#Patient Valve

[silverspleen]

The aforementioned dead patient was something I had been wondering about for a while, the three kinds of death you run into at the hospital as a cardiac sonographer are -

They did not call to cancel the echo order, the nurse is not there to tell you not to go into the patient's room, and the patient is lying in their bed but they are actually just straight up dead and not hooked up to anything and it takes you a minute or two to go, "hold on a fucking second... this person is DEAD" and then you float around the entrance of the room until the nurse shows up to be like "don't go in there!! patient expired!!" and you get to be like "m-hm YEAH I KNOW. Cancel the order." And you are disgruntled at the team for a. wasting your time and b. interrupting the final sleep of some poor person where you were very nearly lightly disrespectful to a corpse (by trying to shake them gently awake and putting stickers on them, as you do to asleep patients)

They called you because there is literally a Code Blue crisis situation happening and there's twenty people in the room, possibly doing CPR or giving meds or giving blood, like a well-oiled machine where you are a massive interloper with your giant ass ultrasound machine being in the way and asking "when do you want pictures? what do you want to see?", and you either get to scan before, during, or after lifesaving procedures, and if you (not the patient, not the family, for this will be a tragedy) are very, very lucky you may get pictures after the patient's heart has stopped moving but before they call the end of the code (and declare the patient officially dead) which means you are there, in the room, not-so-gently (because those pictures are hard to get after CPR) smashing on someone's chest with a piece of plastic as they die and you get to see the heart stop and the blood clot up almost immediately, and it's funny to see something that moves so much not doing much of anything at all.

This patient is already considered braindead and literally being kept alive with machines and they need pictures for organ donation ASAP I hope you know how to burn a CD

And by wondering about I mean, wanted to experience, because I'm a morbid fucker who works in a hospital and wonders about death in a hospital and how it works and what it's like, because that's a crisis situation not many people get to experience in their lives and good news! These are all things I have actually experienced as a cardiac imaging tech in the hospital. Writing it down is funny because I did not expect the trajectory of my life to go in that direction even at all.

[kogarashi-art]

Saw a post cross my dash recently that got me thinking about this. It still remains arguably the most frustrating interaction I’ve had regarding insurance of some sort in my life, though I also admit I haven’t had too many negative interactions overall (I’ve been lucky).

Behind a cut to keep this from getting long on others’ dashboards, but the only real trigger warning (I think) is insurance frustration.

For some necessary background, I have a congenital heart defect (meaning I was born with it) called a “bicuspid aortic valve.” This means the valve on my aorta has two flaps instead of three, because two of them fused together when my heart formed in utero. Due to this defect, the valve doesn’t close all the way when the heart pumps, causing a heart murmur as some blood flows backward with each pump. [Side note: it’s actually amusing the number of doctors who’ve asked to hear it once I mention it, such as two different pediatricians for my children, and an assistant in the office I recently went to for a general health checkup.] When I was five years old, my pediatrician heard the murmur and referred my parents to a cardiologist, who then proceeded to monitor my defect throughout my childhood.

It’s important to note that my childhood cardiologist stressed above all else to my parents that I was still a normal child and should be raised as such, no big fuss over the heart defect. I knew I had it, but aside from taking antibiotics before dental procedures (a recommendation that has since been relaxed sometime in the early 2000s, I believe) and going in for echocardiograms (basically an ultrasound of my heart) periodically, it wasn’t a big thing.

Fast forward many years. I went off to college. Got married. Had a couple children. Moved states twice. Realized I’d lapsed on cardiology visits since I’d become an adult and was responsible for my own healthcare (this is my bad, I own that). I decided to rectify that and scheduled a visit with a cardiologist in our area, got my echo done, everything still looked fine.

Then my husband and I decided we should get life insurance on both of us, just in case. His application went fine. Mine...well.

Apparently, the life insurance company saw the heart defect in my paperwork, cross-checked their repository of medical information, and then declared that I was a higher-risk customer than someone with a terminal cancer diagnosis, and therefore I should be paying the absolute highest premiums they charged. My husband asked why, given this was the first time my heart defect had ever been considered a problem by someone. According to their in-house doctors and their own information, people with my heart defect had a 35-year life expectancy, and since I was 31, I was close enough to that deadline (pun absolutely intended) that they were expecting to have to pay out sooner than they’d like.

I would like to point out that their in-house doctors had never met me. I never had a home visit. They never spoke to my own health team. They just looked at my paperwork, compared it against their notes, and went, “Well, we think she’s going to drop dead in about four years.”

Of course, I was confused. I’d never heard this from any of my own doctors. I went back to the cardiologist I’d only just seen a couple months prior so I could ask about this whole life expectancy thing, and she was just as confused as I. She looked again at my echo results, and pointed out where it looks like the aorta is a bit enlarged (a common result of this particular valve defect) and that’s probably what the insurance doctor saw. But the way she saw it, I might need a valve replacement in my 40s, but there was no way I was more risky than a cancer patient, and the only reason she could figure that the insurance company’s paperwork implied a 35-year life expectancy was because the medical community had only really been aware of and studying this kind of heart defect for 35 years, and it’s not one that’s commonly discovered in adults (likely because adults often get fewer checkups than children, and may not be referred for a heart murmur).

That’s it. 35 years of information somehow equated to “people tend to die at 35” (at our best guess; the insurance doctor never explained their reasoning beyond the excuse given my husband, after all).

Unfortunately, there was nothing the cardiologist could fill out that would convince the insurance company otherwise. She agreed it was stupid, but her hands were tied.

We ended up sticking with it for a year because, if I recall correctly, we didn’t have better options, and possibly because we’d already paid for that year and wouldn’t get a refund if we left early. But we did cancel once the year was up and went with a different life insurance provider that didn’t take into consideration “pre-existing” conditions like congenital heart defects.

We also ended up moving once more after that event, and my cardiologist in our new area didn’t even see any enlarging on my aorta, so...who knows?

This was eleven years ago, by the way. I’m seven years past my “expiration date,” and I’m pretty sure I’m not dead yet.

[sayruq]

Police in the Turkish city of Adana detained 11 suspects, five Israeli and two Syrian, on allegations of organ trafficking, the Daily Sabah reported on 5 May. The Provincial Directorate of Security's Anti-Smuggling and Border Gates Branch began investigating after examining the passports of seven individuals who arrived in Adana from Israel about a month ago by plane for the purpose of health tourism. The two Syrian nationals, ages 20 and 21, were found to have fake passports. Further investigation revealed that Syrian nationals had each agreed to sell one of their own kidneys to two of the Israeli nationals, ages 68 and 28, for kidney transplants in Adana. During searches at the suspects' residences, $65,000 and numerous fake passports were seized. Israel has long been at the center of what Bloomberg described in 2011 as a “sprawling global black market in organs where brokers use deception, violence, and coercion to buy kidneys from impoverished people, mainly in underdeveloped countries, and then sell them to critically ill patients in more-affluent nations.” The financial newspaper added, “Many of the black-market kidneys harvested by these gangs are destined for people who live in Israel.” The organ-trafficking network extends from former Soviet Republics such as Azerbaijan, Belarus, Ukraine, and Moldova to Brazil, the Philippines, South Africa, and beyond, the Bloomberg investigation showed. Accusations of Israeli involvement in organ trafficking also apply to the occupied Palestinian territories. In 2009, Sweden's largest daily newspaper, Aftonbladet, reported testimony that the Israeli army was kidnapping and murdering Palestinians to harvest their organs. The report quotes Palestinian claims that young men from the occupied West Bank and Gaza Strip had been seized by the Israeli army, and their bodies returned to the families with missing organs. "'Our sons are used as involuntary organ donors,' relatives of Khaled from Nablus said to me, as did the mother of Raed from Jenin as well as the uncles of Machmod and Nafes from Gaza, who all had disappeared for a few days and returned by night, dead and autopsied," wrote Donald Bostrom, the author of the report.Bostrom also cites an incident of alleged organ theft during the the first Palestinian intifada in 1992. He says that the Israeli army abducted a young man known for throwing stones at Israeli troops in the Nablus area. The young man was shot in the chest, both legs, and the stomach before being taken to a military helicopter, which transported him to an unknown location. Five nights later, Bostrom said, the young man's body was returned, wrapped in green hospital sheets. Israel’s Channel 2 TV reported that in the 1990s, specialists at Abu Kabir Forensic Medicine Institute harvested skin, corneas, heart valves, and bones from the bodies of Israeli soldiers, Israeli citizens, Palestinians, and foreign workers without permission from relatives. The Israeli military confirmed that the practice took place, but claimed, "This activity ended a decade ago and does not happen any longer." Israel’s assault on Gaza since 7 October has provided further opportunities for the theft and harvesting of Palestinians’ organs. On 30 January, WAFA news agency reported that the Israeli army returned the bodies of 100 Palestinian civilians it had stolen from hospitals and cemeteries in various areas in Gaza. According to medical sources, inspection of some of the bodies showed that organs were missing from some of them. On 18 January, the Times of Israel reported that the Israeli army confirmed reports that its soldiers dug up graves in a Gaza cemetery, claiming its soldiers were trying to “confirm that the bodies of hostages were not buried there.”

[cardiologyassociatesofmorrist]

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[howdoesone]

How does one manage airway and breathing in critically ill or injured patients?

Managing the airway and ensuring adequate breathing is a critical aspect of caring for critically ill or injured patients. In emergency medical services (EMS), prompt and effective airway management can significantly impact patient outcomes. This article will discuss the essential steps and considerations in managing the airway and breathing in critically ill or injured patients. Continue reading…

[021894s]

SIMS ANATOMY - JAKE SIM

SYNOPSIS: you, a top cardiac surgeon, find yourself increasingly frustrated by the distraction over the hospital’s new head of neurosurgery, Dr. Jake Sim. Despite your initial annoyance, you can't help but notice Jake's charm and undeniable skills. As you keep running into each other, Jake’s persistent yet respectful flirtations begin to break through your professional exterior.

PAIRING: neurosurgeon! jake x cardio surgeon! reader

GENRE: workplace romance, situationship

WARNINGS: explicit smut, unprotected sex (don’t), oral (m and f receiving), angst, language, MDNI!!

wc: 12k

You step out of the OR, still riding the adrenaline high from the successful triple bypass surgery you just completed. The intricate dance of sutures and clamps still echoes in your mind as you head towards the nurses' station to update your patient's chart. You’ve always prided yourself on your precision and dedication, and today was no exception.

As you settle into the chair, logging into the system, you can't help but overhear snippets of conversation from the nearby nurses. Their voices are hushed but excited, and despite yourself, your ears prick up at the mention of a new doctor.

"Oh my god, have you seen Dr. Sim yet?" one nurse gushes, her voice practically dripping with admiration. "He's the new head of neuro. I can't believe he's not married with kids."

"Seriously, he's so handsome," another chimes in. "I thought doctors like him only existed in movies."

You roll your eyes internally, feeling a twinge of annoyance. These nurses should be focusing on their patients, not swooning over some new doctor. You know the type—charming, overconfident, used to turning heads wherever he goes. You’ve seen it a hundred times. It’s frustrating to think that professional women, who you’ve seen handle the toughest of medical crises with unflinching composure, could be so easily distracted by a pretty face.

"He smiled at me in the break room," another voice adds, dreamy and far away. "I nearly melted."

You resist the urge to scoff out loud. Instead, you channel your irritation into the chart in front of you, updating the post-op notes with meticulous detail. Your patient, Mr. Harrison, came through the surgery well, and you want to ensure there are no loose ends in his care plan. His vitals are stable, and the grafts look good. You make a note to check on him in an hour.

The chatter continues unabated. "I heard he’s a genius in the OR," someone says. "Apparently, he’s revolutionized some new technique in neurosurgery."

"Brains and looks? Not fair," another nurse quips, and they all dissolve into giggles.

You finish charting, your irritation only growing. It’s not that you begrudge the nurses their moment of levity—being a nurse is hard, often thankless work, and they deserve a bit of fun. But the object of their admiration rubs you the wrong way. You’ve had to work twice as hard to be taken seriously in a male-dominated field, and the idea of a doctor coasting on his looks and charm irks you.

Shaking your head slightly, you stand up and grab the chart. There’s still a lot to do, and you don’t have time to dwell on some pretty boy neurosurgeon. If he’s really as good as they say, you’ll see for yourself soon enough. And if not, well, you’ve never had a problem putting overconfident doctors in their place.

As you walk away from the nurses' station, you hear one last wistful sigh. "I can't wait to see him in action."

Neither can you, you think, but for entirely different reasons.

You step out of the OR, mind still buzzing with the details of the successful valve replacement surgery you just completed. you head to the cardiac unit to check on post-op patients, but something feels off. The usually bustling ward is eerily quiet, with only one nurse, Olivia, stationed at the desk.

“Olivia,” you calls out, her voice cutting through the silence. “Where is everyone?”

Olivia looks up, a hint of guilt flashing in her eyes. “They’re at lunch,” she replies a little too quickly, her tone unconvincing.

you narrows her eyes, knowing Olivia well enough to sense when she’s not telling the full truth. “Olivia...” you say in a stern voice, crossing your arms.

Olivia shifts uncomfortably under your gaze. “Okay, fine,” she sighs, her shoulders slumping. “They’re in OR 2’s gallery.”

Confusion flickers across your face. “Why would they be in the gallery?” you ask, your irritation growing.

“Dr. Sim is clipping an aneurysm,” Olivia admits, unable to meet your eyes.

That’s all you need to know, storming off towards the gallery, your footsteps echoing through the hallways. The idea of your nurses neglecting their duties to watch a surgery infuriates your. Jake’s presence in the hospital had already been a source of frustration, and now he was serving as a distraction for your team.

Reaching the gallery, you push open the door and stride in, your eyes scanning the crowd of nurses huddled around the glass, their attention glued to the procedure below. you spot Jake in the OR, skillfully clipping the aneurysm, his focus unwavering.

“What is going on here?” you demand, voice slicing through the murmurs. The nurses jump, turning to face you with wide eyes. “Why are you all here instead of attending to your patients?”

One of the nurses, Carla, steps forward, stammering. “We... we just wanted to see Dr. Sim’s technique. It’s supposed to be groundbreaking.”

your glare is icy. “I don’t care how groundbreaking it is. Your patients come first. Get back to your stations, now.”

The nurses scurry out, their heads bowed in embarrassment. you watch them go, your anger simmering. Jake’s impressive skills might have captivated your team, but to you, he was nothing more than a distraction. you couldn’t afford to have the nurses slacking off, not when lives depended on their diligence.

you turn back to the OR, eyes locking onto Jake. For a brief moment, your gazes meet through the glass, and you see a flicker of something in his eyes—curiosity, perhaps? Or was it amusement? Shaking off the thought, you storm out of the gallery, determined to keep your team on track and your own frustrations with Jake in check.

