#overall i think i more have impressions than an internal dialogue. not even necessarily images
Explore tagged Tumblr posts
lungfuls · 3 months ago
Text
i'm really in-between on whether or not i have an internal dialogue. i guess i do, it's just sketchy. like, it's more images with captions announced from another room so that i'd have to focus a lot on what was being said to hear it, then after focusing, it'd sound like word salad. it wouldn't surprise me if that's a relatively standard experience of consciousness (rather than an idea of consciousness like what i made the poll about ln)
4 notes · View notes
noteofnaught · 3 years ago
Text
Dante's memory of his mother
Fiddled with what I had written earlier.
The translation was done for me by deepl (translator).
Please let me know if you think it's strange or if there are any mistakes.
The above is purely a personal opinion
Feel free to discuss and exchange.
Dante's memory of his mother
Dante's memory of his mother, or rather that night, seems to have been formally depicted once in DMC5 since DMC1.
So let's start with the DMC1.
In the DMC1 novel, there is a scene depicting Dante recalling the events of his mother's death.
「母さん、母さん……ねぇ、母さん!」
幼子が、地に倒れ伏した母親の身体を揺さぶり続けている。母親の息がすでに絶えていることは、誰の目にも明らかだ。
だが幼子は──すでに自分でもそうとわかっているのだろうが──無
駄な努力を止める気配はない。
「兄さんもいなくなっちゃったんだ! 母さん! ねぇ、母さん!」
亡骸からは未だ、温かな血が地面へと広がり続けている。
幼子は半狂乱だった。
Tumblr media
We can see in the description that Dante tries to wake his mother up next to her dead body, even though he realises that she is dead but he is still trying to wake her up. This is a reluctance to accept his mother's death, a normal emotion and attitude for a small child to have.
And the second half of his sentence [兄さんもいなくなっちゃったんだ!] It is as if he had searched for his brother, but his tone is one of powerlessness, of helplessness, of feeling negative about the outcome. So here I want to convey not so much that he has searched for his brother to no avail, but a sense of powerlessness about the situation. He tries to wake up his mother in this way.
It's close to one: Mom, wake up. My brother is not here/is gone and I don't know what to do/I'm scared, please get up Come on.
Tumblr media Tumblr media
And then in the scene of Neal's death, Dante recalls this as Neal's sacrifice to protect him, just as his mother did that day.
After that he heard the voice of his father's sword, and out of fear and insecurity he was completely drawn to it, thus obeying its words and changing his name until he gained the power to fight against it.
Then, in the battle with Gilvi, when Gilvi stabbed Dante and was covered by the necklace, Dante's internal activity was as follows.
Tumblr media
He credits his mother with protecting him (again) as a child.
Where the mother sacrifices herself to save/protect Dante this is consistent with the DMC1 in-game scene. In DMC1 Dante has a similar line after Trish sacrifices herself to save him. This is the diagram from Precious Tears, with Japanese and English, but both Japanese and English convey that Trish sacrificed herself to save him, as did her own (Dante's) mother.
Tumblr media
This is in line with the content of the DMC3 comic.
In the DMC3 comic, Dante has a nightmare at the office after his encounter with Vergil, a dream that is not in fully recreated form but like a fragmentary form.
Tumblr media
Here the mother has more dialogue than in DMC1, and it is obvious from the comic's footage that there are huge hands behind her that are about to crush her, and Dante reaches towards her as if to retain his mother, who is feeling very scared, while her mother shouts for him to hurry up and hide/hide and not come out no matter what happens. She is then crushed by the huge hand. In the next panel we can see that the demon looks like a bird and says the terrible words "all die". like it is glowing, and on the next page you can also see the huge three foot shadow on the ground, which also looks like the claws of a bird, and the door behind it is the image of burning, while a long shadow is drawn under his feet.
Of course, we know from the comic that Arkham says there was a fire that day, and Vergil's fearful recollection of the house being on fire makes DMC5 even more certain that it was indeed on fire. The glowing eyes, the long, thin shadows and the subsequent bloodstained house in the comic give the impression that something ominous, unsettling and alien is about to happen.
The cartoon after that also shows us Dante waking up with a jolt, his face covered in water, looking at his hand but with only a drop on his end finger, giving the illusion that he has pulled a hook with someone. There is no sweat on his body, however, and of course there are problems of expression in the painting, so it is not painted.
But it is also true that these same fragmentary memories and dreams give Dante unease and fear.
Well, the memory, the feeling of his mother in Dante's vision so far is the following: his mother told himself to hide and not come out, and sacrificed himself to save himself. It is the great selfless motherly love that belongs to Dante.
Although it was a great mother's love, the memory of that day still makes Dante feel uneasy and afraid. The last memory his mother leaves Dante with is the one that tells Dante to hide, and implicitly the will to let him live. If we add the DMC1 novel to the mix here, it is at this very moment that he is drawn to his father's sword.
Again within these memories and fragments, the mother is rendered unknowable to Vergil, meaning that we do not or cannot see in Dante's recollections that the mother ever went looking for Vergil, if not for the presence of the phrase [兄さんもいなくなっちゃったんだ!] we would not even know in this recollection of Dante that he knew that he had a brother. What we can see or what Dante perceives in his vision is that his mother loved him so much that she died in the process of protecting/saving him.
However, it is also a writing device that can be lifted off as suspense.
But again, this doesn't do any damage to the image of Eva as a great mother, because based on what happened that day, the great mother had to choose to save/protect (potentially the closest to her or that she could find) one child and had to give up the other in the face of force majeure. Dante also never said before DMC5 whether his mother loved Vergil or not, whether she ever sought him out or whether she cared for his brother as well.
