in the end we are all creatures in need of love and comfort
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@goldeneye242
in the end we are all creatures in need of love and comfort
"it's okay, i can peel back the layers of you until i find the soft and gentle core of you you've had to work so hard to hide"? no. no, it's okay, i know you're hollow; i'm here anyway. you don't have to pretend it isn't masks the whole way down. whatever face you want to wear, i still love you. i don't need you to be good or unflinching or the antonym of violence. if i did, i wouldn't be here. i wouldn't ask that of you.
i have nothing against a character who is layers of scar tissue and callous protecting a small little sliver of their before self, who just wants to be safe to let that sliver grow and heal
however. when the only thing under all the scarring is more scarring. when there's nothing of the before self left at all. when there was a precipice, and they tumbled over it, and even if they got back up they'll never heal right.
and then to have someone still say i care for you. you are broken and i can't fix you and i'm here anyway. so what if you're a ghost of yourself? you can haunt me
To those who think they are “getting old” or “falling behind” on their 30th birthday...
I didn't get married until I was in my mid thirties
I didn't have a child/start a family until I was 40
I didn't find my longest work experience until I was 40
I didn't find kink until I was in my early 40s
I didn't meet my life partner until I was 47
I didn't understand my trauma enough to do anything about it until I was in my 50s
I decided to give polyamory a go at 54
I didn't get in the best physical shape of my life until I was 55
I'm not done
A lot of you want to come to understand yourselves, evolve to your full potential, and solve all of hardest evolutionary points of your lives just a dozen years after you become an adult. You have 12 years living as an adult before you are 30 years old. You will have 60 or 70 adult years if you live a full and healthy life. There is no time table. You are not running behind.
Memes then and now
A doctor discovers an important question patients should be asked
This patient isn’t usually mine, but today I’m covering for my partner in our family-practice office, so he has been slipped into my schedule.
Reading his chart, I have an ominous feeling that this visit won’t be simple.
A tall, lanky man with an air of quiet dignity, he is 88. His legs are swollen, and merely talking makes him short of breath.
He suffers from both congestive heart failure and renal failure. It’s a medical Catch-22: When one condition is treated and gets better, the other condition gets worse. His past year has been an endless cycle of medication adjustments carried out by dueling specialists and punctuated by emergency-room visits and hospitalizations.
Hemodialysis would break the medical stalemate, but my patient flatly refuses it. Given his frail health, and the discomfort and inconvenience involved, I can’t blame him.
Now his cardiologist has referred him back to us, his primary-care providers. Why send him here and not to the ER? I wonder fleetingly.
With us is his daughter, who has driven from Philadelphia, an hour away. She seems dutiful but wary, awaiting the clinical wisdom of yet another doctor.
After 30 years of practice, I know that I can’t possibly solve this man’s medical conundrum.
A cardiologist and a nephrologist haven’t been able to help him, I reflect,so how can I? I’m a family doctor, not a magician. I can send him back to the ER, and they’ll admit him to the hospital. But that will just continue the cycle… .
Still, my first instinct is to do something to improve the functioning of his heart and kidneys. I start mulling over the possibilities, knowing all the while that it’s useless to try.
Then I remember a visiting palliative-care physician’s words about caring for the fragile elderly: “We forget to ask patients what they want from their care. What are their goals?”
I pause, then look this frail, dignified man in the eye.
“What are your goals for your care?” I ask. “How can I help you?”
The patient’s desire
My intuition tells me that he, like many patients in their 80s, harbors a fund of hard-won wisdom.
He won’t ask me to fix his kidneys or his heart, I think. He’ll say something noble and poignant: “I’d like to see my great-granddaughter get married next spring,” or “Help me to live long enough so that my wife and I can celebrate our 60th wedding anniversary.”
His daughter, looking tense, also faces her father and waits.
“I would like to be able to walk without falling,” he says. “Falling is horrible.”
This catches me off guard.
That’s all?
But it makes perfect sense. With challenging medical conditions commanding his caregivers’ attention, something as simple as walking is easily overlooked.
A wonderful geriatric nurse practitioner’s words come to mind: “Our goal for younger people is to help them live long and healthy lives; our goal for older patients should be to maximize their function.”
Suddenly I feel that I may be able to help, after all.
“We can order physical therapy — and there’s no need to admit you to the hospital for that,” I suggest, unsure of how this will go over.
He smiles. His daughter sighs with relief.
“He really wants to stay at home,” she says matter-of-factly.
As new as our doctor-patient relationship is, I feel emboldened to tackle the big, unspoken question looming over us.
“I know that you’ve decided against dialysis, and I can understand your decision,” I say. “And with your heart failure getting worse, your health is unlikely to improve.”
He nods.
“We have services designed to help keep you comfortable for whatever time you have left,” I venture. “And you could stay at home.”
Again, his daughter looks relieved. And he seems … well … surprisingly fine with the plan.
I call our hospice service, arranging for a nurse to visit him later today to set up physical therapy and to begin plans to help him to stay comfortable — at home.
