tragedyboycentral

[tragedyboycentral]

this post is for, like, three of you but I had to bring it over for the merlintuals

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The Legend of Vox Machina is a deeply philosophical show that asks important questions such as: “what if the Grand Duchess Anastasia Romanov had a gun?”

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[tragedyboycentral]

Luigi Mangione's lawyer is SO good

like, she didn't miss a beat in the arraignment, calling out the police, the perp walk, the mayor...

I hope this trial is televised tbh. i will not miss a second of it if it is

ETA: ANNNNDDD calling out the mayor for not using the word "alleged".. YES!

I get SOO annoyed whenever people complain about the media using the word "alleged", especially when there is video footage of the crime happening... people complain that it's some sort of media bias, and not like... straight up a VIOLATION OF A CONSTITUTIONAL RIGHT if they don't say "alleged"

The presumption of innocence is a right. Luigi's rights have been violated repeatedly in this regard.

And possibly also his right to a fair trial, since they are creating SO MUCH bias against him

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thinking about that one wordless calvin and hobbes sunday strip thats just calvins dad ditching his work to go play in the snow... its going to make me cry

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Friend of mine was submitting a job application and discovered that they REQUIRED a photo:

We're trying to decide which of these is a better option:

or

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this should have been me

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people who don’t wear glasses will never understand the absolute humiliation of dropping your glasses under your bed or in a dark area and feeling around on all fours muttering “my glasses…. where are my glasses” like fucking Velma Dinkley and thinking to yourself BOY WOULD THIS BE A LOT EASIER IF I COUKD FUCKING SEE

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I don’t know who needs this information but the fashion history term for those pumpkin-shaped late medieval shorts is “pansied slops”

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question because i'm curious...

+ tell me your favorite pokemon/reasoning in the tags i'm nosy

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I'm trying to figure out a good way to say "you really should actually learn the basics of small talk" with sounding like I'm biased against autistic people.

[tragedyboycentral]

A doctor discovers an important question patients should be asked

This patient isn’t usually mine, but today I’m covering for my partner in our family-practice office, so he has been slipped into my schedule.

Reading his chart, I have an ominous feeling that this visit won’t be simple.

A tall, lanky man with an air of quiet dignity, he is 88. His legs are swollen, and merely talking makes him short of breath.

He suffers from both congestive heart failure and renal failure. It’s a medical Catch-22: When one condition is treated and gets better, the other condition gets worse. His past year has been an endless cycle of medication adjustments carried out by dueling specialists and punctuated by emergency-room visits and hospitalizations.

Hemodialysis would break the medical stalemate, but my patient flatly refuses it. Given his frail health, and the discomfort and inconvenience involved, I can’t blame him.

Now his cardiologist has referred him back to us, his primary-care providers. Why send him here and not to the ER? I wonder fleetingly.

With us is his daughter, who has driven from Philadelphia, an hour away. She seems dutiful but wary, awaiting the clinical wisdom of yet another doctor.

After 30 years of practice, I know that I can’t possibly solve this man’s medical conundrum.

A cardiologist and a nephrologist haven’t been able to help him, I reflect,so how can I? I’m a family doctor, not a magician. I can send him back to the ER, and they’ll admit him to the hospital. But that will just continue the cycle… .

Still, my first instinct is to do something to improve the functioning of his heart and kidneys. I start mulling over the possibilities, knowing all the while that it’s useless to try.

Then I remember a visiting palliative-care physician’s words about caring for the fragile elderly: “We forget to ask patients what they want from their care. What are their goals?”

I pause, then look this frail, dignified man in the eye.

“What are your goals for your care?” I ask. “How can I help you?”

The patient’s desire

My intuition tells me that he, like many patients in their 80s, harbors a fund of hard-won wisdom.

He won’t ask me to fix his kidneys or his heart, I think. He’ll say something noble and poignant: “I’d like to see my great-granddaughter get married next spring,” or “Help me to live long enough so that my wife and I can celebrate our 60th wedding anniversary.”

His daughter, looking tense, also faces her father and waits.

“I would like to be able to walk without falling,” he says. “Falling is horrible.”

This catches me off guard.

That’s all?

But it makes perfect sense. With challenging medical conditions commanding his caregivers’ attention, something as simple as walking is easily overlooked.

A wonderful geriatric nurse practitioner’s words come to mind: “Our goal for younger people is to help them live long and healthy lives; our goal for older patients should be to maximize their function.”

Suddenly I feel that I may be able to help, after all.

“We can order physical therapy — and there’s no need to admit you to the hospital for that,” I suggest, unsure of how this will go over.

He smiles. His daughter sighs with relief.

“He really wants to stay at home,” she says matter-of-factly.

As new as our doctor-patient relationship is, I feel emboldened to tackle the big, unspoken question looming over us.

“I know that you’ve decided against dialysis, and I can understand your decision,” I say. “And with your heart failure getting worse, your health is unlikely to improve.”

He nods.

“We have services designed to help keep you comfortable for whatever time you have left,” I venture. “And you could stay at home.”

Again, his daughter looks relieved. And he seems … well … surprisingly fine with the plan.

I call our hospice service, arranging for a nurse to visit him later today to set up physical therapy and to begin plans to help him to stay comfortable — at home.

Back home

Although I never see him again, over the next few months I sign the order forms faxed by his hospice nurses. I speak once with his granddaughter. It’s somewhat hard on his wife to have him die at home, she says, but he’s adamant that he wants to stay there.

A faxed request for sublingual morphine (used in the terminal stages of dying) prompts me to call to check up on him.

The nurse confirms that he is near death.

I feel a twinge of misgiving: Is his family happy with the process that I set in place? Does our one brief encounter qualify me to be his primary-care provider? Should I visit them all at home?

Two days later, and two months after we first met, I fill out his death certificate.

Looking back, I reflect: He didn’t go back to the hospital, he had no more falls, and he died at home, which is what he wanted. But I wonder if his wife felt the same.

Several months later, a new name appears on my patient schedule: It’s his wife.

“My family all thought I should see you,” she explains.

She, too, is in her late 80s and frail, but independent and mentally sharp. Yes, she is grieving the loss of her husband, and she’s lost some weight. No, she isn’t depressed. Her husband died peacefully at home, and it felt like the right thing for everyone.

“He liked you,” she says.

She’s suffering from fatigue and anemia. About a year ago, a hematologist diagnosed her with myelodysplasia (a bone marrow failure, often terminal). But six months back, she stopped going for medical care.

I ask why.

“They were just doing more and more tests,” she says. “And I wasn’t getting any better.”

Now I know what to do. I look her in the eye and ask:

“What are your goals for your care, and how can I help you?”

-Mitch Kaminski

Source

[tragedyboycentral]

How fucking annoying is it when you feel so restless with creative energy but you can’t decide what to do with it and when you finally try to create something it comes out shit so you just give up and sit there being all creatively annoyed and jittery.

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line & ayo!!

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I hope the "What if Disco Elysium was about a witch finding her cat in the mountains" post never leaves the gaming discourse vernacular. It will never not be funny to me bc it's got all the Gamer Entitlement™ levels of CoD bros throwing hissy fits about "woke" shit but instead of being couched in far right reactionism it's the exact kind of "Kingdom of Conscience" style liberal outrage at anything with conviction and beliefs that DE waxed on about. Like even chuds who get mad that the game calls you out for being racist interact with the themes of DE better and understand them more than Cat Lady did.