#I feel like I can’t talk to anyone abg it because I have a hard time talking nowadays

[cherrysnax]

blood orange seems to have a song for every emotion ever

[worldofherwords]

You.

Dear You,

I am writing to you because I am sad and I don’t have anyone to talk to. Because all my friends are tired of hearing about this and I feel like they pity me when I do. Also, I may or may not be a bit inebriated.

Our love started good, it was like finding someone you’ve known all your life. It’s like we picked up where we left off, even if we are virtually strangers. I honestly don’t know what made me fall for you, perhaps its how you decided that you want me, and no one has ever wanted me that surely before. Perhaps it’s how easy I found talking to you is, it’s like I’ve known you all my life. It wasn’t awkward even if I’m all but that. Initially, I thought that it’s weird that I had feelings for you because it didn’t make any sense at all. But all I knew is that I want to be with you. Wanted. For the first time, I actually saw a future with someone. I actually wanted to be with someone. I spent a lot of time alone, I was not desperate to be with anyone. Like I told you when we first started talking, I wasn’t planning on looking for a relationship. I was just honestly there cos I was bored and wanted to talk to people. Then I met you.

When you first encountered problems, I told myself that it’s time to leave. It was too much too soon. I wanted to comfort you and be there for you even if I knew you didn’t want to. My stupid mouth slipped and accidentally told you that I love you. Maybe that was the start of the end, beginning of nothing, because it was too much too soon. Perhaps you only got carried away by how I feel so you decided that you also felt the same, even if it wasn’t the reality. Regardless, I pushed that anxiety down because you said you loved me. It felt amazing, like a breath of fresh air. You were telling me things that I’ve never heard anyone say to me, making promises that sounded like I’m the only girl in the world. Too bad they are just words.

I immediately got used to being around you, even when the signs said that you’re not fond of it. I felt like I was bothering you all the time but then you would have moments where you would act like you’re so in love with me. I told myself that maybe the good times are worth it. The best part you did that made me feel like maybe you truly do care is when you spent time with me even after your long shift from work, just to make sure I’m okay. I was holding onto this, so much. Every time someone says that I’mbeing treated like shit, I always tell them no because I’ve seen this part of you that cared. But that’s the thing, I can’t keep holding out to when you decide to be like that again.

February came around and I was so excited because it will be the first time in years that I will be celebrating Valentine’s Day with a boyfriend. The day came and you didn’t even greet me, you said nothing. I felt stupid for hoping that you’d care. I brushed it off, the pain, because I knew it was your birthmonth. I said maybe you’re just not a valentine’s day person. Maybe you’re just not romantic. I pushed all the hurt and anxiety down. I worked tirelessly to earn enough to send you some gifts to make you feel special on your day, because you told me that no one has cared enough to give you a gift. I wanted to make you feel special, even with the distance. I was so happy because I succeeded! You were happy, you felt special! That was the goal. You started being warmer and sweet towards me, I was happy because I thought hey it’s turning around finally! Yay. But I didn’t know that it would last only for a couple of weeks before we got back to you ignoring me again and making me feel as if I don’t matter. I thought that you getting a Nintendo Switch would save our relationship, cos we’d spend more time together. But it didn’t last for long. You got tired of it and we’re back to our normal routine. Maybe you deleting the stupid post I made on your game was enough premonition to me that you didn’t want people to know you’re taken. You explained everything then, I thought to myself – wow he didn’t just shut off. This is progress. I thought you were telling the truth. I believed you.

Admittedly, what I did next is wrong. I listened to people who said that you weren’t serious with me. I didn’t want to believe hem, believe me. But after seeing what they had to show, it was hard not to believe it. Especially knowing that it was a romantic thing that never panned out. It made me feel like you were still hoping to someday be with them. That you’re only with me because I’m the one who’s available. Maybe that’s another problem of mine, I’ve made myself so available to you. Even when I’m busy or not feeling my best, I would always run to you the moment you need me. Give you whatever you need even if I have nothing. Because to me, that’s love. While I was loving you, I forgot to love myself. I started picking on myself, maybe if I look more like them then you’d pay me enough attention. Maybe if I act more like them then you’d feel as if it’s not a chore to be with me. Because those are the things that you made me feel. That I have to act a certain way to be with you. You only wanted Happy me, not the sad depressed mei. Which is so unfair. But I said, hey maybe that’s what lve is. And god, I was dumb to think of that. I tried to push the negativity out again, after we talked. I tried to tell myself that I can do it. That I wouldn’t want to lose the potential future we have. But then I saw you looking at other women, you said you enjoy their content but their content is porn. It made me feel horrible yet again. It made me feel disgusted and disgusting. That maybe you only liked me because of what I am. I felt sick to my stomach seeing you enjoy ABGs shaking their ass on screens, I felt fetishized. You were acting as if you’re single, looking at these women with their tits and asses out. You were giving them the attention that I wanted. Even after promising that you won’t. I tried to bargain against myself, thinking that maybe you’d change but it just doesn’t feel right. I was willing to look the other way and take what you say and believe it. But at the end of the day, those are just words right?

I guess its too much for me to ask to be respected? I don’t know. All I know is that when I’m with you, I feel small. Insignificant. Ugly. Unwanted. Unloved. I’ve never felt this pain before, and I’ve been through so much. Maybe it’s my fault because I ignored all the signs. But I was so in love with you, you don’t even know it. I put you up in a pedestal, thinking you won’t do anything to hurt me. Because I thought we saw each other eye to eye. I didn’t know I was wrong. I guess red flags are just flags when you’re wearing rose colored glasses. All I wanted was honesty, all I offered was honesty. Never have I ever lied to you in the duration of our relationship.

I don’t know why I’m writing. I don’t even know if I’ll send this. Maybe.  Maybe not. Not sober, at least. I doubt you’ll even care. I doubt you’d even read it. I doubt it. Maybe this is the universe’s sick revenge, karma, for all the guys I’ve ghosted and hurt before you.

I want you to know that I really did love you. I’ve given you my all. And this is the same reason why I want you to stop pursuing me. Especially if you’re not ready. Because I will always come back to you. Because you will always have a space in my heart. But if you truly love me, please spare me the pain.

I really wanted it to work. So bad. That I was willing to look past how much I’m hurting. I guess you’re right, maybe I’m too emotional. But it’s something I’m proud of, especially after being robbed of emotions all my life. It’s not wrong of me to feel things, I worked so hard for it. I was so vulnerable with you, completely no walls barred. Maybe that was wrong of me. Maybe I should have left some for myself. That’s just how I am, I love so hard and selflessly. I’m sorry if it was too much for you.  I’m sorry I had to leave the way I did. I needed to save myself of the pain. I just can’t handle it anymore.

Maybe one day, if you find yourself here or I there, maybe we could try again. When we’re both ready for each other. But for now, good bye and thank you for everything. I’m sorry for everything as well.

PS- don’t forget to cut yourself some slack. You are trying your best with what you have, you have overcame a lot and you should be proud of that every single day. As I am.   You will live a fruitful life with someone who will love you unconditionally and understand you completely, without it being so difficult.

[revalise]

After the Sun [M] | 01

Pairing: Chrollo Lucilfer x Fem. OC

Genre: Romance and eventual smut

Rating: M

Words: 2500+

Notes: Huge thanks to Sky @pixiewombat for beta reading this chapter! 

All characters are humans unless otherwise stated in their description. Hence, Zazan is human in the story.

Masterlist | Prologue | 02

Chrollo Lucilfer gets everything he wants, when he wants-even if it means undergoing extreme measures. Nothing bothered him, until an aphrodite, Astra Gerber, appeared one night and stole from the infamous thief. In return that Chrollo doesn’t report her, he strikes a deal. But it could be more than what Astra bargained for. 

BOLD

“What do you mean your necklace was stolen?” Pakunoda eyed Chrollo carefully as he sat behind his desk at his penthouse, looking over the magnificent, illuminating lights of Yorknew City, while she stood in front of him.

“It just was stolen,” he deadpanned.

Pakunoda clicked her tongue. There was no way someone could steal from Chrollo—a bandit himself, and a good one at that.

She thought to herself for a moment. ‘Is he planning to steal the poor girl’s hatsu?’

Once, he had charmed the pants off of a girl who could write fortunes and stole her ability. Despite his obvious antics, he wasn’t found out, thanks to the girl’s inexperience. But when he managed to get a hold of how it should be done, he started doing it again and again. 

