#Vancomycin

[wikipediapictures]

Vancomycin-resistant Staphylococcus aureus

“Staphylococcus aureus colonies on blood agar. Note the golden yellow pigment and beta hemolysis around it.” - via Wikimedia Commons

[heardatmedschool]

“Vancomycin is a bad antibiotic, get over it.”

[contusmpublications]

Treatment-Resistant Vancomycin-Induced DRESS Syndrome in a Post-Operative Orthopedic Patient with Rare Lung Involvement

Read Full Article Here:

https://contusmpublications.com/articles/wjhm-v2-1022.pdf

[virescent-v]

Watching R&I and s3e2 makes me angry every time. Jane does a “fasciotomy” on Maura’s leg. In the woods. With dirty cell phone glass. I use fasciotmy as a loose terms because wut lol.

But the kicker? THEY GO HOME THAT DAY.

Maura would 100000% be hospitalized for days, close to a few weeks at least. She’d likely have a wound vac placed (or they’d even leave it open to drain), a central line for long term antibiotics, and pain meds because that shit hurts. There’s no way she didn’t get an infection, she likely even went septic.

And you’re telling me this girl is just so badass she goes home the following morning??? Walking semi-normally????

Like damn the writers didn’t even try lol

[kylejsugarman]

look i just want to open up "el camino" and walk inside of it and take good care of jesse with all the time and medical equipment and resources i'd ever need and then take my leave once he's recovered and step out and zip up "el camino" behind me. is that so wrong??

[chempriceanalysis]

IMARC’s latest report, titled “Vancomycin Hydrochloride Pricing Report 2024: Price Trend, Chart, Market Analysis, News, Demand, Historical and Forecast Data,” provides a comprehensive analysis of vancomycin hydrochloride pricing, highlighting global and regional market trends along with the key factors influencing price movements. Also get real time price analysis: https://www.imarcgroup.com/vancomycin-hydrochloride-pricing-report/requestsample

[thelastwhimzy]

lol i don't wanna sound like a pessimist but im pretty sure in a few days to a week or two im gonna end up back in hospy with positive blood cultures and that's very frustrating to think about

[redwoodforestwiki]

You should delete that post giving incorrect information about the effects of boycotting Eurovision

my post isnt incorrect, its a different opinion.

[furioussheepluminary]

𝐄𝐯𝐞𝐧 𝐖𝐡𝐞𝐧 𝐈𝐭 𝐇𝐮𝐫𝐭𝐬

Pairing: doctor!lee know x patient!afab!reader, nonidol au

Synopsis: he was the doctor assigned to taking care of you during your last days, and you both knew how this is was going to end. But you gave him hope to do even more for others

Warnings: death, angst, comfort, medical terms, nothing else...

A/n: please do not read if topics concerning leukemia affect you! Lee knows debut fic!

Emergency Department, Seoul Medical University Hospital

Time: 3:17 AM

The stretcher slammed through the ER’s double doors with a clang, the wheels shrieking under the weight of urgency. A sharp scent of antiseptic mixed with blood and sterile gauze clung to the cold air. Nurses barked out vitals while a young intern tripped over the IV line, earning a scowl from the charge nurse. You were barely conscious—ashen skin, lips tinged blue, your breath ragged like shattered glass. Your medical ID necklace glinted weakly under the fluorescent lights.

“Twenty-four-year-old female, history of MDS—high-risk subtype. She collapsed at home. Complaints of severe bone pain, fever, and tachycardia. Suspected sepsis.”

“BP’s 80 over 48 and falling. SpO2 at 86% on room air.”

“Push one liter NS, wide open. Get a CBC, BMP, blood cultures, lactic acid, and coags STAT—”

“Where’s Dr. Lee?!”

That name—quiet but commanding—cut through the chaos like a scalpel.

Dr. Lee Minho arrived moments later, stethoscope already around his neck, white coat billowing like a silent storm cloud. His hair was slightly tousled, evidence he’d been asleep moments before but there was no hesitation in his movements.

“Move,” he said calmly.

He leaned over your body as the team parted. His fingers found your radial pulse, thready. He noted the fever in your skin, the petechiae blooming across your limbs, the raw wince when he palpated your abdomen. “Leukemic transformation,” he muttered under his breath. “Possibly febrile neutropenia with septic shock. She's neutropenic. Start piperacillin-tazobactam and vancomycin. Isolate her. I want a central line and a STAT oncology consult.”

His voice was clinical, sharp, but his eyes? They lingered. Just for a second. On your face. You blinked up at him, barely registering the surgical mask, the depth in his gaze.

“Don’t let me die,” you rasped.

He stilled. And then, softer—softer than anyone had ever heard from him—he whispered, “Not tonight.”

Over the next few hours, your body fought a battle you didn’t witness. Lab values crashed. Your blood cultures lit up like a Christmas tree. A transfusion was ordered, then another. Your oxygen saturation dipped, then slowly climbed under high-flow nasal cannula.

And Dr. Lee stayed.

He charted. Adjusted your IV. Read every previous record like it was a prophecy written in your marrow. The next morning, when the sun breached through sterile blinds, he sat at your bedside in fresh scrubs, his white coat folded neatly over a chair. He wasn't your attending, not officially. But when you woke up with a sore throat and burning muscles, he was there.

---

Seoul Medical University Hospital – Hematology & Palliative Care Wing

The fluorescent lights hummed softly above you as you lay in the private palliative room—Room 417. A gentle breeze brushed in from the cracked window, stirring the sterile scent with the lavender diffuser Dr. Lee insisted on replacing every week. He said it helped his patients sleep. But you knew it was because it helped you dream. Lee Know—Dr. Lee Minho—wasn't the type of physician who lingered unless there was a reason. Stern, efficient, and precise, like the incisions he made during his early trauma residency days. But for you, there was something different. The way his eyes softened when reviewing your lab reports, the slight delay in his steps as he left your room, or the way he’d stand at your door a second longer than needed, fingers flexing as if resisting the urge to turn back.

