#also I’m thinking about emesis blue | Explore Tumblr Posts and Blogs

sepublic · 1 year

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Acknowledging that I may be missing the point by trying to figure out the in-universe explanation and logistics, rather than focusing on the metaphor and symbolism behind Emesis Blue;

I think the Plague Doctor might be Fritz Ludwig from the future, possessed and/or under control of his alter ego (Hence the uncharacteristic act). There’s the obvious fact that Jeremy treats Fritz with hostility and fear, and Fritz’s own hallucination of killing Jeremy’s mom. He has the gouged-out eyes and smile, which Fritz receives at the end of the film after crashing.

At the end of the film, Fritz is brought back in the respawn machine, amidst a bunch of fire. In Archibald’s PSA to newly-respawned mercenaries, there’s an inexplicable fire that enters the room just offscreen, so I think there’s a deliberate connection. The only other possibility is that Fritz respawns as the Conagher Slaughterhouse burns down near the end of the movie (note that this would require someone to perform the manual input on the respawn machine, possibly the Plague Doctor). The abrupt fire at the end of the PSA feels too deliberate of a detail to otherwise ignore. Note that right after the video ends with fire, we cut to some photos taken presumably around that time, including of a burning Fritz…

Likewise, we have an example of time travel being an actual thing, and not just a Diazepam-induced hallucination (note Soldier claiming to have never taken any of the pills, only to later interact with his future self). This would explain how Fritz is in two places at once, which he needs to be, given we see him drive past Soldier in his ambulance, followed by the Plague Doctor’s hearse arriving just moments afterwards.

Now Fritz normally would have no reason to kill Jeremy’s mom, but that’s assuming it’s him in control; More than likely, it’s his alter-ego. Now I’ve watched TheWhat Show’s video on Emesis Blue, so I’m inspired by a lot of what he suggested here. But if we go with the idea that Fritz is being possessed by the spirit of the Tenth Class, this may explain a bit...

Dell’s Bar seems to be the limbo, the purgatory, the waiting room that the mercs and others who go through respawn wait in. And we know the respawn machine creates a fresh duplicate of one’s body, meaning respawned mercenaries can interact with their previous corpses; Hence the motherload of identical dead bodies all over the place.

There’s also the hallucination Fritz has, where he’s trapped in a casket inside the church, while the Plague Doctor watches; Foreshadowing both the church he kills Pyro in, and later his own funeral assassination. But it could also symbolize Fritz’s mind/soul being locked away in his body, or perhaps in a briefcase/limbo, while the Plague Doctor takes over...

If we go by the theory that the Plague Doctor is the vengeful ghost of the Tenth Class who has possessed Fritz, I think things begin to come together. After crashing at the end of Emesis Blue, Fritz’s soul is stuck in limbo, awaiting his next respawn. Due to time loop shenanigans, he is respawned in the past as Archibald records his PSA, possibly with only the Tenth Class’ soul inside; Fritz’s soul may have been left behind in limbo, which may be located within the briefcase. Either way, the Tenth Class in total control now.

The fire is an interesting detail; Did the respawn machine malfunction? And this malfunction caused both the flame and the retrieval of future Fritz, instead of his current self? Or maybe, and this is a bit out there but I just want to say it; Maybe the Tenth Class’ soul was plucked straight from Hell, and in doing so brought some hellfire with him that burned the Conagher Slaughterhouse, the first time. We see an apparition of the Tenth Class when Soldier is about to jump over the chasm leading to ‘Hell’, after all; Maybe the Tenth Class went there.

Something I find interesting is that the Plague Doctor seems to be working with BLU Heavy, Pyro, and Zed and Maynard Conagher. Somebody else was holding up Mama Scout’s head when Pyro kidnapped Jeremy, and it appears BLU Heavy was supposed to pass the briefcase to the Plague Doctor near the start of the film. The Plague Doctor’s hearse is a convenient vehicle to transport BLU Heavy’s body to the Conagher Slaughterhouse, to later be revived by RED Medic into a Mr. X reference.

We know Maynard was the one to lock up Jeremy, “according to specification” as he tells Zed. And the Plague Doctor’s hearse is seen right outside the Conagher Slaughterhouse, burning just as its driver did when he first arrived in the past... Obviously the Plague Doctor isn’t being totally honest with the Conagher brothers, since he presumably gave the key to Jeremy’s casket to Fritz; Zed is confused as to how Jeremy escaped.

If the Plague Doctor is a possessed/evil Fritz from the future, that could explain how he has the key; That, or there's a second copy of the same key that Zed and Maynard don’t know about. Maybe there’s only one key and they threw it out, only for the Plague Doctor to retrieve it behind their backs... OR, Fritz held onto the key after freeing Jeremy, bringing it with him all the way to the film’s end; So when he respawns in the past, he has the key with him. And he slides it under his past self’s door near the start of the film.

What puzzles me is what the Plague Doctor’s goal and motive is; Did the Emesis Diazepam lead to memory loss, meaning he doesn’t realize he’s reliving the same events, just from a different role? Is he trying to end the cycle? Set up Soldier to arrive at the Conagher Slaughterhouse, learn the truth, and kill Redmond and Blutarch, breaking free? How did he convince BLU Heavy, Pyro, the Conagher brothers, and presumably RED Sniper into working with him? Is Archibald aware of and working with these guys? Being led to believe they’re helping him lay low, when in reality he’s just bait for Fritz, BLU Soldier, and BLU Spy?

RED Sniper asks Soldier if he wants to die for something worth dying for, after deriding Archibald; Indicating he’s knowingly a part of some plan to end the Gravel Wars. But why try to kill Soldier at the start? Was that just Plan A, and Plan B was to inspire him to end it? Is BLU Heavy even collaborating with the others after being revived, or has his undead state turned him into an uncontrollable monster on nobody’s side?

#emesis blue #tf2 #team fortress 2 #fritz ludwig #speculation #theory #analysis

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demonir · 3 months

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I spent all day yesterday with my mom talking abt a lot of stuff but amongst all those things she let me intensely infodump about tf2 for hours and I got to show her a lot of things, here are the highlights of me showing tf2 to a white uruguayan 53 year old woman who’s only game experience is bejeweled

I first gave her a very surface level rundown of the game plot which she found nonsensical the more questions she asked, I showed her the meet the merc vids first and at the end of each I gave her extra info about them

She thinks heavy is interesting and she’d probably like him more if he was put in a normal situation where he’s just a civilian living life, she never made a fat joke abt him so lets fucking gooooooo 👍👍👍👍👍👍

Her feelings on scout are mixed and didn’t like when I said he was one of my favorites, she said I need to like smarter people (this will be her downfall later) she did like him a lot more after we watched Expiration Date and found him and Miss Pauling endearing (she was great at picking up the subtext which surprised me) also asked her what age she thought scout had and she said 19 or 20 😭 then made a joke abt his baby face when I told her his actual age