Pakunoda didn’t complain. Chrollo’s Bandit’s Secret was a trump card, not only for him, but for the rest of the group. When Chrollo noticed the drastic advantage the ‘strategy’ gave him, he started using it more often. To him, it felt like a shortcut.

And who would expect someone so sophisticated and pretty-boy looking?

She sighed and put the folder down on his desk.

Chrollo had asked Pakunoda to find the girl who had stolen his necklace. He remained vague about it, but knowing Chrollo, it might be something extremely important. 

He looked over the files, silently reading their contents, taking them in just as he consumed  knowledge from his ancient books. His fingers traced the letters of the name written in bold on one of the pages.

ASTRA BEATRIZ GERBER

Pakunoda gazed at him with suspicion. Meddling with this girl could endanger the nature of the group. She was nowhere near a simple girl, alright. The girl spelled trouble.

She was the illegitimate child of an acknowledged former lawyer, Martin Gerber, before he took over the Gerber family dynasty.  

This information wasn’t exactly kept a secret. It was silent gossip within the small circle of socialites and elites. Illegitimate children weren’t news to the circle. Three out of five families in the circle had a case of their own. But it so happened that the Gerber family was known to be conservative—faithful to their betrothed, or as painted by the media.

Nevertheless, it only took that mistake to have the head of the family, Rod Gerber,  wavering in his trust in Martin. To his dismay, this almost cost him the whole dynasty. Fortunately, Rod was a good man, unlike his son. To secure his position in becoming the next successor as the eldest, Martin had to keep the child and take her as his own.

It shamed Martin to do so, keeping an illegitimate of his own accord. Though his wife was noticeably against it, she had to agree if she wanted to be the wife of the very powerful man. Cleverly, she argued that it would bring discomfort to her family if the child were to live in the same house as them. Rod then agreed that Martin would just have to sustain the needs of the child in the mother’s care.

Chrollo took all of the information  in, almost feeling bad for the girl, if  it weren’t for his own experiences.  

The same thought as Pakunoda had crossed his mind. Her father had connections in law. If Chrollo, say for example, met the girl’s father and he decided to look deeper into Chrollo and his background, it wouldn’t really be a problem. The group knew how to cut their ties. They eliminated those who had seen them. But if worse came to worst, this could have blown the group’s cover. 

The Phantom Troupe weren’t regular thieves. They were thieves with intellect that calculated their every movement. Before they acted on anything, Chrollo, who had a personal philosophy of theological dualism - the balance between good and evil - that influenced his decisions, would first weigh his options. His actions were always calculated.

It was not that they feared the law or the man himself, but the Phantom Troupe managed to blend in with the crowd, no one knew of who they were. And the group loved being free despite the criminality they commit.

From the moment he first laid his eyes on her, he knew she was trouble.

But none of the information stopped him.

***

Zazan promised Astra dinner. But it was way past dinner, and the staff of the three-star Michelin restaurant she had booked kept going back and forth, assisting and asking for her order, which she refused to give until her aunt arrived.

Her aunt, Zazan, was her father, Martin’s, little sister. For all her life, she was her mother figure. Zazan always had her back whenever her father didn’t. Her aunt loved designer and luxury items, and was a designer herself. Hence, her love for luxury and designer.

To state it simply, Astra was given to her aunt after she lived with her dad for two years when her mother died. She was only six then.

She remembers how much scorn she received from Martin’s legitimate family, and how she was treated as less than a freeloader, being an illegitimate child. Not once did her father defend her from them.

After all, she was a nobody, aside from the Gerber blood running through her veins.

Astra, at four, never spoke with anyone, not even the maids that served the family in their mansion. She remained quiet, hiding inside her room, but doing everything she was told—even standing for hours, with no food and water, beside the silver knight decorations in the hallway of their house because her older half-sister told her to. She ignored the numbing sensation in her knees until a helper saw her.

That was, until Zazan returned to the city and took interest in the meek, little girl she once was. And for the first time in two years, she spoke and her voice sounded hoarse. Her words were: “Can I come with you?”

From then on, Zazan took her as her own. Martin had no objections, nor did his family. In fact, the situation was in their favor. In his father’s eyes, as long as Astra wasn’t disobedient or brought problems—more than she already had, being an illegitimate—upon the family, it’d be fine.  

However, it seemed Astra grew up to be a spitting image of Zazan’s personality. Astra grew bolder, braver, and stronger, all because she had Zazan to look up to. But Astra wasn’t nice on a daily basis. She was nowhere near a saint.

“May I take your order, miss?” a smiling boy, who looked a few years younger than Astra, came to assist her. But a girl, wearing the same uniform as him, came to them, gripping his arm.

“Sorry, miss.” The staff leaned in closer to the boy’s ear to whisper, “I’ve been trying to take her order. She’s waiting for someone, but I think she got stood up.”

“Oh...” the boy muttered “Too bad, she actually looks pretty.”

He turned his attention to Astra, about to apologize, when she interrupted him.

Astra laced her fingers together, her elbows on the table, and rested her head on her hands. With a sarcastic tone, she said, “If you’re going to talk shit about me, consider doing it somewhere else where I can’t hear you.”

“S-sorry, miss…” the staff muttered, afraid. All of their customers had power, because only the rich could afford the place. They feared they could lose their jobs. Most of all, they knew who Astra was. They knew of her influence.

“But thanks for complimenting my looks.” Astra flashed a grin that didn’t reach her eyes. “Get me some champagne.”

They scurried to give her what she wanted, too obvious in wanting to leave her sight.

Astra leaned on her chair, her arms crossed over her chest. She clicked her tongue in impatience. For once, she regretted asking for champagne. She felt the urge to leave. To elites like her, hunger didn’t come, anyway; she’d still have a lot of food at home. She could leave before they gave her champagne, and leave cash three times the bill, but her pride made her stay.

And she hated to admit it, but she really needed to see her aunt. She needed someone.

She needed someone to hold her at times she felt like slipping away.

As Astra waited impatiently, a man sat at the opposite end of the table. It happened so quickly, she didn’t have the time to process it. The man looked studly in his crisp suit. He wore a white shirt underneath, topped with a dark blazer and slacks.

“I’m sorry. Did I keep you waiting?” He asked in his most polite tone while he pulled at the opening of his blazer.

Her eyebrows shot up and she clicked her tongue, but she tried to maintain her composure. After all, it was a restaurant for the high-class. Manners above all.

“Sorry, you must have the wrong table.”

The man chuckled. “Oh, have you forgotten about me, miss? Allow me to reintroduce myself,” he grinned, “I’m the man you stole from a few nights ago.”

For a moment, perplexity was etched on her face, ‘Bitch, which one?’ 

Yes, the man looked a little familiar, but with the amount of people she was acquainted with, it was hard to keep track of the long list. 

“Oh, I see,” she said plainly. “I must’ve stolen from you when I was drunk.” 

Astra leaned forward and put her elbows on the table. She whispered, “You see, I have a habit of doing those when I’m drunk.” She flashed her sultry smile. 

Her hands reached for her fuchsia devotion bag made of python skin. It featured an exclusive bejeweled personalized heart closure, inspired by the techniques of fine jewelry, which etched her initials in it.

ABG

Astra clicked her tongue when her eyes met her initials on her bag. She laughed inwardly at how she sent it back to Italy when her initials weren’t in bold.

“How much was it? I could pay for it right now.”

The way the man grinned at her assured her that it’s done for. Game over. She wins. Whatever she did, she got away with it. Not because of her pull and connections, but because of her charm. And she knew it. She grinned at this. 

“Actually,” the man began, “I have other things in mind.”

“Oh,” Astra had a knowing smirk. She knew of what the man could possibly ask. It was no different. He was no different from all the other men she’d met before. ‘A night, perhaps?’

“Let’s hear it,” she said sultrily. 

It was the man’s turn to lean closer and rest his elbows on the table. He laced his hands together and flashed a smile. “I was thinking of jail time.”

Her hypocritical smile dropped. She was rendered shaken. Just as quick as the change in her mood, the sourness and bitterness of being embarrassed in front of the mysterious man in front of her, she showed her true colors. 

‘Where the fuck is my champagne?’ she thought.

Her back rested on her chair and she crossed her arms. “Name?” her tone was as rude as it could get. 

“Now we’re talking,” the man chuckled, and he rested his back on his chair as well. “Chrollo Lucilfer. I believe I already told you that. I’m hurt you forgot about me so easily.”

