#Streamlined Medical Care

[fantascticz]

In today's fast-paced world, the convenience of a personal shopping assistant cannot be overstated. With a service that takes care of all your shopping needs, from finding the perfect gift to sourcing unique, hard-to-find items, the benefits are immense. Imagine the luxury of never having to stand in line again, or the relief of not spending countless hours online searching for products. A personal shopping assistant can provide tailored services that cater to your specific needs, ensuring that your shopping list is handled efficiently and effectively.

By utilizing business licenses and paid subscriptions, a personal shopping assistant service can access discounts that may not be available to the general public, passing on significant savings to you. This can be especially beneficial when it comes to bulk purchases or high-value items where the cost savings can be substantial. Moreover, the convenience of having purchases delivered right to your doorstep cannot be understated, providing a seamless shopping experience from start to finish.

An ever-growing website with daily newly listed items at competitive prices ensures that you have access to the best deals and the highest quality products. This kind of service is not just about convenience; it's about providing a personalized experience that takes the burden of shopping off your shoulders. Whether it's for everyday needs or special occasions, a personal shopping assistant can transform the way you shop, giving you back valuable time to spend on activities you enjoy.

In conclusion, a personal shopping assistant service is more than just a luxury—it's a practical solution for anyone looking to streamline their shopping process. With the promise of lower costs, high-quality products, and unparalleled convenience, it's an option that's worth considering for anyone who values their time and money. Remember, if you need anything, a dedicated team is there to support you every step of the way, making your shopping experience as effortless and enjoyable as possible.

Imagine a digital marketplace, a hub of endless variety and constant expansion, where every refresh brings new discoveries. This is a website that grows daily, not just in the number of products it offers, but in the breadth of categories it encompasses. From the latest in high-definition televisions and luxurious theater seating that promises the ultimate home cinema experience, to the essential dressers that bring order to our bedrooms. It's a place where specialized medical supplies, such as ostomy and enteral feeding supplies, are readily available, ensuring that patients receive the care they need without delay. Here, one can find Accu-Chek Guide test strips and lancets, alongside Amsino Amsure syringes, each product a testament to the site's commitment to health and wellness.

Nutritional needs are met with precision, as the website offers Vital High Protein formulas by Abbott and Glucerna 1.2 formulas, catering to a diverse range of dietary requirements. The medical section is comprehensive, featuring Hollister High Output Bags and innovative solutions like the Stoma Genie for ostomy changes, which bring ease and comfort to patients' lives. The site understands the importance of choice, providing options like the Hollister CeraPlus New Image Wafers for Ostomies, available in multiple types to suit individual needs.

For those seeking support, the Alpha Medical Ostomy Abdomen Brace is there, accommodating a wide range of body types with its extra-large size. Eakin Cohesive Seals and a variety of skin barrier wipes and pastes from brands like Coloplast Brava and Vitus Ostomy Care ensure that every user can find the perfect fit for their skin type and lifestyle. The website also caters to the practicalities of medical care, offering products like Medline Sure Prep protective wipes and Adapt adhesive remover wipes, making the management of medical devices as seamless as possible.

Beyond healthcare, the site ventures into the culinary domain with commercial food warmers and countertop display cases, bringing the pizzeria and pastry shop experience to any setting. Tile Bluetooth trackers promise the convenience of never losing keys again, while the Nostalgia popcorn maker and air conditioners add comfort and enjoyment to any home environment. Even the most mundane of necessities, like toilet paper, are given a place of honor, ensuring that no need, however small, is overlooked.

This website is not just a store; it's a reflection of life's complexity and the myriad needs that arise within it. It's a testament to human ingenuity and the desire to provide a solution for every problem, a comfort for every discomfort. With each passing day, it evolves, adding layers to its already vast inventory, ensuring that no matter who you are or what you need, this website has something for you. It's a digital ecosystem, thriving and ever-growing, just like the world around us.

[neodermatologist23]

looking for online consult dermatologist

In an era where time and convenience are paramount, Neodermatologist emerges as a trailblazer, offering premier online consult dermatologist services via mobile phones. With over a decade of expertise, Neodermatologist has revolutionized the way individuals seek dermatological care, providing swift solutions within an impressive 20-minute window.

This cutting-edge service eliminates the need for in-person visits, presenting a convenient, efficient, and time-saving alternative for addressing skin and hair concerns. Neodermatologist’s platform is designed to connect users directly with seasoned dermatologists, ensuring that professional medical advice is just a few taps away. Whether dealing with persistent acne, hair loss, eczema, or any other dermatological issue, users can rely on the platform’s ease of access and expert guidance. By leveraging modern technology, Neodermatologist bridges the gap between patients and healthcare providers, making professional dermatological care more accessible than ever before. The service operates with a focus on user convenience and reliability. Upon logging into the platform, users can describe their symptoms, upload photos of the affected areas, and receive a tailored treatment plan from a board-certified dermatologist within minutes. This streamlined process not only saves time but also alleviates the stress and inconvenience associated with traditional doctor visits. No more long waiting times, travel hassles, or delayed appointments—Neodermatologist brings expert care directly to your fingertips. One of the standout features of Neodermatologist is its commitment to providing high-quality care. The platform employs a team of experienced dermatologists who are well-versed in the latest treatments and technologies. This ensures that users receive accurate diagnoses and effective treatment plans promptly. Moreover, the service maintains strict confidentiality and data security, giving users peace of mind that their personal health information is safe. In summary, Neodermatologist is setting a new standard in dermatological care with its innovative online consult dermatologist service. By offering quick, reliable, and professional advice within 20 minutes, it redefines the patient experience, making dermatological care more accessible and convenient. Whether you are struggling with a minor skin issue or a more complex condition, Neodermatologist provides a seamless and effective solution, ensuring that expert help is always at hand. Embrace the future of healthcare with Neodermatologist, where quality care meets modern convenience.

[batboyblog]

Things Biden and the Democrats did, this week #22

June 7-14 2024

Vice-President Harris announced that the Consumer Financial Protection Bureau is moving to remove medical debt for people's credit score. This move will improve the credit rating of 15 million Americans. Millions of Americans struggling with debt from medical expenses can't get approved for a loan for a car, to start a small business or buy a home. The new rule will improve credit scores by an average of 20 points and lead to 22,000 additional mortgages being approved every year. This comes on top of efforts by the Biden Administration to buy up and forgive medical debt. Through money in the American Rescue Plan $7 billion dollars of medical debt will be forgiven by the end of 2026. To date state and local governments have used ARP funds to buy up and forgive the debt of 3 million Americans and counting.

The EPA, Department of Agriculture, and FDA announced a joint "National Strategy for Reducing Food Loss and Waste and Recycling Organics". The Strategy aimed to cut food waste by 50% by 2030. Currently 24% of municipal solid waste in landfills is food waste, and food waste accounts for 58% of methane emissions from landfills roughly the green house gas emissions of 60 coal-fired power plants every year. This connects to $200 million the EPA already has invested in recycling, the largest investment in recycling by the federal government in 30 years. The average American family loses $1,500 ever year in spoiled food, and the strategy through better labeling, packaging, and education hopes to save people money and reduce hunger as well as the environmental impact.

President Biden signed with Ukrainian President Zelenskyy a ten-year US-Ukraine Security Agreement. The Agreement is aimed at helping Ukraine win the war against Russia, as well as help Ukraine meet the standards it will have to be ready for EU and NATO memberships. President Biden also spearheaded efforts at the G7 meeting to secure $50 billion for Ukraine from the 7 top economic nations.

HHS announced $500 million for the development of new non-injection vaccines against Covid. The money is part of Project NextGen a $5 billion program to accelerate and streamline new Covid vaccines and treatments. The investment announced this week will support a clinical trial of 10,000 people testing a vaccine in pill form. It's also supporting two vaccines administered as nasal sprays that are in earlier stages of development. The government hopes that break throughs in non-needle based vaccines for Covid might be applied to other vaccinations thus making vaccines more widely available and more easily administered.

Secretary of State Antony Blinken announced $404 million in additional humanitarian assistance for Palestinians in Gaza, the West Bank and the region. This brings the total invested by the Biden administration in the Palestinians to $1.8 billion since taking office, over $600 million since the war started in October 2023. The money will focus on safe drinking water, health care, protection, education, shelter, and psychosocial support.

The Department of the Interior announced $142 million for drought resilience and boosting water supplies. The funding will provide about 40,000 acre-feet of annual recycled water, enough to support more than 160,000 people a year. It's funding water recycling programs in California, Hawaii, Kansas, Nevada and Texas. It's also supporting 4 water desalination projects in Southern California. Desalination is proving to be an important tool used by countries with limited freshwater.

