#medical clinical research jobs

[problogsposts]

Why Should You Consider a Career in Medical Coding?

Introduction

Are you looking for a rewarding career in the healthcare industry that doesn't require years of medical school? If so, medical coding might be the perfect choice for you. In this blog, we'll explore the exciting world of medical coding, its importance in clinical research, and why you should seriously consider it as a career option. Let's dive in!

What is Medical Coding?

Medical coding is like the language of healthcare. It involves transforming medical information such as diagnoses, procedures, and treatments into universal codes. These codes are used for various purposes, including billing, insurance claims, and clinical research. Essentially, medical coders are responsible for ensuring that the healthcare system runs smoothly by accurately documenting patient records.

Why Choose a Career in Medical Coding?

1. In-Demand Career: The healthcare industry is constantly growing, and with it, the demand for skilled medical coders. Hospitals, clinics, insurance companies, and research institutions are always in need of qualified professionals to handle their coding needs.

2. Short Training Period: Unlike many other healthcare careers that require years of education, you can become a medical coder relatively quickly. Numerous institutes offer courses and training programs in medical coding that can be completed in a matter of months.

3. Diverse Opportunities: Medical coding isn't limited to just one type of job. You can find opportunities in various settings, including hospitals, private practices, pharmaceutical companies, and research organizations. If you want to explore related fields, you can also transition into areas like pharmacovigilance, drug regulatory affairs, or clinical data management.

4. Stability and Job Security: The healthcare industry is known for its stability, and medical coding is no exception. As long as there are healthcare services, there will be a need for medical coders. This translates to job security and peace of mind in your career.

5. Work-Life Balance: Many medical coding jobs offer excellent work-life balance. You'll typically work regular hours in a comfortable office setting, allowing you to maintain a healthy work-life balance.

6. Good Earning Potential: While salaries can vary based on location and experience, medical coders generally earn a competitive wage. With experience and additional certifications, you can increase your earning potential even further.

7. Contributing to Healthcare: By ensuring accurate coding, you help maintain the integrity of patient records, improve patient care, and support clinical research, pharmacovigilance, drug regulatory affairs, and clinical data management.

The Role of Medical Coding in Clinical Research

Now, let's delve into the connection between medical coding and clinical research. Clinical research plays a vital role in advancing healthcare treatments and therapies. It involves testing new drugs, medical devices, and treatment protocols to ensure their safety and effectiveness. Medical coding is an essential part of this process for several reasons:

1. Data Accuracy: Accurate coding ensures that the data collected during clinical trials is reliable. Researchers rely on this data to make informed decisions about the safety and efficacy of new treatments.

2. Regulatory Compliance: Regulatory agencies, such as the FDA, require precise documentation of clinical trial data. Medical coding helps maintain compliance with these regulations, which is critical for getting new drugs and treatments approved.

3. Patient Safety: Proper coding helps identify any adverse events or side effects experienced by patients during clinical trials. This information is crucial for patient safety and determining the risks and benefits of a new treatment.

4. Data Analysis: Medical coding simplifies the process of data analysis by categorizing information into standardized codes. This makes it easier for researchers to identify trends and draw conclusions from the data.

How to Start Your Career in Medical Coding?

1. Take a course: Look for reputable institutes or online courses that offer medical coding training. These courses cover topics like anatomy, medical terminology, and coding systems such as ICD-10 and CPT.

2. Get Certified: While certification isn’t always required, it can significantly boost your job prospects. Consider obtaining certifications like Certified Professional Coder (CPC) or Certified Coding Specialist (CCS) through recognized organizations.

3. Gain Experience: Entry-level positions may require some on-the-job experience. Look for internships or entry-level coding jobs to build your skills and resume.

4. Stay Updated: Medical coding guidelines and regulations can change, so it’s essential to stay current. Attend workshops, and seminars, and continue your education to remain competitive in the field.

5. Network: Join professional organizations such as the American Health Information Management Association (AHIMA) or the American Academy of Professional Coders (AAPC) to connect with other professionals in the industry.

Conclusion

In conclusion, a career in medical coding offers stability, good earning potential, and diverse opportunities within the healthcare industry. Moreover, it plays a crucial role in clinical research, contributing to the development of new and better treatments for various medical conditions. If you're interested in healthcare, have an eye for detail, and enjoy working in a structured environment, medical coding could be the perfect career choice for you. Consider enrolling in a reputable training program or course to kickstart your journey into this rewarding field. Your future as a medical coder awaits!

[ccrpsorg]

Medical Research Jobs

Medical research jobs provide individuals with the opportunity to make significant contributions to the advancement of medicine and healthcare. These positions involve conducting clinical trials, laboratory research, and analyzing data in order to develop new treatments for diseases. Working in medical research requires a high level of scientific knowledge, analytical skills, and critical thinking. Professionals in this field often collaborate with other researchers from different disciplines to conduct studies that aim to improve patient care and treatment options. Medical researchers also work closely with doctors, nurses, and other healthcare professionals so they can share their findings and better understand patient needs. With such a wide range of responsibilities, medical researchers play an essential role in driving innovation in the medical industry. The advancement of modern medicine is dependent on the insights that these professionals provide through their investigations. As such, medical research jobs offer ambitious individuals the chance to make a meaningful contribution to humanity’s ever-evolving knowledge of health and well-being.

Clinical Research Associate (CRA): Designs and implements clinical trials according to established protocols. Monitors the progress of trials and reports results to principal investigators. Salary range from $50,000 to $90,000 per year. CRA Certification through CCRPS requires completion of a 8-week course on research principles and methodology plus two years of experience in clinical research related activities such as site monitoring or data management.

Clinical Research Coordinator: This position involves coordinating the clinical aspects of research studies, such as collecting and organizing data, tracking recruitment of study participants, managing patient information, and monitoring research protocols. Salary range: $43,000 to $55,000 per year. Get CRC Certification through CCRPS: Certified Clinical Research Professional (CCRP).

Clinical Trials Manager (CTM): A Clinical Trials Manager is responsible for overseeing the entire clinical trial process from start to finish. They ensure the compliance of all study protocols while managing timelines and budgets. Salary range: $70,000-$90,000 per year; Certification through CCRPS: Certified Clinical Trial Manager (CCTM).

Medical Research Lab Technician: Responsible for performing laboratory tests according to established protocols in order to aid in medical research projects. Salary range: $35,000 to $45,000 per year. Certification through CCRPS: Certified Laboratory Technician (CLT).

Bioinformatics Scientist: Utilizes computer technology and statistical analysis in order to analyze biological data derived from experiments in medical research labs. Salary range: $75,000 to $100,000 per year Certification through CCRPS: Certified Bioinformatics Scientist (CBS).

Medical Writer: Writes and edits materials for clinical trials and other medical research projects, including study protocols and reports for publication or regulatory submission purposes. Salary range: $60,000 to $80,000 per year Certification through CCRPS: Certified Medical Writer (CMW).

Regulatory Affairs Manager: Manages the regulatory affairs process by ensuring that medical products adhere to applicable regulations throughout their development and commercialization phases. Salary range: $95,000 to $125,000 per year Certification through CCRPS for Certified Regulatory Affairs Manager (CARM)

Regulatory Affairs Specialist: Develops regulatory strategies for the submission of clinical trial applications to regulatory agencies, monitors global regulations governing clinical trial design and implementation and tracks changes in legislation affecting the development process of drugs, biologics or medical devices; coordinates communication between sponsors, investigators and regulatory authorities; prepares high-quality documents such as study protocols and amendments for submissions to regulatory bodies; participates in meetings with regulatory agencies worldwide; performs literature searches related to drug development topics; assists with ongoing maintenance of regulatory files as required by regulations. Salary range from $55,000 to $100,000 per year depending on experience level. Pharmacovigilance Certification through CCRPS requires completion of a 8-week course on research principles and methodology plus five years minimum experience in pharmaceutical industry or related fields with emphasis on Regulatory Affairs functions.

[catinfroghat]

What the fuck I'm so sad I had a dream that I got onto a psychedelic research trial and I was so excited I went to tell my auntie about it (She died I want to say... Like 7 years ago?) and it was also Halloween waaaaa I wanted it to be real

[afeelgoodblog]

The Best News of Last Week

1. Arizona governor Ok's over the counter birth control

Arizona Gov. Katie Hobbs (D) has expanded access to over-the-counter birth control that will “soon be available to Arizonans,” according to a press release.

Arizonans 18 and older will soon be able to go to their local pharmacy and purchase oral contraceptives without a doctor’s prescription.

2. ‘Great news’: EU hails discovery of massive phosphate rock deposit in Norway

A massive underground deposit of high-grade phosphate rock in Norway, pitched as the world’s largest, is big enough to satisfy world demand for fertilisers, solar panels and electric car batteries over the next 50 years, according to the company exploiting the resource. About 90% of the world’s mined phosphate rock is used in agriculture for the production of phosphorous for the fertiliser industry, for which there is currently no substitute.

3. U.S. Is Destroying the Last of Its Once-Vast Chemical Weapons Arsenal

Decades behind its initial schedule, the dangerous job of eliminating the world’s only remaining declared stockpile of lethal chemical munitions will be completed as soon as Friday.

4. Chinese scientists create edible food packaging to replace plastic

By incorporating certain soy proteins into the structure, Chinese University of Hong Kong scientists successfully created edible food packaging.

5. World's 1st 'tooth regrowth' medicine moves toward clinical trials in Japan

A Japanese research team is making progress on the development of a groundbreaking medication that may allow people to grow new teeth, with clinical trials set to begin in July 2024. The tooth regrowth medicine is intended for people who lack a full set of adult teeth due to congenital factors.

6. No Longer Endangered: The Bald Eagle is an Icon of the ESA

When the Endangered Species Act (ESA) was enacted in 1973, bald eagle population numbers across the country showed that the species was close to disappearing. Before the ESA, in the 1950s and ‘60s, eagles were shot routinely despite the protection. The ESA listing helped bring public attention to the issue.

Through the early 1970s and into the early ‘80s, numbers increased gradually. Then, as you got into the ‘90s, there was still gradual growth. From the late ‘90s into the 2000s, the population really exploded. There was a doubling rate of every several years or so for a while.

7. Deforestation in Brazil's Amazon drops 34% in first half 2023

Deforestation in Brazil's Amazon fell 34% in the first half of 2023, preliminary government data showed on Thursday, hitting its lowest level in four years as President Luiz Inacio Lula da Silva institutes tougher environmental policies.

Data produced by Brazil's national space research agency Inpe indicated that 2,649 square km (1,023 square miles) of rainforest were cleared in the region in the half year, the lowest for the period since 2019.

----

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[realstrap]

Please help my partner, a black multiply disabled lesbian, get their autonomy back!

‼️URGENT ACTION NEEDED IN 48 HOURS ‼️

01/03/2024

my partner @800-dick-pics is a multiply disabled black lesbian in need of urgent funds for a service dog and the costs associated with travel!!

This is all so sudden and short notice, they happened upon this prospect while doing research and it fell into their lap, a puppy in a breed with the best temperament and size for their mobility needs. This is opportunity is huge for the independence of my fiancé.

For years now, my fiancé has been fighting with the medical system, I've seen them struggle to be believed by doctors due to medical racism, turned away and ignored at the ER, gaslight by ED clinics and multiple times I've physically caught them when they've passed out during a POTS episode. Their POTS EDS and CFS have rendered them housebound in this past year, unable to leave the house by themselves and it's gotten to the point where we both are afraid for their safety when they're alone in any capacity. I worry for them so greatly when I have to leave them for more than 20 minutes at a time because anything could happen.

This has been years in the making, even before we were together even. We've had to put this on hold for countless reasons throughout the years and at this point it can no longer be put off for the sake of my fiance' autonomy independence and quality of life. They're tired of not being able to hold a job or go out with friends or even just experience life outside of the walls of the house. This is incredibly important and this is our chance to change their life forever.

We need to meet this goal THIS WEEK, to be able to secure this opportunity including flight tickets, hotel room, training toys for the dog and food

We would not be asking if it wasn't so urgent, this can't be put on hold and all my fiance wants is to have a life again. Please help us if you're able, this opportunity means the world to my partner!

CA: $sleepyhen

VM: wildwotko

DM me for p@y pal

$0/2600 goal

[swanimagines]

LOST DREAMS | MORPHEUS

Summary: Your ancestor was cursed by Morpheus long ago so the women in your family would be plagued with eternal wakefulness, but you don't believe in the curse or that some ancient Greek god was the cause of it, like your grandmother always told you about. Doctors have told you that the only reason they can think of is most likely a severe case of ADHD in the family and that's why you never feel sleepy. But then you get a job at a Burgess mansion and find something in the basement that makes your grandmother's stories sounding not so crazy after all...

Even on her deathbed, your grandma had talked about the "curse" she claimed the whole family suffered from. You could see how it can be seen as a curse, never feeling sleepy and how you always had energy for everything - because of that, you had had plenty of boring moments every day and it did suck. Not to mention, your friends talking about how funny and good dreams they have had always sparked jealousy within you. It was something you had never experienced.

Doctors had researched you since you were a baby, but they couldn't pinpoint a reason for being unable to fall asleep either. They had you running from test to test, even sent you to another country for more tests with a world top sleep disorder clinic, but nothing worked. Some doctors were afraid that your condition is a type of fatal insomnia, and that you were slowly dying. But those were knocked down too with brain scans, and after your grandma and mother could testify that they had been exactly the same since birth, doctors were facing yet another puzzle. The condition was absolutely unheard of. You heard stories that someone in your family had been burned as a witch for not sleeping, which ultimately made you believe it's something running in the family.

And after some debating between doctors, they too decided that it's an extremely rare type of ADHD, the most severe there is, and your family are the first ones it's been detected to have. They also believed that something in your brains had aligned so perfectly that you not sleeping doesn't affect the brains negatively and expressed their will to be able to take your brains for medical research.

Your grandmother, however, wasn't keen on that thought. She had made up her mind that it's the ancient Greek god Morpheus who had cursed you with it, and nothing would be found from her brains.

"Mother, Morpheus is an ancient Greek god. He's not real," you remember your mother saying as you were visiting your grandma in the hospital. "There's also no thing as curses or magic."

Your grandma had pursed her lips and shook her head. "Oh my dear foolish girl, you just don't understand it. Our ancestor, many centuries ago, was Morpheus' lover, and-"

"She rejected him, we all remember," you interrupted. "He cursed her and everyone in her family to never feel tired."

Your grandma had let out a long breath through her nose. "No, he cursed the women with it. Not men. It is said that he became enraged when his lover refused his kingdom, and when she passed away, he took revenge by striking down all of us with this curse, preventing us from getting proper rest. And now, you're the newest one of our family to carrying the curse. Your future daughters will carry it too, and it will be passed on to their daughters in turn."

You had sighed in chorus with your mother, your grandma had always been clearly delusional about it. Likely brainwashed by her own mother, who had been brainwashed by her mother and so on. But you and your mother were new generation, who didn't believe in such absurd stories and had reliable medical research under your fingertips but unfortunately, you had had to listen your grandma talking about it all your childhood.

When your grandma had passed away, you moved out from your hometown and settling to a nice little town in southern England. You got a job as a cleaner-occasional cook-extra pay caretaker in a fancy mansion owned by an elderly couple, and life was good.

But every mansion has its mysteries, and this mansion had one too. A secret door with a hidden passcode tablet, and only some could go in. No one, besides the guards or Alex and Paul, really knew what was behind it, and no one dared to find it out for themselves. After all, everyone knew that if Alex found out that his servant was going into the room, he would likely fire them, so no one dared to try their luck.

