#cardiology notes

[er-cryptid]

Ventricular Ejection

-- follows isovolumetric ventricular contraction

-- both ventricles continue to contract

-- the ventricular pressures exceed aortic and pulmonary arterial pressure

-- the aortic valve and pulmonary valve open

-- blood is ejected into aorta and pulmonary artery

[napthaliii]

28 June 2023 | Pneumonia

Cardio/pulm are among my top favorites to learn about (ɔ◔‿◔)ɔ♥

[notesbyallie]

[anattempttostudyharder-blog]

3/5/23 (Day 11)

Solved cardiology questions

Studied neurology

Did a liss workout at home

//Feeling meh today. Studied 5 hours today, just not feeling it. Finished Beef on Netflix tho, really enjoyed that.//

[acadarnia]

pringles are the only thing keeping me sane when studying for cardio-physiology lmao

[ellebi-studies]

Hello everyone,

Today I had my cardiology exam, which I have to say was very satisfying. I want to share with you some tips that I used to prepare for this exam and learn how to give a medical report of an EKG.

First of all, I think classes are fundamental for this course. I loved cardiology since it is a conceptual subject rather than a mnemonic one. Try to understand the physiopathology of cardiovascular diseases from the beginning. You will spend time learning details later, but I think it is vital to keep up with the main concepts to understand the following and arrive at the end of lessons with solid fundamentals.

As for the EKGs, practice is essential so try to exercise every day, even for a few minutes. I found it very useful to study "Rapid Interpretation of EKGs" by Dubin and Dale, but "The only EKG book you'll ever need" by Thaler is a good source too.

Also, there are many helpful sites, such as this: https://www.skillstat.com/tools/ecg-simulator. Instagram pages with clinical cases are valid as well.

Try to understand what every wave and complex of the EKG means, and do not limit yourself to learning every pattern by heart.

Concerning the cardio surgery part, I had the opportunity to attend the operating theatre of cardiovascular surgery and Arithmology. Ask your teachers if you have this chance: you do not have anything to lose, and you may find an available professor who will teach you much more than a written book.

If you do not have this possibility, look for Youtube videos of the procedures.

Whatever you do, don't limit yourself to studying surgery only on written material: it will be difficult and frustrating.

Also, I found it essential to make schemes. I do not always do it because it is very time-expensive, but this time there was so much information that I felt the need to organise it. For each disease, identify the pathogenesis, the aetiology, the main findings at physical examination, the EKG pattern, the diagnostic test you should do and the therapy.

Last, I found vital to recall all the topics out loud many times, also inverting the order: it easier to remember the clinical manifestation of aortic stenosis if you just revised the patophysiology, but it might be more arduous to remember the EKG pattern first.

Basically, that's it. Cardiology was one of my favorite exam in my med school career so far, so let me know if you find these tips beneficial or if you would add anything.

And good luck to anyone for the exams! 🍀🍀

[nerdyartisticthing]

Falafel induced coma

[lilisette]

Late Night Introspection | Zayne/Reader

About: A drabble on Zayne's reasons for becoming a doctor. Was it for himself? Or was it.... for you?

Pairing: Zayne/Reader

Notes: Might be invalidated as the story goes on though haha... But I like the idea of Zayne deciding to be a doctor in order to protect you in ways you cannot.

“By helping her, Zayne… You help yourself.”

The words Grandma Josephine uttered on that fateful day still lingered in his mind, even hours after you’ve left the hospital. She made him promise to take care of you on her behalf, to be with you every step of the way as you lived your life. 

Like a parent giving their blessing to a potential spouse. 

Zayne ran his fingers through his tousled hair, mentally waving that stray thought away. Perhaps in a perfect world where tragedies such as these didn’t happen, she would’ve given him her blessing but… That was not the case now. And in a twisted way, if the disaster 14 years ago didn’t happen, he wouldn’t have met you.

14 years ago he made a decision, a decision that was made because of you. 

He still remembered the day when you proclaimed to everyone that you will become strong and become a hunter so you won’t have to rely on someone and be afraid when another disaster strikes, that you will be someone who would protect everyone around them. 

“I will be your protector one day! Just you guys watch!”

And in that moment, a thought appeared in the forefront of his mind–

“Then who protects the protector?”

He wasn’t the only one who had the same thought however. Caleb immediately interjected, snorting at your antics.

“Then who will protect you, dummy? What if you get injured?”

“I won’t! Because you two will have my back, right?”

“That’s not how it works–”

Indeed, that was not how the world worked. Even the mightiest hunter will fall, despite all the challenges they faced and overcame. And so when you turned to Zayne and asked him what he would be in the future, he simply said– 

“A doctor.” 