Your diagnosis: Myelodysplastic Syndrome with progression into acute myeloid leukemia. Your prognosis: Poor. Limited response to induction chemo. You had refused further aggressive treatments. Instead, they assigned you a permanent physician for end-stage palliative care.

Lee Know.

“Your white cell count dropped again,” he murmured, tapping at the tablet in his palm as he sat beside you. His stethoscope—cold, always cold—rested at the hollow of your clavicle, but you barely flinched anymore. “Respiratory rate’s steady. Heart’s holding. You’re stable… for now.”

His voice was gentle, devoid of pity but full of that quiet warmth that had become your only comfort. His dark hair fell slightly over his eyes, and he hadn't noticed until you reached a trembling hand to brush it aside.

“You need sleep, Doctor.”

He smiled, brief and broken.

“So do you.”

Over weeks, your body weakened. Episodes of febrile neutropenia left you gasping between nights. You could feel the silent fear in Lee Know every time he checked your oxygen saturation, his gloved hands hesitating at the pulse oximeter, his eyes betraying a flicker of dread when the numbers dipped.

And yet, he stayed. He brought you coffee-scented candles. He learned how you liked your IV tubes taped—horizontal, not looped. He never wore the white coat inside your room anymore. “It makes you nervous,” he had once said simply, hanging it on the door hook like a promise to be more than your physician, your friend.

Sometimes, he’d sit at the edge of your bed, pulling out your charts, reading labs, but eventually drifting into quiet stories. He told you about how he once missed a suturing exam because he was too busy watching a stray cat give birth behind the med school. You told him about the dreams you had, of running in forests, of dancing with the moonlight in your lungs, free from beeping monitors and blood transfusions.

“Do you think,” you asked one evening, voice barely above a whisper, “if we met somewhere else—if I wasn’t dying—would you have liked me?”

He didn’t answer right away. Instead, he took your frail hand, carefully adjusting the pulse oximeter before speaking. “I already like you. That’s the problem.” He never said the words. But you saw it in the tension of his jaw when you vomited from pain meds, in how he wiped your mouth himself when the nurse was slow to arrive. You saw it in the way he charted your decline each day with surgical sorrow—as though every entry carved deeper into his ribs.

He wasn't supposed to fall. But love, like illness, had its own pathology. Quiet, invasive. Irreversible.

---

Oncology Department – Doctors’ Lounge, Seoul Medical University Hospital

Time: 6:42 PM

The sterile hum of the oncology wing was dimmed in the late evening. Harsh fluorescent lighting overhead had been traded for a warmer amber in the doctors' lounge—a temporary illusion of comfort in a place ruled by cold facts and clinical decisions. Dr. Minho stood by the glass window, arms folded, stethoscope looped lazily around his neck. Outside, the sun dipped low behind the city skyline. Inside, silence hovered, until a voice broke through.

“Lee,” Dr. Chan’s voice was casual, but firm—the kind of tone reserved for both praise and warning. “You’ve been taking a lot of time with Patient Y/N.” Minho didn’t turn. “She needs it.”

Chan stepped inside, sliding the door shut with a soft click. In his hands: your file. Bulky, already stained with color-coded stickers, urgent consults, infectious disease reports, oncology charts, and now… palliative care briefs. “Her numbers are deteriorating,” Chan said. “Hemoglobin’s down again. Platelets are almost transfusion-dependent. And the last marrow biopsy?” He sighed. “Blasts are over thirty percent.”

Minho finally turned. “I know.”

“Do you?” Chan's brow lifted. “You’ve been her doctor for—what—three weeks now? That’s a long time to stay attached for someone not even in your primary caseload.”

Minho stepped forward, expression unreadable. “She’s lucid. Cognitively sharp. No signs of neurological decline. Yes, she’s declining systemically—but she’s still fighting. She deserves someone consistent.”

“And she has someone consistent,” Chan replied gently. “But I need to know if that someone is still you as a doctor—or you as something else.” That made Minho pause.

Silence stretched between them. He didn’t deny it. Not exactly. Not in the way he usually would.

“…She reminds me why I do this,” he said, voice low. “She jokes with the nurses even after chemo wipes her out. She thanks the interns who can’t look her in the eye. She smiles when she’s vomiting. And she knows she’s dying.”

Chan softened slightly. “And that’s why you need to be careful.”

“I’m not crossing any boundaries.”

“Yet.” Minho turned again, staring back out at the window. The reflection of your chart glimmered faintly in the glass, as if your story lived in both worlds, the real and the mirrored.

“She asked me today if I thought heaven had hospitals,” he murmured.

“…And what did you say?”

“I said heaven’s wherever she doesn’t need one.”

Chan exhaled, slow. He walked to the table, placed your file down, and rested a hand on it.

“Just remember—when she lets go, you can’t fall with her.”

---

Scene: Oncology Wing, Room 417

Time: 11:34 AM

The clink of metal cutlery against porcelain was gentle, hesitant. Like the tremble of her hand didn’t want to disturb the quiet peace of the room. A tray sat on the rolling table in front of Y/N, barely touched. Watery porridge, a half-opened yogurt cup, and a slice of apple that looked more like a challenge than a fruit. Lee Know sat beside her bed—not on the visitor’s chair, but on the side of the mattress itself, white coat wrinkled at the hem, stethoscope tucked into his pocket. He had been doing that more lately—sitting with her, not over her. No longer just her doctor. Something else. Something heavier.

“You don’t have to force it,” he said quietly, watching her struggle to lift the spoon to her lips.

“I’m not,” she smiled. “I’m just... negotiating with it.”

