worth the $6k.

But as his words finally registered in your brain, confusion crept in. Companion?

You stared at him, your mind catching up a little too slowly. His eyebrows furrowed slightly, his head tilting as if trying to read your expression. You must’ve looked confused—because you were.

Before you could voice the question on the tip of your tongue, there was another knock at the door.

You froze for a second, then watched as the man—Charles, you assumed—stepped aside to let in whoever was on the other side. And that’s when he walked in.

Another man, just as stunning as the first. His presence hit you like a wave. Taller than Charles, with broad shoulders and an air of confidence that instantly commanded attention. His smile was devilishly handsome, and his dark eyes sparkled with something teasing as he took you in. He introduced himself with a thick, sexy Spanish accent that nearly made your knees buckle.

“I’m Carlos,” he said, his voice so deep it sent a shiver down your spine.

You just stood there, mouth slightly parted, trying to process the fact that two incredibly hot men were now in your hotel room.

─── ･ ｡ﾟ☆: *.☽ .* :☆ﾟ. ───

The room was quiet, a charged sort of anticipation lingering in the air as you moved about, keeping yourself busy. Both Charles and Carlos stood patiently in front of you, but you were distinctly aware of every glance they exchanged, every slight smile they gave each other. In a weak attempt to fill the silence, you turned to the small minibar by the window, which you’d noticed was stocked with a surprising assortment of wines and liquors.

“Would you guys… like a drink?” you offered, trying to keep your voice steady. “I think there’s some champagne, maybe wine, or even whiskey if you want.”

Charles’s eyes followed your every move, and Carlos leaned back with an amused expression, both men seemingly content to just watch as you babbled on.

“And, um, I got some food, too.” You gestured to the tray of tiny sandwiches and fruit that sat on the table near the window, small bites you’d hoped might keep your nerves in check. “You know, just in case anyone’s hungry. They’re little, so they won’t ruin your appetite, but they’re actually quite good! I mean, the hotel did a great job with the whole presentation thing…”

You trailed off, catching the amused smiles that Charles and Carlos exchanged as you kept talking. Charles raised a brow, and Carlos bit back a laugh, clearly enjoying your rambling. You suddenly felt heat rise to your cheeks and stammered a little as you continued, “I just figured, you know, if we’re going to spend some time here together, it would be good to… um, settle in, I guess?”

Carlos leaned against the doorframe, arms crossed as he watched you with a look that was both patient and playful. He exchanged a knowing glance with Charles, who finally spoke, his soft accent lingering on your name in a way that made you freeze mid-sentence.

“Y/N.”

The sound of it in his French accent, low and smooth, made your heart flutter. You could feel yourself hanging on every syllable, the room somehow feeling even warmer as you turned to face him fully.

“Yes?” you murmured, breath catching in your throat.

He held your gaze, his lips curving up at the corners in a gentle smile. “Breathe, relax.” He reached out and placed a comforting hand on your arm, his fingers warm and reassuring. “What are you nervous about, baby?”

It felt like a dam broke, and before you knew it, the words were spilling out. You hesitated, took a deep breath, and finally, with a tentative glance between them, you spoke. “I… well, it’s just been a long time for me,” you admitted. “I haven’t done anything like this in a couple of years.”

They both nodded, their expressions patient and encouraging, inviting you to go on.

“I was in a relationship,” you continued, voice quieter now. “He cheated on me. It… kind of destroyed me, to be honest.” You offered a small, self-deprecating laugh. “He also had a few choice words to say about me before we ended things. Made me feel… insecure, I guess. Like maybe I wasn’t good enough.”

Charles’s expression shifted instantly, his jaw tightening. “What a fool,” he muttered, clearly unimpressed. “He’s an idiot and a piece of shit for saying any of that to you. You deserve better, you know that, right?”

Carlos nodded in agreement, stepping closer with an intense look that softened when he met your eyes. “He didn’t deserve you, mami. But tonight? We’re making up for those two years, trust us.”

They both looked at you, waiting, not pushing, but you could feel the anticipation building between you. It was like standing on the edge of something exhilarating, and a part of you wanted to let go and trust them. You took a breath, feeling a surge of boldness. What were the odds that two men this stunning would walk into your life again?

“Okay,” you whispered, looking between them, the single word hanging in the air with an almost electric weight. They shared a look, subtle but charged, and then turned back to you.

Charles smiled. “Before we get started, there’s just one more thing. We need a safe word. If you want to stop at any point, if anything feels uncomfortable or just too much, you can say it, and we’ll stop, no questions asked.”

You thought for a moment, rolling the idea around in your head before giving a small smile. “How about… wine?”

Both men chuckled, Carlos’s deep laughter filling the room as he tilted his head. “That’s cute, mami. Okay, ‘wine’ it is. And we’ll use a few more, too—just to make sure you’re always comfortable. Say ‘green’ if you want us to keep going or go a little faster, ‘yellow’ if you want us to slow down, and, of course, ‘red’ if you need us to stop. Sound good?”

You nodded, the nervous flutter in your stomach finally beginning to settle. Carlos smiled warmly, eyes meeting yours. “I need verbal confirmation, mami,” he said, his tone gentle yet firm.

“Yes,” you replied softly. “That sounds good.”

