Crunchyroll may have taken Claymore away, but my Claymore complete series on blu ray ain't going anywhere. Plus the little book it comes with has collected some English VA signatures. That's why physical media is king.
Aimer has been my favorite Jpop artist for 5 years. I know almost all her music is on Spotify (where I listen to 99% of my music) but lately I've been collecting CDs of artists and franchises I really love. It wasn't hard to find her albums at Tower Records in Osaka, she's got a whole row, and then some. Coming from the US, I saved about $70 buying these CDs from Japan vs buying them as imports. (Tax refund with passport + no tariffs + taking advantage of the weaker yen) At checkout, the cashier gave me a freebie Shinobu sticker, I assume as promotional bonus with the release of that Demon Slayer album. Shinobu is my favorite Demon Slayer character, so definitely a cherry on top.
Aimer has a lot of great songs, but if I had to pick a single favorite song of hers, it's StarRingChild. Something about the vocals and instruments in that one really resonates with me. Anyway, just wanted to share how happy I am to get my hands on Aimer albums on my first visit to Japan.
Watching Demon Slayer as a healthcare professional: appreciating the little details
Welcome to my medical nerd-out post. If you’re interested in the intersection of real-world medical practice and what’s shown in these scenes, read on! Disclaimer that my current background is in anesthesia, and I previously worked in emergency medicine.
(I’m going to cosplay Shinobu at cons later this year and this will be the sign I’ll print and tape to the back of my costume. I feel like this is a very Shinobu thing to say.)
People joke about this bit a lot, and yeah it looks silly, because Zenitsu looks anything but okay here, but would you believe me if I told you that this is actually part of Basic Life Support (BLS) protocol? In an out-of-hospital emergency, usually what happens first is someone collapses for whatever reason. The first thing BLS trained personnel must do is assess the victim's consciousness, like ask if they're alright, just like what Shinobu did here, before proceeding to other interventions if needed, like CPR, rescue breaths, applying and using an AED, etc. I wouldn't want to jump right into giving CPR if the victim is arousable and can breathe. Another first thing to do to check someone's status is feel for a pulse: carotid artery in adults, brachial or femoral artery in small kids. Things go from 0-100 real fast when there's no pulse or breathing. Reassuring to know that apparently Shinobu is trained in BLS.
Flicking the syringe is a legit thing to do. As an anesthetist I draw up IV medications for surgery all day every day, so I flick my syringes all the time. It's to bring air bubbles to the surface of the liquid, so it's pushed out with the plunger before the medication is given. Air bubbles in veins is no bueno, especially in pediatric patients. Some of those kiddos have congenital holes in their heart, called a patent foramen ovale or PFO, and bubbles going through that hole would plug up the circulation, which would be disastrous. (I’m a preceptor in addition to my basic clinical duties, so I make sure students prime their IV lines and medication infusions properly to flush out any bubbles, especially for kiddos.) Push enough air into the vasculature and you get air embolism, an intraoperative crisis. I appreciate Shinobu doing her due diligence not wanting to give Zenitsu air embolism.
A little detail the anime did not show is using aseptic technique to wipe the injection site before injecting. Skin is a natural barrier to outside bacteria and other pathogens. Anytime you stick a needle into someone to establish an invasive line like IVs, arterial lines, central lines, and even just an intramuscular injection like a vaccine, that skin barrier breaks, potentially introducing pathogens further inside the body. The injection site must be wiped down with some sort of antiseptic prep before inserting the needle and injecting that medication. I understand that most likely for animation convenience, Shinobu is shown giving an antidote to Zenitsu by intramuscular or subdermal injection. In the real world, it would be more proper and beneficial to establish an IV and deliver the antidote that way. Pharmacologically speaking, medication given intravenously achieves its desired effects much more quickly than other routes like oral or intramuscular. You want medicine to work systemically (basically spread all over the body where it needs to go), and the quickest way to do that is via bloodstream. It's like carrying mail or cargo to its destination on the freeway at 70 mph versus a residential road at 20 mph, it's just so much faster by freeway. Almost all medications given in the OR are through IV, that’s why establishing IV access before surgery is so important. Real life standard antivenoms are given exclusively by IV, though at a venom conference I attended very recently, there's a novel antivenom in oral form/powder, so that's exciting development. (This is not a criticism of the anime, just what I think is a good talking point to delve into.)