President Biden took the lead at the G7 on the Partnership for Global Infrastructure and Investment. The PGI is a global program to connect the developing world to investment in its infrastructure from the G7 nations. So far the US has invested $40 billion into the program with a goal of $200 billion by 2027. The G7 overall plans on $600 billion by 2027. There has been heavy investment in the Lobito Corridor, an economic zone that runs from Angola, through the Democratic Republic of Congo, to Zambia, the PGI has helped connect the 3 nations by rail allowing land locked Zambia and largely landlocked DRC access Angolan ports. The PGI also is investing in a $900 million solar farm in Angola. The PGI got a $5 billion dollar investment from Microsoft aimed at expanding digital access in Kenya, Indonesia, and Malaysia. The PGI's bold vision is to connect Africa and the Indian Ocean region economically through rail and transportation link as well as boost greener economic growth in the developing world and bring developing nations on-line.

[faeriekit]

Health and Hybrids (XXI)👽👻💚

[I can't remember the original prompt posters  for the life of me but here's a mashup between a cryptid!Danny, presumed-alien!Danny, dp x dc, and the prompt made the one body horror meat grinder fic.]

🖤Chapter navigation can be found here🖤 Click to browse previous updates.

💚 Ao3 Is here for all parts (now featuring mediocre mouseover translations, only available on a computer)

Where we last left off... Wonder Woman! Robin! Impulse! Danny! Dick drawings! Who says that occupational therapy and learning a second language can't be fun?

Trigger warnings for this story:  body horror | gore | post-dissection fic | dehumanization (probably) |  my nonexistent attempts at following DC canon. On with the show.

💚👻👽👻💚

EXTRA TW for: vomiting, panic attacks (this chapter only)

Danny can hold a spoon now. He is unstoppable.

So, when the lady isn’t there to feed him dinner (more mush), one of the not-the-lady nurses gives Danny a tray, and lays a mat over his lap so that he can eat without completely messing up his bedsheets.

Eat he does. Slowly. Maybe a little messily, and it’s kind of embarrassing to have to admit to himself that food definitely spills out of his mouth and onto his lap. The doctor/nurse/medical person, whoever they are, turns on the television, and Danny doesn’t try to ask for the remote. The television only gets something like ten channels, and none of them are cartoons at lunch hour.

So. News it is.

Most of the news follows the same cycle; the weather, sports teams Danny can now recognize the colors of, traffic cameras, and events with long, scrolling text to detail the happenings onscreen. There’s something about dogs? That’s fun. The scientist/nurse/tech, whoever they are, says something in the tone of Aaw, aren’t they cute? as puppies run about and wrestle on screen.

Danny kind of misses Cujo. He picks at his bedsheet, and doesn’t say anything.

The dog program transitions away— there’s a bright banner in its place. Danny’s seen it before: it’s something to the equivalent of Breaking News. It’s usually weather, or crime, or something.

Um. But it’s not that. Danny’s spoon drops, because a ROBOT LADY lights up the screen with a glistening silver suit, not unlike the Ecto-Skeleton his parents used to keep in the basement. Or, well…this one might be more streamlined?

Danny shifts. He can’t help. He’s here, in the hospital. Or. Uh. The space…hospital. His body is very broken.

But there’s a robot lady wrecking a town on Earth.

And Danny can fly.

…Could fly. Could have flown. If he was. Well.

Danny’s not well, and his body aches and his hands don’t work and his legs work even less, but there’s people out there who need help. People who are getting shot at with rays and Danny can fight them, and humans can’t. Danny can help. He—

His core throbs. Danny chokes. He pulls at his chest, trying to find some kind of purchase on his medical gown to tug himself—up?? Out?? He can’t fly right now, but maybe—?

“Whoah, whoah, whoah, abide, abide.”

Danny grits his teeth. “Look!” he snaps, and jams a finger at the television. “There’s—look! There’s a giant robot out there punching buildings!”

“Wacie,” the human protests, but at least turns up the volume so that Danny can see better. “Wacie, þær eart firas þær nou.”

What does that mean?!

Danny hasn’t lifted himself in forever. His legs don’t work, but his arms…might.

He presses his palms down to the mattress. He pushes.

There is a liberated fraction of a second where Danny’s whole weight is on his arms.

—And then he comes crashing back to reality, his elbows snapping back into place. His butt slams back onto the bed and the whole frame jitters.

Danny pants. His arms quake.

The medic completely barrels through Danny’s usually meticulously-kept personal bubble, trying to make sure Danny didn’t dislodge his IV or rip his ligaments and tendons or tear his muscles or. Something. Danny barely notices, barely cares, because someone else blasts onto the television screen in a red bathing suit and gold boots.

And suddenly, both the people on screen are fighting. It’s brilliant. It’s bloody—it’s physical, in the way that flesh and bone and metal must be. Danny’s never seen serious fighting like that before.

And the new woman flies.

Danny stares.

She flies. She fights. She wins—narrowly dodging or displacing lasers with something shiny on her arms, and getting long hair singed in the process. In the end, the robot is tethered down with some kind of shiny metal rope, screaming and kicking all the way.

…Danny barely remembers to choke in air. That's so cool.

The medical person says something reassuring, but Danny’s too tired to listen. He watches this new woman take her applause, floating down on nothing but air to meet the reporter and answer questions. She looks poised. Confident. People clap. People shout things out. People smile. People cheer.

…No one is screaming. No one is running.

There are no ghost hunters in the crowd.

Danny’s exhale is manual. So is his inhale. His heart monitors are making all sorts of funky pictures most likely, but that’s not his business—he watches a woman in armor who flies take off into the sky, free to come and go as she pleases.

It…it hurts. It’s so beautiful and so peaceful and gentle and it hurts so much.

His eyes well up with tears. Why did she get this? This…niceness? Everyone had hated him when he'd tried to help—the teachers, Vlad, the town, his parents. They’d hated him! All he ever wanted to do was help like she did!

What made him so different?! Why was it Danny who got hunted down and shot at? Why was it Danny who got kidnapped and taken hostage?!

Tears burn his eyes like fire. It’s got to be the salt. Danny’s strangled whine turns into a choked off sob before he can catch it. His hand goes to his mouth, but he can’t stifle the noise.

He doesn’t want to. He wants to cry. He thinks he deserves it.

The tears come until he is sobbing, crying, wailing—because WHY WHY WHY was it so easy to hurt him?! WHY DID THEY HURT HIM, WHY DID MOM HURT HIM, HE DIDN’T DO ANYTHING WRONG!

A towel appears in his hand. They’re so nice to him here. So much nicer than when Mom and Dad had—

Danny’s cries are as much screams as they are anything else.

There are hands on his shoulder. On his back. Rubbing. Danny wants to shove them off but the lady isn’t here, which means that it’s one of the staff-members who isn’t supposed to touch him. They’re not supposed to touch him in case Danny hurts them but one of them gave Danny a clean towel to scream into and is rubbing his back because he’s crying.

They’re trying to be so nice and gentle but EVERYONE JUST WANTS TO HURT HIM.

They’re smart, though. They notice before Danny does, and have a bucket ready by the time heaving sobs turn into outright vomiting.

At least the mush mostly makes it into the bucket.

*

…So.

Having a breakdown…sucks.

Danny has to carefully brush his teeth with an extra-soft bristle brush and rinse out his mouth before he gets more water.

Someone is being very nice. There’s artificial fruit punch flavoring in his drink. He wants to feel grateful but he mostly feels dead.

…His eyes slide listlessly across the room. Ha. Dead.

Danny is horizontal and wrung dry and too tired to do anything but pant by the time the lady comes back to his room. She’s in quicker than usual—her gown is sort of sloppy, hair sticking out of her hair net, and she’s still looping her mask around her ear.

She gets down on her knees beside his bed. She asks him if he’s alright.

Danny’s not alright. He isn’t sure he’s been alright in…ages. Ages and ages. Before he was trapped and tied down. Before he was hated. Reviled.

…Before he was Phantom, maybe; before Danny Fenton had died a shocking, senseless death.

Tears try to wring themselves out of his aching eyeballs, but he’s too dry-eyed to cry; the lady make sad, wet eyes for him, and that’s probably enough between the two of them. Danny’s misery is a vast, gaping void, and all he has to show for it is the shovel he’s been digging through all this shit with for the last few years.

The lady brings her hands closer to his hairline, curled fingers hovering in the air. Her word’s don’t mean anything to him, but the gesture is clear: May I?

“…Mm,” Danny agrees. His eyes fall closed when she gently scratches at his scalp with her fingers.

