#patiently waiting for insurance to approve my surgery so i can get it done and start counting down the days until they're OFF!!!

[canongf]

eddie likes my braces actually!!! he thinks they look good on me and yeah he's excited for the day that i'll get them off but he loves me and thinks i'm pretty now with them on. and the feeling of them doesn't make him want to kiss me any less!!!

[quietcaveat]

Disclaimers and whatnot.

Hi there, this is a venting and complaining discourse blog I made specifically to talk about issues related to sexuality or sex dysphoria since it kind of started stressing me out to see it on my main blog whenever I'd log on just to see something light-hearted for a laugh.

Bad-faith anons get ignored, should they crop up. I'm here to share experiences and open a dialogue or discussion because ultimately I care about finding the best possible solutions and answers for people and I only have the energy to spare for other people who also care about pursuing solutions and knowledge.

This is mostly a context post in case something isn't clear or got forgotten about.

About me & my history (as it relates to sex dysphoria):

[TLDR, I'm a 20-something adult with a history of sex dysphoria since early childhood that transitioned as a minor. As an adult I'm now medically detransitioning about 10 years later for health reasons and because my transition was unsuccessful, but have not yet decided if I will socially detransition or not.]

I'm a 20-something that has had persistent and unabated symptoms of sex dysphoria since early childhood, around 7 years old or so, which is as far back as I can remember anything at all. I was diagnosed with what was then called Gender Identity Disorder and later medically transitioned as a minor -- the very week I turned 15 was when I began HRT which I was approved for prior to turning 15. I was offered surgery while under 18 but refused several times to get doctors and parents alike to stop offering it to me, and I refused it because something felt off about doing it as a kid and so quickly after only just starting hormones. I waited and got the surgery done later as an adult and to this day am still happy that I got it done even though my results are not as great as I'd like them to be.

Now in my 20s I have discontinued medical transition due to health reasons and because my transition was unsuccessful in making me pass as an adult member of the opposite sex. My dysphoria is not as bad as it used to be before I transitioned but it is still quite bad and will never get any better in the future. Currently I'm still deciding whether to continue being social transitioned and weighing my options. The only label I definitively call myself is sex dysphoric and transitioned/post-transition since those are the only objective and unchanging truths of my situation.

I'm very familiar with the ins and outs of what it's like inside an adolescent transition clinic as an underage patient, and I'm very familiar with the details of transitioning from what hormones do to what a trans youth support group is like to how a name-change on different documents gets conducted to how insurance will refuse to cover transition surgeries unless they're labelled as medically necessary in the paperwork. My experiences are based mostly in pre-2020 USA so they may not apply to the European transition scene for example. I also like to read and follow studies and scientific findings about sex dysphoria, and I like to stay updated with current WPATH SoC and transition care procedures and models.

If anyone is ever curious about my experiences with anything I've witnessed or gone through, I'm happy to tell the stories either in a post, ask, or DM. It doesn't even have to be for or against any argument, we don't even have to agree on anything or even bring up debates at all, it can just be if you want to hear about what someone like me has been through.

Bullet list of general opinions:

Minors cannot consent, especially not to something as permanent, potentially harmful, and severe as a medical transition.

Sex dysphoria is a real condition that develops in utero and is permanent. This stems from studies and scientific evidence for which there are much better blogs than mine to find and read about, such as myragewillendworlds or gillygeewhiz.

Genders other than male and female do not exist. Intersex conditions are not new or other genders, they are disordered developmental conditions. See above recommendations for studies and scientific evidences about this.

Sex cannot be changed (as elated as I would be if such a change were possible.)

As far as I know, transition is the only way to alleviate symptoms of sex dysphoria. There is no cure and no way to get rid of it.

Transition might be the only treatment but it is not guaranteed to be effective. Until transition can have you magically grow natural, functioning organs of the opposite sex, it will never be a 100% cure and will not be effective for everybody.

Pronouns = sex (or perceived sex should it differ from sex.) They are identifiers of observations, not requests and outfits to don on a whim.

Neopronouns are harmful and ableist to sex dysphoric people (also called transphobia though I fear that word has lost its edge with its current overuse) by belittling and mocking a very serious and observable condition, equating it to 'pretending' to be something that isn't real.

Sex dysphoria is a very rare condition that affects less than 1% of the population. The majority of people claiming trans labels today are non-dysphorics that are either misdiagnosed or self-diagnosed (which is usually measurable by when and how symptoms appeared; sex dysphorics have a consistent, completely or near-completely lifelong history of symptoms.)

Affirmation care models are harmful to both sex dysphorics and non-dysphorics as it destroys spaces and resources for sex dysphorics by letting in people who do not need them and it misdiagnoses and mistreats said people with no need for dysphoric resources. Careful gatekeeping to make sure as little misdiagnoses occur as possible is important and beneficial to all parties.

Since humans can only be male or female, this also means human sexuality can either be solely same-sex attracted, solely opposite-sex attracted, both opposite- and same-sex attracted, or perhaps lack sexual attraction altogether -- homosexual, heterosexual, bisexual, and asexual respectively. No other sexuality is possible.

Sex dysphoria's recognition as a condition is vital. Without it, transition care would be impossible to access for all but the wealthiest who can afford to pay for it out of pocket, since insurances don't cover cosmetic procedures.

That's all I can really think of at the moment.

[traumasurvivorshelpingsurvivors]

My therapist has done nothing for me--the only thing I hope that she comes through on without any bells and whistles attached is getting the top surgery letter I need to present to my surgeon so I can finally be free of this chest. She's made me feel ashamed for having DID..{She's not educated/licensed in it but still feels the need to make comments..even going as far as saying as I 'identify' with it like DID is some kinda sexuality..Thankfully I got diagnosed by a more competent therapist for the DID way before I had the displeasure of meeting her.} She even asked "Does everyone in your system approve of the top surgery?" like..bitch????..they're all Male????..and they want the best for me??..Why wouldn't they want me to get top surgery???? She's made me feel ashamed of being Trans {Telling me that sometimes top surgery isn't enough/right for trans people and that it could all --even being on hormones since May of 2021 and having presented as Male since I was in middle school --I'm 32 now-- be a trauma response..I know I'm fucking Male and I have always been one.} She told me one day when I was being really rude to myself and telling her that I was never going to find love because I'm broken/ugly/worthless/etc. and she goes "Even ugly people find love!" and holy shit that fucking hurt. One time she even said she didn't want to feel like she was walking on eggshells around me..{She's supposed to be educated in BPD/etc. and shit like we're diagnosed with and does DMT or..whatever the hell it's called,I'm sorry I'm bad at abbreviations but it's a bunch of mindfullness bullshit and a ton of group classes/group talk that would've been WAY too expensive to do for three hours a day --I'm on insurance-- and she expected me to be fronting --everytime-- the --whole time-- which is impossible due to all of my trauma/etc. and then buy a textbook for 30 something bucks when I'm on a fixed income each month with disability and have bills and shit to pay.} Then she told me that 'she didn't know but--' they could decline my top surgery because I have DID and I've literally been in the worst state mentally/physically ever since she told me that..like..I've been waiting YEARS to even get this far and now she's going to tell me speculated things on shit she's clearly not educated on????? I'm only putting up with her (besides making it painfully fucking obvious how she hurt me in the most recent diary entries that she checks before each session) only until she gets my letter taken care of and then I'm on a waitling list for a new therapist (who's actually educated in DID and other stuff.) till the end of january when her patient list opens up...But holy shit,I've been through A LOT of bad therapists but no one like her? I've been sick and spiraling mentally/physically {for the second time since her last 'slip up'} since Tuesday because of how badly her words have effected me but I know she'll turn it around on me our next session and make me guilty like she did last time when I voiced how bad she made me feel/etc. {This bitch is literally doctorate level.} If they decline my top surgery or anything else,my mental/physical health is going to go into the gutter and never come out. It'll fucking destroy me. I'm so fucking scared/anxious/depressed and everything else in between and my BPD and other shit is having a fucking buffet with all of this shit it can attach to. I'm still dealing with all the bad symptoms of the pills my old doctor {no relation to therapist above} decided to put me on without any tests/etc. and I stopped taking those early last year..I literally almost got offed from the side effects and how they interacted with my body and that doctor didn't care (she made so many transphobic comments and asked so many invasive questions and shit when I was there..right down to how they make everything for bottom surgery and then made fun of my anxiety about pap-smears/etc. because I'm a //// and CSA survivor and then she lied about hooking me up with a really great LGBTQIA doctor and had her nurse yell at me when I

asked why she was making promises for things she wasn't educated in/actually had no connections with) I'm sorry for the vent dump. I've literally got no one/am alone in every way possible and this is just so god damn much.. I'm so tired of constantly suffering.

Hey there,

I'm so sorry you're going through all of this. You deserve to be treated much better. It's not fair at all that you have to jump through these hoops. I wish it was easier. Please hold on.

I hope you get a new therapist soon. I hope all of this gets sorted soon. You deserve to get the things you want.

Take care. Reach out to us anytime.

- Mod Misa

[roadsterguysblog]

One guy’s guide to top surgery

I have a little too much experience with surgery in general, and I’ve just had top surgery.  So why not share my experience?

Getting the consultation

Like everything else trans, you need patience.  I know it sucks.  I know it’s not fair.  I’m not patient myself.  But this is the way you have to go.  You need a letter from your therapist.  You need a letter from your primary care provider.  You need to keep on your insurance to approve it.  If there’s a transgender care center anywhere near you, go through them.  A doctor who has experience with getting transgender care approved is worth their weight in gold.

After all of this works through the system, you’ll get the consultation.  Some surgeons are nice.  Some are brusque.  This is completely unrelated to their competence as a surgeon.  If you have a nice one, enjoy the niceness; if you don’t, don’t take the brusqueness personally.  Listen to them.  They might not say what you want to hear.  I was hoping to have periareolar, because I had small breasts, but the surgeon told me my breasts were “too saggy” and I needed a full mastectomy.  That’s life.

You’ll schedule the surgery.  It will probably be a long way off.  Ask to get on the wait list - you might get lucky.  Otherwise - yeah.  Like everything trans, it’s a wait.

Run-up to the surgery

You’ll get a check-in before the surgery.  You might not see the surgeon at all; you’ll see an assistant if not.  Listen to them.  They’ll tell you what will happen, and what to expect.  Once they’re done, ask your questions.  Write down anything you think of in the run-up to the appointment, so you don’t forget.  Ask about the binder - will they provide one, or should you bring yours?  Ask about a cold therapy unit - if you can afford one, will they put the pad under your dressing?  If you’ve ever had any bad surgical experiences, ask about that.  If there’s anything that triggers or helps your dysphoria, ask about that.

Get someone who cares about you to commit to care for you the evening after the surgery, and preferably the whole next week.  Take a sick day on the day of surgery and the day after.  Work from home for as long as you can afterwards.  Get some cheap button-up or zip-up shirts from the thrift store.

Stock up on food that is easy to make and easy to digest.  Put bottles of water in the fridge so you have cold water to drink.

Ask if they’ll give you prescriptions before the surgery, so you don’t have to fill them after.  That’s always way better.  If they don’t give you Hibiclense, buy some at Walgreen’s.

The anesthesiologist will call you.  Do not lie to them.  Tell them your real height and weight, tell them about any drug use, be honest about both smoking and vaping.  They’re here to make sure you don’t have a bad experience.

The day of surgery

The thing about not eating and drinking the night before and morning of is real.  It sucks, but it’s important.  Distract yourself if you’re going nuts from hunger and thirst.  Wash with the Hibiclense according to the instructions they give you.

Wear loose, comfortable clothing.  I wore just loose house pants and a zip-up loose top and sandals, no socks or underwear.  Take out all of your jewelry, head to toe.  If you’re afraid it will close up, buy plastic plugs.

When you go in, the surgical team will ask you lots of questions.  Some will be personal or repetitive.  They’re just trying to make sure they’re doing things right to give you a good experience.

You’ll dress in one of those gowns and put your personal items in a provided bag.  If you’re cold, ask for a blanket.

The surgeon will come by to see you.  They might be distracted, they might be curt.  It’s the assistants’ job to be friendly.

The anesthesiologist will talk to you about anesthesia.  They’ll ask about your prior experiences with anesthesia.  Be as honest as possible.  They’re trying to make sure you have as good an experience as can be made.

A nurse will put in an IV.  This might be tricky, especially as you’ll be a little dehydrated.  Try to distract yourself, breathe, relax.  Once the IV is in, everything gets so much better.  They’ll give you saline, which will rehydrate you and be calming.  Sometimes they’ll push an anti-anxiety med.  Feel free to ask for it, if you’re feeling tense!

They’ll wheel you into the OR, finally.  It will be bright and bustling.  They’ll put an oxygen mask on your face, and as you’re breathing in the oxygen, they’ll ease in the anesthesia.  Everything will go hazy, and then you’ll hazily wake up in the recovery room.

After the surgery

You’ll wake up with a sore throat.  They had a tube down there to make sure you kept breathing.  You’ll be woozy.  You might be high or nauseated.  If you’re feeling nauseated, ask the nurse for something to tamp that down.  If you're in pain, tell the nurse the nature of it.  Make sure they’re all aware of what went well and what didn’t.

If you’ve had surgeries before - well, this was the easiest damn surgery I’ve ever had.  But without that prior experience, I can see it being brutal.  And everyone reacts differently to drugs, particularly the pain drugs.

You’ll have a binder or an Ace wrap on.  It will be tight.  You’ll probably have drains.  The nurse will explain how to take care of them.  This is your time to relax and take it easy on yourself.  Have your care person take you home, prop you upright on the couch with pillows, give you plenty of liquids, and as much food as you feel the stomach for.

Control your pain.  Don’t worry about addiction, the first two days are about making yourself comfortable enough to rest and heal.  Take a pain pill before you go to bed, so you can sleep.  If you need pain pills the next day, take them!  By the end of the second day, the pain should be diminishing to the point where you can wean off of them - especially if you have a cold therapy pad in place.  If you don’t, try to ice it as much as possible with cold pads.  Not ice.

The end results

Well, that will depend on a lot of things.  Biology - some people heal better than others.  Compliance with post-operative restrictions.  The nature of your surgery.