No one, except you. You knew how to get in, and even though you never tried before, you had the feeling that it would work. So you had gone in secretly in the middle of the night, your "curse" as your little helper. You had succeeded in distracting the guards and crept your way down the stairs.

You came to a large, dark hall and you swallowed as you switched the light on. The lights blinded you for a moment, and you raised your arm in front of your eyes, before slowly peeking through and your heart jumped a little upon seeing a figure sitting there. It was a man, who was inside a large glass sphere, not even looking at you gawking at him. Then you realised that he was naked, and quickly turned your head away from his lower regions.

"I'm sorry, I...I..." You stuttered, your voice croaking. "I didn't think there's someone here. Everyone is so mysterious and I wanted to see what is it that is kept here. Wait, you... you aren't kept here as a prisoner, are you?"

The man didn't reply, but his eyes shifted at you, and you felt like a mouse caught in the stare of an owl. His gaze was intense, and a shiver ran down your spine.

You took it as a yes. "Can I help you? Can I do anything?" you continued nervously.

The man kept quiet, but you caught something in his eyes, something which looked like disbelief. You opened your mouth to speak again, but then closed it. You glanced over your shoulder before taking a step towards the sphere, and noticed strange vigils in a circle on the ground.

"What's this?" you asked, still somehow wishing the man would say something. Even when you knew he wouldn't. But his gaze was on the circle now too and he cocked his head slightly at it.

"This sounds stupid, but it looks like a summoning circle. I've probably watched supernatural movies a little too much," you chuckled. The man slowly raised his eyes on you again, and then back down again. You frowned. "Do you... want me to break it?" you asked hesitantly.

The man's piercing blue eyes once again met yours. Then he, very slowly, nodded.

You swallowed hard and stepped forward, fingers trembling as you touched the circle with your foot. It immediately felt like some unknown force was pulling at you, like you were being pulled towards it and you made a stroke, erasing a small segment of the circle.

You let out a breath you didn't know you were holding, and heard noise from the stairway and immediately panicked, looking at the man and then sprinting towards the light. You turned it off and made your way to the farthest corner of the basement, hoping no one would notice you once lights were on.

After a few moments, you heard a chair scrape the stone floor and carefully peered towards the doorway. The other guard had come back and was reading a newspaper. You watched as the man in the glass sphere slowly stood up, pressing his hands on the glass and suddenly, all hell was loose.

A wind surged through the room, knocking the doors open and making a terrible sound. You covered your ears, before realising it wasn't just the wind. There was a bright light, you saw the figure of that man climbing out of the sphere and you screamed, not knowing what was happening.

Suddenly, the guard was on the ground and another bright light appeared. Then the man in the glass sphere was gone, just like that. The light, the wind and the noise had all stopped the moment that man had gone and you slowly got up. Your knees buckled but you forced yourself to go upstairs, to pretend you were never there. You were shaken. What had happened?

---

Some time after that, you were preparing yourself for another book marathon. You didn't feel like watching Netflix right now, so books it was. But then something happened, something that had never happened before.

You fell asleep. You put your head on the pillow and began reading when you were taken over this strange feeling of wanting to close your eyes, so you did. And sleep came. Suddenly, you were transferred in front of a huge castle, dragons and fairies flying over you and a sweet smell that tickled your nose. And you were sure you had lost your mind.

"Hello," a deep voice said from beside you and you twirled around to see the man from the sphere in front of you. Now, fortunately, fully dressed. He smiled and you stared at him, confused.

"How- How are you here?" You asked, frowning. This was absurd, almost like a... dream?

"You're dreaming," the man confirmed your suspicion. Your eyes widened.

"What? H-how?"

"I lifted the curse. So you could meet me."

You blinked. "C-curse?"

"Yes. A long time ago, I cursed a woman who didn't accept my proposal, when I asked her to be my queen when she died. So I told her that every woman who is born in her family, will be cursed by eternal wakefulness." He narrowed his eyes slightly. "I was bitter and inconsiderate when I did that, taken by my feelings and sadness."

"Wait, so... my grandmother was right? You... you are..."

"Morpheus, the King of Dreams." He smirked. "Your kind thinks I'm just a story, but I exist, in fact. The whole dream realm exists, and we can't tell stories without dreams."

You still stood there, dumfounded. "You lifted the curse so I'm... I'm able to sleep and dream now?"

Morpheus smiled slightly. "Yes. As a thank you for releasing me."

You blinked again, and then took in your surroundings. A dragon sat next to you, its wings spread wide and a fairy sitting on top of it, playing with some sort of crystal ball.

"If I may, I can show you around the realm?" Morpheus offered and you gave him a nod. "Very well. Follow me."

You started walking with him, and in a few minutes, you arrived at a forest. The trees were tall and wide, with red flowers blooming everywhere. On your left, you could hear the sound of water flowing and on your right, a waterfall. A beautiful place, one that you wanted to stay in forever.

"There is a lake not far from here, where the fairies usually gather. It is very beautiful, would you like to see it?" Morpheus suggested and you nodded. "Follow me."

He walked into the woods, and shortly after that, you reached the lake. The water sparkled in the sunlight, and the land surrounding it was green. Many little houses were built around the edges, and you couldn't help but stare at them. They reminded you of dollhouses, and you quickly realised that they were where fairies lived.

"This is the most beautiful place I've ever seen," you murmured.

"It is." Morpheus agreed. "Would you like to see my palace?"

You looked at him questioningly and he smiled.

"The house of the king of dreams is located in the heart of the realm. You need my permission to enter it, and only a few may. But you have earned my trust."

You nodded. "Thank you."

He smiled again. "Then follow me."

You walked out of the forest, and suddenly were met with the palace once again. It was bigger than you expected, even though you had been expecting it to be big. The garden was large and full of flowers, while the inside was decorated in a warm golden colour, with paintings hanging from the walls. He led you to the library, and you looked around at the bookshelves and the many old manuscripts.

"I heard you like books, so I thought you would like this," Morpheus said, smiling. "You can read whatever you want."

"Really?" You gasped, and his smile grew slightly. "Thank you!"

You went through the endless shelves, looking at all the books you could see. Some you recognised, others you hadn't seen before. Morpheus stood there for a moment, before exiting the room.

Dreams were even more magical than anyone had ever told you, and you couldn't wait to see a whole new world of them.

---

Requests are always open! FANDOM LIST | PROMPT LIST(S) | RULES (READ!!!)

[naamahdarling]

Maybe it isn't that I actually hate medical professionals? They just suck and are weird sometimes, and a lot of them shouldn't be practicing, but I don't hate them as a group, like, personally.

What I hate is their ability to make my life harder in ways that are often completely opaque to me, and a lot of the crap things they do are not really possible to challenge. And I hate the fact that holding them responsible fort dogshit behavior in any way that will actually benefit me is almost always impossible.

And I also hate the fact that they have to do stupid things sometimes because that's how the system is set up, and those things sometimes mean patients actually get harmed. They aren't fond of that part either! They don't want the system to be the way it is! But they don't have a choice, so sometimes people like me get forced by bureaucracy into doing things that are re-traumatizing. And I can't imagine that feels good for them at all, knowing that their patients are sometimes only "consenting" because that bureaucracy will not let them be helped in any other way. Which isn't consent at all. I imagine that must be pretty traumatizing for them, too, sometimes.

If it were easier to actually access medical care without tremendous delays in this country right now I would have much less trouble finding providers who are good at what they do and are not horrible people, and who have clinic staff who can do their fucking job.

Oh and I also don't appreciate how evasive and unwilling to commit they are out of fear of being held to an answer that turns out to be inaccurate, but I can't make an informed decision about my own care unless they give me at least some information about probabilities and trajectories and typicalities. Genuinely, how the fuck am I supposed to navigate that shit. I get that some patients are really fucking difficult, but I should be able to get a special stamp on my file or something that says I understand that sometimes medicine isn't an exact science and the best answers that my doctors can give may not always prove to be accurate in the long term. I know they don't like being in that situation either.

A lot of medical professionals are fucking assholes, and unfortunately the ones who are not are still hamstrung by a system set up to actively prevent people from getting care.

I miss my old doctor. He gave no shits about anything that wasn't the patient. He prescribed scheduled meds based on what the patient needed and not based on fear of consequences potentially being imposed on him by the punitive patient-hostile drugs-are-bad moral panic machine developed to force suffering people into buying more dangerous drugs off the street in order to prevent far fewer people from maybe getting high off of drugs that at least weren't laced with lethal substances. (The purpose of a system is what it does.) Did he get sanctioned and become locally unhireable? Unfortunately yes he did. Does he now provide concierge care to rich people? Yes he does. He found a way to make it work, God bless him.

Everything about the medical system in this country is fucked. Hospitals, doctors, nurses, pharmacies, pharmacists, pharmacy techs, phlebotomists, clinic administrative staff, insurance companies, medical schools and schooling, licensing boards, drug advertising to both providers and patients, pharmaceutical reps, researchers, research, publishing, medical trials, pharmaceutical companies, manufacturers and distributors, medical equipment, charting software, billing and billing codes, diagnostic criteria, charity and low income services, accessible transportation, home care, the lack of independent individual patient advocates, dietitians and nutritionists, access to physical and occupational therapy and physical and occupational therapists, the massive bigotry of every kind rampant in every corner of the medical field, social work, senior care and assisted living, deprioritization of informed consent and harm reduction, disability applications, inaccessibility of medical records, especially psychiatric notes which are specifically allowed to be withheld from patients, lack of continuity of care for disadvantaged people, care that is equitably accessible to disabled people, telemedicine, patient portals, phone systems, clinic hours, every single aspect of inpatient and outpatient psychiatry, facility security, all sorts of things going on with therapists who are nevertheless probably the least malicious group of people in this entire charade, aaaaaand patients themselves.

Also hospital toilets that are too tall and make it literally physically impossible for me to poop while I'm there waiting for somebody to come out of surgery. I just needed to take a crap, guys. You didn't need to make the toilets so tall that my feet didn't even touch the floor. It is very clean but there is no shitting for short people at St Francis.

[ilianaoftroy]

Every once and a while I think about the forced birther here on Tumblr who basically said I was a sociopath because I work as an embryologist and expressed concern for women suffering pregnancy complications due to the overturning of Roe v Wade. They demanded examples and then rationalized the ones provided away. Admittedly, the legit articles I provided were behind a paywall, bc, you know, real research costs money. It was a non productive conversation because this person felt such circumstances were 'rare' and I guess didn't care if those women died.

The next day I performed an embryo transfer for a woman who had suffered five miscarriages requiring medical intervention in the past. Because of where she lives, she got care, still has a functioning uterus, and can try again to start a desperately wanted family with her beloved spouse. Then I signed congrats cards for 6 patients who had sent our office birth announcements.

It's been a year and I still think about the difficulties the patients I work with would face in other states. How I will never relocate places because I could be left untreated until septic, not to mention not have a job. How I have fewer rights than my mother did at my age. Today I came across this pay wall free paper, fairly limited in scope, confirming the complications in healthcare for pregnant people post Roe v Wade. But what I do know. I just work with people with complex pregnancies every day.

[kittyscupcakeandbunny]

CRAZY OVER YOU x MIN YOONGI

[HYBRID AU]

18 +

PART 6

Take Me Home

Side Characters: Namjoon/doctor, Seokjin/doctor, Taehyung/Hybrid Tiger, Jungkook/Hybrid Bunny, Hoseok/Assistant medical.

Warnings: Smut, mentions of blood, sharp objects, rut, beast behavior, medical experiments, medical procedures and curse words, suicide attempt (not detailed only mentioned).

Word count: 12k

Genre: Fantasy, hybrids au, smut.

SUMMARY》 Yoongi is a black mamba hybrid one of rarest species of hybrids, who’s about to be put down due to his lack of interest in living. But everything changes after the new medical assistance (y/n) takes a liking to him. Meeting after meeting he realise his feelings for her are not the only thing growing.

< previously Final >

. • ☆ . ° .• °:. *₊ ° . ☆. . • ☆ . ° .• °:. *₊ ° . ☆. . • ☆ . ° .• °:. *₊ ° . ☆. . • ☆ . ° .• °:. *₊ ° . ☆. . • ☆ . ° .• °:. *₊ ° . ☆. .

Hybrids lived between us in our human society for a decade already, it was nothing new our society’s view of them had changed dramatically over this years. It wasn't something that stared out positively, at first many people thought the hybrids were some kind of alien and not so surprisingly feared them to the core. it was more of a understanding that was needed in order for us to change our view of the unknown. I was one of the few people who decided to fallow this path, i knew it wouldn't be easy but i had Jin beside me and he played a big part into the reason i became a doctor of special beings. I loved every part of my job as a doctor at the clinic. For years nothing has ever shocked me ever since i began my own work here, having spent almost my whole life working with Jin we grew up together here. No one could understand me better than him.

Shocked? That was an understatement.

To say the least i could nearly put any thought into sense. My mind seemed to still be under process after he spilled the most outrageous thing he could to me, i could feel my entire body run cold under his stare. I was hoping this was some kind of joke of his, the moment couldn't be more perfect for it - right? - but the more i searched in his eyes the more worried i became, there was no shade of entertainment on his features and it hit me like a brick in the head, he was completely serious about this.

Mouth opening and closing repeatedly as no words came out of my lips.

What was there to say?

He just claimed that the impossible had happened.

As much as i would like to believe in him, the situation just didn't make any sense. Many studies had shown how hybrids couldn't impregnate a human, one would think that as hybrids that would be a false affirmation since they were "half humans" but although they had human DNA their bodies the cell's structure that differed them to us were well… completely ‘different’, with both DNAs in their genes their animal genes "treated" the human genes almost like 'pollution' once in contact with another's "pure" human genes. Once a hybrids human DNA is a genetic modification of our DNA, for a hybrid and say a "pure" human to be able to conceive another being it was like mixing oil and water, they simply don’t mix together. I remember being disgusted at one class in medical university were that topic was first brought to me - the thought of humans searching for such possibility mean some people wanted to have such relations with the hybrids and all i could think about was the negative side of that - it was said that many exams and tests were done with hybrids to make sure they could be increased in number but after many years of research the hybrids simply didn't responded to any tests with humans, we simply didn't catch their radar to say the least.

The informations about the very first hybrid was also something no one knew about it, we just knew they are here now and have been for years already.

I had my conclusion in that moment that Jin was completely out of his mind and probably lying about this.

I could feel Jin's hands slowly began to let go of my shoulders sliding them down, he looked down before taking a step back.

- what? - I breathless said, almost not recognizing my own voice.

- I know is crazy but... - he nervously said, running his hand through his hair.

- Crazy? Jin do you have any idea what you are implying here? - i ask him completely staggered.

- I know but.... - he sighted - i found records for old experiments done...

- Jin why didn't you told me before? Why would you wait so long and just spill everything over me now out of all time? - i could feel myself getting heated, none of this was making sense and things had just gotten more complicated now.

- I'm sorry y/n.... I heard what you and Yoongi were talking about and... - his words brought heat to my face, embarrassed I looked anywhere but him - to be honest I've been noticing how you both were acting and I knew something was up.

- Jin, shit I don't even know what to tell you.

Here i thought i was being smarter when he knew everything all along, i was beginning to wonder if anyone else had notice anything going on with me and Yoongi and that thought brought Hoseok into my mind. I knew he’s been very skeptical about Yoongi and it made me question if it could’ve been because he knew about us.