What we see in Dante's vision is basically what Dante can know, but it doesn't mean all of it. After all, comics or game scenes have an obligation to show us the scenes, but it doesn't necessarily mean that the characters actually see all the textures. We, as players/readers, are a kind of God's eye and we can notice things that are not right or different (also a storytelling technique) but as protagonists we are not necessarily fully aware or in the same position as us.
I think if you have seen suspense films, you will also often see that kind of bridge, we all know that this bomb is going to explode this person to kill that person, although there is that kind of explicitly shown in the footage, but the protagonist is still unaware of the appearance, many viewers are in order to pinch a cold sweat, for this reason anxious hope that the protagonist quickly realize.
And DMC5 gives us a formal depiction of that day, not through snippets like a nightmare, you can see in the game's overstory description that it says Dante dreamed of what happened before, which means this time you are shown real memories.
After all, a nightmare is not necessarily a real memory, it is a condensation of a certain memory. Sometimes we have a nightmare like dreaming of a giant cockroach because we are afraid, so we reproduce and amplify this fear in our nightmares, so that a small cockroach we see in the house becomes enormous in our nightmares, the giant cockroach is not necessarily real but the fear is real. Of course, we are not talking about the formation of nightmares here, but only about the fact that nightmares and some fragments of our memories with fear and anxiety may be a recreation of what we felt and what existed at the time, but not necessarily a completely real recreation.
In the DMC5 Eva process screen.
Tumblr media
There is a slight difference between Japanese subtitles and English subtitles, or even Japanese dubbing.
The overall meaning is actually similar to the DMC3 manga, Eva is all over Dante not moving and telling him to hide/hide, the only difference is that she says more words to make Dante forget his past and forget his name and start a new life from scratch/not being Dante but another person to start over. All also contain the mother's wish for him to live well.
The difference is that in the Japanese subtitles, Eva clearly expresses the possibility that she may not return and so tells Dante to listen well to what she says next, whereas in English it is expressed as I promise you will return.
In the English context, although the mother says she will come back, she immediately reverses the 'come back' in the next sentence, saying that she knows it will be difficult, but you're old enough so you'll have to do this if I don't come back. They both mean the same thing, a mother who knows she might not come back and tells her child what she will do if she doesn't come back, as if making a pact with her child: we agreed that if I don't come back, you will remember to do this, I know you can do it.
If you look closely at the animation of the process, you can even see Dante's hand trembling on the cupboard door, he is very scared.
And the BGM here also happens to be called: More Fear
Tumblr media
And of course it is here that we first see Eva looking for Vergil, and it turns out that Eva has looked for Vergil! This doesn't exactly match the information we got on Dante's side earlier.
But are you saying that the DMC1 message contradicts the current message? The DMC1 novel only mentions that he cried next to his mother's body, not that she said anything to him before she died, after which he became obsessed with his father's sword out of fear and terror. And his father's sword statement is the same as his mother's deathbed statement but in a very different series.
The meaning of the mother's words is very clear, the words are all about the desire for her child to live well and to stay away from these things that will hurt him, a good expectation and blessing for her child and the expectation and belief that her child will be able to do so.
「今はその名を隠し、目を眩ませ、逃げ延びよ」
“Now go incognito, confuse the enemy and flee far away!”
The overall meaning of the phrase is that it is dangerous to hide the name, confuse the enemy and run away, and the phrase even takes the form of a command that the child must do what he says.
It's a phrase you'd put in the context of a superior to a subordinate, a captain to his teammates, and in the context of a tense battlefield man telling you to run fast is perfectly fine and appropriate. But Eva's words could only be said by a mother to her child.
When all the memories are linked together, our facts about Eva become a little more complete, and at the same time what effect does it have on Dante?
If his mother only died saving him and he hated his father for her revenge which is quite reasonable, this has to be a blowback from his father's enemies. What is necessary to mention here is what Dante's mindset was regarding DMC1 killing the Black Angel.
In the official publication of the 3124 collection, Dante is said to have killed the Black Angel with "no thought", a word synonymous with "remnant", which is generally translated into Chinese as: regret.
And the DMC1 how-to book has a direct description of his ideas.
Tumblr media
Dante is talking here about Mundus killing his mother and brother.
This is not the same as what we generally think of as objective perception. In the game we see over the course of the game, the Black Angel looks as if he still has a heart, so naturally we think there is still salvation, after all, he is still alive.
But here Dante does not think that it was his own hand that killed the Black Angel, but that Mundus killed Vergil.
Of course we can parse this to mean that killing the man who was Vergil means, but even so within this passage of Dante he is not one of the reasons for Vergil's death, he has no responsibility in Vergil's death and is not responsible for any act occurring in the process, but rather Mundus should need to take full responsibility.
In other words, it means that even if it was he who killed the Black Angel in the course of the battle, then he is not responsible for it, but Mundus is responsible for it, because it was Mundus who arranged it, and how could he have killed it if he had not arranged it there, it was not his problem, it was Mundus' problem.
than what we generally think of as objective factual rational logic going into the judgement: although Mundus turned Vergil into a black angel like that, he himself didn't recognise the killing, more or less he was responsible for it or felt particularly guilty that he didn't recognise it.
Dante's logic leans more towards total emotional logic: It's all Mundus' fault!
And in DMC5 just as Vergil used to think it was a matter of not having enough power, now it's a matter of having too much power, and now that Mundus is gone, not recognizing Vergil (V) for killing Vergil can only be his active choice, not a passive one, and it can only be that his responsibility has nothing to do with Mundus.
Returning to the mother, what arises is in fact the same question. If before it was his mother's great love for him, which was selfless and exclusive to him, now, at this moment, her love is equal, not just his but also his brother's. The "he" whose mother sacrificed herself to save him in the flashback (DMC5) is not really a "he". His mother's did not hesitate to rush out to save her brother, knowing the danger.
