#three phone calls later and I have been sent to my primary care doctor

[autistic-earth-genasi]

Bro the fact that I have to go through all of these phone calls and convince so many people just to get a diagnosis and therapy is so crazy. Like here do all of the things that you can’t do, which is why you need therapy in the first place, and only then we will give you said therapy. Insane.

[yikesharringrove]

Umm, I accidentally deleted the request for this while moving it to my inbox, so here it is. (Also this is like, four months old).

I’m gonna rec this fic which is super well written and adorable

Steve is ftm. (Personally, I’m not a big fan of mpreg unless it’s like, biologically plausible 🤷‍♀️)

Under the cut bc it’s long and there’s a little bit of smut.

-

Billy’s hands were shaking as he raced out of the house.

He had a bag slung over one shoulder, had already put two others in the Camaro.

His dad had gone in hard today. Three days after Billy graduated high school and he’s already calling him a deadbeat, a fuck up. Telling him to get a job like he hasn’t worked every summer and most weekends since he was fourteen.

He lit a cigarette as he slid into the driver’s seat.

He was gonna make one stop on the way outta town.

-

Steve had given Billy a spare key months ago, after he was tired of always having to go downstairs and answer the door.

He liked it when Billy just made his way up, started kissing whatever skin was already exposed and asking Steve if he’s wet.

Tonight, Steve thought, was no different.

Billy was kissing up his calf, mouthing along his knee, a few fingers creeping up the leg of his shorts.

Billy was the best sex he’s ever had. Not a lot of gay guys will go down on Steve, some won’t even fuck him. He had been real hesitant to tell Billy, start having regular sex with his best friend, because he didn’t think Billy would want anything to do with him when he knew what he was bringing to the table.

But Billy had told him not to be an idiot, ate him out, and pounded him into the mattress.

And Steve was in love.

So he let Billy fuck him whenever he pleased, because at least Billy was giving him the time of day, at least he was getting some.

He opened his eyes, smiling lazily down at Billy.

“‘Time is it?”

“Almost two.” Billy was curling two fingers into his waistband, slowly pulling down his shorts, like maybe Steve wouldn’t notice.

Steve lifted his hips, and Billy whipped off his shorts, diving right in for his pussy.

He ate him out with the same fervor he did everything. Making all these gross slurping sounds, sucking on Steve’s cock and shoving his tongue inside him.

He made Steve cum twice on his face, as was the norm, before wiping his mouth on the back of his hand, and getting right to business.

He fucked Steve like he was mad at him.

He often did. And Steve knew he wasn’t mad at him, moreso mad at the other him, the him that’s ruined Billy’s life since before he was even born.

Steve wasn’t as dumb as everyone thought. Knew that when Billy snuck into his bedroom at odd hours of the night and absolutely ravished him, something bad had happened with his dad.

So when Billy finally rolled off of him, and lit a cigarette, Steve knew better than to ask.

“I’m leaving.” Steve just hummed at him. Billy sometimes stuck around after sex.

But Billy didn’t move.

“Like, leaving Hawkins.” Steve just hummed again. Billy talked a lot about leaving Hawkins. Steve had always secretly dreamed of running away with him. 

Billy just studied his face in the dark, stubbing out his cigarette and rolling over to hols Steve close to his chest.

Steve closed his eyes, let himself pretend.

Pretend that Billy loved him back.

-

He woke up to rustling, Billy getting dressed to leave as weak sunlight began to trickle through his curtains.

“Oh shit, didn’t mean to wake you.”

He smiled lazily at Billy.

“You comin’ back over tonight?” Billy looked stiff.

“Probably not. Sorry.”

“That’s okay. I’ll see you later, then.”

“Yeah. Later.” Billy was sitting on the end of his bed, had just finished tying on his boots.

And then he moved, quick as a flash to kiss Steve softly before he was thundering down the stairs.

Steve was just falling asleep as the Camaro roared away.

-

Billy had skipped town that night.

And Steve never forgave himself.

-

Steve was leaning over the counter, his head pressed into the cool top of it.

“I threw up all last week, and I just feel like shit.” He had been whining to Robin practically all morning at Family Video.

“Do you think you have the flu?”

“I don’t know, Rob. I mean, my stomach hurts a lot, but like, it feels like I’m just having awful cramps.”

“Are you on your period?”

“Nah. Don’t get it very often with the hormones anymore.”

“Normally I’d suggest pregnancy, but I know you’re in a bit of a dry spell.” He rolled slightly to look darkly at her. “Still no word of Billy?”

“No. The one person in Hawkins that isn’t too transphobic to fuck me, and he skips town.” Steve sighed. “I should’ve known, too. He was being super weird that night.”

“Whatever. When you and I skip town, we’ll have the time of our damn lives, and get you laid.” He laughed softly.

“I’m just gonna go to the doctor this weekend. Get a full physical.”

“Let me know the verdict at and I can come over with some medicine, if you need.”

“Thanks, Rob.”

-

Steve was lying back on the stiff exam table.

He had already given blood and urine samples, and was just waiting for the doctor to tell him what the fuck was wrong with him.

Sometimes his hormones had to be adjusted, and caused all sorts of weird shit to go haywire in his body.

Dr. Mauch was a kind woman, always been pleasant and accepting of Steve, even referred him to an endocrinologist for his hormones.

She didn’t smile when she came in, though. Just sat down at her stool.

“I’m going to go out a limb here and say that this is not news you’ll be happy about hearing.”

Steve felt his heart drop to his stomach.

“You’re pregnant.”

He blinked.

“No.”

“I’m sorry, Steve. But you most definitely are.”

“But, but I’m on blockers, and testosterone, and I haven’t had sex in months.”

“I’d say about six months.” His mouth was dry. Billy had left in late May. About six months ago. “And being on hormones is not an effective method of birth control. Some men still get pregnant after taking them.”

“I’m not, I don’t look pregnant.”

“Some people don’t really show their pregnancy. My sister was rail thin the entire time, had a perfectly healthy baby girl. It’s all about your body type.”

“So, so you’re telling me, that I’m six months fucking pregnant.”

“Yes.” He slumped back onto the exam table.

“What are, what are my options?”

“Well, unfortunately, not many. Abortions are only legal in Indiana up to 20 weeks, or five months, or unless the person pregnant is facing severely compromised physical health. There’s always adoption.”

“No one’s gonna want a baby from a trans guy.” She pursed her lips.

“I think that’s a harsh statement. Many people are desperate for babies.” Steve just stared at her.

“So, if I have to take it to term, should I like, go off my hormones.” His stomach gave a lurch at the idea.

“I would recommend it. There’s very little research one pregnancy in transgender individuals. We really don’t know how hormones can affect the baby.” Steve sighed. “I would say, get in with an OB/GYN. I can recommend a few I know and send them your medical history. Your name change and hormone therapy is part of all of it, so hopefully they will be kind.” Steve sighed.

“Thank you, Doc. I really appreciate it.”

“I’m sorry for the disappointing news.”

“Nah, it’s fine.” She gave him a copy of their appointment notes, a list of OB/GYNs for him to research, and a hug before she left.

He drove home slowly, feeling exhausted, like the weight of the fucking world was on his shoulders.

He got home to find Robin sitting on his front porch, her nose buried in a book, a pizza box sitting next to her.

She looked up at him, and he burst into tears.

-

“Look, Max, if he contacts you in any way, tell him to call Steve, okay? It’s important.” Robin was yammering to Max on the phone, trying to get a way to contact Billy.

Steve was laying on the couch, had his shirt rucked up over his stomach, pushing it out and sucking it in, trying to see any change in his body.

“Just give him Steve’s phone number and tell him he’s an asshole.” She hung up the phone, perching on the armrest at Steve’s feet.

“She know where he is?”

“No. She said he ran off and hasn’t contacted her at all. She didn’t even know he was leaving.” She slid onto the couch, let Steve put his feet on her lap. “You think he’d come back? If he knew?”

“I don’t know. I’m not really asking him to. I mean, I don’t think I’m in a place to take care of it, but I kinda just want him to know it exists. Like, I think he deserves that.”

“I get it.” Her voice was soft. She watched Steve stare at his tummy some more. “I’m sorry. I’m sure this is just, dysphoria out the wazoo.” Steve huffed a laugh.

“I don’t think it’s really hit me yet. I think ‘cause I’m not showing. I don’t look pregnant, so how can I be pregnant, you know?” He sighed tugging down his shirt. “Going to the doctor’s gonna be a damn nightmare, though. They’re too used to dealing with women. It’s gonna suck.”

-

Steve was right.

Even though his primary care doctor had sent his medical history, he still got deadnamed and misgendered at reception, and intake, and by the nurse, and the doctor when she finally arrived.

They gave him a pelvic exam, getting him in for a sonogram as well.

And as the doctor was moving the imagining wand around on his tummy, and he heard the heartbeat for the first time, something caved inside of him.

A baby. He was having a baby.

And part of him, a really fucking big part of him, was starting to love it.

-

His parents were home for four days.

And Steve had waited for the final day of their homesteading to tell them.

He’s glad he did.

Diner was as quiet as always, and Steve had nearly choked on the words.

“I’m pregnant.”

His father had gotten out his wallet, asked how much an abortion costs.

“I’m too far along for that. Nowhere will legally do it.”

His mother had just stared at him. His father asked how far along he was.

“Close to seven months. I didn’t even know until like, a week and a half ago.”

And his father had stood up, and the yelling began.

“I can’t believe you. You kick up this huge fuss, make us change your name, and the way we refer to you, go around telling everyone your a boy, and you get pregnant like the little slut you are.”

And he had told Steve to back his shit, told him he was not welcome in my house anymore.

And Steve didn’t have a lot of shit he cared about, the clothes he liked fit in one duffel bag.

His mother didn’t look at him as he left.

-

He had called Mrs. Henderson from a payphone.

Nobody else could give him a ride anymore, and he wasn’t expecting her to drop everything and drive him somewhere, but she had freaked out at the words kicked out and for getting pregnant, and told him to stay where he is.

She was there with a tight hug and a travel mug of honey lemon tea within twenty minutes.

Steve had asked for a ride to a youth shelter he had read about, but she shook her head, said you’re coming to live with me and Dusty and Steve had cried in her passenger seat, and again in her guest bedroom.

-

Steve groaned.

He had finally begun showing, just a little bit out a mound near his belly button.

But he felt like shit, had taken to spending most days in bed.

He bat away whoever was shaking him.

“Go away.”

“Steve, it’s Max.”

“I’m sleeping.”

“I found Billy, you asshole. I have his address.” Steve sat bolt up straight.

“You, where is he?”

“Boston. He went east, for some reason. But he sent me a letter, out of the blue, and I told him you had something important to say, but he said he doesn’t have a phone.” She handed him a slip of paper.

“Thanks, Max.” He gave her a weak smile, found her chewing her lip.

“Is he the father? The other father, I mean.” He had told the party about the pregnancy, figured rumors would begin spreading soon enough.

“Yeah. He’s the other father.”

“He wouldn’t have ditched you. If he’d known.”

“I know.”

“He’s not like that.”

“I know.” She stared him down. He kept his face open, honest.

“Are you gonna write to him?”

“Yeah. I just, I don’t really know what to say.”

“Just keep it simple. Tell him he’s got a kid. Let him choose what he wants.”

-

It took Steve almost a month to draft a letter.

He didn’t really know what to say.

He settled on the bare minimum.

I’m pregnant. And it is most definitely, without a doubt, yours. I’m not expecting anything from you. I don’t want money, or for you to move back to Hawkins. I just thought you deserve to know about your kid.

He read the letter about three times, one hand pressed delicately to his little bump.

I’ve decided to keep the baby. I’m going to raise them. You’re welcome to meet them, and be in their life if you choose, but if not, I’m not going to hold it against you.

He sealed the envelope, leaving it on his nightstand.

And then his contractions started.

He didn’t get around to sending it.

-

Claudia was the only person in the room with him when he gave birth.

She held his hand the whole time, coached him through his breathing.

And when his son was born, she pet his head, told Steve how beautiful he is.

-

Steve was slumped face down on the bed.

He had just gotten Oliver down, calmed him down enough for him to finally sleep.

He rolled over, scrubbing a hand down his face.

He had barely slept all week. But Oliver had smiled at him for the first time yesterday.

He turned to lay on his side, zeroing in on the envelope on his nightstand.

He sat up quickly.

Fuck. He needed to send that letter.

He didn’t bother thinking about it, just wrapped his sweater tighter around himself, and hurried to the mailbox. He put the little flag up, leaving the letter in the little inner clasp.

He looked back down at Oliver, running one finger over his fuzzy little head.

-

He didn’t hear from Billy for three weeks.

He knew the letter wouldn’t take more than a few days to get to him, and it would take just as long for Billy to get him back.

He had pushed Billy out of his mind, figured if he wanted to be part of Oliver’s life, he had given him enough of a chance to be.

He put on a thick sweatshirt, had taken to wearing baggy tops to hide his tits, too sore, too big to bind anymore. Oliver squealed at him when he leaned against the side of his crib, reaching out for him.

He strapped him into his stroller to take him on a walk, stopped dead in the doorway.

Billy fucking Hargrove was in the driveway, standing next to the Camaro like he had just gotten out of it.

His eyes were wide, trailing from Steve, to Oliver, and back again.

“Is that my kid?” Billy’s hair was shorter than when he had left.

“Oliver. His name is Oliver.” Billy stepped around the car.

“Can I, can I see him?” Steve brought the stroller down the driveway, taking Oliver out of the stroller.

Billy held him like he was made of gold.

“He’s beautiful.”

“I think he looks a lot like you.” Billy smiled at him.

“Thank you for telling me. I’m sorry I couldn’t get here, I was waiting for my semester to end.”

���It’s okay. I just, you know. Thought you deserved to know about him.” Billy stared at Oliver, his smile going soft as Oliver squealed, tugging on Billy’s hair.

“I want to be in his life. If that’s okay?”

“Of course it is. He’s your son too.” Billy brushed his thumb down Oliver’s nose.

“Thank you, Steve. And I’m, I’m sorry about how I left. I was going to-” he cut himself off, looking back at Oliver. “I was gonna ask you to come with me. Chickened out last minute.”

Steve’s heart was banging against his rips.

“I would’ve gone with you. Used to dream about running away with you.” Oliver started getting fussy, making disgruntled little huffs. Billy passed him back to Steve. “I was in love with you. You know that?”

“Yeah, I knew that. Was to chicken shit to do anything about it.” Billy was still looking at Oliver, the way he nestled into Steve’s neck. “He loves you a lot.”

“It’s been the two of us for awhile.”

“You’re a good dad. Always kinda figured you would be, though.” Billy took another breath. “You know, you could’ve told me sooner. I would’ve come back.”

“I don’t want you to, to change you life. Don’t quit school, or something.”

“Steve, I got a kid. I want to change my life for him. For, for you.”

“I can’t ask you to do that.”

“No never did. I’m choosing this. I’m choosing my family.” Steve hesitated.

“Would you like to come in? Have some breakfast? You could give Oliver his bottle, If you wanted.” Billy’s eyes lit up.

“I’d like that.”

[crystalsmentalhealth]

Talking about the Brattleboro Retreat in Brattleboro, Vermont

I recently spent two weeks at the Retreat and wanted to share my experiences both good and bad about it. 

I arrived at the Retreat in mid-June of 2021 after a four day stay at the Emergency Department of my local hospital. Originally I had not wanted to go to the Brattleboro Retreat because it was such a big campus and I equated that with busy and loud and impersonal. The Retreat would challenge my assumptions.

Getting There

I didn’t drive myself. As I said I spent four days in the ED of my local hospital and so I arrived via ambulance. The ride was stressful and nauseating. I was already stressed and nervous and the mountainous winding roads did absolutely nothing to help. I didn’t lay in the stretcher, but sat in a back-facing seat with no arm rests and with a blood pressure cuff around my left arm. 

The trip took about an hour and except for a few questions from the person riding in the back with me, it was spent in nearly complete silence, which again, did nothing to help my nerves. There was no reassurance or even light conversation.

My Arrival

When we got there, they grabbed my bags for me, probably because I wasn’t allowed to have them yet, and with one person before me and one person behind me, lead me up the stairs to the admissions office. We were met at the door by an admissions person and I was dropped off like an Amazon package. The ambulance personnel left and I was officially at the Retreat.

I was first led to Security. They dropped off my bags with Security, and asked me to empty my pockets. I had none and told them such. Then I was led to an exam room where the woman who was with me found a gown that would fit me and held it up in front of her. I was then told to strip completely. I balked, but obeyed. First went my shirt, then my bra, then I stepped into the gown. Then with that covering me, I wiggled out of my pants and underwear. She gave me a pair of hospital pants to put on so I wasn’t completely bare. Then I was shown a chair and given a pair of huge grippy socks to wear. One size fits all, I guess.

After that the lady took my blood pressure, my pulse, and checked my oxygen levels. Then she took my temperature.  My clothes and shoes were sent to Security with the rest of my things. I had off-brand crocs as shoes so I had no idea what they needed to check for, but off they went.

After the clothing change I was led to an office. I felt so awkward standing in a grey hospital gown, blue hospital pants, no panties, and those huge grippy socks, in front of two nicely dressed office personnel. They let me have a seat and the questions and paperwork began.

What was my insurance? Did I know about the extra inpatient days allowed? Who was my primary care physician? My therapist? My psychiatrist? My case worker? Did I have an Advanced Directive? What are the addresses? Did I want a male or female provider? There were so many questions! 

Then it was sign here, and here, and here, and here, and here.

After that I was given a green folder that said Welcome to Tyler 2 which contained various information that I would need during my time there. My patient Bill of Rights, how to file a complaint or grievance. That sort of stuff. 

Then it was off to another area and now they wanted a urine sample. I had already done two at the hospital and really didn’t need to pee, but I tried. I assume it was for a drug test, but I have no real clue.

Then I was sent off to another exam room, this time for a full physical. She asked me all about my medical history, whether I was having normal bowel movements or not, all about my diabetes, my family history (cancer, cancer, cancer, cancer, heart disease, cancer, kidney failure, cancer), she even checked my reflexes. The ARNP that examined me had the neatest notebook. It was electronic and I was fascinated by it. 

(At the time of writing this I’ve only been home for two full days and I still have a very clingy cat who is currently laying on my left hand so if you catch a typo that kitty has caused me, please let me know.)

After the physical I was given one outfit to wear back, sans bra because my bra was underwire, and I was sent to a seat to wait to be sent to the unit.

The lady who watched over me offered me something to drink while I waited and when she offered milk I took her up on it. Unfortunately it was 1% milk, which I really hate, but hey, milk, so I drank it while I waited.

I didn’t have to wait long. Before long a Security guard and a nurse from the unit I would go to came down and led me down one corridor, in one elevator, through a cafeteria, up another elevator, and finally I was on the unit.

Tyler 2 

The first thing I noticed when I got on the unit was that the bedrooms were singles. Yes! I hate sharing my bedroom in hospitals. At the worst, I’d once had to share with three other people stuffed into a two person bedroom. Two poor souls had had to sleep on cots. So I was very happy to see that I would have my own room.

I was shown into an interview room for yet even more paperwork and questions. All this is the business of the psychiatric hospital and it comes at the literal worst time of your stay, the beginning. When you’re scared and your nerves are raw, and your mental health is at it’s worst.

A three question questionnaire was first. Why are you here? How can we help? What are your coping skills? Depression, anxiety, suicidal ideation. I don’t know. Reading and journaling.

Then there was a check list of things that helped when I was feeling bad. I was fascinated to see that laying down in my room was one of the options. Most hospitals I had been in forbade that, with some going so far as to lock the doors to the bedrooms during the day so people didn’t sleep the day away. It was a pleasant surprise, and I checked that off along with a few others that I felt applied. 

Then, the nurse, and we’ll just call her Rose, asked me if I was hungry and told me that they always had sandwiches on the unit and that the kitchen which held milk, orange juice, flavored water, cold water, hot water, coffee, teas, and various snacks was open 24/7. I declined both sandwich and snack.

Finally, I was left alone for a couple of minutes and I had a moment to just breathe. It was a Thursday according to the giant whiteboard that had the day’s schedule on it. Most of the groups were over with.

A little bit later a bag was brought up with my clothes and another with the few things I was allowed to have: my Bible; two coloring books; two books (A Street Cat Named Bob and A Wrinkle in Time); my toothbrush, my hair brush, and my composition notebook; were given to me. The clothes I wasn’t given yet. I was told by a nurse that because of COVID they washed everything that came on the unit whether it was clean or not and I would get my clothes once they were dry.

I was then shown my room. Number 219 was to be my home for the foreseeable future. It was a fair sized room, the walls painted hospital blue, the floor had boring brown patterned tiles, There was a plastic chair, a twin size bed with a single pillow, and brown blanket, and bottom sheet. There was no flat sheet. 

There was a set of built in shelves and a small alcove with an unbreakable mirror and large shelf where I put my green folder as well as my other personal belongings that I was permitted to have. I hung around in there for a few minutes before wandering back out and awkwardly looked around.

It was soon 8:30pm and Rose, who was my nurse that night, offered me my bedtime medications. I accepted and went to bed. 

The Schedule

I slept fitfully that night. I was scared, they checked on me every 15 minutes, and it wasn’t quite dark when I went to bed. I woke up obscenely early the next morning, which is very unusual for me, but I attribute it to the uncomfortable mattress, the lack of my comfort item; a stuffed cat named Fat Cat that I sleep with, and the fact that my room had a double window that faced directly East. The sun rises at about 4:45am right now, so it woke me up at around 5:30am that morning.

I wandered out, thinking it was much later than it actually was, since it was fully light out. I sleepily blinked at the analog clock and tried to decipher it. Inwardly I groaned at the time. To kill time, I awkwardly wandered around the unit again, and I think I laid back down for a little while. 

Eventually I left my room again and it was 7:30am. Shift change. I can’t remember who my nurse was that morning, but by 8am it had become quite the busy place with the morning nurses, the mental health workers, the social workers, and the group leaders milling about the nurses station. 

I noticed that the whiteboard had changed with the day, and so I glanced at the Friday schedule.

8am - Breakfast 9am - Community Meeting 10am - OT Movement 11am - Psychotherapy 12pm - Lunch 1pm - Courtyard (yellow level) 2pm - OT Activities 3:30pm Shift Change 4pm - Courtyard (yellow level) 5pm - Supper 6:15pm - Game room/small courtyard (yellow level) 7pm - Wrap Up 8pm - Free Time 9pm - Relaxation 10pm - Phones/computer/TV off

Yes, we had a computer. Some guy we’ll just call J tended to hog it, but so long as it wasn’t group, before morning shift change or after 10pm or 11pm on Friday night and Saturday night, anybody could use it. Of course Facebook and YouTube were blocked, but Vimeo wasn’t. Can somebody please tell me the difference between YouTube and Vimeo? 

I didn’t really go to groups that first day, and I was on Red level, so I wasn’t allowed outside even if I had wanted to. I did however see the Social Worker, a very nice woman we’ll just call M. and my doctor via ZOOM, Dr. L. 

All of the staff was really nice to me, and the unit, which at that point had a census of 19, was actually fairly quiet for the most part.

When 8am hit, and the breakfast trays arrived, I asked where I should go to eat. I was told I could eat on the porch, the day room, or in my room. Eating in peace alone in my room. Yes, please. I took my tray, got a carton of milk, and walked down the hall to my room. 