Engineer scares her a small bit and does NOT understand how he’s my number 1 favorite (it was so hard to pretend I am normal about him in front of her) thinks him playing the guitar with a glove is stupid. I explained to her a bit of the conagher family story and she said that dell basically got the short end of the stick (because he’s tasked with fighting in the war AND maintaining the australium immortality devices when australium ran out) 😭

Thinks sniper is okay, I asked her what age she thought he had and she said 50 LMAOOOOO when I told her his actual presumed age she went “oh damn then I’m doing GREAT for my age”. I went on a huge tangent about the comic’s timeline and plot just to explain to her how he’s not ACTUALLY australian and she got sad abt him :( I did not tell her abt the jarate until a lot later bc I knew it would irredeemably ruin her image of sniper, I explained to her the game mechanic and as I was going to say “it gives the enemy a negative effect” she cuts me off and goes “yeah it makes them die from embarrassment” she also made a jarate pun in Spanish that I can’t remember at all rn I’m so sorry

Did not understand a single thing demoman said in the entire video and I don’t really blame her, her English is not good or that advanced it’s quite strange because she can understand some random complex words but had to ask me what “screw you” means so yeah she didn’t understand demomans accent she did however notice it was the same voice actor as heavy. I told her about demomans background and story and she found it so incredibly strange but wished for him to recover from alcoholism because it’s not good for him 💜 I told her abt demomans charms but she wasn’t quite charmed herself sadly (she did enjoy him in emesis blue)

Like mother like child, the Meet The Spy video was her favorite out of the bunch and she very quickly clocked in on the fact spy is scouts father without me saying anything, she said that from a technical standpoint spy is the most valuable mercenary on the team (goddamn not even the medic got considered) she also enjoyed him a lot in Expiration Date and Emesis Blue, I think hes still her favorite as of right now. Also we watched lil pootis and she laughed SO hard when I told her blu spy divorced blu ma and got with blu engie. She also frowned when red spy left lil pootis in the hallway alone and made jokes about mistreating his grandson

She did NOT like meet the medic or medic himself, absolutely creeped out by him and when I told her medic is one of my favorites she looked at me and went “your concept of what’s “comedic” and “fun” is very wrong and I hope you never get a boyfriend because I’m afraid of what you’ll bring home”….. I don’t know if she was serious or not 😭 I also never mentioned liking medic that way but I guess she fucking clocked me for it anyways. I tried to give her some medic propaganda and she found him tricking the devil to be very funny, I haven’t asked her if her opinion on medic has changed after watching emesis blue tho (I’m very curious to know since it’s a very different interpretation of him) I haven’t told her a single thing about heavymedic because I am afraid of what she’s gonna do with the knowledge of tf2 ships and I’m probably gonna keep it that way. She did seem charmed by the way medic genuinely loves his doves since she’s an animal lover herself

Soldier scared her a bit but mostly confused her, her initial reaction was rejection because of his ultra patriotism, nonsensical lines and violent tendencies however he grew onto her rather quickly to even make it to like second or third place on her list of favorites mainly because I told her about his raccoon sanctuary and the fact he is a great boyfriend (I didn’t tell her abt the naked honey fighting… I’ll show her later) and a great friend to demoman as well (she finds their cross faction friendship adorable)

Pyro absolutely TERRIFIES her she was utterly horrified by the meet the pyro video and doesn’t know what scares her more, the idea that pyro doesn’t know what they’re doing or that they do and do it anyway. I didn’t get to tell her abt pyro becoming a CEO in the comics but I’ll mention it eventually, the interpretation of them in emesis blue probably did not help her be less scared of pyro lmao. Also she thought the baby mercs in the meet the pyro video were oddly adorable and wants one….whatever that means

Overall she said the age of the game shows itself in the videos with their quality and what not and I also told her they were animated using SFM and briefly explained how it’s a free software fans have used for years to make fan content. Also she thinks the blu spy head in the freezer is the FUNNIEST shit ever

Her thoughts about Expiration Date:

She noted how this was obviously more recent because the quality was better

When she saw scout asleep in the van she went “that’s how I sleep”

She picked on a lot of details that I didn’t think she would and actually hearing her thoughts about the video after was rather fun, she did note how scout had used what he learned from spy later on the fight against the bread monster with miss Pauling for example

Nearly screamed when the bread monster ate the dove and let out a sigh of relief when she saw it was ok

Found scout very endearing when he explained he knew girls like Pauling don’t like him

The bit with the bucket made her laugh out loud I had to pause the video because she was curled into a ball laughing

I had failed to explain that they have teleportation technology in tf2 so when she saw the teleporters she loudly went “what the FUCK is that”

Loved miss Pauling a lot in fact before watching this video she asked me if we were gonna see her at some point since I had already spent a while talking abt her earlier

She didn’t have a lot of comments about other stuff I showed her that are worth mentioning but she loved emesis blue! She’s like me about liking weird confusing movies so that part she loved a lot but could do with a bit less violence, at one point whenever the characters were in danger she’d cover her face and go “they don’t die do they?” Over and over again lmao

I plan on showing her more stuff although it’s slightly difficult bc of the language barrier, if y’all have any videos or stuff you’d like for me to show her plz share but be aware of that

#demos ramblings #tf2 #team fortress 2 #I love subjecting my mom to shit #I’m abt to go do it again like in 5 minutes #there’s some other stuff she said that I either don’t remember or it would get lost in translation #thinking of asking her to draw a merc just to see what happens #she doesn’t draw often but she’s v talented and her style is realism

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iguessitme · 2 years

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Interesting similarity between Emesis and german horror film

Just watched Emesis blue and I absolutely love this film. The references to” The shining “was so well implemented and an interesting choice (will look into them later) I would like to bring attention to a detail that I'm not 100% sure even is a reference but is interesting to consider.

WARNING SPOILERS AHAED

In the last act Medic skin i really pale, has visible eye bags and is wearing a Black turtleneck.

This look resembles one of the main character from German silent horror movie ‘’ The Cabinet of Dr. Caligari ‘.

Cesare was a lunatic that slept through all 23 years of his life was used by the director of the asylum to commit murders during the night. The doctor was obsessed with the story of an 18th-century mystic named Caligari, who used a Man named Cesare to commit murder In Italian towns. He swore to become Caligari and proceed with the experiments himself as the New coming patient a lunatic will become his Cesare.

Outside of Just Visual similarities i believe there is a strong connection between this film and Emesis blue. The pills that are seen throughout the movie seem to have strong importance to the plot, but it is never explained how relevant they are. In an upload on the Fortress Films YouTube Chanel called „𝙀𝙈𝙀𝙎𝙄𝙎® 𝘿𝙄𝘼𝙕𝙀𝙋𝘼𝙈” we can learn more about this strange medical product.