Of course we must also mention nell, arguably the designer of Dante's double shot.
In the novel, Thor wants Neal to commission and pay a deposit for a double gun for himself, one of which is a secret-made gun he stole from a robbery, and the other is the same type of medieval gun that Neal himself received.
nell is so good to Tony, as is clearly described in the DMC1 novel, because Tony looks so much like her child, and her love for her child is projected onto Tony, and she holds on to her job before she eventually dies, not only because of her love for Tony but also her love for her own child, and more so for the work ethic she has taken on this job and should complete.
But all the same, the person she missed most on her deathbed was her own child, something Tony could never replace, nor could he if he wanted to, which of course didn't mean that nell's love for Tony was false, nell's love for Tony was also real, indeed it was love, it was precisely because of the person of her own child that nell loved so deeply that Tony was loved by her.
Whether it is nell or the mother Eva, their love for their child is not solely Dante's alone and only his, or why they love Dante/Tony, it is because they both love their child, and if they were not such, then Dante would naturally not be loved by them.
His mother's protection and sacrifice is something he feels and desires, something that is personal and emotional for him. It also explains Dante's statement to Trish in DMC1 that "his mother died to protect herself", because Trish, like his mother in his feelings and understanding, has what he calls a "heart".
Of course, because DMC1 is entirely Dante's vision of storytelling (DMC1 is Dante's story), his mother is human in Dante's eyes, and Trish acts like his mother to protect him, or even Dante's ideal mother, so Trish is also a person with a "heart", as to how Trish feels or if that is the case. We will not discuss this issue here.
Surely the mother did not save Dante? This is necessarily a negative, but was it to save him that his mother died, or to hold back the demon who tried to kill him so that he could escape? Again, that is a negative. Wouldn't his mother have done that in that situation? That too is a negative. Wouldn't Dante have wanted his mother? No. Must Dante have never been afraid of not wanting his mother to stay by his side to give him security and protection? Did Dante only want to protect his mother and never wanted her to stay by his side to protect him? All the information above seems to be in the negative.
DMC5 is simply a reinterpretation and addition of information from the past, the only thing overturned is Dante's belief that his mother died to save himself.
This message provides us with an explanation of the origin of Dante's hatred for his brother, as is often the case in many films and novels, in which he blames the child for the death of his beloved wife, even though it was not the child's fault, and believes that if it had not been for him, his wife would not have died. He stubbornly believes that his mother died to save him, not to save his brother, and not because of this he is unable to love his brother; he acts as if he wishes he could have the mother's love all to himself.
For if we are to acknowledge the fact that his mother died to save his brother, we also have to acknowledge something else, and that is that he equally did not want to be left/abandoned by his mother.
Of course, this is not a contradiction or a conflict; it is only natural that a child should be afraid and want to protect his mother, and it is equally natural that he should want to protect her.
The above is purely a personal opinion
10 notes · View notes
imperfekti · 5 years ago
Text
Best Games ep 3 Fuji vs Kirihara report
Tumblr media
The movie theatre screenings started on November 15th. The two shows at Shinjuku Piccadilly included a talk session with Fuji and Kirihara’s voice actors. I was lucky to get tickets to both two shows, so here is my report.
Tumblr media
Unfortunately, there hasn’t been a change in quality, so we’re getting the same as before: some very pretty pictures, some awkward ones, and mostly stiff animation. Voice acting was good though.
The episode is not strictly chronologic, and I wasn’t sure if I liked the order in which they presented things. In any case, before we get to the main match, we see (not necessarily in this order) Sanada calling Yukimura about how everything is going well, Inui winning his match, Seigaku watching Rikkai on video, Fuji reflecting on it further at home, and Echizen’s match against Kirihara.
About that match. For those who are focused on the musicals, it might be a surprise that the only one observing that match is Jackal, not him and Marui. Personally I am happy for this screen time for him - his voice actor is doing a great job and he comes off very cool.
The quality kind of made some parts of this match awkward, but still, seeing Kirihara constantly hitting Echizen’s knee was quite impactful. For most of the time, Echizen doesn’t even make a sound, but at some point he yells out in pain, falls to the ground and holds his leg.
Eventually, we get to the point where Echizen reaches Muga. In this version, the character becomes surrounded by a bright red aura and wind like gusts of air. I guess it’s up to everyone’s taste whether it looks good or not, but I thought the overall impact of the visuals, sounds and how this part was presented in general was pretty good. I could say Echizen going all out in Muga was one of my favourite parts of this episode. I happen to love the image of Echizen in midair with the sun at his back, and this episode definitely played it well.
Tumblr media
One detail I’m curious to hear about though is the impression people have about the blue light in Echizen’s eyes in this part, against the red backdrop. Personally I always imagined this scene in reds and blacks, giving Echizen this almost demon like aura that comes from pure strength instead of violence. The blue they added in his eyes kind of feels like they’re saying “this is still the good guy”. Aesthetically I might have preferred not to have that, though if that was the message they were going for I think it’s fine. But curious to hear how others read these visuals.
When the match ends, Rikkai comes around. I should mention that some of the dialogue has been slightly changed (compared to musicals), so people can look forward to a few new lines in multiple scenes.
Tumblr media
At some point we get to the main match.
About Fuji. Kaida-san is doing a great job with his voice - he sounds very strong and scary in the right parts, and sensitive and insecure in others. My favourite line is the “So it was you behind Echizen’s knee”. He sounds so quietly angry and protective - you don’t mess with Fuji’s kouhai without consequences.
As for the design, as people have seen in the trailers, his hair is really long and thick now, and they really play with it in several scenes. If a more boyish Fuji is your thing, this episode will not provide much of that - it’s all pretty and beautiful.