No one’s touched him gently, on purpose, in…ages. When he was little, Dad used to pop him between him and Mom in bed. Mom would brush out Danny’s bangs with her fingers and Dad would hum. It was always something ill-fitting and silly. Guns N’ Roses. Led Zepplin. Santana. Sometimes Jazz would sit with them, crushing him until Dad had to pull him up and out of harm’s way.

In the quarantine lab, hurting him had just been part of the scientific process. What if there was some new discovery under his fat layer? On the other side of his ribs? Nestled between his alveoli?

Danny sniffles. He’s too dry to cry. He blinks invisible dust off of his eyelashes, and focuses on the weird lady who’s with him now.

Up close, when his eyes work, she looks nice. She has blue eyes, like him. Like Dad. They’re kinda…glowy, maybe? Sparkly? They remind him of ice in the Far Frozen—inhumanly brisk, and impossibly clean. She has eye crinkles where she smiles, tan skin making them more defined than their actual depth. Between her hair net and her medical mask, little wisps of black baby hairs shine through.

She pets him. She smiles. Danny isn’t sure why, but. Whatever. Jazz used to insist that human skin-to-skin contact was an essential need, so this is probably, like, also medical care.

Yeah. Danny squints. …Sure.

Whatever. It’s nice.

So Danny gets petted and it’s fine. He almost doesn’t notice the giant gauntlet under the paper sleeve of her gown, but then it’s right in his field of vision, and. Hey. Didn’t he see that on TV, like, an hour ago?

Danny stares.

He can’t actually tell if they’re gold under the pale blue color of the gown, but. The color is certainly some sort of unusually colored metal, cold to the touch even through the paper-like material of the gown.

…He doesn’t want to touch her, or let her know that he’s touching her. But. He brushes the back of his wrist against the bracelet, and it hums against the paper gown between it and his bare skin.

The lady blinks. She looks down at where they made contact, and asks him if he’s alright.

Danny looks away.

She knows she saw him reach out to her, though, so she takes her hand off of his hair (…hey…) and pulls back the sleeve on her gown. “Sest,” she offers. See?

It is the same kind of bracer he saw on TV. Up close he can see the designed etched into it—geometric lines stretching down from her fingers to her elbow, terminating in something structural. Not quite diamonds. Just…strong.

There’s a couple of very, very tiny letters down towards the bottom. His eyes strain when they try to make any sense out of them; they’re too small for him to actually focus on, which sucks.

She steps back, and pushes her sleeves down to show off her gold bracers. She lifts up the hem of her gown, revealing red boots that go waaaay up her thigh. They have the same gold metalwork as she does on the bracers.

Danny just saw those on the television. His eyes widen.

“You—“ he starts, and then remembers their difference in language. He points his hand at the television. “You fought? You were on TV?”

“Hwæt?”

“The TV?” Danny repeats. She doesn’t understand. Danny doesn’t know how to tell her what he means. “The…you were there?”

She looks at him to expand. Danny looks back at her.

…So they just stare at each other silently.

The door cracks open; the person who’d mediated Danny’s breakdown pokes their head in and says something. “Eower feoht wæs an þe box todæge.”

The lady blinks. Danny blinks. Wait. Did they just call the television the box?

“…Box?” Danny clarifies, and lifts a hand to shakily point at the television again.

The lady blinks, and grins. “Yea!” she returns, pumped up. She stands, to the powerful height she’d had on the television—excuse him, the box—and flexes her now-exposed arms to show off massive biceps.

Holy moly. Danny hasn’t seen any bigger biceps on his Dad.

She flexes one arm, the other, both—in front, and behind. If Danny had that much definition, he’d be showing off too! She leaps back impossibly far—and holy crap she can fly— to show off some mock punches at invisible enemies at speeds that Danny would be hard pressed to follow even with supernatural abilities.

He goggles.

She laughs at him, but she doesn’t sound mean—she sounds show-boating and silly, and teasing and playful, but not mean.

She’s like him. She’s not a ghost but she flies and she’s not human. She’s not human just like Danny. Just like that one green guy. Like the fast kid who visits him.

It’s such a relief. It’s so scary. Who are these people? Why are they healing him? Why are they keeping him?? Why do they have access to so many non-human people? What do they want him for? Is Danny supposed to fight like that?

He would fight. If he had to. He’s done it before.

If they make him fight, Danny’s pretty sure he’s going to fall apart like cheap glass.

The lady comes back when Danny goes quiet, her gloved fingers brushing up against his knuckles. The sensation is enough to bring Danny out of his…fog. Sometimes everything is so cloudy and vague. The pain medicine makes it go away, and the pain medicine brings it back.

Danny curls his hand into a shaking fist. He bumps her knuckles against his.

She makes a surprised noise. Danny feels her gently move his fingers, rearranging, moving where his thumb goes—

He huffs out a laugh. His fist wasn’t good enough to her standards. Her fist bump meets his in the middle with a smirk and a laugh, victory written all over her face.

[bouncyballcitadel]

Hi everyone, and Happy Friday!

First of all, thank you everyone for your support of the new chapter release and participation in the raffle! Look out for two short snippet releases these upcoming weeks, courtesy of our raffle winners.

Second, I've reformatted my Patreon to make everything a little more ✨ streamlined ✨ . There now are only three tiers with the following highlighted perks:

Med Student tier ($1/month): access to detailed progress notes

Resident tier ($5/month): access to a Patreon-exclusive demo with the ability to modify stats, 3-day early access to new chapter releases, 1-week early access to short snippets, access to sneak peeks, access to romance and gameplay guides

Attending tier ($20/month): all of the above + 1-week early access to new chapter releases, opportunity to name a character in Citadel with a minimum subscription commitment of 3 months

If you'd like to support me via Patreon (or peruse the perks in more detail) please click here. Your patronage will go toward commissioning more Citadel art, pet care, and donuts/bubble tea for me and other members of the medical team.

Cheers!

-Bouncy

[misscammiedawn]

Gender, Dissociation and Clinical Stigma - The Third Person

Before I begin I just want to note that typically Media, Myself and I entries are aimed at depictions of dissociative disorders in popular fiction. Today's entry is a graphic novel memoir by a transgender woman with dissociative identity disorder. As it's both not in the public zeitgeist and good representation by virtue of being lived experience of someone who struggled within the mental healthcare system I want to recommend people buy the book (or check it out of their local library). I fully support the artist and want to prop up something good and beautiful.

With that said, let's begin...

CW: therapy abuse

With all the recent hysteria in the US and UK media over transgender healthcare it can be easy to forget the hurdles we all have to climb to receive care. Though Informed Consent is becoming more of a standard practice these days the DSM-5 Criteria for Gender Dysphoria indicates a 6 month requirement for observation before HRT can be prescribed. Many of us needed to jump the hoops of living 6-12 months "in the gender role that is congruent with their gender identity" before we were allowed to begin our gender journey in earnest.

Of course. This requires a clinician (or two for surgical options) to observe this, monitor it and sign off on it. But therapists are humans and are full of prejudice, bias and their own beliefs. They aren't guaranteed to think it is medically necessary or positive for a person seeking gender affirming care to receive it.

So where does DID fit into this picture?

A study, published in 2015, states clearly that 30% of transgender individuals met the criteria for a dissociative disorder.

Yet even still, The World Professional Association for Transgender Health (WPATH), the gold standard for transgender care included this warning in their Standards of Care up until September 2022.

(source)

Fortunately that passage is no longer included in WPATH guidelines as of the 8th revision released in 2022. I shall say the above passage did grant a scare for us, though, as it was very much the practice when we were going for our surgery.

Standards of Care improve and medical understandings of both gender and dissociative care are becoming kinder towards clients.

Even still. There's always that fear. That months of therapy could be wasted on a clinician who was never going to sign off on HRT and was never going to believe our lived experience as a system.

We wouldn't have gotten nearly half as far as we have gotten without our therapist helping us identify our condition, manage our symptoms and develop cooperation and communication.

It's terrifying to think what life would be like if our symptoms not only went unmanaged, but we were made to feel fake and attention seeking by the very person we paid to take care of us...

-

With that intro in mind, The Third Person by Emma Grove is a memoir told in graphic novel format over 920 pages covering the period of life where she began therapy in hopes of receiving feminizing HRT not realizing she had an undiagnosed case of dissociative identity disorder.

When one opens the book they will see an Author's Note declaring that every word in the book is as accurate as Emma's memory will allow and any edits are to streamline the story, not to tailor anything to match the author's point of view and there is a dedication:

"For Katina - We finally did one together"

The story proper begins in media res Winter 2004, as Emma asks her therapist if he would like to hear about the book she was reading and the therapist responds asking why the client decided to speak with him "as Emma" today. Emma, confused, does not understand the question and is probed about her parts, about Ed and Katina and about her childhood. That last word being enough to cause Emma to freeze up, dissociate and...