Astra didn’t reciprocate the demeanor Chrollo was showing. While Chrollo looked composed and polite, Astra, on the other hand, was irking in anger. 

“What do you want?” she spat, so rudely you wouldn’t think that it was the same woman who had been flashing sultry and inviting smiles.

“Nothing much, actually,” he grinned but it didn’t reach his eyes. “If you’ll come with me, I’ll discuss the matter, and I promise you it’d be done with.”

If it were only a few minutes ago, she would have gone with him at that very moment. She would’ve taken him to some backroom and let them do their business. But it was different now. 

To her, it seemed like the man didn’t want any physical relationships. He was danger, nothing else. 

“And if I refuse?” 

“Your scandalous actions will not only be known by your father, Martin Gerber, but your little circle as well,” he replied.

“I’m impressed. You’ve done your research about me,” she scoffed. 

One of the staff who assisted her earlier appeared with champagne in her hands. She kept her head down, but kept a shy smile and gave continuous glances toward Chrollo as she poured the liquid into their respective glass.

“Thanks, miss,” Chrollo flashed the girl a sweet smile. 

Astra could have sworn she saw the girl almost curtsy at that. She rolled her eyes. 

When the girl left, Astra arched her brow. Chrollo on the other hand, ignored her demeanor. “Shall I order you some real food?” 

He was about to call the staff again, but Astra stopped him. “I’m not hungry.”

For a moment, Astra almost regretted her actions because Chrollo might be hungry. But if it’d be the same staff who keep annoying her with how they tried to get the man’s attention, forget it. 

‘What is with this restaurant anyway? Why are they always the same people?’

Once the foam settled on her champagne, she drank it quickly, picked up her bag, and stood up. When she looked over at Chrollo, who still sat on his seat gazing at her, she scoffed. “I’m coming with you. Wait for me outside in a moment.”

“You’ve said that before,” he replied, reminiscing to when she said the exact thing when they met the other night, and then she was gone with his St. Peter’s cross necklace.

“You seriously have something on me. Do you think I’ll run away from you?” Astra argued. “Besides, you’ve done your research on me. So I expect you to appear wherever I am.”

“I don’t believe you,” Chrollo stood up. “Wherever you’re going, I’ll come with you.”

Astra rolled her eyes. If she didn’t have something, it would obviously be his trust. And she had to get it no matter what, if she wanted to get out of the situation quickly.

She turned on her heel and Chrollo followed closely behind her. Suddenly, something rang from Chrollo’s pocket when they stepped out of the restaurant and into the lobby of the luxury hotel. Astra turned her attention to it and then to his eyes looking back at hers. 

“Go,” she nodded at him in a dismissive manner. “I promise I won’t leave.”

Chrollo eyed her carefully, weighing the sincerity of her words, to which she responded with widening her eyes at him. There was a faint smile in Chrollo’s face before he finally took his phone out and turned his back on her. 

Astra lightly shook her head. She didn’t notice, but there was a small smile on her face as well. And just as if the timing couldn’t be more perfect, someone she knew all too well appeared in front of her, looking down at her, mocking her.

“Dad…” she whispered.  

[jcforsapphics]

Fake our way to love- chapter 1

TJ was nervous.

Well, of course he was nervous, what he was about to do was incredibly dangerous. And incredibly stupid. Honestly, he was kind of afraid for his life.

He should be afraid for his life, because Buffy Driscoll could kill him -and everyone else she hates- if she wanted to. And oh, she definitely wanted to kill him.

Since the moment they met, TJ has been nothing but a jerk to Buffy.

Constantly bullying her just for being a girl, never giving her the balls in games. She had every right to hate him.

TJ never really had anything against Buffy, he just did what people expected him to do. He actually thought Buffy seemed rather nice, and that she was a really good basketball player- something he could definitely use, because if he was being honest, the basketball team was a complete disaster.

But of course he ruined any chance he had at being friends with her the moment he told her she'll never be his teammate. Which of course, she end up being- but still, it doesn't really feel like it because he never pass her the ball.

But it was all (hopefully) about to change. If Buffy agree to his deal, he'll pass her the ball anytime she wants. She could be the new team captain, for all he cares. All that matters is that she'll say yes.

Which she probably won't. But it's worth a shot, right?

Buffy walked into the basketball court and TJ made his way to her hesitantly.

"Ummm... Hey, Buffy, can we talk?" He asked nervously

Buffy eyed him suspiciously before she shrugged

"So uh... Ok, this is kind of hard for me to say. Please at least consider it, ok? And don't tell anyone!" TJ warned

"What is it about, Kippen?" Buffy seemed annoyed

"I need you to be my girlfriend." He blurted

Buffy's eyes widened and TJ hurried up to explain

"Not actually my girlfriend! Just... Pretend to be my girlfriend."

Buffy snapped out of her shock quickly and folded her arms "and why the hell would I do that?"

"Because I'll pass you the ball in every game and tell the other teammates to do the same." TJ said without missing a beat

Buffy blinked. "Why do you need a fake girlfriend, anyways?"

"I'll only tell you if you'll agree." TJ folded his arm

Buffy thought about it for a few seconds, and than sighed and rolled her eyes. "Fine. But if the reason isn't good enough, I'm cutting off the deal. But I won't tell anyone you asked me, or the reason. Maybe I'll tell the reason if it's some dirty funny secret about you, but I won't tell them how I found out about it."

TJ blinked. That was a way better compromise than he thought he'll get.

He nodded. "Ok. I'll tell you why after practice, I just don't want anyone to hear."

Buffy looked suspicious again "is it like something really bad? Or are you just tricking me?"

TJ's eyes widened "no!" Buffy raised an eyebrow at how squeaky hus voice sound, and he cleared his throat. "I mean, no, it's not a trick and it's not anything really bad. At least, I hope it doesn't count bad." God, he really hoped it doesn't count bad.

Buffy still looked suspicious but mumbled a 'fine' and went to the middle of the court.

Just then, one of his teammates, Jason, has arrived.

"Dude, what were you doing talking to this Buffy chick? Holy shit, do you have a thing for her or something?" Jason asked with wide eyes

TJ took a deep breath. Well, I guess it starts now, was the last thought going through his head before he spoke: "yeah, man. I mean, she's pretty hot. And I think she's up for it."

Jason eyes widened even more, but he grinned as he said: "dude, that's awesome! We all wondered when you'll finally get a girlfriend! I guess that's mean we should pass her the ball now?"

TJ shrugged "depends on how it goes. We're going to talk after practice, so I'll tell you after if it works out."

Jason nodded, still grinning "yeah, ok, totally. Is it ok if I tell the other guys? I mean, I know Leo though about asking her out, so we should probably tell him so he'll know she's yours. I mean, even if she'll say no, he can't ask her since you did first."

TJ internally cringed when Jason said Buffy was his. Even if we were really dating she wouldn't be my property, he thought, but he just smiled and nodded.

----------

After practice, TJ fidgeted while he was waiting for Buffy.

He was so nervous, both from telling Buffy, and from actually saying this words out loud.

Yes, TJ admitted it to himself a while ago, but it really wasn't that long ago (although deep down he always kinda knew) and he never said this words out loud. He never even told his sister.

To be honest, he found it quite funny that the girl he was bullying was the first person he come out to. And kinda sad, too. But he really hoped she'll react well and won't make him regard telling her.

Buffy narrowed her eyes as she walked towards TJ.

"Well, Kippen, what is it? I don't have all day. Unlike you, I actually have friends to hang out with."

TJ couldn't deny hearing this words hurted him, because he knew they were the truth. But he shrugged it off.

"Driscoll- urgh, Buffy, I need you to pretend to be my girlfriend because-" TJ took a deep breath "I need you to pretend to be my girlfriend because I'm gay."

That's it. He said the words out loud for the first time.

He looked up to Buffy to see her reaction, and his eyes met her wide eyes.

He waited a few seconds for her to speak but she didn't say anything.

"So, uh-" TJ stumbled awkwardly "I kind of have to go- you know, to get food. Before people eat all the good stuff, so uh- yeah. Bye." He finished lamely

Just as TJ turned around, he heard Buffy calling for him.

"TJ, wait!"

He couldn't hide his suprise as he turned to look at her, and saw she was still a bit shocked, but her look softened. He couldn't hide his suprise about how soft her eyes were, too.

"Are you serious? Like, are you really gay or is this some type of weird joke?" She asked

TJ shook his head "no. It's real. I'm really... It's real."