A scene they went all out with the prettiness is of course the scene with Tezuka in the rain - finally animated the way it was in the manga. When the episode comes out, you might want to pay attention to the drops of rain on them - they have this subtly shifting shimmer that makes them look like small crystals. But the best thing for me about this is the evolution of both Fuji and Tezuka’s expressions as the discussion proceeds. It really brings back the feelings of when the series was still younger. These two had a lot of complicated feelings going on.
Tumblr media Tumblr media
Another scene that was great was the flashback Fuji had into Tezuka’s match against Atobe. There is this one brief closeup of Tezuka soundlessly crying out in pain, and the scene really conveys just how big of an impact seeing that had on Fuji.
Without going deeper into the TezuFuji feelings for now, back to tennis. Same as with Echizen, we get to see Fuji hit by the ball a lot. He reacts a lot more than Echizen, with both expressions and voice, so expect to see him in pain.
One thing I found a little bit unfortunate was that they didn’t visualise Fuji finding his strength and going beyond his limits in a more clear way. After all the effort they put into Echizen’s Muga, I felt they should have tried harder to present Fuji’s strength. Especially since Ryuuzaki-sensei has the line about Fuji surpassing Tezuka, I thought that should have been supported with the presentation more than it was here.
Overall, I think the one of biggest impressions this episode had for me had to do about the dynamic between Fuji and Echizen, and both of their connection to Tezuka. Fuji and Echizen are shown lined up when Seigaku are watching the Rikkai videos, and that is followed up with the both of them preparing for the match in their own ways. The both of them have flashbacks to Tezuka during their matches. Like I mentioned already, Fuji has this very heavy tone when mentioning Echizen’s knee during the match. Of course we also have Echizen shouting out advice to Fuji, Fuji thanking him, and at the end, Fuji watching Echizen when he steps on the court. All of this is really heightened by the fact that Tezuka is not even there at the moment.
Conclusion: I love Seigaku’s internal dynamics.
Tumblr media
There could be more to say, but this is getting long so I’ll leave it at this.
A few words about the voice actor talk:
First of all, Kaida-san is so cute and funny. It was my first time seeing and hearing her live, and it was a really good experience.
The talk had some TezuFuji tone to it, haha. Kaida-san was all “Fuji, what are you thinking about in the middle of a match? Focus, focus!” When they put a picture of Fuji in the rain scene on the screen, they went all “Hmm, who is he talking with here… A certain someone… Well, it’s the guy you would expect, isn’t it.” about it.
They also talked about the new song, Dispect, for a bit. Kaida-san said it was quite a challenge to sing. They described the song as kind of a rally, with a lot of back and forth going on.
Both voice actors also talked about their gratefulness of Tenipuri reaching 20 years, the support from fans, and how happy they were to have a chance to do this part of the story again. Kaida-san made the following quote in Fuji’s voice: “As if we would lose… The winner will be… Tenipuri!”
That’s it for now. The DVD of the episode will come out in January, so looking forward to hear what others think then. I’ll try to go see the screening again when they do the ouen version where the audience is allowed to cheer and shout - the voice actors gave some instructions yesterday so I will look forward to participating.
Feel free to ask if you have any questions about the episode!
PS. Me and my boss pulled these coasters as our gifts. I knew we were meant to be. In the professional sense.
Tumblr media
55 notes · View notes
toyfrog · 8 years ago
Text
So thanks to Skyrva I'm breaking down Diego's "one and only" Interview.
And boy, I had to re-read it due to Google Translation because many of his answers are based off raw definition not necessarily tone or slang. But this was enlightening to say the least. I can see why he hasn't spoken on the writing since 318. I mentioned this before: Lead actors that feel frustrated with the writing or story, will vent overseas. Spader did it for Australia. Now Diego for Poland. Unbelievable. No wonder Ryan Eggold was the only one shooting off his mouth. Embarrassing. Eggold acts like his Keen 2 story direction was planned all along. No it wasn't. and it's still not 100% guaranteed. When a lead actor cannot move demos, their Q rating falls. That means Network receives unfavorables with the overall impression of your character. That hasn't changed and once he returns, audience will see it's far too much of him. That's pretty bad because he's only so far in one episode. They'd be wise to cut him as much as possible in order to not jeopardize numbers. But Diego plainly informs the Polish Press one minute his story and character are progressing like a live movie then by the end of the season nothing. And you got to SHRUG IT OFF and "understand it's a process@ [THATS WHAT HW SAY TO ACTORS ON HOLD. IT DOESN'T LAST LONG. ] Here's why. INTERVIEWER: In the third season, your role has changed, and your character saw more of doubt and pain - [Describe how] you played it? Diego Klattenhoff: At first it was great. [AND THIS IS 