The video opens with a reminder of the importance of Sleep to a human body, saying that it can also be assisted by medication. It is recommended to Take one pill of Emesis before sleeping. Although there are side effects to this drug such as drowsiness, memory loss and hallucinations. We can see medic experiencing all of them. Next, we are instructed to stare directly AT images presented on screen. All of them have words „Go to Steep now” blinking In the Middle of them.

It is revealed that the pills doc Has been ta king were the same ones as from the commercial.

As of now i don't have Any strong enough theories of how exactly they relate to the plot and Medici insanity. Clearly their Osage was the main reason for his hallucinations but i think it's possible that under their influence He committed a murder. The one that seems most Lilly to back up this claim is the mysterious Heath of scout's mother. Young mercenary was not pleased to see his friend again yelling that he wants to shoot him dead, why so sudden hate towards a man he was friendly with before? The women had two other appearances (that I can recall), we can see Her behind medic when He was standing before a respawn machine terminal, which instead of the boy himself lead to her apartment. The horrific scene when Her head is Dropped has an unnerving reappearance by the end of the medicine commercial.

That’s all i have for now. No idea if Any of this even matters but i couldn't Get it out of my head and the theories will keep MW up whole night.

goodnight

#tf2 #my ramblings #emesis blue #Team Fortress 2 #team fortress two #tf2 medic #tf2 scout #tf2 scouts ma #tf2 scouts mom #medic team fortress 2

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notawizardblep · 1 year

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About a couple weeks/month ago I read some posts about barely any variance in eye colors for the TF2 Mercs. This post is late to the party but I wanted to publish my own headcannons. My intentions were that the more different eye colors the better, because I found the fact that Demo being the only one who has a brown eye in a sea of blue incredibly boring character design for such well designed characters.

Spy/Scout (Blue): These two are the only ones who keep their single colored blue eyes. Since blue eyes are recessive, they were once an indicator if someone was related or not. (However eye colors are much more complicated than that.) This could be used as a visual hint to the audience/gamer that they are related, especially if they are the only ones out of the group that share the same color.

Demo/Heavy (Brown): I’m not changing Demo’s eye. Why brown eyes Heavy? I don’t really have an explanation for this decision other than because I said so and I wanted more brown eyes. They have the same voice actor idk.

Soldier (Hazel): I also don’t really have an explanation for this one either except that hazel eyes fit well for Soldier to me.

He’s almost always has his helmet on so the only time you would get a good look at them would be when his full facial expression is important to the audience. (In a hypothetical situation.) He also is part of the category of mercenaries where it’s a rare occurrence to see their eyes so they have rarer colors to make the “eye reveal moment” more dramatic. (In a hypothetical situation.)

Medic (Grey): This might be an unpopular opinion, but I don’t really like blue eyes Medic. However I was having trouble sticking with one eye color. The thing with grey eyes is that they can be mistaken for blue eyes unless you are comparing the two together. I also like the part in Emesis Blue where his eye colors change to signify something and I was inspired. Making Medic’s eyes more “reflective” of the lighting color/tone would be a cool effect to implement. As a character, he reacts to the situations given to him rather quickly and having an eye color that’s tougher to distinguish could be used as a visual representation that we don’t know what’s going on in his head.

Medic’s glasses would also do the anime thing where they become non-transparent whenever he’s about to commit an atrocity.

Sniper (Green): I think green eyes just fits Sniper very well aesthetically. The color compliments his orange/yellow sunglasses. Plus, it makes sense for him to have a striking eye color since sight is so integral to his job.

Like Soldier, his eyes would be rarely seen because they are concealed by his sunglasses. The only exceptions would be when the sunglasses are off, or when his expression is more appropriate to see his entire face so his eyes can be seen through the lenses. Personally I would restrict most of these instances to when he’s not in professional mode.

Engineer (Heterochromia: Brown and Blue): I can recall only two times where Engi takes off the goggles, both times being in the official comics. So he definitely fits in the “dramatic eye reveal” category. Was he born with it or is one eye a cybernetic implant?

I picked brown and blue heterochromia as a visual representation for his relation to the Administrator. His family has worked for her for generations. The Administrator’s color is purple, a combination of both red and blue because she is secretly in charge of both teams. Engineer doesn’t work only for red or only blue, but the Administrator.

Pyro (????): Non applicable.

#tf2 #tf2 headcanons #i spent too much time on this

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kellanved-ammanas · 1 year

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TF2 Drabbles: Scout - His Face

Summary: How about the main nine meeting meeting the emesis blue versions of them cause you said to keep it to the main nine and technically the emesis blue versions are the same characters but in a different universe from the main one like how all the of the main nine from these drabbles are the same as the ones from the main universe but with different personalities

[A/N]

I realized that a couple of the requests already in my inbox were easily justifiable as Halloween appropriate so I decided to do those first.

Also, spoilers for Emesis Blue if you haven't seen it yet. Nothing super major, like what is revealed in this drabble isn't told how it came to be (using careful wording here to not give it away if anyone chooses to skip this one for now to go watch the movie spoiler free). Regardless, I recommend going to go watch it because it's quite good.

When Engie had said he’d built a machine that could bring them to alternate realities, Scout had assumed they’d go on a fun little adventure to meet themselves. That alternate him would be different in that maybe he did end up dating Pauling in this universe or had ended up on RED instead of BLU or something else like that. Things that weren’t necessarily small differences but were still neat and recognizable as him.

The latter remained true. He was certainly looking at himself. Even contorted with pain, frozen in death as rigor mortis set in, that was his face. The rest could very will be his body too, just broken and twisted as if it had been writhing in agony at the moment of death. The blood, already congealing, obscured the exact nature of the wounds, especially in the darkness of this wretched basement, which was a mercy but… there so much.

The coppery stench of blood filled the room. It wasn’t just from his own corpse but the other two corpses too and perhaps just the room itself smelled so naturally. Surely it would now as how could this stench ever be fully eradicated?

“Mate, I really think you should look away.” That was probably the third time Sniper had voiced that sentiment. Probably he had a point; what good could looking at one’s own corpse do? But… it was hard to tear his gaze away for good. He kept returning to look some more each time he walked away. It called to him.

They’d also found this world’s BLU Medic. He hadn’t seemed nearly as excited about meeting his alternate self as said alternate was. Scout had tried to pay attention to the conversation everyone else was having with him in the other room but the way he’d looked at Scout had been disconcerting and well… his own self was just over here, broken and dead on a table. Tortured to death.

“I’m fine,” he said, perhaps even managing to sound like he meant it. “I kill people for a living so, you know, death and gore and all that don’t bother me like at all.”

“Yeah but it’s you so… you know.”

That did make it a bit different. Was he destined to die like this too? In pain and agony. Surely not but… it was him. An alternate version of him but still him.

“I’m fine,” he said again anyway though as the tore his gaze away to look at Sniper instead.