Conducting airway exams is done across several medical specialties, especially in anesthesia. Anesthesia providers do more than knock out patients with gas and meds. We also place airway devices like endotracheal tubes, which delivers oxygen, air, and anesthetic gas via ventilator during the maintenance phase of surgery. Assessing a patient's airway before surgery tells us how easy or difficult it would be to place those airway devices. We look for things like mouth opening, anatomical landmarks like the uvula, hard palate, soft palate, and tonsils, neck circumference, any loose, chipped or broken teeth. There’s something called a Mallampati score that anesthetists use to assess the inside of someone’s mouth, that’s why we ask the patient to open wide and stick out their tongue. The less anatomical landmarks seen, the lower the score, so Mallampati 1 is the best and Mallampati 4 is the worst. Signs that point to likelihood of what we call a difficult airway: thick neck, no chin, limited neck range of motion, a Mallampati 3-4 score. When I have a student with me on a given workday, I make them do their own airway exam on our patient and tell me their findings, to see if they align with my own. Of course you can’t really do a proper airway assessment in a non-elective, emergent surgery, like when a trauma patient comes rolling in. (I work at a trauma center, so that situation is not uncommon at all.) When a patient has an unstable cervical spine or a messed up jaw (I’ve seen some pretty screwed up faces from knife and gunshot wounds), that’s where airway management gets real interesting. We have many creative ways to get that endotracheal tube in.
I couldn't help geeking out a little when Shinobu said she put anesthetic in the water she gave to Tanjiro. I headcanon that she laced it with benzocaine, a local anesthetic. In real life, we use benzocaine, more commonly known as hurricane spray, for transesophageal echocardiograms (TEEs). A TEE is basically a long skinny scope that goes down the esophagus and lets the cardiologist look at heart rhythm and function. This is how irregular heart rhythms and valvular diseases are diagnosed. Patients are instructed to swish around the benzocaine and gargle it in their throat to numb it up before the cardiologist sticks their TEE down there. The patient gets further sedation from anesthesia for this procedure.
Local anesthetics definitely have their use, like in spinals and epidurals, but giving too much is actually toxic, and getting to that point is called local anesthetic systemic toxicity (LAST). It’s a big deal; ORs have a supply cart specifically for treating LAST. It’s really important for surgeons and anesthetists to know the maximum dose for a given patient and procedure, so we don’t end up giving the patient too much. Each local anesthetic has its own unique max dose in mg/kg, and the more the patient weighs, the more local anesthetic they can get. I like to think that Shinobu guesstimated Tanjiro’s weight and put an appropriate amount of benzocaine in the water.
Anesthesia is a medical specialty that entails extensive knowledge in respiratory mechanics, anatomy, physiology, and pathology, because it’s how we keep patients alive during surgery, so we are known by other medical specialties as the “airway experts.” Naturally I’m very intrigued by the use of breathing techniques as the magic/power system in Demon Slayer.