You catch sight of Jake coming out of the OR, his surgical cap still on and his scrubs marked with the evidence of a long, intense procedure. He’s engrossed in conversation with another surgeon, but as you approach, he looks up and meets your gaze.

“You must be Dr. Sim,” you say, your voice firm.

Jake smiles, wiping his hands with a towel. “Dr. Y/L/N, I’ve heard a lot about you.”

“I could say the same about you,” you reply, not missing a beat. “Seeing as you’re the reason my nurses are disappearing during their shifts to watch this so-called groundbreaking technique of yours.”

His smile falters slightly, and he raises an eyebrow. “I didn’t realize my surgeries were causing any issues. I’m sorry if they’ve been a distraction.”

“They have,” you state bluntly, crossing your arms. “My team’s focus should be on their patients, not on observing other procedures or a certain brain surgeon, no matter how impressive they might be.”

Jake’s lips curl into a playful grin. “Oh, so you think I’m impressive?”

You feel a flush of annoyance, typical behavior for a neurosurgeon, always so full of themselves. “I didn’t say that.”

“But you implied it,” he teases, taking a step closer. “I’ll take it as a compliment.”

You narrow your eyes, trying to maintain your stern demeanor. “My team doesn’t have time for distractions, Dr. Sim.”

“Fair enough,” he replies, his tone still light but his expression more serious. “I understand, and I’ll make sure to address it with the staff. I didn’t mean to disrupt the unit.”

You study him for a moment, gauging his sincerity. Despite your irritation, there’s something about his demeanor that disarms you slightly. You can’t help but notice his deep brown eyes, plump lips, and the way his Australian accent is way more attractive than it should be. You understand, in that moment, why the nurses might be so captivated.

“Good,” you say, your tone softening just a touch. “I appreciate that.”

Jake smiles again, this time a bit more warmly. “And if it’s any consolation, your reputation as a top cardiac surgeon is well-deserved. I look forward to working alongside you.”

“Likewise,” you reply, giving him a curt nod before turning to leave. As you walk away, you can’t shake the mixture of irritation and intrigue. Jake Sim might be causing headaches for your unit, but there’s no denying his skill and charm. You just hope he proves to be more than just a distraction.

A few days later, you find yourself in the hospital’s busy hallway, reviewing patient charts on your tablet. The hum of activity around you is a comforting backdrop until a familiar voice interrupts your focus.

“Dr. Y/L/N,” Jake calls out, his voice carrying that unmistakable Australian lilt. “Fancy seeing you here.”

You look up, and there he is, leaning casually against the wall, his eyes twinkling with mischief. “Dr. Sim,” you acknowledge with a nod, trying to keep your tone neutral. “What can I do for you?”

“Just thought I’d say hello,” he replies, pushing off the wall and sauntering over to you. “And maybe ask how you’re doing.”

“I’m fine, thank you,” you respond, keeping your eyes on your tablet.

“Busy as usual, I see,” he notes, glancing at the screen. “You ever take a break?”

“Breaks are for people who don’t have critical patients to tend to,” you reply, not looking up.

He chuckles, the sound warm and annoyingly pleasant. “You know, there’s more to life than work. Maybe you need someone to remind you of that.”

You finally look up, raising an eyebrow. “And I suppose you think you’re that someone?”

“Could be,” he says with a confident grin. “I mean, who better to show you the lighter side of things?”

You roll your eyes, but a small smile tugs at your lips. “You’re quite sure of yourself, aren’t you?”

“Confidence is a necessity in our line of work,” he says, his eyes locking onto yours. “But I’ve heard it helps in other areas too.”

“Oh really? Like what?” you ask, despite yourself.

He leans in a little closer, lowering his voice conspiratorially. “Like convincing brilliant surgeons to step out of their comfort zones once in a while.”

You scoff lightly, shaking your head. “I don’t need convincing, Dr. Sim. I have my priorities straight.”

“Of course you do,” he replies smoothly. “But even the best of us need a break sometimes. Don’t worry, I’m not asking you out. Just offering a bit of friendly advice.”

You look at him, trying to figure out if he’s serious. “Friendly advice, huh?”

“Absolutely,” he says with a wink. “Think of it as a, professional courtesy.”

You can’t help but laugh, despite your best efforts to stay stern. “You’re something else, you know that?”

“I get that a lot,” he says, flashing that infuriatingly charming smile. “Anyway, I’ll let you get back to saving lives. But if you ever need a reminder of what fun looks like, you know where to find me.”

later that day, the hospital corridors are quieter than usual as you make your way to the elevators, finally heading home after a long shift. The soft hum of the building is almost soothing after the constant noise of the OR. You press the button and wait, your mind already shifting to thoughts of a hot shower and some much-needed sleep.

The elevator dings, and as the doors slide open, you see Jake standing inside, leaning against the back wall, his expression relaxed but alert. He looks up and his face lights up with a familiar, playful smile.

“Dr. Y/L/N,” he greets, stepping aside to make room for you. “Heading home too?”

“Dr. Sim,” you reply, stepping in and pressing the button for the ground floor. “Looks like it.”

The doors close, and the elevator begins its descent. The enclosed space suddenly feels a bit smaller with the two of you in it.

“Long day?” he asks, glancing over at you.

“You could say that,” you respond, leaning back against the wall. “You?”

“Same here,” he says, a hint of fatigue creeping into his voice. “But it’s all part of the job, right?”

You nod, a brief silence settling between you. It’s not uncomfortable, but there’s an unspoken tension, a mix of mutual respect and something else you can’t quite put your finger on.

“So,” Jake breaks the silence, a teasing note in his voice. “Any plans for the evening? Or are you one of those surgeons who lives and breathes work even at home?”

You raise an eyebrow, a small smile tugging at your lips. “And what about you? Do you have a life outside the hospital, Dr. Sim?”

He laughs softly, the sound warm and genuine. “I try to, when I’m not dealing with brain surgery. But I’ll admit, it’s a challenge. The job can be all-consuming.”

“Tell me about it,” you agree, your tone more relaxed now. “Sometimes it feels like there’s no room for anything else.”

“Maybe that’s why it’s important to find some balance,” he says, his voice sincere. “Even if it’s just little moments here and there.”

You look at him, considering his words. There’s more to Jake than the cocky, flirtatious persona he often projects. “I suppose you’re right.”

The elevator dings again, signaling your arrival at the ground floor. As the doors open, you both step out into the lobby, the cool night air from outside brushing against your skin.

“Need a ride?” Jake offers, his tone casual but there’s a glint of genuine concern in his eyes. “It’s pretty late.”

“I’m good, thanks,” you reply, appreciating the offer but not ready to blur those professional lines just yet. “But I’ll see you tomorrow.”

“Count on it,” he says with a wink. “Have a good night, Dr. Y/L/N.”

“You too, Dr. Sim,” you respond, turning to head towards your car.

As you walk away, you can’t help but feel a strange mix of irritation and curiosity. Jake Sim might be a distraction, but there’s no denying that he’s also starting to become a presence you can’t quite ignore. And maybe, just maybe, that’s not entirely a bad thing.

The next day, you find yourself scrubbing in for a complex procedure. Today’s case is a particularly challenging one: a patient with both a severe cardiac condition and a cerebral aneurysm, requiring the combined expertise of both cardiac and neuro specialists. As you meticulously scrub your hands and arms, you hear the familiar voice of Jake Sim beside you.

“Looks like we’re working together today,” he says, his tone a mix of professionalism and that signature playful edge.

You glance over, meeting his eyes. “Seems like it. Ready for this?”

“Always,” he replies, his confident smile never wavering. “I’ve been looking forward to this case. It’s not every day we get to tackle something this intricate together.”

You nod, appreciating his enthusiasm despite your initial reservations about him. “Agreed. The patient’s condition is precarious. We need to be perfectly in sync.”

Jake gives you a serious nod, his demeanor shifting. “Absolutely. Let’s make sure we give them the best outcome possible.”

You both finish scrubbing in and enter the OR, where the patient is already prepped and waiting. The atmosphere is charged with a mix of tension and anticipation, the surgical team moving with practiced precision. As you take your place on one side of the patient, Jake positions himself on the other, eyes meeting over the sterile field.

“Ready to start?” you ask, your voice steady and focused.

“Ready,” Jake confirms, his expression equally determined.

The surgery begins, and the OR fills with the rhythmic beeping of monitors and the soft hum of machinery. You work methodically, your hands moving with practiced precision as you navigate the complex landscape of the patient’s heart. Jake mirrors your concentration, his focus unbroken as he tackles the aneurysm with equal skill.

“Forceps,” you request, your voice calm and controlled.

“Here,” the scrub nurse says, passing the instrument with a fluid motion. “How’s the heart looking?” jake asks

“Stable,” you reply, glancing up briefly to meet his eyes. “How about the aneurysm?”

“It’s going well,” he answers, his tone steady. “We’re almost there.”

As the surgery progresses, you find yourselves falling into a natural rhythm, your movements synchronized in a way that surprises you. There’s a subtle, unspoken understanding between you, each anticipating the other’s needs and adjustments.

“Nice work on that bypass,” Jake comments, his tone genuinely appreciative.

“Thanks,” you reply, a small smile forming behind your mask. “Your precision with the aneurysm is impressive.”

“Coming from you, that means a lot,” he says, and you can hear the sincerity in his voice.

Hours pass, but the intensity of your focus never wanes. Finally, as the last suture is placed and the patient’s vitals stabilize, you both step back, a sense of accomplishment settling over you.

“Great job, everyone,” you say to the team, who respond with nods and murmurs of agreement.

Jake meets your eyes, his expression one of respect and something more. “We make a good team, Dr. Y/L/N.”

You nod, feeling a surprising sense of camaraderie. “We do, Dr. Sim. Let’s hope the patient has a smooth recovery.”

As you step out of the OR and begin the process of de-scrubbing, you can’t help but reflect on the day’s events. Working alongside Jake, seeing his skill and dedication firsthand, has shifted your perspective. He’s still cocky, still flirty, but there’s depth and talent beneath that exterior.

“Drinks tonight to celebrate?” Jake asks, a teasing glint in his eye as you both head towards the locker rooms.

You laugh, shaking your head. “Maybe another time, Dr. Sim. But good work today.”

“Thanks, Y/N,” he says, dropping the formalities for a moment. “Seriously, it was an honor working with you.”

“The feeling’s mutual,” you admit, giving him a genuine smile before heading off to change.

The next few weeks bring more opportunities for you and Jake to work together, and each collaboration reveals another layer of his skill and personality. Despite his initial cockiness, Jake proves to be a dedicated and talented surgeon, and you begin to see him in a new light. The more time you spend together in the OR, the more you find yourself appreciating his expertise and even enjoying his company.

One evening, you find yourself finishing up some paperwork in the quiet cardiac unit. The day had been long, but fulfilling, with several successful surgeries under your belt. As you look up from your desk, you see Jake approaching, a thoughtful expression on his face.

"Hey," he says, leaning against the doorframe. "You still here?"

"Just wrapping up," you reply, setting aside your pen. "What about you?"

"Same," he says, stepping into your office. "I was going to head out, but I thought I'd check in on you first."

"Checking in on me, huh?" you say with a hint of amusement. "What for?"

"Well, I was thinking," he starts, a bit more serious than usual. "We've been working together a lot lately, and I wanted to say thank you. For trusting me in the OR and for being an amazing colleague."

You feel a warm glow at his words, appreciating the sincerity behind them. "Thank you, Jake. You've been a great partner in the OR. I couldn't have asked for a better neurosurgeon to collaborate with."

Jake smiles, the familiar twinkle returning to his eyes. "You know, I think we make a pretty good team."

"I think so too," you admit, a small smile playing on your lips. "It's been nice, working with you."

"Nice, huh?" he teases, his playful side emerging once more. "I'll take that as a high compliment coming from you."

You laugh softly, shaking your head. "Don't let it go to your head, Sim."

He chuckles, but his expression soon turns more contemplative. "You know, I've been thinking about what I said the other day. About balance and taking breaks. It's something I'm not great at either."

"a little hypocritical to be giving me advice then no?," you reply, your tone light but teasing. "It's hard to switch off when our work is so demanding."

"Exactly," he agrees. "But I've realized that maybe we could help each other with that. Maybe we could find a way to balance things out a bit more."

You raise an eyebrow, intrigued. "And how do you propose we do that?"

"How about we start with something simple?" he suggests. "Like taking a real break. Maybe grab a coffee together, no work talk allowed. Just two colleagues, taking a breather."

You consider his offer, the idea surprisingly appealing. "Alright, Dr. Sim. Coffee sounds good."

Jake's smile widens, a genuine warmth in his eyes. "Great. Tomorrow morning, then? Before our rounds?"

"Tomorrow morning," you agree, feeling a flutter of anticipation.

The next morning, you find yourself at the hospital’s small café, waiting for Jake. The early hour means the space is quiet, with only a few other staff members milling about. When Jake arrives, he’s carrying two steaming cups of coffee, a smile on his face.

“Good morning,” he greets, handing you a cup. “Thought I’d get us a head start.”

“Thanks,” you say, accepting the coffee and taking a sip. “So, what’s on your mind, Dr. Sim?”

“Just enjoying the company,” he replies, sitting down across from you. “And maybe getting to know the person behind the scalpel a little better.”

You chuckle, feeling a bit more at ease. “Alright, what do you want to know?”

“Let’s start simple,” he says, leaning forward slightly. “What do you do when you’re not saving lives?”

You think for a moment, realizing how rare it is for you to talk about anything other than work. “I like to read, mostly. And sometimes I go for a run. It helps clear my head.”

“Sounds nice,” he says, nodding. “I’m more of a swimmer myself. It’s the one thing that keeps me sane outside the OR.”

“Swimming, huh?” you ask, surprised. “I wouldn’t have pegged you for a swimmer.”

“There’s a lot you don’t know about me, Y/N,” he says, his tone teasing but with a hint of seriousness.

“Maybe,” you admit, feeling a strange curiosity about him. “But I’m starting to think I’d like to find out.”

The conversation flows easily, and you find yourself genuinely enjoying the time with Jake. As you talk, you see different sides of him—his passion for his work, his dedication to his patients, and even a vulnerable side that he rarely shows.

When it’s time to head back to your respective departments, you feel a sense of connection that wasn’t there before. Maybe Jake Sim is more than just a distraction. Maybe he’s someone worth getting to know.

As you part ways, he gives you a warm smile. “Same time tomorrow?”

“Same time,” you agree, already looking forward to it.

And so, a new routine begins. Coffee in the mornings, shared surgeries, and increasingly personal conversations. The barriers you once held up start to crumble, and you find yourself drawn to Jake in ways you hadn’t anticipated.

Weeks pass, and the connection between you grows stronger. One evening, after another successful surgery, Jake catches up to you in the hallway.

“Hey,” he says, slightly out of breath. “Do you have a minute?”