Sniper, his head pointedly turned away from the corpse, frowned slightly; he didn’t believe Scout. “Let’s maybe head up stairs, huh?” Instead of just to the other room where the others still were and thus even further away, making it more difficult to come back here to resume staring

“Sure, I guess if you really want to, we can.” He tried to maintain a casual tone but it was hard to when placing the sheet back over his own bent and twisted corpse. Some fresh air would hopefully do some good towards erasing that image from his mind though.

#my writing #tf2 #team fortress 2 #tf2 drabbles #scout #emesis blue #alternate realities

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fatgumsurpremacy-remastered · 2 years

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Have you watched Emesis Blue? What did you think of it?

(I LOVED IT)

I have! I’ve also written some stuff about it!

Cw: spoilers, obvious dark subject matter

Okay, I wanna talk about the beginning and how well they portrayed true relationship between Jeremy and Fritz. It’s clear they’ve got a mutual trust in one another and it hurts all the more when Fritz finds him dead. I’m still 100% devastated by the ugly ass smile Medic gives in the respawn. That hurts me so bad man. The way they portray Fritz’s mental state decaying is chilling but it sheds him in a light that this was bred from necessity. He clearly cares about Jeremy, there would be no reason for him to go to the slaughterhouse otherwise. And while plagued with these visions he doesn’t want to worry Jeremy with trivial detail.

The setup of all of it was amazing and the amount of Kubrick references absolutely had be absorbed. It’s nice to feel a story flesh out certain properties to something entirely it’s own. The looping sequences sent chills down my spine but my favorite mindfuck were the conaghers.

Zed has to be one of my favorite renditions of Engie because of how they portray him as an active threat rather than passive danger. While he appears cool and sadistic, that coolness is out the window the second he gets a chance to play with someone he deems a threat (ie) Fritz. The moment he said “I’da got you.” and starts giggling showed me just how fucked up he was if he wasn’t already. He’s got a childish ass outlook on this, and him stuck inside a place like Teufort is absolutely NOT GOOD. (Love Teufort but it’s the shittiest map. Also my favorite though.)

Maynards design had me frothing at the mouth, I’m just gonna say that straight up. He didn’t even do nothin outwardly he just kind of went along, which- yeah I guess let your creepy younger brother tourture that poor twink. He really does give off the vibe of a man disconnected, Medics whole bit about strangling him was out of left field but necessity. That scene in particular made me feral.

It showed us what I imagine to be an anomaly in the loop correcting itself, but therefore making the entity more aggressive, the entity in question Fritz. That whole scenes cinematography is brilliant.

Now I get on to my absolute favorite character ever.

Fucking soldier.

Never thought that someone could do such a damn good job emulating Rick may but FUCK did they. The lower, and more stark tone to the character made his wacky lines way funnier: it shows someone who seems incompetent being truly skilled at what they do. Surviving. While his methods are ridiculous it’s his leaps of faith that save him.

With bat out of fucking hell sniper he showed that he doesn’t like to give mercy. He shows a side that would make him antagonistic. But throughout the whole film he shows nothing aside from compassion, even towards the people he barley knows. That elevator scene says it all to me. He has reason to be suspicious but through that he chooses to be kind. It sunk my heart seeing the warfeild scene, it was quiet in a way. It was bleak and chaotic but he seemed perfectly fine to be there for just a moment.

Jane lost… a lot. In this film. He lost his coworker to the pits of an evil fucking loop. He lost a friend in Demo when Demo froze. (That scene broke me btw.) He lost dignity and connection and hope. And afterwards he looked so… dead? He won.

He escaped but what was the cost in the end? The loop continued on. His blank stare shared with medic and the attempt to blow him and the venue itself up over spies inaccurate details really shows his need for the truth. This film helped me out a lot with characterizing Solly in the future he’s honestly a darling.

On the topic of the loop and the way they constructed it holy shit. Those beginning shots were so so affective at building the atmosphere. I thought it’d be found footage till the end but NO, it just set up the mood and shit RAGGH

#I’m rabid over the film sorry about my rant

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general-marzipan · 11 months

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hello i have le question. who is your favourite tf2 mercenarie

Hello Heough! My favorite for quite some time has been the Engineer! I love the emotion shown in his Meet the Team short despite his laidback nature. I love his newest cosmetics from the summer update - they really suit him well! Even with the development of my oc Darnell, I get to think about how Dell is written as a character and how he and Darnell would interact on the job (i think about these two constantly!). AND CAN WE TALK ABOUT LIL POOTIS SEASON 2 PREMIERE!! I think about that specific Engie all the time, how it took a completely different interpretation of Dell and still made it believable to the actual character (Dell is such a versatile character i love it).

Though I do think I’m going back to liking Scout again as my favorite merc. I’ve seen a lot of SFMs and other memes and shorts with him lately, and its so funny to see how people would interpret in modern day. The accent is also a plus! I love quoting him at random points of the day - the accent is just so fun to do! You even feel like a Scout when you’re doing it!

However, I’m slowly starting to realize the potential of Sniper being my favorite. Throughout the years, Ive fallen for each class at least once, but somehow never could see myself liking sniper as my favorite. Sure, he’s super cool and professional at his job, you cant deny that, but something was always missing. I’d see every go crazy for him, and i just wouldn’t understand why exactly. Id see sniperscout shippers thirsting over sniper and wonder ‘whats that all about’ (in a good way tho). After rewatching the Meet the Sniper short a bunch of times tho recently, I felt a sort of realization, and a little more of a connection to his character (not much, but enough for me to like him a little bit more than before). Something about his standoff nature always perturbed me before, but now Im slowly starting to unravel the mystery of his character. (Not to mention im also starting to see more SFMs with him in it). Maybe also one day finishing the comics will help me to better understand his character, but for now i just think he’s pretty cool.

Similar to sniper, I’m also starting to realize the potential of medic. Yeah, i kinda liked him before when i first started getting into tf2, but i think that was bc most content was made about him and being shown everywhere. Like you’d find fanart online and it’d be a chibi medic or a medic with slicked back hair or something (lol the 2 genders of fanart). Still, in a way, i never could understand the character more than what people thought of him at the time: “sexy doctor that is covered in blood but also kawaii when heavy is around”. Though, once again, im going through content again and love seeing the character development within all sources of media (i think emesis blue also made me like it bc of his struggle with the events going on around him :p). Still, babysteps when it comes to liking characters i suppose. (The recent SFMs ive seen with him tho are amazing).

But if we’re talking about Soldier, oh man oh man. HE IS ONE OF THE FUNNIEST AND MOST COMPLEX CHARACTERS IN VIDEO GAME HISTORY. Every day i learn something new about him. I love his gruff voice, similar to scout, you’re just compelled to do it all the time cause its so fantastic and comical. I ALSO JUST READ THE SCREAM FORTRESS COMIC FOR THE FIRST TIME FOR HALLOWEEN AND HE’S HILARIOUS IN IT HELLO?!?! Love his dynamic with everyone in that one, he’s such a fricking man child i love it. For the past few days ive been thinking about his scenes in that. Absolutely love it. The SFMs and memes of him are super funny, AND THE RENDITION OF HIM IN EMESIS BLUE IS SO COOL, I DIDNT EXPECT ALL THAT TRAUMA TO HAPPEN TO HIM. Not to mention the workshop taunts i see of him are absolute gold, star spangled strategy will always live in my head rent free. CAN WE ALSO TALK ABOUT HIM IN EXPIRATION DATE PLEASE?! He is so funny in that one, every scene with him in it is hilarious, people are even pointing out new things i havent even noticed before years later. If i could, i would be Soldier tf2. I wanna be him so bad.