- Is okay, y/n… i know what kind of person you are and i trust you wouldn’t do anything that could compromise the hybrids safety - he replied softly - I'm happy Yoongi has you by his side actually.

- Why would you be okay, though? I just broke the protocols, i.. i don’t know what I'm supposed to do to be honest Jin - i finally tell him.

- i can let this slide this time specially since i don’t have any right to judge you, when my father went against the rules I couldn't do anything to stop him before and I didn't even knew Yoongi was my... - he sighted - I didn't even knew I had a brother.

I looked up to meet his eyes feeling as the weight of the world went down over my shoulders, we both have been through so much in this past week and I couldn’t even begin to imagine what Jin must’ve been through all by himself. Finding out you have a brother who’s not even human and how your own father went overboard bad towards him for years torturing him, i can’t imagine which was worst to him and as his friend i couldn’t help but feel somewhat bad for not knowing to support him.

- Oh Jin, - i reached to hold his hand, holding it tightly before continuing - I understand you and i know you must feel like shit now but you should've told me that, you know you can always talk to me.

- I was planning on it and it definitely wasn't going to be like this but, you guys were getting intimate there and Namjoon just texted me saying he's coming to help with Yoongi - he explained softly - I thought you wouldn't want to have him find out like that.

Once he was done explaining i was the one feeling completely dumb, of course Namjoon would be coming soon. I should've thought about it before making any more decisions that could affect both Yoongi and me, my emotions got the best of me in the heat of the moment. I was once again blaming myself for being well… human, in some way i felt so weak when it came to Yoongi it was so unfair honestly how such a being like him ended up having so much power over me. I had tried so hard ever since i first meet him, it was unethical to let such feelings as “love” rise for a hybrid in a place where i was supposed to care for him, professionally.

But the heart wants what it wants, the most irrational and innocent thing a human can do is “love” and to love and be loved are things some can only experience once in a life time, some get to love and some get to be loved. To have both is a treasure.

It felt crazy to me but i no longer wanted to hide my feelings for i had no bad intentions, so unfair how my heart choose Yoongi to love.

Now this entire situation with Jin and Yoongi, I couldn't figure out what i was supposed to do.

- God this is crazy - I leaned on the wall, a long sight leaving me lips.

Nothing was making any sense anymore, I couldn't believe anything Jin was saying and i just couldn't find the background for it to make any sense in my mind. Amidst that i found the courage to ask the thing that was almost burning my head in confusion.

- how are you two... related?

Jin gave me a knowing look before taking his place beside me on the wall, after a long breath he looked up at the ceiling before talking.

- My mom once fell in love with a hybrid too.

His mom?

Jin never talked about her, i only knew what everyone else knew at the clinic. That she had left a long time ago when he was very young so he grew up with his dad, having no contact what so ever with his mom afterwards.

- Oh. I thought you didn't knew her very well, you said she left when you were younger right? - i asked.

- Yeah, but recently I've been doing some research on Yoongis case since i needed to collect proof that my dad was taking advantage of his powers at the clinic and to finally take my father away from the clinic - a sight left his lips.

I was surprised to hear that he would be taking legal action against his father, no matter what he did he was still his dad after all. I couldn't say i wasn't happy about it thought, if we keep letting things like this slip out it will only grow bigger and end in the most unfortunate ways.

- Jin... - i looked at him from my side, this whole time he seemed to be doing fine but now that i took a good look over his features, i could see the tiredness at the lines of his face the eye bags begging to form.

- I know but this has to be done, he needs to pay for what he did to my brother.

- Well I can't argue with that - i looked at the wall in front of me, the emptiness of it and no traces of color did nothing to help my overthinking - is that why you've been trying to help Yoongi this whole time?

- Yeah... I was searching for old documents since everything started years ago we had no updated data of treatment or what so ever of him and I found ... my mother's diary - he paused for a moment before a small smile filled his face turning to look at me - her story reminded me of you two. She meet a black mamba hybrid who was brought here for recovery and he hated everything and everyone too... except her.

- Well that does ring a bell or two… - I shyly looked away for a moment. Thinking of Yoongi and it seemed the grumpiness runs in the family.

- I'm sure you must be wondering how this was even possible - he said, i nodded at him finally the one million question - trust me i too have no idea.

- What? But how do you know he truly is your brother?

- I have the documents of her pregnancy with him, all the exams she took at that time… everything leads to him - he said, a dark cloud surrounding his soft features this time - she was part of the research about hybrids and humans being able to reproduce and... she succeeded, with no one knowing.

Once again i was punched with shock right in the gut, completely dumbfounded. For years I studied the same theory at university and years complimented by my colleagues how assertive my assignments on the impossibility of humans and hybrids reproducing for today, i be proven wrong.

- I couldn't find anything on the research though, it seems everything about how she was able to have Yoongi disappeared - Jin continued, i could already feel the engines on my head burst open as i took in every words coming from his mouth - i found some of my fathers old records it says that after some time she couldn't bear the child anymore and had some problems with the pregnancy and due to that she had to give birth to him too soon.

- I see, so regardless of the impossible being possible she did end up having complications to bear a hybrid - i said, the engines in my head no longer bursted open but begin to work out.

- Yes, he had to be put in a incubator - as he said that he furrowed his eyebrows a clouded expression on his tired features - I remember when i was younger she came home sick and for months she didn’t even left her bed, in that time she never told me anything but it seemed my father only found out about my brother when she was rushed to the emergency that time. When she couldn't hide anymore.

- So she was doing this and no one knew about it? - i asked shocked - it makes no sense, how could hide such thing?

- It wasn’t for long actually, a normal pregnancy would take almost a year but, she mentioned in her diary how it seemed to be moving faster then a normal human pregnancy i’m certain it was due to the hybrids advanced genes and after three months the complications begin to grow and she couldn't hide anything anymore.

Complications would be bound to happen, from years of research on that matter nothing was positive from the begging of a hybrid pregnancy and many complications were reported after the tests. We were not made to carry a hybrid being, our human bodies can only afford to give much and a hybrid requires more then a human body can offer. It goes beyond anything we know.

At the end of the day it doesn't matter how many tests and research we do, we still know very little about them.

- What happened to Yoongis father?

- He was... put down after my father found out. It truly was a miracle that mom got Yoongi and it doesn't make any sense but I have a few theories - he said, making me smile at him. That was the Jin i knew, always having a few cards under his sleeve - I have to do some research to be sure thought.

- I see.... Oh my god Jin, how have you been going through all of this alone?

- I don't know I was just hopeful. I have a brother who doesn't seem to like me much but is okay - he just brushed it off.

- That’s not true, Jin I'm sure he likes you deep down he's just .... - i paused, mind finally putting thoughts of the snake hybrid together - he feels a bit threatened, i think it might be because of me.

- Oh, that's why? I understand he must feel that way specifically since you're human and not a hybrid like him, he must duel between his feelings and instincts as you’re different then him.

I nerves once thought about it like that, I had been so caught up on my own thoughts and emotions I didn’t even thought for a moment how that situation could be affecting Yoongi. Of course things wouldn’t be exactly easy for him, he had a completely different perspective of our relationship then i did. But all I did was judge based on his hybrid personality i didn’t think for a moment he would be so considerate of me for I’m just human.

- is unusual for it to happen like that? - Jin muttered, pausing for a second as if noticing what he said - for like both sides?

- I know, we are away from being normal - i gave him a slight nudge on his side, trying to ease the tension.

- I just wanted you to know that it had happen before - he confessed.

- What exactly?

- Hybrids and humans - he said - Yoongi is proof that is okay if hybrids and humans love each other. After all they deserve it too right?

- I'm just... I don't know Jin, I've been told my whole life it wasn't normal it feels weird now but, I...i love him.

- I'm glad you feel this way about him, he never got the chance to meet mom so I'm truly happy you are the one taking care of him.

- yeah, they do.

His words brought a comfort to my heart i knew i was needing, I’ve been feeling so guilty over my feelings for Yoongi even now that i knew he felt the same way about me. Everything felt so different, like something so far away from reality it certainly does not feel like a normal day and I was sure it wouldn’t even from years from now.

Especially when you spend half your life learning about this beings and grow a career to help them, everything seemed impossible at first that a possibility was never once considered, but now even as i was in the eye of the hurricane i still couldn't believe that it was happening.

- Also, Namjoon will be here soon so you should go back in and calm Yoongi - Jin said, leaning away from the wall to stand in front of me watching me with a apologetic face - I'm afraid you guys can't go farther than a few kisses for a while.

- Shit Jin! - i exclaimed, cheeks burning in heat as i hit him in the shoulder many times - How much did you heard!?

- Don't worry. You perverted girl, he is my brother I couldn't watch that - he made a disgusted face - you should be thanking me, I was the one who turned everything off before anyone else could see it.

- Yah... oh god this is so weird now - i held my temples, trying to calm myself from more embarrassment as he just stood there laughing - but I'll go check on him.

- Maybe we should give him suppressants for a while.... - Jin contemplated.

- Yeah....

- We should talk about this later in particular - he mentioned.

- Yes, also shouldn’t we tell Namjoon? - asked him, just now i realized how Namjoon has literally been out of everything this whole time from the beginning and made me feel bad about it.

- I guess so since... I've some things in mind, it will be weird if he only finds out later - he continues.

- Yeah, wait what things? - i asked.

- I'll explain to you when we get to talk alone later.

- Oh god there's more.... - I mumble - Don't leave me out again thought!

- I won’t.

- Will you come in with me? - I sighted, looking over Yoongis door room - since... brothers?

- Oh no, for the sake of my eyes i won’t - he said lifting up his hands in defeat.

- Ya! I wasn’t- you little... - I immediately stoped as he only chuckled over my embarrassment - wait here and don’t let Namjoon enter before i make sure Yoongi is.. you know what.

- Wouldn't interrupt the love birds, you don’t have to worry.

At that i gave him once last slap on the head before turning on my heel back to Yoongis room.

I had to take a few breathes before entering the room, i had no idea how i would go from now. Things were not what they used to, i still had to process all about the new information Jin just dumped over me - Yoongi being Jin's brother. That didn't change my feelings for him though, but it brought some clarity to my thoughts and it made me realize that Jin was just trying to be there for Yoongi and despite all he still considered him his family.

I desperately wanted him to know everything but it didnt felt like it was my place to let him know Jin was his brother, that he has a family. The more I questioned that the more convinced I was that now wouldn’t be the best time to tell him, especially with everything that happened between Yoongi and his father. For now i would let that slide so Jin can be the one to tell him the truth, my only concern in that moment was how am i supposed to tell Yoongi the grumpy snake hybrid we cannot mate?

With a long sigh i entered the room, the door never felt heavier then now and i didn't know if it was all in my head but his room didn't felt as warm as usual.

- why did it took you so long...? - his voice was low and groggy sounding drunk almost.

I had to swallow hard, my body immediately responded to his presence feeling the heat embrace ever centimeter of skin under my clothes, heart racing the closer I got to him as my eyes took in his figured lying lazily over the mess of covers. It clearly did not look like that before and I felt the realization hit me in a big wave of heat. Oh, damn he was making that nest again.

- sorry, i didn't mean to... - i said, carefully approaching the hybrid.

- Hum... - he slowly sit straight at the edge of the bed, chest exposed by his opened shirt his face was slightly red, lips swollen and he looked me up with lazy eyes.

Something about his heat made him look so dreamy it was hard to concentrate on anything else when he looked like that, I tried my best to stay focused on the matter at hands which was to make him take the suppressants and cut off the mating process quickly and efficiently but, i find out that would be more difficult now that i have him in front of me then a few seconds ago before entering the room.

I continued to swallow hard, heart rate gone loose like a mad horse on an empty field. He looked so heavenly now I wanted to eat him whole, my eyes couldn't stop running to every corner of his exposed skin and his beautiful scales. The small coat of sweat over him made his skin shine even more, it was unreal how enchanting he looked. How unfair.

i didn’t know how much time i had until Namjoon got here so i kept a good distance between me and him. I'm afraid if i took another step he won't make it any easier to me - not that I would mind and that was exactly why I needed that space.

Another hard swallow from me the second he turned his head slightly to the side, eyes staring at me curiously up and down. A frown formed on his face when he realized i wasn't moving any closer, by now i was sure he knew something was going on.

- if you have something to tell me... - he began, eyes staring down at the floor between sounding almost desperate as he looked up in my eyes - come closer and do it, I can't stand you being this far away from me.

I could feel my breath burning inside my chest at his words, the second his eyes moved back to mine i was already making my way towards him. That was honestly all it took from him to have me completely at his mercy, I felt deep in myself how much I couldn’t also stay away from him. Sitting beside him carefully, I felt my body heat up even more wanting so bad to just let myself go and let his arms embrace me into his body, i nervously looked at his hands on his lap biting hard on my bottom lip as if that would bring any relief to my nervous self.

- what is it? Do you… not love me anymore? - he said, almost running out of breath on his words.

I instantly moved closer to him, taking his hands into mine.

- how could you say that…. - i assure him, breathlessly as he stole my words - I wouldn’t be here if I didn’t have feelings for you, Yoongi.

- Then what is it? - he asked, face slowly softening as I called his name.

- Things have gotten a bit complicated... - i tell him, he turned completely to face me worried growing on his soft features.

- Why? That Jin director won't let you be with me? - anger showed clear over his soft features, chest moving up and down faster as he spat the words showing his clear discomfort by the other male.

If i didn’t knew they were brothers i would have view this situation differently but, now that i know everything i couldn't help but chuckle at his reaction which gain me a confused look from the snake hybrid.

- Actually... he doesn't mind at all - i tell him, seeing as how his face changed so fast at my words he looked even more confused now and it made me chuckled again.

- He doesn't? - he mumbles, blinking confused.

- Jin just wanted to let me know that...

- I don’t care what he said.

He didnt let me finished, interrupting me mid sentence. Hands holding my wrists he moved so fast i bearly had any chance to properly process what he was doing until it was too late, my hands were held above my head and he pined me down on the bed straddling my waist.

I could feel his fast breathing over my lips and just like before his skin burned over mine, i immediately felt my body gave in his touch knowingly and in complete defeat - i knew I shouldn't have gotten closer to him.

Namjoon could get here anytime now and stoping a hybrid in heat wasn't easy especially when you were caged under him and every cell in your body longes for his touch, so painfully desperate for him.

- wait... Yoongi? - i tried to call out for him but no effect at all.

I know trying to stop him would be harder even more as my will to stop him was also compromised, as he looked down at me with so much desire and wet lips brushing so closely over mine.

- I need you... - he mumbled, leaning down on my neck.

No. Not the neck.

But he knew already all my weak spot’s which made it all worse and so good at the same time, I immediately felt my body shake underneath his at the feeling of his warm wet tongue over the skin of my neck.

He groaned in pleasure holding my wrists tighter, it was getting more and more difficult to resist.

- Wait please, yoongi - i call out again, this time he stopped his movements looking back into my eyes.

- What? Did i made you uncomfortable? - he said, apologetic.

- No it's just... Namjoon is coming and he'll be here anytime soon - i explained - we can't do this now.

- I understand... but this is not something i can control y/n, you should've thought about this before coming here and bitting me - he said, letting go of my wrists.

- I know, i know... - I carefully held his face caressing his cheek with my thumbs - I'm sorry... i don't meant to hurt your feelings, i want this just as much as you do but...

- The others don't understand... - he whispers.

- They don’t.

- What do we do now.... - he murmured over my lips - how are you gonna take responsibility for doing this to me?

If it wasnt for the smirk on his lips and the playfulness in his voice, I would think he was serious in that moment but i knew it was the opposite and as much as i wanted to comply to his wishes we couldn't do nothing for now.