"And you need a girlfriend so people won't find out?" Buffy asked softly

TJ nodded, still shocked about how soft her eyes were, and about the fact she figured it out so quickly.

"Yeah. The guys on the team... They always ask me when am I finally going to get a girlfriend, you know, since I'm the captain of the basketball team and I'm popular and all that and of course hot girls will like to go out with the basketball team captain- and anyone on the team. But especially the captain. And they know that some girls asked me out, but that I always turn them down. And you know, some of those girls are really nice, and I sometimes wonder if I should say yes, but I know it won't be fair for them, since I'll never feel the same way."

TJ didn't know why he was telling her all that. Maybe it was from relief, that he can finally talk to someone about this. About him being gay. Because he never talked to anyone about this. Or maybe, it was because Buffy was looking at him so softly. And maybe it was both.

And maybe it was just because he needed to convince her to play along. But something inside of him told him it was more than just that. He wouldn't have told her all of this just to convince her.

Buffy looked at him, like she was encouraging him to keep talking. So he did.

"Some of the guys already joked about me being gay, and I know its a joke, but I just want them to stop before they realise I'm actually gay. And of course I'll tell them one day. It's just... Not my time."

It's only when he said that TJ know he was right. It's not his time. Not yet. But one day it will be. Something inside of him told him that and he felt like it was the truth.

Buffy took a deep breath and then look at him straight in the eye.

"Ok. Let's do this."

TJ's eyes widened. He was not expecting that.

"W- what?" What are you talking about? Why would you agree?

"Yeah, I'll do it. I get it. It's a good reason. I might don't like you, but nobody should feel afraid about their sexuality. If it'll help you coming out in the future, I guess I owe you that. So, let's meet tomorrow at lunch and talk about it?" Buffy answered, her expression unreadable.

TJ blinked, and then nodded like an idiot.

He waited until Buffy walked away to bang his head against the wall. He couldn't be so lucky. He just couldn't. He never was.

And he couldn't believe Buffy actually agreed.

He honestly didn't thought about an option where Buffy agree, and he didn't know what to do now. He only thought about an option where she said no, and didn't tell anyone, and an option where she said no and told everyone and he was completely humiliated.

But Buffy seemed to have some sort of soft spot for that kind of stuff. And he was lucky she did.

Well, he thought, tomorrow will be a life changing day.

Tag list: @abg-blah @extrairwin @luzawithoutu @buffysoftie @herculesthedemigod @tyrusstan06 @purplefacey @ravencremisi @tjkxppen @tyrusxmuffins @hellolancemcclain @tyrus-is-godtier

[dxmedstudent]

Hello! You may have previously answered this but from your experience, how would you say the role of a physician associate is different from a junior doc on the same team? when I ask how their role is different I always get the “we’re generalists and medics specialise”. I guess my main query is, when I’m practicing alongside these colleagues in the future, what should I be mindful of in terms of limitations of each of our roles and how better to evaluate skill mix of a team? Thanks :)

Hmm, It’s hard to say. Partly because the role of the PA is still quite new in the UK, and it’s not universal across hospitals. So where trusts are bringing in PAs or DAs or APs or NPs etc, they are giving them slightly different roles in order to fit what they need. For the most part, there seems to be reasonable overlap in what both sides can do. For the most part, it’d mean both sides talking to each other about the limits of their competencies, and what they are comfortable to do; not every PA/NP/DA can do say, cannulas or ABGs, whereas some can do very specialised skills. Personally, I haven’t worked with many people I’d describe as PAs in the sense most people think them, though I’ve worked with DAs, NPs, ANPS, APs etc. I can say it worked well where I’ve worked with such practicioners, but I wouldn’t feel able to comment in detail about a working relationship I’ve not had experience with, yet. It’s be important to ensure neither side is left with all the jobs nobody wants to do, whilst the fun jobs are snapped up. Anyone who is in training needs to have reasonable provisions for their training needs to be met; in the same way that a department which doles out its procedures to FYs or GP trainees but can’t make adequate provision for their CTs to get to clinic/theatre or do the things they literally need to do would not be working well. It can be a fine line to ensure everyone gets to do fun things whilst making sure that people who need to do them aren’t left feeling like they don’t get chances.PAs generally still need senior doctor oversight in terms of their decision making (which of course, junior doctors also need), so it’d be important that junior docs aren’t asked to oversee colleagues in a capacity they aren’t yet able to do. What people can and can’t do, though, might be different from trust to trust. And there can be a huge difference between someone who was once a very senior nurse who retrained into this role, and a brand new PA. Your best bet would be if a PAblr gives us their opinion, though even that would depend on which country we’re talking about.

[ronaldmrashid]

Always Be Grinding! Financial Samurai 2017 Goals And Outlook

Happy New Year Everyone!

Hopefully all of you survived and are ready to rock it in 2017! I spent a lot of time over the holidays thinking about why I failed at so many things, and the consistent answer I came up with was that I wasn’t grinding hard enough.

Why did I gain 5 lbs instead of lose 5 lbs? Answer: Because I didn’t grind hard enough at the gym and give a crap about the way I looked. I worked out maybe twice a month on average and didn’t watch the quality of food I ingested.

Why did I lose all my tennis league matches? Answer: Because I didn’t grind hard enough on the court. I wasn’t practicing my serve and volleys as much as I should. Instead, I was just playing fun matches that did nothing to improve my skills.

Why was my online traffic only marginally up in 2016? Answer: Because I didn’t grind my mind hard enough. Instead of writing more posts, introducing new mediums of communication, addressing new topics, and publishing a new ebook, I left things status quo. I told myself in my 2016 review post I was most proud of not quitting. Come on. That’s weak! Writing is like a full body massage compared to digging for coal or constructing a house in the middle of a Texas summer.

It’s so easy to get soft in America, especially as you get older. As a result, my theme for 2017 is: Always Be Grinding. ABG baby!

Related: Perpetual Failure Is The Reason Why I Continue To Save So Much

Things Feel Different Now

I haven’t been this excited since I first got a job out of college when the sky was the limit. For the past 10 years or so, I’ve been questioning what’s the point of working so hard if the government is just going to take more from us than what we’re able to keep. To finally get some potential tax relief is thrilling!

Everybody should strive to have a higher savings rate than their effective tax rate. Can you imagine saving just 10% of your gross income while paying a 20% effective tax rate? What a joke. Politicians are laughing all the way to the bank for being able to keep the masses enslaved so they can remain in power.

The upside to a corrupt and inefficient government with trillions in unaccounted for tax dollars (see the Dept. of Defense) is that it pushed me towards a life of leisure. I would never have engineered my layoff in 2012 had the correlation between effort and reward stayed intact. I never would have started a lifestyle business either. It’s been fantastic paying less in taxes and not having to work for anybody since my departure. My stress level has gone way down as well.

But now that the correlation between effort and reward is tightening up, it’s time to grind until the window shuts again! Without further ado, here are my goals for 2017. They are divided into three categories: Business, Personal and Personal Financial.

Business Goals

1) Focus on growth by broadening the audience. I’ve received plenty of feedback that I need to write more for the mass market. Even though my advice holds true whether you have $1,000,000 to invest or $1,000 to invest, readers have told me they can’t get their heads around larger numbers. As a result, some readers will tune out and that’s bad for growth.

It’s not my fault the median home price in San Francisco is ~$1.1M. I just write about my first-hand experiences to keep things authentic. Personal finance is too important to be left up to pontification. But I acutely realize the way to mega millions is to relate to as many people as possible. At the same time, I don’t want to make up things I’m not interest in or am not going through.

Therefore, I’ve decided to add my best friend, Sydney from Untemplater, on as a regular contributor. She’ll focus on broader personal finance topics, family finances, women’s finances and be my podcast partner in our little Dojo Talk podcasts going forward. I’m confident there is a great need for expansion in these categories on Financial Samurai.

Sydney is great because she’s living the dream as a business owner and freelancer ever since she engineered her layoff with a severance package back in January 2015. I was her coach. Here’s her severance negotiation story, which I’m so proud of!

2) Publish a new ebook by July 18, 2017. Despite the rise in interest rates, it still takes a gargantuan amount of money to generate $1,000 a month in passive income – we’re talking $300,000 in capital at a 4% gross yield. I was so focused on building a large municipal bond portfolio after the sell-off in November and December that I forgot I could easily write a new ebook and earn $1,000 a month with no downside!