He gave a small huff of amusement. “How’s the negotiation going?”

“Not well,” she muttered, then blinked at the spoonful of porridge. “I offered it friendship. It responded with betrayal.”

Minho let out a quiet laugh, but it was laced with something fragile. This was how it had been since she arrived. At first, their exchanges had been clinical. Precise. Symptoms, meds, charts. But then—between the rounds, after the lumbar punctures, during late nights when her pain spiked—something shifted. She saw through him. Saw past the doctor title and straight to the person.

And somehow, he’d let her in. “Do you ever eat with your patients?” she asked, resting the spoon back in the bowl. “Or am I just the favorite?”

He glanced at her tray. “Only when they’re winning battles.”

“I’m trying to,” she whispered. That whisper—quiet and honest—echoed too loudly in the room. And just as she turned back to try another bite, it happened.

Her stomach clenched. Her face went pale, eyes watering as the nausea hit hard. She dropped the spoon, clutched at her abdomen, and gagged. Minho was on his feet instantly, reaching for the basin, supporting her frail frame as she threw up into it. Her body convulsed against his hands, trembling violently. The food—what little there was—splashed into the basin with a horrible sound. He held her hair back, one hand on her back, rubbing gently in circles.

“It’s okay, it’s okay…” he muttered, voice cracking as he steadied her.

She coughed, then collapsed against his chest, weak and clammy. And despite himself—despite years of training to never get attached—he blinked hard to fight back the tears. He had watched tumors shrink and grow, watched hearts stop and restart. But nothing prepared him for the devastation of watching her suffer.

Still, she chuckled. Breathless. Whispery. But a chuckle nonetheless.

“You know... you look like you're about to cry,” she teased. He swallowed hard. “I’m fine.”

“Liar.”

He helped her lie back down, gently adjusting her IV line. Her breathing was shallow but even now, calm. She stared up at him, cheeks pale, lips dry—but eyes bright with something peaceful. Accepting. Not fighting anymore. Just… being. “Lee Know,” she murmured, using his name without the title. She always did that when it was just them. “Can I ask you something?”

He nodded.

“If it were you in this bed… would you want someone to stay? Or would you rather be left alone so it hurts less when they’re gone?”

He looked at her for a long moment, silence weighing between them.

“…I think I’d want someone to stay,” he finally answered. “Even if it hurt.”

She smiled. A soft, serene thing. “Then don’t leave me yet.”

Minho froze. She didn’t say it with desperation. She wasn’t begging. She was just… reminding him that his presence, his stubborn daily visits, his quiet company—it all mattered. Even as her body failed, her heart still reached for him.

“I’ll tell the nurses to come check on you,” he said suddenly, standing, voice tight.

“Minho,” she said, this time more softly. “It’s okay to care, you know. Just don’t let it drown you.”

He paused at the door. His hand clenched the edge of his white coat.

Without turning back, he said, “You always say things like you’re already gone.”

And with that, he walked out, expression unreadable, throat burning, heart heavy.

Outside, the hallway smelled like antiseptic and ghosted hope. But inside Room 417, you were smiling, your frail hand resting calmly on your chest, as if you’d just whispered a secret the universe would have to hold for him now.

---

Hospital Hallway, Oncology Department

Time: 9:47 PM

The hum of overhead lights was dull, almost weary—like even the hospital itself was tired. Most of the nurses had clocked out. A few interns lingered at their desks. The corridor to Room 417 was dimmer now, the once-bustling ward quieting down as the night shift settled in. Minho stood alone at the end of the hall, back pressed against the cold wall near the nurse's station, arms folded. He hadn’t moved in a while. His coat was still on, but his badge had been unclipped, tucked into his pocket, like he didn’t want to carry the weight of the title anymore. A clipboard rested beside him. Unused. Blank.

Chan, who had just finished his rounds and was headed toward the elevators, slowed when he caught sight of him. The head doctor’s footsteps softened as he approached, reading the tension like it was printed on the walls.

“You still here?” Chan asked, brows lifting.

Minho didn’t answer immediately. Chan looked him up and down. “Have you eaten?”

“Yeah,” Minho lied. His voice was quiet. Distant. “I’m fine.” Chan didn’t believe him, but he nodded anyway, giving him room.

“What are you doing here this late?” Chan asked gently, glancing toward Room 417. “She asleep?” Minho nodded slowly. “Yeah. She vomited earlier. I stayed to monitor her vitals. Just in case.” Chan sighed softly. “Minho… you’ve been here longer than anyone. Every night. You know her numbers as well as her chart does.”

Silence.

“Go home,” Chan said carefully. “You need rest. You’ve done more than enough.”

Something shifted in Minho’s face. Not big, not loud, but enough for Chan to feel it. His jaw clenched, shoulders tightened, and his voice shook.

“No,” Minho said, harshly. “I haven’t.”

Chan blinked. “Minho…”

“I haven’t done enough. If I had—she wouldn’t be like this. She wouldn’t be so damn calm about dying. She wouldn’t be making peace with it while I’m just—just standing there acting like I know how to save her when I can’t.”

His voice broke. It startled Chan—Minho never let himself break.

Minho turned away slightly, breathing hard, hands curling into fists at his sides. “You know what the worst part is? She’s the one comforting me. I hold the chart, I deliver the news, I monitor her stats—and she just smiles at me like that’s supposed to make it okay. She’s dying, hyung. She’s dying, and she’s still trying to protect me.”

Chan’s lips parted, stunned into silence. Minho let out a sharp breath, and suddenly, it was there.

Tears.

