#like i have almost the exact same level of feeling and familiarity toward everybody so far and insight into them as characters etc

[13eyond13]

.

[piercethelenn]

Track two — At the Bus Stop.

Warnings: Mentions of stalking, Y/N is low-key insane and Heeseung is mean(?), light swearing. || Word count: 1250

ㅤ

The term “guilty pleasures” might sound familiar to you, everybody has at least one after all, even if they seem insignificant enough to be overlooked at first, until the moment when you start to question whether other people will be able to understand your attraction towards them. For Y/N’s case though, denominating it a “guilty addiction” felt more adequate, as it had become vital for her, to the point where her attachment was able to influence her in levels that a normal and healthy “liking” would never. Her days were tinted in a gloomy grayscale until the very moment she was able to satisfy her needs; however, it was not possible to do so every day, and the absence of her daily dose caused a painful feeling of abstinence that exponentially impacted her mood in a negative way.

Well, I might be over-exaggerating the issue, but what I’m trying to say is that Y/N really, really liked Lee Seokmin’s voice.

It all started at the beginning of the semester, when our main character left her parent's house behind and moved to a different city in order to finally attend her desired college to pursue music. She had always hated the feeling of being lost in an unfamiliar place, so the first thing she did after the last box of her belongings had been unpacked, was to explore her new surroundings. Off she was, heading to nowhere in particular on a busy morning; coming from the small, quiet town her family had resided in since forever, she felt both amazed and slightly bothered by the fuss.

At some point, a few blocks away from her place, she stopped on her tracks under the shadow of a particularly big tree to check the map on her phone, in search of places of interest near her current location. She could have missed it, given the loud roaring of the car’s engines and her own focus on the screen of her device, but she heard it loud and clear: a honey-like voice that flooded out of an open window she was standing near to.

As if under a spell, Y/N unconsciously blocked her phone and returned it into her pocket, gazing at the exposed brick walls of the house that stood before her. It felt like love at first-hear, dramatic as it sounded; she had never heard a voice so pretty, enough to dethrone the white noise of her mother’s windchimer as her favorite sound.

Coincidentally, a few days after her first encounter with the anonymous singer, she found out that her new workmate Lee Seokmin, vocal coach of the STV academy, lived in the exact same house. When Y/N started some small talk with him on her first day at work, she admitted being new in the city and living alone, so he, as the gentleman he was, gave her his address and contact number in case she had an emergency someday.

At first it had been difficult for Y/N to connect both voices to the same person, because during lessons, Seokmin’s voice sounded more clear and slightly high-pitched in comparison to the one she heard coming out of the window that day. She was not an expert, since singing was not her area of interest in the music field, but she adjudicated Seokmin’s sleepiness in the early morning as the reason why his voice sounded different.

Of course she liked every facet of Seokmin’s angel-like vocals, but she could not help but have a slight preference in his raspy and deep tone; it just felt so much more intimate, she could almost visualize herself sitting on the kitchen counter, comfortably dressed in her favorite pajamas, admiring the man’s look of I-just-woke-up in all its splendor and natural beauty as he made breakfast for the two.

However, she could only dream of her hormonal teenager fantasies, as if she had helplessly fallen into a parasocial relationship with a famous celebrity, because the sad reality was that Seokmin and Y/N were just co-workers, and he was totally unaware of the fact that she would walk every morning a few blocks more than necessary just to take the bus at a stop located close to his house, even if there was one literally in front of the apartment complex she now resided in with Yeojin, her best friend.

Y/N had committed the huge and seemingly irreversible mistake of telling her friends about her doings, earning a life-long teasing in return. Jay had been the only one who got worried, fearing that the pianist might become some sort of creepy stalker, but she assured him that there were no ill intentions behind her actions, all she did was walk past Seokmin’s house to hear him sing, there was no harm done, right? It is not as if she had tried to take a peek inside his house from the window or anything, she knew better than that.

Of course Jay had not been convinced in the slightest, but Y/N had fallen in too deep and there was no cure for her odd addiction. She could not help but come back for more, as if listening to the man’s voice was the only stimulus capable of making her hypothalamus go brrr and produce considerable amounts of dopamine.

(...)

一What do you want?一 Heeseung asked from inside his room, not bothering to open the door even after his older brother's knocking. He was too busy doing his eyeliner to get up from his desk anyways. ��If this is about your stupid academy, no thanks一 The loud music muffled his voice, but the tone of annoyance was clear enough for Seokmin to catch.

一Are you sure? It’s really fun, actually!一 The eldest of the siblings knew it was not worth trying, since talking to Heeseung was like talking to a wall, or a door in this particular case, but a part of him had hoped this time would be different. 一I just know the kids would love to meet such a talented vocalist like you!一. He now understood completely the way Anna felt in that one Frozen scene, it was not cool at all (pun intended).

The door suddenly swung open in a rather aggressive motion, making Seokmin take a step back and stare at his little brother in expectation. On his part, Heeseung simply narrowed his eyes and frowned at him 一As I told you the last time you asked, and the one before that, I don’t sing anymore一. He slammed the door in the older man’s face and turned up the volume of the speakers in his room; a clear sign to make Seokmin take his leave with a sigh of defeat.

It was not easy to deal with a grown-up college student who acted like a rebellious teenager, but the vocal instructor was blessed with the gift of unlimited patience, so he tried his best not to take his brother’s misconduct to heart. Regardless, he could not help but wonder at what exact point did things take the wrong turn; Why was Heeseung studying music if he rejected every opportunity given to him to expose his talents to the public? Was he not confident enough? And most importantly, what did Seokmin do to be treated so coldly by his own family?

As always, there was no result in pondering about those things, so he resigned, yet again, and walked down the stairs with heavy steps.

ㅤ

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[miss-smutty]

Immortal Chapter 3

A/N- My first OC and I'm super excited for it and this story! Hope you love her ☺️

Summary- Thor learns more about his mystery love interest

Word count- 1,952k

Pairing- Thor x OC

18+ Only!

Posted: 21st June 2021

Taglist:- @innerpaperexpertcloud @pandaxnienke @chickensarentcheap @longlostinanotherworld @mostly-marvel-musings @darklydeliciousdesires

Part 1. Part 2.

The last thing Aria remembered before her vision pooled with bright lights and stars, was a car heading straight towards her. She felt the impact, her body flown through the air and crashing back to the ground with a sickening thud. She expected to hear her bones fracture into pieces with the impact of the car, to see her life flash in front of her eyes as she floated through the air. The world around her paused, time going incredibly slow, the speed causing the wind to blow her hair around the curve of her jaw in slow motion. She'd expected to feel the rough tar of the road, peeling away her skin as she landed in a heap, to feel tiny fragments of gravel imbedded in her soft and malleable flesh.

When none of that came though, she wasn't overly surprised. Instead of feeling excruciating pain, she revelled in the feeling of flying, enjoying the moment while it lasted until she was pulled back to earth and ultimately, back to reality. The reality of knowing the look on people's faces as she stood unharmed after a brutal collision that should've left her for dead.

Aria kept her eyes screwed shut, willing herself to just disappear and not have to deal with the backlash. The accident drawing unwanted and dangerous attention to her, attention she'd worked so hard to avoid. I mean she'd run away from her Prince Charming just to avoid this sort of attention, it was kind of ironic really.

Aria slowly opened one of her eyes, her vision blurred and glassy, there were people around her. Lots of faces she didn't recognise, hazy shapes all merging together until her eyes settled on one familiar face. Thor.

His distinct features standing out through the obscurity of her vision. Piercing sky blue eyes shone brightly, until that was all she could see. Eyes so clear she could see straight into his soul, a soul so pure it made her eyes sting. Thor's story playing through her mind like a movie, she blinked repeatedly willing it to stop, wrinkling her eyes tightly shut again.

"Everybody move out of the way, give her space. MOVE!" Thor bellowed over Aria, the crowd dispersing at once with his all commanding tone. He crouched down beside her, giving her body the once over, gulping deeply at the feel of her curves under his touch. Shaking his head while trying to ignore the unwanted thoughts that so helplessly followed. Wondering morbidly if it would be the second and last time he would be able to feel that magnetic pull he felt when their bodies touched.

Aria's tense muscles relaxed at the feel of Thor's hands smoothing down her legs and arms, checking for broken bones he was never going to find. A gasp left her lips when he lifted her T-shirt up just above her belly button, his fingers prodding gently at the softness of her flesh. It took all she had not to giggle, as his fingers tickled against her bare midriff.

Thor continued kneeding his hands softly around her precious torso, more than sure he would find something life threatening. Knowing there was absolutely no way a Midgardian could escape a collision like that with absolutely no lasting scars. His brow furrowed with suprise at finding absolutely no broken bones. Not even one. Even more surprising he found no cuts or bruises, not even a graze.

Aria lay before him, a vision of perfectness, her dark as night hair blanketing her defined features. She bent her hour glass curves, bringing her knees up to her chest. Thor's eyes widened, drawn to the definition of her hips and the swell of her backside in the tight black jeans she wore. He reached forward to stroke the silky hair away from her face, anxious to see her flawless skin and the rosy pink flush of her cheeks.

Aria's eye's fluttered open when she felt Thor's cold fingers brush against her clammy cheek. She recognised the painful look of anguish in his expressive blue eyes, the worry set deep within them.

"I'm ok, help me up please." She stuttered, trying to raise her head from the ground, twisting her body around. Thor's arms immediately reached out, cushioning his large hand behind her head.

"I don't think that's wise, you've been flung about five metres down the street. You need medical assistance. How are you even…" 

"Thor I'm fine, just dizzy. Help me stand please." Aria stopped him mid-sentence, desperate to get out of there before the ambulances arrived, not knowing how she was meant to explain how she was completely fine after being hit by a fast moving car and thrown at speed for quite a distance. The car alone should've broken bones and left her with internal bleeding and that's before she shattered onto the ground five metres down the street. She shouldn't even be alive, never mind perfectly capable of walking away unharmed.

Thor gave in and helped her to her feet, hooking his arms underneath hers and pulling her up gently. Aria's legs buckled when she stood but Thor was there to catch her and hold her steady, the bulk of him stood behind her as he waited for her to find her feet. 

Shaking loose from his grasp, squirming free, she turned to bolt but not before his thick fingers wrapped around her wrist. Aria's heart sank when she realised she wasn't getting away from his restraint, not then and maybe not ever. Thor wasn't about to lose her again, not after she was nearly taken from him for good.

The crowd of people that had gathered around to witness the miracle, the deception of logic, begin whispering between themselves. Sounds of astonishment filled the air at the spectacle before them. Thor pulled Aria against his chest, wrapping his arms around her back in an embrace. The warmth of his body was comforting for her,

the familiarity of his heartbeat thrumming against her ear. The sounds around them melting away as they held each other on the sidewalk, as they became lost in each other once more they heard the faint signs of cheering.

Aria let herself smile, she let herself be happy in the moment if for only a minute before the cheering and whistling was drowned out by the sound of approaching sirens. Thor noticed the visible panic on her face as she pulled back from him, searching the streets for a place to hide. 

If he knew anything after seeing that look in her eyes, that terrible look of fear in her emerald green, Doe eyes, he knew he would do absolutely anything to protect her. Thor knew it the first time he ever laid eyes on Aria, he would always do everything within his power to keep her safe.

Without a moment's hesitation he pulled Aria by the hand, taking her with him as he ran down the street. Glancing at her through his peripheral and taking a moment to appreciate the sight of her next to him, the feel of her fingers wrapped tightly around his hand as she gave her trust to him. The wind blowing through her shoulder length hair as they ran and realising that he hadn't needed to slow his pace so she could keep up. She was running at the exact same speed as him, running along side him effortlessly as they dodged the obstacles in their paths. Aria was just as agile, just as strong and with the exact same level of reflexes as Thor.

If Aria wasn't in a state of panic she would have enjoyed the feeling of running alongside Thor, to finally not have to hold back any longer. It was a big deal for her to put her trust in anybody let alone somebody she had just met but she didn't have much choice. She needed to get out of there and fast. 

They turned the corner together, down a narrower street lined with trash cans and through an even smaller alley.

With no where else to go, they stopped at the end of the alleyway, a metal gate blocking their way. Closed in with no where to escape but luckily no one to escape from. Thor leant one hand against the sturdy gate, studying Aria closely. Waiting with bated breath to see whether she would need to catch her breath, instead she looked up at him bright eyed, crinkling her nose in the cutest way. Then he heard the most glorious sound he has ever heard, like sweet music to his ears. 

Aria couldn't help herself, she looked up at the god of Thunder, a look of confusion etched on his chiselled face and she laughed. Not a cute little girly giggle either but a full belly laugh, holding on to her knees as she struggled to breath through it. The truth was, she hadn't felt that exhilarated in years, running away from danger usually wasn't so exciting for her but having a tall, strong, literal God by her side made her feel invincible. Cheating death also added to the thrill, to that untouchable feeling. She knew it wouldn't last long, it never does, but she would enjoy it while it lasted.

"Why are you laughing?" Thor couldn't hide the amusement in his voice from the warm feeling it gave him seeing Aria laugh.

"The look on… People's faces." She struggled to get out between laughing. Her pink cheeks turning red, her head feeling light from lack of air. "On your face." Her chest rattled as she finally started calming down.

"Yes, although it wasn't funny at the time, I can see why it would make you laugh." He leaned his body against the gate. The sound making Aria jump, goosebumps travelling up her arms as her ears pricked, the laughter dissipated. 

"Relax, it's just me." He soothed, taking note of how easily she startled. Not only eyes like a doe but the behaviour too. "So you're unbreakable, you have no trouble keeping up with my speed and your stamina almost matches mine. That's without even mentioning the feeling I get when I'm near you." 

The uneasy feeling came, as she knew it would. She was deluded to think she would automatically begin to trust. To forget about the way people had used and hurt her in the past. So much so that she'd built a giant wall, locked her heart up and thrown away the key. Luckily Thor had his own hammer to knock down that wall and nothing would stop him finding that key.

"So what are you saying Thor?" She didn't hide the annoyance in her voice. Resting her back against the brick wall and slumping down to the ground.

"I want to get to know you, to figure out why we're quite clearly connected in some way. I don't even know your name?" 

"My name is Aria and I don't know what I am. I've spent my lifetime trying to figure it out. And I don't know, ok?" Aria sniffs.

"It's ok, I'm sorry I didn't mean to upset you Aria. What about your parents?" 

"I don't know my parents, they probably realised what a freak I am and sent me away." 

"I can help you." Thor pushes back from the gate and slides himself down next to her. "We're similar. And you can not deny the connection we have." He nudges her with his elbow, willing her to look at him just as the sound of footfall echoed down the alley towards them. They both turned their heads at the same time, in the direction of the noise. The footsteps drawing closer.

[tripleaxeldiaz]

maybe one day i’ll fly next to you

chapter 2/8

read on ao3

start from the beginning

Autumn Classic doesn’t mean anything, really — the USFSA won’t look at it when considering Olympic spots — but it’s Buck’s favorite competition of the year. It’s his first chance to see new programs, size up competition, gauge where he thinks he’ll be landing this season. It’s also the first buzz of nerves and adrenaline that he feels after six months of break, and it’s a high he keeps chasing all season.

It’s a long flight to Toronto plus time changes, so he’s exhausted by the time they get to the hotel. He blearily accepts his room key from Bobby as he heads to the elevator, leaning heavily against the wall on the short ride up. He’s already dreaming about falling into bed as he opens the door, expecting to see Chimney as usual, but instead sees Eddie, standing in the middle of the room, scrolling through his phone. He looks up as the door shuts behind Buck and gives him a small smile.

“I, uh, didn’t know which bed you wanted, so I figured I’d wait until you got here.”

Buck, brain still half-offline, just looks at him for a minute before saying, “You’re not Chimney.”

Eddie lets out a surprised laugh, “No, not last time I checked. Bobby said he volunteered to chaperone the Juniors floor so he gave him a single. Guess that means you’re stuck with me.”

Buck makes a mental note to hunt Chimney down in the morning, but right now all he wants to do is sleep so he’s at least somewhat rested for practice at the asscrack of dawn.

“This one’s fine,” he says, dropping his bag at the foot of the closest bed before belly flopping onto it. He already feels himself drifting off as Eddie rifles through his own bag.

“Mind if I shower first?” he asks. Buck waves him a “yes” without moving the rest of his body. He thinks he hears a snort before the bathroom door closes and the shower turns on. The drone of the water almost puts him to sleep again, but he gets up with a groan instead, propping himself against the headboard while he waits. He could just say fuck it and go right to bed, but he’s been in three different airports today and feels disgusting, and he’d rather not wake up at 4am to shower in the morning.

He’s scrolling through the schedule Bobby emailed, figuring out the absolute latest he can set his alarm for, when the bathroom door opens again, steam pouring into the room. Eddie emerges, towel wrapped around his waist, droplets of water still falling down his flushed chest and shoulders, and Buck feels like he swallowed his tongue. Because, yes, he might hate the guy, but he also has eyes. Eyes that are currently taking in miles of skin and lean muscle so perfect it looks like he’s carved out of marble. His back muscles ripple as he leans over to grab a shirt from his bag before going back into the bathroom, and Buck actually feels his mouth water. 

He hasn’t had sex in...a while. Two and a half seasons, to be exact. He hasn’t felt this attracted to someone so quickly in even longer. Since his leg healed, his sole focus has been skating — practicing day in and day out to get his jumps consistent, his skating skills back up to speed. And since he’s still having issues, he hasn’t even let sex or relationships cross his mind, didn’t want to lose focus. Apparently, he was a lot more focused than he thought he was, if it prevented him from noticing all this.

That lust — so intense he still feels it lingering in his gut — quickly turns into familiar irritation though, because of course, along with being a world class skater, Eddie also looks like a goddamn supermodel. Buck knows he’s no slouch himself, but this is a stupid new level. A distracting new level, and distractions are not something Buck needs right now.

Plus, he’d never sleep with Eddie anyway. He hates him.

The bathroom door opens again, and this time Eddie is, thankfully, fully clothed. “All yours,” he says, jerking his head toward the door as he sits down on his bed. 

Buck nods, quickly grabbing his things and shutting the door behind him. He turns the shower to cold and gets in immediately, the shock of it waking him up and burning any lasting arousal out of him. He closes his eyes, trying to forget Eddie’s everything and focus instead on the things he needs to work on at practice tomorrow, where he put his KT tape, literally anything else.

He’s better by the time he’s done, just at the usual baseline of annoyance he’s always at where Eddie’s concerned. Eddie’s still awake, TV quietly playing a rerun of some sitcom, when Buck comes back and falls into his bed. He ignores Eddie as much as he can as he texts Maddie and sets his alarm, though he swears he feels his eyes on him when he’s not looking. Exhaustion finally takes over as he turns off his lamp, and he’s asleep as soon as he flips to his side. 

He dreams he’s falling again, but this time, someone with golden skin and a blinding smile is falling with him.

~~~~~~~~~~

The first half of the week goes by in a blur — three days of wake up, skate, eat, skate, sleep, repeat — and before he knows it, it’s short program day. He wakes up to Eddie’s alarm — they had to be up at the same time anyway — and takes a minute to just lay in bed, feel the butterflies already forming in his stomach, excitement and anticipation lighting up every nerve ending.

Rooming with Eddie has been...not terrible, so far. He’s clean, quiet, doesn’t hog the bathroom. The second night, after long practices that left them physically drained but mentally wide awake, they even watched a movie together — some made-for-TV psychological thriller that started as background noise but quickly turned into them coming up with the most ridiculous ways for the movie to end, and Buck actually getting it right.

It’s...weird. Buck has spent most of the last year actively avoiding Eddie, but now that the cold shoulder he usually gives him has thawed out a little bit, it’s not so bad. He’s still irritatingly perfect on multiple fronts, but he can at least hold a conversation with him now.

They leave the room together, grabbing a quick breakfast at the hotel before heading to their last practice. It’s silent, each of them in their own heads about when they need to get ready, but it’s not awkward. Buck would almost call it comfortable.

The practice rink is as chaotic as expected by the time they arrive. All 15 competitors plus coaches and choreographers are there, most in the stands stretching and warming up, watching the first group run their programs on the ice. There’s a small group of reporters as well, snagging people when they can for quotes and comments. They scan the crowd for Bobby, finally see him waving from the spot he and Hen secured at the far end of the stands. They make their way across to them, smiling and waving at familiar faces as they go. It feels forced for Buck, at least — making nice despite the fact that they’re all secretly hoping everyone else will tear or bruise something bad enough that they’ll have to withdraw. Eddie, on the other hand, is genuinely warm to everyone, friendly slaps on backs and laughs at jokes that don’t have a hint of fakeness. He’s nice, even to people he has to know cheer a little bit every time he falls.

Buck resists the urge to roll his eyes, but just barely.

They finally make it to Bobby and Hen and start warming up. Buck takes real stock of the crowd now as he stretches his hamstrings, noting costumes, levels of panic he can see on faces, who’s skating to what music as it loops through the sound system. Overall, he feels good — at a smaller competition like this, he’s usually one of the strongest technically and artistically, and this time feels no different. 

Their group gets called to the ice, and they each have one more chance to run through their program. Buck has two quads planned for his three required jumps, and he lands both of them cleanly and fully rotated. It’s still ambitious, given his consistency — you never know what will happen in front of the judges — but as long as he stays out of his own way, out of his head, he’ll be just fine.

He hopes.

When their time is up, Buck packs his things up quickly, waving to Bobby, Hen, and Eddie as he hustles to the green room to drop off his stuff before heading to the main rink. The first group for the rhythm dance is just starting their warm-up as he finds May in the stands, sliding into the seat next to her. It’s not often that their segments are spread out enough that they can all watch each other compete, but Buck and May always take full advantage to cheer on Maddie and Chim and judge everybody else.

“Did I miss anything?” he asks.

She shakes her head, eyes on the ice. “The Polish team almost collided with one of the Canadian teams, but it looked like an accident.”

“I don’t know, those Canadians love to cut it close during warm-ups, they think it scares the other teams.” 

“They tried it at Worlds and got yelled at pretty bad, I don’t think they’d try it again so soon.” Buck whips his head over just as Eddie sits down on his other side, like he’s part of their little cheer squad too. 

“What are you doing here?” Buck asks, tone a little more accusatory than he wanted.

Eddie just shrugs. “I usually stand in the back and watch, but I saw you guys and figured I’d join,” he says, meeting Buck’s eye. “If that’s okay with you?”

May elbows Buck in the ribs as she turns to Eddie herself. “Of course it’s okay, as long as you tell me everything that went down with that team at Worlds.”

Eddie smiles as he launches into the story. It takes Buck’s brain a minute to catch up with Eddie being sociable and funny, not hiding in the green room and ignoring everyone like he always assumed he did. They all fall into an easy banter as the first team begins their program, and by the end of the first group, they’re having to stifle their laughter and commentary as the people around them shoot dirty looks their way. 

Their cheers are the loudest when Chim and Maddie are announced during the warm-up, and again when they start their program. Buck loves watching Maddie skate — she’s the reason he got into the sport in the first place, and the way she looks so graceful and effortless is something he never gets tired of seeing. Their tango is smoldering, easily covering the ice and drawing the audience in, and their group isn’t the only one giving a standing ovation at the end. They take first place by a good margin, Buck and Eddie letting out matching wolf whistles as their scores are announced. 

Buck never would have imagined being here, cheering on his sister with the guy he’s hated for longer than he can remember, but now that he is here, it’s...nice. Much nicer than he expected. He actually likes hearing Eddie’s opinions on lifts and spins, likes hearing him laugh at his jokes, likes the feeling of their arms brushing against each other in the cramped stadium seating…

Yeah. Nice. Weird and a complete upset of his world view up until the beginning of the week, but nice nonetheless.

~~~~~~~~~~

He may be sitting in the kiss and cry, but Buck still feels like he’s flying. He landed both quads, including his quad loop which is chronically underrotated, and nailed every step and spin. The audience was thunderous when he finished, and he almost wanted to cry because it really felt like the beginning —  the beginning of his redemption, the beginning of chiseling his name into the record books, the beginning of finally achieving everything he’d dreamed of.

He is, of course, miles and miles ahead of himself, but that doesn’t stop an ember of hope glowing brightly in his mind as he gets his score — first place, 20 points above second. Bobby squeezes his shoulders, shaking them in excitement, and he stands and waves to the crowd. They’re just making their way to the green room as Eddie’s name is announced, and rather than avoiding watching himself get knocked to second, he stops just outside the exit and turns back towards the ice.

He’s seen Eddie’s short a million times in practice — usually watching against his better judgement to see if he screws up — but watching it in full in a competition is a completely different experience. The opening notes to “Dust in the Wind” start playing, and Buck watches Eddie’s whole demeanor change, swears he sees his mind locking into all he has to accomplish in the next two minutes and 40 seconds. Pundits always describe his skating as “classic but refreshing”, and Buck is more than inclined to agree. Eddie possesses all the charm and grace of old school skaters, but manages to put his own spin on it, making it feel like something no one’s ever done before. Buck’s a little in awe, if he’s honest, and watching Eddie’s nearly perfect program this time doesn’t fill him with the usual annoyance or ill-placed rage, it makes him feel...something. He can’t quite put a name on it, but he knows it’s a good feeling.

He’s inclined to blame that on the high he’s still feeling from his own skate, but part of him also knows that that’s not the case.

Eddie does knock him into second, but only by five points. There’s a pang of bitterness, but it’s dull, because five points is nothing. Five points is one perfect jump, one spin combo, one seamless step sequence. It’s not insurmountable. And even if the gap were bigger, Buck would be hard pressed to find any flaws in Eddie’s program anyway.

The pundits don’t lie. He’s incredible. And maybe Buck is starting to appreciate it.