“Sure,” you reply, curious.

“I was thinking,” he starts, looking a bit nervous for the first time. “We’ve been spending a lot of time together, and I’ve really enjoyed getting to know you. I’d like to take you out for dinner. No work, just us.”

You feel a flutter of surprise and anticipation. “Dinner?”

“Yeah,” he says, smiling. “What do you say?”

You consider for a moment, then nod. “Alright, Jake. Dinner sounds good.”

As he walks away, you can’t help but smile.

The evening of your date arrives, and you’re both excited and a bit nervous. You’ve chosen a smart but casual outfit, and after a final check in the mirror, you’re ready. Your heart flutters with anticipation as you hear the sound of a car pulling up outside your apartment.

When you open the door, Jake is standing there, looking effortlessly charming in a blazer and jeans. His eyes light up as he sees you, and he smiles warmly.

“Dr. Y/L/N,” he says with a grin. “You look pretty.”

“Thank you, Dr. Sim,” you reply with a smile, feeling a bit flustered. “You look pretty sharp yourself.”

He gestures to the car parked behind him. “Shall we?”

You nod and follow him down to the car. As you slide into the passenger seat, Jake starts the engine and glances over with a playful smile.

“So, are you ready for an evening of fine dining and even finer conversation?” he asks, his tone light and teasing.

“I’m definitely looking forward to it,” you reply, settling into the seat and feeling a mix of excitement and curiosity.

As he drives, the conversation flows easily. Jake talks about his day and a recent surgery he performed, and you share some anecdotes from your own work. The drive is filled with laughter and engaging conversation, making you feel more at ease.

When you arrive at the restaurant, Jake parks and opens the door for you, offering his hand to help you out. The restaurant is a cozy bistro with warm lighting and a relaxed atmosphere. Jake leads you inside and to your reserved table, which is positioned by a window with a view of the city lights.

“This place looks lovely,” you say as you take your seat, admiring the ambiance.

“I’m glad you like it,” Jake replies, settling into his chair across from you. “I thought it would be a nice spot for our first dinner out.”

The evening progresses with delightful conversation and delicious food. Jake is attentive and charming, making sure you’re comfortable and enjoying yourself. As you both talk about various topics, you find yourself opening up more than you expected.

At one point, Jake asks, “What’s something you’ve always wanted to do but haven’t had the chance to yet?”

You think for a moment, considering the question. “I’ve always wanted to take a cooking class. I love to cook, but I think it would be fun to learn some new techniques and recipes.”

“That sounds like a great idea,” Jake says, nodding. “Maybe we could take a class together sometime. I’ve always wanted to learn how to cook Italian cuisine.”

You smile at the thought. “That could be fun. I’d be up for that.”

As the evening progresses, the conversation turns more personal. Jake shares stories about his family and his upbringing in Australia. He talks about the challenges of being far from home and the sacrifices he’s made for his career.

“It’s not always easy being so far away from my family,” Jake admits. “I miss them a lot, especially during the holidays.”

“I can imagine,” you say sympathetically. “My family is close by, and we have our own share of drama, but I’m grateful for their support.”

Jake nods, appreciating your understanding. “Family can be complicated, but it’s important to have that support system.”

You both continue to share personal stories and insights, finding common ground in your experiences. By the end of the evening, you feel a genuine connection with Jake, one that goes beyond professional respect.

When the check arrives, Jake insists on paying. “It’s my treat tonight,” he says with a smile. “Consider it a small thank you for a wonderful evening.”

“Thank you, Jake,” you reply, feeling touched by his gesture. “I really appreciate it.”

. The night air is crisp and refreshing, and the drive home is filled with easy conversation. When you arrive at your apartment, Jake parks and turns to you with a hopeful expression.

“I had a great time tonight,” he says softly. “I hope you did too.”

“I did,” you reply with a smile. “Thank you for such a lovely evening.”

you hesitate for a moment, then look at jake with a warm smile. “Would you like to come up? Maybe just hang out and talk some more?”

he considers the offer, feeling a mix of excitement and curiosity. “That sounds nice. I’d love to.”

He smiles and follows you up to your apartment. As you enter, the space feels even more welcoming with the soft lighting and cozy atmosphere. You both get comfortable on the couch with drinks, and the conversation continues to flow effortlessly.

You find yourselves talking about everything from past relationships to future aspirations. As the conversation flows, Jake starts to open up about his past relationships. “You know, I’ve had my fair share of relationships that didn’t work out. One of the biggest challenges was balancing the demands of work and personal life. It’s not easy to find someone who understands the hours and the emotional toll.”

“I get that,” you say sympathetically. “It’s hard to maintain a relationship when your job takes up so much of your time and energy. My last relationship ended for similar reasons.”

Jake looks at you with genuine curiosity. “What happened?”

You take a deep breath, reflecting on your past. “We were together for a few years, and it started out great. But as time went on, he couldn’t handle the unpredictability of my schedule and the stress of my job. We drifted apart, and eventually, we just grew in different directions.”

“I’m sorry to hear that,” Jake says softly. “It’s never easy to end a relationship, especially when it’s someone you care about.”

“Thanks,” you reply. “It’s part of life, I guess. We both moved on and found our own paths.”

Jake nods, taking a sip of his wine. The easy conversation slows, a new, more, intimate silence settling between the two of you.

Jake shifts slightly, closing the gap between you. his eyes locked on yours. you could feel the heat radiating off his body, and you suddenly felt very aware of your own. He reached out and brushed a stray lock of hair out of your face, his touch sending a shiver down your spine.

your heart raced as Jake leaned in and pressed his lips to yours. you responded eagerly, parting your lips to allow his tongue to explore your mouth. you could feel the heat building between you as you kissed, your bodies pressed together.

Jake's hands began to wander, tracing patterns on your back. you could feel his fingers brushing against the zipper of your dress, and you shivered with anticipation.

Jake pulled away from the kiss, his eyes dark with desire. "May I?" he asked, his hand hovering over the zipper.

You nodded, your breath coming in short gasps. Jake slowly unzipped the dress, his fingers brushing against your skin as he did so. You felt a thrill run through your body as the dress fell to the floor, leaving her standing in just your matching black bra and panties.

Jake's eyes roamed over yourbody, taking in every inch of you. You could feel yourself growing wet as he looked at you, his desire obvious and reflecting your own.

Jake stepped closer to you, his hands reaching out to touch you. You could feel his fingers tracing the lace of your bra, you shivered with pleasure. He leaned in and began to kiss your neck, his lips leaving a trail of fire in their wake.

a soft moan escapes as Jake's lips moved down your body, his hands following close behind. “you’re so fucking beautiful” He reached your breasts, his fingers tracing the outline of your nipples through the lace of your bra. You could feel yourself growing wetter with every touch, your body begging for more. “been thinking about this since the first day I saw you”

Jake reached behind You and unclasped your bra, letting it fall to the floor. He cupped your tits in his hands, his thumbs brushing against your nipples. You moaned as he touched you, your body responding to his touch.

Jake's mouth moved lower, his lips brushing against your stomach. you could feel his breath against her skin, and she shivered with anticipation. “w-ant you” He reached for your panties, “relax baby I got you”, his fingers tracing the outline of your pussy through the fabric.

you gasp as Jake's fingers slip beneath your panties, his fingers exploring your folds. you could feel yourself growing wetter with every touch, your body begging for more.

Jake pulled your panties down, his eyes locked on your pussy, “shit baby, you’re so wet f’me, such a pretty pussy” He leaned in and began to kiss your inner thighs, his lips igniting the heat pooling in your lower belly.

Jakes mouth moved lower, his lips brushing against your pussy. a loud moan leaves your lips as he began to lick at your entrance, your hand instinctively going between your legs to run your fingers through his black locks. “fuck, jake feels so fucking good don’t stop” he hums in response, the vibration going straight to your core.

he’s practically making out with your cunt licking and sucking, his saliva and your juices combined, making a mess on your couch, but that was the last thing on your mind right now. “fuck i’m c-cuming” your orgasm rapidly approaching. “yeah baby cum on my tongue, fuck can’t get enough of you, you taste so sweet”. at his words, your orgasm hits you like a wave, your body shaking with pleasure.

Jake stood up, his eyes locked on yours. you could see the desire in his eyes, and you knew what he wanted. you reached out and unbuttoned his pants, fingers brushing against his hard cock.

Jake stepped out of his pants, his hard cock springing free. while he wasn’t remarkably long, he definitely made up for it in girth. You reached out and wrapped your hand around it, stroking it gently. “ah shit baby” you could feel him growing harder in your hand, your excitement noticable.

he pushed you down onto the couch, climbing on top of you. “condom?” he asked, stopping in his tracks before he gets too ahead of himself. “it’s fine, just put it in” you reach down between you two, taking hold of his length as you begin to guide his cock into your dripping heat. his cock twitches at the thought of feeling you with nothing in between, “fuck, are you sure?”, “yeah, m’on the pill, just fuck me already please” your walls clench around nothing, needing to feel him inside you more than anything.

without another word he slides in. the stinging sensation quickly turning into one of pleasure. your pussy gripping him tightly as he sets a pace that has your eyes rolling to the back of your head. “so fucking tight, pretty, you’re squeezing me so good. pussy was made for my cock mhm?” you can’t even find the words to reply, the pleasure all too much to even think straight.

“feels so good jake” your words encourage him, his thrusts growing more quick, chasing his release as well as your own. the room is filled moans and the sloppy, wet sounds of his cock pounding into your hole. “s-so close, faster baby, want your cum inside me” you don’t have to tell him twice, his hips snapping into a pace that has you seeing stars.

“cum for me baby, cum on my cock” his hand reaches between you to rub your clit in quick circles, sending you over the edge “fuck! i’m cumming!” your release consumes you, his following not too long after.

he collapses next to you on the tiny couch, the both of you panting and out of breath as you come down from your high. “that was amazing” you turn your head to look at him, his eyes closed from pure euphoria he just experienced. “amazing is an understatement. it was fan fucking tastic” you let out a laugh at his pure honesty, a comfortable silence settling in the room.

he pulls you in by your waist, positioning you so your back is against his chest, a more comfortable position since your couch is definitely not meant for this. “i had a good time tonight” you can’t help the smile that grows on your face “me too”

as if the universe was against you, a beeping noise cuts through the silence, ending your moment. his pager was going off, they probably needed him back at the hospital, the realization of your jobs hitting you like a truck. “way to ruin the moment” he says getting up to check the pager “I gotta go, i’ll see you at work?” you smile at him nodding. he quickly gets dressed and presses a quick peck to your lips “get some rest” he tells you before rushing out the door to make his way to the hospital.

you can’t help but be a little disappointed. The obligation of your job was one of the many reasons you didn’t date, simply because it didn’t work. why did you expect this to be any different?

you drift off into a slumber, too tired to let your thoughts cloud your mind.

The next morning, the hospital is bustling with the usual chaos as you walk through the corridors towards your office. Despite the busy environment, your mind keeps drifting back to the night before with Jake. The memory of his touch, his kisses, and the intimate conversations you shared fills you with a warm, lingering sense of connection.

As you turn the corner, you see Jake standing near the nurses’ station, discussing a case with a colleague. He looks up and catches your eye, a slow, knowing smile spreading across his face. There’s a new glint in his eyes that wasn’t there before, a mixture of warmth and mischief.

“Good morning, Dr. Y/L/N,” Jake calls out, his tone playful and a bit louder than necessary, drawing the attention of nearby staff. “Did you sleep well?”

You feel a blush rising but manage to keep your composure. “Good morning, Dr. Sim. I did, thank you. And you?”

“didn’t sleep much, had a lot on my mind,” he replies, his grin widening as he walks over to you. “Must be the excellent company I had last night.”

Several nurses and doctors nearby glance over with curious expressions, but Jake seems unfazed. He stops just a bit too close, his presence commanding your attention. “I was hoping we might catch up over lunch. I’ve been craving some more of those conversations we had.”

You raise an eyebrow, fighting the smile that’s threatening to break through. “Is that so? Well, I’ll have to check my schedule.”

Jake chuckles, leaning in slightly. “You do that. In the meantime, if you need anything at all, you know where to find me.” His voice drops to a conspiratorial whisper, “Or maybe I should say, you know where to call me.”

You can’t help but laugh softly, shaking your head at his audacity. “I’ll keep that in mind, Dr. Sim.”

He winks at you before stepping back, returning to his conversation with the colleague but not without a lingering glance over his shoulder.

Throughout the morning, you find yourself running into Jake more often than usual. Each time, he manages to throw in a playful comment or a flirty remark, making it clear that last night’s intimacy has only fueled his interest.

In the break room, you’re pouring a cup of coffee when Jake slips in beside you. “we meet again,” he says, his tone light. “I was just thinking about how good you look in scrubs.”

You roll your eyes but smile, feeling a flutter of excitement. “Really? I’m sure you say that to all the doctors.”

“Only the ones who make a lasting impression,” he replies smoothly, his eyes sparkling with genuine admiration.

Later, while reviewing patient charts at your desk, you receive a text from Jake. It’s a picture of a heart drawn on a napkin, with a message: “Couldn’t help but think of you during rounds.”

You can’t stop the grin that spreads across your face. It’s clear that Jake’s flirting isn’t just a passing fancy; there’s a genuine interest and warmth behind his actions that makes your heart skip a beat.

Weeks turn into months, and your relationship with Jake settles into a comfortable, intimate rhythm. Without any formal labels, your connection grows deeper, rooted in shared moments and unspoken understandings. Lunches in the cafeteria become a regular occurrence, interspersed with stolen glances across the OR and late-night encounters that leave you breathless and wanting more.

You find yourself looking forward to these moments, the thrill of sneaking around adding a layer of excitement. During shifts, Jake’s flirtatious comments become a highlight of your day.

One afternoon, you’re in the break room, reviewing patient charts when Jake walks in, his usual confident stride and easy smile making your heart skip a beat. He leans against the counter, his eyes sparkling with mischief.

“Hey, beautiful. Busy?” he asks, his voice a low murmur that sends a shiver down your spine.

“Always,” you reply, trying to keep your tone light despite the turmoil in your chest.

Jake walks over, his presence commanding your attention. “You look like you could use a break. How about a coffee?”

You glance at the clock, knowing you have a few minutes to spare. “Sure, why not?”

As you walk to the “coffee shop” side by side, jake quickly takes a glance around to make sure no one is watching and pulls you into the on-call room, the tension between you palpable, you can’t help but feel the thrill of anticipation. The moment the door closes behind you, Jake’s hands are on your waist, pulling you close. His lips find yours in a kiss that’s both urgent and tender, a mix of passion and familiarity that leaves you breathless.

“You’ve been on my mind all day,” he murmurs against your lips, his hands roaming over your back.