Not loud. Not dramatic. Just quiet, stinging tears that sat in the corners of his eyes and refused to fall. Like he was still trying to keep it together, still trying to be the strong one. And then Chan saw it like an echo surfacing from deep memory:

Minho stood in the hallway outside Room 206, white coat brand new, face too young for the grief etched into it. Inside, a little girl lay still. Leukemia. He’d tried everything. She'd written him a thank-you note the day before she passed. He hadn’t cried then. Just stood there while Chan told him, “Some patients you lose... and it never stops hurting.” And Minho had said, “If this is how it starts, I don’t know if I can keep going.”

Now, years later, Minho was still standing in the same place, different room, same ache.

Chan stepped forward slowly, rested a hand on Minho’s shoulder. His voice was softer this time. “She’s not asking you to save her, Minho. She just wants you to be there.”

Minho didn’t respond but his shoulders shook once. Just once. “You’ve done more than enough,” Chan said again, firmer now. “Let yourself rest. Let yourself feel.” Minho finally looked at him, eyes rimmed red, jaw trembling. But he didn’t argue.

Chan gave his shoulder one last squeeze, then slowly pulled away.

“I’ll see you in the morning,” he said quietly. And then he left, footsteps echoing down the quiet hall.

Minho stood there for a moment longer, staring at the linoleum floor like it might offer him answers. Then, without a word, he turned and walked down the opposite corridor. Past the breakroom. Past the surgical prep wing. Into his small, dimly lit office.

He locked the door behind him, dropped onto the couch, and didn’t even bother turning off the lights. He didn’t cry again. He just sat there.

Awake. Listening to the silence and pretending that somewhere in it, maybe she was still smiling.

---

2:17 AM. Y/N’s Room. Room 417. Desk Lamp On.

The hospital room was quiet, save for the distant hum of a monitor and the soft scribble of pen on paper. Y/N sat propped up on a pillow, shoulders trembling under a thin blanket, her oxygen line carefully tucked beneath her nose. Her hands shook as she wrote not from nerves, but from the toll her body had taken. Every breath was a fight, every movement a surrender.

But her eyes were calm.

She paused occasionally, her gaze drifting toward the window where the moonlight bled through the curtains, then back to the letter in her lap. Her words came slowly but purposefully.

To Dr. Lee Minho (but mostly, just Minho),

If you're reading this… then the day has come. And I’m sorry. Not because I’m gone—but because I know you’re hurting. You always thought you had to carry everything on your own. You wore your silence like armor. You thought if you cared too much, it would ruin you. I saw that… even when you didn’t say a word.

But you cared anyway. For me. You were never just my doctor. You were my first real friend in all of this. My anchor. You made this place feel less like a countdown and more like a home. I know you’ll want to blame yourself. You’ll think maybe there was something more you could’ve done. But please… don’t let this become another ghost you carry.

You gave me so many more days than I ever thought I’d have. You gave me your time, your kindness, your silence when I needed it and your voice when I couldn’t find mine. You made me laugh. You listened to all my weird dreams and terrible jokes and watched me cry without trying to fix it. You didn’t run from me, even when I was slipping away. I feel like after I write this things may not go the way we want, and maybe this is selfish… but I need you to promise me you’ll keep going.

I want you to eat real meals, sleep in your bed—not your office. I want you to keep caring for people… even if it hurts. Because you’re good, Minho. So good. And if one day someone asks what happened to your patient in Room 417, you can say, “She lived.” Not for long, maybe—but she lived. Because you gave her reasons to.

I hope you find joy again. I hope someone loves you the way you deserve. And if you ever miss me… just look up. I’ll be in the stars, whispering terrible jokes at you.

Thank you for staying.

Love,

Y/N.

---

4:36 AM. Lee Know’s Office. Monitor Beep. Incoming Call.

Lee Know startled awake, head jerking from the desk, his heart already racing.

“Code Blue – Room 417.”

“No.”

The word was immediate. Guttural. Terrified.

No. No. No. No. No.

His coat was halfway on before he even realized it. The hallway blurred past him—white walls, overhead lights, a nurse calling out his name—and then he reached her door.

Chaos. Inside, nurses worked frantically, pressing paddles to her chest. A senior physician barked vitals. A respiratory therapist adjusted the ventilator. The monitor screamed.

Flatline. Minho’s legs felt heavy. His chest constricted. It was happening again.

“BP still crashing—come on, push epi!”

He couldn’t move. Couldn’t breathe. Then he saw it.

The letter. Folded neatly. Propped against the metal table near the foot of her bed. His name scrawled across the front. His trembling hands reached for it as the chaos unfolded behind him.

He opened it. Each line etched into his brain like a slow, deliberate wound.

She knew.

She knew. The longer he read, the harder it got to see the page, tears spilling, lips parting in silent disbelief. He pressed a hand to his mouth as her words sank deeper and deeper, breaking him open in a place he'd spent years barricading.

A sob broke from his throat. And just as his eyes reached the final line—

Thank you for staying.

—The monitor gave its final, single beep.

And then—

Silence. Stillness. No more rhythm. No more fight. No more noise. Lee Know’s fingers slipped from the letter. It floated down to the cold tile floor like the last petal of something once blooming.

He didn’t speak. He didn’t move. He just stood there, eyes locked on her still form, breathing in the heartbreak that would live with him forever.

“Time of death,” Dr. Yoon murmured, glancing at the monitor before lowering her head.

A nurse gently confirmed, “5:03 A.M.” For a moment, no one moved. The air in the room was heavier than usual. The kind of heavy that crawled into the lungs and sat there, refusing to let go.

Lee Know stood frozen, letter limp in his hand, the final words still echoing in his ears as her body lay motionless before him. Her eyes were closed. Her lips slightly parted like she might still be whispering something into the veil between this world and the next.

“Let’s give Dr. Lee a moment,” Dr. Yoon said softly, ushering the staff toward the door. One by one, they left. Machines powered down. Monitors silenced. The room, once frantic with life-saving attempts, fell into a hush so still it screamed.