Uhhhh the other mercs are also really cool, but i havent made that much of a connection to them, though i will say when they have their moments, they truly shine through. Every day I learn something new about tf2, and it always throws me for a ride.

Lol sorry about the long post, can you tell I like these guys a lot?

#tf2 #gonna save this so i can look at it later #team fortress 2 #can you tell im a man liker #god i wish men were real #anyways hope this answers your question! sorry for the ramble #i think about these guys 24/7

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transgender-scout · 2 years

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Hi Arrow. Do you recommend trying TF2? I like the funny guys but I have no FPS experience

Em. I am gripping you by the face. I have not been thinking about anything besides TF2 for the past two months. I absolutely recommend it.

I’m also not really big into FPSs, but I really enjoy the gameplay for it. There’s a fairly outdated tutorial you can play where it walks you through how to play a few of the classes that I found helpful to get a feel for the game, but there’s also offline training with bots that you can play to get a little more practice with each class until you feel comfortable enough to play online (if you even want to).

There’s also a lot of custom maps that people make just to be silly on (the Mario kart and McDonald’s maps come to mind lol). I’m personally a big fan of Mann vs Machine, where you and five others just fight waves of robots.

The game isn’t super great at walking you through things, so you would probably need to either have someone play with you to explain things or do some quick research on it, like reading the wikis or watching some videos about it. It’s pretty easy to pick up once you get it tho!

Also, TF2 has had a huge problem with bots in the past few years, so to be able to communicate through chat, voice commands, or voice chat, you have to spend at least $5 on the game. I just bought some silly cosmetics from the community shop, but you can also buy taunts and other weapons if you want.

There’s a ton to explore in the game and I learn something new every time I play tbh!!!

But!!! If you want to enjoy the silly guys without playing the game!!!! There’s comics!!!!!!!!!!!

There’s a lot of smaller comics that were released to introduce new updates which is really fun, but then there’s the main comic series that focuses on a big overarching plot that’s sooooo funny and silly and heartbreaking <333

It also (imo) helps establish some of the characters in really interesting way. Like they’re all fucked up little clown dudes, but the comics give a bit of insight for some of them. A couple of the characters get brushed over a bit because there’s nine of them and you can only do so much, but it still did a damn good job of getting me attached to them all.

The only problem is…it’s not finished. The second to last comic was published in 2017 and the last one has been “coming soon!” since then. :( I’d still recommended it tho bc the comics are really good! The art is gorgeous and everyone is sooooo silly.

AND if you don’t want to do THAT! Theres the Meet the Team videos that Valve made to introduce each of the mercs, plus a few other videos for updates and other things. I LOVE these. I watch em all the time lol. My personal favs are Spy, Pyro, and Medic but it doesn’t take long to watch them all.

AND THEN There’s a whole wide internet of SFMs (SourceFilm Maker) on YouTube!! A lot of them are super silly YouTube poop-like videos that are rawrXDomgLOL random. This isn’t super my thing so I don’t have any recs unfortunately.

But there was an SFM recently released called Emesis Blue that is driving me to the brink. It’s a full length psychological horror/thriller movie that’s like TF2 but real fucked up. It’s been living in my brain for a solid week. It lowkey kinda gave me nightmares so you may check out the Does the Dog Die page for it if you’re sensitive to horror, or skip it all together.

Also kind of a blanket trigger warning for all media listed is blood, guns, violence, and bodies exploding into cartoon meat chunks. Fun stuff lol.

So there’s a lot of ways to enjoy the fun mess that is TF2. Let me know if you get into it bc hooooly shit I love this funny hat game so much.

#HOPEFULLY that’s enough info to get you started lol #let me know if there’s anything else lol #ALSO it’s so good to hear from you <333333 #I hope you’re doing well!!!!!#jackandthedevil #nottobeconfusedwithask #terrifiedofjudgement #tf2 #(sorry main tf2 tag I need to organize things or I will die </3)#(although if anyone else has something helpful to add feel free. just pls be nice)

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cheemscakecat · 8 months

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Emesis Blue Medic Headcanon

So I’m 99% sure that Spy’s Disguise takes place before the nightmare sequence known as Emesis Blue, sometime during the height of the respawn failures.

[I’m going to talk about DID. I’m not an expert, and this post about a fictional character should never be used to self diagnose.]

The Bloody RED Engineer sabotaged the respawn machine, which led to his entire team dying for real; then he murdered a group of [supposedly] unrelated BLU engineers, who also died for real.

It’s the reason why Dr Ludwig is even in the area to work on the comatose CyberSpy.

If Emesis Blue is a dream/nightmare people’s jobs may not match with real life, but still tell us something important about them. Soldier being Spy’s assistant tells us that he likes to work in a group rather than alone, even if his teammate is a jerk.

Ludwig being the Chief Medical Advisor could imply that he was the go-to expert at the height of the respawn failures, who had to investigate and report on different accidents when he wasn’t attempting to save a patient from said failures. Whether it was killing him slowly or not, Blu wouldn’t care; not the Administrator or Jules Archibald, at the least.

Jules is shown to be callous about death in both Spy and Soldier’s nightmares, and someone who relies on other people to protect him and do his dirty work to the point he’s incapable of defending himself. I wouldn’t be surprised if he and his crew forced Medic to report on all the gory details of each respawn failure, while being unwilling to attempt to rescue patients or clean up the carnage.

Re-watching the early scenes with Scout it seems that the era of the respawn errors is long gone, and the details are highly classified. Which would explain why Scout is so uninformed about any of the other accidents, but Ludwig had a nightmare that his friend suffered one himself.

Medic’s body language at the Medical office and in the ambulance makes it feel like the doctor wouldn’t be answering all these questions if he wasn’t talking to a friend. Like it hurts to relive that trauma, and the answers he gives are vague. Makes sense if Jules and the team trying to fix the Respawn machine bombarded Medic with questions over and over again, forcing him to picture what happened, no matter how awful it was.

Keeping that in mind:

What if the Funeral Medic is in control of Ludwig’s body when we see him in Spy’s disguise?

Neither of them talk or blink, for one thing. He does wince and cross himself upon rewatching CyberSpy’s robot-seizure, but that’s instinct. Another thing I noticed;

Something is going on with his eyes. This was his reaction to CyberSpy’s neck cracking, and the eyes stay like that.

