my friends and I are planning on getting h i this summer, and we do have I few dea.lers in mind (a friends older brother and an older girl), but what would be the best way to get h i safely? I was looking into he.mp oil/extract, he.mp gummies, and mull.ein leaves (also, where do you get paper and how do you ro.ll up the leav.es 😭). how many m.g. or drags is safe for the first time? is it safe to trust other teenagers, and is it safe to buy online? I wouldn't be able to get any in person (small town).

So I’m a medical student and Ethan happened to share his medical results while I was taking my GI final. Honestly that episode really helped me study so thank you 😅 We did a lot of assignments where we were given a giant paragraph of GI info to try to make a diagnosis, so I am doing this with good intentions and am NOT claiming to know more than licensed physicians.
I could be wrong because I am still learning BUT I strongly suspect Celiac or Chrons. Celiac in my opinion is more likely because when there are skin findings on the face (face is less common for both, it’s usually on arms and legs) it looks almost exactly like Ethan’s rash that he was struggling with. Erythema nodosom (chrons skin findings) is more purple and looks more like bruises. His ancestry makes him more likely than average to have either but I think it was mentioned that his mom has celiac in addition to ulcerative colitis (correct me if I am wrong), which would increase that chance even more. Celiac also tends to show up at ages 40-60 (he’s 42 it fits 😉) whereas chrons is typically younger starting at around 15 but can also go to around 35 (fits if you believe in fake news). His colonoscopy should be able to get him a definitive diagnosis and for the sake of the office bathroom I hope he gets better soon 🙏🏻
ALSO I learned about the pesto poop.
SO to digest fats your liver and your gallbladder release bile into the intestines. Bile is green. Normally your bile is reabsorbed after it digests the fat and does its thing. HOWEVER since whatever he has includes issues with reabsorption in general (that’s what causes most diarrhea) either his bile was being released too quickly to be reabsorbed or it just wasn’t being reabsorbed at all. AND when fat isn’t being broken down because the bile is acting funny it is pooped out and makes your poop look oily. So green+oil=pesto! When I tell you guys I’ve been thinking about the pesto poop since the beginning of the GI block I swear 😂

This was my first major issue during my transition, or "Life 2.0."
Like many with little to no other options, I use Planned Parenthood to "manage" my HRT. I use the word manage loosely as I have done far more managing than they have. Hell, our local Planned Parenthood was burned down and now they operate covertly in an unmarked RV that moves around but never stays in one spot too long.
I had a bad experience at Quest Diagnostics and filed an official complaint, which Quest ignored. When I told Planned Parenthood, their response was just, "Good for you for advocating for yourself," which felt dismissive. They send patients to Quest but expect us to handle issues ourselves.
Ten days ago, I asked my Primary Care Physician (PCP) to do my labs. Since I’m managing this alone, I requested tests based on how I felt: T, E, Kidney Function, CBC (I was slightly anemic before), and a micronutrient test. My PCP's response was, "We're not sure what goes into the micronutrient test or if we can do it." They outsource labs, so all they had to do was draw blood—they could have easily looked it up.
I sent a professional but firm response, highlighting my dissatisfaction with their care since updating my paperwork to reflect my transition. Previously, I had symptoms of dizziness and fatigue and was tested for multiple STDs, including HIV, despite not having sexual partners for almost two years. The doctor didn’t inform me about these tests, and they all came back negative. What I actually had was low iron, but the doctor ignored my recent colonoscopy and didn’t consider it could be hormone-related.
After my message, I heard nothing from my PCP's office for seven days. I sent three messages, one an apology. It wasn't until I emailed the practice management that I received a response at 11 pm saying my PCP is uncomfortable treating me and suggested I find a doctor more comfortable with "cross-sex hormones.
I realize that we aren't everyone's cup of tea and that it's inevitable we will encounter opposition, as we are outnumbered 99.5% of the time. It just feels odd that a doctor who does my yearly checkup and handles the few times I’m hurt or sick isn't "comfortable" treating me. I promise it’s not contagious! However, knowing what I know now and feeling the way I do, if it were contagious, I’m not sure I’d mind catching it!
Although shitty as it may be that someone who liked me just fine until I told him I was trans now isn't comfortable anymore, I'd rather know than continue to see him and have him act weird. I did expect better from a doctor but we're all human after all. But 7 days of no response made it so I couldn't help but feel it was personal.

Throwaway because of the subject. I'm being followed and observed everywhere I go for most of the past year. They seem to be using my cellphone as a tracking device. I notice strange things happenings to my phone, like old emails suddenly changing permissions to my photos and recorded phone activity. When I leave home my security camaras start gliching out and they stop sending notifications. Old facebook accounts which I lost access to start sending email notification of activity but I have no idea what's going on so I close the email accounts.
This same thing happend to my sister a few years ago as well, she ended up hospitalized. They really fucked her up. It all started shortly after a close realtive contracted a local equivalent of a lawyer from the CIA. At first I thought it was a political persecution as I engage online in a local forum and dating sites and sometimes have disagreements with dense people of other wings.
Things get personal quick when people start coming in too close for comfort as if I'm some kind of jihad terrorist. I start recording them as evidence and the motherfuckers start coming with kids to make it look I'm recording them. They are always step ahead of me, I trip on all their sticks.
I start having an STD and get checked out by doctors and treatment. This particular std is known to be related as intel ops to give people cancer. I'm having a wild ride while dealing with a challenging std and these people after me. I start confiding to doctors there's strange people following me. After telling a doc. says she's going to use the phone flashlight to check something out but instead she takes a pic of me. Shit goes south from there, they start doing ops where I eat and buy my food and then feel sick to my stomach, falling ill for a few days at a time.
It gets worse the more people I tell. It's a nightmare. Some days it's an all feminist group, some mixed like there are different groups, no doubt there is a medical group involved fucking up my health. I go to a lawyer to see if there is something the state is involved because it's ridiculous the amount of resources that are being employed on me, it comes out blank.
My family thinks I'm going crazy, they only do it while I'm alone. I see a psychiatrist and change meds, nothings changes things just get wilder. They start doing ops at the fucking pharmacy where I get my drugs like they are tampering with my meds.
Its been at least 3 months I have low-grade fever, fatigue, short of breath and chest pain. Then things get serious when ever I go out to pay bills and while in line people with bags start getting uncomfortable close to me, when I get home I feel absolutely wrecked. I start googling my symptoms and they match with radiation sickness. These people are doing some kind of radiotherapy to me, rendering useless my groin area, I can't even pee properly, can't eat for long periods because of the nausea.
There's also news a iodine 131 sample goes missing from a local med department the same week my house show signs of being broken into. I start having a mirradid of other health problems all linked to radiation poisoning, my house looks like is compromised. I go to my physician and he basically laughs off all of it as if he knew what the fuck is going on. Doesn't give me anything for the pain or symptoms. I get a blood analysis done and my sample get fucking stolen, wtf.
There is some kind of intel group that's summoning other groups to attack my health. Somebody fabricated something on me but they have absolutely no evidence, its seems to be all speculation. They are getting really dense now and I feel they are now trying to kill me with radiation or give me lifelong health complications. On different occasions I reached out to the police and they did nothing since no evidence, then to the municipality and then to a private investigator that basically postponed the meeting several times and ghosted me. My phone is tapped so any action I do there is a countermeasure being done by some other group.
Shit it too much and don't know for how long I can take it. Advice is welcomed if you have anything of value to add, save it if you have shitty whitty comments, enough damage is being done. Heads up, this is a third world country with equally shitty laws.