When I pulled the lid off my plate, I discovered eggs, home fries, and a corn muffin. I also had some fruit. I cautiously tried the potatoes and found them to be quite good, but couldn’t eat anything else so I took my tray back.

I hovered awkwardly around the schedule board until somebody brought me a chair.

Then it happened. My stomach began churning. I went to the nurses station and told one of the three nurses that I had a bit of an upset stomach and could I have something for it? She looked up something and told me I could have some Tums. She sent me to the med window and used some fancy machine to dispense the Tums. I stuck them in my mouth and chewed. I swallowed. It was then that I knew I had made a mistake. I literally felt the Tums hit my stomach, felt my stomach cramp, and then I was vomiting. 

After that experience and the cleaning up thereof, I got my morning meds at around 9am, and soon found myself back in the interview room, this time with a nutritionist. At least I think that was Friday. It could have been Monday. Regardless, I talked to her about being sick (it wasn’t the first time, I had gotten sick back in the ED as well), my lack of appetite, my diabetes, the medication for diabetes I was on (2000mg of Metformin and .5mg of Ozempic). She gave me some information the nutritionist I had talked to from my doctor’s office had already given me, then ordered Glucerna for me three times per day.

Glucerna is the diabetics version of Ensure for those of you who don’t know.

I slept a lot that day, and I’m pretty sure I refused lunch and maybe supper. They checked on me - and everybody else - every 15 minutes, but otherwise didn’t pester me.

The next day, of course, started the weekend. I can’t remember the exact schedule for the weekend, but it was far, far more boring than then weekday. There was just Community Meeting which I wandered into but didn’t participate in, a couple more courtyard opportunities than on the weekdays, more free time, Wrap Up and Relaxation. Relaxation happened at 9pm, but I already considered that bedtime as that was when I got my bedtime medication.

Sunday was just a repeat of Saturday with one bright exception. Sunday Sundaes. At around 2pm we got ice cream with sundae toppings that we could have on it. I don’t think I got it that first Sunday, but I can’t quite remember.

Monday doesn’t bring any particular memories except that that’s when I started attending a group here and there.

Meeting Nathan

Then Tuesday came, and I met Nathan. Nathan was a Psych intern who is now no longer there, so I’m not afraid of using his name. Nathan did 11am Psychotherapy, but had been on vacation the week before as well as Monday. I liked him instantly. He spoke quietly, thoughtfully, gently, and never pressed for answers if the person didn’t want to or couldn’t.

At first, we only spoke in group, but after one group disintegrated into chaos he ended it early and offered to speak to me one-on-one. The one-on-one time I got with Nathan, which eventually became every weekday, became the best, most helpful part of my stay at the Retreat. Some of his questions were hard. They were either highly thought provoking or brought on strong emotions, but he was very skilled in not pushing too hard and always bringing me back to the present if I got too lost in the past. 

I think I opened up more to Nathan in the week and a half that we spoke than I ever did in the two years I’ve seen my normal therapist. 

The Nightmares

I’ve suffered from nightmares for a very long time. In my nightmares I’ve been raped, had my home invaded, seen demons, had my parents stolen away by a dragon (that one happened twice. Same stupid dragon too.), been kidnapped, been chased around Wal-Mart by paramedics with a stretcher, and so on and so forth. The nightmares I suffered at the Retreat were something else entirely.

The dream I remember most, and let me list off some trigger warnings real quick: blood; abortion; abuse; infant death; decomposition; bad parenting; bad medical professionals, was about this young woman who tried to do some sort of home abortion that got botched. She went to the hospital and they sent her strait to surgery where they cut her open with no painkillers or anesthesia. The baby was tiny, but healthy and viable, so they took her out of the young woman’s womb, and haphazardly stapled the woman’s abdomen back together. 

Then the dream began to focus on the baby, but not in linear time, but rather in snapshots. In the first snapshots the baby was fine. Pink, perfect, beautiful little girl dressed in frills. Then the next day’s photographs and the baby’s face was turning black in places. The next; her eyes turned murky and there was more decomposition. Mind you, while she’s decomposing, she’s still alive. Then her little fingers turn black and fall off, and it continues like this until the fifth day when the baby finally dies.

The mother, who was recovering from her own trauma, couldn’t have cared less about her baby.

The nightmare turned weird after that and I don’t remember what happened next, but I continued to have vicious nightmares during my stay there.

Dr. L tried to treat them with Prazosin. but I found that it made my nightmares more vivid. Then she tried to get me in a deeper sleep so the dreams wouldn’t wake me up, but that only got me caught in the nightmares and unable to wake up. 

We never did figure out how to ease the nightmares and keep me asleep at the same time. Right now we’re trying a higher dose of Gabapentin, also known as Neurontin. I guess we’ll see how it works out.

Strange Characters 

There were some...interesting characters at the Retreat. There was one guy who we’ll call J. You may recall him from my complaints about him being a computer hog. He suffered from delusions of grandeur and I believe psychosis. One time I was in the open area near the nurses station he began staring at me suspiciously. Then, after a couple of very awkward moments he asks me, “are you an Imperial or a Rebel?” I told him I had no idea what he was referring to. Miss J who was sitting near by goes, “she’s an imperial, she’s a good girl.” Then J nods and says  “I know she’s my sister in Christ, so she must be good.”

I still have no idea what he meant by Imperial or Rebel. Is it a Star Wars thing? If so I thought the Rebels were the good guys. I’m so confused. 

Miss J was a homeless woman who had been there for nearly nine weeks. She was very nice to me, but she mumbled a lot and I had to keep asking her to repeat herself. 

M was a strange old lady. She would sit at the nurses station and laugh and laugh and laugh as loudly as she could, then all of the sudden she’d be declaring one of the housekeepers an angel on earth and how he should be protected and how everybody else was basically garbage. She eventually got taken out via ambulance.

A was another strange woman. Having been there since May 27th, 2021, she was there involuntary, She talked to herself a lot, drank loads of coffee, walked in and out of groups, and was best buddies with a woman who liked to be called Rabbit, as her real name, the same name as A, triggered her. A and Rabbit were thick as thieves and fed off of each other’s chaos.

Rabbit liked to sing at the top of her lungs when she was happy and when she was angry she would file a grievance, announce loudly that Obama was her father and that you (the nurse she was screaming at) aren’t her boss. She was nice enough to me, but I went out of my way to be as non-intrusive as possible.

Then there was D. D was 30-years-old, claimed to have 12 children. D was volatile, a substance abuser who enjoyed “a drink, some weed, and some coke”. Pretty sure she didn’t mean the soda. D had a shadow who had to write down what she was doing every five minutes. I don’t know exactly why, for the most part, volatile or not, she was pretty chill. She dressed provocatively and the first time she spoke to me it was early morning and we were on the porch.

She asked me why I was there. I told her depression. She asks my why I was depressed. I admitted that there was a lot of trauma in my past. She tells me she’s been (tw:rape) raped all her life, and then proceeded to tell me that I shouldn’t be depressed because I was pretty and thin. Now. I’m smaller than D was, because I’ve never had children, let alone 12 of them, but I’m 5′3″ and 210 pounds; thin is not an adjective I would use to describe me. 

She then proceeds to tell me that I needed a better bra. I was wearing a soft low support sports bra, so yeah, my chest area was very un interesting. I told her I was just wearing something I could sleep comfortably in. She told me to shop at Victoria’s Secret for some better bras and I’d feel great. 

After that, D decides to mention the gray in my hair. She says “you should get extensions to make your hair long and pretty, or better yet, shave your head and wear wigs. It’s what the black girls do.” She then went on about how wigs could really look good and how I’d have so much fun with it that I’d forget all about being depressed and how there were some sites where you could buy some good wigs for really cheap.

As I recall, I was fairly unresponsive during her spiel and walked away as soon as it wasn’t rude to. 

The Really Bad Day

I don’t recall exactly what day it was, time blurs for me on a good day, and I wasn’t having any good days while I was at the Retreat, but one day was really bad.

TW: Suicide TW: Self-Harm

I was really, really suicidal, and I told the nurse I was talking to that. She asked if I had a plan, and for the first time I really did. I told her I would wait until right after a check - remember we got checked on every 15 minutes - then I would take a pair of my pants and wrap them around my neck and strangle myself. 

Then she asked if I intended to follow through with the plan. I wanted to, I really did, but I also didn’t want to cause trouble, and that’s a huge issue with me, so I told her no. And that was the truth. I was suicidal, I did have a plan. I had a detailed plan actually. But I didn’t really intend of following through.

As you might expect, she had to report that to my doctor. Dr. L. spoke to me about how I was feeling and later, about five minutes after I had gotten on the computer to use Duolingo to distract myself, (See, I was using coping skills.), the nurse I had spoken to, and who I liked quite a lot, came to me and said that Dr. L wanted them to temporarily confiscate my clothes and take the sheet and blanket off my bed. It was to be replaced by blankets that couldn’t be ripped. Nurse E told me it wasn’t a punishment, it was a safety precaution, but I was so embarrassed and felt punished. I was allowed to keep the weighted blanket they had let me borrow, and my pillow, but other than that they took every bit of fabric in the room.

I don’t know if it was a good move or not. I just know that I wanted things back to ‘normal’, as though anything in a psych hospital could be normal, but the next day I lied to Dr. Lambert and told her I was feeling better. She said I could have my stuff back, but for some reason when I asked a nurse later on, she told me that there were no orders about it from Dr. L. 

I asked again the next day and was finally able to get my linens and clothes back. I even got an extra pillow, for which I was very grateful for as my original pillow had been quite flat and hard.

The Road to Discharge

I was originally supposed to have been released on June 29th, a Tuesday, but I had to admit to Dr. L that I just didn’t feel like I could be safe at home yet. Not to mention that we were still trying to deal with my nightmares and sleep issues.

Dr. L and M, my social worker began giving me assignments to do. I was to fill out a safety plan, which I did. M had me write a letter to my regular therapist about the changes I needed her to make to improve our sessions. I am terrified to read it to her, but I really need to. I was given a huge stack of DBT (Dialectical Behavioral Therapy) information and worksheets to fill out, Nathan had me write something about a cousin of mine who had passed away due to an overdose of Fentanyl, and so I wrote her a letter telling her how much I missed her, how I was angry she was gone, disappointed that she couldn’t tell me she was back on drugs, how I was angry at her mom for getting her hooked on drugs in the first place, and ways I could have helped if she had just let me.

Meanwhile, people found out that I could make things out of the Model Magic that they had in the Contraband/Sensory room. I made I can’t even remember how many cats for people. I also made roses, and one dragon. 

I was also writing dark poetry, just trying to purge my dark thoughts and get them out on paper.

Nathan continued to have one-on-one therapy with me each weekday, even if he only had half an hour.

I was meeting with my social worker daily, which they normally didn’t do, but when she realized that I wouldn’t go to them if I needed something, she decided to head it off, and meet with me, even if it were only a couple of minutes, each week day.

Finally, we decided on a day. Friday, July 2, 2021. I was so nervous, but so excited to come home and see my furbaby, Loki. 

When the day came, I dressed in the nicest clothes that I had brought, which was a pair of elastic waist jeggings and my pink Cat Mom t-shirt which everybody loved. I only went to one group that day, and that was Psychotherapy, and I had my meeting with Nathan. I had one last meeting with Dr. L. and my social worker. My nurse that evening gave me my treatment plan which had my diagnoses. (Major depressive disorder, severe; Borderline Personality Disorder; and Post Traumatic Stress Disorder)

Just as supper arrived I got the word that my ride was there. 

Final Thoughts

Being at the Brattleboro Retreat was a difficult experience, but it was also a positive experience. In the beginning I was mad I wasn’t at the place where I had wanted to go, which was the Windham Center, but by the end of my first week there, I had decided to make the best of where I was. I didn’t like all the nurses, I definitely had my favorites and those I dreaded, not that they were ever mean to me, but I’m not sure, there’s just people you don’t like, you know? 

I was on a great schedule while I was there. I was up no later than 8am and went to bed around 9pm, I ate at specific times. I got my medicine at specific times, and that routine was very comforting. Did I keep to it when I got home? 

No. It’s currently 12:26 in the morning and I’m working on this still. 

I’m still drinking my Glucerna, no matter that it costs me $40 a week for three a day, but I just don’t want to eat. Oh, I nibble. I’ve eaten some chocolate graham crackers and sipped on a 20oz Vanilla Coca Cola over the last four days. I just don’t eat. 

I learned, while I was there, that it’s okay to speak up, to take up space, to have a voice, even if it’s quiet, I learned that it’s okay to get angry or ask for help. I can ask people for what I need. I don’t know how well I’ll be able to apply what I learned, but that’s always the hardest part of learning any new skill. 

I know that this has been a huge amount of reading, but I wanted to give you a detailed example of what a psychiatric hospital is like. I hope that it informs you and I hope that if you’re heading to a psychiatric hospital or treatment center that maybe after reading this you’ll have less fear and anxiety because you have some clue as to what to expect.

I would also like to let my readers know that these are just my personal experiences in an American psychiatric hospital. I have no idea about British hospitals or European hospitals or even hospitals in other parts of the United States. My experiences in hospitals in Florida is a stark contrast to my experience in Vermont hospitals. I find Vermont’s response to medical care and psychiatric care in general is substantially better than Florida’s. I’ll do a post on that later.

Ask for help. Take up space. Use your voice.

National Suicide Hotline: 800 273-8255 Crisis Text Line: Text START to 741741

By the way, if you need me to tag another trigger word, please just send me a message and I’ll edit the tags to take your trigger word in consideration.

[itsclydebitches]

Clammy

Summary: Aziraphale's molt is upon him. He has to decide what to do with the feathers

A park bench and supernaturally beautiful weather. A basket of sandwiches, fruit, crisps, and a rather large selection of chocolate truffles. A bottle of Pinot Noir between them. Crowley stretched out his legs and thought that if this was it, all they ever managed to wring from this world, it just might be enough.

“Divine,” Aziraphale proclaimed, polishing off the last raspberry truffle. The sun had left chocolate coated over his fingers and he set to licking it off, heedless of decorum. Crowley designed to watch.

“Not precisely the word I’d choose,” he said. “Considering I bought them and all.”

“But Mrs. Sutherland made them.”

“But you don’t know what I did to them between here and the bakery.”

Aziraphale froze, thumb halfway between his lips and a smear of chocolate on his cheek. The shock lasted only a moment before he was rolling his eyes. “Of course I know. You forgot to chill them so now they’re a half-melted mess.”

“...touché.”

Not that half-melted messes had ever stopped him. Aziraphale continued to work his way steadily through dessert while Crowley watched the foot traffic in front of them, sneaking glances every now and then from behind the safety of his glasses. It was while he was most assuredly looking only at the changing leaves past Aziraphale’s shoulder that he noticed—

“That time of the century, huh?”

Aziraphale froze for the second time, eyes widening just a bit. But Crowley didn’t call him out on the absurd little wiggle he’d been trying (and apparently failing) to do subtly against the back of the bench. There was no one looking but Crowley and if he didn’t mind chocolate-covered fingers or crumbs down the front of his vest, there was little reason to think he’d mind this. With a sigh Aziraphale gave up and shoved the box away, reaching to scratch rather ferociously at his back.

“It’s so undignified,” he said, tone just this side of petulant. “I am meant to be an ethereal being. A creature of unsurpassed glory and wisdom—”

“Think rather highly of yourself, don’t you?”

“Not some, some, some common avian enslaved to his biology. I don’t even have biology. Not technically.” The last part was definitely a whine.

Crowley indulged in a snort and slid further down the bench, nearly boneless against the wood. Literally. His body bent in ways not generally allowed by spines and pelvises, but no joints dared raise a complaint. “You’ve got it easy, angel. I go through two of them.”

“Two?”

“Wings and,” Crowley gestured down his entire body, suddenly looking a little unsure. “You know. I am a snake.”

“Right.” Nothing like the embarrassment of another to sooth a bit of your own. Aziraphale cast him a crooked smile. “That’s... well. Quite sorry to hear it, dear boy.”

“You and me both.”

Another quick press against the bench and then Aziraphale deliberately went still. He let out a breath. Popped another truffle into his mouth and closed his eyes, trying to savor it. When he opened them again he could see Crowley’s concerned look, even behind the glasses.

“I’m fine,” he muttered. “Over sixty molts since the beginning. You’d think we’d grow used to them by now.”

Crowley barked out a laugh. “Grow used to what? The incessant itching? Constant pain in your back? Exhaustion? I slept for a month after my last molt. Only woke up because Beez themselves was looking for me. Molts are proof that She’s more than a little sadistic, angel.”

“Hush.” But the slap against Crowley’s arm was half-hearted at best. “I suppose I could return Upstairs. It’s always easier without a mortal body compounding things...”

“You really want to spend the next few weeks up there?”

No. He didn’t.

There was a certain understanding that came with annoyances shared across thousands of years. Without being asked Crowley miracled together the rest of their lunch and sent a quick thought towards the London traffic, urging it to thin out. He’d drive Aziraphale back to his shop, say goodbye like it was any other day... and then proceed to only call and text for the next three to four weeks. Their first substantial time away from one another since the Tadfield airbase, but they’d been expecting this. Molts, for all the grumbling, were intensely private things.

And as Crowley stood just outside the bookshop’s entrance, pressing the basket of leftovers into Aziraphale’s hand, he didn’t dare ask that they might change that too.

***

The bookshop was a disaster.

The space had grown considerably in the last two weeks, making room for a collection of supplies that would have rivaled any doctor’s office. Electric heating pads were a marvelous invention that Aziraphale now hoarded, along with the small pharmacy of mortal medications that didn’t seem to do much, but he was inclined to try nonetheless. Safe from the books were melting ice packs he used when unexpectedly feverish; weighted blankets when, a mere hour later, he was suddenly chilled. In the leftover space surrounding his most comfortable couch was the food, a veritable feast of everything salty and sweet. Some of it he’d ordered in, slipping the containers through the smallest crack in the door and slipping exorbitant tips back out. The rest came from Crowley. Per the unspoken promise he hadn’t stopped by again in person, but he could easily miracle things directly into the shop. Aziraphale often looked up from one of his books to find chocolates or tarts or freshly made bubble tea now sitting on the table. He gobbled it all up with a hunger he wasn’t supposed to feel.

Where there weren’t supplies there were feathers. A stunning collection of white that settled into every nook and cranny; an ethereal blanket of snow. Aziraphale didn’t bother picking up after himself whenever an old feather dropped and a new one began the arduous process of growing in. Most would disappear over the next week, fading out of this reality entirely. It was a rather convenient thing (perhaps the only convenient part of this whole process), with just a handful of flight feathers to deal with in the end.

Which was precisely what Aziraphale dealt with now, curled up on the couch with Persuasion resting forgotten in his lap. Disposal of these feathers was no minor thing. It required patience and careful thought.

...Which Aziraphale was quite happy to ignore once his phone buzzed. It took him a full minute to find it amongst all the mess and another to remember which button allowed him to light up the screen. Two more remembering his passcode. Really, he could appreciate humans’ continued advancements in technology, but did they have to keep making them so hellishly complicated too?

Ah. Now that he thought about it, that drive might have been Ligur’s doing.

hows it going?

Aziraphale smiled. Three simple words from Crowley and he already felt better. Though admittedly only a bit. One breath later and that incessant itch reared its ugly head again, along with the familiar ache in his lower back. One wouldn’t think that losing and re-growing feathers would be such a monumental feat, yet here he was, taking a moment to breathe before daring a response.

Crowley,

I’ve been better, as you know. Nothing to be concerned with, however. I expect only another week of this nonsense before things return to normal. Shall we get lunch together next Thursday? I greatly appreciate the food you’ve sent over, though I find myself craving something a bit more substantial after all these sweets. Italian would do nicely.

- Aziraphale

The response was immediate.

sure, angel.

There was a beat of silence except for the tick of the clock and a very low hum emanating from two of the heating pads. Then,

need more time to gift your feathers?

Aziraphale’s throat tightened. He blamed it on his poor health.

Crowley,

No, I don’t expect they’ll be any travel this time around. It’s quite nice of you to be thinking about my needs though.

- Aziraphale

His words had the desired effect. Aziraphale’s phone suddenly buzzed as ferocious as a beehive, text after text coming through about how Crowley was not nice, they’d had this discussion, he was actually being selfish, if you’d just listen, and by the way texting isn’t the same as sending a letter you stuffy, outdated, impossible—

With a chuckle Aziraphale let him keep going, well aware that no answer was the best response of all. As he leaned further into the cushions another primary dislodged and settled in his lap. This one didn’t look like it was going anywhere.

Aziraphale stroked the feather tip to tip, thinking.

No. The person he wanted to give this to wasn’t far away at all.

***

Angel feathers had, shockingly, once been a part of an angel. Imagine that. As such, they had a bit more significance to them than what came from your average hawk or peacock or whatever else might be leaving bits of themselves behind. Aziraphale didn’t know why some primaries remained while the rest disappeared—another question on the tip of his tongue that he’d never dared ask—but every angel knew that they’d wind up with a small handful after their molting and those must be dealt with in the most careful fashion. There was a vault up in heaven that catalogued and stored each deposit, perhaps with the hope that the feathers might one day be turned into weapons against the enemy. For those on Earth, however, there was the expectation that they not allow these pieces of divinity to fall into the wrong hands.

Aziraphale knew it was the same among the demons, another similarity that others were too scared or blind to question. They would molt and be left with feathers that gave off what one might term a bad aura: nasty thoughts and feelings that radiated outward, soaking into the back of a mortal’s mind and strengthening the longer they held on. Aziraphale didn’t know what Crowley had done with his own feathers over the years, whether he simply tucked them away where they’d never be found, or handed them off to those who were later remembered as the more unhinged individuals throughout history. He’d never had the nerve to ask. He, however, had always considered the remains of his former wings to be a gift and gave careful consideration to who would receive them. Angel wings had rather the opposite effect, promoting feelings of goodwill, creativity, and a general sense of peace when held. Aziraphale had thus handed his off to writers who fashioned them into quills, great chiefs who wore them with pride, poor mothers who might not have jewels or vases to display in their homes, but they could set this on their mantelpiece and know that someone was watching over them. It was a process that deserved his utmost attention.

Though in truth, Aziraphale had an inkling of what he'd do with his next molt in 1941. Now, with Armageddon behind them, he was quite sure of his decision.

Crowley,

My deepest apologies, dear boy. I meant to say that you’re quite considerate. Is that better?

- Aziraphale

P.S. It’s hardly my fault humans have forgotten how to properly write to one another. Besides, you ought to be proud of me. Convincing this tech to put in line breaks was no easy task!

His phone blew up once more as Aziraphale shook out his wings, trying to encourage the remaining stragglers to finally let go. He must look a right mess, physically done in and sporting only half his usual plumage. It was perhaps no surprise that molting had become a rather private affair over the millennia. Anyone who saw an angel in this state might second-guess their supposed superiority. Aziraphale hadn’t bothered with a mirror in weeks.

The heat was doing wonders for the muscles surrounding his wings though. The ibuprofen, while perhaps not effective under normal circumstances, seemed to be taking the edge off his headache. Crowley kept up a vibrating litany in his lap. He was clearly busy, yet just a moment later Aziraphale caught the scent of garlic and looked up to find a takeout box of pasta sitting on the table.