They exchanged another look, a shared understanding passing between them, and then Charles turned to you, his gaze soft but filled with a quiet intensity. He moved closer, settling on the edge of the bed beside you, and lifted a hand to gently stroke a strand of hair away from your face.

“Okay, baby,” he murmured, his voice just above a whisper. “Let’s start.”

─── ･ ｡ﾟ☆: *.☽ .* :☆ﾟ. ───

As you lay back against the silken sheets, your heart raced, caught between excitement and nerves. Charles was so close, his presence enveloping you as he leaned down, brushing his lips against your neck. The sensation sent shivers cascading down your spine, igniting every nerve in your body and causing you to arch instinctively toward him.

“You’re so beautiful,” he murmured, his voice deep and sultry, a velvet caress against your skin. Each kiss he placed along your collarbone was tender yet deliberate, a promise that made you melt into the bedding, your body responding to him without reservation.

His mouth traveled down, kissing a path that made you gasp softly, your breath hitching as he lingered at your chest. The warmth of his body hovered over you, and as he pressed his lips against the soft curves of your body, it felt as though the world outside faded away completely.��

“Let me take care of you,” he breathed, his voice low and commanding as he settled between your thighs, looking up at you with an intensity that made your heart race. The anticipation hung in the air, heavy and sweet, as he moved closer.

“Charles…” you whispered, almost pleadingly.

“Trust me,” he replied, and with that, he pulled down your lacy black underwear pressing his finger on your clit, sending a jolt of pleasure coursing through your veins. The sensation was overwhelming, and you gasped as his fingers slowly entered you, moving in and out slowly. He coaxed you into the rhythm as he curled his finger expertly, finding that spot deep inside you that made you gasp even louder.

“See? There you go,” he praised, his voice smooth and honeyed. “So perfect. So responsive for me baby, hmm.” Each word seemed to seep into your skin, igniting something within you. The room felt alive with the sounds of your breathy moans and the soft rustle of the sheets beneath you.

Charles watched you intently, a smirk playing at the corners of his mouth as he added another finger, stretching you deliciously. “So beautiful,” he breathed, his eyes locked onto yours as he focused solely on you. “You taste so delicious.”

Your cheeks flushed at his words, feeling the heat pool lower in your abdomen as he licked his fingers clean, savoring every drop. The sight of him enjoying you so thoroughly sent another wave of heat through you, your heart racing faster than ever.

“Don’t hold back,” he urged, a low growl escaping his lips as he maintained that intoxicating rhythm. “Let me hear those pretty sounds.”

You could feel yourself spiraling, the pressure building as he curled his fingers deeper, drawing out moans from you. “I… I can’t…” you managed to whimper, the words barely escaping your lips as you trembled beneath him.

“Shh, just let go,” he encouraged, his voice dripping with a mixture of authority and tenderness. “You can do it. I’m right here.”

His confidence flooded through you, and with every thrust of his fingers, the world outside the hotel room faded away completely. You surrendered to the sensations, feeling the tension in your body reaching an unbearable peak. Your vision blurred, and you could feel the heat pooling inside you, ready to explode.

“Charles,” you gasped, feeling the waves of ecstasy start to crash over you. “I’m—”

“Yes, baby, let it happen,” he coaxed, his eyes dark and fierce as he continued his relentless pace. “You’re doing so well.”

With a final curl of his fingers, you came, the pressure bursting as pleasure washed over you in a tidal wave. Your body tensed, trembling beneath him as moans spilled from your lips, each sound wrapping around the dim room like a spell. Charles watched you with an intensity that made your heart race, his fingers never faltering as he helped you ride out the high.

“Good girl,” he praised, his voice a low rumble that sent shivers down your spine. You floated down from the heights of bliss, feeling both blissfully vulnerable and utterly adored.

He leaned in, pressing a soft kiss to your lips, the taste of you lingering between you. As he pulled back slightly, a playful smirk danced on his lips. “Told you I’d take care of you.”

The intimacy of the moment left you breathless, a lingering warmth settling in your chest. You smiled back at him, your cheeks still flushed from pleasure and the glow of the dim light, feeling both exposed and cherished.

But before you could catch your breath, another wave of desire crashed over you, and you felt yourself yearning for more. Charles shifted closer again, his lips brushing against your neck, igniting the fire that still simmered within you. “You’re not done yet, are you?” he teased softly, his breath warm against your skin.

You shook your head slightly, the thought of indulging in this moment with him—and with Carlos, who you knew was still there, waiting, watching, heightening the anticipation—sent a thrill through you. “Let’s see how far we can take this,” he murmured, a wicked glint in his eye as he kissed along your jaw, his lips trailing down your throat.

─── ･ ｡ﾟ☆: *.☽ .* :☆ﾟ. ───

Carlos broke the tension, his voice low and sultry. “My turn now, mami. Let me taste how sweet you are.”

Before you could fully process his words, Carlos was there, his mouth on yours, and it sent a jolt of electricity straight through your body. His lips were warm and inviting as they enveloped you, and the sensation was overwhelming. You gasped, when he pulled away, kissing his way down your body until he’s between your thighs, your hands instinctively finding their way into his hair, gripping tightly as he teased you.

His tongue flicked expertly against your clit, sucking and biting, driving you wild. Each swirl of his tongue sent shockwaves of pleasure rippling through you, building on the lingering sensations from Charles. “Oh, fuck Carlos…” you moaned, your back arching slightly, the pleasure making your heart race.