Total Concentration Breathing actually isn’t totally off-base. In the real world, unfortunately, we can’t use it to pull off superhuman feats and kill demons. But in the setting of controlled elective surgery, that’s basically what we make patients do. It’s called preoxygenation. If you’ve ever had surgery under general anesthesia before, you’re familiar with this experience: being rolled into the OR, having vital monitors hooked up, then a mask placed over your face and you’re asked by the anesthetist to take big, deep breaths. After that you “don’t remember anything” (at which point you’re given anesthetic medications to go to sleep). On room air you’re breathing mostly nitrogen. Right before surgery and going to sleep, we deliver high flow 100% oxygen to the lungs via the anesthesia machine. This optimizes the patient for the next step after induction of anesthesia/“knocking you out”: intubation. The measurement to gauge how oxygenated you are is oxygen saturation (or SpO2 for short). This refers to how saturated the body’s red blood cells are in oxygen. That’s the continuous beep on the monitor you hear in all those medical shows, the light blue wavy line that should normally read 90-100%. The pitch of the beep correlates with the amount of saturation: the higher the saturation, the higher the pitch. If you work in the OR, one of the most ominous sounds is a low SpO2 pitch. (The sound of my nightmares!) The reason why we want a patient to have the best SpO2 they can achieve before going to sleep is because the most common medications we give during anesthetic induction, propofol and rocuronium, stops breathing and paralyzes muscles respectively (muscle paralysis sounds scary, but don’t worry, there’s a reversal drug given at the end of surgery!) The clinical term for this cessation of breathing is apnea, like in sleep apnea. Healthy patients have an apnea window of a few minutes. During that apnea window, the patient is intubated and connected to the anesthesia ventilator for the duration of surgery. Some patients don’t have great functional reserve in their lungs, like kiddos (due to their physiology) and sick people (due to some pathology), so their apnea window is much slimmer, so less time to intubate before their oxygen saturation starts to drop. SpO2 dipping under 90% makes OR staff nervous.
As mentioned in the anime, it’s true that greater blood flow and lung capacity benefits your respiratory function. Some patients, however, have suboptimal parameters and that complicates anesthetic management. Common causes include major blood loss, obstructive or restrictive lung diseases, being significantly overweight. In addition to that, many childhood syndromes negatively impact the lungs, one of the many reasons why pediatric anesthesia is more challenging than adult anesthesia. In some thoracic cases where surgery needs to be done on a lung, like to remove a lung tumor or something, that lung needs to be deflated through one-lung ventilation and placement of a special double-lumen endotracheal tube. These can be very tricky cases to handle from an anesthetic standpoint, because the patient is getting ventilated through only one lung, but I like doing them. I could very easily get lost in the weeds of respiratory physiology, but I’ll cut it short here.
Because Hashiras are in peak shape and are so proficient in their breathing techniques, I expect their oxygen saturation to be no less than 100% if they came in as patients for surgery! I’m sure that of all the Hashiras, because of her medical background, Shinobu has the greatest technical understanding of breathing techniques.
I love to explore how real-world science and medicine is featured and applied in pop culture, so I hope you found this post educational and entertaining. Next post I want to do is categorize Hashiras into medical specialties, that'll be fun.
I brought Demon Slayer's resident toxicologist to a venom conference hosted by the Asclepius Snakebite Foundation (which I'm a member of as a healthcare worker). Modern AU Shinobu would absolutely geek out over this event.
This. This scene made me decide Shinobu is my favorite character in Demon Slayer.
Art imitates life. Shinobu's angry smile perfectly captures enduring the day-to-day shenanigans and BS as a healthcare worker. She's in the medical field herself, she gets it.
Speaking from my specific perspective as an anesthetist, I occasionally deal with difficult surgeons, nurses, and patients, and when some patients in certain cases need to be sedated/somewhat awake/not totally knocked out with general anesthesia, you have to be cognizant of what you say and do. And as an Asian woman, I've been a target of sexist and racist comments from patients before. I've managed anesthesia for convicted criminals, murderers, sex offenders, thugs covered in white supremacist tattoos, etc. I gotta put on a smile through all of it to keep the peace and maintain professionalism, even when I'm seething with rage or frustration inside.
Shinobu totally gets it. Her facade ultimately comes from a different source, but speaking from experience, I'm more than sure that she applies that same attempt at a coping mechanism in her medical work.
I've been revisiting Xenoblade Chronicles 3 via NG+ after completing it the 1st time a year and a half ago, and a thought struck me: how did Nimue, someone from a peaceful colony isolated from normal contact (let alone fighting), rise to power as another colony's military strategist and its commander's right-hand woman?
I like to think that Isurd saw her potential during his time recovering at the Lost Colony, like he played a strategy board game or something with her and she turned out to have a talent for tactics.
