#the cardiologist tells me its anxiety

[cextra-loz]

The longer it takes for my doctors to prescribe me anything other than metoprolol the more powerful my rage and fury becomes.

[randomestfandoms-ocs]

Ok yes hi tell me all the headcanons and vibes for that Richie & Kirsty au? 🥺

okay okay so it all started bc in one episode I watched yesterday, one of the challenges was learning a swing dance routine and of course my first two thoughts were "twins at the danceathon" and then "twins on the amazing race"

(warning, in my mind this is delicate-verse, just don't ask the logistics of when Richie is the first gentleman idk)

so first of all, amazing race always loves a Story™ with its competitors so of course i mean, you've got this set of twins raised by a single teen mom, completely non contact with their bio father. Richie overcoming a severe anxiety disorder to be on the show, being all but disowned by his grandmother (and actually disowned by his dad’s parents) for his sexuality, married to the first openly queer (and polyamorous, and latino) president of the United States, became a cardiologist primarily as a response to his grandfather’s two heart attacks and his twin sister’s near-fatal heart condition. Kirsty battling alcohol and drug abuse as a teenager, having her first two children at 18, professional ballerina and former Broadway actress who had to quit after almost dying in labour due to a heart condition, and so many injuries that she was told she’d never be able to dance again. The twin dynamic, really raising each other, Richie being the one to get Kirsty sober and to be her primary support through all of her health issues, Kirsty being a surrogate for Richie’s daughters despite the risks to her own health, both twins having service dogs, maybe something about how Kirsty had lost out on a lot of dreams for her life because of her heart (particularly after the triplets) and she used to love the show, and despite his anxiety Richie wants to give her a chance to still (relatively safely) have some of the experiences that she thought she’d never get to have.

But also the vision for the challenges, Kirsty wanting to do all the adrenaline ones (bungee jumping off a cliff especially) and Richie for sure doesn’t want to but is also very worried about her, all the time spent in the car and the camera crew keep getting the most precious clips of him getting her comfortable for the drives, Richie showing everyone up at puzzles, both of them and all of their very random trivia knowledge from Lorelai and their knowledge of different languages, and they quickly become everyone’s favourite because when they start to struggle, most teams I’ve seen get snippy with each other and start blaming each other and fighting and can get kind of nasty but the twins always just take a minute to hug, breathe, and either try again or decide together if they need to take a break (or a penalty)

And then I just have a vision of the story through some gifs of the twins doing interviews & of challenges but mostly being told through social media (mainly twitter) edits of people watching the show and reacting to it (eg - user: I don’t even think I’m as careful getting my kids into car seats as Richie Gilmore is when he’s getting his sister in the car / user: okay but kirsty finishing the bungee jump and then stopping to show richie that she’s okay before getting a clue? my sister would have pushed me off the cliff without the harness)

This has been 98% of my brain capacity for the last 24 hours it’s a problem

[fragmentedink-archived]

🫠 the cardiologist is telling me he doesn't think its pots. AND HE REALLY BLAMED ANXIETY AND STRESS FJSGHSGSHS. I'm actually either going to start crying or laughing lmao. he said he didn't think I needed a tilt table test BUT e wants to put me on a beta blocker and wear a HEART MONITOR but i don't need a tilt table test and I don't have pots. it's just anxiety and stress and dehydration even tho there was a difference in my bpm of 30 beats from laying down to standing up

as soon as I saw it was a male doctor my stomach dropped and he did exactly what I was worried he was going to do. I know the difference between MY ANXIETY and THESE SYMPTOMS. I literally feel like I'm dying but noooo I'm just anxious and stressed out 😖

[ed-recovery-affirmations]

So I hope you don’t mind my rant 🪻

Basically Ive been fighting my undiagnosed issue for years. I dont feel valid enough to call it an ED. But basically I went through a very stressful time years ago leading me to severely restrict my intake and only eat one meal a day which obviously lead to weekly binges. I purged everyday for several months. Lost a significant amount of weight. When the stressor left I maintained my new lower weight . the behavior persisted for years albeit to a lesser extent.

I had come to a place where while self conscious i was somewhat healthy. I ate well and enjoyed cooking and baking. I had treats without worries. I loved dancing and actually had energy to exercise and adored it. I did struggle with a constant urge to exercise though. Id been purge free for an entire year and I have been binge free for a few years

April comes and the stress of that time throws me back into restriction. At first I tell myself its okay. I make an effort to harm reduce and I eat three meals a day. Even with taking vitamins and exercising and losing weight the so called healthy way I have stomach pains and bloating, Im exhausted.

It continues and worsens and I restrict lower and lower. Often skipping a meal or only having one. My fatigue is terrible, I struggle to sleep and my anxiety is out of control. My skin is dry. My stomach gets painfully full easily. I am emotional. I cry all the time. I have sharp chest pains and I am cold. I an constantly dizzy and it is hard to breath when I stand up.

I am barely underweight. But I want to feel better.

Ive already been to the doctor twice but was too afraid to come forward about the restriction. Im going to a cardiologist soon.

Here is the real issue. I lied on the mental helath screening bcs I was afraid of being committted into a psych ward and My pcp recommended therapy. I made an appt and then cancelled. Since my anxiety is now so bad i cant manage i call to reschedule and try it and give it an honest effort.

Just the thought of going made me so upset I began purging again half of me wants to hide my issue from my therapist or cancel and the other half wants to come forward and see about getting help. This is also encouraging me to lose more because i feel i have to be sicker in order to get a diagnosis or be deserving of help. Im also so afraid of being committed or going to inpatient. It is my biggest fear. What do I do ?

I don't mind your rant, anon. It sounds like you're dealing with something really difficult and I think you are indeed allowed to call it an eating disorder.

I can understand your fear around being diagnosed, as it can change your life significantly. At the same time, anon, you will not be able to get help unless you take the steps to reach out for it (and follow through on them!) I know it's really hard and really scary, especially the thought of going to inpatient.

I get a lot of people saying "I feel like I need to be sicker." However, on the flipside, imagine all the people who've done lasting health damage to themselves, who may wish they'd gotten help before they'd gotten as sick as they did! An eating disorder is an eating disorder, and all sufferers deserve the opportunity to get help for the underlying cause of their disorder no matter what stage of ED they're in. You don't have to get "sick enough" to validate the fact that you're suffering. You can validate it to yourself. In fact, let me say it to you, anon. I see you. I see that you're suffering. You are worthy and deserving of help and support. I wish you healing.

(I'd like to add a sidenote here that just because you don't feel you look emaciated doesn't mean you aren't sick. Most human bodies have a LOT of safeguards against weight loss, especially in individuals who have a pattern of restricting, eating again, restricting, eating again...your body can still be struggling and deprived of nutrients even if it's stubbornly refusing to let go of pounds to try and keep you alive. It sounds as though your body is trying to express its distress to you in other ways, but are you ready to listen to it? That's up to you.)

I think you need to ask yourself what self-care steps you need to take in order to schedule a therapy appointment and stick to it. I think you know that the urge to comfort yourself by purging is counterproductive. What other things can you do to self-soothe in a healthy way? What are some small comforts you can use to show your body that you believe it deserves comfort and compassion while you work up the nerve to re-schedule?

When you do go to therapy, perhaps you could write down a script of stuff you're ready to talk about and stick to that script. A good therapist will gently push you but will also let you go at your pace and will not force you to talk about things that you're not ready to talk about. If you don't feel that connection with the therapist you meet, you can always search for another one. Yeah, I know, it's really hard to go through those steps AGAIN when you're already struggling so much. It's important, though. And when you're done, perhaps you can reward yourself with a treat. It doesn't have to be a food treat, if you are not at a point where you can effortlessly enjoy food. It can be any little thing that makes your body or soul feel rewarded, a fancy soap or a bath bomb, some art supplies or a little home decoration. Anything that helps you focus on giving yourself some love without engaging in ED behaviors.

You can go to cardiology, but until you're honest about what's straining your body, you'll only be putting band-aids on a much bigger gaping wound. I mean, still go to cardiology. But I think you know that you need to start treating the disorder, and finding ways to stay out of the disorder when stressful times come around.

I also want to address your fears around inpatient treatment. A lot of doctors and counselors will be willing to work with you around an outpatient treatment plan if you show that you want to heal and feel better and are willing to keep working toward that end. However, some people do end up in inpatient and I know it's scary to end up in a new environment and feel like all your control is being taken from you. But remember, while being able to engage in ED behaviors feels like you're controlling your life, every time you do it, the eating disorder takes more control of YOU. Think about it. You're already struggling. You're engaging in behaviors that take away the energy and time you had for the true joys in your life. You want medical professionals to help you, but you're not giving them the full range of information to help you. Do you feel like you're really in control of your life right now?

If you show willingness to work outpatient, I think your supports will probably work with you on this. However, I cannot 100% promise you will not end up needing to do inpatient. I know that's scary. You're allowed to be scared! I invite you to sit with that feeling and hold compassion for yourself and know that you're not the first person to ever be scared of going into inpatient. You also may have to talk about the possibility while seeking treatment. It's okay to be scared, I hope you know that. That's why I suggested bringing a script to therapy, so you can give your therapist a baseline for what you're able to confront right now. A good therapist will develop a rapport with you so that you feel safe working through scary topics. Healing is not the absence of fear, but knowing you have a safe person equipped with tools to help you cope with fear. Someone who will meet you with compassion, not judgment, and lay out your options for you in a way that you understand.

I wish you the best of luck in this difficult journey, anon. I hope you find healing.

[wawawawawawawawawawawawawa]

It wasn’t even a cardiologist who prescribed them to me either!!! In theory they were supposed to be a safe bet because they had been prescribed to me in the past (for social anxiety,, by a psychiatrist who didn’t gaf abt me,,, & I never even really took them).

But that was before I found out they could cause hallucinations!!!! And sometimes??? something else called Toxic Psychosis???????? Don’t know what the FUCK that is!!!!

I’m also still supposed to see a cardiologist and get one of those 24/7 halter monitors, but I just keep putting it off.

(It’s bad I know - but I gotta call and make an appointment and then drive across town to MAYBE get the fuckin thing)

Also Metoprolol is another one that is known to more commonly cause hallucinations and stuff too, since both Metoprolol and Propranolol are both lipophilic agents.

| Metoprolol 🤝Propranolol |

Psychological warfare

This covers it better/goes into it more ->

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7292560/#:~:text=The%20phenomena%20of%20nightmares%20and,monoamine%20and%20metabolite%20of%20serotonin).