It’s almost as if somebody trained himself not to blink, so he’d make people uncomfortable.

[nods once, flares nostrils in irritation]

It’s starting to feel like the Funeral Medic is meant to put people off of approaching Ludwig. If that is the case, we have proof that it works despite looking like Fritz, not his scarier version from Emesis Blue. I also noticed he really doesn’t like CyberSpy and Buddy Engineer.

He’s like “The revolver… exists! But you two just had to keep using that broken disguise kit anyway.”

Normally these Respawn Failures are completely accidental, and the patients are innocent [in that context, anyways]. So for two people to cheat by using body modification, and drive an enemy teammate to insanity? Any deeper coldness and anger reserved for Archibald and his cronies would emerge.

And he had to set up a camera before touching the patient… I really think this personality is mute. People with DID have been studied, and their brain structure is different between personalities. Their pets can tell the difference, and some personalities have physical ailments that the rest of the system doesn’t. So it isn’t impossible for one of Medic’s alters to be mute or selectively mute.

Ludwig’s nightmare version of this alter is associated with the respawn deaths in his mind too. He must have been switching during the investigations, with Funeral Medic performing surgeries and dealing with Jules. But for a time there would have been a lot of casualties, and Fritz may believe that this personality was intentionally letting patients die.

Could contribute to the nightmare imagery of being helpless with this personality around.

The fact that the real alternate personality and the nightmare version move so fluidly could be showing us another important detail.

Funeral Medic has exceptional aim and reaction times. Probably in order to react to injuries caused by the respawn machine, and to perform the needed treatments as effectively and precisely as possible. That’s why he moves like that.

My theory is that Electric-Eye Medic is a protector personality that comes out during RED v BLU matches when someone keeps targeting Fritz and needs to be put in their place. And most other situations now that the respawn failures aren’t happening like before. It’s why he’s the first other personality to take control, and keeps showing up.

And Funeral Medic is a gatekeeper personality who used to take control to prevent Ludwig from getting more trauma from Respawn Failures and patient deaths. Normally he stays inside the mind and keeps other people’s trauma from resurfacing, but the events of Emesis Blue were so serious that he needed to front.

It’s why he only shows up at the end.

When someone has DID, communicating with their alternate personalities and understanding what they’re trying to do is key. But Dr Ludwig wasn’t diagnosed with DID [or multiple personality disorder], he was diagnosed with Schizophrenia. And he’s Catholic, so he’s really likely to mistake Funeral Medic for a demon.

It’s one of the reasons why I want Emesis Blue to be a nightmare; so Ludwig and his personalities can talk/write things out and deal with their inner conflict. They need to, and I think he deserves a happy ending.

If RED Medic has his stolen wedding doves, it’d fit BLU to have an emotional support animal.

#emesis blue #blue medic #character analysis #This is NOT written by a psychologist.

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priestofberath · 1 year

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Fellow Emesis blue fan?

If not I’m sorry how awkward that was-

HELLO ! Yes Emesis Blue is good !! Honestly I need to rewatch it, I only watched it a good few months ago and I want to make a red yarn conspiracy board about it. Also maybe try doing some screenshot redraws.

I think they should have let Soldier and Demoman kiss

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findrppartners · 1 year

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Coming in with a request for a Team Fortress 2 RP.

Essentially I (23) have become obsessed with the SFM Emesis Blue and would love to do a Medic/Scout plot with me writing Medic and you writing Scout (M/M). I only write with people 20+, and novella length. Please no one under 20 or one-line/one-paragraph writers.

I was thinking we could either do a plot hashing out their relationship before the respawn machine starts having trouble or we could write our own plot. I also like the idea of exploring an alternate end where Scout lives. Naturally it will be less silly and canonical to the comics, and have a much darker vibe. I’m open to NSFW and I absolutely live for drama, angst, abuse and things of that nature. Fluff and cute stuff is also great but I like darker subject matter. Abuse is not an absolute must but if you like it, all the better. I prefer writing Medic as a dom with Scout as a sub but I’m also open to them both “switching”. Gore, blood and power dynamics may occur, so just know what you’re getting into.

I’m looking for about 80% plot and 20% or less smut. I also love ooc interactions so if you need a new tf2 friend- I’m happy to geek out. Like this post and I’ll send you my discord.

#20+#novella rp #team fortress 2 rp #canon x canon #roleplay finder

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sitpwgs · 3 years

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Any book recommendations?! Hopefully something similar to rwrb, or any of your favourites! (btw, I read The Violent Delights cuz of your review, and it was a really cool book)

wait that's so lovely 🥺🥺 i'm so glad you enjoyed these violent delights!! are you in the mood for anything in particular? i'm a big contemporary reader, so those are where most of my favorites are!

i recently read and loved people we meet on vacation (also called you and me on vacation) by emily henry, which is a childhood friends to lovers adult contemporary romance that reminds me of love, rosie! i also really enjoyed her debut, beach read.

if you like red white and royal blue, i'd recommend casey mcquiston's one last stop (obviously) and honey girl by morgan rogers! honey girl is a coming of age story first, with strong romance components, and follows 29 year old grace as she figures out her life post-PHD & post-accidentally-marrying-radio-show-host-yuki-in-vegas!

i'm super super behind on this, but i finally read the blood of stars duology (spin the dawn & unravel the dusk by elizabeth lim) a few weeks back, and i'm still thinking about this magnificent project runway meets mulan story! it's ya fantasy!

trigger warnings under the cut as always 🤍

come talk to me about books!

people we meet on vacation: death of a parent, loss of friendship, sexual content, animal death, grandparental death

beach read: alcohol, cancer, car accident, death of parents, cheating, child abuse/neglect, cult, emesis, fire, grief, physical abuse

one last stop: mentions of death (grandparent, other relative) in chapters 11 & 16, brief allusion to/mentions of fire + hate crime (Upstairs Lounge Fire) in ch 11, mentions of a car crash in chapter 16, mentions of addiction/alcoholism, police violence, homophobic violence and hate speech, childhood neglect, racism, arson, drinking, light drug use (weed), semi-public sex, exploration of depression and anxiety, memory loss and cognitive issues, familial estrangement, familial death, grief, missing persons, implied PTSD

honey girl: discussion and depictions of mental illness, self-harm (scratching skin, nails digging into skin as an anxiety coping mechanism, cutting), past suicide attempt by a side character, anti-Blackness, racism, homophobia, casual alcohol consumption, minor drug use (marijuana), mentions of war, PTSD, past parent death (side character), grief, medical talk, self-destructive behavior, police, mentions of amputation (chapter 4)

spin the dawn: death, loss of loved ones, blood, imprisonment, threat of sexual assault, some homophobic and ableist language, sexism.

unravel the dusk: violence, blood, disfiguration, bruises, demons, death

#post: answered

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bigyack-com · 5 years

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A Doctor’s Diary: The Overnight Shift in the E.R.