This simple intro gives us all the context a reader needs to understand the antagonistic dynamic between Toby, the therapist, and his patient(s). Both client and patient are unable to understand the other and harbor suspicions about the other's intentions.

Without the context we only know Emma had a book, she no longer has a book and she suspects her therapist of being a mean person who is playing tricks on her.

We will get context later.

The first chapter of the book provides an introduction to the author's late teens and early 20s where they explore their gender identity and have their first experiences with their masked dissociative disorder.

The book goes to lengths to show the stress of the author dividing themselves between having to present male in their public life and sneaking out to bars where they can wear make-up, wigs and outfits to present female.

They take on their legal name, Ed, during their public life and when going out to clubs take the name Katina, from the first bar they visited presenting femme. The name Emma comes later when the system is working to transition into living as a woman in all aspects of their shared life.

The book patiently explores the stress of having to divide ones own self for their safety in spaces where they cannot present their truth without threat from an intolerant society. If 30% of transgender people suffer from dissociative disorders then a much higher number of them know the stress of having to compartmentalize themselves into different presentations for different audiences.

For us, we know that pain all too well. Our birth identity remains with us as a member of our own system. Less a ghost of our past and more a remnant of a mask we constructed to perform the version of self required for our safety.

The artwork does a good job of displaying switches and co-consciousness with subtle expression work, the hair style/wigs that each alter favors. For example we have the left displaying co-consciousness and a switch.

As the years go on, Katina finds ways to go out to the club and exist in her comfort and Ed labors hard to ensure that they can live for the times they get to "become" themselves.

Katina is established to be a fierce personality who will get aggressive when people push against her. She loves to dance and sing and party at the club. She is both a free spirit without inhibition and a fierce protector who will keep the system safe.

I recall feeling a deep fondness and connection towards Katina when we first read the book.

Once the narrative has firmly established the history that lead to the system seeking HRT we are brought into the meat of the book. A white void with a sofa and an armchair. The therapist's office where Katina, Emma and Ed speak with Toby.

Toby is a trans man that Katina believes to be an ally who will sign off on their HRT once the prerequisite 3 month waiting period is over. Unfortunately over the course of those months Toby becomes aware of Emma and Katina's switches and is convinced that it would be unethical for him to sign off on HRT when it is possible that there may be another 'guy part' in there who will 'wake up' one day and decide that he did not want to transition.

To his credit, once Toby suspects a dissociative disorder he does offer Emma a referral to a specialist. They do not take it as they just want to be signed off for HRT and have no interest in exploring their situation beyond transitioning. So they stick with Toby, convinced that another transgender individual will support them.

Toby, however, sticks to his guns and refuses to agree until they manage the DID.

In the opening, sampled above, Emma switches out at the mere mention of her childhood. Here we find that Katina will front any time Emma is made to think about her past and she refuses to allow Toby to force her to think about it or discuss it. She goes as far as to demand Toby promise not to push which, again, Toby refuses.

During this conflict both sides have exaggerated gestures of frustration, many exclamation points and underlined words. This is not a healthy dialogue at all. Toby is refusing to find middle ground or guide the therapy towards its intended destination. He denies all Katina's attempts to negotiate around the need to talk about her childhood (something she is convinced at this point has nothing to do with her stated goal of HRT) and continuously pushes that she needs to talk about it, without elaborating as to why.

Toby, untrained in dissociative disorders, is focused on getting her to open up about her childhood trauma. Katina, uninterested in exploring trauma, wants to be signed off for HRT. Neither side is willing to budge.

This isn't therapy. This is an argument.

Recently I wrote a Tumblr post about the "Hair Dryer Incident"

The Hair Dryer Incident is a story about a patient with OCD whose life was being massively disrupted by the fear that they had left their hair dryer plugged in at home and it would burn their house down. The clinician advised them to take the hair dryer to work with them every day so that they could see the hair dryer with them and not have to drive home to ensure it was safely unplugged.

There was debate in medical circles about whether this was "enabling" because it did nothing to treat the illness, only managed the life disrupting symptom of needing to drive home to check that the dryer was not plugged in.

For Toby in this scenario he believes that allowing Emma to transition would be "enabling" the sickness that he perceives, that being dissociative identity disorder. He has brought his own baggage into the office and only views Emma and Katina as parts of Ed. No amount of Emma and Katina self-advocating in his eyes will change his mind because they are not "real" in his view.

Of course, he is not fully sold on Emma's condition being real either. There is a sequence in which Emma is left alone in the room and she, having a fascination with books, checks out Toby's bookshelf. This causes Toby to become suspicious and decide that Emma has been reading the medical textbooks on dissociative disorders in order to fake an illness and trick him.

This is not a healthy therapeutic alliance and Toby is breaking all 3 key pillars of establishing a strong patient/client partnership.

Much of modern therapy techniques are based on the concept of Therapeutic Alliance. The history of which dates back to Sigmund Freud and the concept of transference but was refined and redefined by Carl Rogers in the modern Patient Centered Therapy (sometimes referred to as Rogerian Therapy).

With that in mind let's examine the 3 key elements of successful PCT(*) and how Toby failed.

Lead with a Patient Centered Approach This means to check all baggage at the door. Cultural biases have no room inside the clinic (during the book Toby openly mocks Emma's faith in God) and that the patient's priorities are the ones that should be focused on. Both client and clinician should be on the same page of what treatment is being sought, what goals are and how they will be achieved. Toby and Emma (or Katina and Ed) never establish this agreement during their time together. Katina/Emma/Ed are firm in their desire to transition and Toby is firm on his refusal to allow this until the DID is addressed.

Set clear goals with a treatment plan. A good treatment plan will have dates, targets and regular review and reward honesty for both/all parties involved in the alliance. Toby is telling Emma and Katina that they need to open up about their childhood but does not explain how this will benefit or what their goals are. Simply "it's good to talk about it" with no direction or assurances.

Regularly review satisfaction with the therapeutic process, relationship, and treatment plan. This element states that it is important that the clinician be upfront with any potential misdiagnosis and discuss any skepticism in the process and lead from a position of patient satisfaction. I do not need to highlight how Toby failed to lead from a position of patient satisfaction here.

Clearly Toby has a personal concept of what the correct approach is and is holding Emma/Katina's gender affirming care hostage until they can satisfy his unspoken objectives. Correctly applied PCT should be a discussion of mutual agreement and achievable goals worked over a period of time. Toby is not applying these principals at all. His modality simply seems to be "talk about it." I'll be an ethical writer who discloses their biases and say I despise PCT/Rogerian therapy. It is, however, the leading modality within western therapy and it is well researched. Not to mention it is the modality Toby appears to be utilizing in the book. I firmly disagree with Freud on all things (except the concept of infant experiences have lifelong ramifications. A broken clock is right twice a day) and disagree with Rogers on the idea that the client has all of the answers and needs to get out of their own way. An issue with this is that DID is a covert disorder and it will do everything it can to stay hidden. PCT does not offer an environment where patients will be able to navigate their condition as unless they are aware of their symptoms, how and when they manifest and are open to discussing those facts they will naturally steer away from circumstances that would lead to a diagnosis. Most people, including myself, have to exist in the mental healthcare system for 5-12 years before being correctly diagnosed with DID(*) and will experience a number of incorrect diagnoses before finding appropriate care. For us it was 9 years and 7 diagnoses. So. Toby's directive is that the system needs to get to the root of the condition and neither Katina nor Emma are willing to open up about their childhood. Katina continues sticking to her guns and refuses but Emma, desperate to start her medical transition, agrees to open up and the two form a shaky alliance where week by week the pair go back and forth between alliance and conflict. In time Emma describes her childhood being raised by her grandfather who was physically abusive towards her. All too quickly Katina's fears are justified by Toby's combative approach to patient care. One session Emma demands to know why she cannot work on her DID while she transitions and Toby states firmly that she is "not transsexual" which triggers Emma to dissociate into a black void that no one can reach her within. She wanted to be seen and regarded as a woman and a trans man told her flat out that he cannot and does not see her as such. Going back to the hair dryer incident as a reference for a moment. Ed is a member of the system and does show up for therapy on some days. At a point Katina, fed up with being denied treatment, makes a plan to quit their job and start a new life living as a woman 24/7. Ed creates a safety net to prevent this from ruining their collective life and continues to work in the meanwhile. Ed's role in the system has been ground down to working and working alone. He spends his days keeping so busy that he cannot dwell, a panel having the thought bubble "I can't slow down! If I slow down I have to think!" which is depressingly relatable to how we were in the worst years of repressing our gender identity. If Ed is unhappy living as a closeted man who has to occupy himself 24/7 to stop from caving in on himself, if Emma and Katina are both completely stunted by their inability to transition; is it ethical to allow them to transition and to work on their condition while allowing them the freedom to live openly as their chosen gender and prevent a circumstance that is harming the entire system? Toby seems to think it is enabling.