3A.]The role was significantly different than at the beginning, [DIEGO IS EXPLAINING HIS ROLE IN STORY IN 3A WAS A SHARP CONTRAST COMPARED TO 3B AND HE KIND OF THROWS SOME SHADE HERE BETWEEN THE TWO STORY DIRECTION. In 3A THE PRODUCTION CREW WROTE IT LIKE] [More like a] “movie series.” I was much more strongly involved in the hunt for Liz. [HERE HE EXPLAINS HE HAD STORY INPUT AND DIRECTION WITH HIS CHARACTER HE WAS MUCH MORE INVOLVED IN THE STORY PROCESS. SOUND FAMILIAR?] Later we returned to a more [PROCEDURAL] nature of the Blacklist . [THE POINT HES MAKING IS IN THE BEGINNING HIS ROLE WAS INTERPERSONAL TIED TO THE SERIAL NATURE of the original canon. IN 3B it's PLOT PLOT PLOT PROCEDURAL NO INTERPERSONAL DIALOGUE ITS DIFFERENT. And RATINGS REFLECTED THAT] The point is not that there is some magic formula that we should stick to, [DIEGO PREFERS CHARACTER DRIVEN STORYTELLING NOT PLOT IT WAS CHARACTER DRIVEN FOR HIM TO HUNT DOWN LIZ BECAUSE OF HIS JOB AND HIS FEELINGS FOR LIZ -CONFLICT IS STORY. WHEN THERE IS NONE, your show CANNOT PROGRESS] but [Its] very interesting [To see] how such changes [AH THERE IT IS. PROOF THAT 3B WAS ALTERED DELIBERATELY-HE WAS LED TO BELIEVE ONE STORY THEN THEY DROPPED IT AT THE END] affect the series itself and its perception by the audience. [INTERESTING TO HIM HOW THOSE CHANGES IN 3B occurred and how it's PERCEIVED BY THE AUDIENCE] INTERVIEWER: Ressler was torn by internal conflicts. I think that it [played very well]. Yes, [On] the one hand, he wanted [To arrest her] [Because she's a killer] on the other hand … he loved her. [Lets take this apart because it's important. HES GIVING STORY DIRECTION. DIEGO WAS TO PLAY 3A ,CONFLICTED BECAUSE ON ONE HAND HE WANTED TO ARREST A CRIMINAL. On The other hand..HE LOVED HER. SO THERES YOUR CONFIRMATION. RESSLER IS STILL IN LOVE WITH LIZ. AND HE WAS TO PLAY IT THAT WAY. But then 3B changed everything and he mentions that. He is not happy he's frustrated and u cannot blame him.] Just as in life. [NOW THIS IS INTERESTING. He's basically saying, YOU LOVE THIS PERSON, but you want to "kill them" at the same time when they HURT YOU. HE IS ALSO EXPLAINING THE CURRENT STORYLINE NOW. RESSLER/LIZ WENT DIFFERENT WAYS FEELINGS THERE BUT NOT TOGETHER. He's BASICALLY USING A REAL ANALOGY TO DESCRIBE THAT RESSLER RIGHT NOW HAS THAT SAM/DIANE LOVE/Hate thing going on because Liz makes him crazy...and do crazy things...she violates his ethics...but he's got feelings for her So he copes] I do not mean that specifically with Megan, [NO WE GET IT DIEGO ] but to people in general. There are certain things that you love. [THERE ARE CERTAIN THINGS THAT YOU LOVE IN REGARDS TO A PERSON ][When you start to go in a different direction theres more fun] [NOW WE ARE BACK TO STORY DIRECTION] Not always to the end, [AS IN THE LAST 3 EPISODES WERE CHANGED ] you know which way everything is moving, [As IN EVERYTHING WAS MOVING FORWARD WITH KEENLER THEN IT STOPPED AT GREGORY DEVRY] but then you just have to shrug and tell yourself that this is a process that also depends on the other person. [SO THE DUMB ASSED WRITERS HAVE RESSLER IN LOVE WITH LIZ, BUT RESSLER BELIEVES LIZ IS IN LOVE WITH TOM (SO SICK SERIOUSLY BUT THATS WHY RATINGS ARE DOWN RESSLER IS IN LOVE WITH LIZ WHEN HE SEES HER AT THE SUMMER PALACE BUT HIS WORLD OF BLACK AND WHITE[Shes with Tom he won't touch that] Since [Its about] both of you. [He's saying IT CANNOT BE ONE SIDED] Let’s say - you appear in [a scene], [NOW HES TELLING YOU WHAT HAPPENS BTS AS IN YOU SEE THEM GIVE EYES A LOOK SIGNALING MORE THAN JUST IN THAT MOMENT SOMETHING ELSE IS GOING ON AND HE CANNOT PLAY IT LIKE THAT WITHOUT MEGAN GIVING AS MUCH AS HE DOES IN THOSE SCENES. How she gives moon eyes to him] and although you do not see the [scene] make sense, [HES TALKING ABOUT WITHOUT DIALOGUE ACTION IS MOVABLE STORY NOT JUST IN STUNTS BUT INTERPERSONAL DIALOGUE AND WHEN ITS GONE, THEY PLAY TENSION OR AS WE SAY IN THE SCRIPT LIKE AT THE END OF LADY AMBROSIA PLAY THE MOMENT. LIZ LOOKED LIKE SHE WAS LONGING FOR RESSLER] you have to do something, because I have to. With this, it was very pleasant. [I THINK HE USED A DIFFERENT WORD BUT YOU GET THE GIST. THEY CREATED SOMETHING OUT OF NOTHING WITH THOSE LONGING LOOKS. AND THIS IS 3A & 3B HES TALKING ABOUT. THERES SOMETHING UNDER THE SURFACE. A SCENE MAKES NO SENSE BUT THEY GIVE THESE LOOKS.] Megan is a great person, very well with her game, she can contribute a lot to the show, so this type of relationship is very engaging. [AGAIN HES REFERRING TO KEENLER AND ENGAGING I DON'T THINK HE USED THAT WORD EITHER I think he used APPEALING SAME MEANING] We’ll see how it unfolds in the year. [SO HERE AGAIN DIEGO EXPLAINS KEENLER IS UP IN THE AIR NOT DEAD BUT UNEXPLAINED AND ALTHOUGH SCENES MAKE NO SENSE THEY ARE STILL PLAYING SOMETHING ELSE. EXAMPLE: Blacklist PR ASKED "DO WE SENSE SOME TENSION?" That one scene episode 3, Liz stares down Ressler in his office. He looks down. That's deliberate SO HE IS TELLING FANS A YEAR. TRULY DISGUSTING HIS CHARACTER IS ON HOLD TILL THE DAMN KEEN2CRAP PLAYS OUT. But that's basically what he's saying. Keenler isn't dead, just limbo] [I SAID THIS BEFORE WITH RATINGS IN FREE FALL THEY'D BE SUICIDAL NOT TO DO KEENLER AFTER ALL THIS GARBAGE. THEY WERE HEADED IN THAT DIRECTION SO GO BACK BEFORE THE SHOW DIES BECAUSE OF ONE CHARACTER. DIEGO NEVER MENTIONS HIM AND HE DOESNT GIVE STORY INPUT ABOUT LIZ FEELINGS EITHER, JUST HOW MEGAN