Back home
Although I never see him again, over the next few months I sign the order forms faxed by his hospice nurses. I speak once with his granddaughter. It’s somewhat hard on his wife to have him die at home, she says, but he’s adamant that he wants to stay there.
A faxed request for sublingual morphine (used in the terminal stages of dying) prompts me to call to check up on him.
The nurse confirms that he is near death.
I feel a twinge of misgiving: Is his family happy with the process that I set in place? Does our one brief encounter qualify me to be his primary-care provider? Should I visit them all at home?
Two days later, and two months after we first met, I fill out his death certificate.
Looking back, I reflect: He didn’t go back to the hospital, he had no more falls, and he died at home, which is what he wanted. But I wonder if his wife felt the same.
Several months later, a new name appears on my patient schedule: It’s his wife.
“My family all thought I should see you,” she explains.
She, too, is in her late 80s and frail, but independent and mentally sharp. Yes, she is grieving the loss of her husband, and she’s lost some weight. No, she isn’t depressed. Her husband died peacefully at home, and it felt like the right thing for everyone.
“He liked you,” she says.
She’s suffering from fatigue and anemia. About a year ago, a hematologist diagnosed her with myelodysplasia (a bone marrow failure, often terminal). But six months back, she stopped going for medical care.
I ask why.
“They were just doing more and more tests,” she says. “And I wasn’t getting any better.”
Now I know what to do. I look her in the eye and ask:
“What are your goals for your care, and how can I help you?”
-Mitch Kaminski
Source
A beautifully written account of what it is like to be a good doctor, whose only concern is: “how can I help”.
One of the greatest doctors I’ve known in my life, Marc Smaldone at Fox Chase Cancer Center, asked my mom this. And he helped her. God, did he help her. He helped all of us.
This is what doctors SHOULD be. ♡
Dioooooos
Watching the first one: Yes, my brain that is used to Atlantic coastal dolphins registers that as the size that orcas probably are.
Watching the second one: OH LAWD HE COMIN'
First orca: oh cool! What a lovely thing to see that close and capture the moment on film. How nice!
Second orca:
listen i do not mean this in a furry way at all and i know the actual tread of this would be ass but let me say. i would very much like it if there were boots that made animal tracks instead of boot tracks. i just think thatd be neat
doc marten edition this one goes out to the goths
*inhales* COWBOYS CATBOYS MILVES AND DILVES COME GET YA JUICE!!!!!!
I have good news
And some bad news
Here’s the crafter’s website.
@spiritspodcast
Ch🧐
Literally how they did it in the original movies
This is truly incredible.
Always worth the reblog!
This was FASCINATING
here's a bunch of spongebob titlecards i hoarded
The intimacy of answering the phone “Hey you.” The intimacy of stopping to wait when someone needs to tie their shoe. The intimacy of knowing when someone’s voice is thick with worry or sleep. The intimacy of singing (badly) with someone in the car. The intimacy of huddling together under a shelter/umbrella. The intimacy of instantly recognising someone’s handwriting. The intimacy of trying to make plans and, “Oh no we can’t, you’re working that day.” The intimacy of matching your pace to theirs as you walk. The intimacy of being there for someone as they cry. The intimacy of “How did you know that?” “Because I know you.” The intimacy of feeling someone’s warmth through their clothes when you hug. The intimacy of being given change that’s warm from the heat of someone else’s hand. The intimacy of shared, comfortable silence. The intimacy of knowing how someone would react. The intimacy of keeping the radio off when someone falls asleep on a long car journey. The intimacy of sharing one earbud each. The intimacy of noticing someone’s nervous habits. The intimacy of “I had a dream about you.” The intimacy of inside jokes. The intimacy of feeding someone food as they drive (or really any other time). The intimacy of knowing just how someone likes their tea/coffee. The intimacy of trying something new together and having no idea what you’re doing; the shared hesitancy. The intimacy of someone saying “Text me when you’re home safe.” The intimacy of someone falling asleep next to you. On your shoulder. In your company. The intimacy of sharing secrets in the nighttime, because 3am will never tell. The intimacy of someone’s pet recognising you and coming over to say hello. The intimacy of “This made me think of you.” The intimacy of borrowing a jacket still warm from their body heat. The intimacy of seeing someone’s unfocused eyes when they first wake up. The intimacy of ordering food and “shall we share it?” The intimacy of someone sharing the meaning behind their tattoos. The intimacy of just looking at someone and dissolving into laughter together.
ELLA PURNELL as LUCY MACLEAN Fallout | Season 1, Episode 1, "The End"
How I look trying to find a fresh way to say a character punched someone:
How it feels to search up diagrams of the components of different types of guns:
Trying to keep track of my character's injuries and how long it takes them to heal:
Figuring out what each character knows and who's lying and how much the villain reveals and when:
His throwing skills only get better
not all heroes wear capes
I love how doesn’t even pretend to wonder if he’s the a-hole in this situation, he knows he isn’t