“Fuck, baby, that’s hot,” Charles muttered, his eyes dark with desire as he watched Carlos work his magic. The sight of your pleasure fueled him, and you could feel the heat radiating off both men, the intensity of the moment heightening every sensation.

Carlos wasn’t holding back; he was relentless, his mouth moving skillfully as he worked your clit, driving you further into ecstasy. And when his tongue plunged in and out of your warmth, every movement made you whimper, the sound escaping you before you could catch it.

“God, yes…” you breathed, your hips instinctively rolling against his mouth, seeking more, needing more. The world around you blurred, and it was just you and the exquisite sensations you were feeling.

“Ride my face, mami,” he groaned against you, the vibration of his voice sending an additional thrill through your body. You obliged, moving to sit on his face, your hands on the headboard as you instinctively moved to grind against him, the pleasure building higher and higher.

“Ohh, fuck,” you yelped, feeling the tight coil in your abdomen beginning to unravel. The waves of pleasure crashed over you, and you felt your body respond, shaking under the intensity as you approached the precipice of your next orgasm.

Carlos continued his relentless assault, slipping three fingers inside you, and you moaned loudly at the feeling, pulling his hair tight, urging him on. “Yes! Just like that,” you gasped, the combination of his fingers and mouth driving you wild. “P-please don’t stop!”

And he didn’t, his mouth and fingers working in perfect harmony, drawing you closer and closer to the edge. As he inserted a fourth finger, the sensation was overwhelming. You felt yourself teetering on the brink, ready to plunge into that sweet abyss of pleasure.

“Carlos! I’m gonna—” you gasped, feeling your body tensing, the waves crashing around you.

“Let go, mami. I got you,” he encouraged, his voice deep and sultry as he lapped at you hungrily. At those words, your orgasm hit you like a tidal wave, leaving you gasping and shaking, your body writhing under him.

Carlos didn’t stop; he continued to eat you out through the waves of your orgasm, each thrust of his fingers and flick of his tongue sending aftershocks through your body. “Oh my God, Carlos!” you cried, feeling the intensity of it all consume you.

“Fuck mami, you taste so good,” he murmured against your sensitive skin as he licked you clean, his eyes filled with a mix of awe and lust. “I could stay in between these sexy thighs of yours all day.”

Completely breathless, your body a trembling mess of pleasure, as you basked in the aftermath of everything. Carlos finally pulled away, leaving you dazed and reeling from the intensity of what just happened. Your legs felt like jelly, and you were sure you’d lost all sense of reality for a moment.

Charles chuckled softly, clearly entertained as he watched you come down from your high. “I’d say that’s a successful start,” he teased, his voice filled with satisfaction.

You managed a breathy laugh, your heart racing as you looked between the two of them. “You two… wow.”

Carlos grinned, wiping his mouth with the back of his hand, a glint of mischief in his eyes. “Just wait until you see what else we can do, mami.”

Charles leaned closer, a playful spark in his gaze. “What do you think, baby? Are you ready for more?”

─── ･ ｡ﾟ☆: *.☽ .* :☆ﾟ. ───

“I think I’m ready,” you said softly, your voice steady and filled with determination.

Charles’s eyes lit up, and Carlos’s smirk widened. “Good,” Charles replied, his tone sultry. “Because we’re just getting started.”

“Close your eyes, mami,” Carlos said, his voice a deep, seductive whisper that sent shivers down your spine. You hesitated, a flicker of doubt creeping in. “Wait, what? Why?”

“Do you trust us?” His tone was confident, teasing yet soothing, coaxing you into submission.

You took a deep breath, feeling the weight of the moment settle over you like a warm blanket. This was all new territory, a blend of exhilaration and trepidation. “Yes,” you finally admitted, your voice barely above a whisper. You closed your eyes, surrendering to whatever they had in store for you.

You heard a soft sound, like fabric ripping, and your heart raced as you felt something cool and smooth wrap around your eyes. The realization hit you: they had blindfolded you. The world around you shifted into a haze, every sound amplified, every sensation heightened. You could feel the heat radiating from both men as they surrounded you, their presence both comforting and electrifying.

“Just relax, mami,” Carlos murmured, and you felt him lay down beside you. His lips found your skin, kissing up along your breasts, his mouth moving with deliberate care as he bit and licked, teasing you into a frenzy.

A soft moan escaped your lips, involuntarily. The sensation was exquisite, a mix of pleasure and delicious anticipation, your body arching towards him, craving more.

As his mouth worked its magic, you felt another warmth against your thighs, a slow, deliberate caress. “You’re so sexy, baby,” the voice said, and you realized it was Charles. His breath was hot against your skin, teasingly close but never quite touching.

Your heart raced, the anticipation leaving you trembling. They were both here, right next to you, guiding you into a world where your senses reigned supreme. You felt someone’s hands travel up your thighs, moving closer to your core, teasing you. “You like that?” Charles asked, his voice deep and low, sending another shiver down your spine.

“Y-yes…” you gasped, biting your lip as the sensations heightened. You could feel the tension in the air, thick and charged with unspoken promises.

“Let’s make this even more fun, shall we?” Carlos said, his voice low and seductive.

Suddenly, you felt warm wax drip onto your stomach, and the sensation made you gasp, your body instinctively reacting to the heat. “What are you doing?” you managed to stutter, a mixture of excitement and fear flooding through you.