The rest of the day passes in snapshots: pressers, watching May win gold in the ladies’ event, dinner with the team that was overflowing with excitement tinged with nerves about free skates the next day. He’s asleep as soon as his head hits the pillow, distinctly not thinking about how he and Eddie sat shoulder to knee at dinner, or how Eddie’s eyes glowed almost golden in the low lighting of the restaurant, or how crushed he might be if he doesn’t win tomorrow.

~~~~~~~~~~

Buck’s skating last, which means he’s going to be nauseous for the next two hours while he watches everyone else go. He considers just putting his headphones on and ignoring everything, going in blind to the scores, but he can’t. He has to know where he stands, his margin for error, how much perfection is needed.

He alternates between watching the first group on the TVs in the green room and going through every possible scenario of him screwing up and how he’ll fix it mid skate. Eventually, he’s just picturing himself falling on every jump, over and over, placing last and going home a loser before the season even officially starts.

He’s not sure if it’s doing more harm than good, preparing him for success or failure, but they’re announcing the second warm up group, so it looks like he’s about to find out.

Eddie goes right before him, because the universe really wanted to test the strength of his stomach, apparently. Buck always loves “Hallelujah” programs, but Eddie’s is, of course, on a completely different level. He puts every emotion — the anguish, the uncertainty, the faint hope — into his movements, and it pulls at Buck’s heart so hard he’s afraid a blood vessel will snap. He’s so enthralled that he almost doesn’t notice that Eddie was supposed to do a quad toe on his last jumping pass.

But he doesn’t. 

He triples it, losing him five base points.

Buck feels bad (which is...new), but he also feels a surge of hope buzzing in every bone.

Does that make him a bad person?

He doesn’t have time to process that as Eddie’s scores are announced and he moves into first place. He stands and waves at the crowd from the kiss and cry, smiling widely and looking genuinely pleased. Maybe he didn’t know he messed up? Maybe he’s still in blissful ignorance, will stay that way until he looks at his protocols? That’s the only thing that makes sense to Buck — he’s aware of every mistake as soon as it happens, and even minor ones send him right off the rails, no amount of points able to bring him back for days.

There’s a hand on his shoulder, squeezing as it passes. He meets Eddie’s eyes, and that genuine smile is still there, directed him now.

“Good luck out there,” Eddie says, and Buck blames the flutter in his heart and flush on his cheeks purely on adrenaline and nerves.

The audience cheers as he skates to center ice, and he sees Maddie and Chim, still wearing their silver medals, near the top of the stands. He takes a deep breath as he stands in his opening pose, letting the crowd, the noise, the worry, everything wash away. This is all that matters, these next four minutes that could define the rest of his season, the rest of his path to the Olympic podium. Maybe it’s too much pressure for a preseason competition, but Buck’s been fighting for it, clawing his way through for the past four years, and a strong start is exactly what he needs to convince himself and every other coach, analyst, and skater, that he is here to win.

The music starts, and everything just clicks, like the notes are flowing through him while he moves, carrying him along. Every jump is clean and balanced, every spin is fast and poised. The music itself is about birds, flying through and away as quickly as they came, and that’s exactly how Buck feels. Like if he jumps high enough, he’ll float away like he does in his dreams, but this time, it’s not scary. There’s no jolts to his brain while he jumps, pulling him carelessly to the ground, and he takes every one with a bit of gratitude, knowing how easily he could second guess himself and make it all come crashing down around him, figuratively and literally. But there’s none of that today, just confidence and precision and joy that he only ever gets at moments like these. He still feels like he’s flying as he stops in his final pose, audience on their feet around him.

If he could, he’d bottle this sound and take it with him everywhere, have it follow him through Grand Prix, through Nats, all the way to Beijing. If this is the way the season is starting, he feels like he can’t go anywhere but up.

Or anywhere but down, a terrible voice whispers. Luckily, it’s drowned out with the crowd before it burrows too deep.

Bobby is all smiles when he comes off the ice, hugging him and slapping his back as they sit in the kiss and cry. He’s just catching his breath as they announce his score — first place, 9.5 points above Eddie. He wishes the gap had been a little bigger, but he’ll take what he can get. He waves at the crowd as they roar again, but he doesn’t have long to bask in it all before he’s whisked away for the medal ceremony.

It’s short, thankfully — no fanfare, just the president of Skate Canada and an ISU official handing out the flowers and medals. Buck skates out as his name is announced, taking his place on the highest podium between the bronze medalist from Japan and Eddie. Eddie beams at him, that same blindingly earnest smile, and Buck can’t help but smile back.

He gets a little misty when they play the national anthem. It’s not so much the song itself, but the accomplishment it represents, the fact that his blood, sweat, and tears were all for something. 

Eddie falls in step with him as they make their way to the presser, shoulders brushing in that casual way they’ve made a habit this past week. Buck doesn’t know if they’re friends just yet, isn’t sure if a week is long enough to shed a decade of bad feelings, but he does know that there’s something about Eddie that keeps drawing him in, makes him want to dig past the annoyingly perfect exterior and figure out what’s going on inside. Is he always this positive and friendly? What makes him snap? He’s spent years trying to think as little about Eddie as possible, but it’s been harder and harder to do, and Buck doesn’t really want to fight it anymore. It was taking up too much energy, and he has bigger things to worry about.

“Congrats, man, you looked great out there,” Eddie says, squeezing his shoulder again. This time, Buck squeezes back.

“Thanks, so did you. Your triple axel was so perfect it literally looked computer generated.” Eddie laughs, sharp and bright, and something in Buck wants to keep hearing that sound as often as he can.

There aren’t many reporters, but they ask all the same questions — how did they feel about their performance, what are they looking to improve, how do they feel about the other competitors, blah blah blah. As they’re given the two minute warning, the last reporter stands, pointing her microphone towards Buck.

“Evan, you really started this season with a bang. Do you think you’ll be able to keep coming out on top?”

Yes, he thinks automatically. I can and I will.

Maybe, says the whisper again, or maybe you won’t.

“Anything could happen,” he says, a phrase he has a feeling he’ll be repeating again and again, “but I’ll keep fighting no matter what.”

[beauregardlionett]

various storms and saints

AO3 Link

The deck was essentially saturated from the storm brewing steadily fiercer around them. Beau had parted ways with Caduceus just before the skies had opened up in torrential downpour, and she was distinctly relieved to not have to smell his wet fur. She loved the dude, but after the day they had had, that was the last thing Beau wanted to experience.

Slightly hunched against the wind as she kept a firm grip on the wheel, Beau hoped that she was doing this right, hoped that she wouldn’t let Fjord down by steering them wrong in the rain and dark of night. She had been working hard at training to be his first mate and the last thing she wanted was to fuck up when he entrusted her so easily with the helm.

At some point though, the rain and wind become too much and she’s not sure where Orly came from, but the tortle lumbered to her side and took the wheel. Beau shouted over the rain and wind, asking if he needed her to stick around. But the old tortle simply waved her off and told her to stay dry below decks, that he would fetch her if he really needed her assistance.

Grateful for the reprieve, even if she felt like she was abandoning her post, Beau scurried carefully down the slick stairs to the main deck, aiming to get below as quickly as possible.

And really if she hadn’t been steeped with guilt, eyes flicking around to spot any crew members that might see her, Beau wouldn’t have noticed Caleb.

He was pressed underneath the overhang to the doors that lead into an above deck storeroom. His arms were wrapped around himself, bandaged fingers twisted into the worn fabric of his dirty coat and clinging with a tension that Beau could see even through the rain. His eyes were fixated on the middle distance, lost at sea among the turbulent waves.

She almost bypassed him, almost ducked below decks and left him there alone – but something stopped her. It sounded vaguely like Caduceus’ voice in the back of her head.

Ducking under the overhang beside the wizard – finding the space surprisingly dry – Beau gave Caleb a moment to notice her presence (which he did not do). Reaching out to carefully nudge his arm with her elbow, gentler with him than she would have been a few months ago, Beau flashed him an easy grin when bright blue eyes flicked her way as Caleb startled.

“Couldn’t sleep?” Beau offers neutrally. She doesn’t push it when Caleb nods wordlessly, his fingers trembling (not from the cold, she can tell) against his coat. They stare silently out at the rain hitting the deck, at the waves that try to climb up the sides of the ship and mount the deck, for what feels like a short infinity. Eventually, Beau’s clothes start to cling in a chilling and unpleasant way to her skin. She knows she needs to go sit by the fire and warm up, but she’s also reluctant to leave Caleb alone.

With a restrained sigh, Beau turns her gaze back the wizard’s way and offers, “I know where they keep the coffee down below.”

It’s not a question, and not quite an offer, but Caleb seems to understand the implications behind it. Beau is asking if he wants to join her, to get out of the cold, to maybe talk if they find enough stability against the tossing and turning deck. He looks back at her for a long moment and then nods decisively. They duck out from the overhang together and scurry through the slanting rain to get below decks. They walk at a more reasonable pace once they’re sheltered from the downpour, shoulder to shoulder, to the galley. Caleb’s slightly curled hair is dripping a little onto his coat’s lapels, but he seems distant and unbothered. Beau makes a mental note to make sure he sits beside her in front of the fire.

(She’s not sure who had the brilliantly stupid idea of putting a fireplace on a wooden ship, but it seems to be working for them so she’s not complaining.)

They arrive in the galley and Caleb suddenly seems to lose all sense of direction, freezing a few steps past the entrance, blue eyes wandering around the empty room. Beau slips her hand into the crook of his elbow and wraps careful fingers around his arm. He flinches slightly, like he forgot that she was there, but he doesn’t pull away. Beau takes that tiny victory as it comes and leads Caleb towards the fireplace, guiding him to sit about two feet away from the hearth, taking care to put his back to the fire. The last thing he needs right now is to stare into flames.

“Don’t move. I’ll be right back.” Beau doesn’t say this gently, because that’s not what Caleb needs right now. A gentle tone is not going to keep him grounded, and Beau’s never been good at comforting people, but she knows that a firm, quiet tone will be enough for Caleb to understand that her promise is good. She’s not leaving him alone.

He nods absently, already absorbed in the grain of the wooden floorboards in front of him, and Beau hesitates for only a heartbeat before striding off to make coffee. She is in no way a cook, but she’s self-sufficient enough to know how to brew a pot of coffee. They’ve been drinking Caduceus’ tea for so long that she’s a little worried about the very probable caffeine buzz they’re going to hit, but she also doesn’t really give two shits right now.

A few minutes later finds Beau pouring out two mugs of coffee, the steam curling lazily off the dark surface and the smell of roasted beans wafting heavily over Beau. It was oddly calming, and she felt some tension she hadn’t realized she’d been holding in her shoulders release. Carrying one in each hand back out to Caleb, Beau was both relieved and a little worried to find Caleb in the exact position she had left him.

Dropping gracefully down beside the wizard, the mugs barely sloshing at all, she all but shoved his into his face, Caleb startling slightly as the steam drifted across his cheeks. He looked to her with wide eyes for a brief second before looking back down at the mug and taking it with slightly shaky fingers from her hold.

Once her hand was free, Beau reached around to leave a careful pat on his shoulder, simultaneously testing the dampness of his coat and his level of tolerance for physical contact. The coat was already significantly drier thanks to his proximity to the fire (Beau herself could feel the pleasant heat crawling up the exposed skin of her back already). Caleb also flinched just slightly at Beau’s touch, but it seemed to be more a result of instinct than a genuine attempt to get away from her.

Either way, Beau withdrew her hand and wrapped her fingers around the warm ceramic of her mug. The heat of the coffee inside burned at her chilled fingertips a little, but it felt good, felt grounding.

Glancing from the corner of her eye at Caleb, she saw him staring again at the floor, entirely lost in the intricate swirling of the floorboards. She hated to think of him lost in a similar maze of his mind. And despite how much she would outwardly protest it, she and Caleb tended to have very similar trains of thought. Beau knew that she thought everyone hated her because she hated herself first. In the same vein, she knew Caleb was the same. They had conversed often enough for Beau to pick up on the intricacies of “Caleb-speak” and most of his little tells.

She wanted to reach out and say something, but every sentence starter that presented itself was far too coarse – even for their usual level of banter. Again – she was not good at comforting people. Beau was sharp edges and biting wit, forged from a childhood that taught her everything except kindness.

Caduceus’ voice was suddenly in the forefront of her mind, though; their conversation from earlier coming to a head.

We’re going to comfort everybody, we’re going to take care of ‘em, we’re gonna feed ‘em, and it’s going to be our job to feel good for them. They did good work, they just don’t believe it.

Her eyes flit to the mug in Caleb’s hands, and it wasn’t quite food, but it was warm and it was comfort. It was taking care of him. She hadn’t been lying to Caduceus before when she said she felt good after leaving the nightmare that was the Happy Fun Ball. She was comfortable and familiar with the fringes of disaster, chest deep in danger and fueled by the adrenaline of survival. But this…this aftermath in which she was the only one reveling in the ache of sore muscles and bruised knuckles and being alive while everyone else felt miserable – this was where she faltered.

This was where she ran out of words.

You did good.

More of Caduceus’ words, offering her a beginning to a conversation she had no roadmap through.

Bringing the mug of coffee to her lips, Beau stared out over the empty galley and spoke to the steaming surface of her coffee, words directed at Caleb.

“You did good, you know. In the Happy Fun Ball.”

Caleb was quiet for a few heartbeats before he shifted in Beau’s peripheral and muttered, “Do not lie to me, Beauregard.”

“Fine, you did a piss poor job in there.”

Seemingly startled by her abrupt change, Caleb turned his head to look at her fully, blinking and studying her profile like he was trying to figure her out. (Which was absurd because out of everyone in the Nein, he was the one that knew the most honest version of herself.)

“What?”

“That was a lie, man. You did do a good job. You protected us in that first chamber; you had our backs. You were cautious and explored as much as you possibly could in the study, and you got books out of there, right? That’s valuable shit between those pages I’ll bet. And Nott told me what happened after you guys got to the room with the dragon – after I left.”

Caleb visibly flinched at that, his bandaged fingers tightening noticeably around his mug as he averted his gaze from Beau. She didn’t know what he was expecting her to say, but he clearly thought she was disappointed in him or something.

“She said you left as soon as you could, that it looked like everyone else had cleared out of the room. Nott said you protected yourself.” At this point, Beau is looking directly at Caleb, and the wizard looks like he’s about to be sick right into his coffee mug.

“I’m glad you did.”

That’s clearly the exact opposite of what Caleb was prepared to hear, because he turns towards her sharply and opens his mouth as if to protest. She cuts him off before he gets the chance.

“I was the first to leave, you know.” He stops, stares at her. A hint of bitterness towards herself builds in Beau’s chest. “It was entirely unintentional, I just didn’t know how the sphere worked. I thought we would have to mess with it like we did to get in here. But the second I touched it, I was gone. I was giving Fjord shit for touching things recklessly and then went and did the exact same thing.

“And I know it’s not the same as what you think you did wrong, but I’m kicking myself a little for not staying longer and helping Jester out more. Whatever she isn’t telling us clearly fucked with her. But also, that dragon was no joke. I was pretty fucking useless seeing as I’m the only one in this group that doesn’t have magical powers. That dragon would have killed me. So in a twisted way, I’m glad I left when I did. And I think most of us are glad you took care of yourself and got out of there as soon as you could. No offense – because you’re pretty powerful – but that dragon would have ended you in one shot.”

Caleb seems stuck looking at Beau, his blue eyes frozen, locked on her features and she gets the distinct impression he’s searching every shift in her expression for some sign that she is lying. Beau stares evenly back at him, quelling the self-hatred in her chest because as much as she wishes she could have offered her friends more protection in there, that was a fucking dragon. And at the end of the day, she’s just a human with nothing but her fists and her staff.

And at the end of the day, Caleb is just a human who is remarkably easy to hit.

The silence stretches a little longer, and Beau works hard to not fidget, to not be the first to look away, because she wants Caleb to believe her. None of them begrudge him for leaving as quickly as he did. Hell, half of their party had already left by the time he did as far as Beau knows.

Caleb opens his mouth, looking like he’s about to argue before an expression of resigned exhaustion settles into the lines of his features.

“Thank you, Beauregard,” he all but whispers before listlessly lifting the coffee mug to his lips and finally drinking some.

Beau’s not quite sure it’s a victory, but she takes the point and shifts a little closer, pressing their knees together in the silence of the galley, the fire crackling and popping quietly behind them.

“You did good, too,” Caleb’s voice just barely registers with Beau he speaks so softly. When it does, she turns a quiet, slightly startled look his way and he clearly notices as the corner of his mouth quirks up with a tired lilt.

“I see you do good day after day,” he continues in that quiet tone, making Beau feel like something in her chest is tightening like she’s about to cry. “You should be proud.”

Beau fumbles for something to say for a moment before she just takes a big swig of her coffee and pretends that it doesn’t burn her tongue as badly as it actually does. She decides the safest thing to do instead of speaking around the lump in her throat is to just lean over and give Caleb’s shoulder a gentle shove with her own.

They’re silent as they finish off their coffee, the dulled sound of rain hitting the deck above their heads and the fire snapping behind them, but Beau knows he understands what the gesture meant.

Thank you.

[circuitlover]

Neon Genesis Evangelion: The End of Analysis

Is this a ridiculously naval-gazing post about Evangelion? Yes. Is it an accurate assessment of the franchise as a whole? I have no idea. I tackled this as an unknown initially, starting the series with zero contexts beyond the usual recommendation of “you should watch this.” Which is part of the reason why I’ve been a little hesitant about even broaching this subject to begin with. I’m so removed from the zeitgeist, both in terms of not being a regular anime viewer, as well as it being long past Evangelion’s relevance as a franchise, that it seems everybody already has their opinion on Evangelion all figured out. So at least indulge me, as I scramble around for something.

‘The End of Evangelion’ is a certainly a gratifying conclusion, as we finally get to see much of what was being concealed behind the veil (well, as much as one could reasonably hope for). It also reminds us of some long-standing questions. Why do the Evangelion possess such a bizarre tendency to be ill suited for battle? How do NERV’s continue to run unabated from governing bodies? What exactly is the mystery surrounding the origin of the ‘Geofront’? These were all broad strokes of why I felt unsatisfied by the original conclusion (the hastily arranged make good of the final few episodes of the series), and though I don’t expect every minor detail to be answered about such a multi-faceted world, I still feel these were questions pertinent enough to have been resolved in some fashion. Now I’m a little more aware of the troubled events leading up to that ending and it’s quite admirable that they managed to deliver something, despite the haphazard nature of those final two episodes.

 It’s clear that End of Evangelion intends to underline the original series from the start, dropping us back at the critical juncture where episode 24 had left us. Even if one could feasibly state that we reach the same point after the events of EOE, I’d argue that we inhabit a vastly different headspace by the time we reach it here. It’s not difficult to surmise what happens between the gaps left between the final two episodes, though everything is lent much more credence here, now that we are left to witness the macabre reality of what the entire series has been building towards. NERV headquarters is finally attacked by SEELE, and with this, we finally see the bloody climax. Now free to depict the attack in full detail, the opening half is certainly full of action and excess, though far from mindless, with only the most unflinching of viewers (or those divorced from its context) likely to derive any sort of baseless enjoyment from these scenes. The various lingering shots of deaths sit uncomfortably here, but nonetheless punctuate the finality of it all. If anyone could have accused the series of taking a wholly unexpected (and saccharine) turn towards it’s finale, then EOE is it’s biting rebuttal.  As cold as the NERV headquarters is, with almost everything bad that has occurred almost exclusively originating from within it’s walls, it’s still disconcerting to see such a familiar setting being callously destroyed in a matter of minutes, along with it’s inhabitants. The conflict has essentially existed as a faceless one; both the audience and Evangelion’s protagonists seldom knew what they’re truly been up against. It’s a war being played out by the pawns, and here we see the severity first-hand.

 As their headquarters are crumbling, so are the pilots. Shinji is in no fit state, evidenced by his own bemusement over his actions towards a comatose Asuka. It may be shocking, and his actions are far from admirable, but given the context, it’s hardly surprising. After all, his confidence had been built up; only to be meticulously broken the instant Kaworu reared his head. This compounded with his earlier apprehensions after Toji’s departure, his various disingenuous, failed, and otherwise doomed relationships leaves his mental state in tatters. I personally don’t like Shinji, but then again, it’s quite clear to see that you’re not really supposed to. Even without Hideki Anno’s spiteful intent of wanting to deconstruct the typical shonen hero propelling Shinji’s arc, it’s quite safe to assume that anyone who had any lingering empathy for Shinji will almost certainly have abandoned such notions at this point. The Shinji we were first introduced to, awkward, unlikeable, with an overriding sense of hate and self-loathing, has now given way to complete apathy. “I’m so fucked up” seems to ring more an acknowledgement, than it does a realization.

 Like Shinji, Asuka too has succumbed to her trauma, but on a much more literal scale, being broken in both mind and body. They are two characters that are seemingly analogous to one another. But again, first appearances can be deceiving, as by the point of Asuka’s introduction, we are already keenly aware of Shinji’s nature. He openly laments his position; Meanwhile, Asuka is brash and outspoken, embracing her identity as a designated hero, rather than cowering behind it. How they choose to define themselves is different, but the underlying reasons are gradually revealed to quite similar. Both driven by an inherent self-loathing, we witness the pair at varying levels of despondency, though rarely at the same time. In fact, for as consistent as emotional turmoil is through NGE, it is rarely overt, leaving most characters to wallow in their own abject misery. Almost everything operates on a certain level on duplicity, some of which, admittedly, isn’t apparent upon first viewing.

 Rei is ostensibly disconnected from the very beginning, though that makes the act of attempting to interpret the character, quite difficult. Very little is revealed about her, and most of the development is concerned with what she is, rather than what she does. Her role is pivotal to the overall narrative, and the themes being explored, as she is, by design, a doll that emotes. Which I guess is where her appeal lies. The mystery intrinsic to the character is never completely done away with, even at the very end. And the case could be made if the third incarnation of ‘Rei’ is even the same character that we’d become accustomed to, as her eventual rejection of instrumentality is a stark contrast to the cold pragmatist that bookended the TV series.

 The (quite literal) congratulatory nature of the series conclusion was always conspicuous in its inclusion. Evangelion had never been a work that had an interest in servicing its audience, at least in terms of a ‘happy’ ending. Which isn’t to say that wasn’t a possibility, but the tonal dissonance in which it was delivered never quite rang true. As an audience, we were conditioned to cautiously enjoy any brief respites afforded to our characters, as more often than not, it was simply a prelude to the turmoil that was soon to be heaped upon them. All of which (keeping with tradition), means the course correcting of EOE ups the stakes by an order of magnitude. The imminent attack is at the worst possible time, with each pilot being indisposed. The first big sequence, the assault on NERV, is a veritable massacre. Everyone’s fates are conclusively played out, whilst the Evangelion units become the focal point. 01 is promptly captured, whilst 02 (along with Asuka) is sunk to the bottom of the lake. This leaves Misato to attempt to galvanize an unstable Shinji. It’s kind of galling to see Shinji act so despondently in the face of her imminent death, though his selfishness probably obscures that fact until it’s too late. For me, Katsuragi is probably the most well meaning of the entire cast, but tragically, is someone woefully inept of providing the emotional support that others around her need. Her own weaknesses are clear to see, and although many of her problems are often emphasized for comic affect, she is still one of the few who straddles the line between her duties and profession life, perhaps the most convincingly. Like most other characters, she serves as juxtaposition to Shinji’s own conflict, and highlights how everyone is dealing with their own issues, just with varying levels of inadequacy. Her final actions echo her previous (failed) attempt at comforting Shinji, with her own loneliness giving way to fleeting intimacy.

Everything hits a crescendo once the Evangelion finally make their appearance, quite literally. Asuka awakens, and with it, her centrepiece battle takes place. I’m sure that it isn’t really something that I need to go into exacting detail about, because the following scene is enduring all by itself. Though it is notable as a culmination of the various elements all coming together; music, animation, along with the story. This is where EOE leverage’s its theatrical status for all its worth, eschewing the patchwork TV production in favour of something grander.  The actions scenes are often impressive and horrifying in equal measure, and there is probably no greater proof than here. Asuka’s death is certainly disturbing, and much of that is down to how they chose to portray that violence. For me, it recalled earlier moments, where the eldritch abomination like nature of the Evangelion had been evoked. These moments give the audience a brief pause for thought, where much is suggested of how horrifying their (The Evangelion) unshackled nature truly is. The unease, which these moments produce, suggests that something is terribly untoward. Most of which is conveyed in how we (the audience) see others react, gleaning what we can from cutaway shots of onlookers recoiling in horror. If recollections of Unit O1’s previous ‘feast’ already served to perturb, then this surely toys with our imagination yet further. We only see Unit 02 itself being devoured, and now knowing what we do about the distinctly human aspect of the Evangelion, the horror of Asuka’s fate here, trapped inside, now inhabits an altogether more unsettling space. The series ending, try as I might to appreciate it, was never going to suffice. It was nice to see Shinji’s own paradigm being settled, but I felt like it would have been more effective with a little more of that ambiguity stripped away. For as much as Neon Genesis Evangelion likes to steep itself in duplicity, this is where it’s felt like it was something of a compromise. The inner turmoil was my key takeaway from the work as a whole; it forms the crux of every relationship, and dictates the course of every action. It’s a lonely show, something that if not apparent from the get-go, slowly permeates throughout the narrative. Shinji is an initially an awkward character to relate to, bumbling his way through his scenes, though much of this weak nature is revealed to be a product of his environment. The world in which this all takes place is irreparably damaged, and even if the true extent of the second impact isn’t made expressly clear, it becomes quite apparent that humanity lives on in its own self-inflicted dystopia. It is this inherent contradiction that defines nearly every relationship, as each is unwilling (or unable) to acknowledge their true feelings. It is ultimately a self-destructive existence for the likes of Shinji, who permeates multiple meanings to his interactions with people, the paradoxical nature of which is explored in the conflict that defines the multiple endings and interpretations. Shinji is our proxy, but even so, it can be difficult to empathize with him. A hero he may be, but it’s more by designation than by design. It’s a role, which he consistently questions, as he exhibits almost none of the values we typically associate with someone tasked with such a mammoth task. He ostensibly comes of age throughout the series, gradually gaining some semblance of self-worth, though it a precarious act as he constantly seeks assurance from his father, and later anyone (which becomes something that Asuka resents him for). No character is treated like a proverbial puppet more than Shinji. In fact, it is SEELE themselves, who objective turns out to ultimately “break” Shinji, rendering his ego to naught. For all intents and purposes, it could be argued that the whole world is literally against him, at least by his own perceptions. His relationship is Asuka is extremely strained, initially showing hints of affection, with their hilariously depressing kiss encapsulates this dichotomy; Neither the circumstances (nor the characters) allowing for anything to take place. Even the slight reprieve offered in the finale (Asuka’s acknowledgement amidst the fallout) is obfuscated by the context in which it’s delivered.

Shinji’s journey dictates the ending, first, in the original series, where his perspective colours the ambiguity from which we see the fallout. Thematically this works (and I can see why some may prefer the agency it gives the audience), though I feel that the abstract nature of this ending, robs it of some emotional resonance. This conclusion is also hampered (at least for me) in how abrupt it is, with certain story threads left dangling. In my opinion, ‘End of Evangelion’ lives up to it’s billing as it gives a much more balanced and subjective conclusion, where we see first-hand “The Human Instrumentality Project” in effect. I was suitably invested to the point where I wished to see how the end was reached, and of course, see something that wasn’t cobbled together with recycled animation or slight of hand. I can certainly appreciate the original ending as a companion piece, which serves as a more personal and intimate resolution. But the fact remains, a lot of the fascination surely lays with how incomplete this all feels, with each finale, seemingly answering as many questions as they create. That said, I find that both endings offer up a surprisingly optimistic message. The original may be more overtly upbeat, but I think that EOE’s is lent more credence by virtue of the horror that precedes it. The life affirming message is delivered in the most tragic of circumstances, and I perhaps find that most heartening of all. By no means does ‘End of Evangelion’ end on a positive note, but I think it’s enough that it carries the promise of one. The somber sentiment may be more prevalent for some, though my rebuttal would point to the fact that, for as depraved and unethical the means may be, everyone ultimately wants to be happy. There is something to be said about the apparent theology that makes up a large part of Evangelion, and even if it has no real implication beyond the aesthetic (those initial warnings from long-time fans that, yes, a lot of the pseudo Christian imagery is window dressing at best. ), I still feel that its prominence casts a large shadow over proceedings. If nothing else, it certainly lends a morbid atmosphere to the show. When one starts to take this aspect into closer consideration, it’s easy to see why theory regarding Evangelion has become so prevalent. One of the constants throughout is the titular Evangelion. Though they remain a focal part, their function, both narratively and thematically, are constantly shifting. Initially agents of change, they are presented as a mysterious, if helpful force. Gradually this is peeled back, as various allusions are made to what they actually are. Throughout, we see how their pilots are affected by their experiences in their cockpits. Shinji is continually drawn and repulsed by the idea of piloting his Evangelion, seeing it as a means to forge something meaningful, whilst at the time, also aware of how dependant he becomes of his new role. Rei is driven by a sense of twisted duty, one that routinely sees her sacrificing herself (needlessly) for the cause. And Asuka perceives her role as raison d'être to obfuscate her own past, this being both a strength and a weakness. For better or worse, the Evangelion define them, and as the story progresses, we see that this takes on altogether more sinister connotations.  When viewed as an allegory, I think Evangelion holds multiple meanings, depending on what part is being referred to, or indeed who is viewing it. My initial impressions were pretty much taking it at face value, though I think the misdirection of the opening is a deliberate ploy for the most part. I’ve read that some take it as a deconstruction of the very genre it inhabits, though not having much experience with that myself, I choose to focus solely on the emotional aspects. Indeed, the psychological (and philosophical) strands become much more prominent as the series progresses, as it steadily veers into becoming a wholly oblique affair. Humanity may live on, but in spite of itself; something which is made abundantly clear, throughout.

Though its message initially seems quite muddled, I still feel it one that still manages to remain pertinent. I certainly can’t fault it for ambition. And there is something to be said about a piece of work that I simultaneously feel, is one of the most bleak and uplifting things I have witnessed, flawed or otherwise. I appreciate the themes that it chooses to explore. I like the characters, even in spite of everyone being contemptible in some glaring way. And in that respect, this series is nothing, if not a parade of characters struggling to deal with their emotions. But maybe that’s why I like it amidst all the abstract craziness; it retains a very human message.

[highestintentcoach-blog]

LIFE COACHING 101

What is a ”Life Coach” and why do I need one?

We all experience times when life seems too certain or too uncertain. We sometimes develop patterns that seem unbreakable. A life coach can help you to break those patterns by examining your 6 Human Needs, assessing your beliefs and honestly considering the decisions that you have made in the past and continue to make today. What decisions did you make early in life that have determined the path that your life has taken? Did you decide not to become like your parents or have you spent your life trying to seek their approval? Patterns such as these are not who we are but what we “do”. This knowledge can be used to help you to find your own power so that you can change the “stuck” that you are in. In doing so, you can have that happiness and joy that you crave and desire. A Life Coach will give you the tools that you need to make this happen for yourself.

What are some of the strategies that a life coach uses?

One of the major patterns that people get “stuck” in is the “Crazy 8” pattern (it resembles a figure 8). When a person feels a strong emotion, such as “sadness” and the person does not know what to do with this emotion they may quickly gravitate toward “anger”. Which side they gravitate to first depends on what that person values more. Take a look at yourself. When you are engaged in an argument with another person, do you feel an extreme emotion and then swing into another extreme emotion? It is human nature to move out of an extreme emotion after a period of time because the body and spirit need rest from the emotion. Have you ever noticed that when a person is crying, they eventually stop crying. If a person is angry, they will eventually stop being angry. If the problem that caused the extreme emotion is not dealt with then the swing from one to another will continue until the mind, body or spirit are exhausted. When a person falls into this dilemma, a Life Coach teaches that person to stop the addiction of Crazy 8 by redirecting the person. An example would be: A wife is angry with her husband. He doesn’t respond the way that she believes that he should to her anger. After a while, she moves to crying so that he will give her the attention that she believes that she needs. If that doesn’t work then she moves again to anger, and so on. A Life Coach would teach her that she can stop the craziness any time that she wants to by simply redirecting her own thinking and how she communicates her feelings to her husband. The way out of this craziness is UP! Life Coaches teach people to change their rules and their model of the world.