My name is Dr. Smith, not my real name of course, but for purposes of storytelling it will have to suffice. I have been practicing medicine at an Asian country as a general practitioner. I'm relatively new and I practice at a small village, not too far from civilization, half a day's travel by car and a few hours by boat from the country's capital, but very rural nonetheless, complete with superstitious beliefs and customs. I decided to stay here when I first graduated and passed the licensure exam for two reasons: first, I have a place to stay here, my family's ancestral home (although none of my direct relatives have lived there for years), said ancestors being one of the first people to settle in the area and second, because my family had always been the physicians in this small community as far as anyone remembers. Me, my grandfather and his father before him all went to the city to study medicine and went back here to practice it, like there was a pull, a calling, to sacrifice the convenient, fast-paced city life for the quiet and serene. My mother hated the idea, as clingy as she is to me, saying things like she wanted me to always be around where she could protect me, but you can't really help it when purpose calls. To be honest, it feels good providing a wide range of services to the honest people of our small, humble town, no greater feeling than helping the less privelaged, educating them and dispelling preconceived notions and old wives tales which are aplenty in my country, especially here.
I still recall how everything began. I made a makeshift clinic at one of the rooms of my ancestral home, it used to be my grandfather's office, but it felt old, antique, and perhaps too... professional, nothing wrong with that, but I wanted my patients to feel a more homely setting. So, I rearranged a bit, removed the imposing self portrait of my great-grandfather wearing his white coat that hang on the wall and transferred it to a more private area of the house. I changed the dim, barely functioning lights into brighter, more modern ones, removed the exceedingly extravagant chandelier and equipped the room with materials and equipment that I deemed necessary for my practice. I retained the wooden floors, but outfitted the walls with charts and more colorful decorations, in anticipation for the occasional pediatric patient. It was beginning to look less like an old abandoned house where teenagers went for the spooks and more like a place of healing and betterment, a clean place offering a clean mind...or so I hope.
"Your grandfather would have a heart attack if he wasn't dead already, seeing what you've done with his old clinic" quipped Martha, our housekeeper. All I know about Martha is that my grandfather hired her as a young teen and she has been here since then, she babysat and raised my mother as her own, and even took care of me as a toddler. Considering her age, she mostly supervises the younger and more capable help rather than doing tasks herself. None of them stay at the house, but they get called upon when me or any of my relatives were expected. Most of the family consider her as one of our own at this point.
"Well i'm sure great grandpa on the other hand enjoys the change of view" I replied jokingly. "Besides, I bet the patients would appreciate not being treated in such a dark, gloomy room."
"You know how your grandfather was..." she replies, that the idea of a dark, gloomy, old man liking dark, gloomy, old places was a no brainer. "...but everything aside, it is so nice to see you again, have you been feeling better? What did your mother think of you staying here?" she said with what I felt as outmost sincerity, "I used to chase and carry you around this estate and now look at you, about to carry out your family's legacy as a physician yourself" she continued, with a hint of pride from her tone.
I smiled. I myself couldn't think of a reason why a well respected man, revered even, by this town and it's people for everything he has done would act nonchalant and depressed, always with a jaded look in his eyes and stay in an equally dim and depressing part of his house, I've always known him to be like that, but was he always?
"I am better now. It's good to see you too, I'm glad you're staying healthy, and mom sure did not like it but well...she told me to say hi on her behalf" I told Martha. She beams up and smiles on my mother's mention.
"Well...I took the liberty of digging up your grandfather's documents, records and his patient charts, I doubt many of them still live but I thought maybe you'd like to have a look, I placed them around your desk but I can relocate them if you want me to"
"No, that's perfect. That's something I actually intended to do, i'll give it a read, thank you" I replied. I know some of those patients were either old or probably dead to be honest, but seeing data as well as the cases my grandfather had to deal with might help me in the future.
"The villagers already know Dr. Smith's grandson is here, they know you're a doctor, so expect to have a patient one of these days, perhaps as soon as you give the word that your clinic is open" Martha said, as she walks out of the room smiling and slightly waving, signalling a goodbye.
"I'm not even surprised" I think to myself. Places like these, words spreads like wildfire on topics like these, the idea of someone from a known family, coming back from the city, not to mention deciding to stay indefinitely, like the whole village needed notification, like the village demands explanation.
Hours passed and as I was satisfied with my new setup for the clinic, I took a break, sitting down and looking at the mountain of paperwork and folders placed on and around my desk. I picked one, thinking to myself that I might as well have a look now, with nothing else of note to do.
Patient #010438 Name redacted 43/Female
History of present illness: Patient had 3 day history of undocumented fever, dysuria, and bilateral flank pain Did not seek consult, no medications taken
Past Medical History Unremarkable
Personal and Social History Unremarkable
OB history illegible
Physical Examination BP 110/80 HR 102 RR 20
Nonhyperemic tonsils No murmurs Clear breath sounds Nontender abdomen (+) Kidney punch test
Noted a signature of the patient claiming she was not pregnant as a form of waiver
"Jesus grandpa, couldn't your history and physical exam get any lazier?" I thought to myself. Seeing pertinent history not asked and multiple organ systems ignored on physical examination. Given, some of the writing were already faded, the quality of the paper had deteriorated greatly, and plenty of details already illegible, all in all the documents weren't that bad. It sure doesn't help though that he writes like someone in the middle of a warzone practicing heiroglyphs.
I skimmed through more of the documents and patient files, most of the cases are relatively benign, majority are outpatient visits, some are emergency cases and there are the rare ones requiring transfer to a more developed town hours from here with better services and equipment. Time passed and as I lay down the last folder in a pile, I noticed a moderately sized box, probably the size of a briefcase, placed on the floor, dusty but obviously ornate. It piqued my interest although in my mind, I was pretty sure it was nothing but more documents, I decided to give it a look.
I picked a stack up and I started to read:
Patient #00512c Name redacted 32/Female
"Weird" I thought, it was numbered differently, and definitely none of the other documents were lettered. I continued reading:
History of present illness: This is a case of a 32 year old female who came in on date redacted due to a chief complaint of multiple hematomas, abrasions, burn wounds and lacerations on her face, trunk and extremeties..."
"Trauma? An accident? Possible abuse?" I contemplated.
"...patient allegedly noticed easy bruisability 2 weeks prior to consult, followed by alleged spontaneous appearance of abrasions and lacerations 2-3 days from onset of bruising, supposedly waking the patient at night due to the sudden sharp and searing pain, initially small cuts 3-5cm widest on her extremeties and face but eventually progressing to deep cuts measuring approximately 10-50cm on her back, chest, abdomen and lower extremeties. 1 week prior to consult, patient started noticing burning sensations on her skin, causing extreme pain and leaving reddish burn marks on her body, patient also experienced lack of appetite and inability to sleep due to loud voices and..."
"Spontaneous appearance? Easy bruising could be a lot of things, but for it to occur with 'spontaneous' abrasions and lacerations? Not to mention burn marks?" I thought out loud, having doubts about the credibility of the use of the word "spontaneous". Surely it was not an accident, considering it started 2 weeks ago with noted progression. "It could be a hematologic problem with the bruising, but that wouldn't explain the sudden appearance of cuts...maybe accompanied by a dermatologic one, the patient is prone to breaks in the skin? But then again the burn marks...the voices..." I analyzed. I was leaning towards abuse, where the cuts and bruises were inflicted by someone else and the abused, whether in some form of fear or coping, decides that it was "spontaneous" rather than inflicted, but why bother lying to yourself, perhaps the one who did it to her is a partner? Or a loved one? It made sense, someone progressively becoming more aggressive with her as time went by, becoming more and more extreme, from bruises to eventually burning.
It could a combination of illnesses to be honest, one on top of another, perhaps an overly sensitive or extremely dry skin that breaks and peels until it bleeds, an allergic reaction prompting the patient to unconciously scratch till her skin became red and lichenified, voices due to lack of sleep or a mental disorder. But looking at my grandfather's physical examination of her, none of the findings solidifies the possibility of those i've mentioned. Truth be told I also partially allowed myself to tunnel vision on the prospect of an abuse, to the point I've skipped some of the chart's contents that I deemed weren't important and tried to look for information to support my claim, or perhaps to disprove it, rookie mistake, but well, I am a rookie then.
"Patient is widowed, lives alone at a secluded area near redacted, only goes out to buy some necessities from redacted but has very minimal interaction from anyone in the village"
Okay then, either she is hiding the fact someone was with her, who is abusing her like I initially thought of, or it's self harm. "I'm pretty sure grandpa considered everything that went through my mind right now. Let me check his initial impression" I thought, with a tinge of annoyance, considering I felt that the patient lied to my grandfather, and was lying to me, decades after the fact.

1 Trauma, to consider physical abuse versus self harm;

"Alright, now we're getting somewhere" I said to myself, with a bit of pride having the same thought process as a physician with decades more experience than I do.

2 To consider mental disorder, probably psychotic - premature dementia

I chuckled. Premature dementia, didn't think i'd see that term, I thought everyone including those from his time would have used schizophrenia already, then again medicine and medical knowledge isn't as easily passed around as it is now. Psychiatry as a science would be relatively new during his time compared to other disciplines so the fact he considered it based on the patient hearing "voices"? Bravo gramps.
"Well...", I thought to myself, "...plenty of things to consider and rule out, let me check what else is there." A bit of cockiness on picking my grandfather's brain out and feeling good about my train of thought, a practice consult and so far, I'm on my way to a perfect score...

3. To consider possession probably secondary to malevolent spirit

.................
I gave the document a stern look, unmoving, unblinking, emotionless. Time has stopped, and I haven't noticed. My brain trying to digest the information, the same way my stomach would probably digest a block of steel...it's just not possible. I read one of my grandfather's diagnosis again:

3 To consider possession probably secondary to malevolent spirit

I never been one for faith. Evidence is everything. Science is everything. You can replicate it, you can prove it. Most importantly...It. Makes. Sense. I look at beliefs not based on evidence and feel nothing but skepticism if not disdain. Why won't people listen to expert opinion? Why won't people believe in facts? Why explain the unknown in such convoluted ways, requiring submission of oneself when the only thing the truth requires is but comprehension. I looked at that diagnosis feeling disappointment.
Then I felt anger. "Grandpa, what the fuck is wrong with you?!" I thought to myself. Here is a woman, full of bruises, cuts and burns all over her body, claiming that she has been suffering for weeks, barely eats or sleeps, was having auditory hallucinations, in dire need of medical, if not emotional and psychological support and one of the things that comes across your mind is possession.
I tried to calm my mind, these are records of the past anyway, I thought. Maybe it was a resignation born out of incompetence. Maybe grandpa wasn't as good of a doctor as I thought he was, that the shortcomings of his knowledge and limited technology of his time prompted him to adopt a more...liberal viewpoint to medicine. Maybe he was just superstitious himself. Maybe the people of this place had leaked some of their local beliefs into his psyche. Maybe isolation changed the man. Or maybe...just maybe...there's something to it.
I've never been one for faith. That goes for my faith in science as well. To just say that something is stupid because it doesn't align with standard, accepted scientific belief is just as detrimental as its counterpart.
I decided to investigate further when I heard the entrance to the room open with force. One of the maids leaning onto the wall by the entrance, still grasping the doorknob and evidently out of breath.
"Sir...ma'am Martha...calling...for you...says...it's...it's...an emergency..." She says in between breaths.
I quickly stood up, feeling sorry for the woman, she just ran, obviously gasping for air as she arrived at the clinic and now has to lead me back to wherever she came from with the same urgency. At first I was worried something might have happened with Martha, what the maid said didn't really give much clarity, but upon arriving at the main hall I noticed Martha, standing beside a middle aged man and woman, carrying a child, no more than 10 years old. I notice the clear panic and worry on both of their eyes as the man held the boy, who was uncontrollably shaking.
"I know you're not taking any patients yet and I was considering the time, but nobody knows what to do so I..." Martha explains, quite concerned while I ordered the parents to put the child flat on the ground, with me assessing the situation. The first thing I noticed was that the child was burning hot, "possibly febrile seizure? No, too old" I thought. I asked both the parents important details while I ordered the other maid to time the duration of the child's seizure. All the while thinking of possible diseases that may present as such, "Seizure disorder? Epilepsy? Meningitis? Encephalitis?" Eventually the shaking stopped, much to the parents' relief, and I ordered them to carry the boy as we made our way back to the clinic.
"Was this the first time it ever happened?" I inquired, as I put the child on one of the beds in the clinic, securing the corners with additional pillows, noticing the sunken face and apparent exhaustion from the boy, possibly due to the ongoing fever and the recent seizure episode. Once secured, I face the parents and continued my inquiries, I eventually explained everything, elaborating on what I believe happened, I explained that for now, lowering the fever and investigating the source were what we could address, the battery of tests I plan to do (disappointingly, most of them cannot be done here, and I would have to accompany them to a hospital on another town as soon as first light breaks), and the medications and management I plan to give. Everything proceeded as planned and I asked both parents to relax and take a breather, offering them a seat and asking the help to give them water.
Things eventually settled, little Johnny's fever subsided and color came back to him. Nowhere near clear, he can worsen anytime, but that was the best that we could do at that time. The parents were still worried, understandably so, but to an extent reassured, we have a plan after all. Martha, as well as Diane (the help from earlier), now at a calmer state. We discussed the plan, how we would travel, who would accompany us and what we would bring. Eventually, our conversations became relaxed, started to shift to other things, trivial matters, such as were they lived in the village, the date and time of my arrival, recent gossip, where Martha was more than happy to share.
"I was worried the evil spirits might have gotten my baby..." Said the mother nonchalantly, as we talked about the occurrence on a lighter note. "...that's how they got Mrs. Johnson's middle child. That poor boy was never the same after."
I smiled. Not wanting to immediately correct them and sound like an uptight individual. It's part of our culture afterall, old belief systems and a way for people to cope with loss or difficulty, who was I to deny them that. I won't approach these people the hardheaded way, but I will slowly show them the realities and truths of the things they may not understand, well, at least with regards to their health.
"Well, little Johnny is safe here, we'll do what we can" pointing to their son.
Only, their son wasn't where he was supposed to be. I look at the parents, I look at both Martha and Diane, everyone who looked at where I pointed were just as shocked as I was, a split second of silence before panic ensued. Suddenly, everyone stood up on high alert and was looking everywhere. Under covers, under the bed, corners of the room, the desk, behind curtains, hell, I saw Diane look at one of the damn drawers, as if a 10 year old would fit there.
Suddenly I heard loud vomiting, retching, followed by sounds of splashing. I follow where the sounds came from and see a large pool of black, tarry liquid at a corner of my room. I slowly trace where it was coming from and there he was...little Johnny...standing...upside down...on the ceiling.
I hear everyone in the room scream, I was probably screaming too, I couldn't remember. I do remember little Johnny screaming with us though, extremely high pitched and mockingly, with bloodshot eyes, upside down, while black liquid poured from his mouth, covering his face and dripping from his hair. How was that even possible, screaming while liters of unknown fluid dripped from his mouth? I don't know.
Then he laughed, although I was pretty sure that wasn't his voice. It was deep and guttural, it cannot be the boy's voice, it cannot be any boy's voice.
Time seemed to move in slow motion, I was noticing every detail, every expression from everyone's face, I can feel the seconds hand on my wall clock move, the slow dripping of the viscous dark liquid from little Johnny, I can feel every drop of sweat on my body. I could not cope with what i'm experiencing, was it a trick of the mind, an organized prank, have I gone mad...again? So I did the only thing I know how to do...
I tried to diagnose.
"Maybe it was dengue shock all along!" I thought to myself. "Vomiting blood, paleness, fever, an episode of seizure and definitely change in sensorium" I reasoned to myself. I was coping, and I was coping hard. I was ready to drown on my self absorbtion when a booming voice snapped me out of my thoughts.
"YOU DUMB FUCK, WILL ANY ILLNESS EXPLAIN WHY YOUR FUCKING PATIENT IS HANGING UPSIDE DOWN ON THE FUCKING CEILING?" Said little Johnny, or at least whoever was speaking on his behalf, because from where I'm standing, I can clearly see that the boy was not mouthing any of the words he said.
"YOU'RE A FUCKING FAILURE, DOCTORS LIKE YOU SHOULD KILL THEMSELVES! HAHAHAHA" he laughed, I never knew laughs could sound like that, as if the words were nails, and his voice box a chalkboard.
"OH WAIT, YOU FAILED AT THAT TOO DOC! FUCKING PATHETIC!"
Of all the things that were happening...a young boy hanging upside down, a mother crying on the floor hysterically, a father staring at his son, eyes wide open and mouth agape, Martha and Diane, both crying while sharing a rosary, in the act of what I assume to be prayer...the thing that snapped me out of my trance was the words that came from little Johnny. Knowledge nobody but the closest to me should know. A secret I planned to leave behind when I left the city, a wound I intended to forget as I started anew.
Visions of my memories came flashing back...medical school...overwhelming duty...familial expectations...failure...depression...my attempt...a bottle of medications...my mother...crying...on my bedside...
"LEAVE MY SON ALONE!" Johnny's father screamed. Starling everyone in the room.
Nothing matters, the past is in the past, I am better now, and that boy needs help, more than anything.
"YOUR SON? WHY DON'T WE ASK THAT CRYING WHORE IF JOHNNY REALLY IS YOUR SON" The voice says, laughing.
At that point the mother stops crying, looks up towards johnny, then towards his husband, in a state of shock. Like what the voice said is crazier than whatever was happening at the moment.
"THE ONLY REASON THAT WHORE STUCK WITH YOU WAS BECAUSE JOHNNY'S REAAAAAAAL FATHER WOULD NOT TAKE HER!" The entity says, continuing the hysteric laughter.
We were being played. It was toying with us. And from the look on the mother's face...it seems like little Johnny did not even need to lie to do it.
Then, to everyone's horror..."It" started to run.
It ran across the ceiling in a rabid frenzy, erratic and forceful, running and jumping, hopping sideways then going on all fours, still attached to the ceiling, splashing bile and blood all over the room, all the while making a "hihihi" sound...childish and terrifying. It ran and ran, repeating the same erratic change in movements, repeating the same eerie giggle until it reached the window, stopping and standing straight, it stared outside for what felt like forever...then all of a sudden...johnny just fell, like whatever was attaching him to the ceiling just gave, headfirst into the floor, giving a very audible cracking sound.
I heard a gasp from johnny's mother. I can at least detect some miniscule chest expansion, but that cracking sound cannot be anything good. As if thinking the same thing, Martha, who was the nearest to where Johnny fell, while still clinging tightly to Diane's rosary, approached the boy.
"Johnny?" She said softly, all the while approaching an inch at a time.
As she was almost at arms length of the boy's body, she gives the mother a knowing look, confirming that he was breathing. Martha suddenly produces a piece of cloth from one of the pockets of her uniform, possibly to pack the bleeding from the head. She intended to put the cloth on top of the boy's head, but looked towards my direction, urging me forward, perhaps for me to place it properly. I walk towards the boy, takes the cloth from Martha and as I fold the cloth to circle Johnny's cranium with Martha's help, the boy immediately sat up, looks at Martha and smiles ear to ear...literally ear to ear.
"GET YOUR WRINKLY HANDS OFF ME YOU DUSTY OLD FUCK!" He barks at her, Martha screams in fear and I was taken aback.
That was all the time Johnny needed to stand and jump towards the window, breaking it and running towards the mountainside. I hear his father scream his name, quickly breaking more glass so he could fit, and immediately giving chase. The mother was still on the floor, wailing towards the direction of her child and husband. Martha, in shock, still holding the cloth she intended to wrap johnny with.
It took me a while to notice Diane shaking me vigorously. "Doctor!" She screams. "Doctor Smith! What should we do!?" She voices out, with obvious desperation.
I ignored her.
I feel scared, but taking all into consideration, I predominantly feel tired. Defeated. Insulted.
I have nothing more to give in the face of whatever that thing that took Johnny was.
I slowly walk towards my desk, I open my drawer, I take a piece of paper and I pull out my pen.
Patient #00001a Name redacted 10/M
I write, giving no thoughts to the people on the same room as me, those left behind by little Johnny and his father. "Did he catch up to him? Was the boy alright now?...is his father alright?" I wonder. I'll find out soon enough, I figured, rumors spread like wildfire around here anyways.
I continued to write with resignment, absorbed in my own little world, consumed by the horror I witnessed, the breaking of my spirit, of my beliefs, the questioning of my knowledge. I want to escape it, deny it, but that's not what should be done to the truth. So I surrendered.

1 To consider possession probably secondary to malevolent spirit

END

I just completed my freshman year of college. I came into college as a bio chemistry major on the pre-PA track but I left on the predental track but I’m starting to wonder am I pursuing dentistry for the right reasons. I was interested in becoming a physician assistant because it was only a masters degree program I would have the ability to switch specialties whenever I want without having to go through any sort of specialty residency program and I would have many of the same responsibilities as a physician (diagnosing,treating,prescribing,referring,etc.). However after shadowing a PA I realized I do not want to become one. PA’s are handed the less complicated medical cases while physicians take on complex patients. I also don’t like the idea of working under someone else for the rest of my life. I also became really interested in surgical specialties but as a PA I would only be a first assist in surgery I would never be able to perform surgery independently.
A couple of months ago I got my wisdom teeth removed though. My oral surgeon was black and as a black man this was really shocking most of my dentists have been either white or Asian so it was cool to see a black man in such a cool position. He asked me what I was in school for and what I wanted to do as a career. I told him I wanted to become a PA. He says that is a cool profession but why not go to medical school instead. I couldn’t come up with a good reason so I just said the schooling for physicians is really long. He responds and says whether I am working as a PA or still in residency time will go on. I knew this before but hearing it from an actual medical professional made it Actually mean something.
At the time I was still reconsidering pursuing PA school so I started researching dental school for some reason and like the prerequisites and other requirements. Dental schools actually have a lot of the same requirements as PA school which I thought was cool so I wouldn’t have to take any extra classes/classes outside of my major. I also started looking up day in the life of dentists and oral surgeons and like what dental professionals actually do which is when I really started to get interested in the dental profession.
I didn’t realize how many diseases and conditions can be prevented just by seeking dental care. The mouth is also not as simple as I thought before and it would be cool to learn more about the mouth. Also dentists are basically surgeons for your mouth. If I went to PA school or medical school there is still a chance I could end up in a non-surgical specialty like pediatrics or family medicine. But if I go to dental school I will be a guaranteed surgeon when I graduate. Dentists also have many of the same responsibilities as physicians and PA’s, they all diagnose,treat,refer and prescribe medications. Dentists also have the benefit of not having to work under anyone. It’s also really cool how most of the time dentists can treat a condition right then and there rather than having to wait for results.
The thing is I’m not sure if I am even pursuing dentistry for the right reasons. Before this I had never been interested in becoming a dentist. The thought of touching all inside of people’s mouths disgusted me but now it interests me for some reason which is very confusing. The main reason I actually looked into becoming a dentist is because I saw another black man in the field for the first time which I thought was cool and inspiring. Before this I was all about pursuing PA if someone would’ve asked me about becoming a dentist I would’ve said ewww and ran.
I’m sorry this is so long but I can’t get the idea of becoming a dentist out of my head now. I was supposed to get my EMT certification this summer but I dropped out of the program after I became interested in becoming a dentist and have been thinking about getting my Dental Assistant certification instead.
I’m not sure what exactly I want out of this post. I just want to see am I pursuing dentistry for the right reasons? And what reasons did yall decide to pursue dentistry?

Odd question, but I was just diagnosed with ringworm and the physician I saw suggested that it might have come from our cat, since I'm not involved in physical sports and likely didn't get it from someone.
I was doing some research, and our cat doesn't seem to have any symptoms that would line up with it, but she's a long hair and I read that it can be common for them to be asymptomatic carriers. I'm probably going to call our vet tomorrow to see, but it is it relatively easy to test for? Just looking to try and learn what I can before setting things up.