“you pulled me away for this?” you let out a slight chuckle. “mhm want you so bad” his lips move down to your neck “jake we’re at work.”

your eyes shut closed, enjoying the feeling of his soft, plump lips on that sweet spot behind you ear that he always found instantly. “doors locked, no one’s coming in here” he mutters out.

you give in, your hands immediately going to his pants and undoing the tie on his scrub bottoms. “well in that case, I wanna suck your cock” you whispered, lowering down into your knees in front of him. Jake's eyes widened in surprise, but then he grinned.

"Fuck, yeah," he said, dropping his pants and boxers. His cock was hard and thick, the tip already glistening with precum, your heart pounding with excitement.

you reached out and wrapped your hand around his cock, stroking it gently. Jake groaned and closed his eyes, his head thrown back. you leaned forward and licked the tip of his cock, tasting the salty precum. Jake's groan grew louder as you opened your mouth and took him in, lips sliding down his veiny shaft.

you started to suck, head bobbing up and down as youworked his cock. Jake's hands were in yoir hair, guiding you as you sucked him off. you could feel his cock throbbing in your mouth, his balls tightening as he got closer to cumming.

"yeah, baby," Jake groaned, his hips thrusting forward as he fucked your mouth. "You're gonna make me cum so hard."

You moan around his cock, the sound vibrating through his shaft. You could feel his cock twitching in yourmouth, his balls tightening even more. you continued faster, fingers digging into his thighs as you worked him.

Jake's groans grew louder, his thrusts more urgent. you could feel his cock swelling, his precum flowing freely. you sucked harder, cheeks hollowing as your mouth got him to his release.

"Fuck, I'm gonna cum," Jake groaned, his hips bucking as he came hard in your mouth. You swallowed, throat working as you took every drop of his cum. Jake's hands were in you hair, holding your head as he came, his hips still thrusting as he emptied himself into your mouth.

When he was done, you pulled back, wiping your mouth with the back of your hand. Jake's cock was still hard, but it was starting to soften. You stood up, smiling at him.

"Did you like that?" you asked, voice soft and seductive. Jake grinned, his eyes still glazed with pleasure.

"I loved it," he said, pulling you into a kiss. "That was amazing."

As the weeks went on, you and Jake continued the little rhythm you had set in place. He flirted with you every chance he got. The both of you ending up in each others beds more often than not.

One evening, after a particularly grueling day at the hospital, you’re sitting in your apartment, staring blankly at the schedule in front of you. Your mind keeps drifting back to Jake—the way he looked at you during lunch, the warmth of his hand on your back as he guided you through the crowded cafeteria. The realization hits you like a tidal wave: you’re falling for him. Hard.

It terrifies you.

You’ve always prided yourself on being focused, dedicated, and in control of your emotions. But with Jake, everything feels different. The boundaries you set for yourself are blurring, and you’re not sure if you can handle the implications.

The demands of your job loom heavily over you. The long hours, the constant pressure, and the emotional toll of the medical field leave little room for anything else. As you stare at the schedule for the coming weeks, packed with surgeries and patient consultations, the reality sinks in: maintaining a relationship would be nearly impossible. The thought of trying to juggle your career and a growing emotional commitment to Jake feels overwhelming. After much soul-searching, you come to a difficult conclusion. It’s not fair to him or to yourself to continue something you can’t fully sustain. With a heavy heart, you decide it’s best to end things, believing that stepping back is the only way to preserve the little balance in your life.

The next day, you’re in the break room, trying to focus on patient charts when Jake walks in. He greets you with his usual easy smile, his eyes lighting up when he sees you.

“Hey, what are you up to?” he asks, his voice a low murmur that sends a shiver down your spine.

“just charting, the usual,” you reply, trying to keep your tone light despite the turmoil in your chest.

Jake walks over, his presence commanding your attention. “You wanna step away for a bit and grab lunch with me?”

You hesitate, the words on the tip of your tongue. You want to say yes, but the fear of what it might mean if you keep going down this path holds you back. “Actually, I have a lot to catch up on. Maybe another time.”

Jake’s brow furrows, a flicker of concern in his eyes. “Everything okay?”

You force a smile, trying to keep your emotions in check. “Yeah, just a bit overwhelmed with work.”

He doesn’t push, but you can see the worry in his eyes as he nods and leaves you to your charts.

Over the next few days, you start to pull back, keeping your interactions with Jake strictly professional. You avoid the on-call room, decline his offers for lunch, and keep your conversations short and to the point. It’s not easy, and you can see the confusion and hurt in his eyes every time you brush him off.

One evening, you’re leaving the hospital when you run into Jake in the parking lot. He’s leaning against his car, arms crossed, his expression serious.

“Y/N, can we talk?” he asks, his voice a mix of frustration and concern.

You nod, knowing you can’t avoid this conversation forever. “Sure.”

He takes a deep breath, his eyes searching yours. “What’s going on? You’ve been avoiding me, and I don’t understand why. Did I do something wrong?”

You shake your head, feeling the weight of your emotions pressing down on you. “No, Jake, you didn’t do anything wrong. It’s just… I’ve been thinking a lot about us. About what we’re doing.”

Jake’s expression softens, and he steps closer, his hand reaching out to gently cup your cheek. “Talk to me, Y/N. What’s going on?”

You shift uncomfortably, feeling the weight of your decision pressing down on you. “I’ve realized that I can’t keep up with a relationship right now. Our jobs are so demanding, and I’m constantly running on empty. I don’t think I can give you the attention and commitment you deserve.”

Jake’s expression shifts from confusion to hurt. “Y/N, I thought we were making this work. Why now? What changed?”

You struggle to keep your voice steady, the lump in your throat making it hard to speak. “It’s not about you. It’s about me and my inability to balance everything. I’ve been trying to make it work, but I can’t keep up with both my job and a relationship. It wouldn’t be fair to you.”

Jake’s eyes drop to the floor, and he takes a deep breath, trying to process what you’ve said. “So, this is it? You’re just… ending things? before they even started?”

You nod, feeling tears well up in your eyes. “I think it’s best. I care about you a lot, but right now, I can’t handle more than what I’ve got.”

Jake remains silent for a moment, then looks back at you with a pained expression. “I get it, Y/N. If this is what you need, then I respect your decision. But it doesn’t make it any easier.”

You reach out, touching his arm gently. “I’m so sorry, Jake. This isn’t what I wanted, but I need to focus on my career right now. I hope you understand.”

He nods, his eyes filled with a mix of sadness and acceptance. “Yeah, I understand. It doesn’t make it any less painful, but I get it.”

As you turn to leave, you feel a deep ache in your chest, knowing that you’ve made the right decision for yourself, but also feeling the weight of the loss. The break room seems colder now, and the empty space where Jake used to stand feels like a gaping hole in your heart.

Adjusting to life without Jake is more challenging than you anticipated. The hospital, once a place of shared glances and flirtatious banter, now feels strangely empty. The absence of his smile, his reassuring presence, and the warmth of his touch leaves a void that’s hard to ignore.

At work, you focus intently on your patients and your responsibilities, but the familiar routine feels different. The small moments that once brought you joy—a playful comment during a surgery, a quick coffee break together—are now replaced with an uncomfortable silence. Conversations with Jake are limited to work-related topics, and every interaction is laced with a professional distance that feels foreign and awkward.

In the OR, you work side by side, your focus on the patient and the procedure. Jake’s skill and calm demeanor are still impressive, and you find yourself appreciating his expertise even more now. But the casual camaraderie you once enjoyed is gone, replaced by a formality that feels both stifling and isolating.

During breaks, you find yourself missing the easy conversations you used to have with him. You used to share small victories and frustrations, but now those moments are spent in solitude or with other colleagues who don’t quite fill the gap Jake left behind.

Despite your best efforts to maintain your composure, you can’t help but feel the pangs of loneliness. Your personal life remains focused solely on work, and the connection you once had with Jake seems like a distant memory. You remind yourself why you made the decision, focusing on the demanding nature of your job and the need for balance.

Gradually, you begin to adjust, finding solace in the routine of your work and the support of your colleagues. The initial pain of Jake’s absence dulls over time, replaced by a newfound focus on your career and a deeper understanding of your own needs. Though the void remains, you learn to navigate your days with a renewed sense of purpose and dedication.

You’re passing through the hospital lobby, your mind preoccupied with patient charts, when you spot Jake standing near the information desk. He’s engaged in a conversation with Dr. Choi Miyeon, the oncology attending. Your steps slow involuntarily as you notice the easy laughter between them.

Jake’s smile is wide and genuine, his eyes crinkling at the corners in a way that once made your heart flutter. But today, the sight of that smile, directed at someone else, sends a pang of jealousy through you. Dr. Choi, with her poised demeanor and confident air, seems to be enjoying his attention, and the familiarity between them feels almost too intimate.

You try to focus on your task, but your gaze keeps drifting back to the two of them. Jake’s hand gestures animatedly as he talks, his face lighting up in a way that you haven’t seen directed at you in weeks. Dr. Choi’s laughter is soft and melodic, and she tilts her head slightly, clearly engaged in the conversation.

The sight of Jake looking so at ease with someone else brings an unexpected rush of emotion. You find yourself clenching your jaw, trying to ignore the gnawing sense of loss that accompanies the jealousy. It’s a reminder of the connection you once shared and the void left behind by your decision.

You force yourself to look away, turning back to your work with a renewed determination to focus on your patients. But the image of Jake’s smile and the easy rapport he shares with Dr. Choi lingers in your mind, leaving you with a mixture of regret and longing that’s hard to shake.

As you continue with your tasks, the memory of Jake’s interaction with Dr. Choi lingers, clouding your focus. Every time you glance up from your charts or interact with colleagues, your thoughts drift back to that moment in the lobby.

In the break room later that day, you catch sight of Jake entering, still visibly animated from his conversation with Dr. Choi. He looks up and sees you, his face lighting up with that same welcoming smile that used to be exclusively for you. The sight of it only intensifies the pang of jealousy you felt earlier.

“Hey, Y/N,” Jake says, approaching you with his usual warmth.

“Hi, Jake,” you reply, trying to keep your voice steady. You make a deliberate effort to maintain your professional composure, avoiding any mention of the earlier encounter.

Jake seems to sense a change in your demeanor but doesn’t press. Instead, he casually starts discussing the upcoming surgery, his tone light and engaging. You nod along, responding with the necessary professionalism, but your mind is elsewhere. You keep picturing him with Dr. Choi, the way they interacted so naturally, and it’s hard to ignore the twinge of regret.

As you wrap up the conversation and head to your next task, you can’t help but feel a deepening sense of frustration. The realization that you still care about Jake more than you initially admitted weighs heavily on you. The professional distance you’ve maintained seems more like a barrier than a solution, and the void he left behind is harder to ignore than you thought.

Later that evening, as you drive home, you replay the scene in your mind, questioning your decision. You wonder if stepping back from Jake was truly the right choice, or if you were merely trying to shield yourself from the possibility of a meaningful connection. The jealousy you felt is a clear sign of unresolved feelings, and it becomes evident that the emotional aftermath of ending things is more complex than you anticipated.

By the time you reach your apartment, you’re left grappling with the realization that you might have made a mistake. The lingering image of Jake’s smile, coupled with the undeniable ache in your chest, leaves you pondering whether there’s a way to reconcile your fears with the genuine affection you still feel for him.

But it would be utterly selfish of you to go running back to him when he’s seemingly started to move on. This was all your doing after all. He had every right to find what you couldn’t give him in someone else.

The ache in your chest refuses to fade. The image of Jake smiling at Dr. Choi replays in your mind like a loop, and the jealousy you felt transforms into a deeper, more introspective turmoil. You sit in your apartment, the stillness of the room amplifying the thoughts racing through your head.

You replay the conversations and moments you shared with Jake, recalling the comfort and joy he brought into your life. The connection you had felt real and profound, and now that it’s gone, the void seems more pronounced than you expected. The professional distance you’ve maintained does little to mitigate the lingering emotional impact, and the space between you feels even more significant.

The next day, you find yourself in the hospital, struggling to maintain the professional facade you’ve carefully constructed. Every interaction with Jake, though polite and necessary, feels strained and awkward. You avoid his gaze when you can, focusing solely on your patients and tasks, but the undercurrent of unresolved feelings remains.

During a particularly intense surgery, Jake is once again by your side, and the familiarity of working with him brings back a rush of memories. His presence, though professional, is comforting, and you find yourself drawn to him despite your earlier resolve. As you work together seamlessly, the shared glances and brief touches become almost impossible to ignore, reigniting a flicker of the intimacy you once had.

After the surgery, you’re in the on-call room, trying to catch your breath and clear your mind. Jake enters, a small smile playing on his lips, and for a moment, the professional barrier you’ve erected feels flimsy. He approaches you, his tone soft but playful.

“Everything okay, Y/N? You seem a bit distracted today.”

You look up, meeting his gaze. His concern and warmth are genuine, and it only adds to the confusion you’re feeling. “Just a lot on my mind,” you admit, forcing a smile. “It’s nothing.”

Jake’s eyes linger on you, a hint of frustration and worry evident. “If you ever want to talk, I’m here. You don’t have to go through this alone.”

His words cut through the walls you’ve built, and for a moment, you allow yourself to consider what you’ve been missing. The idea of opening up to Jake, of sharing your fears and feelings, feels both daunting and inviting.

As the day goes on, you grapple with the decision to reach out to him. The barriers you’ve erected are crumbling, and you realize that avoiding Jake might not be the solution you hoped for. Instead, you begin to consider whether there’s a way to address your fears and find a balance between your demanding career and a meaningful relationship.

The thought of reaching out to Jake, of possibly reconciling your emotions with the connection you still feel, starts to take shape. It’s a daunting step, but one that feels increasingly necessary as you navigate the complexities of your feelings and the emptiness left by his absence.

The days following your realization feel like a mix of regret and self-reproach. You can’t ignore the growing sense of remorse over ending things with Jake. The emptiness left by his absence is more acute than you anticipated, and the thought of missing out on something meaningful drives you to act.

One evening, determined to make things right, you head to Jake’s apartment, hoping to talk things through. Your heart races as you reach his door, and you take a deep breath before knocking.

After a moment, the door opens, and your heart sinks when you see Dr. Choi Miyeon standing there. Her presence immediately sends a wave of jealousy and discomfort through you.

“Doctor Y/L/N?” Miyeon says, her tone a mix of surprise and curiosity.

You stand frozen for a moment, the sight of her at Jake’s door intensifying your doubts. “Doctor Choi,” you manage, trying to keep your voice steady.

Miyeon’s expression shifts to one of mild confusion. “Did you need something?”

The thought of Jake being with Miyeon, combined with the realization that you’re intruding on what feels like an intimate moment, makes your decision for you. The hurt and uncertainty you’ve been feeling come to a head, and you realize you’re not ready to face him under these circumstances.

“I uh actually I’ll come at a better time”. Without another word, you turn and walk away from the door, your heart heavy with a mix of regret and frustration. You can hear Miyeon’s voice calling after you, but you don’t stop. The realization that you’ve arrived at the wrong moment only deepens the sense of regret.

