#ive been rotating them in my mind 24/7 my god

[s0up1ta]

Ok I am going to be very insane about them and your designs for them for a second category 5 moment coming up I'm very sorry

BUT OHHH MY FUCKGIGN GOD THATS EXACTLY HOW I PICTURE THEM THOSE DESIGNS ARE SO GODDAMN SPOT ON AND PERFECT!!!!! PETERS HAIRCUT AND FRECKLES, RUMIS HORNS BEING MADE OUT OF THE CRYSTALS THAT REFRACT THE LIGHT AND ARE COLORED BLUE AND PURPLEE AHDNDB FUCJGJISHGIDHSIHRISHROSHRIEHDK!! ‼️‼️ AND RUMI'S JACKET THING MEANS THE WORLD TO ME GOD JUST THEM IN YOUR STYLE <3 <3 <3 <3 <3 ohhHHH ANDDD THE OPENINGS ON THE SIDE OF THEIR TIGHT UNDERSHIRT-THINGY SHOWING THEIR SKIN WITH THE GOLD PLATESSS IM GOING FERAL!!!! PETERS VEST IS PERFECT TOO LIKE IM ACTUALLY SO INSANE ABOUT THIS YOU DONT EVEN UNDERSTAND MAN. YOURE SO FUCKING TALENTED BTW HAVE I EVER MENTIONED THAT BECAUSE I NEED TO MENTION THAT. FUCK!! WHAT THE FUCK!!!!!!!

Also I know its a part of Rumi's official design but I actually really really love the openings on the sides of rumi's clothes because I hc healing magic in a really specific way. Like to cast it you have to physically lay your hands on the person, but it doesn't have to be on the injury, just the person. So you could hold their hand and cast it (which is what Rumi does for Peter, they hold his hand or cup his face ((very lovingly)) WOAGH who said that anyway) and it would work the same as touching any other part of their skin; BUT!! you can't cast it through clothes. So when Peter goes to heal Rumi he would put his hands on their hip openings and cast his magic then.

I'm pretty sure that exandroth is the one who can cast healing magic?? But I'm going to pretend both of them can after Peter figures out the low level magic :3

So if it was pre-biblically-accurate-androgynous-sex, then Peter would typically hold their hand or touch their neck or something and Rumi would grab his hands and bring them to their hips because there's more skin to touch, meaning more room to cast. And then the biblically-accurate-androgynous-sex made Peter feel much more confident in a lot of different ways, but also much more confident when it came to Rumi, so post-biblically-accurate-androgynous-sex he would do it without hesitation :]

This also goes the same in reverse, Rumi would just hold his hand to heal him after a battle, (andddd maayybbeee the hand-holding lasted a little longer than the time it took to cast a healing spell because they just wanted to hold hands) but after their night together it became much more common for Rumi to lift Peter's shirt up to look at the injury and heal it directly or cup his face in their hands and heal him that way.

ANYWAYY!! SORRY FOR THE RANT ABOUT MAGIC FOR SOME REASON IN YOUR INBOX AND THANK YOU FOR TAGGING ME IN YOUR DESIGNS BECAUSE YOURE A FUCKING AWESOME ARTIST AND I ADORE YOUR STYLE!!!!!!! see ya ✌️

I AUSGHSHDUSGUSHDHHDGDHHS

IM SO NORMAL ABOUT THIS

THIS IS LITERALLY CANON YOU CANNOT CONVINCE ME OTHERWISE

ALSO THANK YOU SO MUCH IT MEANS THE WORLD TO ME THAT PEOPLE LIKE MY DESIGNS AUGDHFHJDBF

im a very much visual person when it comes to brainrotting so i cant put into words how much i agree with everything you just said so just know that UAGSHDHUDHSJBFJDBFJDJBD

((drawing ideas perhaps 👁️👁️) what was that i didnt say anything

[angelcstasy]