Not knowing if we would ever get that chance, I simply pushed my lips over his kissing him desperately as if his lips were water and I've been locked away without a single drop of it. My thirst for him was eternal.

- make sure i pay you back - i tell him, chest rising up and down against each other.

- I will.... - he promised.

He got up from above me holding a hand out for me to get up, once i did he closed his other arm around me waist. Making me look up into his eyes, he stared into mine nervously almost as if he had been caught on a lie.

I just giggled at his reaction.

- please don't tell me you'll make me suffer more by going on heat alone - he pleaded.

- What if i do? - i playfully teased, earning a serious look from him as i made my way towards the small cabinet with medical supplies.

I wouldn’t let him go through it knowing how painful it could be, for now he would be under a small dose of suppressants until we know what to do.

- if you do... - he said fallowing behind me - I'll take you now....

For the second time he had spin me around completely taken me by surprise, holding my body tightly against his. I couldn't tell before but now it seemed his heat was getting more intense as if he wasn’t before, his usual dark eyes had a more yellow color around it, his cheeks were red and his fangs were more noticeable this time.

I could tell he was getting on the edge of losing from his finger tips tightening on my waist painfully, it could be really difficult if it gets too intense.

- no matter who enters this room... - he whispered over my lips - I'll make you mine.

- I won't do anything to hurt you - I whisper back, it seemed to be enough to wake him up from the trance.

He smiled softly eyes closing slowly and opening, he was breathing through his mouth a few drops of sweat sliding down the sides off his head to his neck. Yoongi has been holding his heat for days now, i couldn’t even imagine how uncomfortable this must feel for him and it made me feel bad for starting this but the situation calls for a pause now.

Feeling his fingers slowly lessen the grip on my waist letting go of me, I turned around to get him the suppressants quickly preparing a small dose of suppressant on a syringe before turning back to him.

- this will work faster so you don’t have to suffer tonight - i explain.

- Ok... - he took off his shirt completely before I even ask, for a moment I thought he was only being helpful but the sly smirk on his lips told me otherwise

He was doing it on purpose to provoke me, knowing very well how on the edge I was.

- And you were afraid of me teasing - I mumbled, he chuckled as i inserted the needle into his arm.

- Is good to know you're affected by me - he said, I quickly disposed of the syringe before turning back to him.

- How could i not? You...

Before i can finish the door is burst opened by a nervous Namjoon and a confused Jin fallowing right behind him.

- y/n are you okay? - Namjoon rushed to me - sorry i left so quickly.

I looked over to Jin who gave me a small smile then at Namjoon who shares his stare between me and the hybrid.

- she's fine.. i didn't eat her - he said to the male, double sense dripping from his lips through his smirk as he began to dress into his shirt.

My cheeks immediately went hot a low chuckle coming from Jin which he quickly tried to cover up by looking away, the situation was somewhat different now heaving the brothers in the same room sharing the same joke.

It made me feel at ease.

- I'm fine, Yoongi is on suppressant so he didn't do anything - i tell Namjoon, earning another chuckle from Jin.

- Ok that's good, Jin told me the mating process was canceled - Namjoon said.

- Yeah, we figured is better since is what the hybrids feel more comfortable with - i tell him - don't worry Joon we’ll fill you with all the details later, right Jin?

- What? Oh, yeah, oh yes later - jin said nervously.

I only stared at him shaking my head side to side.

[…]

It felt like i was living a movie ever since i meet the snake hybrid, how could i imagine all the events that would be fallowing the moment i decided to get myself between Yoongi and the clinic. I couldn't believe everything even after we left Yoongis room so he could rest, he needed to adapt to the suppressant before we moved him back to his room so as soon as we made sure everything was fine we left to carry on our different activities. Not only he needed to adapt but i knew this would take some time before i can begin to process it, now more then every we needed to be aware of the decisions we make in this process. It did not only involve Yoongis safety but the entire clinic.

At the same time i wanted for Jin to make his father pay for his mistakes, i fear he would try to do something and make things more complicated.

Whatever may happen i was sure to be there for Jin, we still needed to sort everything out as soon as possible.

Namjoon was the most confused between us all, after all Jin had the most impact on him right after we left Yoongis room he turned to Namjoon with the more serious expression on his face as if he was on a mission.

- we have import things to discuss later.- he said with a hand on his shoulder, and the most dramatic look on his features.

- Alright...? - Namjoon was so puzzled he could bearly say anything after he left. - is everything okay with him?

- He's good… see ya?

- see ya.

I knew things were set for drama later on, but now i could tell a weight seemed to heave left Jin's shoulder - mine too now that i was sure he wasn’t bother by my feelings for Yoongi, especially since they are brothers. I was happy he was the one to know about us first, we seemed to share the same thoughts and stand together on the same page when it came to Yoongi. Jin being his only family now i was happy for him, Yoongi wasn’t alone anymore.

Things were bound to happen and secrets can't stay hidden forever, but we had each other and we have the same goal in mind.

Save Yoongi.

Not knowing my day would star with such events in the morning, i didn’t assigned much appointments for today since i would be focusing on Yoongis treatments and his mating process but now that it was all canceled the plans had changed and my schedule was more clear today, i had to make sure a day before today for any case Yoongi may need my assistance but since he was on suppressants from now i would only have to go with his normal appointments now. I found myself completely bored a few hours later after checking on my patients.

After noon i was going back to check on Yoongi when i felt my phone vibrating on my pocket assuming to be Jin and chuckling since i was right ''meeting. My office.'' It read and i could almost picture his teasing smile on his face while sending this.

Truth is ever since the situation with Yoongi was set to our care we have been so stressed and on the edge with it all, one after the other, all the worst cases possible were just being dumped on us and i knew it wasn’t going to be any easy from that point, now that Jin has opened up about his father i knew why he was so distant this whole time and so eager to get things done.

Just like me he too was going through a hard time but now that we finally talked about everything all that worry and fear seemed to be gone, i could feel how much lighter his humor seemed to be and i too felt more comfortable despite my worries for Yoongi.

I was making my way to the elevator to meet up with him when the the alarm went off and all the halls were lighted by the red color and my whole body immediately moved in alert. This was a red coded situation and different from the tiger hybrid accident last week, this one was emergency alert. Not thinking twice as i rushed through the corridors hearing the voice on the speakers requested assistance on the main entrance of the clinic - was there a hybrid making an escape? Not just any hybrid but a red code one?

Today gotta be my lucky day, right after lunch someone tried to escape? The situation couldn’t call for a better moment and i worried for all the other hybrids safety and the timing couldn’t be more perfect as it just so happened to be when the hybrids were coming back from the canteen.

Once I finally got there i was ready to assist with anything but, i found myself watching a scene that for my disappointment was exactly what i was praying wouldn’t happen.

A few doctors circle around the main entrance not moving clearly unsure of what to do as the coded red hybrid held one of our patients by the neck, rushing through the people around i stood in front of the scene feeling a breath close on my throat at the sight of the bunny hybrid i was treating being held by the neck on his knees.

For a moment I thought that this couldn’t be a hybrid who stood there holding Jungkook, i was skeptical as he didn’t show any characteristic of an animal until he looked up in my direction looking straight into my eyes. He didn’t have human eyes, they were bright orange his pupils closed on a thin line sharp enough to bring a chill to my spine. The light shined better over his face making known the golden color of what i knew very well were scales, he was a snake hybrid.

The painful groan from jungkook on the floor immediately woke up the rage inside me, if he wanted to hurt me it was fine but to go after one of my patients it was something else and before i could even think for a second I was already walking towards them, ignoring the few rushed warnings of the people around me.

Making my way towards the snake hybrid i never felt so angry before, being with Yoongi certainly raised my confidence with his kind.

Once i was one step away from the hybrid, looking straight into his sharp snake eyes he smirked at me. Tilting his head to the side as he licked his bottom lip, analyzing my face.

- let go of him - I demanded, anger spitting the words from my lips.

- I don’t want to...

This time i closed the distance.

- you don’t have a say in this, i can wait all day if i must - I demanded again, never even blinking away from his eyes - now be a good boy and let go of my patient.

This time his smile faded completely from his face into a bitter look and he slowly let go of jungkook, who almost fell on the floor over his face. I carefully lowered myself to help jungkook up holding his hands, his neck was red from the tight grip of the snake hybrid and he had tears on his eyes.

- are you okay? - i asked him. He nodded only and I quickly rushing him towards one of the doctors standing there.

- You're not like them... - the hybrid in front of me mumbles, making me turn back to him watching as his orange eyes looked me up and down before stoping over my neck.

I nervously swallowed, i know hybrids have much higher senses and from the look on his snake eyes i was sure by now he too knew about Yoongis bite on my skin still covered by a badge. Heat fallow up my face, knowing from experience he could probably smell Yoongis scent all over me and i prayed he wouldn’t say anything about it in front of every one.

- i don’t know what you mean by that - i tell him, trying my best to sound stern - now will you come with me to your room so i can get you treated or... do you want to go sedated?

He chuckled.

- lead the way doctor - he said, teasingly.

At his words the people around us seemed to have calmed down and soon one of the doctors came to my side with the hybrids documents and a collar to put on him, he looked at me worriedly but i only smiled trying to easy out the tension brought by the snake hybrid, i made sure to take the collar from him and quickly turned back to put on the hybrid.

Anger no longer seemed to be running on my system and i felt nervous once again, but i tried my best to keep my composure while closing the collar around his neck.

Closer now to him i could tell that different from Yoongi, this hybrids scales went higher up his neck stoping right under his ear, his blonde hair was bright almost white and i could pick a citrus scent on him.

I was curious to know what kind of snake hybrid he was.

- i can smell this is not your first time doctor - the snake hybrid insinuates, careful with his choice of words.

- It is not, fortunately for you I'm the one they call when hybrids like you don't have manners - i reply, which makes him smirk even more.

- Lucky me - he mumble, eyes looking up and down at me as he licked his bottom lip showing his sharp fangs.

I didn’t needed to question that he was sure a poisonous snake hybrid, I fear that differently then Yoongis bite his would actually be deadly.

Lucky me.

We didn't know if he would behave until he is all set on his room so me and another doctor were quickly to bring him there, we had to make sure to do this fast to ensure the other hybrids safety. I was glad he didn’t try make another scene but i still held my guard up, walking behind the hybrid as the other doctor took the front guiding us to his room.

Once in his room he was quick to walk up to the bed at the center of the room, sitting on the edge of it i fallowed behind o take the collar from him.

Stoping in front of him as the doctor responsible for him prepared his medication, i focused on carefully tacking the silver collar from his neck. His scales were much different then Yoongis, his had a more yellow and golden sparkle to it which made it look like he was covered in gold in contrast with his almost white hair.

With the collar off his neck he quickly held my wrist stoping me from moving away, he looked up at me, pupils fuller this time, only a small bit of orange around his full pupil told me he was calmer now, he brought my wrist up to his nose closing his eyes as he smelled.

- i smell another hybrids scent on you... - he whispered amused, the smirk never leaving his lips as he watched me - i never seen a human mate with us before..

I took my wrist from his hold harshly, feeling the heat creeping back to my face. Turning on my heel i walked back to assist the doctor, listening the snake hybrid chuckling behind me.

- what do we have? - i asked the doctor, trying to brush the emotions off my nerves.

- he is a piton snake hybrid, red coded but not by poisonous…. - he said.

- i can tell… - I murmured taking the documents from him as he prepared a sedative for the hybrid.

Usually the code red is attributed to a hybrid for one of two reasons, he is a predator which does demand a different approach before we can proceed with any further treatment or he has a history of misbehavior mostly being attempted escape or attempt to harm others, usually they only attempt in harmful behaviors.

I wasn’t surprised to find in his file that hes been assigned to our clinic for treatment after trying to kill one of the doctors on his past clinic, the list goes on and i wasn’t sure what to do.

Name: jp01301095 Male Species: Snake/Piton

Code: Red. (Destructive behaviors)

Date of admission: 13062016

Current status: to be treated for aggressive behavior and attempt to suicide.

Resume: Patient jp01301095 has shown no sign of improvement on past treatments, has been unable to socialize with his kind and the doctors responsible for his treatment. Patient didn’t show any symptoms of recovery, due to his destructive behaviors against others he is required to be isolated from anyone and to be excluded from mating process.

This would be one hell of a patient to treat, the more i read his file the more i became concerned about him. All i could think about was the words “attempt to suicide” on his file, how they never bothered to give him an actual name all made me question if the clinic he was before even cared to treat him correctly, he was the first patient i have heard off that actually tried to harm himself. No matter how many pages of his aggressive behavior towards others i read nothing was making me see him as a threat, I was afraid that just like Yoongi he too was only acting out of fear, looking up at his figure he stared at me smirking i wondered if all wasn’t just a mask he decided to wear to hide what he truly felt.

On his file i notice the dates of all the incidents involving him that, his behavior worsen after his attempt to end his own life. After treating Yoongi and finding out all the mistreatments done to him in this clinic, i was sure this snake hybrid has been gone through the same if not… worse in his past.

I turned to look at him as he stared at us amused and decided on taking matters in my own hands if needed.

- you can ask anything to me... - the hybrid said getting up and walking over to where i was.

It wasn’t like i was some kind of fearless human that i somehow always managed to get in this situations, i just felt more understanding of the hybrids pain then the others and I couldn’t ignore the fact that every time i looked at him, i saw someone who needed help even though he tried to hide it and did very well. He was the victim here but others may not be able to see it as i do, turning to the doctor I smile softly at him.

- call for Namjoon - I whispered to him and he nodded quickly.

I knew he would be the only one after me who could treat this snake hybrid, Namjoon was stronger then me and i knew better then to let myself act any recklessly with this hybrid. He was letting me go now because he wanted, from his files i knew it wouldn’t take a second before he try to hurt me. I needed someone who i could trust to care for him and that was Namjoon.

Once the doctor left i walked up to the hybrid. I knew this was dangerous but i saw what Yoongi did to the other staff and i knew this couldn't go any different if i wasn’t careful.

- well, I'm y/n I'll be taking care of you before we proceed with further treatments - i tell him.

- Please do... - he said, a smirk fallowing.

I took the sedative with me. When we go through traumas our brain tend to mask it as the opposite feelings as a safe mechanism, hybrids were no different then us when it came to that. I could tell he was using a flirting tone and a smile to mask his feelings probably also to provoke a reaction from me since he knows about Yoongi from his scent on me, i questioned if he uses that as a way to get things he wants from people - was it that how he got closer to his past females doctors?

I saw first hand how he can be when acting out on rage, but the more I looked at him now if I didn’t watched before I wouldn’t even believe he was capable of such thing. Right now he looked like a complete different hybrid then the one i read on the file, he wasn’t much taller then me, had a small figure and was covered on a gray uniform from his old facility, his white hair messily covered some of his face, his skin looked so pale it made the scales on his body shine like gold.

When he wasn’t smirking the soft features on his face made him look almost angelic, he was beautiful indeed - was it common for all snake hybrids to be this beautiful?

I quickly brushed off.

- what is your name? - i ask him.

They never once bother to give him a name, clearly no one even treated him kindly before for it. It was noticeable to me they didn’t thought of him for more then an aggressive being, only seeing him for his flaws but never trying to care for his wounds.

- I’m sure you read in the file, is jp01301095…. - he said, nonchalantly.

- yeah, but I’m sure that is not how you actually call yourself - i tell him, approaching softly - I’m asking for your real name.