Hey, sorry for this long rant; I’m in some turmoil regarding my future.
My fear, of course, is the rise of artificial intelligence, and the takeover of the job market. I’ve been following OpenAi’s GPT 4-o and Google’s new io. These Ai systems look very promising. I understand it is only a demo – and I should not really be trusting a demo. But with the rapid speed of machine learning, Ai is only going to get better with time.
I suppose in the foreseeable future Ai will be taking over jobs, changing jobs, and creating new jobs. Administrative jobs and minimum wage are soon to be gone, but I believe new tech jobs will emerge. Right now, Ai is not taking over humans jobs – but instead, we work as team – at least for now.
I currently work in law. People say not to worry about my future, but I’m scared Ai will cause me to be unemployed. I’m not talking about Chatgpt, which spits out made up stuff, but industry specific Ai. Like what Thomson Reuters is working on in the legal industry.
I know lawyers have undergone technological changes before – for example. lawyers would spend hours in a library researching, now we use boolean search to assist with legal research. Soon they will be able to do legal research using large language model. This may not get rid of them completely but would allow more lay people to do most of our work themselves; hence, getting rid of a large majority of us.
I understand Ai only knows what it’s been taught, and the cost of what I’m talking about will be crazy expensive to achieve – maybe not even worth it as it may create a diminishing point of return for most businesses. Like the dairy industry where it’s plausible to be fully automated, but unless you have enough cows and revenue, it makes more sense to be semi automated.
In the medical industry, robots perform surgery, of course, with surgeons in the room in case something goes south. So surgeons may be fine, but I think with a large language model, Ai will be able to become your physician taking your symptoms and running it in their database to find possible diagnoses and then give orders to the nurses to perform tests – ending with the prescription.
I keep trying to tell myself it will be fine, but with how rapidly Ai is developing and changing. I watched a video on YouTube of a graphic designer losing their job to Ai and that scares me.
Ergo, I want to be able to protect myself from the future. It reminds me of when I worked in an automated factory. But even with parts being built by robots, we still needed techs to fix them every time they broke down.
That’s what I’m thinking, Ai will create jobs for people to run them, build them, and fix them. I know we can not predict the future, but what jobs do you think I should be looking into?
Thanks for reading; I know it was long.

Hi I’m looking for a wfh remote job to make some money, can anyone here help set me up with anyone who’s outsourcing freelance work?
Worth mentioning- i am a Dentist and a UK certified aesthetic physician (on a little break from clinic work and seeking wfh jobs)

This happened three months ago, i still remember it thanks to the news.
It was a Wednesday night, i had woken up because i needed to take a piss, but as i was finished, someone started knocking at the door. I washed my hands and went to the door, checking the peephole first.
There was a man standing there, he was so still, almost like a lifeless statue, but i couldn't see him very well because the porch light wasn't on. I knew that answering the door to a complete stranger, especially in the middle of the night, was a very bad idea, but i was too curious.
I turned on the light and opened the door slightly, with the chain on, of course. I looked through the gap and i can see him much clearly now; He looked chubby, he wore a black zipped-up flight jacket, ragged jeans, dirty trucker boots, and a black beanie on his head.
But that wasn't all, i couldn't tell if it was the shadows, but his skin looked bluish-grey. His eyes were baggy, as if he was really tired and needed better sleep.
"Hey man, i can-"
"Does Derek live here?" the man interrupted me before i ask, he said in a monotonous, yet serious sounding voice.
I gulped and waited for a second if he was going to interrupt me again, then i said "Derek? I dunno any guy named Derek, i think you got the wrong house"
The man just stood here, still motionless, before saying "Sorry dude, have a good night" as he turned and walked away. I closed the door, and as i did, i heard his footsteps that sounded squelchy, as if he was completely soaked in water.
In fact, i forgot to mentioned this but when i opened the door, there was a faint odour of salt lingering off this guy. Another thing i noticed was when i looked at his shoes, there was a rope tightly around his right ankle, it looked like it was snapped off of something heavy.
Days went by and i nearly forgot about him, i theorised that he was probably some homeless man looking for his friend or something, until i heard the news.
Long story short; A man named Derek Martínez, a co-leader of some cartel drug operation, was found murdered in a cheap motel, which served as his hideout from authorities. He had been strangled and stabbed with a kitchen knife multiple times, but it was clear that the strangling killed him first.
It was a personal killing, and to their surprise, no DNA evidence was found.
And this is where shit gets fucking crazier; The police also fished a body of a man, twenty-three miles from the local beach. He was identified as Samuel Austin, a drug dealer who worked for Derek and apparently, Derek was very abusive towards him. The abuse got to the point where Samuel snitched on Derek and the other members of the drug operation. Everyone was arrested, except for Derek as he managed to get away.
After the DEA got the operation shut down, Samuel was at a phonebooth, trying to get a lawyer until Derek knocked him out by slamming his head viciously against the dial pad, then stealing a boat where he tied a cement block to Samuel's right ankle and pushed him into the dark, cold, and unforgivable ocean.
I knew that guy looked familiar, we weren't friends but i remember walking my dog the other day and passing him. He first offered if i wanted any of his "stuff", which i declined, and he never got desperate for cash unlike most dealers. He was actually very understanding and even gave me a thumbs up for making the right choice. I'm glad he got his revenge.

Hi! I am from a smaller town near Macon where in comparison to a large city such as Seattle or Atlanta there isn't anything to do at all except for a couple things and I think I'm really interested in moving to Seattle as it has a lot of the things I'm looking for in a city after I'm done with getting my Associates Degree in Nursing but after looking at some other posts and comments here from some older posts by Southerns, I'm worried I may be glamorizing the idea of moving to Seattle and moving there as someone who has been in Georgia my entire life that moving to Seattle may not be all I thought it is. Even though I love the idea of living up in the Pacific Northwest, being in a more liberal state without having to be around a constant majority of conservatives in rural Georgia who make life feel very unpleasant especially since I happen to be trans, having a lot of the drizzling rain which I adore, and the nature as well as the outdoors feeling much more pleasant to be in without the mosquitos, pollen or gnats or absurdly high temperatures we often have here. I feel like it would be really nice to live in a big city with so many more things to do but I have a few things I'm a bit worried about being:

1. Are the highways up there really that much worse than Atlanta? I heard there is only one highway and I feel like could cause major issues if just one thing happened?
   
2. When I as looking at locations for card game shops that I could play Pokemon or Magic at, fencing clubs, and I am curious about getting into paintball and airsoft so I looked that up too but I saw all the results on Google Earth or maps seemed to have significantly smaller numbers of these places in Seattle and the state of Washington where when I looked up locations of these places on Google Earth and maps I saw that that these types of locations had double to triple more in Atlanta and the State of Georgia than in the former which I found weird but maybe I was just looking at the wrong thing?
   
3. Are the winter months really that bad? From what I was seeing people say that half of the year is cold, gloomy and just awful in general but I am curious if that is true? From what people were saying is it just no vegetation left with everything dead and just snow and rain with no sun? I wouldn't mind it that much just probably the temperature a little bit if it got under 45 since that feels a bit uncomfortable to have outside in but I suppose the weather will be pretty similar anywhere right? I would certainly love not having the extreme heat of the South though!
   
4. I'm a bit on the younger side being 18 at the moment and if I were to eventually move to Seattle I would be 20 so I am curious to how it is for younger people there? What are some of the best ways to establish myself within the city and try to make friends within things I like to do or hobbies I have? I am a bit introverted but I like to think I do an okay job with trying to meet new people and make friends try to maintain those connections. I would also probably go back to college hopefully at UW to either get the prerequisites and pursue the career of being a provider or physician so I am curious to what the college life is like in Seattle?
   
5. I haven't like researched this at all since it's not a huge priority of mine at the moment of course but I've heard some people say that Seattle has an awful dating scene where a lot of people are into polyamory and if your not into that then your out of luck and I was wondering if that's really true or just people complaining a bit? Are there any particular dating apps that are popular in the Seattle area?
   
6. I doubt I'll get much insight on this question but one of the reasons I wanted specifically to be an RN in an inpatient psychiatric hospital is because I don't like how I was treated during my stays in our hospitals in Georgia and I think I could make things better if I at the very least didn't treat patients like animals who were just a nuisance and I've also had that experience of unfortunately being a patient myself lol, so I feel like I would be able to connect with patients and try to make things easier in an appropriate way of course and I don't know much about how the Seattle healthcare system works and of course haven't seen much of it but I was wondering if like it would actually be more of a negative if I did my nursing education in Georgia and then just jumped ship to go to Seattle since I don't know if like I would have insufficient knowledge of how to be a good nurse in the way Seattle's medical system works and would the patients see me more of a threat since I'm not from Seattle or the state or someone they don't like since I'm from the South which is of course known to be very conservative and from what I've heard from people from the West coast say that we are fake nice and I wouldn't want to be perceived as that or do any misservice to anyone from Seattle.
   
7. The major thing that worries me I suppose more than any other is that I won't fit in there in Seattle as I do here in Georgia or Atlanta and from what I've seen from other posts and comments here from Southern folk and people from Seattle alike is that "Southern charm" doesn't seem to be like a thing in Seattle where people are nice just to be polite? Are people in the those posts making it out to be more than it really is? I don't really care about not saying Ma'am or Sir but or expecting a retail worker to have all cheery and smiley while their doing their job but I guess what I've grown used to and quite like is people in my city and the South seem to be very friendly and easy to get along with and be friends with each other very quickly just not in a super serious sense mostly just stay friends only in the sense of where you meet like in my case fencing or the card game store but I feel as even while I was at a summer camp up in Atlanta or the psychiatric hospital everyone was very quick to make genuine interest in being nice to each other and getting to know one another and I'm a bit afraid that I'll be lonely in Seattle since I think I expect a certain level of friendliness and niceness just because of my upbringing only being in a small Southern town although it's county name is called the most progressive county in Georgia it is still quite rural. Another minor concern of mine is that people will notice if I have a Southern accent and think I'm a rude asshole if I try to be nice or strike up conversation but I don't think I have that much of an accent? I would really like to make moving to Seattle work but I'm just not sure if it's the environment I really want.
   