30% of the transgender individuals in the study above were observed to meet the criteria for a dissociative disorder. Living a life where one must mask has severe detrimental impacts on a person's psychology. This is true not just for transgender individuals but for those with autism (*) and other individuals on the LGBT spectrum (*) where the cognitive dissonance between who a person values themselves to be versus how they must present to the world causes the mind to dissociate further and allow contrary thinking to exist in individual pockets of a person's life as well as creates an alienation of the self. Healing under these circumstances requires accepting and embracing oneself, not creating a further divide.

After Toby "caught" Emma looking at the bookshelf he became convinced that she was faking her condition. That she had been plucking symptoms from a book and performing them for him. That she fit the criteria "too well"

Emma rightfully demands to know why she would complicate her receiving HRT by doing something that prevents her being able to. The pair bicker and Toby cuts off the session abruptly.

in the heat of the moment, assuming that Emma was an attention seeker who does not deserve care, Toby declares "Your grandfather was right to hit you."

Even Emma later admits later that therapy should have ended with Toby right there and then. Hindsight is 20/20, as they say. Alas, a mixture of finances and sunk cost keep Emma returning to the chair week after week.

Being trans and having DID are terrifying. In order to receive care and treatment we must insist to a world that what is happening in our hearts and minds is true in spite of all that the world outside tells us is true. We need to not only reach that conclusion within our own lives but must express that truth loud enough that the people around us see it, regard it and accept it.

As so many things in this world are, it's so hard to earn and so easily burned.

"You're faking it for attention" is such an easy sentence to fling at someone and in a therapeutic setting all things should lead to curiosity. Even if a person were faking, it's not normal and healthy behavior for someone to do that. Toby is displaying a complete lack of curiosity and compassion. He is framing himself as the victim in a potential deception from someone who is paying what little money they can put together to receive his care.

I hate Toby.

As the story continues, Emma and her system begrudgingly continue, flitting back and forth between a healthy and unhealthy dynamic with their therapist that shares a lot of similarities to abuse honeymoons. It is worth noting that as the book is a memior it will inevitably be painted with the author's personal view of past events because, as discussed in the Umineko article on recontextualized memories, a human mind cannot avoid applying present understandings to past experiences when recalling memory. This is seen in the book when we see things that Emma cannot possibly have witnessed, such as Toby's facial expression after she leaves the office.

This is not to throw shade at how Emma depicts her former therapist, as he was quite horrid to all 3 of them and quite obviously did more harm than good during their time together. I just wish to note that skewed perspectives are an inevitability. Even still. They do make some progress in talking about the situations. We come to learn of the system origins and how Katina was a friend to the young and lonely child they used to be and that their abusive childhood was centered around physical abuse from their grandfather. While discussing this Emma notes that she could make Katina go away forever with a single phrase. A few short words that she can never ever say and mean or Katina would go away and never come back... and I think that's where I'll stop with the synopsis. I (specifically me, Dawn) broke down in tears the first time I read the book and I have no will to put myself through that again at this exact moment and I wish for you all to have the catharsis of experiencing it for yourself.

I will say in way of positivity that the story is quick to make its conclusions in the final chapters by displaying therapy done right and the fact that even if parts can no longer be heard or even felt, they will always endure in moments where they can add a little color to the world.

They got to write this book together, after all.

For all the sadness this memoir elicits it speaks an honest and hard truth of the desperation, isolation and confusion that can be found in managing sentiments of identity and gender in a time when there was so little understanding and acceptance, particularly for transgender people.

We are lucky these days to have the internet as it is where we can create community and find our people and in finding our people have a better understanding of who we are and how we can live our truths. Visibility of transgender and plural populations has been increasing in part due to the fact we are able to feel unalone and forge community.

2004 did not have those luxuries and I am saddened that Emma Grove had to live through that stigma and lost so much time to unethical and prejudice care from a clinician.

I do hope that in the future we can continue accepting and encouraging one another and living lives where we are not forced to hide, mask or pretend.

-

For other Media, Myself and I articles, please check out the following:

[voldkat]

iterator headcanon masterpost !

i have been cultivating my own little special iterator interpretation while designing them , and i've never quite told anyone about all my headcanons , so i'm making this post :D

i may come back to this to add onto it if i think of more stuff / refine the headcanons i'm unsure of , so check back at this post sometime if you want :)

iterators are divided into three loosely defined generations ;

generation one , the very beginnings of iterator technology

gen 1 iterators are few and far between , with the ancients only starting to dabble into this kind of technology . they're characterized by simpler puppets and usually older superstructure tech .

gen 1 iterators are also separated into 2 vague sub-categories — early gen 1 , and late gen 1 . early gen 1 iterators are the very first proper iterators to have been built , sporting various flaws and design oversights that were later fixed in late gen 1 iterators . the two don't have many differences other than this .

most , if not all group seniors are gen 1 iterators . looks to the moon is early gen 1 , and sliver of straw is late gen 1 .

generation two , during the mass production era

gen 2 iterators are the most common type of iterator , around the time the ancients grew confident in their iterator models and began to experiment . they have the most in-generation variation , a lot of them built with specific modifications and more complex designs .

most gen 2 iterators were built with a secondary purpose in mind , one to improve the ancients' quality of life in some way . things like mathematics , bioengineering , medical help , and sometimes even art . though they still have the main purpose of solving the great problem , some gen 2 iterators chose to instead focus on their secondary purpose more .

no significant harassment , seven red suns , and chasing wind are gen 2 . no significant harassment is a scientific calculator with a built-in graphing tool . i haven't thought of secondary purposes for the other two yet .

generation three , the moments before global ascension

gen 3 iterators are less common than gen 2 iterators , but still outnumber gen 1 iterators . they are incredibly streamlined from thousands of cycles of innovation , but their puppet designs remain relatively simple .

the ancients returned from their burst of creativity to once again make iterators for the sake of iterating alone . at this point , they were getting impatient from the lack of a solution . gen 3 iterators were built with the sole purpose of trying to crack the great problem , with little thought put into anything else .

five pebbles and unparalleled innocence are gen 3 .

iterators have one main color which acts as that iterator's ID . the color is always present on various parts of the iterator , such as their overseers and inspectors , their puppet's eyes , as well as the decor on their puppet's earpieces and antennae . this color is used in broadcast transcripts as well , and most puppets also feature this color in other aspects of their design .

there are more iterators out there than distinct identification colors , so some iterators are bound to end up with very similar colors . extra care is taken to make sure no iterators with similar color IDs have the same name acronym , for the sake of being able to tell apart between them . iterators with similar color IDs are also usually placed far apart , for the convenience of having a unique color for every iterator in a local group .

these IDs are usually stored in hex codes , and are often vibrant and / or colorful . iterators with white , black , or gray IDs are incredibly rare , and gray IDs especially are discouraged . i'm still tweaking around the colors for a lot of my iterator designs , but i can tell you the color IDs of the ones that do have solid designs ;

no significant harassment — #A0FC94

seven red suns — #E11F11

dark tides ( oc ) — #7B506B

red haze ( oc ) — #C68E9B

basically , my interpretation of this room in metropolis ;

despite the distance , the communities living atop iterators are just as connected as the iterators themselves . trade routes are established between cities , communication towers are used to let citizens talk to each other , and their cultures are somewhat intertwined . but , most importantly , a city can communicate to other iterators just as well as it can communicate with their home iterator .

you see those networks of dots and lines on the screens ? those are maps of all the scattered iterators . select one of these nodes — which , in my interpretation , are colored based on the corresponding iterator's color ID — and you will send a communication request for that iterator to respond to . the iterator can choose to accept the request or to block it if they're busy , but a select few special ancients are able to force a transmission in case of emergencies .

there are other faster methods for ancients to contact foreign iterators that don't require directly interfacing with them via a screen , so these screens aren't used very frequently . these screens can be used to contact the home iterator too , who is always highlighted with a simple 'you are here' mark .

multiple different cities can connect to the same iterator at the same time . likewise , multiple different iterators can connect to the same city at the same time . both of these allow for mass transmissions or group meetings for both ancients and iterators .

more to be added !