- 💛

YOWHAT my first peracription for propanolol was ALSO for anxiety, ALSO by a psychiatrist who didnt gaf abt me!!! i told the story a while back but she treated me like i was [SLUR REDACTED] once she pegged me as autistic and tried to UNdiagnose me with aspd and diagnose me with bpd. the SECOND TIME SHE SAW ME!!! like its clear she just thought i had bpd bc i was autistic and traumatized and she saw me as a woman and That's The Traumatized Girl One!

do i aktually have bpd? iunno, i cant trust these cucks!!! i do have some traits of it tho nglllll but just traits teehee. funny enuf i had an oc back in 2018, way before my diagnoses, who had aspd/npd with bpd traits. what in the foreshadowing

ANYWAY toxic psychosis sounds like some new buzzword the narc abuse people made up. i am afraid to know what it ACTUALLY is bexause it sounds really very not good

GO SEE THE HEART DOCTOR!!! the sooner u get ir it done the sooner its OVER WITH!!! also if u get the kind that sticks to ur chest, tape it down when u sleep or wear a REALLY tight shirt, otherwise itll peel in the morning. like the tape tjar keeps it on u yk. tell then ur having CHEST PAIN. doctors donf fuck around with chesr pain. if u can somehow trigger a heart episode in urself that would also be poggers. anything to get them to listen but yeah say u have CHEST PAIN and u can feel ur heart beating in ur chest. worked for me!!!

also ty for the studuy!! ill read it 2morrow and make sure to NOT get metoprolol cuz ion want a repeat of the SAME ASS PROBLEM or worse.......a worse peoblem

[fallinghorizontally]

I come here again hat in hand, sack hanging off a stick behind my shoulder, and praying for answers from myself lol

My anxiety is still so fucked. Feeling new symptoms that are just so fucking rude to me. Always related to my heart. I've been 2 cardiologists' guinea pig for the past 6 months and nothing has been found. I feel like I know its anxiety but I just cannot break through this illusion. Recently had a spell of panic attacks which are a lot rarer these days though. I feel like I have the answer right at the tip of my tongue like I just need an epiphany like those movies where everything falls into place when the asshole looks off in the distance when he hears the most ambiguous shit. I really wish shit was like the movies. Anyway I decided to write here again because of some dreams I've been having.

My sleep schedule has been so fucked this past week. I literally sleep during the day. Anyway, I've had really meaningful dreams these past two nights or days? idk whenever I sleep. Yesterday, I dreamt about my mom. I think we get into an argument? Something she says deescalates me or rather unlocks something in me, it makes me fall into a little boy again but not physically only mentally, I go to hug her, and I tell her how scary it was and I'm assuming what I meant was everything my step father put me through. I ask her why she didn't help me but she just continues hugging me. I woke up sobbing.

My next dream was about my father, only he wasn't actually in it. It was about my uncle, his brother and my grandma, his mother. I was in a home but it didn't belong to them, it was where I visited them at, though. I told them that I've been having trouble with school and that im struggling really bad. They begin to berate me and they become agitated and they ask what's wrong with? and why can't I try harder? Usually irl, they're very docile and quiet and reserved but not in this dream. The berating goes on for a while until I snap and yell and ask," why couldn't you say all this shit when I was a little boy? Why not try harder for me instead of watching me fail my whole life?" Anyway I started sobbing again but this time I cried harder when I woke up.

After I woke up and cried a bit an then came to my senses, I quietly said wow im actually pretty fucked. Always thought I was over everything, holding no grudges. Staying stoic or whatever the fuck kind of man the world wants me to be. But im not, im soft, sensitive, and really fucking hurt and I don't know what to do about it.

[nathank77]

5/14/24

7:18 p.m Added to/Edited

I fell asleep by 6 a.m. The combo of the 3 knocked me the fuck out. I woke up at 12 and I really needed to pee but I didn't let myself bc I wanted one more hour. So I fell back to sleep after hearing a sorta scream from my auditory hallucination cause yea that's how I know I'm falling back to sleep....

Then I woke up at 1 p.m, I used the bathroom and decided to get my bloodwork done for my thyroid bc I had to do it sometime this week or next. Last month I did it on the 16th of April. So the 14th isn't too bad. I had extra time and made the appt at 2 p.m and then made it to my doctor's at 3:15 p.m.

I didn't have much to talk to her about. I mentioned very briefly that I didn't sleep well for a couple weeks of April. I was very brief. I told her the Hydroxyzine with the Xanax helps me stay asleep longer. I brought up the ER visit and my cardiologist appts. I asked her about the right branch block and it could be bc of the wire placement. So that's hopeful. I also showed her my tongue again. And I asked to get my testosterone levels pulled before my next shot. So that's scheduled for next week right before my testosterone shot. I got to be there at 3:30 p.m now cause I haven't had my levels done in a very long time. Granted I've been on the same dose 99% of my whole journey on testosterone. For a few months I was on 1.1 instead of 1 ML but other than that it's been consistent.

She was okay with seeing me in August for my physical but I was like well I always have problems so she had me schedule something for July to see me after my cardiologist appt. She also gave me 25mg of metopolol. Incase. My heart rate was 103 there which is high.

I was in another room so idk if its accurate but appearantly I'm 179 pounds now. Which means I lost another 2 pounds since last week... was it bc the scale is slightly off? Or is my dieting continuing to cause healthy weight loss? With the combination of white mulberries? Or am I hyper? I'll at least find out if I'm hyper, Hypo or normal soon from the Bloodwork..

I'm worried that she's loosen the leash and not going to give me Xanax anymore... she didn't say that but she was keeping a tight leash on me wanting to see me every month or month and a half and then she was okay with seeing me in August at the end of August... that's why I was like umm I'd like to see you sooner... idk. She was just happy I'm sleeping and getting better quality sleep. I don't really think she's taking it away or going to perscribe a placebo if she ever did cause- I had heart palpitations which are withdrawal effects and my brief mention of not sleeping well for a couple weeks of April will tell her if I ever was prescribed a placebo it did not work as well as the actual medication...

But who knows if it was a placebo or not. And I know I'm just worried cause like I know Xanax is the only reason I fall asleep. She's prob just loosen the leash cause I'm not asking for more and I'm on top of my health. If I didn't have the physical I'm sure she would have wanted to see me in a couple months.

Yet I worry. But we will see. I don't think she's going to take it away/ give me a placebo but I can't help but worry.

Also i gave her my paperwork for the MRI and I should be able to schedule that tomorrow hopefully before the 28th bc if I don't get it done by then I can't get it done.

I went out for waters cause I didn't plan to today but I realized I needed them... and I didn't want it on my list of things to do tomorrow cause I was supposed to go grocery shopping tomorrow and knowing I needed waters would have gave me extreme anxiety and panic.... potentially panic attacks.. it might have effected my ability to sleep.

I grabbed some food and other stuff. I got to go back to the grocery store Friday for other stuff.. the waters was the hardest part bc of the panic but i haven't seen the gross POS for a few weeks.. I hope they fired him but that's happened before I just didn't see him for a couple weeks and then all of a sudden he was there again.

I'm going to new Hampshire prob Saturday. I got to schedule my oil change at Firestone for prob may 28th. My Dr's appts are finally slowing down. I'll prob go to Southington at 5 pm.

Next month i have like the cardiologist on the 26th and just my biweekly Testosterone shot. July I have my insomnia appt and my biweekly Testosterone appts as well as my ENT visit which I think my hearing is getting worse... but whatever I just won't wear my hearing aids so I can find a girl friend...

This month I still got my disability appt at 1:30 Friday...... and I have the dentist next Tuesday at 4:30 as well as my testosterone bloodwork and shot on Wednesday at 3:30... but after next week things will start to slow down. Just got to get disability out of the way, new Hampshire, my testosterone shot and the dentist.... and ideally my oil change which I can charge to my credit card and keep my Firestone card active...

Anyways as of last night I started taking 2000mg of White mulberries... I feel like I noticed almost immediate progress. I'm going to do 2000mg a day unless I get undesired side effects. I had some silence while I wrote my poetry... some. Still not allowed to think about my hallucination without hallucinating but either way I think the combo of 100mg of cbd and 2000mg of white mulberries could help facilitate the pathway and build healthy connections. I just got to work through the narrative the hallucination created.

It says, "the bussy cunt" and it may not be able to finish the sentence sometimes but I have been, "filling in the blank." Bc I heard the phrases so clearly and learned them and it broke my brain in so many more ways than just this constant hallucination... it says, "the bussy cunt" and even if i think a dominant thought like I need to make a sandwich... my back thought is, "feels bad for deadname last name.".. so I'm trying to change the narrative at least saying, feels bad for Nathan last name... but it's hard.

That's the issue it FUCKS UP YOUR WHOLE BRAIN..

Hopefully this combination of supplements make a difference. Idk.

And I hope that I'm really 179 and I'm normal levels... I also hope that my heart rate was only that high bc I was at the doctors White coat syndrome or whatever but who knows. Maybe I'll make it to 170 idk that's hopeful. I'd love to make it to 165. I'd fucking hit the fuck out of that gym.

[ilhoonftw]

never had an attractive doctor or an ultrasound but I totally get what you mean 😬 can you imagine having a hot guy as your gynecologist? I'd probably ask him to buy me dinner first lmao

ultrasounds are awkward in general (no matter which bodypart) but goodlooking person doing them... just adds more pressure 🙈 all gynos in my area are old men who are about to retire and don't take you seriously god bless female doctors in their 30/40s who are actually trying. goodlooking doctors are dime a dozen, it's just lately i had strange luck lmaoo

[pettydavis]

the problem with mental illness and going to the doctor is that medical professionals will often write ur physical symptoms off as a product of anxiety when its like. im TELLING you, ive had a specific pain over a period of time thats consistent and NOT going away. you cant keep chalking it up to “oh youre just over-worrying”. and this is an even bigger issue when youre black because ppl ALREADY dont take our ailments seriously.

[what-do-1000-swords-look-like]

5x01 Hospital Scene

This whole scene, under the surface, is about Eddie (and Buck with a little of Ana). The dialogue alone absolutely cements it:

Dr. Salazar: “Well, it’s not a heart attack.”

Ana: “Oh, thank God.”

Eddie: “It wasn’t?”

Dr. Salazar: “You sound disappointed.”

Eddie: “No, just surprised. It sure felt like one.” While this dialogue mirrors Eddie's and Lena's from the grocery store in 3x05 about the guy he beat up (a stand-in for Buck) and confirms that this is Eddie's season 3 arc peeking its head up, this also is wordplay for the real heart of the issue: Eddie.

Dr. Salazar: “Panic attacks can often present as heart attacks.”

Eddie: “That’s not what this was. It’s not possible, I don’t panic.”

Dr. Salazar: "Because you're a guy?"

Christopher: "And a firefighter."

Dr. Salazar: "Now that's a stressful job."

Eddie: "This didn't happen on the job." (notice Eddie's glance over at Ana here and then his look back to the doctor, his jaw tightening - this is clearly about something relating to the job and this panic, otherwise why would he be so defensive? And why did he glance over at Ana quickly but we're not shown her reaction?)

Dr. Salazar: “Panic attacks aren’t rational, Mr. Diaz. But they can be an indicator of some underlying anxiety. Have you experienced any lifestyle changes recently? Any new stressors?”

Eddie: “No. Nothing. It’s been great. Right?” (Ana stays quiet when he looks to her - I think here he was looking for her to confirm that everything has been great but she's not being supportive but she's also not calling him out on how things haven't been great, she's staying quiet aka neutral)

Christopher: “He got shot.”

Ana: “Eddie was shot four months ago on duty. He almost died.”