A good, non-woo-y physical therapist is the best.  I have generally good results with scars because I get physical therapists to do scar mobilization techniques.  Forget about all the creams and ‘natural’ treatments.  Anecdotes are just that.

You’ll have a post-op appointment the week after your surgery.  They’ll talk about the timeline for re-mobilization and physical therapy at that point.  Up to that point - do as little as you can get away with.  Rest.  Relax.  Heal.

For me - well, if I had gone through a cis male puberty, the results would be a surprise, and very little would be under my control.  So I’m just rolling with it.  I’ll probably scar.  It probably won’t be as beautiful as I would like.  I don’t care.  I’m a man and I want to look like one.  Nobody owes it to me for me to be a handsome man!

Good luck.  Love your chest.  Be good to yourself.

[pitiless-achilles-wept]

Always Waiting: The Cost of Never Being Done

Hi all,

I kept waiting for a time when I felt like I had time and energy to write and...surprise! It turns out that's not just around the corner when you have a chronic illness and are still working full time (not to mention trying to keep up a social life and maintain all your relationships). But I figure some information is better than none at all, so I'll get through what I can. 

You all remember (I think) that I went to Dana-Farber after my December CT scans showed significant growth of my primary tumor despite the metastatic sites holding steady. I came out of that meeting with two recommendations for clinical trials. One--my top pick--was being run out of Massachusetts General Hospital and Dana-Farber and involved an antibody-drug conjugate (IMMU-132) that has been shown to be super effective for triple-negative breast cancer but which got held up at the FDA approval stage. Doctors are pretty frustrated that the approval is still pending and that the only way to use it is on a trial, but there's hope that it might get approved in the next 6-9 months. The other is being run out of UPenn by the same doctor whose study I was on before and who I really like. It looks at the effect of chemo + an immunological agent vs. just chemo.

There were several reasons to prefer the MGH study (even though it would have necessitated traveling to Boston during the coldest months of the year), among them that I wouldn't have to endure chemotherapy as part of the trial. And it looked for a while as though I was going to be able to join it. It wasn't actively enrolling but there was a spot. I waited, in the days right before Christmas, to hear. And my doctors all worked hard, calling the PI and discussing the option of enrollment at either location. But it didn't work out. Another patient made exactly the same call I would have made--and I cannot fault them for that--and I am several places down on the waiting list. Spots open up when people leave the study, so presumably when their disease worsens or a better treatment option opens up. It only happens every couple of months. Doing the math, it seemed more likely that the drug would get approved by the FDA than that I would get to enroll.

I was pretty angry. And it was hard because there was no single person to be angry at. Not at my doctors, all of whom knew my preference, did all they could, and gave sincere apologies when it didn't work out. And not at the other patient who took the chance that I so hoped I'd be given. If anything, I was angry at the FDA for not approving the drug faster, or at whoever was funding the study for not allowing there to be more than 68 patients on it at any given time. The fact that groundbreaking, life-saving medical research is also a business constantly makes me angry. Sometimes it works in my favor (IMMU-132 will likely get fast-tracked on its second go through the FDA because someone will make money) and sometimes it doesn't (why fund more spots than you need on a clinical trial just because people want to be in it?).

So then there was more waiting. So much of having Stage 4 cancer is a waiting game. Waiting for promising new research directions. Waiting for that research to get funded. Waiting for those studies to enroll and complete. Waiting for FDA approval. Waiting for insurance approval. And, the biggest one by far, waiting to see if it works.

I was home for the holidays, not meant to see an oncologist until mid-January. A third option was proposed, which was staying on the study I had been doing with the PARP inhibitors but first doing a short course of radiation on the breast tumor. When I got home at New Year's I booked in to a radiology consultation, even though I felt a suspicion that it wasn't the best option. (Several oncologists told me that if the PARP inhibitors had stopped working on the initial tumor it was only a matter of time--and likely not much of it--before they stopped working on the metastatic sites too.) After spending nearly an hour with yet another very helpful doctor who had studied the whole history of my case (and a little bit of my research, once I told him what to Google) I saw that I was right. A tumor this size, he said, would only benefit from a pretty lengthy radiation course and we only had a grace period of 2 weeks for me to get back on the PARP study. He reminded me that it would be an option later and wishes me luck.

I'd like to pause here to do something I haven't done before and ask you all a favor. I understand exactly why this happens but please, to help me out, don't ask anymore about why I am not (yet) having surgery or radiation on the tumor. Yes, the primary tumor is the biggest and nastiest and pains me every day. You can be sure I'm also asking that question of my doctors, not only when there's a treatment change but when I tell them that it's hurting me. I know that it seems simplest to just cut it out (even if this means altering my body in a way that I am not eager to do) or try to shrink it. And I know that's why people ask. All the time. ALL the time. Unfortunately, it leaves me feeling defensive--do they not know that I have thought of this option every single day as I carry around the painful, swollen weight of a 6cm tumor?--and like I have to justify my decision. I imagine one or both those things will happen immediately. I have many (medical) reasons for not doing them yet. When I decide to do them, you will know and I will tell you more about why. But it would make me feel a lot better if I knew people weren't going to keep asking. Thank you.

Ok, back to what happened one I decided that radiation was out. Essentially, last week I officially consented to the study that's at Penn and that involves chemo. My first session will be on January 30th. I'll be going every 3 weeks. The agent I'm receiving is one of the oldest (carboplatin) and will be given in a higher dosage than when I went every week. This means it's likely to make me sicker. (The doctors did say that I'd feel worst on days 2-5 and better as the cycle wore on.) No one told me that people tolerate this one especially well and, having been so relatively lucky with side effects before, my worst-case-scenario brain assumes my luck will now be bad and that I will really struggle, lose all my hair, not be able to work, etc. Unhelpfully, although they can speak in averages, no one can predict how anyone will react to chemo. So just...wait. As usual.

To join the study, of course, there are a great many hoops all of which involve trips to Philly. I had a biopsy yesterday (Wednesday) and am spending tomorrow (Friday) getting CT and bone scans. There was an ongoing fight with my insurance company today when I got a phone call first thing in the morning telling me that they had canceled tomorrow's CTs because I didn't have authorization. Without authorization, no CT. Without a CT, no joining the study. Without joining the study, no starting chemo on time (lots of rearranging of my work and ride/support schedule). Lucky for me, my doctor's office was the one to do the calling and arguing. But it's frankly absurd to deny authorization for a CT scan to a documented Stage 4 cancer patient. I cannot even imagine what further information they would need for that one. And if I hadn't been joining a trial there would have been no rush and, likely, I would have been the one calling. The amount of admin involved in being chronically ill is frankly staggering. The end result, luckily, is that I am going in tomorrow.

And that's why I must get to bed. I know I make it sound like swinging by the hospital for a biopsy is no big deal - it's an outpatient procedure with only local anesthetic! I ate Shake Shack afterwards and went to work today! But, in fact, it's stressful to the body as well as the spirit to be on an operating table, numbed up with local anesthetic, and pierced in the lymph node or breast by an ultrasound-guided needle ten times (because you are doing so many studies and they all need research samples). The scans tomorrow will be easier - all I have to do is not eat beforehand, drink barium, lie in an x-ray contraption while having contrast dye injected through the port that's plumbed into my artery...then take a break before being injected with a radioactive tracer that will infuse my bones for a couple hours until I lie perfectly still and have them imaged. Easy, right?

I like to say that this stuff is no big deal--that it's just a lot of waiting in different places. And that's true, to an extent. The CTs don't hurt and they aren't physically demanding (although I'm not great at drinking that much barium milkshake that fast). The bone scan is kind of cool and I plan to wear my "Biohazard" t-shirt. But my normalization of the massive apparatus surrounding being ill and my incorporation of it into my everyday life does, I think, minimize the physical as well as emotional toll I pay each time I have a test or treatment. Not only are those reminders of the insidious disease that has taken so much of my life from my control--I'm not even thinking about that consciously most of the time--it's just all so relentless. There's always another call to make, appointment to keep, symptom to track, bill to pay, person to text or call. I am never, ever done.

On that last item, I do often feel burdened with guilt. I want support, but don't feel that I can always pay it back in the form of updates or thanks to those who so generously give it. But I do hope you all know that I'm here, appreciating each and every piece of it that I get. Social media may not be great for some things but it is wonderful for the small kindnesses that can buoy me up on a tougher day. This has been one, so I'm off to bed. But I send you gratitude and love.

Bex

[desperationandgin]

Deep as the Road is Long (Part II, Chapter 16)

Rating: General Audiences

Also Read on: AO3

Previous Chapter

A/N: Surprise! A bonus chapter. I realize I haven't gone through and replied to anyone's comments for the last chapter that was posted. I need to and I will, but in the meantime, I wanted to offer a chapter early as my sincere and heartfelt gratitude. The feedback has been passionate all the way around regarding this story whether readers have been frustrated with Jamie, sad for him (sad for both of them) or firmly on Claire's side. I know I've said this before, but I really didn't think anyone would ever read a story with this specific subject matter; I was just writing it for me. So, I'm really touched and floored at the reception of it all. Here's hoping I stick the landing, and here's to goodbye to Part 2! 

Thank you all so, so much from the bottom of my heart. Part 3 begins on Thursday.

December 2016

When the monitors began to pick up the rhythm in which they beeped, when Faith’s breathing changed, Claire knew. She’d yelled, that much she remembers, the screaming for Jamie, for someone to find him. Without thinking, she’d climbed right onto the bed with the little girl, reached out to touch her cheek, to beg her not to go, not yet. There were no life-saving measures performed; that hurdle and those signatures from Jamie to not resuscitate had been taken care of two weeks ago. And so, all Claire could do was hold Faith as she took her final breath, unable to process that it happened, that she was gone. The only sound was the single tone until Jamie thundered in, looking like a complete mad man, eyes wild as he took in the scene in front of him. Never in her life had she felt so much like nothing, trying to apologize while cradling his dead daughter.

Eventually, she’d moved so that he could take over, pulling Faith to his body and crying in a way that was so loud and so guttural Claire thought he might die, too. In the immediate days afterward, she tried telling herself she’d lost patients before, that she’d been the witness to more parents’ tears of agony than she could remember, but even with that thought, she knew this was different. Different because she’d started to fall in love with Jamie and she already loved Faith. The pain, at that time, was unmatched by anything she’d ever felt in her life. Even her husband’s death. When the police notified her of Frank’s accident she’d felt numb, felt nothing for such a long time. When it happened, she couldn’t imagine anything that would ever feel worse.

She learned after Faith’s funeral, there’s always a worse.

She’d been able to feel it, the shift between her and Jamie. Claire knew it was only a matter of time before he told her to go. To his credit, he never said that, exactly.

Your best wasna good enough.

When he said it she’d known he was right; the rest of the fight (could she even call it that?) was a blur to her, registering his words and letting them settle on her heart. After getting on the plane back home, she’d cried (her poor seatmate) until the flight attendant brought whisky minis and an extra pillow. Sleep for the duration of the flight was fitful, but once she was home she’d collapsed in bed and hadn’t moved for twelve hours. The harsh light of day only served to bring into focus what she couldn’t do anymore: treat terminally ill children. Not until Faith died in her arms did Claire realize how many devastating moments she had already been witness to, and couldn’t bear the idea of going through more. She hadn’t stopped second-guessing herself, wondering if she’d done the right thing, if the treatment had been the right course. For an entire day, she’d pored over Faith’s chart and all of her medical records; it did nothing to help, nothing to ease Claire’s mind. She should have recommended surgery or donor stem-cells; anything but what she’d done.

The doubt hadn’t left by the time she returned to work and she knew the second she stepped foot in her office that this branch of medicine wasn’t something she could physically do anymore. That was the day she spoke to her direct superior and decided to take a leave of absence at the hospital, knowing upon her return (if she returned) it wouldn’t be to that wing. All of her current patients and courses of treatment were explained and passed on to the only doctor she knew would give the same level of care - Joe Abernathy. He was a good man, and as they’d hugged, he’d kissed the side of her head, knowing (even if he didn’t know) this last death had done a number on her. With one more sweep of her office, Claire’d left, gone home, and hadn’t returned. She’d always been good with money; it was the one thing her Uncle Lamb had never worried over in regards to her well-being. She had the rest of Lamb’s money to live on for a while, everything she’d inherited when he died, along with Frank’s life insurance money. All she’d done with the latter was pay for the funeral, everything else has been in a savings account, waiting for the day it could be put to good use.

June was spent doing as little as possible, not letting herself drink anymore but not doing much else in the self-care department. Tears seemed to turn on like a switch being flipped; dinner one night was pizza ordered in, and all it’d done was make her sob for two hours before going to bed without eating a single slice.

In July, she decided she wasn’t ready, that going to work wasn’t something she could stomach yet, and so she’d turned in her phone, the phone that technically belonged to the hospital. When she’d finally made the decision to replace it she was asked if all of her contacts should be imported to her new device, if her photos should be. With hesitation, she’d finally said yes to keeping everything; photos of Faith and Jamie. Jamie’s number. She’d kept it all even though looking at the pictures did nothing but hurt.

Finally, in August, Claire knew she couldn’t avoid making an income again, and so she’d applied for and accepted a job as a general practitioner in a pediatrician’s office. Sore throats and objects stuffed in noses, healthy babies at normal checkups, that’s what she could handle. It worked out, it eased her mind, and slowly she fell into a routine again that was hardly living. She existed in the world, and it would have to be enough. She wasn’t making decisions anyone put all of their hope into, she didn’t have to watch anyone suffer because she did something wrong. Weeks passed; she went to work, saw her patients, and went home. Forgiving herself was slow going, but eventually, the pressure in her chest eased just a little.

And then Jamie called.

It was early on an October morning; Fridays the doctor’s office was closed, so she was home when his name flashed on her caller ID. Jesus H. Christ. Mostly, she’d listened after she picked up. His words registered, that he didn’t truly blame her, but the way he’d looked at her when he said it--he’d meant it then. Maybe he didn’t believe it anymore, but he had then. She heard him say she hadn’t let him down around the same time she’d started to cry. He promised to call again, and he had. He’d called the next day, then the next. Sometimes they didn’t say much, just sat on the line with static between them. Other times they spoke in circles around Faith, not saying her name, but remembering.