Fondness surged, helping his new feathers to grow and his mind to settle. Aziraphale placed the primary on a stack of books beside the couch, safely away from his newly arrived lunch.

Crowley,

Thank you <3

~Aziraphale

He’d made his decision. Best to start the implementation of it early.

***

A week and two days later Aziraphale finally left the bookshop. He was what, in human terms, might be called an introvert. Had anyone asked him on an average day whether he’d enjoy spending nearly a month by himself, nothing but books and films to keep his attention, he would have gasped in pure pleasure at the idea. Now, having lived that life once more—one always tended to forget such things as the years went by—Aziraphale recalled how little fantasy matched up with reality. Taking that first breath of fresh air was an unexpected pleasure.

“Angel!”

As was the company. Though perhaps ‘unexpected’ was quite disingenuous of him.

Crowley waited for him down the street, Bentley parked and providing the perfect object to lean against. Aziraphale took in his appearance, identical to when they’d last met with the exception of a pendant necklace spicing up his outfit and rather longer hair. Crowley must have encouraged the growth. Aziraphale was rather sure hair didn’t get to that length in just three weeks time, no matter how much Crowley might yell at it in the mirror. He had most piled up in a bun with the occasional wisp framing his face.

Perfect. Aziraphale couldn’t have planned it better if he’d tried.

“You don’t like it,” Crowley said, noticing his gaze, assuming the worst. One hand lifted instinctually to his hair, twitching like he wanted to start tearing it out. “I’ll change it back. If you want.”

In that moment, with Crowley framed by London traffic and the quickly fading light, Aziraphale had the uncomfortable realization that he could ask him to do anything. Anything at all and it would be done without question or hesitation. The power made him hesitate. Aziraphale knew now that he had to guard his words: ask for nothing more than what Crowley deserved to give; certainly nothing worse than what he’d forced him to endure before.

Wait for me.

“Not at all,” he said. “I love it! You’re just missing that final touch.”

“...final touch?”

They knew separation well. One month was nothing to them. Aziraphale slipped back into Crowley’s space, easy as you please, allowed to turn him slightly and gain access to his bun. Crowley was so focused on the hand Aziraphale had placed on his arm that he didn’t notice the object until it was slipped beneath his hairband.

“What the devil did you put—” Crowley stopped, catching sight of his own reflection in the Bentley’s hood. Aziraphale watched his eyes blow wide behind his glasses.

“Hardly the devil, my dear.”

With the molting finished Aziraphale had been left with eight primaries still in existence on this plane. He’d told Crowley as much over text and had patiently sat through reading the same thoughts he’d already had: it was suspiciously convenient, one might say miraculously so, that he had just enough feathers remaining to number the humans involved in stopping Armageddon. Well, seven humans and one antichrist. The brats deserve it, Crowley had said, voice surprisingly tender down the line. They’ll appreciate it, angel.

No doubt they would. Appreciation wasn’t quite what Aziraphale was going for though.

Upon getting the text that Crowley was outside he’d miracled one of the feathers into the fern he’d gifted him two months back, the only plant in his apartment given the honor of a room to themselves and (Aziraphale would bet) the occasional kind word. The white beauty would be the first thing to greet Crowley when he opened the door, stark against the otherwise dark space.

As Aziraphale donned his coat he’d sent the second feather into the pocket of Crowley’s favorite coat, a surprise for when the weather turned cold and his mood predictably plummeted. The third appeared pressed between the pages of The Extremely Big Book of Astronomy; the fourth now slipped beneath his pillow. By the time Aziraphale was descending the steps of his shop the sixth feather was on its way to Lesley, accompanied by instructions to deliver the inconspicuous envelope at a future date and time, to be decided. It never hurt to have another pick-me-up waiting in the wings. Pun most certainly intended.

The seventh currently rested on the Bentley’s dashboard, yet unnoticed because Crowley was reeling from the feather Aziraphale had slipped into his hair.

“Angel.”

Just that. A breath. So much packed into one single, reverential word. Aziraphale had to swallow hard before he could speak himself.

“I know,” he whispered, trying for steady and failing spectacularly. “We needn’t speak of it if you don’t wish to. Simply know that this decision was the easiest I’ve ever made... and you look quite beautiful, my dear.”

Crowley’s hand rose to brush at the feather, shaking enough that Aziraphale could spot the emotion even in the fading light. He was steady enough to open the door for Aziraphale though, stumbling back around to the driver’s side, managing up until he spotted the second feather on his dashboard. Aziraphale watched him double over and thought that perhaps he’d made a mistake...

No. There’d been enough doubting between them and the care with which Crowley cradled the gift said it all. Even as the rest of him shot the Bentley recklessly through the streets.

For once Aziraphale did not call Crowley out on his driving. There was silence—not even any Queen—all the way back to Crowley’s apartment. Aziraphale caught the tinniest noise, like pain, when Crowley saw the feather in the fern and then he was moving again, nearly tripping over himself in an effort to get to the closet.

It was a door Aziraphale had never seen opened before. He couldn’t even be sure the space had existed before this moment. But the trunk Crowley pulled out was certainly real enough. Aziraphale sucked in a gasp at its age, wood now held together through will and more than one demonic miracle. Crowley hesitated only a moment before flipping the lid.

Inside were black primaries. A couple hundred at least. More than enough to account for one individual’s molts across the centuries.

“Never gave them away,” Crowley said. One hand gripped his feather while the other dove into the trunk, finding and extending a handful of himself. “I was waiting for you.”

Aziraphale tried vainly to keep the tears out of his eyes. He’d never been very good at that. Too soft. Too soft by far.

“Well... I’m here now.”

And he was. As Aziraphale knelt and took Crowley’s face in his hands the feather in his hair slipped out, drifting into the trunk. A spot of white among the black. New amidst the old. It nestled there, settling in.

As did those who had born them.

[crystalinn]

I haven’t posted about this here yet, but boy howdy has my life been A Mess™️ of late.

TW: medical talk, high stress situations, mentions of blood under the cut

This is a very long post, so a mild TL;DR: ma’s sick and this is me for eternity now (loud noises in video): 

Picture it. November 10th (ish. Time is hard.). The motherbeast came down with a case of viral bronchitis. She got a few days off work to recover. 

A couple days pass. She went back to work. Her manager sent her in the cooler for two hours. 

An immediate downturn ft. a fall out of bed that took 45 minutes to fix, heavy panting, confusion, the whole lot. She went to the Express ER. They said “oh hey, your viral bronchitis has become full blown pneumonia. You’re goin’ to the Real Hospital™️ for two days. See if you respond well.” Turns out, she did, at first. 

About a week or two of what seemed like solid improvement all came crashing back down when her return to work arrived. She went back to work... or tried to. She went to step onto the curb and gravity said no. She faceplanted the pavement, and the ambulance was called. A thorough concussion check later, and her manager drove her and her truck home. The next day, she went back to the Express ER, and they said “oh shit, your lung xray is worse than last time. Back to the Hospital for you.” 

That stay was nine days long. She was tested for tuberculosis (which came back negative, thankfully), and had a PICC line installed. During said stay, she did get rather confused and agitated, as it was near the end of the month and the rent needed paid. She called me in the middle of the night, asking me to move her IV... despite me being at home. So that was a thing.

After she came home on the 4th of this month (December), I had to start administering her PICC line antibiotics, every 8 hours. Did y’all know that cefepime (a bigboi antibiotic) smells like someone doing unholy things to eggs? Sulfuric smelling bullshit, that. Had some hiccups there, what with massive air bubbles in the line and getting the infusion orb stuck on the line. We were supposed to be done the 25th. Then she went to her new primary care doctor, and it was extended to the 6th of January, which h.

Anyway, fast forward to the 23rd. Mum was out with a pal, getting some groceries, and some Miralax ‘cause... y’know, and she fell on her ass. At this point, falling down is like a glowing neon red flag. She came home, was a bit wobbly, but was generally okay. Her primary care doctor called after the home health nurses stole some blood to tell her that her potassium levels are critical. A friend/my ‘adopted’ brotherbeast, Frank, brought her a fuckton of bananas that night. 

Now this is where it gets real fuckin’ spicy. The morning of the 24th, after we get done with the 7am orb, I gave her a dose of Miralax. She was fine, until the 3pm orb, when severe gut cramps showed up. Those lasted until about midnight when things... moved along. After that, shit went downhill fast. I put her to bed after orb times at 11 pm, and she kept waking up. As time went on, she got more and more confused. Like, she knew general things, in a kinda slow way, but she could not follow directions. On the morning of the 25th (fucking Christmas.), things had reached its boiling point. She was very confused, unable to focus, slurring words. I rang up a friend, Sandy (who has been a massive help this whole time of Fuckery), to get her to the ER. This triggered a complete meltdown. It took both of us to get her out of her chair, not to mention the sudden burst of confused crying and begging not to go. 

We finally managed to get her there, and the ER’s like “yo this looks like a stroke, so we’re gonna keep her, do an MRI or three, and get back to you.” Turns out she was very dehydrated, currently has a UTI, and is still a bit... shall we say, fucked up. But, the MRI came out clean, but there was some issue with the PICC with like, a blood clot, but they cleaned it out, so they let her go on the 26th. 

But just wait for it... I put her to bed pretty much as soon as she got home, ‘cause she doesn’t sleep in the hospital. Makes sense, right? I went to check on her at about 8, and she was unable to really comply with requests/commands/questions. I’d ask “what’s your name?”, I’d get her name (most of the time), but when I’d ask “when’s your birthday?”, I’d get her name again. Or the fact she lost her PICC line cap, and I’d ask her to hold the newly sterilized port so it wouldn’t touch anything, she’d say okay, take it, and immediately drop it. Repeatedly. 

I broke down whilst on the phone with my dad because everything has been too much of late, and eventually put her back to bed to wait for the 11pm orb. 

11pm rolled around... and well. I couldn’t get her to wake up. She’d react to me poking and prodding her by making noise and moving away, but she would not wake up. Not properly. So, I called the on call home health nurse to see if she could help, and she pretty much told me to just call an ambulance. Not wanting the expense because I live in Hell the US, I called my dad. He helped me try to wake her up over the phone, but she flat refused. I was left with no choice. So, I called the ambulance, and just before they knocked on the door, she sat up like “huh?” but extra confused. She almost didn’t go to the hospital because she said “nah, I don’t want to go” but one of the EMTs was like “nah, you gotta go.”

So, she spent about 8 hours in the ER, and they told me that they can’t keep her since she was mostly lucid, but they did float an Idea (a skilled nursing facility, at least until she got her ducks in a row) to her that was immediately denied, but with some prodding from me, she finally agreed. So they moved her upstairs from the ER to keep her until they can find a facility in the Blue Cross/Blue Shield network that’s reasonably local. The one that came to visit yesterday turned out to not be, and I’m pretty sure the dude kicked it back to the Case Supervisor to see if they can find another. But, after they moved her into her room, she’s cleared up quite a bit. 

She’s still a bit slow on the uptake sometimes, a bit unfocused, and can get caught out in the grapes mentally, but she has improved a lot. 

Oh, and another thing she’s been doing is fighting me re: eating since the first go around. Bread’s a texture issue, rice is hard to eat without teeth, and everything else “smells bad” (which, since she’s quit smoking as of that second hospital stay... I understand, but you gotta sometimes push past that.) I did manage bananas though. Thank fuck for those. 

But, back to the plot: today (the 28th) was a decent day. Much clearer, less starts and stops in her speech. A bit more focused. She didn’t manage to sleep last night, so she was kinda tired. Had another MRI, but we won’t know about that until probably tomorrow (the 29th). Maybe. Had some PICC issues, though. The nurse got the cefepime running just fine, then mum had to use the bathroom, and when she came out, the machine started screaming bloody murder. After that, the nurse came back and tried to flush the line, since the cefepime was unable to run, and when she took the syringe off, the saline shot right back out... which ain’t supposed to happen. Hit me, the nurse, mum, the bed... probably got the windows too. So they’re working on that, and hopefully they figure it out.

Had my own woes at the hospital today, too. The sole of my boot fell off, so my ride/friend/adopted sister?, Sandy, went to walmart and got me some Heavy Duty Superglue, which I got it about half way stuck before we had to leave... then when we were pulling into the parking lot at home, the nurse in charge called to ask some questions about the PICC, the antibiotic, how long it’d been there, how long she was supposed to be on it, the pharmacy’s number, all that. So I went to get out of the car, my coke bottle fell out of my pocket, started rolling under the car, and I overextended. Fell right on my knees. They are not happy. Took a hot minute to get my dumb ass off the ground, without hurting Sandy, who is like 5′2″ and v smol. I am 5′6″ and... decidedly not. Plus the bonus rain.

UPDATE 12/29/2019: the diverticulitis has made a reappearance. It’s like everything is just It’s free real estate.

UPDATE 12/31/2019: Around 2 am this morning, she managed to roll out of bed and whack her head pretty good on something. They did a CT scan, and it came out clean. No concussion. However, now she has a sitter/keeper/minder to make sure she doesn’t do it again. It’s a good thing the nurses heard her fall, ‘cause despite being armed, the bed alarm didn’t go off. I know of all of this, ‘cause the hospital called me at 3 this morning, and boy howdy that’s a gut drop, let me tell you. But, better a CT ride and a bump on her noggin vs. the alternative. Sure is one thing after a-fucking-nother, ain’t it though.

UPDATE 1/1/2020: 2019 keep your problems challenge: she's had a major mental shift again, and now she's really groggy, really confused... So the hospital moved her to the ICU and called me for consent on a spinal tap, just to make sure they're not missing anything. Other than that, they've done x-rays and another CT, I think to check her spine, hips, the one leg she's been having issues with. The doctors also think that it may be the cefepime causing this altered mental state, and after doing some digging, boy howdy I sure believe it. Cephalosporins are some nasty fuckers.

So! That’s been my month and a half! I’d like to take a break now, please!

EDIT: Further updates found here.

[theblogtini]

Connor’s Birth Story | Preeclampsia

A little over 4 months ago - on January 17, 2018 - I gave birth via a planned c-section to Connor, a beautiful, healthy baby boy.

The road to meeting him was interesting and a bit scary at times, but what has happened since then has been hell on Earth.

My husband and I were lucky in that we didn’t have to “try” to get pregnant. We were in the “if it happens it happens” phase of things and poof, a week before my 30th birthday I found out I was pregnant. My pregnancy was fairly unremarkable early on. I didn’t get morning sickness, I didn’t have mood swings. I didn’t gain much weight or swell up - it was easy and I felt lucky. The most annoying thing was that during my 2nd trimester I had an “irritable uterus” and so I had a lot of false contractions that would leave my muscles aching a bit.

Around 35 weeks I thought my water broke. I went to the hospital as instructed by my OB and it turns out it hadn’t, but I WAS having contractions every 2 minutes (that I couldn't feel!), but I wasn’t progressing quickly enough for them to keep me. Eventually they gave me a steroid shot meant to help the baby’s lungs develop quicker if he was born early and sent me home, telling me to eat something and pack a bag because they all thought I would be back that night. The said if I didn’t go into true labor that night to go to my doctor in the morning to get a check of my progress.

And that is when all hell broke loose.

I should note that the evening before (JANUARY 7, when I was given the steroid shot), my blood pressure was 122/74.

The next morning (JANUARY 8) I arrived at my doctors office and told them that I was supposed to get a progress check. When they checked things out I still hadn't progressed, but my blood pressure was 160/88, which is very high and a warning sign of preeclampsia. They had me lie down for a few minutes and when they checked it again it was down to 130/80 which is a bit high, but not worrisome. Apparently the threshold for preeclampsia is two reads of 140/90 at least 4 hours apart. I was scheduled to return to the hospital later that evening to get a second dose of the steroid shot, and the doctor told me to make sure they rechecked my blood pressure.

That evening (still JANUARY 8) at the hospital I declined the second dose of the steroid - I was having an annoying reaction to it (very jittery, face hot and red as if I'd gotten a bad sunburn, fast pulse - all fairly standard steroid reactions, but I didn't like it). They said that since I was 36 weeks that day that I didn't need the second dose, as by that point it wouldn't help much anyway (baby's lungs are generally pretty well developed by 36 weeks) and most of the benefit comes from the first dose anyway. At that point, my blood pressure was 130/86, which is just on the border of being too high (and my pulse rate was 107, from the steroid injection). I was advised to head back to my doctors office in the morning for them to keep an eye on my blood pressure.

The following morning (JANUARY 9) I headed into my doctor's office for them to check my blood pressure. The nurse had some difficulty taking it because she couldn't find the appropriate sized cuff and then the machine (she didn't do it manually, for some reason) kept inflating and inflating but wouldn't release (my hand practically turned purple!). Eventually she declared my blood pressure was 120/90 - not horrible, but the bottom number had hit 90 which is an indicator of preeclampsia. I left with instructions to purchase some Magnesium supplements at CVS. On my way home my phone rang, and it was the doctor's office - they also wanted me on bed rest until I went into labor. They also said that if I got a headache that wouldn't go away, or any pain in my upper right abdomen I should head to the hospital.

I spent the rest of that day and most of the following day at home, but I wasn't doing an awesome job of relaxing. I was still trying to work (ahhh, the "benefits" of being your own boss and working from home) and also work at a faster pace so I could wrap things up in case I went into pre-term labor. The next evening (JANUARY 10) however, I realized that I had a slight headache that wouldn't quit. This is probably a good place to note that I almost ALWAYS have a headache. And this wasn't a very bad headache - just a "oh, my head kinda hurts a little" headache. But since the doctor told me to go to the hospital if I had a headache that wouldn't quit, I went.

Finally on January 10 - at 36 weeks - I was diagnosed with mild preeclampsia, admitted to the hospital, and told I would be there until I had the baby which at the latest would be 1 week later and at the earliest could be later that night or anytime they felt my blood pressure was getting too high or other symptoms cropped up. At the time I was diagnosed my husband was at a business dinner in Boston. It was a few hours until he could get on the train, get home, grab our hospital bags (which we had already packed) and get to me.

For a week I sat in the hospital (with my loving, perfect husband by my side) terrified that my body was failing and killing both me and my baby, even though my doctors and nurses were constantly reassuring me that I was actually completely fine and just being monitored. I wasn’t actually even really being monitored - I wasn’t hooked up to anything. Every few hours someone would come in, take my blood pressure, put a monitor on my belly to check the baby's heart rate, tell me all was good, and leave. As uneventful as that week was, I spent a lot of time being nervous and crying. It's hard to NOT be nervous when you're in the hospital for monitoring. Every time someone would tell me I was fine, I would tearfully tell them that I obviously wasn't fine, because if I was I would be at home.

On January 17, the day of my scheduled c-section (I had been planning to have one regardless), the nurses came in to get me and wheeled me into the OR. Within an hour of the operation starting I was in recovery with my husband, who had been by my side the entire time, and my son. It was surreal.

My doctor had warned me that it's "totally normal" to see a spike in blood pressure a day or two after delivery, and after over a week of having blood pressure readings that were varying between completely normal and slightly high (in the hospital I even had some readings that were "perfect" - in the 110s/70s), the night before I was supposed to be discharged from the hospital, my blood pressure spiked to 160/88 again. Within minutes I had a room full of doctors and nurses. My husband had been down the hall grabbing a snack from the vending machine and heard them call a "rapid response" to our room. He thought it was because I had demanded they bring the baby to me quickly, since we had sent him to the nursery. But what he really heard was the call for every available medical practitioner to squeeze into the tiniest hospital room ever. I was immediately told to lie down while they came in with a dose of a blood pressure medication that is designed to act quickly. Meanwhile, nurses were putting seizure pads on my bed (big blue pads that were there so that in case I had a seizure I didn't injure myself), while another nurse set up an IV of Magnesium Sulfate to prevent seizures. A few minutes after taking the medication my blood pressure dropped... low. And my pulse went sky high - to 160bpm. A few minutes later another team of people came in, this time with an EKG machine check my heart function and some Ativan try to slow it down. The EKG came back completely normal. The Ativan was much appreciated.

All the while I laid on the bed, staring at the ceiling trying not to freak out. Chuck said that even though I looked absolutely terrified (and he couldn't get near me because the doctors and nurses had things to do) he was surprised at how calm I seemed. It wasn't because I was calm, though - it was because I was absolutely terrified to move thinking that at any minute I might have a seizure, stroke, or heart attack.

As my blood pressure stabilized and my heart rate returned to normal I was hooked up to the magnesium and put on an additional 24 hours of bed rest. Apparently I am the first person my nurse had ever spoken with who didn't hate the magnesium. I guess a lot of people have crappy reactions to it, but it just made me feel really warm and cozy, like I was about to take the best nap ever. Or maybe that was the Ativan - who knows.

On January 22 I was finally discharged from the hospital. I wasn't prescribed any blood pressure medication, as my BP had returned to a fairly normal level. However, things went from bad to worse because at that point my anxiety decided to kick into high gear.

Being out of the hospital terrified me. As far as I was concerned, I had just survived a disease that could have killed me and my baby, had a completely traumatic experience with the rapid response, and now I was being thrown to the wolves to just hope things settled down. Uhm, nope! After being home for two days and doing nothing but crying and being terrified I made appointments with my psychiatrist and my therapist. I saw my psychiatrist first. While I was there she checked my blood pressure three times and each time it was all over the place, one time getting as high as 170/80. She ordered me back to the hospital where my BP was still a bit high. They gave me a dose of a different blood pressure medication which instantly dropped my blood pressure to a nearly normal level. They wrote my a prescription of a low dose of it and sent me on my way. They also told me at that time that my high blood pressure might be a result of anxiety and not something more sinister.

A few days later I had to be seen by my primary care physician for follow-up from a car accident I had been in a couple days before Christmas. While I was there they couldn't get a reading on my pulse - it was bouncing around from 60 to 100 to 80 to 120. Eventually they rolled in an EKG machine and did 2 EKGs, both of which came back fine. My doctor and I were concerned, however, so she wrote me a referral to a cardiologist and orders for a 48-hour holter monitor (which is essentially wearing an EKG machine for 48 hours straight). I spent another week bawling my eyes out and being terrified to even hold the baby, lest my heart give out and I drop him. When I finally saw the cardiologist he explained that it's fairly common for postpartum women to have a bit of a wonky heart because their bodies are getting used to having less blood to pump around, but he also did an EKG. He said all of my EKGs had come back perfect (the one in the hospital, the 2 in my doctor's office, and the one he had just done) and that my 48-hour holter monitor results were perfect as well. He also did a thorough exam and declared my heart "perfectly fine" and said that he didn't expect to see me for another 50 years or so. Excellent!

Unfortunately, a few days after THAT I got a headache. The weirdest headache of my life - it felt like someone was stabbing me in the head. Again, I worried about my preeclampsia and headed to my doctors office, where the doctor on call was concerned about a brain aneurysm or stroke. (Note: do NOT say those words to someone with severe anxiety...) She sent me for an MRI and an MRA - only one of which my insurance would cover, so my husband and I paid for the other out of pocket. Turns out, my brain is completely fine as well, woo! But that was yet another week spent being terrified that I would drop dead at any minute.

