#it says treatment do you think i can get insurance to pay for it

[inkskinned]

you have to go to work so you can pay for your doctor, who is not taking your insurance right now, and if you say i can't afford the doctor's you are told - get a better job. it is very sad that you are unwell, yes, but maybe you should have thought about that before not having a better job.

(where is the better job? who is giving out these better jobs? you are sick, you are hurting - how the hell are you supposed to be well enough for this better job?)

but you go to the doctor because you had the nerve to be hurt or sick or whatever else. and they tell you that it is because you have anxiety. you try your best. you are a self-advocate. you've done the reading (which sometimes pisses them off worse, honestly). you say it is actually adding to my anxiety, it is effecting my quality of life. so they say that you are fat. they say that all young people have this happen to them, isn't it a medical marvel! they say that you should eat more vegetables. they say that you probably just need to lose a little more weight, and that you are faking it for attention.

(what attention could this doctor possibly give? what validation? that's their fucking job, isn't it?)

there is always a hypochondriac, right. someone always tells you about a hypochondriac. or someone who is unnecessarily aggressive during the worst days of their life. or someone looking "for a quick fix". or some idiot who wasn't educated about how to properly care for themselves who just abandons their treatment. and again, the hypochondriac, the overly-cautious hysteric. these people don't deserve to be treated like humans (right), and since you might be one of these people, you also don't get treated like a human. because those people can really fuck with the system, you now have to pay for it. and besides. you're actually probably faking it.

(more often than not, you find a 2:1 ratio of these stories. for every "hypochondriac", there are 2 people who knew something was wrong, and yet nobody could fucking find it. the story often ends with pointless suffering. the story often ends with and now it's too late, and it's going to kill me.)

you are actually just making excuses. someone else got that procedure or that diagnosis and he's fine, you should be fine too. someone else said they watched a documentary about other inspirational people with your exact same condition, maybe you should be inspirational, too. you're just too morbid. your pain and your experience is probably just not statistically concerning. it is all self-reported anyway, and you're just being a baby.

(once, while sitting down in the middle of making coffee, you had the sudden, horrible thought - i could kill myself to make the pain stop. you had to call your best friend after that. had to pet your dog. had to cry about it in the shower. you won't, but that moment - god, fuck. the pain just goes on and on.)

you know someone who went in for routine surgery and said i still feel everything. they told her to just relax. it took her kicking and screaming before they figured out she wasn't lying - the anesthetic drip hadn't been working. you know someone who went in for severe migraines who was told drink water and lose weight. you know someone who was actively bleeding out and throwing up in the ER and was told you're just having a bad period.

in the ER there are always these little posters saying things like "don't wait! get checked today!" and you think about how often you do wait. how often the days spool out. you once waited a full week before seeing the doctor for what you thought was a sprained wrist. it had actually been broken - they had to rebreak it to set it.

but you go into the doctor. the problem you're having is immediate. the person behind the counter frowns and says we're not taking your insurance. you will be paying for this out-of-pocket.

they send you home with tylenol and a little health packet about weight loss or anxiety or attention deficit. on the front it has your birthday and diagnosis. you think about crying, and the words swim. it might as well say go fuck yourself. it might as well say you're a fucking idiot. it might as well say light your money on fire and lie down in it. and the entire fucking time - the problem persists.

it's okay. it's okay, it's just another thing, you think. it's just another thing i have to learn to live with.

[imtryingbuck]

Divorce Came With A Price

~ gif not mine credit goes to owner ~

Pairing: Bucky Barnes x fem!Reader

Summary: it’s been 6 months since he last saw you.

Word count: 1295

Warnings: Angst, I’m sorry. Death, cancer, suicide – please don’t read if the warnings upset you.

A/N: my mum cried when she read this.

Masterlist

Part 1

It’s been 6 months since Bucky last saw you, he’s hated it. He misses you. He misses your beautiful face, the way your smile makes his heart tingle. Misses the way your eyes shines brightly when you’re talking about your hobbies and interests. Misses the feel of your soft skin under his calloused hands. He just misses the love of his life, his other half - his sweet perfect wife. 

He remembers how your smile dropped as he tells you he wanted a divorce. Remembers the heartbreakingly look in your eyes as he told he’d been having an affair. That one look has haunted his dreams, his every waking moment. He can still feel the acid in his throat as he wills himself to nod as you ask that one question. Nothing more nothing less. You just wanted that one question to be answered and he couldn’t even look at you let alone answer verbally. He didn’t even know you left the house until the divorce hearing; he watched you walk away with Matt and Foggy wishing he could say something but nothing comes out. He watched as your feet falter when you see Carly. He knows exactly what you’re thinking.

But It’s over now.

It’s over now and he can get you back.

It’s over now and he’s hoping and praying that you’ll understand and forgive him.

It’s over now and he’s going to move heaven and earth to have his love back in his arms.

He finds out you’ve been staying with Matt since he broke both of your hearts. How does he do this? How does he knock on the door hoping that neither one of you punches him in the face (not that he doesn’t deserve it) he just hopes you’ll listen to him.

Bucky walks into the florist to get the biggest bouquet of your favourite flowers he can get. 

The skies start to turn dark even with the sun shining brightly, if he didn’t know any better he’d think it was forewarning for what’s to come.

Knocking on the wooden door it’s Matt that greats him. “What? What are you doing here” if Bucky wasn’t a super soldier he’d be scared with the tone in Matts voice.

“I-um I need to see Y-Y/N. Please”

“She’s not here. She’s not here anymore” Bucky can’t understand why Matt sounds broken.

“Well um where does she live now?” He’s trying not to stumble off his words.

“No James you don’t understand” Matt looks up towards the ceiling then continues but doesn’t get the chance.

“What do you mean I don’t understand? Matt look I know you hate me for what I did to Y/N but I had a reason, I just need to see her to explain it to her. Please Matt just tell me where she lives”. He begging and pleading and it’s clear as day in the way his voice wavers.

Matt speaks in a fast manner “Get inside before Ms Jenson comes out and complains” 

The apartments a mess, there’s takeaway boxes laying around, the sinks full of pots and there’s trash overflowing in the bin. The apartment looks nothing like it did 8 months prior when Y/N and himself went round for a double date with Matt and some woman he can’t remember the name of. Matt sits down and lazily waves his arm round for Bucky to sit to.

“Matt wher-“ he doesn’t get to finish his sentence.

“James she’s gone, she’s dead.” The air is cut off. The room is spinning. His world has ended. He doesn’t know what to do or say so he stares blankly at Matt waiting for the punchline of a joke that isn’t even remotely funny. Matt understands he needs to say more so he does. “That day you told her you wanted a divorce to be with your side piece she’d been at the hospital for her results. It was cancer. Terminal. She’d been told she had about 6 months to a year left. Her insurance didn’t cover her medical expenses so she stopped treatment, I told her I would pay but you know what she’s like-was like. 3 weeks ago she made me go out on a date with Karen she said she’d be fine and made me promise I’d have a good time. I got home around 11 and went to bed. The next morning, I couldn’t hear her walking around, so I went into her room, she um she’d taken pills, enough to end her life. It was too late to do anything, they said she’d been gone for 18 hours. Id only been gone for an hour” tears stream down both of the men’s faces. Matt struggles to continues “she begged me not to say anything to you, she didn’t want to get in the way of your relationship. She thought if you knew you’d change your mind and not divorce her just because she was dying. Y/N begged me James so I couldn’t I couldn’t do that to her-“ Bucky cuts him off. 

“I didn’t have an affair. I swear. Hydra was after me again and I had to divorce Y/N so she wouldn’t get hurt. I told her I had an affair so she would divorce me, I knew cheating was a deal breaker so I lied. I fucking lied and she’s dead. I lied and she’s not even going to know the truth.” He tries so hard to continue but can’t his airway is closing up. He passes out.

10 years have been and gone, the pain of losing the only person he has ever loved didn’t stop not that he wants it to. Bucky wants to remember the pain. 

In the 10 years that have passed he’s visits your grave every Friday, wedding anniversary, the date you two got together, the date he proposed, your birthday and on Christmas. After the fifth year Steve told him he needed to move on, and well long story short they had a fight and Bucky cried saying he couldn’t move on. In the end everyone around him understood that he would never move on from the love of his life. He sits there no matter the weather and talks to you for hours. He told you Matt and Karen were having a baby girl, then told you they named her after you. Told you all about his cat Alpine. After every visit without fail or another thought he tells you he loves you and can’t wait to see you again.

It’s been 10 years 5 months 12 days since you passed away and Bucky’s on his way to see you.

He’s on a mission that’s gone horribly wrong he’s been shot too many times. He’s so tired and Steve’s trying to get him to stay awake but it’s no use.

“Stevie p-please stop. I w-wan-t to be w-ith my Y-Y/N I need to be with h-er” Even though Bucky gasps for breaths his voice is strong enough to let Steve and the team know that this is what he wants. Steve gives him a slow nod with tears sliding down his cheeks, he clasps hands with his best friend and keeps locked tight long after Bucky takes his last breath.

He leaves the world with a smile on his face.

You stand there waiting for him and as soon as you lock eyes with him you’re running. Jumping into his arms and before he can say anything you kiss him. Hard. After you separate you tell him you know the truth. You heard him every time he would visit your grave. You tell each other how much you love one another. You take his hand and lead him into your new life.