TELL ME ABT YOUR OCS PLEASE I WANNA KNOOWWWOWOWOW

OH MY GOD? I THINK I KNOW WHO THIS IS MAYBE NOT BUT :GRABS YOU ANON. ANON I ACTUALLY WENT :O :DDD! IRL WHEN I SAW THIS NOTIF !! THANK YOU SO SO MUCH FOR ASKING GAHHH <3

ok so!! i have a lot of ocs from different stories but heres 2 charas ive been rotating in my brain 24/7 nonstop for a while ^_^ !!! so theres these 2 guys from my psychological action-gorey horror webcomic idea, the fine game of agony, dubbed the prisoner and the warden! they have real names but shhh im not telling publicly yet :] in 200~ ad ancient rome, a man becomes a serial killer and despite his carefulness gets caught and the townsfolk plan to torture and execute him so he makes a deal w/ the devil to become immortal and be able to revive from death and heal unnaturally fast from injuries. he is, of course, the prisoner. the townsfolk brutalize the shit out of him and he dies a few times over the course of abt 2 days but he always comes back good as new, the townsppl are horrified so after some discussion, they realize the prisoner made a deal w/ the devil to become immortal so someone needs to become immortal and resilient just like the prisoner to guard him. another man willingly steps in, the warden. the townsfolk perform a ritual of sorts and make him immortal and be able to revive from death and heal unnaturally fast from injuries just like the prisoner. so thats where they get their names from! in 400 ad unfortunately the prisoner escapes and the warden goes after him and thattt is pretty much the start of their uhhhh Awful Horrific Relationship! so yeah to end this off, the fine game of agony is abt the cycle of horrible mutual abuse the warden and prisoner have been keeping each other in for 1800ish years and the story explores the highs and lows of both of their lives and how trauma and ego and hate have warped and rewired the way their minds work and how they would love to just simply cease to be, but not without taking the other down with them first :D THIS IS PRETTY LONG AND I NEED TO GO TO BED ILL RB THIS AND TALK ABT SMTH MORE LIGHTHEARTED TMRW + ELABORATE ON My Horrific Men some more if you want!!

[momtemplative]

Watching My Diet.

Of Words and Images, That Is.

As for a spoiled life, no life is spoiled but one whose growth is arrested.—Oscar Wilde, from The Picture of Dorian Gray.

1.

When I was pregnant, I was astounded by the amount of shit-advice people felt entitled to force upon me, thanks to the visual whistle-blower of my growing belly.

I kept the book, Ina May’s Guide to Childbirth, by Ina May Gaskin next to my bed like a sacred text. The second half of the book contains a collection of empowered women sharing inspiring stories of their natural birth experiences. I read at least one story every night to off-set the deflating stories that were pushed at me. (One, still clear as day in my mind over a decade later, came from a woman who had never had kids! She said, in low tones and with concern in her eyes, “It’s the most painful thing you will ever experience. You WILL NEED DRUGS.”) 

I would often fall asleep with Ina May’s book on my chest, thinking maybe the positive messages would cause seep into my being, like a topical treatment.

Now, during the era of COVID19, the news is an IV drip of mounting catastrophe into all of our collective veins. And the way we receive news during these current times is 24-7, on screens, visual, relentless and without limits. (PS: as said in Time, “media images can be so intense that they can cause symptoms of acute stress or even PTSD.”) 

Like many, I find myself falling into the habit of using my few-far-between windows of space to either read updates from the Post and the Times, or to check social media. While informative at best, these word-venues are, nutrient-wise, anemic crumbs not suitable for a bottom-feeder.

So why the impulse to keep going back?

According to Time Magazine, “The human brain is wired to pay attention to information that scares or unsettles us—a concept known as “negativity bias“. Meaning, our brains are predisposed to go negative, and the news we consume reflects this.”

On a personal level, my intake of news is rising by the day—sometimes seemingly out of my control. I’ll just be grabbing my phone to check the weather and suddenly I’m well into an article on the pandemic, as if in a trance. 

Without clear boundaries and a bit of mindfulness, the news and media we are ingesting can be far more toxic than beneficial. The effects of constant negative-news consumption are real and complex. 