As you leave the building, the cool night air hits your face, offering a brief respite from the emotional storm you’re navigating. You’re left grappling with the decision to return, to try again, or to accept the possibility that you might have missed your chance. The weight of the encounter with Miyeon only adds to the complexity of your feelings, leaving you to ponder your next steps in the solitude of the evening.

The following days are a haze of frustration and introspection. Seeing Miyeon at Jake's apartment made you feel even more disconnected from him. At work, maintaining your professional facade becomes more difficult as your emotions threaten to overwhelm you.

One morning, you’re at your locker, preparing for your shift, when Olivia walks in, her usual cheerful demeanor tempered by concern. “Hey, Y/N, you okay? You seem a bit off lately.”

You force a smile, trying to mask your turmoil. “Just a lot on my mind, Olivia. Thanks for asking.”

She nods sympathetically. “If you ever need to talk, I’m here. We all have rough patches.”

You thank her and head to the OR, trying to push your thoughts aside. But every encounter with Jake is a reminder of what you’ve lost. You see him in the corridors, in meetings, and every interaction is laced with a painful awareness of the distance between you.

One afternoon, you’re in the middle of reviewing patient files when Jake approaches you. His expression is neutral, but there’s an underlying tension in his eyes. “Y/N, can we talk?”

You nod, setting your files aside. “Sure, what’s up?”

He leads you to a quieter corner of the hospital. “I’ve been meaning to talk to you about the other night. I saw you at my apartment, and then you just… left. What happened?”

You take a deep breath, the memory of that evening still fresh and painful. “I came to talk to you, to explain that I made a mistake in ending things. But when I saw Miyeon, I realized I couldn’t do it.”

Jake’s expression softens, a mix of understanding and frustration in his eyes. “Miyeon and I were just going over some research. There’s nothing between us, Y/N. But I get why you’d feel that way.”

The weight of your regret feels heavier now, knowing you misinterpreted the situation. “I’m sorry, Jake. I’ve been struggling with everything, and seeing you with her just… hurt. I felt like I’d already lost you.”

He steps closer, his voice gentle but firm. “You haven’t lost me, Y/N. I care about you. But we need to figure out what we’re doing here. This back and forth isn’t good for either of us.”

You nod, feeling the weight of your emotions. “I know. I’ve been scared, Jake. Scared that our jobs would make it impossible to have a real relationship. But I realize now that pushing you away was a mistake.”

Jake’s gaze softens, and he reaches out to gently take your hand. “We can make this work if we both want it, Y/N. But we have to be honest with each other, and we have to be willing to try.”

You squeeze his hand, a sense of relief washing over you. “I do want to try, Jake. I want us to work.”

He smiles, a genuine warmth in his eyes. “Then let’s take it one step at a time. We’ll figure this out together.”

As you stand there, hand in hand, you feel a renewed sense of hope. The road ahead won’t be easy, but the thought of facing it with Jake by your side makes it seem possible. For the first time in weeks, you feel like you’re on the right path, ready to face whatever challenges come your way.

The days following your night with Jake are a blend of professional decorum and personal confusion. You both agreed to take things one step at a time, but it's hard to ignore the magnetic pull between you. At work, Jake is as focused and brilliant as ever, but there’s an added layer of warmth in his interactions with you, a silent acknowledgment of what you share.

One afternoon, you find yourself in the break room, sipping coffee and going over department paperwork . Jake walks in, his eyes lighting up when he sees you.

"Hey, Y/N," he says, his tone casual but with an underlying hint of playfulness. "How’s your day going?"

You look up, trying to suppress a smile. "Busy as usual. Just finished a tricky valve replacement."

Jake nods, moving closer. "I heard. You did a great job."

You feel a flutter in your chest at his praise. "Thanks, Jake. How about you? Any groundbreaking surgeries today?"

He chuckles, leaning against the counter. "Just the usual brain stuff. Nothing too exciting." He pauses, his eyes twinkling with mischief. "So, dinner tonight? My place?"

You glance around to make sure no one is within earshot. "Are you asking me out, Dr. Sim?"

Jake’s grin widens. "Maybe I am, Dr. Y/L/N. What do you say?"

You pretend to ponder, then nod. "Alright. Dinner sounds good."

The evening arrives, and Jake picks you up from your house. He’s dressed casually but still looks incredibly handsome. The drive to his place is filled with light conversation and laughter, easing any lingering tension.

Once inside his apartment, you feel a sense of familiarity and comfort. Jake leads you to the living room, where he’s set up a cozy dinner with candles and soft music playing in the background.

"This looks amazing," you say, genuinely touched by the effort he’s put in.

Jake shrugs modestly. "I wanted to do something special."

The dinner is delicious, and the conversation flows effortlessly. You talk about your families, past relationships, and the challenges of balancing demanding careers with personal lives. As the night progresses, you feel the barriers between you dissolving.

After dinner, you move to the couch, a glass of wine in hand. The atmosphere is relaxed, and there’s a growing sense of intimacy.

"Tell me more about your family," Jake says, his voice soft and curious.

You take a sip of wine, thinking about your parents and your brother. "Well, my parents are both retired now. My mom was a nurse, and my dad was a teacher. My older brother is a lawyer. We’re close, even if we don’t see each other often."

Jake listens intently, nodding. "Sounds like a solid family. Mine’s a bit scattered. Parents divorced when I was young, so I spent a lot of time between Australia and the States. I have a younger sister who’s an artist. She’s currently exploring Europe."

The conversation continues, each revelation bringing you closer. You talk about your past relationships, the heartbreaks and lessons learned. There’s a vulnerability in the exchange, a mutual understanding of the complexities of your lives.

As the night deepens, you find yourself leaning closer to Jake, the warmth of his presence enveloping you. He reaches out, gently brushing a strand of hair from your face.

"Y/N," he says softly, his eyes locking onto yours. "I really care about you. I want this to work, despite the challenges."

You feel a rush of emotions, the sincerity in his words touching you deeply. "I care about you too, Jake. I want us to work."

He leans in, capturing your lips in a slow, tender kiss. The kiss deepens, your bodies pressing closer together. The desire that has been simmering between you ignites, and you find yourself losing track of time as you explore the depths of your connection.

You found yourself crossing the room to stand in front of him, heart pounding in your chest. You'd reached out, hesitantly, and brushed a strand of hair from his forehead. And when he'd looked up at you, his eyes dark with desire, you knew that you couldn't resist any longer.

You leaned in, pressing your lips to his in a kiss that was both gentle and passionate. He'd responded eagerly, his arms wrapping around you and pulling you close. And as you kissed, you felt a surge of desire coursing through your veins.

You pulled back, just enough to look into his eyes. "Jake," you whispered, voice husky with longing.

"Yeah, baby?" he'd replied, his voice low and rough.

And then you stripped, slowly and deliberately, letting him watch as you revealed her body to him. You’d seen the heat in his eyes as he'd taken in the sight of you, and you knew that you had him.

You moved closer, pressing your naked body against his clothed one. You reached down, unbuttoning his pants and freeing his hard cock, dropping to your knees, taking him into your mouth and sucking him deep.

He'd groaned, his hands tangling into your hair as you worked magic on him. “s-shit baby, taking me so good, that’s it” you sucked and licked and teased, driving him wild with pleasure. when you felt him on the brink, you pulled back, smiling up at him.

"Fuck me, Jake," you commanded, voice husky with desire.

He'd obeyed, lifting you up and carrying you to the bedroom. He laid you down on the bed, spreading your legs wide and burying his face between them. You cried out as he licked and sucked your clit, bringing you to the brink of orgasm.

And then he entered you, driving deep and hard. Your wrapped her legs around him, meeting him thrust for thrust as you made love. It had been passionate and intense, a connection that went beyond the physical and was different from the previous times you had indulged in each other’s bodies.

when you finally reached your peak, collapsing in a tangle of limbs, you knew that you made the right decision. You finally acted on your attraction, and in doing so, you found a deeper connection with Jake.

You both lie there, still engulfed in the bliss of this newfound feeling between the two of you. He can’t help what he says next, feeling as if keeping it in was impossible. “i love you Y/N”.

you snap your neck in his direction, maybe it’s the post orgasm haze but you search for reassurance anyways.

His big brown eyes confirming his words. “I love you too jake”.

The next morning, you wake up in Jake’s arms, the sunlight filtering through the curtains. He stirs beside you, his sleepy smile a welcome sight.

"Good morning," he murmurs, his voice rough with sleep.

"Good morning," you reply, feeling a warmth spread through you.

As you lie there, wrapped in each other’s arms, the world outside seems distant and unimportant. In this moment, you feel a sense of peace and certainty. Whatever challenges lie ahead, you know you can face them together.

At the hospital, the dynamic between you and Jake shifts subtly but unmistakably. The stolen glances, the brief touches, the shared smiles—all are infused with a new depth of intimacy. Your colleagues notice, but no one comments, respecting the unspoken bond you share.

In the weeks that follow, the relationship deepens. You navigate the challenges of your demanding careers, finding solace and strength in each other. The on-call rooms become your private sanctuaries, the moments of stolen kisses and whispered confessions a lifeline in the chaos of the hospital.

One evening, after a particularly grueling shift, you find Jake waiting for you in the parking lot. His presence, as always, is a balm to your weary soul.

"Hey, pretty" he says, pulling you into a hug. "How was your day?"

"Tough," you admit, resting your head against his chest. "But it's better now."

He kisses the top of your head, his arms tightening around you. "Come on, let's go home."

As you drive back to his place, the city lights blurring into a comforting glow, you realize just how much Jake has come to mean to you. The fears and doubts that once plagued you have faded, replaced by a certainty that you can face anything as long as you're together.

Back at his apartment, you settle into a comfortable routine, cooking dinner together and sharing stories about your day. The conversation flows easily, punctuated by laughter and affectionate touches.

After dinner, you move to the couch, your bodies naturally gravitating towards each other. Jake pulls you into his lap, his hands resting on your hips as he looks into your eyes.

"Y/N," he says softly, his voice filled with emotion. "I know we've had our challenges, but I want you to know that I'm all in. I want to be with you, no matter what."

Your heart swells with love and gratitude. "I feel the same way, Jake. I want us to be together, through everything."

He smiles, his eyes shining with affection. "Good. Because I can't imagine my life without you."

You lean in, capturing his lips in a slow, tender kiss. The world outside fades away, leaving just the two of you, wrapped in each other's arms.

As the night wears on, you find yourself reflecting on the journey you've been on together. From the initial tension and uncertainty to the deep, abiding love you now share, it's been a rollercoaster of emotions. But through it all, you've found something rare and precious: a connection that transcends the challenges of your demanding careers, a love that grows stronger with each passing day.

and as you fall asleep in Jake's arms, you know that whatever the future holds, you'll face it together, hand in hand.

taglist: @hyunjinheartbreakprince @jaehoonii @enhaslxt @sumzysworld @justalittle-hee @seunghancore @curiousgworge @blockbusterhee @ribbioniki @chocolate-scoups @ineedsomezzz @theonewithouttheuwus @rairaiblog @chansloverr @armycarat2612 @slutforjaeyun @lovingvoidgoatee @jjklvr9 @fertilizedtoesw @ikeuverse @yohanseyebrowmole @mysticalenchantress @hchoes @en-gine @jakesbbygirl @miszes @simpjay @soobieboobiedoobiedaboobie @vveebee

[hareofhrair]

I wanted to put this one the previous post but it was long and this is a tangent but- In regards to the hypothetical "If House was my doctor I'd just tell him everything. Rip to all his other patients but I'm different."

The whole point of the show is that you wouldn't. Like a major theme of the show is about how the various shames and stigmas and habitual dishonesties that plague our societies both metaphorically and literally kill us. "Everybody lies" isn't just a cynical catchphrase, it's the shows thesis. Because of how we operate as a society, everyone feels compelled to suppress and hide things and that inevitably leads to suffering.

And there are plenty of episodes where this is obvious, ie "I cheated on my partner and gave them an STD." But there's also much more of "This little girl went through early puberty and because of the way our society stigmatizes women's bodies her single father never discussed puberty with her and she was so afraid and ashamed of her new pubic hair that she tried to shave it without telling anyone and mutilated herself, leading everyone to think she'd been abused and throwing off the whole case until House figured out her hormones were going crazy because she'd been exposed to her father's low T medicine, which he hid because of how our society regards masculinity, which he started taking because he began dating a younger woman (because of shame stemming from our society's unrealistic expectations wrt sex in relationships) which he was hiding from his kids, because of shame regarding our societies toxic views on monogamy."

A particular episode stands out as a really good example. S06E15 "Private Lives," which aired in 2010 but was fairly prescient about where social media was heading. The patient was a blogger who documented literally every moment of every day for her followers. She made it very clear she left *nothing* out, from her and her boyfriend's sex life to, eventually, asking for feedback from her followers on whether to get her heart valve replaced with one from a pig or a "vegan" plastic one. She handed the whole blog over to House as soon as he took the case and the team poured through the whole thing. Surely this is proof you're wrong about everybody lying, the team says to House. She's give us her whole life and you still can't find out what's wrong! Spoiler, it turned out the crucial symptom that allowed House to put it all together? Was the one thing she *didn't* include in the blog- Her bowel movements. Shame and stigma around talking about *poop* nearly killed this woman. It was also a detail that should have been picked up immediately by a normal doctor, who would have asked about her bowel movements as part of the standard checklist of diagnostic questions. But this woman was so confident that she'd laid out every relevant detail of her life in her blog, she wouldn't answer those questions, obfuscating what she was actually ashamed of underneath a pile of curated, rationalized, narritivized junk she could pretend was proof of a lack of shame and not simply a skill at creative writing.

When I say "I'd just tell House everything" is ridiculous, I don't just mean "well, because of the way the show works, you HAVE to be hiding SOMETHING." I mean literally, you- because you are a human being- are ashamed of *something.* And because you are a human being, the more info you try to give House the more deeply you will bury whatever it is you're actually ashamed of. And, because of the way the show works, that *will* end up being the key to what's making you sick.

[midnight-shadow-cafe]

Engines and Affections

Pairing: Poly 141 x Assistant!reader

AU: Mechanic 141

Warning: fluff, the boys are a bit touchy

Authors note: I hope yall enjoy, it’s not poly until about half way through. I had to change a lot of this because it was similar to someone’s post that they posted so this is the newer one

Word Count: 2.2k

Masterlist

MDNI18+MDNI18+MDNI18+MDNI18+MDNI18+

The air at Price’s Auto Garage buzzed with the sound of engines and tools, the usual symphony of work that set the place alive each day. Price, Soap, Gaz, and Ghost moved around the garage with quiet confidence, focused on their tasks. They were the best at what they did, hands skilled and practiced, but the front desk? It was a mess. Calls went unanswered, invoices piled up, and the schedule was a puzzle no one had time to piece together. Price finally decided they needed help at the front.

