fuckballs and lemonade

Still here. Still too mad at G-d to go home. Still turning tea and food into B-minus puns and a shadow.

[dynamite5ftjewishbitch]

Of all the blind-side chip shots that Noah Kahan has hit me with, “American Cars” was never one that landed.

But when my little sister told me today that hearing that he’d written it for his older sister had hit her like a brick, that hit me.

You’ve been driving all day,

But you’re home and I’m so grateful you are.

‘Cause you’re gonna fix it, you’re gonna patch it up.

Honey, we’re fragile; you’ve always been so tough.

You know that I’ve missed you. You always come runnin’ back

Whenever I ask.

[dynamite5ftjewishbitch]

ALCHEMICAL IS A WORD, YOU DWEEBS

[apolladay]

Did you work during any of the Covid lockdowns?

yes outside the home

yes but from home

yes to both of the above

no but I wasn't/couldn't/didn't work anyway

no Covid stopped my job at some point

nuance/other/results

Voting ended onJun 24

[dynamite5ftjewishbitch]

Was randomly flung back in memory today to an episode of TOUCHED BY AN ANGEL (I’m Jewish. I know. Don’t get me started.) that I watched at like age 10 wherein a child roughly my age died of cystic fibrosis as his mother (country music then-superstar Wynonna Judd) sings in the background.

My kid sister has no recollection of this. She grew up in my mom’s Ladder 49 era. I feel like I’m trying to recount a fever dream.

[televisionforwhales]

Absolutely bonkers how the magicians went out in such a spectacular fashion it's gatekept by its own biggest fans like so much of it is SOo GOOD ‼️ don't ✋ watch it tho 🚨 I saw it and am changed 💅 and you should not do that thing 🚫 trust me 😔😏

[dynamite5ftjewishbitch]

I mean, at least they kept true to the source material. So well done…riiiight up until the last act.

[dynamite5ftjewishbitch]

I’d like to stop being first-on-scene to car accidents, please. Especially ones where smoke starts to seep from under the hood RIGHT as you realize you’re standing in a puddle of gasoline and the driver is disoriented and combative and won’t get out or turn off his engine.

[skinilivein]

[reallyreallyreallytrying]

people will be like "i'm bored" meanwhile there's baking soda and vinegar in the cupboard. make a volcano dude

[lindleland]

okay

[lindleland]

[dynamite5ftjewishbitch]

No because I’ve heard from (two different) patients this week that coating one’s penis in baking soda or in vinegar is being touted on the internet as a treatment for erectile dysfunction and I joked earlier “what if they see both ads?!”

[cbartonscoffee]

this is so cool and so nice actually. as someone trying to connect better with his culture i get it so bad.

Isa Briones for LA Times (x)

[dynamite5ftjewishbitch]

I am—and I cannot stress this enough—going to get absolutely fired from my job if someone comes into my office asking about this shit.

[dynamite5ftjewishbitch]

I genuinely love the ED.

I cut my teeth in the ED.

My daydream job when I was a CHILD at age 7 was ER doc; I spent years of my life taking notes every Thursday during “ER” and the rest of the week looking things up.

Once I grew up, I spent ten years in various roles in the ED before I ever even went to nursing school.

It was an ED doc* who nudged me along the path and told me that if I couldn’t bring myself to go to medical school (because I was raising my sister), then I should go to nursing school, and hey while I was at it, maybe I should consider becoming an NP.

After graduating with my RN, I took a job as a float nurse and relished the shifts I spent in ED.

I very frequently think about going back to the ED now that I’m a nurse practitioner.

ALL THAT TO SAY, I love and respect the ED and I know full well what it’s like to work in that environment, from so many different angles.

So when I sent a patient to the ED yesterday because his kidney function fell off a cliff (from a GFR of 65 to 9, from a creatinine of 0.83 to 5.39) and he developed bilateral hydronephrosis without being in urinary retention, and when I called the ED to tell them why I was sending him in, and asked them to do a CT and call me when it inevitably showed a mass in his abdomen so that we could come poke holes through his back and into his kidneys so he didn’t die, and then he spent 7 hours in a waiting room, I was disappointed to say the least.

He left. He couldn’t sit in those chairs anymore and he went home.

I called him and begged him to go back this morning. Miraculously, he did.

When I went to round today, I deliberately entered through the ED.

“Hey, where’s Mr. [LastName]? I sent him up here, I figure I ought to say hello before I start my rounds. … What do you mean he’s in the waiting room? His GFR is 9.”

The ED doc goes, extremely confidently, “no, that’s falsely low. GFR is weight-based. We saw him yesterday and the triage nurse put his weight in as kilograms not pounds, by mistake, and it hasn’t been fixed yet. Unless he gained 120 pounds overnight, it’s just a calculation error.”

ED docs are brilliant, they have to know so much. I have so much respect for them.

It always feels so personal when they’re assholes.

One, don’t talk to me like I’m fucking stupid. I know how an eGFR is calculated. I can do it by hand.

Two, even if it was a calculation error, with them overstating his weight, his GFR would’ve been falsely elevated to 9. Not falsely decreased.

Three… “That lab result was from before I sent him up here. It was why I sent him up here. The weight error wasn’t made until after his eGFR was calculated to be 9. Is creatinine weight-based, too? Because it’s almost 6. He needs neph tubes. My surgeon had IR on standby when I sent him up here yesterday.”

I called. I gave report. It’s in his chart that I initiated the transfer.