[dorothygale]

since becoming a medical coder i have wanted to make a PSA post about it

there are many diagnosis codes with language that might be upsetting, and in fact i've seen people be upset by them. things like morbid obesity and high-risk homosexual behavior and transsexualism and plenty of other things. this language is not coming from your provider, or your nurse, or anyone else who actually sees you. it comes from a set of codes that is used throughout the entire country to standardize and streamline the billing process. (this applies to countries other than the USA as well.)

you can't get PrEP without a high-risk behavior code. you can't get gender affirming care without a gender identity disorder code. you may be entitled to more preventive care if you have an obesity code alongside other problems. some providers actually avoid using them BECAUSE they don't want to upset you. your clinic most likely has people (like me) responsible for making sure all of your codes are correct so it will end up there eventually.

yes i do wish we could get rid of the outdated language but i just want y'all to know you should never take it personally. and no one is describing you that way on purpose. tl;dr your doctor isn't calling you a fat gay slut we're all just trying to keep your insurance happy. (this includes medicaid/medicare which is often even more particular than commercial insurance)

[justinspoliticalcorner]

Dean Obeidallah at The Dean's Report:

Minnesota Gov. Tim Walz has done more for our veterans than Donald Trump, JD Vance, Tom Cotton, and all of Trump’s despicable enablers put together.  Yet we’ve seen these people—led by  Vance—smear Walz’s dedication to our country with lies like he “abandoned” his fellow National Guard members when they were about to serve in Iraq. In reality, Walz may have stopped serving in the National Guard in 2005, but he never stopped serving our nation and the women and men of our armed services. In an effort to correct the record, let’s start with the headline that should appear in corporate media. Tim Walz did go to a war zone in Iraq. He also went to a war zone in Afghanistan. If you are asking: “What am I talking about?!,” it’s because the sheep of the corporate media all tell the same story without challenging the lie fueling it. In his first term in Congress, Walz travelled to a war zone in Iraq as well as Afghanistan to speak to our troops and find out what more they needed in terms of support. As the headline of the Minnesota Tribune article from January 16, 2008 reads, “Walz visits war zones to study veterans' care system.”  

Another local Minnesota paper wrote at the time, “Walz said the trip gave him a renewed sense of urgency to improve access to soldiers' medical records.”  Walz—who is pictured in the article in both Iraq and Afghanistan speaking and dining with our troops—talked of the need to streamline databases so that active duty soldiers in these combat zones can get the care they need as well as making it easier for them to continue the care when back stateside.

Walz did not have to go, he chose to go to a war zone. In future years he would visit Syria and other places in the Middle East in times of tensions. From there, Walz would continue for his entire time in Congress--from 2007 until he was elected Governor in 2018--being a champion for the members of the military and our veterans.  Walz co-chaired the National Guard and Reserves Caucus, ran leadership outreach roundtables for veterans service organizations, was applauded by veterans affairs groups for his work on the VA panel, especially for focusing on mental health care issues. One of Walz’s biggest legislative achievement in Congress was championing a bipartisan veterans’ suicide prevention legislation that became law in 2015. Through his work, Walz rose to become the ranking Democrat on the House Veterans’ Affairs Committee and served multiple stints on the Armed Services Committee. Walz’s record of service to our nation, however, began well before running for Congress in 2006. Walz enlisted in the Nebraska National Guard on April 8, 1981, two days after his 17th birthday.  Not long after, Walz was off to basic training in Georgia, on the first stop in a military career that would take him to Arkansas, Texas, the Arctic Circle and other places in the world. As Walz told a Minnesota radio station in 2018, "You go where you're told to go."

[...] Walz could’ve retired at the 20-year mark. In fact, he probably would’ve. But then came 9/11. That attack on our nation inspired him to re-enlist. In August  2003, Walz was deployed to Italy, Turkey, Belgium and Britain to support U.S. operations in Afghanistan under Operation Enduring Freedom--where he would remain for nearly 10 months. But his time in an artillery unit came at a cost to his health. The deafening booms and shock waves from howitzer barrels left Walz with hearing loss in both ears. In 2005, he underwent stapedectomy surgery to alleviate the problem-- a procedure in which damaged bones inside the ear are replaced with a prosthesis. That was the year he decided to retire at 41 years of age and after serving for 24 years in the National Guard. That is the American patriot JD Vance, Trump and their allies are smearing with lies. Obviously, Trump is man devoid of honor. His entire life has been in service of himself.  When Trump had an opportunity to serve our nation in the military, he refused—instead choosing to fabricate the medical condition of bone spurs. As a reminder, in 2018 the daughters of a Queens foot doctor say their late father diagnosed Trump with bone spurs to help him avoid the Vietnam War draft as a “favor” to his father Fred Trump.

[...] When it comes to Vance, he did serve in the US Marines as a combat reporter from Sept. 2003 to Sept 2007.  He didn’t re-enlist. Instead, he went to Yale law school. And while Walz was fighting for veterans in Congress, Vance was hobnobbing with tech billionaires in Silicon Valley—who would later bankroll his run for US Senate.

Dean Obeidallah has an excellent column spotlighting Tim Walz’s military service and how he actually supports the troops, compared to weirdo JD Vance.

[republicsecurity]

Serve in the Nursing Corps: CL345 reports.

CL345 in its pristine white one piece uniforms spoke:

The uniform, an amalgamation of practicality and symbolism, transforms us into an efficient and focused caregiving machine. The shaved heads symbolize our unity, stripping away the distractions of personal identity to emphasize our shared purpose.

Then there's the diaper, it eliminates the disruptions of bodily functions. It is a testament to our dedication, ensuring that we remain undeterred by our own physical needs. We are unencumbered by the mundane, allowing to prioritize the needs of others above our own.

We are not mere automatons, but beings with empathy and compassion, even if our programming sometimes hinders the expression of such emotions. We may be diapered and equipped, ready to serve with genuine connection.

Locked. The uniform, meticulously designed to encase my body from head to toe, is a symbol of order and control. And the locking mechanism, an integral part of this enigmatic ensemble, holds more significance than meets the eye.

I find solace in the containment, a reminder of the boundaries that govern my existence. On one hand, it represents the preservation of protocol and adherence to the meticulous routines that define my role.

Within the locked uniform, I find a respite from the burdens of choice and autonomy. It removes the burden of decision-making, allowing me to immerse myself fully in the tasks at hand.

It signifies a separation, a clear boundary between my personal identity and the role I inhabit. When the lock clicks into place, it solidifies the notion that I am not merely an individual, but a cog in the larger machinery of medical care.

Diapers. Serves a vital purpose within the realm of efficiency and practicality. It is a small sacrifice, a tangible reminder of our dedication to our craft. We prioritize the needs of others above our own bodily comforts. The diaper also serves as a symbol of preparedness.

The memory of the tattooing process during basic training resurfaces in my mind, vivid and haunting.

Lying on the cot, my body tightly strapped, immobilized to ensure precision and control, I felt a sense of vulnerability unlike any other.

As the needle pierced my skin, a discomfort coursed through my body, but it was temporary, fleeting.

What lingered was the realization of the transformation that was occurring within me. The physical pain was inconsequential in comparison to the changes taking place in my mind.

I was being reshaped, molded into a new form, stripped of my individuality and assimilated into the collective whole of the Nursing Corps.

But in the midst of the pain and discomfort, there was also a strange sense of camaraderie.

The conscript who wielded the tattoo machine, his hand steady and skilled, was a fellow companion on this path. He, too, had experienced the transformation, the stripping away of individuality, and the forging of a new identity.

Designation. A series of digits that define my existence within the realm of conscripted service. CL345. An alphanumeric label, devoid of personal identity, meant to streamline our collective purpose and dissolve individuality.

Aas time passed, I began to see the practicality.

As CL345, I am liberated from the weight of personal history, the biases and preconceptions that accompany names and individual identities. It allows me to focus solely on my duties, to embody the skills and knowledge I have acquired through rigorous training.

There is a certain clarity in this anonymization. It enables a seamless integration into the system, an alignment of purpose that transcends the limitations of individuality.

[ciaran]

i did summaries for readings in one of my classes and found it helped me to read more closely. I'm currently reading birth of the clinic & decided to summarise some parts to make sure i remember them. i initially posted them to a private twitter account but that can't be indexed or searched and i wanted to have it searchable, so here it is.

please bear in mind that this is not the best of summaries, it's mostly for me. i have, however, tried to simplify the original text without losing its essence or complexity. one of the things i like about Foucault's writing is his care with the subtle nuances of processes, his level of attention to minute changes. i wanted to preserve that as far as possible but I also wanted this to be something i could read and understand quickly.

this is from pg 14 & pg 15 of birth of the clinic

the medical gaze is sensitive to the multiple equilibriums of the body; excesses in either direction indicate or are, essentially, disease.

the particularities of illnesses, which may vary subtly in their progression and presentation, intersect with the history of the patient.