Another strategy of importance is “Learning to overcome self-sabotage”. How many times have you set a personal goal and did not complete the goal? Chances are that those situations are many rather than few. We can and do make lists for our personal goals, wishes, or desires. We dream of accomplishing something that we have always wanted to do. What stands in our way? The answer very often is self-sabotage. We allow our fears of success or failure get in the way of simply doing the next task that will lead us toward the goal we have set for ourselves. A way to redress this pattern is to change the way we look at our personal goals. If you have decided to go on a weight loss diet and have failed on that diet even once, this is why. You have made a decision to follow a program and to see it through. The diet gets boring and you lose heart. Soon enough you return to the exact same eating pattern. What if you didn’t diet? What if you simply started eating foods that are good for you in a balanced way? What if you just took a walk each day in order to be with nature and find some peace. The natural by-product of that way of eating and movement will produce weight loss. What diet?

Have you been afraid to express your thoughts, feelings and emotions for fear of being shunned? Do you keep a wall between yourself and others? All humans use defense mechanisms in order to preserve our inner world (our identity). We will do and say almost anything to protect that person within us. This is the very most private part of our nature. This is the space that we can say and think whatever we want to without any social consequences. This is the space that we really do tell our friend that she/he is being an idiot. Some of us have mastered the art of masking those thoughts and feelings so well that we have lost touch with what it feels like to actually take a risk and say what we think. We are hypnotized by societies rules and demands. Over time, the risk to step outside the box becomes seemingly insurmountable. The fear of feeling uncomfortable becomes so great that in order to survive, we decide to take that self we know and tuck him/her away. So what do you do about that? A Life Coach will teach you how to breakthrough that hypnosis and strive to be the person that you really do love deep inside of you. You know….the one that laughs at inappropriate times? We often hear people say this wonderful comment. “I cannot wait until I get old so that I can say whatever I want, to whomever I want and whenever I want. Everybody excuses old people!” Does this sound familiar to you? Who said you can’t do that now? Who made the rule that you can’t speak your mind until you are aged? We don’t deliberately hurt people but if someone feels hurt by what we say then usually that person is the one who needs to look at themselves and their reactions. Be honest with yourself and others by speaking your mind! Then you can hope to not only get back in touch with that person inside of you but you will find the joy in sharing him/her with those around you.

All problems are emotional! If a person changes an emotion, they change the problem! A Life Coach teaches that we can all overcome challenging emotions. Our emotions do not have to control us. We have the power to embrace and use those emotions for a greater good. Life Coaching provides many strategies and solutions to achieving that Highest Intent of joy, happiness and fulfillment. Coaches are the providers of the tools and you are the one that has the power to do the work! You can be empowered with the skills, ideas and strategies to make it easier to create change in your life. At the end of the journey you will know who you are, learn to help yourself, and help those you care about at every level of your being.

Kari Petruch is a Life Coach at Highest Intent Life Coaching in Georgetown, Texas and was trained by Tony Robbins and Cloe Madanes.She practices Strategic Intervention which targets people who need to find balance and strengthen their happiness skills.

[paleorecipecookbook]

RHR: How to Fight Practitioner Burnout with Dr. Akil Palanisamy

In this episode, we discuss:

Burnout among healthcare practitioners

How common the problem is

The results of widespread physician burnout

The difference between burnout and moral injury

How technology is contributing to the problem, not alleviating it

How to fight physician burnout

Show notes:

The Paleovedic Diet by Dr. Akil Palanisamy

The Sutter Health Institute for Health & Healing in San Francisco

Unconventional Medicine by Chris Kresser

1440 Multiversity retreat for healthcare professionals

Akil Palanisamy’s website, DoctorAkil.com

[smart_track_player url="https://ift.tt/2MsScI1" title="RHR - How to Fight Practitioner Burnout with Dr. Akil Palanisamy " artist="Chris Kresser" ]

Chris Kresser:  Hey, everybody, Chris Kresser here. Welcome to another episode of Revolution Health Radio. This week we’re going to be talking to Dr. Akil Palanisamy, who is a friend and colleague in the Functional Medicine space. And I’ve known him for several years. He is the author of The Paleovedic Diet, a really interesting book combining Paleo and Ayurveda, a traditional Indian medicine which is an interest of his. And he also runs the Paleo Symposium that’s put on by the Institute for Health & Healing at UCSF every year, that I’ve been a featured speaker at since it started.

But today actually, we’re going to be talking about something different, which is burnout amongst healthcare practitioners. It’s a really important topic that has pretty significant implications not only in terms of the effect on individual clinicians, but on patients and their access to care, things like medical errors and just the healthcare system overall.

So if you’re not familiar with Akil, he’s an integrative medicine physician who blends his medical training with Functional Medicine in Ayurveda, the traditional medicine of India. He studied biochemistry at Harvard and received his medical degree from UCSF and completed his residency at Stanford. Dr. Akil also completed a fellowship in integrative medicine with Dr. Andrew Weil at the University of Arizona. He sees patients at the Sutter Health Institute for Health & Healing in San Francisco, where he also serves as physician director for community education. He’s been a consultant with the medical board of California for many years and as I mentioned, he’s the author of The Paleovedic Diet: A Complete Program to Burn Fat, Increase Energy, and Reverse Disease.

So I’m really excited to dive into this conversation with Akil. I think you’ll find it interesting, even if you’re not a healthcare practitioner that’s experiencing burnout, because we talk about a lot of issues that are relevant to anybody doing any kind of work, really. So I hope you enjoy the conversation. Let’s dive in. Akil, thank you so much for joining us. I’m so glad to have you here.

Akil Palanisamy:  Thank you, Chris. Pleasure to be here.

Burnout among healthcare practitioners

Chris Kresser:  So today we’re going to talk about a really important topic that I don't think gets enough attention, and this is physician burnout. So, and I would extend it to burnout for any healthcare practitioners. We might be focusing a little bit on physicians because this is where most of the statistics are available, but it’s certainly a problem across the entire healthcare world whether we’re talking about:

Nurses

Nurse practitioners

Occupational therapists

Chiropractors

Acupuncturists

Anybody working in the care profession

In my book Unconventional Medicine, I talked a lot about how this is one of the major challenges within medicine in general, not just conventional medicine, but also integrative medicine and Functional Medicine. And it's something that we need to develop a sensible approach to if we’re going to meet our goals in terms of preventing and reversing disease. So this is something that Akil has thought deeply about and has been involved in a number of different initiatives from his work at Sutter to working with medical students and other physicians to address this problem. So I'm really looking forward to having this conversation. So why don’t we start a little bit with the stats on burnout, Akil?

Ask yourself: Does medicine still feel like your calling? If daily stress and exhaustion are turning you away from the profession, you might be headed toward physician burnout. Find out what causes burnout and learn how to rediscover your sense of purpose.

How common the problem is

Akil Palanisamy:  Sure, yeah, I think it's really rampant, and most studies report around 50 percent or higher of physicians report some significant burnout. And that's up from about 40 percent just five years ago. So, I think the numbers are really scary and also this is a global problem. So this is across the board. Many countries throughout the world and also regardless of the stage of training. So medical students, residents, physicians, even the number of years of practice has no impact.

Chris Kresser:  Wow.

Akil Palanisamy:  I will check on this number, so, I mean, I know because I did my medical training 20 years ago, and it was like, I would say, a soul-crushing and exhausting process.

Chris Kresser:  Right, right.

Akil Palanisamy:  So I started early in this topic, and that’s why I’m so passionate about it.

Chris Kresser:  Yeah, yeah. That’s really revealing in some ways. If medical students are as burned out as people who've been in the profession for 10 or 20 years, that's an indication that something’s already going wrong, even at that very early stage.

Akil Palanisamy:  Right. I came across a really fascinating study. They interviewed almost 3,000 medical students about burnout and 53 percent of them reported feeling burnt out. About 15 percent were depressed, about 5 percent had seriously considered suicide. But the interesting thing was 100 percent of the students, every single one reported feeling humiliated at some point, demeaned, disrespected as part of their training. And that had huge effects on their performance and judgment, and that was my experience too. It’s part of the culture of training doctors.

Chris Kresser:  It really is, isn’t it? It’s almost like fraternity hazing or something. I've heard for residents that it's … and it seems to be perpetuated for some of the same reasons, like this, “I went through this, so you have to go through it,” type of mentality. And I've even read the studies that support that.

Akil Palanisamy:  Yeah, right. When I started my residency, I was super thrilled because they had just passed a law limiting the work hours, continuous work hours to 24 hours in a row. That was like a huge drop.

Chris Kresser:  That’s a big development.

Akil Palanisamy:  And I was like, “Wow, this is fantastic. I only have to work 24 hours in a row, like, every week.” And people thought that would solve the problem of burnout. But it hasn’t because that’s just one of many factors.

The results of widespread physician burnout

Chris Kresser:  Right, and so we know that there’s a huge problem with the shortage of primary care physicians. I don't remember the exact number from the study I shared in my book, but it's something like, predicted to be a shortage of around 50,000 primary care providers by the year 2025, which is not very far off in the future. And yet one of the costs of burnout, as you said, is that two-thirds of physicians know a doctor who is likely to stop practicing medicine or at least to reduce their access to patients, switch to concierge model, or something like that within the next five years as a result of burnout. So this is a real problem that's really kind of having an outsize effect on our healthcare system.

Akil Palanisamy:  Yeah, absolutely. I mean, I think it is genuinely a public health crisis. And I think that that word is increasingly being used in the literature because this really does impact not just individual physicians but patients, healthcare organizations, the entire healthcare system in our country and other countries around the world. So I think the scope of the effects and the impact of burnout is being recognized now and it's huge in terms of not just the individual level, but medical errors as well. So, recent studies have shown that there’s a strong relationship between physician burnout and medical errors. And already medical errors are one of the major leading causes of death in the United States. And so I think as we get more burned out physicians and higher rates of medical errors, I think that's one of the big issues in terms of the costs of this problem.

Chris Kresser:  Yeah, this is critical, and I highlighted this in my book. But if you go to a site like CDC or a general website and you search for the top 10 causes of death, let’s see what happens if we do that right now. Cardiovascular disease is still holding at number one, and then you’ve got lung cancer or you’ve got other diseases that come shortly after that. The data is often changing. Cancer continues to go up the list. But you’re not going to see medical errors on these lists, right?

Akil Palanisamy:  Right.

Chris Kresser:  There was a study published in the British Medical Journal in 2016, just a couple of years ago, and then another one by Barbara Starfield, who’s since passed away, back in 2000 in JAMA. And both of those found the same thing, that medical errors are actually the third-leading cause of death. And since only 5 to 15 percent of the atherogenic events are even reported, Dr. Starfield actually speculated that medical errors could be the number one cause of death if all of the atherogenic events were reported. So this is something you don't see on the typical list, but that doesn't mean it's not true.

Akil Palanisamy:  Right, exactly. Yeah, because when you experience burnout, the impaired judgment, lack of attention to detail, communication breakdown, all the things, the depression, that just greatly increases the risk of medical errors.

Chris Kresser:  Right. So this is a, it's a common problem, it's a problem that has not only effects on individual practitioners and their health and their lifespan, their feelings about their work, but also to patients and their safety and their ability to get the care that they need, and then to society as a whole. The healthcare crisis continues to deepen, and we need more doctors, rather than fewer. The fact that 50 … that two-thirds of physicians know a doctor who’s likely to stop practicing medicine in five years is exactly the opposite direction that we need to be going in here.

The difference between burnout and moral injury

So let's talk … so, we’ve been throwing this term “burnout” around, and I'm sure that means different things to different people. But you actually emailed me before the show with a really interesting distinction that I want to highlight—the difference between burnout and moral injury. So can you talk about that a little bit?

Akil Palanisamy:  Yeah, absolutely. So traditionally, burnout is defined as a work-related syndrome characterized by emotional exhaustion, a cynical feeling, and feeling like you're ineffective on the job. But this concept of burnout really doesn't resonate with doctors. I can tell you from talking to many of them that they really don't connect with this concept of burnout because the problem is you're pointing the finger at doctors. And you’re saying, “You’re burned out, you need to start doing yoga and eat granola, and just like change your lifestyle.” But you know, these are some of the most resilient people out there.

Chris Kresser:  Absolutely.

Akil Palanisamy:  Medicine, I mean we’ve survived decades of intense training, sleep deprivation, the training process itself is incredibly stressful, the work demands. So these are some of the most resilient and resourceful people out there. And so I think the problem is really,  a big part of it is the system. But the distinction that you mentioned between moral injury and burnout, the concept of moral injury actually was first used to describe how soldiers responded to what they did during war and when they came back, having to do things that went against their morals.

In healthcare, it refers to physicians being unable to provide the high-quality care that they would really like to, essentially, not being able to be true to themselves. So I think the problem is not that physicians are burned out and so we don't care. The problem is that we care very deeply.

Chris Kresser:  Care too much.

Akil Palanisamy:  Yeah.

Chris Kresser:  Not too much, but it’s the care that’s causing the problem, yeah.

Akil Palanisamy:  Right and then as a result, in our current healthcare system, it's so hard to consistently meet patients’ needs and provide the kind of care that we envisioned we would going into medicine. Because most doctors think of medicine as a calling, and so that failure and inability to meet needs of patients in the way that we really envision, that is hugely damaging, and I think that has a huge effect on physician well-being. And so that's the concept of moral injury. So I think that it's really much broader than just pointing the finger at doctors.

Chris Kresser:  I think that’s really, really important to understand, and I've always made it clear that when I'm criticizing conventional medicine and its shortcomings, I'm not criticizing individual doctors. Of course, I might be criticizing some individual doctors, but not as a group because the vast majority of doctors that I have met are people that genuinely want to help their patients. They went into medicine for all the right reasons and they do recognize that they're not having the impact that they would like to have, and it's painful for them. But there's, they feel like their hands are tied because of the way that the system is set up. And they’re just as much victims of the system as the average patient is.

And I think this is a good example of how that plays out where we all want to have meaningful and rewarding work. We all want to get to the end of the day and feel like we really made a difference. And doctors, I think, especially. That's the path they chose. They didn't go into private equity. They didn't choose to go into a career that was really not about helping people, but more about making money or enriching their own lives. Not that there's necessarily anything wrong with that. They willingly chose to go through a very arduous path that involves many, many years of schooling and as you said, rigorous training with residency, working 24 hours straight, often graduating with hundreds of thousands of dollars of debt. I mean, it’s an enormous risk to take, an enormous amount of investment of money and time and energy to become a physician.

So you don't make it through that generally, unless you really have a guiding moral compass that is pushing you through it. And so it's really, I think, even more important and critical that we figure out a way to, where we create a path forward for doctors and other healthcare practitioners that really do want to have that feeling at the end of the day. Because that's the antidote to burnout, where when you really do feel like you're transforming the lives of the people that you're working with, and you're having a huge impact. Because in that situation it doesn't mean you won't get tired and it doesn't mean you won't occasionally feel, “Geez, I need a vacation.” But you're not going to have that moral injury, and that’s what makes all the difference in the world.

Akil Palanisamy:  Yeah, I know, exactly. And I think that the rates of suicide among physicians is a real wake-up call because it’s twice that of I think active duty military, and then there was a report from the UK that there was a young junior doctor who, she took her own life by walking into the sea.

Chris Kresser:  Yeah, that’s not, yeah.

Akil Palanisamy:  Statistically, women physicians are a significantly higher risk of completed suicide than matched females in other professions. So it’s not uncommon, unfortunately, and I think that, yeah, exactly what you said about that moral compass that physicians have, I think being able to feel like you're true to yourself. That's a basic need that all of us have, and I think especially those who go into medicine, we feel that pretty intensely.

How technology is contributing to the problem, not alleviating it

Chris Kresser:  Right. And there may be lots of choices every day that they have to make that are, don't feel true to themselves because of the way that the system is set up. And I know from my own research and I know you and I have talked about this, one of the influences in terms of burnout has been the rise of electronic medical records or electronic health records, EMRs and EHRs. Initially these were hailed as, that this is going to dramatically reduce the amount of paperwork that doctors would have to do and they were going to be great time-saving and productivity devices, and they were going to be doctors’ best friends. But the reality has not quite lived up to that, has it?

Akil Palanisamy:  No, no. Yeah, I would, I think that studies show that about like half of the average physician’s workday is spent entering data or doing other clerical work in the EHR. So the amount of time actually spent with patients is less than a third, and for me I think it's a bit of a double-edged sword. Because it does make it easier to respond to patient messages rather than playing phone tag with patients. But on a typical day, I might get 50 to 60 electronic messages in addition to charting visit notes for each patient, and each of these questions or patient calls, etc., requires some thought.

And increasingly we’re being measured on how quickly we can respond to these messages because the priority is patient satisfaction, and that's eventually going to be tied to financial compensation and that kind of thing. So I think this EHR, it takes up so much time, and it really hasn’t translated to the reduced workload and that sort of thing. And when we deal with insurance in my practice, I think that's a huge benefit for patients because it improves access, and for Functional Medicine and integrative medicine, I think we need to move in that direction where insurance covers services. And so we offer that, but then it creates a whole universe of responsibilities in terms of the paperwork, the criteria for each progress note when we’re billing insurance, the forms, the prior authorizations, the other kind of paperwork. So it just adds another layer of paperwork to everything else that we’re dealing with in terms of the EHR every day.

Chris Kresser:  Yes. And then there’s another issue of when you're actually in the room with the patient, that connection that you're trying to make with the patient is now being mediated by a computer screen and having to type into the computer. And we’ve all seen, I've heard many stories of people going to doctors and complaining that their doctor was hardly even looking at them because they were working on the computer the entire time, and this is especially true with younger doctors from what I've heard, who never operated without an EHR.

So they never had the experience of being in a visit with the patient without the computer being part of that. And I think with all the data that we now have in terms of how important the physician-patient relationship is to the outcomes in care and the research on the placebo effect, and just the, in Carl Rogers's words, the unconditional positive regard and the type of connection that is made just is therapeutic in its own right. And I think the EHR can compromise that in some ways.

Akil Palanisamy:  Yeah, absolutely. And I'm always torn because I want to maintain good eye contact and really be present with each patient, but then if I don’t touch the EHR at all, then at the end of the day I’m like, this one’s like …

Chris Kresser:  You’ve got eight more hours of work.

Akil Palanisamy:  Exactly.

Chris Kresser:  It’s really challenging, and, I mean, my solution to that, which is not possible for everybody because of the model I work independently, so I’m able to just kind of set things up how I want. But I have a nurse practitioner that's by my side at every appointment, and she takes the notes. So I'm able to just maintain eye contact with my patient and not really look at the computer. And I recognize that's not a viable solution for most practitioners, but it's something that I felt compelled to do because I, like you, didn't want to get home and do four hours of data entry into the EHR after a full day of seeing patients. And but I didn't also want to sacrifice the connection with the patient.

So I think the other thing that's also not always in an individual physician’s control is the quality of the EHR or the EMR system. So many of them are just completely bloated and full of functions that they'll never use, and just really difficult to navigate, and they’re a nightmare in terms of software development. They’ve been just sort of cobbled together and put on top of each other, and it’s, for anyone who likes software and technology, EMR software is not going to be particularly inspiring for the most part.

Akil Palanisamy:  Yes, yeah. No, I think you’re right on that. And the point about having additional support for progress notes, I think, is a good one because studies show that having some type of help with the charting actually reduces burnout, and it's obvious, right? And I think at Sutter Health where I work, they really take burnout quite seriously. And so they’ve supported having scribes, which is the same thing. They take notes and they kind of do everything, and you just have to sign the note.

So I think it’s really, it’s a shared issue with burnout between individuals and healthcare systems and organizations. So I think it’s very important that all of these systems realize they have an important role to play, and I think Sutter Health is a really great example of that. They've supported a lot of these changes, and like this example of scribes and with our EHR, which is Epic, just helping us to use it in the most efficient way possible. So I think systemic changes are really a huge part of the solution as well.

Chris Kresser:  Absolutely, and this is a recurring theme in this conversation. It's that individual physicians can only do so much when they're employed in a larger organization, and they’re not free to just do whatever they want. And so we have to continue to work to raise awareness institutionally about these issues so that the institutions themselves can make the changes, and then individual physicians will benefit from those.

Akil Palanisamy:  Right.

How to fight physician burnout

Chris Kresser:  So let's talk a little bit about some of the work you've done in the past with medical students and other doctors at Sutter on burnout. What kind of things have you done to approach this?

Akil Palanisamy:  Yeah, I think for me during medical school, it was really a survival mechanism. Because I was pretty burned out and the training, yes, I absolutely had that being belittled and demeaned when I was on the wards in my rotations. And so I really got interested in the certain classes that were offered on finding meaning in medicine and really connecting with your purpose or actually reconnecting with why you went into medicine, and keeping that front and center. And also developing tools for maintaining well-being like mindfulness.

So mindfulness is one thing that has been studied. There’s actually been about 14 studies looking at physician burnout and mindfulness, and nine of them have shown positive outcome in terms of:

Reducing burnout

Improving well-being

Improving mood

Improving resiliency

So I think, I don't think that's the entire solution, but the more tools you have in your toolkit, the better. And we don't really get any training in general in terms of how to deal with stress and how to manage emotions during our healthcare training. And so I think I got into mindfulness very early, studied MBSR, developed a daily meditation practice, became involved in educational programs teaching people about mindfulness. And then since … then during residency and now practice, after that I've been very interested in workshops and events that kind of focus on that aspect of meaning and really reconnecting with a sense of purpose, a sense of direction. Kind of helping people be true to themselves.

And so I think small group exercises and workshops where people are getting out of their left brain and reconnecting with their right brain, using art and things like that, have been really effective. So for me, I've benefited as much as I’ve helped anybody in this work, and it's been just partly for my own gains, but I think you teach what you have to learn. And for me, being involved in burnout and teaching people about it has been a lifesaver.

Chris Kresser:  That’s so great. I think all of those are fantastic tools for kind of exploring the causes of burnout on an individual level and helping people respond in a way that will reduce the risk of moral injury, if we will. And I know for me, one of the ways that I've approached this personally and also with people that I've worked with and that I’ve trained is just to make sure that I feel like the work I'm doing is having a big impact on my patient’s lives. Because that’s one of the reasons I really love that distinction that you make between burnout and moral injury. Because if I look at it that way, I think, “Okay, well, that's the biggest risk is just getting to the end of the day and feeling like I'm not making a difference. Feeling like all of my efforts are for naught really. Or they’re not really having the impact that I would like them to have.” And to me, that's the greatest risk in terms of burning out. When I know that my work is making a difference, my endurance and stamina are considerable.

Akil Palanisamy:  Right.

Use Functional Medicine to prevent it

Chris Kresser:  But when I don't feel that way, it doesn't take much to make me feel tired and like what I'm doing is not worth it. So this is, I think, where a Functional Medicine approach has a lot to offer, not just as a treatment modality, but as a means of really actually making a difference in the patients’ lives. Like getting to the root cause of the problem and actually addressing the problem and helping the patient to recover and feel better without the use of unnecessary drugs and surgery. For me that was one of the most appealing things about Functional Medicine, and I think it's one of the less talked about but most important gifts that it has to offer to individual physicians who shift their practice in that direction.

Akil Palanisamy:  Yeah, I think that's what motivated me to go into Functional Medicine as well, just to get that sense of fulfillment and satisfaction when you help someone really get a permanent solution to something and by uncovering the root causes and taking that holistic approach. So I think that's what drew me to Functional Medicine as well.

Schedule a retreat

Chris Kresser:  Absolutely. So another area where I know, or a kind of antidote to burnout that I know that you and I are both passionate about is a retreat. So I've been a big believer in retreat. I’ve done annual retreats myself for many years. I’ve done meditation retreats for about 25 years and I just can't really imagine my life without that opportunity to step away from my day-to-day life and experience and to get a different perspective, to slow down, to have more spacious existence for a few days were the busyness of life is not overtaking me and where I can just hear myself think and feel my body, and just look at things from a fresh perspective. It's just crucial for me. And I've always felt like my wish has been that others can experience this. That we can, because I really believe in its transformative power.

Connect with colleagues

Akil Palanisamy:  Yeah, absolutely. I do as well, and I’ve had a number of retreats over the years in terms of individual retreats and also group retreats. And especially in the professional setting, I find that ability to connect with other colleagues and professionals in that informal, nonwork setting is so powerful because in healthcare there's so much isolation. There are so many individual silos.

Everybody's just doing their thing trying to get through the day, and you rarely have a chance to step back and step out of that situation to just really deeply connect with people who are in the same boat and really understand what they're going through, share their story, listen to their stories, and really deepen your connection and solve problems together.

So I think that sort of deep connection is so important because that's like a huge need for all human beings, and especially in such an isolating profession like in healthcare. I think it's essential.

Chris Kresser:  Absolutely, yeah. So many clinicians can just spend, we spend most of our time in a room with patients and we’re interacting with patients, but we’re not, we’re interacting with them in a certain way. We’re playing a certain role. We’re the clinician, they’re the patient, and those can be rich and rewarding interactions. But it's not the same as connecting with other colleagues and being able to talk about the issues that we face professionally and share together. So yeah I think that group experience is really powerful. And I’ve been writing about this recently.

I’ve been sharing some book recommendations, and Akil and I have actually teamed up to offer a retreat for healthcare practitioners at 1440 Multiversity in October. It’s from October 5th to 7th this year. And so it starts on Friday afternoon, Friday evening, and it goes through Sunday midday. And the retreat’s called “From Burnout to Brilliance: Rediscover Your Passion and Purpose, Reclaim Your Health, and Create a Practice You Love.” So the intention of this retreat is to address the issues that we've been talking about in the show and to help healthcare professionals explore their own situation, help them rediscover their passion for medicine and healthcare, and reconnect with a sense of meaning and purpose in their work to take some practical steps. Break those down into really doable actionable steps that they can take to reclaim their health and well-being. Rediscover parts of themselves that are not typically expressed in the course of their day-to-day work and just kind of cultivate a sense of energy and vitality that they may have been missing for many years.

And I'm really excited about doing this. I’m excited about doing this with Akil, who I've known for several years now and I really respect, and I'm excited about doing it at 1440. It's an incredible new retreat center, which I think you did a retreat there with Michelle Tam with Nom Nom Paleo last year, Akil?

Akil Palanisamy:  Yes, yes beautiful, beautiful place. Yeah.

Chris Kresser:  So this is, and for those of you who are not familiar, it's in Santa Cruz Mountains, right?

Akil Palanisamy:  Yeah, it’s surrounded by redwood trees and there's all these amazing hiking trails. And yeah, a beautiful place.

Chris Kresser:  Yeah. I haven't actually been there yet, but I know several people who’ve taught there and who’ve been there. And if you go to 1440.org, click on the stay button and check out some of the pictures. It's an absolutely beautiful campus. Really nice accommodations, gorgeous dining hall with lots of different food options. They've got daily yoga classes and massage, and a spa and other health offerings there. And they’ve got, of course, gorgeous hiking trails because it's in the redwood forest there. It just looks to me like they're really doing it right. I've been to a lot of retreat centers. I actually lived at a retreat center in Big Sur called the Esalen Institute …

Akil Palanisamy:  Oh. sure.

Chris Kresser:  … and many people may be familiar with. When I was still really sick and dealing with my health issues, I got to a point where I just decided, I kind of reached the end of the line of supplements and diets, and medications, and I decided that I would explore the psychological, emotional, psycho-spiritual aspects of what was going on for me. So I moved to Esalen and lived there for a couple of years. So I'm very familiar with retreat centers. I've been to many others around the country, both for Buddhist meditation retreats and other retreats, and I have, they're all great in many ways. But they’re, I can see that 1440 is bringing it to a different level.

So I'm excited to be a part of that. I'm excited to get together with a group of professionals that are all wanting to cultivate more meaning in their work and to find that work/life balance that can be so elusive. And I just can't wait to get together and support each other and share because that's, I mean, we all have so much to offer, and I think when we come together with a similar purpose, it's really powerful.

Akil Palanisamy:  Yeah. I am also really excited about the upcoming event, and I think for anyone who feels like they're not being true to themselves in their work or as to themselves as they would want to be, I think this is a great opportunity to really reflect. And I think our vision for that weekend is that it's going to be a very introspective weekend and really focused in small groups and interactive elements. So it’s not going to be just mostly didactic.

Chris Kresser:  Yeah. It’s not going to be Akil and I standing in front of the room talking at you the whole time. Definitely going to be the opposite of that.

Akil Palanisamy:  Right, exactly, yeah. Because I think that this work is really about looking within and then sharing and connecting with other people. And so that's the focus of the weekend, is really building that sense of community with whoever comes and really learning to deepen your own sense of meaning and purpose in work, and look within to reconnect with that vision for what drew you to this work initially. Because I think that's the ultimate goal is having that feeling like you're really being true to yourself at the end of the day and having the kind of practice that you envision.

Don’t be afraid to make changes

Chris Kresser:  Absolutely. I shared the story of Sheri in my book Unconventional Medicine, who is a clinician that was working in the VA. And she's a doctor and was mostly seeing patients with diabetes. That's the most common health challenge for veterans. And it was, she was counting the days until retirement. It was just really a factory-medicine type of situation. She often didn’t even have time to go to the bathroom during the day because she was just that busy from appointment to appointment. And as we've discussed, there was a real risk of moral injury because she didn't feel like she was making a difference. She was just handing out medications to these people and she wasn't, she knew as an athlete herself who tried to pay attention to her diet, she knew that wasn’t the best way to go about it. But what else could she do in the amount of time that she had?

And she moved into kind of a more, started incorporating more of a functional approach in her work, and then eventually left and started her own Functional Medicine practice. But for her, it was just a total game changer. She went from counting the days to retirement, to not ever being able to imagine retiring. And that's the kind of shift that’s possible, I think, when you really address the root causes of burnout and take the opportunity to step out of your current system, your current day-to-day, and really give yourself the chance to discover something new. And even if that’s maybe moving in a different direction entirely, or maybe staying in your current situation but just making a series of small changes that collectively can have a big impact.

Akil Palanisamy:  Yeah, I think for me, my whole approach has been in terms of incremental change because I know that for many people, they have gone out of the insurance model and set up their own Functional Medicine practice, and that can be fantastic. But my work is really just building change within the system. Because if the people within the system leave and do their own thing, then the system itself is going to not be changed. And so I think that a big part of this is also figuring out solutions within systems and incremental steps we can take, and I think that'll hopefully be part of what we talk about as well. Just if you do belong to a system, how you can take a leadership role and effect change within that system as well.