He looked at me suspiciously certainly i was the only one who ever bothered to ask for his name, i could see how his mask dropped for a very short second before he smirked taking another step closer.

- you can call me Jimin…. - he said, sarcasm dripping his words - did they send me here because i misbehaved?

- Why you think that? - i asked softly, I realized the calmer i sounded the more his pupils dilated - did you do something bad?

- Humm... i hurt someone - he murmured, eyes shining brighter as if remembering exactly what he did - that's why they didn't assign any females as my doctors...

His files did mentioned a few females assistants who were unfortunate on the receiving side of his anger, it made me wonder why he prays on them more then males. Was it a women who inflicted the pain on him? Or was it that he just thought of us as being easier to hurt?

- I see... well nothing I haven't seen before - i tell him. Which brought a cold chuckle from him.

- You have some courage - he walked closer to me - is it because you stink of a snake hybrid? You think hell protect you?

- I can protect myself Jimin - i tell him.

The mention of his name did got a reaction from him as i imagined, for the second time i saw the mask fall for another split second before i took the chance to grab his wrist carefully. He didn’t fight me not did he tried to hurt me from touching him, i was surprised at that not exactly expecting him to let me guide him back to his bed. He sat down watching my every move.

- you are not here to be punished, Jimin… - i decided to call him by his name.

I took the sedative the doctor prepared, all his symptoms were under a red pen marked as dangerous on his file and everything was pointing how Jimin wasn’t physically hurt but mentally. He was unstable and so on for the first appointment he must be asleep, as much as i hate it I can’t do the opposite , he could still try to hurt someone and i was set on changing that behavior of his.

- you are here to be treated and recover - i said.

Turning to him i sat beside him taking his shirt to the side to insert the needle on his shoulder. He didn’t move or said anything while i did it. It was only when i was done that he gave me another sarcastic response.

- are you this sweet with your little snake lover too? - he said, trying to provoke another reaction.

- I'm careful with all my patients - i said, the words I chose are important. Anything could trigger a reaction from him and it was a matter of one wrong choice that could change everything.

- Oh... was he the one who did that? - he pointed at my arm covered by the white badge.

- No, he would never do anything to hurt me - i tell him - maybe you should learn some manners with him.

He scoffed.

I watched closely for his reaction at the mention of him and another hybrid like him, it didn’t seem to after him too much and that is a good thing.

The door opened revealing a worried Namjoon. I walked up to him.

- you really have no will to survive - he said to me.

- Sorry, everyone was scared so i did what i do best - i tell him, handing the file to him - i just sadeted him, he is all yours.

- Wait you won’t help me out? - he asked as i turned to leave, seeing as the hybrid as already falling over the bed due to the sedative any worry I had left in me was gone.

Everything would be fine from now.

- I have enough snake problems to resolve.

[…]

Indeed i had enough problems to resolve, after the alert was out i had to head back to all my patients and make sure they were doing fine - especially Jungkook who could've had end up hurt if i didn't show up.

Me and Namjoon were not the only ones who had assignments to deal after the alert, Jin too was called to assist the others and our meeting had to be moved to another hour later.

I just found out then how Yoongi could get even more grumpy under heat suppressants and nothing seemed to ease that grumpiness of his but i was relived to be with him in that moment regardless of his shitty humor, after the deep dive on the new snake hybrid file and uncover another series of mistreatment to another being like Yoongi my own humor had gone down bad blue and gray.

After bringing Yoongi some food i was impressed at how much he behaved like an old man when he's grumpy.

- did you eat everything? - i asked him.

- Yes boss.... - he mumbled, sucking on the red lollipop i gave him in the hopes the sugar would melt a bit of his grumpy humor. It didn't.

Instead he just looked at me bored while lying lazily on the bed, the covers were all over the floor and some were even scratched in pieces.

- were you fighting with the bed? What a mess - I commented. Hearing a grunt from him, i chuckled at his reaction - if you keep behaving like that...

- What? Will you punish me doctor y/n - he said teasingly, sitting over the edge of the bed were i stood up in front of him.

- Yes i will, i won’t give you any kisses - i tell him turning away to leave.

As I expected not a second later he pulled me back by the arm, i watched as he stared up at me much softer than before. This sly snake.

- I'm sorry... - he said, slowly massaging my wrist - i’m feeling moody because of the meds.

- I know, is okay - i gave in, carefully caressing his long hair.

- You'll still give me kisses, right?

- Of course...

I leaned down pressing our lips together in a soft kiss, feeling his smile grow against my lips tasting the sweet flavor of strawberry lollipop on his tongue. He groaned moving his hands up and down my sides slightly pulling me closer but before things got any deeper I quickly leaned back. Making my leave to carry on my assignments, leaving a now less grumpy snake hybrid behind.

We still needed to discus the matters with Jin and tell Namjoon of all that's been going on the past days, I felt bad for hiding it from him for this long but things were certainly not looking good and sometimes it is better to tell the other when you have things figured out so you don't bleed on them.

Thats what i thought at least, while making my way to get in the elevators after messaging Jin about the meeting.

When he gave me his confirmations I quickly left to head to his office.

I knew things would get better for Yoongi from now on and i was hopeful that Jin would win this one against his father, from now we had agreed on keeping an eye on all the hybrids in the clinic to make sure such thing never happens again.

Once i entered Jin's office Namjoon was already there as they shared a brief conversation. I took the seat beside Namjoon in front of Jin's desk as he looked as us both.

- well was is this all about? - Namjoon asked.

- I don't really know were to start.... - Jin said, looking a bit nervous - a few days ago we were here to discuss how you both would be taking care of Yoongis case and now, I'm here to... kinda fill you in why he won’t be put down anymore.

I know that already, but hearing for the first time right now felt more reassuring. I knew yet it felt like it was finally happening, Yoongi was free.

So on Jin begin to tell Namjoon about everything we have kept from him this whole time, how his father passed the case to him to put yoongi down, the first time we treated him and how he researched the files for Yoongi finding out all about his mistreatments.

He told us about how a few days before the mating process start he found his mothers diary and the documents for Yoongis birth, passing them to Namjoon who had the same reaction as me when i found out.

The entire time Jin was he only one talking, i wasn't sure what to expect once he was done though. As much as i was feeling positive i couldn’t ignore the anxiety i was feeling in that moment, i was hoping Namjoon would understand and maybe help us too but i couldn't force him to do that not was i expecting him to accept all of this at first.

The moment Jin told him about them being brothers our relationship was fallowed right after, Namjoon didn’t looked at me in any moment, his entire attention was still on the papers on his hands but i notice how he reacted at the mentioned of me and Yoongi.

- what? - he then said, looking up at Jin.

I swallowed nervously as Jin looked at me with the same feeling.

- i mean... i don't intend to be rude - he continued - this is the first time i heard of such thing.

- so you don't mind? - i asked.

He turned to look into my eyes.

- it's nothing that bothers me, i mean hybrids should be treated fairly like us not like some kind of savages, right?  - he added - i think if that's how you feel about him, i shouldn't judge you. We are friends too.

I was grateful for his words, so far I've been beating myself up over this matter. I couldn't help but wonder if me and Yooongi could ever have a relationship, we were far from normal and completely opposites to one another. But our feelings were mutual, a spark gluing us together.

For now i knew that my friends were together with me and that was very comforting due to our situation, i still have no idea how I'll ever manage a relationship with a hybrid in the clinic. I was sure it wouldn't be possible to maintain such a secret here and even more intimacy, wasn’t exactly comforting to be intimate with Yoongi at the same place i treated others.

It seems that no matter how many obstacles we go through, things never get easy for me and Yoongi to be together in the end something always separates us.

- is that why the mating process was canceled? - Namjoon asked.

- oh, no - Jin quickly replied - i simply don't want to force Yoongi into that, he clearly doesn't seem comfortable with it.

- i see... what will we be doing now then? - Namjoon putted - with him i mean.

- I intend to set Yoongi for adoption.

- what?

I almost gagged at my own saliva at his statement.

- that's what i wanted to discuss with you - Jin stared at me - i dont't want him to stay here any longer. Yoongi has been so much already or years i think is about time he has his own home but since the protocols for hybrids require an adoption document I'll set him for applications.

- a black mamba snake hybrid... it will be difficult to find good people interested - Namjoon comments.

I knew this would come sooner or later. Some of the hybrids here at the clinic are set for adoption application after their full recover, that is green coded hybrids. I couldn't understand why Jin would want to set Yoongi for adoption especially with him being red coded. He needed special care and time for recover to all his mistreatments, not only that but he certainly needed space to be able to have his heat which we had to interrupt for a while.

- are you planning on adopting him then? - i ask.

- oh… no - he said - i don’t think he would want to come with me and part of the process is that is a mutual thing with both sides, even though we are brothers i… wouldn’t want him to feel obligated to accept me just because of that.

- I understand but if you’re setting him for someone else, don't you think is too soon for this? - i asked Jin.

- i know what you're thinking, that's why i want you to apply for his adoption - he said. I could feel my eyeballs almost sprout open at his words.

- me?!

- it makes sense... - Namjoon muttered and i stared at him stupefied - i mean, he only likes you and you like him. Why not?

- i know this might be sudden y/n given how it has been so far but, i ask you to consider this - Jin said softly, eyes locked with mine

- yes, it is very sudden - i tell him - I'll have to think about this first, this is a lot of responsibility.

- I'll be here once you decide.

It mostly is a lot of responsibility, is not only about me but Yoongis well being as well. I can't make such decisions without thinking about this through, i know that Jin trusts me with this because of the relationship i have build with Yoongi and he being his only family is trying his best to help him but i can't do something that would possibly make Yoongi uncomfortable.

It hasn't been long since we've been together, living with one another is much different, sharing the same house together would be something he's never experienced too. I wasn't sure i would be able to meet his needs with my small apartment, certainly being a doctor at the clinic would help a lot with any medical needs he may have but what else would i be able to offer him?

Truth is I'd give him the world if i could but, i can't.

- well count me in to help guys - Namjoon said - but don't keep me out from now on.

He pointed at Jin.

- sorry bro, won't keep you out anymore - Jin said.

- y/n, don't even think about leaving me with that other Snake hybrid of yours - was his turn to point at me now.

The mention immediately reminds me of the piton snake hybrid who was admitted today, Jimin the piton hybrid's definitely seemed like a case new to me. He didn't seem to respect any boundaries and was a extremely trouble maker, from his files i read today there was many cases highlighted of his doings, doctors being hurt by him and many tries to escape that ended with not only the staff hurt but some of the hybrids.

Not only that but his mental state doesn’t seem the best either, i felt deeply concerned for him.

- what? But he is not my patient? - i tell him. I would gladly take the case if it wasn't for Yoongi, he's been very sensitive to all the smells around, i was afraid that if Jimin gets too close and leave some scent he might go off really bad.

- you mean the new snake hybrid, he’s a piton... - Jin adds - if I'm not wrong he hasn't been assigned to a specific doctor yet, if the situations seems favorable y/n would you mind taking him?

- i don't know, Jin...

- i think it could be good for Yoongi, maybe we can introduce them two and see if they can become friend - Jin continues - i think that it would be good for him.

- I understand Jin but, that is something to be discussed more in the future - i tell him - we need to move slower, Yoongi just started to adapt to a new routine and you are already thinking of putting him into adoption process. He's been through a lot, he might need more time to process all of this. He doesn't even know about you.

- oh, you are right... well then let's keep the in mind for the moment but please - Jin looked at me, a soft expression on his face - do think about what i told about his adoption, I'm sure... you are be the best suited to this.

[…]

A few days have gone ever since Jin mentioned about Yoongis adopting process, I haven't gone a single minute without considering all the pros and cons for that, as Jin asked me. I knew he wanted me to carry on that process but, i wasn't sure about it. We haven’t even told Yoongi about that, since it was still something that needed to be worked on and we were not sure how we would react to it, Jin was taking his time with it. But not only for those reasons, i was assuming he was even more busy this week then ever before. He did carry on the matters with his fathers wrong doings, but nothing much could be done besides making him step down from his position at the clinic so Jin could take his place.

Jin mentioned in a meeting about the situation with his father that, he was afraid that by exposing Yoongi and making known how there was a possibility for humans and hybrids to reproduce together would only cause future troubles for the hybrids and the last thing he wanted was for the hybrids to be put on a lab and be tested on again.

I know he only had good intentions and i trusted he did what he could in the situation he was in, for that reason we decided to delete all traces of his mother relation with the hybrid and her pregnancy. All the documents were destroyed to ensure no harm would be done to any hybrid in the future.

I didn't wanted to but, Jimin was in the end passed down for my care. The piton snake himself made the request for Jin the day after he was set in the clinic, from then i knew there was nothing i could do but at the same time i was glad he was showing good signs.

I decided it would be best to talk about it with Yoongi which only made me more nervous about it.

- he's like me? I doubt - he said that time - i don't really care though.

I was perplexed at his unbothered response at first but then I began to wonder if it was only because of the suppressants he's been taking, whatever reason it was it made possible for me to carry on Jimins treatments more closely.

The piton snake was slowly making process, so far he had no episodes of anger his only problem seemed to be he was just a brat, whenever he could he would bother Jungkook the bunny hybrid and I remember Namjoon mentioning that it was because he was a prey hybrid. Jungkook only acted annoyed at Jimins bickering at him, clearly the bunny hybrid was much bigger then the piton hybrid but I wouldn't want to bet on that matter - although i did saw some colleagues betting on them in the lunch room.

Jimins misbehaving got less serious as the days went by, he decided to be extra annoying to me though. He would always send flirting comments to me whenever he could, trying to be cute the second he realized i was seriously unbothered. It was baffling how much he just throws those comments every now and then never missing a chance, i even set him for heat examination but he came clean. He was just dirty minded but a least i knew he wasnt trying to kill anyone here like he would on his past clinics. He did improved a lot and I was glad he was doing better now, after a few days Jimin has proven to me how even code red hybrids could recover if you just give them some time and space to heal after all they too get mentally exhausted.

Jimin was constantly left on open space with other hybrids at his old clinic which to some hybrids can be very overwhelming since some still fell very territorial, i heard from him how some other hybrids would act out because of it but the clinic never did anything about it.

From then he started to open up more to me about his past, i was right about him being mistreated and that made me even more protective of the small piton hybrid. He wouldn’t talk much about himself and i notice how he would quickly brushed off with a flirty comment whenever the conversation went too serious, i was surprised to discover how much of a soft hybrid he was. But it seemed he didn’t liked when people noticed that side of him.

Little by little i would mention to him if he would like to meet with Yoongi, he would usually make some unserious comments and I understand that he wasn’t ready for that in the moment.

A week has gone by since Jins father has stepped down from his position, i could tell things were changing around the clinic evere since. Jin was giving extra attention to every case to ensure that everything was doing fine. Through that time i notice more people coming to the clinic to apply for Yoongis adoption, i was happy more people seemed to be interested in taking him in but I couldn't ignore the bitter feeling it came with it.

I grew worried about it every day that went by, usually when hybrids begin adopting process the director review the documents of the people who applied and after the review a meeting with the people is set for them and the hybrid to meet each other and ensure things go smoothly for both of them.

I was glad Jin was taking this slowly for everything that Yoongi went through and specially since he still doesn't know about this yet it could make things more difficult. The grumpy snake hybrid was still grumpy from the suppressants and we still needed to discuss about his heat, it would be good for the hybrid to hold that much longer.

I knew it would come to a moment were a meeting would be set for him and i became even more anxious, it was selfish of me to think about it this way but just the thought of Yoongi going away set a pinch to my chest so deep it was enough to drive me insane.