The moment you walked in for the interview, they noticed.

You stood in the doorway, posture relaxed, radiating a confident smile as you scanned the space. Even though garages weren't exactly familiar territory, you weren’t about to let that show. Price gave you a welcoming nod, gesturing you inside, while Soap looked you over with a smirk, already leaning against a toolbox. Gaz offered a warm smile, while Ghost stood off to the side, arms crossed, as unreadable as ever.

Price glanced through your resume with a quick nod, but it was clear they’d made up their minds as soon as you walked in. A few questions later, and the job was yours.

It wasn’t long before you found yourself in the midst of the garage’s organized chaos. The phone rang constantly, schedules made only partial sense, and sometimes, the invoices looked like a language of their own. You tried your best to keep up, but this was a whole new world.

“Ah, I think… these are for you?” You handed Price a stack of papers one morning, hesitating when his eyebrows lifted in surprise.

“Love, these are last week’s invoices.” Price held back a chuckle, his eyes kind even as he gently corrected you. “I’ll show you how we sort ’em out, alright?”

His large hands guided yours through the stacks, showing you the little tricks they used to keep things organized. He took his time, explaining everything patiently, his voice low and calm as he brushed your shoulder every now and then. By the end of it, you had a better grasp—sort of.

Soap, however, took a different approach. Every few hours, he’d call you over, pulling you away from your desk to check out whatever project he was working on.

“Oi, lass, come look at this,” he called out one afternoon, grinning as he waved you over to the car he was working on.

You tried to seem interested, leaning in as he explained the engine in detail, even though the terms were lost on you. Your confidence started slipping as he talked about pistons, valves, and all kinds of parts you’d never heard of, but you nodded along, pretending to understand.

“See this part here?” He pointed, smirking as you leaned in closer, glancing from him to the engine.

“Oh, yeah! The… thing,” you managed, biting back a laugh when he rolled his eyes, grinning even wider.

“You’ve no idea what I’m on about, do ya?” He chuckled, nudging you playfully with his elbow. “Don’t worry, lass, I’ll teach ya everything I know. Might just take a bit.”

Despite your confusion, his excitement was infectious, and you found yourself laughing along, even if you still didn’t understand a word.

Gaz was the one who always made sure you felt comfortable, sensing when you were a bit overwhelmed. Every morning, he’d bring you a coffee, setting it on your desk with a small smile.

“To keep you sharp,” he said with a wink, and you’d thank him, feeling a little less lost in the unfamiliar world of auto repairs.

One afternoon, as you struggled with the printer again, Gaz appeared by your side. He’d noticed your mounting frustration and stepped in without a word, reaching over to press a few buttons with expert ease.

“Here, let me show you.” His hand rested on yours as he guided you through the steps, his voice soft and patient. You felt his presence close beside you, his attention entirely on helping you, and your nerves calmed as you finally figured out the tricky machine.

“You’re getting it,” he said with an approving nod, his fingers brushing yours for a moment longer before he stepped back, a quiet sense of pride in his smile.

Ghost, meanwhile, kept his distance—until you made a mistake too big for him to ignore. One evening, you’d accidentally given the wrong keys to a customer, causing a brief mix-up in the garage. Ghost’s expression was steely as he came over to you, clearly unimpressed.

“These keys belong to the truck in the back,” he said, his tone gruff but calm as he held them out to you.

“Oh, I’m sorry, I just—” You stammered, caught off guard by the intensity in his gaze.

He took a slow breath, running a hand over his face before meeting your eyes again. “Just double-check before you hand ’em out next time, alright?”

You nodded, cheeks flushed, but Ghost’s expression softened almost imperceptibly when he noticed your nervousness. Later, he quietly came over, placing the keys in their correct spots while you watched, making sure you’d gotten it right.

“Just remember,” he said, his voice low, “no rush. Take your time.” And with a small nod, he returned to his work, his rare show of patience lingering with you.

---

One rainy evening, as you prepared to leave, you stood by the door, staring at the downpour. You’d forgotten your jacket, and with the way the rain was coming down, you’d be soaked in minutes.

Ghost was passing by, his eyes flicking between you and the rain outside. He let out a sigh, already pulling out his keys. “Come on. I’ll drive you.”

Surprised, you followed him to his truck, slipping into the passenger seat as he climbed in. The ride was quiet but comfortable, the steady rhythm of the rain filling the silence. His presence was somehow reassuring, and you found yourself relaxing, even sneaking a few glances at him as he drove.

“Thanks for this,” you murmured as he pulled up to your place, his gaze still fixed forward.

He gave a small nod, his voice barely above a whisper. “Just get yourself a jacket next time.” But the corners of his mouth turned up slightly, and you knew he didn’t mind.

After that night, you’d started to find your rhythm in the garage. The guys were quick to help when you needed it, and slowly, you felt like part of the team. The way they each looked out for you in their own way brought you a quiet sense of belonging that you hadn’t expected, making the unfamiliar chaos of the garage feel like somewhere you could finally call home.

——

Over the next few months, the garage became more than just a workplace—it became a second home. The guys were always there, whether to lend a hand, share a laugh, or tease you about some new mistake. You noticed how each of them had their own way of making sure you were taken care of. And somewhere along the way, your small, shared moments with each of them started to feel… different.

Price became more attentive, stopping by your desk to chat with you about your day, his warm gaze lingering a moment too long. Soap’s teasing got softer, almost affectionate, his laughs filled with genuine happiness when he saw you smile. Gaz made a habit of bringing you coffee every morning, but now he’d stay a little longer, brushing your hand as he passed the cup, his gaze lingering on your lips. Even Ghost, usually distant, had become gentler, staying around the garage a little longer just to make sure you got home safe.

The four men started to notice each other’s shifts in behavior too. What was once harmless camaraderie and teamwork started to feel like an unspoken rivalry, each of them vying for more of your attention. Eventually, it reached a tipping point, and one late night at the garage, they decided to address it head-on.

“Alright, lads,” Price began, crossing his arms as he looked at the others. “It’s about her, isn’t it?”

Soap scoffed, trying to brush it off. “You mean the way you get all soft whenever she’s around?” he said, though there was no real bite to his tone.

Gaz chuckled, running a hand over the back of his neck. “We all know it’s not just Price. Let’s be honest with ourselves here.”

Ghost, silent as ever, watched the others, his gaze thoughtful. “You’re not wrong,” he admitted, his voice low but steady. “Guess we’ve all got feelings for her. Question is, what’re we gonna do about it?”

They sat in silence for a moment, each processing the quiet admission that their feelings ran deeper than simple friendship. Price broke the silence, his voice firm yet understanding.

“We’re not just co-workers; we’re a team,” he said. “So, if we’re all on the same page about her, then maybe it’s time we tell her.”

A few days later, the four of them gathered the courage to bring up the subject with you. It was the end of a long workday, and you were about to head home when Price called you over, his tone uncharacteristically serious.

As you walked into the main garage, the four of them stood there, exchanging glances as if silently confirming that this was the right moment. You felt your heart race, sensing that whatever was about to happen was important.

Price cleared his throat, his usual steady demeanor softening as he looked at you. “We, uh… have something we need to talk to you about. All of us.”

Confused, you looked between them, giving a small nod. “Okay, I’m listening.”

They each took turns explaining, their words stumbling a little at first but then gaining confidence as they shared their feelings. Price told you how much he admired your kindness and resilience, how you made the garage feel like home. Soap shared how much he loved making you laugh, how your presence was the highlight of his day. Gaz spoke of his protective instincts, how he felt compelled to make you happy. Even Ghost, usually guarded, admitted in his own quiet way that he’d come to care about you deeply.

It was overwhelming but touching, hearing each of them express feelings that you hadn’t dared to think might be mutual. Finally, Price looked at you, his eyes searching yours with a question that didn’t need words.

“Would you be open to… to something with all of us?” he asked gently.

It took a moment for you to process what they were asking, but as you looked at each of them, you realized that the idea didn’t scare you—in fact, it felt right.

“I… I would be,” you admitted, smiling as their tense expressions melted into ones of relief and happiness.

From that point on, your relationships with them grew deeper and more intimate. You shared quiet mornings with Gaz, who’d bring you coffee and pull you close, his arm around you as you eased into the day together. Soap’s playful teasing turned more flirtatious, his laughter warm as he’d brush your hair back, stealing little kisses when no one was looking. Price had a way of grounding you, his strong arms always there to wrap around you at the end of a long day, pressing soft, lingering kisses to your forehead that made you feel safe. And Ghost, though still reserved, became more open, offering a gentle touch here and there, his presence comforting in a way that words couldn’t quite describe.

One evening, after closing up shop, you found yourself nestled between them on the worn leather couch in the break room. Gaz leaned close, his hand tracing gentle patterns on your back, while Soap’s arm draped across your shoulders, pulling you close as he whispered jokes in your ear, his voice warm and soft. Price sat at your side, his hand resting on your knee, thumb drawing small circles as he met your gaze with a soft smile, his eyes filled with a quiet understanding.

And Ghost, ever the silent observer, brushed a gentle hand over your shoulder, his fingers lingering at your neck. You felt their affection surrounding you, each of them bringing their own unique warmth and comfort, and you knew that this—this closeness, this shared connection—was something rare, something to be cherished.

Over time, your moments together grew more intimate. The nights you spent with them were full of whispered words and gentle touches, each one of them showing their love in their own way. Soap’s playful nature softened, his teasing replaced with gentle affection as he held you close, his laughter quiet as he stroked your hair. Gaz would pull you into his lap, his hands warm against your back as he kissed you deeply, his eyes filled with warmth as he traced his thumb over your cheek. Price, always steady, would hold you close, his presence reassuring as he kissed you with a softness that made you feel cherished, his voice low as he murmured words of love.

And Ghost, though still quieter than the others, would sit beside you, his fingers brushing over yours, his touch reverent as he watched you with a gaze that spoke volumes. When he held you, it was gentle, almost hesitant, as if he couldn’t believe you were there with him.

In these shared moments, you found a kind of love and connection that you’d never known. Together, you formed a bond stronger than any you’d ever imagined, a family bound by love and trust. And in their arms, surrounded by their warmth, you knew you’d found a home, one where you were loved wholly and completely by each of them.

Hope you enjoyed! Please follow, like and Reblog💜 -Midnight’s Cafe

[muletia]

Happy Christmas Mul and a happy new year! 😊🎁🎄

I've been thinking of the shatter glass universe and what our bots and cons counterparts would be like ���

Optimus Prime: Has no rizz, is so deep in his fantasy with y/n that he mistakes them for real life, protective and wants to be pegged

Shattered Glass Optimus: Roses are red, violets are blue. I'd let you hit my valve if you want too

a pinch of 18+ valveplug content

If they were to be compared to dog breeds, Optimus would be some kind of livestock guardian dog:

Patient, gentle, incredibly defensive of you, but never the one to start a fight.

A gentle giant type, content just being in your presence, although secretly (key word) yearning for closeness.

If you don’t take the first step yourself, he’ll torment himself with his intense feelings for the rest of his life—or until he loses his mind.

His main shtick is that, for your sake, he’d only ever harm himself, and others only in critical situations. Literally the "I’d die for you" type beat.

SG!Optimus is a rabid Rottweiler:

Aggressive toward anyone who gets too close to you, or even dares to linger their gaze a second too long. Such a bot is immediately punished because he’s always with you. You’re always nearby. Sometimes, it’s just so he can deliberately bait some bot into looking at you, providing Optimus with entertainment. The torn, energon-drenched optics are then presented to you on a tray.

SG!Optimus doesn’t need extra inspiration to ruthlessly crush millions, but when you’re around, it suddenly brings him even more joy. He doesn’t need a reason, but if you asked him to destroy an entire civilization, he’d do it with fiery enthusiasm, only to return to you smeared with energon/blood/bodily fluids and demand interfacing.

He’s also incredibly touchy and starved for stimulation. At the most unexpected moments, you feel his servos slipping under your clothes, indifferent to time or place.

This openness, combined with a complete lack of morals and his bloodthirsty nature, means you immediately know about his bizarre attachment to you. There will be no playing games here. The moment SG!Optimus realizes his spark craves you, you end up in his servos, and the most venomous and perilous valve stands open before you, ready to serve.

[transformers-spike]

TFA Megatron and femme cybertronian who’s so childish and energetic at some point megs has to shush her somehow…😣

That sounded so corny omg forget I said it like that. Anyways he just fucks the shit out of her to make her be quiet😭

Tysm if u do this💗💗

He's such a fun character to write for, I swear

“Stay still,” he orders.

Maybe you should have shut up from the start, stopped bombarding him with questions for the past month and a half and kept on working as their morally dubious (and unpaid) PR manager. He could have snapped earlier. He should have snapped earlier. From the way he has patiently answered your questions compared to Lugnut and Blitzwing who’ve threatened your life more times than you can feasibly count, he has shown nothing but tolerance in the face of your overexcited blabbering. But now? Oh, you’ve gone too far. And there’s no turning back. “Are we… sure about this? I mean, not that I’m complaining,” you say while chuckling nervously. You wriggle in his servo to no avail, his grip is firm, nowhere near painful, but inescapable. “You’ll manage,” he reassures with amusement tilting his voice. His timbre is soft and rumbling, so close you can feel it in your bones. This isn’t your first time getting freaky with the likes of him, but considering the circumstances, you’re apprehensive he may kill you with his spike- “Oh hey, that’s a new model!” you exclaim the second you catch sight of it. Grey and black, lined with red biolights, and much more feasible for someone of your body type to take. “Wow, did you get it from that purple guy? Was it Swindle or something? Anyway, I knew he sold you cool stuff but I didn’t expect him to sell spikes too. Ooh, does he sell valves? If you get a smaller one can I peg you? I promise I’ll do better this time! Pretty please? Please, please please please-” He gives you a warning squeeze. “Fuck! Okay, sorry. I got the message.” You mimic zipping your lips shut and give him a thumbs up. He looks unimpressed. His spike is cool against your thighs from the generous coating of lube, but its tip is deliciously warm. It’s certainly the biggest dick you’ve taken until now, and you consider yourself a size queen. “Oh uh… did you pick, like, the third smallest to give me an extra challenge?” You dare unzip your mouth. “I appreciate you believing in me, but… I don’t think I can survive that ,” you nudge your head in its direction, shivering from the mere thought of it inside of you. “It was custom-ordered,” he says, leering down at your tiny form. He runs his thumb over your breasts, a bead of transfluid forming at the tip of his spike, pink and shiny. You swallow hard. “Believe me,” he continues, breath slick with oil, “this is as small as they could go.” You claw at his servo when he presses it into you, a searing pain shooting through your core. “You could have prepared me at least, you know?” you hiss through gritted teeth. “Yes,” he admits, not a hint of apology behind the mirth in his tone. “But I believe you can manage just fine.” Bold words from someone who’s trying to stuff you like a Thanksgiving turkey. You would call him a cunt if you weren’t throwing your head back and groaning at the feeling of his free servo rubbing circles around your clit. “You really are a bastard,” you squeak, caught between pleasure and pain. His spike is halfway inside of you with no hint of stopping.