Chris Kresser:  Absolutely. That's why Akil and I are a good team, because I’m outside the system and he’s inside of the system, and we have different perspectives. So that's another reason I'm happy to team up with him. I mentioned this in the beginning, but I'll throw it out there again. You need not be an MD to participate in this workshop. It's really for all healthcare practitioners and providers who are experiencing burnout. And so this could be anyone from a health coach to a nutritionist to a dietitian to an occupational therapist to a chiropractor, a naturopath in addition to MDs, and DOs, and MPs, and PAs, and all of the other abbreviations and acronyms. Anyone working in healthcare really would be welcome. And we’re not even limiting it to people working in healthcare. We don't want to exclude people here, so if you're not working in healthcare and the things we've been talking about resonate with you, maybe you work in emergency services or something else, you are absolutely welcome to come.

Akil Palanisamy:  Yeah, and I would add that even if you're not feeling burned out, I think that prevention is really the best medicine.

Chris Kresser:  That’s true.

Akil Palanisamy:  So I think learning about the research and the science, because we know how to prevent it, and it's much better to prevent burnout than treat it once it happens.

Chris Kresser:  That is a very good point. Yeah, and I guess if the statistics are any indication, we know that even if you’re not feeling burnout now, chances are statistically you will at some point.

Akil Palanisamy:  Right.

Chris Kresser:  Especially without any intervention. It’s kind of like the diabetes example I used before. If you’ve got high normal blood sugar, now’s the time to get it under control rather than waiting until it turns into diabetes.

Akil Palanisamy:  Right.

Chris Kresser:  Great, well, thank you so much, Akil, for being with us. It’s a fascinating and important topic, and I’m really looking forward to leading this workshop with you. Again, in the retreat, you can go to 1440, it’s 1-4-4-0 dot o-r-g, and when you get there on the website, you just hover over Learn, and then under programs click on Professional Development. And if you scroll down there, you’ll see our program, which, again, is on the first weekend of October, October 5th to 7th, it’s a Friday through a Sunday.

And there’s a tuition for the program, and then there’s several different accommodation options available there. It’s really neat. I like what they've done with that. Everything from a private room to a suite to a really cool bunk style, kind of modern bunk-style accommodation that's much more affordable. I don’t know if you saw those last time.

Akil Palanisamy:  I did, yeah.

Chris Kresser:  Check the pictures out, they look pretty cool. They call them pods.

Akil Palanisamy:  Right, yeah, yeah. They’re pretty comfy. I’ve seen them.

Chris Kresser:  Yeah, yeah, it looks great. So lots of different accommodation options. If you’ve never been to this part of the world, the Santa Cruz Mountains are a beautiful, beautiful area, gorgeous redwood forests. You can head down to the beach before or after in Santa Cruz there. It’s a funky, cool little town. Great, great part of the world. So I hope you can make it. Those of you who have been listening to this and resonating with it, we’d love to meet you in person and have a chance to explore these topics with you.

And then Akil, is also, we haven’t talked much about his other work, but he’s also an author in addition to being a clinician. And he organizes the Paleo Symposium every year that I've been fortunate enough to be a speaker at. So why don’t you tell everyone a little bit more about your work and where they can find out more about your work.

Akil Palanisamy:  Oh sure, yeah. So I practice integrative medicine and I combine Functional Medicine with the Paleo approach and Ayurveda, which is the traditional medicine of India. And still that has led to my book which is called The Paleovedic Diet, combining Paleo and Ayurvedic medicine. And the best way to connect with me would be through my website, which is DoctorAkil.com. Just doctor spelled out, A-k-i-l dot com. And yeah, I wanted to thank you, as well, Chris, for having me on the podcast. I’m very excited to be working on this event with you, and it was really a pleasure to talk today.

Chris Kresser:  Pleasure is mine, Akil. And I'm sure we’ll be in touch before October, but I look forward to seeing you then and anyone else who's listening, who wants to join us. So 1440.org, and thanks for listening, everybody. Keep sending your questions in. I know I haven’t answered many of them recently. We’ve been doing a lot more interviews lately. But I do see that I have a few Q&A episodes coming up, and we do read all of your questions, and we also consider them for writing articles or emails.

So even if we’re not able to answer them on the show, it helps me to understand what you're thinking about and what you want me to write about and talk about. So please do keep sending them in. That’s ChrisKresser.com/podcastquestion. And thanks, everyone, for listening. And thank you, Akil, and we’ll see you next time.

Akil Palanisamy:  Thank you, Chris.

The post RHR: How to Fight Practitioner Burnout with Dr. Akil Palanisamy appeared first on Chris Kresser.

Source: http://chriskresser.com August 23, 2018 at 02:07AM

[alia-turin]

Fic Title: Take It and Run [cowboy au] Chapter: 4. Prison Cell Previous Chapters:  Prologue | Chapter 1 | Chapter 2 |  Chapter 3 Rating: G (Warning: some swearing) Characters: Cor, Luche, Noctis, Glado, Ignis, Prompto, Tredd, Nyx, Luna, Ravus, Libertus, Crowe. Tagging: @birdsandivory @jojopitcher @lazarustrashpit @yourcoolfriendwithallthecandy @themissimmortal @kairakara101 @ladychocoberry @littlestfangirl @parjiljehavey

A note: So things will start picking up from now-ish. I had to add my OC Ada to the story, she doesn’t have much of a role and will just make a cameo here and there, I just needed some extra characters for extra drama. Also poor Nyx. 

“We need a fight.” Luche said as they were walking to the general store. “We need Nyx in a fight. Or something.”

“You will have better luck convincing Crowe to like men.” Tredd spat on the ground right in front of a well dressed man that was just passing. The man gave him angry look but as soon as he saw Tredd he decided it was better to walk away. “The man is not a saint he won’t just randomly jump someone.”

“If Nyx gets in a fight, the Marshal or the sheriff need to arrest him. Nyx stays in prison he has no idea his horse is missing.” Luche had another idea about Nyx, but that could wait. The horse was more important now. Part of him felt bad for using Nyx, they were friends after all and have been through a lot. Another part of him couldn’t stop thinking about getting his home back. “What happened with your rancher?”

“You wouldn’t believe it. So, I’m with this girl last night…” Tredd started.

“To the point I do not want to listen about your dick or any of her body parts. Or how she screamed your name.” Luche knew how that went and he had zero interest in it.

“You are terrible friend.” Tredd pretended to be offended but Luche knew better. “Anyway, I’m with this girl and turns out the night before she screwed the rancher’s son. Boy started talking with her, turns out daddy is out of town with half of his ranch hands. They have couple of guys on the property. Just him, his little sister and some servants.”

That sounded way too good to be truth, but he wasn’t going to complain about the sudden luck. Now they just needed the provisions and materials and they could do their thing. He still had to figure out how to get Nyx in jail.

The general store seemed a bit too crowded for is peace of mind. They were buying only supplies and ropes so no harm in that, right? Nobody would suspect anything. Luche realized he was getting too anxious about the whole thing. It wasn’t fear that they would be caught, of course that was a possibility, but if he were careful enough it wouldn’t happen. It was the thought of home and finally quitting this sort of life that was making him excited to level of anxiety. Once that was over, he could focus on things he really enjoyed. He was picking stuff from the shelves next to the door and passing them to Tredd as a soft voice with very familiar accent spoke next to him.

“Excuse me.” A redhaired girl was standing next to them trying to get to the door but they were blocking her path.

“Ma’am.” Tredd took his hat off as if her words were asking him to introduce himself.

Luche just stared. She was a petite thing, wearing expensive riding dress. He opened the door for her and held it, wanting to say or do something but at the same time he neither had time for that nor thought she would talk with him.

Tredd didn’t have that problem. He used the open door to just dash after her his spurs ringing with every step he made. Luche just gaped. Tredd caught up with the woman, moved in front of her and started talking. Luche couldn’t hear the words but could image something vulgar and not very profound coming out of his mouth. Whatever line he delivered was it ended with Tredd smiling with the corner of his lips. He knew that smile. Tredd was swearing by it saying every woman jumped in his bed after that, Luche would say it was about eighty percent success rate. The redhaired woman had her back towards Luche and he couldn’t say if she was talking or what was her expression at whatever Tredd said, but shortly after Tredd’s famous smile her hand lashed out and slapped him so hard his head turned to the side. Luche couldn’t hold his laugh and he was still laughing when Tredd walked in the store rubbing his cheek.

“What on earth did you tell her?” Luche was way too amused.

“Something about her riding dress and riding me…it works with most women.” He was still rubbing his cheek which had turned a bit red. “She might be in love with me.”

“Tredd, it works on the girls in the saloon. Did you see her? That dress wasn’t some cheap rag farm girls wear, and her boots were some fine leather too.” Luche had no idea how he managed to spot all these little details in such a short time.

“You are terribly observant.” Tredd said with his sulking voice obviously realizing his mistake. “Let’s make a bet. Whoever goes under her dress first owes the other hundred dollars.”

“I’m not betting with you over a woman.” Luche started grabbing the stuff they needed – ropes, horseshoes, crates, canned food. That was foolish. It wasn’t that he thought he could lose against Tredd. He just had other things to focus on. If he were to bet with him he had to figure out who she was, where she lived. He sighed. He was not thinking about that.

“You are scared you will lose.” Tredd taunted him.

“I’m scared I will break your heart.” His ego was killing him wanting to prove he was better, but he had more important things to do. Also, last thing he needed was Tredd to feel bitter over some girl.

“It takes more than a pretty girl in expensive dress to break my heart and you know it.” Tredd left all the stuff on the counter and waited for the shop keeper to pack them. “Come on it will be fun. There isn’t much to do around anyway and we will be here for a bit.”  

Luche just shook his head finding it pointless to argue. Tredd could be like a little child once he figured something could be ‘fun’.

As they walked out Tredd elbowed him hard in the ribs almost making Luche drop all the things he was carrying. He was about to kick the other man as he saw his hand pointing somewhere left of them.

“We should include him in the bet.” Tredd was pointing to the Marshal who right now was holding the horse of that exact same woman they had seen. Luche thought for a moment and realized that he did mind betting against Tredd, but he had no restrains in embarrassing the Marshal. No. He had other things to worry about.  

 Gladio was sitting in the corner table with Cor observing the saloon. He couldn’t stand the idea that one or more of the guys drinking here and laughing could be responsible for his father’s death. If he could have it his way they all would be arrested and interrogated, but that wasn’t possible. Cor was right, whoever they were looking for might not even be here. In fact, they might be smart enough never to turn up here again. Gladio hoped that wasn’t the case. He hoped they were stupid enough to show up again and do something even more stupid than shoot the sheriff or the mayor. Although, if they try to shoot the mayor now, Gladio was personally going to load the gun for them and shake their hand at the end.

“This guy has a gun.” Cor pointed to a man playing poker on one of the tables. Those were the guys that arrived yesterday and had given all their guns according to Noct. Gladio tried to see what Cor was seeing but he failed.

“I don’t see it.” Gladio had to eventually admit.

“You see his coat hanging on the chair?” Cor pointed with his glass. “The left side is hanging straight down, there is something heavy in his pocket. If you look carefully you can see the shape of a gun.”

Gladio followed where Cor was pointing, and damn, the Marshal was right. He could see the coat hanging in a weird way and the shape of a gun in the inner pocket.

“Excuse me.” Gladio got up and started walking like a drunk man towards their table. He made sure to make a good enough show out of it so everyone would buy into his drunkenness. “Hey fellas, do you have a seat for another player.” He placed one hand on the shoulders of the man with the gun and another on the guy sitting next to him. “Every other table seems busy…” Gladio pretended to lose his balance, his hand slid down from the man’s back and ‘accidentally’ pushed the coat on the ground. The fabric muffed the thud sound produced by a heavy piece of metal, but it didn’t silence it completely.

“Oh, I’m so sorry, one too many drinks.” Gladio smiled innocently. He leaned forward to grab the coat and pretended to pat it from some sort of invisible dust. “Oh, what’s that?” His hand found the inner pocket and pulled the gun out of it. Everyone on the table went completely silent. Cor had joined them, placing a hand on the man’s shoulder.

“It would be better if we do that in a calm manner.” Cor said, his voce was low, but threatening. His free hand was already resting on his own revolver.

“That’s not mine.” To the man’s credit he wasn’t freaking out or trying to be aggressive, Gladio could respect that. Better to lie calmly than doing it while screaming.

The whole saloon was silent everybody’s eyes fixed on the Marshal and his deputy. Of course, as low key as Gladio was trying to be, everyone would stop and look in a situation like that.

“Is that your coat?” Gladio asked, still holding the duster.

“Yes, but the gun isn’t mine.” The man insisted.

“Come on. Don’t make it ugly. We just want to chat.” Gladio pushed the man gently in Cor’s direction.

“Nyx…” one of the guys on the table started, but the man they were just about to arrest just shook his head.

“Okay, Marshal, I’m coming.” The man called Nyx got up and followed Cor, Gladio was walking behind them.

To his credit the man walked calmly and as soon as they were out Gladio could hear the saloon returning to the usual mixture of shouting and music. Probably half of the people inside wouldn’t remember what happened if they were drinking Cid’s poison.

“The gun is not mine.” The man protested as Cor pushed him in the cell in the marshal’s office.

“You can keep him company.” The Marshal told Gladio. “I will take a ride around town to make sure everything is calm.”

Gladio waited for Cor to walk out and then pulled his chair so it would face the prisoner. He placed his feet on the desk, his heavy boots making a loud noise.

“So not your gun, huh?” Gladio stared, as he was playing the revolver they had taken from the man’s pocket. “What’s your name again?”

“Nyx Ulric.” The man was holding the bars firmly as if trying to test how string they were. “You cannot hold me here forever and it’s not my gun, someone put it there.”

“And who is that someone?” in Gladio’s experience it was always someone else who did it. Once he and Cor caught a horse thief, on the horse he has stolen, while running from the ranch he stole it from and the man said it was someone else who stole the horse.

“I don’t know.” The man was angry and Gladio was happy to see that. His old man used to say angry men do stupid things.

“Well, Nyx Ulric, you are in luck.” Gladio grabbed his hat from the desk and placed it on his face. “Owning a gun is not a federal crime, so neither me nor the marshal can do anything about it. It’s the sheriff’s business.”

“Then bring the sheriff.” The man almost shouted at him and Gladio enjoyed that.

“It’s in the middle of the night. I’m not going to wake up the sheriff or interrupt whatever he might be doing. I will fetch him in the morning.” Gladio was smiling under the hat.

“Are you fucking kidding me? I have work to do in the morning.” Nyx kicked the cell’s bars and stared walking in circle.

“You better hope your buddies can do that work without you then. You know how it is. Small town, middle of nowhere. We are not in a hurry.” Gladio was still smiling under his hat. That was way too amusing.

 Tredd was sitting on his horse and watched from around the corner as Nyx got arrested. It was giving him so much pleasure knowing the man would spend the night in prison. He didn’t hate Nyx Ulric, but his self-righteousness was certainly pissing him off.

“You are a genius.” He told Luche. He knew the man was smart, but he didn’t imagine he could pull something like that. “How did you know they would arrest him? I would have never spotted the gun.”

“While you were busy drinking with Axis during the day, did my research.” Luche sounded very pleased with himself and Tredd was going to give him that one because it was truly brilliant. “Turns out our Marshal here is something of a prodigy. Faked his own age to join the military, once he was out he became lawman. He was given this territory and picked Insomnia as his base because he knew the then sheriff and mayor. He is a straight arrow, but smart one. He has a record on catching local bandits and keeping the peace not just in town but the whole area. There is also a story that he has been shot ten times and he is still alive. Couldn’t find out, however it was ten times in one shooting or over a period of time.”

“Ten times?” Tredd found that had to believe. In his whole life he had been shot twice, neither of them fatal, but both times he thought he was dying.

“They call him the Immortal for that. Anyway, I figured a man like him doesn’t survive that long just relying on luck. He certainly has other skills like observation.” Luche had a smile on his lips. Tredd knew that smile, he has seen it every time Luche won while playing cards. “Figured out a well-placed gun, would be noticed.”

“You are a genius.” Tredd said before pulling the bandanna over his mouth.

“Let’s still us some horses.” Luche pulled his bandanna as well and tipped his hat so it would cover most of his face.

[t0mat0-pot4to]

#JayDickWeek2017 Day 1: De-Aging

This is the first time I'm publishing in Tumblr in English so don't be too harsh on my writing.

It's kinda messed up and hard to follow near the end but yeah~

And also, pieces were missing so in your mind fill it up.

Don't mind the time. I really have a messed up schedule and all the international times. And so on and on.

        Jason is a kid. 

        It's weird.

"Thanks Dick...Really..." Zatanna gave him a little smirk, before letting him in. She noticed, quite quickly, someone following him close behind. Once the door was closed from the outside, she turned and stared at them. "I thought practices were between us only."

The guy, who was taller than Dick by a few inches, just remained near Dick. They whispered something to each other before facing her, ready to explain.

"Zatanna, we both know how the magic rules goes around here. And... Well, I pretty much broke the first rule..."

"Just get to the point Grayson," pleaded the host. A faint feeling forced her to keep track of the new-comer, whom looked familiar in a weird way.

"Yeah...I'm sorry. Zatanna, this is...Jason..."

By the introduction, the new guy took the hood and sunglasses used as a disguise. He clearly didn't look at her, he couldn't. Not with with his new reputation. But he was thoughtful to her reaction anyways.

A single gasp. Then quiet. Both men knew where this was leading. It had happened a few times back with other members of the Young Justice and once with the Teen Titans. They expectations were high to get them surprise.

"He is the Red Hood, isn't he? Why is he here? Does Batman know about this? Dick! Why on Earth did you think bringing a serial killer to my house was a good idea?! Do you know what he has done?" Fear mixed with anger, and a touch of confusion was the recipe of her reaction. Before she even knew it, she was on a defensive pose. Dim clouds of purple glitter covered her fists.

Instantly, Dick's body reacted to stand in front of Jason as a shield of some sort. He knew his friend was more than capable to get to Jason, but he had to pretend he could protect his brother for some peace of mind.

Nobody moved in three minutes. Just standing there like a photo. Zatanna didn't even bother looking at Dick, who was to blame if anything happened in the next long hours, but had eyes fixed on Jason's.

The Red Hood.

The killer.

"Zatanna, please listen to me. I am more than aware of Jason's previous actions...on Gotham and outside but you also have to know that..."

Somehow, those words struck Jason like lightning. He knew better than anyone what he did on the streets. He knew why Zatanna was scared and angry. Yet the never noticed how calm Dick was about it, like he didn't even knew the truth. But then...they have fought about it. Every single time they saw each other, they fought. Dick screaming that he should stop, that he could still be good and Jason just giving nothing less than careless words. It had always been that way ever since the Red Hood was born.

"...Just this one time, please. You won't even noticed he is here..." The oldest of the three still tried to convince his friend. Not moving an inche away from Jason. And again, Jason had just noticed how protective his older brother was of him no matter what. "I know he doesn't have any weapons on him right now. I promise that. And...I swear on my life that if anything happens today, I'll take all the blame..."

Things seem to lighten up. Not at the speed of light but improvement was being made. It was a hard time on Zatanna. Surely, she didn't really truly know who Jason Todd was. However first impression meant everything in the world of superheroes. A single mistake could ruin a hero.

"How can I be sure of that?" Her words came out like a silent cry, almost a whine. Of course she hesitated at every single word Dick had said, it was understandable from her.

"You trusted me with your life. Today is no difference." Dick slowly left Jason to approach her. Hands lifted in the air as a sign of safety. A soft grin ran across his face as her hands lowered to her side, eyes now locked in his. "See? It's okay now. You can trust me. He won't hurt you."

"I'll trust you for now. But if he does anything stupid, I won't hold back."

Dick's grin widened quite a lot. He was back to his usual self. Then his attention was drawn back to the other male guest, Jason. With a normal speed he was back in front of him, now facing him.

Jason grunted as the image of his brother appeared in front of him. He really had an ego and was to clearly too proud to let in lower. The recent memory of this morning's chat was fresh on his mind, now regretting the proposal.

"Lil' wing," his voice as soft as usual called, "are you okay? I'm sorry this happened...Guess I should've call her ahead and all that..." He was a bit embarrassed at the scene he has just played, a sign of this were the pale red in his cheeks. His right hand settled behind his head as his eyes looked down.

"Do you ever shut up?" Jason's answer came out aggressive. But this time he wasn't looking at Dick directly. He couldn't do it, even if he tried. Thoughts messed his head around and soon he could no longer think straight.

"You wish I would, don't you?" Joked less worried. At least things weren't awkward as he planned, good news for everybody. Without waiting for an answer, he dragged Jason to follow Zatanna to a special-secret room.

Jason was just staring at the way Zatanna smiled in concentration and how Dick tried his best not to move when something was going his way. It amazed him how real everything was.

As a kid, he used to spend a lot of time in the streets. So often he encountered magicians, even if their tricks were cheap, he loved them. It was one of the few things that kept him busy during the day and out of trouble.

Watching the practice reminded him of himself as a kid. He felt the same way. The exact same feeling of happiness and peace inside of him. The more he thought about it, the less he believed it was all real. But somehow Dick's cries and Zatanna's chuckles kept him with both feet on ground.

Soon he found himself closer to the practice and smirking. He forgot his new life for once since it all started. For once he was not scared nor worried. It was all okay as long as the show kept going.

On the other hand, Dick couldn't stop thinking about Jason. All though his body looked forwards for some attacks, his mind was going on and on about how Jason was smiling again. He noticed Jay's eyes fixed on every inche of him at some point, but didn't gave it much thought.

"Guess the old Jason is still there." Thought Dick.

Dick remembers vividly how, back when he just started the Nightwing thing and Jason was Robin, Jason had told him about loving magicians so much. That they made him happy but taught him that he could change reality at will, and wasn't anywhere near wrong.

That boy, who he holds dearly in his heart, was beginning to show himself without even noticing. Maybe bringing him along was, after all, not a bad idea. Even if Jason hasn't said anything at all, he was showing enough emotions and for Dick, that's enough.

"How 'bout a break now? I seriously need a quick break." Zatanna said as she relaxed all her muscle. It's been no less than three hours, and she could feel the pain in her muscles already. She looked over at Dick, who just nodded in respond. "Okay, I'll be back in thirty. Help yourself with anything you please." Then she disappeared through the door.

Dick quickly took seat in front of Jason, whom tried concentrating on the room instead of the older of them two.

"Sooooo...You do like it?" He asked after failing to wait for him to look at him.

"What can I say?" Came out as a whisper. A really quiet one. And Dick was nothing less than surprise, even if he was faking it.

"You liked it. I saw you smirking and all. Even sat closer to watch." Teased the older with a playful smile.

A delicate blush was painted in Jason's face.

"What the f* is wrong with me?!"

"So you just won't talk to me, huh? Guess I was expecting too much."

"Just talk Jason...Say something for the love of whoever!"

"You know? If Bruce ever finds out about this, I'm probably gonna be send of to Bludhaven or somewhere out of Gotham. I'm not sure anymore about the old man, but he's a good guy."

"Why the hell is he tellin' me this? Wait...Does he think he's gonna get in trouble with B?"

"Bruce is having a harsh time with Damian. The little kid is really getting in his nerves to a whole new level. However, he's is good kid...beneath all that cruel, indifference towards other people, is a scared kid." Dick's voice decrease in tone as he talked, with his small grin as usual. "I'm really trying my best...but sometimes I feel I'm not good enough. Nothing will erase those years with the League of Assasins...And I'm scared that I won't do enough..."

And before Jason had a chance to even open his mouth to respond, the host entered the room. Those few seconds he stopped looking at Dick, made him missed such a drastic change in his expression. When he glanced again, he saw a big smile but knew better than anyone that he was faking it. No-ones goes from talking about a troubled-kid who kills to a happy guy who's life is perfect.

He knew better than no-one how many times this had happened.

And it scared him too.

"Am I interrupting? I can come back later if you want me."

"Oh, no. It's okay. Just trying to get some talk out of Jay." He stood up and stretched. They were going to continue with practice until 4:30 was on the clock, just when everyone knew practice was finish.

Zatanna just nodded and shrugged. She didn't have any siblings so she didn't really knew about the topic.

"So, ready to continue?"

"Sure thing, lady."

The next two hours went okay. Jason couldn't stopped wondering about Dick and it really was pissing him off. Did he do it on purpose? Was he thinking about this through practice? Why did he tell me that? Was he indirectly talking about me? Whatever reason Dick had, it was making Jason paranoid.

...

A spell away from Zatanna.

...

Passed Dick.

...

A direct hit to Jason.

A heavy cloud of purple glitter covered him full body. It spread throughout the room, which wasn't good. The two who didn't get hit, covered their mouths and closed their eyes instinctively. Not a sound was heard until the cloud had completely vanished. As their instincts kicked in again, they rushed to Jason just to find a small child in his place. His clothes were too many sizes bigger. They figure out, without words, the impact must have had knocked him out.

"Zatanna...What...What is happened to Jason?" Fear dripped out of his words. He trembled and couldn't even think of hiding it. Knees were weak. His whole body was sweaty. Words struggled to come out his throat.

Zatanna was quiet.

She was frozen.

A big part of her felt guilty. Felt bad. What has she just done? How was she going to fix it? Was there a way to fix it? But a small side of her was so... happy. Jason couldn't kill anyone, if he doesn't remember who he is. Even if he did, he'd be too weak to go hand-on-hand with anyone.

"Zatanna." Called Dick again. Now with a broken voice.

"I'm...I...This wasn't...I didn't mean..." Guilt was the main reason she feared. Not on what she did but what Dick's actual reaction will be. She didn't know what happened at all. It was too fast.

They both had to take a break. Really. They needed it.

A few minutes of silence, sitting quite far from each other. Zatanna going through the list of spell she was practicing. Dick holding that kid with Jason's hoodie. He wasn't even sure if it is Jason. The first time they meet was when Jay was around 12 and this kid looked 4 at least.

But...

Looking at the bright side, Dick felt quite calm with him in his arms. The slow breathing and tiny body was just too much for him. He had to hold back the tears from his eyes. This little kid was too cute to handle. He did have characteristics that reminded him of Jason.

"Hey, Dick? I think I found out what happened," Zatanna mentioned dropping books on the floor then walked over to the oldest with one. She opened a book in front of him and showed him the spell. It has weird drawing and un-readable writing, if it was actual writing. "It's a de-aging spell, as you could tell by the result. It was an accident. I misunderstood two spells and mixed them and that happened. I might take a bit of time to find a cure...I'm really sorry..."

Sigh. "It wasn't your fault. It wasn't anyone's fault. Just try and look for something that will reverse this... I'll see what I'll do with him..."

"I think it's only fair that I take full responsibility. You know how everyone is going to react..."

"No. I know you mean good but it'll slow your work." Dick gave her a grin to calm her off, before locking his eyes into Jason's body. He wasn't truly sure what was going to happened but the sooner Zatanna starts working, the sooner everything will be back to normal. "He's a kid. I deal with them in a daily basis. It's not gonna be so different at what I already do."

She just stood there silently. Not sure what to say.

"I think it's the perfect moment for me to spend some queality time with him, since I've missed him so much this passed few years." And he meant it. Meant every word. Maybe he wanted to spend time with Jason so bad that everybody else had just disappeared all of the sudden. "Listen to me Zatanna, I really want this to work. And this is the only way it will."

"Dick...I don't want to do this but...if it makes you happy, then we'll do as you say." She said, with a little smirk.

Now Dick was walking with a kid in his arms. It was late as he decided to wait until dark, when he could go from roof to roof without anyone catching him. Although Zatanna had a house near the Wayne manor, he had to be careful in every corner of the streets. No-one could catch him, at least not without his Nightwing suit. His eyes caught dim lights that rushed below him. He feared.

"May I know what you are trying to do?" A soft voice made Dick stop, frantically turning to find the owner of the voice. Someone landed in front of him, and showed himself.

"Tim, what are you doing out so early?" He asked, covering the kid the best he could. However, he knew Tim had seen his actions. He just wondered if his little brother knew who it was.

"I asked first. You tell me, then I'll tell you. That's the fairest exchange I can offer." His hands reached his hips, waiting for an answer.

"Fine. I just came back from Zatanna's house. You know, I help her to practice with her spells and whatever she needs."

"B send me early today as he had to go to a Justice League meeting. Riddler was going to hit Gotham's museum." Explained Red Robin before pointing at whatever his older brother was holding. "What is it?"

"Who is it...Come home and I'll explain. Any chance you could reach B?"

"Always."

After Dick explained everything to the whole Bat-fam, with a straight face before having to take a step back to chuckle under his breath. Nobody said anything for a few seconds, they just looked at each other in confusion. Half of them opened their mouths to talk but closed it later when the words wouldn't come out. The other half still had to put two and two together.

"I know what you might be thinking...No, actually no. Together or not, I'll make this work." Dick's voice echoed in the bat-cave, bouncing at everybody's ears. Jason was still sleeping in Dick's arms, breathing slow and eyes closed tight. "I know he is...I know what he does in his Red Hood suit but now...Now he's a kid and I promise you he doesn't know this. Zatanna is trying her hardest to solve this, and my part is to give him a good time...Just...I'm not asking for everybody's help...I just want all of you to not give him a hard time...That's all I'm asking you...Please."

Still no words from anyone. Dick was starting to panic and his eyes gave him away. They were looking at everyone, not still for a second. And somehow that made things worst for the others. It was hard and nobody knew what to do.

"Are...Hum...Are you sure he doesn't anything about being a grown up?" Tim finally asked, taking a step toward from the back of the room. Although all eyes were fixed in the youngest, he knew that their thought were on him.

"He shouldn't know. Even if he does know, there's nothing he can do until Zatanna finds a cure or something."

"Why don't, I mean, why don't we leave him as a child? You know, if he doesn't know anything then he wouldn't be the Red Hood." Stephanie brought up, even if her own words sounded unsure.

"That's just wrong." His answer was cold and his expression changed.

"I didn't...I didn't really mean it...I'm sorry Dick..." She quickly apologized. Somehow Dick's response just was too much, in a weird way.

"So, B, it's up to you know. Can Jason stay in here or do I have to go somewhere were he can be safe?"

"He is your responsibility now, until Zatanna finds a way to reverse all of this mess." Replied Bruce, taking his Batman mask off to see Dick. Slow steps then a hand in Dick's right shoulder. "Don't worry. He's still family after all." Those words were soft and only the receiver could hear them. Those words were from Bruce, not the Bat, which only calmed him down.

"Thank you Bruce." Whispered back, after offering a small smile. He was tired but he had no reasons to be, he just was. Bruce seem to picked this up easily, since he didn't demand to him to change to his suit.

"Listen up all. I'll be going back to the meeting. I want Kate and Babs covering East side. Damian and Luke will go West. Steph and Duke will go North. Tim and Cass will cover South and the heart of Gotham." Ordered the Bat putting his mask back on, voice deeper now. "Dick will stay as back-up if anything happens, but I trust everyone to do just fine. If by any mean things start getting out of hand, do not hesitate to call me. Understood?"

Everyone replied with nods and ‘yes’.

Dick opted for a bedroom near his or B's for Jason, since he hasn't woken up yet. But because none were available, Alfred just recommended to share his bedroom since the bed it's big enough for both of them and that will be a sure way to keep him in sight. He absolutely didn't think of that and thanked Alfred.

After getting some clothes from Damian, due to the fact that his clothes will never fit him at that age. They were a few sizes bigger but nothing compared to Jason's hood. Jason was dressed and sleeping in bed. Then e changed his clothes for sweatpants and a skin-tight shirt. Comfy and simple. Now, to work.

As hard as it might sound, he managed to convince Alfred to let him stay watching the others for a few hours before bed. Nevertheless, his eyes were watching the screen with a mind around Jason. Ever since this morning he couldn't stop thinking about him. Not only because of the spell but in general.

How much he's changed. How much he missed him. It was a weird feeling. Of course it was. Growing up, at least a few years, had an impact on him...on both. Sure, Jason wasn't the perfect role model back then either but...Compared to now days, Dick can truly say they've grown up.

"Master Grayson, I'd like to point out you've staring at a message for more than 20 minutes. Should I be concerned?" Alfred's voice bought Dick back in his feet. Perfect timing like always. Just there when you needed him, or advise.

"Yes...I mean no. No. I'm just so over-worked with the Jason thing and some other cases from Bludhaven."

"May I recommend you something master Grayson?"

"Sure. I can't say no to advises when I need them."

"Go to bed. Now you're tired, so is your brain. Rest and tomorrow you'll see the image better."

Everything happened so fast. But now things seemed to go as slow as it could just to annoy him and the worst part is that it was working. Again, he had no real reason to be annoyed but he was. And he hates it.

"Hey, Jason?"

"Get the hell out of my house."

"Just listen, ok? Today, I've got practice with a magician. Want to come?"

"Why on Earth, on my right mind, on my common sense will I go with you?"

"C'mon. I promise you'll enjoy it."

"Sure pretty boy."

"Do it for the good old times."

"It wasn't good for me. Dick, hear yourself talk for a second. B doesn't even know you are here. You're asking me to go somewhere with you for the 'good old times' crab. But have you forgotten what really happened in the old times?"

"No, I haven't. Not a single day of my life. B's parent died. My parents did too, then yours. Tim's...I get the point but what I mean is when being a Robin gave you magic."

"Don't use that on me."

"Just..For the old Jason Todd and Dick Grayson, ok?"

"Whatever..."

And now he was that one regrets taking him. If only he had knew but there was no way he could know. Still he blame himself although he told Zatanna that it was nobody's fault.

Eyes caught on empty-nothingness dark. He had heard the others coming back and quietly getting to their rooms, he grew up there. He knew every single sound, even Bruce's. One thing he was glad for was that no-one checked on him as he knew he wouldn't be able to provide a convincing answer.