Tags: @learisa @bruher @pattiemac1 @kentokaze @almosttoopizza @yvessaintmuerte

~ banners credit goes to @sweetpeapod ~

[cushfuddled]

When I first started shoveling Jayvik fanfic into my mouth a month and a half ago, I was shocked and delighted at the avalanche buffet of top Viktor and dom Viktor content. But I've started to feel like the detective who kneels down and touches some footprints in the dirt like, "Something happened here..."

Because I can't remember the last time I saw a fanon concept become...so ubiquitous? Even in fics where Viktor bottoms, he's a power bottom/topping from the bottom. Spotting a fic with an overwhelmed sub bottom Vik in the Ao3 tag feels a bit like the moment a snow leopard graces your Himalayan trail cam.

I DO NOT mean to suggest anyone "should" write more inexperienced/bottom/sub Viktor! It's just...as someone who likely missed whatever ancient discourse might've plagued the Arcane fandom years hence, I've been through this fandom song and dance enough times to recognize the smell of...what say, capital-O Obligation.

I just want people to know they can write whatever kind of fanfic they want. That's the point of this post. I hope someone somewhere reads this and feels emboldened to let loose/goof off/get freaky/whatever.

Because I can see why people would feel Obligated to portray Viktor as a top/dom/the sexually experienced one. He's physically disabled and chronically ill. Ableism so often takes the form of paternalism and infantilization. There's this pervasive notion that disabled people don't have sex. People think we're too "pure" for sex, or assume we're "undesirable" as romantic partners/that our physical or mental disabilities would make sex impossible. With that cultural context, it's a radical act for so many people to come together and choose to portray Viktor—a disabled, terminally ill man who struggles with suicide ideation—as a sexually experienced top.

One of the hardest things about being disabled/ill is the lack of control. You can't plan for the future; you don't know whether your pain levels will be better tomorrow or demand another trip to the ER; your life is totally in the hands of overworked doctors who don't care about you. So it feels kind of like an act of reclamation to put Viktor in a dominant position. In a safe, sane, consensual arrangement, all parties have control over the situation, but with topping and/or domming comes the Role of authority/power. Making Viktor an experienced, sly top/dom gives back Viktor's autonomy and agency.

So yeah. I get why this trend is pervasive within the fandom! It's fantastically subversive. I just hope nobody feels like they HAVE to fall into this dynamic.

I remember a Tumblr post from years ago where someone described the drawbacks of a supposedly "feminist retelling" of Cinderella or Sleeping Beauty, wherein the heroin saves herself by her own strength and wits. This, I would argue, is a perfectly fine story to tell...but its lack of intersectionality betrays a shallow definition of feminism. In casting those retold fairy tales in a feminist, "empowering" light, one ignores the realities of the people who found escapism in those helpless damsels.

In a paradoxical way, when my MCAS knocked me flat on my ass for two years, I was always out of control of my life AND forced to take control all the time. All those overworked, traumatized, apathetic doctors meant I had to be my own patient advocate. I had to do my own research; figure out which treatment plans made the most sense; find doctors who took my insurance and could see me within six months; argue with Medicaid when they didn't want to pay for one of the drugs I'd been prescribed; find new and creative ways to feed myself when my body reacted like it was allergic to everything other than water and Cheerios. And god, I had to self-police myself all the time. At the doctor's office, you have to look sick enough that they believe you when you say you're hurting, but you don't want to seem TOO sick because the desperation will make the doctor diagnose you with "hysterical woman" (or they'll just assume you're fishing for drugs). At home, you want to project some amount of strength so you don't worry your loved ones or make yourself too much of a "burden." (You also don't want to have to manage other people's anxiety on top of your own.) My disability (autism) and chronic illness (MCAS) are invisible, but I imagine there's a lot of masking that goes into navigating public spaces with a visible disability/illness, too.

So...when everything's this constant battle for control—when you're forced to project strength every day regardless of your pain level—of course some people are going to find relief in stories where they're allowed to shut down. I think it's important to let disabled characters be vulnerable and overwhelmed and even dependent on someone else, because as often as disabled and chronically ill people are infantalized, so too are we expected to "overcome" our disabilities/illnesses through miracles of resilience and cunning. We're pushed to perform strength, cheer, and "normalcy" for the public, who find our disabilities "sad" and "uncomfortable." Every time someone refuses to put on a mask, or a relative tells us to simply get more exercise, or a politician rails against "wellfare queens," or a bus route gets cut or a bench gets removed or our doctors hand-wave our symptoms, our world reinforces the message that we are Too Much; that our needs are exorbitant, our very existence a drain on society. So many of us throw ourselves into self-sabotaging grasps at independence. We work ourselves far past our limits to prove we aren't a burden on society. We refuse help just to maintain that tiny sense of control over our lives.

I find it deeply comforting to read stories where ill and disabled characters are...allowed to be helpless, I guess. To break the fuck down and let someone else finally take the reigns for a while—to lift some of that burden off their shoulders. I love when ill and disabled characters trust someone enough to take off that heavy armor, revealing the pain and weakness beneath the facade they were forced to take up to survive, and are rewarded with warmth and reassurance and care.

At a certain point...is it not a little ableist in itself, to restrict a disabled, chronically ill character to one specific role? To essentially lock them out of a position where they're allowed to relinquish control and be taken care of?

In essence,

Disabled and chronically/terminally ill people are not a monolith. As I always say, what offends one person will uplift another. It's an uncomfortable reality, but there's really no such thing as perfect representation. I think part of intersectionality is being willing to accept that multiple things can be true at once, because everyone's lived reality is different. It's absolutely fine to prefer one trope over another. But if I find a fanfic offensive or uncomfortable, I can always click the back button with the knowledge that there's almost certainly someone out there who'll find that same so-called problematic content empowering. Whether fic writers prefer top Viktor, power bottom Viktor, bottom Viktor, switch Viktor, sub Viktor, dom Viktor, experienced Viktor, virgin Viktor, omega vs. alpha Viktor, and every niche in between...I just hope they go where their heart tells them and write what they want.

[sysmedsaresexist]

Today we're once again reminded of the levels of cruelty people are capable of.

I missed most of the drama with the bait accounts, but I want to offer some positivity and solace to those affected.

Many of you actually cared about the fake child behind the screen. You wanted to help, you sent kindness and support, and I watched many of you worry in private on discord-- everyone was very realistic about the claims. Obviously they were probably wrong, but goddamn, they needed help.

Don't be embarrassed or ashamed that you fell for it.

You are a good person, who sees good in the world.

You aren't gullible or easily manipulated.

You are still capable of trust, and you should be so proud of yourself for manging to hold on to that trait after everything you've been through.

Don't let this do further damage to you. Don't be angry with yourself, don't lose that faith in the good of humanity.

Don't let sick people trick you into thinking the world is full of only horrible people. Don't let yourself become more skeptical, because that's what they want.

Continue to believe survivors

In Canada, we have a saying.

"Better that someone abuse the system, than for someone who needs it to not have access."

Stay with me, I'm going somewhere with this.

When we talk about Universal Healthcare with Americans, this topic comes up a lot. "But people will abuse the system."

Yes, but more people actually need and use the system appropriately. You can't allow bad people to harm everyone. Everyone loses in that case.

As proof:

We pay less in taxes than Americans, and still get free Healthcare. I take home more money than you, and still get more out of it. The myth that our waitlists are months long is fake and orchestrated by American insurance companies.

Consider, for a second, how your background plays into your beliefs and skepticism regarding these topics. Maybe I was just raised to be more trusting, I don't know.

But I certainly don't think the mindset is harmful.

You can read interviews on the isstd website with clinicians that were working during the satanic panic. One interview stood out to me in particular.

Imagine for a second that you have a patient sitting in front of you. They tell you that they have dreams about being abused by a satanic cult. They give you details of these dreams and you talk through them together. For now, you're focused on how these dreams affect them. Are they losing sleep? Is their daily life affected? Anxiety? They begin to tell you about their paranoia, and how people they recognize are in the dreams.

You probe a bit deeper.

They wonder aloud if maybe it happened in real life.

How do you respond? Really think about how your response will come across.

This was the satanic panic.

The ISSTD didn't find their patients themselves. Doctors from across the world referred their patients to the ISSTD's treatment program in Chicago. The doctors at the ISSTD trusted the referring doctors, who had already done the majority of work and background gathering (meaning the ISSTD met these clients long after they had made their claims, rather than "implanting" those memories themselves). Police were involved trying to sort through all the information to find real culprits. Everyone was terrified. No one knew what was happening or who to trust or believe. It looked real.

In the back of every doctor's mind was the question, "What if they're telling the truth?"

Many doctors didn't believe their clients, but telling them that to their face would be bad practice.

This large scale hysteria was something no one was prepared for. They were flying by the seat of their pants, hoping for the best and that an answer would fall from the sky.

Yes, many of the claims were fake. Whether they were consciously made up, or stand-in pseudomemories for real abuse (a well-documented thing), and the rare cases mixed in that were genuine-- doctors tried to take their clients' claims at face value.

Imagine you tell your doctor about your abuse and they say, "that sounds a bit extreme, I don't think that's possible."

Programmed DID existed before the panic, it exists to this day. Just because you can't find the research doesn't mean it isn't there.

By claiming something specific isn't real, you also discredit the abuse leading up to it.

Let me put it another way, who cares if programmed DID is possible? Organized and ritual abuse is real. Trafficking, CSA films, war crimes, conversion groups, churches. DID is real.