“And you should have learned to shut your intake ages ago,” he answers in his silky voice, crookedly smiling down at you. The very sound of him speaking is enough to send a wave of heat to your groin, making your walls involuntarily twitch around him. You glare up at him, his smile widens. The pace he starts at is excruciating; slow shallow thrusts pulling at your pussy, thumb drawing circles around your clit. He stays quiet as always, the only hint of pleasure on his part being the steady whirring of his cooling fans and the hot air being ex-vented against your skin. Soon enough, his spike is fully sheathed inside of you. You can barely move, filled to the brim by something that should decidedly never fit inside a human. “Overwhelmed?” he croons, voice caressing your poor aching nerves. “Fuck you,” you unwisely declare, visibly shaking in his fist. “I’ll consider that a yes,” he adds, mocking, pulling out of you just enough to give you the impression of hope, only to crush it once he stuffs himself back in. He fucks you for what feels like hours, leaving you speechless and numb from his brutal branch of pleasure, twitching around his spike, having cum enough times to leave you shaking in his grasp. You send a prayer to the All Spark when he finally finishes inside of you, filling you up to the brim with transfluid, enough to spill out of you and trickle down the crack of your ass. Your throat is sore from begging for mercy, and if you had any dignity left, you would look away in shame from those piercing red eyes. “Something the matter? You seem awfully quiet,” he teases, still rubbing his digit over abused nerves. “Bitch…” you rasp between ragged breaths.

[macgyvermedical]

The Difference Between Heart Attack, Heart Failure, and Cardiac Arrest

I think fiction has done us a huge disservice when they conflate the above, but even my nursing students were kind of on the edge of not understanding this, so we're gonna talk about it here.

Heart Attack: A blockage in the coronary arteries

A heart attack, also called a myocardial infarction, is when one of the arteries that supplies the actual muscle of the heart gets blocked by a blood clot. When this happens, the muscle the artery was supplying starts to die. The more muscle impacted, or the longer the heart attack goes untreated, the worse the outcome for the patient.

Symptoms of this are different between men and women:

Treatment for a heart attack usually involves inserting a small tube into the wrist or groin, snaking it up to the blocked artery, and stenting open the blockage, thus returning blood flow to the heart muscle.

Heart Failure: A problem with the heart's ability to pump

Heart failure occurs when the heart is not beating hart enough or well enough to adequately get blood out to the body. This can occur for several reasons. It can be because of damage from a heart attack, because a valve in the heart isn't working right, from poorly functioning electrical system, or from long term exposure to untreated high blood pressure.

The symptoms of heart failure come both from blood collecting "in front" of the heart waiting to get pumped (swelling, shortness of breath, weight gain), and not enough blood getting pumped out to the body (dizziness, fatigue).

Heart failure is treated with medications that make the heart beat more normally and get rid of excess fluid to take workload off the heart. It can also be treated with surgery if the problem is with a valve, or with a pacemaker if the heart is beating too slowly.

Cardiac Arrest: A problem with the heart's electrical system

The heart beats in a synchronized way because it is made of muscle cells that are responsive to electricity. Special cells called pacemaker cells generate small electrical currents, which wash over the heart. When the cells are stimulated with that current, they contract, creating a beat.

Cardiac arrest occurs when that normally organized current becomes disorganized, and lots of cells, not just the pacemaker cells, start making their own currents. This can happen because of a lack of oxygen, too much or too little of particular electrolytes like potassium, an electrical shock, or damage to the muscle from a heart attack.

See below for a comparison between the normal electrical activity of the heart (top) and the disorganized rhythm of ventricular fibrillation:

When the electrical rhythm is disorganized, the heart isn't beating, just quivering, and no blood gets out to the body. This is treated with CPR to keep some blood flowing to vital organs, medications that can stabilize the heart's electrical system, and defibrillation. Defibrillation works by stopping the heart with an overwhelming amount of electricity and letting it restart (hopefully) in a normal rhythm.

If someone has no electrical activity in their heart (known as asystole), defibrillation won't work, but sometimes medication will.

[schoenpepper]

All Sorts of Love

Intro: Kalim hasn't felt this kind of love before.

Warnings: bad writing, awful grammar, proofread by quillbot, yandere, one google translated arab word

A/N: For that one anon I hope you like this because I have spiralled into "what kind of yandere would Kalim be" and boyyyy I tried. I don't like the ending too much though. But honestly I feel like even if he was yandere he'd still turn to Jamil, right? They're like overly codependent. Also had way too much fun with the colors.

Masterlist

Kalim knows what love is.

Growing up, he'd been surrounded by a lot—maybe too much of it. From his parents to his siblings, he was spoiled, adored, and loved. He used all that love and poured it into himself like a valve, letting it flow right back to the world from within his body. He loves the sun, the sky, and his family; he loves his friends, the sea, and the wind as it ruffles his hair when he's on a magic carpet ride. He loves you.

Because you're his friend too.

He looks at the page in his notebook. One hour into Trein's lecture, and it's void of actual notes—only your name, little chibi doodles of you, and little hearts surrounding everything. He thinks you're so cute. He's glad that you two are friends and that you're so close with him. He has lots of friends, but you're different. Because you're best friends, like Jamil!

(Jamil denies it sometimes, but he doesn't mind. Jamil is still the closest person to him, even after the whole inky disaster.)

The bell rings, and he sweeps everything from his desk right into his bag. Jamil has basketball practice today, so hey, maybe he can hang out with you! You like hanging out with him, right? A happy tune is on his lips as he walks out of the classroom, his feet leading him towards the first years' classes. Your dismissal for this class was about thirty minutes later than his own, so he sits down on a bench and sways his feet, waiting patiently.

(He memorized your schedule so you guys can hang out more!)

He can't do much while waiting, except for playing on his phone. He sees a picture you'd posted on Magicam yesterday and clicks the like button—it's of the two of you, so he comments with a 'WE LOOK SO GOOODDDD' and saves the image, using it as his screen wallpaper. The background was the amusement park he'd begged you to go to with him, cotton candy swirls in your hands as you stood together with happy smiles. Jamil took the photo, which is great! Because for some reason, even though the two of you are his best friends, he doesn't like the thought of Jamil standing next to you or doing as he did in the picture and feeding you a piece of his cotton candy. Just thinking about it made him upset. He doesn't like feeling upset, so he doesn't want to think about it anymore.

The bell rings, and the freshmen pour out of their classrooms like a swarm of insects. Several Scarabia first-year students greet him, and he smiles in turn, while his ruby-red eyes scan the crowd for your figure.

Too short, too tall, wrong hair color, wrong hair texture—ah!

It's you.

"Y/N!" Kalim all but runs over to you with the widest smile on his face, almost bowling you over to the ground with his hug.

"Kalim!" You smile back just as happily, ignoring Grim, who'd fallen to the ground from your shoulder. Kalim beams brighter when he feels your arms wrap back around him, and he stays still until Ace speaks up.

"Uh, are you guys gonna keep hugging, or can we get going?"

"Right! Y/N, come with me, okay? I wanna show you something." He knows you'll fall for his wide, pleading eyes when he asks the question. As expected, you only nod and follow him, leaving Grim with the two Heartslabyul boys with promises of tuna when you pick him up later.

Kalim holds your hand the whole time as he pulls you back to Scarabia. He listens to how your day went with all 110% of his attention span, letting you finish your story before opening the storage room door. "Huh? What are we doing here, Kalim?" He giggles and runs with you over to one corner. He doesn't like that he has to let go of your hand, but he dives headfirst into the mountain of gold to try and find the thing he's looking for. He pulls a small box out of the pile and collapses to the floor, out of breath. "Uh, are you okay?" You ask, barely holding back your laughter.

"I'm okay!"

He loves seeing you laugh. He thinks you shouldn't hide it.

"So what did you want to show me?"

He stands back up and opens the box. Inside is a gold bracelet with little heart-shaped rubies, the same color as his eyes. "This! I just remembered that my parents sent it with me when I got into NRC. It was my jida's. Do you like it?"

You smile and admire the bracelet.

But you never touch it.

"It's gorgeous, Kalim."

"Great!" He fumbles a little bit as he takes it out of the box, gesturing for your hand. "I'll put it on for you!"

"What? No, I can't accept that, Kalim."

"Please! They told me to give it to an important person, and you're very important to me," he insists. You look at him hesitantly, but still refuse. "That's different, I don't think they mean that kind of important, Kalim."

"Y/N...am I not important to you?"

Finally, finally, you waver and fold. You let him put the bracelet on you. He can't help himself; he intertwines your fingers with his own as he admires the way it sits on your wrist. He can almost imagine the way his own grandmother had worn it in the past. She must've looked beautiful, but he thinks no one could ever compare to you. You two sit down on some random carpet in the store room as he continues to appreciate how it shines on your skin, his thumb subconsciously rubbing circles on your hand. When he looks back at your face to say something, he freezes for a few seconds. 

You're looking at him so...adoringly.

Eyes soft and sweet, like honey is swirling within your irises. Your lips are slightly parted, as if you're hesitating to say something, and your grip on his hand is tightening. He watches you take a deep breath and speak.

"Kalim," you say his name like it's nothing he's ever heard before. "I like you, as more than a friend. No, Kalim, I love you."

And for once, he doesn't know how to respond to this love.

For all the love given to him by his parents, his ancestors, his siblings, his cousins, his human friends, his animal friends—none of it had prepared him to be loved by you, no, not like this. He loves you. But... as a friend.

Right.

Because loving you like that, what would it mean? Would it let you spend more time together or less? Would you smile at him or fight with him more? What does that kind of love entail?

He likes your friendship.

So, "Can't we just stay friends?"

He sees your heart crack from the way you look at him, how you pull away, and how you immediately unclasp the bracelet and put it back in his hands. There are tears streaming down your face and leaving trails down your cheeks as you speak, and your voice is so shaky that he feels so bad for what he said. But he can't take it back. "Okay, I'm, I'm so sorry." You stammer out through choked sobs as you stand up and start to walk away.

"Hey, Y/N!" He tries to go after you, but you break out into a full run before he can do anything.

Maybe he should leave you alone for a while. With all the thoughts in his mind that he can't make sense of at the moment, maybe he needs that alone time just as much as you do.

He sighs.

First Jamil, now you.

(Since when has friendship been so hard?)

The 'alone time' takes at least three days.

By the fourth day, Kalim is ready to be your friend again. He can't handle the awkward glances or seeing your teary eyes just the day after the incident, but he can't leave you forever! You're his best friend, and he wouldn't lose you over this. He'd thought that after giving you some space, you would bounce right back and maybe go on a magic carpet ride with him again.

So...why are you still avoiding him...?

He'd lost sleep over the past three days, lost focus. Jamil had been on his tail about homework and projects. But he's so distracted. Where are you? What are you doing? Are you okay now?

Do you still love him?

He walks over to your cafeteria table, where you're seated with your friends. "Y/N!" He's blocked by a very angry Grim, hissing and all fur standing on end. He's so confused when Ace and Deuce try to get him to leave, when Epel is glaring at him, when Jack is hiding you behind his muscled figure, when Ortho is just quietly scanning him, a strange red laser pointing to his forehead, or when Sebek is yelling at him that you don't want him around.

Do you really...not want him around?

He's pulled away by Jamil when Ortho's eyes start glowing red.

Why are you avoiding him why why why why why why why why why why why why why why why why why why why why why why

He doesn't like it when you avoid him.

Don't avoid him, please.

You're taking longer, more inconvenient routes, if only to steer clear of the path he takes. Your friends guard around you in the cafeteria, and days turn to weeks, and Kalim is...okay.

He's okay.

(Jamil finds him sobbing in his sheets in the middle of the night, crying out your name.)

He's okay when he sees you gradually brightening up again. He's okay when he finds you're slowly talking to him again, but not treating him like a friend. He's super okay and totally fine when he sees you spending more and more of your time with Deuce alone, just the two of you. And he's great when he notices the boy's blushing, awkward movements, similar to what you used to do in Kalim's presence.

Come back to him please Y/N please please please come back why won't you come back he's your best friend right why won't you come back Y/N Y/N Y/N Y/N

"Do you like Y/N?"

Kalim's feet are swinging off the edge of the balcony as he leans back on his arms. His gaze stays on the fountain in the middle of the dormitory, clearly lost in thought, before being brought back by Jamil's question. He doesn't need to think twice about his answer. "Of course! They're my best friend too, so it's a little upsetting that they're not hanging out with me anymore."

"No." Jamil rolls his eyes. "More than a friend."

"I don't think so."

"Really?"

Kalim nods.

(It's okay that he wants to be your best friend, your only friend, right?)

"Kalim, let's get this straight, okay? I don't want to see you sulking anymore. You're in love with Y/N." Jamil puts both hands on Kalim's shoulders, stooping a little lower to look him in the eye. "Do you want to be with Y/N all the time? Do you want to touch them? Kiss them, maybe? Do you feel annoyed when you see them with other people? Do you hate the thought of a future without them by your side, like you can't even stand it? Kalim, yes or no, are you in love with Y/N?"

Kalim feels like he's just been dunked in a vat of ice water.

"I love them that way?" he asks softly.

Jamil shakes him lightly. "Imagine you saw Deuce kissing the—"

Oh. Okay. So he loves you after all.

"Kalim!"

He never even noticed the heavy rain that suddenly started after Jamil said those words. It's his magic; he can feel it, but Oasis Maker is out of his control, and he doesn't feel like stopping it. "Sorry Jamil, I just, I can't imagine it." He's crying, why is he crying? Is it because he hates the thought so much that it makes him want to—

You wouldn't kiss Deuce no no you wouldn't you wouldn't why would you kiss him do you like him does he like you have you moved on do you not love Kalim anymore please love love love love love why would you do that don't abandon him he loves you too so please please please please please please please please please please please please please please please please please please please please please

"Jamil?" Kalim holds onto his retainer's wrists. "Do you think...Y/N still loves me?"

"I don't know, Kalim."

"If they don't love me anymore," Kalim smiles, it's a little desperate, but mostly, it's pained. The corners of his lips twitch as his grip on Jamil's wrists tightens. "Will you help them remember how much they love me?”

[cardiologyassociatesofmorrist]

Struggling to recover from heart attacks or cardiac surgeries? If yes, then read our blog on 'The Benefits of Cardiac Rehabilitation after a Heart Attack or Surgery' and get tips to enhance your cardiovascular fitness, emotional well-being, and long-term heart health.