By the time December rolls around, they’ve spoken every single night since late October, never missing, even if the conversations are short. They FaceTime every now and again, and when her phone rings today, she can see it’s for video. Looking at herself in her phone camera she groans at hair that’s a mess piled on top of her head, the reading glasses she’s wearing and the ratty t-shirt with holes she has on. He’s caught her cleaning, but still, she accepts the call.

“Good morning,” she greets him, holding the phone out. She has to puzzle out what’s filling the screen on his end, tilting her head from side to side before giving up. “What am I looking at?”

Jamie’s face finally comes into view and he sits back. She recognizes the room he’s in, the library at Lallybroch with all of its old books and secrets. “Afternoon, technically,” he corrects for his own time zone. Then, he shows her the book she’d had an extreme close-up of. “I’ve been going through the books, trying to make some sort of catalog so we know what we have,” he explains. “And this one, well. I thought perhaps ye might like it as a gift.”

She can see the author is e.e. cummings and raises an eyebrow. “A gift for me, really?”

“Aye. Because it’s an original edition.”

That gets her full attention, and Claire frowns in disbelief. “Jamie, why would you give that to me? You should keep it. That has to be valuable, or at least mean something to your family.”

He makes a noise in the back of his throat. “I thought that, until I started to read and--” he pauses, looking down at the book in his hand now, swallowing.

“What, Jamie?”

There’s quiet for a few beats before his gaze meets the camera again. “I started to read it and everything reminded me of ye. So, I thought the book should belong to you instead.”

A lump feels lodged in her throat and when she finds her words again, they’re quietly spoken. “Which poems?”

“Och, Christ, dinna ask me that,” he says in a rare show of, well. Not quite embarrassment, even though his cheeks do turn a little pink.

“I can’t take something from your home without knowing.”

There’s a long pause before finally, he opens the book and simply begins to read. She doesn’t recognize the words, but his voice and soothing lilt make her heart, for the first time in months, unclench a bit.

“My blood approves and kisses are a better fate than wisdom. Lady, I swear by all the flowers. Don’t cry--the best gesture of my brain is less than your eyelids’ flutter which says we are for each other. Then laugh, leaning back in my arms. For life’s not a paragraph. And death, I think, is no parenthesis.”

By the time he finishes there are tears threatening to fall from her eyes, and she takes a deep breath, sniffling and brushing any moisture away. “Reminded you of me?” she reiterates.

“I want ye to have it. And perhaps ye could come get it.”

She isn’t sure of what he said, still too wrapped up in the poem. When it registers, she furrows her forehead. “Come and get it?”

Jamie clears his throat, quiet as he waits for it to sink it.

When it does, Claire’s eyes go wide. The last time she’d been to Scotland it changed everything she thought she knew about her life. “You want me to come there?”

“Aye, I do. But if ye canna do it, if I ruined it, if I...what I’m trying to say, Sassenach, is that I dinna want ye to be alone for Christmas. Everyone here would be glad to see ye.”

“You...you would be glad to see me?”

Jamie nods, his gaze intent. “I shouldn’t have let ye leave the first time.”

He’s apologized so many times, tried to make it right, what he’d said, what he’d done. She believes him now when he says she did her best, when he tells her that he knows there was nothing else she could have done. It doesn’t inspire her to pick up where she left off, though. She’s happier now, content to answer the questions of first-time parents and assure them they’re doing just fine. Still, even with forgiveness, she never thought Jamie would ask her back to Scotland, that they would ever share the same space again. She hears herself saying she’ll come, though as she lays in bed that night after purchasing a plane ticket, she can’t quite believe it.

She’d tried, a little more than a year ago now, to wrap her mind around her feelings for Jamie; the attraction was there, no doubt. Now as she lays in bed, she wonders if they fell into one another because he was sad and she took advantage of him as he sought some sort of anchor. If she hadn’t done exactly that, then was Faith the only link between them? Without her, and with her death leaving such a large hole in both of them, would there be anything left with Jamie to salvage? This trip, she knows, will give them both the answer either way.

When she arrives and makes it down to baggage claim she sees him right away; he’s hard to miss, giant that he is. Making her way to him, there’s a moment of not being sure whether or not to hug him before his arms wrap fully around her.

It’s the best she’s felt since February.

“It’s good to see ye, Claire. In person, I mean.”

When he pulls back she immediately feels bereft, but there’s a small smile playing on her lips. “It’s good to see you, Jamie. You look well.”

He walks with her to get her bag, turning his gaze to her. “Speaking of looking well. Were those glasses in the video last we spoke?”

Grabbing her suitcase, she raises an eyebrow. “They were. For reading. I had to bite that particular bullet in September.”

“I havena seen ye wearing them before,” he says, wracking his brain and going through every FaceTime conversation they’ve had since October.

“I never happened to be wearing them. The other day I was cleaning, going through bills and organizing paperwork.”

“Ye should do more paperwork when I call,” he teases lightly, taking her bag from her to carry.

He liked her glasses, and Claire ducks her head a little as she walks behind him a bit, letting him lead the way to his car. It’s still there, she thinks. Whatever it was, the embers are still warm. She remembers how he made her feel, what the guilt was like when he’d told her it was her fault and hers alone that Faith was gone. It doesn’t go away with smiles and conversation, but he is trying to fix it. Day by day, he tries to add another suture to the wound he made. She knows he’s trying, knows he sees a therapist twice a week. He’s trying, and rather than shut him out, her heart tells her not to give up on Jamie.

At Lallybroch, that same sense of family she felt the first time she ever stepped inside envelops her now. It makes her feel connected to something, close to people who’d treated her like family. Instead of Jenny needing to warm up to her, Jamie’s sister greets her like an old friend with a hug, Ian replicating the gesture. The children dogpile her as well; even young Michael who was so small back in May offers her grins and lets her hold him on her hip as they walk to the living room. Claire hadn’t been sure what to expect; everyone still in mourning, maybe because she felt that way for a long while. But there are so many smiles and so much lightness that a peace she’s never been able to find on her own settles against her like a blanket.

This is what healing with family does, and she suddenly, desperately, never wants to let it go.

Instead of staying in Jamie’s room, this time she has her own, and she crashes almost immediately, sleeping through until breakfast the next day. She lets the chatter of family around a table wash over her, and on a walk with Jamie afterward, confesses to him she’s never had that.

Somewhere between the house and the stables, Jamie stops walking, turning to look at her fully before lowering his head. Tentatively, his hand reaches out, index finger hooking around hers. “I ken ye’ve been alone for a verra long time, Claire. I’ve been waiting to say this, was hoping to do it face to face, but…” When he looks at her again, meets her eyes, his own look like a raging sea. “I left ye to go toe-to-toe wi’ the grief alone. I pushed ye away and sent ye home to nothing. That ye found your way out of the dark anyway is a miracle. It took Jenny and Ian both to get me there. So it leaves me to believe one thing about ye.” Raising her hand, he kisses her knuckles before finally letting her go. “You’re stronger than I am, Sassenach.”

There’s a lump in her throat that she can’t quite swallow, and she shakes her head, wrapping her arms around herself. “I’m still in the dark, Jamie. Or at least the shadows. I don’t know anymore.”

“And that’s my fault,” he tells her; not a question. An acceptance. “I’m no’ sure why you're even bothering to give me the time of day, truth be told. I never expected ye to answer the phone when I called, or to keep doing so after the first time we spoke. I can never do or say enough to make what I said right.”

“I changed my entire life because of what you said to me, Jamie.”

“Claire, I--”

“No. No, I need to say this. I need to talk now.” She has no idea where that comes from, but he respects it, and once he nods for her to continue, Claire clears her throat. “I changed my life. I couldn’t stop second-guessing myself, I couldn’t...stop questioning every decision I was making about treatment plans, which meant I couldn’t do my job. And that was your fault.”

His head bows but he doesn’t interrupt.

“It was also your fault that I started thinking about all of the times I might have to go through this again. In my job, the ideal, obviously, is to beat cancer, and I have before. I know I would have again. But one more loss like that...I don’t think I could do it. I don’t think I could go through it and make it to the other side a second time. So, it’s your fault I realized I need to do something different. I need to see the joys of life through a child, not fear and pain and sadness.”

Jamie steps forward when Claire stops speaking, tentatively reaching up to stroke her cheek with his thumb. It’s a light touch, hovering almost. “I hurt ye. And no matter what revelations came of it, that will no’ change. I would spend the rest of my life making it up to ye if I could. If ye’d let me.”

Claire looks at up him, bringing a hand to rest over his that’s still tucked close to her face. “Faith brought us together, Jamie.”

“Aye,” he whispers, slowly moving until his forehead can press against Claire’s. “I will no’ let her be the reason we’re apart. Stay in Scotland. Stay for a while until the darkness is gone and there are no more shadows.”

For a moment her eyes close and all she can do is breathe him in. But she feels herself nodding, nose grazing his.

“Wild horses couldn’t keep me away.”

Through the darkness to the dawn And when I looked back, you were gone. Heard your voice leading me on Through the darkness to the dawn. Love is deep as the road is long And it moves my feet to carry on. It beats my heart when you are gone. Love is deep as the road is long.

Next Chapter

[somethingjustsouthofbrilliance]

Heartsick (chapter 3)

@tonystark5ever and I are back with a new chapter. Finally. Progress :D

Tagging a few folks here. If I forgot somebody, pls, let me know. 

@i-fucking-love-the-avengers @random-fandom-stuffdom @keltainen13 @giulisetta @bad-days-and-beautiful-nights @ashleymarie1684 @itsafandomaddict @konoriart @swanheart69 @almhw85

Link to chapter 1 (masterlist)

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

Chapter Three

“Dr. Rhodes?”

A young voice, quiet and unsure, pulls his attention away from Stark’s retreating back, stopping short his intention to follow after the man.

He turns, frowning slightly at the skinny, curly-haired teen that stands behind him, fiddling nervously with the line of his IV pole.

“I’m… I’m… I’m Peter.  Peter Parker.”

Rhodey feels his lips twitch into a smile despite his unpleasant mood.  “Ah, yes, Mr. Parker. I had the pleasure of listening to you play just now.” He nods toward the room the teen has recently vacated. “Very impressive.” And it had been, the bit he’d heard.

His grin widens as the teen ducks his head at the praise, the tips of his ears flushing pink.  Adorable, Rhodey thinks, amused, and feels the uncomfortable sting of anger at the idea of Tony Stark doing anything that might put the kid in harm’s way. “What can I do for you?”

“I...uh….” Peter starts fidgeting with the IV pole again; throws a hesitant glance at Rhodey’s face.  “I heard your argument with Mr. Stark just now and…”

“I see.” His mood sours instantly; Tony Stark is the last thing he wants to talk about with this kid. He frowns, waiting for the boy to continue with whatever was on his mind.

“You need to get him to hire you back!”

The unexpected nature of the request and the heat of the conviction behind it bring him up short.

“What?”

“I… I mean….” Peter takes a step back, flustered, his gaze dropping back down to the floor.  “Mr. Stark, he’s… he’s a really good guy.  He… he takes care of everyone around him, but he doesn’t really… he doesn’t let others take care of him.” The kid looks up again, brown eyes intent. “And he needs to,” he insists heatedly.  “Especially now. His heart-”

“You’re defending him…” Rhodey can’t quite hide the incredulity coloring his voice.  “Even after what he’s done to you. Taking your place in line?” he adds at the puzzled expression on Peter’s face.

The teen’s expression darkens, his large brown eyes hardening in clear disapproval. “That was my decision,” he says mulishly.  “Mine and my aunt’s. We came to Ms. Potts when we found out from Tony that things were getting worse. We made her agree not to tell him, as a matter of patient confidentiality. He was never supposed to find out about it.”

“Is that so?” Somehow Rhodey had assumed that Peter and his aunt had been kept in the dark. The fact the kid knew about it almost made it worse. “And why is that?”

“Because he never would have allowed it if he knew.” Peter shakes his head, heaving out a dejected sigh before he plops tiredly onto the nearby bench. “I just wanted to help him. I wanted… and now, because it’s me, because he knows it’s me, he won’t…” The teen trails off, eyes momentarily squeezed shut; wraps his fingers around the IV pole in a white-knuckled grip.  When he looks up again, the desperate intensity of his stare nearly forces Rhodey to take a step back.  

“I wouldn’t even have a place in line if it weren’t for Mr. Stark. He is the reason I have a chance to live, Dr. Rhodes! And I… I can’t be the reason he loses his!”

And that right there? Definitely not what Rhodey was expecting to hear.  He frowns down at the earnest, wide-eyed gaze that meets his; bites his lip at the guilt-tinged despair he sees there.  

“Alright, kid.” He knows he’s already given in; doubts there’s anyone alive out there who can stay strong in the face of these imploring puppy eyes.  He just really hopes he doesn’t come to regret this later. “There’s a couple things I need to get straight, and I think you’re the one to help me.”

“What do you mean?”

“How about you tell me all about Tony Stark over a cup of hot cocoa, huh? Start with why you think you owe him your place on the organ recipient list.”

Peter watches him silently for a few moments, his expression wary. Nods, his curls flopping over his forehead. “Okay.”

***

They settle on a bench outside some ten minutes later, Peter cradling a cup of chocolate ice cream he opted for instead of hot cocoa. It’s nice and quiet out here, the air pleasant, tinged with a mild spring morning chill, and Rhodey finds himself relaxing just a bit, letting go of the angry tension he’d been carrying around since daybreak.

“Thanks Dr. Rhodes,” Peter speaks up beside him, poking hesitantly at the mound of chocolate in his cup. “Dr. Banner told me to try and beef up my calorie intake since I can’t eat much.”

“Well, I hope you enjoy it,” Rhodey responds, smiling encouragingly as the teen scoops up his first spoonful.  Urges mildly, “Whenever you’re ready, Peter.” He doesn’t want to push the boy, but time isn’t exactly a luxury he has to waste.