Then the door clicked shut. And Minho broke. He staggered forward, fingers gripping the foot of her bed as the sobs came in waves, unfiltered and raw.

“Why… why did it have to be you?!” he whispered, voice crumbling under the weight of grief. “You weren’t supposed to be next…”

His shoulders shook violently as he collapsed into the chair beside her bed, head bowed, hand reaching—slow, trembling—until it found hers. Cold. Too cold.

He held it anyway. The letter trembled in his lap, her words now carved into the softest, most shattered parts of him.

“I wasn’t ready,” he choked. “I wasn’t ready to let you go. I didn’t want to say goodbye yet. I still had more to tell you…”

Tears spilled endlessly onto his hands, her sheets, her skin.

“You were so brave,” he whispered, voice nearly gone. “You never gave up. Even when you were in pain. Even when you knew this was coming…” He squeezed her hand like it might bring her back. Like maybe this time, if he held on tightly enough, the outcome would be different.

But it wasn’t. The silence stayed. So, he wept freely, brokenly, like the man behind the coat and stethoscope was nothing more than a boy who had just lost someone irreplaceable.

And for the first time in years…

He let himself grieve.

---

On-call Room, Three Weeks Later

The room was quiet except for the soft hum of the vending machine and the occasional footsteps of nurses beyond the door. Lee Know sat slouched on the small couch, a half-empty coffee cup in one hand, Y/N’s medical journal in the other. It was worn from her fingers, the pages slightly curled at the corners. Her handwriting danced across every page—sometimes shaky, sometimes strong—but always hers. Her voice in ink.

He’d read the first few pages a dozen times already, but tonight… tonight he couldn’t stop.

April 4th, 2:03 AM

"Dr. Lee said my blood pressure’s better today. I think he’s just trying to be nice. But he also brought me a banana (I hate bananas), and I ate the whole thing because he looked proud. I think… I’m starting to care too much. That’s dangerous."

He exhaled a quiet laugh, eyes misting. “You always hated bananas.” He flipped to another page.

May 17th

"I dreamt last night I was healthy again. I was running and Dr. Lee was yelling at me to slow down. I told him, ‘Catch me if you can!’ He didn’t. He just stood there smiling. I wish dreams could keep you alive."

Lee Know’s jaw clenched. He turned to the very last entry.

June 1st

"He sat with me for an hour today. Said nothing. I didn’t either. I think we both knew I was slipping. But the silence didn’t feel empty—it felt full. I think that’s how you know you love someone. When silence speaks more than words."

A tear landed on the page. And another.

He gently closed the journal, pressing it to his chest as he leaned back against the couch, eyes shut tight, trying to breathe through the pain. The quiet around him was vast, endless until the door creaked open.

“Minho?”

He looked up. Chan stood there, lab coat half-buttoned, eyes lined with fatigue—but soft with concern. Lee Know quickly wiped his face with the back of his sleeve. “Hey.”

Chan stepped in, closing the door behind him. “You’ve been here since the funeral.”

Lee Know gave a small nod. Chan eyed the journal. “Her handwriting?”

“She wrote every day,” Minho whispered, voice cracking. “Even when she couldn’t speak. Even when the pain was so bad her fingers locked up. She… didn’t want to be forgotten.”

Chan sat beside him slowly. “She won’t be.”

Minho shook his head, his fingers curling around the book. “I lost her, hyung. Just like the first one. Just like that kid three years ago… Remember? The one in PICU? I swore I’d never feel that helpless again.”

Chan let out a breath. “I remember. That broke you.”

“This…” Minho looked down. “This shattered me.”

Chan placed a gentle hand on his shoulder. “And yet—you’re still here.”

Minho closed his eyes. “You're still reading her words. Still mourning her right,” Chan continued. “That means she mattered. And it means you did your job—with everything you had.”

“I don’t know if I can do this again,” Minho whispered. “Not if every goodbye hurts like this.”

Chan smiled gently. “But you will. Because this isn’t about not hurting. It’s about choosing to keep going, knowing it hurts. That’s what makes you the doctor patients remember—even after they’re gone.”

Lee Know looked at him, eyes glassy. Chan leaned forward, squeezing his shoulder. “You loved her, Minho. That doesn’t make you weak. It makes you human.” Just then—an overhead voice pierced the stillness.

“Code Yellow. Cardiac arrest. ER, Room 12.”

Minho froze. Chan looked up, then back to him.

“Come on,” he said softly. “Let’s go save someone else.” Minho stared at the journal one last time… then carefully set it on the table, kissed his fingers, and brushed them against the cover.

“For her.”

And he rose.

They both did—coats flying behind them, stethoscopes swinging—two doctors stepping back into the fire. Because the world hadn’t stopped. And neither would they.

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[microbes-in-hats]

Staphylococcus aureus

Staphylococcus aureus is a type of bacteria with many known strains that have become resistant to antibiotics. Methicillin resistance (MRSA), vancomycin intermediate resistance (VISA), and vancomycin resistance (VRSA) are some examples of strains that are partially or fully resistant to antibiotics, making them major concerns in hospitals. It's estimated that only 2% of S. aureus strains are sensitive to penicillin antibiotics.

[ramblings-in-imagination]

No Answer (Part 2)

The ambulance screeched to a halt outside the emergency department, the back doors flying open as the paramedics jumped into action. Hen and Chimney worked quickly to wheel you out, while Eddie and Buck trailed close, both of them white-knuckled and panic-stricken.

“RA118, rolling in!” Hen called out. “27-year-old female, febrile to 104.2, altered mental status, tachycardia at 140, BP 88 over 55, tachypnea at 34. Suspected sepsis, rapid onset.”

The trauma team met them at the bay doors, gloves snapping on as they prepped the trauma room. Dr. Singh, the attending ER physician, stepped forward.