And I feel the wear-and-tear in my mental state, to be sure. I’ve been taking in the news every night, just before bed, via my tiny phone screen as if that makes it less potent and more manageable. Not the case. I can easily slip into helplessness, along with tasting the vinegar of potent rage in the back of my throat, even as I’m trying to settle in for sleep. 

Anxiety and stress create cortisol, which can wreak havoc throughout the physical body and beyond. My neck and shoulders feel like they are clutching with white-knuckles for some unseen disaster, pretty much all the time. Yoga and breathing provides a world of help while doing it, but the muscle memory is so deep, that the bad patterns often return within moments of back-to-life.

This is not to say the solution is to bypass the news entirely. But if we are in this for the long haul, deliberate choices need to be made, for the stability of everyone.

2.

Last week, my dear friend, Steph, mailed a box of crafting goodies to my girls. An eclectic mix of junk-drawer extractions and art things—things that have the potential to clutter up a house. But, when assembled in a package with intention and love, feel like vintage treasures from another world. Girl scout patches, circa the early 1990’s, ribbon in original packaging from the Carter administration, an untethered bouquet of white plastic glitter flowers. And in the midst of this treasure chest: a hardcover copy of the Oscar Wilde book, The Picture of Dorian Gray.

It was a fancy, old-timey edition that I had read through and written-in during college, using the same red ink from the same red pen the whole way through. My handwriting is young—an un-mastered version of my current script. But my brain is searching and inquisitive. I’m not sure why Steph wound up with the book, but there was a time when I passed out Oscar Wilde books like a communist would pass out propaganda and I likely forced it upon her.

Back then—over twenty years ago, more than half my current age—Oscar Wilde spoke to me in a way I was not accustomed to being spoken to, and brought about feelings that literature rarely provided. I indulged in Him, collected photos, quotes, and bought multiple used copies of his books. He became an unwitting spiritual guide of sorts. I carried the story of his tragic incarceration and subsequent death with me the way a god-fearing man would hold the image of Jesus’ crucifixion close to his heart. If they sold Oscar Wilde on a necklace, I’d have bought one, for sure.

Placing my hands on the cover of that book—while my girls squealed and unpacked the rest of the boxed treasures—was not far from the feeling of placing my hands on a body to massage. Flesh—living, breathing flesh. Cracking open the book brought with it not only the slight sigh that takes place in the inner ear during a good stretch, but also a swell of emotions. I flipped through the pages, feeling saved.

The article, What You Read Matters More Than You Might Think, in Psychology Today discusses the difference between “deep and light reading.” Deep reading is defined as reading that is slow, immersive, rich in sensory detail and emotional and moral complexity. It is distinctive from light reading, which is little more than the decoding of words. The author continues by saying deep reading is great exercise for the brain and has been shown to increase empathy, as well as inspiring reflection, analysis, and personal subtext to what is being read. 

A passage from The Picture of Dorian Gray—”Words! Mere words! How terrible they were! How clear, and vivid, and cruel! One could not escape from them. And yet what a subtle magic there is in them! They seemed to be able to give a plastic form to formless things, and to have a music of their own as sweet as viol or of lute. Mere words! Was there anything so real as words?”

Another passage (how can I resist?): “In this country, it is enough for a man to have distinction and brains for every common tongue too wag against him. And what sort of lives do these people, who pose as being moral, lead themselves? My dear fellow, you forget that we are in the native land of the hypocrite.”

How I missed that man. And what a time for him to pay a visit.

3. 

Last weekend, I was feeling particularly ill-at-ease. My speech had edges like so many sharp river rocks. Tears and sadness rotated through in unpredictable gusts. 