“Why?”

“Someone has to take care of you when you’re hurt.”

“I won’t get hurt!”

“Sure.”

So he did. The decision was made. He began his journey into the field of medicine and worked tirelessly to get here. Even though contact between you and him lessened over the years, he had never forgotten his decision, his promise to be by your side when you needed him the most.

As Zayne gained renown and respect within the field over the years, many research facilities and academic institutions had tried to lure him to have him work for them. He refused them all, however. He joined the field not for money, nor for fame and respect. 

But for you.

“You’re good at not giving into temptation.” You jokingly said then. He had no intentions from straying from his path, especially not when you became a hunter despite all the heart conditions you had. He had specifically chosen to study cardiology because he was aware of the problems you had since the disaster. And while there are many capable doctors in said field, he just couldn’t rest easy. 

The thought of you being transferred to someone else’s care made him apprehensive. Why should you rely on another’s care when he could do it instead? 

When he knows you and your heart better than the others ever will?

The sudden ‘ping!’ resounded throughout his office, bringing him out of the recess of his thoughts. He picked up his phone and the corners of his mouth lifted when he saw who it was, contacting him this late at night. 

“Sorry for calling so late earlier. I just needed to know the truth… I’m still reading through them.”

“Go to sleep, it’s late. The documents will still be there when you wake up.”

Just like he will when you wake up. 

He will always be here, as long as you need him.

[dragonnarrative-writes]

im the anon who sent that gaz ask and omg kyle's interlude was so good!!!!! im just giggling thinking of kyle wondering how much does she know? did she catch on somehow? fuck I have to take her out quick before she finds out how many projects ive finished and the whole time miss new girl is like. wow this guy fucking sucks at his job i want him gone from my hospital >:(

mans thinks shes gonna file a case with a police and she just thinks he's incompetent as shit

I'm so tickled. That's exactly what's happening.

CW: discussions of death and dying, autopsies, medical neglect

There’s something going on on the cardiac floor that you just… can’t quite put your finger on.

This isn’t the first hospital you’ve worked at, but you’re also new to urban healthcare, so you don’t want to rock the boat by being paranoid. But traffic from the cardiac floor is… steady. You’ve read the papers, know the stats like the back of your hand. And the cardiac floor is perfectly in line with expected trends. Every. Month.

There are fluctuations, of course. Plus or minus three to seven lives is nothing remarkable in cardiology. Macabre, maybe, but true. But that’s unnatural. In the seven months you’ve worked here, you’ve seen waves elsewhere in the hospital. The plastics floor had a month with zero deaths followed by a month of a persistent infection sweeping through the otherwise reasonably healthy patients. Oncology has seen a steady decline in patients sent your way, thank goodness. Even emergency and intensive care aren’t as fixedly consistent as the cardiac floor.

When you wonder about it aloud to the director, Dr. Martins just shrugs. “We have a good team up there. Very good at keeping things clean and double and triple checking their work.”

“But if that’s the case, then the number of deaths should be going down,” you point out.

Dennis gives you a rueful smile. “That’s not always how human bodies work, unfortunately. You know that.”

You do know that. Which is why the consistency grates against your nerves. So you decide to do a little digging.

The name that comes up the most often in the chart notes is one Kyle Garrick.

That’s actually not 100% accurate. He’s charting exactly the way he’s supposed to. And no nurse has complete, individual access to patients 24/7. But every dying patient he has access to is… perfect. Their blood work, labs, vitals, prognosis, medication adherence and refusal is almost too-the-letter, textbook precise.

The most obvious answer is that Garrick, and probably a couple of other nurses on the floor, are fudging the numbers.

The idea is infuriating. You hate the way the administrators keep changing medical record systems just as much as the next person, but inaccurate charting is a safety issue. People can, have, and do die because someone writes down the wrong timing for medications or assumes that a patient’s vitals are unchanged. If anything, this is probably worse than that. The fact that everything is so pristine probably means that some patients are just being written off. The nurses might be deciding who gets the excellent care the hospital is known for and who gets neglected.

You stay three hours late investigating the next cardio patient that ends up in your morgue.

After examining the body and reading, rereading, and re-re-re-reading his chart, you find it. A stutter in the dosages of blood thinners, a slightly higher blood pressure reading from someone who isn’t nurse Kyle fucking Garrick. Just enough evidence to have you testing the body with an aspirometer almost too late. And there it is. A fatal air embolism.

You want to scream, but the dead man doesn’t deserve that.

Three weeks later, sipping from your water bottle, someone calls into the office. “Knock knock.”

