#because guess what. it freaking IS.

[itspileofgoodthings]

As this generation’s iteration of Dido Taylor breakup news will never go down easy. Speaking purely as an onlooker on the good of the culture, I can appreciate that.

[lucabyte]

i feel like people are sleeping on the occam's razor situation of how buckwild it is to outright accuse a guy of being a clone of your friend even if you DO have a lot of circumstantial evidence. there's other options is what im saying. they could just be like. a guy. that's a sensible deduction. you should explore that deduction. ignore my shirt that reads I <3 RED HERRINGS.

i still think odile has the correct theory on lock but she's smart enough to know it needs like... a real smoking gun to be able to bring it up without sounding insane.

anyway. (mirabelle voice) i know its rude to speculate but has anyone else noticed the grieving? they seem to be grieving. does anyone have any thoughts on the grieving? i have some thoughts on the grieving.

[egophiliac]

What do you think of Rook's savanaclaw card? <333

I didn't get him (and I need to save my keys for Silver's birthday, sob) so I looked up his groovy, and I'm not over how incredibly dramatic and epic and cool it looks in direct contrast to the absolutely ridiculous context. just look at that dynamic action and his majestic sparkling tears and keep in mind that this is pretty much right after a bunch of characters have been dance battling for his soul.

and then even the actual moment of the groovy is just like

this is NOT a negative in the slightest, I love it all, this truly was an incredible update in so many ways

[thethunderthedragonfruit]

need-to-know basis

when chromedome backed up brainstorm's lie about being forged was he being a true bestie or did he genuinely not know. this haunts me

[ahaura]

im sure its been said already but as the election draws near more and more liberals will come out of the woodwork to shame people with a conscience to give away their vote to the democrats for free. i'm already seeing posts saying "why aren't people more concerned about a trump presidency?" you want to know why? it's because people already know he's bad. everyone already knows what he is and what he's done and what he'll do. there's nothing to discuss. he's a racist despotic worm of a man. there's nothing else to say.

biden is currently president. the genocide is happening under his watch. he's the one funding isra*l and arming them; he's sidestepped congress more than once to give them weapons. by oct. 27, the biden administration already knew that "Israel was regularly bombing buildings without solid intelligence that they were legitimate military targets." the state department/biden have engaged in atrocity propaganda, cast doubt on the legitimacy of the death toll recorded by the gaza health ministry, and so on. the united states is currently in the process of trying to pin the "war in gaza" on netanyahu (see sen. schumer's speech) after months of backing blatant genocide as a means to act as if they're "doing something" about the genocide (Instead of, say, threatening to cut off all aid to israel with the condition that all hostilities in gaza, the west bank, and occupied jerusalem are halted immediately and permanently, allowing palestinians freedom to travel, allowing aid into gaza, etc etc etc.)

the long and short of it is that liberals view their own lives as being worth more than palestinians'. that's it. they'll vote for another 4 years of the guy ushering in genocide and supporting apartheid + settler colonialism because he isn't outright attacking them (despite various laws and rulings happening both at the supreme court level and at the local level all over the country that will endanger people). they'll settle for the illusion of safety and security and shame anyone with a conscience and accuse them of "supporting the republicans" when in an actual democracy you would be able to use your vote as leverage to extract concessions from those who want to be elected. that's how it's supposed to fucking work.

democrats are not owed people's vote. if biden loses, it will be biden's fault; it will be his campaign's fault; it will be the democrats' fault. trump is bad; the republicans are bad. we already know this. this is not an endorsement of either. but if democrats are too cowardly and feckless and servile to the motivations of the american empire and never do anything for their constituents then why the fuck should anyone vote for them. you want to get mad at someone, why don't you do something useful and stop worrying about team-sports with a purely selfish basis and start hounding the people in power who are supposed to serve you, the voter.

[warning-heckboop]

Was going to write a little ficlet to go with this, but. Vaccine tiredness is killer.

A little bit of art for the FOP Nature au by @bunnieswithknives. I cannot recommend checking it out enough.

[front-facing-pokemon]

[gods-perfect-idiots]

damn this hyperfixation got HANDS (and claws and fangs to boot)

[the-sussy-imposter2]

I thought Will would like messing with louise sometimes. Louise doesnt seem to like his sense of humor, though.