On the particular day I refer to, a book called Ordinary Magic, Everyday Life As Spiritual Path all but did a swan dive from my bookshelf and landed at my feet. The cover-image was dated and sun-bleached. The font and spacing came directly from the early 90’s, which is when it was published. I have a vague memory of buying this book at Half-Priced Books in Columbus, just before I made my move out west, in 2002, eighteen years ago. It’s a collection of Buddhist essays that focus on sectioned-out, topics—creativity and community, for example. It did not take long to realize that the editor, John Welwood, steals the whole dang show. His intros to each chapter sparkle with the quiet wisdom of one who is not the headliner, but knows his own worthiness.

(As with Oscar Wilde, I could include countless quotable phrases, but a taste is all you need.) In his introduction to the creativity essays, Welwood said, “By being still and receptive, instead of busily trying to find solutions, we give our intelligence the time and space it needs to find an appropriate way to proceed.” I read that line and gently set the book on my lap to take pause and think to myself, Thank god.

Another account of being liberated by the right words.

The Unknowing. Yes, that is the landscape we all inhabit now. How do we work with such potent feelings of lack-of-control? A classic solution would be to distract the hell out of ourselves so the low hum of anxiety doesn’t seem as loud. Or, we could try to re-frame our reaction, teach the brain that there could be another approach. 

Our lives are, in many ways, on hold as we await a vaccine to protect our collective physical health. But our mental health is not on hold. Our intellect is under non-stop media siege and our sanity begs to be nourished and protected now more than ever. An essential piece of that puzzle (the puzzle of avoiding going clinical insane, that is)—more so than what’s contained in a bottle or that can be purchased online with a credit card—may very well already live on our bookshelf.

John Welwood also said, “What is fresh and alive comes only from the unknown.” I’m pretty sure I’m going to have that phrase tattooed on my forearm  in old-english script after this whole thing is over. 

May 17, 2020

[wenightmareyou]

92 Truths

michaela @agentdanaascully isabelle @carefuldaughtercas and i found this old tag meme that michaela and i did in 2015 so we’re redoing it 7 years later! i cant believe we’ve been on here this long jfc

(copying all of my old answers and keeping the funny ones bc there are some gems in here)

Once you’ve been tagged, you’re supposed to write a note with 92 truths on it. At the end choose/tag 25 people. (not doing this lmao)

I was tagged by michaela and isabelle in real life lmao

OPTIONAL: NAME: Kodie AGE: 23 Now here are the 92 questions:

WHAT WAS YOUR: 1. last beverage = Tazo awake tea 😌 2. last phone call = my mom lol 3. last text message = isabelle carefuldaughtercas 4. last song you listened to = heaven help us live 5. last time you cried = today listening to heaven help us live lmao

HAVE YOU EVER: 6. dated someone twice = technically? 7. been cheated on = yup 🙃 8. kissed someone & regretted it = yes 9. lost someone special = like as in died? if so yes 10. been depressed = maybe 11. been drunk and threw up = no 😇 

LIST THREE FAVORITE COLORS: 12. RED (keeping this answer the same as 2015 bc im endeared by the all caps 🥺) 13. black 14. yellow

LAST YEAR (2014) (lmao) HAVE YOU: 15. Made a new friend = yes 16. Fallen out of love = no 17. Laughed until you cried = yes 18. Met someone who changed you = yes 19. Found out who your true friends were = obsessed w the 2014 energy radiating off of this question. um yes i do know who my true friends are and i love them 20. Found out someone was talking about you = yes in a good way? 21. Kissed anyone on your [FB, Twitter, Tumblr Etc] List? = no GENERAL: 22. How many people on your [Fb, Twitter, Tumblr Etc] list do you know in real life = i know so many mutuals irl i have no idea,,,, like 20? 24. Do you have any pets = no :( im definitely definitely gonna get either a cat or a bird after i graduate though 25. Do you want to change your name= I really think I will someday actually <—-awww that was my answer in 2015 and i did 🥰 i love my name now, if anything i could see myself changing my last name someday but that depends 26. What did you do for your last birthday = lmao got boba and watched the lost boys with michaela 27. What time did you wake up today = i think 11?