Peter’s expression darkens, the second spoonful dropped half-heartedly back into the cup.   “I’m… I’m not supposed to tell anyone about this. I could get in big trouble, but even worse Mr. Stark could get in big trouble. I had to sign some huge non-disclosure agreements, there were lawyers there and everything, it was crazy. If anyone ever found out I told you, then they could sue Mr. Stark and he could even go to jail.” He shoots Rhodey a slightly anxious, pleading look. “So… you… you won’t tell anyone, right Dr. Rhodes?”

“I won’t tell anyone,” Rhodey agrees, his curiosity piqued.

“No, no, I need-- you have to understand. No one can know.”

“Peter. I promise. On my word as a doctor, doctor-patient confidentiality, do no harm, Hippocratic oath. I won’t tell anyone.”

This seems finally enough to reassure Peter and he leans forward, a frown of worry on his face that speaks of a lot of fear and anxiety… more than he would expect for one so young. “Okay, well. It all happened about two years ago. The hospital was losing money, all the political stuff going on right? So they hired a consulting company to come and make it profitable again. You have to understand, there were talks of closing the doors.”

“Right,” Rhodey nods his understanding. He’s not surprised, even given the hospital’s reputation for excellent care; healthcare in general was facing a major crisis and there were systems all over the world taking the same kind of steps in order to keep their doors open.

“So the first thing they do is fire all the administrative people here,” Peter goes on, ice cream forgotten. “Let them go with severance only. I remember it a little bit because the nurses and doctors were in a huge uproar about it, it wasn’t pretty.”

“I’ll bet!”

“Well yeah. So they hire this new guy, Thaddeus Ross.”

Somehow Rhodey thinks the shudder that goes through Peter at the mention of that name has little to do with the morning chill.

“Ross… Yeah, I’ve heard of him. He did some great things for that hospital system in Orlando.”

Peter scoffs. “Wherever you heard about that, I’ll bet it didn’t mention a body count,” he counters darkly.

“No… it didn’t as a matter of fact.”

“Well, I can practically guarantee you that there was one. Because Ross doesn’t come in and fix things, he comes in and he cuts corners. First thing he did after firing the administrators was fire all the experienced nurses and techs. Forced some of the higher paid doctors into early retirement -- claimed their judgement would be called into question and their malpractice insurance would go up, that kind of thing.”

“Peter,” Rhodey cuts in, trying, rather unsuccessfully, to keep the skepticism from his voice, “even if that were true, how could you possibly know about it?”

“Because I’m one of the schmucks that almost got killed!”

“Oh…” He pulls back, stunned silent by the teen’s outburst.  Motions for him to continue.

Peter nods grudgingly, huddles in on himself.  “I was born with hypoplastic left heart syndrome and had, like, three surgeries when I was a baby and all that. I was doing good, real good, until a year ago I got bit by a spider. So like, not normally a big deal, but for me it was. I got super sick. But Dr. Banner… he’s my cardiologist, right? He found a treatment, and it seemed like a miracle because there was nothing anyone else could do. I mean… it was a miracle. Only the drug I was on was crazy expensive, like $20,000 a dose.”

Rhodey lets out a low whistle and Peter huffs angrily in response.

“I have to take it every three months for three years,” he says, nodding toward his IV bag. “Obviously, there was no way for us to afford it. Our insurance wouldn’t cover it because it’s technically not even approved by the FDA. So the hospital was writing it off. You know. They were using it as a charitable donation, which means it technically doesn’t cost them anything because they get the money back in tax credits and government payouts. Only...” Peter falters, a muscle in his jaw twitching.  “Only they weren’t making money off it.” He gives a vicious stab at his now mostly-melted ice cream before hurling the cup into the garbage can with a bit more energy than was strictly necessary.

“Right.” Rhodey can already see where this is heading, and he feels his own fingers itch with the urge to curl into fists. Money. Of course. Of-fucking course! Everything always comes back to money. It was one of the reasons why he’d gone into medicine, to do something about this kind of thing, to do surgery for the right reasons and not to make a buck.

“Yeah! Right!!” The teen slaps his hand palm down on the bench, agitated. “I mean, can you believe I had the audacity to exist and want to live and not have a disease that the hospital could benefit from? Ross came through and he eliminated most of those programs. The ones that helped people.”

“Why don’t people know about it?” Rhodey interjects. “Why wasn’t any of this on the news?”

“Oh it was.” The sharp bitterness in the teen’s voice surprises Rhodey. For as broken, small, and sick as the kid appeared, he had clearly developed quite the backbone.  “The headlines were ‘Local CEO Turns Failing Local Hospital into Model of Health Care Efficiency.’ He’s a jerk but he’s not an idiot! Dr. Banner did what he could but they were threatening his license. There were a couple of assault charges thrown around when Dr. Banner got really mad during a meeting and punched the guy. Satisfying, right? Except now he was suspended and I was getting sicker and sicker because no medicine. And this is the only pediatric cardiac hospital in three states that’s able to deal with my problems. We were looking at moving to Colorado but I was too sick and May, my aunt, had been out of work to take care of me so no money. I was…”

There’s a suspicious hitch in the teen’s voice, his breath coming a little harsh, a little fast. He shakes his head viciously, swipes irritably at his cheeks where thin trails of tears cut a path across anger-flushed skin.

“I was so tired,” he admits in a whisper, “I wished I could just die and get it over with!”

“Okay,” Rhodey exhales past the stunned horror of the teen’s admission, “okay.” Reaches out haltingly to put a soothing a hand on the kid’s trembling shoulder. “Do you… uh… do you need a break from this?”

“No.” It takes him a few moments, but Peter swallows down his emotions; manages to steady himself. “Sorry. It was just… it was hard. I hated it. I was sick and things were getting so much worse. It was hard to see these things taking their toll on May.”

Rhodey gives the boy’s shoulder one last squeeze before letting his hand fall away.  “I imagine she must have been pretty upset.”

“Upset doesn’t even begin to describe it,” Peter scoffs.  “She was furious. And she wasn’t taking it sitting down either. She was calling our legislators, trying to see about the legalities, but we weren’t having any luck. She tried to go after him directly, you know, suing him for medical malpractice. Failure to treat. Medical neglect.” He shrugs, exhaustion written into every line of his body.  

“Like I said, it got ugly.  And here I am… dying because my heart is failing, and I get sick on top of it and it’s looking like the end for me. They start talking about hospice and making me comfortable, but I’m in the ICU in the meantime…”

“What happened?” Rhodey prods cautiously, afraid to push too hard because the kid is a walking war wound and it feels like even the slightest amount of pressure could cause him to bleed out.

Peter blinks as though coming out of a trance, his expression softening, pale lips pulling into a small smile. “Tony Stark happened,” he murmurs, sounding simultaneously awed and fond. “He got admitted the same time as me, just on the adult side, and he was being monitored because he was on some weird drug that was giving him trouble, but he was not so sick as me. He bumped into May in the hallway one time, and they got to know each other a bit. They had a lot in common, you know? Going through all this. Tony, see, he wanted to help, he offered to pay for everything. And May, she was real thankful and she wanted to take him up on it, but the thing is? Ross could just turn around and do it again to some other kid and their family. May said if it happened again it was because of them not fighting so she wanted to keep pushing on.”

Rhodey shakes his head, a bit conflicted. On the one hand there’s an already familiar flare of annoyance at Tony Stark, whose answer to everything seems to be to throw money at it.  Yet on the other - it was a hell of a thing for him to offer to do for someone he had just met.

He also can’t help but admire May Parker’s bravery and tenacity. To go up against the hospital with all of its money and its fancy lawyers all on her own? That took guts.

“One night, Ross himself comes by and says he has a court order to withdraw treatment on my case.”

Lost in thought, it takes Rhodey a moment to realize that the kid is talking again, and once the actual meaning of the words registers, he feels himself grow cold all over. “What??”

“Yeah.” Peter swallows hard several times, a bitter smile twisting his lips. “See… what he’s done is… he’s accused May of child abuse. For doing all these expensive treatments and prolonging my life. He got all these doctors to say that it wasn’t in my best interest, it was causing pain and suffering. He had all these records that showed it was harming me and wouldn’t save my life in the end and he said a third party should be asked to make medical decisions on my behalf. Basically, Ross made it so the government had medical decision-making power over my course of treatment.”

Rhodey sits back, stunned silent once again. He knows there are certain laws for that kind of thing, but they are meant to protect kids from abusive parents, who use medical diagnosis to harm their kids-- Munchausen by Proxy, that kind of thing. He can’t believe anyone would do what Peter’s describing.  It’s… it’s... unconscionable!

“Ross and May get into a big fight, and May… she’s in tears, alright? I hadn’t seen her like that since my uncle died. She starts pleading with him.  Promises to back down if Ross doesn’t withdraw treatment. Says she’ll stop the lawsuits and the push to get the laws changed - drop the whole thing just… just to keep me going.” Peter grits his teeth, his breath hitching once again.  “Ross was in my room, see,” he continues, voice tight with barely controlled emotions.  “He didn’t want anyone witnessing what he was doing, and he’s right in her face, laughing at her tears. And I’m… I’m just lying there like a rag doll, useless!”  

Peter’s face screws up as if in pain, eyes squeezing shut, and Rhodey can’t help reaching for the teen once more; lays a gentle hand on his back.  Peter nods in mute thanks; breathes, slow and deep, in an attempt to calm down, in and out, in and out.

“And then Mr. Stark walks into the room, out of nowhere,” he continues, hoarse, “with like three lawyers in tow. I don’t know who called him or how he got there so fast, I don’t know any of that. He’s just there, looking like a king even in a hospital gown, you know? The lawyers, they’re talking fast, serving Ross with all kinds of notices and cease and desist orders, and there’s even…”

Peter’s voice chokes up a little, and he fists his hands around the edge of the bench, white-knuckled fingers digging in.

“There’s even a restraining order, so he has to leave us alone. He can’t say anything to May or me, not ever again. And he never… he never does. Ross never has talked to us again.  And I start getting my medicine. Because of how sick I got without the medicine, I was moved way up on the list, but then thanks to Mr. Stark, I’m okay now. I’m good to wait. It’s actually good for me to wait, to get stronger, let this medicine heal my body.”

He turns, his gaze boring into Rhodey, intent, pleading.  “But Mr. Stark, he… Dr. Rhodes, he can’t wait anymore. He passes the rope again, he, maybe, won’t be around when a chance comes back up again. That’s why… that’s why we went to Ms. Potts about giving him my spot.”

Rhodey nods grimly, digesting that information.  “What about Dr. Hammer?” he wants to know.  “He did the surgery on Mr. Stark, didn’t he? How did that--”

He trails off, taken aback by the abrupt shift in the teen’s expression.  Peter’s whole face darkens, lips twisting into an ugly, bitter grimace.

“Hammer’s a hack,” he spits out with such venom that it leaves Rhodey gaping at him in frank surprise.  “He botched that surgery.  On purpose probably, too, I’m willing to bet!”

“Come on, Peter…” Rhodey shakes his head in disbelief, because an accusation like that? It’s utterly ridiculous!

“Ross threatened Mr. Stark, did I tell you that?” the teen cuts in as though Rhodey hasn’t spoken.  “When they were arguing in my room, when Mr. Stark told him to get out? Just before he left, he pinned Mr. Stark against the wall and he told him, told him Mr. Stark would regret doing this.  And you know what the last thing he did before leaving the hospital for good?”

“He assigned Dr. Hammer to do the surgery,” Rhodey guesses, feeling a horrible numbness spread forth within his chest. “But… why?”

“Hammer’s a butcher,” Peter sneers, voice dark with resentment, “everyone knows that.  He only ever got to be a surgeon thanks to his daddy’s money and Ross’s influence.  He never should have… he never should have gone anywhere near Mr. Stark.”

“He… I heard the nurses talk after. Hammer ignored the warning on Mr. Stark’s chart; gave him a drug that should never have been combined with the medicine Mr. Stark was taking.  Nearly killed him right on the operating table. It’s what… it’s what’s killing him now!”

The teen grits his teeth; drops his gaze to where his hands are clasped impossibly tight in his lap.  “I visited him the day after his surgery.  He looked… he…  I’ve never seen him look so bad.  Like… like death.  And he was in pain.  He was trying to hide it, but I could tell.”  He looks up again, his face twisting in anguish.  “He’s dying, Dr. Rhodes. And there’s no one who can help him but you.  Miss Potts, she told me, she said you’re the best in the field.  That’s why I told her to take my spot, so you could… so you could save him. And then I hear he fired you, Dr. Rhodes, and I don’t… I don’t know what to do.”

He looks at Rhodey with such raw, open worry that Rhodey wonders if he’s ever felt worse in his entire life, as if he’d kicked a puppy or pulled the wings off a butterfly. Killed a mockingbird, all that. Guilt and shame spread through his chest with hot prickles, as well as a burgeoning fear that he’d done something irrevocably foolish. He’d just thrown away the one chance he had to save someone… someone who is, despite what he’s been initially led to believe, utterly worth saving.

At the same time, he’s not sure how much he can rely on the opinion of a child, much less one so obviously emotionally compromised. There’s a chance that Stark had manipulated him, he hates to think it but it is a fact. People do... desperate things when they are desperate.

But Peter seems so damned earnest.

“Peter. I… I didn’t know any of that,” he manages finally -- as close to “I’m sorry” as he can get.

Peter nods gravely, brown eyes boring into Rhodey’s, dark, urgent. “I know, sir. I know. But… the thing is. Now you do. So what are you going to do about it?”

***

He doesn’t mean to eavesdrop, he really doesn’t.  He went looking for Pepper after he dropped the Parker kid back in his room, and he will honestly blame his conversation with the teen - the conversation that left him so thoroughly shaken and off his game that he doesn’t become aware of his surroundings until he nearly collides with a group of interns that huddle in an oddly conspiratorial-looking clique in the middle of the hallway in front of Pepper’s office. It is only then that he snaps back to the here and now.  It is only then that he becomes aware of the raised voices coming from behind the closed office door, and of the awkward glances the interns are throwing each other as they wait for Rhodey’s reaction.

“I refuse to allow it, Tony!” Pepper’s voice rages from behind closed doors, and Rhodey can see through the haphazardly open blinds as she paces angrily in her spacious office.  “I can have you blue slipped!”