My choices as a doctor in the emergency room are up or out. Up, for the very sick. I stabilize things that are broken, infected or infarcted, until those patients can be whisked upstairs for their definitive surgeries or stents in the hospital. Out, for everyone else. I stitch up the simple cuts, reassure those with benign viruses, prescribe Tylenol and send home.Up or out is what the E.R. was designed for. Up or out is what it’s good at. Emergency rooms are meant to have open capacity in case of a major emergency, be it a train crash, a natural disaster or a school shooting, and we are constantly clearing any beds we can in pursuit of this goal.The problem is, traffic through the emergency room has been growing at twice the rate projected by United States population growth and has been for almost 20 straight years, despite the passage of the Affordable Care Act, and through both economic booms and recessions. Americans visit the E.R. more than 140 million times a year — 43 visits for every 100 Americans — which is more than they visit every other type of doctor’s office in the hospital combined.The demand is such that new E.R.s are already too small by the time they are built. Emergency rooms respond like overbooked restaurants during a chaotic dinner rush, with doctors pressed to turn stretchers the way waiters hurriedly turn tables. The frantic pace leaves little time for deliberating over the diagnosis or for counseling patients. Up, out.Private exams on stretchers in hallways, patients languishing without attention for hours, nurses stretched to the breaking point; all of it has become business as usual. I think about this on nights like tonight, when I start my shift inheriting 16 patients in the waiting room. I think about what I will learn that these people need, and about what I will fail to provide.Image

10 p.m.

Work starts simply enough. Twenty-two-year-old was drunk and drove into a tree, now has a sore elbow. The X-rays are normal and he is sober enough to walk: discharge home with girlfriend. Woman with a migraine holding a towel over her eyes and a crumpled blue emesis bag in her right hand, for when she vomits. I start the standard “migraine cocktail” of IV drugs and turn off the lights in her room. I will wait until she feels better, then discharge her, too.More. A woman six weeks pregnant with cramps and vaginal bleeding; I check whether her miscarriage is inevitable. A drug overdose, likely a suicide attempt; I clear for psychiatric care. Homeless man with foot pain, back pain and a cough, but here mostly because it’s too cold outside. I hand him a sandwich.Then an ambulance crew rolls a gaunt man with one leg toward me on a stretcher. The paramedics hand over a thick packet of paperwork from his nursing home and walk away. I read the label: Jean-Luc. Age: 38.Jean-Luc doesn’t have a typical amputation stump. His left hip is also missing. According to his file, 10 months ago an aggressive strain of bacteria attacked his thigh and quickly began to liquefy his flesh. Antibiotics would not work fast enough; the only way to stop the bacteria’s spread was to cut out the infected parts.The paperwork tells me nothing about who Jean-Luc was 10 months ago. All I know is that those few hours of surgery rendered him dependent on nurses for most things he used to do himself.I leaf through Jean-Luc’s packet and find a scribbled nursing note. Someone was concerned that his urine looked different the past few days, and this morning he spiked a fever. Did he have a urinary tract infection? Jean-Luc’s belly is tender over his bladder, and his urine looks cloudy and smells pungent. I send some samples to the lab.

1:18 a.m.

You get little hints about the quality of nursing homes from the patients they send us. If a patient’s hair is combed and his clothes are neatly pressed, the nursing home is probably decently staffed. Most impressive is healthy skin. The skin of a bed-bound patient is paper thin; keeping it intact, like the unbroken film on a French pudding, requires a herculean effort.Jean-Luc’s skin had not been so fortunate. He had a bed sore; it was less than an inch wide, but I could probe an instrument through it to the bone. Once such holes form, doctors don’t really know how to coax the skin to heal itself. Creams, high levels of oxygen, even maggots — nothing works reliably. This is going to be a problem, I think to myself.Forty minutes later, the lab results come back positive for a urinary tract infection. I start Jean-Luc on antibiotics. The E.R.’s role is considered completed at this point. Up, not out. The waiting room is busy; I should admit Jean-Luc to the hospital for IV antibiotics and free up his stretcher.I look over from my desk. Jean-Luc is polite and not a complainer, but I can tell he is depressed. A month ago the nursing home put a catheter through his penis and into his bladder, presumably because emptying a bag is easier to schedule into a shift than running over every time he rings a call bell asking for help, and safer than letting him sit in his own urine, which would further break down his skin.But for bacteria, that plastic tube is a boulevard into the body. He would be better protected by a condom catheter, which catches urine the way a condom catches semen. I start to mull this over when a nurse calls me: “Gina, Bed 5 is vomiting and says she needs more pain meds.”

2:28 a.m.

Cynthia, in Bed 5, recently completed a round of chemotherapy. She tells me her pain and nausea have been unbearable, just as they were two weeks ago, when she was here after her previous treatment. I examine her, check her labs to make sure there isn’t another reason she is dry-heaving and type in a request for a hospital bed.Cynthia is on a state-of-the-art cancer therapy, available only at a few of the top centers in the world. It is also expensive, experimental and extraordinarily taxing on her body. The discussion with her oncologist must have been difficult: the possibility of improvement weighed against the risk that the treatment could cause her to spend most of her remaining days in hospitals, hooked up to IV drugs.For the E.R. visit, Cynthia will be charged more than $1,000 plus about $600 in professional fees for the few minutes of critical thinking I expended on her. That is the thriftiest part of this arrangement: Her admission stay for several days in the hospital will be billed at about $10,000.To the hospital’s finance department, each case like Cynthia’s is another base hit, a fuss-free bill to collect from the insurance company requiring minimal work from E.R. personnel. But to what extent will this hospital stay prevent Cynthia from returning in two weeks, when she is again due for chemotherapy?Maybe a different regimen of cancer drugs would sit better with Cynthia. But finding it involves trial and error and is seen as work that doesn’t have to be done — work that could get the oncologist in trouble for rocking the boat, that exposes the hospital to liability. A plan focused on keeping Cynthia out of the hospital would require more frequent check-ins at her home, which the hospital isn’t set up to do. We are choosing the path of least resistance for us, even though it is the path of last resort for her.One in five people who stay in American hospitals are on the same morbid merry-go-round as Cynthia and Jean-Luc and will wind up back in the E.R. within one month of leaving. We tell ourselves the E.R. is meant only to stabilize patients, that someone else will handle the rest. But the problems I punt in the E.R. are also punted by the hospital’s doctors upstairs and by primary care doctors outside. No matter where I send patients, these gaping holes in care fester, like bed sores tunneling to bone.So I wait in the E.R. for the same patients to return even sicker and even more dependent on the hospital. I’m thinking about this when an overhead speaker calls me to the resuscitation room for a “Level 1,” the highest level of urgency in the E.R. I hang up on Cynthia’s oncologist and head to the north side of the department.

4:12 a.m.