🚨THERES NO 28 🚨 

29. Name something you CANNOT wait for = for Panic! to finally start releasing new music <—LMAOO RIP AT MY 2015 ANSWER 💀 uhhhh the mcr shows this fall/seeing rhys darby on monday!! 30. Last time you saw your mother = maybe a week ago? 31. What is one thing you wish you could change about your life = I wish I could drive <—KEEPING MY 2015 ANSWER BC I STILL CANT FUCKING DRIVE but yeah god i wish 32. What are you listening to right now = the hum of the refrigerator/michaela and isabelle also filling this out rn 33. Have you ever talked to a person named Tom? = tom my best friend tom who’s tom? wambsgans 🥺 but no irl i dont think ive ever met a tom, i just have the fictional one i rotate in my mind 34. What’s getting on your nerves right now= waiting for a text back 🙄 35. Most visited webpage = tumblr dot edu dot gov 37. Nickname = i dont have one :(  38. Relationship Status = single 39. Zodiac sign = scorpio 40. He or She = they 41. Elementary School = tbh i wonder w old ask memes like this what kind of response they wanted. like are they asking the name of your school? are they asking if you enjoyed it? if you remember elementary school? bc honestly i do not remember elementary school, love and light 42. High School = again what do they want w this?  43. College = i miss it! a little bit! 44. Hair color = dark brown/red 45. Long or short = short 46. Height = 5'4" 47. Do you have a crush on someone? = no <3 48. What do you like about yourself? = i like to think im funny 49. Piercings = none 50. Tattoos = none 51. Righty or Lefty: righty

FIRSTS: 52. First surgery= wisdom teeth 53. First piercing = ears but i let them close 54. First best friend = her name was haley 55. First sport you joined = I’ve never actually done a sport before <—love the way i flat out lied when i did this in 2015 lmao. i did cross country for a few months when i was 13 56. First vacation = mexico 58. First pair of trainers = i’m sorry this is such a funny question i don’t know why someone would remember this

RIGHT NOW: 59. Eating = nothing 60. Drinking = tazo awake tea lmao 61. I’m about to = make lunch 62. Listening to = isabelle and michaela still lmao 63. Waiting for = a text back still!

YOUR FUTURE: 64. Want kids? = hmmm maybe? that sounds like a question for future me 65. Get Married? = ^^^ 66. Career? = finishing my last year of law school rn so probably a lawyer unless something drastic happens lmao

WHICH IS BETTER: 67. Lips or eyes = still both! 68. Hugs or kisses = kisses 69. Shorter or taller = taller 70. Older or Younger = preferably same age <—jfc this is still so true 71. Romantic or spontaneous = both! 72. Nice stomach or nice arms = not to be like all stomachs and arms are nice but they are :(( 73. Sensitive or loud = both 74. Hook-up or relationship = no comment 75. Trouble maker or hesitant = sun in trouble maker, rising hesitant, moon in hesitant

HAVE YOU EVER: 76. Kissed a stranger = yes 77. Drank hard liquor = yes 78. Lost glasses/contacts = yes 79. Have dated = yes 80. Broke someone’s heart = i think so? 81. Had your own heart broken = yes 82. Been arrested = no 83. Turned someone down = yes 84. Cried when someone died = yes 85. Fallen for a friend = i’m gay of course

DO YOU BELIEVE IN: 86. Yourself = yes 87. Miracles = maybe? 88. Love at first sight = okay like yes but not in the way where you’re literally in love with them? but i definitely think you can have one interaction w someone and *know* if you had more time together you would fall in love 89. Heaven = yes maybe kind of but also no except when its yes but not actually yes no <3 90. Santa Claus = no 91. Kiss on the first date = lol yes 92. Angels = im copying isabelle and michaela and saying cas 

this was so fun, i cant believe we’ve been on here long enough to make these answers dated and cringy. i’m not tagging anyone but do if you want to! if im still on here in seven more years i’ll do this again lmao

[ktkski2017-blog]