“Just trust us, mami,” Carlos cooed. “You’ll love it.”

As he leaned down to kiss the area right next to the wax, the contrast between the heat of the wax and the coolness of his mouth was intoxicating. He pressed gentle kisses along your skin, creating a delicious tension that left you breathless.

The moment felt electric. With every kiss and caress, you surrendered a little more, letting them guide you deeper into this world of pleasure. Carlos’s fingers lightly traced your clit, teasing you, while Charles’s kisses grew more passionate, sloppy and eager on your mouth.

Suddenly, you felt Carlos’s fingers slip lower, just brushing against your asshole. A sharp gasp escaped you as he continued to tease you, working you into a frenzy. “You’re doing so well, baby,” he praised, his tone dripping with lust. “Just let go and enjoy.”

The tension built inside you, a knot of anticipation tightening with every flick of his fingers. You could feel your body responding instinctively, the heat pooling low in your stomach. “Carlos…” you moaned, your heart racing as he continued to tease you.

Then, with deliberate slowness, Carlos pressed his finger inside you stretching you and making you squirm. “Shhh,” he soothed, as you felt the slight burn of being filled. “Just relax, mami. It’ll feel good, I promise.”

You could hardly process the pleasure coursing through you as he added a second finger, moving in and out, stretching you just right. “Oh, fuck!” you gasped, your body arching into him as the sensation intensified.

“That’s it,” Carlos murmured, his breath hot against your skin. “So good for me, mami.”

Charles, ever watchful, leaned closer, kissing you more deeply, coaxing your tongue to dance with his. You melted into the kiss, feeling utterly consumed by them both. The combination of their touches was intoxicating, and you surrendered completely, losing yourself in the pleasure.

“Three fingers now,” Carlos warned, and your breath hitched in anticipation. He pushed a third finger inside you, and your body quivered, an involuntary moan escaping you as the sensation hit you like a bolt of lightning. The stretch was exquisite, a heady mix of pleasure and slight discomfort that made your heart race even faster.

“That’s it, mami,” Carlos coaxed, his fingers curling just right inside you. “You’re taking it so well.”

Charles pulled back slightly, looking into your eyes, his expression a mix of admiration and lust. “You’re incredible,” he said, breathless.

The combination of their praises and the sensations swirling around you was almost too much. You felt yourself teetering on the edge of ecstasy, ready to plunge into that sweet release. “I’m—” you began, but Carlos cut you off.

“Not yet, baby,” he said, his tone firm yet playful. “I want you to feel every second.”

And with that, he began to move his fingers in a rhythmic, deliberate motion, curling and pressing against your most sensitive spot, coaxing you closer and closer to that edge. You couldn’t help but moan louder, your body betraying you as you let yourself slip into the abyss of pleasure. “Please, Carlos… I can’t hold on much longer.”

“Good,” he replied with a smirk, clearly enjoying the control he had over you. “That’s exactly where I want you.”

Charles leaned in closer again, capturing your lips in a passionate kiss, deepening the sensation and pulling you even further into the haze. You felt your body quivering, the heat coiling tightly in your belly as Carlos continued his movements, the rhythm building higher and higher.

With a final thrust of Carlos’s fingers, you let go, your orgasm crashing over you like a wave, intense and consuming. You cried out, your body trembling as pleasure surged through you, leaving you breathless.

“Fuck, yes,” Carlos said, his fingers continuing to work you through your release, coaxing every last bit of pleasure from you. You could feel his excitement radiating, and your heart raced with the intensity of it all.

“Perfect, mami,” he murmured, kissing your thighs softly as you came down from the high.

You lay there, utterly spent, but also electrified. Charles and Carlos exchanged knowing glances, clearly pleased with how you had responded.

“Are you okay, mami?” Carlos asked, his tone softening as he brushed a strand of hair from your face.

“Yeah,” you breathed, trying to catch your breath. 

"That’s good baby. Are you ready?" Charles murmurs, his accent wrapping around each word. You nod, and he gives a small, reassuring smile, waiting for your permission as he begins slowly pushing himself into you, the sudden stretch making your back arch off the bed as you cry out in a mix of pain and pleasure.

He’s patient, attentive, and entirely focused on you, each movement deliberate and giving you the time to adjust to his size. The slow, steady rhythm of his thrusts pulls you in, allowing you to relax into the experience. Feeling bolder, you breathe out, “More.”

Charles raises an eyebrow, smirking slightly as if surprised, but a spark lights his gaze. “What was that, baby?” he teases softly, his voice playful, inviting.

“Faster, please,” you manage, giving in to the sensation. His grin widens, satisfied. And as he begins to deepen his thrusts as he moves faster. 

Charles’s pace was relentless, every thrust deeper and harder than the last, driving you closer and closer to the edge. Your back arches, your fingers gripping the sheets as your body moves with his. His hands grip your waist firmly, pulling you closer to him as he pounds into you, the room filled with the sounds of skin slapping against skin and the breathless gasps escaping your lips.

“Fuck, baby, you feel so good,” Charles groans. His pace doesn’t slow, his body moving with precision and force. You can feel your orgasm building, the tension winding tighter with every thrust until it feels like you’re going to break.

“Damn, mami. You look so pretty like that,” he murmurs, his gaze smoldering. “Look at that face, those lips… I love those lips,” he says, leaning closer until he’s right by your head. “So beautiful. Open up that sweet mouth for me, please.”