Therefore, I’ve decided to publish a unique book on real estate investing. It’s going to be one of the most entertaining and thorough books about real estate on the market. It’ll be an actionable book that anyone from beginning investors to experienced investors can use to help create wealth, build passive income and avoid extremely bad mistakes. I promise to write in my usual no BS style.

3) Focus on three business partnerships. I’ve got about 10 business partnerships with Financial Samurai right now. It’s very easy to get spread too thin as the main writer and business development guy. Instead, I need to identify three things I’m most passionate about and tilt my writing towards these three topics to build a deeper portfolio of articles. Then I need to identify the three best products that match these topics to create incredible business synergies.

I’m currently most excited about entrepreneurship, real estate crowdsourcing and family finances.

I’ve got so much to share about being an entrepreneur and earning side income after eight years. The upside is unlimited when you work for yourself. So many people believe they can’t do anything because they don’t have an idea or don’t believe in their abilities. The truth is that nobody has everything figured out in the beginning. They just start, learn and pivot as they go.

Real estate crowdsourcing is the perfect solution for real estate enthusiasts like me who don’t want to buy another physical property for a while. Dealing with tenants and maintenance issues as I get older is very counterproductive to living a good retirement life. However, real estate has been instrumental in achieving financial freedom (~50% of my passive non-online income) and I want to continue investing wisely in various projects around America for hopefully higher returns.

Finally, talking about important family financial issues will be topic du jour for 2017 now that I’m hitting middle age. I’ve already tested the waters with posts such as, Is Private Grade School Worth It? and Scraping By On $200,000 A Year to a warm reception. Now I plan to go deeper. Sydney is really going to be of great help in this endeavor.

4) Send two to four e-mails a month. I’ve been paying $150 a month to send out only one newsletter a month for the past couple of years. What an underutilization of resources. What’s held me back from sending more e-mails is believing I have to write meaty e-mails to add value. Instead, I plan to write shorter, punchier e-mails to connect with all my newsletter subscribers. There’s like 30,000 of you or so. All I’ve got to do is get into a routine, come up with a consistent topic, and not worry too much about trying to impress.

Personal Financial Goals

1) Create a million bucks of wealth. Last year my goal was to growth my net worth by $500,000 because I had a neutral-to-bearish outlook. Given I’m now bullish on my business, it’s only logical to shoot higher. In a strong business environment, valuations for businesses start expanding like magic. If I can grow earnings and expand valuation multiples, then growing wealth becomes much easier.

The equity you own in your business is one of the biggest reasons why everybody should start their own business. Not only can you make money every month from your business, you might also have the option to sell your business based on a multiple of revenue or earnings one day. As an employee, you can only sell your talents to the highest bidder. As a result, you’ll always be stuck having to trade your time for money.

I already spoke to the CFO and CMO of one publicly traded company and one private company about a potential acquisition. As a result, I’ve got an idea of the valuation of my company. Now all I need to do is grow my brand, traffic numbers, search rankings, and revenue and I’ll be set!

Value Creation Scenario

Potential acquirer: We’ll offer you $6,000,000 for Financial Samurai based on a 8X operating profit plus a $500,000 earn out if you stay for two years.

Me: Given my operating profit is growing by 25% a year for the next two years at least, and the S&P 500 is trading at a 18X operating profit multiple, let’s split the difference. I’ll sell for $9,750,000, based on a 13X operating profit multiple, and will stay on for two years at $200,000 a year to make sure everything transitions smoothly.

Potential acquirer: You’ve got yourself a deal.

See how easy it is to create some wealth? All you’ve got to do is create something of value. I don’t plan to ever sell my company, but for the right price, I will and then start a new company. That’s the American dream.

Related: The First Million Might Be The Easiest

2) Invest at least $20,000 a month without fail. The $20,000 a month doesn’t have to be in the stock market. It can be in bonds, real estate crowdsourcing, private equity, private debt, or paying down a mortgage. I actually did a deep dive analysis of my investing habits for 2016, which I’ll share with you guys in an upcoming post. It’s pretty eye-opening how much we think we invest versus how much we actually invest. By investing $20,000 a month minimum, I should be able to grow my net worth by at least $240,000 this year.

3) Start earning $20,000 a month in passive/semi-passive income by year end. My passive income is currently averaging about $17,600 a month over the past six months. To increase my passive income by $2,400 a month, I’ve got to publish my real estate book by year end, market it well and update my severance negotiation book for 2017. My products will be my main passive income growth driver once again.

The other growth driver will hopefully be the redeployment of roughly $400,000 into higher returning investments compared to the ~4% return that money was getting in a CD and a LIBOR+ private investment. Instead of earning $16,000 a year from the $400,000 investment, I could feasibly earn $32,000 a year, or $2,667 a month total ($1,333 extra) via an 8% returning investment. Hence, my focus on higher income producing investments for this year. Thank you bond sell-off!

RE outperforming since 2001, and roughly inline with the S&P 500 since 2011 at ~12% annual return

4) Spend like I’ll be dead within 10 years. I’ve been frugal my whole life. It’s one of the main reasons why I was able to hit the eject button at 34. But, I’ll be 40 in 2017 so it’s time to live it up for the second half of my life. You don’t have to be as stealth in middle age because people are more accepting of those who’ve spent 20+ years working. If they aren’t, then they’re just being jealous idiots who weren’t willing to work hard for a long enough time themselves.

I will buy my mid-life crisis car that costs $60,000 – $80,000. I will pay an extra $100 for Economy Plus seats to Hawaii each way (still can’t afford first class comfortably). I will buy the latest version TV instead of buying the previous version to save $300. I will pony up $400 more for 1 TB of hard drive space for my new laptop. I will pay $6.25/hour for parking after driving around the block once. I will turn the heat on full blast when it gets to below 60 degrees. I will always pay up for convenience gosh darn it!

Every time I buy something, I feel guilty for not using that money to invest because I’ve been an investing addict since sophomore year in college. I also grew up middle class working summer jobs at McDonald’s and moving furniture. My upbringing is probably the reason why I felt so comfortable giving over 500 Uber rides as a financially independent adult so far. I’m not too proud to do whatever it takes to support my family.

Therefore, I plan to always invest the $20,000+ a month first before splurging on anything to counteract my the uncomfortableness in spending.

5) Don’t chase the stock market. Although I’m bullish on my business, I’m lukewarm on the stock market and the economy. The higher rates go, the more consumers get squeezed. The period between 2009 – 2016 was a great time to focus on growth stocks. For 2017, I think it’s a great time to focus on income now that equity valuations are stretched and the bond market has finally sold off some. Always be vigilant about protecting your gains.

Instead of having a majority of my public investments in stocks in 2016 (~70%), I’m rebalancing to 40% stocks and 60% bonds (80% municipal bonds). Besides stretched valuations and more attractive income yields, I think there will be roadblocks on Capital Hill to pass what everything Trump has promised.

With 40% exposure to stocks, I’ll still be able to participate reasonably well in any further exuberance. Further, I’m already highly leveraged to the tech industry through my SF real estate holdings and corporate consulting business.

I just feel way too lucky with my investments now after a +10% unexpected return in 2016. To now be able to get a ~4.5% gross yield on the fixed income portion to cover two mortgages that cost 2.5% and 2.375% is nuts!

Related: The Proper Asset Allocation Of Stocks And Bonds By Age

Personal Goals

“When you’re coasting, you’re going downhill.” – Unknown

1) Scare myself out of my comfort zone. I haven’t been personally challenged in a long time. With a portfolio of over 1,300 posts on Financial Samurai, I know with decent confidence that if I write 152 new posts a year, I should be able to grow traffic and revenue by ~10% a year if I do nothing else. But writing 2-4X a week is an easy goal to achieve.

Once I turn 40 this summer, I think it’ll be fun to challenge myself with more live events. I’ll first start with my Dojo Talk podcasts with Sydney to improve my speaking skills. Then I’ll move onto bigger audiences if I have the opportunity. I’ll be the moderator for a panel of crowdsource company CEOs in San Francisco with an audience of ~100 – 200 people sometime in February. That should be fun. I’ll post the details here once I know more.

The other thing I’m considering is being a more public figure starting in 2H2017. By July 1, I’ll have collected the final severance payment from five years ago. Further, I’ll have hit my five-year goal of seeing whether my writing can stand on its own without my promotion. Now that it has, to be able to combine a public persona with my writing could be a very powerful combination.

2) Really make a difference in 12 people’s lives. At the end of the day, the best feeling in the world is when a reader sends a private e-mail or writes a comment that says how much a particular article or the site in general has helped them achieve their dreams. Being online for almost eight years has enabled me to read people’s stories on how they’ve changed over time.