Eddie: “He’s dead and I’m not. I don’t even think about him anymore.” (this clearly is not about Ethan; the way Ryan delivers this line almost reminds me of that scene with Eddie and Bobby in 4x06 where he says "I'm still not over it. Over her." - Eddie is referring to someone else here and I'm pretty sure we all know who that someone is)

Dr. Salazar: “That could be called repression.” (this confirms this isn't about the sniper, this is about Eddie and that someone else)

Eddie: “Or just moving forward.” (the fact that Eddie is staring ahead as he says this, that he's been making eye contact with Dr. Salazar this whole time when she speaks but in this one moment he doesn't, speaks volumes - and it's the final nail in the box proving that this particular part of the dialogue is about that someone else)

Dr. Salazar: “Maybe.”

When the doctor tries to give him the pamphlet and he says he won’t be needing it but dr is insistent, Eddie looks to Ana again, she gives him a look, and he takes it saying “Fine. I don’t panic.”

Bottom line is, the fact that a cardiologist is telling him that he may be repressing anxiety about an event, in an episode that's all about heart, where he gets triggered to panic by his friend being called Christopher's mom by accident, where Buck kept insisting that he and Ana are about to take the next step, two episodes after Carla told him to follow his heart, that he thought he had a heart attack because it felt like the real thing but instead turned out to be a panic attack...all of this is about Eddie and something else (despite the trauma and anxiety) he is repressing, that he's refusing to deal with or give voice to. This whole dialogue contains serious subtext and the fact that Tim and Juan chose to use the word "repression" in this scene is loud. They could have used any other word to describe that action. But no, they chose that one, purposefully.

And looking at this scene through the subtext lens, Ana's reactions alongside Eddie's with Christopher speaking up when needed make a hell of a lot more sense than the scene actually called for.

Eddie having some serious realizations about himself is on the docket. This scene confirms it. It's just a matter of getting him past the denial stage, and to stop doing what he thinks everyone else expects him to do, and following his own heart like he was advised to.

[lastoneout]

So my doctors appointment went kinda meh?

She did give me the referral I needed for the eye place I'm going to on Friday who will likely be doing the MRI I need to figure out whats up with my brain, or at least rule out a tumor anyway. And she also referred me to a new rheumatologist which is nice cuz the old one never really listened to me and talked super fast and diagnosed me in like 2 seconds which sucked. She also prescribed me a beta blocker to help with my rapid heart rate and slightly elevated blood pressure, which will also hopefully help my anxiety and manage my migraines better, which is also nice.

But she kinda wasn't really listening to me either. I told her that two doctors have recommended that I be evaluated for MS, and another one(the physical therapist that SHE referred me to) says I should be evaluated for EDS, but she was kinda squirrely about it and said that "zeroing in on a specific diagnosis doesn't make sense at this stage" which was like?? What?? If I have MS or EDS or POTS isn't it good to start at least ruling other things out, because if I have any of those, especially fucking MS, I need to know soon so I can get treatment before things progress to far??

She also gave me the "well you aren't very active" speech when I brought up my heart rate even tho I told her that I would LOVE to be more active, but one my more sedentary lifestyle is due to my debilitating chronic pain and migraines, and two I dont think me being lazy can cause me to go from 94bpm to fucking 125bpm when all I did was stand up. She also said that "well it could be caused by anxiety" even tho I repeatedly stressed that my anxiety meds have never helped my heart rate and this happens no matter how anxious I feel. I mean at least a beta blocker is supposed to help with the migraines and anxiety and is a treatment for POTS, but I def feel like she's just throwing pills at me to make me go away.

And thankfully she did refer me to a new rheumatologist because she said that MS and EDS are autoimmune conditions and so that type of specialist would be the one to evaluate me for them. So hopefully I can get that doctor to fucking listen to me about whats going wrong. I was also kinda miffed cuz she kept asking me if I've ever dislocated a joint or if my skin is really soft and tears easily when I know for a fact not all types of EDS have those symptoms, on top of the fact a friend who has EDS and studies this stuff said that you can repeatedly dislocate joints without ever noticing it with EDS. My primary also didn't listen when I told her I have a family history of hyper mobility so that was fun.

I really would have liked to be referred to a cardiologist or a neurologist but maybe if another specialist reccomends that I can get it in writing and she'll actually do it. Cuz I def think I'm going to have to be incredibly insistent on both getting a physical, paper copy of my files and that the specialists send my chart over to my primary as soon as possible. Cuz yeah I really don't think she's gonna listen to me unless I have written instructions from another doctor.

Oh she also told me to monitor my blood pressure cuz there can be interactions between my Adderall an my beta blocker but then like didn't tell me what the readings I need to look out for are. So that was fun. Gonna call them today and be like "um hello wtf are good or bad blood pressure readings??" Plus my heart rate is actually still spiking when I stand, but its more from 86bpm to 96bpm so that not as bad I guess.

So yeah, good and bad I guess. I'm honestly probably gonna find a different primary at some point, but for now I'm kinda stuck with her cuz my insurance won't pay for the ophthalmologist I'm seeing if my primary didn't refer me and she's my primary. But I'm also gonna call a physical therapist my friend knows who specializes in EDS and see if he can help either with the pain or just with getting either my primary or my rheumatologist to fucking listen to me about all this.

[petulantskeptic]

