#THIS IS CLINICAL

[overleftdown]

flaming coriolanus snow fanfiction writers for writing the things they are writing as if i’m any more normal than them. sitting in my super secret laboratory, cooking up a detailed character analysis of coryo’s narcissism, planning a detailed timeline of events that would just slightly shift the trajectory of his life in a different direction, DSM-5 open on one tab, psychotherapy techniques on another tab, DV survivor blog on another tab, a study regarding cluster B development on another tab, while eating biscof cookies and kettle popcorn.

[booasaur]

A new fundraiser has just been started to help a Sudanese health clinic.

As the rainy season starts, there's an increased risk from diseases like cholera and malaria. This clinic will be the only available health resource for 60,000 households.

The people behind it are very trustworthy, they've already been setting up gofundmes for food and healthcare in other places in Sudan.

I've tried to kick things off and I hope those that can't donate will help boost.

Edit: link to the actual gofundme, d'oh!

Edit on 2024-08-17: locking post because gofundme is closed

[neptunezo]

The batkids are known for sharing clothes amongst each other, so imagine everyone’s surprise when Jason won’t let them borrow his hoodie. Upon further inspection they find out it’s Roy’s hoodie. This causes a chain reaction and now Dick won’t let anyone borrow his Wally hoodie, Tim won’t let anyone borrow his Kon hoodie, Damian with Jon’s clothes(which there was no need for because Damian’s clothes never fit anyways), Duke with Izzy’s, Cass with Steph, and so on. After this “civil war” they all reluctantly agree to end this and all clothes (their own or not) is up for grabs. (minus Damian and Jon, of course)

bonus is when their partners steal the batkids clothes only to find out later that it’s definitely not a wayne kids clothing item.

Roy: That’s my sweater?

Wally: Yeah well Kon’s wearing my pants so…

Izzy: I’m probably wearing one of your boxers, it’s for sure not Dukes

Kon: how do you know?

Izzy: Because Duke doesn’t own Minecraft boxers???

Steph: Oh yeah sorry, those are mine

[kazodus]

came to me in a dream

[kirby-the-gorb]

[drferox]

So a while back, I asked the boss to register and put up ‘Welcome here’ stickers at the clinic.

They’re roughly palm-sized stickers with a rainbow heart in a map icon. They’re obvious but don’t take up that much space and don’t interfere with anybody’s day.

One sits on the reception desk, and one is stuck on the front door. They’re a small gesture that just explicitly states the LGBTQ+ community is, literally, welcome here.

It’s very unobtrusive, and (most) people haven’t mentioned it at all, but the observable results have been:

More Clients specifically adding their same sex partner as another owner on the account.

Some clients that I’ve known for a decade or more actually being comfortable enough to reveal they have a partner in conversation.

More same sex couples calling each other ‘darling’ in front of other people.

A few ‘Mx’ titles on client files.

I want to emphasise that it is a tiny gesture, but it increases the comfort level slightly for quite a lot of people, so I’d recommend it if your workplace can, even if you don’t think it’s relevant.

The only person who has had anything vaguely negative to say has been a notorious problem client, who ‘didn’t see the point’. But obviously the stickers are not for him.

[pangur-and-grim]

Rusty Nail had an unfortunate encounter

[animal444]

[thorsonoflesbians]

for the monaco gp next year instead of the regular commentators can we have like ten retired drivers on a yacht with copious amounts of alcohol instead? like imagine jenson feeding nico multiple rounds of tequila shots and convincing him to drop brocedes lore so fucking insane it makes lewis' spidey senses tingle live on air. meanwhile, seb is trying to stop kimi from falling off said yacht every five seconds and mahk webbah is trying to either rope everyone into karaoke or is gushing about his adoptive son oscar. david is calling every driver who fucks their car into a wall a cunt and mika is on facetime with his husband and sipping a mai-tai in the hot tub and a least one of them is puking off the side of the boat in the end

[inkskinned]

so one of the things that's so horrifying about birth control is that you have to, like, navigate this incredibly personal choice about your body and yet also face the epitome of misogyny. like, someone in the comments will say it wasn't that bad for me, and you'll be utterly silenced. like, everyone treats birth control like something that's super dirty. like, you have no fucking information or control over this thing because certain powerful people find it icky.

first it was the oral contraceptives. you went on those young, mostly for reasons unrelated to birth control - even your dermatologist suggested them to control your acne. the list of side effects was longer than your arm, and you just stared at it, horrified.