Your eyes meet his, filled with desire, and you nod, parting your lips invitingly.

parting your lips as Carlos slides his cock into your mouth, his grip firm but gentle on your throat as he begins to fuck it. The sensation of being filled from both ends sends your mind spiraling, the overwhelming pressure making it impossible to think of anything but the pleasure consuming you.

Charles’s pace quickens, his grip on your hips tightening as he continues to fuck you relentlessly. Your moans are muffled around Carlos’s cock, but you can feel the vibrations from your sounds as they travel through your throat. The weight of it all—the fullness, the pleasure, the intensity—has you clawing at Charles’s thighs, trying to ground yourself, but it’s futile.

“So sexy,” Carlos praises, his voice rough as he thrusts into your mouth, his grip on your neck keeping you in place. “Doing so good mami… taking both of us like this.”

The praise only spurs you on, even as your body threatens to give in to the intensity of it all. Your mind is foggy, lost in the pleasure as Charles hits that spot inside you that has your toes curling, a rush of heat surging through your core. The tension in your body snaps, and before you know it, you’re coming hard around his dick, your thighs tightening around him as waves of pleasure crash through you.

Charles doesn’t slow down. He continues to fuck you through your orgasm, each thrust pulling more pleasure out of you until you’re trembling, your body a mess of overstimulation. Carlos’s hand moves to pull your hair, holding you steady as his cock moves deeper into your throat. You feel tears prick at the corners of your eyes from the overstimulation but the heat between the three of you only intensifies.

Your body shakes with the aftershocks of your orgasm, but Charle’s fast pace pushes you toward the edge again. His grip tightens on your hips, as he moves faster before he pulls out realising on your stomach.  

Carlos’s thrusts grow erratic, and with one final one, he comes down your throat, his groans mixing with Charles’s. You swallow easily, the warmth of him filling your mouth.

─── ･ ｡ﾟ☆: *.☽ .* :☆ﾟ. ───

You’re still reeling from the intensity of your orgasm when you hear Charles's low voice. “You’re so beautiful like this,” he says, his tone sultry and full of admiration. “But I think it’s time for us to give you a taste of something truly unforgettable.”

Carlos looks at you, a mischievous glint in his eyes. “You ready for that, mami? We’re going to take care of you.” His confidence radiates, and you feel that familiar flutter of excitement mixed with nervous anticipation.

“W-What do you mean?” you ask, your breath still shaky from the pleasure they’ve already given you.

“We want to show you just how good it can be when you let go completely,” Charles explains, moving closer, his body brushing against yours, making you acutely aware of every part of him. “You’re going to feel incredible, I promise.”

“You can handle us,” Carlos says, and your heart races. 

“Okay,” you reply softly, feeling a surge of warmth at their reassurance. 

“Good girl,” Charles praises again, his voice rich with affection. You hear the sound of movement, and you can only guess at what they’re doing. Then, you feel the bed shift as both of them position themselves closer to you.

“Now, let’s have some fun,” Carlos murmurs. You feel his warm hands on your thighs, gently pushing them apart, and your pulse quickens as anticipation builds.

“Are you ready for us, baby?” Charles asks, his voice husky and low. You nod, your breath catching in your throat as you feel the heat radiating from both of them.

“Remember, you can say the safe word at any time,” Carlos reminds you. “Just relax and let us take control.”

“Okay,” you whisper, feeling both excitement and a hint of nerves. “I’m ready.”

You feel one of them—Charles, you think—kissing along your thighs, slowly moving closer to your center, while Carlos positions himself at your ass. You can feel the heat from his body, the weight of him above you, and it makes your heart race even faster.

“Don’t worry, mami,” Carlos says, leaning down to brush his lips against yours. “I’ve got you.” You can taste the sweetness of his breath, and it ignites something primal within you.

As Charles starts kissing your folds, you gasp, the sensation sending ripples of pleasure coursing through your body. “So responsive,” he praises, his voice muffled against you. “I can feel how much you want this.”

You arch your back instinctively, craving more of the delicious sensation. “Charles!” you moan, the name slipping from your lips as he devours you, his tongue flicking expertly over your sensitive clit.

“More, baby?” he asks, teasingly slow. You can hear the smile in his voice, the confidence that makes you feel safe.

“Yes. Please!” you gasp, urging him on.

Just then, you feel Carlos’s mouth on yours, his kiss deepening as he leans in closer. Charles, the pressure inside you builds again, and you feel your body responding instinctively. Carlos pulls away just enough to let you catch your breath. “I want you to look at me while we do this,” he says, his dark eyes locking onto yours, filled with a heat that makes your skin tingle.

You nod, focusing on him, even as you feel Charles continuing to work his magic below. The two of them are a perfect harmony of pleasure, each taking you higher as they share their attention. Then you feel it, the burning stretch as Carlos’s dick enters your ass. You can’t help but moan “Oh fuck!” at the sensation, feeling him fill you up so deeply in parts that never been touched before. The world outside fades away, leaving just the three of you, locked in a moment of raw ecstasy.

“Keep your eyes on me,” Carlos urges softly, watching you intently as he thrusts in and out of you slowly, his fingers griping your ass, as he works to increase the pace.