AND HIM WERE PLAYING IT IN 3A and then how they continued to play it in 3B] INTERVIEWER: I assume that a few weeks after the death of Liz people accosted you on the street and asked for information, and you could not tell them anything …[YES HE WAS ON GAG ORDER WHENEVER A SHOW IS DARK ACTORS CANNOT REVEAL STORY INPUT. ILL BE REALLY SURPRISED IF BLACKLIST LEAKS-Not because OF SPOILERS BUT BECAUSE THEY CHANGE STORY ALWAYS AT THE LAST MINUTE. [THEY NEVER STICK TO THEIR OWN ARC] Frankly, given the nature of the shocking death of [Liz] my character had neither too long nor too many scenes that relate to it. [HERE HE IS FRUSTRATED AGAIN. AND WE ALL KNOW WHY. THEY DIDN'T TELL HIM ANYTHING AT THE END. STORY AS HE MENTIONED WAS GOING FINE UP UNTIL THE END] That’s why I was surprised that people ask [me] about it. Because several of these people were, [Yes they wanted to know where was RESSLER AND WHY DIDN'T HE HAVE SCENES ] I agree. [I DO LOVE THIS SHADE HE GIVES, BECAUSE HES RIGHT. How they wrote 3B was selfish and deceptive.] It is unfortunate that the writers did not pay more attention to this, [or] how this situation has affected Ressler. [YES THIS IS WHY BOKENKAMP/Eisendrath PROMISED DIEGO IN SEPTEMBER THEY WERE WORKING ON STORY FOR HIM YET DIEGO DIDN'T TWEET BACK NOR ENGAGE IN ANYTHING AFTER LAST YEAR SINCE 318-WHEN THE STORY CHANGED IN PRESENT TIME FOR HIM] I was a little surprised, in the end they were partners. There was some animosity between them in the first and second season, but then everything started [To play like they got along well ] [But] There has not been any romantic themes. [Now this is IMPORTANT. Go back to 317-318 320 dialogue-LIZ WEDDING COOPER GIVES THE SPEECH] I spoke with our television series advisor. The FBI and various police about what feeds the feelings to your partner. [CRYPTIC DIEGO GIVING YOU STORY DIRECTION WITHOUT REVEALING STORY. GO TO ARTAX NETWORK AND READ TOM KEENS TEXT TO AGNES DOCTOR AND HOW TOM AND LIZ THOUGHT OF EACH OTHER AND YOU MATCH THAT TO WHAT DIEGO SAYS HERE. Same with the wedding vows] Everyone said that due to the fact that so much time is spent away from the family, the partners become for you family. I think this year, this knowledge somehow pays off. [SO YOU HAD BOKENKAMP AT THE BEGINNING OF THE SEASON TALK ABOUT THE TASK FORCE AS A FAMILY YET NONE OF THEM INTERACT LIKE A FAMILY YET RESSLER AND LIZ ARE PARTNERS AGAIN AND TOM IS GONE. OK SO ARE WE GETTING THE GIST OF WHAT HE IS SAYING? ILL GIVE YOU A HINT IN NATALIE LUCA ALONG WITH THE FORBIDDEN LOVE ANGLE LIZ SHOUTS AND RESSLR ADMITS THE COUPLE FELL FOR EACH OTHER IN THE WORKPLACE, LIZ AND TOM REFER TO KEEN 3 as "This family" not "our family." BOKENKAMP WROTE IT AND ITS DELIBERATE DIALOGUE BECAUSE THEY BOTH REPEAT IT BEFORE ADMITTING THEY ARE FALLING APART EVEN THOUGH THEY ARE TOGETHER.] image INTERVIEWER: It’s nice that there was a little warm feelings from Samar. Whether it will develop? I do not think so. [THAT WAS MATTER OF FACT.] They wanted to go this route, but later it became a one-off, a closed issue. [I KNOW WHY LOL EISENDRATH WANTED THIS SO KEEN2 COULD HAPPEN] I do not know what will happen after the fourth episode of the new season. [BUT HE KNEW SAMAR HAD FEELINGS FOR ARAM.] Samar discovered [Her] feelings [For Aram] before Ressler, but I do not know yet how he will approach this. [RESSLER DIDCOVERS SAMARS FEELINGS FOR ARAM BUT HE DOESNT KNOW HOW HE APPROACHES IT.] INTERVIEWER: What is the beginning of the fourth season for the Ressler? We begin where it left off [from] the previous season. We’re trying to find Liz. Ressler follows the footsteps, trying to find Tom, and then Agnes. It is not easy for him, because he lives in a world where everything is black or white, good or bad, right or wrong. In this matter I think nothing has changed. [PLOT MODE] INTERVIEWER: Some of the current topics feature almost predicted the events that occurred in the real world. This applies to several series, which played in the Homeland. Is this something you are looking for, what do you care? [IS DIEGO LOOKING FOR STORIES ON THE BLACKLIST TO REFLECT REAL LIFE LIKE HOMELAND? HERES ONE HINT: SALKE IS.] I think it goes hand in hand with a good script. [SHADE] [It worked out really well for Law and order. Homeland [showed] almost exactly what happened in Paris. But those scenarios were created months earlier. [Predicting the future.] Much depends on whether the [STORY] board [has writers] who feel what can happen and which way [the] events will turn out. Something like this testifies to the fact that the show is good, it is well written. [AND WE KNOW FROM THE RATINGS, the plot mode of 3B THAT THE SHOW IS HORRIBLE AND ITS WRITING.] I hoped that was easier to read. IMO I'd expect the worst, until the show gives concrete story to give you otherwise. [THE SHOW IS DARK FOR A REASON] PS I haven't seen this gift before what was the dialogue surrounding it because once again these two are expressing mutual sadness that relates not to the case but each other. That's a medium panoramic and it's done to capture reaction simultaneously. Such as...👇🏻
Tumblr media Tumblr media
18 notes · View notes
ynsespoir · 7 years ago
Text
Using E-Consults to Prevent Unnecessary Referrals: A PCPs Guide
In today’s world, Primary Care Providers (PCPs) have the monumental task of managing 100s’ of specialty provider relationships and understanding over 150 specialties and sub-specialties.