Thanks for reading and sorry if I said anything really dumb or entitled or whatever
also the biggest concern of all is how come there is no dunkin donuts or waffle house in seattle :(

This is one I'm having a hard time seeing articles or posts about for advice as this as much a final interview as it is a tour. I am under no delusion that I have this job, I am taking the approach of "this is mine to lose" as in I want to push the idea of being a good fit. But they're spending good money just to meet me.
We spoke maybe 30 minutes already about how we do mesh in our work ethic and approach toward end user and patient satisfaction. The resume, the qualifications and experience were not in question. So I don't want to go in puffing my feathers, I want to go in asking questions and seeming like I want to mesh with the overall team.
I can write a book on what I do but I'm ultimately an Electronic Health Care Systems Analyst/TraineImplementation Specialist. I know the process of healthcare from start to finish because it all touches databases and user interfaces now and it is my job is to make literally everyone's lives easier. Patient to Physician to Biller.
So to cut to the chase I will be flying out to another state and am being put up for a night in order to do a tour of the company sites (3 in close proximity in a major city), to meet the support team I will be interfacing with, and to sit with HR to discuss compensation and benefits. Yes, I'm not hired until I signed on the line which is dotted. But after taking this week to research and think of things I'm struggling to not just repeat myself in interview 1 beyond specifics (how does your team triage tickets?)
I'm definitely going to meet with HR, some clinical people (I've already spoken to the lead Physician of Informatics) but my role will need to make 1) Quality 2) Billing 3) IT 4) Accounting and Procurement 5) Senior Leadership 6) Doctors across multiple disparate specialties including ones that have differing reimbursement models like Dentistry and Optometry 7) And in many ways my favorite to bolster is the Front Line Staff.
I ask this because this shit is so uncharted waters, ust looking to bounce ideas.
If anyone doesn't have specifics in my niche ass field, what should a company sponsored on site visit to discuss pay and reporting structure look like?

I’m an Indian 28F, moved to Canada when I was 10 years old. I met my boyfriend during my fourth year of undergrad. He was finishing up his masters in the same university. We became friends, then started hooking up (for about 6 months), we fell in love and have been inseparable for almost 8 years now. I’m a non us IMG, finishing up medical school. He is a manager for fast growing company, salary is in the 100k+ range.
My father is a little conservative, him and I have had conversations about my relationship for the past 5 years. He broke down into tears and told me that the 4 things that concerns him about my future.

1. He is not gujarati
   
2. He is worried that if I decide to have kids by 32-33 my partner would be 40.
   
3. He doesn’t own a house. (I come from a very well to do family)
   
4. He became bald at a young age, 24-26. So now he just shaves his head. I honestly never cared. I mean I’m overweight because of hormonal issues and stress. I’m on a weight loss journey and basically a holistic self healing journey because I have ignored my health and well being pacifying others in my life. Not once has he or his family said I needed to loose weight to marry their son.
   

I have told him that I’m not attracted to gujaratis, I’m not a fan of family dynamics in gujju culture. I don’t like the intrusive and petty behaviour that comes along with their culture. Gujju people just make me uncomfortable because that’s all I have seen throughout of my life and I’m not a fan of the whole hypocritical behaviour that exists ( I know it happens in other communities as well, but his family is closest thing to my family, NGL I feel more comfortable in his family than my own)
The whole having kids thing, I have pcos. So I told him that if god wants to bless us with kids it’ll happen. But if it’s not in our destiny then no matter what we do it won’t happen, which I’m okay with as well. There are plenty of options considering I’m becoming a physician myself.
I’m between clinical training and still not sure whether I want to settle in Canada or America, looking at the economy right now, I’m more inclined towards a residency in Texas region and it doesn’t make sense to invest over 600k in a house he won’t even live in for the next 2 years. We might as well invest the same money in Texas and get a great starter house.
I agree he’s concerned about my future but so far in my life I have done everything he wanted me to do, even as far as I didn’t want to become a doctor but I’m becoming a doctor for him. However I can’t throw away the years I have invested in this relationship to the point where even if another man held my hand it would feel like cheating to me, it would feel wrong. I can’t compromise on this aspect of my life.
My siblings support my bf and I. We have convinced my dad to meet up with him and just get to know him.
Please give me advice!!!!

patient is F28 about 5’3 maybe 150 pounds, will try to get med info in an edit asap. was a chronic smoker for several years before catching bad pneumonia
ok so this is incredibly important, we’re wondering if lipomas are the answer to my gf’s debilitating and undiagnosed chronic neck & back pain of 3+ years. would greatly appreciate anyone’s feedback. description of symptoms near the end if you wanna skip background.
my gf has one of the worst chronic back issues i’ve seen, and it’s completely undiagnosed. she had a scary severe case of covid pneumonia for several months and somewhere along the way developed chronic pain in her neck, iirc it was characterized by sharp severe pain where she could barely move her head left or right at all without major pain. that lasted two years with no solution/diagnosis to be found.
one night a year ago she was laying in bed and reached over to grab something and felt pain shoot down her back. can’t remember if it was the next morning or gradual over days/weeks but basically the pain ended up traveling almost entirely from her neck to her mid to lower back. she can now move her neck almost like normal with little pain, but her back is now an absolute nightmare. she can’t work, standing up and sitting down is a deliberate cautious affair, her entire life is centered around this and the debilitating 10/10 pain (she said 14/10 without meds, 9/10 with).
PRIMARY SYMPTOMS: -muscle spasms that travel (yesterday they were bad, she tried massaging herself and ended up “riddled” with spasms) and when i trace her back she can’t tell me exactly where the spasms are bc they move so much ig? she had trouble articulating what she felt and why i couldn’t pinpoint it. they’re less painful the more sleep she gets in a night -pressure pain the spasms are always “on,” the only slight relief she gets is when there’s no pressure on them. laying back in a seat is hell, she has a heat pad that left marks on her skin bc she had to use it so high and often to feel some relief (she now uses the lowest setting after discovering the skin thing)
big one: moveable lumps under skins i don’t know her history of how hard doctors looked into the lumps but she feels two noticeable ones right up against her spine in the center of where the pain and spasms usually gravitate. she can move them around without massive spikes in pain (possible these two aren’t relevant but smaller undetected ones are???)
somewhere along the way she was told or got the impression that those lumps weren’t related to her spasms or pain. however from what she’s told me no doctor has ever really looked at them more than cursory (which i asked several times for her to confirm cuz that sounds insane to me). she has had an insane amount of tests done (like, recently ruled out MS) including a full body MRI but it found nothing, and they weren’t looking specifically for lipomas.
No one has ever said the word lipomas to her. she randomly found the word a couple days ago and found some posts on the lipomas sub i think, one of which was another chronic back pain case and 100% relatable to her. she went on to find info about how these can be painful and hard to detect when they’re in muscle tissue and up against nerves or the spine.
but she’s nervous this isn’t the answer because she thinks they would have spotted this on the MRI.
would they have, if they didn’t know to look for these specifically? i see cases of people saying theirs got painful and doctors severely underestimated their size when they were removed.. i’m worried she has small ones all over her back and maybe even neck? i saw they have some kind of causal relationship with the severity of pneumonia so i’m wondering if tiny hard to detect ones are in her lungs too.
begging for any information/suggestions/insights. tears on my cheeks as i type this out at the possibility that this might finally, fiiiiiinally be the answer to chronic pain that has made her suicidal at times. thank you for reading, and especially thanks to those of you physicians who take time to reply. this sub seems incredibly valuable.

Tl;dr: It has been difficult for me to find aPCP for myself so I worry about having a good* doctor during pre-, during, and post- pregnancy. I just want the best for my child. (*knowledgeable, responsive, respectful, understanding)
Full:
I went to a doctor’s appointment yesterday with another new primary care. To be honest, I have not had the best luck with finding a PCP. Partly due to insurance changes with work, but mostly because I just don’t vibe with the doc (e.g. they don’t listen to my concerns, don’t seem to care, don’t have the time, or act like they know better).
The physician I met yesterday was nice. I scheduled the visit as a preconception visit with a general well-being. When I talked her, it seemed like the first time she ever heard of SMBC, so it took about 10 minutes for me to explain. (She just kept repeating, “so, you plan to get pregnant but you don’t have a partner”.🤦🏽‍♀️) Then, she spent about 30 minutes looking up information to give me and where to refer me for the next steps.
As a healthy individual, seeing her once a year for just a checkup would have been fine. She was nice, tried to be understanding, and wanted to be helpful. However, with what I plan to do in the next year, I wish I had someone more informed. At the same time, I realize it probably shouldn’t matter because I would be working with an OB/GYN during pregnancy and post.
I haven’t been successful with finding an OB/GYN. For one, she and her office were a mess. There were several success stories, but I just saw all the things that could go wrong. The other has such a full schedule, I had to wait three months to see her. It also seemed like a bad sign. Should I keep looking for an OB? Does it matter at the end of the day? Is it unlikely that the person I see will be the same person who delivers my child? Based on what’s available in my area, it’s likely I’ll be seen by a department instead of a specific doctor…

Here is the recap of the 8 monetized posts from Kylea and Joseph "Joe" Gomez of Kylea G Weight loss Journey on 05/17/24.
"Truth is like the sun. You can shut it out for a time, but it ain't goin' away." Elvis Presley
⚠️ Compuslive Buying Disorder (CBD), aka shopping addiction, Disordered Eating, Domestic Violence, Gaslighting, and Religion will be discussed.
Disclaimers: I am not a physician, influencer, or paid content creator. I am not affiliated with WW. I am semi-retired from the healthcare field with multiple college degrees. These opinions are my own based on social media content. I wish no harm to Kylea or Joe Gomez.
☎️ If you or someone you know is struggling or in crisis, please call or text 988 for assistance.
☎️ National Domestic Violence Helpline: Confidential Help is available 24/7 at 1-800-799-7233. Or text START to 88788.
The tagline of Kylea G Weight loss Journey is, "I changed my entire life with prayer and a playlist of songs. No surgery, no meds. Just Jesus."
DAILY STATS 05/17/24:
0/8 posts discussed prayer
0/8 posts discussed music
1/8 posts mentioned walking outside
0/8 posts shared a recipe
2/8 posts were about something Kylea ate or drank
1/8 posts was about driving home
2/8 posts were about a current pet
1/8 posts "Joe" discussed Kylea being a dog mom
1/8 posts "Joe" made about Kylea sending him McDonalds
📢 For our friends at Meta, that means that approx. 50% of the monetized posts had nothing to do with weight loss, which is the tagline and purpose of her page.
⚠️ Disordered Eating- Daily WW Points Used (Data compiled from monetized content):
2 WW Points: Plate of scrambled eggs + plate of fresh fruit + Peanut Butter Chocolate Muscle Milk in coffee.
8 WW Points: Double Shot Espresso over ice with almond milk, sugar-free vanilla, 1/2 of Peanut Butter Chocolate Muscle Milk shake, with cinnamon on top. Turkey, bacon, cheddar & egg white sandwich.
📢 For our friends at Meta, that means Kylea consumed 10 out of (up to) 30 daily WW points in maintenance mode= Disordered Eating. This is dangerous and potentially deadly messaging for those on a weight loss journey.
Recipes Shared: ZERO
🚨 Please speak with a medical professional about any questions or concerns you have about your health.
Comments: In my opinion, Kylea falsified the timeline of her arrival home. She frequently lies and has a history of mental breakdowns during travel. Let's see if you agree...