“Can you feel how good that is?” Charles asks, looking up at you, his dark eyes filled with mischief and desire. “I want to see you come again. Show me how much you want it.”

“Oh fuck! Too much!!” you cry, feeling another wave of pleasure crash over you. The combination of his movements, the way Carlos is fucking you, it all blends into a perfect storm of sensation that’s utterly overwhelming.

“Yeah, just like that, baby. I love those sounds,” he says, his voice sultry and encouraging, and you can hear the excitement in his tone.

“More, please,” you beg, your body writhing against the sheets as you surrender to the pleasure.

Charles moves to lay in front of you, his hands moving your leg to lay over his waist as you feel his dick enter your pussy. Not expecting that, you yelp. “Charles!” The initial thrusts are slow, giving you a moment to adjust, but the sensation is still overwhelming. You feel every inch of them as they slide in and out of you, each movement perfectly synchronized. It’s too much, too intense, and yet you can’t stop the moans spilling from your lips.

As their pace quickens, your body gives in to the pleasure, the overwhelming fullness pushing you toward another climax. You try to hold on, but the sensation is too much. “Oh fuck,” you gasp, your voice barely holding together as they both pound into you. “It’s too much… I can’t…”

 “You’re such a good girl for us,” Carlos praises, his pace relentless as he pounds your ass.

“Come for us, mami,” Carlos urges, his voice deep and throaty. “We want to feel you around our cocks.”

You can’t hold back any longer; the sensations are too intense, too beautiful to resist. “Oh, oh fuck” you cry, your body arching as pleasure overwhelms you, a wave crashing over you that leaves you gasping for breath.

They don't stop, their pace quickens, thrusting in and out of you even faster, fucking you through your orgasm, driving you further into ecstasy. “That’s it, baby. So beautiful,” he praises, his voice filled with desire. 

As you ride the waves of your release, you feel Carlos leaning in, kissing you softly, his lips warm and inviting. “You’re so perfect,” he murmurs against your mouth, and you can feel the heat of his body against yours, adding to the delicious tension.

“Can you handle more?” Charles asks, a wicked smile on his lips as he watches you with dark, hungry eyes.

You nod, feeling that familiar heat igniting again. “Yes, I want more,” you breathe, craving both of them in ways you never knew possible.

“Alright, let’s give you what you want,” Carlos grins, moving to position himself behind you while Charles remains at your front, his dick still buried inside you.

You can feel Carlos adjusting himself behind you, the anticipation making your heart race. “Are you ready, mami?” he asks, his voice a deep growl that sends shivers down your spine.

Yes,” you whisper, your body aching for their touch.

“Good,” he replies, and then you feel him moving closer, pressing against you, the weight of him enveloping you. “Just relax for me, okay? We’ll take care of you.”

With that, he gently slides into you against Charles's cock, filling and stretching you in a way that you've never experienced before, sending a jolt of pleasure and pain through your body. “Oh my God!” you scream, the sensation overwhelming as both of them stretch you beyond your limits. 

“Just breathe, mami,” Carlos whispers, his voice soothing yet filled with desire. “We’re going to make you feel so good.”

Charles leans in, capturing your lips with his, the kiss deepening as you feel Carlos thrusting behind you, his movements slow and deliberate, each thrust pushing you further into bliss.

“You’re doing so well, baby,” Charles praises, his voice low and sultry against your lips. “Just let go and feel everything.”

You’re too full, your body overstimulated, your mind unable to process the sheer intensity of both of them stretching you. Pounding into you at the same time, the feeling is indescribable, leaving you on the edge of tears as your body adjusts to the fullness. Every inch of you feels like it’s on fire, and yet, you crave more.

You nod, surrendering to the sensations as they both take you higher, your body responding instinctively to their every touch. Carlos grunts, quickening his pace behind you while Charles continues his relentless pace too as he kisses you deeply, every brush of his lips igniting sparks within you. 

With each thrust, you can feel the pressure building again, your body teetering on the edge. “I’m so close!” you cry. As their pace quickens, your body gives in to the pleasure, the overwhelming fullness pushing you toward another climax, the sensation is too much. The pressure builds again, stronger this time as their movements become more urgent. Both of them drilling in and out of you leaving you in a blissful fucked state. 

“Come for us, baby,” Charles urges, his voice a low whisper filled with desire. “We want to see you fall apart.”

With a final thrust from them both, the wave crashes over you, and you scream out in ecstasy, your body shaking as pleasure washes over you completely.

“That’s it, mami! So sexy, fuck!” Carlos praises, thrusting into you as you ride out your orgasm, the world fading into a haze of bliss.

Charles looks at you with that wicked smile. “You’re incredible,” he whispers, and you feel your heart swell with warmth and desire.

As you come down from your high, you realize that you’ve never felt more alive than in this moment with them.

─── ･ ｡ﾟ☆: *.☽ .* :☆ﾟ. ───

As the aftershocks of your intense release begin to fade, you nestle comfortably between Charles and Carlos, feeling a comforting warmth envelop you. The dim lighting of the hotel room casts a soft glow, highlighting the contours of their bodies as they lean in close, their breaths mingling in the sultry air.

“Are you okay, Y/N?” Charles asks, his voice low and filled with genuine concern. He studies your face, searching for any sign of discomfort or hesitation. There’s something tender in his gaze, making your heart flutter unexpectedly.