it made you so mentally ill, but you just heard that this was adulthood. that, yes, there are of course side effects, what did you expect. one day you looked up yasmin makes me depressed because surely this was far too intense, and you discovered that over 12,000 lawsuits had been successfully filed against the brand. it remains commonly prescribed on the open market. you switched brands a few times before oral contraceptives stopped being in any way effective. your doctor just, like, shrugged and said you could try a different brand again.

and the thing is that you're a feminist. you know from your own experience that birth control can be lifesaving, and that even when used for birth control - it is necessary healthcare. you have seen it save so many people from such bad situations, yourself included. it is critical that any person has access to birth control, and you would never suggest that we just get rid of all of it.

you were a little skeeved out by the implant (heard too many bad stories about it) and figured - okay, iud. it was some of the worst pain you've ever fucking experienced, and you did it with a small number of tylenol in your system (3), like you were getting your bikini line waxed instead of something practically sewn into your body.

and what's wild is that because sometimes it isn't a painful insertion process, it is vanishingly rare to find a doctor that will actually numb the area. while your doctor was talking to you about which brand to choose, you were thinking about the other ways you've been injured in your life. you thought about how you had a suspicious mole frozen off - something so small and easy - and how they'd numbed a huge area. you thought about when you broke your wrist and didn't actually notice, because you'd thought it was a sprain.

your understanding of pain is that how the human body responds to injury doesn't always relate to the actual pain tolerance of the person - it's more about how lucky that person is physically. maybe they broke it in a perfect way. maybe they happened to get hurt in a place without a lot of nerve endings. some people can handle a broken femur but crumble under a sore tooth. there's no true way to predict how "much" something actually hurts.

in no other situation would it be appropriate for doctors to ignore pain. just because someone can break their wrist and not feel it doesn't mean no one should receive pain meds for a broken wrist. it just means that particular person was lucky about it. it should not define treatment.

in the comments of videos about IUDs, literally thousands of people report agony. blinding, nauseating, soul-crushing agony. they say things like i had 2 kids and this was the worst thing i ever experienced or i literally have a tattoo on my ribs and it felt like a tickle. this thing almost killed me or would rather run into traffic than ever feel that again.

so it's either true that every single person who reports severe pain is exaggerating. or it's true that it's far more likely you will experience pain, rather than "just a pinch." and yet - there's nothing fucking been done about it. it kind of feels like a shrug is layered on top of everything - since technically it's elective, isn't it kind of your fault for agreeing to select it? stop being fearmongering. stop being defensive.

you fucking needed yours. you are almost weirdly protective of it. yours was so important for your physical and mental health. it helped you off hormonal birth control and even started helping some of your symptoms. it still fucking hurt for no fucking reason.

once while recovering from surgery, they offered you like 15 days of vicodin. you only took 2 of them. you've been offered oxy for tonsillitis. you turned down opioids while recovering from your wisdom tooth extraction. everything else has the option. you fucking drove yourself home after it, shocked and quietly weeping, feeling like something very bad had just happened. the nurse that held your hand during the experience looked down at you, tears in her eyes, and said - i know. this is cruelty in action.

and it's fucked up because the conversation is never just "hey, so the way we are doing this is fucking barbaric and doctors should be required to offer serious pain meds" - it's usually something around the lines of "well, it didn't kill you, did it?"

you just found out that removing that little bitch will hurt just as bad. a little pinch like how oral contraceptives have "some" serious symptoms. like your life and pain are expendable or not really important. like maybe we are all hysterical about it?

hysteria comes from the latin word for uterus, which is great!

you stand here at a crossroads. like - this thing is so important. did they really have to make it so fucking dangerous. and why is it that if you make a complaint, you're told - i didn't even want you to have this in the first place. we're told be careful what you wish for. we're told that it's our fault for wanting something so illict; we could simply choose not to need medication. that maybe if we don't like the scraps, we should get ready to starve.

we have been saying for so long - "i'm not asking you to remove the option, i'm asking you to reconsider the risk." this entire time we hear: well, this is what you wanted, isn't it?

[overleftdown]

not often do my interests collide but archie madekwe filming a coming-of-age roadtrip with a suspiciously queer looking friend group for a folk song featuring bon iver… that was insane. never forgetting that one.

4 minutes and 30 seconds and suddenly i need an whole indie movie about them like cmon.

[lavendorii]

completely independent and well adjusted woman

[reasonsforhope]

Story from the Washington Post here, non-paywall version here.