“A psychiatric hold, really?” Stark sounds peeved, his temper from earlier having escalated even further. “Don’t think I won’t sue you if you pull that crap, Potts! My lawyers are faster and smarter than your corporate lackeys. I’m not your hostage or your science experiment and you agreed, you agreed! I say when I’m done. And I’m done!”

“Well I take it back! You can’t do this! I won’t let you!”

Pepper is shouting now, her voice - a heart-rending mix of anger and despair, and Rhodey doesn’t even have to pretend not to overhear them now. Everyone in the vicinity can hear their argument, and the interns once again begin talking in low voices to each other, flicking awkward glances in the direction of the office.

Rhodey has had enough.  Calling on his most authoritative tone, he shoos the interns back to work.  Waits a few beats as he watches them disperse, chastised, and then marches determinedly toward the office, trying his best to ignore the angry rise of Stark’s voice.

His ears register an abrupt, almost choked-off cessation of Stark’s response just as his fingers curl around the door handle, followed by a clatter of office supplies being knocked off the desk and a heavy thud of a body hitting the ground. Alarmed now, he yanks open the door and freezes, just out of their line of sight, struck momentarily dumb by the scene that opens before him.

Stark sits on the floor, slumped gracelessly against the desk, his legs splayed out before him. His eyes are closed, ashen face pinched in pain, his trembling left hand tugging unsuccessfully at something inside the pocket of his pajama pants.  

Pepper is kneeling before him, wide-eyed and almost as alarmingly pale as Stark himself, one hand resting on his rapidly heaving chest, the other gently pushing Stark’s hand out of the way to take out what the former has been so desperately trying to reach.

A bottle of pills.

Odd, Rhodey thinks, squinting as he tries to make out the label.  Because he doesn’t remember seeing any mention of any specific pills in Stark’s chart.  And yet...

“How many of these did you take? Tony? How many?” The undeniable urgency in Pepper’s voice cuts off his train of thought, and Rhodey notes the undisguised worry on his boss’s face.

“Three,” Stark huffs out, barely audible, eyes still stubbornly closed.

Pepper pulls back, lips pressed together into a thin white line, the bottle clasped tight within her trembling fingers.

“You know that's not safe,” she says finally, sounding like she’s pleading with Stark.  “You know they're just supposed to give you time. They’re not a cure! Tony, these damage your heart if you take them too often, you know this! You know--”

“Yeah,” he cuts her off abruptly, pain-glazed brown eyes sliding open to stare back at her with tired defiance. “Yeah, I do know Pepper. I’m the one who helped develop the damn things. Mixing Palladium and Epinephrine, not in the usual bag of tricks. So yeah. I know.”  He nods weakly to the bottle almost completely hidden within her crushing grip.  “I need one now, though.  Please.”

She watches him a heartbeat longer; sucks in a quick, shuddered breath.  “Okay,” she concedes finally, carefully jiggling one out into her hand. “Okay, Tony, you win.”

Dejectedly she hands the pill over to him; stretches to get a bottle of water from her desk, while he pops the pill into his mouth.  Reaches out to support him as he drinks, washing down the pill. It takes another few minutes before he nods to her, shifting as though to get up, and she helps pull him to standing, careful, anxious, her hands lingering on his shoulder, as if unable or unwilling to let go.

“Please, Tony, please promise me you won’t take any more of these today,” she pleads, and there’s an uncharacteristically vulnerable note in her voice, one Rhodey has never heard before. “Just… just give me some time, I’ll sort this out somehow--”

Stark smiles in response, weary and almost apologetic.  Leans in to place a soft kiss on her cheek.  

“Okay. Time. Sure,” he agrees placatingly. “All I got is time, Pep, you can take all of it you need to.”

The words sound wrong somehow, coming out of his mouth, like their meaning is different, like Stark is saying goodbye. And Pepper must sense the same thing, for Rhodey sees her open her mouth in protest…

Stark shakes his head, presses a gentle finger against her lips, silencing her.  “We both knew it was a long shot, Pep. Part of the journey is the end, all that; I've been on borrowed time, I'm not about to borrow any of Peter's. We knew this doctor was a hail mary and it didn't work out. Let me leave, Pep. Okay? Just for a little bit.  I'll see you soon.”

Rhodey doesn’t stay to hear her response.  Steps back outside, letting the door close softly behind him.  Mere moments later the door creaks open again, and Stark walks out, shuffling slowly toward the elevators.  Rhodey watches him go, wondering briefly if he should go after him and stop him.  But there are things about him he still feels he needs to know, needs to understand.  So after a moment of hesitation he turns on his heel and pushes his way back into Pepper’s office before he can change his mind once more.

***

He finds Pepper seated back at her desk, face buried in her hands, shoulders trembling ever so slightly.  It’s an uncomfortable sight, to be sure, and he has half a mind to tuck tail and run, but she raises her head just then, a pair of tear-filled blue eyes pinning him firmly in place.

“Dr. Rhodes.” She straightens out, a professional mask slamming back into place.  “What can I do for you?”

And he flinches despite himself.  Because this is Pepper.  He’s known her for years, been a close colleague of hers for years.  And he has been “Jim” or “Rhodey” to her for nearly as long.  But the look in her eyes now is cold as ice - the same look he’s seen her level at those who dared cross her, and he finds it frankly terrifying to be on the receiving end of it.

Though, to be fair, he supposes he deserves it.

“I… I formed an opinion about a man based on the word of someone I don’t respect as a surgeon and barely tolerate as a human being,” he begins carefully, stepping closer to her desk, gauging her reaction.  “What I have seen until recently seemed to have confirmed that opinion for me.  And yet…”

“And yet?” Pepper prods, blue eyes narrowing in silent warning.

“I can’t help feeling that I’ve missed something,” he admits.  “A couple people pointed out to me that maybe I was wrong in my initial assessment.  That… that I should get a second opinion.”

He takes a deep breath, trying his best not to fidget under her steely glare.  Squares his jaw in quiet resolution.  

“So this is me,” he finishes softly, spreading his arms out to the sides, “asking for that second opinion.”

TBC

[mytransvoice]

Small update for 6/20/20:

I communicated with UCLA patient pre-registration and patient financing and was told that I won't find out if my insurance has been approved or denied until at least a couple days before my surgery and that the total payment is due at least 24 hours before my surgery day. So there's literally nothing I can do now but wait and hope UCLA is doing their job and working things out with my insurance.

This past week, I was sent an e-mail from UCLA with instructions to watch a video about anesthesia. I was also called yesterday by an anesthesiologist asking about my general health and any allergies and how the whole process will go on my surgery day. I guess I'll be getting a local anesthetic along with IV anesthesia, probably just to keep me relaxed during the procedure. All of this anesthesia preparation has helped me feel like the surgery is actually going to happen, but I still have my doubts. I'm still about 220% sure it's not going to happen and that I'll have to fly home without having had it done for some reason or another.

I've been working at the bar this past week, only 3-4 hours a day. Despite my shifts being so short, they've definitely been making each day drag on. It would've been nice to be able to laze around my apartment this whole week before my trip to California, but I knew I'd be scheduled to have this surgery the same week I'd be returning to work. Something inside me was saying it'd happen, just like how something inside me is saying this surgery isn't going to happen.

Will I turn out to be asymptomatic, or will my COVID test be a false-positive and I'll have to reschedule for another week/month/year? Will something else go wrong? Will I feel stupid for being so skeptical after everything goes just fine and I end up actually getting this surgery in 4 days? I don't know for certain. I do know that I WANT all of this to go off without a hitch. I want this surgery in 4 days. I've been waiting 5 years to experience my voice changing and I can't wait any longer.

Until next time.

[jenniez-tv]

Hello Everyone,

Its been awhile since I’ve updated you all on this. I had some people ask me when I was planning on updating. I didn’t realize you guys were still reading. <3 Thank you for caring. Anywho, its been about 3 months since I found out I was in remission/done with chemo. Every 3 months I have to get a CT scan, for the next 1-2 years. After that I don’t know how often I will need to. That means that I just got my first post remission CT scan. Man, I got to tell you, the week of the scheduled date I was so nervous the whole time worrying about it. The anxiety is no joke when it comes to getting it done and then having to wait for results. EEP. I got the scan done yesterday morning and I am not seeing my oncologist until Monday for a follow up and the results of the scan. I was not looking forward to worrying about the results all weekend. THANKFULLY though, my doctor who did my colectomy surgery read the results a couple hours after it was submitted and then called me directly to let me know! Ugh, I really do have the best doctors. It just feels amazing that they go out of the way to do a gesture that impacts the patient greatly! And... the results were that it looks the SAME aka still CANCER FREE!! Yay! Now I could finally breathe and enjoy the weekend!

Work wise - which many of you have asked.. I have started working again about 3 weeks ago. Now don’t go jumping for joy, its only 4hour shifts twice a week for now. It is also doing admin work, not direct patient care working on my L&D unit. Baby steps! (Ugh). I was the one that asked work and my doctor if I could go back to work. It just felt like my brain was melting away not being used. And it felt like I had no reason to get out of bed and do anything. It also felt like I wasn’t needed. Don’t get me wrong, I have so many limitations written by the doctors for what I can and cannot do at work because I still have so many side effects from chemo that I am still waiting (really impatiently now) to go away. - I will go over these in a minute. With work though, so far, so good. Slowly getting back into the routine and hoping to up my hours soon. I was told by multiple health care workers to stop trying to rush to go back to work and do this for like 6 months until I am due for another evaluation. I legit said.. I mean the only reason I want to work more is because who can live off of only working 8 hours a week?? Not me... I was BLESSED enough to get so many donations from so many people last year when I first found out I had cancer. But as you all know, all those doctor appointments, surgeries, chemo, etc is not cheap.. even with insurance. And of course I still had bills to pay monthly. So all the donated money is now depleted and I need money to pay my bills. Otherwise, I really wouldn’t rush into working my body that has just been through hell. Don’t worry though, I’m not jumping in and am really trying to be realistic. Plus, its not like I’ll get approved to go straight back in anyways even if I wanted lol. Honestly though, any suggestions? Oh and just for shits and giggles.. my very first day back working only 4 hours.. I went home and slept for 5 hours.. LOL

As for my side effects, I was told they would start going away after a few months (and now that its been a few months..) GO AWAY! I still have neuropathy - tingling, numbness, pain in my fingers and toes (which is also the most annoying one), fatigue, loss of balance, wonky ass emotions, chemo brain, umm.. I know I have a few more but I’m having trouble thinking of it. (Example of my stupid chemo brain winning). The neuropathy is worse during the winter because of the cold weather and ugh it is just so frustrating. Having trouble buttoning/zipping up my clothes/jackets, tying my shoelaces, holding/picking up stuff that’s cold, bending my fingers to grip and hold stuff.. you get the picture. Its hard at work too because the office I am using is shared with 2 others. One of them likes it cold.. and her temperature of it feeling nice is my omg its freaking freezing!! My hands are so cold (even with hand warmers) that it becomes hard to type. My fingers legit get cold as soon as I stop holding the hand warmer. I also have a hand warmer that plugs into the computer but it doesn’t get my fingers =\. I think i need to buy a small portable personal heater that goes on my desk and it pointed right at my fingers or something. =[. I was told if i still have neuropathy after a year it may never go away. Thankfully, I think it is a little better than before when I was still on chemo. So I’m really hoping it will go away. *fingers crossed*.

I did start working out again! I’m only going about twice a week and I have to stop a lot because I’m nauseous, lightheaded, dizzy, and really fatigued. I have to use the lightest weights and do all the exercises slower. It’s annoying because its such a backtrack from where I was, but hey, at least I’m working out again right? That’s what I have to keep telling myself. -_-.

As for my incision.. its getting better. After it healed all nicely (the last picture that was posted) it decided to hypertrophic on me!! Aka it like tripled in size and raised up! It also got super red! I feel like it happened over night or something. SO upsetting.. I swear I thought I was in the clear and the incision would be so thin, light pink and not very noticeable. Sigh. I also have a lot of scar tissue all over my abomden from the surgery that really is limiting my range of motion. So, I started seeing a chiropractor who do ART (active release technique). Pretty much it means that this technique is used to help break up scar tissue, decrease the pain, and increase the range of motion. (Its used for many other things but that’s what it is used for for me). I have been going twice a week for about 6 weeks now. When I first went, I showed the doctor how far I could lean back and was literally just standing up super straight hahahaha. Now, I can definitely lean back about maybe 30% on a good day? It likes to retract back so fast so i need to continuously stretch it out. THey do/use so many different tools and techiniques to work on it.. but lets just say.. NONE of it feels good. In fact, its pretty uncomfortable lol. I mean its breaking up scar tissue.. why would it feel good? The pain is worth it because not only do I have more range of motion, the pain is definitely less and the scar is actually softer/smoother. I’m no where near close to being done but I’m off to a good start, that’s for sure!

Anywho, I feel like I typed a lot and everything looks like its just being mashed together so I think I’m done for now. Feel free to ask me any questions though! Or/and let me know what other stuff you’re curious about so I can make sure to address it in my next post!

[rashiira]

[Cut for Personal/Medical stuff.]