1. Unknown Breakfast Location: Kylea does not even vaguely mention her sister's presence and shows a closely cropped picture of food and a beverage.
   
2. "Joe" posted this, "My wife has been waiting to be a dog mom for a long time. I'm so excited for to be welcoming one into our home soon. 🐶 🏠"
   

*I kept the wording of the quote exactly as it appeared. "Joe" shared an old photo of Kylea holding RayRay's face (her mommma's Frenchie) and kissing him above his left eye.
⏸️ Remember, Kylea was traumatized from a dog biting her face as a child and told her followers she wanted a puppy from a breeder because of this event. This was an odd picture to share.

1. Unknown Starbucks Location for Lunch: A tightly cropped image of an empty Starbucks paper bag, Iced Beverage, and Muscle Milk is shared. There is no mention of her sister, leading Reddit users to believe Kylea was in an airport, possibly alone. How is she consuming all these dairy products without issues this trip?
   
2. God is Good: Kylea's sunburn disappeared from yesterday in this tightly cropped photo of her near a flowering plant. Her location is not disclosed. "I've just been walking around and appreciating all of the beauty of the world around me today. God is so good!!"
   

⏸️ This suspicious photo led Reddit users to believe Kylea was either already home, almost home, and/or there was a serious disagreement with her sister (they have a history of this happening). Why buy a Go City Pass and barely use it? Why go to CA to whale watch and not complete the task? Why so secretive this trip? Was she alone the majority of the time? The entire vibe has been off.

1. "I think Oliver is missing his Mom 🐈‍⬛️ 🐾" An old 📸 of Kylea sitting on the floor, squeezing Oliver to her chest (he looks like he's trying to get away), is shared. This is the 1st mention of Oliver this trip. She normally posts more often about missing him while traveling...
   
2. "Joe sent me a picture of the fur babies and they both look like they're ready for me to be home 💖" An (allegedly) old 📸 of Oliver and Alice on the back of the couch is shared.
   

Concern has been growing for weeks about the welfare of Alice. 🐈‍⬛️ I hope she is okay.

1. Driving 6 Hours Home: "The last few days of adventure in California was fun but I'm so ready to get home to my hubs!! I had a long day of travel today. ✈️ Now for the 6 hour drive back home! 🚗 Ready to cuddle my cats 🐈‍⬛️ and introduce you to our new family member later this weekend! 🐶 🐾"

⏸️ Notice, Kylea never says "we" today. This fuels the speculation of a separate return trip home from her sister. I would hardly call scrambled eggs, fruit, salsa chicken salad, and coffee an adventure. Her photos (if they were even hers) showed empty tourist destinations. I learned nothing of note from her "California adventure." What an odd trip.

1. "Joe" posted McDonalds: "I worked late last night and my wife still made sure that I got one of my favorite dinners. I love McDonald's cheeseburgers! 🍔 🍟"

I have shared resources this week on domestic violence. Not only is McDonalds triggering content for those on a weight loss journey, why is Joe Gomez unable to buy his own food? These photos (Joe holding the takeout bag) remind me of a young child posing with objects for praise.
📢 To our friends at Meta, "Joe" posting (under Kylea's account with her name) 25% of her content today is ridiculous. The page name is not "Kylea and Joe's Journey." This is not a lifestyle page. Kylea blatantly violates many monetization policies with her content. Please follow your policies and take action.
Final Questions: Do you believe Kylea traveled alone or with her sister? Do you think they were together the entire time? When do you think she arrived home? What did you learn about San Diego? How did she do as a travel blogger? 🤔
Takeout: Unknown breakfast restaurant for KG= $18 est + tip; *Possible breakfast for sister= $18 est + tip; Starbucks for KG (unknown location)= $15 est + tip, *Possible lunch for sister= $15 est + tip, Muscle Milk for KG= $3.50 est;
Shopping/Travel Expenses: Airport Parking (up to 50% off with prebook)= $16 est; Return Flight for KG on Unknown Carrier at unknown time (I do not believe she ever had a $45 round trip flight)= $82 + fees; *Possible Flight for Sister (same issue as above)= $82 est + fees; Mileage Dallas, TX to Joplin, MO= (350 est mi/33mpg) x $3.85 est= $40.83 est;
All info from Reddit. ✌️

Hello,
Physician here, I handed in my resignation 6 months ago with a May end date. In addition to patient care, I previously held some administrative roles that I relinquished earlier in the year, and began looking at other opportunities as I didn’t agree with the direction the hospital was going in and wanted to cut back on my working hours. I just received a email from HR regarding a complaint asking for my removal for “unprofessional conduct”.. thing is my last week is already next week and has been for quite some time.
Nothing has occurred the last few months that would warrant unprofessional conduct, but I could see how relinquishing my administrative duties may have put me out of favor of some higher ups.
I’m suppose to hear more in the upcoming few days. Physicians do have a national database that I imagine this could be reported to (although I assume they have to prove I actually did something), and I assume something like this could affect my future job opportunities? Is this something I should consult a lawyer about or is that overkill at this juncture?
Thanks.
Will glad to answer more questions but just don’t want to be too specific.

Hello all:) I am 19 yr old college student and a now former 44H (US size). I had long, full, and sagging heavy breast along with large areolas for as long as I can remember. I have wanted a breast reduction for a few years, which I mentioned to my primary physician every year during my yearly checkups size around 16 yrs old. She finally send the referral out last November after a few more reminders. I went to my consultation in January, got measured, and a few weeks later I got the call that my insurance would cover everything. During the consultation, my surgeon told me that I would need to get a free nipple graft because of the measurements. I was told I would have no feeling of my nipples and I would lose the ability to breastfeed in the future, but for me, the benefits outweighed the cons. I have hyperpigmentation under my breasts and on my underboob from where the skin rubbed together, deep dents in my shoulders, back pain, etc. My main reasons for getting the surgery were to be able to do more exercises as it is hard to run with large breasts, to help alleviate pain, to be able to wear button up blouses, to be able to wear bras from places other than Lane Bryant, and the list goes on.
I got my surgery date scheduled for May 17th (yesterday). My nurse woke me up after surgery and I was groggy because of the anesthesia. I looked down and I was able to see my stomach for the first time which was a shocker to me and an encouragement to lose weight. My doctor came in and the first thing I asked him was how much he removed and he said he sent it in to be weighed so he didn’t know yet but it was a lot. He said he was not worried about the weight but just wanted to make sure he produced great results. I could already tell that my breasts were much smaller and about the size of my hands which I was very pleased with. My guess is that I am a C or D cup now as I will not know for sure until 2-3 months out. I left wrapped in gauze and large ace bandages which gave me compression.
The biggest shock for me was that I was hardly in any pain in my breasts, it was just difficult to get around. Later, I got nauseous even with scopolamine patch and ended up vomiting when I went home. Today (1DPO) I am in very little pain, just some discomfort where I can feel the stitches. I will be able to see them for the first time tomorrow when I change my bandages, I have no drains in. I will also take a shallow bath tomorrow because I absolutely cannot get my nipples wet because of the grafts which are held in place by tape.
P.S. - I am willing to answer questions and any post-op/recovery advice would be greatly appreciated! I do not own any surgical bras yet as I was told I won’t need them until after I get my stitches removed and I’m not sure where to get them or what size to get. I’m also a black woman so I would like any advice on taking care of scars.

I benefitted a lot from the advice on this subreddit and used a lot of it to guide my approach to M3 year; now that I've had the chance to sit the exam, I wanted to create an exam write-up in the hopes that it will be useful to others. This write-up is lengthy, as I wanted to include advice for any new M3 students about how to maximize 3rd year, as well as some Step 2-specific strategies and advice.
A little about me: I am a non-traditional student (in my 30s) at a mid-tier US MD school. Pre-clinical grades were good (honored 2nd year, 0.5% away from honoring 1st year). Honored every rotation in 3rd year. I am a peer tutor at my medical school and was actively involved in tutoring 1st and 2nd year students throughout my M3 year and dedicated.
I am a big believer in students teaching students and the idea that if we all work together, we all become better students and clinicians. In that spirit, I welcome you to ask me any questions that you have below.

Overview

In general, my advice boils down to:

1. Don't try to use EVERY resource. Choose a few high-quality resources and really know them well.
2. Doing well on Step 2 (and shelf exams, tbh) requires active learning strategies and continually trying to think about what the next step would be. Practice questions are a great way to do this, but challenge yourself to go beyond what each individual question to build a broader knowledge base. That way, you won't only know the answer to that specific question, but also to a whole host of related questions.

General studying tips for 3rd year + dedicated
I am a big believer that the most effective study strategy involves four big components:

1. A question bank (UWorld) - gives you primary exposure to the material and helps to identify where your gaps are.
2. A system for continuously reviewing content - I used Anki (I discuss this more below). You can also use other strategies (note-taking, old school flash cards), but the important thing is that your review strategy needs to be ACTIVE (i.e., not just re-reading your old notes, but actively quizzing yourself and covering up the answers) and it needs to be CONTINUOUS. I did not pause any Anki cards during 3rd year, so by the time I got to dedicated, I had been actively, continuously reviewing content for months.
3. Resource(s) for primary sources - this is where you go when you need to refresh on pathophysiology, look up treatment/diagnostic testing for a disease, or understand the symptoms. I prefer UpToDate for this broadly, and used some additional resources on specific clerkships that I will discuss below.
4. Practice exams - NBME practice shelf exams ("CMS forms") and NBME Step 2 practice exams; do them timed to practice pacing.