(Characters are will and louise from @peachnewt 's story, getting in deep !!)

[x-enocyon]

new ldb in the works

[olive-nothere]

It’s kind of insane (and unfortunately predictable) how western society acts when it comes to public health, specially after the pandemic. The amount of times I see people not wearing masks when they’re visibly sick or see people say they don’t want to wear masks because it’s uncomfortable to wear… you know what’s actually very uncomfortable and outdoes your feelings about wearing masks? BEING SICK.

Seriously, it should not be controversial or considered weird to wear masks when you’re sick; it should be THE BARE MINIMUM TO WEAR A MASK WHEN YOU’RE SICK, COVID OR NOT. How any of these people are able to go outside while sick and not care about other people’s health is insane to me. Despite the obvious fact that being sick affects everyone’s health, what about the people who are most vulnerable?

Wearing masks while sick should be the norm and honestly we as a collective should shame people who are sick and not wearing a mask in public.

[skyloftian-nutcase]

Provider Discretion (LU in Healthcare)

(Lots of technical jargon in this one, lovelies, hope you don’t mind)

Something wasn’t right.

The patient herself was… okay. Mostly. She had called 911 because she’d had back pain that had just been getting worse, and she’d said she couldn’t even get around anymore.

Mo and Hyrule often exchanged a somewhat exasperated look when someone called an emergency line for something that had been an ongoing problem, but today this… was different. She just didn’t look well.

“I’m really sorry,” the patient apologized for the fourth time as Hyrule and Mo loaded the stretcher into the ambulance.

“It’s okay,” Hyrule quickly reassured her. His heart ached a little at how much this woman wanted to seem to shrink into oblivion. Even Mo, who, despite his big heart, often came across a little standoffish, had tried to make her smile multiple times. “This is what we’re here for.”

With a chief complaint of back pain, there wasn’t much to do outside of check vital signs. Mo could easily take this call. But Hyrule just… this felt wrong.

“Let’s get a 12-lead,” he said, already grabbing the cables for it while Mo got vitals. His partner didn’t argue, helping him place the leads in the right positions.

Vitals looked mostly fine. The patient’s blood pressure was high. She said she had a history of hypertension, so perhaps between that and her pain that would explain it. Though 180/98 did not make Hyrule particularly happy. But he couldn’t treat that.

The 12-lead showed normal sinus rhythm. Nothing wrong there. But something just didn’t feel right.

Grabbing the blood pressure cuff, Hyrule checked it again, but on the opposite side.

There was a discrepancy.

Hyrule and Mo looked at each other, eyebrows pinching. Mo took a manual on the left. Hyrule took a manual on the right.

They still didn’t match.

Feeling dread fill him, Hyrule told Mo, “I’m taking this call. Let’s get going. We don’t need lights but… just drive expediently, ok?”

The transport was blessedly uneventful. But the discrepancy remained. Her blood pressure was high, but higher on one side than the other. Coupling that with back pain…

Her aorta. Hyrule was worried about her aorta. The biggest artery in this woman’s entire body could getting ready to tear apart.

When Hyrule texted Warriors later, he got his answer.

Dissection. They rushed her to the OR. You pointing out the BP difference really tipped off the doc. Good catch.

Mo whistled. “Good thing she didn’t rupture in our truck.”

Hyrule blew out a breath. He was just thankful he trusted his gut.

XXX

The dispatch information had been for diabetic emergency. Fire had gotten there first, which Aurora was thankful for since she and Dawn were coming from the hospital and therefore farther away than if they’d responded from the station.

When they arrived, the house was a nightmare. The street was so narrow that the ambulance and fire truck blocked the road entirely, the stairs were so narrow Aurora felt like she had to squeeze her arms in just to climb up them, and the turns were so sharp she wasn’t sure how any kind of equipment could get up there. The patient was lying on his bed, altered, and unable to move.

According to the patient’s friend, he’d heard him fall and came up to check on him. He knew he was a diabetic and figured his blood glucose had to be low. Fire had already checked it, saying it was over two hundred. As the firefighter paramedic gave information to Aurora, he said, “He could be acting like this because of his sugar. Could be a stroke. We’re not sure.”