The idea of "sleeping your way to the top" likely doesn't even compute with these Agnian and Kevesi soldiers who have no concept of things like romance. So they wouldn't be thinking and saying stuff like that. But I assume there was likely still initial skepticism, maybe even resentment, at the time Nimue first joined Isurd's colony. I doubt they would have accepted some random girl Isurd brought in as their strategist right off the bat. She probably had to prove herself through a fair share of battles against Keves to earn respect from Colony Lambda and earn her place as its strategist, and prove that Isurd's high regard of her isn't unfounded.
That made me think that's partly why Nimue regards Taion with fondness and compassion. Maybe by seeing him struggle as a budding tactician and getting pushback from his peers, it reminds Nimue of her own struggles with assimilating into Colony Lambda.
Anyway maybe I'm rambling at this point. I love to fill in room between the lines for interpretation of minor characters I like.
When you're carrying around at work the resident petty vindictive tsundere of Unicorn Overlord but patients and coworkers say "I like the pretty angel on your badge." (art and keychain by MorVertCrafts)
In a way, Naamah is canonically a dog person. She has Glasya-Labolas at her beck and call. Agrat definitely seems like a cat person. Lilith is canonically a snake person. Eisheth is a people person. As in an I-love-ripping-off-limbs-and-eyes-from-people person.
Did Agrat pulled a time travel and meet King David?
Agrat is an ancient demon, so I don't think she needs to time travel and it's very possible she was around when David was alive. Multiple Jewish texts state that Agrat is the mother of Asmodeus, not Naamah, but for some reason Vengeance lore says otherwise. According to some of those texts, Agrat spent a night with David to bear Asmodeus. I like to think of it a little differently, so here's my fan reinterpretation:
Agrat and David met and knew each other during the time he was a boy in his late teens, before he became king and around the time he had to slay Goliath. As a newly minted Qadištu at the time and Lilith's daughter, Agrat was pressured by Lilith to find someone to sire an heir, preferably someone kingly to equal Agrat's lofty status as a queen of demons.
She traveled to the human world in human disguise and wandered in her travels until she found David, who at first glance looked like a lowly shepherd boy, but with her divination she foresaw his destiny to become a great king. Initially she got acquainted with him as a means to an end, but eventually they developed genuine love for each other. It was Agrat who advised David how to kill Goliath and gave him the encouragement he needed to be a brave leader.
Once Agrat became pregnant, however, Lilith commanded her to return to the netherworld, cut ties with David, and wipe his memory of her existence. Agrat had no choice but to obey. On the day David killed Goliath, Agrat wiped his memory and returned to the netherworld to give birth to their son Asmodeus and raise him as a prince of demons.
Asmodeus grew up not hearing and knowing much about his father. Agrat is reluctant to talk about David beyond brief mentions, because deep down she still carries the heartbreak of leaving him and being forgotten. As a demon, Agrat is no stranger to seducing and exploiting humans to her benefit, but David was the only one she truly loved.
Centuries later, the Nahobino reminds her of David, and that's why in some of her demon haunt conversations she implies feelings for him and likes the thought of him being the king to her queen in ruling demons.
Proof that Agrat is an anesthesia provider (kidding kind of)
Currently I'm playing SMT V Vengeance as the main way to destress after work. This line from Agrat in the first pic basically describes what I do for a living (delivering and managing anesthesia in the operating room).
Makes people feel sluggish and sleepy. Has to "titrate to effect," delivering just the right doses, so nobody dies. Administration of magic/medicine can still lead to some undesirable side effects. Most importantly, she sits in (an invisible) chair. She checks all the boxes. Agrat is an anesthetist. Tao even pulls the classic "blame anesthesia" move ("It was you...all those people. You made them all sick!")
Like a lot of people, I adore Agrat's skeleton-doll-witch hybrid design, her being voiced by the queen Cherami Leigh (who voices my other fav Makoto Niijima), and how she's a crit beast in gameplay. Wanted to add here my own reason to gush over my favorite character in this game. How Agrat reminds me of my line of work makes me like her even more.