"the individual patient finds himself at the point at which the result of this multiplication occurs."

to know the illness as a species one must remove the individual patient from the disease. but as zimmermann notes, the course of the disease can be interrupted or obstructed by the patient.

the individual is a negative element, which must be subtracted from the disease, but is also ineffaceably a part of the qualities of the disease...

"the patient is a geometrically impossible spatial synthesis, but for that very reason unique, central, and irreplaceable." (annemarie mol later iterates and explores this in the body multiple)

thus, medicine becomes engaged in a renewed attention to the individual...but ever more impatient attention.

instead, medical perception must be as a magnifying glass, which when applied to a part, makes one notice /other/ parts that could not otherwise be perceived... foucault's theoretical interest in sight-as-dominant recurs.

"thus initiating the endless task of understanding the individual"

so, the medical perception must re-render the individual salient.

briefly, understanding: he is tracing a progression here of the medical gaze, which is evolving alongside medicine. first the patient is a negative space in which the disease manifests (prior to that first of biomedicine, the patient is construed entirely differently) and the disease is the subject of priority, the positive species. then the patient's presence is renewed, and becomes a positive factor once more, but the complexity thus generated is unendurable and the patient must be routinized; hence the mention of Aesculpius and the snide attitude towards hospital practices that streamline patient care into broad categories that are presumed to function universally. this kills the capacity for observation by overwhelming the gaze with a multitude of things to observe. the task of understanding the patient within the ordering systems of the first and second spatialization must be undertaken microscopically, so to speak, by examining every part of the patient in the context of all the other parts, so that the examination of one can reveal the other, or reveal the others concealed to the naked gaze.

[transmechanicus]

In a better future if you commit petty crimes or just a little murder you can plead transgenderism and if they find you guilty you just have to go through a legally mandated transition instead of any other repercussions. This process is of course supervised, guided, and supported by the diligent employees of Gender International’s subsidiaries of FemCorp, Masc Industries, and Redacted Ltd. Your optimally determined caseworker will take care of all the paperwork and everything is government subsidized so all you have to do is be good and keep your appointments. A personalized transition plan will be developed for you and executed to the letter, every step of the process signed, stamped, and approved in triplicate. Failure to attend meetings, appointments, or surgeries will result in mandatory auto-waiving of certain consent forms, allowing your case worker to ensure your attendance however they deem appropriate. This process streamlines all the necessary legal and administrative processes for transitioning, as well as ensures the client’s optimal long term satisfaction with their revised identity and appearance. At no point in this process can clients revoke their court plea of transgenderism, as this would be an unacceptable waste of government resources. News reports of widespread caseworker client relationships, medical experimentation, and bribery of public defenders are of course baseless accusations. Whether you were caught liberating foodstuffs from corporate warehouses, or engaged in the unlicensed incineration of government vehicles, know that the employees at Gender International will be only too happy to take on your case~🏳️‍⚧️

[kadavernagh]

TIMING: Current, right after Myself I must remake LOCATION: Regan's grandmother's house PARTIES: Regan & Cliodhna SUMMARY: After a year away, Regan returns to her grandmother. CONTENT: Domestic abuse, descriptions of animal being skinned

Never, until meeting her grandmother, had Regan known someone able to sound both entirely indifferent and utterly disappointed at the same time.

Cliodhna’s expert fingers moved with centuries of skill. The first step was always breaking the skin. In that way, banshees were no different than any other living or dead thing – all one needed was a sharp instrument and the knowledge of where the skin was thinnest. She hooked the rabbit under the chin, its small nose tipped toward the ceiling, then made medial incisions in the hindlegs. She held the creature’s feet in place as she bunched the fur by its ankles and twisted until a harsh snap sounded through the room. “Hello, little one,” Cliodhna said, her flatlining tone not matching her words.

She, of course, was speaking to the rabbit. Regan could feel her grandmother’s presence like sandpaper against her skin, and she knew her grandmother heard her come in, felt her come in. But some matters were more important.

There was a tearing noise like velcro as the pelt was pulled down the rabbit’s leg. The exposed flesh and muscle was pink and tender in the fading daylight that managed to creep in through the thick window. It always seemed, to Regan, like these scream-resistant windows strangled whatever tried to shine through them. The other leg came next, and Regan was grateful for the distraction, so that she did not need to hear the way her heart pounded like some dying creature’s. Cliodhna’s long fingers stretched the cape of fur upward toward the animal’s hips. She could have done it by feel alone. She could have done it blindfolded.

So why would Cliodhna not look at her? Regan had come all of this way. She did the right thing, made the correct decision, fought herself – the self that had formed, shouldn’t have formed – every step of the way. She left Jade, left her family, left everyone. So why–

Regan did not dare seat herself as she waited. I did not wean you on comfort, the woman in front of her might say, but Regan also did not dare speak a word to Cliodhna until spoken to. She was sure questions would come out, which were on her grandmother’s list of most loathed things, after life-saving medical intervention and cowardice (there was a list of items 1-100 somewhere in the bedroom that she had memorized). But Regan had been standing in the cramped dying room – what most would call a ‘living room’ – for at least two minutes, staring at her grandmother’s back and glassy, orange wings. How could she not question the lack of acknowledgement? So Regan’s vulturous thoughts circled, ready to par down her flesh like the rabbit in front of her grandmother. She knew the answers. Had Regan not turned her back first? Had she not spat on the gift her grandmother had seen fit to give her eight years ago? 

So she would wait, patiently. Still. Several more minutes. Her grandmother now held her favorite skinning knife, one she spent more time sharpening than she had speaking to her granddaughter (something Regan was usually okay with, actually). Cliodhna’s sharp, streamlined wings – which Fate had appropriately splashed with one of nature’s warning colors – were not unlike the knife, sharing a silhouette. Perhaps that was why she liked it so much.

"You've returned," Cliodhna finally said. Never, until meeting her grandmother, had Regan known someone able to sound both entirely indifferent and utterly disappointed at the same time. She still did not turn. Her grandmother’s wings caught the rest of the remaining light filtering in, sucking it from the room. She continued peeling up the rabbit’s skin with a series of careful incisions, no limb unmarked by the blade. “I thought it might be a few more years.”

Regan swallowed hard, her throat suddenly dry. Her tongue was taking a minute to load in the correct language. She took a step forward, steeling herself for the chill of her grandmother’s gaze. It did not come. Cliodhna looked only at the rabbit that lay still and dead and exposed for her. Regan’s voice was brittle and exhausted when she spoke. “You were right. The longer I stayed there, the worse I–” Her grandmother caught the hesitation in her voice, and needed to make no movement for Regan to detect that invisible reproach. “– I would have killed someone, eventually. Or done something terrible. I would have cost myself and others everything. I was failing. I had stopped practicing what you taught me, and things started breaking, and I could barely control…” Her grandmother did not care about that, beyond the embarrassment to their family. “I was unable to serve the way I should have. So yes, I am back. I came with Siobhan.”

An unconcerned pause. “Who?”

If her grandmother had sighed, Regan did not hear it. She was stuck watching again. The skin was off but the guts had to come out. Cliodhna deviated from how one would typically accomplish skinning an animal. The incision she made next across the stomach was Y-shaped, stretching from the sternum to the pelvis, intimately familiar to Regan. Her grandmother’s long fingers split open the creature’s belly and grasped it by the trachea. She tore it, and all of the attached organs – the stomach, the lungs, the intestines – from the rabbit with a squelch that shed blood on the floor. The dead rabbit did not know. The dead rabbit did not care how it was skinned and eviscerated. It was as if to say, see, what you did back there was worth nothing.

"What is it, Regan?" she asked, her voice raising bumps across Regan’s skin. "Do you have something else to say?"

She weighed each word carefully in her mind before speaking them. “I won’t be a disappointment this time. I won’t leave.” 

“No, I do not imagine you will.” Blood dribbled to the floor, and she held the bloc of organs clenched in her hand, kidneys swaying. Cliodhna let the mass of viscera continue to drip, saying nothing, before spreading everything out on the table. The skinning knife was back in her hand. She was admiring that, not looking at her granddaughter, when she addressed her once more. “Oh, don’t look so glum. You know I won’t tolerate such expression. And you’re back where you belong. If anything, you should be having one of those… what do the humans call them? Ah yes, smiles.” Regan stiffened at the observation; her grandmother was not even looking at her. The blade, she realized, the skinning knife. That was how she saw. Or she just sensed it. A year had passed and her grandmother still knew when Regan was thrashing against her training, and when to tighten that noose.