Honestly, Aurora couldn’t see the patient all that well from her vantage point. Dawn had already walked in and started assessing, they’d handed a reeves stretcher to the firemen, and they were working on loading him on to it. The girl went downstairs to prep the stretcher for their arrival. Once they managed to get the patient into the ambulance, Aurora stared.

This man’s entire right side of his face was noticeably drooping. He was moving his head a little to the left, eyes somewhat moving, pupils equal. Aurora quickly asked him to look at her, to follow her finger. While he could stare at her, he couldn’t track at all, and his eyes wouldn’t move to the right. He blinked once while attempting, and was only able to blink his left eye.

Who the hell thought this could be his sugar??

Once Dawn got in the truck, they were quick to get vitals and a 12-lead. He was hypertensive, all other vitals fine.

“We need to stroke alert this,” Aurora immediately said.

“But he was last seen normal three hours ago,” Dawn said uncertainly. “Isn’t that outside the window? Or is the window four hours now?”

“I think it’s four,” Aurora answered. “And it doesn’t matter either way. This is absolutely a neuro issue. Drive us hot, okay?”

Dawn nodded, heading to the front. She drove to the hospital with the lights and sirens on, allowing them a faster transport time, while Aurora called it in to the hospital. As they progressed, she tried to get the patient to follow commands, but he couldn’t. He held up his right arm but couldn’t hold his left up at all, and he still didn’t really track any movement.

When they arrived at the hospital, they were placed in a major room, transferring him quickly to the hospital bed. Warriors was charge that night, working on coordinating all the help they’d need for this patient. The ED physician entered, looking the patient over, and then turned to Aurora, asking, “So what makes you think he’s having a stroke?”

Aurora stopped in mid motion, looking at him with the most enraged and bewildered expression. “I’m sorry, what?”

“Why do you think he’s having a stroke?” The doctor repeated.

“What makes you think he isn’t?!” Aurora snapped, completely mind blown that this was even a debate. “His face is drooping so low it’s hitting the earth’s fucking crust, he’s altered, not tracking movement, blinking with one eye, down on one side, is hypertensive, and you’re asking why I—do you even know what a stroke is??”

“Let’s just alert it,” Warriors said calmly as he walked into the room, clearly sensing that the paramedic was about to explode. “It’ll get us a CT to rule it out.”

Aurora was fuming, and she stormed out before she could hear a response. Dawn tried to gently check on her, only to be subjected to her ranting for the next hour.

Later, Warriors texted Hyrule, who relayed the message. “You were right.”

“OF FUCKING COURSE I WAS!”

XXX

Legend wasn’t particularly a fan of working triage.

There were aspects of it that were exciting - he was the one to make first contact with patients who didn’t come in via ambulance, and he determined their acuity. But there was also a public relations aspect to it, a patience dealing with impatient people, a kindness and sympathy for those who were genuinely hurting or needing help but had to wait anyway. It was understandable, but public relations… was not Legend’s forte.

There was a reason he was put in triage, though.

It wasn’t always obvious, what was wrong with someone. But there were times when a patient just didn’t look right. Legend saw the man limp over, listened to him as he explained that he had some leg pain that had been going on for the last few days, how he thought maybe he’d strained a muscle but the pain hadn’t improved.

There were always signs to look out for. Little things, cues that something was off. The man looked resigned, reluctant; he clearly had been talked in to coming to the hospital, and he commented that his wife insisted on it. Legend saw the clothes he wore, heard the accent he spoke with, saw his muscles, and pieced together that he was probably a farmer.

Farmers never came to the hospital.

“We’ll get you back as soon as we can,” he finally said after completing his assessment. Usually, this patient would be low on the acuity scale—a muscle spasm or strain was not nearly as important as a heart attack, pneumonia, sepsis, strokes, traumas—but Legend made him a yellow rather than a green. Just to be sure.

That higher acuity score got him a room far faster. That faster room made a doctor assess him and notice that his left leg was bigger than his right. That doctor made sure he got an ultrasound of his leg, found clots in his leg. She also learned the man was short of breath sometimes, which his wife insisted was new, and got a CT scan.