“Okay, let’s get her on the bed: Hen, give me a hand. Chim, what’s her latest set of vitals?”

“Still febrile, unresponsive,” Chimney rattled off. “BP’s dropping—88 over 55 and falling. HR’s 142, sinus tach. O2 sat’s 90 percent on a non-rebreather. IV fluids wide open.”

Dr. Singh nodded. “All right, priority one: airway, breathing, circulation. Let’s get two large-bore IVs, start a second bolus of 500ml normal saline. Draw blood cultures, lactic acid, CBC, CMP, coags. Hang broad-spectrum antibiotics—vancomycin and cefepime. Let’s get a portable chest X-ray and a head CT if there’s any concern for meningitis.”

Hen squeezed Eddie’s shoulder, eyes glassy. “We’ve got her, okay?” she whispered. She’d always seen you like a little sister. The fear on her face was a mirror of the panic in Eddie’s chest.

Buck, his whole body tense—hovered just behind Eddie. “Did she have a cut or scrape or anything?” he demanded, voice tight. “Eddie, did you see anything? Could that have let an infection in?”

Eddie shook his head, voice ragged. “No…nothing that I saw. She was just… tired. She didn’t even recognize me.” His eyes filled with tears.

Bobby’s calm voice cut through the panic. “Hey, both of you listen to me. She’s in the best place possible now. Let them work.”

But Buck’s hands trembled, his eyes locked on the trauma room as they wheeled you in. “She’s my sister, Bobby. I should have…”

“You are here,” Bobby said, steady and calm, placing a hand on Buck’s shoulder. “Right now, that’s all you can do. Let the doctors handle the rest.”

Inside the trauma room, the team was a flurry of motion.

“Push another 500ml of saline. Let’s get a norepinephrine drip ready if her BP keeps dropping,” Dr. Singh barked, his tone urgent but composed. “Monitor urine output, we need a Foley catheter in place.”

A nurse worked quickly, catheterizing you while another placed an arterial line for continuous BP monitoring.

“She’s developing mottling in her extremities,” one nurse said, worry in her voice. “Possible septic shock.”

“Give me a stat lactate,” Dr. Singh ordered. “Call Infectious Disease for consult. Start her on vasopressors if systolic drops below 80.”

Chimney, his hands slick with sweat, stepped aside and pulled out his phone. His own heart was pounding, your big sister needed to know. He dialed Maddie’s number with shaking fingers.

“Maddie, it’s me,” he began, voice cracking. “It’s Y/N. She’s really sick, possible sepsis, high fever. They’re working on her now, but you need to get to the hospital.”

On the other end of the line, Maddie’s voice caught. “Oh God. Okay… I’m coming. Tell them I’m on my way.”

Back in the hallway, Buck paced like a caged animal, running a hand through his hair. “Eddie, what if I missed something? What if I didn’t see a cut? I…I should have checked her….”

“Hey, man,” Eddie said, voice tight. “You can’t think like that. She’s strong, okay? She’s gonna fight. She’s my girl, she’s tough.”

Bobby stood between them, his voice a steady anchor. “Buck, you didn’t miss anything. This is just—sometimes, these things happen. The important thing now is that she’s here, and they’re giving her everything they’ve got.”

Inside the trauma room, Dr. Singh’s voice called out again. “BP’s dropping—start norepinephrine at 0.1 mcg/kg/min. Draw repeat blood cultures—lactic acid is 6.5, she’s definitely in septic shock.”

“Airway’s stable,” the respiratory therapist said, adjusting your oxygen mask. “We’re maintaining sat at 94 percent.”

“Keep a close eye on her mentation,” Dr. Singh instructed. “If she doesn’t respond to fluids and vasopressors, we may need to intubate to protect her airway. Let’s keep pushing fluids and get that ID consult rolling.”

Every line, every beep of the monitors was a war drum in Eddie’s chest. He pressed his forehead to the glass window, tears streaming down his face.

“Come on, baby,” he whispered. “Fight. Just fight for me, okay?”

And even though she couldn’t hear him, he refused to leave that window. Because that’s who Eddie Diaz was a fighter and a protector, even when he felt helpless.

And Buck, his hands still trembling, We’re in this together,” he whispered, voice breaking.

“Always,” Eddie choked out.

And in the chaos of the trauma room, your family; found and blood, held their breath.

[scifimedic]

Hi! I just found your blog and noticed you have some posts where you explain how to write certain medical conditions, and I was wondering - could you perhaps do a post on blood poisoning, please? I am struggling with it a little lol.

I have a character that got stabbed, and I don't know what are the odds they could get blood poisoning and if yes, how fast and generally how it progresses.

If you don’t have time or something, don't sweat it, it's just a silly idea I got lol :D

Episode 4 of SciFiMedic Explains: How do I write sepsis?

Hi Anon!

So, your character got themselves stabbed, huh? Before we get to the nuts and bolts of how this is going to progress, we have to clear up a little choice of words here. 

The term blood poisoning is not the medically correct term for an infection inside the blood- we call it sepsis. Unless you meant literal poison from the weapon (which I can do a follow-up post on, if that’s the case) I’m going to guess that we’re talking about a severe, system-wide infection of the blood. 

Let’s walk through a few options: 

Scenario 1: 

Your character is stabbed in an area with lots of big blood vessels (highlighted red in diagram), and while everyone does all they can, the poor guy quickly dies of blood loss. There’s no time for infection to set in. 

Scenario 2: 

Your character is stabbed in a non-lethal area, like the arms, legs, or shallowly on the gut (highlighted green in diagram) They’re able to bandage themselves up, or maybe someone helps them out and they manage to get the bleeding stopped. 