Without positive reader feedback, it’s harder to keep going at my pace long term because I also occasionally get haterade from random folks who are upset with their lives. Instead of choosing to see what’s possible, they adopt a welfare mentality and lash out.

If enough haterade piles up, it makes me want to just take a break and relax since I’m not getting paid by readers to write anything. With most of my traffic coming from organic search, and most of my online income passive as a result, there’s no need to write much of anything anymore.

Here’s a comment a newish reader left that gave me a power up.

I salute you brother as well. Fight on!

3) Start a family. It’s about time we start a family. My wife and I feel we’ve done everything we’ve wanted to do as adults. We’ve both engineered our layoffs. We don’t have the itch to travel too much anymore after visiting over 60 countries. We have no desire to climb anybody else’s corporate ladder, but our own.  After two years, our house is finally remodeled to the way we want. We have a digital business that allows us to be present for our child. Finally, we’ve developed a steady stream of passive income that should support a family of up to four comfortably in expensive San Francisco or Honolulu.

With so much responsibility in raising a child, it’s only natural to plan as thoroughly as possible before becoming parents. I commend those of you who had the courage to have multiple children earlier on and make things work. I’ve seen so many things go wrong with a relationship after having children, it’s made me nervous.

If we do successfully start a family, my number one goal will shift towards not dying before 69. I’d like to live until my child officially becomes an adult. Now where are my veggies?

Readers, what are some of your goals for 2017? How do you see the economy, the government, the real estate market, and the stock market doing? Will you always be grinding in 2017 on something to improve your situation?

from http://www.financialsamurai.com/always-be-grinding-financial-samurai-2017-goals-and-outlook/

[dxmedstudent]

Hey dx. Any tips for being speedy, efficient and time-effective when on-call (both clerking and ward cover)? I'm a new f1 and struggle with this a lot. I don't know how to be thorough, run everything past a senior AND be time-effective and my seniors are getting annoyed with me.

Hello!There’s no easy way around it; being oncall requires a level of efficiency that is almost superhuman at times. Quite simply, there’s often just a lot to do, and we’re all just trying to do the best that we can. So if you’re still learning the ropes, absolutely don’t let it make you feel bad. Experience really does help, and there’s no easy way to gain experience. But that doesn’t mean that you can’t try to foster some good skills and make a conscious effort to improve; I think it’s great that you’re thinking ahead and trying to do your best. In general, I recommend my hashtag #tips for new docs or #tips for new FY1s, because I’ve got some posts that specifically dump quite a bit of advice for getting through on-calls.

I’m putting this behind the line because it is long :)

Clerking:For clerking, there’s usually a proforma in most trusts that covers the basics, and allows you to work through a system without forgetting anything obvious. If there isn’t, try to stick to a clerking layout that works for you. For example, I’d usually start with presenting complaint and the history of that, work in a review of systems by this point (and add in anything I think of later when I examine them), work my way through their medical and social history, then explore their concerns and expectations, and finish on drug history and allergies (why? Becuase I find writing up drug charts in the middle ruins my flow, but by the end you’re basically just chatting and wrapping up loose ends, and if there’s anything I am likely to forget and have to go back to ask, it’s allergy history, until I realise I can’t prescribe anything without asking that question!). You may find a different order works for you; the only thing that matters is getting all that information down, and letting your brain process it to formulate a diagnosis and therefore plan of action. The tricky thing is that patients will sometimes go off on a tangent, and you have to weigh up the importance of getting back on track with just not being rude or seeming like you don’t care. I usually let them talk for a short while about something that is irrelevant, then explain that we can explore X thing later, and that I’ll make a note of it, but right now we need to focus on Y. They say that at the beginning of a consultation, if you let someone talk for 1-2 minutes, they will almost always give you most of the information that you need. So the general rule is that you start off with open questions ‘What’s brought you in?’ Or ‘What’s the issue today?’ etc, and then, once they’ve had a chance to  say what’s on their mind, you can hone it down with closed questions to find out exactly what you need to know. It takes practice, and some people are still going to be vague, and others will still go on tangents. with time you realise how to most efficiently get investigations done; rather than wait for A&E to do it, sometimes I’ll take bloods/cannulate myself (because waiting longer for the result would be worse for the pt and myself because I’ll be 3 patients down the line by that point), or I’ll request imaging or ask nurses to prepare a treatment before I’m done wrapping everything up and documenting, if I think it needs to happen urgently. Start treatment as soon as possible, but if you are worried, then get senior help involved early. Even if you can’t quite post-take yet, you can always discuss them with an SHO or reg.

Ward Cover:Ward cover is its own kind of hell, and it’s really hard to be efficient when your bleep keeps going off, and you get all sorts of jobs that are different levels of urgency and severity. I would advise you to take a few sheets of paper with you, and be prepared to write down your bleeps and jobs as they happen.Firstly, I triage the jobs I’ve received at handover in terms of severity; sometimes I write numbers next to the names in order of priority, at other times I just remember which order I’ve decided to do things. There will be jobs you’re asked to do at particular times (that ABG in 2 hours’ time, those bloods in the morning) that you’ll need to remember to do. Then, as you get bleeped, write down the number first (in case you get a barrage of bleeps in rapid succession), then, once you call, write down each patient , leaving space between them so you canfill in some details and put a mini tick list next to each one. Do not put down the phone until you have the following: Name and Surname, DOB and hospital number, and bed number on the ward (plus ward name); anyone escalating concern regarding these patients in anything other than an arrest situation has time to get you these pieces of information. Be kind and patient with the nurse or student nurse on the phone, but explain that you need as much information as possible to be able to do your job. Whilst you’re on the phone, you can use the opportunity to ask the nurse to help you; ask for a new set of obs (if not done; usually they’ll call you just after doing one). If they can take bloods, ask them if they can please so. If they can get kit (like a catheter, or NG tube) ready, ask them if they can please do so. Things like bladder scans, female catheters, NG tubes, sometimes bloods and cannulas and cultures can sometimes be done by nurses. Each hospital is a little different, but after a short while you’ll kow what you can reasonably ask for help with. Don’t take the mickey; nurses will value and respect you if you’re clearly not just trying to make them do all your work. Explain that you’ll be around as soon as you can, but that if they can do XYZ it’ll help you deal with the patient faster. In turn, be helpful to the nurses and if you can see they are busy, then do simple things like repeat a set of obs etc yourself. When you walk onto the ward, find the nurse who called you, and make sure they remain accessible for support or to action whatever plan you agree on; sometimes people will want to walk off and do other things, but remember this rule: if the patient is clinically sick enough for them to call you to see them rapidly, they are sick enough for the nurse looking after them to stick around within reach when you are assessing or treating them. If the nurse looking after them is on their break, someone else will ahve to cover and give antibiotics/fluids/nebs etc. Sometimes this means politely asking people to stick around with you if it looks like they are about to walk off to do something relatively unimportant. Yes, they will have their other jobs, too, but a sick patient should be everyone’s priority first and foremost. You should never hold them back from other work unnecessarily, but if things look or sound dire, make sure you have all hands on deck. Even basic life support requires 2 people; you cannot and need not handle a sick patient alone.

Once you have taken some messages, your triage order of priorities might have to change; ‘review patient’s sore toe’ has to come below ‘ patient is wheezy and struggling to breathe’ or ‘febrile patient, ? sepsis’.  That way, when you work through, you’ll feel like you are dealing with the most urgent things first. Anything non-urgent left at the end of the night can be left for the day team; you can chat with them in the morning if you want to make sure it’s not missed. Meanwhile, if you find yourself overwhelmed with sick patients, talk to your seniors. Call your fellow FY1 covering the other side. Call your SHO. If things are dire, call your reg. You have people who can help you, so let them know if you have too many sick patients to handle, or if you’re not sure how to triage them. If you’re swamped with bloods/cannulas, most ward sisters can help with those in a pinch, as can site managers. Most site managers can also certify the dead; this is a low priority job for me overnight (dead patients aren’t getting any deader if you ‘confirm’ they are dead 1h later, and live patients are more important), but you’re usually not the only person who can do that job. Remember to prioritise based on clinical urgency first and foremost. It’s OK to tell whoever is calling you that ‘I’ll try to come when I can, but I have sick patients to see, first”. If the issue is something non-clinically urgent like “relatives want to discuss grandma’s laxatives at 10pm but you’ve never met grandma and you have 3 septic patients and a crash call first”, it’s perfectly OK to tell the nurse this: you will try to come when you can, and the relatives are free to wait (visiting hours permitting) as long as they wish. But you cannot guarantee that you will come any time soon, or at all, as you have sick patients to see at this point in time. If they wish to speak about a plan put in place by the day team, you recommend they call the ward in the morning to book a meeting with the day team to discuss their concerns. I rarely tell my colleagues or patients ‘no’ outright, because I do want to help whenever I can, but I’ll be honest if a particular job has to be low on my priority list because I have sick patients to see. This is also true for talking to the nurses escalating concerns on the phone, or cheekily grabbing you in passing to rewrite 5 drug charts once you finish seeing a sick patient, when you’re power-walking your way to your next patient. Do those jobs if I have nothing to do, but if you’re busy, apologise and explain that you’ll do them when you can; people are reasonable when you are.