Dennis practically lights up. “"Good morning, Kyle. Been a bit since you've come to see us. Care for some tea?"

Your eyebrows shoot up. Dr Martins hates unexpected visitors. Then you look over your shoulder, and you understand. Even old queens aren't immune to pretty privilege. The man that’s leaning in the doorway is gorgeous. Maybe its because you work with dead bodies all day, but his eyes and skin seem to glow, even under the fluorescents.

"Can't," the man says, apologetically. "Just dropping someone off."

"Well, at least let me introduce our new nurse!"

The fact that you’re wiping crumbs off of your mouth over a paper plate is the only reason no one sees your face fall when you hear him say, “Nice to meet you. Kyle Garrick.”

[oh-saints]

You could write something like friends with benefits with Ruben Dias but he really falls in love w reader 😬 ? you can decide the rest just make it angst

you really can blame back to december (taylor's version) for this. who's ready?

saudade

(portugese) a deep emotional state of melancholic longing for a person or thing that is absent; desiderium.

it was a word rúben only learnt in front of his oldest flame. his favourite flame. however, between the two of them, did time heal everything?

rúben dias x doctor!reader word count: 4.5k prompts: above + summer fling + @julianalvarez9's post here (sorry, girlie, gotta twist your idea a bit) tw: explicit foreplay but suggestive smut 👀 note: y'all can blame ms. swift's newly released album, okay? well, aside from the depressive mood lately and recent work stress, the particular song kickstarted me to write my arse off like i just broke up with my ex (when it's an old news already lol). but as usual, i happen to write this at dawn so not beta-read yet. song: back to december + all too well

“oh, there she is!”

oh for the love of god, you know you were late, okay? when you hadn’t stopped running back and forth for two consecutive days straight to save everyone and their mother’s lives, it was pretty understandable to take the chance of hibernating the first thing you had a day off, right?

“after an eon of disappearing,” the groom—your favourite cousin but god did he love basking attention—raised his glass towards you, and you could only smile his way through the gritted teeth. “I’m glad you decide to grace us with you presence, Your Majesty.”

but of course your family wouldn’t understand that, for they lived a totally different lifestyle to yours, despite begging you to enrol yourself to the most prestigious medical school. ironic now that they were the ones who always begged you to come home when you felt like you’ve moved to your home the moment you got accepted to the most reputable cardiology and cardiothoracic department in the country.

so you smiled wider—for the appearance, of course—but you said nothing back.

you were still regulating your breaths, palpable by your huffs and puffs as you took the empty seat—god if the bridezilla got mad because you took the wrong seat, you’d fight her because it was already a sacrifice on your end to drag your ass to this weekend full of wedding festivities—and before you could do anything else, a glass of water was shoved your way gently.

“you look like you need one.”

you were not surprised by the voice. he sounded like he looked like—rough, buff, strong, bulk. you were rather surprised at the small smile thrown your way when he handed you the crystal, filled with clear liquid.

oh, the choice of drink, too, by the way. in a weekend that would soon be filled with endless flow of champagne and other alcoholic and questionable options, he chose still water.

realising you were still eyeing the glass in his hand, his demeanour changed slightly. “not a fan of water?”

“I thought you’re kind of a beer guy.”

your response sent him into a laughing fit because honestly, rúben was expecting you to throw a flirty banter. with an evening gown that rocked a thigh slit as high as the bride’s ego, you looked more ready to have some fun from the get-go.

but the sound of that deep, masculine laugh did wonders to you. heat immediately run through your entire body, and you immediately knew you liked it more than you thought you should because you kept wanting more. more of his laugh, more of his voice, more of his smiles, more of his scent. more of him.

“it’s too early for that, no?”

with the way he lifted his eyebrows teasingly, you almost questioned your decision to become a doctor. you’d definitely been missing out this special specimen beside you, due to burying yourself in between your patients’ body—literally, in order to save their lives. you really need to go out more often.

or maybe, you need to step up the game while you can before hospital took your fair share of fun as soon as you landed back home. shivers ran down the underside of your arms at the last thought.

fuck it, then. if there was one thing hospital taught you the hard way, it was to might as well enjoy things while it lasted.

you grabbed the glass of water from his hands—his skin felt exactly like it seemed—before signalling for two flutes of champagne. the server went to grab your request as you shoo away your thirst with the water and then proceeded to down the champagne when the server was back in the vicinity, all while never straying your eyes from his. “in Italy, nothing’s too early, no?”

and that was another laugh you’d come to like. god, if coffee did no longer work on your bloodstream, someone should get her that as her daily fix of adrenaline dose before her night shift started.

the man in front of you took his portion of champagne and said his thanks, his eyes held yours like there was no tomorrow. despite the roughness in his facial features, stubbles and all, his smile was warm. and for you, the whole combination was what made your knees weak.

how could someone look so sexy and smug in all his friendliness?