Grey Faction and TST want you to stay in the mindset that it's more important to weed out fakers and malingerers than to trust people in the hopes you help just one person in a real way. They want you to be skeptical of everyone and everything in order to maintain their public image, because if you look too hard, you'll see the terrible things they have done.

GF has a bad habit of being like, "The TST doesn't take part in LARGE SCALE MURDER AND CANNIBALISM, that's not even real, it was debunked during the panic," as if to say anything less severe isn't worthy of note and also must not be real. It's surprisingly effective, and by connecting more absurd ideas with RAMCOA and the ISSTD, they manage to discredit huge swathes of the field.

Some people like to think they took the red pill, and that they've ascended to a higher level of intelligence with a new, better ability to look at things impartially, when they're really just assholes falling for bullshit. They hurt real survivors and still think they're in the right.

It's vile behavior done for cheap kicks and internet brownie points. Even 4chan types wouldn't go that far or be that pathetic.

Who else could look someone in the face and say, "I don't believe you."

They want you to think they're better than you, but which is better?

Outward and vocal skepticism and dismissal, or quiet, thoughtful reflection with the longterm goal of helping this person find their truth?

Some of you would make much better doctors than others.

The bad people aren't the ones "faking" or lying. Those people at mentally ill and still deserving of help.

The bad people are the ones who want to dismiss every claim because one person once lied about it.

Don't lose your faith. Don't let this set you back. We need more people like you.

I'm proud of you for caring about people.

What happened will further stigmatize survivors, it did real damage to people. You're not alone.

Don't let them win, you did the right things.

Stay safe, everyone.

We survived this kind of discourse once on a much larger scale. We'll do it again.

[lizzydizzyyo]

I think what's really compelling about House's absolute unwillingness to bow down to anything or anyone (the ethical board, the law, extra rich CEO, vindictive police officer, and even the patients themselves) regardless of how absolutely batshit and downright illegal his actions are, is because it's coming from a chronically disabled person, in more ways than one.

He cannot walk without agony or his cane. His chronic and severe pain led him down the path of deep Vicodin addiction until he also becomes psychologically dependent on it too (once, Dr Cuddy gives him saline placebo and it "works", in that he is not feeling his leg pain anymore for a few hours).

He understands it deeply just how desperate people can be when they're in pain and nobody can (or are willing to) help them—at least, so far, until they land on his doorstep. Which is canonically the most extreme step patients take when everything else fails—you don't just go straight to Plainsborough Teaching Hospital and to Dr Gregory House MD's office; you have to go through dozens of other doctors in various specialties and failed treatments too.

(Although that's a separate discussion about how doctors, particularly resident ones, are overworked and underpaid and redtaped by shithead insurance companies even if they do know how to treat a patient and want to).

He knows, from the bottom of his heart, that having such a painful and life-limitting debilitating condition is comparable to hell on earth, because he has one. He knows, that despite his disability being visible to everyone, yet no one wants to put an effort to help him deal with it—is also hell on earth.

Cuddy simply throws money at him and turns the other way to his Vicodin abuse, like she is saying, "I don't care if he takes 10 Vicodin pills a day or more, and I have to pay at least $1M every year for lawsuits, as long as he gets the job done," (and when they decide to go into relationship, she immediately drops him when he relapses, even if the reason for his relapse is her—although, yes, there is another discussion to be had about keeping yourself and your child(ren) safe being a priority compared to helping an addict, recovering or not). Wilson, as loyal as he is to House, simply either enables him or lectures him without going into the root of the issue and thoroughly help House that way. His subordinates, especially after the original trio, are simply too scared, too ignorant, or too ambitious to even approach the issue and choose to keep their job than help House (also another discussion to be had about how you can't help people who don't want to help themselves and so on).

So when he sees a patient who has gone through hell trying to get a correct diagnosis and treatment, he becomes laser-focused on doing everything under the sun to get to the bottom of it and cure the patient. He doesn't care if he has to break into countless of houses (haha pun) and collect insane and probably biohazard samples to do it—he absolutely will, no question.

Yes, hate-criming and being a bigot is his favorite hobby (still livid at the asexual ep and the production's choice for the resolution, let's just say I still have beef with Hugh Laurie and the entire production team for it), and so is insulting patients in so many ways that Shakespeare would personally fly to New Jersey and shake his hands if someone manage to successfully perform necromancy on ol' Billy boy. But House is no one if not dedicated. "Yes, my patient is an idiot, everyone is an idiot too, but I WILL cure their condition like my life depends on it," is basically his middle name.

Besides, you can make the argument that he is more compassionate than all the other doctors around him, because despite his absolute disdain towards some of his patients' beliefs and stupidity, he still works his ass off to treat them. He will call your god an idiot in 7 different languages while putting you in a diagnostic machine he manipulated the whole hospital into letting him use so that you could get a test which weren't available to you before. He will tell you that your currently-happy marriage will end in a bloody divorce and your ex will leave you penniless so love is not real while injecting you with a medication he had to hack the CDC's database for.

There are even episodes that show him being truly earnest, like the clinic duty scene where he is snarky as usual to a girl who seemingly stupidly had unprotected sex until she lashes out, and House is like, "Oh shit, this is above my paygrade", and immediately goes to Cuddy with a very serious expression and no sarcastic dilly-daliying, demanding her to transfer the patient to someone else because he is not good with "curing" rape case (interesting choice on the writers' part to make the patient insist to have therapy with House, though).

There is an episode about a very workaholic woman executive in a fashion company who has tremor and partial paralysis, and later on it's shown that she seems to tie her worth as a person to her corporate success while band-aiding her deep psychological issue like her suicidal ideation, and House genuinely asks her, "Do you want to live? I cannot help you unless you want me to," or something along the line.

There is also the cursed 9-year-old terminal brain cancer episode where Chase kissed the patient (ew), where at first it shows House being a usual misanthophe to Wilson and saying, "She is not brave, it's the brain tumor clot talking because it must be near the amygdala." Later in the episode, House sits near the patient alone, and compassionately asks her if she even wants to live, going through the rest of her short-lived but horrible agony, even if they catch the clot. The surgery to find and get rid of the clot is risky and can debilitate her even more, and this is why House is laying the decision to her hands. That she gets to choose. This is what truly reveals to him that she is genuinely brave (aside from the scan showing the clot to be so far away from her amygdala), but for the wrong reason. She is brave for her mom, willing to go through horrible surgery and drag out her already painful cancer-ridden life because, "My mom needs me". When everyone is congratulating her in the end, you can tell House has a bittersweet expression of both awe towards her bravery, and sadness that this 9-year-old sick girl has to bear the brunt of her horrible pain just so that her mother is not sad. That he couldn't convince her to be a child until the nearing end of her life.

The most interesting evidence of his compassion to me is the gunman hostage episode. It might sound weird because in the whole episode, he is depicted to first want to outsmart the gunman patient, then becomes laser-focused but only because he sees it as a puzzle, then absolutely selfish and dangerous because he volunteers himself as the last hostage and gives the gun back to the guy after the MRI. I do think it's true that his dedication to solving patients-are-just-puzzle-to-me conditions shines through in the episode, especially the scene of him returning his gun, but there is something else I catch when I rewatched it before.

When the gunman patient is put in the MRI because Cameron tells him a theory through the hostage call, the remaining doctors in the room including House are wary at the gunman but also hopeful. Yet, when the result shows up on the screen, he realizes that the theory is wrong and the guy let go his only bargaining chip for nothing. If you watch this part carefully, you'll notice that House actually looks pitying and sad at the gunman's disappointed demeanor and expression. He realizes he is going to be another notch in the guy's failed doctors list, and at this point (with the gun given away and even the best, most talented doctor also not finding out what's wrong with him), the guy has given up hope that he will ever see the day he will be cured, certainly not behind the bars.

Yes, his thirst for puzzle is House's big driving force in giving back the gun, but you'll be lying to yourself if you don't notice House's compassion for the guy because he doesn't want the guy to go out empty-handed, with absolutely no more hope because House knows once they step out of the door, this guy will never, ever be allowed to be in the vicinity of any hospital or doctor ever again in his life, aside from jail's bare-minimum exams and medications. House can't handle the thought of putting someone else through his own disappointment—that nothing works to help his leg pain. He especially doesn't want to be the cause for this gunman guy's case either. Even in the end when House realizes the guy is a fucking moron because he doesn't know that Florida is, in fact, in earthwide-horizontal tropical zone and this is what stumps most of the guy's previous doctors—House still gives him a subtle salute to the guy while being handcuffed and led away, almost to say, "Enjoy your healing and the defeat of your arch nemesis The Sickness™, glad to be part of it."

Majority of his drive to stop at nothing until his patient is cured is definitely thanks to his own fucked-up leg, even if there are some dialogues with Cuddy and Stacy Warner (House's ex wife) that seem to imply he has always been a misanthrophe whose hobby is getting into malpractice (or general) lawsuits. I wholeheartedly believe that after his leg clot rendered him disabled and with chronic pain, he became much more dedicated and obsessed with getting to the bottom of a patient's medical information, even for info that seems innocuous or irrelevant that always turn out to be important (probably more like a plot armor than established characterization, to be honest), almost like this is his method of relating to the patients in his own weirdly human way, and maybe a little bit (actually, a lot) of projecting.

Thank you for coming to my TED Talk.