If you miraculously have not too much on your plate, then I like to ask the ward if there are ‘any other issues’ before I leave it to go to the next ward (because walking those long corridors after they bleep you for paracetamol 30 mins later is a time waster). You can still tell them that you’ll come back to do some jobs, or just tell them that some jobs are something the day team can handle, if you think it can/should wait. But it can avoid that annoying ‘running between the same 5 wards constantly every 15 mins for pointless stuff they could have told me earler’ feeling’. Also, just let the nurses know that you’re one person covering X number of wards (and probably hundreds of patients) so it’ll take you a while; many of them just don’t know what ward cover looks like at night from a doctor’s perspective. A lot of nursing students or nurses are shocked when we chat about that kind of stuff. There’s absolutely ways to have that conversation without being snippy or coming off as defensive. Take your break when you can. I like my break around 2-3 am on a night shift, because that’s when things tend to settle. But if things pipe down for you a bit sooner, take that opportunity whilst you can. Try to drink plenty of fluids, even if it means availing yourself of vile NHS tea or coffee or tap water. When you feel like the world is ending, it’s time to drink something and have a biscuit. 

Ward Rounds:For ward rounds; make sure your blood requests are always out for the phlebotomists before they come around. If you have new patients in the morning, try to see if you can get those cheeky requests put in in the morning just before the phlebs come around.  For the ward round, you’ll have to work out a system to prepare the notes for your consultant as fast as possible, depending on how many juniors you have, and your consultant’s personal way they like things done. If there’s 2 or more juniors, I usually tag team it with them; we both see half the patients, but whilst I’m getting the notes for one ready, they can see one with the consultant. Some consultants love this approach, others hate it. In terms of the ward notes, different specialties will like different kinds of basic notes. I’ve laid out mine quite differently depending on consultants’ preferences and how different specialties run things. But most are amenable to something like the following layout as a rough rule:

(date and time in the margin)

Dr X ward round.(I use the  Dr Y/Dr Z, bleep 1234 model when it’s just me and the registrar)

(age) (gender) and brief summary of salient points/presenting complaint.

e.g 64 year old female presenting with SOB and cough, purulent sputum, 4 days.

Then their brief medical background

Then a list of current issues.For example 1) CAP, on day 3 amox and clarithro. 2) UTI, 3) hyponatremia, 4) ongoing physio

You can then briefly write out any bloods and investigations under their own heading.

Following this, I leave a gap for talking to the patient and examining them. There will usually  be a SOAP framework for assesing them on observation. I draw out my little lungs and hexagonal abdomen so I leave enoug space.

Finish up with impressions/issues (leave a gap for a list), and then plan (definitely leave a gap for a list).

The best notes I ever saw utilised a lot of bullet points and numbered lists; it was care of the elderly/geriatrics, so everyone naturally had like 5 comorbidities minimum, 6 issues at any one time, and long, long lists of plans. And I’ve taken that with me into future jobs. Never be afraid to take up space in notes; making things clear, well-spaced and easy to read will always serve you better than cramped-close set notes that are barely legible. Give your notes space to breathe, but don’t write any more words than you need to, when preparing them.

It’s a rough and meandering, far from exhaustive bunch of tips, literally off the top of my head, but I hope this helps :)

[dxmedstudent]

Hello, I'm a 4th year med student from a southern European country (6 years program). As of now, I really feel inadequate compared to my colleagues from other countries. I'll explain: here on tumblr I read lots of posts written by students who do lots of practical things: delivering babies, giving shots, helping interns and residents around, and they even have shifts to cover with their tutor. They don't simply study medicine, they learn how to /practice/ medicine. (1/3)

Here in my country instead, we only study. We never do anything practical. Professors don’t do their job well and most of the time we’re left on our own. I know how to do blood drawings, but only because last year I was lucky to meet a kind nurse who proposed to teach me, she said “I find it unacceptable that the university never teaches you stuff like that, so as long as I work here I’ll teach what I can to as many students I meet”. (Shout out to you, Mrs. C., you’re the best!)

I know you can’t do anything about it, but I just wanted to tell someone about my feelings, I feel so frustrated and useless, because I don’t think that my uni will prepare me for being a doctor… 

Hello!  I’m glad that you felt able to tell me your feelings. I can’t change your uni, but I’m happy to listen to you if you want to talk about it. I’m sorry you’re not getting the training you wish for. In some ways, I know exactly how that feels like. And it sucks. Mrs C sounds like a star! I’m glad that there are people out there teaching useful skills. If it helps, you can usually find online tutorials for practical skills like that. It’s not quite the same as practising, but it helps? Sometimes students practice on each other, and whilst I’m not going to officially recommend poking each other with needles, I’m not going to tell consenting adults what to do, either. ;) I’ve noticed this a lot about European schools, particularly through talking to grads from various places in Europe. A lot of places seem to really value detailed knowledge of, say, anatomy and pathology. Good, solid subjects. But teaching appears to be quite traditional, with a lot less emphasis on communication skills.Here in the UK, it’s the opposite. It’s not that we don’t learn anatomy or pathology; but we learn less of it; we cover it again in more detail relevant to our chosen speciality in postgraduate exams. So in med school we focus more on examination, communication skills, practical skills, things like that. So a lot of UK med school grads might well know less tan you do about lots of things, and have different skills. what I’m trying to say is that your training, and you, are not less than anyone else. The reason lots of countries put less emphasis on such skills is because in a lot of countries, it’s nearly always nurses doing those tasks (and yup, I’ve confirmed it with my nurse colleagues who trained in Europe; they have some iiiiiinteresting stories about what doctors in their home countries will and won’t do!), so there’s often not as much of a need for docs to learn. Whereas say a UK FY1 HAS to know how to take bloods, put in cannulas, take ABGs etc because many nurses don’t know how to do those things, and it’s usually part of our responsibility, not theirs. I don’t know what new doctors in your country are expected to know, but I wonder if you could befriend any of the more junior doctors where you are training? I’m sure if you had a chat with them about the skills they needed, perhaps they’d give you an idea of what you need, or maybe a lesson or two. The more people I meet from around the world, the more I realise that we really can’t compare our training; not only is learning to be a docotr very different aronund the world, but our everyday lives as doctors, what we’re xpected to do and the level of independence or support varies considerably. We work in different systems. We’re normally trained to optimally work in the system of the country that we’re training in; for example UK med students are trained to be at the level expected of a UK FY1 doctor; transplant us to another country and we’d have a lot to learn! For example, trainees in the UK from other countries are significantly more likely to fail exams which involve a communication aspect; they are often very technically skilled and very knowledgeable, but perhaps haven’t yet developed the level of communication skill we expect in the UK.  Those people still know a lot, and are competent, capable docs, they just need to adapt to the system. They just need time and some support. If I’m reaaaaally honest, I personally get the impression that the training US docs get more intense than ours. Or at least, they get to do lots of the kind of stuff we do as an FY1/intern in their final year of med school. And I feel their residency looks more structured, with a lot more actual training; sometimes I’m a little bit in awe. Maybe that’s why it’s shorter. But I can’t change the system I work in, or the training I have access to; I can only do the best with what I’ve got. We have a saying here, “Comparison is the thief of joy”.It means that if we compare with others, it erodes our happiness. Because there’s always something that others have better than us. And it’s true; sometimes it really hurts when we think about how things are for us versus for other people.It sounds like you’re working really hard to be the best that you can be. And I know it hurts to see lots of people talking about their studies, and realising that they get to do things differerently. Maybe they get more training, or more support. Perhaps they get to to more exciting things. Your feelings are valid, and there’s nothing wrong about wishing that you were getting better or different training. I’m sure you’ll pick up the skills you need, though it might be later than you hope for. Perhaps you might need to work together with friends, or junior docs or nurses as best as you can, to learn as much as you can. Medicine is a world of impostor syndrome; most people I know seem convinced that they don’t measure up against everybody. Some days, I feel it too. So it’s perhaps an almost universal feeling; to feel that we’re not quite good enough, and that others are better. And it’s something we all have to work around, live with, and fight. Sometimes we need to learn more or do better, but none of us are awful. And everyone deserves their place in medicine. But I hope you can eventually also look at how far you’re coming, how much you’re learning and realise that you’re awesome too in your own way. You’ll get there, one step at a time. I wish you all the best, let me know how you get on :)