“it’s rúben, by the way.”

with the small smirk slowly tugging the corner of his lips as he sipped the champagne, rúben should really consider himself lucky you didn’t jump on him and replaced the crystal flute under his lips instead.

＊✿❀○❀✿＊＊✿❀○❀✿＊＊✿❀○❀✿＊

despite your initial dislike towards the bride—purely because you thought she had a severe princess disease—you tried so hard not to rain in her parade. no matter what, it was still her special day, probably one she’d been dreaming since she was a toddler.

also, have you mentioned that the groom was one of your favourite person on earth?

so you didn’t even dare to move anywhere outside the safe sanctuary of your table because you knew you’d be bombarded by the elders for how rarely you showed your face again in family functions like these, or for how you could not even show up with a boyfriend in tow. amongst the lineage, you were the only one left without a lover or some sort, but instead of draining your energy to explain how exhausting it was to live so that other people can live too, you stayed put.

that, and the fact that rúben provided 1001 reasons why you should stay behind with him. yes, sexiness aside, you found yourself able to converse so many things outside the medical jargons and it kind of made you miss it—the ordinary life everyone else was leading. you missed talking about the latest blockbuster movie, you even missed wearing something else than the hospital scrub and your favourite crocs for more than 10 hours straight.

you even missed the flirting phase, thanks to rúben’s impeccable ability to chime in some subtle but straightforward seduction. rúben himself already exuded some hotness, his laugh and words managed to shoot some warmth throughout your body, and the champagne tripled the heat all over you.

rúben was only downing another glass of negroni and you were only watching the liquid move from his mouth to his throat, but you needed to excuse yourself. your brain was no longer cooperating with every other organ intact to your body—you couldn’t shouldn’t think all of these forbidden thoughts inside of your mind because rúben had been nothing but a gentleman, yet you were the one who kept wanting to cross the line.

yes, rúben might’ve dropped some not-so discreet touches down your arms, on top of your knees, under your knees. yes, he twirled with your unkempt hair, tucked them behind your ears. but the groom used to do that all the time with you, just to tease you around, so what made this time different?

“I thought you hit the jackpot or something.”

and there was rúben again, his voice matched the concern written all over his face. even in times like this, when her inside was a mess all over, rúben managed to think of her well-being. damn it, he really made it so hard for you to contain the burning desire.

there, she said it. desire—a word so foreign in her dictionary recently, for she’d momentarily lost her want to study the human anatomy since the moment she walked into this party late.

“what, you’d run away or something if I did?”

despite you hyperventilating earlier, as you ran towards a balcony of this huge Italian castle looking for air, you were sure rúben couldn’t see a trace of it anymore. you were already sporting the provocating look you’d come to realise only come into the surface when stirred right—aka only rúben managed to do so by far.

and only rúben could take the outmost pride in enticing such vixen from her hiding place. you wouldn’t have braved the face to sport such dangerous dress if you didn’t have the energy in you, and he was more than glad you ended up taking your seat beside his, despite knowing you were supposed to be seated somewhere else later into the night, for he could satisfy himself with the sly and slightly naughty look you only threw his way whenever he wanted.

he’d be the worst liar on this planet if he said he wasn’t tempted to kill distance between your lips and his, so many times tonight. but his father taught him courtesy, and to do such radical act in a room full of other people’s guests would be an insolence and disrespect to the bride and groom.

but now that the matter of prying eyes was gone…

“I’d brush your teeth, of course,” a small gasp from you didn’t escape his ears. “what do you take me for?”

you smiled but you were shaking your head disapprovingly as you folded your arms in front of you. “when are you going to stop being a gentleman, rúben?”

“why should I?” the man stepped closer to you, and you wished he was still wearing the dark blue vest because you certainly couldn’t handle those specs ghosting behind the white shirt. “do you want me to be a bad guy?”

but you couldn’t also deny you’d want to see those chiselled chest. combined with that smirk and fascinating kind of mirth dancing in his eyes, would you be dead and sent to heaven? “can you?”

you were both now so close, rúben only needed to lift your chin towards his face to claim your lips. “oh, is that a challenge?”

he could easily did, by the way, with the way your lips were gaping as soon as he gripped his chin gently. but he decided to tease you more, as his nose reached down to touch yours while his body pushed you to the railing, giving him the excuse to catch your body in his arms.

your brain was now completely unwired, your limb was moving the way rúben orchestrated yourself like a maestro to his favourite instrument. all you remembered was to hold on to the back of rúben’s neck and the side of his strong arm, as he gathered you in his sturdy embrace, and chanting don’t fall, don’t fall to your now-airhead.

when he finally tipped your chin to his desired angle and your lips caressed one another, your breath turned shaky and it gave him an immense sense of pride. he’d been wanting to have this, dropping hints here and there so you’d let yourself free of expressing your inner self, because he knew you wanted the same thing too.