2019 has really been shit. There’s a lot I haven’t said here and still may not, but I’m going to at least cover a couple of bases of things that have had me in almost constant stress for awhile. First of all, in July, my mother was diagnosed with Colon cancer. It came completely out of nowhere. They found it during a colonoscopy, as apparently, Colon cancer doesn’t have symptoms. So it’s lucky that they found it. But it was a huge blow to my mother. It was hard to see her during that time, looking defeated when she’s usually one of the positive driving forces in this household. Several times, she wanted to just cancel any and all treatment, insisting she ‘felt’ fine, but eventually with a bit of pushing from my father and I and the doctors, she gave in and decided to get the large tumor removed through surgery. That took place two weeks ago. They were gone for about a week and a half and I spent most of that time by the phone waiting for news and information.  I’m ecstatic to say that it not only went well and my mother is on the mend, but they determined that her cancer is very likely gone. The operation removed an entire foot of her large intestine so they could collect all the polyps around it too, just to be sure, and her appendix went, as well. But they determined that her cancer, though it had pretty large growth, did not breach the walls of her intestine and therefore she did not need chemo or radiation treatment (which is good, because she flat-out refused to do it anyway). She’s in her 6-8 week recovery period now. Dad and I take care of her and make sure that she’s following her recovery steps. I know it’s frustrating for her, because she feels good and she wants to do all the things, but she’s taking things slowly and I’m proud of her. She’s been through a lot. She made it through. And it was a trying time for the family, but in the end, the results could not have been better. Things very well might have been catastrophic or too late if the cancer wasn’t discovered, but that wasn’t the case. She got treatment. She’s (hopefully) cured. Fast forward to yesterday. I'm back from out-patient surgery in the ER yesterday afternoon. What I thought was a sore throat and swelling (first started about 4 days ago) that I went to the local walk-in clinic to get checked out early yesterday morning turned out to be something called Acute Peritonsillar Abscess and it was taking over my throat/airway. They referred me to the ER about 30 mins away and I nearly had a break-down in their office, as it was not something I expected to hear when I went in. I had a CT scan for the first time in my life. An IV for the first time in my life. And then went through what was probably the singular most painful thing I've ever endured. When numbing solutions don't work because you have too many nerves in the back of your mouth and they try four times with different solutions to numb it without success? And they hold your head down when they come in with the needles? You're going to have a bad time. I was not at all prepared for what happened, but I'm thankful it was taken care of before the swelling got any bigger. I'm really grateful for the support I had from friends and the extra push not to let it go 'another day'. I will be recovering for a few days. Throat is still sore and doesn’t like solid foods. But I went to my follow-up today and the doctor said the swelling has gone down and she’s very pleased. She doesn’t think I’ll need to come back unless something worrisome happens and I just need to finish my 14-day antibiotic treatment. And on the bright side? They said that popsicles and ice cream are probably literally the best thing for me right now. So I get to enjoy some soft treats to numb the throat pain. Furthermore, as of this morning, I was approved for medical insurance. At last. I’ll be the owner of an official Medicaid card in 3 weeks and they will cover all of the surgery costs and even allow me to get reimbursement on my prescriptions. The lady who talked to me about it literally came to the operating room in the ER where I was and got my info and stuff right there. It was laughably easy compared to the hoops I was jumping through to get insurance up to this point. And then she called me back today, just a day after, saying I was approved and all set. I’m extremely happy for this. All in all, though 2019 really has been a kick in the face and elsewhere numerous times, there are some good things to come out of them, too, and I won’t forget that. I know most people are not here for personal stuff about me or my family, but I wanted to share this with those who do want to know what’s been happening and the friends I have here. I know I don’t share too much on tumblr (because I fled after the n s f w ban), but I’ve been in such a stressed state over it all this year that it was hard to get my feet on the ground and really share much until things were over and done with. Thanks for reading/listening! And I hope 2019 has been better to you folks. If it hasn’t, let’s all keep our heads up for and concentrate on the good stuff, if we can. It’s not easy. But we can try.

[destroyyourbinder]

two articles on psychiatric medication

I'm planning on writing a bigger psychiatry-critical piece soon about how the overwhelming majority of both leftists and trans people that I know believe themselves to be necessarily reliant on either psychiatric medication or therapy or both, and permit themselves (rather, semi-deliberately evacuate themselves of agency in identification with those harming them, I do not wish to victim blame) to be extensively abused by the psychological-psychiatric medical system in a fruitless search of validation for their malaise in some horrible cycle of iatrogenic dependence.

In particular, I know at least two transgender people personally (one male, one female) who are so heavily medicated that I have few compunctions about calling what is being done to them a kind of chemical lobotomy. They have both been left minimally functional and dramatically changed in personality by their "treatments", but both still seek out psychiatry to endorse their transgender interpretation of themselves, despite the fact their doctors are brutally and with little humanity "re-adjusting" them out of inconvenient behavior through repeated hospitalization, high and probably inappropriate doses of lithium alongside multiple other medications, and of course their whole gender treatment paradigm.

So I am continually startled by not only the distinct lack of modern leftist criticism of psychiatric medical institutions but outright collaboration with these institutions. Many people in the broader community-- whether radical queers or lesbian feminists-- purport to value self-reliance and peer support networks, distrusting well-funded and politically undermining officially-sanctioned institutions, but I am not sure I know a single gay person in my everyday life who is not regularly attending counseling sessions of some variety or another or who is not taking psychiatric medications-- prescribed by a psychiatrist that they see monthly or sooner-- that they believe they cannot live without.

One of the reasons I am so critical is that I was once one of these people: I have been on at least fourteen different psychiatric medications in various combinations throughout my life, and both I and many of my doctors believed that I was so critically ill that I could not live a meaningful or even minimally functional life without them. I, or my depression-- we were coextensive, inseparable, my personhood was inconvenient to assessment, I suppose-- was considered so deeply treatment resistant that I had multiple psychiatrists tell me to my face that it might not be possible to help me (of course, while still holding the prescription pad). I was lucky to never have been on lithium or Lamictal, nor subjected to electroshock, but all were floated as an unfortunate but potentially necessary part of my treatment plan. I was indeed considered such a hopeless case that I was actually approved for disability payments for mental illness, without appeal, an extreme rarity in the United States, especially at such a young age (23). I do not know for sure or not whether I could have set the grounds to get my shit together without the intervention of psychiatry-- I did survive long enough to leave an abusive home, after all-- but I do not consider it a coincidence that I did not get my shit together until I stopped having a therapist whispering in my ear and stopped having these substances in my body.

I don't think you can understand the modern transgender movement-- whether the push to identify various gender-distressed people as having a disorder or just niche lifestyle in need of medicalized affirmation, or the ideology that demands we believe that gender identity is an essential characteristic of human beings-- without understanding the history of psychiatry as a coercive practice attempting to normalize the socially abnormal, often in service to extremely oppressive interests, and the history of therapy as inherently individualizing and anti-political, an authority-laden substitute for discernment and appropriate and healthy social feedback.

In any case, I want to keep it short today, and it's with this context I want to share with you two articles, one from the New Yorker and the other from NPR.

The first article, by the amazing writer Rachel Aviv, who has previously covered dense and thorny ethical issues regarding psychiatric treatment and the construction of mental illness, is a critical article about how many modern psychiatric patients come to take consecutive strings of multiple psychiatric medications, coming to have and then losing faith in their doctors and medications to fix their ills. It follows a woman who decided to withdraw from her medications and the people she meets as she must build her own support network during her process of withdrawal, given her unhealthy dependence on the psychiatric network treating her and the psychiatric industry's public denial that medication discontinuation symptoms even occur, nonetheless can have severe and life-disrupting effects. Aviv gives a contextual history and science of the use of several classes of modern psychiatric medications, including their incredible limitations given psychiatry's practice and value system; in a description that will read eerily familiar to any detransitioned woman, she states that "there are almost no studies on how or when to go off psychiatric medications, a situation that has created what he [Allen Frances, chair of the DSM-4 committee] calls a 'national public-health experiment.'"

An important excerpt relevant to both general psychiatry and the practice of transgender medicine and health care:

A decade after the invention of antidepressants, randomized clinical studies emerged as the most trusted form of medical knowledge, supplanting the authority of individual case studies. By necessity, clinical studies cannot capture fluctuations in mood that may be meaningful to the patient but do not fit into the study’s categories. This methodology has led to a far more reliable body of evidence, but it also subtly changed our conception of mental health, which has become synonymous with the absence of symptoms, rather than with a return to a patient’s baseline of functioning, her mood or personality before and between episodes of illness. “Once you abandon the idea of the personal baseline, it becomes possible to think of emotional suffering as relapse—instead of something to be expected from an individual’s way of being in the world,” Deshauer told me. For adolescents who go on medications when they are still trying to define themselves, they may never know if they have a baseline, or what it is. “It’s not so much a question of Does the technology deliver?” Deshauer said. “It’s a question of What are we asking of it?”

The second article, which also contains a longer-form audio interview with the author, is about a new book by Harvard historian of science Anne Harrington called Mind Fixers: Psychiatry's Troubled Search for the Biology of Mental Illness. What I found particularly striking about her interview is Harrington's assertions about the state of psychiatry and psychiatric pharmaceutical research now-- she claims that the psychiatric medication market has stalled because of research finding that many common antidepressant medications work no better than placebo versions, and that pharmaceutical companies therefore are de-investing from psychiatric medication research and development because they can no longer use their previous strategy of slightly tweaking the chemical components of previously monetizeable drugs. She states there have been very few innovations in finding new classes of antidepressant medications in particular (the most easily marketed psychiatric drugs, for whom the target population can easily be expanded).

I think her points here are crucial to understanding exactly why pharmaceutical companies and psychiatry have become increasingly invested in transgender health care and in expanding the market for hormones and transgender-related surgeries through promoting interventions like HRT and "top surgery" as elective procedures suggested as ways to "affirm a patient's identity" rather than "treat a disorder". The gender critical blogger Brie Jontry, a mother of a formerly trans-identified female teen, calls this practice and ideology "identity medicine", a term I find useful to describe the unholy conglomeration that is the individualized medicalization of gender-related distress and the advertising of medical treatments (particularly those provided by cosmetic surgeons) as ways to facilitate self-expression and authenticity. Given increasing attempts by gender doctors to create patients permanently dependent on exogenous hormones (those children left with non-functional gonads after treatment with GnRH agonists like Lupron and cross-sex hormones, or those transgender people who have had theirs removed) or to convince patients that gender dysphoria is a life-long, inescapable condition that they had already failed in not treating/affirming earlier (because you Always Were A Boy), I have to note parallels with psychiatric medicine's anti-recovery, anti-patient-autonomy assertions about other recently marketed drugs such as atypical antipsychotics, on which patients are also purportedly permanently dependent, or antidepressants (as above) where withdrawal symptoms purportedly prove that a patient is doomed to relapse should she cease psychiatric treatment. "Informed consent" and the formation of transgender resources outside a "gatekeeping" paradigm, where patients need not seek insurance approval nor the opinions of several doctors of different specialties for transgender medical interventions, nor wait a set period of time prior to transitioning, is often lauded as progressive and anti-institution by radical transgender activists, who can rightly see issue with a psychiatry put in charge of policing the intimate personal beliefs, coping mechanisms for misogyny or homophobia, and individual gender expression of its patients. However, I can't but see this as part of a new and terrifying medical strategy regarding transgenderism, where a loss of patient agency is replaced with the false sense of consumer choice; we have seen this in other realms of psychiatry, where forms of psychiatric incarceration were rebranded as the choice to take a break or "finally" seek help after self-negatingly denying it for so long, where tranquilizing drugs were rebranded as assistive devices for women struggling to have it all, and where high-risk, heavily sedating antipsychotic medications were rebranded as ways to give other psychiatric medications a "boost" should you still experience unhelpful emotions after complying with psychiatric treatment. "Gender dysphoria" is increasingly nebulous, something you might have had all along if you experienced various forms of generic malaise or failed to have your suffering sufficiently validated and thereby dissipated by psychiatry; funny that we've seen this before with other conditions and their treatments, and psychiatry somehow always comes up with a money-making solution for its own problems.

[bigskydreaming]

I’m so mad, I’m so.....fuck. I feel like this doctor had no intention of ever doing this surgery because its like ever since I actually CAME UP with the money, its been one thing after another about why I need to do this still or that, and it feels like they kept stalling or trying to get me to give up, like....idk, nothing I come up with makes SENSE, all I know is they were perfectly fine and helpful in getting me a diagnosis and scans, and then sent me off after I did the final molds/impressions and said the only thing left was they couldn’t move forward until I paid x amount of money...and then I did, and all of a sudden its oh that’s not the right amount, I don’t know who quoted you that (umm you) but actually we need 20K up front because insurance claims can’t be submitted until after treatment and we might not be reimbursed (which again, then why did YOU make me wait to send my insurance preauthorization requests if your policy is to make patients pay in full upfront and wait for reimbursement which...what)...and THEN if there was STILL never a chance of me getting this surgery without paying in full upfront, why did they make me wait around for another week and a half while we waited on getting my insurance approve an access to care form that made this doctor in network (previously she was out of network for my insurance, but I had my insurance check for in network providers and there’s no one in network within a 100 miles of me who does this specific surgery)....like, if even being in network, they still weren’t going to take Blue Shield’s formal, written letter detailing what exactly was covered under my plan and they were intending to pay out....WHY WAIT FOR THIS FORM TO GO THROUGH AND GET THE LETTER BACK AT ALL????

It makes NO fucking sense. I feel like they never expected me to actually be able to come up with the money and idk what, like, she actually doesn’t know how to do the surgery or she doesn’t fucking doesn’t like me or want to or what like, lmfao I don’t even know, it MAKES NO SENSE.

But of course, its super obvious they were putting off calling me and hoping they could ride out the clock and I wouldn’t call today because I can tell the office manager doesn’t like being the go between and having to only give me bad news, but like, tough, that’s your fucking job, and maybe if you’d been a little less ‘gentle’ about it and just flat out admitted you guys were never gonna fucking do this surgery for me, I wouldn’t have WASTED an entire fucking month sitting on my ass, draining my account of money I can’t afford to waste, because my shitty jaw has progressed to the point where I can barely sleep, barely even eat because I have to manually fucking close it with my hand when I chew anything harder than rice, lmfao, and just....

God. The only thing I can think of to do now is try calling every other oral/maxillofacial surgeon in the county and see if they can do these procedures and accept my insurance. I know there’s no in network ones, and I already checked and my insurance can’t help me find a list of out of network ones, I have to basically just google every oral surgeon in LA and even though they’re all apparently out of network if they’re able to perform this surgery at all, I can at least probably get them in network by doing an access to care form again with them too, like since clearly this doctor turned out to not be a viable option? Idek man. Ugh. Jfc. And who knows how long this is gonna take. Ugh if they’d at least just fucking owned up to it and just called me this morning when they decided this still didn’t change shit, I could have had all day to be calling other offices instead of waiting for them to call and hoping this time at least they were aware enough of my DESPERATE FUCKING SENSE OF URGENCY BECAUSE HAVE I MENTIONED CONSTANT FUCKING OWWWWW AND ALSO HEY MY COMPLETE INABILITY TO FUNCTION IN ANY KIND OF MEASURABLY PRODUCTIVE WAY??? that they’d actually KEEP their word this time about calling when they said they’d call.