P.S: Eisheth is the surgeon. (Now I'm imagining the utter chaos of the Qadištu working as an operating room team)
(Disclaimer that some of these headcanons go against SMT V Vengeance lore, as I'm drawing from various sources texts on Jewish mysticism and mythology that say otherwise. Demons are slippery things, open to many different interpretations.)
-Being ancient and well-learned demons, the Qadištu speak and understand a great number of languages, though their native tongue is Hebrew.
-Lilith and Agrat are mother and daughter. Naamah is Lilith's younger sister, therefore Agrat's aunt. Eisheth is Naamah's favorite lover. They take the crown for being Da'at's darkest, weirdest, most dysfunctional family.
-Agrat's full name is Agrat Bat Mahlat because despite Lilith being her biological mother, Agrat spent her early years raised by a foster mother and demon named Mahlat. Lilith wanted proof that her offspring would in time become strong and worthy before welcoming Agrat as one of the Qadištu.
-With her love of rainy weather and talent for dancing, Agrat lives up to her nickname as the "demon dancing on the roof" by spending her free time tap dancing somewhere up high, happily twirling her umbrella under a shower of rain.
-Eisheth loves to carve works of art with her absurdly long nails on all kinds of surfaces. The fleshier the better, of course.
-Eisheth has the soul of an artist. In her free time she travels to the human world in disguise to visit art museums and admire the greats.
-Eisheth is also a culinary connoisseur and has a vast appetite. Naamah is convinced that Eisheth's stomach is a bottomless void somehow connected to a black hole somewhere in the universe. One time Eisheth was challenged by the rest of the Qadištu to an eating contest. Even combined, the three of them still lost.
-Agrat enchanted her hat so it stays on her head at all times, even through blustering winds and howling blizzards.
-Agrat and Eisheth fight like cats and dogs, Agrat using every chance she gets to piss off and egg on Eisheth (a very easy target), while Eisheth constantly calls her whelp, kid or brat, and hardly ever refers to Agrat by her proper name.
-As the oldest, Lilith is the matriarch and the glue keeping the Qadištu together all these years, acting as peacemaker whenever the other three get into petty spats.
-Agrat has a son named Asmodeus, who she had with David before he became the king of Israel. Being half-demon, he ages very slowly. He has lived for hundreds of years but appears physically nine or ten years old. He has a penchant for impish mischief and can have nasty temper flare-ups (literally, complete with hair and eyes on fire), but also has razor-sharp cunning and intellect that make his mother proud. He goes by his nickname Mo when referred to with affection and endearment.
-Unlike most demons who entirely leave their offspring to fend for themselves, Agrat has been invested with educating and caring for Asmodeus since his birth, due to the unusual attachment she feels for his father David. She teaches Mo everything from magic and music to the ways of the demon and human worlds.
-The only thing that annoys Eisheth more than Agrat ("Whelp") is Mo ("Whelp Jr.") Whenever they're in the same room, Eisheth says dramatically "Oh Goddess there's two of them."
-Naamah has had so many lovers and demonic offspring over the centuries that she can't bother to keep track of them and remember all their names. Eisheth being the exception, of course. Their dates typically consist of human killing sprees.
-Naamah has no interest in protecting and raising her own children, but dotes on her grand-nephew Mo and encourages his attempts at pulling pranks. It won't happen anytime soon (give or take a few centuries), but she looks forward to the time he's matured and grown so she can teach him how to be the ultimate ladies' man.
-Lilith dotes on her faithful snake companion, who is never far from her and in turn closely protects his mistress. She likes to feed him live prey and doesn't mind the bloody mess he makes when he's crunching into something over her shoulder.
-Out of the four, Agrat is the most scholarly and especially knowledgeable in medicine and disease. She's more interested in the knowledge and application of diseases, of course.