“what do you want?”

if anyone went wet at his usual voice, wait until you heard this version of rúben.

you could already feel yourself turning into a weak excuse of a puddle. your brain was melting, your inside was evaporating.

“tell me what do you want, baby, and I’ll give ‘em to you.”

it wasn’t that you were shy to voice them, but it was because you couldn’t find the words. funny how you could read endless words and medical jargons and yet, gone was everything inside and outside of yourself, including your so-called dignity you were often praised for when you were doing your rounds, when he dropped the word baby to call you with.

so you raised yourself on your tiptoes and pushed yourself towards him.

“uh, oh,” damn it, you forgot he was a footballer. he was paid to use his reflexes on weekly basis. avoiding your advances were nothing against his job. “words, baby.”

“you,” you managed to breathe out the simplest word you could find in the currently short-circuited brain of yours, but the very word seemed to please the man, whose smirk went wider oh-so sexily. “want you, rúben.”

if it wasn’t for the fireworks going off at the background five minutes later, rúben would’ve succeeded in making you fall apart in record time. but rúben didn’t know the word give up so while he kept to himself for the remaining of the night, he’d come looking after you as soon as the party ended and everyone went back to their respective suites.

you, too, certainly didn’t see this coming. but when rúben immediately kissed you senselessly as soon as you opened the door—well, as soon as he pushed you inside and opened your pathetic excuse of bathrobe, that is—you weren’t complaining. you even helped him shed the rest of your fabrics before unbuttoning all of his, all without separating yourself from him, because the last time you did, you never got the chance to chase your high.

“but, rúben, tomorrow’s the wedding!” you squealed as he lifted your body, your legs immediately locked your position against the large man, as he walked you both to your bed. “we’re so gonna be late, rúben.”

he was peppering your neck with kisses as he placed you down the mattress, rousing giggles from your end. “that will give them a story to tell, no?”

“you’re crazy—oh, oh,” the crispiness of your laughter was interrupted by the sensation of rúben’s tongue devilishly sucking your sensitive spot. “oh, fuck! fuck, rúben, fuck!”

if his tongue wasn’t twirling the bruising skin so well to soothe the pain, you’d smack the smile you felt against your skin. “well, they say that what happens in Italy, stays in Italy.”

“I think you’re mistaken for what happens in las vegas, stays in las vegas—oh, fuck, rúben…! don’t fucking stop.”

“is that so?” oh, how dare he stop?! you sat up when rúben halted the wet ministrations of his tongue against your breasts, about to protest the footballer, when he pinched your budding nipples. your head immediately fell back to the pillow, surrendering yourself instead. “can’t seem to remember. you keep distracting me, meu anjo.”

the sensation of his warm saliva against the coldness of his fingers’ pads were unlike no other that you mewled out the loudest moan you’d ever done. so disgusting you had to bring down his lips towards you to shut yourself up. “should we go to las vegas instead?”

“tonight?” rúben popped a now-hardened nipple of yours, and the sight was definitely something you could not erase from your memory. “I can call my plane.”

“don’t tempt me, rúben, because we know this weekend is going to be boring from the looks of it.”

“let’s bring las vegas to us, then.”

long story short, rúben brought you las vegas and its glory every chance he got during the weekend.

＊✿❀○❀✿＊＊✿❀○❀✿＊＊✿❀○❀✿＊

“must we go back to reality tomorrow?”

the giant central back chuckled at your submission. you were tucked under his arms, your fingers were drawing air on his chest, and somehow he knew you were pouting as you did so. it never ceased his wonder how you could be a temptress for a minute, then turned into a cutie-patootie—your words, not his—the next second.

it never ceased his wonder too as to how you’d always spurt out the same question all over again, every weekend you both got the chance to escape reality, despite knowing the definite answer of yes, we all have a life to lead tomorrow from him.

many of your colleagues had inquired about your relationship with the familiar face they’d seen over the weekend on their TV screens, but you didn’t know what to answer them. you were texting and flirting all the time but you were certainly wasn’t dating. you had sex, and you happened to repeat them whenever things got tough for either of you.

it was starting to become a vicious cycle, you and him. it was an impending doom, escaping the harsh reality only to seek for harsh and explosive sex instead of facing them head first.