Midnight and his eyes were as open as today's morning. Thoughts, thoughts and more thoughts. One lead to another, then two more, then four, then twenty. All around the one little person sleeping in front of him.

Despite the fact that it was way over bed-time, he stood up and walked to the training room. Not the only below in the Bat-cave. Admitting defeat to his mind, his body did nothing more than train as a way to feel tired. He became so numb about everything when he trained that completely forgot to go to bed that night. Basically just working out like mad with short breaks.

"Dick?" Tim's voice alerted Dick's senses. "What are you doing in the gym? It's like five in the morning right now."

"Is it? Sorry, I didn't know what time it was. You know how I get when I work out." A bad excuse, even he was aware of it, that Tim would never take.

"You've been acting weird ever since yersterday. Something's off?"

"Perfectly fine. I just didn't feel like sleeping so I got myself busy with something." Standing tall, not showing any signs of exhaustion compared to the younger brother. "Why are you up so early anyways?"

"Just woke up and couldn't go to sleep again. I was passing by then I saw the door opened and I had a feeling it was you. Since Kate didn't stay, neither did Babs. Steph is too noise. Cass wouldn't come here if she was to wake up early. Duke is usually up right after Alfred is. Luke doesn't wake up 'til breakfast. And Damian will be on the cave."

"Well, they don't call you a detective for nothing, huh?" Dick joked before stretching his legs and lower body. "Wanna join me? I promise I'll be quiet."

"Then I should be scared." Tim chuckled like Dick did. He entered the gym, closing the door behind him. As much as he hated it, he choose something near Dick. It was always safe near him, in all senses and he didn't have a clue on why this is. "Wanna tell me some juice story?"

"Wow, I thought you wanted quiet."

"Did I?"

"Ever since you joined the Young Justice and Damian joined the Teen Titans, I've been pretty lonely." The oldest started, focusing his eyes in his own workout. "And Jason's been with the Outlaw thing with Bizarro and Artemis."

"Huh? I thought it was Arsenal and Kori. Wait, no. Nevermind. I don't even know who is in who's team anymore." Tim held his head with his left hand, trying to remember the last files of the lastest team from the Watchtower and Bat-computer. When nothing popped in his mind, he gave up. It was his normal morning schedule but without coffee yet.

"All of you make me proud." Mumbled Dick without looking up. His muscles started to ache but time taught him that he could take more than this in worst conditions. "Teams. Leaders or not, you have teams. And that's all I care about right now, so go make your big bro' proud."

"I can't do it without coffee..." The younger one struggled to stand up, which was obviously faking. Dick glazed over his shoulder to see his brother trying to stand up, with a little laugh he stood up and helped him get up on his feet. "Thank you my knight in spandex...Wait, now that was awkward."

"Let's get you your coffee then we'll come back later." With his right arm he pulled Tim to his chest by his neck. They both laughed as some memory was remembered, both two different memory. "It's Saturday, wanna come with me to the mall to get some clothes for Jason? I could use an extra hand."

"Sure...It's just...You are gonna...WE are gonna be on the news, know that?"

"Hum...Like I care at this point.

(Jason is only 4 years old and his first languaje isn't English so~   <Yep, it's pretty basic English>)

It was probably around seven-thirty that Jason finally woke up.

He was a confused little boy in a giant bed. Clothes bigger than him. Nothing around him looked familiar but they just woke his curiosity up. As fast as he could, he got up and started checking all the drawers and closest. Going on and on around a stranger's stuff, with a careless carisma. Although the was careful not to take anything out...just in case.

"Well, morning. You've been sleeping a long time." Jason's eyes caught someone big and built up. Not a scary person but he didn't trust a stranger. It was strange because, well, he looked familiar. Their eyes meet and it was tricky somehow. The mix of excitement and confusion was equally divided between them two. No a word. No a motion. Just staring into each other's eyes trying to figure out what to do next.

"Who you?" His shy question drew Dick's attention quickly, but he didn't move. A few second more of silence before an answer came out.

"I'm your friend," responded softly. Suddenly he found himself shaking slightly like he never experience nervousness. Like it was a new feeling. Absolutely nothing stayed in his mind long enough to give it much thought, only few broken phrases and loose words.

On the other hand, Jason was just curious. This man, standing feets away from him, was just an interesting person. Not only because he was older but the fact that he claimed himself as his friend played a big role. Three steps closer, their gazes still holding together.

"I am hungry," demanded the youngest holding his tummy. "I wan' foo'."

A chuckle filled the room and without noticing Jason was high above the ground, held in the stranger's arms. He couldn't help but hold himself to the shirt. He also notice he was moving from his initial place, maybe a few inches but nothing big.

"My name is Richard, but you can call me big brother." Wanted to say Dick but restrained himself from doing it. Perhaps it wasn't the right moment...Perhaps he didn't want to be seen that way to Jason.

"What your name?"

"My name is Richard, and you're Jason."

"Hum...Jason?"

Nobody complained, really. Considering the fact that neither actually had full time to take care of him, they let it passed. But whenever Dick needs them, they don't hesitate to lend him a hand.

-

"Tem?" Asked the little boy walking towards his caretaker with a drawing in his hands. Tim left enough space in the solo sofa for the little one to climb up.

"What's up Jay?" His book rested in his lap as he offered full attention to the new-comer. It didn't take him long to see what was the matter.

"I draw thi'." He held the paper above his head in a weird angle but tilted enough to let Tim see it. After that he lowered in his lap, glancing at it proudly. Then he started pointing at the drawings. "Thi' is you! And thi' is Damien." He named first. The oldest noticed something particular about the drawing.

"Why are we dressing like that?" Curiosity took over as they were all dressing in their suits.

"Wayson show me photos!"

"Oh! Silly me." A laugh scaped his lips. "Do you have a pencil?"

"For what?"

"To write our names in the paper."

"Oh! Yes!"

-

"Bab!" Called the young one as he rushed to the kitchen.

"I'm here Jay. What happened?" She questioned closing the fridge after putting some stuff on the bench. When Jason was next to her, she crouched down running her right hand on his cheek.

"Alfew say to go shopping for thi'." Carefully, like it was glass, he handed a piece of paper to her. He didn't know what were those things but figure out that were food since he had heard them talk about it before.

"Oh, sure. Wanna come?" She asked folding the paper and putting it inside his jean pocket. The enthusiasm in his face gave himself away. "Ok. I'll get my purse. You go tell Alfred. No running." He nodded in response before walking away, but started running when he thought she couldn't see or hear him.

-

"Kath," sobbed the little one as she rushed to him. When she was close enough, he pointed to his knees with a few scratches and blood.

"Oh dear, what happened?" She interrogated as she picked him up to take him inside the manor. Inaudible sobs still coming from Jay kept him from telling her. "See baby, if you don't tell me, I can't do anything to avoid that happening again. Do you understand me?"

"I was on the tree and I fall." Confessed hugging her by the neck. "It hurt."

"Worry not! I'll take care of you baby."

-

"Damean?"

"What is wrong?"

"I found hurt bird. Me want to help bird."

Damian went for everything they will need while Jason cleared a table to work in. Once the older one was back, the younger sat patiently. Due to his lack of understanding of the animal world, Damian did everything to help the bird.

"Where did you found it?" Asked Damian while patching the creature.

"Outside under tree. You think he fall from tree?"

"I think a lot of things but that sound accurate."

-

"Stef, Stef." It was late night and Dick wasn't home from a mission so Steph offered to look after the toddler. "I wan' cookie!" He demanded in a non-scary way, more like a plea.

"It's almost midnight Jay-Jay." She picked him up as she headed to the kitchen for some water. Although she was an active person, Jason had more energy in him for some reason. "Why are you still up?"

"Wayson not hea'. Me waiting for him."

"Aww, that's so sweet of you but I promised Richard that you'll be in bed before midnight." Carefully she settle the younger one on top of the table so she could grab a glass for water. Always double-checking he wasn't grabbing anything or moving.

"But me hungry."

"Jay-Jay, you know I'm not allowed to give you treats after dinner." She glanced at the cookie jar on the other side of the table. "But if you don't tell anyone, I could give you one."

"I pomised."

-

"Luk, is Wayson home?"

"No. Richard is in a meeting with Bruce." He just stood there, fixing his tie in front of the mirror with a toddler leaning in the door.

"Can I go too?" Jason requested, hopefull. In some way he wasn't looking to get out of the mansion. Sure, it was cool and big and had a lot of things but he felt like he belonged in the streets...And he wasn't seeking for answer...yet.

"Gotta ask Alfred first, ok?" His hands rested in his hips as he turned to him the little kid. Maybe it wasn't that bad after all, nobody seemed to complained so why not take care of Jason for once.

"I go ask him!"

-

"Caz? *Alfew say you hea'." Before entering the room, he waited for an answer. Which was a simple 'Come in'. "Can you read book for me? Everybody is busy." He was hugging a book, which was almost the size of his chest.

"Hum, sure thing Jason." She settled her own book down, and lowered the classical music playing on her phone. Jason swiftly sat next to her giving her his book. "Where did you got this from?" She asked curiously as she recalled seen this somewhere on the manor.

"Wayson say the book is mine." He replied with confusion in his voice. He doesn't remember this book from anywhere, and he can't even read at this level. Something seemed odd but suddenly increased when Cass started reading. Even the text sounded familiar. The book cover too.

"You okay Jason?" She asked leaning the book on her lap after she noticed him not listening at all. The thought of smacking Dick in the head for giving Jason one of his old possessions rushed to her mind.

"Thi' book mine?" He asked, looking at the pages filled with words in amazement. He hasn't connected two and two together and hopefully he wouldn't do it now, at least that's what Cass wished.

"How about you read with me?" She rested the book between them, catching Jason's attention. She started pointing at the first words then read them, a mumble tried following her. "Slowly Jason. I don't understand you."

"Sowwy."

-

"Duk, I like thi' park very much." Chanted Jason while swinging back and forth. The other kid's laugh was as loud as his, so there wasn't any competition between who's the loudest.

"Yeah, it's nice." Duke planted himself next to the swings, to looked after a Jason. Anyone who had taken Jason out had to run to chase him down and he didn't really wish to do that. "Did anyone take you here before me?"

"Dunno. I remember me hea' but dunno who take me." The thought of having been here already was present every passing second. Maybe it was just his imagination but it felt real. Even he felt like someone was pushing him in those visions. Familiar laughter. The sun bright and hot. But then it all faded away whenever he was about to see that person behind him.

"Oh...Hum...Forget it chump. Let's go to the slides, shall we?" He always messed things up but Jason just got up and pulled him to the slides. Saved by the bell. He feared not running the same fate later on.

-

"Buise! Buise! Look! Look!" He was doing simple backflips, which he learned watching the rest doing it. Bruce had to stop looking at his computer to see the marvelous work Jason was doing on his own.

"That's amazing." He forced himself to get up and go to the bed were Jason was, and patted him in the head. "I'm so proud of you Jason."

"Dad...?" He called not sure if he could use that word.

Warmth filled Bruce. And as much as he hate to admit it, he was touched.

"One day, I gonna be like you!"

"You don't want to be like me Jason."

"I do! You good person! You help people! You give them your money and they build better things."

"Yes but..." It was wrong telling him off. He was a kid after all but soon he'll be his old self. "When you grow up you will understand what I mean, but now you have to be Jason. The one and only Jason Todd. And trust me when I say that I'm proud of you...Even if you have done wrong. I'll always be."

Jason didn't understand what Bruce meant but felt like hugging him, so that's exactly what he did. He got up and hugged Bruce. Soon strong arms surrounded his tiny body.

"I love you dada." He whispered.

"I love you too, Jason.”

Nearly two months had passed and Dick will always check on Zatanna at the end of the week. Since the others were getting along with Jason, he had time to continue his Nightwing role around Gotham...

But it was extraordinary how everything was different without the Red Hood on t streets. Kids will usually come up to him and ask for Red Hood, and each time he made a new excuse. From fighting aliens in another universe to punching death in the face. The more he tried to convince them that Jason was coming back, the more anxious he was about it.

He couldn't denied loving Jason as a toddler but...

He wanted his Jason back.

He wanted it more than anyone knew.

He wanted the boy that got stolen from him. The boy who died on the job and came back later to become an outlaw. The boy who saw him grow up in the Nightwing suit. He wanted that boy back.

And the more he craved for it, the farther it looked.

Those nights with the kid in his arms were the only thing that kept him sane.

The fact that Jason, as Robin, would come up to him to cuddle to sleep hunted him in the little boy.

<<Hey, Dick?>>

The ringing of his phone woke him up at four in the morning. Without trouble he managed to grab his phone and answer. "Zatanna?"

<<I finally found it. I'm so so so sorry it took me this long.>>

"It's okay." He gave a pause to yawn. "When do you want me be there?"

A pause.

<<I thought I'd call you before-hand so you could spend some quality time with Jason, since things are gonna go back to the way they were before.>>

"Oh..."

<<Is everything okay?>>

"You have no idea how much I've been longing for this moment...But now that you found a cure...I just realize how little time I had spend with Jason this 2 months...How selfish of me..." He smiled bitterly. His eyes searched for Jason's body, who was hugging his chest from one side.

<<Well, you are the one who's gonna decided when I change Jason. So, you still have a lot of time.>>

"Yeah but...But he deserves to be himself..." He changed the hand he used to answer the phone to his left hand so his right hand was free. Cautiously he ran his hand across his messy hair, while he thought.

<<There's no hurry Dick, don't stress yourself over it.>>

"I'm trying Zatanna. I'm really trying."

<<You know, spend today with him and tomorrow both of you come to my house. That's my option for you. Now it's all up to you.>>

"Yeah...Anyways, what are you doing up right now?"

<<Couldn't sleep but now that you mentione it, I'm getting kinda tired.>>

"Take care."

<<You too Dick and don't give it too much thought.>>

Dick switched his phone off and left it on the night table. It was dark in his room but early birds were singing outside his window.

"Wayson?" A tired child voice woke Dick up from his thinking. "You ok?"

"Yeah, yeah. Go back to sleep lil' wing, it's too early."

"Is okay. I not tired." He let Dick go, sitting up to see the oldest in the eyes. Something like a flame sparked in the oldest one's eyes, with even as a child he could tell that flame was tired and sad. "You sad, why?"

Dick didn't reply instantly like usual, now he really needed to think every single word he was to say. It was his last chance and he was losing it already.

"Want to hit Gotham up?" He proposed before standing up to stretch. He felt eyes staring at him in confusion, so that was his clue to turn around and face the toddler finally. Smile as bright as a sun, eyes shining like midnight stars. "Come on lil' wing, it's early and I don't want to sleep anymore. You coming or staying. Hit or miss. Last and only chance."

Jason was quiet but didn't take long to respond.

"Where we going?" The youngest asked standing up in a jump. His hands were fists ready to punch the sky. He was ready to rock anything.

"We'll see when we are out there."

So now, there were two guys dressed in black. One old enough to have a job and the other one older enough to still have his night lights. The oldest clearly knew what he was doing, jumping from roof to roof like there was a safe net underneath it all but no. He looked freed after so long. He was one with a wind and each jump meant less and less fear. On the other hand, the toddler was as excited as his partner. Sitting in his shoulders, holding himself from letting go.

Their first stop was the Gotham Museum. They climbed, the oldest climbed while the youngest held him, to the top were glass panels that served as roof-tops. With clean moves and noiseless actions they managed to open one of the locks without breaking it. With rope and a hook they slided down to the first floor. Like child's game they outsmarted every security lock and every security gadget they had. Careless of being caught on camera as masks covered their faces, even smiled at them before disappearing to the next room. Fourty minutes was up and they were gone.

Second stop was the zoo. It was easier as the only obstacle were slippery walls. Most animals were woken up by smells and some stayed in their sleep. As entering the zoo wasn't a challenge, they traced down the aquarium. It was a whole new view of the zoo.

Hospitals to leave some cards.

Business. Fire-department. Anything that was a building could be entered by them. Even the Wayne Company was infiltrated. By the time 11 in the morning they were done with a big part of the main buildings.

"That was fun!" Exclaimed Jason taking his mask off to set it aside. Dick was changing his clothes to more *normal clothes, so did Jason. "Now?"

"Breakfast then I'll show you another part of the city."

Dick was in his Nightwing suit, and Jason with old clothes. They were in the sewerage, in an abandoned part of it. It was all dry and stuffy. Rats and rubbish, like a typical American-movies. Although Nightwing was just checking some weird vibration that the Bat-computer picked up from last night. Jason kept asking questions about it, especially why it was abandoned. At the end they made up a non-real reason.

Dressed as normal people, covering most of their main characteristics. They hit the poor side of Gotham were the streets were busy like every other street. Magicians doing cheap tricks was the main show that caught Jason's attention. It was a total deja vu. But didn't say anything. They kept moving. Helping whoever needed it. With Dick beating few bad guys who thought were king of kings.

Afternoon came and now the theater was the point. Movies and movies. Popcorn. Drinks. Candy. More movies. More candies. And because it was sort, they went to the mall to see and purchase random items they just gave away randomly to strangers they saw.

Then night came. It wasn't safe to take Jason on patrol so that was out of boundaries, so instead they just stayed home and read some books. Time passed really fast as they had a good time together.

Midnight was here and Dick's mind started getting serious. He had clearly enjoyed today's activities more than any other day but it was time to face what he's been avoiding all day.

Jason was so different to Dick now. It wasn't a side he'd never been allowed to see from Jason, but now things started to make sense or at least to him. Jason's childhood was taken away from him the day he was born. It was rough but he managed to pass another day each night.  The kid was the only part the was worth keeping after all...

Now he had to say goodbye to it all, once again. Tomorrow Jason will be back and the kid will be hidden in the deep of their memories. It was too much for Dick. It was always too much for him. The second everything happened, he knew things weren't going to be easy...especially for himself.

"Jason?" Dick called sitting on the edge of his bed. It was time to say goodbye. Jason rushed to his side with no hesitation, but the look in the foreign eyes told him it was serious. "You had fun today?" He started.

"Yes..."

"I'm glad." He bit his lower lip to hold back everything for a few more seconds. "I love you, did you know that? But...I know you aren't going to understand what I'm talking about but...

••••••••••••••••••

"Don't talk to me Grayson. Stay away from me...please..." Jason was back, just like Dick wanted at the beginning. Zatanna let them talk so it was only them two in the room. Jason was backing away from Dick, even if he didn't want to do it he had to. After revealing the truth.

"Jason, please, listen to me..." pleaded the oldest. Voice at the edge of breaking and eyes cristalized. "Just...Just tell me...Tell me and I'll leave you alone...I'll never bother do anymore..."

...I know you aren't going to understand what I'm talking about but...I love you. Not the way I love Damian or Tim...Not even Babs...

"I can't do it!"

This is probably my hardest fight ever since, well, you are a kid right now. Everytime I see you in this state, I blame myself. If this was an accident, I can't imagine what will happened if someone try to hurt you on purpose...

"I can't answer..."

And I know that you don't love me...I don't even think you see me as a trusted person. And I understand. I have failed you many times...But now...But I'm making my biggest mistake...

"Dick, don't do this..."

...by loving you and telling you. Maybe you won't remember this tomorrow when Zatanna reverses you to your normal age and it'll be okay, but if you do...

"Don't do this to me..."

If you do remember this tomorrow. I just want to let you know that I'll accept whatever your answer is...I can't force you but I can't keep myself from breaking everytime I see you and know...

"Don't do this to yourself..."

...and know that you are slipping away from me. It hunts me to know that I can't be you with. It hurts me to know somebody else will make you happy... But I need to get this out of me. I'm sorry if I ever disappointed you...

"You'd never disappointed me Dick..." Jason's whisper brought tears to his eyes. Dick rushed and hugged him tight. "You are an idiot."

"I'm sorry..." He whispered back. "But I love you. And I don't know if that's enough to warm up a broken heart..."

Jason was crying in Dick's shoulder. He hated that he remembered everything that happened when he was a toddler. Especially because of Dick.

"I've loved you since I saw you. And I felt in love with a kid with issues. I had just broken up with Babs, so I didn't know if it was right to do a move. Then years passed and you died...You don't know how devastated I was. Knowing I could have done something...Stayed back in Gotham...Going as back-up...And my chance was off...

}But I never learnt to stop loving you so I lived with a broken heart hidden far away from anyone. Then the Red Hood and the outlaws. Another chance gone... I saw my chance come and go...And didn't do anything...

}And I hate myself for it. All this years and I just needed to ask a simple question...Since this is my last chance...Jason, will you be my boyfriend?"

Dick was home.

Dick was all he ever wanted.

All he ever needed.

"If it doesn't work?"

"We'll make it work. As long as you are with me, everything will work..."

"Then we are in this...together."

[concussed-to-pieces]

The Kindness; Part Five

Fandom: Fallout (3)

Pairing: Female Lone Wanderer/Charon

Rating: Holy shit M.

AN: Part five of twelve!

Spoon had awoken that morning in a pleasant, alcohol-induced haze. She sat in her chair for what felt like hours, watching the way Charon's back shifted as he breathed. The ghoul had slept on the floor in front of her chair, his combat armor shucked to the side. Well, slept or passed out, she wasn't sure. The sun's weary rays peered through the sheets of metal on the walls, catching the dust motes and making them dance through the beams. She had made a small, contented purring sound, stretching and positioning herself more comfortably in her chair while she examined him. Even with his body slack in sleep she could see the strength he had.

  Of course, she didn't really need to watch him while he was sleeping to know he was strong. He had certainly proved it to her during yesterday's events, if not before. Watching him now allowed her to appreciate him when he didn't have his guard up, let her see how calm he could look when he was relaxed. She wasn't sure why that was important to her, just that it was.

  He must have been something else before he got ghoulified. Spoon thought with a yawn, getting up and meandering around his large form. Goddamn giant red-headed motherfucker. Bet he broke all the girls hearts .

  “Lucas owes me some caps for yesterday's fiasco.” Spoon explained as they headed down the steep steps a little later, her cheeks feeling unnaturally hot as she thought back on her lazy morning. “So we're gonna' visit him, and then I have to go to Craterside. I'm finally low on ammo.” Charon nodded, easily keeping up with her shorter strides. “Ah, here we are,” Spoon said with a hint of relief, her voice still rough from the Nuka-whiskey mix. “Simms, have I got a fucking story for you!” She grinned while she shook the sheriff's hand.

  Simms' brow furrowed as he looked at Charon and gave the ghoul a tight nod. Charon returned the gesture after a moment. Simms didn't particularly care for ghouls, but he also operated on the, 'Do Unto Others' policy, so he wasn't about to start trouble. And for that, Spoon was forever grateful. “What happened to you yesterday? Stockholm said you came home on the big bastard's back.” Simms said worriedly.

  Charon gave an exasperated huff, and Spoon glanced up at him. The ghoul's eyes were somewhat pointedly aimed over Simms' head towards Stockholm's 'nest'. Spoon smiled uneasily. “He's exaggeratin'! If you calm your tits, I'll tell you what happened. Besides, you know how batty Stockholm can get.”

  “Well alright then. Lay it on me.” Lucas said, lighting a cigarette and looking at Spoon expectantly.

  “Ah, we cleared 'em out at any rate,” Spoon began lamely. Lucas raised an eyebrow and Charon made a sound that was suspiciously close to a chuckle. “That is, there were what...maybe eight of them in their hole?” She continued, somewhat flustered.

  “Nine.” Charon corrected quietly.

  “Right, nine. Sorry. During the skirmish on the overpass they shot up my shoulder. I got knocked out. We were sort of...”

  “Kidnapped.” Charon filled in for her. “I was chained up.”

  “Yeah. He thinks they worked for some slavers. They were talking about selling us.” Spoon explained.

  Simms looked surprised, then worried. “They're getting too bold. That's way too close to Megaton for my comfort.” He sighed after a minute, digging around in his coat pocket. “As long as you wiped 'em out, there's really nothing else to do for the moment. Here's the caps.” He said, passing a small sack to Spoon.

  Spoon nodded, tipping her hat in a farewell. “So long, Calamity.” She grinned, making Lucas laugh and doff his own hat.

  “Boy, I got vision, and the rest of the world wears bifocals.” Simms said with a smile, waving them off.

  “What was all that about?” Charon asked once they were out of earshot.

  Spoon gave him a sidelong smile. “He's a big fan of the old-world westerns. My...someone I knew in the vault was too, so occasionally I quote something at him and he quotes right back.”

  “Ah.”

  “Do you like westerns?”

  “Too many horses for my liking.” Charon grumbled.

  “Aw.” Spoon was disappointed, but excited that Charon expressed a personal dislike that had nothing to do with the safety of their locale.

    “Spoon! Come on in, just clearing up a little infesta--oo, who's your friend?” Moira bounded around the counter, eyes wide as she pressed her hands to Charon's chest. The ghoul started in surprise, stepping back and snarling while Spoon began to laugh.

  “Hands off Moira, he's mine.” Spoon said with an easy grin.

  Moira pouted. “Psh, you would swing that way, Vaultie. I don't suppose I could rent him out for a spell? Clearly, I have some research to do.”

  “Nice try, love.” Charon watched the flush that spread across Moira's cheeks at the term of endearment, “I'm no slaver. Show my partner some respect for his personal space. I'm here to buy, and maybe sell you some of this junk. 'Sides, I could never part with Charon. He's saved my ass one too many times.”

  “Aw fine. You're no fun, y'know that?” Moira grumbled, turning away to walk back behind her counter. Spoon crept up beside her, deftly pulling the redhead towards her into a graceful dip. Charon swallowed hard as Spoon murmured something quietly to the shop owner.

  This woman is something else, the ghoul mused while Moira sputtered and turned bright red. Spoon released her, again mentioning that she was here on business. It was a decidedly giddier Moira that began to haul out boxes of ammunition and accoutrements, babbling all the while about her experiments.

    “Gold star! You handled her like a champ!” Spoon praised Charon teasingly as they headed back to her house with arms full of ammunition and other supplies.

  Charon shook his head. “You had an...interesting way of changing her tune.” His voice held quiet disapproval that did not go unnoticed by Spoon.

  The scavenger shrugged as she fumbled around unlocking the door with her hands full. “She's used to people avoiding her because they think she's nuts. Now, I ain't saying she isn't, but she's not a bad sort.” Spoon carried on as she dumped her ammunition into her comfy chair, “I use almost the exact same tactics on any trader I come across, anyhow. It's only gotten me shot at a few times. Mostly by angry wives.” Spoon sniggered. “It even worked on Ahzrukhal.”

  “Why would you have tried it on Ahzrukhal?” Charon seemed to have a difficult time getting the words out of his mouth. “I-I mean...what made you think it would work on a ghoul?”

  “It was a gamble. I didn't know it would work. I just hoped real hard.” Spoon smiled, putting a hand on Charon's arm. “I'm glad it did, though.” Realizing what she was doing, she quickly pulled away with a cough. “I mean, y'know. You've been really helpful with stuff. And I hope you're more happy. Anything's probably better than leaning against that wall for hours.”

  “You have no idea.” Charon mused, his expression troubled. He knelt, spreading an old, stained cloth on the floor.

  Spoon was now very familiar with the ritualistic cleaning of his shotgun that occurred every evening. She watched him sometimes, silently of course. She didn't want to interrupt. He didn't really seem happy, per se, but there was a quiet contentment in his body language that wasn't present any other time. She sat down on the floor, and started tugging off her heavy boots. Charon paid her no mind as he carefully unloaded the shotgun and began disassembling it. Spoon pretended to be occupied with sorting out the different types of ammo, sneaking cautious glances at Charon's sure movements.

  Within a half hour, Charon was done. He held out a hand abruptly, making Spoon jump and almost drop the ammunition she had been 'sorting'. He looked up at her, raising an eyebrow. “Your gun. Want it cleaned?”

  Spoon cleared her throat, feeling caught and very awkward. “Show me how you do it? I've probably been doing it wrong this whole time. I've never had anyone to show me so I just kind of figured it out.” She admitted, passing the ghoul her rifle and sitting back down next to him.

    “See, normally I just kind of swab it out with a damp cloth an' call it quits. It's kept it going for this long.” Spoon explained.

  Charon grumbled to himself, already noticing the built-up layers of grime in the rifle's barrel. “You're lucky as hell that this thing hasn't exploded in your face, smoothskin.”

  “I never said it didn't!” Spoon protested, and Charon noticed for the first time (with a flicker of amusement) that her eyebrows were growing back in odd patches. “But it's the first weapon I ever found, and...I kind of love it, y'know?” She said weakly. “I mean, that thing and my knife have saved my hide probably thousands of times.”

  “Well I'll show you the basics, so if I ever...I mean, if you ever decide to part with my contract, you can, uh,” Charon cleared his throat, “Stay safe.”

  “Thanks.”

  The quiet word was so genuine it made Charon feel uncomfortable. He busied himself with wordlessly showing her the basic ways to clean the weapon. Numerous times he was forced to put his hands over hers to guide them, as her fingers were somewhat indelicate and unsure, and he found himself silently hoping that she wasn't disgusted by his touch.

  “I left the vault with nothing but a BB gun and a baseball bat, and I didn't even know how to upkeep them, so you can imagine how foreign this all is to me.” Charon almost jumped when she spoke, hastily reigning himself in as he automatically scanned the room for threats. Spoon sighed heavily. “Everybody in the place was either trying to kill me or telling me to get the fuck out. I was lucky I got out alive.”

  “A Vault-Dweller, huh?” Charon commented, keeping his tone level. Spoon nodded, an unhappy look turning her face dark. Charon was surprised to find that he missed the way her face was before. Preferences were...odd. When he worked for Ahzrukhal, he didn't need to worry about preferences. There wasn't all that much to worry about. Certainly not much to think about or do. Knock a few heads in, leave Patches at The Chop Shop. Clean his gun. Try to recall what it felt like to eat on a regular basis. Sometimes in a desperate bid to keep his sanity, Charon would make lists in his head. Songs he remembered, places he had been. He didn't want to forget. Charon rotated his shoulders and stood, grumbling low in his throat. Now isn't the time for this shit.  “I'm tired.”

  He felt the prickle of something that he vaguely recognized as guilt when he saw her eyes flash with poorly concealed hurt at his dismissal. But she quickly mastered herself, getting up and bidding him goodnight.

  Her hand lingered on his arm too long again. Charon found that sleep eluded him for quite a while.

    The low rattle of crank gun fire told them where the mutant was long before they could hear it hollering. “I'll come about down this hall. You flank him from the other hall. Stay low, shoot in the reload zone.” Charon hissed.

  Spoon nodded grimly, and bolted for the hallway. She gritted her teeth against the fear she felt swelling in her chest. She hated super mutants, hated their smell, their yelling, and especially their nasty penchant for making themselves goody bags of human remains for later. Spoon skidded to a stop beside a doorway as the crank gun whirred to a stop.

  Shoot in the reload zone.

  Spoon whipped her gun around the doorframe, cracking a shot off into the super mutant's neck. Blood spurted as the mutant let out an enraged bellow, fumbling with the crank gun. Spoon managed to get two more shots off, both burying themselves uselessly in the beast's shoulder.

  Charon where are you? She thought in a panic, scrambling away from the doorway as the crank gun whirred back to life. Bullets started to rip through the wall over her head, and she fled back down the hall.

  “Found you!”

  Spoon couldn't suppress the scream that bubbled up in her throat as a massive hand landed on her shoulder and spun her around. She fired point-blank into the mutant's stomach, the panic making her jerk the trigger twice.

  The rifle jammed.

  The mutant grinned, exhaling a foul breath into her face. Spoon flicked the trigger forward and then back. Nothing. The super mutant picked her up around the neck and Spoon hastily wrapped an arm around its hand, saving her neck from instantly being snapped by the weight of her body. She frantically pumped the trigger of the rifle as the mutant laughed, tears starting to come as she prayed for the damn thing to work work work please-!

  She pressed the muzzle of the gun to the mutant's face as her vision started to gray out. All she could hear was the maniac, discordant laughter of the creature and the useless clicking of her gun.

  So this is how I die? The calm thought surprised her into ceasing to struggle for a minute. Huh. This is definitely looking like how I die. I only wish I could have been stronger. Strong enough to kill this giant, dumb--

  The rifle abruptly fired into the mutant's face, neatly shearing through the skull and taking a chunk of minuscule brain with it. The mutant stopped laughing, face frozen in shock. The fingers around Spoon's neck tightened into a throat-crushing grip, and then relaxed as the beast slumped to the ground. Spoon rolled away, coughing and sucking air into her lungs. She flung an arm out and scooped up her rifle, standing on shaky legs.

  Charon. Where is Charon? She wondered, rummaging through the super mutant's armor for anything useful. She wished she was strong enough to easily use the crank gun, but no such luck. Those things weighed a ton, and no matter how good they were in a pinch there was no way she was lugging one around. The worry for Charon started to eat away at her, and she cautiously crept further down the hall. She could hear grunts and struggling in a room ahead, but it was too dark to see anything. “Charon?” She hissed, one hand on the wall and the other on her gun as she carefully felt her way forwards.

  “Time to die!” The scream cut through the black, making Spoon blanch from how close it was.

  “Charon!” She called, fumbling in her pockets and coming up with a matchbook.

Part Six

[kizardofkoz]

I’m giving up Zillow for Lent. And other thoughts on bravery.

I felt a nag. The thought seeped into the back of my mind like sunlight slowly stretching in the narrow cracks of a pulled shade in the early morning.

 Haunting me. Taunting me. It’s been on my heart for weeks. And It’s time I face the reality.

I feel like I am supposed to give up Zillow for lent.

Please God, anything but Zillow. This is possibly the biggest sacrifice I could possibly make.

Sure, my actual realtor will send me notifications of a home that fits the exact credentials that I need as a mother of three growing boys who teaches piano lessons out of our home and would love a great backyard, four bedrooms, two full baths, and if that puppy had a circle drive, then sweet baby Jesus, I have been gifted my real estate unicorn.

But in reality, Zillow has actually probably robbed me hours of my life, and there is a direct correlation between the accumulating time I have spent searching the same two zip codes over and over, and the pulsating anxiety that grows over finding the perfect home (Spoiler alert: doesn’t exist). Anxiety over lusting over homes both in and out of our budget (what would $50,000 more look like? Spoiler alert: Bitterness over not being able afford homes in that price range ). And anxiety over calculating and re-calculating the mortgage calculator as if starving children in Africa would be fed if I could only find the perfect balance of listing price, down payment percentage, and monthly payment.

I need released from my Zillow prison.

My big house, big house.

Shit.

SO!!!

Let’s Re-cap!

I’ve been busy!!