Legend glanced at his chart later to see him being admitted. Confused and curious, he did some digging.

The man had a pulmonary embolism.

Huffing with a small smile of satisfaction, Legend closed out of the chart as another patient approached.

XXX

Time had to admit, he did not spend as much time assessing his patients as he should. His hours were stolen away in the OR, unpredictable and chaotic as his line of work was. So sometimes he didn’t get to round, sometimes he didn’t have a chance to walk in and chat with the patients and the nurses and the licensed independent providers who took charge of their care.

Today he was glad he did.

The patient was actually calm and pleasant, had little complaint of anything except for some lower back pain. In the world of uncomfortable hospital beds, it wasn’t a huge surprise.

But Time saw something. Some staining, bruising, around the patient’s groin. He peeked around their gown, turned them a little, and saw it.

Their groin was purple. He asked the nurse, who said they were told this had been baseline for a day or two, and that the independent providers over them had acknowledged the finding and moved on.

Time walked into the doc box where the providers were. “I want a CT abdomen for room 3. She’s got some bruising that’s concerning. Her H&H has been down trending steadily.”

“Her JP drains haven’t put out much,” the physician assistant noted, looking over the patient’s chart.

“She might have a retroperitoneal bleed,” Time pointed out. “Let’s just be sure.”

Years of education and even more years of experience had taught the trauma surgeon well. The war was especially humbling and educational. So when he got a text from the PA that the patient did indeed have a retroperitoneal, he wasn’t surprised. But he was disappointed that he had to be the one to notice it.

Sometimes, he supposed, it took the leader to point out the problem.

XXX

Four… didn’t like this.

Report had been bad enough. The day shift nurse spoke of how the patient had been previously septic and was recuperating well before her pressor demand had gone up during the day. She looked… not great. She was so edematous they were constantly changing the sheets underneath her arms because her body was leaking fluid from every inch of itself - they had dumped fluids into her over the last few days just to maintain her blood pressure. She was on a lasix drip to get her lot o pee off the fluid as best as possible, and her kidney function was… decent, but not great.

As Four assessed her, the clenching his chest only worsened. She was alert, oriented, a little miserable but trying to be in good spirits, bless her. She was peeing a decent amount, her pulses were present despite the swelling, her lung sounds were a little coarse but overall mostly clear. Her abdomen was soft and non-tender, her pupils were equal and reactive, and she didn’t have much complaint of pain aside from being sick of laying in bed, which Four could understand.

But still. This just… didn’t look great.

As the night progressed, the woman’s pressor need climbed. Four continued to increase epinephrine, increase norepinephrine. He tried not to increase the vasopressin too much as it had such a profound effect on vasoconstriction that it could cause necrosis. Also, the woman had a history of heart failure and had a pretty weak heart.

Four eventually went to the resident in charge of the patient for the night. “Hey. Can we maybe give 11 some albumin? She has plenty of fluid to give, but clearly it isn’t in her vasculature - she’s peeing ok but her pressure isn’t tolerating it. I feel like it could help.”

The resident shuffled on his feet uncertainly. “The surgeon really wants to make sure we can get this fluid off. I’d rather keep her negative and not give her more fluid, you know?”

“Yeah, I get that,” Four greed before continuing, “But albumin is only 250mL, and if it helps suck in the fluid that’s third spacing, it’ll still help. We’re dumping fluid in her through the pressors anyway.”

The resident continued to waffle, before the night attending asked, “She’s on vaso, right?”

“Yes.”

“Just go up on that.”

Four stared a moment longer, starting to doubt himself. He hadn’t been a nurse for long, and if an attending physician was saying this, then… it had to be true, right?

Sighing, he went back to the room and did as he was told. The patient’s blood pressure improved well enough, and the night progressed fine.

The next night was not as fine. At rounds, Four suggested that perhaps she should be lined for CRRT, a continuous dialysis that would allow for Four to control how much fluid they were pulling and would likely be better for the patient to tolerate. The night doctors shrugged, saying they’d mention it to the day team.