You nod, feeling a rush of warmth spread through you. “I’m more than okay,” you reply, a smile breaking across your face. “That was... amazing.”

Carlos chuckles, his dark eyes sparkling with mischief. “We aim to please, mami.” He shifts slightly, pulling you closer to him, and you can’t help but revel in the sensation of being sandwiched between two incredibly attractive men.

As Charles gets up to get the warm cloth, Carlos remains beside you, his fingers lightly tracing patterns on your thigh. “You’re still shaking still,” he observes, his voice dropping to a more serious tone. “You sure you’re okay?”

“Honestly, I’ve never felt anything like that before,” you admit, your cheeks flushing at the memory of the pleasure you just experienced. “It was overwhelming.”

Carlos nods, his expression softening. “That’s completely normal, mami. Just take your time. You did an amazing job.” His voice is warm and reassuring, wrapping around you like a comforting embrace.

Charles returns with the cloth, a bottle of water, and some snacks, pouring a glass for each of you. “You were perfect, baby,” he says, laying back down next to you, a satisfied smile on his face.

You snuggle between them, your heart swelling with gratitude and affection as their presence envelops you.

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[noirandchocolate]

RICE Alzheimer's Research Institute

Terry died on 12 March 2015, having given his PCA a run for its money.  Open about his diagnosis, he has helped to unlock the secrecy and stigma that often surrounds dementia.  His legion of fans is undoubtedly grateful that despite the inevitable progression of the PCA he was able to fight his ‘embuggerance’ and continue to produce a number of both well-received and well-reviewed books.  Terry was also a great example to me in emphasizing how important it is that, in caring for people with any type of dementia, we always look for what people with a condition like PCA can still do, rather than what they can’t: by maximizing what is possible, a person can still live well with dementia for a significant time.

–Professor Roy Jones, Director of RICE (taken from “Terry Pratchett: His World”)

I wanted to post something for the Glorious 25th about the Research Institute for the Care of Older People (RICE) in Bath, where Sir Terry Pratchett received treatment for Post-Cortical Atrophy, the type of Alzheimer’s disease that eventually took his life. From the organization’s website:

RICE established one of the first memory clinic services in the UK in 1987 – a service which has since been widely replicated and is now considered standard and best practice by the NHS. In fact, RICE now runs the NHS Memory Clinic in Bath and North East Somerset on behalf of the local clinical commissioning group and local authority through a sub-contract with HCRG Care Group. To date, we’ve assessed, diagnosed, treated and advised 12,000 people with memory problems and their families in our memory clinic. 

Most of RICE’s clinical services and research activities take place in our own purpose built, specialist centre located on the Royal United Hospital site. The building of the RICE Centre was possible as a result of generous donations from major donors, trusts and foundations, and members of the public. RICE moved into the ground and first floor of the centre in 2008. Following the success of the DementiaPlus Appeal and further generous donations from major donors, trusts and foundations and members of the public, RICE converted the attic floor in 2019 to create more office space. This has given us access to much needed additional rooms and offices which will enable us to grow and run more services and activities. We’ve worked hard to ensure that the areas of the centre visited by our patients meets their needs and we regularly receive feedback on how much our patients enjoy their visit to our centre.

RICE not only provides clinical services to patients, but also conducts research into aging and dementia, including performing clinical trials for new drug treatments for memory-related diseases and developing other “techniques for diagnosing, managing, treating and understanding dementia and memory changes in older adults.”

Lady Lyn Pratchett is the patron of the organization, and the website includes a page about how people can donate funds or volunteer at the clinic and participate in fundraising events.

SO, if you’d like to help fund Alzheimer’s research on this Glorious 25th of May–or at any time–in honor of the Man in the Hat, take a look!

[copperbadge]

Hi Sam, could you please recommend any resources/websites to learn about ADHD medication? Until reading your post about second-line meds I thought Adderal was the only one

I can definitely talk about it a little! Always bearing in mind that I am not a doctor and this is not medical advice, etc. etc.

So, I've had many friends with ADHD in my life before I got my diagnosis and I picked up some stuff from them even before getting diagnosed; I also spoke with my prescribing psychiatrist about options when we met. If you think your psychiatrist might be resistant to discussing options, or you don't have one, doing your own research is good, but it's not really a substitute for a specialist in medication management. So it's also important to know what your needs are -- ie, "I want help with my executive function but I need something that's nonaddictive" or "I want something nonsedative" or "I don't think the treatment I'm on is working, what is available outside of this kind of medication?"

The problems you run into with researching medication for ADHD are threefold:

Most well-informed sources aren't actually geared towards non-doctor adults who just want to know what their options are -- they're usually either doctors who don't know how to talk about medication to non-doctors, or doctors (and parents) talking to parents about pediatric options.

A huge number of sites when you google are either AI-generated, covert ads for stimulant addiction rehab, or both.

Reliable sites with easy-to-understand information are not updated super often.

So you just kind of have to be really alert and read the "page" itself for context clues -- is it a science journal, is it an organization that helps people with ADHD, is it a doctor, is it a rehab clinic, is it a drug advertiser, is it a random site with a weird URL that's probably AI generated, etc.