Washington Post stop blocking linksharing and shit challenge.

"The young woman was catatonic, stuck at the nurses’ station — unmoving, unblinking and unknowing of where or who she was.

Her name was April Burrell.

Before she became a patient, April had been an outgoing, straight-A student majoring in accounting at the University of Maryland Eastern Shore. But after a traumatic event when she was 21, April suddenly developed psychosis and became lost in a constant state of visual and auditory hallucinations. The former high school valedictorian could no longer communicate, bathe or take care of herself.

April was diagnosed with a severe form of schizophrenia, an often devastating mental illness that affects approximately 1 percent of the global population and can drastically impair how patients behave and perceive reality.

“She was the first person I ever saw as a patient,” said Sander Markx, director of precision psychiatry at Columbia University, who was still a medical student in 2000 when he first encountered April. “She is, to this day, the sickest patient I’ve ever seen.” ...

It would be nearly two decades before their paths crossed again. But in 2018, another chance encounter led to several medical discoveries...

Markx and his colleagues discovered that although April’s illness was clinically indistinguishable from schizophrenia, she also had lupus, an underlying and treatable autoimmune condition that was attacking her brain.

After months of targeted treatments [for lupus] — and more than two decades trapped in her mind — April woke up.

The awakening of April — and the successful treatment of other people with similar conditions — now stand to transform care for some of psychiatry’s sickest patients, many of whom are languishing in mental institutions.

Researchers working with the New York state mental health-care system have identified about 200 patients with autoimmune diseases, some institutionalized for years, who may be helped by the discovery.

And scientists around the world, including Germany and Britain, are conducting similar research, finding that underlying autoimmune and inflammatory processes may be more common in patients with a variety of psychiatric syndromes than previously believed.

Although the current research probably will help only a small subset of patients, the impact of the work is already beginning to reshape the practice of psychiatry and the way many cases of mental illness are diagnosed and treated.

“These are the forgotten souls,” said Markx. “We’re not just improving the lives of these people, but we’re bringing them back from a place that I didn’t think they could come back from.” ...

Waking up after two decades

The medical team set to work counteracting April’s rampaging immune system and started April on an intensive immunotherapy treatment for neuropsychiatric lupus...

The regimen is grueling, requiring a month-long break between each of the six rounds to allow the immune system to recover. But April started showing signs of improvement almost immediately...

A joyful reunion

“I’ve always wanted my sister to get back to who she was,” Guy Burrell said.

In 2020, April was deemed mentally competent to discharge herself from the psychiatric hospital where she had lived for nearly two decades, and she moved to a rehabilitation center...

Because of visiting restrictions related to covid, the family’s face-to-face reunion with April was delayed until last year. April’s brother, sister-in-law and their kids were finally able to visit her at a rehabilitation center, and the occasion was tearful and joyous.

“When she came in there, you would’ve thought she was a brand-new person,” Guy Burrell said. “She knew all of us, remembered different stuff from back when she was a child.” ...

The family felt as if they’d witnessed a miracle.

“She was hugging me, she was holding my hand,” Guy Burrell said. “You might as well have thrown a parade because we were so happy, because we hadn’t seen her like that in, like, forever.”

“It was like she came home,” Markx said. “We never thought that was possible.”

...After April’s unexpected recovery, the medical team put out an alert to the hospital system to identify any patients with antibody markers for autoimmune disease. A few months later, Anca Askanase, a rheumatologist and director of the Columbia Lupus Center,who had been on April’s treatment team, approached Markx. “I think we found our girl,” she said.

Bringing back Devine

When Devine Cruz was 9, she began to hear voices. At first, the voices fought with one another. But as she grew older, the voices would talk about her, [and over the years, things got worse].

For more than a decade, the young woman moved in and out of hospitals for treatment. Her symptoms included visual and auditory hallucinations, as well as delusions that prevented her from living a normal life.

Devine was eventually diagnosed with schizoaffective disorder, which can result in symptoms of both schizophrenia and bipolar disorder. She also was diagnosed with intellectual disability.

She was on a laundry list of drugs — two antipsychotic medications, lithium, clonazepam, Ativan and benztropine — that came with a litany of side effects but didn’t resolve all her symptoms...

She also had lupus, which she had been diagnosed with when she was about 14, although doctors had never made a connection between the disease and her mental health...

Last August, the medical team prescribed monthly immunosuppressive infusions of corticosteroids and chemotherapy drugs, a regime similar to what April had been given a few years prior. By October, there were already dramatic signs of improvement.