Again, the woman’s blood pressure was tanking. Again, Four had to increase pressors. Vaso had been turned down and was told to be left alone because the woman’s systemic vascular resistance was so high the attending was worried about her heart. (Four couldn’t help but feel a little bitter about it, because he knew that was going to happen)

This time, though, she went into atrial fibrillation as well. As Four called the resident and attending into the room, they deliberated the matter, muttering, “Maybe we should line her for CRRT.”

Four blinked. Stared. Was he… losing his mind?? Was he invisible? He’d suggested this earlier!

Ultimately, Four had managed to keep the patient stable enough so that it wasn’t needed. Ultimately, the shift ended uneventfully.

But when Four came back for his third night, he could hear the woman’s breathing from the door, he could hear how she was drowning in fluid because she couldn’t tolerate losing fluid but had too much for her lungs and heart to handle. The day team had lined her for CRRT, but her pressors were almost maxed out at their dosage, and she was so hypotensive that the renal nurse who had set up the machine was hesitant to start it up, saying it would further bottom out her pressure.

Tonight was different, though. Tonight, the provider in charge of making decisions and orders was a nurse practitioner, someone who was used to this unit. She walked in, saw the issues Four had seen, and she walked right back out, making a call.

Four struggled to keep the patient alive long enough for the ECMO team to arrive as the patient fell apart. He felt frustration boil his blood as he had to hand off her care after fighting for her, had to watch as the CV ICU nurse came in to take over while surgeons put large cannulas into the patient’s body to redirect blood flow around her heart so she could still perfuse her organs. He watched as they wheeled her out of the trauma ICU to go to the cardiac ICU where she would remain while on such extreme support, and he threw his pen on the desk, burying his face in his hands, fuming.

They should have listened to him.

[dailykugisaki]

Day 355 | id in alt

I was out here just "Wow I should color this so they know I'm gonna put air Jordans on Kugisaki Nobara fortnite tomorrow" then I didn't and just slapped some random shit on. She looks nice though.

[thousandyearphantombunker]

"women need to be meaner! Men shouldn't dictate a girls boundaries"

You couldn't handle Connie Maheswaran setting healthy (and much-needed) boundaries with her best friend. You freaking called her toxic and abusive. While season 3 of Amphibia is a hot mess Sasha Waybright being upset with Marcy isn't the problem! It makes sense she'd be pissed that she found out her friend borderline kidnapped her! Even if she can be read as kind of hypocritical, I think she has every reason to be upset! She's like what 14 at the oldest? In a terrifying situation?

It's always "set healthy boundaries" until they set boundaries with your favorite baby and don't spend 100% of their time supporting them/don't forgive their friends for their actions that hurt others

I'm sorry that Steven is your woobie child and Marcy is your comfort character but Connie and Sasha have a right to their feelings and a right to focus on their needs! It's always 'don't feel guilty about focusing on your needs' except not really because apparently focusing on yourself is actually selfish and it's morally wrong to feel certain ways about people! Connie isn't toxic- she acted really mature about the whole situation and while Sasha definitely is toxic- I think she has the right to be mad her friend borderline kidnapped her and broke her trust.

I am a firm believer in setting healthy boundaries and never letting anyone decide your boundaries for you especially when it comes to being supportive. Even if the person you are helping is a good person going through a rough patch you should still have boundaries with them- you can be supportive if you want but you should be your main priority in the need and as callous as it sounds it's not mandatory to give support to everyone especially if your being worn thin

[pixelatedraindrops]

Yuma Month: Day 10: Memories

…but there were none to think of…

[illicien]

Every so often I see... interesting takes about Zemo that leave me questioning if we... all saw the same stuff.

Like, you know he commanded a death squad before his fam even died, right? This man is not a good dude. Sure, maybe it was in the name of his country but also... his country was a shit show and he said as much.

So I am absolutely perplexed by the number of "he wouldn't do x" and "why does everyone make him so toxic" kinds of things. He actively waterboarded Vasily Karpov like one of the first times we saw him. He was put in the RAFT because he is a fucking terrorist.

This feels like another one of those things I guess that reminds me of Hannibal. Him being polite doesn't make him any less of a cannibal. You can be both polite and a bad person.