It is amazing what I like to think about and do when I’m not pregnant and new-babying! In January I decided I was really going to go after some dreams. 

Business Concept A.), which I found a partner for at a funeral. Where all of the best business partnerships are formed. 

B.) A Podcast, which basically feels like a funeral right now as it is taking a back seat to taxes and Business concept A. 

And C.) I signed to an agency a few days before Christmas last year and have been working on getting some print and commercial work. “Commercial Modeling” is different from “Runway Modeling” because the commercial world is composed of women under 5’8” who can still love and eat pizza. Which is perfect because those are two of my most qualifying credentials.

But I have been very intentional recently with what I am seeking, putting my energy toward, and I have not ceased to be floored at the opportunities that have been opened up because I quit thinking “Maybe someday?” and I started asking “If not now then when?”. Literally. It’s a mantra.

It’s even applicable when I’m in the parking lot of a place and I just can’t bring myself to go inside and run another stupid errand. The number of times I’m literally in the parking lot of any store and the idea of going inside seems about as hard as running 5 miles, or emptying the dishwasher. But dammit! Probiotics, razors and pancake mix aren’t just going to go buy themselves! I’m a trailblazer. For myself. Doing crappy things that I don’t want to do.

And awesome things that I do want to do…

I was randomly sitting eating my lunch this week at a local restaurant and decided to eat in their lower level as I know it’s less crowded and I wouldn’t be taking up a full table by myself, because I am an insanely selfless patron.

The owner was downstairs having a meeting with two other women about an event they are putting together. I was very focused on my work - I had a 10:00am appointment with my C.P.A. the following day to go over my 2018 taxes. The 72 hours leading up to my CPA executions appointments, are a very weird time where I am in this dreamlike oblivion where I don’t know if we are going to feel the sweet and exotic relief of a tax refund, or the more familiar dread of needing to scrounge up a lotta coinage to begrudgingly give to Ceasar on the 15th of April, this Christian Calendar year. I am in a self-employment purgatory, warded by an all-powerful tariff sheriff. Basically I’m picturing Jafar as the evil genie at the end of Aladdin demanding my quarterly payments, receipts, write-offs and then laughing as he says I owe 10% more as if *I* was the crazy one even though he’s the one who chose to be a serpent. Dumbass.

Anyways.

So I was sitting, eating my lunch, refiguring for the 57th time what my income was last year (where did it go?! Tar-get…) and these lovely ladies were talking about their event. The theme, intention, needs, location, keynote speakers, ideas, *record scratch*, heart race, look up, “What kind of keynote speakers are you looking for?” Sometimes, before Head-Kiley even has a chance to filter the way a normal person would, Heart-Kiley is already on the fearless train. Bags packed. Talking to strangers. 

After a brief exchange of information, niceties, and the 3 seconds of courage that any scary situation requires, I offered myself up as a keynote speaker.

WHAT?! 

HAHAHHAHAHHAHHAahhahahahhaaHAHAHAHAHA

But.

It’s something I always wanted to do. Ever since church camp when I was younger, I always pictured myself some day speaking in front of a crowd. Sharing personal stories. Combining some of my favorite things: vulnerability, authentic real talk, inviting people to laugh at the hilarity of life, and being the center of attention. 

:)

In my mind, if I ever became a keynote speaker, it would eventually come from writing in my semi-annual blog (eat that Victoria Secret Sale), or from growing my other entrepreneurial endeavors, or maybe even a really bitchin viral video of me breathing fire (Yes. Yes I can.) while folding a fitted sheet. 

Just kidding, no one knows how to fold a fitted sheet.

But there was an opportunity. And I saw it and I spoke up. 

Because this is the year.

I’m almost 35, and “If not now, then when?”.

This component of my personality completely baffles and frustrates my husband. The Emperor of Excel, planning, editing, and thinking things through until he talks himself out of any given action, he is completely mystified, and even annoyed, that I can sashay into any situation, and operate with the most potent and confusing cocktail of unabashed unselfconsciousness, unnecessary confidence that is pretty much entirely fueled by complete obliviousness to how society typically operates. 

I think of it more as this very real and visceral feeling that on a daily basis, I subconsciously keep a baseline awareness that this is the one chance I have at life, and I don’t really care too much about taking risks and failing.

 It’s not that things work out for me because I have a weird magic, good luck, and opportunities that others don’t, it’s that when I see a possible opportunity for good luck, my only weird magic is that I could kind of give two shits if I fail.

The worst case scenario in any situation is that I don’t try. If I don’t succeed, I end up in the exact same place as I would if I didn’t try in the first place, only with the core-cleansing content exhale that I was true to myself. I took a risk. And at the very least, I probably have a really funny story that came from all of it.

I don’t know if anything will come from my weird self-proposing-speech giving. Honestly, I don’t even care (a ton) because I’m really just proud of myself for speaking up for something that I’ve always wanted, when the opportunity presented itself. How lame would it be to write about when I wanted to do something and I didn’t. Instead, I get to do stuff and laugh at how ridiculous it is. And it gets remarkably easier the more I do it.  Heart-Kiley: 1

A practice of tenacity, spunk and fearlessness.

To me, that’s kind of what life is. A chance to practice being our most fearless, spunky, wild selves. And day after day, we have chances big and small to practice ceasing opportunities, and making choices. From the breakfast we eat (I actually choose the same one every morning - sautéed greens, two fried eggs with a slice of melted American cheese on top and black coffee. It makes me so happy. Ambrosia.). To even being fearless in choosing what we will wear. Plaid? Florals? Sequins? Only if it’s all together! 

And bigger choices of fearlessness, like choosing (or not choosing) our partner. Choosing the number of children to have (and may I recommend all boys?). Or choosing whether to buy the $6.99 bottle of champagne because it’s on sale from $9.99, or do we buy the $9.99 bottle because it’s on sale from $17.99? Spoiler alert: They are both going to do the job so just pick the cheaper bottle because this year we are also focusing on our finances and the extra $3 bottle isn’t going to change your life.

It’s not like when you are sitting eating your lunch and doing your taxes and eaves-dropping and then insert yourself into a meeting and suggest that you are what the people are looking for.

But I do think champagne would be very helpful in that scenario as well.

Maybe to celebrate.;)

And if that opportunity doesn’t pan out, another one will. 

And it will still require courage. 

Spunk. 

Tenacity. 

Either the courage to speak up for yourself and say “Yes. I should be the person for this opportunity.” Or perhaps, the even braver courage to say “No, Zillow. I know I’ve had two glasses of wine and at this point you are whispering sweet nothings like “Fireplaces”, “Finished basement”, and “padded kids playroom you can lock from the outside” but I see through you and I am not giving you an undeserving 23 minutes of my life and then 6 more during the next commercial break, because you will leave me feeling both indulgent, deprived, and with an unscratchable itch to try out a new down payment percentage whilst simultaneously looking up mid-century color pallets on Pinterest, because ‘It’s good to be prepared.’ BUT NOT ANY MORE!!!!” (Or respectively, March 6th-April 18th, Happy Early-Lent, everybody.)

Plus, I’ve got keynote speeches to not give.

And Jafar-Ceasars to revolt against.

Nor will that $6.99 bottle of champagne drink itself.

Now.

Time to get back to Business Prop. A.

Because If not now, then when?

Taxes

This is just a great photo of Blair in his chameleon costume climbing off of the couch.

Did you know when you apply at a modeling agency, you have to have photos of you with no make-up and natural hair? Yeah, neither did I and thank God my endlessly talented and selfless friend Heidi Drexler met me in my driveway and took pictures of me while I wore a black tank top that I bought and returned to Target the same day. Because when you see an opportunity, sometimes you ask favors and hope the people along the way know how endlessly grateful you are. 

And you BRING IT.

LATER!

[artificialqueens]

Bitch Fest (Group Fic / Supermodel AU) - Sira

AN: So I haven´t writen in a while, I was really busy, but now I came up with this idea and I hope it´s not a total washout (I just found out that word lmao), in the story all of the queens are females, and there are going to be lots of pairings but mainly Pearlet and Shalaska, and I took a lot of creativity license cause I know nothing about the real world, anyway, I hope you like it and let me know what you think <3

Ps: Sorry if my grammar sucks, it´s still a fucking challenge to write in english for me haha

Tw: Implied eating disorder

Tonight was the big event, the anual festivity of the agency. Every year there was a party to celebrate the fact that “Ru Paul´s Model Agency” was still the best place to find any kind of models. Their fame had increased considerably when they were the first ones to actively accept the diversity of body shapes and nationalities. And this night, specially this night, everybody would be there, and everybody meant everybody. All the models that were part of the agency, as well as the photographers, editors, staff, the media and of course the directives, which were only two now. Violet looked in the mirror again, they were doing her hair, her makeup was all done, and she looked amazing, but again, she always did. Sitting by her side was Katya that seemed really interested by something in her phone, she was probably texting with Trixie, Violet rolled her eyes, they really could never stay away from each other. She knew that if Trixie wasn´t in another room, Katya would most probably had abandoned her by now. They had them separated by “level of importance” as Violet liked to call it, mostly because said that way, it sounded worse than it was, and she loved feeling like a bad bitch using that term. To be honest, the only difference was that they had the models that were the most popular ones, or got the most remarkable jobs during the year, in “special treatment” which meant they were borrowed more expensive clothes and the hair and makeup was sure to be made perfectly so each of them looked their best tonight, at the end of the day, people wanted to see them. Violet loved this kind of events and this kind of separations, it made her feel special, like a rewarding to all of her job, she had her place secured now, and that was something only a few people could say. 9 to be exact, the only 9 people to ever be the face of the agency, it was an honor, or at least that´s how she saw it. Being the face of the agency means that everybody loves you, you are the fucking sensation and every teenager in the world wants to be you, let alone teenagers, everybody wants to be you, and she could said she had been there. She looked in the mirror again and smiled, and her smile just got bigger as she spotted someone at the end of the giant room, wearing a robe and drinking from a bottle of water. She tried to catch her attention waving her hand, hoping the other girl would turn around and see her reflection, fortunately she did, and when she realized who was waving at her, she smiled and started walking towards them. “What´s up bitches?” Pearl asked positionating herself between Violet and Katya, careful not to bother the hairstylist that was still working on Violet. Katya seemed to wake up at the sound of Pearl and turned to look at her with a frown. “What are you doing here?” She asked genuinly confused. Violet couln´t stop the loud laugh that left her throat. “Well hello to you too” The newely arrived girl answered in an offended tone, Katya just started giggling after realizing just how rude she might have sound and held Pearl by the arm. “Sorry, it wasn´t meant to offend anybody, just…” “Just that if you are here that means Trixie could, should, or would, not sure which one, be here too” Violet finished knowing exactly what the russian blonde was thinking. Katya turned to see her open mouthed and after brief seconds she concluded “Right, just what she said” The three girls laughed a little and then it was Pearl´s turn to speak and answer all the questions that the other two girls could have. “Well, first of all, how do you know I shouldn´t be here?, I just want to remind you that I´ve been doing a great job” She said crossing her arms. “Oh, we know Pearly, but your name just wasn´t in the list” the brunette girl said. “Wait, how do you even know that?” Violet just smiled and winked her eye at her. After rolling her eyes Pearl finally answered, “I guess they just made a mistake, you are right, I wasn´t in the list, but something happened, I don´t know what, but Bianca was really mad” Bianca was the person in charge of all the logistics, she was the one to take care of practically everything to do with the events of the agency and the PR. After that Katya was called to get her outfit and the hairstylist finally finished what he was doing, leaving Pearl and Violet alone. “I´m actually really happy they made a mistake” Violet said taking Pearl´s hand. “Someone´s feeling bold today” “Oh hush, see? Nobody is around” Violet ended the sentence stealing a quick peck from Pearl´s lips, the other girl just smiled, she couldn´t really be mad at her. “Are we going home together, or do you preffer going separate ways?” the blonde asked. They had been living together for a while, well, more less, Pearl still had her aparement in a nice building, but during the last 6 months, she had been sleeping almost every night at Violet´s place, all of her important stuff was there too, the only reason she still kept the other  apartment was just a facade so people wouldn´t actually know where she was living. The decision to keep it as a secret was taken by the two of them , after what happened with Sharon and Aalaska and the media going crazy, they thought that it should be known until it was strictly necesary. “Let´s go home together, I don´t think anybody will suspect anything, at least not tonight."                                                            *** All the models were lined up ready to get into the cars that would take them to the the red carpet. The red carpet was the most expected moment for the paparazzi, such a unique thing to see the line of beautiful models entering the lobby of the salon, but first, pictures, of course. Alaska could feel the all too familiar adrenalin flowing through her body, this was her year, she had worked so fucking much to have this, probably harder than any of the other girls here, she was sure. All those hours crying and starving herself to death had to worth something, and here was the result, hundreds of periodists trying to take a picture of her, everybody following her on twiter, facebook, instagram, snapchat, all to see what she was wearing and what she was doing. She called the shots here, she decided what was cool and what was not. She felt powerful and wanted, but that didn´t stopped her body from feeling incredibly weak, she had to keep it together, it´s not like she hadn´t done this before, there were times her body was screaming at her to stop the abuse, but she hadn´t, she had worked hard despite everything, and look where it got her, the top of the world. She felt really dizzy for a moment so she took a sip from the bottle of water that Pearl had given her earlier after asking if she was okay, of course she was, she was fucking famous. While she drank the water that tasted a little bitter in her mouth she could see Sharon through the corner of her eye, she was talking with Katya. She looked beatiful and scary, more mature now, Alaska had to admitt it, since the breakup both of them went through a hard time, there was a time when she almost lost her job because she always looked so sad and bad in general, but then the time passed and she focused in what was important, and she had donde it, and of course, Sharon had too, she had always been a winner, so unique and perfect as she was, no wonder why she fell in love with her. She sipped the water again, and again and again, it almost felt like it was only making it worse. "Ready girls?, we are sending you in groups, section A come with me, the ones with partners, they are waiting in the lobby” that separation was made every year, section A, the one that Alaska belonged now permanently was taken to the lobby where they would call their names and guide them to their cars, if they had no partner sometimes they would put some of them together in the same limousine. They were just waiting now, Alaska was kind of immersed in her own world, like she always did when she was tired, she didn´t know why she was so tired though, but a hand in her shoulder made her inmediatly come back to real life. “Hey Alaska? Are you okay?” it was Sharon, why was everybody asking that lately? “Yes, thanks” She answered with a smile and she had to held her hands together so the other girl couldn´t see they were shaking, she didn´t know why the were shaking, it was probably just the adrenaline, she was under a lot of preassure at the end of the day, plus the bang of nervouness that she always got when Sharon talked to her didn´t help at all. It was stupid to be honest, it had been 3 years now since the break up and they kept the relationship as a long friendship, of course that didn´t sttoped Alaska from crying all night when she found out that Sharon was dating someone else. Sharon opened her mouth to say something else but quickly closed it when Bianca got in. “Okay ladies, you all know what to do, look pretty and be charming, now I need Alaska to go with Steve…” Alaska didn´t hear much after that, she searched Steve with the look and once she found the guy, she started making her way towards him. “Wait!, emm, take care Lasky, have a good night, enjoy yourself please…” Sharon told her while sofly grabbing her hand and the letting go of it, Alaska could start feeling her eyes watering ,and a warm sensation took hold of her body, she didn´t understand why this was affecting her so much, she wasn´t this sensitive in a normal basis. The only thing she could do after that was give a silent nod and a little sad smile. Sharon saw Alaska turn around and follow this dude Steve alongside Bob and Naomi, and she could tell just by the way she was walking, something was off with her ex, earning her a feeling of concern that she wasn´t able to shake off during the entire night.                                                          *** They were all in the red carpet now, hundreds of pictures were being taken and of course people fighting to get interviews with the most wanted girls in the moment, that was Fame´s favourite part, she loved posing in front of a camera at any time and at any moment, this event was always so much fun to her, from finding the perfect dress, to chosing the perfect shoes and of course reuniting with old friends. She was making a flawless serious face for the many photographers when she could see from afar Violet posing, maybe as flawlessly as she was, with Trixie and Katya by her side. She just couldn´t stop the little smile that made her way through her face, it had been so long since they last saw each other, they used to be together all the time, but then she got married and work started to take different ways, so it was always a pleasure to at least spend some time with her. Slowly but surely she made her way to her friend, while still posing for the cameras. “Hey Vies” she said sliding her hand on the brunette´s waist. Violet instantly turned to see her, becoming surprised to see Fame in front of her. “Oh my God, Fame!” She said trying not to do many body language, she gave her a very subtle hug and two elegant kisses, one in each cheek. They really had to look pretty all the time, at least for now. They took a few more pictures before it was time to go inside the salon cause the event was about to start, It was divided in two parts, first there was like a ceremony, where they would post a video, and Ru would talk, Michelle would talk, this year Alaska would also talk, and it was all live on T.V, as well as the red carpet, there were many famous guests too.The other half was the private party. They were all entering the building ,and as fast as they were out of sight they hugged each other so tight they could hardly breathe. “I missed you bitch! Violet said once she gave a step back to look at her face. "Me too, I really did miss you a lot my love” They smiled warmly at each other before Violet squealed happily. “Well, now that you are here, I have soooo much things to tell you, like a lot” “And I can´t wait to hear them, we have like 5 minutes before we necesarily need to be at our places, so spill the T in order of importance” “Okay, okay. Well first, you are not going to believe this, but my dream is finally coming true, the agency decided that it was a good idea to invest in a new project related to me, and in a couple months, you are not going to believe this..” “Bitch, you are scaring me, just say it!” Violet stared at her for a couple more seconds with a huge and anxious smile. “In a few months, we start working on my clothes line collection” They stood in silence looking at each oher for about five seconds, Violet still with that huge grin and Fame was left speechless with wild eyes that got bigger with the time, everything was silence until her shout. “Oh my God! Oh my God! Oh my God!, This is huge I´m so happy for you!” Fame hugged Violet again, but this time they couldn´t stop jumping around like teenagers. “I knowww, right?, but please don´t tell anyone, you are the only person in the world tha knows about this, well, apart from Miichelle, and Ru, but not even Pearl knows” “Really? Why not?, you and Pearl seem very close lately” Fame rememebered a few years ago when Violet had this strong crush on the girl, she never accepted it out loud though, but seeing as they were so close now, made her suspect some things, even if neither of them had confirmed anything yet. “I just want it to be a surprise” “Oh okay, well, anyway I´m so happy for you” They shared another hug before they started finally making their way to the reception vanishing in the small crowd of guests that were doing the same thing. “Oh and Fame?” Violet said once they were walking, Fame turned to see her, she was looking at the ground with a dreamy smile on her face, her aura was kind of insecure and vulnerable, something really rare in Violet. “Mmmh?” “I think I might be falling in love” Fame couldn´t be happier for her friend now, she could still listen to Violet telling her that she woud never fall in love, she could have affairs, lovers, even stable relationships, but love meant putting the other person first, on top of anything and anyone, including yourself, and nobody was worth more than her. Things had definitely changed in their time apart. “Really, how´s so?” “I don´t really know, I just think I find the right person you know?, the one that´s worth it” Her friend only smiled, held the girl´s hand, and squeezed it. She knew better than to push her, Violet would open up to her later, when she felt more secure about her feelings. “It must be a really great person”                                                              *** Willam sat in exactly the place she wanted, it was such a struggle to get it, but it was just the angle she needed so the pictures would come out perfectly, it wasn´t in the same table so it wouldn´t look suspicious but it was near and with the perfect view of Pearl. She had planned this for months now, and the fact that her friend Courtney was  in the agency and going in dates with the feared Bianca Del Rio helped a lot. It wasn´t personal against Pearl, she just needed something fresh. “House of Eswards” was the main gossip center of all times, they started like a magazine, and now they even had their own T.V channel, they were a beast of the media, and they always got the biggest news in  record time, but tonight things were going to change a little. Willam had made her way to the top of the ciberworld by her own resources, who doesn´t love a drag queen with the hottest gossips, and an even hotter personality?, her blog was now one of the most visited ones, and her youtube channel was just as famous. She started getting free tickets to cover events, and one of them was the anual anniversary of RuPaul´s Model Agency, but there was always a problem, sure people loved seeing pictures and interviews with beautiful models, but things were starting to get a little boring for her, and if she wanted to beat the House of Edwards for this one, she needed to do something about it. She smiled and looked at the hour in her cellphone, it was almost time. The place was starting to get full and after all the greetings and salutations, the people strated to go to their places, once Pearl was in her seat Willam knew it was just a matter of time before the real drama started. Michelle was the first one to talk, she went to the podium, that was in the middle of an scenario, that had a little runway to it. “Hello, welcome everybody, tonight we celebrate, as every year, the glory and success of our beloved agency, this started as a project to show the world that every person is different but equally gorgeous, we have in our hands a group of people that have fought to get where they are now, working and looking always…” Willam was constantly looking into Pearl´s direction, bearly hearing what Michelle was talking about, every year was the same anyway, they would talk about the work they have done, and how they are awesome, in fact, this all damn thing was to show off, she was sure. Her target was still the same way as she arrived, sure the girl always seemed a little high and sleepy, so it was difficult to see if it was working. “…Now, with that being said, let´s receive the creator of this wonderful company” As soon as those words left Michelle´s lips, the place got all dark with the exception of a reflector pointing to the same podium. Willam had her camera ready, this was always the best part, each year they seemed to get richer, and the event got fancier and fancier. The music started playing, and some different lights appeared making fugures in the background, the moment the bit of the music got faster, Ru appeared using an incredible dress, as always. Everybody got up and started clapping and screaming, Willam turned to see Pearl, only to find her in her feet and clapping lazyly, but she wasn´t sure if it was just  because of the girl´s slow demeanor. When she sat down and stared in concentration to the front, she looked exactly the same way as she did in the beginnig. Willam checked her phone again, she was suppoused to be fainting by now, she groaned in exasperation and turned to the front to pretend she was listening. “… cause´ if you can´t love yourself, how the hell you are gonna love somebody else?” Everybody clapped again, and a video was projected in three different big screen, one above the podium and the other two at the sides. The video was the highlights of the year for each model, the center of attention being Alaska for what she accomplished, but almost every model got to appear, even if it was just in the background. Willam smiled as he saw Courtney and Alaska together in a shoot, Courtney had been friends with her since they moved together to New York, and she getting into the agency and becoming kind of famous about it, helped them both a lot, just like today, of course Courtney didn´t know anything about the Pearl thing, now that would be a problem. The girl also made her and Alaska become good friends, she could almost say they were her only two friends, it was weird, Willam never thought that her two bests friends were going to end up being supermodels, one of them super famous. They never went out in public, Alaska liked seeing Courtney and Willam in their apartment or vice versa, she hated dragging attention to them together for some reason. Then suddenly there was clapping again and Willam´s attention went back to Pearl, she was exactly the same way as always, something was wrong. The lights changed again, making the runway all blue, and all the girls that had once being the face of the agency started modelling, Alaska was a the end, and after all the girls divided into two lines, she walked through the space between them until she was at the front, making a pose and leaving everybody screaming, but Willam´s attention wasn´t on her again. Pearl was on her feet, but this time she looked a little more sleepy, she closed her eyes, and leaned on the table, holding it tightly with one hand. This was the moment. Willam took her camera, and held it close to her face, making sure she had the perfect vission of her. Then the model just closed her eyes and shook her head, then opened her eyes again, Willam´s mouth dropped, and then Pearl was clapping again like nothing happened. She put her camera down and stared in desbelief. “What the fuck?” She whispered, good luck nobody on her table was looking at her, they were all so bussy paying attention to Alaska, which she wasn´t, she had bigger problems right now. “What if she didn´t drink the all water?, what if she gave it to somebody else?” she thought, but that couldn´t be possible, she hadn´t thought about it, she herself watched her drinking it… before she went away with this other model, Violet, and what if she drank it?. She turned to see Violet with urgency,that could also work, but she prefered it was someone that wasn´t that important and not in the stage, but the girl seemed perfectly fine. She could feel her heart beating with force, she was nervous, and that didn´t happened often, maybe she was overreacting, maybe nobody drank it… Willam´s thoughts were interrupted by a gasp by someone on her table, making her turn her face inmediatly to the front, Alaska was giving her speech, or at least she was suppoused to be doing that, her eyes were closed and she was leaning on the podium, a loud gasp could be heard when her knees gave in and she had to almost hug the podium for support.  “Fuck” Willam whispered again, this time full of fear and a, growing with the minute, regret. Just as some security dudes and a few guests started to make their way to the girl in order to help her, she fell to the floor unconscious. “Fuck, fuck, fuck…” Willam could her the screams, and all the people standing up and going to the front to see something, and Willam´s panic started getting bigger, just as eveyone elses. The security people were now gathered around the sleeping girl making everybody step back, and the flashes were all around tha place. She could see Laganja, the pothead dancer of House of Edwards get some good shots. This wasn´t suppoused to be this way, sure, the drama was bigger now, this was some high quality entertainment news, but that was her friend in there, she had chosen Pearl for a reason, besides the fact that it would have been so funny cause eveybody is making fun of her being a sleepwalker all the time, she was lowkey famous, which meant, nobody payed her enough attention, but everybody knew who she was, it would have been entertaining yet it wouldn´t have stole the show. An ambulance could be heard from affar, and Willam´s attention went back to all the people in the stage, and the doctors that were allready taking care of the girl, why the ambulance?, it was just a painkiller dissolved in water, the doctors there could take care of that, they could even wake her up now, of course she considered Pearl being healthy enough… She closed her eyes and tried not to think about the fact that she probably put in danger one of her friends, and on top of it all, she had nothing, a few pictures of Ru entrance, an interview with Alaska from a few hours ago and that was it, one force making her stay just where she was, and not going to the front to take the last pics of Alaska in the ground with the doctors, guilt. “Fucking fuck”                                                           *** Violet and all the models that were on the stage besides Alaska were now being dragged ou of it, they were instructed to join the rest of the guests, and Michelle would tell them what to do in a moment, Alaska´s health being the main prioritie right now. There was one feeling that could even be palpable at the moment, panic. Nobody knew what happened and sounds of the ambulance, that was now parked outside, didn´t make things any better. Violet searched Pearl with the sight finding her in a corner all alone, she turned to see her other companions, but they were all looking at each other talking about what just happened with concern, when no one was looking at her, she made her way towards her girlfriend. When she was in front of Pearl she could see the girl closing her eyes and holding the bridge of her nose, she only held the bridge of her nose when somethig was wrong. “Hey, what´s wrong Pearly?” she said taking her hands away from her face, interwining their fingers. “Nothing pumpkin, I just feel a little dizzy, I don´t know why” “Are you sure?, I mean Alaska was feeling just dizzy like 20 minutes ago” Violet answered allready feeling concerned. “Don´t worry, it´s fine I promise, I feel worse when I´m very high” The girl giggled and then leaned to give her girlfriend a sweet kiss. “Now who´s the one feeling bold?” Before Pearl could answer, someone calling the name of Violet broke the moment, the girls quickly stepped away from each other. “Oh Violet, it´s so nice to see you” “Hi Santino” Violet gave a quick hug to the man and then a kiss in the cheek. Santino used to work for the agency a long time ago, but he was still friends with Ru, so they would work together some times, that´s how he knew Violet, He had a clothes line, and recently he had opted for opening his own model agency, but in the past Violet had work for him, actually she assisted to many of his runways, and she always got the best dresses, Santino always used to tell her she was as beautiful as a doll and as graceful as a swan, she was his favourite in the industry, and that´s how they became friends. Pearl on the other hand, gulped and started counting the seconds until they could walk away from this man. “And hello miss Pearl” He said turning to look at her. Pearl faked her best smile and tried to hide the nerveousness that always came when she was near him. “Hello"  That seemed to be enough for him, that just turned to look at Violet. "Have you been thinking in what I propoused you?” Pearl frowned, what exactly were they talking about? Violet laughed a little bit, and then looked at him shyly. “I´m afraid the answer is still a no” Santino had offered Violet many times to switch agencies, that she would be very welcomed in his agency, and of course she would have priorities, and maybe in another time Violet would have consider it, but since Ru Paul herself was taking the risk on invest in her and her clothes line, she couldn´t really complaint, actually she was more than grateful and happy and she wouldn´t change that for anything in the world. Santino laughed a little and then accepted the answer, not going further in the conversation. “If that´s the case, then I can only dream about it right?” Violet nodded still with a smile, she thought the conversation was over until one las comment was added. Santino turmed to look at Pearl directly at her eyes,who still had that akward uncomfortable demeanor. “Yeah, we´ll see” and with that, he gave one last smile to Violet and walked away. Pearl frowned again and started questioning what this was all about, she definitely didin´t like being around him, and she definitely hated her girlfriend being around him even more. Violet chuckled a little seeing as Pearl was so lost in her thoughts. “Hey, don´t laugh at me, you still have a lot of explaining to do” “Oh, do I?” Violet answered in a teasing tone. “Yes, like since when you and Santino are best friends?” At first Violet thought she was kidding, they would always play like that, teasing each other and making small fake dramas, but looking into Pearl´s eyes she could sense the girl was serious, she had an eyebrow raised and her mouth was a straight line, no hint of a smile in there. Violet laughed to herself a little and then leaned to whisper in her ear “So, I don´t know what´s with you today, or why are you acting so weird, Santino just want me to work with him, to which I ansewered with an ovbious no, but If we can stop talking about it, maybe I can start concentrating in what´s important, and start thinking how are you gonna make my night fun” she finished and then she bit the blonde´s earlobe, Pearl turned to see her with awe and biting her lip, she was right, the night was young, and with all of this happening tonight, they needed a stress relief. Michelle´s voice echoed through the place as she instructed everyone to go back to their places. They smiled to each other and Pearl watched her beautiful girlfriend walk to her table, she was so fucking lucky. 

Next Chapter: -How did Willam do it? (Water drama) -What´s with Pearl? -Some Trixya for your nerves -Oh, and smut ;) 

[cropad]

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[shapesnnsizes]

RHR: How to Fight Practitioner Burnout with Dr. Akil Palanisamy

In this episode, we discuss:

Burnout among healthcare practitioners

How common the problem is

The results of widespread physician burnout

The difference between burnout and moral injury

How technology is contributing to the problem, not alleviating it

How to fight physician burnout

Show notes:

The Paleovedic Diet by Dr. Akil Palanisamy

The Sutter Health Institute for Health & Healing in San Francisco

Unconventional Medicine by Chris Kresser

1440 Multiversity retreat for healthcare professionals

Akil Palanisamy’s website, DoctorAkil.com

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Chris Kresser:  Hey, everybody, Chris Kresser here. Welcome to another episode of Revolution Health Radio. This week we’re going to be talking to Dr. Akil Palanisamy, who is a friend and colleague in the Functional Medicine space. And I’ve known him for several years. He is the author of The Paleovedic Diet, a really interesting book combining Paleo and Ayurveda, a traditional Indian medicine which is an interest of his. And he also runs the Paleo Symposium that’s put on by the Institute for Health & Healing at UCSF every year, that I’ve been a featured speaker at since it started.

But today actually, we’re going to be talking about something different, which is burnout amongst healthcare practitioners. It’s a really important topic that has pretty significant implications not only in terms of the effect on individual clinicians, but on patients and their access to care, things like medical errors and just the healthcare system overall.

So if you’re not familiar with Akil, he’s an integrative medicine physician who blends his medical training with Functional Medicine in Ayurveda, the traditional medicine of India. He studied biochemistry at Harvard and received his medical degree from UCSF and completed his residency at Stanford. Dr. Akil also completed a fellowship in integrative medicine with Dr. Andrew Weil at the University of Arizona. He sees patients at the Sutter Health Institute for Health & Healing in San Francisco, where he also serves as physician director for community education. He’s been a consultant with the medical board of California for many years and as I mentioned, he’s the author of The Paleovedic Diet: A Complete Program to Burn Fat, Increase Energy, and Reverse Disease.

