1936, Union of Soviet Socialist Republics
It is the year 1936. Joseph Stalin acts as Chairman of the Communist Party and Premier of the Soviet Union carefully bides his time. Ever since his failed bid to remove the Central and Left Oppositions in 1927-28 seized him the Premiership, he had carefully spent nearly a decade rebuilding his influence and network to the point that he can try a second attempt to dispel his political rivals and not a moment too soon. Within a years time, the Man of Steel predicts the Congress of the Soviets would gather to reexamine and most likely replace the old 1924 consitution with something that would give the lethargic titan purpose. If the premier gets his way, this new document will be a Stalin Constitution.
Meanwhile, Leon Trotsky stews in exile from his current residence in London, the famous Bolshevik a guest of the likeminded Oswald Mosely. In fact, he has spent a great deal of time writing theory for a new socialist system to, in his words, 'Provide a Total answer to the schism between the Bolshevik east and the Syndicalist West.' However, the Revolutionary is not content to rot away in western Europe. He too has been patient, he too has rebuilt his influence and recruited supporters within the Soviet Union knowing that the window is closing for him to return triumphantly within the halls of power and direct the Permanent Revolution towards crushing the forces of reaction.
Perhaps he is confident in his return as his supporters back home have informed him about the shaky foundations of the Central Opposition. Officially, this political bloc was led by the 'Troika' or the alliance between Joseph Stalin, Lev Kamanev, and Grigory Zinoviev. In reality, this triumvirate was primarily under Stalin's control, who only retained the other two when it became clear the Right Opposition would not be easily uprooted. Neither men, however, forgot Stalin's betrayal and how close they came to being removed from power. Gigory Zinoviev, General-Secretary of the Comintern, has drifted (in secret) closer to elements of the underground Left Opposition. On the other hand, Lev Kamanev has quietly reached out to elements of the Right Opposition, more out of necessity and a shared hatred for Stalin.
Speaking of which, the Right Opposition. Partially born out of Nikolai Bukharin's admiration for the New Economic Policy and admiration of the successful French and British Revolutions. With the rise of Syndicalism in the west, the concept of a partially decentralized economy has seemingly been vindicated. With Bukharin's popularity and Alexei Rykov's experience both in politics and economics, the Right Opposition was transformed into the 'Bolshevik Syndicalist' wing of the Party. Crucial in defeating Stalin's first seizure in the late 1920's, Bukharin and Rykov have represented the opposition to Stalin's Center Tendency. Perhaps by the end of the year, they will finally overcome Stalin's decade long reign as Premier and mend the rift between Paris, London, and Moscow.
Lastly, there is the odd man out: Ivan Smirnov. A strong supporter of Trotsky, rabid enemy of Stalin, and General-Secretary of the Communist Party of the Soviet Union. After his expulsion from the party in 1927, Smirnov was eventually reinstated not just as a member of the party, but put in one of its most powerful positions for one simple reason; he could be trusted not to play favorites. He disliked the Right Oppositions sway towards Syndicalism, despised Stalin and most of the Center, and the man he actually did support was a continent away, his supporters scattered. What's more, Stalin believed he controlled Ivan, the man being one mistep away from being exposed as a Trotskyite and expelled from the party again or worse. However, Ivan is not broken. Though he has sworn off Trotsky he still speaks quietly with likeminded men of the Left Opposition, his friendship with Grigory Zinoviev still holds strong, and Bukharin and Rykov are far less infuriating then Stalin ever could be. Smirnov will play a vital role in the politics of the coming months. Whether Trotsky returns, the Center bucks Stalin, the Right ascends, or the Man of Steel reigns triumphant, Smirnov will play a pivotal role in that outcome.