“She was like ‘Yeah, I gotta go,’” Markx said. “‘Like, I’ve been missing out.’”

After several treatments, Devine began developing awareness that the voices in her head were different from real voices, a sign that she was reconnecting with reality. She finished her sixth and final round of infusions in January.

In March, she was well enough to meet with a reporter. “I feel like I’m already better,” Devine said during a conversation in Markx’s office at the New York State Psychiatric Institute, where she was treated. “I feel myself being a person that I was supposed to be my whole entire life.” ...

Her recovery is remarkable for several reasons, her doctors said. The voices and visions have stopped. And she no longer meets the diagnostic criteria for either schizoaffective disorder or intellectual disability, Markx said...

Today, Devine lives with her mother and is leading a more active and engaged life. She helps her mother cook, goes to the grocery store and navigates public transportation to keep her appointments. She is even babysitting her siblings’ young children — listening to music, taking them to the park or watching “Frozen 2” — responsibilities her family never would have entrusted her with before her recovery.

Expanding the search for more patients

While it is likely that only a subset of people diagnosed with schizophrenia and psychotic disorders have an underlying autoimmune condition, Markx and other doctors believe there are probably many more patients whose psychiatric conditions are caused or exacerbated by autoimmune issues...

The cases of April and Devine also helped inspire the development of the SNF Center for Precision Psychiatry and Mental Health at Columbia, which was named for the Stavros Niarchos Foundation, which awarded it a $75 million grant in April. The goal of the center is to develop new treatments based on specific genetic and autoimmune causes of psychiatric illness, said Joseph Gogos, co-director of the SNF Center.

Markx said he has begun care and treatment on about 40 patients since the SNF Center opened. The SNF Center is working with the New York State Office of Mental Health, which oversees one of the largest public mental health systems in America, to conduct whole genome sequencing and autoimmunity screening on inpatients at long-term facilities.

For “the most disabled, the sickest of the sick, even if we can help just a small fraction of them, by doing these detailed analyses, that’s worth something,” said Thomas Smith, chief medical officer for the New York State Office of Mental Health. “You’re helping save someone’s life, get them out of the hospital, have them live in the community, go home.”

Discussions are underway to extend the search to the 20,000 outpatients in the New York state system as well. Serious psychiatric disorders, like schizophrenia, are more likely to be undertreated in underprivileged groups. And autoimmune disorders like lupus disproportionately affect women and people of color with more severity.

Changing psychiatric care

How many people ultimately will be helped by the research remains a subject of debate in the scientific community. But the research has spurred excitement about the potential to better understand what is going on in the brain during serious mental illness...

Emerging research has implicated inflammation and immunological dysfunction as potential players in a variety of neuropsychiatric conditions, including schizophrenia, depression and autism.

“It opens new treatment possibilities to patients that used to be treated very differently,” said Ludger Tebartz van Elst, a professor of psychiatry and psychotherapy at University Medical Clinic Freiburg in Germany.

In one study, published last year in Molecular Psychiatry, Tebartz van Elst and his colleagues identified 91 psychiatric patients with suspected autoimmune diseases, and reported that immunotherapies benefited the majority of them.

Belinda Lennox, head of the psychiatry department at the University of Oxford, is enrolling patients in clinical trials to test the effectiveness of immunotherapy for autoimmune psychosis patients.

As a result of the research, screenings for immunological markers in psychotic patients are already routine in Germany, where psychiatrists regularly collect samples from cerebrospinal fluid.

Markx is also doing similar screening with his patients. He believes highly sensitive and inexpensive blood tests to detect different antibodies should become part of the standard screening protocol for psychosis.

Also on the horizon: more targeted immunotherapy rather than current “sledgehammer approaches” that suppress the immune system on a broad level, said George Yancopoulos, the co-founder and president of the pharmaceutical company Regeneron.

“I think we’re at the dawn of a new era. This is just the beginning,” said Yancopoulos."

-via The Washington Post, June 1, 2023

[canidus]

ps. this is an absolute NEED.

(image found on pinterest)

[drferox]

Two types of people

A dog comes into work wearing a harness with the brand name ‘PetPlay’ emblazoned on the side.

Me: You know, ‘PetPlay’ isn’t a great name for a dog harness.

Nurse 1: *starts laughing*

Nurse 2: I don’t get it

[lotus-pear]

HIII SORRY FOR NO NEW ART have some concept sketches for the fic i'm working on instead