Life in Chogoria

February 6, 2017

Today was day 7 in a row of working at PCEA Chogoria Hospital. For the previous six days Dr. Clark and I have been rounding on the men’s ward (the males and females are split between two inpatient wards – the other wards include surgery, pediatrics, OB/GYN, and private). Over the weekend the coverage reduces and procedures, discharges are somewhat on hold – which makes inpatient medicine with sick people very challenging. We have had several deaths on the men’s side that have been challenging to bear – in Traverse City I have only had one patient pass away on my service and he was very ill in the ICU and opted for comfort measures. Since being in Chogoria there have been six within the last 7days. I take them very personally and a dark place in your mind wonders "is it because of me?” – but then I remind myself how much I advocate for these patients during the day and just how sick they are. We had one guy with a hemorrhagic stroke who had expansion of his bleed due to resistant hypertension – in a ward where the blood pressure cuff works 50% of the time and there is a delay of hours to days when a new medicine order is put in, and where we do not have access to percutaneous intervention. Another patient had severe nephrotic syndrome with recurrent ascites filling his abdomen that was resistant to treatment. He passed away from respiratory failure prior to being placed on dialysis because the machines had been broken for a while and the technician/specialist who could initiate dialysis wasn’t due to arrive for a few more days – he was in his twenties. However - undergoing dialysis is not comfortable. Patients often feel sick when they get dialysis and it usually lasts up 4hours every other day - for the rest of your life - which is ultimately shortened anyways due to the severity of disease required to consider even initiating dialysis. If he had survived long enough to get dialysis, it is quite possible that it would have been an unpleasant and still very much shortened life. Another twenty something year old was emaciated from HIV and the lab technician missed drawing his labs for three days despite reminders and pointing out the patient. I have noticed that patients with known HIV that has progressed to illness and malnutrition tend to get less attentive care from nursing and ancillary services like xray and laboratory. In a system where it is not common for very ill people to not get labs drawn for a few days, this can certainly accelerate patient mortality. However, if you calculate a patient’s prognosis (expected life outcome) due to the severity of their HIV illness, even with top notch medical care you may not extend their lifespan more than a few months or a year once they have become so ill. So perhaps it ends up being the kinder end to pass away with an acute illness rather than drag on living in a hospital for 12 more months with such poor quality of life. It certainly depends on your outlook on life because this can look suspiciously like neglect and bias against those with HIV. In Kenya the idea of Do Not Resuscitate does not work, because culturally this looks like neglect. Palliative care has similar negative connotations in the US and Kenya however is perhaps less welcome in Kenya – in the US I think if more people were educated in what it truly means there would be little resistance whereas here in Kenya, if people were more educated on it they would still resist it.  

While the patient deaths and hospital inefficiency challenges have been difficult (albeit not unexpected), I have had some really great experiences too. I really enjoyed working with Janet and Musa while on men’s inpatient ward. We created a nice team of collaboration and were all engaged with the patients and patient care. There was no oppressive hierarchy – we were all contributing to improve patent wellness. We went out to dinner at Lenana’s with the clinical officers and visiting medical students on Thursday night and had an interesting discussion regarding strikes and protests internationally, prompted by a new national nursing strike in Kenya on top of the already going physician and university strike. The food was lacking (and this was the second time we went to Lenana’s and they had run out of food) but this might be biased by the fact that we asked for pilau w vegetables and received chicken rice with cabbage. We returned for lunch the following day (we had heard their lunch menu typically was more robust) and I was not disappointed with a mashed root vegetable with spinach-like greens. They also have fresh squeezed tropical fruits (sooo good). On Saturday afternoon we hiked the ravine behind our apartment compound to look for a waterfall. Due to the drought we found some boulders and mosquito breeding cesspools, but the view at the top of the boulder pile/head of the ravine was beautiful as we got our first glimpse of Mount Kenya in the background. Chogoria rests in the foothills of the mountain so it is hard to see it with the intervening hills. We had to shower after the walk back on the dusty red dirt road. On Sunday evening we lounged for several hours in Dr. Clark’s backyard, picking vegetables and herbs, reading on her swing, basking in the sunlight (slathered in SPF 30), and she made us dinner that we ate on her front porch with a dessert of papaya, passionfruit, lime, and freshly picked mint. We then played cards until the sun went down while listening to the a capella singing of the several surrounding girls’ schools. We have also been eating significant amounts of tropical fruit (perhaps spurred on by reports of winter storms and below-freezing temperatures back home). Today I had half a mango for breakfast (with yogurt) and probably one third of a yellow pineapple for dessert. Not to mention my avocado grilled cheese I also had today and the taste/trial of horny melon that we had prior to dinner (I think it wasn’t ripe yet – unless it’s supposed to taste like a sour cucumber). Jen picked a papaya from the tree behind Dr. Clark’s backyard and we have our eyes on the avocado tree and neighboring mango trees.