he should’ve said no to every of your calls, but you crying over another life you failed to save wasn’t something in his card to ignore.

you should’ve said no to every of his calls, purely because you knew you were another rebound or another anger fuck from the losing game, but you didn’t have the energy in you to think of any reason to say no, not when you’ve racked your brain to save the failing life of your patients.

you both became a constant fixture, the only thing guaranteed good, when all else failed in your respective lives.

including the romantic aspect of your life.

but how could it not fail when rúben always picked up your calls when you had a bad day—that bad that you didn’t have the energy to have sex with him? he’d listened to you crying before stopping yourself, he’d listened to the silent you gave him because you were processing things. he’d listened to them all before offering to pick you up from work, no matter how stupid it looked like for him to slide in his vehicle at 5 in the morning when he had to be back at the training centre at 9 sharp.

when he couldn’t be around when you were having a mental breakdance, rúben would send you and your team a mini buffet for your lunch so you could share happiness the same way you shared him your devastation. so you could be back on your feet in no time because time is of essence for your job, your patients need you to be strong and healthy so they too could do and feel the same.

rúben—bless him—even spared his time to visit your patients when december came around the corner. he’d cheered them up, like the way he always did around you and for you, and even gave the kids and their caretakers gifts so they didn’t feel bored spending the festive holiday at the hospital. the next week, he brought over his entire football team just because one of the elder patients said he was a fan of his team.

he did all that, like a true gentleman you’d met the first time at your cousin’s Italian wedding, only to drop you the biggest nuclear bomb right on top of your head, right on christmas eve.

it was a dinner hosted by one of his teammates. he’d asked you to come because he knew you didn’t prepare for any last minute plan when your surgery schedule fell through—the patient died before you could save her—and thought the merry atmosphere would turn your sour mood to a better one.

you, from the beginning, didn’t want to go because you didn’t feel like intruding. and maybe, you shouldn’t have come.

the host, rúben’s captain, asked what kind of relationship you both were having, just as you were about to call for the men to join the women in the kitchen because the food were all ready to be served by now. but you never joined either side because of rúben’s answer.

“I’m getting married,” you remembered vividly. “she was nothing but a good fuck.”

＊✿❀○❀✿＊＊✿❀○❀✿＊＊✿❀○❀✿＊

but that was—what, five years ago?

you’d moved on with life, and that included moving far away from home to london. you obtained your specialist degree and was now under the tutelage of the best cardiovascular professor in town. you were often credited as prof. nagelsmann’s golden child because of how much the professor adored you, for your vast knowledge and eagerness to learn, as well as your hardworking attitude.

if people knew that you were studying till you broke your neck and had constant nosebleed till exhaustion took over your body at first only to put your mind somewhere else…

well, they didn’t need to know that. people only needed to know that you lived and breathed for the hospital now, because you’d now come to terms that life and death was two of the things that you were sure of to happen. nothing else were as definite as those two.

well, maybe also the jinx when you stashed away your hospital scrub for ordinary clothing as you clocked out of your shift.

as soon as your junior called your name, just five steps beyond the hospital territory, not even your car in sight yet, you knew you had to go back inside and save your kdrama marathon for another time. “code blue?”

your junior nodded and immediately jumped to describe the dire emergency. you were also handed the patient’s medical record. “male, 35 years old with CoA[1]. his stent’s infected so we have to do replacement but his CT scan shows hemothorax[2] and raptured aorta as well.”

your legs wanted to give away when your eyes spotted the name.

it’s ivan dias.

＊✿❀○❀✿＊＊✿❀○❀✿＊＊✿❀○❀✿＊

rúben couldn’t believe his eyes.

there you were, explaining the whole procedure his brother would be going through. clad in your hospital scrub with no make-up, you were still as beautiful as he’d remembered. not even signs of time grazing your skin, as if the cold temperature of the operating theatre froze away the concept of time from your face.

your natural look was what initially drew him into you. in a room full of people caking their faces in the latest make-up trend, you definitely stood out in his eyes. you even outshone everyone else, including the bride, if he was being honest. and when he found out you were more than a pretty face, it didn’t take him another minute to settle his decision to make you stay behind in the table with him, so no one else could take you far away from him.

possessive, people would say to him. a trait he thought he’d hated in everyone else, but a trait that turned out to be something that showed up only whenever you were concerned.

but god, did rúben want you. so bad he felt like he could kill anyone else who casted you a seductive glance, despite you not acknowledging them.

and it made him hate himself because he was turning to be everyone else he’d come to hate. he didn’t want to be selfish, he didn’t want to push everyone else for what he solely wanted. he didn’t want you all for himself—he shouldn’t want you all for himself.