Death of the calorie

For more than a century we’ve counted on calories to tell us what will make us fat. Peter Wilson says it’s time to bury the world’s most misleading measure BY PETER WILSON The first time that Salvador Camacho thought he was going to die he was sitting in his father’s Chrysler sedan with a friend listening to music. The 22-year-old engineering student was parked near his home in the central Mexican city of Toluca and in the fading evening light he didn’t notice two tattooed men approach. Tori Amos’s hit, “Bliss”, had just started playing when the gang members pointed guns at the young men. So began a 24-hour ordeal. Strong willed and solidly built, Camacho was singled out as the more stubborn of the pair. He was blindfolded and beaten. One robber eventually threw him to the ground, put a gun to the back of his head and told him it was time to die. He passed out, waking in a field with his hands tied behind his back, almost naked. Camacho survived but, traumatised, he sank into depression. Soon he was drinking heavily and binge eating. His weight ballooned from a trim 70kg to 103kg. That led to his second near-death experience, eight years later, in 2007. He remembers waking up and blinking at bright lights: he was being wheeled on a stretcher into a hospital emergency ward, with an attack of severe arrhythmia, or irregular heart beat. “A cardiologist told me that if I didn’t lose weight and get my health under control I would be dead in five years,” he says. That second crisis forced Camacho belatedly to deal with the trauma of the first. To help with what he now understands was post-traumatic stress disorder, he started having counselling and taking anti-depressants and anti-anxiety drugs. To address his physical health, he tried to lose weight. This effort propelled him to the centre of one of the most fraught scientific debates of our age: the calorie wars, a fierce disagreement about diet and weight control. Today, more than a decade after his cardiologist’s stark warning, Camacho lives in the Swiss city of Basel. He is relaxed and confident, except when two topics come up. When he recounts his kidnapping his gaze drops, his smile vanishes and he becomes noticeably quieter, although he says his panic attacks have virtually disappeared. The other touchy topic is weight control, which causes him to shake his head in anger at what he and millions of other dieters have gone through. “It’s just ridiculous,” he says with exasperation and a touch of venom. “People are living with real pain and guilt and all they get is advice that is confused or just plain wrong.” The guidance that Camacho’s doctors gave him, along with a string of nutritionists and his own online research, was unanimous. It would be familiar to the millions of people who have ever tried to diet. “Everybody tells you that to lose weight you have to eat less and move more,” he says, “and the way to do that is to count your calories.” At his heaviest, Camacho’s body-mass index – the ratio of his height to his weight – reached 35.6, well above the 30 mark that doctors define as clinically obese. Most government guidelines indicated that, as a man, he needed 2,500 calories a day to maintain his weight (the target for women is 2,000). Nutritionists told Camacho that if he ate fewer than 2,000 calories a day, a weekly “deficit” of 3,500 would mean that he would lose 0.5kg a week. With a desk job as a planning engineer in a Mexican hospital, he knew it would take real discipline to trim his pudgy frame. But as his kidnappers had quickly realised, he is an unusually determined character. He began getting up before dawn each day to run 10km. He also started accounting for every morsel of food he consumed. “I filled in Excel spreadsheets every night, every week and every month listing everything I ate. It became a real obsession for me,” says Camacho. Out went the Burger King Whoppers, fried tacos packed with pork and cheese, and tortas (Mexican sandwiches filled with meat, refried beans, avocado and peppers). Out too went his usual steady flow of beer and wine. In came carefully measured low-fat cheese and turkey sandwiches, salads, canned peach juice, Gatorade and Coke Zero, with three Special-K low-calorie diet bars a day. “I was always tired and hungry and I would get really moody and distracted,” he says. “I was thinking about food all the time.” He was constantly told that if he got the maths right – consuming fewer calories than he burned each day – the results would soon show. “I really did everything you are supposed to do,” he insists with the tone of a schoolboy who completed his homework yet still failed a big test. He bought a battery of exercise monitoring devices to measure how many calories he was expending on his runs. “I was told to exercise for at least 45 minutes at least four or five times a week. I actually ran for more than an hour every day.” He kept to low-fat, low-calorie food for three years. It simply didn’t work. At one point he lost about 10kg but his weight rebounded, though he still restricted his calories. Dieters the world over will be familiar with Camacho’s frustrations. Most studies show that more than 80% of people regain any lost weight in the long term. And like him, when we fail, most of us assume that we are too lazy or greedy – that we are at fault. As a general rule it is true that if you eat vastly fewer calories than you burn, you’ll get slimmer (and if you consume far more, you’ll get fatter). But the myriad faddy diets flogged to us each year belie the simplicity of the formula that Camacho was given. The calorie as a scientific measurement is not in dispute. But calculating the exact calorific content of food is far harder than the confidently precise numbers displayed on food packets suggest. Two items of food with identical calorific values may be digested in very different ways. Each body processes calories differently. Even for a single individual, the time of day that you eat matters. The more we probe, the more we realise that tallying calories will do little to help us control our weight or even maintain a healthy diet: the beguiling simplicity of counting calories in and calories out is dangerously flawed. The calorie is ubiquitous in daily life. It takes top billing on the information label of most packaged food and drinks. Ever more restaurants list the number of calories in each dish on their menus. Counting the calories we expend has become just as standard. Gym equipment, fitness devices around our wrists, even our phones tell us how many calories we have supposedly burned in a single exercise session or over the course of a day. It wasn’t always thus. For centuries, scientists assumed that it was the mass of food consumed that was significant. In the late 16th century an Italian physician named Santorio Sanctorius invented a “weighing chair”, dangling from a giant scale, in which he sat at regular intervals to weigh himself, everything he ate and drank, and all the faeces and urine he produced. Despite 30 years of compulsive chair dangling, Sanctorius answered few of his own questions about the impact that his consumption had on his body. Only later did the focus shift to the energy different foodstuffs contained. In the 18th century Antoine Lavoisier, a French aristocrat, worked out that burning a candle required a gas from the air – which he named oxygen – to fuel the flame and release heat and other gases. He applied the same principle to food, concluding that it fuels the body like a slow-burning fire. He built a calorimeter, a device big enough to hold a guinea pig, and measured the heat the creature generated to estimate how much energy it was producing. Unfortunately the French revolution – specifically the guillotine – cut short his thinking on the subject. But he had started something. Other scientists later constructed “bomb calori­meters” in which they burned food to measure the heat – and thus the potential energy – released from it. The calorie – which comes from “calor”, the Latin for “heat” – was originally used to measure the efficiency of steam engines: one calorie is the energy required to heat 1kg of water by one degree Celsius. Only in the 1860s did German scientists begin using it to calculate the energy in food. It was an American agricultural chemist, Wilbur Atwater, who popularised the idea that it could be used to measure both the energy contained in food and the energy the body expended on things like muscular work, tissue repair and powering the organs. In 1887, after a trip to Germany, he wrote a series of wildly popular articles in Century, an American magazine, suggesting that “food is to the body what fuel is to the fire.” He introduced the public to the notion of “macronutrients” – carbohydrates, protein and fat – so called because the body needs a lot of them. Today many of us want to monitor our calorie consumption in order to lose or maintain our weight. Atwater, the son of a Methodist minister, was motivated by the opposite concern: at a time when malnutrition was widespread, he sought to help poor people find the most cost-effective items to fill themselves up. To see how much energy different macronutrients provided to the body, he fed samples of an “average” American diet of that era – which he believed to be heavy in molasses cookies, barley meal and chicken gizzards – to a group of male students in a basement at Wesleyan University in Middletown, Connecticut. For up to 12 days at a time a volunteer would eat, sleep and lift weights while sealed inside a six-foot-high chamber measuring four feet wide by seven feet deep. The energy in each meal was calculated by burning identical foods in a bomb calorimeter. The walls were filled with water, and changes in its temperature allowed Atwater to calculate how much energy the students’ bodies were generating. His team collected the students’ faeces and burned that too, to see how much energy had been left in the body in the digestion process. This was pioneering stuff for the 1890s. Atwater eventually concluded that a gram of either carbohydrate or protein made an average of four calories of energy available to the body, and a gram of fat offered an average of 8.9 calories, a figure later rounded up to nine calories for convenience. We now know far more about the workings of the human body: Atwater was right that some of a meal’s potential energy was excreted, but had no idea that some was also used to digest the meal itself, and that the body expends different amounts of energy depending on the food. Yet more than a century after igniting the faeces of Wesleyan students, the numbers Atwater calculated for each macro­nutrient remain the standard for measuring the calories in any given food stuff. Those experiments were the basis of Salvador Camacho’s daily calorific arithmetic. Atwater transformed the way the public thought about food, with his simple belief that “a calorie is a calorie”. He counselled the poor against eating too many leafy green vegetables because they weren’t sufficiently dense in energy. By his account, it made no difference whether calories came from chocolate or spinach: if the body absorbed more energy than it used, then it would store the excess as body fat, causing you to put on weight. That idea captured the public imagination. In 1918 the first book was published in America based on the notion that a healthy diet was no more complicated than the simple addition and subtraction of calories. “You may eat just what you like – candy, pie, cake, fat meat, butter, cream but count your calories!” wrote Lulu Hunt Peters in “Diet and Health”. “Now that you know you can have the things you like, proceed to make your menus containing very little of them.” The book sold millions. By the 1930s the calorie had become entrenched in both the public mind and government policy. Its exclusive focus on the energy content of food, rather than its vitamin content, say, went virtually unchallenged. Rising incomes and greater female participation in the workforce meant that by the 1960s people were eating out more often or buying prepared food, so they wanted more information about what they were consuming. Nutritional information on foodstuffs was widespread but haphazard; many items carried outlandish claims about their health benefits. Labelling became standardised and mandatory in America only in 1990. The emphasis and use of this information shifted too. By the late 1960s, obesity was becoming a pressing health concern as people became more sedentary and started eating highly processed foods and lots of sugar. As the number of people who needed to lose weight grew, changing diets became the focus of attention. So began the war on fat, in which Atwater’s calorie calculations were an unwitting ally. Because counting calories was seen as an objective arbiter of the health qualities of a foodstuff, it seemed logical that the most calorie-laden part of any food item – fat – must be bad for you. By this measure, dishes low in calories, but rich in sugar and carbohydrates, seemed healthier. People were increasingly willing to blame fat for many of the health ills of modern life, helped along by the sugar lobby: in 2016, a researcher at the University of California uncovered documents from 1967 showing that sugar companies secretly funded studies at Harvard University designed to blame fat for the growing obesity epidemic. That the dietary “fat” found in olive oil, bacon and butter is branded with the same word as the unwanted flesh around our middles made it all the easier to demonise. A us Senate committee report in 1977 recommended a low-fat, low-cholesterol diet for all, and other governments followed suit. The food industry responded with enthusiasm, removing fat, the most calorie-dense of macronutrients, from food items and replacing it with sugar, starch and salt. As a bonus, the thousands of new cheap and tasty “low-cal” and “low-fat” products which Camacho used to diet tended to have longer shelf lives and higher profit margins. But this didn’t lead to the expected improvements in public health. Instead, it coincided almost exactly with the most dramatic rise in obesity in human history. Between 1975 and 2016 obesity almost tripled worldwide, according to the World Health Organisation (who): nearly 40% of over-18s – some 1.9bn adults – are now overweight. That contributed to a rapid rise in cardiovascular diseases (mainly heart disease and stroke) which became the leading cause of death worldwide. Rates of type-2 diabetes, which is often linked to lifestyle and diet, have more than doubled since 1980. It wasn’t only wealthy countries that saw such trends. In Mexico, middle-class urban families such as Camacho’s got fatter too. As a child Camacho was fit and loved playing football. But at the age of ten, in 1988, he was one of many young Mexicans who started stacking on weight as increasing trade with America saw cheap sweets and fizzy drinks flood the shops, a process known as the “Coca-colonisation” of Mexico. “There were suddenly all these flavours you had never tasted, with chocolates, candies and Dr Pepper,” Camacho remembers: “Overnight I got fat.” When his uncles teased him about his bulging waistline, he cut back on sweets and stayed in good shape until his kidnapping 12 years later. Other Mexicans just kept bulking up. In 2013 Mexico overtook America as the most obese country in the world. To combat this trend, governments worldwide have enshrined calorie-counting in policy. The who attributes the “fundamental cause” of obesity worldwide to “an energy imbalance between calories consumed and calories expended”. Governments the world over persist in offering the same advice: count and cut calories. This has infiltrated ever more areas of life. In 2018 the American government ordered food chains and vending machines to provide calorie details on their menus, to help consumers make “informed and healthful decisions”. Australia and Britain are headed in similar directions. Government bodies advise dieters to record their meals in a calorie journal to lose weight. The experimental efforts of a 19th-century scientist stand barely changed – and are barely questioned. Millions of dieters give up when their calorie-counting is unsuccessful. Camacho was more stubborn than most. He took photos of his meals to record his intake more accurately, and would log into his calorie spreadsheets from his phone. He thought about every morsel he ate. And he bought a proliferation of gadgets to track his calorie output. But he still didn’t lose much weight. One problem was that his sums were based on the idea that calorie counts are accurate. Food producers give impressively specific readings: a slice of Camacho’s favourite Domino’s double pepperoni pizza is supposedly 248 calories (not 247 nor 249). Yet the number of calories listed on food packets and menus are routinely wrong. Susan Roberts, a nutritionist at Tufts University in Boston, has found that labels on American packaged foods miss their true calorie counts by an average of 8%. American government regulations allow such labels to understate calories by up to 20% (to ensure that consumers are not short-changed in terms of how much nutrition they receive). The information on some processed frozen foods misstates their calorific content by as much as 70%. That isn’t the only problem. Calorie counts are based on how much heat a foodstuff gives off when it burns in an oven. But the human body is far more complex than an oven. When food is burned in a laboratory it surrenders its calories within seconds. By contrast, the real-life journey from dinner plate to toilet bowl takes on average about a day, but can range from eight to 80 hours depending on the person. A calorie of carbohydrate and a calorie of protein both have the same amount of stored energy, so they perform identically in an oven. But put those calories into real bodies and they behave quite differently. And we are still learning new insights: American researchers discovered last year that, for more than a century, we’ve been exaggerating by about 20% the number of calories we absorb from almonds. The process of storing fat – the “weight” many people seek to lose – is influenced by dozens of other factors. Apart from calories, our genes, the trillions of bacteria that live in our gut, food preparation and sleep affect how we process food. Academic discussions of food and nutrition are littered with references to huge bodies of research that still need to be conducted. “No other field of science or medicine sees such a lack of rigorous studies,” says Tim Spector, a professor of genetic epidemiology at Kings College in London. “We can create synthetic dna and clone animals but we still know incredibly little about the stuff that keeps us alive.” What we do know, however, suggests that counting calories is very crude and often misleading. Think of a burger, the kind of food that Camacho eschewed during his early efforts to lose weight. Take a bite and the saliva in your mouth starts to break it down, a process that continues when you swallow, transporting the morsel towards your stomach and beyond to be churned further. The digestive process transforms the protein, carbohydrates and fat in the burger into their basic compounds so that they are tiny enough to be absorbed into the bloodstream via the small intestine to fuel and repair the trillions of cells in the body. But the basic molecules from each macronutrient play very different roles within the body. All carbohydrates break down into sugars, which are the body’s main fuel source. But the speed at which your body gets its fuel from food can be as important as the amount of fuel. Simple carbohydrates are swiftly absorbed into the bloodstream, providing a fast shot of energy: the body absorbs the sugar from a can of fizzy drink at a rate of 30 calories a minute, compared with two calories a minute from complex carbohydrates such as potatoes or rice. That matters, because a sudden hit of sugar prompts the rapid release of insulin, a hormone that carries the sugar out of the bloodstream and into the body’s cells. Problems arise when there is too much sugar in the blood. The liver can store some of the excess, but any that remains is stashed as fat. So consuming large quantities of sugar is the fastest way to create body fat. And, once the insulin has done its work, blood-sugar levels slump, which tends to leave you hungry, as well as plumper. Getting fat is a consequence of civilisation. Our ancestors would have enjoyed a heavy hit of sugar perhaps four times a year, when a new season produced fresh fruit. Many now enjoy that kind of sugar kick every day. The average person in the developed world consumes 20 times as much sugar as people did even during Atwater’s time. But it is a different story when you eat complex carbohydrates such as cereals. These are strung together from simple carbohydrates, so they also break down into sugar, but because they do so more slowly, your blood-sugar levels remain steadier. The fruit juices that Camacho was encouraged to drink contained fewer calories than one of his wholegrain buns but the bread delivered less of a sugar hit and left him feeling satiated for longer. Other macronutrients have different functions. Protein, the dominant component of meat, fish and dairy products, acts as the main building block for bone, skin, hair and other body tissues. In the absence of sufficient quantities of carbohydrates it can also serve as fuel for the body. But since it is broken down more slowly than carbohydrates, protein is less likely to be converted to body fat. Fat is a different matter again. It should leave you feeling fuller for longer, because your body splits it into tiny fatty acids more slowly than it processes carbohydrates or protein. We all need fat to make hormones and to protect our nerves (a bit like plastic coating protects an electric wire). Over millennia, fat has also been a crucial way for humans to store energy, allowing us to survive periods of famine. Nowadays, even without the risk of starvation, our bodies are programmed to store excess fuel in case we run out of food. No wonder a single measure – the energy content – can’t capture such complexity. Our fixation with counting calories assumes both that all calories are equal and that all bodies respond to calories in identical ways: Camacho was told that, since he was a man, he needed 2,500 calories a day to maintain his weight. Yet a growing body of research shows that when different people consume the same meal, the impact on each person’s blood sugar and fat formation will vary according to their genes, lifestyles and unique mix of gut bacteria. Research published this year showed that a certain set of genes is found more often in overweight people than in skinny ones, suggesting that some people have to work harder than others to stay thin (a fact that many of us already felt intuitively to be true). Differences in gut microbiomes can alter how people process food. A study of 800 Israelis in 2015 found that the rise in their blood-sugar levels varied by a factor of four in response to identical food. Some people’s intestines are 50% longer than others: those with shorter ones absorb fewer calories, which means that they excrete more of the energy in food, putting on less weight. The response of your own body may also change depending on when you eat. Lose weight and your body will try to regain it, slowing down your metabolism and even reducing the energy you spend on fidgeting and twitching your muscles. Even your eating and sleeping schedules can be important. Going without a full night’s sleep may spur your body to create more fatty tissue, which casts a grim light on Camacho’s years of early-morning exertion. You may put on more weight eating small amounts over 12-15 hours than eating the same food in three distinct meals over a shorter period. There’s a further weakness in the calorie-counting system: the amount of energy we absorb from food depends on how we prepare it. Chopping and grinding food essentially does part of the work of digestion, making more calories available to your body by ripping apart cell walls before you eat it. That effect is magnified when you add heat: cooking increases the proportion of food digested in the stomach and small intestine, from 50% to 95%. The digestible calories in beef rises by 15% on cooking, and in sweet potato some 40% (the exact change depends on whether it is boiled, roasted or microwaved). So significant is this impact that Richard Wrangham, a primatologist at Harvard University, reckons that cooking was necessary for human evolution. It enabled the neurological expansion that created Homo sapiens: powering the brain consumes about a fifth of a person’s metabolic energy each day (cooking also means we didn’t need to spend all day chewing, unlike chimps). The difficulty in counting accurately doesn’t stop there. The calorie load of carbohydrate-heavy items such as rice, pasta, bread and potatoes can be slashed simply by cooking, chilling and reheating them. As starch molecules cool they form new structures that are harder to digest. You absorb fewer calories eating toast that has been left to go cold, or leftover spaghetti, than if they were freshly made. Scientists in Sri Lanka discovered in 2015 that they could more than halve the calories potentially absorbed from rice by adding coconut oil during cooking and then cooling the rice. This made the starch less digestible so the body may take on fewer calories (they have yet to test on human beings the precise effects of rice cooked in this way). That’s a bad thing if you’re malnourished, but a boon if you’re trying to lose weight. Different parts of a vegetable or fruit may be absorbed differently too: older leaves are tougher, for example. The starchy interior of sweetcorn kernels is easily digested but the cellulose husk is impossible to break down and passes through the body untouched. Just think about that moment when you look into the toilet bowl after eating sweetcorn. As with so many dieters, Camacho’s efforts to accurately track his calories “in” were doomed. But so too were his attempts to track his calories “out”. The message from many public authorities and food producers, especially fast-food companies that sponsor sports events, is that even the unhealthiest foods will not make you fat if you do your part by taking plenty of exercise. Exercise does, of course, have clear health benefits. But unless you’re a professional athlete, it plays a smaller part in weight control than most people believe. As much as 75% of the average person’s daily energy expenditure comes not through exercise but from ordinary daily activities and from keeping your body functioning by digesting food, powering organs and maintaining a regular body temperature. Even drinking iced water – which delivers no energy – forces the body to burn calories to maintain its preferred temperature, making it the only known case of consuming something with “negative” calories. A popular expression in English tells us not to “compare apples and oranges” and assume them to be the same: yet calories put pizzas and oranges, or apples and ice cream, on the same scale, and deems them equal. After three years of dedicated calorie-counting Camacho changed tack. While recovering from running the 2010 marathon in San Diego he took up Crossfit training, an exercise regime that includes high-intensity training and weightlifting. There he met people using a very different method to control their weight. Like him, they exercised regularly. But rather than limiting their calories, they ate natural foods, what Camacho calls “stuff from a real plant, not an industrial plant”. Fed up with feeling like a hungry failure, he decided to give it a go. He ditched his heavily processed low-calorie products and focused on the quality of his food rather than quantity. He stopped feeling ravenous all the time. “It sounds simple but I decided to listen to my body and eat whenever I was hungry but only when I was hungry, and to eat real food, not food ‘products’,” he says. He went back to items that he’d long banned himself from eating. He had his first rasher of bacon in three years and enjoyed cheese, whole-fat milk and steaks. He immediately felt less hungry and happier. More surprising, he quickly began to lose his extra fat. “I was sleeping so much better and within a couple of months I stopped the depression and anxiety medication,” he says. “I went from always feeling guilty and angry and afraid to feeling in control of myself and actually proud of my own body. Suddenly I could enjoy eating and drinking again.” The weight stayed off and in 2012 he moved to Heidelberg in Germany, a world away from the hectic streets of Mexico, to study for a masters degree in public health. “The idea hit me that I could combine my own experience with academic work to try to help other people overcome these various barriers that I had found.” After his masters he embarked on a doctorate on how to tackle obesity in Mexico. Today he is married to a German scholar, Erica Gunther, who has studied food systems around the world. Their diet includes things he used to shun, such as egg yolks, olive oil and nuts. Two days a week the couple stick to vegetarian meals but otherwise he devours steak, kidneys, liver and some of his favourite Mexican dishes – barbacoa (lamb), carnitas (pork) and tacos with grilled meat. His wife enjoys making a traditional Mexican sweet pastry called pan de muerto (bread of death). “Before I would have run an extra two hours to compensate for eating that but now I don’t care, I just make sure it is a treat, not an everyday thing.” Having spent years trying to forgo alcohol, he has a glass or two of wine several times a week, and goes for a beer with friends from his gym. Sweating through three or four workouts a week, he is as well-muscled as a professional rugby player. A stable 80kg, he has very little body fat, though he is still considered overweight by the body-mass-index charts, which rate many beefed-up professional athletes as too heavy. The only relapse of anxiety he suffers nowadays happens when he hears Tori Amos singing “Bliss” – the song playing when he was kidnapped – which he says “is a real pity because it’s a great song”. Today Camacho could be described as a calorie dissident, one of a small but growing number of academics and scientists who say that the persistence of calorie-counting compounds the obesity epidemic, rather than remedying it. Counting calories has disrupted our ability to eat the right amount of food, he says, and has steered us towards poor choices. In 2017 he wrote an academic paper that was one of the most savage attacks on the calorie system published in a peer-reviewed journal. “I’m actually embarrassed at what I used to believe,” he says. “I was doing everything I could to follow the official advice but it was totally wrong and I feel stupid for never even questioning it.” Given the vast evidence that calorie-counting is imprecise at best, and contributes to rising obesity at worst, why has it persisted? The simplicity of calorie-counting explains its appeal. Metrics that tell consumers the extent to which foods have been processed, or whether they will suppress hunger, are harder to understand. Faced with the calorie juggernaut, none has gained wide acceptance. The scientific and health establishment knows that the current system is flawed. A senior adviser to the un’s Food and Agriculture Organisation warned in 2002 that the Atwater “factors” of 4-4-9 at the heart of the calorie-counting system were “a gross oversimplification” and so inaccurate that they could mislead consumers into choosing unhealthy products because they understate the calories in some carbohydrates. The organisation said it would give “further consideration” to overhauling the system but 17 years later there is little momentum for change. It even rejected the idea of harmonising the many methods that are used in different countries – a label in Australia can give a different count from one in America for the same product. Officials at the who also acknowledge the problems of the current system, but say it is so entrenched in consumer behaviour, public policy and industry standards that it would be too expensive and disruptive to make big changes. The experiments that Atwater conducted a century ago, without calculators or computers, have never been repeated even though our understanding of how our bodies work is vastly improved. There is little funding or enthusiasm for such work. As Susan Roberts at Tufts University says, collecting and analysing faeces “is the worst research job in the world”. The calorie system, says Camacho, lets food producers off the hook: “They can say, ‘We’re not responsible for the unhealthy products we sell, we just have to list the calories and leave it to you to manage your own weight’.” Camacho and other calorie dissidents argue that sugar and highly processed carbohydrates play havoc with people’s hormonal systems. Higher insulin levels mean more energy is converted into fat tissues leaving less available to fuel the rest of the body. That in turn drives hunger and overeating. In other words the constant hunger and fatigue suffered by Camacho and other dieters may be symptoms of being overweight, rather than the cause of the problem. Yet much of the food industry defends the status quo too. To change how we assess the energy and health values of food would undermine the business model of many companies. The only major organisation to shift the emphasis beyond calories is one dedicated to helping its customers slim down: Weight Watchers. In 2001 the world’s best-known dieting firm introduced a points system that moved away from focusing exclusively on calories to also classifying foods according to their sugar and saturated fat content, and their impact on appetite. Chris Stirk, the firm’s general manager in Britain, says the organisation made the change because relying on calories to lose weight is “outdated”: “Science evolves daily, monthly, yearly, let alone since the 1800s.” Many of us know instinctively that not all calories are the same. A lollipop and an apple may contain similar numbers of calories but the apple is clearly better for us. But after a lifetime of hearing about the calorie and its role in supposedly foolproof diet advice we could be forgiven for being confused about how best to eat. It’s time to lay it to rest.