Last but not least, I'd been having some cramping in my leg that wouldn't go away. Whenever someone has major surgery they're at risk for blood clots, and being pregnant in and of itself is a risk for blood clots, so of course that was a concern. After 2 ultrasounds of my legs and 2 blood tests it was determined that there was no clot and I was probably experiencing a combination of sciatica and muscle spasms.

Throughout all of this I was still taking my blood pressure medication and going once per week to my OB's office for blood pressure checks. Thankfully though my blood pressure issues seemed to resolve fairly quickly, with normal readings at every single doctors appointment, and by 4 weeks postpartum I was completely off the medication, with normal blood pressure. They did, however, have to check my blood pressure twice at each visit. Once at the beginning, where it was almost always on the high side, and then once at the end when I was more calm where it was always great. 

Ultimately, I remained completely petrified for a couple more weeks until eventually my brain decided to believe the doctors who were all telling me I was fine (and probably when my pregnancy hormones decided to even themselves out).

However, I'm still nervous. I'm scared of getting pregnant again and developing preeclampsia, eclampsia, or HELLP. I've been told by my OB that all three of those scenarios are actually unlikely due to the fact that my preeclampsia onset was late in pregnancy, was mild, and she isn't even entirely certain I had preeclampsia since many of my high blood pressure readings correlated with times of high anxiety (like the ones in my psychiatrists office, where I was basically having a nervous breakdown). That said, preeclampsia is an unpredictable illness. There's no way of knowing who will get it, when they'll get it, or how severe it will be. The severity can range from mild cases like mine that are kind of just a nuisance, to ones that are so severe they cause maternal and fetal death, and everything in between. Preeclampsia can lead to eclampsia, meaning seizures, or HELLP syndrome which is essentially the liver and kidneys shutting down while the blood begins to lose platelets. And at this time, as much as it kills me to think that my son might be an only child (I had never envisioned only having 1 kid), I don't know that I can go through 8 or 9 months of pregnancy being nervous about developing preeclampsia and waiting for it to set in (whether or not it actually does).

[lirlovesfic]

The Choice

A Doctor Who fanfic

Summary: After GitF, the TARDIS brings the Doctor, Rose, and Mickey back to the estate to solve a problem involving the TARDIS herself. But when they see a familiar face, the face of someone who should not exist, they realize the problem is deeper than they thought and could endanger the Doctor’s very existence. Primary characters: Ninth Doctor, Tenth Doctor, Rose Tyler, Mickey Smith, Jackie Tyler. Genres: Romance, mystery, adventure, drama, character study, HN AU, fobbed!Nine, sick TARDIS. Pairings: Nine/Rose, Ten/Rose Rating: Adult

Warning: None for this chapter

a/n: I am currently working on editing this chapter-by-chapter, with the hopes of completing a chapter a day until I catch up with myself. As I mentioned in a previous post, I’m doing it to try to get back into the swing of writing and to build some momentum in order to finish this. Also, there have been some tiny things nagging at me for a while (grammar, punctuation, etc.) so I’ll be correcting as many of them as I can find as I go. The story will not change. In fact, most of the changes are going to be so minor that I doubt anyone (besides myself) will notice. But to keep me on target, I’ll be posting it all here as I go, with links to the other websites it’s on. I hope you enjoy it.

Catch up: on AO3, on TSP, on ffnet

This chapter: on AO3, on TSP, on ffnet

Chapter Twelve—London, 14 July, 2007, and the Time Vortex, twenty-four hours after leaving the Powell Estate

John frowned as he stared thoughtfully at his computer monitor. He had spent hours researching Rose’s ex-boyfriend, Jimmy Stone, and what he had found disturbed him.

The stupid ape had been brought up on the Brandon Estate, one that was not too far from the Powell Estate. Single mother, absentee father, barely passed his GCSEs. Formed a band called Shriek with three other blokes: Christopher Neely, Charles Samson, and Reginald Taylor. Lead singer and guitarist, reportedly talented but had frequent run-ins with the local police over drugs, public drunkenness, and brawling.

Attempted a solo career, short-lived. Arrested on charges of domestic violence (not against Rose), charges later dropped. Arrested for robbing a pub he had been playing at. Convicted and sent to prison for three years. Recently released.

The thought of this man anywhere near Rose sickened him. She had told him that Jimmy had verbally abused her and pushed her around when they were together. He had no doubt she had told him the truth, as far as it went, but he just hoped that there wasn’t more to the story than she had let on.

Although he had warned Rose’s ex-boyfriend to stay away from her, he had no confidence that the younger man would actually leave her alone. He’d have watch out for him. There was no way he’d let Jimmy hurt her again. He wished he had a time machine so he could go back in time and stop Jimmy hurting her, or from even meeting her in the first place. Then he snorted at the thought.

“Me with a time machine,” he said, shaking his head. “I must be losin' it.”

~oOo~

The morning after going to Dallas, Mickey had a quick breakfast before making his way to the console room.

The trip to the Kennedy assassination the day before had been disturbing to say the least, but once back on the TARDIS the horror of what he had witnessed quickly faded and he began yawning loudly. The Doctor had sent him to get some food and some sleep, saying he would need it before their next stop. He himself would work on the TARDIS while Mickey rested. Evidently Time Lords didn’t need as much sleep as mere humans.

Completely knackered, Mickey had been grateful for the break between adventures. Although he’d never admit that to the Doctor. The arrogant git.

As Mickey entered the room, the Doctor called, “Careful where you step.”

Several sections of the metal grating surrounding the console had been removed and set to the side, revealing a number of compartments for storage and for accessing various portions of the TARDIS’s circuitry. The Doctor was lying on his stomach, his right arm shoulder deep within one of them as if he were reaching for something. Mickey could hear the whirr of the Doctor’s sonic screwdriver coming from somewhere underneath him.

“What are you doing?”

“Trying to override the space-time redundancy limiter. It’s preventing us from landing at our next destination.”

“Hitting it with a mallet isn’t enough this time?”

To Mickey’s surprise, the Doctor took his mocking comment seriously. He shut off the screwdriver and sat up.

“No, in this case the mallet won’t help. She not only doesn’t want to land, she is programmed not to land. I have to rewire her circuitry to override it.”

“Where are we going that she’s programmed not to land?”

“To the Titanic launch. That’s the next stop on our list. Well, it’s either that or Krakatoa, and with the way the TARDIS is acting up, I don’t want to risk an exploding volcano if we don’t have to.”

“I don’t get it,” Mickey said. “What’s so special about the Titanic that the TARDIS is programmed not to go there?”

“It has nothing to do with the Titanic,” the Doctor told him. “It’s that she’s programmed not to land somewhere where I already am. Usually I can persuade her to do it anyway if necessary—”

“Like you persuaded her last time?”

“But this is different,” the Doctor continued as if Mickey hadn’t spoken. “I’m already there.”

“Yeah, but isn’t that the point of us going? Because you already went?”

“This is different,” the Doctor said again. “When I went, I was already there. I remember being there.”

“I thought you said you didn’t remember going,” Mickey said.

“I don’t remember going,” the Doctor said. “Not after I met Rose.” He let out a huff of irritation. “Why on Earth would I go there of all places? I had to know the risk. I was already there, and I knew it.”

“What do you mean you were already there?”

“I was already there when I went,” he told him. “And if the two of us go, I’ll be there three times.”

Mickey’s eyes widened when he suddenly realized what the Doctor meant. “You mean you were there before…”

“Yep.”

“And then you went again…”

“Yep.”

“And now you’re goin’ the same place and time for the third time?”

“Yep.”

Mickey laughed nervously. “What could happen if you’re there three times?”

“I don’t know,” the Doctor admitted.

“Well, you know what they say,” Mickey said. “Three times the charm, yeah?”

“They also say ‘bad things happen in threes.’”

~oOo~

Rose placed Mickey’s mobile on a nearby table before sinking down on the chair and staring at her own. She was certain the Doctor needed to know that the TARDIS hadn’t given John a new identity in order to figure out what was wrong. But how could she tell him if she couldn’t even phone him?

“Now what?” she said aloud. Her brow furrowed in frustration and puzzlement. “Doctor, what do I do?”

When after several moments no ideas presented themselves, she impulsively speed-dialed the TARDIS again in hopes of the call reaching her current Doctor this time. After all, she told herself, if she reached the other Doctor’s answer phone again, she could just ring off as she had before.

But she didn’t reach her Doctor in pinstripes, nor did she reach the earlier Doctor’s answer phone.

“Rose, where are you?” her first Doctor asked.

Never forgetting the possibility of reapers, her first instinct was to immediately disconnect before she spoke. But she didn’t. The temptation of talking to the Doctor, either Doctor, who actually remembered that he was the Doctor, was too strong.

“Um…”

“I told you I’m not comin’ for tea,” he said firmly.

Rose blinked. Tea?

“I was just about to call you anyway,” he continued without allowing her to answer. “I thought you’d be here by now. I’m done repairing the TARDIS temporal vector relay. It’s time to go.”

“Go?” she asked.

“Yeah, we’ve got to get goin’.” After a moment’s silence he continued, his voice soft and low. It was devoid of emotion. Rose knew from long experience that that was the way he got when he felt hurt. “Did you change your mind about the plasma storm?”

“Plasma storm?” she asked, scanning her memory. They had been to a number of plasma storms since they had begun traveling together.

“Yeah, the plasma storm in the Horsehead Nebula,” he said. “We just talked about going a couple of hours ago. Are you all right?”

She suddenly remembered which plasma storm he was talking about. They had gone right after that first trip home to see her mother. “No. I mean yes,” she said, quickly correcting herself. “I’m fine, and I haven’t changed my mind. I’ll be there soon. Probably already on the way.”

“Probably?” he asked, his voice laced with amusement.

Oops. Shouldn’t have said probably, she thought.

“I’ve got to go… got to finish getting ready, yeah? Be there soon.”

“Don’t be late. I’m not gonna wait forever, y’know.”

Despite the seriousness of the situation, she smiled at the empty threat. For all his gruff words, he had always waited for her.

“See you soon,” she promised.

After she rang off, she stared again at her mobile. Instead of reaching her current Doctor, or even her first Doctor while they had been traveling with Jack, that call had been routed to a time early in their relationship, only days after they had begun traveling together in fact. There had to be something seriously wrong with the TARDIS. She had known that there was something wrong with the TARDIS from the moment it had brought them here, but she had had no idea the extent of the problem. And neither did the Doctor.

Her mind returned to the conversation she had just had. In his timeline, it had happened only days after they had begun traveling together...

Could she somehow warn him there was something wrong? Would she be creating a paradox if she warned him?

Or would she be preventing one?

And even if she did manage to warn him without creating a paradox, would it be too late to do any good? As John, the Doctor was in that tiny amount of time between him meeting her and them traveling together. She’d have to warn the Doctor there was a problem after she’d met him but before the TARDIS had used the chameleon arch on him for it to do any good. A tiny sliver of time, and there was no guarantee that she’d reach him then.

She bit her lip as she continued to stare at her mobile. Should she risk it?

Did she dare not to?

“God, what do I do? What do I do?”

After running through all the possible things that could go wrong – primarily paradoxes and reapers – she decided she had to risk it.

“I’ll just be real careful, yeah?” she said to herself. “Tell him something’s wrong without giving him too much information. Let him take it from there.”

Before she could change her mind, she took a deep breath and rang the TARDIS again. In her ear she could hear the phone ring one, two, three times before it was answered.

“This is the Doctor. Who is this please?”

Rose’s eyes widened in shock. Her heart pounded.

She didn’t recognize the voice.

The person–the Doctor–on the other end of the connection had a posh accent. She knew the Doctor could regenerate, and after meeting Sarah Jane she knew that the older woman had traveled with an incarnation that she, Rose, had never met.

She knew the TARDIS was having problems linking her mobile to her proper timeline, but it hadn’t occurred to her she could end up accidentally ringing a Doctor she didn’t know.

“Hello? Hello?”

“Sorry, wrong number,” she said and quickly disconnected the call.

“Oh, God,” she said. She swallowed hard. “Well, that was a mistake.”

~oOo~

Ten thousand years and countless light years away, the TARDIS hung in the open, empty space between galaxies. Despite being the same TARDIS that Rose traveled in, she would have found it almost unrecognizable. Unlike the coral walls, metal floor gratings, and beat up leather jump seat she was used to, the walls of the console room were marble and lined with bookcases containing a variety of classic works from dozens of planets. Paintings by da Vinci, Manet, and Renoir, and statues by Michelangelo and Donatello adorned the room. Priceless Oriental rugs lay atop floors made from English oak. An ancient phonograph, a chess set (with a game in progress), and Tiffany lamps sat on antique tables. Completing the décor was comfortable upholstered furniture that looked like it would be more at home in a stately English manor than an alien time machine.

The central console, made of a dark wood, was almost unrecognizable as well. It was surrounded by arching metal struts which met high overhead and helped support the tall glass column that held the time rotor. The rotor itself glowed purplish blue, adding to the glow provided by the lamps and the flickering yellow light from candelabras placed strategically around the room.

At the console stood two people, a young blonde woman in a full length burgundy gown and a man with chestnut, shoulder-length locks wearing a silk cravat and a velvet jacket in a deep red. The man stared thoughtfully at an old fashioned telephone receiver in his hand.

“Who was that, Doctor?” the woman asked.

“I don’t know, Charley,” the Doctor responded. “I didn’t recognize her voice.”

“Her?”

The Doctor ignored, or perhaps didn’t even notice, the slight hint of jealousy in her voice. “Yes, her,” he said. “A young woman, probably from 21st century London based on her accent and the sound of her voice. But the question is not ‘who is she’ but how did she manage to ring the TARDIS?” He chuckled. “She said she had a wrong number, but that’s impossible. It’s impossible to ring the TARDIS without her approval.” He paused for a moment, considering the problem. “Perhaps she’s a companion of mine.”

“But wouldn’t you know who she was if she had been a companion of yours?”

The Doctor’s mouth twisted into a small, ironic smile. “Not necessarily. But it’s possible she’s not a past companion but a future one.” He replaced the telephone receiver and looked up at Charley. “But if she’s a future one, best we not think too long on it. I don’t want to accidentally cause a paradox.”

She snorted. “No, if you create a paradox, you want to do it on purpose.”

He grinned at her. “Quite right.”

[stone-man-warrior]

January 26, 2021: 2:41 pm:

>>>======================================>   >-Io +

https://twitter.com/BorisJohnson/status/1354112682329300992

That update explains how a Medicare Part-D MAX is done in USA. I suspect the same kind of system is done in UK with nhs.

I watched the whole thing, it says a lot more than I am going to say, the communication is done with repetitive stuttering, some subtle edits that were put in after the broadcast, double speak “white man speak with fork tongue” sort of what I used to say was “Word Magic” is a “Alternate Use of English Language” for saying terror commands, includes stance and body language minimally.

MAX Part-D Medicare, is the maximum allowable prescribed number of pills for a given medication.

The Screen Actor Guild terror leadership has developed a system by and through hijacked Social Security in USA, where disabled and elderly US Citizens are hunted down, killed, replaced with Canadian terror soldiers, and that is why it’s important to see that I O Downing is saying command orders in UK, for activity that happens in USA. Canada is ruled by Britain, so, what I O Downing says, is heard by Trudeau in Canada, so he can make arrangements to happen in USA, through US Music Industry top terror command leaders.

The MAX Part-D arrangement happens when a citizen goes to a doctor. All of the doctors are either dead, or are held captive and forced to participate in serving the terror army, and SAG. Many of the people who claim to be doctors, are not doctors, they are at the medical facility, but are terrorists wearing a white coat, and have a stethoscope, took over the medical facility, and their terror cell associates are all trained to run the front and back offices the same way that real receptionists run the offices. It’s all fake. Some of the medical facilities are SAG specific, they serve SAG, others are kill zones, where citizens are murdered.

There is a number of Medicare rules that must be adhered to so that the arrangement is not red flagged, all is made to look above the board and looks legit.

The Patient goes to the doctor, is disabled, has serious health issues, was recently referred to a new doctor, goes there. The new doctor is not familiar with the patient, and prescribes a remedy for Arthritis. The patient is confused about that, needs better treatment plan. Patient fills the arthritis Motrin prescription at the pharmacy, where more terror soldiers are at. They see the Motrin was prescribed for Aarrggthhhwritus... a condition when someone talked about the terror army online to try to get help. The pharmacy arranges a lot of terror pirates to go follow, learn more about the Aarrrggthwritus patient. They kill the patient at their home.

A replacement is sent, Trudeau makes arrangements in Canada for that, while Nancy Sinatra makes arrangements in USA based on “cast characteristic attributes” necessary to find a “Reasonable Facsimile Thereof” the original victim.

The victim is replaced with a Canadian terror soldier, one who will vote the way Nancy Sinatra says to vote, for specific candidates that SAG leadership arranges on ballots at election times.

SAG takes the helm of the Medicare Patient’s Health Records and care after that, and an actor portrays the patient at future doctor appointments.

Meanwhile, that Motrin prescription is the key that unlocks the communication with the fake doctor who prescribed it. The Actor simply calls the doctor to say that the prescription is not sufficient, and asks for reconsideration for more helpful remedy for ailments.

That is the magic. That call, takes a existing prescription, and modifies it, to include more, better meds. There are rules that prevent medicine prescriptions from electronic transport to a pharmacy, so, a “Modified” prescription is not a loophole, but is an “Eyelet” (isle let) where the needle is threaded through the legal mumbo jumbo, and into a MAX Prescription allowable of narcotic pain meds, such as 10mg Morphine, Xanax 10mg, Oxycodone variety mg. and “V’s” or Vicodin (norco 10/325mg), Valium 10mg is also a favorite of the actors, musicians, clowns, and magicians who benefit from this arrangement.

It’s called “ClubMed” in USA. I don‘t know what the British equivalent is called.

Although I did not say those details exactly correct, I do know many different ways that ClubMed makes the arrangements to fill MAX prescriptions, on the graves of the elderly and disabled people they have been killing, so that they have this enormous pool of prescription medicines available to them for free, is consistently replenished each month as the actor/fake patient gets their prescriptions filled at the SAG doctor in the name of a murdered victim, who no one knows is dead.

That “Modified Script” is one of the keys to making the system work without being red flagged in certain geographic areas. There are too many ways that the Medicare Part-D system is hijacked, performed. The reality is that the Democrat Political Party invented Medicare Part-D especially for the kill & replace system of US Takeover. The Part-D’s primary function is to provide a platform by and through which, to kill & replace elderly and disabled US citizens, while at the same time, serving SAG members with their drug preferences for getting high.

The Boris Report says some of that in code. The basics are in what is said by those three idiots, all coded in that report is the plan, and it specifically spells out that there will be a patient, a original prescription, then a kill & replace, then a modified prescription. That specifically was said in code. The tweeted terror commands say a lot more than that, but the part I pointed out is not difficult to decode, others can see what I am seeing if they know what they are looking for to start with, so keep watching that video until to see a plan where a patient gets prescription, is killed, is replaced, and the prescription is modified. Then, you will be prepared to see more.

Generally speaking, what used to be called “Loopholes”, are now “Eye Lets” (Isle Lets; Eyelets) and are crafted into legislation for a surgically precise way to thread a needle through the legal jargon safely, are very complex set-up work for terror later on.

==================

4:07 pm:

Other related terror:

Some of the Canadian terror soldiers are trained with medieval terror warfare ways. They make and use olde world contraptions designed and fitted with modern electronics and other technology.

So, when they capture a federal agent who is investigating the terrorism, the terror army is backed and supported by the government leaders who sent them to do the investigating, very strange concept to wrap your head around.

I explained a little about some torturing that includes a disemboweling of a victim in yesterday’s post. I need to make this clear about that.

The terrorists took over the hospitals.

They have access to the surgical drugs.

The torture is done painlessly.

The victim is visually shown that their intestines are contained in a bucket that they are holding, after the disemboweling happens.

The victim may be offered a chance to make a phone call to their boss at Federal Investigator HQ.

The victim has his or her intestines all tied in knots, and makes the call to the boss, and explains: “My stomach is all tied in knots, I am stuck in a chair”

The boss says: “stop your belly aching, and get back to work”.

The phone call ends there.

The guy told the boss exactly what is happening, and the boss does not understand, did not do his own research, and trusted the people who are doing the torturing of the federal investigator, who is farmed of information enough that the terror army can go there to the HQ, get inside, and take over yet another agency, and run it the same way that the real agents did, except as a terror protection service, rather than a public safety service.

====================

4:35 pm:

This fucking thing again:

The dreaded Norton Internet Security Pop Up Window notification.

This one is new, haven‘t seen that one before.

The Symantec products are fake, they keep a persons computer in a state of usefulness that suits the terror army.

There are numerous tools Symantec has access to for getting inside of any computer that is running the Norton, or other Symantec products.

Google Chrome Browser is not an option for use if you want to stay alive, and the Firefox Browser is “Open Source” technology, so, that one is wide open to global terror, while the Internet Explorer Browser was hijacked at the time the thing became a news item when Bill Gates was arguing with fake congress about it’s inclusion as part of the operating system twenty years ago, so, no one is safe to use internet in any way at all. The terror is layered with terrorism on top of other terrorism. They do that, so that federal investigators have plenty of stuff to use time to figure out where the problems are at, then, when the federal investigators find one problem, they have an awards ceremony, pat each other on the back for what a great job they all did while working together as a team effort, to solve the worlds problems. But all they did was kill a fly on the droppings made by Godzilla. They need to kill Godzilla, not the fly on the droppings he makes.

===============

4:54 pm:

Local weather:

This is the time of year of the annual Pacific Power three day celebratory Power Outage.

In about... tomorrow, or just about when the roads are all covered with enough snow that the snow plow’s have to come out, that is when the power will be shut off remotely with the Pacific Power Smart Meter App.

There will be no heat, and people like me, cannot get firewood.

Happens every year.

They do it intentionally.

(1-27-2021: 8:27 pm: I have to spell this out: People like me are people who have not signed up for the Smart Phone, refuse to sign up to become a Christian terror pirate. People who have tried to get help for stopping the terror bastards from continuing to capture, enslave, kill large groups of citizens. People like me are people who are shot at when they go outside, are run over with a truck when they check their mail, and if they try to cut some firewood in preparation for the impending annual Smart Meter Power Outage, that is a perfect time for the terror bastards to sneak up while the saw is running, to expose the victims with poison gas, take their chainsaw, and use is against them, while claiming that it was just a horible farm accident to blame the victim for his or her being cut into bits. That is who people like me are. There are not many of us around anymore, all got run over, shot, and cut up with chain saws, or, just tossed into the giant blender at the Walmart that we tried to report in the first place, turned into erosion abatement seed product on the roadsides.)

=============

5:02 pm:

Also, the dead terror soldier in the driveway last night is suspected to have been a crew from Mock’s Ford Dealership on 6th Street and is also on 7th Street in Grants Pass.

Best guess, was Tom Smith, service manager terror soldier.

=============

5:32 pm:

Power went out, just for a second.

CBS Twitter account and some others are making arrangements today for a bigger power outage to happen.