you both were only friends after all.

at least, that was rúben used to think of. because who the hell listened to another person crying for hours, if not for friends? who the hell picked up another person at 5 in the morning, if not for friends? who the hell reminded another person to eat so they could take care of their patients, if not for friends?

so he did everything he could, including dating around till he painted the town as red as the possessiveness he wished to hide, in hope he could diminish this niggling feeling that was bothering him day and night. he sought help and read endless books, just so he could validate the peculiar emotions he was feeling, that only vanished when you were around.

but nothing satisfied him. nothing was the answer to his long-standing question. even when he decided to jump the big gun and got married with someone else that didn’t even understand a simple arithmetic question, rúben still felt the gnawing hole inside of him, that was still thirsty of something he didn’t know of.

the hole grew into a big, black, gaping hole as his marriage went on. the hole even swallowed the existence and the idea of the two of them, the couple that could perfectly plaster the covers of bridal vogue, into a mere memory, burned to ashes and blown to the sky.

even then, too, rúben only wanted to see you. because being around you always brought strange waves of calmness to him.

so he did, only to find you go off the grid for good. he’d asked for you to everyone he knew and everyone he thought could possibly knew of your existence, to no avail. he’d thought of going to your home and asked to your parents but he decided to go against it because he respected you and your decision—he always does from the first moment he met you.

he remembered he didn’t even want to touch you until you succumbed yourself entirely to his palm, and he promised you he’d do that and he intended to keep his end of words, be it when you were around or not. he could only pray to God to meet you again in due time and course, when you were ready to see him again.

but now… god, did he want to scream out loud in happiness. you were still as gentle as ever, having handled fragile lives in your hands of both the parents and the guardians. your voice still reminded him of an umbrella under a blazing hot day, as you elaborated ivan’s condition to his parents. your hands still reminded him of a silk handkerchief tucked properly under one’s suit, as you touched his parents in reassurance.

only then did he realise that this sharp feeling inside of him, only you could provoke such intense emotions like a dagger stab to his heart, was longing.

he’d longed to have you in his arms again, despite having you there all his previous times with you. he’d longed to have you around him again, despite being around you. no distance was still a distance per his standard. and he realised he’d made the biggest mistake by not proclaiming you when he had the chance.

fuck possessiveness, he wanted you back.

after all these years, he still wanted you so bad.

“I knew you’d succeed,” rúben sat down with two cans of your choice of beer. “I haven’t had the chance to congratulate you. congratulations, by the way.”

“thank you,” while you flashed him a smile, you smiled rather awkwardly and scooted further away from him. like you were scared of him. like a child was scared of what a stranger had in their hands. “i—”

he didn’t like that you were getting further away from his reach. he couldn’t launch his old moves on you again if you did. “I hope you still like Budweiser.”

“I do, but I’m sorry, do I know you?”

but it seemed like he’d lost you now, the way he’d lost you years ago.

[1] coarctation of aorta; a birth defect in the aorta, where it is far narrower than normal, blocking the blood flow to the body. on severe cases, it is so narrow that it can back up the blood flow to the left ventricle, forcing the muscle there to work twice as hard in order to distribute blood the way it’s supposed to be.

[2] hemothorax; a presence of blood is detected between the chest wall and the lungs. commonly, may be caused by blunt trauma or by complication of a disease.

[kieraspsychonautssideblog]

Why Hollis Forsythe is a Deeper Character Than You Realize

So ya'll seem to like my essay on why Loboto's Labyrinth is a good tutorial level for Psychonauts 2. I've wanted to write an essay on the rest of the cast as well, so I decided to start with the second character we head into the mind of: Hollis Forsythe.

We are first introduced to Hollis when she comes to greet the cast after they land at the Motherlobe. I have played this game with my friends and my step-dad, and both parties initially believed Hollis was the mole due to her saying she didn't hear the crew's call for help and her initial dismissal at the idea of a mole being in the Psychonauts.

She is shown to be strict, serious, and maybe has a bit of an ego due to her preference for "Second Head" instead of Lesser Head, and with how she conducts herself after the casino mission. She isn't exactly soft towards interns, particularly Raz, and she can easily be seen as intimidating.

I do think it's rather odd that she would put a psychic intern under the mentorship of a non-psychic employee, but think of the situation she has been put in.

Truman is out of commission, and she has to keep the whole place running, and a mole is possibly running around about to bring back the biggest threat to the Psychonauts ever, their budget is getting tight, and a new intern has plopped into her lap.

I am choosing to believe that Hollis put Raz under the mentorship of Nick Johnsmith as a temporary thing, and would have given him a proper mentor afterward (given that none of the interns are mentoring under Sasha, I believe that Hollis would have given Raz to Sasha if things went differently.)