So for example, ADDitude Magazine, which is kind of the pre-eminent clearinghouse for non-scholarly information on ADHD, is a great place to start, but when the research is clearly outlined it sometimes isn't up-to-date, and when it's up-to-date it's often a little impenetrable. They have an extensive library of podcast/webinars, and I started this particular research with this one, but his slides aren't super well-organized, he flips back and forth between chemical and brand name, and he doesn't always designate which is which. However, he does have a couple of slides that list off a bunch of medications, so I just put those into a spreadsheet, gleaned what I could from him, and then searched each medication. I did find a pretty good chart at WebMD that at least gives you the types and brand names fairly visibly. (Fwiw with the webinar, I definitely spent more time skimming the transcript than listening to him, auto transcription isn't GOOD but it is helpful in speeding through stuff like that.)

I think, functionally, there are four types of meds for ADHD, and the more popular ones often have several variations. Sometimes this is just for dosage purposes -- like, if you have trouble swallowing pills there are some meds that come in liquids or patches, so it's useful to learn the chemical name rather than the brand name, because then you can identify several "brands" that all use the same chemical and start to differentiate between them.

Top of the list you have your methylphenidate and your amphetamine, those are the two types of stimulant medications; the most well known brand names for these are Ritalin (methylphenidate) and Adderall (amphetamine).

Then there's the nonstimulant medications, SNRIs (Strattera, for example) and Alpha-2 Agonists (guanfacine and clonidine, brand names Kapvay and Intuniv; I'm looking at these for a second-line medication). There's some crossover between these and the next category:

Antidepressants are sometimes helpful with ADHD symptoms as well as being helpful for depression; I haven't looked at these much because for me they feel like the nuclear option, but it's Dopamine reuptake inhibitors like Wellbutrin and tricyclics like Tofranil. If you're researching these you don't need to look at like, every antidepressant ever, just look for ones that are specifically mentioned in context with ADHD.

Lastly there are what I call the Offlabels -- medications that we understand to have an impact on ADHD for some people, but which aren't generally prescribed very often, and sometimes aren't approved for use. I don't know much about these, either, because they tend to be for complex cases that don't respond to the usual scrips and are particularly difficult to research. The one I have in my notes is memantine (brand name Namenda) which is primarily a dementia medication that has shown to be particularly helpful for social cognition in people with combined Autism/ADHD.

So yeah -- hopefully that's a start for you, but as with everything online, don't take my word for it -- I'm also a lay person and may get stuff wrong, so this is just what I've found and kept in my notes. Your best bet truly is to find a psychiatrist specializing in ADHD medication management and discuss your options with them. Good luck!

[sizzlingsandwichperfection-blog]

You may wonder what this whole Awesome Coffee Club thing is all about. Today I was reminded what it’s all about:

In 2019, the unpaid intern who runs this tumblr account visited Sierra Leone’s Kono District. Kono is the among the most impoverished communities in the world due to a long history of enslavement, colonialism, and civil war. A decade ago, Kono’s healthcare system was in a state of collapse--clinics had no running water or electricity or paid staff, and inconsistent supplies of medications and other necessities.

As a result, Kono was the epicenter of the global maternal mortality crisis: One out of every seventeen women could expect to die in childbirth. Over 10% of children died before the age of five. 

Beginning in 2014, Partners in Health began working with Sierra Leone’s Ministry of Health to bring change. This started with the basics at the region’s hospital, Koidu Government Hospital: running water, 24-hour electricity, and hiring nurses, community healthworkers, cooks, facilities management staff, and so much more. 

At the time, KGH’s maternity ward had a dirt floor. Many people were dying for want of an emergency C-section or a blood transfusion. By 2019, this was getting better--two functioning operating rooms were able to perform C-sections, and a blood bank could address postpartum hemorrhaging. But it was still inadequate, and maternal and child mortality were horrifyingly routine.

To address the crisis, PIH Sierra Leone directors Jon Lascher and Dr. Baillor Barrie wanted to build a world-class maternal and child health center that could save thousands of lives yearly while also serving as a teaching hospital to train the next generation of Sierra Leonean healthcare workers. They told us they needed $25,000,000 to break ground, and would probably eventually need another $25,000,000 to support the hospital’s operation over its first few years.

I am, as unpaid interns go, doing quite well, but not THAT well. So our family committed what we could and asked others to join us, and within two years, we passed that $25,000,000 goal. Together, we’ve now raised close to $40,000,000. 

Today, I visited the site of the Maternal Center of Excellence, the first wards of which will hopefully open next year. Nearly all of the construction team are from Kono, and 65% of them are women--they work as welders, engineers, planners, laborers, and so much more. You see three of them above. I had the privilege of talking with them about this project. The young woman to the right, Success, told me that her dream is to work for the hospital her whole life, helping to maintain and support it. One of the other women told me, “We are passionate about this work because it is the future of our country. And we know that we and our friends will someday give birth here.” I am so proud that our projects support their training and livelihood, and so grateful to have them as colleagues in this work.

The hospital--which will include over 100 maternal beds, a NICU, and enough operating suites to perform over 10 emergency C-sections per day, will also require ongoing funding for staff, stuff, systems, maintenance, and more. Our hope is that open-ended projects like the Awesome Coffee Club and Awesome Socks Club can help provide that funding, although the most efficient way to support this project is to donate directly! 

So that’s why this tumblr, and the awesome coffee club, exists. World-class maternal and infant healthcare is coming to Kono, a wonderful and  too long impoverished by colonialism and extractive capitalism. It is only a first step. There is so long to go. But what a first step.