[dxmedstudent]

So, I'm a med student and I'm currently living and in the same rotation with this absolute GUNNER (Who is also genuinely smart (top of the grade) and hardworking, but is also a snake) and I cannot STAND HER. It's really affecting my mental health negatively. Any tips on how to focus on myself/ stop comparing/ stop letting her take all the opportunities? The doctors LOVE her since she's so sweet, smart and... tall blonde white girl. It sucks for all of us in her rotation and she doesn't care

My commiserations. Placements sometimes have limited possibilities, and it can suck when things aren’t shared equally. And although your seniors probably aren’t judging you half as much as you think, it still feels like you’re being compared. I used to hate placements when it was just the two of us the absolute most, because it felt too much like it would always be ‘the eager one’ and ‘the one who isn’t putting in as much effort’. I’ve been both, and it sucks etiher way. To answer your actual question, it’s hard to completely avoid people, but you can manage how you all interact with the Ms Snakes in your lives. I do hope you’re not in the same house or flat (hospital accommodation, right?), because that sounds like no fun. I’d suggest planning group-wide social events (that way she may be around, but Snakey’s never the only person you’re stuck with. Remember that you have other colleagues. You have friends. And whilst I’d say it’s probably uncalled for to badmouth Snakey to your clinical group (bitching can backfire, and it doesn’t build a nice working environment for anyone, so I’d really advise against it. If you have to say anything about Snakey to your peers, try to keep it to making neutral observations. Observations that perhaps some people are getting more exposure than others, or whatever. You don’t want to make the entire group descend into infighting, and you don’t want to come across as the one obsessed with Snakey to the point that people assume you are rivals in a cartoon series. But when it comes to talking to your friends? Knock yourself out. Blow off as much steam as you want. Let them know how much it’s really bugging you. Naming someone isn’t even relevant, it’s the sheer act of just expressing your frustration that can keep you sane. And don’t forget to give yourself alone time where you don’t need to deal with them. Remember that you have lots of great features, perhaps they just aren’t the same ones as Snakey. It’s easy for all of us to fear that we’re the worst student. That everyone knows more, does better, and is generally destined to be amazing whilst we’re left behind and undeserving of even being there. It’s a common feeling; impostor syndrome is almost ubiquitous in medicine. The secret is that all of us, at some point, feel like we’re not good enough to be here. But like a protagonist in a shonen anime, we keep on taking the punishment and keep fighting through the self-doubt. So trying to limit your exposure to people who rub you up the wrong way can be a really good idea. But there will be times when you have to deal with them, or at the very least have to ensure you don’t totally lose out. But you also don’t want to be rude or confrontational, because that doesn’t usually help things very much.  So here are some of my tips for devious niceness: In terms of work, the thing about Ms (or Mr) Snakes  is this; most people are OK, but a small minority try to sabotage others. So don’t give them the chance. Your consultants/seniors/FY1s will usually want one peson to be the ‘contact’ for the group; don’t let that be Mr Snakey, if you can avoid it. I’ve had friends being told completely the wrong time/venue for teaching by the snakes in their group. So instead of letting them have all the power, or hog information, kindly suggest that it might spare Snakey (or the docs) the effort of contacting you all  individually if the senior or FY1 just puts all of you in a whatsapp group (or you could even make it, if you wish) so that relevant info like teaching times etc can be shared. On the plus side this also makes it a bit easier to let people know if things are cancelled, running late etc.  This prevents them from telling you one time/date etc and telling everyone else another. Or keeping things to themselves. This important because the junior docs supervising you don’t really want to be remembering who’s done what; they have more important things to worry about, like patients not dying.  They don’t really care if one student took slightly more opportunities than the others. It’s not that we don’t hate unfairness (everyone hates Snakes), but unless something major is going on, we’re usually too distracted for it to trigger our radar. So work with what you have. Anything that makes their life more easy will be readily accepted. Make their life easy. A little bit of planning and chatting with your peers can go a long way. It sounds like your placement doesn’t have rigid timetables. I’ve noticed they usually work better when people know where they should be, and if I have been on a placement which sort of says ‘well, just turn up to clinic or ward, IDC, you can be the one to add structure. If there’s a problem with making sure that you all get to clinic, or clerking etc because she (or someone else) is always hogging clinic, because they are always there first, politely draw out a timetable (Microsoft excel is a wonderful thing)  and suggest to the group (perhaps even in front of the seniors responsible for you) that everyone gets a chance. I find this quite useful even when there isn’t a problem with specific people, just because there are often more students than opportunities, so if you don’t plan out where you will all be, then you’ll forever be turning up to find 5 people at the same clinic, etc. If you’re worried about a little snakey sabotage, you can always be sneaky and mention your idea to the rest of the group first, so that by the time it has to be mentioned to Ms Snake. You can’t really draw up a timetable for cannulas or procedures. They just sort of happen when they happen. But you can ask the juniors for more opportunities. You can try to put yourself forward whenever an opportunity arises. Snakey can’t take them all! It might mean asking around more, but your seniors will respond you your making an extra effort. It’s pretty difficult to put yourself forward for things, but it gets easier with time. And sometimes it really is the best way to get opportunities. Another thing is a bit of team work. Some of your colleagues will be really shy. But you can speak up for them, even if it’s hard to speak up for yourself. Sometimes it’s easier to say “Um, Charlotte hasn’t had a chance to do a cannula/take a history yet, I wonder if she’d like to try” might help. Or a loud “Ah, Kiranpreet, weren’t you saying you really need to get an ABG signed off?” can be great.  Within a group, you pretty much all know how well you are all doing on getting your competencies signed off, and actually a bit of team spirit rather than ‘me me me’ helps. By working with the group, you in turn encourage others to work with you, and anyone who doesn’t play along in the spirit of friendship would start to look much more odd. Mos people do this just because they are nice; you’ll probably have helped your colleagues lots of times without really having an ulterior motive. But here you’ve got an added extra; if everyone plays nice, then putting yourself forward for everything begins to look a lot less… acceptable. And that’s what you all want; playing fair to be the done thing. If you were feeling really bold, you could even go a step further and just say “Ah, Snakey McSnake, I think you picked up last cannula?” when they offer to do their umpteenth procedure in a row whilst the rest of you are twiddling your fingers. That’s a bit riskier (and cattier) but it might be all in the delivery. Say it innocently enough, like it’s a statement, not an accusation. After all, part of the problem is that you and your colleagues are a bit too polite to put yourselfves forward. The aim here isn’t to pick a fight, so it’s only something you can really do if you can keep your cool. It needs to be effortlessly casual, almost as if you don’t really care. Of course, most of us aren’t Oscar winning actors who can pull something off like that. If you really thought that the person would be receptive to it, you might even consider something radical like having a chat with them. Perhaps they don’t even realise they are grabbing all the opportunities, and perhaps they don’t realise they are a bit too overeager to answer all the questions. Not everyone who is irritating is necessarily out to make others look bad; I’ve known people who pretty much look and act like gunners (perhaps they are really socially inept), but when you speak to them as individuals, they end up being a lot less… nasty than you expected. In fact, they were nicer than plenty of other students. I just don’t think they’d really realised how their keeness came off.  Sometimes talking helps, sometimes it doesn’t. But I don’t feel any answer would be complete without the suggestion that you try to deal with it like grownups. Unfortunately, sometimes handling it the grownup way isn’t possible.I hope this helps! Finally, there’s one thing to remember. This too shall pass. You really won’t be stuck with them forever, or even for very long. You’ll get plenty of chances to work alongside people who understand the meaning of teamwork. I really hope this doesn’t ruin the med school experience for you. Most people aren’t Snakes after all. Hope it works out for the better!