A young woman is gasping loudly through the oxygen mask that paramedics put over her face, screaming, crying and thrashing all at once. She swats at the nurses trying to hold her arm down to place an IV, and at the technicians cutting her clothes off with shears. Her sweat prevents the electrical leads we try to attach to her chest from sticking.This is routine for us. Many things can make a patient acutely agitated: pain, drugs, rapid blood loss or a shortage of air. Until we know the cause, we carry on even when patients resist. With little explanation, we surround them on all sides, pin them down and undress them, placing probes and leads while we get our bearings.Someone tries to calm the young woman down while I scroll through her electronic chart. Mariah is 23. She has severe asthma and has been to the E.R. many times. She has bipolar disorder. The last time she was in the hospital proper, two months ago, she left abruptly once her breathing stabilized, before we could send her home with an inhaler and a steroid regimen for her asthma.As far back as I look in her records, I find no visit with a primary care doctor. Like many patients in the E.R., especially younger ones, she doesn’t see any other doctors regularly. In effect we have been her primary doctors, although we didn’t know it and didn’t do much primary care.I close the screen and look back at her. She is now on the monitor, the beeping display of her heartbeats and respirations scrolling along in green and red like a stock ticker at the bottom of the evening news. The numbers are terrible. She isn’t resisting us anymore, and her breathing has slowed. Mariah is starting to look confused.We had achieved a sense of control, but it evaporates in an instant. Everyone starts moving quickly, jumpily, trying to suppress the sinking feeling that this is not like the other asthma flares we see, that this person is too sick for us to save. We focus on our roles. I’m worried she will stop breathing, so I come to the head of the bed and tell her we’re going to sedate her and put her on a ventilator.Through the breathing tube and the IVs, we give everything we have already given, again: albuterol, epinephrine, magnesium, helium, antibiotics, lidocaine. Nothing is working; her lungs remain stiff and in spasm. Her heart slows, then stops. We start chest compressions and push more medications. We probe her heart and lungs with the ultrasound, trying to find something we can reverse. Nothing.I look at the senior doctor in the room. He knows I’m asking if there is anything else we can do, and he shakes his head. We record the time of death.

5:47 a.m.

There is a silent pause in the room. Before it passes, the unit secretary hands me the packet of paperwork for the deceased.A death certificate differs from other medical records. It presents not one lone diagnosis field but four nested together, each line asking for the proximal cause of the line above. In the first line I write the diagnosis: cardiac arrest. I consider why her heart stopped, and in line 2 — “CAUSED BY” — fill in: respiratory failure. Line 3, CAUSED BY: severe asthma exacerbation. I am ashamed, but I know the cause of this as well. In line 4 I write, CAUSED BY: no medications at home to control her asthma.This is the first patient all shift for whom the modern E.R. and I have acknowledged the root cause of illness. Our failure was not today but a few weeks ago, when she was last in the E.R. and we didn’t find a way to get her asthma inhalers to her at home. Maybe we assumed the medical team upstairs would handle it; maybe that team expected a primary care doctor would do so. Now our failure is the bottom line in black ink, pressed into the carbon-copy pages that will accompany Mariah’s body to the morgue.Should the emergency room treat only emergencies? More than 80 percent of our patients arrive without sirens blazing, by walking in or after parking their cars with the valet out front. A rash that won’t stop itching, a lower back that won’t stop aching, a child who won’t stop vomiting. If their problems aren’t in our manual of emergency conditions, we say they are misusing the E.R. and try to dispense of them as quickly as we can. But here they are, having waited six hours to see me, asking for help. What to do for them?I click a few perfunctory buttons in their charts. I say there’s nothing life-threatening going on as I hand them boilerplate discharge paperwork to sign. Someone calls me to see my next patient. I send them back to their families, jobs and responsibilities equipped with little more than these unceremonious goodbyes.Almost one in 10 — 8.2 percent — of these discharged E.R. patients return to an E.R. within three days. What I leave unaddressed — persistent pain, nagging uncertainty about a diagnosis, a social dilemma — tends to stay that way, begetting yet another visit. An E.R.’s success is measured by how fast it sees these patients, not by whether it breaks these cycles.The waiting room is empty now. I review the labs on an elderly man in Bed 3, enter the admission details for Cynthia and Jean-Luc, check that the woman with the migraine feels better and print her paperwork, and look at my watch: 7:00. My shift is over.

7:01 a.m.

Although the E.R. was built to quickly get the sick “up” into the hospital, it has exposed, better than anywhere else, what patients lack while “out” in their otherwise private lives. Patients like Cynthia and Jean-Luc will survive devastating diseases under our care “up” in the hospital, but we send them “out” unable to sustain their precarious conditions without us. Patients like Mariah make their needs clear in the E.R., but we are too busy to meet them, and by the time they come back it’s often too late.From 2012 to 2014 the federal government, recognizing that neither up nor out was solving the problem for a growing group of patients, financed an experiment at the University of Colorado. The typical E.R. has surgeons on-call to treat patients with broken bones; following that model, the E.R. in Colorado set up a team on-call for patients with broken homes.Disadvantaged patients who kept returning to the E.R. were matched to social workers, health coaches and doctors who visited them where they lived and kept in touch for several months. By staying involved after the E.R. visits and not letting details fall through the cracks, the team reduced these patients’ need to revisit the hospital by 30 percent compared with the need of those in a control group.The E.R. at Yale, where I work, addressed a different group in need. Elderly patients who came to the E.R. after a fall were offered a follow-up at home. There, they were screened for risk factors that might lead to another fall, such as loose rugs, medications that increased their risk of balance problems, or lack of necessary equipment or support at home. Over the next month, those who received such visits called 911 about half as often as similar patients who did not participate in the program.Programs like these are not considered the E.R.’s core business, so they often rely on grants — and they end if funding dries up. Of the slim resources that E.R.s do set aside to address patients’ barriers outside the hospital, most are put toward hiring social workers and care managers. But these employees, stymied by mountains of paperwork and unrealistic patient loads, never get outside the hospital to see their patients, either. The programs at Colorado and Yale succeeded by framing the E.R.’s resources differently. They recognized that the E.R. staff could identify problems that were destined to arise after discharge — and empowered those employees to help. Both programs orchestrated follow-ups outside the E.R; those teams worked on the day-to-day problems at home that go unaddressed in hospitals and clinics and can cause catastrophes.As I zip up my bag, I head to Jean-Luc’s room to talk to him about urinary catheters. But when I arrive I find only our custodian with a mop, pulling the crumpled sheets and throwing out the extra tubes of blood. Up or out; Jean Luc is already up. His fate is out of my hands now, and I worry that he won’t keep his spirits up, that his bed sore will never heal.Only a few minutes have passed, and the waiting room has filled up again. A man with a nosebleed has arrived. A nurse hands him a nasal-compression clip and a basin to spit in. He and his wife look around, wondering how long they will have to wait. By now, Jean-Luc’s bed is freshly made. For this couple, his quick move upstairs was a blessing. It means that, on my way out, I can tell them that they will be called back soon. A room just freed up. Read the full article

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