[am-i-the-asshole-official]

AITA for making my mom cry (in the hopes of continuing a years (?) long lie)

starting off: BIG SHINY ED TW

Context/Background:

• I’ve had an ED (OSFED) since I was 14

• I went to treatment (forced) as a teen. I hold zero anger over this by now and understand why my parents did it. I would have done the same.

• Both times I coasted until discharge, at which point I went back to ED behaviors, just more secretively.

• I’m now 22(F), living w my parents

—

The Lead Up to The Predicament:

• Relapsed age 21, and kept it secret

• My mother eventually noticed, and recommended treatment; I agreed, & got taken into IOP

• I’m still on my parents’ very good insurance, so treatment was covered pretty much entirely

• I did treatment with the same strategy I’ve used before: coasting until discharge, then keeping it secret. I have no intention of ever pursuing actual recovery, and do not believe it is possible. I don’t want to get rid of this problem, but I want it to be my problem only.

• Unfortunately, this means I essentially have to lie to everyone, because they won’t discharge you if you say “I’m doing this purely so I won’t run myself into the ground, and so my mom will leave me alone”. So I lied my ass off.

• I’m continuing to lie to my nutritionist, who recently approved me for “as-needed” appointments, and I kept putting off finding a therapist until my mom forgot and stopped asking about it, because I just don’t have the energy to continually lie to a therapist, and conversely, I don’t want to actually, honestly talk to a therapist.

—

The Predicament:

• Bill for $600 (part not covered by insurance) came from the treatment center

• Mom offered to pay it; I said no, I’ll pay for it

• Did this because I could not live with the guilt of my mom paying for treatment that she thinks actually put me on a path towards health, that I secretly used to lull her into a false sense of security

• She insists, and I insist back

• I pay it that night

• She finds out I paid it and breaks down crying because she thinks I did it because I assumed she couldn’t afford it and now she thinks she has failed me because I don’t think I can rely on my mother

• I try to explain that I’m an adult and it was my issue and my treatment and that I work full time and should be expected to pay my own medical copays

• This makes her feel worse and she expresses that my trying to pay my own way has been a pattern since I first got a job at 14, and that she should’ve asserted herself as a financial caregiver when she had the chance

• I freeze, because I don’t know how to explain what I really mean without admitting that I lied for months in an attempt to get people to stop worrying about an admittedly possibly-fatal illness

• I let her continue to cry

—

AITA FOR: Not explaining and just… letting her believe that?

What are these acronyms?

[roseapprentice]

Please don't fall for the line, "But health insurers only take this tiny % of US healthcare expenses!!! They're such maligned innocents uwu."

I have news for you:

THE MONEY THAT INSURERS COME AWAY WITH ≠ THE POVERTY THEY LEAVE IN THEIR WAKE

Insurers create poverty when I can't contact my doctor for a vital prescription because his secretary spent all day submitting and revising prior auth forms instead of answering the phone. The money for her labor gets flushed down a burocratic drain, and the insurer doesn't get a cent of it. Money goes to the time my doctor spends begging his employers to hire more secretaries, and the time his employers spend coming up with reasons to say no.

Money goes into the time pharmacy workers go back and forth with patients about why we can't have the medication we need to walk, or live, or think. It goes into the time they play phone tag with the doctor, then the insurer, trying to figure out where the care got blocked, so they can give us a clue how to unblock it.

Money goes into the time professionals spend convincing me not to self-harm when I can't get the meds my doctor prescribed, psychiatric or otherwise.

Often I'm denied a medication that only costs a few dollars out of pocket with the right coupon. Medicine I could afford, if buying medicine out of pocket when you have insurance didn't create more red tape than it cuts through. If I spend hours in therapy because an insurer cheated me out of $8 of medicine, even the insurer loses money. But they net more gain than loss, because most patients don't have time to fight them like I do.

If my body weren't worn out from years fighting this battle, my thyroid would probably be dying more slowly. Society would have to pay for fewer blood tests and doctor's visits, for lower dosages of levothyroxine.

If my insurance covered more frequent thyroid tests, I'd spend less time symptomatic. My kidneys would be safer, and so would every system in my body that works better when it's easier to move. In a million little ways, the restrictions insurers place on our care will land society with heftier medical bills down the line. Bills for treatment that many of us won't want if we get sick properly at 80 after long life.

Then there's the cost incurred when medical workers are bone-weary and soul-weary from fighting for us, and they make expensive mistakes. There's the lapses in care because so many workers get worn away to nothing and leave the field understaffed, leading to preventable emergencies and hospitalizations.

Part of what makes the insurance industry so ghoulish is that they could still rake in millions in decent ways. Fewer millions, and more slowly. They could ensure that seniors can refuse unwanted care; it would cut costs massively while reducing cruelty. They could offer better preventive medicine. Ensure easier access to group counseling, so paid experts can stretch their time farther and more people can find a support network. There are ways to make medicine cheaper while also making it kinder. Execs have chosen an antagonistic stance toward patients and doctors because it pays off somewhat bigger and a lot faster. It looks better on a quarterly report. The fight that's resulted is wildly expensive for everyone.

THE MONEY THAT HEALTH INSURERS BRING IN DOES NOT REFLECT THE COST THEY INCUR ON OUR HEALTHCARE SYSTEM

...let alone the cost they incur on the human beings trapped inside it

[uhdrienne]

𝐭𝐡𝐢𝐬 𝐬𝐮𝐦𝐦𝐞𝐫 ˚₊· ͟͟͞͞➳❥

05. he made sense though

🌼 warnings: mentions of a creep, injuries

🌼 word count: ~2.7k

"Y/N!!"

"Delia?? What are you doing back here?"

She shrugs. "I quit."

"What?!" You exclaim.

She looks at you. "Some creep wouldn't stop bothering me," She says lightheartedly, but one look at her expression tells you she's not feeling too great at all. "The doctor wouldn't take action even when she saw it in the flesh. Said something about not ruining our reputation. So I left." She promptly bursts into tears, and you're quick to draw her into a tight hug.

"Oh, god." You murmur. "Okay. It's okay. You're safe now, Dee. Come on in first."

"I'm jobless!" She chokes out a laugh through her tears, as you settle her on your couch. "Amazing, huh?"

"No, don't think like that," You insist, before a bright idea pops into your head. "Work with me. Over here. You like the village, don't you?"

"What? I-I do, but-"

"I don't have a nurse right now," You explain, getting more excited. "I could use the help."

She looks up at you, hope creeping into her face. "Really?"

"Yeah. It would be amazing if you stayed with me," You breathe out.

She squeals and tackles you. Amid her excited ramble of thanks, you catch the hint of relieved laughter

Loud bangs on your door wake you and Delia up.

"What the..." Delia grits out, shoving a pillow over her face. "It's 8am!"

You pull yourself out from the warm covers, and very grumpily, open the door to see Wonwoo. "Come on out," He says. "We have weekly village cleaning on Saturdays."

"It's a weekend!" You exclaim. "Who in their right mind wakes up this early --"

"We do," Wonwoo smirks at your cranky state. "Ten minutes. See you out there."

"See you never," You mutter, and he turns back to you to warn, "You better go get ready. Don't go back to sleep."

"You can't make me."

"Don't make me pull out the megaphone."

You huff and close the door.

He pulls out the megaphone. Right. At. Your. Doorstep.

And so fifteen minutes later, you find yourself in the ugliest neon green vest ever, a broom in your hands, sweeping the streets with a grumpy and groggy Delia by your side. Joshua and Seungkwan come by to say hello to your best friend, and Delia brightens up considerably after Seungkwan compliments her hair.

"He's so charming!" She sighs after they walk away, as you half-heartedly sweep up some dead leaves.

"Mmhmm. Got it." You don't even process her words, only scowling at the annoyingly dapper town chief.

"Y/N! We have a patient!"

You leave your office and to the counter, where you find Wonwoo and one of the grandmas you handled squids with standing together. You bow, and take the grandma's chart for a look.

"Grandma Lee," You read off the paper. "Pain in the elbow, extending to the wrist..."

"She does heavy work by the docks sometimes. You handled squids with her," Wonwoo supplies.

"Okay, got it. Would you come with me? We'll take a look."

Ten minutes, later, after a series of questions and quick presses to the painful areas, you conclude.

"So, you'll probably need a form of therapy," You say. "A few weeks' worth of exercises and physio to relax the surrounding joints and let it heal. It might be because of the constant strain and pulling. I'll get some pain relief for you in the meantime, but don't rely only on it. Healing the injury is key."

Wonwoo nods, and checks to make sure Grandma Lee understands.

"Doctor?" Grandma Lee speaks up.

"Yes?' You turn to her. "Any questions about the treatment?"

"How much would it cost?"

"Ah, your insurance will cover most of it."

"How much would I need to pay?" Grandma Lee looks up at you from her chair.

"It really differs by the number of sessions." You ponder. "But as a ballpark..." You scribble down a rough estimation, and her eyes widen as she sees the figure.

"Oh, that's so expensive!" The lady exclaims. "I wouldn't spend so much money just on my arm. Forget it."

"Grandma-" Wonwoo tries to interrupt.

"There are home-based exercises that we can try out if the cost doesn't work out for you," You attempt to placate her. "However, doing them under guidance is much better so you don't risk getting injured and making it wor-"

"Oh, never mind that," She says impatiently. "I'll just have painkillers."