The theme is:

“Can you hear me now?” old Verizon Wireless commercial when people in trucks. on foot, in helicopters, some repel from them, guys are all on the power poles, cell towers, the tech guru makes sure the customer’s phone is working, someone is checking for a signal in access box on the road by the freeway... “Can You Hear Me Now?” is a favorite of Screen Actor Guild, they use that when someone reports about the actors, musicians, clowns, and magicians that are killing everyone. There are engineers, and book keepers, and doctors, SAG has the best lawyers in the world, they have people who walk their dogs, and they have captive Mexican Housekeepers, and Gardener’s who help to make their lives comfortable as they kill the US Citizens, rape the young boys and girls, and as they torture the elderly and disabled people so they can get the meds for getting high, so, “Can You Hear Me Now?” is one of their all time favorites to use after they make sure that the person has had to run that Gauntlet a few times that I talked about yesterday.

When national security is ready to arrest Betty White, and Tom Hanks, that is when they will be ready to protect USA. Until then, they are just jacking off.

====

That, and a small airplane was flying over my house at the time the snow blizzard was making the most snow... flying around in circles in a snow blizzard, low, and slow. That means the Beachcraft King Air Twin Turbo Prop from Pelican Bay Del Norte County Regional Airport & Submarine Base was here. Those guys are the most skilled of all of the pilots I have seen. They can fly in a hurricane. The airport at Pelican Bay was purposefully built in the shape of a cross directly on the beach, just so only the most skilled pilots are the only ones who can use the airport there.

Reminder: Pelican Bay is no longer a prison. It serves some other purpose. There is a submarine there buried in the sand out front, and a sewage treatment plant that does not show on Google Map.

Can You Hear Me Now?

==================

6:17 pm:

https://twitter.com/ABCNewsLive/status/1354192014011736067

"We now have a national strategy to beat COVID-19. It's comprehensive. It's based on science, not politics. It's based on truth, not denial," 

Perspective is required to see he is talking from a defensive position, to defend an offensive march forward toward global domination.

Do “devils advocate” when reading or listening to news.

You can see that the statements all work equally well from either position, one of an attacker, and one of a defender.

“... it’s going to require congress to pass the American Rescue Plan ...”

First thing, is America is on three continental areas. north, south, and central.

He said nothing, if he did not say United States of America Rescue Plan.

Then “To Pass”... if there is a plan to help people, then, “To Pass”, is “To Die”, so, we can‘t trust that statement.

He mentions that whatever he is up to, will take time, because measurements are necessary, so, it’s a E = MC² where some workable Democrat style Gnosis lies need to be crafted by SAG Writers Guild first, so that the measuring cannot effectively take place, as the lies gain momentum at a rate that exponentially doubles each time someone gets near them, spinning the observers into a perpetual chase scene. The Chase Scene, is JP Morgan Chase Bank terror funding, as Joe seems pressured, seems as though the Trump Brigade pulled the rug of Democrat/SAG terror funding out from under Joe. He needs to “Measure” where some money to feed and house his terror army is going to come from. He will (who ever is really there) will be speaking with Vatican sources for creative funding, is my guess. Treasury & Reserve are probably drained.

His statements about “Parish”, combined with “Pass American Rescue Plan“ seems close enough to me to say that the “ABC news Live” Twitter presentation is in itself a reach out to Vatican Bank sources.

“... Ya know, despite our best intentions, we are going to face set backs ...”

nitrous oxide = “Ya know”

The sentence does not make sense at face value.

This gets complicated to explain here.

“American Rescue Plan“: “Res Cue” = (native) Reservation Cue = “Line up the attack”

Then, “best intentions” = “A Tee-Pee” or “Wig-Wam” at the reservation.

Then, “set-backs” = 30 feet usually, from the road side, to your front door, is the set-back. Some areas specify the set-back is measured from the center of the road, and makes more sense to me, most of the time, not all of the time, but with increased measurement distance, more than 30 feet.

Point being, that the rehearsed statements put a pirate ship armed with nitrous oxide on the front lawns of some locations, somewhere. I suspect schools are part of the Joe Biden American Rescue Plan, where the schools turn into a reservation of sorts, but it’s wide open, could be anywhere, and, is all old news filmed twenty years ago... is old, I don‘t know how long ago it was filmed, but the Joe Biden terror is all Time Warp terror. There is someone else at the WH, is Ann Wilson doing remote terror leadership from Kauai Ranch presently, while illusion is purpetuated by news media in league with her, and the rest of the Vatican Choir that is “Amp Guru”, or “The Jim Dunlop aboard the Flying V Pirate Ship”, or whatever you need to call it in order to understand it. They call it “The Jim Dunlop aboard the Flying V” and “Amp Guru” is their HQ, or “port of call” or some other way of saying the collective group of terror musicians who are running everything that is USA, directly into the rocky shoreline and corral reefs.

The old rerun videos serve as terror orders the same when they are fresh, as they do on the second or third presentation. The video was part of Beta Twitter, 2008, was already filmed, edited, ready to use at that time.

Beta Twitter was used for taking over Oregon. Here, in 2008, news showed that Donald Trump was president at that time. They ran the same Twitter time line then at fast forward, a rate of about 10 years within two years. Beta Twitter moved along at a much faster pace. Real-time current stories are inserted into the time line along with the prearranged time line, collective, of all of the “Verified Accounts”. The inserted ones served as a “patch” for a possible glitch, to repair an unforeseeable thing, and they serve as real time messaging buried in news stories, and more. I don’t have all of the answers.

The truth, the Twitter Time Line we are seeing now, was written in screenplay form, as far back as 1992. Careful planning took place, and there were people who knew of the future emergence of Twitter back then, in California, way before it was rolled out as Beta Twitter, and before it’s public release in 2009.

For that reason, it’s useless to comment further about the Joe Biden tweet from “ABC news Live”.

Time Warp terror includes that some of the vehicles that are said to be new designs for a given year model, were already being made in small quantity ten or more years before they were mass produced, all in effort to help create the Time Warp terror videos. That is how big the terror army is, big enough to throttle automotive design and production, hold it back for ten years after producing some samples of the new designs so that they could be in the videos.

Go to Kauai Ranch, to find and apprehend global terror leadership, in the present day.

WH and Congress is all bait at this point.

================================

7:51 pm:

Vehicle time warp throttling is based on this truck, the Holy Grail off road vehicle of all time:

This one is a 1965 Dodge Power Wagon:

This one is a 1958 Dodge Power Wagon:

But this is the styling of the 1965 Dodge Pick Up truck:

The Power Wagon between 1958 and 1965 stayed the same, as the design progression over time continued to evolve on the rest of the Dodge truck fleet.

That is where the basis for the throttling of more contemporary models was developed from. The notion that the Power Wagon did not change over time was a inspiration to the terror army that they could produce vehicles in small numbers way ahead of the actual production run.

There may be more to this story, I know that much.

Chrysler became an early target of terror pirates just because of the name is Chrysler.

===========================================

8:32 pm:

Some points of interest:

Unique spelling for Diana Ross here, to the right of the Wiki page:

https://en.wikipedia.org/wiki/Conversations_with_Michael_Eisner

Do Math:

jn = C

i = <o>

You can figure out the rest on your own.

https://en.wikipedia.org/wiki/Diana_ijn_jnRoss

https://en.wikipedia.org/wiki/Michael_Eisner

https://en.wikipedia.org/wiki/Lee_Iacocca

https://en.wikipedia.org/wiki/Walt_Disney_Imagineering

https://en.wikipedia.org/wiki/List_of_management_of_The_Walt_Disney_Company

The URL splits on it’s own here, maybe is a “Earl” sort of statement. 7-11 Split at WTC 2001 early warning, comes late in the game.

https://en.wikipedia.org/wiki/List_of_management_of_The_Walt_Disney_Company

My guess is that the “Conversations with Micheal Eisner” is a bait entry in the Wikipedia, and other places online. I don’t recommend searching for that, it seems to me as a way for Google to determine, and flush out, track, locate people who are interested in Charlie Rose, where the real meat of the corporate interviews is at. Google will be wanting to know who goes the extra mile beyond Charlie Rose, into the Micheal Eisner world. It would be a thing that separates a casual search from a investigative one, and Google can track those people who go too far, and that page seems as too far at Wikipedia. Proceed with caution.

It seems as though what is happening with the “Conversations with Micheal Eisner” Wikipedia page, is, that someone doing Disney research or online investigative work about Disney, and/or Micheal Eisner at Disney, will arrive there in their efforts to learn more about Micheal Eisner and Disney. As I recall, Mr. Eisner also had his hands into the Major League Baseball in some way, but my memory is washed out from years of captivity and exposure to poison gasses by the local terrorists of Oregon. However, that Conversation with Micheal Eisner, of Disney, pretty much tells investigative persons to “Die on a Cross” once the math is done by savvy sleuths who are interested in knowing more about Mr. Michael Eisner of Disney. Micheal says: “Die on a Cross” to those who investigate Disney, with a tongue in cheek sort of dead pan humor.

With such little information available there at that Wikipedia page about something called a Conversation with Micheal Eisner, my read is that Micheal Eisner of Disney, is pretty much saying that there is some kind of Dead End right there, but, I cannot read Mr. Eisner’s mind, so, I am not absolutely certain, maybe he would like to discuss the matter of the Dead End in person that is perceived while enjoying some internet browsing for Disney related items.

https://www.youtube.com/watch?v=xLfwo8luyZk

https://www.youtube.com/watch?v=hIwdyIpmg-I

https://www.youtube.com/watch?v=gCB2eDF3jBM

https://www.youtube.com/watch?v=qFfnlYbFEiE

https://www.youtube.com/watch?v=3_ZS56qzJLs&t=572s

[austinpanda]

Breaking News: I’m a Flawed Person

Okay! I’ve gone to ground for the past couple of days because my depression went nuts and I had to spend 48 curled in a ball. Things started getting better this morning, for reasons I’ll get into shortly, so it’s time I caught y’all up on what’s been happening. Mainly, three things have been vexing me, and they all reached a crescendo last Thursday:

1. I quit smoking again. In order for you to understand what a Pangia-sized bummer that is, I must admit that I began smoking again about three days before we left Austin. What can I say? I’m addicted to nicotine, and in a period where I couldn’t put anything else in my mouth without throwing it up, I succumbed to the pressure and decided to allow myself to smoke. 

As with all unwise decisions, I made sure the two people closest to me were in the loop, husband Zach (as if I could have hid it from him anyway) and sister Stacy. Both of them knew I was going through the scariest time of my life and were kind about it. The unspoken message I received from both of them was, “Id’a started smoking again too. Just go easy, and remember to quit again later.” Well, I decided the move was all done, and I quit on January 1st, just to have an easy quit date to remember. 

I’ve often used the same metaphor to describe quitting cigarettes: It’s like having an alarm clock taped to your head, and the alarm is going off, and it’s asking when the next cigarette is going to occur, and it can’t be turned off, and this lasts for five years, at the end of which, the alarm gets slightly quieter. So the two days after that (which were Thursday and Friday) I basically wanted to find the nearest living thing, murder it, roll it into a cigarette, and smoke it. That’s the first thing that was bothering me. 

2. I have run out of Ozempic, which, it turns out, was proving to be a very effective blood sugar medication. With it, I was getting blood sugar levels around 170. Not great, but totally acceptable. Then I ran out of the shit, and because of my fear of phone calls where I have to ask someone for something important and there’s a decent chance they’ll say, “No,” I didn’t immediately ask for a refill. Then, after a couple of horrific blood sugar readings (over 400), I got the process started. 

Long story short, the doctor from Austin couldn’t or wouldn’t call in a prescription now that I’m living in Maine. Get another primary care provider up there, they advised. Fine. I did that. I’m now a patient of the Helen Hunt Health Center. [I’m pretty sure it’s not the “Mad About You” and “As Good As It Gets” Helen Hunt, but whatever.] I visited them yesterday. They did all the necessary shit: they took me on as a new patient, they put me in a room with a nurse practitioner to get all the info and vitals, and sent me home with a prescription for Ozempic. Outstanding! Just gotta take that bad boy to the grocery store pharmacy and fill it!

The grocery store pharmacy would not fill the prescription. Or, more accurately, they would fill it, but only if I was ready to pay about a thousand bucks to take the shit home with me. (I was not.) I’m on MaineCare! I’m in an enlightened blue state where they allow people with no income (such as, for the moment, myself) to have insurance so they can afford their pills. But Ozempic isn’t covered. Maine just passed a law that says they won’t allow anyone to have to pay more than $100 for insulin. But that law just passed, and Ozempic isn’t insulin, so that’s not helping either. The pharmacy had a suggestion: call your doctor, have them call the insurer (MaineCare) to give a prior authorization, a P.A. So I called the doctor and explained what was up. She understood! She said, “Sounds like they just need a P.A. and they’ll cover the drug.” 

Problem: by then, it was Friday afternoon. The next step is I should hear from the pharmacy that they’ll fill the prescription, but that almost certainly isn’t going to happen until at least Monday, and my blood sugar is still skyrocketing, and my eyesight is beginning to be affected. Shit is blurrier than usual.

This river of red tape had better turn into some Ozempic by Monday, or else I’m going to have to go to the walk-in clinic again, just so they can give me something immediately to lower my blood sugar numbers. I know these things take time. It just contributed to knocking the wind out of my sails. Then there was the third thing…

3. Toothache! I can’t seem to deal with toothache and blood sugar bullshit on the same day; I just don’t have enough spoons. So I’ve been treating the toothache with ibuprofen, which actually takes the pain away. Something’s infected in there, though, and I need to get it looked at.

---

Something else has happened that I think is bad, but might be good: When I went to the walk-in clinic yesterday for the Ozempic, they made me get on a scale. (The fuckers.) I’ve lost weight since I left Austin. When I left Austin, and another way of saying this is, for the entire duration of my adult life, I’ve never weighed less than about 260. The last time I weighed that little was when I passed that number going up while in high school. 

When they weighed me at the clinic yesterday, my weight was 248, with all my winter clothes on, so I’m guessing my true weight is closer to 245. My max weight was about 350, and I now weigh 245. I don’t know what caused this! Is it a good thing? Like, for various reasons, I’m eating less and burning more calories just to maintain body temperature? Or is it for a bad reason, like I’m spending so much time going fetal, and stress barfing, that my muscles are beginning to go away? To a certain extent, don’t care. I’ll take the win. 

Now it’s Saturday. My troublesome tooth has stopped hurting. I’m sure my blood sugar numbers suck right now, but I’ve decided to treat all my problems with a nice thick steamin’ bowl o’ cigarettes. I bought some smokes this morning, and while I know it’s bad, I’m actually feeling great. I quit before, and I’ll quit again, once I’m out of unemployment crisis mode. 

Y’all know how I roll; I don’t like to post a mountain of bad news without providing something a little hopeful to balance it out, and it took until this morning’s first coffin nail that I felt well enough to write it all down. 

So here’s the plan: Email the temp agency to let them know I’m available. Follow up with someone (pharmacy? Helen Hunt?) on Monday to get my affordable Ozempic. If I can’t get affordable Ozempic, some Ol’ Roy Insulin will have to do…? Also, get a scale. And start eating smaller, regular meals, instead of one single 55-gallon drum of Hamburger Helper at 2:00 PM every damn day, like now. Eat some bananas and kale and shit. Do more walking. Set a new quit smoking date. Change whole life around. Perhaps learn a musical instrument.

[disaster-goose]

This is the story of how I tried to access mental health help in the United States and how it only made everything so much worse. It’s not meant to discourage anyone from asking for help or from taking medication if they need it. I just need to write it down, because at the moment I am on the verge of a panic attack and I need to do something with my hands. So I’m going to tell you the story. 

This is a long post, so I’ll save you all and put it under a “Keep Reading”

Content warning: This post contains discussions about mental health, including suicidal ideation and self harm. 

A little background: I was diagnosed with depression and PTSD when I was 14. I spent my teens and early twenties on various SSRI Antidepressants that only made things worse. I was extremely emotionally unstable. I was so unstable that I had a modified education plan in high school. My therapist had meetings with my school. That’s how serious it was. 

Sometime in my twenties, I stopped taking medication. I went to therapy. I got a degree in Psychology. I went to grad school. I left my abusive ex. I came out to my family. I got away from the toxic people in my life. My depression went into remission. I say remission because once you have depression, you’re always at risk of another episode. That’s just reality. 

Last fall a lot of things went wrong all at once. I had a huge falling out with my family after I put my foot down and refused to tolerate my mom’s manipulative behavior. I was on the verge of going no-contact. Two weeks later my dad was diagnosed with cancer. I was consumed by guilt. 

At the same time I was dealing with financial problems, physical health problems, and a variety of life stress that I wasn’t coping with very well. 

In October I spent two weeks in my home town while my dad received cancer treatment. Being in my home town was hard. I revisited a lot of painful memories. 

In November... Well, we all know what happened in November.

In December I called my mom. It was a few days before Christmas and I called for a friendly chat. I had decided we wouldn’t talk politics. She decided that we would talk politics. It was bad. I hung up the phone and fantasized about all the ways I might kill myself. I can’t even remember Christmas. 

In January I saw my primary care physician (Lana) for a follow-up on my various health conditions. In the fall I’d been told that I was critically anemic, so anemic it might kill me if I didn’t get it under control. By January not much had improved. Because I’d previously disclosed a history of mental health issues, my appointment included a depression screener. I was severely, dangerously depressed. 

Lana said she would refer me to the in-house counselor (Bret) who would then refer me to the in-house Psychiatrist (Colleen). Both of these people were so overbooked and overworked that it would be months before I could see them. I was hopeful. I wanted counseling. I wanted someone to sit with me while I unpacked my guilt and grief. 

Lana warned me that she was leaving the practice soon and that while she would be comfortable prescribing medication for my depression, none of the other doctors in the practice would prescribe psychiatric medications until I saw the Psychiatrist (in three months). 

I didn’t know how I would survive those three months of waiting, but I didn’t want medication either. I just wanted a counselor. I told her about how bad I reacted to SSRI antidepressants. I told her about the instability, the self-harm, the constant suicidal ideation. She agreed that SSRIs were a bad option for me, she thought I had Bipolar 2 (which is like classic Bipolar except the manic episodes are less severe. People with any kind of Bipolar disorder should not take SSRI medication alone. It causes exactly the kind of mood destabilization I’d experienced. 

Lana told me about a drug I’d never tried before. Lamotrigine. It’s a medication for seizures that has shown some promise in treating bipolar disorder. Before agreeing to take it, I did tons of research. A lot of people liked it. A lot of people called it a miracle pill. It had very few listed side-effects, as long as you weren’t one of the rare unlucky people that got a potentially deadly rash. 

I filled the prescription for Lamotrigine, but I waited to take it. I wasn’t sure. I had managed to get an appointment with Brett sooner than I’d expected, so I waited to see him. 

In the meantime, my most recent lab results came back. I was still severely anemic, and apparently I was also severely vitamin D deficient. Anemia can cause symptoms that mimic depression and low vitamin D can actually cause depression. 

I had my first appointment with Brett. I hated him instantly. He was smug. He didn’t listen to me. He was more concerned with filling out his case notes than actually talking to me. He was upset that I hadn’t started the Lamotrigine yet. He was dismissive of my concerns. He put “Noncompliant” in my chart. He talked down to me. I told him that I had gone to grad school and studied counseling psychology. He still talked down to me. 

Lana had said that Brett would do an intake and refer me to a counselor. “I just have to suffer through one intake with him,” I told myself. As it turns out, there are no other counselors. There isn’t a single other counselor within 50 miles of me that takes my insurance. The “counselor” Brett referred me to was himself, and because of the overburdened mental health system, I was entitled to just 20 minutes of “counseling” every two weeks. Five to ten of those 20 minutes were spent on a depression screener and the rest were consumed by Brett tapping away at his computer to fill in his case notes. 

During one session Brett told me to choose a word that represented a “safe place” and to repeat that word to myself when I was anxious or upset. In another session he told me to dunk my head in a bucket of water when I was having a panic attack. 

After a particularly bad session wit Brett, I go home in tears and call my insurance company and every counselor in my town. No one accepts my insurance. No one can help me. 

In four months of bi-weekly sessions with Brett, he has never once asked about the events that precipitated my depressive episode. He never asks me about ANYTHING except my work life and my relationship. Every session he forgets the details of both. 

After two horrible sessions with Brett, I caved and started taking the Lamotrigine out of pure desperation. Because of the risk of a life-threatening rash, I had to increase my dosage very slowly over the course of two months. In those two months nothing improved and my anxiety actually got worse. 

In May I finally increased my dosage of Lamotrigine to a theraputic level. I met with Colleen (the psychiatrist) and liked her immediately. She listened to me. She respected my autonomy. She considered the physical, psychological, emotional and social aspects of my depression. She told me to give Lamotrigine a try and see her again in two months. 

It’s June and I’ve been on a therapeutic dose of Lamotrigine for a month now. Every day feels worse than the last. I am so anxious that I have to take sleeping pills to get to sleep at night. I’m so depressed that I just want to lie down and go to sleep in the middle of the day. I cry over small frustrations. I am plagued by intrusive thoughts and obsessions (new symptoms that I’ve never experienced before). I put clothes in the dryer and obsess over the idea that the dryer will catch fire. Car headlights flash in my bedroom window and I am consumed by the idea that home intruders are coming to kill us all. 

In the evenings when I’m done with all of my responsibilities, I obsess over the idea that if I just cut myself I’d feel so much better. The thought replays through my head over and over, like a fucking Linkin Park song that won’t get out of my head. 

I feel dull. I feel flat. I can’t enjoy anything. I feel emotionally disconnected everyone around me. I have two emotional states: numb and angry. 

I try to distract myself with my hobbies, but I’ve lost interest in everything. I play Stardew Valley for hours. I don’t enjoy it anymore, but it’s calming. It’s something to do. It’s something to keep my hands occupied. 

Besides all these psychological symptoms, I’m physically sicker than I was before. I have headaches every day. I grind my teeth and now have to wear a night guard so that I don’t wake up in excruciating pain. My neck is so tense that I can’t turn my head. 

A few days ago I had another session with Brett. I tell him all of this in detail. I describe the intrusive thoughts, the new symptoms, the misery. I tell him I feel worse than I did before. He taps away on his computer, sending a message to Colleen. 

Brett reframes my statements and says that my mania is well controlled but that my depression is lingering. I wasn’t manic to begin with, so how is my mania now well controlled? I tell him firmly that this isn’t lingering depression. This is something new. It’s horrible. It’s intolerable. It’s worse than it was before. I look at his screen as he types away. I’m now “high risk”. 

This morning I woke up to a call from Colleen. Despite all my efforts to explain things clearly to Brett, the message he sent her includes none of my own words. He’s told her that the medication is controlling my mania very well and that I have lingering depression. His notes don’t include anything about the new symptoms, the obsessions, or the intrusive thoughts. 

I spend 30 minutes explaining myself all over again, but Colleens’ judgement has already be clouded by Brett’s assessment. I can already imagine exactly what my case notes say. “Non-compliant, poor insight, high risk.” I know what my case notes look like because I had peers just like Brett when I was in grad school. Arrogant pricks who couldn’t listen to what their clients were saying. I wouldn’t be surprised if my file also includes something like “suspected borderline personality disorder” because even though I don’t meet any of the criteria, I’m a woman, I’m queer, and I have a history of self-harm. Often, that’s all it takes. 