Did you know there are 21 sub-specialties just for internal medicine alone?
With this type of challenge, how do PCPs guide patients to the most appropriate doctor for further treatment under their care when they do not know the best options available.  What’s worse, 55% of the time patients should not even go to another provider and can remain under the PCPs care if provided with guidance from their specialty care counterparts.
What is an E-Consult
Electronic consultation (e-consult), a telehealth modality, is a mechanism that enables primary care providers to obtain specialists’ inputs into a patient’s care treatment without requiring the patient to go to a face-to-face visit.
The primary care provider (or other continuity provider) initiates the econsult through a traditional referral pathway, ideally supported by clinical checklists. The specialist then gives advice or renders an opinion that the primary care provider (PCP) receives and acts on.
An e-consult can be as simple as a “curbside” opinion between the specialist and PCP that is intentionally general, often undocumented, and can not only delay treatment for the patient, but carry a large malpractice risk. Did you know that 80% of all serious medical errors involve miscommunication during care transitions to different care settings.
Considering in the United States that more than a third of patients are referred to a specialist each year, the need for solutions to improve communication is greatly needed.
Despite the frequency and the importance of the specialty-referral, the process itself has been a long-standing source of frustration for both primary care physicians (PCPs) and specialists due to only 45 percent of patient referrals being necessary.
Oftentimes, the clinical question is answered solely via e-consult, although the specialist will sometimes eventually see the patient in a face-to-face encounter. The rate of conversion to face-to-face depends on the clinical condition. When a face-to-face is required, only one visit will often be needed thanks to the pre-visit preparation completed via e-consult.
Viewing diagnostic images at a time after data collection is another store and forward telehealth application with radiology, dermatology and ophthalmology (retinal scanning) being common examples. The line between this telehealth application and e-consults is somewhat blurry, as e-consult platforms are also able to store and forward images attached to the e-consult.
  Why is Provider Communication a Problem Today?
Poor access to specialist care can be detrimental to patients’ health. Excessive wait times and delays in care can cause anxiety in patients and their families. They can also reduce patients’ ability to carry out day-to-day activities and lead to deterioration in patient’s’ overall health as important diagnoses are delayed. In addition, 3 out of every 10 tests or services are duplicated needlessly, causing frustration for patients and providers alike.
The most significant gap identified with EHR is that vendors lack common functionality or the ability to customize e-Consult functionality within the EHR to meet the unique needs of each client.
While use of Direct messaging is available amongst EHR systems, the drawback of using this as a sole means of e-Consult functionality is the lack of closed-loop tracking, reporting and reconciliation of electronic consultations back to the patient chart in a fluid manner. Agnostic platforms like ReferralMD meet this capability very clearly, providing bi-directional data integration to maximize data flow for clinicians.
  How do Primary Care Doctors Get the Advice They Need?
Unfortunately it can takes years to develop specialty care relationships through a combination of networking, and recommendations from other physician partners, or outreach campaigns from specialist looking to drum up referral business.
In the past a PCP had little control and found it hard to find great specialty care partners to seek advice about their patients. This is all changing now with technologies such as ReferralMD, a referral network management platform.
Quick Takes:
Improving the interface between primary and specialty care requires a new perspective on care delivery by providers. In-person referrals have developed as the mechanism for primary care providers to get assistance from specialists, but there are other ways to access this expertise and co-management support E-consults eliminate the language of “denials? and “approvals” and instead is focuses on collaboration to find the best facility for a patient to receive care.
Providers are concerned that the patients will perceive innovations such as e-consults as barriers to care if they do not result in a face to face visit. To address this concern, PCPs should discuss the positive attributes of electronic referral and consultation systems, which include closer collaboration between PCPs and specialists in co-management of patients and the convenience to the patient associated with avoiding additional specialty clinic visits.
Respecting the patient’s desire to see as specialist in person is important. If the referral is necessary or the patient requests a visit, ReferralMD allows for all information including the patient medical records to be sent over electronically without need to fax.
Collaboration between primary care and specialty care providers offers an opportunity for informal training and for providers to practice their full scope. With the Advent of EHRs, the old-fashioned curbside console has been lost, but he E-consults bring back this opportunity for dialogue.  EHRs are not necessarily developed to encourage dialogue and interaction, both of which come from people using the tool.
Selecting the right specialist is critical, as is providing constructive feedback to both PCPs and Specialists about the quality of their communication with one another.
Thanks to the California Improvement Network
Make a List and Check it Twice
Since it is getting close to Christmas, I wanted to share a very nice report that you can use to identify who you should align yourself with as a PCP.
The report is simple to use and can be filtered by city, specialty, organization name, provider name and more, and is available from the ReferralMD platform.
Apply now for a demo.