So I’m really excited to dive into this conversation with Akil. I think you’ll find it interesting, even if you’re not a healthcare practitioner that’s experiencing burnout, because we talk about a lot of issues that are relevant to anybody doing any kind of work, really. So I hope you enjoy the conversation. Let’s dive in. Akil, thank you so much for joining us. I’m so glad to have you here.

Akil Palanisamy:  Thank you, Chris. Pleasure to be here.

Burnout among healthcare practitioners

Chris Kresser:  So today we’re going to talk about a really important topic that I don't think gets enough attention, and this is physician burnout. So, and I would extend it to burnout for any healthcare practitioners. We might be focusing a little bit on physicians because this is where most of the statistics are available, but it’s certainly a problem across the entire healthcare world whether we’re talking about:

Nurses

Nurse practitioners

Occupational therapists

Chiropractors

Acupuncturists

Anybody working in the care profession

In my book Unconventional Medicine, I talked a lot about how this is one of the major challenges within medicine in general, not just conventional medicine, but also integrative medicine and Functional Medicine. And it's something that we need to develop a sensible approach to if we’re going to meet our goals in terms of preventing and reversing disease. So this is something that Akil has thought deeply about and has been involved in a number of different initiatives from his work at Sutter to working with medical students and other physicians to address this problem. So I'm really looking forward to having this conversation. So why don’t we start a little bit with the stats on burnout, Akil?

Ask yourself: Does medicine still feel like your calling? If daily stress and exhaustion are turning you away from the profession, you might be headed toward physician burnout. Find out what causes burnout and learn how to rediscover your sense of purpose.

How common the problem is

Akil Palanisamy:  Sure, yeah, I think it's really rampant, and most studies report around 50 percent or higher of physicians report some significant burnout. And that's up from about 40 percent just five years ago. So, I think the numbers are really scary and also this is a global problem. So this is across the board. Many countries throughout the world and also regardless of the stage of training. So medical students, residents, physicians, even the number of years of practice has no impact.

Chris Kresser:  Wow.

Akil Palanisamy:  I will check on this number, so, I mean, I know because I did my medical training 20 years ago, and it was like, I would say, a soul-crushing and exhausting process.

Chris Kresser:  Right, right.

Akil Palanisamy:  So I started early in this topic, and that’s why I’m so passionate about it.

Chris Kresser:  Yeah, yeah. That’s really revealing in some ways. If medical students are as burned out as people who've been in the profession for 10 or 20 years, that's an indication that something’s already going wrong, even at that very early stage.

Akil Palanisamy:  Right. I came across a really fascinating study. They interviewed almost 3,000 medical students about burnout and 53 percent of them reported feeling burnt out. About 15 percent were depressed, about 5 percent had seriously considered suicide. But the interesting thing was 100 percent of the students, every single one reported feeling humiliated at some point, demeaned, disrespected as part of their training. And that had huge effects on their performance and judgment, and that was my experience too. It’s part of the culture of training doctors.

Chris Kresser:  It really is, isn’t it? It’s almost like fraternity hazing or something. I've heard for residents that it's … and it seems to be perpetuated for some of the same reasons, like this, “I went through this, so you have to go through it,” type of mentality. And I've even read the studies that support that.

Akil Palanisamy:  Yeah, right. When I started my residency, I was super thrilled because they had just passed a law limiting the work hours, continuous work hours to 24 hours in a row. That was like a huge drop.

Chris Kresser:  That’s a big development.

Akil Palanisamy:  And I was like, “Wow, this is fantastic. I only have to work 24 hours in a row, like, every week.” And people thought that would solve the problem of burnout. But it hasn’t because that’s just one of many factors.

The results of widespread physician burnout

Chris Kresser:  Right, and so we know that there’s a huge problem with the shortage of primary care physicians. I don't remember the exact number from the study I shared in my book, but it's something like, predicted to be a shortage of around 50,000 primary care providers by the year 2025, which is not very far off in the future. And yet one of the costs of burnout, as you said, is that two-thirds of physicians know a doctor who is likely to stop practicing medicine or at least to reduce their access to patients, switch to concierge model, or something like that within the next five years as a result of burnout. So this is a real problem that's really kind of having an outsize effect on our healthcare system.

Akil Palanisamy:  Yeah, absolutely. I mean, I think it is genuinely a public health crisis. And I think that that word is increasingly being used in the literature because this really does impact not just individual physicians but patients, healthcare organizations, the entire healthcare system in our country and other countries around the world. So I think the scope of the effects and the impact of burnout is being recognized now and it's huge in terms of not just the individual level, but medical errors as well. So, recent studies have shown that there’s a strong relationship between physician burnout and medical errors. And already medical errors are one of the major leading causes of death in the United States. And so I think as we get more burned out physicians and higher rates of medical errors, I think that's one of the big issues in terms of the costs of this problem.

Chris Kresser:  Yeah, this is critical, and I highlighted this in my book. But if you go to a site like CDC or a general website and you search for the top 10 causes of death, let’s see what happens if we do that right now. Cardiovascular disease is still holding at number one, and then you’ve got lung cancer or you’ve got other diseases that come shortly after that. The data is often changing. Cancer continues to go up the list. But you’re not going to see medical errors on these lists, right?

Akil Palanisamy:  Right.

Chris Kresser:  There was a study published in the British Medical Journal in 2016, just a couple of years ago, and then another one by Barbara Starfield, who’s since passed away, back in 2000 in JAMA. And both of those found the same thing, that medical errors are actually the third-leading cause of death. And since only 5 to 15 percent of the atherogenic events are even reported, Dr. Starfield actually speculated that medical errors could be the number one cause of death if all of the atherogenic events were reported. So this is something you don't see on the typical list, but that doesn't mean it's not true.

Akil Palanisamy:  Right, exactly. Yeah, because when you experience burnout, the impaired judgment, lack of attention to detail, communication breakdown, all the things, the depression, that just greatly increases the risk of medical errors.

Chris Kresser:  Right. So this is a, it's a common problem, it's a problem that has not only effects on individual practitioners and their health and their lifespan, their feelings about their work, but also to patients and their safety and their ability to get the care that they need, and then to society as a whole. The healthcare crisis continues to deepen, and we need more doctors, rather than fewer. The fact that 50 … that two-thirds of physicians know a doctor who’s likely to stop practicing medicine in five years is exactly the opposite direction that we need to be going in here.

The difference between burnout and moral injury

So let's talk … so, we’ve been throwing this term “burnout” around, and I'm sure that means different things to different people. But you actually emailed me before the show with a really interesting distinction that I want to highlight—the difference between burnout and moral injury. So can you talk about that a little bit?

Akil Palanisamy:  Yeah, absolutely. So traditionally, burnout is defined as a work-related syndrome characterized by emotional exhaustion, a cynical feeling, and feeling like you're ineffective on the job. But this concept of burnout really doesn't resonate with doctors. I can tell you from talking to many of them that they really don't connect with this concept of burnout because the problem is you're pointing the finger at doctors. And you’re saying, “You’re burned out, you need to start doing yoga and eat granola, and just like change your lifestyle.” But you know, these are some of the most resilient people out there.

Chris Kresser:  Absolutely.

Akil Palanisamy:  Medicine, I mean we’ve survived decades of intense training, sleep deprivation, the training process itself is incredibly stressful, the work demands. So these are some of the most resilient and resourceful people out there. And so I think the problem is really,  a big part of it is the system. But the distinction that you mentioned between moral injury and burnout, the concept of moral injury actually was first used to describe how soldiers responded to what they did during war and when they came back, having to do things that went against their morals.

In healthcare, it refers to physicians being unable to provide the high-quality care that they would really like to, essentially, not being able to be true to themselves. So I think the problem is not that physicians are burned out and so we don't care. The problem is that we care very deeply.

Chris Kresser:  Care too much.

Akil Palanisamy:  Yeah.

Chris Kresser:  Not too much, but it’s the care that’s causing the problem, yeah.

Akil Palanisamy:  Right and then as a result, in our current healthcare system, it's so hard to consistently meet patients’ needs and provide the kind of care that we envisioned we would going into medicine. Because most doctors think of medicine as a calling, and so that failure and inability to meet needs of patients in the way that we really envision, that is hugely damaging, and I think that has a huge effect on physician well-being. And so that's the concept of moral injury. So I think that it's really much broader than just pointing the finger at doctors.

Chris Kresser:  I think that’s really, really important to understand, and I've always made it clear that when I'm criticizing conventional medicine and its shortcomings, I'm not criticizing individual doctors. Of course, I might be criticizing some individual doctors, but not as a group because the vast majority of doctors that I have met are people that genuinely want to help their patients. They went into medicine for all the right reasons and they do recognize that they're not having the impact that they would like to have, and it's painful for them. But there's, they feel like their hands are tied because of the way that the system is set up. And they’re just as much victims of the system as the average patient is.

And I think this is a good example of how that plays out where we all want to have meaningful and rewarding work. We all want to get to the end of the day and feel like we really made a difference. And doctors, I think, especially. That's the path they chose. They didn't go into private equity. They didn't choose to go into a career that was really not about helping people, but more about making money or enriching their own lives. Not that there's necessarily anything wrong with that. They willingly chose to go through a very arduous path that involves many, many years of schooling and as you said, rigorous training with residency, working 24 hours straight, often graduating with hundreds of thousands of dollars of debt. I mean, it’s an enormous risk to take, an enormous amount of investment of money and time and energy to become a physician.

So you don't make it through that generally, unless you really have a guiding moral compass that is pushing you through it. And so it's really, I think, even more important and critical that we figure out a way to, where we create a path forward for doctors and other healthcare practitioners that really do want to have that feeling at the end of the day. Because that's the antidote to burnout, where when you really do feel like you're transforming the lives of the people that you're working with, and you're having a huge impact. Because in that situation it doesn't mean you won't get tired and it doesn't mean you won't occasionally feel, “Geez, I need a vacation.” But you're not going to have that moral injury, and that’s what makes all the difference in the world.

Akil Palanisamy:  Yeah, I know, exactly. And I think that the rates of suicide among physicians is a real wake-up call because it’s twice that of I think active duty military, and then there was a report from the UK that there was a young junior doctor who, she took her own life by walking into the sea.

Chris Kresser:  Yeah, that’s not, yeah.

Akil Palanisamy:  Statistically, women physicians are a significantly higher risk of completed suicide than matched females in other professions. So it’s not uncommon, unfortunately, and I think that, yeah, exactly what you said about that moral compass that physicians have, I think being able to feel like you're true to yourself. That's a basic need that all of us have, and I think especially those who go into medicine, we feel that pretty intensely.

How technology is contributing to the problem, not alleviating it

Chris Kresser:  Right. And there may be lots of choices every day that they have to make that are, don't feel true to themselves because of the way that the system is set up. And I know from my own research and I know you and I have talked about this, one of the influences in terms of burnout has been the rise of electronic medical records or electronic health records, EMRs and EHRs. Initially these were hailed as, that this is going to dramatically reduce the amount of paperwork that doctors would have to do and they were going to be great time-saving and productivity devices, and they were going to be doctors’ best friends. But the reality has not quite lived up to that, has it?

Akil Palanisamy:  No, no. Yeah, I would, I think that studies show that about like half of the average physician’s workday is spent entering data or doing other clerical work in the EHR. So the amount of time actually spent with patients is less than a third, and for me I think it's a bit of a double-edged sword. Because it does make it easier to respond to patient messages rather than playing phone tag with patients. But on a typical day, I might get 50 to 60 electronic messages in addition to charting visit notes for each patient, and each of these questions or patient calls, etc., requires some thought.

And increasingly we’re being measured on how quickly we can respond to these messages because the priority is patient satisfaction, and that's eventually going to be tied to financial compensation and that kind of thing. So I think this EHR, it takes up so much time, and it really hasn’t translated to the reduced workload and that sort of thing. And when we deal with insurance in my practice, I think that's a huge benefit for patients because it improves access, and for Functional Medicine and integrative medicine, I think we need to move in that direction where insurance covers services. And so we offer that, but then it creates a whole universe of responsibilities in terms of the paperwork, the criteria for each progress note when we’re billing insurance, the forms, the prior authorizations, the other kind of paperwork. So it just adds another layer of paperwork to everything else that we’re dealing with in terms of the EHR every day.

Chris Kresser:  Yes. And then there’s another issue of when you're actually in the room with the patient, that connection that you're trying to make with the patient is now being mediated by a computer screen and having to type into the computer. And we’ve all seen, I've heard many stories of people going to doctors and complaining that their doctor was hardly even looking at them because they were working on the computer the entire time, and this is especially true with younger doctors from what I've heard, who never operated without an EHR.

So they never had the experience of being in a visit with the patient without the computer being part of that. And I think with all the data that we now have in terms of how important the physician-patient relationship is to the outcomes in care and the research on the placebo effect, and just the, in Carl Rogers's words, the unconditional positive regard and the type of connection that is made just is therapeutic in its own right. And I think the EHR can compromise that in some ways.

Akil Palanisamy:  Yeah, absolutely. And I'm always torn because I want to maintain good eye contact and really be present with each patient, but then if I don’t touch the EHR at all, then at the end of the day I’m like, this one’s like …

Chris Kresser:  You’ve got eight more hours of work.

Akil Palanisamy:  Exactly.

Chris Kresser:  It’s really challenging, and, I mean, my solution to that, which is not possible for everybody because of the model I work independently, so I’m able to just kind of set things up how I want. But I have a nurse practitioner that's by my side at every appointment, and she takes the notes. So I'm able to just maintain eye contact with my patient and not really look at the computer. And I recognize that's not a viable solution for most practitioners, but it's something that I felt compelled to do because I, like you, didn't want to get home and do four hours of data entry into the EHR after a full day of seeing patients. And but I didn't also want to sacrifice the connection with the patient.

So I think the other thing that's also not always in an individual physician’s control is the quality of the EHR or the EMR system. So many of them are just completely bloated and full of functions that they'll never use, and just really difficult to navigate, and they’re a nightmare in terms of software development. They’ve been just sort of cobbled together and put on top of each other, and it’s, for anyone who likes software and technology, EMR software is not going to be particularly inspiring for the most part.

Akil Palanisamy:  Yes, yeah. No, I think you’re right on that. And the point about having additional support for progress notes, I think, is a good one because studies show that having some type of help with the charting actually reduces burnout, and it's obvious, right? And I think at Sutter Health where I work, they really take burnout quite seriously. And so they’ve supported having scribes, which is the same thing. They take notes and they kind of do everything, and you just have to sign the note.

So I think it’s really, it’s a shared issue with burnout between individuals and healthcare systems and organizations. So I think it’s very important that all of these systems realize they have an important role to play, and I think Sutter Health is a really great example of that. They've supported a lot of these changes, and like this example of scribes and with our EHR, which is Epic, just helping us to use it in the most efficient way possible. So I think systemic changes are really a huge part of the solution as well.

Chris Kresser:  Absolutely, and this is a recurring theme in this conversation. It's that individual physicians can only do so much when they're employed in a larger organization, and they’re not free to just do whatever they want. And so we have to continue to work to raise awareness institutionally about these issues so that the institutions themselves can make the changes, and then individual physicians will benefit from those.

Akil Palanisamy:  Right.

How to fight physician burnout

Chris Kresser:  So let's talk a little bit about some of the work you've done in the past with medical students and other doctors at Sutter on burnout. What kind of things have you done to approach this?

Akil Palanisamy:  Yeah, I think for me during medical school, it was really a survival mechanism. Because I was pretty burned out and the training, yes, I absolutely had that being belittled and demeaned when I was on the wards in my rotations. And so I really got interested in the certain classes that were offered on finding meaning in medicine and really connecting with your purpose or actually reconnecting with why you went into medicine, and keeping that front and center. And also developing tools for maintaining well-being like mindfulness.

So mindfulness is one thing that has been studied. There’s actually been about 14 studies looking at physician burnout and mindfulness, and nine of them have shown positive outcome in terms of:

Reducing burnout

Improving well-being

Improving mood

Improving resiliency

So I think, I don't think that's the entire solution, but the more tools you have in your toolkit, the better. And we don't really get any training in general in terms of how to deal with stress and how to manage emotions during our healthcare training. And so I think I got into mindfulness very early, studied MBSR, developed a daily meditation practice, became involved in educational programs teaching people about mindfulness. And then since … then during residency and now practice, after that I've been very interested in workshops and events that kind of focus on that aspect of meaning and really reconnecting with a sense of purpose, a sense of direction. Kind of helping people be true to themselves.

And so I think small group exercises and workshops where people are getting out of their left brain and reconnecting with their right brain, using art and things like that, have been really effective. So for me, I've benefited as much as I’ve helped anybody in this work, and it's been just partly for my own gains, but I think you teach what you have to learn. And for me, being involved in burnout and teaching people about it has been a lifesaver.

Chris Kresser:  That’s so great. I think all of those are fantastic tools for kind of exploring the causes of burnout on an individual level and helping people respond in a way that will reduce the risk of moral injury, if we will. And I know for me, one of the ways that I've approached this personally and also with people that I've worked with and that I’ve trained is just to make sure that I feel like the work I'm doing is having a big impact on my patient’s lives. Because that’s one of the reasons I really love that distinction that you make between burnout and moral injury. Because if I look at it that way, I think, “Okay, well, that's the biggest risk is just getting to the end of the day and feeling like I'm not making a difference. Feeling like all of my efforts are for naught really. Or they’re not really having the impact that I would like them to have.” And to me, that's the greatest risk in terms of burning out. When I know that my work is making a difference, my endurance and stamina are considerable.

Akil Palanisamy:  Right.

Use Functional Medicine to prevent it

Chris Kresser:  But when I don't feel that way, it doesn't take much to make me feel tired and like what I'm doing is not worth it. So this is, I think, where a Functional Medicine approach has a lot to offer, not just as a treatment modality, but as a means of really actually making a difference in the patients’ lives. Like getting to the root cause of the problem and actually addressing the problem and helping the patient to recover and feel better without the use of unnecessary drugs and surgery. For me that was one of the most appealing things about Functional Medicine, and I think it's one of the less talked about but most important gifts that it has to offer to individual physicians who shift their practice in that direction.

Akil Palanisamy:  Yeah, I think that's what motivated me to go into Functional Medicine as well, just to get that sense of fulfillment and satisfaction when you help someone really get a permanent solution to something and by uncovering the root causes and taking that holistic approach. So I think that's what drew me to Functional Medicine as well.

Schedule a retreat

Chris Kresser:  Absolutely. So another area where I know, or a kind of antidote to burnout that I know that you and I are both passionate about is a retreat. So I've been a big believer in retreat. I’ve done annual retreats myself for many years. I’ve done meditation retreats for about 25 years and I just can't really imagine my life without that opportunity to step away from my day-to-day life and experience and to get a different perspective, to slow down, to have more spacious existence for a few days were the busyness of life is not overtaking me and where I can just hear myself think and feel my body, and just look at things from a fresh perspective. It's just crucial for me. And I've always felt like my wish has been that others can experience this. That we can, because I really believe in its transformative power.

Connect with colleagues

Akil Palanisamy:  Yeah, absolutely. I do as well, and I’ve had a number of retreats over the years in terms of individual retreats and also group retreats. And especially in the professional setting, I find that ability to connect with other colleagues and professionals in that informal, nonwork setting is so powerful because in healthcare there's so much isolation. There are so many individual silos.

Everybody's just doing their thing trying to get through the day, and you rarely have a chance to step back and step out of that situation to just really deeply connect with people who are in the same boat and really understand what they're going through, share their story, listen to their stories, and really deepen your connection and solve problems together.

So I think that sort of deep connection is so important because that's like a huge need for all human beings, and especially in such an isolating profession like in healthcare. I think it's essential.

Chris Kresser:  Absolutely, yeah. So many clinicians can just spend, we spend most of our time in a room with patients and we’re interacting with patients, but we’re not, we’re interacting with them in a certain way. We’re playing a certain role. We’re the clinician, they’re the patient, and those can be rich and rewarding interactions. But it's not the same as connecting with other colleagues and being able to talk about the issues that we face professionally and share together. So yeah I think that group experience is really powerful. And I’ve been writing about this recently.

I’ve been sharing some book recommendations, and Akil and I have actually teamed up to offer a retreat for healthcare practitioners at 1440 Multiversity in October. It’s from October 5th to 7th this year. And so it starts on Friday afternoon, Friday evening, and it goes through Sunday midday. And the retreat’s called “From Burnout to Brilliance: Rediscover Your Passion and Purpose, Reclaim Your Health, and Create a Practice You Love.” So the intention of this retreat is to address the issues that we've been talking about in the show and to help healthcare professionals explore their own situation, help them rediscover their passion for medicine and healthcare, and reconnect with a sense of meaning and purpose in their work to take some practical steps. Break those down into really doable actionable steps that they can take to reclaim their health and well-being. Rediscover parts of themselves that are not typically expressed in the course of their day-to-day work and just kind of cultivate a sense of energy and vitality that they may have been missing for many years.

And I'm really excited about doing this. I’m excited about doing this with Akil, who I've known for several years now and I really respect, and I'm excited about doing it at 1440. It's an incredible new retreat center, which I think you did a retreat there with Michelle Tam with Nom Nom Paleo last year, Akil?

Akil Palanisamy:  Yes, yes beautiful, beautiful place. Yeah.

Chris Kresser:  So this is, and for those of you who are not familiar, it's in Santa Cruz Mountains, right?

Akil Palanisamy:  Yeah, it’s surrounded by redwood trees and there's all these amazing hiking trails. And yeah, a beautiful place.

Chris Kresser:  Yeah. I haven't actually been there yet, but I know several people who’ve taught there and who’ve been there. And if you go to 1440.org, click on the stay button and check out some of the pictures. It's an absolutely beautiful campus. Really nice accommodations, gorgeous dining hall with lots of different food options. They've got daily yoga classes and massage, and a spa and other health offerings there. And they’ve got, of course, gorgeous hiking trails because it's in the redwood forest there. It just looks to me like they're really doing it right. I've been to a lot of retreat centers. I actually lived at a retreat center in Big Sur called the Esalen Institute …

Akil Palanisamy:  Oh. sure.

Chris Kresser:  … and many people may be familiar with. When I was still really sick and dealing with my health issues, I got to a point where I just decided, I kind of reached the end of the line of supplements and diets, and medications, and I decided that I would explore the psychological, emotional, psycho-spiritual aspects of what was going on for me. So I moved to Esalen and lived there for a couple of years. So I'm very familiar with retreat centers. I've been to many others around the country, both for Buddhist meditation retreats and other retreats, and I have, they're all great in many ways. But they’re, I can see that 1440 is bringing it to a different level.

So I'm excited to be a part of that. I'm excited to get together with a group of professionals that are all wanting to cultivate more meaning in their work and to find that work/life balance that can be so elusive. And I just can't wait to get together and support each other and share because that's, I mean, we all have so much to offer, and I think when we come together with a similar purpose, it's really powerful.

Akil Palanisamy:  Yeah. I am also really excited about the upcoming event, and I think for anyone who feels like they're not being true to themselves in their work or as to themselves as they would want to be, I think this is a great opportunity to really reflect. And I think our vision for that weekend is that it's going to be a very introspective weekend and really focused in small groups and interactive elements. So it’s not going to be just mostly didactic.

Chris Kresser:  Yeah. It’s not going to be Akil and I standing in front of the room talking at you the whole time. Definitely going to be the opposite of that.

Akil Palanisamy:  Right, exactly, yeah. Because I think that this work is really about looking within and then sharing and connecting with other people. And so that's the focus of the weekend, is really building that sense of community with whoever comes and really learning to deepen your own sense of meaning and purpose in work, and look within to reconnect with that vision for what drew you to this work initially. Because I think that's the ultimate goal is having that feeling like you're really being true to yourself at the end of the day and having the kind of practice that you envision.

Don’t be afraid to make changes

Chris Kresser:  Absolutely. I shared the story of Sheri in my book Unconventional Medicine, who is a clinician that was working in the VA. And she's a doctor and was mostly seeing patients with diabetes. That's the most common health challenge for veterans. And it was, she was counting the days until retirement. It was just really a factory-medicine type of situation. She often didn’t even have time to go to the bathroom during the day because she was just that busy from appointment to appointment. And as we've discussed, there was a real risk of moral injury because she didn't feel like she was making a difference. She was just handing out medications to these people and she wasn't, she knew as an athlete herself who tried to pay attention to her diet, she knew that wasn’t the best way to go about it. But what else could she do in the amount of time that she had?

And she moved into kind of a more, started incorporating more of a functional approach in her work, and then eventually left and started her own Functional Medicine practice. But for her, it was just a total game changer. She went from counting the days to retirement, to not ever being able to imagine retiring. And that's the kind of shift that’s possible, I think, when you really address the root causes of burnout and take the opportunity to step out of your current system, your current day-to-day, and really give yourself the chance to discover something new. And even if that’s maybe moving in a different direction entirely, or maybe staying in your current situation but just making a series of small changes that collectively can have a big impact.

Akil Palanisamy:  Yeah, I think for me, my whole approach has been in terms of incremental change because I know that for many people, they have gone out of the insurance model and set up their own Functional Medicine practice, and that can be fantastic. But my work is really just building change within the system. Because if the people within the system leave and do their own thing, then the system itself is going to not be changed. And so I think that a big part of this is also figuring out solutions within systems and incremental steps we can take, and I think that'll hopefully be part of what we talk about as well. Just if you do belong to a system, how you can take a leadership role and effect change within that system as well.

Chris Kresser:  Absolutely. That's why Akil and I are a good team, because I’m outside the system and he’s inside of the system, and we have different perspectives. So that's another reason I'm happy to team up with him. I mentioned this in the beginning, but I'll throw it out there again. You need not be an MD to participate in this workshop. It's really for all healthcare practitioners and providers who are experiencing burnout. And so this could be anyone from a health coach to a nutritionist to a dietitian to an occupational therapist to a chiropractor, a naturopath in addition to MDs, and DOs, and MPs, and PAs, and all of the other abbreviations and acronyms. Anyone working in healthcare really would be welcome. And we’re not even limiting it to people working in healthcare. We don't want to exclude people here, so if you're not working in healthcare and the things we've been talking about resonate with you, maybe you work in emergency services or something else, you are absolutely welcome to come.

Akil Palanisamy:  Yeah, and I would add that even if you're not feeling burned out, I think that prevention is really the best medicine.

Chris Kresser:  That’s true.

Akil Palanisamy:  So I think learning about the research and the science, because we know how to prevent it, and it's much better to prevent burnout than treat it once it happens.

Chris Kresser:  That is a very good point. Yeah, and I guess if the statistics are any indication, we know that even if you’re not feeling burnout now, chances are statistically you will at some point.

Akil Palanisamy:  Right.

Chris Kresser:  Especially without any intervention. It’s kind of like the diabetes example I used before. If you’ve got high normal blood sugar, now’s the time to get it under control rather than waiting until it turns into diabetes.

Akil Palanisamy:  Right.

Chris Kresser:  Great, well, thank you so much, Akil, for being with us. It’s a fascinating and important topic, and I’m really looking forward to leading this workshop with you. Again, in the retreat, you can go to 1440, it’s 1-4-4-0 dot o-r-g, and when you get there on the website, you just hover over Learn, and then under programs click on Professional Development. And if you scroll down there, you’ll see our program, which, again, is on the first weekend of October, October 5th to 7th, it’s a Friday through a Sunday.

And there’s a tuition for the program, and then there’s several different accommodation options available there. It’s really neat. I like what they've done with that. Everything from a private room to a suite to a really cool bunk style, kind of modern bunk-style accommodation that's much more affordable. I don’t know if you saw those last time.

Akil Palanisamy:  I did, yeah.

Chris Kresser:  Check the pictures out, they look pretty cool. They call them pods.

Akil Palanisamy:  Right, yeah, yeah. They’re pretty comfy. I’ve seen them.

Chris Kresser:  Yeah, yeah, it looks great. So lots of different accommodation options. If you’ve never been to this part of the world, the Santa Cruz Mountains are a beautiful, beautiful area, gorgeous redwood forests. You can head down to the beach before or after in Santa Cruz there. It’s a funky, cool little town. Great, great part of the world. So I hope you can make it. Those of you who have been listening to this and resonating with it, we’d love to meet you in person and have a chance to explore these topics with you.

And then Akil, is also, we haven’t talked much about his other work, but he’s also an author in addition to being a clinician. And he organizes the Paleo Symposium every year that I've been fortunate enough to be a speaker at. So why don’t you tell everyone a little bit more about your work and where they can find out more about your work.

Akil Palanisamy:  Oh sure, yeah. So I practice integrative medicine and I combine Functional Medicine with the Paleo approach and Ayurveda, which is the traditional medicine of India. And still that has led to my book which is called The Paleovedic Diet, combining Paleo and Ayurvedic medicine. And the best way to connect with me would be through my website, which is DoctorAkil.com. Just doctor spelled out, A-k-i-l dot com. And yeah, I wanted to thank you, as well, Chris, for having me on the podcast. I’m very excited to be working on this event with you, and it was really a pleasure to talk today.

Chris Kresser:  Pleasure is mine, Akil. And I'm sure we’ll be in touch before October, but I look forward to seeing you then and anyone else who's listening, who wants to join us. So 1440.org, and thanks for listening, everybody. Keep sending your questions in. I know I haven’t answered many of them recently. We’ve been doing a lot more interviews lately. But I do see that I have a few Q&A episodes coming up, and we do read all of your questions, and we also consider them for writing articles or emails.

So even if we’re not able to answer them on the show, it helps me to understand what you're thinking about and what you want me to write about and talk about. So please do keep sending them in. That’s ChrisKresser.com/podcastquestion. And thanks, everyone, for listening. And thank you, Akil, and we’ll see you next time.

Akil Palanisamy:  Thank you, Chris.

The post RHR: How to Fight Practitioner Burnout with Dr. Akil Palanisamy appeared first on Chris Kresser.

[denisalvney]

RHR: How to Fight Practitioner Burnout with Dr. Akil Palanisamy

In this episode, we discuss:

Burnout among healthcare practitioners

How common the problem is

The results of widespread physician burnout

The difference between burnout and moral injury

How technology is contributing to the problem, not alleviating it

How to fight physician burnout

Show notes:

The Paleovedic Diet by Dr. Akil Palanisamy

The Sutter Health Institute for Health & Healing in San Francisco

Unconventional Medicine by Chris Kresser

1440 Multiversity retreat for healthcare professionals

Akil Palanisamy’s website, DoctorAkil.com

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Chris Kresser:  Hey, everybody, Chris Kresser here. Welcome to another episode of Revolution Health Radio. This week we’re going to be talking to Dr. Akil Palanisamy, who is a friend and colleague in the Functional Medicine space. And I’ve known him for several years. He is the author of The Paleovedic Diet, a really interesting book combining Paleo and Ayurveda, a traditional Indian medicine which is an interest of his. And he also runs the Paleo Symposium that’s put on by the Institute for Health & Healing at UCSF every year, that I’ve been a featured speaker at since it started.