A note on AMBOSS vs UWorld
A lot of people I know use AMBOSS and like it. Some people want an additional bank of questions to study from. I didn't personally use AMBOSS at all during 3rd year, and only used it for Ethics and QI during dedicated (and honestly, it was only marginally useful - may have gotten me 1 or 2 extra points on the real step 2 exam, but not more than that).
I think the smartest way to approach Q-banks is to make sure you have enough time to complete and thoroughly review at least one. For me, UWorld was more than enough to prepare well for each shelf exam and step 2 (honored every rotation). I think that a lot of people who try to use both AMBOSS and UWorld never finish either Q-bank in its entirety, or don't really review the Q-bank adequately. I decided it was a better use of my time and money to review only one but really know it well.
A note on Anki
Anki is a powerful tool that can really help with your long term retention, but it is dangerous if used incorrectly. I suspect that many people who don't find Anki helpful simply don't use it effectively.
The purpose of Anki is spaced repetition. In order for this to work, you have to keep up with reviews and you can't pause cards. I also caution students I tutor to be cautious of relying solely on a premade Anki deck; I used the AnKing deck, as well as this deck and a home-brew deck at my medical school.
During M3 year, I would start each rotation with UWorld from day 1, and as I came across each concept in UWorld, I would do a search through my Anki cards and unpause all the cards that related to that topic (so, for instance, when I got a question about diverculitis, I would then unpause all the diverticulitis cards). I found that doing this ensured that the new Anki cards I was adding were reviews of concepts I had just studied (via UWorld), so I was able to both reinforce the new content via Anki and also ensure that the new Anki cards I was adding were concepts that I was actually familiar with. I recommended this approach over the one that I saw many classmates using (just unpausing all the cards tagged for a clerkship at the start of the clerkship and "raw dogging" them, as my friend put it). It's also a good way to keep your daily new cards (and thus, your reviews) at a manageable number. On a typical day in 3rd year, I added between 50-100 new cards and averaged 250-350 reviews daily. I was nearly always able to complete my reviews while I was at the hospital each day, leaving my home study time free for UWorld.
More on how to effectively use Anki
A note on staying sane and prioritizing high-yield content
As others have said, I think that the best way to do extremely well on Step 2 CK is to approach M3 as a yearlong dedicated period. Doing well on Step 2 is not just about your preparation for the Step 2 exam, but also your learning during each rotation and your preparation for your shelf exams. Even if you're not at all interested in a particular specialty, there is a lot to learn from each rotation that will be valuable to you as a future physician. Additionally, each specialty has its own way of approaching medical decision-making, and paying attention to these patterns of thought can help you to reason through questions on exams, as well as be a better communicator with physicians in each specialty when you become a resident and attending.
As you progress through 3rd year, there are also a few things that I think it's wise to keep in mind:

• Remember that you are a person first and a medical student/doctor second. I put this first because it's the most important. It's hard to learn when your basic needs aren't being met or you're so anxious, stressed, or depressed you can't remember anything. Find something that keeps you grounded and whole and sane and make that a priority. For me, it's distance running. I ran nearly every day of 3rd year and dedicated (often at 3 AM, before rounds). I finished 3 marathons during M3 and dedicated, including running the Boston Marathon 2 weeks before I took step 2. Running relieves anxiety, gives me an excuse to step away from studying, and evens out my mood. In total, I ran over 2500 miles during my M3 year. I don't think I would have done anywhere near as well in M3 without it.
• Get really, really good at preventive care. The US Preventive Services Task Force guidelines are highly tested on all shelf exams and on Step 2, and there really aren't that many of them. Before my family med rotation, I made an Anki deck of the A and B recommendations based on the most recent updates and kept those in rotation through Step 2 (about 150 cards total). If you're at the beginning of M3 year, (or really any point in M3) I would suggest doing this right now. Every time you see a patient in clinic, think about "what screening exams should this patient have". If you get in the habit of always doing this, by the time you get to the exam, those screening questions will be free points (and there are usually a bunch of them).
• Try to approach every patient encounter as though you are the sole physician responsible for that patient's care. Formulate your own plan independently of residents or attendings. Ask questions about all these things in your patient interview, and present the answers to your attending. You will learn more if you push yourself to try to think about management from the beginning of 3rd year rather than relying on plans from your residents.
• Pay attention to sensitivity and specificity of tests. This is becoming a bigger and bigger deal on NBMEs and Step 2. Knowing sensitivity and specificity can help you determine whether a given finding in a question stem is significant or not.
• Look up every imaging test and diagnostic procedure you come across, whether in clinic or on a practice exam. A good rule of thumb for whether you understand a test is "Do I know when this test is appropriate, when it is inappropriate, and could I explain it to a patient?". I had a surgery fellow pimp me on when to order an ERCP vs MRCP; this stuff is important because it prevents unnecessary testing and allows you to get the most "bang for your buck", both in terms of diagnostic accuracy and scoring points on the "next step" questions on exams.
• Pay attention to thresholds for follow-up observation vs treatment. If a patient has a AAA that's 3 cm, you do serial ultrasounds and watch it clinically; if it's 7 cm, you operate. Many, many conditions have similar thresholds, and you should look for the differences in how you manage a condition based on the thresholds. Sometimes this stuff is buried in the UWorld explanations, so when you see it, make a flash card or add it to your review.
• Know the USPSTF screening guidelines like the back of your hand. There aren't that many of them, and it's basically free points on every single shelf exam + step 2. Make a flash card deck with the most updated versions on day 1 and review it throughout 3rd year. Especially high yield on FM + IM, but they appear on every shelf.
• Think about what things a specialty "cares about" when you're rotating on that specialty.
  • OBGYN: gestational age, STI history/screening, social/fam Hx of risk factors for gyn cancers (breast, cervical, ovarian, endometrial).
  • Surgery: is the patient safe to take to surgery (comorbidities, heart failure, coagulopathies, meds, etc)? When is surgery indicated (i.e., do they have to go now, or can they wait)? Antibiotic prophylaxis (who needs it, and what antibiotics)? Post-op complications (the "5 W's", leaks, nearby structures that can be injured)? Normal post-op care/patient safety (DVT prophylaxis, catheter removal, infections, etc).
  • Peds: developmental milestones/normal development/growth curves, rashes (pediatricians love rashes), upper respiratory infections, stuff that gets treated differently in kids (ex. febrile UTI), neonatal hyperbilirubinemia (basically guaranteed to get at least one question on this on any peds exam)
  • IM: Preventive care/screening, vaccines, hypertension, diabetes, heart failure, ACS, liver failure/cirrhosis.
  • FM: IM + Peds + OBGYN, with a heavy focus on preventive screenings
  • Psych: Pay attention to timelines; think of every psych disease as a continuum (i.e., <1 mo = brief psychotic disorder, 1-6 mo = schizophreniform, 6+ = schizophrenia, schizophrenia + mood symptoms = schizophreniform). Find something that makes sense to you for the personality disorders (I personally mapped them all onto Harry Potter characters and now I will never have to re-learn them).
  • Neuro: Differentiating causes of stroke, multiple sclerosis, when to get an MRI (answer: always get an MRI in neuro), different types of dementia

Subject Review

This section is intended for those who are starting or still in the midst of M3 year. If you're already in dedicated, this section may be less useful.
For all rotations, my strategy was generally:

1. Complete the UWorld Shelf exam Q-bank with 1-2 weeks to spare
2. Make/unpause Anki cards as I worked through UWorld
3. Take timed NBME practice shelf exams regularly throughout the rotation(I sat down at the start of each rotation and planned these out every 1-2 weeks so they were evenly spaced throughout the rotation). Get through every practice exam by the end of the rotation. Doing them timed is important because it helps you to practice pacing. One 50-question exam at 90 seconds/ question = 75 minutes total. I also wrote down the diagnosis for each question so that when I reviewed the exam, I could see whether any wrong answers were a problem with making the wrong diagnosis vs knowing the next step. Doing the NBME shelf exams also gives you a good sense of what the "pet concepts" that tend to occur over and over are (for instance, SCFE vs Legg-Calve-Perthes comes up shockingly often)

Order of rotations:
I did my rotations in the order listed below and I really liked this order. I know many people advocate for finishing on Internal Medicine, but I was very glad I started with it, because I think it laid a strong foundation for everything else. As long as you have a solid strategy for reviewing the IM content continuously throughout the year, I think it's a smart choice for the first rotation, especially because basically every other shelf exam will have 5-10 IM questions on it.
Medicine
Resources: UWorld (IM shelf bank + 1/2 of Ambulatory), Case Files Internal Medicine (did ~50% of it), USPSTF A & B guidelines, NBME practice shelf exams ("CMS forms"), Emma Holliday review
Advice: If you have free time 1-2 weeks before starting IM, get through as much of Case Files as you can. It lays a good base and helps you get into the mindset of IM. Once you start the rotation, crank through UWorld. I'd suggest trying to finish the UWorld Q's with 1-2 weeks to spare at the end of the clerkship in which you can review incorrects and/or shore up any weak areas.
Raw Score: 85
Neurology
Resources: UWorld, Case Files: Neurology, NBME practice shelf exams ("CMS forms")
Advice: Case Files Neuro is a little in the weeds, but it will help a lot with some of the more off-the-wall pathologies that aren't really seen in the UWorld bank.
Raw Score: 90
Psychiatry
Resources: UWorld, Case Files: Psych, NBME practice shelf exams ("CMS forms"). A lot of people swear by First Aid for the Psychiatry Clerkship; I didn't use it (but I think Case Files accomplished much the same purpose)
Advice: Pay attention to timelines + enjoy the psychation! This is the lightest rotation for most people. Take it in the summer if at all possible and enjoy the nice weather and free time. If you can, get it somewhere in the middle of 3rd year so you can have a little break.
Raw Score: 94
Family Medicine
Resources: UWorld (FM bank + 1/2 of ambulatory bank), Case Files: Family Med, NBME practice shelf exams ("CMS forms"), USPSTF A & B guidelines, CDC vaccination schedules
Advice: Try to take FM after IM, if at all possible. DO NOT underestimate the family medicine shelf exam. It is the broadest shelf exam, and it's heavily weighted towards prevention, so plan your studying accordingly. Know the USPSTF guidelines and vaccine schedules like the back of your hand (this is at least 25-30% of the shelf exam).
Raw Score: 85
Surgery
Resources: UWorld (Surgery bank + EM bank), de Virgilio's Surgery, NBME practice shelf exams ("CMS forms") for EM and Surgery, American College of Surgeons TEAM (Trauma Evaluation and Management) course book, Emma Holliday review
Advice: The surgery shelf exam focuses heavily on the pre- and post-surgical management of surgical patients, trauma assessment (hence the EM questions/CMS forms above), and knowing the indications for surgery. You will not be asked how to do a surgery on the shelf exam, but you will be expected to know when a surgery is indicated vs when medical management should be used instead (and also what that medical management is). De Virgilio's is a great and under-utilized resource that has a fantastic question bank at the end of each chapter. I would recommend reading at least the GI, vascular, breast, endocrine, and trauma sections (and honestly, as much of it as you have time for).
Raw Score: 85
Obstetrics and Gynecology
Resources: UWorld, Case Files: OBGYN, NBME practice shelf exams ("CMS forms"), ACOG guidelines, UWise questions
Advice: OBGYN is all about timelines (at least, the OB part is). Pay attention to gestational age requirements for diagnosis of various conditions. Know the various labs that are used to diagnose Pre-eclampsia with severe features, and really pay attention to risk factors for the various obstetric complications. As one nurse midwife I worked with put it, "The biggest risk factor anything in L & D is usually a history of the same complication". I didn't really find the UWise Q-bank that useful, but if you have extra time, it's a nice source of extra practice questions, or a good way to reinforce any trouble spots.
Raw Score: 87
Pediatrics
Resources: UWorld, Case Files: Pediatrics, NBME practice shelf exams ("CMS forms"), CDC vaccination schedule, Emma Holliday review
Advice: Know the general trends of pediatric vital signs (what's normal for an adult is abnormal for most pediatric patients and vice versa), pay attention to rashes and dermatology, and review these as often as possible. It's well worth your time to do a good review of all the glycogen storage diseases, inborn errors of metabolism, lysosomal storage diseases, etc that you forgot after Step 1. For this reason, if you can do Peds as your last rotation before Step 2 it's kind of nice...then you only have to re-learn all this stuff once. This stuff is fair game for Step 2 (and I did personally get questions on it on my exam).
Raw Score: 91