In order to steer patients to the most appropriate, high-quality doctor, you need an updated physician directory that shows which doctors in you area work with you employed/contracted providers or the competition (in/out of-network affiliations) based on important criteria such as…
Accepted insurance
Proximity to patient
Wait times
Experience
and much more
Your care coordinators will love the immediate access to information at the point of care as they send referrals out or request consults.
ReferralMD Example:
  Another option, think about who advises your patients before they end up in one of your examination rooms and begin your list with those names.
Continue your list with the non-competing clinics in your area you can think of (even if you think their loyalty lies with another doctor)—basically, any other office in town that treats people or provides any sort of medical advice. Make your list as long as you possibly can without self-editing.
Once your list is exhaustive, refine it by asking yourself these questions:
Who do you already know and get along with well? (This is obvious, but you would be surprised how many facilities do not discuss their relationships fully with other staff or clinicians they work with)
Which clinics are on top of their marketing?
Keep your eyes open for ads on TV and in local publications.
Also try web searches to see who’s proactively taking advantage of online traffic. To review your competitors website utilize tools like
Are there any impressive new doctors in town that are already doing a lot of business—or whom you would consider an up-and-comer? (Which doctors have full schedules and can’t fit in many new patients?)
Recommend taking a look at your local county clerk’s office and review new doctors that have just received their business licence. May be a great way to build solid relationships early on and offer assistance to a up and coming doctor.
Are any doctors breaking off to build a new practice of their own? (Again, keeping your eyes open for advertisements or announcements in local publications will help here.)
Of the clinics whose loyalty lies with your competitors, do they have any competing clinics you can reach out to?
With the answers to these questions, you can establish the top targets to invite into your mastermind group. You may want to create a first choice and second choice list. The two lists will help you determine who to spend time on, if a doctor is already at the top of his or her respective positions you may want to eliminate that person from the list. Targeting the people who will be initially receptive to an invitation will be an important time-saver.
Additional Information on:  How to Build a High-Performing Physician Referral Network from Scratch
E-Consult Benefits
A number of factors are leading to rapid adoption of e-consults in certain areas of the healthcare marketplace, particularly where specialty access is challenging and pressures to increase value are more acute. The set of common experiences in ambulatory specialty practice described below illustrate opportunities where e-consults could be used to improve physician satisfaction, patient experience, quality of care and utilization of specialty services.
Incomplete work ups. Specialists often enter an examination room to see a patient referred by a PCP and find that not all of the tests needed to assess the question or problem have been done.
Low value visits. Studies suggest that a significant percentage of referrals, depending on venue and specialty, are actually for issues that could be resolved and managed at the primary care practice level.  (examples: neurology 17 percent, cardiology 36 percent, hematology 48 percent, nephrology 63 percent).
The referral is directed to the wrong specialist. Much to the frustration of all involved, specialists sometimes see a patient for an initial consultation and discover the question or problem is not appropriate for their specialty practice.
Poor access. PCPs and patients are often faced with long wait times to see a specialist.
Feedback delayed/disconnected. In many systems, the results from a specialty consultation can take weeks or months to be returned to the PCP, decreasing the chances that the PCP will learn from each referral and, over time, make fewer referrals for the same clinical question.
E-consults are designed to address and mitigate each of these negative experiences.
  E-Consult Challenges
E-consult implementation is not without challenges such as:
Dual documentation. Providers are sometimes required to document in dual systems and are legitimately concerned about dual entry being time consuming and a potential source of errors.
Lack of payment models. Payment models for e-consults vary. Using e-consults in a value based payment system is optimal. Those at risk need to be confident that if specialists are paid for e-consults, face-to-face visits will actually decrease.
Transitions of care from remote specialists. E-consults allow a specialist outside of a strained local network to provide access, but if there is a later transition to an in-network, in-person visit based on acuity, the transition can be challenging and can create redundancies and, therefore, must be monitored.
Workflow consistency within practices. Using e-consults for some patients and not others (for instance by payer) is difficult and may inhibit adoption.
PCP adoption. Some referring providers will resist change and want their patients to be seen face-to-face. Identifying physician champions who understand the value of e-consult is essential to the success of the model.
  E-Consult Market Developments
Evidence for the effectiveness of e-consults in safety net healthcare is building. Several articles detailing outcomes in a safety net environment have begun to emerge. These studies show high satisfaction among primary care providers, reductions of in-person consults of 40 percent, and overall cost savings.
This growing evidence is also translating into payment. The State of Connecticut’s Medicaid program has just begun paying for econsults initiated by PCPs at federally qualified health centers (FQHCs). Colorado and Oklahoma have pilot payment programs and Washington is planning a pilot. In California, where providers bear more risk than providers in other states (including risk for FQHCs in the near future), econsults have been implemented or are currently being implemented in a number of arrangements. The 1115 Waiver Global Payment Program in California specifically calls out econsults under a service category example. Continued dissemination of econsult use should be expected as local departments of public health begin to respond to the global budgets.
E-consultation is a telehealth solution that is gaining more widespread use. Companies have emerged to fulfill the need, offering SaaS models and pre-designed clinical checklists for referrals, as well as additional specialist capacity to address access problems. Market need, proven results, and commercially available products are likely to bring about rapid adoption in settings where specialty access is limited.
Conclusion
Building a referral network has gotten much easier due to technology allowing PCPs to work more closely with their specialty care counterparts.  If you have not made the leap yet, we highly recommend that you do, the ROI and benefits to your patients are massive.
The post Using E-Consults to Prevent Unnecessary Referrals: A PCPs Guide appeared first on ReferralMD.
from Health Care Technology – ReferralMD http://ift.tt/2AuPjQQ via IFTTT Using E-Consults to Prevent Unnecessary Referrals: A PCPs Guide Health Care Technology from topofbestone http://ift.tt/2hPvNTx via IFTTT
0 notes