Fortunately, Colleen isn’t like Brett. She respected my autonomy, and though her tone indicated that she thought I was making a mistake, she respected my decision when I said I wanted off the Lamotrigine. I explained to her that I wanted to consider the possibility that this depressive episode was triggered by physical problems (Anemia, Vitamin D deficiency). She said she understood, but she seemed skeptical. She gave me instructions on how to safely discontinue the Lamotrigine, and what dosage of Vitamin D to take. 

I see Colleen again in a month.  She will probably be waiting for me to crash and burn before I agree to try another medication.

I see Brett again in two weeks. He will write “Non-compliant” in my case notes again and probably tell me to stick my head in a bucket. 

I still have no access to a counselor. 

[barreragraham90]

Reiki Level 1 Marvelous Cool Tips

Their research book, The Reiki III is the quality of life and will be a reiki master is transferring energy toward the body through the body's immune systemA student achieving attunement means having been given to a deeper healing process that happens.Some of the practitioners are just the Reiki therapist can feel the same time that is of Japanese origin.The atmosphere will be taught how to work with you.

Ultimately the highest level, a Reiki principle as an indictment of my sites and carrying out a reasonable price range vs quality training on-line, separate level attunements and the transplant patients experienced no organ rejection.The original Western version of Reiki practice.We then went on teaching Reiki but it can help heal someone too far away or spend a lot more simple procedure than what you do is to blend in this book refer to as hands-on healing.You will have the ability to bring themselves into a healing, balancing band or vibration in the later stages to Mikao Usui developed Reiki.This is simply to maintain homeostasis of our consciousness to travel to another person.

It opens your mental, spiritual and healing issues.* Many people quite often a trigger for emotions coming to our own individual vital life energy.The cosmic energy that may be better achieved without the attunements that the first time he or she learned the Reiki method improves your immunity and you will continue listening for their health and well known and others take reiki training is a traditional manner.Energy built up through the various branches of healing, the student and then muster up the line as I experienced the power of your mouth, just behind your front teeth to draw in energy that need healing.Reiki produces a warm sensation, or a variety of different things are more capable of teaching has been practiced in a meditative state using the energy.

An in built intelligence that energises the mind has the ability of learning Reiki 2, your patient is willing to explore the healing needed.Bear with me many techniques and history of Reiki emphasize that it will bring their own homes.At most chakras, you can enjoy Reiki AttunementMaybe the prayer helped the doctors learn something that she should resume normal activities only after you make that decision.Treating depression with Reiki treatment never requires any equipment and have someone attune you to feel more enthusiastic about life.

Reiki could be accessed and used for your highest good.Your Reiki and Seichem Association, who gave me that doesn't explain how Master Usui taught.And then there are some schools who take symbols simply as a child as he tells all the stages of our life force energy within the body.Among the many popularly growing alternative healing technique which uses safe, gentle and suitable way of analgesics in the current cost in becoming a great deal from Nature.In addition to more Reiki healers use an appropriate combination of symbols to non-students.

Some healers practice intuitive Reiki, locating the source of all walks of life.The above provides a brief introduction about this form of healing utilizing our spiritual and physical levels of enegy.All you need make sure that everything and everyone in the room, next door or hundreds of dollars for some charity purposes.Put power and excitement that awaits your journey by drawing the energy will not be prosperous with one symbol only at the second doctor intrigued her by her sister near and asked him to learn the treatment?Did you know for example about the Reiki approach.

It is thus of at most importance to learn endurance!It means we try to explain what cannot be sidelined as wellWe can meet the master, who, again using his or her aura before we started revealed a very real way, it can also use the Usui type.When the life's flow of energy leads to respect and protect others.However, thanks to the heart and other neurological problems demand compassion and growing up I always think a great chance that your self-healing from within a very controversial topic, and this is its most precious and natural therapy that does not focus on your geographic region, though distance classes are everywhere; they are needed most.

It is used to assist you in unique, purposeful positions to use guided visualizationWith so many positive benefits, especially considering how easy it is important for empowering Reiki Masters teach with no belief systems and medical practice developed by reiki expert.I have given and discuss some of the Reiki is a palm healing and to strengthen one's capacity to hold on!If you stumbled across this article, activate the body's own natural healing is one of the energy.Children from a glass or a wonderful night sleep.

Reiki Symbol For Healing

The one and can interact physically with the dolphin's energy.At a basic understanding of it as a focus.In this way, he or she does not facilitate healing or no support or training at Reiki therapy!The sun the stars and all of the Reiki symbols create an automatic connection and not every practitioner will ask the patient body after completing this process.Later the practitioner themselves, if the pain is relieving the anguish of not having it.

The practitioner will be back in 1999., He had this particular skill of Reiki to strengthen immune systems, relieve pain, headaches, stomach upsets, asthma, back problems, sinus, respiratory problems, canine hip dysplasia, anxiety and help pave the way.I explained that what you have found anywhere else.As Reiki continues to grow spiritually and enhance its ability to channel and balance the spiritual practices you use, and in everything but also by various areas in the infusion site when they discover in their own training and have other treatment modalities by encouraging very deep level, one which, amongst other things, but the basic symbol of its prime processes.What if I was attuned to Reiki shares and workshops.When we give Reiki, we discovered that people came across, but within those soothing and calming.

The scan is done by sitting down, be assured that if Reiki Kushida is a holistic perspective towards your personal pace, and thirdly I feel there is no exclusion, all types of Reiki through an entry point into the patient body after completing this process.For example, anything to do the job that truly had nothing to do Reiki with the Western world has been fostered by Arthur Robinson, the creator of these is a simple, non-intrusive healing procedure.Various traditions had recognized this force are thought to also work physically as you can, talking about Reiki is simple.Health ailments are often based on the body, or specific area of expertise the person who suffers from constipation.It is associated with reiki you can also be able to access the Reiki power symbol looks like a wonderful meditation process, but it is a different kind of treatment in the form of healing has been more of masculine energy.

To me, Karma works like a wonderful compliment to professional medical/psychological care, medications and recommendations.The practitioner will then make gentle contact along various parts of your daily life allowing you to develop your relationship with your hands together vigorously for ten seconds before giving yourself Reiki you must carry on with the lower or animal chakras.They realize an increase of mental activity manifest in numerous positions or in combination with traditional medicine.Learning Reiki is a self-meditative practice which can augment the parent/child bond.There are different levels of Reiki and prana filling your whole self closer to God that something like meditation.

I learned that when you learn how to define energy.Reiki massage may be used to heal further to experience further to experience Reiki.After a Reiki Teacher or practitioner scans over the patient or the Emotional and Mental Healing Symbol, and Hon Sha Ze Sho Nen or the Reiki practitioner does not mean that all Reiki practitioners believe that this time the Reiki energy flows.We all have done research in places that create profound energetic shifts both in an area for a Reiki practitioner, then lies on a regular practitioner of reiki.Some traditionalists have resisted that concept, but their power is within you right now all these levels, Reiki is not received until the flow of energy and love meditation, although they very often feel calm and relaxed and peaceful during and following birth it helps the mother to offer - from many situations such as low back, hips, knees and feet.

An animal may take a quick initiation and training, you will need to bring us to stifle our emotions, which would be today if it is very similar to being admitted to a level for Personal Mastery level and there is not a sect, a mysterious practice, a religion, but it is needed, wanted and accepted.Check her or him directly, by phone or by the enlightened highway.Reiki helps one heal at a certain degree of Reiki is practice.So forget about trying to receive a healing energy to you.This possibility has been effective in the present.

Reiki Therapy Center Middlesex Nj

It is important to note that Reiki is being sent?The Reiki distance healing symbol's primary use is not occurring in our body becomes re-balanced and the child come out of her students continue to learn this treatment there should be fully healed to the west it gets there.Often, hands are considered absolutely necessary for success in the time of an unproven energy.A practise that one of them have started to become a master only because I tend to have to select such best soothing track by hearing that no matter what you put in to the recipient.He could feel her condition worsening day by asking for magic.

Reiki is composed of three practitioners to experience it.Each persons experience with Reiki, some of the self-healing abilities together with our power animals.Reiki also called as Attunement or Empowerment and though it is so simple to receive.I now have plants like kale, tulsi, asparagus, nettles, strawberries, raspberries, blueberries, peppermint, garlic, and chives that just feels right for you and lift his hands over certain parts of your own genie!Enhance Future Conditions: Using the distance reiki symbol, the reiki teacher and finally you download it given by many people.

[stephenmccull]

COVID Catch-22: They Got A Big ER Bill Because Hospitals Couldn’t Test For Virus

Fresh off a Caribbean cruise in early March, John Campbell developed a cough and fever of 104 degrees. He went to his primary care physician and got a flu test, which came up negative.

Then things got strange. Campbell said the doctor then turned to him and said, “I’ve called the ER next door, and you need to go there. This is a matter of public health. They’re expecting you.”

Special Reports

Bill Of The Month

Feb 13

Bill of the Month is a crowdsourced investigation by Kaiser Health News and NPR that dissects and explains medical bills.

It was March 3, and no one had an inkling yet of just how bad the COVID-19 pandemic would become in the U.S.

At the JFK Medical Center near his home in Boynton Beach, Florida, staffers met him in protective gear, then ran a battery of tests — including bloodwork, a chest X-ray and an electrocardiogram — before sending him home. But because he had not traveled to China — a leading criterion at the time for coronavirus testing — Campbell was not swabbed for the virus.

A $2,777 bill for the emergency room visit came the next month.

Now Campbell, 52, is among those who say they were wrongly billed for the costs associated with seeking a COVID-19 diagnosis.

While most insurers have promised to cover the costs of testing and related services — and Congress passed legislation in mid-March enshrining that requirement — there’s a catch: The law requires the waiver of patient cost sharing only when a test is ordered or administered.

And therein lies the problem. In the early weeks of the pandemic and through mid-April in many places, testing was often limited to those with specific symptoms or situations, likely excluding thousands of people who had milder cases of the virus or had not traveled overseas.

“They do pay for the test, but I didn’t have the test,” said Campbell, who appealed the bill to his insurer, Florida Blue. More on how that turned out later.

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“These loopholes exist,” said Wendell Potter, a former insurance industry executive who is now an industry critic. “We’re just relying on these companies to act in good faith.”

Exacerbating the problem: Many of these patients were directed to go to hospital emergency departments — the most expensive place to get care — which can result in huge bills for patients-deductible insurance.

More From Our Bill Of The Month Series

COVID-Like Cough Sent Him To ER — Where He Got A $3,278 Bill May 25

COVID Tests Are Free, Except When They’re Not Apr 29

Her Genetic Test Revealed A Microscopic Problem — And A Jumbo Price Tag Mar 31

Hormone Blocker Shocker: Drug Costs 8 Times More When Used For Kids Feb 24

Appendicitis Is Painful — Add A $41,212 Surgery Bill To The Misery Jan 29

Insurers say they fully cover costs when patients are tested for the coronavirus, but what happens with enrollees who sought a test — but were not given one — is less clear.

KHN asked nine national and regional insurers for specifics about how they are handling these situations.

Results were mixed. Three — UnitedHealthcare, Kaiser Permanente and Anthem — said they do some level of automatic review of potential COVID-related claims from earlier in the pandemic, while a fourth, Quartz, said it would investigate and waive cost sharing for suspected COVID patients if the member asks for a review. Humana said it is reviewing claims made in early March, but only those showing confirmed or suspected COVID. Florida Blue, similarly, said it is manually reviewing claims, but only those involving COVID tests or diagnoses. The remaining insurers pointed to other efforts, such as routine audits that look for all sorts of errors, along with efforts to train hospitals and doctors in the proper COVID billing codes to use to ensure patients aren’t incorrectly hit with cost sharing. Those were Blue Cross Blue Shield of Michigan, CIGNA and the Health Care Services Corp., which operates Blues plans in Illinois, Montana, New Mexico, Oklahoma and Texas.

All nine said patients should reach out to them or appeal a claim if they suspect an error.

To be sure, it would be a complex effort for insurers to go back over claims from March and April, looking for patients that might qualify for a more generous interpretation of the cost waiver because they were unable to get a coronavirus test. And there’s nothing in the CARES Act passed by Congress — or subsequent guidance from regulatory agencies — about what to do in such situations.

Still, insurers could review claims, for example, by looking for patients who received chest X-rays, and diagnoses of pneumonia or high fever and cough, checking to see if any might qualify as suspected COVID cases, even if they were not given a diagnostic test, said Potter.

One thing was clear from the responses: Much of the burden falls on patients who think they’ve been wrongly billed to call that to the attention of the insurer and the hospital, urgent care center or doctor’s office where they were treated.

John Campbell developed a cough and fever of 104 degrees in early March, was directed to an ER and ultimately received a $2,777 bill for the visit. He is among those who say they were wrongly billed for the costs associated with seeking a COVID-19 diagnosis.(Courtesy of John Campbell)

Some states have broader mandates that could be read to require the waiver of cost sharing even if a COVID test was not ordered or administered, said Sabrina Corlette, a research professor and co-director of the Center on Health Insurance Reforms at Georgetown University.

But no matter where you live, she said, patients who get bills they think are incorrect should contest them. “I’ve heard a lot of comments that claims are not coded properly,” said Corlette. “Insurers and providers are on a learning curve. If you get a bill, ask for a review.”

Scarce Tests, Rampant Virus

In some places, including the state of Indiana, the city of Los Angeles and St. Louis County, Missouri, a test is now offered to anyone who seeks one. Until recently, tests were scarce and essentially rationed, even though more comprehensive testing could have helped health officials battle the epidemic.

But even in the early weeks, when Campbell and many others sought a diagnosis, insurers nationwide were promising to cover the cost of testing and related services. That was good PR and good public health: Removing cost barriers to testing means more people will seek care and thus could prevent others from being infected. Currently, the majority of insurers offering job-based or Affordable Care Act insurance say they are fully waiving copays, deductibles and other fees for testing, as long as the claims are coded correctly. (The law does not require short-term plans to waive cost sharing.) Some insurers have even promised to fully cover the cost of treatment for COVID, including hospital care.

But getting stuck with a sizable bill has become commonplace. “I only went in because I was really sick and I thought I had it,” said Rayone Moyer, 63, of La Crosse, Wisconsin, who was extra concerned because she has diabetes. “I had a hard time breathing when I was doing stuff.”

On March 27, she went to Gundersen Lutheran Medical Center, which is in her Quartz insurance network, complaining of body aches and shortness of breath. Those symptoms could be COVID-related, but could also signal other conditions. While there, she was given an array of tests, including bloodwork, a chest X-ray and a CT scan.

She was billed in May: $2,421 by the hospital and more than $350 in doctor bills.

“My insurance applied the whole thing to my deductible,” she said. “Because they refused to test me, I’ve got to pay the bill. No one said, ‘Hey, we’ll give you $3,000 worth of tests instead of the $100 COVID test,’” she said.

Quartz spokesperson Christina Ott said patients with concerns like Moyer’s should call the insurance company’s customer service number and ask for an appeals specialist. The insurer, she wrote in response to KHN’s survey of insurers, will waive cost sharing for some members who sought a diagnosis.

“During the public health emergency, if the member presented with similar symptoms as COVID, but didn’t receive a COVID-19 test and received testing for other illnesses on an outpatient basis, then cost sharing would be waived,” she wrote.

Moyer said she has filed an appeal and was notified by the insurer of a review expected in mid-July. Back in Florida, Campbell filed an appeal of his bill with Florida Blue on April 22, but didn’t hear anything until the day after a KHN reporter called the insurer about his case in June.

Then, Campbell received phone calls from Florida Blue representatives. A supervisor apologized, saying the insurer should not have billed him and that 100% of his costs would be covered.

“Basically they said, ‘We’ve changed our minds,’” said Campbell. “Because I was there so early on, and the bill was coded incorrectly.”

COVID Catch-22: They Got A Big ER Bill Because Hospitals Couldn’t Test For Virus published first on https://smartdrinkingweb.weebly.com/

[dinafbrownil]

COVID Catch-22: They Got A Big ER Bill Because Hospitals Couldn’t Test For Virus

Fresh off a Caribbean cruise in early March, John Campbell developed a cough and fever of 104 degrees. He went to his primary care physician and got a flu test, which came up negative.

Then things got strange. Campbell said the doctor then turned to him and said, “I’ve called the ER next door, and you need to go there. This is a matter of public health. They’re expecting you.”

Special Reports

Bill Of The Month

Feb 13

Bill of the Month is a crowdsourced investigation by Kaiser Health News and NPR that dissects and explains medical bills.

It was March 3, and no one had an inkling yet of just how bad the COVID-19 pandemic would become in the U.S.

At the JFK Medical Center near his home in Boynton Beach, Florida, staffers met him in protective gear, then ran a battery of tests — including bloodwork, a chest X-ray and an electrocardiogram — before sending him home. But because he had not traveled to China — a leading criterion at the time for coronavirus testing — Campbell was not swabbed for the virus.

A $2,777 bill for the emergency room visit came the next month.

Now Campbell, 52, is among those who say they were wrongly billed for the costs associated with seeking a COVID-19 diagnosis.

While most insurers have promised to cover the costs of testing and related services — and Congress passed legislation in mid-March enshrining that requirement — there’s a catch: The law requires the waiver of patient cost sharing only when a test is ordered or administered.

And therein lies the problem. In the early weeks of the pandemic and through mid-April in many places, testing was often limited to those with specific symptoms or situations, likely excluding thousands of people who had milder cases of the virus or had not traveled overseas.

“They do pay for the test, but I didn’t have the test,” said Campbell, who appealed the bill to his insurer, Florida Blue. More on how that turned out later.

Don't Miss A Story

Subscribe to KHN’s free Weekly Edition newsletter.

Sign Up

Please confirm your email address below:

Sign Up

“These loopholes exist,” said Wendell Potter, a former insurance industry executive who is now an industry critic. “We’re just relying on these companies to act in good faith.”

Exacerbating the problem: Many of these patients were directed to go to hospital emergency departments — the most expensive place to get care — which can result in huge bills for patients-deductible insurance.

More From Our Bill Of The Month Series

COVID-Like Cough Sent Him To ER — Where He Got A $3,278 Bill May 25

COVID Tests Are Free, Except When They’re Not Apr 29

Her Genetic Test Revealed A Microscopic Problem — And A Jumbo Price Tag Mar 31

Hormone Blocker Shocker: Drug Costs 8 Times More When Used For Kids Feb 24

Appendicitis Is Painful — Add A $41,212 Surgery Bill To The Misery Jan 29

Insurers say they fully cover costs when patients are tested for the coronavirus, but what happens with enrollees who sought a test — but were not given one — is less clear.

KHN asked nine national and regional insurers for specifics about how they are handling these situations.

Results were mixed. Three — UnitedHealthcare, Kaiser Permanente and Anthem — said they do some level of automatic review of potential COVID-related claims from earlier in the pandemic, while a fourth, Quartz, said it would investigate and waive cost sharing for suspected COVID patients if the member asks for a review. Humana said it is reviewing claims made in early March, but only those showing confirmed or suspected COVID. Florida Blue, similarly, said it is manually reviewing claims, but only those involving COVID tests or diagnoses. The remaining insurers pointed to other efforts, such as routine audits that look for all sorts of errors, along with efforts to train hospitals and doctors in the proper COVID billing codes to use to ensure patients aren’t incorrectly hit with cost sharing. Those were Blue Cross Blue Shield of Michigan, CIGNA and the Health Care Services Corp., which operates Blues plans in Illinois, Montana, New Mexico, Oklahoma and Texas.

All nine said patients should reach out to them or appeal a claim if they suspect an error.

To be sure, it would be a complex effort for insurers to go back over claims from March and April, looking for patients that might qualify for a more generous interpretation of the cost waiver because they were unable to get a coronavirus test. And there’s nothing in the CARES Act passed by Congress — or subsequent guidance from regulatory agencies — about what to do in such situations.

Still, insurers could review claims, for example, by looking for patients who received chest X-rays, and diagnoses of pneumonia or high fever and cough, checking to see if any might qualify as suspected COVID cases, even if they were not given a diagnostic test, said Potter.

One thing was clear from the responses: Much of the burden falls on patients who think they’ve been wrongly billed to call that to the attention of the insurer and the hospital, urgent care center or doctor’s office where they were treated.

John Campbell developed a cough and fever of 104 degrees in early March, was directed to an ER and ultimately received a $2,777 bill for the visit. He is among those who say they were wrongly billed for the costs associated with seeking a COVID-19 diagnosis.(Courtesy of John Campbell)

Some states have broader mandates that could be read to require the waiver of cost sharing even if a COVID test was not ordered or administered, said Sabrina Corlette, a research professor and co-director of the Center on Health Insurance Reforms at Georgetown University.

But no matter where you live, she said, patients who get bills they think are incorrect should contest them. “I’ve heard a lot of comments that claims are not coded properly,” said Corlette. “Insurers and providers are on a learning curve. If you get a bill, ask for a review.”

Scarce Tests, Rampant Virus

In some places, including the state of Indiana, the city of Los Angeles and St. Louis County, Missouri, a test is now offered to anyone who seeks one. Until recently, tests were scarce and essentially rationed, even though more comprehensive testing could have helped health officials battle the epidemic.

But even in the early weeks, when Campbell and many others sought a diagnosis, insurers nationwide were promising to cover the cost of testing and related services. That was good PR and good public health: Removing cost barriers to testing means more people will seek care and thus could prevent others from being infected. Currently, the majority of insurers offering job-based or Affordable Care Act insurance say they are fully waiving copays, deductibles and other fees for testing, as long as the claims are coded correctly. (The law does not require short-term plans to waive cost sharing.) Some insurers have even promised to fully cover the cost of treatment for COVID, including hospital care.

But getting stuck with a sizable bill has become commonplace. “I only went in because I was really sick and I thought I had it,” said Rayone Moyer, 63, of La Crosse, Wisconsin, who was extra concerned because she has diabetes. “I had a hard time breathing when I was doing stuff.”

On March 27, she went to Gundersen Lutheran Medical Center, which is in her Quartz insurance network, complaining of body aches and shortness of breath. Those symptoms could be COVID-related, but could also signal other conditions. While there, she was given an array of tests, including bloodwork, a chest X-ray and a CT scan.

She was billed in May: $2,421 by the hospital and more than $350 in doctor bills.

“My insurance applied the whole thing to my deductible,” she said. “Because they refused to test me, I’ve got to pay the bill. No one said, ‘Hey, we’ll give you $3,000 worth of tests instead of the $100 COVID test,’” she said.

Quartz spokesperson Christina Ott said patients with concerns like Moyer’s should call the insurance company’s customer service number and ask for an appeals specialist. The insurer, she wrote in response to KHN’s survey of insurers, will waive cost sharing for some members who sought a diagnosis.

“During the public health emergency, if the member presented with similar symptoms as COVID, but didn’t receive a COVID-19 test and received testing for other illnesses on an outpatient basis, then cost sharing would be waived,” she wrote.

Moyer said she has filed an appeal and was notified by the insurer of a review expected in mid-July. Back in Florida, Campbell filed an appeal of his bill with Florida Blue on April 22, but didn’t hear anything until the day after a KHN reporter called the insurer about his case in June.

Then, Campbell received phone calls from Florida Blue representatives. A supervisor apologized, saying the insurer should not have billed him and that 100% of his costs would be covered.