Now of course, none of these places are open on Saturday from the looks of it, so I won’t even be able to START calling around until Monday, and ugh. jfc. why. why the fuck did they string me along all fucking month if they knew at the end of it all no matter what, they weren’t gonna budge from trying to get me to pay 20K upfront, out of pocket, like I hadn’t told them from the START there was no way I could manage that, and hadn’t told them AGAIN when they TOOK my fucking money in the first place, when I paid them the $6,200 they INITIALLY told me would be my downpayment for this surgery, like I told them THEN that getting the loan for $10K in order to come up with the EXACT amount they specified took every bit of goodwill I could wring out of a lender with the credit I do have and there was ZERO chance of me coming up with ANYTHING more than that amount upfront....so why the fuck didn’t they tell me at least THEN when they ‘corrected’ me on the amount that it didn’t matter HOW MANY fucking hoops I jumped through with my insurance to try and get this doctor the reassurance or surety that they’d be reimbursed for x amount by Blue Shield...like....I COULD HAVE BEEN DOING ALL THIS A GODDAMN MONTH AGO. I’ve been waiting TWO YEARS for a fix to this shit that affects EVERY SINGLE ASPECT of my life, I FINALLY got a fucking diagnosis, a doctor who told me she could fix it, who said she could restore full function and wipe out the problems I have from it completely, no more headaches, no more pain, no more vertigo, no more nerve flareups....and now turns out I’ve wasted ANOTHER full month that got me not a single fucking step closer to this being DONE and FIXED and like.....

I’m so mad. And just. So frustrated. And SO. FUCKING. TIRED. Jfc. I hate them, I really fucking do, like they literally just fucking don’t give a shit no matter how many times I really fucking calmly and civilly lol tried to express how much it gets worse every single day like it has been CONSISTENTLY for the past two years, like never fucking plateauing, no matter HOW bad I think its gotten, it ALWAYS fucking manages to find a way to surprise me when I wake up the next day and yet AGAIN its somehow managed to shift so things are just enough different I NEVER get a chance to even get used to a ‘new normal’ and just fucking adjust to it, as shitty as it might be....ugh. God. I’m just.

LMFAO I honestly think right now I hate this doctor more than the fucking gay-bashers who caused this fucking drama by kicking me in the goddamn face over and over 15 fucking years ago and if THAT’S not hysterically fucked up I REALLY DONT KNOW WHAT IS.

Anyway. So that’s my mood tonight, how’s everyone else doing? LOL.

This might be a longshot, but on the off chance that ANYONE knows or is friends with or related to an oral surgeon or oral maxillofacial surgeon in the greater LA area, like, this specifically is what I’ve been told I need to get done:

I need a Mandibular splint, a Total joint surgery on the left tmj (Temporomandibular joint) and an Orthognathic surgery. They specifically ruled out that I didn’t need a jaw replacement surgery because I have enough of the original bone that goes in that joint like, still there, so I didn’t actually need to get a prosthetic joint or the jaw replacement surgery which is apparently riskier and less effective anyway? Idek. If I can even trust anything they told me at this point, lmfao, but let’s just assume I can because not sure this fucker’s depression hour can handle thinking I might have to start back from square one NOPE NOT GONNA HAPPEN NOT THIS GUY I FUCKING REFUSE.

LOL as though my objections have any fucking effect on any of this anyway. BUT I DIGRESS. So yeah, that’s what I supposedly need done, I actually have really fucking good and expensive Blue Shield insurance that I’ve gouged myself a new asshole getting and keeping this year, not to mention needed donation posts and help with that just to still ultimately scrape by and not lose it, all specifically because I knew there was not a chance in hell I could ever afford the treatment I was being told I needed, like, out of pocket, and the irony is due to how expensive living out of a motel is and how like, I couldn’t afford to take any money AWAY from my many doctor visits in order to at any point this past year come up with enough money to put first and last month’s rent down on an apartment (and I look too much like a tweaker apparently, with constant twitches and fidgets and fixing my jaw, for like, anybody to want to just rent a room to me apparently, and even giving them the full story ended up seeming like “im too much drama” hahahaha oh LA I fucking HEART you sometimes), so there was never really any fucking alternative TO living out of motels currently, at least not until I can manage to stay upright on my feet long enough to get a part time job and use that to get a permanent address around here.....AND bottom line is in order to take in enough money from work and then ultimately from help with donations too, in order to keep my motels paid daily and not get kicked out and still manage to eat at least every other day....that was just enough money that it looks from my bank account that I make too much to need or justify Medicare taking on all this for me, ruling that out as an option, even though none of that money in my bank account was ever fucking LEFT by the end of each day after paying rent/food, and I usually only had like three bucks in my account by the time I went to bed each night....doesn’t fucking matter because lolol all they give a shit about is your MONTHLY statements. And I’m well past the point where I can even manage busing all the way around LA to downtown and shit in order to make the daily trips required to get Medicare offices to eventually give enough of a fuck to hear me out, like...a five minute bus ride to Best Buy today to buy a replacement keyboard for this laptop practically wiped me out ahahaha.

Anyway, I’m just venting and purging like I do. Don’t worry, I promise not to actually go supernova and ignite the atmosphere like I threatened earlier, that was all for show, we all know I’m WAY too petty and spiteful an asshole to ever settle for anything less than full fucking victory here and then like...eventual world domination because lol not like I’m letting those frathole rapist gaybasher fuck-offs WIN, like, have you MET me? I have survived this long on ire and spite, I will make it as far as I need to its, just...

*pathetic whines*

I dont fucking waaaaaaaaaaaaant to, I’m tiiiiiiiiiiiiiiiiired, I wanna go to beeeeeeeeed.

Anyway, yeah. So if anyone like, is related to one of those surgical types or KNOWS someone who is, like, my good fucking insurance is set up to pay for having the operation done at Cedars fucking Sinai no matter who does it, like, as long as the doctor has any kind of pre-existing relationship with them, enough to get them to book an OR for them, I guess? I still dont fucking know how all this works, apparently Grey’s Anatomy is not an accurate source, who knew, how dare.

Like but yeah, the endpoint of that particular stream of consciousness vomit was if anyone knows ANYONE who knows ANYTHING about ANY of that surgical medicalese blah blah blah that I posted, like...my anons are open, feel free to pop in with a name and number or suggestion or referral or whatever the fuck, I will take ANY connection no matter how flimsy if it exists at all, I don’t care if its your second grade teacher’s dog’s veterinarians second cousin by marriage’s roommate. That’s GOOD ENOUGH FOR ME.

[flawlesspeasant]

Would love to reread that oneshot! Thanks for offering to post it!

Sorry I forgot to get it up this weekend. I’ll be adding it to the master post soon enough but until then, here you go! I hope this is the one you’re talking about???

Jo pressed her thumb into the top of the ballpoint pen and crossed her legs as she sat in the chair, just so she’d have a hard surface to write on. She put the blue clipboard on her lap and mindlessly began scribbling down her daughter’s information, bouncing her leg up and down to distract herself from the inherent boredom of sitting and waiting in a bitterly cold, overly bright patient room.

In the chair next to her, Alex adjusted the little girl on his lap and rested his head back against the wall. He watched as Jo wrote their daughter’s entire medical history down on one single sheet of paper.

It somewhat amazed him that she was able to memorize everything without so much as taking a moment to think. Every ache, pain, itch and scratch Lyla ever had, Jo wrote it without thought. She rattled her insurance number off without looking at the card and her social security number as well. He always knew she was gold with numbers, but he never truly realized until that moment.

“You need her policy number?” he asked, noting that she paused and stalled progress once she got to that line.

Jo shook her head at him and tapped the pen on the clipboard, deep in thought. He watched her for a few more uninterrupted seconds before tilting his head downward and relinquishing his attention to his daughter, who was sitting cradled on his lap like she was a lot younger than six years old.

He combed his fingers through the locks of her tousled light brown hair and propped his chin atop her head, pretending to be interested in the episode of whatever TV show was playing on his iPad. He recognized the show. After working with kids and having his own, he managed to pick up on some of the television shows that played on the kids’ stations, but never once did he bother to learn names. He just wasn’t all that interested.

“Daddy?” Lyla lifted her head up a little, tapping the iPad screen with her index finger to pause the show. “What’s tontils?”

Alex adjusted the grip he had on her and pulled her up more on his lap so she didn’t fall. “Those nasty things in the back of your throat. They help you get rid of the germs, but sometimes germs like to hang out back there and they mess with the tonsils and make the tonsils mad. Then they get infected and gotta be taken out before they make your whole body mad,” he explained as easily as he could for a child of her age. “But don’t worry. Once they’re out, you’ll be back to terrorizing the house in no time, nightmare.”

Lyla nodded her head. He explained it in such a way that she understood completely.

“Daddy? It’s almost time?”

“Almost,” Alex lied.

Truthfully, he didn’t know just how much longer it would be. They had only been sitting in pre-op for about an hour, and it wasn’t like a tonsillectomy was at the top of the list. It was a simple 20 minute same day procedure, but still. There were other procedures that needed to be taken care of and a tonsillectomy was either at or near the bottom of the priorities.

Lyla was growing impatient, though. She didn’t understand why it was taking so long, and it never occurred to her that other people might need surgery too. Granted, she was grateful for the lapses that granted her more time on the iPad as she laid in her father’s arms with her feet on her mother’s lap. That in itself was reason enough to want to stay. But more than that, she was grateful for the prolonged process because she was, in all sense of the word, nervous. The closest she ever got to an operating room was a few months back when she broke her arm and her Mommy had to put pins in the fracture. Even then, that was nothing like having surgery. Even with two surgeons as parents, she didn’t know what to expect.

So far, it seemed okay though. They got to the hospital and some nice lady that she never met before gave her a few bracelets and took them upstairs to the room they were currently sitting in. After that, Mommy made her take her clothes off and put on a nightgown with dinosaurs on it and no undies. And ever since then, she had been laying on Daddy’s lap with the iPad. It didn’t seem too complicated just yet. In fact, it even seemed a little bit…fun. The only part she disliked was the fact that her tummy was rumbling because the last thing she ate was spaghetti for dinner, yesterday.

“Mommy,” she called Jo next. Jo stopped writing again and looked at her. “Can you get me food? My belly is growlin’.”

“No baby,” Jo shook her head and picked up her daughter’s sock-covered foot. “I’m sorry. You can’t eat anything though. Not ‘til after your surgery.” Lyla poked her lip out and went back to watching the iPad, a look that broke her mother’s heart. Something about starving her child didn’t set well with Jo. She knew that people weren’t allowed to eat before surgery and that was a very strict rule, but it seemed utterly ridiculous now that it was her child being denied food.

“Ly,” Alex jostled her to get her attention. Lyla just looked at him. “When you’re done with your surgery, we’ll take you to get some ice cream. Since your throat’s gonna be hurting.”

“From Dairy Queen?”

“From Dairy Queen,” Jo confirmed Alex’s proposition with a nod.

With a smile, Lyla rested her head back in the middle of her Daddy’s chest and unpaused her show again. This day was perfect. She got to hang out with both her Mommy and her Daddy without any interruptions from her whiny baby brother. Mommy gave her all the hugs and kisses in the world. Daddy was letting her lay all over him. She was allowed to play with the iPad, she was allowed to lounge around in no undies AND she was getting ice cream after?!

Surgery was sounding better and better by the moment.

—

After yet another hour of enjoying the complete serenity of being doted upon by both her parents, Lyla was halfway through an episode of Shake It Up when the sound of gentle knocking on the glass door to her room startled her.

“Little miss Lyla, we’re all ready for you!” The gentle looking nurse came into their room with a pink surgical cap in his hands. He seemed bright and cheerful and for some reason, he reminded Lyla of Olaf, the snowman from Frozen.

Jo sat up straight and smoothed her own hair back, finally being pulled out of playing an hour straight of Candy Crush. She stuffed her phone down into her purse and stood up. Finally, the waiting game was over. Being a surgeon herself, she knew just how long patients could end up waiting before being taken back to the OR on same day procedures, but it never seemed that bad until she was on the receiving end of the wait. She made a mental note to be more time-efficient to her own patients, eventually.

Alex stood up and walked his daughter over to the bed she hadn’t sat in since they were admitted. Lyla was content to lay in his arms and on his lap and though he wouldn’t admit it, Alex liked the fact that she would rather lay on him than in the bed too. The bed just didn’t have much use. He deposited her safely on the bed and took his iPad out of her hands, eyeing the loose French braid he spent the last hour doing and undoing in her hair.

“Alright, just gotta give you this one last stylish little bracelet,” the nurse said. He gingerly strapped it around Lyla’s wrist and gave her a smile. “I like your braid. You look just like Queen Elsa.”

Letting her shy, timid nature overcome her, Lyla lowered her head and gave him a nervous, but not at all forced, smile. When she was younger, most people mistook her shyness for brattiness because she rarely ever spoke to people when she was spoken to. She had gotten better with it though. She no longer needed to look toward her parents for approval when someone spoke to her, which was a big deal.

“Thank you,” she whispers softly, touching her fingers to the braid intricately woven into her light, golden hair. “My Daddy did it.”

“Really? Excellent!” The nurse smiled. He was one of the few people that understood the difference between a child being shy and a child being a spoiled brat. Lyla was sometimes both, but at the moment, she was just shy. “You think maybe your Daddy can do my hair sometime?”

Lyla giggled and shook her head. “Yours is too short!”

“Yeah I guess it is, isn’t it?” He laughed too. “It was worth a shot.” Still laughing, he put the pink cap down on her bed and took the brakes off so he could wheel it. “Let’s get you on back to the operating room now.”

Lyla excitedly nodded her head and crossed her legs as she sat in the middle of her bed. She hadn’t been this excited about something since her birthday! She knew that her throat was going to hurt, but she could handle that. She was tough, just like her Mommy. And besides, Daddy was going to be there so it wasn’t going to be that bad. As the nurse began wheeling her bed out of the room, she turned her head and looked around. And that’s when it dawned on her. Why was Mommy standing up but her purse was on the floor? Why was Daddy leaving his coat on the chair?