"Please don't worry. I know medical prices can be very burdensome. We can discuss this further only after you're properly healed," You console. "Right now, the payment isn't my concern. The pain seems to be quite serious in some places--"

Wonwoo takes her arm as she tries to get up. "Grandma, why don't we hear the doctor out and consider it first? She's a professio-"

"Nothing pain medicine can't fix," She complains as you address her.

"Ma'am," You explain. "Injuries aren't always something you can fix with painkillers. If we don't fix the root cause, the pain will persist and it might get worse-"

"Hey, you don't have to scare her-" Wonwoo seems alarmed.

"Do you happen to be... in need of financial aid?" You blurt out in a moment of weakness.

"Hey!" Wonwoo starts, eyes widening.

"What?" Grandma Lee asks, looking offended. "Who do you take me for- I'll have you know, the land I own here is bigger than others! My kid works at a high-end company in Seoul. Do you think, what, I can't afford it?"

"Okay, um..." You blow out a breath, and look back down at your clipboard, clicking your pen shut. "Then...why don't you discuss this with your son first? We can do another consultation and see what we can do once we're all on the same page."

"Fine!" Grandma Lee retorts angrily, before pushing herself up and hobbling out of the room. Wonwoo starts to call for her, but she's already gone. He whirls on you.

"Did you have to?" Wonwoo asks exasperatedly.

"What?" You ask, annoyed.

"Ask about financial aid and all of that shit -- is that really what a doctor should say?"

"I asked because she was being stubborn."

"Stubborn-- have you thought that she maybe doesn't want to bother her family with the fees?" Frustration is laced into Wonwoo's words, his voice slightly louder than before.

"No, I haven't thought about it." You answer angrily, without missing a beat. "And I don't really understand that. She would rather endure the pain than get it resolved, just for her son?"

"Why are you like this?" Wonwoo half-shouts, getting up. "Look...I don't have time for this. You-"

"Neither do I," You say, folding your arms. "And please don't overreact. You're not her legal guardian."

He shoots you a glare, full of hurt and disappointment, before he grits out, "People really don't change so easily, do they." He then turns on his heel and storms out of the room.

Sighing, you return to perusing her chart.

You're still pondering over it that evening, and Delia is about to lose her marbles over your brooding when you get a text from Wonwoo.

"Meet me at the harbour."

When you reach the same spot where you ran into Joshua and Seungkwan and Wonwoo, this time it's just the chief alone. You sit a small distance away from him. "What is it?"

"She called her son earlier," He begins with no preamble. "And he said he wanted to wait a while since he's paying off the kids' school fees and he hasn't gotten his promotion."

You stay quiet. You know about the financial issues patients sometimes face. You've already made your decision to cure her after a long think and consulting with Delia, but you decide to listen anyway.

"We've told you about Grandma Lee." He starts. "And you know how she is. She wouldn't spend money on her treatment because she doesn't want to tell her family and stress them out. Her son has a family to support."

You stay silent, but he says nothing about it. He turns to you fully. "What I'm saying is, I'll pay for her treatment. Just don't tell her it was me. Say... say you had some kind of free treatment or something."

"I can't," You say immediately. "I have to be responsible for anything I do as a doctor. If I'm trying to help her get better, it would be unethical if I didn't inform her of the whole process from treatment to payment, black-and-white."

"Fine," Chief Jeon nods in understanding. "Make up any excuse within your limits. Just don't say it was me."

"Why are you being stubborn on this, too?" You ask softly.

"Grandma Lee raised me," He insists. "We take care of the people we love. She never likes to trouble her son--"

"So she just bears with the pain?" You interrupt, then sigh slightly. "That's a little selfish."

"Selfish?" Wonwoo says exasperatedly. "She's the most selfless woman I know. How could you even say that?"

"Because it's frustrating to watch." You look down at your hands.

"Don't you know anything about sacrifice?" Wonwoo confronts you hotly. "She's sacrificed so many things her whole life--"

"Why are you getting upset?" You retort, becoming just as irate. "Do you know what it means to be a good parent?"

He goes quiet, and so you continue, eyes blazing. "It means taking care of themselves and staying healthy for a long time."

His eyes flick back to yours, anger immediately draining from them. You ignore it and keep going.

"They shouldn't be putting aside their well-being in the name of not burdening their family!" You exhale sharply. "They should care for their own health the most, for the good of themselves and their loved ones. She shouldn't be putting herself through so much pain and letting herself suffer. Don't you get it?"

And with the outburst, you get to your feet and storm off. Wonwoo watches you leave.

Once you get back through the door you pass Delia's closed door, go to your room, and sink into a chair. You hated it, disliked the feeling so much, but something about Grandma Lee just couldn’t tear you away from her case. You rub your eyes in exhaustion.

We take care of the people we love.

It looks like you had a grandma to visit.

"Is anyone home?" You mutter as you enter her front yard the next evening.

"Who's that?" You can hear her voice and her footsteps as she ambles slowly out of her house.

"Oh. It's you," She says as she catches sight of you. You wonder if it's too late to turn back and escape, but you make yourself stay put, and bow to her. "Grandma Lee."

She sighs. "Since you're already here, might as well eat. Have you had dinner?"

As your head shakes no awkwardly, she tuts something about not eating properly before she ushers you into her home, to a seat at her table. You try to refuse, but she waves you away and goes back to her kitchen, and before long you hear the clangs as she makes a tray and sets it before you.

"Go on, eat!" She says as she opens a steaming bowl of soup. "I made these fresh myself, using kimchi we made. Try it."

You murmur a soft thank-you to her before you cautiously take a bite.

It tastes...like what you would have at heaven's gates. Rich and flavourful, the kimchi adds just the right tang of sour and crunch. "It's... really good,” You mumble quietly.

"Oh, that's good. I was afraid it wasn't good, you know. Nowadays, I'm not as agile as before. Bending over and making kimchi gets harder as you age. I ache everywhere after I make it." She chuckles awkwardly, and you smile softly along with her.

"And your arm wouldn't make it easier since it's in pain, right?" You attempt probing a step further, and she sighs and shakes her head. "I guess not."

"Then how could you think just painkillers would solve the problem?" You admonish, no anger in your words, and she smiles sheepishly.

But just like that, the tension eases a little, and you're relieved when she reverts to her slightly chatty self, going on about how doctors should be eating more to keep themselves going.

It feels like your own grandma watching to make sure you ate well, and you're maybe, just probably, starting to understand why Wonwoo adores her so much. Her presence is comforting, like a confidant you could come home to.

After you eat she brings you outside to the yard with some chilled barley. You sit with her on the porch as she tells you childhood stories of Wonwoo and Joshua and Seungkwan, and how they were called The Little Daredevils, and she pauses when she gets to Wonwoo leaving the town for a good three years. You smile at the right places, and look at the way her greying hair (white in some places) blows in the breeze as the sun sets and night falls.

"Ah, that boy," She sighs as she massages her feet and you pour her a cup of barley. "I was worried when he left, you know. And he didn't call anyone back here. He was different when he came back. Not the energetic chief we see now."

You nod awkwardly, remembering your spat with him. "I see. I'm glad he got better, didn't he?"

"He even offered to pay for the treatment!" She says, before shaking her head in fond exasperation. "He's mischievous, but he's a good man."

"...He is," You affirm, rather reluctantly. You cast your eyes down and shake your head as you recall his prior attempts to explain Grandma's situation to you. God, how he would laugh when he found out about this!

"And my son said to hold off on the treatment, so..."

That helps you recall why you're here in the first place.

"Grandma Lee, I came to tell you... come back to the clinic." You mumble.

She looks up, startled at your direct words. "Hm?"

"I might not be able to give you a hundred percent discount," You tug at the hem of your dress nervously. "But... I thought about it, and Wonwoo spoke to me... I wanted to apologise. I should at least try to understand your hardships. So...I won't charge you full price. Maybe just for the consultation."

"Oh..."

"Don't tell anyone, though," You try for a smile. "It can be our secret."

"If it's bad for business, you don't need--" She begins, flustered, but you wave your hands in refusal, face flushing. "It's not that, really."

She waits for you to continue.

"I won't get to see my parents retire and move to a peaceful place," You say quietly. "I won't be able to see them get to your age, or see them make kimchi and cook delicious things. So... I just thought I should try my best to give you more chances to do what you like. You shouldn't be in pain if you want to do it all."

You avoid eye contact, fiddling with your fingers, staring at the glowing lamppost, the peeling green paint of her gate, and the worn-out slippers on her feet, everywhere but at her, as she surveys you for what feels like forever, a mix of curiousity and sympathy laced in her expression.

When she finally reaches out to take your hand and pat it silently and gently with hers, wrinkled and lined with the wisdom of her years, the way grandmas always do, you let her.

She sighs. "Wonwoo really is a nag, isn't he."

The sudden lament coaxes a huff of laughter out of you. "I have to admit he made sense though."

It felt beyond strange to concede to the village chief for once, but when Grandma smiles and continues patting your hand, you couldn't help but think you finally did something right.

Wonwoo leans back, hands behind his head as he lies down on the ground. The red lighthouse glows in the distance and the sound of the waves fill his ears. Your voice fills his head

"Do you know what it means to be a good parent?"

"It means taking care of themselves and staying healthy for a long time."

He blows out a breath. It looked like he had a doctor to visit, and not for medical purposes.