Today we went to Chapel in the morning (every Monday this is a time for the hospital to make announcements and introduce new people). Although the prayer was appx 10minutes long I did stay focused long enough to hear the sermon – there was mention of Trump and his ridiculousness name calling this “so-called judge” and fear mongering in the context of Kenya’s election coming up later this year. The message was focused on putting God first during this challenging time however the guy lost me when he started mentioning the evils of homosexuality and taking religion out of schools. Instead of rotating on the men’s ward today I followed Jason for the morning in the NICU and on pediatrics.

In the NICU incubator is a 35day old infant who was born between 24-26week estimated gestational age by spontaneous vaginal delivery. Today is the day we are going to see how he does outside of the incubator as he is now 1.7kg.

On pediatrics we had to inform a mom that her 11month old had end-stage liver disease. The patient had evidently presented with hepatitis and diagnosis of biliary atresia approximately 6months ago and was referred to Nairobi for a stent placement (to drain the blocked duct) – however when the surgeon opened the abdomen it was obvious that the liver had suffered too much damage so they had to close the abdomen without placing the stent. Since that time the family has been home, however the mother re-presented to Chogoria due to worsening jaundice and poor feeding. The poor baby had ascites, venous congestion with veins criss-crossing the abdomen, jaundice, and was small for her age. The process of explaining the disease and need for palliative care to the mother was challenging to begin with but almost impossible when there was a language barrier. The clinical officer tried however I am unsure whether the empathy was well transmitted.

Another 6year old kiddo who has mysterious systemic lymph node swelling, low platelet counts, hemoglobin, and no obvious derangement on peripheral smear was scheduled for a bone marrow aspiration today. Provi – a US trained physician who was raised in Kenya as a young child – showed such care for him as she carried his small frame from the pediatric ward to the minor theatre (operating room) and held him tight while he had his IV placed. He did so well with the bone marrow aspiration; we did sedate him with ketamine but prior to that he lay calmly on the operating table next to his dad, gingerly holding his new IV site. He has the thickest eyelashes I have seen so far while in Kenya.

Afterwards I rounded with Provi, Lena, and Eric on female medical ward, so I spent the morning getting to know the new group of patients. I was again impressed with Provi’s compassion with patients – it really helps when you are able to speak the same language and you have such good bedside manner. I couldn’t help but duck over to the men’s ward a few times today to check on the status of our more ill patients and wave/smile hello, habari to a few others. This is when I heard of the passing of one of our mystery illness patient’s. He had been encephalopathic for several days after previously being able to chat with us and developing renal failure after we diuresed him from heart failure exacerbation. He likely had severe sepsis from an unknown source, likely meningitis, however the empiric antibiotics we started were not sufficient to overcome his illness. A point-of-care cardiac ultrasound performed earlier today showed a barely pumping heart. We actually received some lab results back on him after he had passed away – he had an INR of 50 suggesting systemic coagulopathy. We were unable to perform a CT scan of his brain to rule out stroke versus infection as he was not on the national insurance plan and his family had not come to visit him so we had no one to pay for it – in Kenya you pay for the procedure or imaging prior to it being performed. If you cannot pay, you cannot get the procedure.