I was done dueling on the matter but I had to tell him about it first, before making any decision i needed to let him know his options. I felt the need to let him know that he wasn’t an accessory but a being who had a life and he could make his own choices.

After much thought i decided to tell him at his lunch, but I couldn't make out any words as i just stood there in front of him as he eat his food quietly.

- you've been too quiet - he mentions.

- ah, yes I'm just thinking about something... - nervously replied.

- is it about me? You seem... weird - he said, putting the bowl down beside him. He brushed his hair to the side, dark eyes staring deep into mine as if trying to make out my thoughts.

- i know that it might be too soon... - i begin, sitting down beside him, ignoring his eyes as i stared at the floor bitting into my lower lip - i wanna know your thoughts on... hum… adoption.

- what do you mean by that? - he asks, i feel him move beside me turning to me completely - you wanna adopt? Is it... like a pet? Or...

He didn't continued realizing by my silence exactly what i meant. I sighted.

- Jin set you for adoption a few days ago.... - I blurted out.

- he... what? - he said - why didnt you tell me before? Why am i only finding out now?

- because i... I wanted to ask you first... - i looked up at him nervously, feeling heat creeping up on my cheeks.

Seeing as his dark eyes shined angrily at mine and his eyebrows furred into a thick line, his hair was still a bit wet from his early bath, i could smell the scent of lavender coming from his skin. He grew the habit of closing only the last four bottoms of his silk shirt, exposing his beautiful skin and the scales on his sides and his neck to my eyes. Yoongi knew exactly what he was doing when he let those bottoms opened, it was on purpose and he made that clear a few days ago during one of his bath.

Even under suppressants i realized his desire was just unstoppable and unfortunately for Jin who usually entered the room right when we were sharing a heated kiss, it was not the best scene to be present.

Maybe it was the fact that so many people showed up for Yoongi that made me finally step up, i knew ever since we shared a bite on his mating room I wouldn’t be able to stay away from him anymore and having to balance our relationship in the clinic wasn't enough not was it possible anymore.

- I’ve been meaning to ask you this but i was so nervous, Yoongi... - i tell him honestly - the truth is... ever since Jin brought this up first I've been thinking about it every day...

- what are you trying to tell me y/n? - he said, leaning closer he held my hand in his. - are you trying to say goodbye?

- i.... - i stopped immediately.

How could i even put this into words to him? I was so nervous my hands were shaking, seeing how he seemed to grow sadder i felt desperate.

- i want to adopt you Yoongi.

At my words his face immediately lightens up, eyes staring into my with much surprise.

- you mean... for real? - he was breathless.

- yes, i wanna take you to my home as mine - i tell him.

He immediately pulled me into his arms and i never been held so tightly by him before, i hugged him back softly caressing his hair.

- I'm all yours then... - he murmured in my neck.

My chest was almost exploding in excitement.

[...]

The morning after…

- here -  i said handing Jin the single paper.

- oh, what is it? - he asked, before taking.

- i thought i should hand it to you personally.... - i tell him - i didn’t wanted to waste any time.

He stared at me suspiciously before reading the paper i gave him, I chuckled at his immediate surprise response eyes opening enough to almost pop out off his head then slowly fading into a knowing smile as he looked up at me.

- what took you so long? - he said.

- overthinking maybe?

We both shared a smile before he put the paper down getting into a more serious mood.

- well then... should we discuss the meeting?

- yes, the sooner the better.

I couldn't even begin to believe it. Yoongi would leave this clinic for the first time in his life and it was going to be with me.

. • ☆ . ° .• °:. *₊ ° . ☆. . • ☆ . ° .• °:. *₊ ° . ☆. . • ☆ . ° .• °:. *₊ ° . ☆. . • ☆ . ° .• °:. *₊ ° . ☆. . • ☆ . ° .• °:. *₊ ° . ☆. .

Next?

Notes: I’m sorry for any grammatical mistakes 😅😅 and the long wait, is not my best but it’s here. I hope you guys like it. See y’all 💖🙏

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[transmutationisms]

any thoughts on the obsession with "hyperprocessed foods"? is there even such a thing and if so how much of the stuff around it is fake?

such a flawed useless categorisation lmao; this phrase comes from the nova scale, according to which an "ultra-processed food" is identified by a lack of sufficient "intact" food and the presence of "sources of energy and nutrients not normally used in culinary preparations" and additives specifically "used to initate or enhance the sensory qualities of food or to disguise unplatable aspects of the final product" (other additives, such as preservatives, antioxidants, and stabilisers, only qualify a food as group 3, "processed"). ultra-processing is defined as "a multitude of sequences of processing [...] includ[ing] several with no domestic equivalents," and ultra-processed foods are "usually packaged attractively and marketed intensely."

......so ok, first of all, this is very obviously reliant on a lot of assumptions about what 'normal' cooking and cooking equipment means, lmao. i do all kinds of shit in the kitchen that would have been inaccessible to someone in the mid nineteenth century; has the food become 'less processed' because i can make it at home now? if i obtained the equipment to hydrogenate oils myself would they magically not be ultra-processed simply because they came from my kitchen and not from an industrial setting?

this is just quasi-scientific language to express a fundamental distrust of food produced in ways that currently can't be replicated in [researchers' definitions of] a [normal] home kitchen. it's barely more sophisticated than platitudes like michael pollan's command to "eat only foods your grandmother would recognise". using the nova classifications to make assumptions about the healthfulness or danger of a food is just silly; the presumption is that the dietary and medical effects are not due to the food itself but to how it's produced, an idea that has led researchers to conclude that "the NOVA system suffers from a lack of biological plausibility so the assertion that ultra-processed foods are intrinsically unhealthful is largely unproven."

fundamentally the only evidence that nutritional scientists have been able to produce is observational studies showing a correlation between certain ill health outcomes and consumption of 'ultra-processed food'.

But the observational studies also have limitations, said Lauren O’Connor, a nutrition scientist and epidemiologist who formerly worked at the Department of Agriculture and the National Institutes of Health. It’s true that there is a correlation between these foods and chronic diseases, she said, but that doesn’t mean that UPFs directly cause poor health.

Dr. O’Connor questioned whether it’s helpful to group such “starkly different” foods — like Twinkies and breakfast cereals — into one category.

[...]

Clinical trials are needed to test if UPFs directly cause health problems, Dr. O’Connor said. Only one such study, which was small and had some limitations, has been done, she said.

ie, when evaluating the healthfulness of foods you have to actually look at what they are and what the human body does with them, and not just make a bunch of wild assumptions based on fears about their lack of proximity to 'naturalness' or propensity to be advertised (unlike, i guess, other more intact foods, which are not commodities. who knew!)

and there are like a million trillion other reasons why this correlation might hold: off the top of my head, for instance, people who rely more on the convenience of ready-made foods likely to be categorised as 'ultra-processed' are likely to be people who can't cook because they don't have time because they're working. so as usual nutrition and health science does a dogshit job distinguishing between the health effects of socioeconomic status and those of whatever some dickwad wants to publish a splashy study about.

there are certainly 'ultra-processed' foods that we can be extremely confident are harmful to human health---for example, trans fats. but the categorisation as a whole is so conceptually flawed as to be useless for any purpose besides as a term that 'scientises' culturally held beliefs about the wholesomeness and healthfulness of home food preparation, and the corresponding danger and artificiality of industrial production and methods.

[sagan-starstuff]

XF Meta: Scully's Medical Training Timeline

At the request of @randomfoggytiger, I wanted to do my damnedest to make Scully's education and training timeline make even a little sense. I'm a physician (specifically a specialist in adult infectious diseases), and it's fairly clear to me that CC and Co probably didn't actually talk to any doctors about how medical training works. Love my girl - I'm a Scully Effect kid, I don't think I'd be a doctor at all if it weren't for the inspiration of Dana Scully. But her timeline is...iffy at best.

Disclaimer: My medical school and post-med school training occurred from 2009-2018, Scully's occurred in the 1980's-90's. From what I can tell, the durations of many residencies and fellowships don't seem to have changed much, but I can't say that for certainty for all programs at all institutions. I am also from the US, so I cannot speak to medical training in other countries.

Our girl was born in 1964, and so unless she skipped a grade (which some schools would do if students were classified as "gifted" or otherwise exceptional, she would have graduated from high school at age 18 in 1982 and went straight to college. Let's assume she didn't skip a grade, for the sake of argument.

You have to have a Bachelor's degree to apply to medical school. These degrees typically take 4 years, though if someone arrives at college with credits from dual-enrollment high school classes or AP exam credits OR if they take summer classes some people can complete them in 3 years. I don't know what the availability of dual enrollment or AP classes was like in the early 80's (and like CC, I'm too lazy to do the research to find out), so we can assume that Scully graduated from college in 1986.

Medical school is 4 years long - no shortening this at that point in time, and even now in almost all cases. So that puts medical school graduation in 1990 IF she's following a traditional timeline and went straight from college to medical school.

Now, if someone is going to go into practice they have to do a residency in at least one of a variety of specialties (Internal Medicine, Pediatrics, Surgery, etc.) in order to be board certified and practice independently. There are very, very few job options in clinical medicine if you DON'T do a residency, so if you want to practice, you have to do it. Residencies can be anywhere from 3-5 years, depending on the specialty. You can also further subspecialize after a residency by doing one or more fellowships (typically 1-3 years depending on the fellowship) before sitting for your board certification exams and starting independent practice. For example - after medical school I did a 3-year residency in adult internal medicine, then a 2 year fellowship in adult infectious diseases to be eligible to sit for the boards and enter my specialty, so 5 years further training after medical school before I could get a job, get board certified, and practice.

Scully is a forensic pathologist. She would have had to do a 3 or 4 year pathology residency (both were options at the time) followed by a 1 year forensic pathology fellowship. You CANNOT perform autopsies right out of medical school, if you are going to be a forensic pathologist you HAVE to do this training. So, following a traditional timeline this puts her as having completed forensic pathology training in 1994 or 1995. Pilot starts March 7th, 1992, so this is loooooong after she's canonically already an FBI agent and teaching at the academy.

But our girl's a smart cookie, so let's take a little leeway with her timeline. Let's say she skipped a grade some time in K-12. This puts high school graduation in 1981. Let's say she ALSO graduates with a bunch of AP credit and does summer semesters and finishes her undergraduate degree in Physics in 3 years. This puts her as starting medical school in 1984, with graduation in 1988. She'd still need to do that pathology residency and forensic pathology fellowship - let's assume a 3 year residency, then 1 year fellowship, so she'd finish training in 1992.

Still doesn't fit.

Let's go totally off the rails here - we know Scully was recruited out of medical school to the FBI, so she didn't do a traditional residency at all - UNLESS the FBI has an internal forensic pathology residency. It would HAVE to be accelerated in some way - some programs combine residency and fellowship by giving less elective time and more focus to the fellowship content. It's not common but they exist. Let's say in theory the FBI has an accelerated forensic pathology residency that takes 3 years, in addition to the 20 weeks of the FBI academy training. This has her finishing residency AND FBI academy training some time in 1991.

This is the ONLY way she could have finished forensic pathology training AND the FBI academy with enough time to be a fully certified forensic pathologist and FBI agent with some time left to teach at the FBI academy before being assigned to the X-Files on March 7th, 1992.

I can suspend my disbelief enough to be on board with this. You'd have to be pretty damned special, which we know she is, to get recruited out of medical school by the FBI. Maybe they even developed the accelerated combined residency/fellowship just for her! She's Dana Katherine Motherf***ing Scully, people!

Now, IWTB is where things get REALLY unbelievable. (Disclaimer: I have not watched IWTB since seeing it in theaters in 2008. I'll get around to rewatching it someday soon. Probably with a bottle of wine. Not a glass. A bottle.)

Mulder and Scully go on the run in 2002. We don't know how long they were in the wind, but by 2008, she's been allowed to resume a career and is practicing at Our Lady of Sorrows. Clearly in pediatrics - but general pediatricians sure as hell don't do stem cell transplants, so she'd almost certainly have to be a pediatric oncologist. We aren't told what her specialty is specifically, but that's what she'd have to be to do a stem cell transplant.

(That scene in the OR isn't even what stem cell transplants LOOK LIKE but that's a rant for another day, back to my point.)

MEDICAL BOARDS DON'T JUST LET YOU CHANGE YOUR SPECIALTY FOR FUNSIES.

(Deep breaths. Serenity now. Ok, let's do this.)

Scully would have had to do an ENTIRELY NEW residency AND fellowship in order to practice as a pediatric oncologist. Pediatrics residency is 3 years long. Pediatric Hematology/Oncology fellowship is 3 years long. In order for this to be even remotely possible, she would have had to START residency in 2002 to finish fellowship by 2008 and start her job at Our Lady of Sorrows.

And she's a former FBI agent harboring a known felon, on the run from government officials and alien hybrids who want her and Mulder dead.

There is absolutely no way even the smallest, most hard-up pediatric residency program is going to accept her with that hanging over her head. I'm not going to get into all the details of how rigorous and stressful the post-medical school residency application and match process is, but even if she didn't apply until she KNEW it was safe to come out from underground, she'd still have to explain a multi-year gap in her resume/CV to the program directors. Multi-year gaps in career and training without a reasonable explanation like a medical issue, time off to care for an ailing family member, time off for research, time away in a different, legitimate career are NOT looked on kindly when applying for residency positions. She would have a HELL of a time getting into a totally different residency.

It could happen - if anyone could do it, she could. But there's absolutely no way there's enough time for her to complete that training by 2008.

"But sagan-starstuff, it's CC, it's X-Files, we know there was no show bible and no one but the fans gave a shit about continuity or things making sense, there's no logic just vibes"

I KNOW, OK. I KNOW. And I love this insane, beautiful masterpiece anyway. I love exploring the possibilities of how and when it all could have happened with my fellow insane Philes who work so hard to glean meaning and order from this perfect mess of a show.

But couldn't CC have talked to one (1) doctor about what medical training is like at some point between 1993 and 2018? Just one?

Anyway. Yeah. That's my meta. Scully's training timeline makes no goddamned sense. Compels me, though.

@randomfoggytiger, this is for you. Honorable mention to @precedex-files who I ranted about this with in messages a while back.

[problogsposts]

Balancing Benefit and Risk in Clinical Research

Introduction

The fields of medicine and healthcare are rapidly developing. Companies and research institutes play a vital role in advancing medical knowledge through clinical research. Clinical research surrounds various aspects, including medical coding, pharmacovigilance, drug regulatory affairs, and clinical data management. These fields are essential in ensuring the safety and effectiveness of new medical treatments. However, conducting clinical research comes with its own set of challenges, particularly when it comes to balancing the benefits and risks involved.

The Role of Clinical Research

Clinical research is the backbone of medical progress. It involves the systematic study of new drugs, medical devices, treatments, and procedures to determine their safety and efficacy. Companies and research institutes conduct clinical trials to gather data and evidence before these medical interventions are approved for widespread use.

Key Areas of Clinical Research

1. Medical Coding: Medical coding is like the language of healthcare. It involves translating medical records, diagnoses, and procedures into standardized codes. Accurate coding is crucial for proper billing and maintaining patient records.

2. Pharmacovigilance: This field focuses on monitoring the safety of drugs and vaccines post-approval. It helps identify and prevent adverse effects and ensures that patients receive safe medications.

3. Drug Regulatory Affairs: Drug regulatory affairs professionals work with regulatory agencies to ensure that new drugs meet safety and efficacy standards before they reach the market. They help companies navigate complex regulations.