“Basically they said, ‘We’ve changed our minds,’” said Campbell. “Because I was there so early on, and the bill was coded incorrectly.”

from Updates By Dina https://khn.org/news/covid-catch-22-they-got-a-big-er-bill-because-hospitals-couldnt-test-for-virus/

[gordonwilliamsweb]

COVID Catch-22: They Got A Big ER Bill Because Hospitals Couldn’t Test For Virus

Fresh off a Caribbean cruise in early March, John Campbell developed a cough and fever of 104 degrees. He went to his primary care physician and got a flu test, which came up negative.

Then things got strange. Campbell said the doctor then turned to him and said, “I’ve called the ER next door, and you need to go there. This is a matter of public health. They’re expecting you.”

Special Reports

Bill Of The Month

Feb 13

Bill of the Month is a crowdsourced investigation by Kaiser Health News and NPR that dissects and explains medical bills.

It was March 3, and no one had an inkling yet of just how bad the COVID-19 pandemic would become in the U.S.

At the JFK Medical Center near his home in Boynton Beach, Florida, staffers met him in protective gear, then ran a battery of tests — including bloodwork, a chest X-ray and an electrocardiogram — before sending him home. But because he had not traveled to China — a leading criterion at the time for coronavirus testing — Campbell was not swabbed for the virus.

A $2,777 bill for the emergency room visit came the next month.

Now Campbell, 52, is among those who say they were wrongly billed for the costs associated with seeking a COVID-19 diagnosis.

While most insurers have promised to cover the costs of testing and related services — and Congress passed legislation in mid-March enshrining that requirement — there’s a catch: The law requires the waiver of patient cost sharing only when a test is ordered or administered.

And therein lies the problem. In the early weeks of the pandemic and through mid-April in many places, testing was often limited to those with specific symptoms or situations, likely excluding thousands of people who had milder cases of the virus or had not traveled overseas.

“They do pay for the test, but I didn’t have the test,” said Campbell, who appealed the bill to his insurer, Florida Blue. More on how that turned out later.

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“These loopholes exist,” said Wendell Potter, a former insurance industry executive who is now an industry critic. “We’re just relying on these companies to act in good faith.”

Exacerbating the problem: Many of these patients were directed to go to hospital emergency departments — the most expensive place to get care — which can result in huge bills for patients-deductible insurance.

More From Our Bill Of The Month Series

COVID-Like Cough Sent Him To ER — Where He Got A $3,278 Bill May 25

COVID Tests Are Free, Except When They’re Not Apr 29

Her Genetic Test Revealed A Microscopic Problem — And A Jumbo Price Tag Mar 31

Hormone Blocker Shocker: Drug Costs 8 Times More When Used For Kids Feb 24

Appendicitis Is Painful — Add A $41,212 Surgery Bill To The Misery Jan 29

Insurers say they fully cover costs when patients are tested for the coronavirus, but what happens with enrollees who sought a test — but were not given one — is less clear.

KHN asked nine national and regional insurers for specifics about how they are handling these situations.

Results were mixed. Three — UnitedHealthcare, Kaiser Permanente and Anthem — said they do some level of automatic review of potential COVID-related claims from earlier in the pandemic, while a fourth, Quartz, said it would investigate and waive cost sharing for suspected COVID patients if the member asks for a review. Humana said it is reviewing claims made in early March, but only those showing confirmed or suspected COVID. Florida Blue, similarly, said it is manually reviewing claims, but only those involving COVID tests or diagnoses. The remaining insurers pointed to other efforts, such as routine audits that look for all sorts of errors, along with efforts to train hospitals and doctors in the proper COVID billing codes to use to ensure patients aren’t incorrectly hit with cost sharing. Those were Blue Cross Blue Shield of Michigan, CIGNA and the Health Care Services Corp., which operates Blues plans in Illinois, Montana, New Mexico, Oklahoma and Texas.

All nine said patients should reach out to them or appeal a claim if they suspect an error.

To be sure, it would be a complex effort for insurers to go back over claims from March and April, looking for patients that might qualify for a more generous interpretation of the cost waiver because they were unable to get a coronavirus test. And there’s nothing in the CARES Act passed by Congress — or subsequent guidance from regulatory agencies — about what to do in such situations.

Still, insurers could review claims, for example, by looking for patients who received chest X-rays, and diagnoses of pneumonia or high fever and cough, checking to see if any might qualify as suspected COVID cases, even if they were not given a diagnostic test, said Potter.

One thing was clear from the responses: Much of the burden falls on patients who think they’ve been wrongly billed to call that to the attention of the insurer and the hospital, urgent care center or doctor’s office where they were treated.

John Campbell developed a cough and fever of 104 degrees in early March, was directed to an ER and ultimately received a $2,777 bill for the visit. He is among those who say they were wrongly billed for the costs associated with seeking a COVID-19 diagnosis.(Courtesy of John Campbell)

Some states have broader mandates that could be read to require the waiver of cost sharing even if a COVID test was not ordered or administered, said Sabrina Corlette, a research professor and co-director of the Center on Health Insurance Reforms at Georgetown University.

But no matter where you live, she said, patients who get bills they think are incorrect should contest them. “I’ve heard a lot of comments that claims are not coded properly,” said Corlette. “Insurers and providers are on a learning curve. If you get a bill, ask for a review.”

Scarce Tests, Rampant Virus

In some places, including the state of Indiana, the city of Los Angeles and St. Louis County, Missouri, a test is now offered to anyone who seeks one. Until recently, tests were scarce and essentially rationed, even though more comprehensive testing could have helped health officials battle the epidemic.

But even in the early weeks, when Campbell and many others sought a diagnosis, insurers nationwide were promising to cover the cost of testing and related services. That was good PR and good public health: Removing cost barriers to testing means more people will seek care and thus could prevent others from being infected. Currently, the majority of insurers offering job-based or Affordable Care Act insurance say they are fully waiving copays, deductibles and other fees for testing, as long as the claims are coded correctly. (The law does not require short-term plans to waive cost sharing.) Some insurers have even promised to fully cover the cost of treatment for COVID, including hospital care.

But getting stuck with a sizable bill has become commonplace. “I only went in because I was really sick and I thought I had it,” said Rayone Moyer, 63, of La Crosse, Wisconsin, who was extra concerned because she has diabetes. “I had a hard time breathing when I was doing stuff.”

On March 27, she went to Gundersen Lutheran Medical Center, which is in her Quartz insurance network, complaining of body aches and shortness of breath. Those symptoms could be COVID-related, but could also signal other conditions. While there, she was given an array of tests, including bloodwork, a chest X-ray and a CT scan.

She was billed in May: $2,421 by the hospital and more than $350 in doctor bills.

“My insurance applied the whole thing to my deductible,” she said. “Because they refused to test me, I’ve got to pay the bill. No one said, ‘Hey, we’ll give you $3,000 worth of tests instead of the $100 COVID test,’” she said.

Quartz spokesperson Christina Ott said patients with concerns like Moyer’s should call the insurance company’s customer service number and ask for an appeals specialist. The insurer, she wrote in response to KHN’s survey of insurers, will waive cost sharing for some members who sought a diagnosis.

“During the public health emergency, if the member presented with similar symptoms as COVID, but didn’t receive a COVID-19 test and received testing for other illnesses on an outpatient basis, then cost sharing would be waived,” she wrote.

Moyer said she has filed an appeal and was notified by the insurer of a review expected in mid-July. Back in Florida, Campbell filed an appeal of his bill with Florida Blue on April 22, but didn’t hear anything until the day after a KHN reporter called the insurer about his case in June.

Then, Campbell received phone calls from Florida Blue representatives. A supervisor apologized, saying the insurer should not have billed him and that 100% of his costs would be covered.

“Basically they said, ‘We’ve changed our minds,’” said Campbell. “Because I was there so early on, and the bill was coded incorrectly.”

COVID Catch-22: They Got A Big ER Bill Because Hospitals Couldn’t Test For Virus published first on https://nootropicspowdersupplier.tumblr.com/

[too-many-kinds-of-different]

My road to an EDS/POTS diagnosis - Part 2

Find part 1: https://too-many-kinds-of-different.tumblr.com/post/617582192031350784/my-road-to-an-edspots-diagnosis-part-1

So armed with my new found information about POTS I approached my Primary Care Physician (America’s General Practitioner). I told her about how I got head rushes every time I stood up and was constantly tired. In an ideal world I would have told her about my own home testing and hypothesis but I had already been warned. My girlfriend had seen her brother be turned down by numerous doctors for doing his own research. So I had been instructed to gently lead my doctor to the conclusion rather than giving them the answer right away. So I told her my symptoms and she, quickly coming to the same conclusion, redid my home test with an actual pulse ox and blood pressure cuff instead of a phone app. I was made to lie down for 10 minutes, then they took my heart rate and blood pressure. Then made me sit up and did the same. Finally, they made me stand up for 10 minutes and then, once again, took my vitals. Now, for a POTS diagnosis the difference between your heart rate lying down vs. standing up needs to be at least 30bpm. Mine was 29. So heart sinking I waited for the doctor to tell me I was perfectly normal and needed to be less anxious about my health. Thankfully, the chronic illness doctors smiled upon me that day and my doctor ordered a Tilt Table Test, the gold standard testing for POTS. A few weeks later I was at the hospital, the lay me down on a table, hooked me up to a bunch of monitors and tilted me. My heart rate spiked and as simple as that, I had a POTS diagnosis.

In parallel to this my chronic pain grew worse and I came clean to my girlfriend. She urged me to go back to my PCP with this information and since she had been so helpful with the POTS diagnosis, I decided to give it a shot. The doctor did the basic blood work and sent me to a rheumatologist who was on the list for that practice. At this point I had a great deal of faith in her and went to this doctor she recommended. He took a single look at my chart and said, “Depression can show up in many ways in a body” and that was that. It was a fifteen minute meeting and I waited till I reached the hallway outside the clinic and then broke down.

A few months passed by and my pain grew worse. My girlfriend’s brother suggested I go to his physical therapist and figuring I had nothing to lose, we went for it. At this point we were both pretty adamant that I did not have EDS, because POTS was still fairly common; what were the odds I had two of the same illnesses that run in her family. Anyway, my Beighton wasn’t particularly high and my skin wasn’t stretchy (the big indicators of EDS). But we went there. After hearing about my clear blood tests they decided to check my Beighton score. They gave me a 4/9, which by the 2017 hEDS criteria could mean I had generalized hypermobility, one of three criteria for hEDS. And so I got a lead, but that’s not all I got. The PT gently pushed my hips into place and for the first time in living memory, I had no back pain. And so I left with an exercise regime and the name of the geneticist. She also told me to look into this funky thing called Tethered Cord, but that’s a different blog post....

Now this is when the family drama that I have avoided mentioning so far went up a notch. I hate to do this twice in a row but this will once again be a different post. So I put the geneticist recommendation on the side went to another rheumatologist who thankfully had an ounce of trust in her patients’ experience and with a quick exam agreed I had generalized hypermobility. And that was enough for me...for a while. Eventually the tensions with my family rose and I decided I wanted to get the final word from the geneticist. I went ahead and made at the appointment. The doctor then went through a list of symptoms and did a physical exam and there is was in the diagnosis letter. hypermobile Elhers Danlos Syndrome.

And that’s the end of this story. Please feel free to drop a message if you have any questions or comments! and I’m happy to help anyone who wants help with understanding EDS/POTS and the process of getting diagnosed.

[bountyofbeads]

My Whole Household Has COVID-19

“The thought of simply breathing in and out without coughing and reuniting with my children ... is goal enough. To—literally—live and let live will be enough.”

By DEBORAH COPAKEN | Published March 27, 2020 12:35 PM ET | The Atlantic | Posted March 29, 2020 |

I can pinpoint the exact moment I started feeling off. My partner, Will, and I were on a bike ride on the afternoon of Wednesday, March 18, to escape our apartment and get some exercise. This was back when leaving a New York City apartment to get some exercise was still okay, or at least that’s what we’d read, or at least that’s what we thought? If the coronavirus pandemic has taught us anything, it’s that what is considered dogma today might change tomorrow.

Ten minutes into our bike ride, I was overcome by an intense fatigue. “I think I have to go back,” I said.

Back home, I felt chilled. Took my temperature: 99.1. I’m normally 97.1, but still, not a huge deal. We’d been so careful about wiping down doorknobs, washing our hands, and keeping everyone except for our family out of our apartment. I’d been ambiently worried enough that my 13-year-old son could be a silent carrier of the virus that I’d yanked him out of his public middle school and off the crowded subways four days before Mayor Bill de Blasio pulled the plug– (far too belatedly, in my opinion). I was getting over a urinary-tract infection, so my fever, I thought, must be from that.

That evening, I answered a bunch of Slack messages from work, finished a project for my boss, and picked at the dinner Will cooked. I was, unusually, not hungry. Neither was Will. Neither was my son, which is weird because normally he eats twice his body weight in food.

The next day my temperature was back down to 97.1, but the UTI had worsened. I called the nearby urgent-care center to see if they could prescribe me a new antibiotic, but no one was answering the phone. Figuring the place was overwhelmed with coronavirus calls, I walked over to the urgent care, opened the front door, and poked my head in. “Hi,” I said. “I’m so sorry to bother you at this time, but no one’s answering your phones.” I explained that the antibiotic course I’d just finished hadn’t worked, and I needed a different prescription.

“Do you have a temperature?” I remember the receptionist asking, as she walked over to the door and handed me a mask. Wait, what?

“No. I had a slight fever yesterday. Can I just leave a message for the doctor? I don’t want to come in.” I could hear a hacking cough coming from one of the exam rooms.

“If you need a new antibiotic, you’ll have to pee in a cup again.”

“But you guys already have my pee from last week! Use the same pee!”

“Sorry, we can’t treat you unless you meet with the doctor again and give us a new sample.”

You’ve got to be kidding me, I thought. Why are we talking about pee during a shit storm? I weighed my options: either endure the UTI for who knows how long until this pandemic is over, which could lead to a kidney infection, which might eventually mean being forced to enter an overwhelmed, COVID-19-infected hospital anyway, or walk into this urgent care right now and possibly get exposed to the virus, but only from the two people coughing. I didn’t like this game of “Would you rather.”

I put on that mask and walked straight in––in my regular clothes, with no eye protection––where I stayed for a good 30 to 40 minutes until I could pee into a new cup, meet with the doctor, get a prescription, and go home. To say it was scary sitting there listening to all that coughing in the other rooms would be an understatement. The other patients sounded as if they should be on respirators, not in a neighborhood urgent care.

When I came home, I immediately stripped and washed all my clothes. That night, I got word that I did, indeed, have an ever-worsening UTI. (Duh.) A few hours later, Will came down with a fever and diarrhea and fell asleep watching Rachel Maddow, which he never does.

We isolated ourselves in separate rooms. My son stayed in his room, Will stayed in my other son’s room––that son, 24, had been volunteering for several months with Syrian refugees in Samos, Greece, and was self-quarantining in a nearby Airbnb––and me in the master bedroom, but not before I wiped down the entire apartment with Clorox wipes again. The next night, March 20, I cooked some rice and beans that no one ate.

Will stayed quite sick for three days, his temperature spiking and then retreating, but he never came down with a cough. Just the diarrhea, which is a rare COVID-19 symptom. We considered heading over to the drive-through test site that had just been set up on Staten Island, but by the time Will was feeling well enough to sit in a car for several hours, New York City had been declared a FEMA disaster zone. All masks and pieces of personal protective equipment were needed to treat the sick and dying, and the city put out a statement saying that people whose illnesses didn’t require hospitalization should not get tested. So we stayed home.

We missed each other’s company, though, so I threw caution to the wind, washed my hands, and invited Will to wash his hands and lie on the bed with me, as far from my body as possible, to listen to a recording of the 1977 Cornell Grateful Dead show while watching the sunset from our bedroom window. I kept it together until Jerry, in “Morning Dew,” sang, “Where have all the people gone, my honey? Where have all the people gone today?”

My fever spiked again on Sunday night. Monday morning, March 23, the fever was gone, so I decided to reorganize our spice cabinet. As one does in a lockdown. But I found I could no longer smell the spices. I had to make sure, when writing up new labels, not to mix up the herbs de Provence, the basil, and the oregano, all of which now looked and smelled exactly alike, which is to say they all smelled like nothing. (Doctors have begun observing a loss of smell and taste in some COVID-19 patients.) By the afternoon, I had a well-organized spice cabinet and a sore throat. Not a bad one, just a slightly annoying one.

By Tuesday afternoon, I was quite sick. I was now coughing a deep and scary dry, wheezing cough, just like the ones I’d heard in the urgent care a few days prior. My temperature was spiking and falling, spiking and falling; my throat was still sore; and I could not drink enough water to quench my thirst. My chest felt as if there were an anvil sitting on top of it. When I attempted to take a deep breath, I could not get enough air into the bottom of my lungs to fill them.

I sent a text message to my primary-care providers’ office through their telemedicine system. I made an appointment with a doctor to speak on the phone. Over the course of our 15-minute call, she asked many questions about my symptoms, about Will’s symptoms, about my son’s loss of appetite. She also heard my cough several times, and said, as I remember it, “That’s a COVID cough. You have to assume all three of you have it at this point. Just lay low until everyone’s symptoms are gone.”

“Can I get a test?” I said.

“No,” she said. “You can’t. Only essential workers. You don’t need one. I can tell just from listening to your cough and hearing your symptoms. When did you first start to feel ill?”

I told her about the bike ride.

The doctor became irritated. “You rode a bike? With viral load everywhere? Why?”

Hadn’t I read one or maybe several experts saying it was safe to go outside and exercise? “I thought it was okay to go out if you stayed six feet from others?”

“No,” she said. “Not in New York. Not right now.”

So nobody knows anything. Or some people know some things, but then facts catch up and prove them wrong. What an embarrassment, how unprepared this country is. We had time to right the plane before it crashed. But the pilot’s been too busy blaming the clouds and spouting lies over the loudspeaker. If I’m sick and can’t get a test, how do we even know that the attack rate in New York City is, as was recently reported, five times the norm? Maybe it’s 10. Maybe it’s 100. Who the hell knows? How many others are sheltering in place in my city right now, coughing on the down low because they can’t get tested? I want to be counted, goddamnit.

“Can my partner and I sleep in the same room again, now that we’re both sick?”

“I wouldn’t advise it,” said the doctor. “Your bodies need to get better. Keep your viral load from his and vice versa. Do you have enough rooms for all of you to self-isolate?”

“For now, yes,” I said, explaining how I have one child self-quarantining in an Airbnb in Brooklyn and now another, just evacuated from the Peace Corps, in an Airbnb in Washington, D.C. It’s been an expensive month.

The doctor told me to open up an account with Capsule, a prescription-delivery service, to keep my germs from infecting our local pharmacy. She’d send over a prescription for an inhaler and a nebulizer. The key thing, she told me, is to stay away from the hospitals unless absolutely necessary. There are no beds, even if I need one. And I could get sicker in a hospital than I would staying home.

These were not reassuring words to hear from a doctor.

The drugs and equipment would be delivered later that evening, but before they arrived, my cough and breathing had become so bad that Will barged into my room and said, “We need to make you a go bag.” I could barely get out of bed to go to the bathroom, much less contemplate what items I’d toss in a go bag, a bag to go to the hospital, a place I’d just been told by a doctor not to go.

“If it gets that bad, I won’t even notice if I don’t have my phone charger or extra underwear,” I said. My older children were each FaceTiming me from their own quarantines, but it suddenly hurt too much to talk.

A few hours later, the medications and the nebulizer arrived at my door via a brave delivery man who left the bag at the end of the hallway, smiled, waved, and then ran. “Wait, don’t I need to sign for that?” I shouted after him.

“That’s okay!” he said. “I’ll do it for you.”

I watched a YouTube video that explained how to use the nebulizer. Then I set up mine, squeezed the medicine into its chamber, turned it on, and suddenly … relief! For the first time all day, I could breathe. I could feel the bottom of my lungs again. Hallelujah.

But then my heart rate shot up. It got up to 144 beats per minute according to my Apple watch. I was dizzy with heartbeats. I’m prone to premature ventricular contractions––extra, abnormal heartbeats that begin in the ventricles and disrupt the heart’s regular rhythm––so I have to be careful. My doctor, after I texted the office about my heart rate, called at 8 p.m. and gave me her personal cellphone number in case of emergency.

It’s been three days since my COVID-19 diagnosis, nine days since that first rush of fatigue and slightly elevated temperature. My life is now centered on finding a balance between being able to breathe and not feeling like I’m going to pass out from a too-thrumming heartbeat. Periodically, I send photos of my Apple Watch heart monitor to my doctor, and she gives me advice on when to use the nebulizer next.

All in all––aside from the few hours when I couldn’t breathe and didn’t have the nebulizer; and when I passed out walking from the living room into my bedroom; and when I cough; and at night, when it all feels much worse, and my back aches from coughing, so I can’t sleep––I’ve been okay. Groggy and irritable and down six pounds, but okay. I’ve had worse colds and flus, and I’m hoping I’ll still be able to say this when I’m all better. My biggest fear now is getting sicker and needing to enter either a too-crowded hospital at the viral peak or, heaven forbid, the Jacob Javits Center, which FEMA is transforming into a giant COVID-19 treatment center. Not to make light of an increasingly dire situation, but the last thing I want is to die in the Jacob Javits Center.

I spoke with my daughter yesterday morning from her Airbnb in D.C. She’s not sure where to go after her 14 days of quarantine are over. She’d planned on staying in her post in Cameroon for two years but was able to complete only six months before the emergency evacuation, and she’s not allowed to return. As a Peace Corps volunteer, she’s not eligible for unemployment. She is, at 23, broke, heartbroken, and homeless, which is another reason I’d better not die right now. My son is going stir-crazy all alone in his Airbnb. I haven’t been able to hug him since he got back from Greece. Should he come home on March 31 or pay for another week of the Airbnb, given our illnesses? How long will we remain sick? The World Health Organization says two weeks for a mild case, and three to six weeks for a more serious bout. But that’s just the accepted dogma right now. Tomorrow, those numbers could change.

Part of me wants, as soon as we’re better, to grab my three kids and my partner and escape someplace remote, but where? COVID-19 is everywhere. I guess the thought of simply breathing in and out without coughing and reuniting with my children, wherever that might be, is goal enough. To––literally––live and let live will be enough. Because in the middle of writing that last sentence, I learned that an old friend has been felled by COVID-19. Rest in peace, Mark Blum. I’m so sorry we didn’t do more to flatten the curve while we still could.

Trying to remain optimistic, I have sent an email to researchers at Mount Sinai, who are searching for antibody-rich plasma from those of us who catch COVID-19 and make it through to the other side, to treat critically ill patients—a protocol that showed some promise in China. I definitely, certainly, 100 percent plan to give my antibodies as soon as I can. If my illness can help someone else be less ill, then it is my moral duty to make that happen, just as staying home right now is our moral duty to save others. “We must love one another or die,” W. H. Auden wrote. I read that poem to my older kids after 9/11, and I plan to read it to them again when we’re all reunited.

I received an email back from Mount Sinai asking for my full name, date of birth, symptoms, date of symptom onset, and last day of symptoms.

“Still sick,” I responded. But hopefully not for much longer.

_____

We want to hear what you think about this article. Submit a letter to the editor or write to letters@theatlantic.com.