𝐭𝐡𝐢𝐬 𝐬𝐮𝐦𝐦𝐞𝐫 ˚₊· ͟͟͞͞➳❥

🌼 summary: going back to the countryside where you grew up was at the bottom of your list. unexpectedly, your life changes course, and you eventually find your home in weekly village cleaning, the sound of the waves, and with the local jack-of-all-trades, jeon wonwoo.

🌼 pairing: wonwoo x reader fic (fluff, angst, hometown chachacha!inspired)

🌼 genre(s): fluff, mild angst, yn can be mean sometimes at the start (this is inspired by the kdrama hometown cha-cha-cha, so some parts of the plot and characters are similar), wonwoo is an overall sweetheart

ch.05: he made sense though

prev. masterlist. next.

🌼taglist: @gaslysainz @lev1hei1chou

writer's note: soo... i hope she's trying to be better...? hahaha thank you for reading!!

[alpaca-clouds]

Dear Americans,

I really feel I need to tell you this. But no, living in a country with universal healthcare does not mean, that people in those countries get every health thing covered by their healthcare.

I am saying this, because this year I heard so often from American friends: "Huh, but you live in a country with universal healthcare! Why would you have to carry these costs?"

Here is the thing: Every country is different, but generally speaking not all treatments are covered by healthcare. Here in Germany, a lot of dental health is in fact not covered, and the healthcare provider will neither pay for my glasses, nor for all of my mobility aids.

Friends in other countries have also received care, that their health care provider would not cover. Maybe because a treatment is too new and not yet put into the bureaucracy. Maybe because this treatment does not work for 70% of people - you have bad luck if you are part of the 30% for whom it works. And again: Dental, glasses, mobility aids? Yeah, most healthcare does not cover that fully.

Mind you, I generally get a lot more covered than the average German. Mostly because I have the skill of being really, really nice on the phone, so when my healthcare provider declines to cover something I will phone there, have a nice half-hour conversation with some overworked guy in the call center, that will end me with actually getting to talk to someone who can make decisions. I will be nice to them and in the end, they will find that one loophole that will get whatever covered for me.

Heck, I managed to get on dental thing done for free two years ago, because the dentists made a few calls and ended up asking me: "Hey, would you mind if your tooth replacement was made by someone finishing up their training as their final piece? It would be for free in that case." I was like: "If it is for free? I don't care who makes it."

But also, I am aware that this ability - especially for someone autistic like me - is fairly rare.

Generally: Look, my healthcare will look somewhat better than that of the average American. Also, I generally do not have to think that much about "in network" and "out of network" care. While there are some doctors in Germany, who will not take every health insurance, most of them take everything. Those that don't are in fact fairly rare. Sure, some might treat people with private insurance better, but generally speaking: it works.

But holy fuck, healthcare is fucked over sideways in a lot of countries. And it only gets worse.

Is healthcare in Germany (or generally Europe) better and more affordable than in the US? Yes. Absolutely. Is it good and generally affordable? ... Not if you are poor.

Sincerely

Alex

[daidi-dragan-glas]

Just a quick update.... Oncologist has confirmed that I'm one of the most stubborn people she's ever run across.... Almost 2 weeks ago I had my 41st infusion of FOLFIRINOX (chemo cocktail for stage 4 colon cancer with Mets to liver, lungs and lymph nodes)... I'm told that most people have to stop taking it at infusion number 12 or 15, and the most she(my oncologist) has ever had a patient handle was 38.. until me. I've NOT allowed them to reduce my chemo for "their" fear of MY side effects ... Hell, half the questions from them are "is this side effects getting worse?" Whether it's nausea, neuropathy, energy, bloodwork levels, etc, and always seemingly with an eye towards "we should cut back on this drug so you FEEL better... FUUUUUUCK THAT! I want this fucking cancer GONE... Not just reduced and I feel great until it kills me... I'll HAPPILY go thru the neuropathy that makes it hard to think, hard to work, hard to even type on a keyboard or work with a mouse, yes, that's coming from an IT person, I'll HAPPILY feel unsteady, feel like shit all day, up 5 to 10 times a night to run to the bathroom, and half of those times to actually have to clean up grrrrrrrrrrrrr, I'll happily take the vitamins, the injections, the pain pills and patches, the sore burning ass, the weakness and the frustration of it all, AS LONG AS I'M DOING EVERYTHING I CAN TO BEAT THE FUCK OUT OF THIS SHIT. And that means DO. NOT. DECREASE. MY. CHEMO. SO. THAT. I. FEEL. BETTER. TODAY. AND. TOMORROW..... YOU KILL THOSE GODDAMN CANCER CELLS, I got it, I can deal with the rest, I'm my own Huckleberry!!!

It's not as effective anymore though.. and the Mets in my liver are growing fairly quickly in some concerning spots...

I pushed my oncologist for alternatives.. even 2nd or 3rd opinions and experimental treatment... And she wrote a letter to the Mayo Clinic. I'm told the Mayo will not even consider giving an appointment unless they feel there is something they can do for you that is better than what you're getting. I had a phone interview, they got all my records, had a care team review my case in detail and a week and a half later, they called to set up an appointment.

I'll be doing some packing today (Sunday July 14) to leave Monday morning and be in Rochester MN at the Mayo Clinic facilities for appointments there on Monday, I'll stay overnight (quite probably in my car since things are fairly tight lately) and more appointments on Tuesday.

So, we will see what they say and what kind of treatment plan they come up with.

(yes, things are tight... Cancer treatment is NOT cheap y'all. Each and every one of my infusions gets billed to the tune of $42,000 per... Not including the testing, the Dr appointments, the hospital visits, the drugs to combat the side effects, the drugs given in combination with the chemo to combat the "essentially" allergic reactions to the chemo... {Yes, I had to ring the bell beside my chair once and had every nurse in the facility converge on me and work to reverse what was going on}... So, so far, me and my insurance company have been billed somewhere upwards of 2.2 million dollars since November of 2022. My insurance happens to be pretty good, so my portion is somewhere around half a million at this point, and as stubborn as I am, when they ask for payments, I stick to my guns and pay an affordable amount each month, to show that yes I'm making payments, and fuck you if you want more. I'm lucky!)

I would like to add... IF you are in a position to be charitable, please do one of the following:

go to one of your local oncology clinics, ASK them what their patients might need (I know there are many of you that found fulfillment in making masks during COVID, put that same effort into making hats for patients losing their hair, donate button down or zip down Henley style shirts (most of us have a port installed in the upper right side of our chest and easy access to that for blood draws, infusion and other treatments without having to fully remove your shirt is NICE), donate homemade afghans or blankets

And if you're really squirrelly, pick a local patient and befriend them, take them to appointments, make sure the snow is cleared from their driveway (chemo takes your strength and endurance away and it makes it HARD sometimes to do the simple things around the house). Rake the leaves, mow the grass, vacuum, Help them out with whatever they need (MORE THAN JUST ONCE). find out what they CAN eat and take it to them several times a week, you cannot imagine just how much that one small thing you do for them can make a HUGE difference in their actual survival!!!

Find an organization close to you that you can donate money towards local cancer patients medical bills.

Sorry, turned out to be not so short of an update and there's some rant in here too, sorry not sorry.. lmao!

but I'm sure hoping for the Mayo to pull something phenomenal out of their hat... I don't even care if it ruins my health or quality of life for awhile, I don't care about short term, I can deal with the shit of it, but I DO care about sticking around until people can honestly say... "Thank GOD that fucker is finally dead, let's PARTY!" Yes I still plan to live until I'm a total pain in the ass for even those few that love me, and then when I've died at 103 yrs old, they can spread my ashes on the Appalachian Trail across TN NC and VA and if they wish to visit they can go into the mountains and woods and I'll come to them as the breeze and whisper of the beauty of nature to them

[wanderingfool2023]

How it works on the inside - billing inside hospitals and clinics

Years in this field. There are not enough words to explain my anger at the system. The primary point is that it is broken, everyone on the "inside" has known for ages, COVID was the death knell.

I could make post after post on why it is broken but I think it is easier to explain how it is intended to work for the first one. Because I will be real with you people on the inside that WORK ON THESE TEAMS do not even fully get it.

This example is for a hospital (think ortho, cancer centers, surgery, etc) - clinics, like your primary care clinic use a very simplified version of this.

The first people you usually speak to are called "Patient Registrars" the team is usually called PAS (Patient Access Services). These are the front line staff that get you scheduled, take your insurance, get your authorizations. It is the doctor that SENDS the referral who is responsible for getting your initial authorization. Usually this is for a consult. The authorizations after are done by the folks above.

Side bar - what is an authorization? it is a request by your doctor for something you need that the payor/insurance company agrees that they will pay for. These can be for a one time service like a MRI, or something that is based upon time/dosage - like chemo. The latter must have re-auths done by the team mentioned above.

Lets say this all goes according to plan, which it does for the most part. What happens after you get your first visit?

The doctor goes into their medical record (sometimes called an ELECTRONIC MEDICAL/HEALTH RECORD -EMR/EHR; these used to not be electronic and be on paper, some facilities are still on paper. The medical field is the last bastion of faxing in this nation) and documents what was found/discussed - their diagnosis, prescriptions, next steps like treatment or routine meetings etc.

That information (regardless of format) flows to a team called the Medical Records Team. They do a QA, make sure the registration folks didn't miss any forms, the nursing staff got all the stuff they need and then ship it over to coding/charging.