4. Clinical Data Management: Managing clinical trial data is essential for maintaining the integrity of research. Data managers organize and validate information collected during trials.

Balancing Benefit and Risk

While clinical research is definitely important for medical progress, it also involves risks. Here are some ways in which companies and research institutes can strike a balance:

1. Ethical Considerations: Ethical guidelines and standards are the foundation of clinical research. Researchers must prioritize the well-being of participants and ensure that their rights and privacy are protected.

2. Informed Consent: Participants must provide informed consent before participating in a clinical trial. They should be fully aware of the potential risks and benefits, enabling them to make an informed decision.

3. Safety Monitoring: Continuous monitoring of participants' safety is essential. Any adverse events should be immediately reported and addressed.

4. Transparency: Transparency in reporting research findings is crucial. This includes disclosing both positive and negative results, helping to avoid biased information.

5. Regulatory Compliance: Companies and institutes must adhere to regulatory requirements in their respective fields, ensuring that the research meets high standards of safety and quality.

The Importance of Training

To ensure that clinical research is conducted responsibly, professionals in the field require acceptable training. Courses and training programs are available for medical coding, pharmacovigilance, drug regulatory affairs, and clinical data management. Proper training equips individuals with the knowledge and skills needed to conduct research while minimizing risks.

Job Placement in Clinical Research

For those interested in pursuing a career in clinical research, the job placement aspect is essential. Companies and institutes often offer placement opportunities for trained professionals, ensuring that they can apply their skills in real-world settings.

Conclusion

Balancing benefit and risk in clinical research is a complex but essential endeavor. Companies and research institutes play a critical role in advancing medical knowledge, but they must do so responsibly. Ethical considerations, informed consent, safety monitoring, transparency, and regulatory compliance are key factors in achieving this balance. Moreover, individuals interested in clinical research can benefit from training and job placement opportunities, enabling them to contribute to the field while ensuring the safety and well-being of patients. In this way, we can continue to make significant strides in healthcare while upholding the highest standards of ethics and safety.

[ccrpsorg]

Clinical Research Monitoring: A Guide to Clinical Monitoring

Clinical research monitoring is a vital part of clinical trials and it involves various activities to ensure the safety and accuracy of the data collected. It is important that the clinical trial is conducted in a way that meets regulatory standards, protects human studies participants, and minimizes potential risks to their health and well-being. Clinical trial monitoring can include activities such as auditing study sites, evaluating data for accuracy and completeness, review of protocols and amendments, reviewing case report forms (CRFs), identifying any deviations from the standard operating procedures (SOPs) or protocols, managing corrective action plans (CAPs), following up on safety reports, tracking progress against enrollment goals and much more. Apart from evaluating data quality, clinical research monitoring also ensures compliance with all regulatory standards like GCP (Good Clinical Practices) ICH (International Conference on Harmonization), FDA regulations and local laws. In addition to this ongoing monitoring throughout a study's duration, there may be audits conducted by sponsors or regulatory authorities at any time during or after completion of a clinical trial. All these efforts are dedicated towards ensuring that the results obtained from a clinical trial are accurate, reliable and applicable for use in making medical decisions.

Steps to Clinical Monitoring

1. Establish an Effective Monitoring Plan: Ensure that the plan is comprehensive and contains all applicable elements, such as the types of monitoring activities to be conducted, frequency of monitoring visits, data collection methods, and specific criteria for acceptable performance.

2. Develop Appropriate Documentation: Design protocol-specific monitoring tools and forms to document information from site visits including source documents, data collection instruments, case report forms (CRF). In addition, develop a Monitoring Log or Tracking System which will enable better accountability for study activities.

3. Execute Monitors’ Visits: Depending on the complexity of the trial and regulatory requirements, conduct pre-study qualification visits (PSQV), pre-initiation visits (PIV), initiation visits (IVs), periodic monitoring visits (PMV) and close out visits (COV). During each visit, ensure that good clinical practice is followed at all times by reviewing source documents and data collection instruments. Review patient enrollment logs to ensure accuracy and record any discrepancies in the visit report.

4. Report Findings: Generate detailed yet concise reports per each monitor's visit with clear recommendations for corrective actions if required; provide professional feedback to investigators regarding their performance; identify any areas of noncompliance with protocol requirements or applicable regulations; recommend training or educational sessions when appropriate; track all follow up activities related to corrective actions taken in response to findings from monitors' visits; ensure that essential documentation is complete before closing out a particular study site.

5. Quality Assurance: Validate accuracy of tracking systems used by monitors during their visits; assess risk associated with various deficiencies identified during monitoring process; carry out periodic internal audits/assessments to ensure compliance with established SOPs/guidelines related to clinical research monitoring activities; take preventive measures based on audit/assessment results in order to strengthen internal quality system processes.

Types of Clinical Trial Monitoring

1. Types of Clinical Research Monitoring: Clinical research monitoring is the process to assess the quality and integrity of clinical trial data and ensure compliance with applicable regulatory requirements. It can be done through three primary methods: onsite monitoring, centralized or remote monitoring, and risk-based approaches.

2. Onsite Monitoring: Onsite monitoring is considered the "gold standard" for clinical research monitoring, as it requires the presence of a monitor at a study site during the entire duration of a trial. The monitor will typically review source documentation such as patient records, lab results, and investigational product dispensing logs to assess accuracy and conformance with study protocols and good clinical practices (GCP). The monitor also interviews staff members responsible for conducting the trial to verify that procedures are being followed properly.

3. Centralized or Remote Monitoring in Clinical Trials: Centralized or remote monitoring enables sponsors to conduct clinical research monitoring without needing to send someone onsite to each study location. This is accomplished by using technology such as web portals, video conferencing, and virtual meetings that allow monitors to remotely review data from various sites simultaneously and quickly flag any issues that arise. Additionally, centralized/remote monitoring allows sponsors to be more proactive in identifying potential risks associated with a trial prior to sending monitors onsite for an assessment.

4. Risk-Based Approaches: Risk-based approaches use data analytics tools such as descriptive statistics and predictive algorithms to identify potential trends or outliers in clinical trial data that may represent heightened risk of noncompliance with GCPs or other regulations. By leveraging technology, these approaches can help sponsors identify issues earlier in the course of a trial so they can take corrective action before something goes wrong.

5. Benefits of Clinical Research Monitoring: Utilizing effective clinical research monitoring strategies helps ensure that trials are conducted ethically, safely, correctly according to protocol standards, within timelines agreed upon with regulatory authorities, and within budget constraints set out by sponsors/CROs/investigators/other stakeholders involved in a study’s execution.. Clinical research monitors act as an independent third party who are able to provide objective insight into how studies are being conducted across multiple sites which helps minimize errors due to bias from investigators or other personnel who may have vested interests in outcomes associated with their studies.. In addition, effective clinical research monitoring helps ensure patient safety by providing oversight about how drugs or medical devices used in trials are administered as well as ensuring patient confidentiality is maintained throughout the course of a study.. Lastly, robust clinical research monitoring protocols help reduce costs associated with delays caused by errors made during trials which can add up significantly over time if not avoided through proper oversight methods both pre-study start up until closeout occurs after all enrolled patients have completed their participation in a given trial

Clinical Research Monitoring Guide

1. Understand the Basics of Clinical Research Monitoring: Clinical research monitoring is a key part of the clinical research process, ensuring the safety and accuracy of results. It involves periodically assessing study sites to confirm that data is being collected properly, according to ethical and legal requirements, as per Good Clinical Practice (GCP) guidelines.

2. Know What Types of Studies are Monitored: Clinical research monitoring can be used for a variety of studies, including clinical trials, observational studies, epidemiologic studies, and public health surveys. It is important to know what type of study you are monitoring in order to ensure that the appropriate procedures are followed.

3. Understand How to Monitor a Study Site: The primary goal of clinical research monitoring is to confirm that the protocol and informed consent form have been followed properly at each site. This requires a thorough review of all relevant documents such as case report forms (CRFs), source documentation (e.g., physician notes), internal audit reports (audit trails), and external quality assurance reports. Additionally, it involves evaluating compliance with GCP guidelines during study visits or remote reviews, as well as conducting interviews with staff members to assess how they are handling data collection and reporting processes.

4. Become Familiar With Regulatory Requirements: In addition to GCP guidelines, there may be applicable regulations from local governments or other institutions that must be adhered to when conducting clinical research monitoring activities. Understanding these regulations is essential for ensuring compliance with applicable laws and regulations related to clinical research activities.

5. Develop an Effective Monitoring Plan: An effective monitoring plan should include a detailed timeline for visiting sites, information about any specific areas where focused attention is required (e.g., enrolling/randomizing patients or managing adverse events), and plans for auditing/reviewing data generated by the study site(s). Additionally, it should incorporate measures for controlling risk associated with data collection processes so that issues can be identified early on in the study process before they become problematic later on down the line.

Clinical Research Monitor Job

The job of a Clinical Research Monitor is to ensure that clinical trials are conducted ethically, safely and in compliance with established standards. The primary responsibility of the monitor is to protect the rights, safety and well-being of the human subjects enrolled in the trial. Duties typically include developing protocols for clinical studies; coordinating study start up activities; conducting site visits; monitoring data for timeliness, accuracy and completeness; auditing files for regulatory compliance; managing investigator queries/issues; preparing visit reports; reviewing update protocols related to study operations; resolving issues raised through audit reports or other sources; providing technical guidance to sites regarding protocol implementation or study conduct; and escalating complex issues or potential risks as needed.

Clinical Research Monitor Salary

Salaries for this position tend to vary depending on education level, experience and geographical location but can range from $60,000 per year for entry level positions up to around $90,000 per year for more experienced professionals. In addition to salary many employers also offer benefits such as paid vacation days, health insurance plans and retirement packages.

Resources for Clinical Research Monitoring

1. National Institutes of Health (NIH): Clinical Research Monitoring

This link provides information on NIH's guidelines for monitoring clinical research, which include topics such as the roles and responsibilities of the investigator, data safety monitoring boards, and protocols for reporting unanticipated problems and adverse events.

2. National Institutes of Health (NIH): Guide to Clinical Research Monitoring

This comprehensive guide walks readers through all aspects of clinical research monitoring, including topics such as study design, randomization strategies, regulatory compliance requirements, data management, monitoring plans and reports, quality improvement initiatives, and safety assessments.

3. US Food and Drug Administration (FDA): Guidelines for Clinical Trials Monitoring

This resource from the FDA outlines the importance of effective monitoring in clinical trials and provides an overview of the different roles within a clinical trial as well as details about essential elements for implementation of an effective monitoring strategy such as risk assessments and adverse event tracking.

4. International Conference on Harmonization of Technical Requirements for Registration of Pharmaceuticals for Human Use (ICH)

ICH has developed standards that provide a set of harmonized technical requirements for clinical trials conducted across countries in the European Union (EU), Japan, and US with an emphasis on quality assurance and safety monitoring during trials.

5. Association of Clinical Research Professionals (ACRP)

ACRP's guidelines provide best practice recommendations for conducting clinical research studies in accordance with applicable regulations and standards to ensure patient safety monitoring during studies as well as data integrity throughout the process from start to finish.

6. Pharmaceutical Research & Manufacturers of America (PhRMA)

The PhRMA guidelines provide an overview of expectations around clinical research activities with respect to ethics, data integrity, safety reporting, resource allocation and more. It defines roles and responsibilities of all those involved in overseeing a clinical trial such as a Clinical Research Monitor or CRA who has primary responsibility for ensuring that the protocol is implemented correctly throughout a study’s duration

Clinical Research Monitoring Review

1. What is the main purpose of clinical research monitoring?

A) To ensure that a research study is conducted in accordance with applicable regulations and ethical standards

B) To ensure that data collected during a research study is accurate and reliable

C) To evaluate the safety of participants enrolled in a research trial

D) To oversee the financial management of a research project

Answer: A) To ensure that a research study is conducted in accordance with applicable regulations and ethical standards. Clinical Research Monitors are responsible for ensuring compliance with Good Clinical Practice guidelines, protecting participant privacy, verifying data accuracy, and evaluating protocol deviations. In addition, they may also be involved in reviewing participant eligibility requirements, conducting site assessments, providing training to investigators and staff on proper study procedures, as well as monitoring progress towards completion of all requirements of the study.

2. What type of individuals typically serve as clinical research monitors?

A) Physicians

B) Nurses

C) Regulatory specialists

D) All of the above

Answer: D) All of the above. Clinical Research Monitors can come from various backgrounds such as medical doctors (MDs), nurses (RNs), pharmacists (RPhs), regulatory specialists (e.g., Regulatory Affairs Professionals or Paralegals), or biostatisticians/data analysts who have experience in clinical trials and understand local regulations related to human subject protection. Each monitor has specific job duties depending on their education and experience, such as assessing compliance with regulatory guidance or analyzing data sets for accuracy, completeness, integrity, or validity.

3. What kind of activities do clinical research monitors need to perform?

A) Protocol reviews or verifications

B) Ensuring appropriate documentation completion

C) Site visits to observe investigator conduct

D )All of the above

Answer: D )All of the above. Clinical Research Monitors need to perform several activities including protocol reviews or verifications; ensuring appropriate documentation completion; site visits to observe investigator conduct; liaising between sponsors and sites; assisting with resolving issues associated with adverse events; reviewing case report forms for completeness, accuracy, consistency and correctness; evaluating subject safety throughout enrollment process;and writing reports detailing their findings at each visit.

4. What is one benefit gained from having an effective Clinical Research Monitor on-site? A) Reduced risk for legal liability stemming from negligence

B) Improved protocol adherence by investigators

C) Increased patient engagement during trial period

D )All of the above

Answer: D) All of the above . An effective Clinical Research Monitor encompasses several benefits such as reduced risk for legal liability stemming from negligence due to thorough oversight and accurate record keeping; improved protocol adherence by investigators through continued communication between sponsor representatives and researchers on-site regarding best practices; increased patient engagement during trial period due to more detailed explanations about potential risks/benefits offered by having monitor on-site ; and improved efficiency when dealing with complex protocols that require multiple levelsof oversight due to familiarity with protocol specifics which decreases time spent troubleshooting errors or unclear instructions..

5. How often should Clinical Research Monitors visit a particular site?

A) Weekly B) Biweekly C) Monthly D) Quarterly

Answer: C) Monthly . It is recommended that Clinical Research Monitors visit sites at least once per month in order to maintain active surveillance over ongoing studies at each location while also providing timely feedback regarding any issues discovered while on-site visits are taking place within a shorter timeframe if needed based upon changes made midstream or other unanticipated circumstances which might require immediate attention by sponsor personnel.

[trickphotography2]

The Perfect Match

Every third week in March, fourth year medical students find out where they'll be going for their residency. A quick 2.2K word one-shot of Jake's girlfriend going through that process.

-----------------------------------------------------------

The nervous energy in the auditorium was almost overwhelming as the clock ticked closer to 11:50AM. All across the US, fourth-year medical students gathered in ceremonies like this, ready to find out where they would be headed in just a few months to begin their residency. It had been a long week - on Monday, everyone received an email letting them know if a residency program had selected them. For those who got one, it was a waiting game to see where they would be moving. Those who hadn't been selected went through the nerve-wracking SOAP process, hoping to secure a job after graduation. With the number of medical graduates increasing faster than residency positions, it wasn't always a guarantee. 

You, however, already knew where you were going and what specialty you would be practicing. For months last year, you'd flown across the country, interviewing with residency programs at different installations and civilian hospitals—backups in case you didn’t match with a base hospital and had to compete for a civilian spot. And a perk of matching through the military was getting notified of your posting in mid-December, while civilians had to wait until the third week of March. 