And they fucked around for so long on the SECOND DAY that he had to be transported 40 minutes away (because our hospital only has interventional radiology until 5pm on fridays) . Which means his extremely elderly wife has to drive 40+ minutes away to the trauma center and navigate a city and pay to park to be with him while we try to save his life. Which is substantially harder now that we’re 36 more hours behind the goddamn 8-ball.

My problem with the ED is this: from their foxhole, there are two types of patients that can walk into any given ED. The type that doesn’t belong in any ED (“why are you here?”), and the type that doesn’t belong in this ED (“why are you here?”)

If a patient can’t be taken seriously when another provider has already pre-vetted their emergency, who the fuck CAN be taken seriously in the ED?

[dynamite5ftjewishbitch]

He died.

He was dying anyway—he was damn near 100 and had metastatic prostate cancer. But he didn’t have to die from this and he could have spent his last days comfortable if he had just been…cared for.

I’m so frustrated.

I don’t know what we’re doing here sometimes.

[dynamite5ftjewishbitch]

I genuinely love the ED.

I cut my teeth in the ED.

My daydream job when I was a CHILD at age 7 was ER doc; I spent years of my life taking notes every Thursday during “ER” and the rest of the week looking things up.

Once I grew up, I spent ten years in various roles in the ED before I ever even went to nursing school.

It was an ED doc* who nudged me along the path and told me that if I couldn’t bring myself to go to medical school (because I was raising my sister), then I should go to nursing school, and hey while I was at it, maybe I should consider becoming an NP.

After graduating with my RN, I took a job as a float nurse and relished the shifts I spent in ED.

I very frequently think about going back to the ED now that I’m a nurse practitioner.

ALL THAT TO SAY, I love and respect the ED and I know full well what it’s like to work in that environment, from so many different angles.

So when I sent a patient to the ED yesterday because his kidney function fell off a cliff (from a GFR of 65 to 9, from a creatinine of 0.83 to 5.39) and he developed bilateral hydronephrosis without being in urinary retention, and when I called the ED to tell them why I was sending him in, and asked them to do a CT and call me when it inevitably showed a mass in his abdomen so that we could come poke holes through his back and into his kidneys so he didn’t die, and then he spent 7 hours in a waiting room, I was disappointed to say the least.

He left. He couldn’t sit in those chairs anymore and he went home.

I called him and begged him to go back this morning. Miraculously, he did.

When I went to round today, I deliberately entered through the ED.

“Hey, where’s Mr. [LastName]? I sent him up here, I figure I ought to say hello before I start my rounds. … What do you mean he’s in the waiting room? His GFR is 9.”

The ED doc goes, extremely confidently, “no, that’s falsely low. GFR is weight-based. We saw him yesterday and the triage nurse put his weight in as kilograms not pounds, by mistake, and it hasn’t been fixed yet. Unless he gained 120 pounds overnight, it’s just a calculation error.”

ED docs are brilliant, they have to know so much. I have so much respect for them.

It always feels so personal when they’re assholes.

One, don’t talk to me like I’m fucking stupid. I know how an eGFR is calculated. I can do it by hand.

Two, even if it was a calculation error, with them overstating his weight, his GFR would’ve been falsely elevated to 9. Not falsely decreased.

Three… “That lab result was from before I sent him up here. It was why I sent him up here. The weight error wasn’t made until after his eGFR was calculated to be 9. Is creatinine weight-based, too? Because it’s almost 6. He needs neph tubes. My surgeon had IR on standby when I sent him up here yesterday.”

I called. I gave report. It’s in his chart that I initiated the transfer.

And they fucked around for so long on the SECOND DAY that he had to be transported 40 minutes away (because our hospital only has interventional radiology until 5pm on fridays) . Which means his extremely elderly wife has to drive 40+ minutes away to the trauma center and navigate a city and pay to park to be with him while we try to save his life. Which is substantially harder now that we’re 36 more hours behind the goddamn 8-ball.

My problem with the ED is this: from their foxhole, there are two types of patients that can walk into any given ED. The type that doesn’t belong in any ED (“why are you here?”), and the type that doesn’t belong in this ED (“why are you here?”)

If a patient can’t be taken seriously when another provider has already pre-vetted their emergency, who the fuck CAN be taken seriously in the ED?

[tpwrtrmnky]

Analyzing the politics of a work that's meant to be apolitical is actually a really interesting exercise because it asks you to critically examine what the creator considers to be "political" in the first place. Which ideas are just How Things Are, and which ones are Political, and how is that influenced by the creator's beliefs?

[takashi0]

Usually this just ends up with you looking like a moron btw

[tpwrtrmnky]

Angrily lashing out at the suggestion that it's possible to do basic media analysis was foundational to the ragebait ecosystem of the 2010s, from which we got basically the entire culture of modern far right politics, btw.

[iteh3xael]

I genuinely believe myself and others are being so sincere and literal when we say TOUCH GRASS

[tpwrtrmnky]

I went outside and got an education, that's where I learned that you can obtain knowledge and insight through analytical methods, then noticed that some people who sit on the internet yelling at strangers get really mad about that constantly.

[pensivegladiola]

Don’t make me point to the Omar Sakar poem

[dynamite5ftjewishbitch]

“It is that deep, you’re just not that deep.”

[dynamite5ftjewishbitch]

In COMIC SANS is crazy.

[dynamite5ftjewishbitch]

@beyoursledgehammer Hey look, it’s you!

[dynamite5ftjewishbitch]

Sky for @that1girlarreis

[dynamite5ftjewishbitch]

The feeling of running a complex case past your [new] mentor and being told you covered every angle already and that after 40 years in practice, he wouldn’t have done anything differently should be bottleable.