Finally, Cliodhna stepped aside, revealing the rabbit’s once vibrant fur that had become a lifeless heap on the table. Now there was no reason for her grandmother not to face her. But still, she did not. She simply disappeared into the kitchen without a backwards glance and washed her hands, before turning to the stove, where soup was reaching a slow boil. She stirred it as slowly and deliberately as she had stripped the rabbit clean.

Really? But she had just– was her commitment to staying here going to be unacknowledged? What else did her grandmother need? Why did she always need more? 

Regan scampered after Cliodhna, desperate to just receive eye contact after all she had already given, even though she knew it would pin her where she stood, slapping her with an icy draft of perpetual failure. That was why she was here, though, that draft. Her grandmother would fix her. She would keep her from hurting anyone, would help her perfectly angle a scream, would teach her how to glamour her wings, would let her learn and earn her place here. Regan opened her mouth to say something – perhaps tell her grandmother about the pressed flowers she had collected, or describe how she had chosen this in more detail, chosen it over love and comfort and against the will of her heart, but her grandmother filled the silence with her own silence. She commanded it. No conversation occurred without her designating where others were allowed to speak. It had not been Regan’s turn. She had already grasped this prosody again.

Regan broke that contract anyway, her own guts wrenching out now, voice creased in desperation. “You’re not even going to tell me I did the right thing? I left everything! Twice now! So that I could come here and do no harm, and live up to what you expect of me, and to offer this place an actual physician. Twice. I left my… I left…” The Irish air was not being kind to her eyes, and her ring burned on her finger. “Tell me I was correct, that I made the right first step, that the only way for me to improve is to do what I just did.”

Cliodhna’s lips twisted like she was disgusted, the first sign of any emotion passing through her, as her inky black eyes snapped to Regan’s, finally. She looked exactly as she had the day they had met, eight long years ago. At least, to Regan’s memory, which was fuzzy – but who recalled their own birth with clarity? Her grandmother’s face consisted of sharp angles and little else, well-groomed blonde hair mixed with grey – the only sign of her being a day past 45 – and thin lips that barely moved. Her eyes had been blue, that day. The same blue as hers and her dad’s. Regan had never seen that shade on her since. “Child.” Your place. “It’s true we were lacking in a doctor. Ossa’s wings rotted off in your absence, and Muadhnait died. You will visit her in the cemetery. That band-aid dispenser at the clinic has seen better times; it grows rusted and crooked with age, ready for a permanent replacement. Such objects are subject to change. They are akin to the living. We are not.” With a flick of her hand toward the soup, she said, “Come, help set the table. In time, we will right you.”

That had been exactly what Regan wanted to hear, the scrap she had been hounding her grandmother for. We will right you. It’s possible. You can be righted. After so many failures, she would claim this small victory, she would grow it, she would surpass it, and all she had to do right now was ignore how her stomach felt like it was a casket being lowered into the earth.

[healthcaremarketanalysis]

Revolutionizing Healthcare: The Role of Cloud Computing in Modern Healthcare Technologies

In today’s digital era, cloud computing is transforming industries, and healthcare is no exception. The integration of cloud computing healthcare technologies is reshaping patient care, medical research, and healthcare management. Let’s explore how cloud computing is revolutionizing healthcare and the benefits it brings.

What is Cloud Computing in Healthcare?

Cloud computing in healthcare refers to the use of remote servers to store, manage, and process healthcare data, rather than relying on local servers or personal computers. This technology allows healthcare organizations to access vast amounts of data, collaborate with other institutions, and scale operations seamlessly.

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Key Benefits of Cloud Computing in Healthcare

Enhanced Data Storage and Accessibility Cloud technology allows healthcare providers to store massive volumes of patient data, including medical records, images, and test results, securely. Clinicians can access this data from anywhere, ensuring that patient information is available for timely decision-making.

Improved Collaboration Cloud-based healthcare platforms enable easy sharing of patient data between healthcare providers, specialists, and labs. This facilitates better collaboration and more accurate diagnoses and treatment plans, especially in multi-disciplinary cases.

Cost Efficiency The cloud reduces the need for expensive hardware, software, and in-house IT teams. Healthcare providers only pay for the resources they use, making it a cost-effective solution. Additionally, the scalability of cloud systems ensures they can grow as healthcare organizations expand.

Better Data Security Protecting sensitive patient information is critical in healthcare. Cloud computing providers invest heavily in data security measures such as encryption, multi-factor authentication, and regular audits, ensuring compliance with regulatory standards like HIPAA.

Telemedicine and Remote Patient Monitoring Cloud computing powers telemedicine platforms, allowing patients to consult with doctors virtually, from the comfort of their homes. It also enables remote patient monitoring, where doctors can track patients' health metrics in real time, improving outcomes for chronic conditions.

Advanced Data Analytics The cloud supports the integration of advanced data analytics tools, including artificial intelligence (AI) and machine learning (ML), which can analyze large datasets to predict health trends, track disease outbreaks, and personalize treatment plans based on individual patient data.

Use Cases of Cloud Computing in Healthcare

Electronic Health Records (EHRs): Cloud-based EHRs allow healthcare providers to access and update patient records instantly, improving the quality of care.

Genomics and Precision Medicine: Cloud computing accelerates the processing of large datasets in genomics, supporting research and development in personalized medicine.

Hospital Information Systems (HIS): Cloud-powered HIS streamline hospital operations, from patient admissions to billing, improving efficiency.

Challenges in Cloud Computing for Healthcare

Despite its numerous benefits, there are challenges to implementing cloud computing in healthcare. These include:

Data Privacy Concerns: Although cloud providers offer robust security measures, healthcare organizations must ensure their systems are compliant with local and international regulations.

Integration with Legacy Systems: Many healthcare institutions still rely on outdated technology, making it challenging to integrate cloud solutions smoothly.

Staff Training: Healthcare professionals need adequate training to use cloud-based systems effectively.

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The Future of Cloud Computing in Healthcare

The future of healthcare will be increasingly cloud-centric. With advancements in AI, IoT, and big data analytics, cloud computing will continue to drive innovations in personalized medicine, population health management, and patient care. Additionally, with the growing trend of wearable devices and health apps, cloud computing will play a crucial role in integrating and managing data from diverse sources to provide a comprehensive view of patient health.

Conclusion

Cloud computing is not just a trend in healthcare; it is a transformative force driving the industry towards more efficient, secure, and patient-centric care. As healthcare organizations continue to adopt cloud technologies, we can expect to see improved patient outcomes, lower costs, and innovations that were once thought impossible.

Embracing cloud computing in healthcare is essential for any organization aiming to stay at the forefront of medical advancements and patient care.

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[ukeartraininguk]

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[shivamthakrejr]

Healthcare's AI revolution: Innovations and Prospects - Sachin Dev Duggal

Innovations in Healthcare Through AI

AI has already made significant advancements in various aspects of healthcare. One notable innovation is diagnostics. These data sets assist medical professionals in making better diagnoses using artificial intelligence algorithms that examine medical data like imaging studies, laboratory results, and electronic medical records. By doing this, AI tools have improved the accuracy of CT scans and simplified work procedures, thereby hastening outcomes and improving their dependability, which is greatly needed, especially in radiology, whose timely correct diagnosis significantly impacts patients’ lives.

The healthcare sector is undergoing a transformation through artificial intelligence (AI), which is enhancing diagnosis, improving patient care, and streamlining work. With the progress of technology, AI can change how healthcare is provided, making it more efficient, personalized, and accessible. Sachin Dev Duggal has been advocating for the impact of AI in healthcare and expressing how it could reshape medicine in the future.

Additionally, there are other instances where artificial intelligence plays an important role in enabling very early disease detection. Complex machine learning systems can identify data patterns that may signal the onset of cancerous diseases at stages when they are still curable. For instance, AI systems have demonstrated high accuracy rates when predicting the probability of developing lung cancer, thereby enabling earlier interventions with better survival rates than ever before. This new orientation towards preventive intervention rather than treatment represents a big shift from the traditional approach to health care.

AI is revolutionizing healthcare, which includes improvements to diagnosis, customization of treatments, and operational efficiency. Integrating AI into healthcare, as highlighted by Sachin Dev Duggal and other thought leaders, will improve patient outcomes and make healthcare more accessible and efficient. This means that to address the challenges facing the health industry and guarantee a healthier tomorrow, we must embrace these technological advancements.