Unfortunately, 12 hours later, they notice red streaking coming from around the wound. They also: 

Feel freezing cold, but have a high temperature

Are dizzy

Are shivering

Can’t quite catch their breath and feel the need to pant

Throw up

Look pale

These are all signs of the injury going septic, which is when the infection spreads away from the site of the wound and into the bloodstream. It happens fast. From the onset of these symptoms, they can be dead within only 12 hours. 

Here’s what needs to happen for them to survive: 

1: Hospital. No buts, no delay. If you want them to survive, they need advanced medical treatment, detailed below. (I will allow for a field hospital, or a makeshift hospital with a trained professional and plenty of supplies.) 

2: Blood and wound cultures. This means taking a small tube of blood from the arm, rubbing a cotton swab in the wound, and then sending both samples to the lab for study. They will smear the sample on a slide, put it in a warm, wet environment, and wait for it to grow out. Then, they’ll pop it under a microscope and run chemical tests on it to find out what the infection is. This process can take up to 4 days. The good news? The more pathogens that’s in the sample, the faster it will grow out. If you have blood that is severely infected, it could take as little as 12 hours to see results. (I know this from personal experience.) 

If you’re in a field hospital, unfortunately this is a luxury you don’t have. See next step. 

3: IV antibiotics immediately. Since you don’t know the bacteria causing the sepsis, you don’t know which antibiotic to give. Good news, people a lot smarter than I have created a plan for this. 

3a: According to this study done by the National Library of Medicine, 67.9% of people presenting outside a hospital setting had their wounds infected with either Staphylococcus aureus or Pseudomonas aeruginosa.  3b. Thankfully, we have two very strong antibiotics- Vancomycin and Ciprofloxacin- that can each treat these pathogens. Unfortunately, each antibiotic is effective against only one of these pathogens, and nearly useless (or has developed resistance) against the other one!  3c. Good news, these antibiotics can be safely run together. Boom, you’ve just slammed (and it’s a slam- these drugs are horrible for you long term) 67.9% of patients with the right antibiotics to start treating their sepsis.  3d. What about the other 32.1% you may be asking? Good news, they’re not doomed. Just because a given antibiotic isn’t the best choice against a certain pathogen, it doesn't mean it will be completely ineffective. You may be buying them more time for the cultures to come back. You can also take your next best guess, and switch the antibiotics after a few hours if they aren’t having any effect. 

4. Fluids. IV time! The biggest tell that someone has sepsis is that their blood pressure plummets to dangerous levels (which is what will eventually kill them, but we’ll get to that.) In order to prevent that drop, we need to raise the blood pressure by adding more volume to the blood through fluids. They might also need a blood transfusion, depending on how much blood they lost from the initial stab wound. 

It’s important to note that it may not be possible to gain IV access, because when the blood pressure is that low, the veins tend to shrivel up and disappear (not literally.) In that case, your next best option is an IO, which is a needle drilled into the center of the upper arm bone, or lower leg bone. Yes, it hurts. 

5. Vasopressors. Fancy name for medications that force the blood pressure to come up. There are four main pressors: 

Norepinephrine

Epinephrine

Phenylephrine

Vasopressin

They should be added in that order, although this article admits there isn’t too much hard evidence to back this up.

It’s important to note that this is ICU level care, and unless we’re in the middle of the woods, we will have transferred there.

How do you know if it’s time to add another pressor? You’re not getting the results you need- AKA the blood pressure is continuing to stay or fall too low. In the ICU, we use a different measure of blood pressure that most people aren’t as familiar with, called a MAP score. It’s easy, I promise. 

We use this method because it’s more representative of the amount of blood actually getting to the organs- though that is debated quite a bit in various circles. In America however, that’s the way most ICUs do it. 

The ultimate goal for a sepsis case is to have a MAP above 65 mmHg. You can use this calculator to play around with the numbers and see if the blood pressure you’re thinking is within those parameters. If it’s not, time for another pressor. 

At this point, your character is passed out most of the time. They’ve got a high fever, rapid heart beat, and are covered in sweat. They might also have a seizure from the fever and general stress on their body- at the very least they’ll be shaking from the chills. Their skin will be very, very pale, and might look kinda blue or gray in places- kinda like spots. 

6. Hold your breath. No, not literally. But at this point, you’ve done all you can and you have to wait for them to either get better, or get worse. 

If they get better, they’ll slowly start to maintain their own blood pressure, the fever will come down, and they’ll be able to string a coherent sentence together again. Recovery from sepsis can take a long, long time- as many as two to four months in the hospital. It totally depends on the person and how strong they are. The fittest, luckiest patient I’ve seen recover from sepsis was with us in the ICU for three weeks, then spent another month in a step down unit doing various therapies to regain strength. 

However… if we’re looking at failure… well, then it’s time to move onto scenario 3. 

Scenario 3: 

After completing all of the above steps, they end up getting worse. Don’t worry, it’s not your fault- sepsis is fickle and kills fast. At this point, their kidneys are starting to fail from the inadequate blood pressure- you’ll need dialysis for that. They might stop breathing, or be unable to oxygenate their blood properly, then they’ll need a ventilator. At this point, they’re not stable enough to go into surgery anymore, so there’s no hope there. Eventually, the high fever will cause seizures, which will lead very quickly to brain death. As little as 12 hours after the initial dizziness and red streaks, their heart stops and they’re pronounced dead. 

Summary: 

The odds of your character developing sepsis from a non-fatal stab wound without immediate medical care are high- 90% 

If they’re rushed to a hospital, their odds are better- 50%

If they do develop sepsis inside a hospital, they’re likley to survive- only 10.55% of people die of this kind of wound infection.

If they develop sepsis outside a hospital, then it’s almost certain they will die- 99% 

Disclaimer: Although I’m in school to become a medical professional, I’m not one yet. All mistakes are mine, and I’m always open to discussion.