-Out of the four, Naamah is the most knowledgable and invested in cosmetics. She keeps a huge secret stash of makeup that she refuses to share with her fellow Qadištu. Her love and sharp eye for good aesthetic is why she and Eisheth get along so well.
-Eisheth somersaults in place midair when she's bored.
After 100+ hours I finished my first playthrough of Unicorn Overlord today and here are my (very) scattered thoughts, opinions, and reactions (spoilers ahead):
-Melisandre is best girl and was my ring of the maiden choice. From the start she cracked me up over how she has it down BAD for Alain (and even straight up tells him as much). Their last rapport was really touching and sealed the deal for me to give her the ring. She leads my swordfighter unit and was my go-to with holding down the fort at the command post.
-On the other hand, Scarlett just didn't quite work for me as a romantic interest. I don't sense a lot of natural chemistry in her interactions with Alain, despite the game seeming to push the player in her direction. Fiora from Xenoblade Chronicles was another main girl/childhood friend archetype, but I liked her a lot more. Maybe I have a weakness for girls with dual swords. I will say that I like Scarlett as a healer in gameplay and in rapports with other characters (that don't have to do with petty jealousy and rivalry with other girls). Just not a fan of her as a romance option for Alain.
-Virginia is another very cool character and absolutely kills it in my Hilda-led, real damage-dealing all-girls unit. I've never seen her fall, like ever. She may be slow but she knows how to take hits like a tank and dish out real damage.
-Same with Berengaria and Hilda. Really cool designs, real tough badasses, reliable fighters that always crush everything in their path. Love the sibling dynamics they have with Travis and Primm, respectively.
-I tend to suddenly obsess over very minor characters and in Unicorn Overlord, Raenys became the one. She comes in so late into the game, but her VA gives her a fantastic voice and she succeeded Ochlys to lead my alpha strike angel unit in late game, since she can fly plus provide arrow assist.
-I love talking animal characters, so Bastorias naturally became my favorite country to explore. The bestral unit led by Morard became one of my best hard hitters in late game. They're my night strike team.
-Character design is very hit and miss for me, particularly the women. Some like Virginia and Berengaria look absolutely cool and it certainly helps that their armor looks reasonable, but others make no sense and look absurd like Amalia's steel armor underwear.
-Sharon x Ochlys is my non-Alain OTP. They're so cute together and it's so painfully obvious they have a thing for each other. Romancing any of them as Alain felt wrong to me.
-My other crack OTP: Selvie x Bruno's gluts. Their rapport had me rolling on the floor.
-"I hope you get little eggshells in your omelettes for the rest of your life" from Nina is my new favorite insult.
-The localized writing/script sometimes feels needlessly embellished and elevated. Some of it is okay, but I feel like they overdo it at times. It's like seasoning with spices: sprinkle here and there for flavor, don't throw in so much that it just becomes overwhelming. I suspect they took inspiration from fantasy staples like Lord of the Rings and Game of Thrones, among other things.
-Foraging and collecting stuff in overworld is lowkey kinda addicting. When I see a blue shiny light from the ground, I have to run over to collect it.
-The graphics for the rapport building meals look incredibly delectable. Someone should make a little cookbook on all the recipes.
Mrs. Niijima had succumbed to postpartum hemorrhage just a few days after delivering Makoto. Eight year-old Sae was by her mother's bedside, and her father was away to check on baby Makoto in the NICU, when the vitals suddenly plummeted and her mother lost consciousness. Sae was jostled aside by doctors and nurses to a corner of the room in their rush to perform lifesaving interventions, which ultimately failed. After several minutes of being barred from the room, Mr. Niijima was finally able to break through to retrieve his terrified, petrified daughter, who was left forgotten in the chaos. He pulled Sae aside to console her and shield her from the sights and sounds of the crisis, but the damage was already done. Sae was left with a strong, deep-seated fear and hatred of hospitals. The idea of having children herself takes her back to that traumatic day she witnessed losing her mother. Despite this, she doesn't blame Makoto at all for their mother's death.
Sae was more than academically capable to go through medical school and become a physician. She just has absolutely no interest in the field.
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