[pllandcompany]

I Choose You

Summary: Hospital AU! A look into how Roman and Logan’s relationship developed.

Pairings: Pre-romantic into Romantic Logince, background QPP Moxiety

Warnings: discussion of medical procedures, blood mention, violence/shooting mention, mention of drug use/addiction, anxiety, crying, a (and one almost) kiss

Tagged:  @shxtxpp @apologieslogan  @crofters-jam @asylia5911 @ab-artist @band-be-boss-blog @unbefuckinglieveable@flyingfreeyt @thecatchat @thefallendog @backatthebein @insufferablegayastronaut

Notes: Guess who’s back at it again after months of writer’s block?? I’ve wanted to write this story for a while. It does reference a few other fics I’ve written in this AU so here, here, and here are the links for those stories if you want more context as the events of this story are not in order of how they happened based on the established timeline. Also, heads up that I’ve only linked the first part of Out Loud (last link) and Don’t You Remember (second link) but If you want full details (or if you just love my writing so much, insert eye roll here), go to my masterlist and read all of the parts. Still, it should be fairly clear even without reading the previous stories. Okay! Enough talking! Enjoy!

Why wasn’t he awake?

That deadly, nerve-wracking, gut-twisting question had been bouncing around Dr. Roman Courtland’s mind for five days now. The deadline of the withdrawal of care date loomed over his head like a terrorizing and expansive storm ready to break open at any moment. Fourteen days was just simply not enough time. Did the man have no hope?