On December 15th, you received that wonderful email alerting you that you had matched into Emergency Medicine at Naval Medical Center San Diego. Not only was Emergency Medicine a competitive specialty, but the location meant that you would finally be able to be close to your long-distance boyfriend, Jake, after seven long years.

A chance encounter over Spring Break freshman year led to late-night calls when he returned to Annapolis and you to College Park. For four years, you lived 35 minutes apart in Maryland, stealing as much time as possible together over the weekends. And after graduation, you had a long conversation about your future.

Jake had been clear from the beginning that he wanted to be a pilot, just as you had been firm about attending medical school. He supported you as you struggled through Organic and Biochemistry and tutored you in Physics. He would try not to laugh as you traced his skin, naming the muscles, bones, and systems as you reviewed for anatomy. Care packages showed up at your apartment when you spent as much time as you could getting clinical hours, volunteering in a research lab, and studying for the MCAT. Jake knew how important getting your CV ready was and tried not to complain too much when your weekends spent together were mainly catching up on chores or sleep.

Senior year, you were offered a spot at Florida State University College of Medicine. Jake had been notified in his junior year that he had been accepted into the flight program.

After graduation, you and Jake packed up your things and drove to Florida together. He had a few weeks until he had to report to Pensacola, just a 3-hour drive down I-10 from where you would be in Tallahassee. The apartment you got was right across the street from the med school, a small one-bedroom, but you knew you wouldn’t spend much time there anyway. It would be a place to eat and sleep, but most of your time would be spent on campus or driving to Jake’s in Pensacola. He would only be there for a few months until transitioning to the next base, and you wanted to spend as much time together as possible. 

Unlike other medical schools, FSU required students to start in the summer to complete the Anatomy course. Over the short term, students would complete a full-body dissection. The smell of formaldehyde became commonplace, and the TAs warned you to wear shoes and scrubs you wouldn’t hate to throw away in August. 

They were right. 

It was a rough transition to med school, but it was manageable. And you loved it. Your professors ensured you treated the cadavers with the utmost respect while gently encouraging competition by announcing a dissection team winning each week. The faculty brought you to a rural community to learn about rural medicine, sharing food and stories with those less fortunate. The physician assistant students joined on the trip, and you learned about an inter-professional day that you’d be expected to participate in later - role-playing a case with MD, PA, pharmacy, and social work students. 

And while you were working toward your dream, Jake was getting closer to his. Nights were spent catching up, and he was so excited to tell you about his flight training. He promised to get his civilian pilot license as soon as possible and rent a plane to take you up in the air. On the rare weekend you didn’t need to spend in the anatomy lab cramming for an exam, you drove to his place late Friday night and headed back to Tally on Sunday morning. 

In August, Jake requested time off to come and see you celebrate finishing your first semester. Seated in the audience, he watched as your faculty member helped you don your first white coat, and you recited the Hippocratic oath. The one-week vacation before Fall term started wasn’t long enough, but you enjoyed waking up in Jake’s bed and going to the beach.  

Joining the military had never been in your future, but the longer you spent around Jake and his friends, the more commissioning in the Navy seemed attractive. A medical officer recruiter spoke at the college, and you signed your paperwork. After spending a few weeks working in a clinic during the summer after the first year, you headed to Rhode Island to complete Officer Training. Jake called you as soon as you graduated, welcoming you into the service with only some light teasing about outranking you. As an Ensign, you would be forced to salute your Lieutenant boyfriend when you saw him. 

It was harder to see each other when he graduated from flight school and was stationed in California, but you managed to get by with phone calls and vacations. Toward the end of your second year, Jake was sent on deployment as you studied for the Step 1 exam - testing your foundational knowledge and one of the most intimidating exams you faced. The school gave you dedicated study time, and you took advantage of his offer to study at his apartment in Lemoore. His buddy, Coyote, met you at the airport and drove you to Jake’s apartment. A bouquet of flowers was sitting on the counter, and you stared at them as you mentally ran through Anki decks to quiz yourself.  

Jake came home the last week you were there. Fully recovered from the 8-hour exam, you greeted him with all the other family members on the flight line. It was the first time you saw him in his jet, and you made sure he knew how much you appreciated the sight. But too soon, you had to return to Florida and pack up your apartment in Tally to move to Pensacola for your last two years of medical school. On your last night in Lemoore, Jake took you out dancing and promised he would request leave to visit soon. 

Between your rotations and his shitty schedule as a junior officer, it was hard to see one another. At the end of your third year, you hit a rocky spot and talked about breaking up. But cooler heads prevailed, and you promised to do your best to match into a residency near him. He agreed to try and get orders to be closer to you once you graduated. 

Jake had been your first call on December 15th. Sobbing, you told him you’d join him in San Diego, where he’d been stationed for the last four months. 

The last-minute plane tickets had been expensive, but it had been so worth it to spend Christmas with him, making plans to move your stuff across the country, and finally be together. He’d held your hand as you pulled your name from the NBME Match Database, officially alerting the civilian hospitals you’d interviewed at that you were no longer hoping to match with them. 

So, while your friends waited anxiously to open their envelopes, you felt a sense of calm. In nine short weeks, you would be back in this auditorium wearing your dress whites under your cap and gown. After getting your diploma, your new orders would be published, and you would be promoted to Lieutenant. And after? Jake was scheduled to return from a deployment in a month and requested leave to help you pack up your apartment and start the cross-country road trip. 

Eight years of hard work would culminate in moving in with the man you loved. Who could support you in person as you went through the hell of residency and got used to being a full-time Naval officer. 

The Dean crossed the stage and welcomed everyone. As the clock struck noon, she encouraged everyone to open their envelopes.

Tearing it open, you stared at the words confirming your future - Emergency Medicine, Naval Medical Center San Diego. 

Jake.

Cheers broke out, and you turned to hug your friends as they screamed with happiness or smiled to hide disappointment on not getting their top choice. 

The ceremony began with each regional campus called up to allow the students to announce their match.

You hadn’t planned on going on stage. The trip back to Tally had only been to see your favorite staff members and to support your friends as they found out where they would be moving. They had brought their family members, partners, and kids to share in the moment. You had come alone, preferring your family to go to graduation instead. But your friends dragged you into the line and handed your name card to the smiling staff. 

“Hi,” you said, leaning into the microphone after the Regional Campus Dean introduced you. “I just wanted to say thank you to all of my friends and family. Without you, I wouldn’t have made it through all of this. I matched in Emergency Medicine and will be moving across country to be with my boyfriend, who kept me sane throughout all of this. And I’ll be at Naval Medical Center San Diego

The crowd cheered louder than they had for any of your classmates. Blushing, you lifted your hand and waved, stepping back and quickly walking toward the Campus Dean to shake his hand. But as you neared, he smiled and took a step back.

You froze.

Jake grinned. 

Wearing his dress whites, he quickly strode toward you, pulling you into his arms. “What are you doing here?” you demanded, blinking away tears. 

“Wasn’t gonna miss your Match Day, darlin’,” he replied.

“You’re supposed to be on the carrier!” 

“Might have lied about that.” There wasn’t a trace of regret on his face. “You worked so hard for this, and I wanted to surprise you. My beautiful, smart, adrenaline junky doctor girlfriend.”

“Not yet - won’t be a doctor for another few weeks.” 

“You’ve got it in the bag. But I figured since you’re already trading in a couple of ranks - med student and Ensign…” Taking your left hand, he reached into his pocket and lowered himself to one knee. 

Vaguely, you heard the crowd get louder, but you couldn’t tear your gaze away from Jake as he held out a diamond ring. 

“I thought maybe we could change girlfriend to wife. Will you marry me?” 

Unable to speak, you nodded quickly. Jake leapt to his feet and kissed you, smiling against your mouth. 

The next few minutes were a blur. You hugged the Deans while Jake shook their hands, and your parents met you off stage - Jake had called to let them in on his plan. His parents texted him after watching the proposal on the school’s livestream. After promising to meet up after the ceremony, Jake joined you in the student section while your parents returned to their seats. Your friends hugged you, whispering excitedly as you showed them your engagement ring. 

And later, after a celebratory dinner with your family and drinks at the beer garden with your classmates, you tumbled into bed with Jake. You could taste the beer on his tongue as he licked into your mouth, and you grinned when your ring caught the light and shimmered.

“Lieutenant and Lieutenant Seresin,” Jake chuckled, catching your hand and kissing your ring. “Sounds kinda nice.” 

“Mmmm,” you hummed. “My diploma will be issued in two months, Seresin. Then I’m applying for my medical license and getting all my onboarding paperwork done for NMCSD. I might have to go by my last name for a bit… but I kinda like how it sounds with Lieutenant…”

 “It does sound nice,” he agreed. “You sayin’ I’ve got 2 months to get it official, or are you telling me you wanna keep your last name?” 

“Dunno,” you shrugged. “I’ve spent the last four years thinking I’d practice under my own name.”

“How do you feel about hyphenating?” 

Your eyebrows shot up, “You’d be okay with that?” 

“Darlin', you did the hard work, and it’s your name. As long as I can call you Doctor Seresin at home, I don’t care.”

In the middle of May, you stood at attention on stage in your whites, having quickly changed out of your cap and gown. The medical recruiter, a local chief petty officer, had been called onto the stage to publish your orders. Forcing yourself not to smile, you pressed your lips together as he read out your name — your new, hyphenated last name and all. 

-----------------------------------------------------------

Notes: I used to work in a medical school, and went through three years of working on Match Day. It was one of my favorite events because of the level of excitement. (And yes, we did have a proposal one year.) But it can also be a really hard day - as state above, the number of residency spots is lower than the number of people who graduate. Every year, people go through the SOAP process and don't match. Which means they have to find something to do for a year, and then start the process over again.

Definitely didn't plan on writing this - I think in about an hour? - but I watched a class I worked with Match today and it kicked up a lot of feelings. I had the pleasure of watching young students grow into doctors, and play some small part in that.

As always, thank you to @mamachasesmayhem for encouraging me to write this, and for giving feedback.

[rare-average-system]

I wish there was less abject denial to receive clinical information about DID within this community. That pointing out medical journals or studies or diagnostic manuals is seen as an attack.

I think there's a few layers to what that can stem from. Fear of being wrong. Fear of losing their alters if they "heal too much". Or not wanting to heal at all. And those are all valid things to feel.

But accepting things about this disorder isn't going to *poof* and delete your system.

So as someone who touts the high value on clinical research readings, I will be vulnerable and tell you how I juggle living on both sides of this coin.

Before I recognized my system existed, I had high levels of dissociation and didn't have much issue talking about it. It's a more "socially accepted" experience. After 2 therapists caught onto it being DID, things got louder in my head. Working toward my diagnosis, awareness of alters and amnesia happened rapidly. To a point it scared me to realize how little control I actually had all these years. Realizing my rigid lifestyle was my system trying to keep us functioning undetected all these years.

The panic eased up and moved into comfort. I had comfort knowing another part could always step in to handle something that I couldn't. It felt like a safety net.

And when my therapist finally confirmed my diagnosis we had a serious talk that before we can start real deep trauma work, I need to be ready to accept I may lose alters. And accept that my system growing is a sign of new trauma or treatment moving too quickly.

So. Am I ready for that? Not fully. It's a terrifying thought that healing means taking on the jobs I had split into my alters. It means I will now have to do the things that were too hard for me to handle.

The idea of fusion is scary. It feels lonely. I can acccept that I have these fears. I can accept that my alters exist to keep me safe. The fear of losing them is simply another manifestation of the disorder. The fear is how the alters want to keep me safe in the way they always have.

It's okay to not WANT to change everything. It's okay to not be ready yet. It's okay to be afraid. It's okay to make mistakes along the way.

But it matters most that you understand the WHY. Knowing doesn't mean you have to DO.

With love. 🩵

[covid-safer-hotties]

Also preserved on our archive

Swab, swirl, squirt, sit tight. By now, you’re likely familiar with the ritual of performing a COVID test at home or on the go. Disease detection has evolved swiftly since 2020, when you may have had to seek out a pop-up testing clinic or wait hours in line at your local health department, with clinicians on standby to stick a cotton swab up your nose.

Rapid COVID tests have since become a staple of cough-and-cold aisles across America, and just weeks ago the federal government resumed its periodic distribution of four free tests per household. But the convenience of self-testing comes with a caveat: The onus is on you to report your results.

First, know that test reporting isn’t mandatory in the U.S., so you’re hardly in hot water if you haven’t documented your COVID infection or lack thereof with the Centers for Disease Control and Prevention (CDC) or state or local public health authorities. Though perhaps more people would self-report if it were a requirement, says Dr. Sujata Ambardar, an infectious disease specialist at Inova Fairfax Hospital in Falls Church, Va.

“People probably are not self-reporting because they don’t want to have to not go to work—or they may want to go to work—it’s different reasons, and they may not want other people to know,” Ambardar tells Fortune. “Human nature is that they’ll probably only do it if they have to do it. Once you make it non-mandatory, then they tend not to do it.”

Today, if you get an antigen or PCR COVID test in a clinical setting, it’s still your health care provider’s job to report your results. While you’re well within your rights not to report your home test results, not doing so can come as a detriment to public health.

Between Feb. 1, 2022, and Jan. 1, 2023, an estimated 54 million adult COVID cases were unaccounted for in official records, according to a national study published Sept. 30 in the journal JAMA Network Open. That’s more than twice as many as those documented. At the state level, unaccounted infections ranged from 59,000 in Wyoming to 6.3 million in California. Researchers cited the government-led mass distribution of at-home tests as a possible driver of the discrepancies.

Report COVID results at MakeMyTestCount.org In theory, Ambardar says, reporting your COVID test results is “just one extra step.” But when that second line appears on the test card, confirming the disease has hit your household, formally documenting the outcome may not be your first priority. Even if you’re negative, you were likely feeling poorly enough to take the test in the first place and may not feel up to self-reporting.

But if and when you choose to do so, visit MakeMyTestCount.org to securely and anonymously report both positive and negative COVID test results. The site is a collaboration between medical data firm Care Evolution and the National Institute of Biomedical Imaging and Bioengineering, part of the National Institutes of Health.

MakeMyTestCount.org is free to use and doesn’t require you to immediately self-report. In fact, your results don’t even have to be recent. As of early October, the site allowed for the input of home test results going back to November 2021. If you need proof of illness for work or school, the site provides documentation. And while over-the-counter tests that screen for both COVID and flu aren’t as common as those that screen for COVID alone, you can report those results on the site, too.

Keep in mind that it’s just as important to report negative results as positive ones. The week ended Sept. 21, national COVID test positivity was 11.6%, CDC records show, down from 13.4% the previous week. If not for the inclusion of negative results, test positivity would always be 100%.

Depending on the brand of COVID test you’re using, you may not have to visit MakeMyTestCount.org at all. Some brands, such as iHealth, offer a free corresponding smartphone app. With the tap of your finger, you can forward your results to the CDC and/or your health care provider. If you have the time, notifying your doctor can help guide the course of COVID treatment in your community, says Dr. Donald Dumford, an infectious disease specialist at Cleveland Clinic Akron General.

“The more we know about the true number of cases of COVID, the better we’re able to understand the transmission of COVID at this point in time, as we go from it being pandemic to endemic, which means it’s just something we live with now,” Dumford tells Fortune. “It also helps us to identify the potential rise of new strains of infection, especially if you’re seeing a strong uptick in cases.”

Study Link: jamanetwork.com/journals/jamanetworkopen/fullarticle/2824211