But today actually, we’re going to be talking about something different, which is burnout amongst healthcare practitioners. It’s a really important topic that has pretty significant implications not only in terms of the effect on individual clinicians, but on patients and their access to care, things like medical errors and just the healthcare system overall.

So if you’re not familiar with Akil, he’s an integrative medicine physician who blends his medical training with Functional Medicine in Ayurveda, the traditional medicine of India. He studied biochemistry at Harvard and received his medical degree from UCSF and completed his residency at Stanford. Dr. Akil also completed a fellowship in integrative medicine with Dr. Andrew Weil at the University of Arizona. He sees patients at the Sutter Health Institute for Health & Healing in San Francisco, where he also serves as physician director for community education. He’s been a consultant with the medical board of California for many years and as I mentioned, he’s the author of The Paleovedic Diet: A Complete Program to Burn Fat, Increase Energy, and Reverse Disease.

So I’m really excited to dive into this conversation with Akil. I think you’ll find it interesting, even if you’re not a healthcare practitioner that’s experiencing burnout, because we talk about a lot of issues that are relevant to anybody doing any kind of work, really. So I hope you enjoy the conversation. Let’s dive in. Akil, thank you so much for joining us. I’m so glad to have you here.

Akil Palanisamy:  Thank you, Chris. Pleasure to be here.

Burnout among healthcare practitioners

Chris Kresser:  So today we’re going to talk about a really important topic that I don't think gets enough attention, and this is physician burnout. So, and I would extend it to burnout for any healthcare practitioners. We might be focusing a little bit on physicians because this is where most of the statistics are available, but it’s certainly a problem across the entire healthcare world whether we’re talking about:

Nurses

Nurse practitioners

Occupational therapists

Chiropractors

Acupuncturists

Anybody working in the care profession

In my book Unconventional Medicine, I talked a lot about how this is one of the major challenges within medicine in general, not just conventional medicine, but also integrative medicine and Functional Medicine. And it's something that we need to develop a sensible approach to if we’re going to meet our goals in terms of preventing and reversing disease. So this is something that Akil has thought deeply about and has been involved in a number of different initiatives from his work at Sutter to working with medical students and other physicians to address this problem. So I'm really looking forward to having this conversation. So why don’t we start a little bit with the stats on burnout, Akil?

Ask yourself: Does medicine still feel like your calling? If daily stress and exhaustion are turning you away from the profession, you might be headed toward physician burnout. Find out what causes burnout and learn how to rediscover your sense of purpose.

How common the problem is

Akil Palanisamy:  Sure, yeah, I think it's really rampant, and most studies report around 50 percent or higher of physicians report some significant burnout. And that's up from about 40 percent just five years ago. So, I think the numbers are really scary and also this is a global problem. So this is across the board. Many countries throughout the world and also regardless of the stage of training. So medical students, residents, physicians, even the number of years of practice has no impact.

Chris Kresser:  Wow.

Akil Palanisamy:  I will check on this number, so, I mean, I know because I did my medical training 20 years ago, and it was like, I would say, a soul-crushing and exhausting process.

Chris Kresser:  Right, right.

Akil Palanisamy:  So I started early in this topic, and that’s why I’m so passionate about it.

Chris Kresser:  Yeah, yeah. That’s really revealing in some ways. If medical students are as burned out as people who've been in the profession for 10 or 20 years, that's an indication that something’s already going wrong, even at that very early stage.

Akil Palanisamy:  Right. I came across a really fascinating study. They interviewed almost 3,000 medical students about burnout and 53 percent of them reported feeling burnt out. About 15 percent were depressed, about 5 percent had seriously considered suicide. But the interesting thing was 100 percent of the students, every single one reported feeling humiliated at some point, demeaned, disrespected as part of their training. And that had huge effects on their performance and judgment, and that was my experience too. It’s part of the culture of training doctors.

Chris Kresser:  It really is, isn’t it? It’s almost like fraternity hazing or something. I've heard for residents that it's … and it seems to be perpetuated for some of the same reasons, like this, “I went through this, so you have to go through it,” type of mentality. And I've even read the studies that support that.

Akil Palanisamy:  Yeah, right. When I started my residency, I was super thrilled because they had just passed a law limiting the work hours, continuous work hours to 24 hours in a row. That was like a huge drop.

Chris Kresser:  That’s a big development.

Akil Palanisamy:  And I was like, “Wow, this is fantastic. I only have to work 24 hours in a row, like, every week.” And people thought that would solve the problem of burnout. But it hasn’t because that’s just one of many factors.

The results of widespread physician burnout

Chris Kresser:  Right, and so we know that there’s a huge problem with the shortage of primary care physicians. I don't remember the exact number from the study I shared in my book, but it's something like, predicted to be a shortage of around 50,000 primary care providers by the year 2025, which is not very far off in the future. And yet one of the costs of burnout, as you said, is that two-thirds of physicians know a doctor who is likely to stop practicing medicine or at least to reduce their access to patients, switch to concierge model, or something like that within the next five years as a result of burnout. So this is a real problem that's really kind of having an outsize effect on our healthcare system.

Akil Palanisamy:  Yeah, absolutely. I mean, I think it is genuinely a public health crisis. And I think that that word is increasingly being used in the literature because this really does impact not just individual physicians but patients, healthcare organizations, the entire healthcare system in our country and other countries around the world. So I think the scope of the effects and the impact of burnout is being recognized now and it's huge in terms of not just the individual level, but medical errors as well. So, recent studies have shown that there’s a strong relationship between physician burnout and medical errors. And already medical errors are one of the major leading causes of death in the United States. And so I think as we get more burned out physicians and higher rates of medical errors, I think that's one of the big issues in terms of the costs of this problem.

Chris Kresser:  Yeah, this is critical, and I highlighted this in my book. But if you go to a site like CDC or a general website and you search for the top 10 causes of death, let’s see what happens if we do that right now. Cardiovascular disease is still holding at number one, and then you’ve got lung cancer or you’ve got other diseases that come shortly after that. The data is often changing. Cancer continues to go up the list. But you’re not going to see medical errors on these lists, right?

Akil Palanisamy:  Right.

Chris Kresser:  There was a study published in the British Medical Journal in 2016, just a couple of years ago, and then another one by Barbara Starfield, who’s since passed away, back in 2000 in JAMA. And both of those found the same thing, that medical errors are actually the third-leading cause of death. And since only 5 to 15 percent of the atherogenic events are even reported, Dr. Starfield actually speculated that medical errors could be the number one cause of death if all of the atherogenic events were reported. So this is something you don't see on the typical list, but that doesn't mean it's not true.

Akil Palanisamy:  Right, exactly. Yeah, because when you experience burnout, the impaired judgment, lack of attention to detail, communication breakdown, all the things, the depression, that just greatly increases the risk of medical errors.

Chris Kresser:  Right. So this is a, it's a common problem, it's a problem that has not only effects on individual practitioners and their health and their lifespan, their feelings about their work, but also to patients and their safety and their ability to get the care that they need, and then to society as a whole. The healthcare crisis continues to deepen, and we need more doctors, rather than fewer. The fact that 50 … that two-thirds of physicians know a doctor who’s likely to stop practicing medicine in five years is exactly the opposite direction that we need to be going in here.

The difference between burnout and moral injury

So let's talk … so, we’ve been throwing this term “burnout” around, and I'm sure that means different things to different people. But you actually emailed me before the show with a really interesting distinction that I want to highlight—the difference between burnout and moral injury. So can you talk about that a little bit?

Akil Palanisamy:  Yeah, absolutely. So traditionally, burnout is defined as a work-related syndrome characterized by emotional exhaustion, a cynical feeling, and feeling like you're ineffective on the job. But this concept of burnout really doesn't resonate with doctors. I can tell you from talking to many of them that they really don't connect with this concept of burnout because the problem is you're pointing the finger at doctors. And you’re saying, “You’re burned out, you need to start doing yoga and eat granola, and just like change your lifestyle.” But you know, these are some of the most resilient people out there.

Chris Kresser:  Absolutely.

Akil Palanisamy:  Medicine, I mean we’ve survived decades of intense training, sleep deprivation, the training process itself is incredibly stressful, the work demands. So these are some of the most resilient and resourceful people out there. And so I think the problem is really,  a big part of it is the system. But the distinction that you mentioned between moral injury and burnout, the concept of moral injury actually was first used to describe how soldiers responded to what they did during war and when they came back, having to do things that went against their morals.

In healthcare, it refers to physicians being unable to provide the high-quality care that they would really like to, essentially, not being able to be true to themselves. So I think the problem is not that physicians are burned out and so we don't care. The problem is that we care very deeply.

Chris Kresser:  Care too much.

Akil Palanisamy:  Yeah.

Chris Kresser:  Not too much, but it’s the care that’s causing the problem, yeah.

Akil Palanisamy:  Right and then as a result, in our current healthcare system, it's so hard to consistently meet patients’ needs and provide the kind of care that we envisioned we would going into medicine. Because most doctors think of medicine as a calling, and so that failure and inability to meet needs of patients in the way that we really envision, that is hugely damaging, and I think that has a huge effect on physician well-being. And so that's the concept of moral injury. So I think that it's really much broader than just pointing the finger at doctors.

Chris Kresser:  I think that’s really, really important to understand, and I've always made it clear that when I'm criticizing conventional medicine and its shortcomings, I'm not criticizing individual doctors. Of course, I might be criticizing some individual doctors, but not as a group because the vast majority of doctors that I have met are people that genuinely want to help their patients. They went into medicine for all the right reasons and they do recognize that they're not having the impact that they would like to have, and it's painful for them. But there's, they feel like their hands are tied because of the way that the system is set up. And they’re just as much victims of the system as the average patient is.

And I think this is a good example of how that plays out where we all want to have meaningful and rewarding work. We all want to get to the end of the day and feel like we really made a difference. And doctors, I think, especially. That's the path they chose. They didn't go into private equity. They didn't choose to go into a career that was really not about helping people, but more about making money or enriching their own lives. Not that there's necessarily anything wrong with that. They willingly chose to go through a very arduous path that involves many, many years of schooling and as you said, rigorous training with residency, working 24 hours straight, often graduating with hundreds of thousands of dollars of debt. I mean, it’s an enormous risk to take, an enormous amount of investment of money and time and energy to become a physician.

So you don't make it through that generally, unless you really have a guiding moral compass that is pushing you through it. And so it's really, I think, even more important and critical that we figure out a way to, where we create a path forward for doctors and other healthcare practitioners that really do want to have that feeling at the end of the day. Because that's the antidote to burnout, where when you really do feel like you're transforming the lives of the people that you're working with, and you're having a huge impact. Because in that situation it doesn't mean you won't get tired and it doesn't mean you won't occasionally feel, “Geez, I need a vacation.” But you're not going to have that moral injury, and that’s what makes all the difference in the world.

Akil Palanisamy:  Yeah, I know, exactly. And I think that the rates of suicide among physicians is a real wake-up call because it’s twice that of I think active duty military, and then there was a report from the UK that there was a young junior doctor who, she took her own life by walking into the sea.

Chris Kresser:  Yeah, that’s not, yeah.

Akil Palanisamy:  Statistically, women physicians are a significantly higher risk of completed suicide than matched females in other professions. So it’s not uncommon, unfortunately, and I think that, yeah, exactly what you said about that moral compass that physicians have, I think being able to feel like you're true to yourself. That's a basic need that all of us have, and I think especially those who go into medicine, we feel that pretty intensely.

How technology is contributing to the problem, not alleviating it

Chris Kresser:  Right. And there may be lots of choices every day that they have to make that are, don't feel true to themselves because of the way that the system is set up. And I know from my own research and I know you and I have talked about this, one of the influences in terms of burnout has been the rise of electronic medical records or electronic health records, EMRs and EHRs. Initially these were hailed as, that this is going to dramatically reduce the amount of paperwork that doctors would have to do and they were going to be great time-saving and productivity devices, and they were going to be doctors’ best friends. But the reality has not quite lived up to that, has it?

Akil Palanisamy:  No, no. Yeah, I would, I think that studies show that about like half of the average physician’s workday is spent entering data or doing other clerical work in the EHR. So the amount of time actually spent with patients is less than a third, and for me I think it's a bit of a double-edged sword. Because it does make it easier to respond to patient messages rather than playing phone tag with patients. But on a typical day, I might get 50 to 60 electronic messages in addition to charting visit notes for each patient, and each of these questions or patient calls, etc., requires some thought.

And increasingly we’re being measured on how quickly we can respond to these messages because the priority is patient satisfaction, and that's eventually going to be tied to financial compensation and that kind of thing. So I think this EHR, it takes up so much time, and it really hasn’t translated to the reduced workload and that sort of thing. And when we deal with insurance in my practice, I think that's a huge benefit for patients because it improves access, and for Functional Medicine and integrative medicine, I think we need to move in that direction where insurance covers services. And so we offer that, but then it creates a whole universe of responsibilities in terms of the paperwork, the criteria for each progress note when we’re billing insurance, the forms, the prior authorizations, the other kind of paperwork. So it just adds another layer of paperwork to everything else that we’re dealing with in terms of the EHR every day.

Chris Kresser:  Yes. And then there’s another issue of when you're actually in the room with the patient, that connection that you're trying to make with the patient is now being mediated by a computer screen and having to type into the computer. And we’ve all seen, I've heard many stories of people going to doctors and complaining that their doctor was hardly even looking at them because they were working on the computer the entire time, and this is especially true with younger doctors from what I've heard, who never operated without an EHR.

So they never had the experience of being in a visit with the patient without the computer being part of that. And I think with all the data that we now have in terms of how important the physician-patient relationship is to the outcomes in care and the research on the placebo effect, and just the, in Carl Rogers's words, the unconditional positive regard and the type of connection that is made just is therapeutic in its own right. And I think the EHR can compromise that in some ways.

Akil Palanisamy:  Yeah, absolutely. And I'm always torn because I want to maintain good eye contact and really be present with each patient, but then if I don’t touch the EHR at all, then at the end of the day I’m like, this one’s like …

Chris Kresser:  You’ve got eight more hours of work.

Akil Palanisamy:  Exactly.

Chris Kresser:  It’s really challenging, and, I mean, my solution to that, which is not possible for everybody because of the model I work independently, so I’m able to just kind of set things up how I want. But I have a nurse practitioner that's by my side at every appointment, and she takes the notes. So I'm able to just maintain eye contact with my patient and not really look at the computer. And I recognize that's not a viable solution for most practitioners, but it's something that I felt compelled to do because I, like you, didn't want to get home and do four hours of data entry into the EHR after a full day of seeing patients. And but I didn't also want to sacrifice the connection with the patient.

So I think the other thing that's also not always in an individual physician’s control is the quality of the EHR or the EMR system. So many of them are just completely bloated and full of functions that they'll never use, and just really difficult to navigate, and they’re a nightmare in terms of software development. They’ve been just sort of cobbled together and put on top of each other, and it’s, for anyone who likes software and technology, EMR software is not going to be particularly inspiring for the most part.

Akil Palanisamy:  Yes, yeah. No, I think you’re right on that. And the point about having additional support for progress notes, I think, is a good one because studies show that having some type of help with the charting actually reduces burnout, and it's obvious, right? And I think at Sutter Health where I work, they really take burnout quite seriously. And so they’ve supported having scribes, which is the same thing. They take notes and they kind of do everything, and you just have to sign the note.

So I think it’s really, it’s a shared issue with burnout between individuals and healthcare systems and organizations. So I think it’s very important that all of these systems realize they have an important role to play, and I think Sutter Health is a really great example of that. They've supported a lot of these changes, and like this example of scribes and with our EHR, which is Epic, just helping us to use it in the most efficient way possible. So I think systemic changes are really a huge part of the solution as well.

Chris Kresser:  Absolutely, and this is a recurring theme in this conversation. It's that individual physicians can only do so much when they're employed in a larger organization, and they’re not free to just do whatever they want. And so we have to continue to work to raise awareness institutionally about these issues so that the institutions themselves can make the changes, and then individual physicians will benefit from those.

Akil Palanisamy:  Right.

How to fight physician burnout

Chris Kresser:  So let's talk a little bit about some of the work you've done in the past with medical students and other doctors at Sutter on burnout. What kind of things have you done to approach this?

Akil Palanisamy:  Yeah, I think for me during medical school, it was really a survival mechanism. Because I was pretty burned out and the training, yes, I absolutely had that being belittled and demeaned when I was on the wards in my rotations. And so I really got interested in the certain classes that were offered on finding meaning in medicine and really connecting with your purpose or actually reconnecting with why you went into medicine, and keeping that front and center. And also developing tools for maintaining well-being like mindfulness.

So mindfulness is one thing that has been studied. There’s actually been about 14 studies looking at physician burnout and mindfulness, and nine of them have shown positive outcome in terms of:

Reducing burnout

Improving well-being

Improving mood

Improving resiliency

So I think, I don't think that's the entire solution, but the more tools you have in your toolkit, the better. And we don't really get any training in general in terms of how to deal with stress and how to manage emotions during our healthcare training. And so I think I got into mindfulness very early, studied MBSR, developed a daily meditation practice, became involved in educational programs teaching people about mindfulness. And then since … then during residency and now practice, after that I've been very interested in workshops and events that kind of focus on that aspect of meaning and really reconnecting with a sense of purpose, a sense of direction. Kind of helping people be true to themselves.

And so I think small group exercises and workshops where people are getting out of their left brain and reconnecting with their right brain, using art and things like that, have been really effective. So for me, I've benefited as much as I’ve helped anybody in this work, and it's been just partly for my own gains, but I think you teach what you have to learn. And for me, being involved in burnout and teaching people about it has been a lifesaver.

Chris Kresser:  That’s so great. I think all of those are fantastic tools for kind of exploring the causes of burnout on an individual level and helping people respond in a way that will reduce the risk of moral injury, if we will. And I know for me, one of the ways that I've approached this personally and also with people that I've worked with and that I’ve trained is just to make sure that I feel like the work I'm doing is having a big impact on my patient’s lives. Because that’s one of the reasons I really love that distinction that you make between burnout and moral injury. Because if I look at it that way, I think, “Okay, well, that's the biggest risk is just getting to the end of the day and feeling like I'm not making a difference. Feeling like all of my efforts are for naught really. Or they’re not really having the impact that I would like them to have.” And to me, that's the greatest risk in terms of burning out. When I know that my work is making a difference, my endurance and stamina are considerable.

Akil Palanisamy:  Right.

Use Functional Medicine to prevent it

Chris Kresser:  But when I don't feel that way, it doesn't take much to make me feel tired and like what I'm doing is not worth it. So this is, I think, where a Functional Medicine approach has a lot to offer, not just as a treatment modality, but as a means of really actually making a difference in the patients’ lives. Like getting to the root cause of the problem and actually addressing the problem and helping the patient to recover and feel better without the use of unnecessary drugs and surgery. For me that was one of the most appealing things about Functional Medicine, and I think it's one of the less talked about but most important gifts that it has to offer to individual physicians who shift their practice in that direction.

Akil Palanisamy:  Yeah, I think that's what motivated me to go into Functional Medicine as well, just to get that sense of fulfillment and satisfaction when you help someone really get a permanent solution to something and by uncovering the root causes and taking that holistic approach. So I think that's what drew me to Functional Medicine as well.

Schedule a retreat

Chris Kresser:  Absolutely. So another area where I know, or a kind of antidote to burnout that I know that you and I are both passionate about is a retreat. So I've been a big believer in retreat. I’ve done annual retreats myself for many years. I’ve done meditation retreats for about 25 years and I just can't really imagine my life without that opportunity to step away from my day-to-day life and experience and to get a different perspective, to slow down, to have more spacious existence for a few days were the busyness of life is not overtaking me and where I can just hear myself think and feel my body, and just look at things from a fresh perspective. It's just crucial for me. And I've always felt like my wish has been that others can experience this. That we can, because I really believe in its transformative power.

Connect with colleagues

Akil Palanisamy:  Yeah, absolutely. I do as well, and I’ve had a number of retreats over the years in terms of individual retreats and also group retreats. And especially in the professional setting, I find that ability to connect with other colleagues and professionals in that informal, nonwork setting is so powerful because in healthcare there's so much isolation. There are so many individual silos.

Everybody's just doing their thing trying to get through the day, and you rarely have a chance to step back and step out of that situation to just really deeply connect with people who are in the same boat and really understand what they're going through, share their story, listen to their stories, and really deepen your connection and solve problems together.

So I think that sort of deep connection is so important because that's like a huge need for all human beings, and especially in such an isolating profession like in healthcare. I think it's essential.

Chris Kresser:  Absolutely, yeah. So many clinicians can just spend, we spend most of our time in a room with patients and we’re interacting with patients, but we’re not, we’re interacting with them in a certain way. We’re playing a certain role. We’re the clinician, they’re the patient, and those can be rich and rewarding interactions. But it's not the same as connecting with other colleagues and being able to talk about the issues that we face professionally and share together. So yeah I think that group experience is really powerful. And I’ve been writing about this recently.

I’ve been sharing some book recommendations, and Akil and I have actually teamed up to offer a retreat for healthcare practitioners at 1440 Multiversity in October. It’s from October 5th to 7th this year. And so it starts on Friday afternoon, Friday evening, and it goes through Sunday midday. And the retreat’s called “From Burnout to Brilliance: Rediscover Your Passion and Purpose, Reclaim Your Health, and Create a Practice You Love.” So the intention of this retreat is to address the issues that we've been talking about in the show and to help healthcare professionals explore their own situation, help them rediscover their passion for medicine and healthcare, and reconnect with a sense of meaning and purpose in their work to take some practical steps. Break those down into really doable actionable steps that they can take to reclaim their health and well-being. Rediscover parts of themselves that are not typically expressed in the course of their day-to-day work and just kind of cultivate a sense of energy and vitality that they may have been missing for many years.

And I'm really excited about doing this. I’m excited about doing this with Akil, who I've known for several years now and I really respect, and I'm excited about doing it at 1440. It's an incredible new retreat center, which I think you did a retreat there with Michelle Tam with Nom Nom Paleo last year, Akil?

Akil Palanisamy:  Yes, yes beautiful, beautiful place. Yeah.

Chris Kresser:  So this is, and for those of you who are not familiar, it's in Santa Cruz Mountains, right?

Akil Palanisamy:  Yeah, it’s surrounded by redwood trees and there's all these amazing hiking trails. And yeah, a beautiful place.

Chris Kresser:  Yeah. I haven't actually been there yet, but I know several people who’ve taught there and who’ve been there. And if you go to 1440.org, click on the stay button and check out some of the pictures. It's an absolutely beautiful campus. Really nice accommodations, gorgeous dining hall with lots of different food options. They've got daily yoga classes and massage, and a spa and other health offerings there. And they’ve got, of course, gorgeous hiking trails because it's in the redwood forest there. It just looks to me like they're really doing it right. I've been to a lot of retreat centers. I actually lived at a retreat center in Big Sur called the Esalen Institute …

Akil Palanisamy:  Oh. sure.

Chris Kresser:  … and many people may be familiar with. When I was still really sick and dealing with my health issues, I got to a point where I just decided, I kind of reached the end of the line of supplements and diets, and medications, and I decided that I would explore the psychological, emotional, psycho-spiritual aspects of what was going on for me. So I moved to Esalen and lived there for a couple of years. So I'm very familiar with retreat centers. I've been to many others around the country, both for Buddhist meditation retreats and other retreats, and I have, they're all great in many ways. But they’re, I can see that 1440 is bringing it to a different level.

So I'm excited to be a part of that. I'm excited to get together with a group of professionals that are all wanting to cultivate more meaning in their work and to find that work/life balance that can be so elusive. And I just can't wait to get together and support each other and share because that's, I mean, we all have so much to offer, and I think when we come together with a similar purpose, it's really powerful.

Akil Palanisamy:  Yeah. I am also really excited about the upcoming event, and I think for anyone who feels like they're not being true to themselves in their work or as to themselves as they would want to be, I think this is a great opportunity to really reflect. And I think our vision for that weekend is that it's going to be a very introspective weekend and really focused in small groups and interactive elements. So it’s not going to be just mostly didactic.

Chris Kresser:  Yeah. It’s not going to be Akil and I standing in front of the room talking at you the whole time. Definitely going to be the opposite of that.

Akil Palanisamy:  Right, exactly, yeah. Because I think that this work is really about looking within and then sharing and connecting with other people. And so that's the focus of the weekend, is really building that sense of community with whoever comes and really learning to deepen your own sense of meaning and purpose in work, and look within to reconnect with that vision for what drew you to this work initially. Because I think that's the ultimate goal is having that feeling like you're really being true to yourself at the end of the day and having the kind of practice that you envision.

Don’t be afraid to make changes

Chris Kresser:  Absolutely. I shared the story of Sheri in my book Unconventional Medicine, who is a clinician that was working in the VA. And she's a doctor and was mostly seeing patients with diabetes. That's the most common health challenge for veterans. And it was, she was counting the days until retirement. It was just really a factory-medicine type of situation. She often didn’t even have time to go to the bathroom during the day because she was just that busy from appointment to appointment. And as we've discussed, there was a real risk of moral injury because she didn't feel like she was making a difference. She was just handing out medications to these people and she wasn't, she knew as an athlete herself who tried to pay attention to her diet, she knew that wasn’t the best way to go about it. But what else could she do in the amount of time that she had?

And she moved into kind of a more, started incorporating more of a functional approach in her work, and then eventually left and started her own Functional Medicine practice. But for her, it was just a total game changer. She went from counting the days to retirement, to not ever being able to imagine retiring. And that's the kind of shift that’s possible, I think, when you really address the root causes of burnout and take the opportunity to step out of your current system, your current day-to-day, and really give yourself the chance to discover something new. And even if that’s maybe moving in a different direction entirely, or maybe staying in your current situation but just making a series of small changes that collectively can have a big impact.

Akil Palanisamy:  Yeah, I think for me, my whole approach has been in terms of incremental change because I know that for many people, they have gone out of the insurance model and set up their own Functional Medicine practice, and that can be fantastic. But my work is really just building change within the system. Because if the people within the system leave and do their own thing, then the system itself is going to not be changed. And so I think that a big part of this is also figuring out solutions within systems and incremental steps we can take, and I think that'll hopefully be part of what we talk about as well. Just if you do belong to a system, how you can take a leadership role and effect change within that system as well.

Chris Kresser:  Absolutely. That's why Akil and I are a good team, because I’m outside the system and he’s inside of the system, and we have different perspectives. So that's another reason I'm happy to team up with him. I mentioned this in the beginning, but I'll throw it out there again. You need not be an MD to participate in this workshop. It's really for all healthcare practitioners and providers who are experiencing burnout. And so this could be anyone from a health coach to a nutritionist to a dietitian to an occupational therapist to a chiropractor, a naturopath in addition to MDs, and DOs, and MPs, and PAs, and all of the other abbreviations and acronyms. Anyone working in healthcare really would be welcome. And we’re not even limiting it to people working in healthcare. We don't want to exclude people here, so if you're not working in healthcare and the things we've been talking about resonate with you, maybe you work in emergency services or something else, you are absolutely welcome to come.

Akil Palanisamy:  Yeah, and I would add that even if you're not feeling burned out, I think that prevention is really the best medicine.

Chris Kresser:  That’s true.

Akil Palanisamy:  So I think learning about the research and the science, because we know how to prevent it, and it's much better to prevent burnout than treat it once it happens.

Chris Kresser:  That is a very good point. Yeah, and I guess if the statistics are any indication, we know that even if you’re not feeling burnout now, chances are statistically you will at some point.

Akil Palanisamy:  Right.

Chris Kresser:  Especially without any intervention. It’s kind of like the diabetes example I used before. If you’ve got high normal blood sugar, now’s the time to get it under control rather than waiting until it turns into diabetes.

Akil Palanisamy:  Right.

Chris Kresser:  Great, well, thank you so much, Akil, for being with us. It’s a fascinating and important topic, and I’m really looking forward to leading this workshop with you. Again, in the retreat, you can go to 1440, it’s 1-4-4-0 dot o-r-g, and when you get there on the website, you just hover over Learn, and then under programs click on Professional Development. And if you scroll down there, you’ll see our program, which, again, is on the first weekend of October, October 5th to 7th, it’s a Friday through a Sunday.

And there’s a tuition for the program, and then there’s several different accommodation options available there. It’s really neat. I like what they've done with that. Everything from a private room to a suite to a really cool bunk style, kind of modern bunk-style accommodation that's much more affordable. I don’t know if you saw those last time.

Akil Palanisamy:  I did, yeah.

Chris Kresser:  Check the pictures out, they look pretty cool. They call them pods.

Akil Palanisamy:  Right, yeah, yeah. They’re pretty comfy. I’ve seen them.

Chris Kresser:  Yeah, yeah, it looks great. So lots of different accommodation options. If you’ve never been to this part of the world, the Santa Cruz Mountains are a beautiful, beautiful area, gorgeous redwood forests. You can head down to the beach before or after in Santa Cruz there. It’s a funky, cool little town. Great, great part of the world. So I hope you can make it. Those of you who have been listening to this and resonating with it, we’d love to meet you in person and have a chance to explore these topics with you.

And then Akil, is also, we haven’t talked much about his other work, but he’s also an author in addition to being a clinician. And he organizes the Paleo Symposium every year that I've been fortunate enough to be a speaker at. So why don’t you tell everyone a little bit more about your work and where they can find out more about your work.

Akil Palanisamy:  Oh sure, yeah. So I practice integrative medicine and I combine Functional Medicine with the Paleo approach and Ayurveda, which is the traditional medicine of India. And still that has led to my book which is called The Paleovedic Diet, combining Paleo and Ayurvedic medicine. And the best way to connect with me would be through my website, which is DoctorAkil.com. Just doctor spelled out, A-k-i-l dot com. And yeah, I wanted to thank you, as well, Chris, for having me on the podcast. I’m very excited to be working on this event with you, and it was really a pleasure to talk today.

Chris Kresser:  Pleasure is mine, Akil. And I'm sure we’ll be in touch before October, but I look forward to seeing you then and anyone else who's listening, who wants to join us. So 1440.org, and thanks for listening, everybody. Keep sending your questions in. I know I haven’t answered many of them recently. We’ve been doing a lot more interviews lately. But I do see that I have a few Q&A episodes coming up, and we do read all of your questions, and we also consider them for writing articles or emails.

So even if we’re not able to answer them on the show, it helps me to understand what you're thinking about and what you want me to write about and talk about. So please do keep sending them in. That’s ChrisKresser.com/podcastquestion. And thanks, everyone, for listening. And thank you, Akil, and we’ll see you next time.

Akil Palanisamy:  Thank you, Chris.

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