[mostlysignssomeportents]

When private equity destroys your hospital

I'm on tour with my new novel The Bezzle! Catch me TOMORROW in PHOENIX (Changing Hands, Feb 29) then Tucson (Mar 9-10), San Francisco (Mar 13), and more!

As someone who writes a lot of fiction about corporate crime, I naturally end up spending a lot of time being angry about corporate crime. It's pretty goddamned enraging. But the fiction writer in me is especially upset at how cartoonishly evil the perps are – routinely doing things that I couldn't ever get away with putting in a novel.

Beyond a doubt, the most cartoonishly evil characters are the private equity looters. And the most cartoonishly evil private equity looters are the ones who get involved in health care.

(Buckle up.)

Writing for The American Prospect, Maureen Tcacik details a national scandal: the collapse of PE-backed hospital chain Steward Health, a company that bought and looted hospitals up and down the country, starving them of everything from heart valves to prescription paper, ripping off suppliers, doctors and nurses, and callously exposing patients to deadly risk:

https://prospect.org/health/2024-02-27-scenes-from-bat-cave-steward-health-florida/

Steward occupies a very special place in the private equity looting cycle. Private equity companies arrange themselves on a continuum of indiscriminate depravity. At the start of the continuum are PE funds that buy productive and useful firms (everything from hospitals to car-washes) using "leveraged buyouts." That means that they borrow money to buy the company and use the company itself as collateral: it's like you getting a bank-loan to buy your neighbor's mortgage out from under them, and using your neighbor's house as collateral for that loan.

Once the buyout is done, the PE fund pays itself a "special dividend" (stealing money the business needs to survive) and then starts charging the business a "management fee" for the PE fund's expertise. To pay for all this, the PE bosses start to hack away at the company. Quality declines. So do wages. Prices go up. The company changes suppliers, opting for cheaper alternatives, often stiffing the old company. There are mass layoffs. The remaining employees end up doing three peoples' jobs, for lower wages, with fewer materials of lower quality.

Eventually, that top-feeding PE company finds a more desperate, more ham-fisted PE company to unload the business onto. That middle-feeding company also does a leveraged buyout, pays itself another special dividend, cuts wages, staffing and quality even further. They switch to even worse suppliers and stiff the last batch. Prices go up even higher.

Then – you guessed it – the middle-feeding PE company finds an even more awful PE bottom-feeder to unload the company onto. That bottom feeder does it all again, without even pretending to leave the business in condition to do its job. The company is a shambling zombie at this point, often producing literal garbage in place of the products that made its reputation. Employees' paychecks bounce, or don't show up at all. The company stops bothering to pay the lawyers that have been fending off its creditors. Those lawyers sue the company, too.

That's the kind of PE company Steward Health was, and, as the name suggests, Steward Health is in the business of stripping away the very last residue of value from community hospitals. As you might imagine, this gets pretty fucking ugly.

Steward owns 32 hospitals up and down the country, though its holdings are dwindling as the company walks away from its debt-burdened holdings, after years of neglect that have rendered them unfit for use as health facilities – or for any other purpose. Tcacik's piece offers a snapshot of one such hospital: Florida's Rockledge Regional Medical Center, just eight miles from Cape Canaveral.

Rockledge is a disaster. The fifth floor was, at one point, home to 5,000 bats.

Five.

Thousand.

Bats.

(Rockledge stiffed the exterminators.)

The bats were just the beginning. One of the internal sewage pipes ruptured. Whole sections of the hospital were literally full of shit, oozing out of the walls and ceiling, slopping over medical equipment.

That's an urgent situation for any hospital, but for Rockledge, it's catastrophic, because Rockledge is a hospital without any hospital supplies. Steward has stiffed the companies that supply "heart valves, urology lasers, Impella catheters, cardiac catheterization balloons, slings for lifting heavier patients, blood and urine test reagents, and most recently, prescription paper." Key medical equipment has been repossessed. So have the Pepsi machines. The hospital cafeteria had its supply of cold cuts repossessed:

https://www.reddit.com/r/massachusetts/comments/1agc1j4/comment/kolicqo/

It's not just Steward's nonpayments that reek of impending doom. Its payments also bear the hallmarks of a scam artist on the brink of blowing off the con. The company recently paid off a vendor with five separate checks for $1m, each drawn on "a random hospital in Utah" (Steward recently walked away from its Utah hospitals; its partners there are suing it for stealing $18m on their way out the door).

This company – which owns 32 hospitals! – has resorted to gambits like sending photos of fake checks to doctors it hasn't paid in months as "proof" that the money was coming (the checks arrived 22 days later).

Steward owes so much money to its employees – $1.66m to just one doctors' group. But the medical staff keep doing their jobs, and are reluctant to speak on the record, thanks to Steward's reputation for vicious retaliation. Those health workers keep showing up to take care of patients, even as the hospital crumbles around them. One clinician told Tcacik: "I watched a bed collapse underneath a [patient] who had just undergone hip surgery."

Rockledge has nine elevators, but only five of them work – the other four have been broken for a year. The hospital's fourth floor has been converted to "a graveyard of broken beds." The sinks are clogged, or filled with foul gunk. There's black mold. Nurses have noted on the maintenance tags that the repair service refuses to attend the hospital until their overdue bills are paid. The fifteen-person on-site maintenance team was cut to just two workers.

Steward is just the latest looting owner of Rockledge. After the Great Financial Crisis, private equity consultants helped sell it to Health Management Associates. The hospital's CEO took home a $10m bonus for that sale and exited; Health Management Associates then quickly became embroiled in a Medicare fraud and kickback scandal. Soon after, Rockledge was passed on to Community Health Systems, who then sold it on to Rockledge.

Steward, meanwhile, was at that time owned by an even bigger private equity giant, Cerberus, which then sold Steward off. That deal was performatively complex and hid all kinds of mischief. Prior to Cerberus's sell-off of Steward, they sold off Steward's real-estate. The buyer was Medical Properties Trust, who gave Cerberus $1.25b for the real-estate: three hospitals in Florida and three more in Ohio. Steward then contracted to operate these hospitals on MPT's behalf, and pay MPT rent for the real-estate.

This complex arrangement was key to siphoning value out of the hospital and to keeping angry creditors at bay – if you can't figure out who owes you money, it's a lot harder to collect on the debt. The scheme was masterminded by Steward founder/CEO Ralph de la Torre. De la Torre is notorious for taking a massive dividend out of the company while it owed $1.4b to its creditors. He bought a $40m yacht with the money.

De la Torre was once feted as a business genius who would "disrupt" healthcare. But as Steward's private jet hops around "Corfu, Santorini, St. Maarten and Antigua" as its hospitals literally crumble, he's becoming less popular. In Massachusetts, politicians have railed against Steward and de la Torre (Governor Healey wants the company to leave the state "as soon as possible").

Florida, by contrast, is much more friendly to Steward. The state Health and Human Services Committee chair Randy Fine is an ardent admirer of hospital privatization and is currently campaigning to sell off the last community hospital in Brevard County. The state inspectors are likewise remarkably tolerant of Steward's little peccadillos. The quasi-governmental agency that inspects hospitals has awarded this shit-and-bat-filled, elevator-free, understaffed rotting hulk "A" grades for quality.

These inspectors jointly represent a mismatched assortment of private and public agencies, dominated by a nonprofit called Leapfrog, the brainchild of Harvard public-health prof Lucian Leape, who founded it in 2000. Leapfrog likes to tout its "transparent" assessment criteria, and Steward are experts at hitting those criteria, spending the exact minimum to tick every box that Leapfrog inspectors use as proxies for overall quality and safety.

This is a pretty great example of Goodhart's Law: "every measurement eventually becomes a target, whereupon it ceases to be a good measurement":

https://xkcd.com/2899/

But despite Steward's increasingly furious creditors and its decaying facilities, the company remains bullish on its ability to continue operations. Medical Properties Trust – the real estate investment trust that is nominally a separate company from Steward – recently hosted a conference call to reassure Wall Street investors that it would be a going concern. When a Bank of America analyst asked MPT's CFO how this could possibly be, given the facility's dire condition and Steward's degraded state, the CFO blithely assured him that the company would get bailouts: "We own hospitals no one wants to see closed."

That's the thing about PE and health-care. The looters who buy out every health-care facility in a region understand that this makes them too big to fail: no matter how dangerous the companies they drain become, local governments will continue to prop them up. Look at dialysis, a market that's been cornered by private equity rollups. Today, if you need this lifesaving therapy, there's a good chance that every accessible facility is owned by a private equity fund that has fired all its qualified staff and ceased sterilizing its needles. Otherwise healthy people who visit these clinics sometimes die due to operator error. But they chug along, because no dialysis clinics is worse that "dialysis clinics where unqualified sadists sometimes kill you with dirty needles":

https://www.thebignewsletter.com/p/the-dirty-business-of-clean-blood

The bad news is that private equity has thoroughly colonized the entire medical system. They took hospitals, fired the doctors, then took over the doctors' groups that provided outsource staff to the hospital:

https://pluralistic.net/2020/04/04/a-mind-forever-voyaging/#prop-bets

It's illegal for private equity companies to own doctors' practices (doctors have to own these), but they obfuscated the crime with a paper-thin pretext that they got away with despite its obvious bullshittery:

https://pluralistic.net/2020/05/21/profitable-butchers/#looted

The financier who decides whether you live or die depends on an algorithm that literally sets a tolerable level of preventable deaths for the patients trapped in the practice:

https://pluralistic.net/2023/08/05/any-metric-becomes-a-target/#hca

Private equity also took over emergency rooms and boobytrapped them with "surprise billing" – junk fees that ran to thousands of dollars that you had to pay even if the hospital was in network with your insurer. They made billions from this, and spent a many millions from that booty keeping the scam alive with scare ads:

https://pluralistic.net/2020/04/21/all-in-it-together/#doctor-patient-unity

The whole health stack is colonized by private equity-backed monopolies. Even your hospital bed!

https://pluralistic.net/2022/01/05/hillrom/#baxter-international

Then there's residential care. Private equity cornered many regional markets on nursing homes and turned them into slaughterhouses, places where you go to die, not live:

https://pluralistic.net/2021/02/23/acceptable-losses/#disposable-olds

The palliative care sector is also captured by private equity. PE bosses hire vast teams of fast-talking salespeople who con vulnerable older people into entering an end-of-life system before they are ready to die. Thanks to loose regulation, the nation is filled with fake hospices that can rake in millions from Medicare while denying all care to their patients (hospice patients don't get life-extending medication or procedures, by definition):

https://pluralistic.net/2023/04/26/death-panels/#what-the-heck-is-going-on-with-CMS

If you survive this long enough, Medicare eventually tells the hospice that you're clearly not dying and you get kicked off their rolls. Now you have to go through the lengthy bureaucratic nightmare of convincing the system – which was previously informed that you were at death's door – that you are actually viable and need to start getting care again (good luck with that).

If that kills you, guess what? Private equity has rolled up funeral homes up and down the country, and they will scam your survivors just as hard as the medical system that killed you did:

https://pluralistic.net/2022/09/09/high-cost-of-dying/#memento-mori

The PE sector spent more than a trillion dollars over the past decade buying up healthcare companies, and it has trillions more in "dry powder" allocated for further medical acquisitions. Why not? As the CFO of Medical Properties Trust told that Bank of America analyst last week, when you "own hospitals no one wants to see closed." you literally can't fail, no matter how many people you murder.

The PE sector is a reminder that the crimes people commit for money far outstrip the crimes they commit for ideology. Even the most ideological killers are horrified by the murders their profit-motivated colleagues commit.

Last year, Tkacic wrote about the history of IG Farben, the German company that built Monowitz, a private slave-labor camp up the road from Auschwitz to make the materiel it was gouging Hitler's Wehrmacht on:

https://pluralistic.net/2023/06/02/plunderers/#farben

Farben bought the cheapest possible slaves from Auschwitz, preferentially sourcing women and children. These slaves were worked to death at a rate that put Auschwitz's wholesale murder in the shade. Farben's slaves died an average of just three months after starting work at Monowitz. The situation was so abominable, so unconscionable, that the SS officers who provided outsource guard-labor to Monowitz actually wrote to Berlin to complain about the cruelty.

The Nuremberg trials are famous for the Nazi officers who insisted that they were "just following order" but were nonetheless executed for their crimes. 24 Farben executives were also tried at Nuremberg, where they offered a very different defense: "We had a fiduciary duty to our shareholders to maximize our profits." 19 of the 24 were acquitted on that basis.

PE is committed to an ideology that is far worse than any form of racial animus or other bias. As a sector, it is committed to profit above all other values. As a result, its brutality knows no bounds, no decency, no compassion. Even the worst crimes we commit for hate are nothing compared to the crimes we commit for greed.

If you'd like an essay-formatted version of this post to read or share, here's a link to it on pluralistic.net, my surveillance-free, ad-free, tracker-free blog:

https://pluralistic.net/2024/02/28/5000-bats/retaliation#charnel-house

[mychlapci]

I’m constantly plagued by thoughts TFP Soundwave being the one to lay broods of vehicon eggs despite his narrow ass hips, Megatron just watches patiently as Soundwave struggles to force the protoform eggs out of his tiny valve not even letting him use his data cables to hold himself open, instead he’s straining and breaking his valve the way Primus intended. Once he’s done Megatron probably reaches in with two fingers to jack off Soundwave swollen and gaping cervix to make sure all the birthing fluids are out and clear the way for the next batch of eggs

oooooh Soundwave being the one who births the vehicons…. he’s so skinny, not built for carrying at all, but Megatron enjoys watching him squirm and pant, his poor valve struggling to birth the large pods.

and of course, as much as it hurts, Soundwave should be into it. If Megatron is horny for it, so is he, just from the knowledge that he’s making Megatron feel good by breaking his little port to birth his loyal soldiers.

[watchyourbuck]

buddie AU where Buck goes missing and Eddie can’t handle the firefighting life without him anymore so he exploits his medical skills and becomes a cardio thoracic surgeon and builds a new life for himself but then years pass and he’s called in for an emergency surgery in the middle of the night for a John Doe that showed up in the ER confused and drugged and had a heart attack and he’s suddenly operating on this man and boy he’s so tired but the patient’s organs are shutting down and he has to do a valve replacement and it’s hard and it takes him hours but then he succeeds bc he’s just that good he’s amazing he’s even heroic and so the strange man with no name is taken to post op and he’s stable and holding on and Eddie wants to go home and sleep so badly but he has to check in on him bc he’s his patient and he’s nothing if not a good doctor so he’s walking he has the chart and he’s repeating the instructions he’s gotta give the nurses in his head but then he steps one foot inside the room and all the air leaves his lungs bc the man, the stranger, the patient he just operated on has the birthmark he’s spent the last twelve years dreaming about and wishing he had kissed and his voice comes out trembling and soft and he has to hold onto the doorframe if he doesn’t want to black out and “Buck?”