Now this next step does involve traditionally 2 teams. It can deviate by facility, some are merged, some are not. Lets talk about a bigggg ass facility with all the proper teams and staff.

Charging - this is a sub team of either 3 different departments: Health Information Management (HIM), Patient Financial Services (PFS), or Revenue Integrity (RI). Regardless these folks sit down, review what the doctor wrote and generate charge codes based upon it. There is a dictionary (several truly) in every hospital with every price for every service. These prices are set based upon a few factors but I will delve into that in another post called Charge Master or CDM.

From there it goes to coding. Coding reviews these records and documents in extreme depth. They assign codes (which are dictated by CMS - the gov office that oversees Medicare) that is digestible to insurance companies. If anything looks off they send it back to the correct team to fix - most of the time their communication is directly with the doctors themselves. These communications are part of your EHR and available to you if you request them.

Once coding is done then it goes to billing/PFS. PFS then does another QA (sometimes this is done via the tools not a human) and a claiml is generated and sent to a clearing house.

A clearing house is not a bank - it is like a transit center for facilities and insurance companies and their banks (Change Healthcare is owned by UHC and is the biggest clearinghouse in the nation). So a claim goes to the clearing house, it is scrubbed AGAIN for errors, and then sent to the respective insurance company. The insurance company then goes through a fun little circus which is again another post. Eventually they tell the facility (via the clearing house) the claim is either denied, partially denied or fully approved and sends the $ to the clearing house. Sometimes that money goes directly to the bank of the facility ymmv. Regardless the PFS team goes and pulls this data from the clearing house and updates the patients record accordingly.

They will then begin the denial process of fighting the insurance companies. There are hundreds of denial types, but generally they are called technical denials or medical necessity denials. Another post.

This usually takes months of arguing, sending information, resubmitting, rinse and repeat. At the very very end of it the patient (only if the insurance agrees) gets a bill. From THERE the patients will then reconnect with the hospital billing team and maybe the financial assistance team.

This lovely system is called the REVENUE CYCLE. It is sometimes a division, sometimes its left as standalone departments, each functioning on their own. Sometimes the facility is small enough there is only 1 person responsible for a function instead of teams.

I will make a few more posts - specifically break downs. Reach out if you want me to dive into anything specific.

[justinspoliticalcorner]

Dean Obeidallah at The Dean's Report:

No, Donald Trump is not “flip-flopping” on abortion as some corporate media headlines are claiming. But the silver lining to this debate is that it elevates the issue of reproductive freedom to the forefront in the closing months of the campaign—reminding people Trump was “honored” to “kill” Roe v. Wade and that his abortion bans are literally killing women. What sparked the headlines about Trump’s so-called “flip-flop” on abortion was when Trump first stated last week that he opposed the GOP enacted six week abortion ban in Florida. Trump told Fox News this six-week ban was a “mistake,” adding, "I think six weeks, you need more time.” However, after the pro-forced birth activists and Christian nationalists expressed outrage, Trump reversed course, saying he would vote no on the proposed Florida ballot measure that would repeal the state's six-week abortion ban.

Trump did not “evolve” on the issue of reproductive freedom. In reality, he has no core beliefs other than racism and sexism. The convicted felon simply sees the same polls and election results we have when it comes to abortion. Trump gets that a recent Gallup poll found only 12% of Americans support the GOP’s total abortion bans—while 85% of Americans believe abortion should be legal in all or certain circumstances.  Add to that, a recent CNN poll found nearly two thirds of Americans oppose the 2022 Supreme Court decision overturning Roe v. Wade.

Trump simply wanted to appear more reasonable on abortion given new polls show Americans overwhelmingly trust VP Harris to handle the issue of reproductive freedom--which has contributed to a record gender gap.  This explains Trump’s latest proposal regarding in vitro fertilization (IVF) that he claims will force insurance companies to pay for the costs of in vitro fertilization (IVF.) I’m sure we will see this “amazing” IVF plan the same time we see Trump’s “great” healthcare plan that he repeatedly promised since 2015 he would be unveiling in “two weeks.” Never happened.

Trump’s new IVF is not even original--he stole it from the Democrats. In June, Senate Democrats proposed legislation known as the Right to IVF Act that would have both enshrined into federal law a right for individuals to receive IVF treatment and would’ve mandated coverage for fertility treatments under health insurance plans. In other words, what Trump says he now wants to do. However, that legislation was blocked by all but two Senate Republicans included Trump’s own running mate, JD Vance.

What Trump and the GOP don’t get—or care to grasp—is that stripping women of a 50-year constitutional right to reproductive freedom is not a political issue, it’s personal. In fact, nothing is more personal than Republican laws that force women against their will to carry a fetus to term. And that is exactly what Republicans have done in 14 states they control with their total abortion bans that in essence mean on day one of pregnancy, a women’s uterus becomes property of the GOP.  (An additional eight GOP controlled states have also implemented abortion bans still far more restrictive than under Roe v. Wade.) These abortion bans—as studies have now detailed—are literally killing women. One study found that “women in states with abortion bans are nearly three times more likely to die during pregnancy, childbirth or soon after giving birth.” A July study found that “the highest rates of maternal mortality can be found in the Mississippi Delta, which includes Arkansas, Louisiana, Mississippi, and Tennessee.” These states—as well as Texas and others--all have extreme abortion bans that have resulted in preventing women from receiving an abortion to address a women’s health needs. Rather, a woman must be on the doorstep of death before doctors are permitted by law to perform an abortion to save her life.

Abortion bans are harming and killing women, point blank. These have the imprimatur of Trump-appointed justices and GOP legislators across the nation, along with Trump himself.

[cbk1000]

So, just got home from my appointment with my new doc. I gave him the Cliff Notes version of all the issues I've been having for the last few months, and I forgot a copy of the initial iron panel that I had done, unfortunately (I meant to bring it and even left it on my computer so I would remember; how did that work for you, dumbass?) but I remembered my numbers, and as soon as I told him what the results were for my initial iron panel, he immediately said, 'That's low."

I KNOW. PLEASE TELL DR. CRAZY THAT.

Basically, he listened to everything I said, asked relevant questions, asked if I'd had my thyroid levels checked (because thyroid can definitely cause some of these problems), said if necessary in future if there are still issues, we can do a thyroid scan, but let's get an updated iron panel done to see where I'm at and if we can increase my dose, work on the iron deficiency, and then go from there. I asked about iron infusions to speed things up, and he said, "Yeah, definitely, we can see if we can get that covered for you if you want to do that." I said I know insurances are a pain when it comes to coverage and a lot of them won't pay unless your hemoglobin is low, and that I have a health savings account and am able and willing to pay out of pocket, and he was like, "Ok, good."

He also offered to refer me to a hematologist, and I said I had thought of asking my last doctor for that, but he was difficult to work with (understatement of the year) and that I figured an appointment with a hematologist would probably be pretty far out anyway, and I'd prefer to try and get in a lot sooner if possible for an infusion. He said, "Yeah, hematology is always backed up." I did say I had been in touch with a telehealth hematologist about possibly ordering an iron infusion, but thought it would probably be faster to go through a local doctor if it was possible to get it ordered through him, but that's at least an option; he was glad to hear I'd been in touch with a hematologist. He wants to see where I'm currently at with my iron panel (I haven't tested it for six weeks) and then figure out what the best course of treatment is based on my numbers. (If I'm at a certain level, an infusion wouldn't be safe, because I'd risk overload, but considering that in four weeks of supplementing, I went up nine points, and then in another four weeks, I went down a point, I'm gonna' be extremely shocked if he comes back like, "Yeah, your ferritin went up to 150, so we can't do an infusion right now."

He actually even brought up POTS and said some of my cardiac symptoms were similar, and I said, "Yeah, I had thought of that, but my heart rate isn't really consistent." He asked if I meant that it wasn't going up when I changed positions, and I said, "Well, it's been coming down as I've been supplementing, and I don't think it would do that if it were POTS. Also, my normal resting heart rate is in the 60s, and on bad days, just lying down in bed, not doing anything, my heart rate is in the 90s. It goes up higher the more I exert myself, obviously, but even lying down doing nothing it's a lot higher than my normal resting heart rate."

I told my previous doctor all of this, and he just ignored all of it and continued to blather on about how the shot had given me POTS.

Do you know what this doctor did? He said, "Oh, yeah, probably not POTS then. Also, if cardiology already checked you out and they didn't even mention it as a possibility, it's probably not."

He also asked if I had a history of iron deficiency anemia, and I said I hadn't had labwork done at the time so I didn't know what my iron levels were or if my hemoglobin was abnormal, but many years ago after a blood donation I started feeling really sick, had the high heart rate and shortness of breath and could barely get off the couch, and I was still living at home at the time, and my mom was a nurse and just put me on iron supplements and that resolved my symptoms, and that those cardiac problems seem to just be how my body responds to low iron.

And he just. Took that at face value. Like, ok, you have a history of this, then, let's work on getting it sorted out and then look at other possibilities if it doesn't all clear up with iron treatment.

So I'm getting my iron panel done Friday, and then we'll go from there with treatment options.