Dedicated Study

I completed my first pass of UWorld during my M3 core rotations with an average of 74%. I did reset UWorld and begin a 2nd pass during dedicated, but I found that the questions repeated a lot of content that I knew well, and ultimately decided it wasn't a good use of my time. I only completed about 20% of my 2nd pass of UWorld with an average of 92%.
My main resources during dedicated were NBME practice exams (I did 8-14 timed), UWSAs, and the Free 120. I also listened to some Divine Intervention episodes on my runs and reviewed the Emma Holliday shelf exam reviews (I had previously listened to these during my M3 rotations). Of the podcasts, I found the Divine Intervention Free 120 review the most helpful, and would strongly recommend listening to those episodes after you take the Free 120. It did a lot to help me with some test taking strategies that I used on exam day.
General advice for dedicated:

• Keep on a regular sleep schedule, even on your days off. I went to bed at 10 and got up at 6 every day, because I wanted my schedule to be close to what I would need to do on test day.
• Take days off. I took at least 1/2 a day off every week. I also ran a major marathon 2 weeks before my test day, so that was a very light weekend in terms of studying.
• Keep exercising and doing things you enjoy. For me, this meant running a marathon (something I do regularly). You don't have to go as crazy as I did, but do something to get outside and stay active. It will help you keep the anxiety under control and see the sunlight every so often.
• Take practice exams regularly and spend plenty of time reviewing them. I made a google doc to keep track of incorrects and assigned each one to a category of "why I got it wrong" (i.e., "overthinking", "knowledge gap", "guessed wrong of 2", etc). This helps to identify trends. I found that I have a tendency to overthink questions, so identifying this helped me to address this weakness and gave me confidence to go with my gut instinct on the exam.
• Don't be afraid to adjust your study plan during dedicated. I started a 2nd pass of UWorld, but after about 2 weeks of dedicated, I felt like I wasn't really getting anything additional out of it and I was remembering too many of the questions from my 1st pass, so I just stopped using it. I spent that time on other resources instead (more practice exams). Take the time to really analyze which activities are actually helping your learning. Don't just do something because that's what everyone else is doing during their dedicated.
• Keep up with your review strategy. For me, this was Anki. I spent 2-4 hours every morning during dedicated doing Anki. At times, I worried that this was too much time on Anki, but part of what makes Step 2 (and all USMLE exams) challenging is the sheer breadth of content. The best way to prep for this is to keep consistent with your review strategy.
• If there's a concept you dread seeing in a question stem, STOP, do not pass Go, do not collect $20. Take a second to go to a primary source (UpToDate, a textbook) and review that content. Make some flash cards and review it regularly.
• Practice your timing. I came up with my exam day break strategy at the start of my dedicated, and every time I took a practice exam, I practiced my break strategy (at least, the first 5 blocks of my break strategy). This made it very easy for me to execute on test day because I was already used to doing 5 blocks in a row exactly this way. I took my lunch break after block 5 instead of block 4 (because I liked the psychological factor of knowing the exam was more than halfway done). Coming back for 3 more was no problem on test day.

My practice exam scores:
CCSE: 254 (my school requires this, and it was given a few days after the final shelf exam, right at the start of my dedicated period)
NBME 9 (30 days out) 269
NBME 10 (21 days out) 268
NBME 11 (18 days out) 262
NBME 12 (15 days out) 251
NBME 13 (7 days out) 264
NBME 14 (2 days out) 264
UWSA 1 (25 days out) 254
UWSA 2 (9 days out) 268
UWSA 3 (5 days out) 266
New Free 120 (3 days out) 85%
Predicted score: 265

The Day Before

Just take a break, for the love of all that is good. I went for a run, watched some old TV, read for fun, had a nice pasta dinner, and tried to go to bed early. Laid out everything I needed (lucky t-shirt, snacks, testing permit, ID, keys, etc).
Of course, I ended up tossing and turning most of the night and slept very poorly. When I woke up, I considered trying to postpone my test, but ultimately I decided I just wanted it over and done with and I wasn't willing to wait any longer. My point here is that even if you have anxiety and/or a single bad night of sleep before the exam, you can still do very well if you've done the work. As we say in the marathon world, trust your training.

The Test

Got to the testing center 45 minutes early. Made sure the last thing I did before going through security was to take a bathroom break. Brought plenty of snacks, headache medication, chocolate, and a healthy and delicious lunch (I think there's some psychological power in knowing you have a delicious lunch awaiting you).
During the exam, I took a break of at least 5 min after every block. Personally, I found the mental break was extremely helpful. On the whole, I found the exam to be quite reasonable.
Step 2 CK: 277
My last piece of advice will be that I think doing well throughout third year is the best thing you can do. If you've had a break after 3rd year or you are an IMG or someone coming from a non-traditional program, doing a thorough content review with the CMS forms before starting Step 2 specific practice exams is a good idea.
Ultimately, I think the most important things are:
1.) Choosing a FEW, QUALITY resources to review
2.) Continuing your ACTIVE, CONTINUOUS review strategy
3.) Keeping a consistent schedule with time for sleep, healthy eating, exercise, and something you find fun (ideally something other than TV).
4.) Staying off Reddit. Really, I mean it. Especially during dedicated, it's just a black hole of anxiety and angst and you should avoid it at all costs. Come back after you get your amazing scores and pay it forward to others.

My partner and I have been romantically together for about 3 and a half years. I've known him for maybe 12 years now. We are semi-long distance, 3 and a half hours away but we spend a couple weekends each month visiting. Sometimes for 4 days at a time around holidays and frequently meet in the middle of our distance to spend time together. We also go on vacations together. We are working to close the distance this summer with him moving in with me, because financially that makes the most sense.
He is ndx but thinking about talking to a physician and starting therapy. It took us a long time to get to this point, because he was in denial about the possibility of having ADHD even though a physician many years ago suggested he be put on Ritalin. At the time his mother said no and that was the end of that.
Fast forward 15+ years later as an adult and about 2 and a half years into our romantic relationship and I bring this up in conversation and he's passively rejecting the idea. "Yeah, idk this is just how I am. I've been fine my whole life, I'm not diagnosed but you're right I probably do have it. But I'm doing okay, it's not as bad as it used to be." Despite me having plenty of experience with ADHD, Autism, ODD, OCD, you get the idea. I'm not a doctor by any means but I've been in my field almost 7 years now and I am familiar with it enough that I feel comfortable to suggest he talk with a physician. But I left it alone, it's his life and I love and care for him deeply and I'm just going to have to find ways to cope and support us.
PRESENT: I sat him down about a month ago and mentioned that his excessive talking has gotten worse and its to the point where hes not physically listening to me anymore. When I say excessive talking I mean talking for an hour at a time. Which I don't mind, he's always talked for long periods of time and I'm not a talker but I just ask that he listen when I speak. Lately he had been calling me, to talk for an hour and then he asks about my day and then i start realizing that he's not listening. Admittedly lately I will stop mid sentence sometimes to see if he notices- and he doesn't. I get a: "yeah okay sounds like you had a busy day" "I just mentioned that I had to write 3 people up today and you have no reaction? Not even a question as to why?" "Oh, I didn't hear that"
I shut down, told him that I needed some space and that I'd call him back, because I was frustrated. I called him back an hour later. Told him about my frustrations and what I needed from him. A week later he mentioned that he started looking into finding a doctor and pursuing a dx based off that conversation and reflecting on previous ones. I also want him to find a therapist that specializes in ADHD. But baby steps. Will bring that up when I feel appropriate, and not force or overload him into something. He tends to shut down when he feels like he's being told what to do. So, I know it's going to be a big change, but I want him to come to that conclusion on his own.
Things got better until a couple days ago, he did the same exact thing, I called him out on it, and he completely shut down, has been distant and I know he's frustrated with me. I get that. But I told him that these are the things I need from you as my partner and potentially my husband, because I'm tired of feeling empty, not heard, etc. I don't get to talk about my day anymore without being interrupted or you start talking about yourself and your interests. I'm exhausted and I don't feel heard or supported right now. He said, "You're right, I need to get it together, you shouldn't feel that way." The next day, he's done a complete 180 and turned things around, but extremely moody like he usually gets after we have these sit downs. Today he's a little better. (I started reading into this sub and someone mentioned RSD, I hadn't heard about it, but maybe that's what he feels and would make a lot of sense why he takes the the things I say so harsh. I'm not sure, but maybe.)
But I'm tired, I feel like giving up, but I don't want to give up. I really want to see him get help and I want to support him through that, I want him to be my life partner but it's REALLY taxing on me emotionally. I love him so much and want to continue to support him but, I'm so so exhausted and I need some help/support/advice on how to navigate things. What can I do differently?

Mochi Health Review When deciding on a semiglutide provider I scoured the Internet for the right company looked at tons of reviews and weighted my options. Price, reliability, customer service, since I had seen that people may be getting prescribed products that were completely useless. So I thought I would share my experience with mochi health so far.
Cost: Mochi Heath subscription $79 get $40 using code: FILD1A (this includes a physician and a nutritionist) Then on top of the subscription fee you have the cost of the medication
Compound Semiglutide: $175/ per month Compound Tirzepatide: $325/per month (The first month they give you $100 off)
Processing/ Timing: When you sign up they instantly charge you $79 and then you can set up your appointments with your physician and nutritionist. I had to wait 11 days to get in with their first available physician but because of this they did give me $40 off my next months mochi subscription. They did call me the day after I signed up as well to see if I had any questions, which was nice.
At the time I'm writing this I just had my first meeting with my physician and she was great! Answered all my questions she was also very pleasant made me feel at ease and didn't rush me. Her name is Amisa Patel and her referral code is Referral Code: jk80vg She prescribe me the lowest dosage of Tirzepatide to start out and said well go up from there she also said she wants to see me again in 3 months.
So far their customer service has been top notch! I will report back with my updates! Lmk if you guys have any questions!