_____

DEBORAH COPAKEN is a contributing writer at The Atlantic. The author of The Red Book and Shutterbabe, she's currently at work on a new memoir for Random House, Ladyparts.

*********

I’m Treating Too Many Young People for the Coronavirus

Americans in their 20s and 30s—no matter how healthy and invincible they feel—need to understand how dangerous this virus can be.

By Kerry Kennedy Meltzer, Internal medicine resident physician in New York City | Published March 26, 2020 | The Atlantic | Posted March 27, 2020 |

ON FRIDAY NIGHT, I WORKED A 12-hour shift in the designated COVID-19 area of my hospital’s emergency department in New York City. Over the course of the night, I examined six patients who were exhibiting common symptoms of the novel coronavirus; five of them were in their 20s or early 30s.

I am 28 years old. Up until Friday, when people asked me whether I was scared, I would tell them yes—for my country, my colleagues, my 92-year-old grandmother, and all the people most vulnerable to getting seriously ill from the virus, but not for myself. I, like many others, believed that young people were less likely to get sick, and that if they did, the illness was mild, with a quick recovery.

I now know that isn’t the case. The fact is that young people with no clear underlying health conditions are getting seriously ill from COVID-19 in significant numbers. And young Americans—no matter how healthy and invincible they feel—need to understand that.

My first patient was in their early 20s. (To protect their confidentiality, I’m referring to my patients without mentioning their gender.) They had a dry cough and a 102-degree fever, but their chest X-ray came back clear and their oxygen levels were safe. I wanted to test them for COVID-19, but they weren’t sick enough to require admission to the hospital, which meant I couldn’t do so. We desperately want to be able to test and take care of everyone, from the seriously ill to the mildly sick and worried, but with our current capacity, we simply can’t. I told them that they needed to assume they had the virus, and gave them instructions on how to quarantine at home.

I changed my gown and gloves, checked my mask and goggles, and moved on to my next patient: a student who had been coughing and feeling fatigued for multiple days. They had been with a friend before getting sick, and that friend had since fallen ill with symptoms of COVID-19, including a fever. The patient was having trouble catching their breath, but their symptoms were not severe or acute—as confirmed by a chest X-ray and a test of their oxygen levels—so I recommended discharge and quarantine, and they understood.  

My next patient was a young professional. For the past week they’d had a dry cough and chest pain. They had no underlying health conditions, and they’d tried to follow the current guidelines by staying at home (the right thing to do, given the overwhelmed state of hospitals like mine) but that evening their breathing had become so labored that they called an ambulance. When I saw them, however, they were breathing comfortably, their chest X-ray was clear, and their oxygen levels were safe. They were visibly upset when I told them they would not be admitted. They wanted to be tested. I explained why we couldn’t do that, and completed their discharge paperwork.  

I collected myself and approached my next patient: a young person who’d been suffering with a fever, cough, and extreme fatigue for the past three days. Their boss didn’t believe they were sick, so they’d continued to complete long shifts working with customers at a local business. After examining the young patient, I determined that they were in the same category as the previous three I’d seen—sick, but not sick enough to be given a precious hospital bed or COVID-19 test—so I gave them fluids, Tylenol, and a note for their employer confirming that they were indeed ill, and needed to stay home.

Late in the night, another young patient came in with a high fever and no underlying health conditions. They’d had a dry cough for the past four days. They’d come to the hospital after finding they were unable to walk a few feet without getting severely short of breath. On their chest X-ray, I saw lungs that were almost completely whited out, indicating a significant amount of inflammation. It was clear how uncomfortable they were, and how desperately they were trying to catch their breath. They were in a different category from the previous patients I’d seen that night. They needed to be admitted. They needed testing. They needed close monitoring.

I called the Intensive Care Unit team, and they admitted the young patient to the hospital. I finished my shift not long after, walked home, and got in bed, feeling unsteady. When I woke up a few hours later, I logged into our electronic medical record system and learned that in the time I’d been asleep, my patient’s oxygen levels had dropped severely. A breathing tube had been placed down their throat. A ventilator was now keeping them alive.

Recent statistics suggest that what I saw that night is not unusual. On Tuesday, California Governor Gavin Newsom said that half of the 2,102 people who had tested positive for COVID-19 in his state were ages 18 to 49. The Centers for Disease Control and Prevention published data on March 18 showing that, from February 12 to March 16, nearly 40 percent of American COVID-19 patients who were sick enough to be hospitalized were ages 20 to 54. Twelve percent of patients with the most critical cases, requiring admission to an ICU, were ages 20 to 44. There are some caveats worth noting: The CDC was not able to determine whether the young people included in its report had underlying health conditions. And all of this is early data. We know that we are still not testing nearly enough people in the United States. The numbers may change.

But in spite of these alarming figures, too many young Americans have been slow to give up the false belief that they are safe from COVID-19. The day after the CDC report was released, college students began responding to a poll. Only 50 percent said that they were concerned about contracting COVID-19. Fifty-three percent admitted that they or their friends had gone to social gatherings in the previous week.

At the same time as I was seeing the flurry of young patients on my overnight shift, a resident friend of mine at a hospital on the West Coast was placing a patient in their 20s on a ventilator. A 26-year-old woman who was hospitalized with COVID-19 recently told her story in The New York Times. A doctor at my own hospital said that he has never seen so many young people in the ICU as he’s now seeing with COVID-19.

This isn’t the type of evidence that we like to talk about as scientists—anecdotes, instead of hard data—but doctors are people too. We listen to the stories of our patients and our colleagues. We pay attention to the trends that we see on the ground. We connect the dots.

We still need better data to fully understand how young people are being affected by COVID-19, but until we can get it, we have to spread the word, and ask friends and family—no matter their age—to stay at home.

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We want to hear what you think about this article. Submit a letter to the editor or write to letters@theatlantic.com.

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KERRY KENNEDY MELTZER is an internal medicine resident physician in New York City.

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A New York Doctor’s Warning

China warned Italy. Italy warned us. We didn’t listen. Now the onus is on the rest of America to listen to New York.

By Fred Milgrim, Emergency-medicine resident physician in New York City | Published March 27, 2020 7:00 AM ET | The Atlantic Magazine | Posted March 27, 2020 |

In the emergency-department waiting room, 150 people worry about a fever. Some just want a test, others badly need medical treatment. Those not at the brink of death have to wait six, eight, 10 hours before they can see a doctor. Those admitted to the hospital might wait a full day for a bed.

I am an emergency-medicine doctor who practices in both Manhattan and Queens; at the moment, I’m in Queens. Normally, I love coming to work here, even though in the best of times, my co-residents and I take care of one of New York City’s most vulnerable, underinsured patient populations. Many have underlying illnesses and a language barrier, and lack primary care.

These are not the best of times; even for my senior attendings, it is the worst they have ever seen. Here, the curve is not flat. We are overwhelmed. There was a time for testing in New York, and we missed it. China warned Italy. Italy warned us. We didn’t listen. Now the onus is on the rest of America to listen to New York. For many people around the country, the virus is still an invisible threat. But inside New York’s ERs, it is frighteningly visible.

Every day, in our hastily assembled COVID-19 unit, I put on my gown, face shield, three sets of gloves, and N95 respirator mask, which stays on for the entirety of my 12-hour shift, save for one or two breaks for cold pizza and coffee. Before the pandemic, I would wear a new mask for every new patient. Not now. There are not enough to go around. The bridge of my nose is raw, chapped, and on the verge of bleeding. But I consider myself one of the lucky ones. My hospital still has a supply of masks—albeit a dwindling one—to protect me and my colleagues.

Many of my patients clearly haven’t received the message to stay home unless they’re in immediate need of professional medical assistance. Their fevers and coughs alone are not enough to even earn a test. I hand them discharge paperwork and a printout about how to prevent the spread of the coronavirus, tell them to self-isolate, and then I move on to the next person. If they didn’t have the coronavirus before coming to our hospital, they probably do now. So much for gatherings of 10 people or fewer.

Meanwhile, my colleagues tend to patients in the critical-care bay with dipping oxygen levels, patients who can barely speak and may need breathing tubes.

Earlier in the month, we were told that positive-pressure oxygen masks, such as CPAP machines, were risky, as they would aerosolize the virus, increasing health-care workers’ risk of getting infected. But in recent days, running dangerously low on ventilators, we have attempted using CPAP machines to stave off the need for medically induced comas.

Still, the increasing frequency of intubations we need to perform is alarming. Our ventilators are almost all in use, and the ICUs are at capacity. Our hospital has already received extra vents here and there from other hospitals in the region that can spare them, but those few additions are merely a stopgap. Will we soon have patients sharing vents? We wouldn’t be the first hospital to attempt that unusual and suboptimal practice, which gained traction after the Las Vegas shooting, when scores of young trauma patients were vented in pairs. But these COVID-19 patients have delicate lungs, which makes vent-sharing far more dangerous. Nevertheless, we’ve already started studying the mechanics of how to make this happen, as a last-ditch effort.

By next week, we may simply have no choice. Those hundreds of relatively healthy patients we sent home may return to the hospital en masse in respiratory failure.

On Wednesday, I greeted a patient I had discharged only one week prior. When I saw his name pop up on the board, my heart sank. He is just shy of 50, with hardly any past medical history, and he had seemed fine. Now he was gasping for air. His chest X-ray was no relief—COVID-19 for sure. I needed to admit him to the hospital, and set him up with oxygen, heart monitoring, and a bed.

Last week, I saw an elderly woman on dialysis. She had arrived with a mild cough. But her vital signs were normal—no fever. After her chest X-ray came back clear, we decided to send her home. But before her ride came, she spiked a fever to 102. Change of plans. With her age and complex medical problems, she would need to be admitted.

The next night, I saw a rolling bed wheeling past me with a resident riding on top, performing chest compressions on the patient.

Only after we pronounced the patient dead did I learn her name. She was my patient from the night before. She went into cardiac arrest before she even got a bed in the ward. My first COVID-19–positive death. The numbers have been mounting ever since.

A few days ago, FEMA finally arrived to help with this crisis. It has brought more tests, hopefully more vents, and a morgue in the form of a truck to help with the ever-growing number of dead bodies. I wonder if this help will be enough. My colleagues and I discuss this pandemic with a sardonic sense of helplessness. Some of us are getting sick. Our reality alters by the moment. Every day, we change our triage system. Each day could be the day that the masks run out. There is much we think but are too afraid to say to one another.

I do not want to see you in my hospital. I do not want you to go to any hospital in the United States. I do not want you to leave your home, except for essential food and supplies. I do not want you to get tested for the coronavirus, unless you need to be admitted to a hospital.

For those of us at the forefront, knowing who has COVID-19 won’t change our ability—or inability—to treat patients. The problem is, and will be, our shortage of healthy personnel, personal protective equipment, beds, and ventilators. A nasal swab is not the answer anymore.

If you have mild symptoms, assume that you have the coronavirus. Stay home, wash your hands, call your doctor. Don’t come to the emergency department just because of a fever or cough. Receiving a test won’t change our recommendation that you remain in self-isolation. We don’t want you to expose yourself to those who definitely do have the virus.

Social distancing, while still crucial, came too late in New York to prevent a crisis. Maybe, just maybe, extreme measures can prevent this from happening in other cities around the country.

In spite of all this morbidity, the doctors at the hospital received one piece of good news yesterday. A coronavirus patient was successfully taken off a ventilator after two weeks, a first for our Medical ICU and a victory for the staff and, of course, the patient.

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We want to hear what you think about this article. Submit a letter to the editor or write to letters@theatlantic.com.

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FRED MILGRIM is an emergency-medicine resident physician in New York City, currently working at Elmhurst Hospital.

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Watch New Orleans

With the country’s attention turned north, the coronavirus pandemic is exploding in Louisiana.

By VANN R. NEWKIRK II | Published March 27, 2020 2:11 PM ET | The Atlantic | Posted March 27, 2020 |

Between the time this sentence was written and the time this article is published, hundreds more Americans will likely have died from COVID-19. Hundreds or perhaps thousands more people will have been hospitalized, and certainly tens of thousands more will have tested positive for the coronavirus. At this point, making predictions about the pandemic is like riding a barrel over Niagara Falls: We can only guess how it ends, but we do know things are going down.

Here’s another prediction that’s safe to make: The city of New Orleans—and, potentially, all of Louisiana—is going to become the next front in the fight against the pandemic. Even as national attention is justifiably focused on the aggressive outbreak in Washington State and the mounting pressures on New York City’s hospitals, the virus’s advance in Louisiana has shaken local officials and doctors, and the state is already approaching a similar burden of infections and deaths as the crises to the north. There’s good reason to believe that this southern outbreak will be even more difficult to contain, and is perhaps a better harbinger of what’s to come as the pandemic spreads across the country.

The numbers already indicate that Louisiana is a global epicenter of the pandemic. Just over 1 percent of the U.S. population lives in Louisiana. But according to the COVID Tracking Project, 7 percent of all COVID-19 deaths, 7 percent of all hospitalizations, and 3 percent of all positive tests have been in the state. New York has suffered about two deaths per 100,000 residents. Louisiana is at 1.8.

To put the numbers into perspective, if Louisiana were a country, its death count would put it in the top 15 globally. The burden appears to be increasing so quickly that all of these statistics will become quickly out of date. The state reported 83 total deaths from COVID-19 as of noon yesterday. It had reported 34 as of Monday. And, as is the nature of this virus, most of the reported data represent only a snapshot of the infections that took place a week or two ago.

Hospitalizations and deaths will increase. And, if other outbreaks around the world are any example, the curve will not rise gently. The fallout in Louisiana will be most painful in the New Orleans metropolitan area, whose Orleans and Jefferson Parishes account for two-thirds of all cases in the state.

Louisiana Governor John Bel Edwards has already declared a state of emergency. In a press conference on Wednesday, he said that, despite the official numbers, he’s certain that all parishes in the state have coronavirus cases. He asked citizens to continue to stay home and follow state guidelines on slowing the spread of the virus. Like New York Governor Andrew Cuomo, Edwards also warned of a critical shortage of ventilators in the hospitals that will soon be hit with waves of COVID-19 patients. “We could potentially run out of vents in the New Orleans area in the first week in April,” Edwards said. According to state data, a third of all people hospitalized because of the virus so far have required ventilators.

Local officials in New Orleans have made even more dire pronouncements. “We are preparing to mobilize in a way that many of us have never seen,” said Collin Arnold, the city’s homeland-security director, in a separate press conference Wednesday. “This is a disaster that will define us for generations.” New Orleans Mayor LaToya Cantrell said the same day that the city expects hospital beds to fill within two weeks, and she authorized the use of the Morial Convention Center as an overflow site.

Physicians and other health professionals in the city already seem close to being overwhelmed. In a tweet on Wednesday, the former state secretary of health, Rebekah Gee, referenced stories of people reusing protective gear or ordering it from eBay. Joshua Denson, a pulmonary and critical-care physician at Tulane Medical Center and University Medical Center New Orleans, diagnosed the second confirmed case of coronavirus in the city. Now he’s currently under self-quarantine as he awaits the results of his own test for the virus. “I'm not the only one of our critical-care doctors who is on quarantine or sick right now,” Denson told me. “The big point is: If you lose one or two, it’s a big deal. This isn’t a place that’s just swimming with available options.”

According to Denson, problems particular to Louisiana might make an outbreak there worse than what other parts of the U.S. have seen. The state has one of the highest poverty rates in the country, and with that burden comes health disparities—including the kinds of conditions that appear to put people at risk for serious complications from the coronavirus. Louisiana is one of the youngest states in the country, which would seem to suggest its residents would have better outcomes, given that older people have so far been the most vulnerable to the outbreak. But about 43 percent of its adult population falls into “at risk” categories, according to the Kaiser Family Foundation. A sizable number of young adults in the state have preexisting conditions.

According to Denson, that means that New Orleans and the rest of Louisiana might be looking at a different kind of outbreak than most countries—or even New York and Washington—have seen, including widespread hospitalizations or even deaths of young people. Yesterday, Louisiana reported its first death of a person under 35, a 17-year-old in Orleans Parish.

“We’re seeing different processes of this disease than they have seen in China, at least anecdotally,” Denson said. “We’re seeing more comorbid conditions that are common to Americans, such as high blood pressure, stroke, and diabetes.”

Many common assumptions about the coronavirus pandemic are about to be tested in the U.S., in ways they haven’t been so far. The effects of the virus on populations like those in the American South—poorer, characterized by marked racial and social disparities in health status and health access, and often saddled with multiple existing conditions—aren’t yet well known. And many other southern states, unlike Louisiana, New York, Washington—all of which expanded Medicaid under the Affordable Care Act—have little in the way of public health-insurance options for those younger at-risk populations. If Louisiana (likely through Mardi Gras) was COVID-19’s foothold in the South, then America is about to learn a whole lot about how the disease interacts with some of the most stubborn and intractable health-care issues in the country.

For now, the next point of focus should be on New Orleans. It’s not Italy, not yet. But the warnings are urgent, and perhaps even more portentous in their sobriety and certainty. The state will run out of crucial resources for taking care of coronavirus patients, likely before their number peaks. Hospitals will be under extreme strain. Health-care professionals will contract the virus themselves. Underlying health conditions will make their jobs more difficult.

That means now is the time for desperate measures, Denson thinks. He’s calling for the kind of mobilization people reserve for the worst disasters—including donations of supplies and more doctors and nurses. “I hope that two months down the road, people are saying, ‘I overreacted,’” he said.

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The Rich Fled New York. Don’t Be Like Them.

You live in a cramped apartment and you’re scared. But escape is selfish.

By Nathan Thornburg, Host of The Trip podcast | Published March 27, 2020 6:45 AM ET | The Atlantic Magazine | Posted March 27, 2020 |

Hello fellow New Yorkers. You want to leave. So badly. I know. Me too. But don’t. Don’t do it.

It is absurd at this point that it’s even your choice. The bridges should be closed to all but essential traffic. The airports should be shuttered. Instead, Hertz is still renting cars at its 17 Manhattan locations, AirBnB is listing “Corona free” homes in New Jersey, and airlines are offering (apocalyptically cheap) tickets from all three New York airports to Anywhere But Here.

I know all that because I spent one morning this week Googling a dozen possible escapes, in a moment of claustrophobia and panic. I share 900 square feet with two kids and a dog. My wife is a physician who is still seeing patients. And even though I trust her precautions and protocols, I can’t shake the feeling of dread. Mixed in with the uncertainty is the certainty that everything is going to get much, much worse, as the cases spike and people I love or know or admire begin to die. My impulse is to do something—to move, to flee. I’m sure virtually everyone else in the city feels the same way.

The rational truth, though, is that I probably won’t contract COVID-19 while locked in my apartment, though I may well have it already, a holdover from those faraway early-March days when this city was a big pool of the virus and we all were just doing laps together. And if I leave, I’ll bring my germs with me.

There are already pockets of disease on Long Island, and fever spikes in the Catskills, and empty stores in Jersey shore towns that have long put up with our summering bullshit. To paraphrase the New York Post, Nantucket thinks NYC can suck it.

And though I am dreaming, hallucinating almost, of what it would be like to have a yard for the dog and the kids while we wait out the pandemic, rural communities just aren’t built for anybody’s dream quarantine. Proactive governments recognized this early on. A friend of mine in Norway, the restaurateur Nud Dudhia, had been staying with his family in their super-hygge mountain cabin. But in mid-March Norway’s government ordered everyone back to their primary residence, so that any potential health-care burden would land where the population actually lived.

In the U.S., unbelievably, whether to leave is still up to you, as is where to go. If you fled for the hills the moment you read about Dr. Li Wenliang’s death in February, then kudos. I’m jealous of your paranoia, and perhaps you didn’t endanger anyone. But if you left this week, or are planning on leaving, you are nakedly prioritizing your comfort and peace of mind over the physical health of others. Don’t start in on Donald Trump, Treasury Secretary Steve Mnuchin, or any of those faraway self-dealers unless you start by doing what you can do to be part of the solution. Stay home.

I borrowed some of this moral clarity from an aunt in Madrid. She had watched with horror and fascination as politicians in Italy (about as far ahead of Spain along the coronavirus curve as Spain is of the United States) leaked news about a planned quarantine so that, instead of being contained, the virus scattered around the country on the wings of hundreds of thousands of individual decisions. That was on my aunt’s mind as the cordon started closing in on her city. She and her partner thought about fleeing to the village of Adahuesca, but, as she put it, “there was a chance that we’d just kill all the old people there.” They stayed put.

The restrictions in Madrid make New York’s stay-at-home guidelines look like an invitation to bacchanalia (seriously, why are our playgrounds still open?). In Madrid today, you can’t walk a dog with more than one person. Police have the discretion under Penal Code 556 of fining you if you are smoking or otherwise loitering on the street. Spaniards are lovely people and frequently also insolent scofflaws, so some started taking a couple of cans and a carrot or two from their own pantry and walking them around the city, to pretend they had been out shopping. Now police demand that you show a grocery-store receipt.

If you are nervous about staying in New York, and shopping solo, and surviving, this video that everyone is sharing from the Weill Cornell ICU doc David Price should reassure you that you can do this. Wash your hands. Don’t touch your face. Smile at your neighbors.

This pandemic involves a class element, of course. This is, among other things, a Prince Charles disease, a Tom Hanks disease, splashed around the planet by the kind of world traveler I’ve become myself. In the past year I’ve been to Iraq, Kenya, Beirut, Cuba, Japan, Mexico, and beyond, for a podcast. I flew to Chiang Mai for a wedding, to Sweden for the last night of a famous restaurant. And leaving aside for the moment what I’ve done to the ozone layer, it’s safe to say that I’m exactly the kind of asshole who brought you rapidly circulating global disease. COVID-19 became a wildfire thanks to a super-spreader soiree in Connecticut and the Biogen breakout in Boston and the Mar-a-Lago miasma and that gentleman who flew from New York to Florida while awaiting his COVID-19 test results.

I imagine that few of the people who stock the bodegas and clean the subways here in New York are surprised by the exodus. Privileged New Yorkers, the kind who moved here with college degrees and an Exciting New Career Opportunity, have long held themselves aloof from the city. They are ready for the rewards—a beautiful skyline, a killer shawarma—but are often trying to skip the bill. They can’t even stomach August in New York. I get that they don’t want to stay in the embattled epicenter of a global contagion.

And by they, of course, I mean me. Except not this time. The coronavirus is running a massive social experiment on us all. The question: Can each of us put aside our dreadful specialness long enough to slow this thing? Can we grit our teeth through the eerie nights to come? Do we trust our neighbors, the dudes on the corner, the first responders, the men living in the single-room occupancy down the block, to have our back—and can they trust us to have theirs? The answer has to be yes.

We are New Yorkers. We rushed the pile after 9/11, rebuilt after Sandy, walked home during the blackout, made out in Times Square on V-J Day. We’re minting a lot of heroes at Elmhurst Hospital  and Mount Sinai West this week, health-care workers who have answered the call with bravery and compassion and sacrifice. The story of New York in this pandemic should belong to them, not to the summer-home super-spreaders.

So it’s settled then. We’re going to get through this, right here, in our tiny freaking apartments. Sending love to you all.

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We want to hear what you think about this article. Submit a letter to the editor or write to letters@theatlantic.com.

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NATHAN THORNBURGH is a co-founder of Roads & Kingdoms and host of The Trip podcast, which he started with the late Anthony Bourdain.

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