[tepli-mravenci]

hey homonoromo! a czech related question: how is it with queer acceptance in your country? preferrably in brno, haha. and especially about trans people? do you think it'd be possible for me to transition there? and how much would it cost in general? and do i have to get psych approval and wait in the queue for years or stuff like in the uk?

i know you're not a consultant or anything, i just don't know who to ask. also, i guess that's way more than one question

Aight so when it comes to acceptance it really comes to individual people but regarding transition there's a couple things to consider:

- according to law you are required (among other things) to get sterilized to complete your transition if you're transitioning fully from one binary gender to another (aka you want your personal documents say you're that gender and you want a name that's purely given to people of that gender), also there's no nonbinary option for the "full" transition, you either have M or F on your ID

- before you're allowed to start taking HRT you need to go to a therapist essentially, it really depends on WHERE exactly and WHO your therapist is and I don't know the Brno situation but there are forums (mostly on Facebook I think) where people discuss their experiences (also čumblr Brňáci might know more than me)

- this is also individual when it comes to how long you'll be waiting, how long they'll be examining you and how long it will take you to transition

- I'm not sure how MONEY works when you have a non-czech insurance company (since I have no idea how insurance works) but if you do have one that operates in the Czech republic they WILL pay for your transition as if it were any other medical treatment (there's of course examinations and shit that determine whether it will psychologically benefit you to receive that treatment), you should still check if your insurance covers these kinds of things tho

- during your examination period you're first required to "try out" presenting yourself socially as the gender you're transitioning to which includes using a gender neutral name

- a recent GOOD development here is that you can now change your name to a neutral one ANYTIME even if you're not "officially" transitioning! Here's a list of legally approved gender neutral names!

- there are invasive and unnecessary examinations that should not be mandatory for the transition but your therapist can still try to make you go through them, depends again on the specific one, it's also important to remember that the way trans people are diagnosed here is reportedly ancient and just...really stupid? (to quote what my classmate told me, they asked him things like "did you play with dolls or cars as a child?")

- if you are married (to someone of the opposite sex) or in a registered partnership (with someone of the same sex) pre-transition, you have to get divorced when you complete transition because they're not the same on a legal level

Trans*parent is a great Czech resource when it comes to transition and trans stuff in general

I am not sure how different it is with foreigners or even if you'd find a therapist who speaks english honestly. Don't quote me on this but you might need to get Czech citizenship first? But I really don't know.

If I said something stupid or inaccurate (or no longer relevant) here pls correct me!!

[monstersinthecosmos]

can i vent about the healthcare system lol

This year I have health insurance for the first time since I was a child and when I tell you it sucks, I hate this, I hate participating in this system, I miss when I was just in pain all the time and didn't even bother going to the doctor bc I didn't have insurance anyway, I don't love this system where I read my insurance policy and think something is covered and then it isn't except maybe it is and maybe it got processed by a bot and I have to call the insurance to dispute but then I have to call my doctor to dispute and then I have to call the insurance back to dispute like, guys I have phone anxiety I'm gonna just pay you all this money instead of making phone calls I guess.

i have nerve damage and my treatment options so far are a $1,300 shot that might not actually help and I'll have to get another one in a few months anyway or I can go to physical therapy where they want to see me 2x a week for $250 per session. My insurance only covers a certain number of sessions and even if I did go to all of them, I still wouldn't hit my deductible. The PT place has a financial assistance program but it's only for people who have hit their deductible. (What's the point lol).

I'm also at a dead end trying to get diagnosed & treated for hypothyroidism because "weight gain" is listed as a symptom and BCBS says they don't cover "weight loss" treatment even though that wasn't what the fuck I asked and I was more concerned that my hair is falling out and I'm freezing all the time. Like where does it end, every time a symptom of something includes weight gain. What if a skinny person has it. Is this discriminatory? Is it a coding error? Will I pay the $215 I got charged for having my thyroid tested and simply not continue treating it now, because I don't have the constitution to make 100 phone calls and argue with people? lol.

the spine specialist orders an MRI and says I'm too young to have surgery so I should just do pain management. the pain management doctor tells me to lose weight. (it's hard, because, I think my thyroid doesn't work.) he says lyrica might help with my nerve pain but it causes weight gain so he advises against it. i wonder at what point does BCBS decide that spine & nerve pain is because I'm fat and won't help me anymore because it's weight loss related.

And let's not talk about how I was like, you know what, I would rather just build up some medical debt and pay it off slowly because I'm terrified that I'm going to have permanent nerve damage, and I applied for financial assistance with the hospital, and they approved me, but they don't help for any bills which are under $2000. So my $900 MRI or my $400 nerve test or my $1300 shot are not eligible for financial assistance, even though my hospital balance would be over $2000. I go to set up a payment plan and it won't let me set the number I can afford. I manually enter a bit at a time and they won't stop emailing me that I owe them money because I didn't use the official interface for a payment plan. I call their financial assistance to ask why they didn't adjust my MRI bill, they tell me because it's under $2000, I get so overwhelmed and start crying on the phone like an asshole so I hang up before I remember to ask about adjusting the payment plan.

like is better that I'm now $1300 in the hole for tests that told me I have nerve damage and arthritis and disc degeneration when I can't afford any of the treatments? Is it better to at least know? But what's the point if I can't do anything about it anyway except YouTube yoga and Aleve for breakfast, which I was doing anyway when I was uninsured. Thanks, now I know! I cannot feel my leg! Pray for me that I don't wind up paralyzed from ignoring it!

(I think part of me committed to these tests because I was like, well, if there's NO damage I will know and I can stop worrying, but there is damage, so now idk how to feel.)

anyway it's just. I've always known this system was garbage from the outside when like, I've spent years having to treat things by myself at home, I've had so many times where I didn't go to the ER when I probably should've, I've passed on really fun outings with my friends like snowboarding or roller derby because I'm too scared I'll get injured, my mental health is at all times hanging on by a thread because I can't get medicated (put a pin in this one bc I finally got an appointment for an evaluation but my insurance doesn't cover most of the meds LOL). It already sucked on the outside and was already a huge embarrassment to me as an American but like. I finally have insurance and it wasn't' even worth it.

and like. there's stuff I can afford. I'm making better money than I did in my 20s. Like, okay, it sucks but I can pay $215 for my thyroid test at the end of the day. But I don't want to. It sucks and it's not fair. I shouldn't have to. And like it's $215 now and then how much later. It's not sustainable at all. And if there's a way for them to cover it and not discriminate against me for being fat, it's behind so many barriers of me trying not to cry my eyes out on the phone and tbh I don't see it happening LOL.

but elon is on track to become the first trillionaire and our taxes are bombing children in tents, cool cool cool

I just don't understand who the fuck this is even for. WHO is out there with $2,000 to drop every month on physical therapy. Who is this for!!! WHO IS IT FOR!!!!

[cottoncandysecretlair]

If this is such a free fucking country, why the fuck can't we apply informed consent to more things? Why the fuck do I have to beg a doctor and convince him I'm not insane just to get a medication that has a chance at helping me?

Like. I have PCOS. Spironolactone is prescribed for PCOS symptoms caused by androgens, like hair loss, hirsutism, and acne. I have PCOS and I have those symptoms. So why the fuck do I have to debate my doctor into offering it because "Oh but have you tried to lose weight? Here's nutrition guidelines, ask me again in a few months."

Like yeah. Medications have fucking risks. The estrogen in my fucking birth control puts me at a higher risk of stroke and raises my blood pressure, but going on the med that can balance my hormones and lower my blood pressure? Oooooh we gotta think about that.

And what about diagnostic shit too! Not even just medicines! Like yeah I get that you can't give an exploratory major surgery every time someone fucking asks, but why the hell can't I just walk up and just ask for an MRI scan? Or an x-ray? Fucking ultrasound? We gotta have daddy doctor's permission just to CHECK?

And what about fucking CPAP machines? My partner has sleep apnea and it's horrific to learn. You basically have to pay out of pocket for the fucking things even with insurance, but YOU HAVE TO GET A PRESCRIPTION. Okay listen. No one is going to be fucking harmed if they use a machine to help them breathe better at night, even if they don't need it like what the fuck is it gonna do that's a problem?

The claim there is "Oh but you want to be sure you get the right one because some people need extra features" and all I can think is like. Is it BETTER for someone with sleep apnea to have NOTHING AT ALL? That's like denying someone a basic rescue inhaler when there's a formulation that works better, like maybe it's best they DON'T choke.

I just. Idk. I'm not anti medical or anti science. I'm just fucking chronically ill and tired, and there's no help out there. I'm tired of having to deal with doctors making decisions that involve leaving me to suffer when I can't do anything about it.

Like. The main barrier to treatment for my longest term condition is a fucking diagnostic test. I have a muscle condition that makes it impossible for me as is, and physical therapy confirmed it was likely worsened by the pain and inflammation, and the muscle work alone wouldn't fix it.

And they could accommodate me. I've met so many people shocked that they won't, because they were accommodated. A muscle relaxer, a xanax, topical numbing, laughing gas, even putting me under are all options that others in my position have been offered. And I get denied any of those options because "it's not standard" and "you need to suck it up" over involuntary muscle spasms...

I don't care about fucking risks anymore, because is it really any less of a risk to live in pain, feel my body weaken from fatigue and dysfunction, all while there's something in my body actively causing harm to me and I have no way of even knowing how far it's spread, how serious it is, if it's harming my internal organs, anything...

Why the fuck can't I just sign a form saying I understand all the risks and then just ask for what I fucking need? I don't want to sound like I have a big head, but I've never been wrong about this shit. Every fucking issue or problem I spent years trying to convince doctors to listen and look into my concerns, and consistently when they eventually finally do, I turn out to be right. I hate it.