Note to self: Remind Logan to change that stupidly short time period when he wakes up.

In all actuality, Logan being in a coma was not the expected outcome. It was a nearly perfect surgery. The bleeding was minimal and deftly controlled by his swift hand when it occurred. There was no sign of post-operative stroke or brain death. He should be awake. Yet there Logan lay as still and pale as driven snow, the steady beep of the machines being the only sign of life in the room. It shouldn’t be the case, but it was and Roman was damned determined to find out why. This wasn’t just any patient. No, this was a colleague and a gifted one at that; Logan was quite possibly the most brilliant cardio-thoracic surgeons this hospital had ever seen. Not only was this a professional point of pride, Logan was also the man who saved his brother’s life while simultaneously putting up with his relentless torment the entire time Remy was hospitalized. Roman knew he had been unfair to the surgeon, cruel even and he has certainly spent an exorbitant amount of energy trying to make up for that fact since, including personally taking on his case when Logan turned up with a brain tumor. Shortly before his diagnosis, the two finally found themselves on better terms and Roman was…looking forward to getting to know the doctor more, figure out what truly makes him tick. Now he was potentially the surgeon responsible for destroying that precious of a mind, for squandering the opportunity to…learn more about Logan? Roman refused to accept that reality. Logan Taylor was going to wake up if he had any say in it. He had to; Roman wasn’t ready to lose him-

“Roman? What are you still doing here?”

Patton. Damn it. “Looking over Logan’s post-op scans.” Roman felt the deep sigh more than he heard it.

“For the hundredth time, I bet. Roman, take a break, please. You have to step away at least for a moment. Have you even eaten anything?”

“Have I figured this out yet? Then the answer is no and I’m not leaving until that changes.” A small pang of guilt tightened Roman’s chest briefly. Yelling at Patton was like kicking a puppy, a completely undeserved action. As usual, Patton didn’t even seem fazed which only served to make the neurosurgeon feel worse. Instead, he simply sat across from the distraught doctor, empathy shining in his eyes.

“Roman, you can’t keep doing this to yourself.”

“Then what the hell else am I supposed to do?!” Roman flailed his arms in sheer frustration, the force of action flinging the scans everywhere. He roughly ran a shaky hand through his hair and breathed deeply, trying to control himself while Patton quietly picked up the discarded films.

“I wish I could tell you what to do, Roman. I don’t know how to fix Logan. But I do know you’re not going to find the answer like this. Please take a break. Get some sleep. Come at this again in the morning.”

Roman buried his head into his hands. “What if something happens when I walk away? What if he gets worse and I’m not here to stop it? What if I can’t figure this out and I…and we lose him?” Patton gently took Roman’s hands out of his hair and smoothed the wavy locks down, a solemn yet knowing smile playing on his lips.

“I know you’re scared. I am too. But we don’t get to know what’s going to happen sometimes. All we can do is our best. Which you can’t do if you’re exhausted. So, come with me. We’re going to have dinner and then you’re going to an on-call room to lie down. You don’t have to sleep. You can ramble all the medicine at me that you want, every detail. Maybe then we can come up with something together. How does that sound?” Roman nodded silently, allowing Patton to lead him out of his office.

An hour and a sandwich later, Roman was out like a light and Patton was quietly sneaking out of the on-call room.

Mission successful.

****

“Good morning, nerd!”

God, Roman was insufferable. Logan let out a soul-exiting sigh. “Dr. Courtland, must you insist on calling me that?”

“Oh, don’t get your briefs in a twist, Dr. Taylor; you know I tease only out of love.” Logan hoped the tenseness in his shoulders wasn’t noticeable.

There he was using that word around him again.

“You cannot possibly love me. We’ve only known each other a few months. Besides, I seem to recall you having a certain disdain for me when I first arrived here. It would be impossible for that to have resolved itself in totality so soon.” Out of the corner of his eye, he saw Roman stop and turn back to him. Suddenly, Logan was grateful they were the only two in the lounge.

“Logan…you still think so ill of me?” The cardiologist barely held back the gasp that bubbled in his throat at the hurt look on the neurosurgeon’s face.

“No…not of you?”

“Then of yourself?” Roman sat next to Logan, setting his thigh ablaze when they brushed against each other. Logan hesitated for a moment as his mind struggled to find the best way to answer.

“That’s not it either. I simply meant that we are very different people with not much in common. I’m not certain as to how we will coalesce outside of being coworkers.” If we will.

“Well, that isn’t always a negative thing. I like that we’re different. Means there’s much we can learn from each other.”

“Of course. Our specialties differ greatly; there’s bound to be new information learned between us.” Roman chuckled warmly. 

“While I find your habit of taking things literally quite refreshing, in this case it led you astray. You’re so much more than the job, Lo. You are strong and wise, brilliant and beautifully complicated in ways I’d like to know more about. If you’d let me that is.” The neurosurgeon’s face held so much hope, it metaphorically made Logan’s heart just…stop. How ironic that he, the cardio-thoracic surgeon would be the one to need pulmonary resuscitation from just one look from the towheaded neurosurgeon. ​ It just wasn’t reasonable how one person could be so disarming, so confounding, so attractive…

Logan had to get out of there.

“Ah! Yes, well, then I concede to your point, Dr. Courtland. Fare-farewell.” The older doctor jumped up like a jack in the box and practically sprinted out of the room, the edge of his white coat narrowly missing Roman’s face. 

It didn’t bother him too much once he realized that Logan hadn’t said no.

****

“Okay, Logan. Let’s try this again. Pick up the pencil and write your name.” Logan stared at the yellow No. 2 as if it would jump up and slap him at any moment. “Can we go back to the ball?”

Roman almost chuckled. “You’ve already done that portion. Your grip strength is greatly improved. Now we need to build your prehensile strength back. Go ahead, pick up the pencil. Just try.”

After a few tense moments, Logan finally held the writing instrument. His heart pounded with anticipation as he gingerly placed the tip to the paper in front of him. He pressed down ever so slightly and began to write his name.

He didn’t make it through the ‘g’ before the force of his tremor snapped the graphite.

In a fit of pure rage, Logan swiftly grabbed the pencil in his left hand and threw it across the room. It sailed past Roman’s ear so close he felt the wind move his hair. Before he could react, Logan was standing and tossing his chair across the room. A loud clattering sound stunned Roman into stock still reticence, not daring to test the cardiologist in this state.

“Damn it! Damn it all to hell!”

“Logan, just try to stay calm- “

“No, you said this would work! Yet it’s been a month and I still can’t use my hand! An entire month and I still can’t operate because you make promises you can’t keep!” Silence. “I’m sorry. That was…an unbecoming display.” He moved to restore the room to its original order but Roman intercepted him. He placed two warm hands on Logan’s shoulders, drawing a gasp from the sudden contact.

“You don’t have to apologize, Logan. I understand. I’m surprised you’ve held it together this long.”

Logan refused to make eye contact with Roman. “I still should not have behaved in that manner. Especially after everything you’ve done for me, I shouldn’t be lashing out at you, I am alive because of you, I should just be grateful for that- “

“Dr. Taylor, will you please look at me?” When Logan didn’t move, Roman took his hand under the surgeon’s chin and gently lifted his head. His heart nearly broke at the shattered look on Logan’s face. “See? I’m not mad. What you’re feeling is normal because what you’re going through is hard. It’s okay to get frustrated.” Roman pushed back a lock of the cardiologist’s dark hair and Logan’s eyes closed, leaning into the touch. His head dropped alarmingly close to Roman’s forehead and the neurosurgeon shifted to hold his face with both hands. Logan’s lips parted and his gaze suddenly changed to something…insistent, almost desperate. The question he was asking was obvious and oh, how Roman wanted to acquiesce. Maybe he could, maybe it would be okay…no, it wouldn’t be right; Logan was his very vulnerable patient right now and his coworker. Complicated wouldn’t even begin to describe the nature of their involvement. Roman took a step back and cleared his throat, turning to grab the chair and returned it to the table.

“Look, your hand works. You just have to remind your brilliant brain that it does. And it takes time to build new neural pathways so…try again. Write your name, as much as you can.” Logan swallowed tensely, seating himself once again in the chair. He closed his eyes in a silent prayer, willing the pressure in his chest to release. He looked when he felt velvet skin against the back of his hand: Roman was holding it. Smiling gently at the supportive touch, he picked up the second pencil Roman had conjured from his white coat.

This time, he made it through the ‘g.’

****

“Tell me a secret.”

“…what?”

“We’re getting to know each other. Setting aside our differences, becoming…friends. Friends tell each other things so…tell me a secret.”

“We are sitting on a bench on our lunch break in the middle of our workday. What about this setting makes you suddenly want to have an intimate conversation?”

“Deflecting…”

“Oh, for heavens’ sake, fine!”

“…Paging Dr. Taylor? Are you actually going to say something?”

“I…I want children. Or at least a child. I want to be a father.”

“Well, that’s a mighty forward proposition.”

“Dr. Courtland…”

“Oh, hush now, you know I’m kidding! But why is that such a secret?”

“Because no one expects it of me. People see me as cold and emotionless; no one would think me fit to be a father, much less have a desire to raise children. I’m not like Patton; I don’t seem like ‘the type,’ if you will.”

“I don’t agree with that at all. I think you’d make an excellent father. You’re very practical and you’re extremely dedicated to your patients. There’s no way that wouldn’t translate over into being a parent.”

“Oh…well, uh, thank you. I, uh, believe it is your turn.”

“…I have a twin.”

“In addition to your four other brothers?”

“No, he’s one of the five of us. His name is…was Remus.”

“Was?”

“Truth be told, I don’t know if I should be saying is or was about him. I don’t even know if he’s alive or not.”

“Roman…”

“He was a surgeon in the military. Reconstructive surgery was technically his specialty but over there he functioned mostly as a trauma surgeon. He loved it; he was never phased by gruesome injuries or the horrors of combat. He just did his job saving as many lives as he could so they could go on to keep ours back home safe. One day, their compound was raided and…he was never heard from again. A lot of soldiers died that day but…they never found his body.”

“Oh, Roman…you have my deepest condolences. The amount of grief you’ve had to endure…it’s quite unfair.”

“Don’t worry, Specs. I’m all right. I know it may sound…completely ridiculous but he could still be alive. It’s one of the few things I still hope for…that one day I’ll see my brother again.”

“I understand even more why you’re so protective of the brothers you have here now.”

“Congratulations, Doctor. You just figured out why we tell each other secrets.”

****

The first thing Roman felt when he woke up was pain. Pain in his chest, pain in his throat, God, it felt like he was choking on something-

“Roman? Roman, calm down, don’t fight the intubation, okay? We’ll get it out, just hold on.” That sounded like Virgil, why was Virgil taking him off a vent?

Oh. Right. He got shot.

He got shot and almost died.

He got shot and needed surgery. He had just had surgery to take a bullet out of his chest. Chest…cardiovascular…where was Logan?