“I’ll see you when you wake up, okay?” Jo stood beside her bed and grabbed ahold of Lyla’s hand. “Mommy’ll be right here when you wake up. I’ll be here when you get back. Gimme a kiss?”

Confused, Lyla just nodded her head. She elevated her chin and allowed her mother to give her a quick peck on the lips. It sounded like a goodbye… But why? Why was Mommy kissing her goodbye? Jo stroked her cheek. Why did she do that?

“Be tough in there, monster. Ice cream when you get out.” Alex offered her his fist to pound as his own personal form of goodbye. Lyla tapped her fist to his. “See you later.”

See you later?! Why?! The nurse began wheeling her bed out the door again, and when she saw that yes, Mommy and Daddy were staying behind, that’s when something snapped. It was like a lightbulb went off in her head, a string was cut, the lock was unlatched and the floodgates were opened. She pushed herself up onto her knees and turned her body all the way around, only to see her parents still standing in the room while she was in the hallway.

“M-Mommy!” She yelled, tears running hot and thick down her cheeks. “MOMMY! MOMMY!” She turned back toward the man that was wheeling her away. “STOPPIT! I WANT MOMMY! STOPPIT! DADDY!”

Just then, both Alex and Jo came rushing out of the room and to the bed. The nurse stopped wheeling Lyla’s bed and took a pause. He knew how to deal with kids that were scared. Sometimes they just needed a little extra comfort.

Lyla held her arms up like a toddler and sniffed. “Daddy?”

Jo put her hand on the back of her head and stroked her hair to calm her down, an action that almost always worked but was failing this time around. “La, you said you were okay… You were doing so good baby, what’s wrong? What happened?”

“Why you guys leavin’ me?!” She rubbed her eyes hard and coughed. Her bright blue/green eyes welled up with tears again and she sniffed. “Come!”

“Butthead, we can't…” Alex shook his head. “We can’t come with you. You’ll be fine, alright? We can’t come with you.”

“But you come with everybody else! You told me I was gettin’ surgey but you a surgeon for babies so why can’t you come? You come with everybody else…”

“I’m not… I’m not working, Butt. See? I’m not wearing scrubs today. I’m not working. I can’t come back with you.”

“No, Daddy! Please?!” Lyla stood up on her knees and wrapped her arms around Alex’s torso. “Why? You come with other girls… You my Daddy… Why not me? Don’t leave me Daddy… No. No… Daddy…” She sniffed again. “Just come…”

Alex sighed and looked at Jo, who was watching the scene with her own tears in her eyes. She couldn’t stand seeing her daughter so scared. He looked back down at the top of Lyla’s head and once again fingered the braid he put in her hair. He wasn’t working and he knew that it be a huge liability for him to go back into the operating room with his own child while he wasn’t working. But it was his child. It was his daughter, his little girl. And she was right. How could he be there for dozens of strangers every day and not her? He was there for many kids, none of which were his own. He couldn’t do that. She was his little girl and the center of his universe, along with his son.

“Alright,” he sighed and picked her up. Lyla put her head down on his shoulder and rubbed his ear with her thumb and index finger, something she always did when she needed comfort. “Hey… Thompson,” he mumbled to the nurse. “You think maybe… I could just come sit with her? You know, until she falls asleep? I’ll leave once she’s out, I swear. I won’t stay.”

“I dunno Karev, that’s breaking so many policies…”

“I know what it’s doing,” he spat, growing annoyed. He didn’t ask for a lecture. Obviously he already knew that he was breaking rules, otherwise he wouldn’t have even asked. “She’s not gonna go without me. I’ll just sit there by her head and hold her hand. Once she’s out, I’m out too. It’ll be quick… Just lemme go in.”

“…Alright,” nurse Thompson nodded. “You have to make it quick though.”

“I will,” Alex promised.

[arabian-magic]

In the end, it’s all about experience

In a matter of two years, I’ve been rejected NINE TIMES for the same type of job.

I just want to be an equine vet tech (or even an assistant). I’ve applied to every single horse clinic within an hour of me for either a tech or an assistant position. Some places even more than once if another opportunity opened after.

I’m not yet licensed in New York. I’ve stated this plainly on my resume, that I was finishing up school and I’ve already taken and passed the VTNE. Essentially I’m 95% there. The only thing I’m waiting for now is the school to approve and finalize my graduation so I can send my transcript to the state. That is all.

But they clearly saw potential, why else would they have me come in for an interview?

I’ve worked for the past year as an assistant with extended duties. I have experience with being a tech via an internship. The problem is both are strictly small animal.

I’ve done an externship and volunteered at an equine hospital. About half of the jobs I’ve had in the past have been with horses. I’ve had three horses. I ride consistently. I am more comfortable with handling a horse a lot more than I will ever be with a cat or dog. And I grew up with both cats and dogs!

Yet somehow it just isn’t enough.

Nine different applications, nine different interviews, some working, some not, all with one rejection. The very last one was the only one considerate enough to tell me why they haven’t decided to hire me: lack of experience.

It stings. How am I supposed to get experience when they don’t take a chance and hire me?

It’s like I’m 17 years old again. The moment I got my driver’s license, I was applying to any job that I would qualify for with nothing to show for it. I remember beginning an online application for a sales associate position at K-Mart. The first question it asked was did I have any previous experience in retail. I answered no, and I was automatically rejected. For a simple sales associate position.

My friends tell me “Why not just find a job at a regular vet?” Well I’ve looked. I still look. 99% of the positions are asking for licensed vet techs with years worth of experience. 2, 3, 4, sometimes 5. I only have a years’ worth of experience as an assistant and 5 months worth of experience as a technician intern. I can’t compete with that.

The difference between the equine ads and the small animal ads? Most of the equine ads are asking for someone with horse experience. Not as a vet tech specializing in equine for x amount of years. Just a tech or assistant with previous horse experience. And even then? Most of the time it’s not even a REQUIREMENT, just a preference.

I’m so tired of it. I’m tired of my current job. My boss can’t afford to hire me full time because we don’t have enough doctors to support it. When I get licensed I was promised a raise, but without full time is it even worth it? I have no health insurance, and day by day that becomes more concerning. I was scratched and bitten yesterday at work, and I’m thankful neither caused enough damage to warrant a hospital visit. I feel like I can’t expand my skills either. My boss chooses to stick me in rooms all the time and just restraining patients. I’ve expressed interest in stepping in surgery and doing dental procedures (which I have experience with both due to the internship, and she knows this) but i’m still doing the same thing, talking to the same people every day and dealing with the same 50 Yorkies, Shih Tzus, Malteses and Poodles that show up on a daily basis.

I’m tired. I want a change. I need a change.

[mychemicalmenopause]

Whoops, I meant to update the other day when I heard from Dr. Williams after speaking with Dr. Lipscomb. He started off the conversation by saying, “So, what’s this I hear about the front desk and a Google review?” The way he said it was more annoyed than intimidating, like he had gotten in trouble and he had absolutely no idea why. I told him that I had left several messages for him, his staff, and the Regional Manager and I hadn’t heard back from anyone. He told me that the front desk was trying to “cover” for Karie by not delivering my messages, when they “really did need a push” to get things done. As a former receptionist, it really makes me wonder if that’s what actually happened, or if they used the front desk as a scapegoat for Karie. Either way, shame on them. 

Dr. Williams repeated what Dr. Lipscomb said earlier in the day, “We can do better,” and asked if I was willing to continue treatment as planned. I told him that I’m nervous about not being able to get questions answered in a timely manner when I do start meds, especially now that I’ve gotten Karie in even more trouble, unintentionally. He said, “Well, everyone in the office knows who you are now, but if you need anything, just send a message through MyChart instead of calling in.” I told him that I tried that the first time I had questions and it took eight days just to get an acknowledgement. He apologized for that and tried his best to assure me that it won’t happen again. He promised that the Lupron had definitely been called into the pharmacy and that they should just be waiting on my insurance to authorize it. I told him I had talked to them earlier in the day and they said to call back on Friday if I hadn’t heard anything. 

I talked to my therapist on Thursday and told her that I still felt very unsettled about the whole thing. I felt a little guilty that the apparent “big boss” doctor had to get involved and that everyone got in trouble, but damn - do your job and give a shit about your patients and maybe that won’t happen again. I did apologize and told Dr. Williams that I didn’t mean to be a bitch or a difficult patient, that I wasn’t being hostile when I called and have been kind to everyone I’ve spoken with. Ariel (my therapist) told me not to feel guilty for advocating for myself, but I still did. She asked if I was comfortable moving forward with Dr. Williams and I said I wasn’t sure, so she advised me to continue as planned. I value her opinion and advice, so that’s what we’re doing.  

This morning I got a message from Karie saying my insurance had denied coverage for Lupron. “Their letter stated that approval requires the diagnosis is confirmed by surgical or direct visualization or histopathological confirmation in the past 10 yrs.” Because we’re doing things a little backwards, it would not benefit me to have surgery to diagnose Endometriosis and then go back in, in 6 months to take everything out. So Dr. Williams filed an appeal explaining why he’s wanting to prescribe Lupron and we’ll see what happens. 

I’m just flabbergasted as to why my insurance would approve a total hysterectomy (around $50,000), but not a medication. Why do insurance companies have the right to override a doctor’s prescription? Who the hell are these people to say yes to SURGERIES but not meds? It’s absurd and mind-blowing and fucking exhausting. Not one single thing has been easy with this and I just want the surgery already.  

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PMDD is so freaking weird, man. Today was a typical Monday - didn’t get enough sleep last night, got an extra visit added to my schedule, had to run errands, introduce a sitter to a dog, and did an interview. For the last 2.5 - 3 weeks I’ve felt like shit, but I’m not in a bad mood today. So much so that it caught me off guard a little until I was like, ‘This is what you’re supposed to feel like,’ bit of a headache from the day but overall OKAY. 

[shinra-makonoid]

Hey. I'm the anon with the ask about fear of law changes. Thank you for your long response. Though I feel something like a hysterectomy is more difficult to get than HRT with "other reasons" . My consolation is, that the surgeries I already got covered by the insurance (like with an approval letter) will count even after a law change, which is why I will try to get the other potential surgeries also covered as soon as possible.

And maybe the fact that my countries government still decides whether they should stick to winter/ summertime or get rid of one, which was first suggested in like 2014 or something.

The "radical" left in my country actually tries to get "more supportive" of trans people by allowing them via the "Selbstbestimmungsgesetz", " law to decide by yourself", to change your name and gender status once every (certain time interval) and reduce the requirements for HRT and the mandatory therapy.

I don't think that's a good progress. Maybe getting rid of the fees associated with the name change process. Because it cost me 1600 Euro (800 for one individual letter of an independent psychiatrist). But I think the therapy made sense to me, as did the waiting time. 6-12 Months is not that much I think.

What do you think about the general laws that should apply to transsexuality in regards to gender changing process and limitations/ waiting times for medical procedures?

Tbh in France we also change hours despite the fact that it has been researched that losing an hour stress people out so much that it can trigger heart attacks. So.... Yeah.

Damn, I think getting rid of the cost would be the number one priority yeah. Idk if people in your country can do that but you can have free therapy that have some waiting times (depend on how many month you have to wait) but then again we're plagued with Freud so it's not always a good thing either. I did that and when I was done and sure I went to an independent psychiatrist and he was okay so I was gucci. At the time I was like "bro that was so fast that's irresponsible" (because I'm sure even without therapy I would have had that letter) but now I'm like, you know what whatever.

At some point I stopped seeing HRT as being "a medical procedure only diagnosed people should take" and started considering it a biological enhancement chosen by the people who want it and can consent to it. In a transhumanist way if you will. Patients who want it should be assessed to see if they don't have some sort of mental health issues that could impact their happiness on the long run (for ex BPD could) but I don't think dysphoria per se should be the factor for it anymore, or at least, I don't think we need to be definitive that the person has dysphoria for them to take it. Just like I don't think someone should be impaired physically to get access to enhancement features to hear, see or move better.

One thing that bothers me in the change or ID is that changing names, at least in my country, doesn't mean changing sex. Which means I am technically still legally female, but since I got a male name and a male face, they fucked up on my ID and put a M on it. I won't complain, but I'm technically with an Id that has an error on it. I think it's dumb that the change isn't for both at the same time, and I think it's even dumber you need to get to the tribunal to change your sex marker here. A simple check about whether you fit in society the way you claim to be fitting should be enough (and I suppose that is a bit subjective). As for a waiting period to change it again, I don't think there should be one. But I do think there should be a good legitimate reason for it to happen, to prevent having people changing every 2 months for fun.

As for medical procedure, well I'm not sure. I'm in a phase where I don't believe/trust psychiatrists/psychologists anymore. I think that, at least in my country, diagnosis are badly made, rely on nothing, and are subjective. I think they're mostly incompetent. So I don't believe one can accurately determinate if someone truly has dysphoria or not.

I still think there should be some sort of therapy, before, maybe a few months, like 2-3 months, if the patient wants it, and then during transition, for the adaptation to the new world, passing, misgendering, transphobia etc, if the patient wants it. Then maybe after each surgery, but again only if the patient really wants it. The 2-3 months before transition would be to explore solely the feelings regarding transition, dysphoria if there's any, and after that therapy, the Psy giving their opinion about transition to the patient, but not forcing it on them. Like "I think there are underdevelopped ideas that could lead to you feeling you should be the opposite sex that aren't related to dysphoria but I will still give you the letter necessary to access HRT on your own free will". Something like that (that also include "you cannot sue me if you regret you got my opinion"), or "I think transition would be the right path for you." Mostly letting them know that whatever happen they'll always have a spot to get therapy/help too.

Then for surgery I'm not sure either. It should be on a case by case basis and especially make sure the person isn't pressured by anyone including themselves, to do this. I took my time before taking the stance that I would, in fact, get a mastectomy and probably a phalloplasty. But I really needed my time to make my own mind about it, and not getting forced/pushed to do it by anyone around. Things often unlock themselves alone and that's a thing you cannot really force. Respecting people's choice and paths for transitioning is important and should be for everyone involved in it.

I think that answers all of your question. Note that this is my personal opinion I don't think it's better or worse than anyone else's on that question because it's pretty subjective.