However, after she gives your mentor, you can ask her about her diploma, and she mentions being an intern at the Neurological Hospital for one year before joining the Psychonauts.

We learn in Hollis's mind that the reason she left was because while she was interning there, she came up with a new method that could save lives, but Dr. Potts had stolen her work and claimed all the credit. Appallled at this, Hollis used Mental Connection to try and mess with Dr. Potts, but ended up breaking him and they had to call in the Psychonauts to help. Truman gave her the position after this.

It is interesting that this hospital internship seems to be so central to Hollis as a character given that it was only for one year. However, it does seem to have affected her character greatly. She is immensely worried about the safety of the children she mentors, after all, and there are several figments of people being hurt or being cared for in both of her minds. Hollis's Classroom, while important to establish Hollis, is not where Hollis's character shines.

That will have to be Hollis's Hot Streak.

In Hollis's Hot Streak, we go through the Pharmacy, the Maternity Ward, and Cardiology to get three gazillion dollars to enter the High Rollers lounge and fight the Lady Luctopus. In each of these areas, we get a good insight into Hollis's thought process.

Side note: the fact that the hub area is a six-sided DIE in the MORGUE...

This game and its pun.

Anyway, in the Maternity Ward, we see that Hollis actually has a very cynical view of babies and those who want them. Most obvious is the rich couple who only want a baby for their own gain. The fact that there's some emotional baggage only accessible through dark thoughts is also something to think about. In this area, when we go to the backroom, we hear Hollis say "Well, of course, the whole system is rigged! But I mean, I'm just one person! What could I do about it?" which reads very heavily like learned helplessness almost. Given that, if you go talk to Hollis in the Motherlobe after your family arrives, she mentions that "all families are terrible", it does imply Hollis might not have a good relationship with her family.

In the Pharmacy, the entire point is to fix the Pillinko Machine so you can win. With Hollis's heart in the wrong place, it's up to us to try and make better connections in order to get to the backrooms. When we're there, Hollis says "Swallowing your feelings sounds bad, but really, who wants to hear about those ugly things anyway?" She's clearly had to repress these emotions for a while.

In Cardiology, you bet on suits of cards in race. However, Hearts has a broken leg. Although Hearts is told to stay off the leg by their doctor, their doctor is also their boss, and if they miss another race, they'll be fired. They are being exploited. Makes me wonder if that's how Hollis felt when Dr. Potts stole her work. In the backrooms, Hollis says "Different race, same runner. I can do this on my own, I don't need anybody's help, I CAN'T need anybody's help." Hollis clearly feels overworked and stressed about the situation but feels as though she cannot ask for help from those around her.

There's still a lot about Hollis's mind that interests me. The mental barriers you have to shoot through blocking your way, the religious imagery that's also in her mind, etc. But overall, I think Hollis is a much deeper character than we're lead to believe, as she doesn't get to do much after the Casino mission. But still, Hollis is really interesting to analyze.

EDIT: I AM COMPLETELY DUMB AND FORGOT TO MENTION: The fact that Hollis associates being a doctor with gambling is also really interesting. Yes this is because of Raz's actions, but the several ways she associates the two is fascinating. You have to wonder how many patients Hollis might have seen die in her time as an intern.

[er-cryptid]

Path of Blood Flow Outside the Heart

Oxygenated blood leaves the left ventricle

Aorta

Arteries

Capillaries

Gas exchange occurs

Venules

Veins

Superior and inferior vena cava

Right atrium of heart

[napthaliii]

1 July 2023 | Cardiac Auscultation (heart sounds)

The atria pump blood into the ventricles, the valves between the atria & ventricles close to prevent backflow. The “lub” (aka S1) is the sound of these valves closing. When the ventricles contract to pump blood away from the heart, the aortic & pulmonary valves close making the “dub” sound (aka S2). 🫀

[notesbyallie]

[anattempttostudyharder-blog]

22/7/23 (Day 91)

Studied flagged notes of endocrinology

Went through all the questions of the same

Went through my flash cards

Went through flagged notes of- anatomy, anesthesiology, breast surgery, cardiology, critical care and dermatology

//Studied 7 hours. The exam nerves are getting real lol. Had a lot of yummy food at home so that was good//

[dr-scarlette-witch]

10.07.2023

Started reading cardiology from scratch.

Went to buy groceries.

Applied for the state PG counselling.

The weather was very pleasant and I was able to open my windows and enjoy the view while studying.

Made my cardio notes in orange because cardiology is orange and also all the photos I took are orange :p