Anon, this was a fun prompt! If this isn’t quite what you were looking for, feel free to submit another ask with more follow up questions!

Everyone else, also feel free to send me an ask, or reblog this (or any SciFiMedicExplains Episode) with a scene you’d like me to help you write!

[thedee-n]

Bacillus licheniformis:

This is a gram positive bacterium commonly found in soil. It’s found on bird feathers especially chest and back plumage. It’s common in ground dwelling birds too. Is it harmful to man ? Yes it is has been found to cause infection in several cases of immunocompromised patients. It’s the causative agent of ventriculitis, ophthalmitis, bacteremia and endocarditis.

Treatment: it is sensitive to antibiotics such as cefepime, carbapenems, aminoglycosides and vancomycin.

…. Health is wealth …

[mineralsrocksandfossiltalks]

Monday Musings: Copper and Your Health

Did you know that copper is a mineral that we need in our bodies? In fact, there are several metals we need to live healthy lives. What exactly do we need copper for? A few things actually. It is needed for the normal growth and development of human fetuses, infants and children.

In adults, it is necessary for the growth, development and maintenance of bone, connective tissue, brain, heart and many other body organs.

Copper is involved in the formation of red blood cells, the absorption and utilization of iron, and the synthesis and release of life-sustaining proteins and enzymes. These enzymes produce cellular energy and regulate nerve transmission, blood clotting and oxygen transport.

Copper is also known to stimulate the immune system, help repair injured tissues and promote healing. Copper has been shown to help neutralize "free radicals," which can cause severe damage to cells.

Despite all its uses, we only need about .9 mg of copper a day. Crazy right?

Where do I get copper in my diet? Copper-rich foods include grains, nuts and seeds, organ meats such as liver and kidneys, shellfish, dried fruits, legume vegetables like string beans and potatoes, chicken and some unexpected and delightful sources such as cocoa and chocolate.

I don't know about you, but several of those are definitely in my diet.

Okay, next question, what happens if I don't get enough copper in my diet? A deficiency in copper is one factor leading to an increased risk of developing high cholesterol levels and coronary heart disease in humans. Copper deficiencies are also associated with premature births, chronic diarrhea and stomach diseases.

But of course, there are also risks if you consume too much copper too. It can cause nausea but thankfully, it's really hard to hit toxic levels of copper. Just don't go around eating copper wire and you should be fine.

The last fun fact I have for you is that there are clinical trials in effect right now to see if frequently touched surfaces and air ventilation systems in hospitals made out of copper or copper alloys can help stem bacterial infections in hospitals. Copper has some antimicrobial abilities and they are hoping it can stop infections of deadly diseases like MRSA.

Initial studies at the University of Southampton, UK, and tests subsequently performed at ATS-Labs in Eagan, Minnesota, for the EPA show that copper-base alloys containing 65% or more copper are effective against:

Methicillin-resistant Staphylococcus aureus (MRSA)

Staphylococcus aureus

Vancomycin-resistant Enterococcus faecalis (VRE)

Enterobacter aerogenes

Escherichia coli O157:H7 and

Pseudomonas aeruginosa.

Wild stuff, am I right? Who knew copper could be so useful outside of conducting electricity? Hope you enjoyed today's musings. Tune in tomorrow for one last trivia on copper before December is upon us! (I can't believe it's almost December. What happened to November?) Fossilize you later!

[eatrockstheyrock]

A question that’s risen in my mind recently: can Logan ever get sick?

This came to my mind because well I’m a sucker for sickfic. A character in pain and then getting appropriate care and comfort to both heal and build stronger bonds with their loved ones? Perfect. But you can’t really write a sickfic for Logan, right? Well, maybe.

See in your stomach you have natural bacteria, the good kind. Gut flora is necessary for digestion and your health gut health overall. Logan of course has these, but they can be killed. Antibiotics. Of course they kill bacteria and can wipe out the average persons gut flora. Logan’s would likely be super strong, but if he was constantly pumped full of an incredibly potent one (i.e. Vancomycin 3.0 the strongest antibiotic there is) then it would theoretically overwhelm his body temporarily.

As seen when his adamantium skeleton was ripped out, under immense stress and damage his healing factor can be messed up, so it’s reasonable to suggest if he was captured in a form and tortured while having the steady stream of antibiotics the stress on his mind and body would fuck with his healing and wipe out his gut flora.

For the average person recovery from having their gut biome wrecked would be about one-two months, possible longer. So for Logan this would probably be about one week at most, but that still one week of sickness for a man who hasn’t really been sick since 1845, which would mess with him severely.

Basically yeah, he can get sick but of course as with everything Logan related he’d gotta suffer majorly to suffer more to recover.

I don’t think anyone cares about this or wants it but if any fic writers crave the angst of a sickfic with Logan but have believed he can’t get sick, I bring the answers. Of course you can always just say ‘fuck you he’s sick my fic my rules’, that works too.

[lunarw0rks]

Nurse y/n: i need to see ur arm so i can start that iv and giv u that vancomycin

Ghost: no thank ill just sleep it off

Nurse y/n: EXCUSE ME?! YOU HAVE MENINGITIS

Its all fun and games for ghost until he pisses y/n off to the point he gets re-assigned to the 5ft2 Filipino charge nurse who doest take shit from NOBODY

Charge rn: okay Riley i need to see ur arm and get this vanco drip done

Ghost: N.O.

Charge rn: N.O.? Thats not going to happen. you have 2 choices. Comply or become intubated,sedated,and restrained. So what ls gonna be.

Ghost: *low key terrified. Slowly putting his arms out*

and just then, the king felt true fear for the first time.

nah but ghost being a fussy patient because he always refuses help. and the nurses/doctors are so fucking over it. all they have to do is threaten sedation and he complies...

he could literally be on death's door and be like " 'm fine. "