Roman knew he wouldn’t be able to get much out at first, but he had to try. He took a breath that rattled in his throat and attempted to speak. “Lo…Lo-”

“Shh, shh, don’t try to talk, Ro. I know who you want; I’ll go get him.” Virgil turned to leave, not even making it one step before he was stopped short by a vice-like grip on his wrist. He turned back to see Roman staring at him with wide eyes, almost pleading with him to understand. Virgil nodded; the message clearly received.

“I know you’re grateful. I’m not hurt. I’m just…really glad to see you make it, man.” Virgil left before anyone could acknowledge the tears threatening to stain his face and Roman found that being alone was scarier than it should be. After all, he had no idea where the shooter was; Logan could have hidden him away to fix him, he could still be here somewhere, lurking, waiting to take another shot that would surely end his life this time-

“Roman? Calm down, your heart rate is way too high. Just breathe, you’re safe.” The neurosurgeon’s eyes met with two dark pools of worry and he locked onto them, Logan urging him to match his breathing. “That’s right; breathe with me. You’re safe. We’re safe right now.” Once Roman’s chest evened out, Logan reached over and grabbed a paper cup full of lukewarm water and handed it to the eager patient.

“Don’t drink too fast, Roman. Slow sips. There you go.” A moment of silence passed. “I’m sorry it’s not cold, I couldn’t seem to locate any ice.”

“The…the shooter-”

“Dead.” Logan’s tone was abrupt and cold. “The shooter is dead; you don’t have to worry about him any longer.”

Roman nodded slowly to not aggravate his already sore body any further. “You saved me.”

Logan nodded absently, staring a hole into the linoleum floor. “I know.”

“Then you know…you know I cannot thank you enough- “

“How dare you?” Logan whispered softly.

“Wh- what?”

“How dare you! How dare you just…waltz into my life and torture me and make me hate you then apologize and befriend me and make me respect you?”

Roman’s eyes widened in shock. “I-I’m sorry- “

“No! No, you do not get to apologize because…because you don’t even leave it there; I can’t just respect you, you then start to make me like you and want you around and want to be near you and then, oh God, you even go as far as to make me fall for you! And just when I figure that out, just when I’m finally able to admit the depth of my feelings for you to myself, just when I finally muster up the courage to even consider telling you about how I…feel, then you decide to go and almost die on me?! And on top of it, you make me be the one to have to save you! How DARE YOU?!”

The entire room stuttered to a halt, save for Logan’s ragged breathing. He was outright crying at this point and quite honestly, Roman wasn’t far behind him. “Logan…I’m so sorry- “

“Shut up! Just shut up! Please just…just tell me you want me too. Tell me I’m not crazy. Tell me that I don’t ever have to live without you because today I learned that losing you feels far too similarly to dying myself so if that is not the case…tell me now so I can figure out how to survive.” A long, tense, quiet moment passed before either of them spoke again.

“Logan,” Roman coughed abruptly, wincing as the motion sent shockwaves of pain through his ribs. He cleared his abused throat and tried again. “Logan, look at me.” The dark-haired surgeon looked up into the soulful eyes of the injured man laying in the hospital bed below him.

“Roman, please,” he pleaded, his voice impossibly soft.

“You can survive without me…but I promise you, as long as I am alive, you will not ever have to.” Logan’s head shot up and before he could control himself, he launched into the bed with Roman, just barely remembering to avoid his ribs and all the wires attached to him. He mumbled a hushed prayer of thank you, thank you, thank you as he curled himself into the space between Roman’s body and the railing of the bed. Roman took a moment to settle before he rested his head against the taller man’s shoulder, exhaustion beginning to blur out the edges of his vision. Logan kissed the crown of his head and wrapped his arms around his newfound love in the gentlest protective hold he could muster, allowing the neurosurgeon to succumb to sleep.

“Rest, Roman. I have you. You are safe. You’re safe with me.”

****

Dr. Picani was a typically patient man but this? This argument he was deeply tired of.

“What I fail to understand is how I continually prove myself to be trustworthy over and over again and you continually shut me out!”

“It is not about you, Roman.”

“Then what is it about? Why wouldn’t you tell me about something like this?”

“I’m telling you now!”

“Yeah, two weeks after the fact and I technically had to hear about it from Virgil!”

“Have you considered that. just maybe, I felt some shame? I had achieved six months of solid sobriety and I nearly threw all of that away in mere minutes!”

“You were obviously triggered by something.”

“I was weak! I failed to keep myself together yet again! And if it weren’t for Virgil dragging me to a meeting and convincing me to tell you, I’d probably still be failing.” Struggling doesn’t make you weak, Logan. The therapist scribbled the thought in his notebook, making a reminder to bring that point up later. He was about to interject when he realized that for the first time in a few minutes, there was silence. Dr. Picani’s head snapped up at the sudden quiet to see Roman’s eyes rapidly filling with tears. Well, this is unexpected.

“Roman? What’s wrong? Say what you’re thinking.”

“I…am I the trigger? Have I pushed you too far?” Good job, Roman, the therapist praised silently, way to take ownership!

Logan’s stomach churned guiltily at the tentative question. “No. You have gotten so much better about that. You did nothing wrong, you are perfect, it’s me, I am…broken.” Logan cursed himself internally for how his voice cracked at the end of his sentence, but he had to keep going. “I want to be good enough for you, but I constantly fail you and I don’t want you to see it. But I fear that one day you will and the fact that I love you won’t be enough to make you stay.” And good job being honest about your fears, Logan. These two have come so far.

While Roman knew just how necessary it was for Logan to admit how he felt, God, how it broke Roman’s heart. He reached out slowly and touched Logan’s hand, chest tightening even more when he felt the muscles jump under his palm. He breathed a sigh of relief when the brunette managed to make eye contact with him, the shared gaze giving him the courage to continue.

“Logan, you’re forgetting one very important thing. I love you too. I don’t want you to be perfect. I want you to be you. Yes, you are strong and brilliant, and I love when you are confident and at your best. But I don’t just love you then. I also love you when you’re hurt, when you’re scared, when you’re less than perfect. Lord knows that I am all those things and you don’t shy away from any of that with me. We’re all a little bit broken but we need each other to keep ourselves together. So, yes, I want you to be strong and healthy but if you can’t be? If it gets hard for you to be that? I still want you.”

“All of me?” Logan whispered.

“The whole damn thing.” Roman paused suddenly, a moment of deliberation passing through his eyes. Logan watched as he seemed to come to some sort of internal decision. He felt the grip on his hand tighten into a gentle squeeze…and then gasped as he watched Roman slide off the couch they shared and drop to one knee.

“Oh my God,” Logan choked out. A loud clatter sounded in front of them as Emile dropped his notebook, both hands flying up to either side of his face,

“Oh my God!” Roman chuckled damply at the poorly contained squeal.

“Save it for the end, Picani.” He pulled out a small black box from his pocket, relishing in the way Logan’s eyes lit up at the sight of it. “I’ve been carrying around this thing for weeks wondering when the right time to ask you was, but truth be told, I could have done it anytime. I didn’t have to wait for some perfect moment because every moment is perfect with you. An appropriate time period in our relationship didn’t need to pass because every minute that goes by is another minute that I am undoubtedly grateful to have spent with you. I didn’t need a counselor to tell me if I’m making the right decision. I just need to look at you and see that all my futures, all my forevers and tomorrows live in your eyes. You are the answer to every question I’ve ever had, even the ones I didn’t know I was asking. So today, I am not proposing marriage. I am affirming my sure commitment to you for the rest of my life. The ring is yours today, tomorrow, and for years to come. There’s no time limit, no expiration date. All you have to do is take it when you’re ready.”

Logan sat in stunned silence as his mind turned over every word of Roman’s confession. Slowly taking the sapphire studded ring from the now open box, he turned it over in his fingers and watched as the light danced with the gems, searching the depths of his heart for any hesitation. He handed the ring back to Roman and slowly turned his hand over, palm facing down.

“Put it on me. I’m ready.”

The squeal that Dr. Picani let out threatened to break glass.

****

“Patton, I must insist that you let go of me before you completely cut off my oxygen supply!"

Patton somehow managed to squeeze Logan even tighter for the briefest of seconds before releasing him.

“Sorry, Doc, I’m just so darned excited for you both! Virgil, isn’t it just amazing? They’re getting married!” Virgil chuckled at the giddy look on Patton’s face.

“I swear, you are a living heart eyes emoji. And yeah, it’s pretty damn cool considering you guys hated each other when you met.”

“My God, you would bring that up,” Roman rolled his eyes as Logan and Patton collectively groaned. Patton delivered a playful smack to Virgil’s arm.

“Virgil! Leave them alone, they’re in love now.” Virgil raised an eyebrow down at his partner’s glossy eyes, almost feverish with excitement and something close to…envy? He elected not to comment as turned to embrace the newly engaged pair one more time.

“Whatever, I know the truth. But seriously, congratulations. I’m sorry I’ve gotta run, I’m assisting on a general surgery case and I’ve gotta change out of chief attire. I’ll see you both later this week, celebratory sushi? Friday night?”

“You bet, Tickle-Me-Emo!” Virgil glared at the nickname as he disappeared into the bathroom of the attendings’ lounge. Patton went in for the hundredth hug and jumped as his pager suddenly went off.

“Uh oh, gotta run, looks like a crash C-section. Congrats to you both again! Bye!” he shouted boisterously as he ran down the hallway.

“I’m afraid I must depart as well, my love. It does not inspire respect in my residents if I’m late for rounds.” Roman beamed at the cardiac surgeon, seemingly unaware of anything he just said. “What?” Logan asked hotly.

“You called me your love. You claimed me.” Embarrassment curled up Logan’s neck as he shook his head fondly and leaned in to kiss his now fiancée.

“You are so endearingly sentimental. I will see you at home, my love.” He smirked as he walked out of the door at the way Roman’s knees seemed to buckle just the smallest amount. The neurosurgeon stood in the middle of the room chuckling to himself when he heard a low, smooth voice speak up behind him.

“You’re engaged?” Roman turned around, his face falling in sympathy at the person behind him.

“Oh, Declan…yes. Yes, I am.” The fellow surgeon turned his face to the side to hide his tears, displaying the long scar that ran down the left side of his face. Without warning, he was suddenly being embraced by Roman who seemed to be unable to stop his own tears as they soaked the corner of his scrubs.

“You know, if Remus were here and we weren’t already married by now, we could have planned a double wedding,” Declan murmured.

“He would have loved that. He loved you so much.” Declan pulled away, his glance suddenly dropping to the floor.

“I wish I could tell you what happened to him.” Roman placed a hand on the orthopedic surgeon’s shoulder.

“It’s okay. I know you weren’t there. You couldn’t have done anything to change it.” Declan smiled weakly, nodding a silent goodbye before leaving the room. He paused at the doorway facing the empty hallway.

“Congratulations. Really, you deserve to be happy.” Roman let out a small sob as Declan left, swiftly brushing the tears away before heading to his own rounds.

Neither of them remembered that Virgil was in the bathroom, listening to their entire conversation…and absolutely seething with fury.

[parkminijiminie]

Love yourself, love BTS

If you've ever read people say "BTS give me strength", "BTS help me so much", "BTS come to you exactly when you need" but never really felt it - be patient, my child, you probably will because it is true and it happened today, with me.

We've all watched medical series and although so much of them is pure and overdramatized fiction, let me tell you being a doctor is challenging, exhausting and mf difficult. Being young, suffering anxiety and battling to become a Cardiologist (news flash: Cardiologists are arrogant assholes and medical teams are full of snakes) is so not easy, either. I mean, I'm doing it so take my word for it.

So, there I am today - being swarmed with paper work, scolded not entirely fairly and smiling into the face of a woman I have the strongest desire to deck, and lo and behold - someone turns on the TV and halfway through singing (in my mind) to a very known song, I realize it is none other than MIC DROP. The happiness that came over me was so real, I never thought I'd feel it over a song.

'Cause you know, it ain't just about one song or one group, it's about the fact that these 7 boys, who came from a small company, who were seen as underdogs and outsiders in their field and only had each other and that dream, made absolute history, broke every obstacle down and made that dream come true. They achieved more than they ever dared to think and even made it to the television in a small European country they're probably never heard of and couldn't place on a map.

The fact that it took them 5 years - exactly as long as my residence - gave me that much more motivation and hope.

Through determination, hard work, ethics, drive, as well as talent, of course, they made it. And so will I. So will you.

And yeah, not everyone who deserves success gets it but if BTS could, maybe you and I can too.

BTS are so motivational.

P.S Being Jimin biased comes with its own perks, as now everytime I have a hard time I dutifully do as he said and think of him. Much better than the grumpy face of my attending, I'll tell you that.

(And a much prettier image, trust me)

[mymisfortuneforyourenjoyment]

March 8, 2019, 4:31pm

I have a chronic illness called POTS - that’s postural orestatic tachycardia syndrome. In simple words, my nervous system is broken and the biggest problem it causes is with my heart.

My doctors have sent me to cardiac rehab. Which, apparently, is something I’m supposed to be ashamed of? At least that’s the impression that I got when a 60-some year old woman also at the rehab clinic whispered, “Are you here for... cardiac rehab?”

By the way, I’m not ashamed. Not one bit.

I’m annoyed, though. The last time I saw my cardiologist, he said to me, “I can’t prescribe exercise in a pill. It’s up to you. I can’t do anything about it.” True, doc. That’s true. But my good dude, stop acting like I’m not trying. Stop assuming that I’m not doing what I’m supposed to be doing. I have been exercising, to the best of my ability. He doesn’t believe me, though.

I’m also just pissed, frankly. I’m in shape. I can do whatever the exercise doctors asked me to do. It’s the day after that fucks me up. The “postural” in POTS means that my symptoms are tied to what position I’m in - laying, sitting, standing, moving. The “tachycardia” bit means that the more vertical I am, (so the longer I’m standing) the higher my heart rate goes. Anyway, all that to say that the day after exercising, I can’t stand for more than ten seconds without fainting. I started this exercise program twice before, at home. Both times, I ended up in a wheelchair for a month after because when I stood, and sometimes when I sat up, I fainted.

So now I’m going to the hospital each time I exercise. Today was the first day. It’s a 36 week program, three times per week. This is basically how my day went:

Bought a bus ticket on my phone through an app. I rush my service dog to do her business before we got to the bus stop. She nearly makes us late. The bus driver and I make eye contact. The bus driver sees my service dog. I give a “what the fuck” face and throw my hands up because she’s not slowing down. The bus skids to a stop. I get on, show her the ticket on my phone and say, “Thanks.”

I get off at the right stop. I rush to the office - I have anxiety. A man snaps and whistles at my dog. “Please, don’t.” Got there a half hour early like I was told to, perfectly on time. I check in at the front desk. The receptionist calls me by the wrong name, my given name. I cringe and try to correct her, but she doesn’t let me speak. She ogles at my dog. The receptionist says I’m too early. She takes me back to the gym anyway.

She tells me to sit down but then blocks the chairs, talking to a nurse. I feel awkward so I let my dog sniff around the equipment, it’s a new place and all. She’s not very interested.

“Is that a dog we can’t touch?”

“Right.”

“Can we talk to her?”

“No. It distracts her.”

“There’s a new girl here. She has a dog.”

I want to die.

I sit down and tuck my dog under my seat. Good dog. I forgot treats. I feel bad because it’s a new situation and she could use the encouragement. She does wonderfully, though. 

A woman wheels up and talks to the dog. She doesn’t ask to pet her. Another woman, the one that whispered cardiac rehab, insists on showing me a picture of her daughter because, to her, we look so much alike. We don’t. The daughter  has kinda short brown hair that resembles mine. “She has an easy smile, just like you.” I smile and want to say thanks, but choke on my words because I’m anxious.

The woman teases and guesses that my name is Chip. I thought about saying yes, but told her the name I go by instead. Took her three times to hear me right. My name isn’t hard. Just a bit too masculine sounding for her to accept that it’s my name, I think. She introduces me to everyone there. She’s trying so hard to be welcoming, but no one will shut up about my dog and everyone’s assuming I’m a girl and I’m anxious.

A man sits next me. He’s three times my age and reminds me of my grandfather. He asks what breed my dog is, boxer lab mix. I’ve had this conversation with strangers so many times, I swear I need to start counting just so that I can add that bit of information in the conversation so that people can better understand my annoyance. He struggles with his phone, wanting to show me a picture of his dog, a labradoodle. I explain how to get to the picture he wants to show me. The woman from before insists on showing me her dog, a mutt.

Three doctors finally stride into the room perfecting in sync together in a little pack, which is funny to me. I watch them in the mirror. I can’t see around the huddle of ten people waiting for them.

I’m handed a packet of information. I take my time reading it. My doctor is annoyed that I’m actually reading it and taking so long - I’m dyslexic. She sits down and runs over it with me. It’s a lot of information and I can’t remember any of it.

She takes me into the gendered locker room, the women’s, and shows me how to put on the heart monitor. It’s a chest strap that correlates to a watch. I lift my shirt and show my scars from top surgery as she puts it on. I wanted to say that I’m transgender and I use they/them pronouns, but the words catch in my throat and I say nothing.

She walks me through the rest of the process. It’s long and confusing. She teaches me how to use the recumbent bike, with all of its functions on the screen. She’s impressed that I do so well. I told her that exercising is not the problem. It’s the day after. She bids me good wishes for tomorrow as I leave.

I walk to the bus stop. The bus comes very soon after I get there. I am the only one at the bus stop. I make eye contact with the driver. He speeds past. “What the fuck!” I swear more and pace around. I feel bad that I’m acting the way I am around a teen boy that cannot make eye contact with me and sits on the sidewalk with his legs bent up in at weird angles. I think I’m making him nervous.

I look up on my phone when the next bus will come. I sit on a cement base of a flagpole nearby. I take out my phone, texting friends about being passed up completely. That’s the second time it’s ever happened to me. My phone is at 30%. It dies. Probably from the cold. My fucking bus ticket is on my phone.

I try to get into an education building. It’s a Friday, the university campus should be open. The building was locked. I walk back to the hospital in the cold. My dog is shivering.

I ask the concierge if there is a way to charge my phone. He says that there are no charging stations and apologizes. I walk up to a group of four people sitting in a cluster of chairs in a waiting area. A woman is on the phone. I stand awkwardly until I get up the courage to say, “Excuse me, I’m really sorry, but does anyone have an iphone charger?”

The woman on the phone says that she does. Her daughter, sitting next to her, says that her charger won’t work because her mother has an android. The mother pulls out a universal charger. I thank her profusely.

I sit on the floor by a plug. I hold my phone up by the plug that’s 2 feet off the ground. The cord is only 6 inches long. My phone turns back on. It’s at 24%. I want to wait 15 minutes at least and leave in time to walk back to the bus stop. I charge for my phone for 12 minutes. My phone is at 30%. The woman’s car was brought up by the valet and she needed to leave. I thank her profusely.

I rush to the bus stop, even though my dog pulled towards the grass, wanting to do her business. I tell her that we’re in a hurry - I’m anxious. We get to the bus stop ten minutes early. I let the dog pee and sit on the cement block by the flagpole. There are other people around. The bus comes. I pull my phone out and the app actually turns on without loading for 4 minutes. I board the bus.

My phone is at 24%. I turn on music because I’m anxious. My phone dies but I leave my headphones in. I get off at the right stop. I decide to begin chronicling my bad days and my bad thoughts on a public social media platform. I don’t care if anyone read it or if anyone follows me.

[shihtzuman]

GM set to start 4,000 white collar layoffs - CNN

Layoffs for about 4,000 salaried staff at General Motors are due to start Monday -- a previously announced move that comes just as President Donald Trump prepares to trumpet American manufacturing at next week's State of the Union address.

The layoffs are part of a 15% reduction in white collar jobs in North America that the automaker first announced back in November. At the same time, it announced plans to close four US plants as well as a fifth in Canada.

The job cuts and plant closings are part of ongoing cost reductions to free up $6 billion annually to invest in a new generation of autos, such as electric and self-driving vehicles. It is also making a push to develop a ride hailing service that will allow GM to make more money by selling rides to customers rather than vehicles.

But the move enraged Trump, who repeatedly lambasted GM CEO Mary Barra over the decision. In his rebuke of GM, Trump focused on the closures in Ohio, a state he won in the 2016 election. The company also announced plans to shutter facilities in Maryland and Michigan.

He said the company would face punishment for the closures, which included a plant in Lordstown, Ohio, that Trump personally promised to revive during the 2016 campaign.

The president said he was "very tough" on Barra in a phone call after the company announced the closures, and referred to the federal auto bailout money the company received in 2008.

"You know, the United States saved General Motors, and for her to take that company out of Ohio is not good," Trump said in November.

'We are the magic wand,' former GM worker of 40 years tells Trump

'We are the magic wand,' former GM worker of 40 years tells Trump

He commiserated about the closures in a series of phone calls with his Canadian counterpart Justin Trudeau. And he claimed GM would soon announce steps that could counteract the effect of the plant closures, though what those actions are remain unclear.

Trump is due to tout his economic successes on Tuesday during the annual State of the Union address to Congress. A senior administration official said Friday the speech's theme would be "Choosing greatness."

Overall, Trump is presiding over a strong American economy. Friday's job report beat expectations, showing more than 300,000 jobs were created last month. But trade tensions and global economic anxiety have led some companies to rethink their business plans and sparked concerns about the risk of a slowdown.

The GM plants, which include about 6,000 hourly jobs, have yet to close, GM is moving ahead with the salaried staff reductions, a GM spokesman confirmed Friday. The timing of the layoffs was first reported by the Detroit News.

The company had about 2,300 salaried staff accept voluntary buyout packages that were offered to 18,000 employees. In addition, there were 1,500 contract employees who were not retained by the company.

GM workers will have job options — but they may not be as good

GM workers will have job options — but they may not be as good

That leaves the remainder of the 8,000 planned job cuts to be accomplished with the involuntary layoffs.

GM (GM) is due to report financial results Wednesday and it is expected to report lower earnings.

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It's been nearly 200 years since white performers first painted their faces black in minstrel shows. It was racist and offensive then and still is today.

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