The Issues They Face
The NEP vs Five Year Plans - One of the most divisive issues plaguing the party is whether or not to commit to either a fully reorganized NEP, or to double down on the system of Five Year Plans to increase the Soviet Unions heavy industries. Ever since Joseph Stalin rose to Premiership, the Soviet economy has been pulled in two separate directions. One is championed by both the Left Opposition and Stalin himself, that being the collectivization of farmland and an economic focus on heavy industries. The opposite is Bukharin's 'Reorganized New Economic Plan', a full rework of the NEP along more Syndicalist lines. In years past the Soviet Union has partially adopted both economies with surprisingly positive effects, but now the economy and bureaucracy is stumbling under the weight of the two systems and a choice has to be made; Full-send on collectivization, or stay the course with the NEP?
Socialism in One Country vs Permanent Revolution - Perhaps one of the prime failures of Stalin was his commitment to the concept of Socialism in one Country, in which the Soviet Union must look inwards to build its strength before reaching out to the wider world. This was made under the assumption that no other nation would collapse to revolution, with or without the Soviet Unions help, so Stalin and others like him looked quite foolish when the Italian Federation and British Empire collapsed and Syndicalism rose in its place. Under Stalin, the capital of the world revolution was not in Moscow, but in Paris. Under Stalin, rather than uniting against the common threat of reaction, the socialist world divided between the anarchist Internationale and the Bolshevik Comintern... and the Comintern is losing. Either Stalin must overcome the red portion of western Europe or swallow his pride before his failings become someone else success...
The Ost Wall - The Treaty of Brest-Litovsk was a great shame Lenin had to accept to ensure peace between Russia and Germany. With the Civil War still raging and Germany only getting stronger, the writing was on the wall. While in the end very little ethnically Russian land was lost, the Soviet Union was not built on an ethnic model. The shame of Brest-Litovsk still burns, and while peace was achieved, more and more voices find the call of revolution and war burn brighter in their hearts. The Soviet Union's industry is growing at an exponential rate, and the Red Army expands and modernizes with every year. What's more, the cracks in Germany's eastern armor have finally begun to show as it's eastern 'allies' struggle to appease their disgruntled peoples. For the men who lead the Union, their experience all tells them the same thing: War is coming, whether they want it or not.
Soviet Union Paths
The Man of Steel (Totalism) - Despite all efforts to stop him, Stalin is finally ascendant within the Soviet Union. Trotsky, Bukharin, Smirnov... all of these men are now gone, politically (and soon, literally). The Foundation of the Cult of Stalin has already been laid, and lists are being written. Lists of names, hundreds of names, thousands, hundreds of thousands of names. Soon, Stalin will clean house. Soon, no one shall be safe from Stalin and his megalomanic paranoia. Soon, Russia will have a new religion, the creed of Stalinism.
"The more things change, the more they stay the same."
Return of the Triumvirate (Radical Socialist) - Though Trotsky and Bukharin's lot were finally subdued, Stalin cannot deny that he could've done it alone. Lev Kamenev and Grigory Zinoviev (Or one of them and Smirnov) have entrenched their position as Stalin's right and left hands. Stalin has won, but he must contend with his old rivals and allies as equals once more. Perhaps in another ten years, Stalin could revisit their necessity as allies but for now, the Troika reigns supreme.
"Caesar, Crassus, and Pompey once more rule the Third Rome."
Heir of Lenin (Totalism) - After a decade in exile, Trotsky has returned has crossed the Rubicon and ousted his enemies. The triumphant revolutionary can now reshape the Soviet Union along the path it was truly meant to take, and serve as a shining example of Marxism-Leninism-Totalism. Already the Red Army begins to mobilize and the factories churn out guns as Trotsky plans in tandem with his socialist allies in France and Britain and the German Empire shudders as the Russian Bear awakens.
"The Ghost of Lenin stirs in his grave."
The Siberian Dark Horse (Totalism) - Much like the man who occupied the office before him, Smirnov has managed to play everyone off one another until he alone remains standing. The Right Opposition is in chaos, Stalin and his lackey's are gone or turning their coats to the winning side, and without Trotsky the Left Opposition has rallied around his natural successor. Ivan Smirnov was never in the cards to come out the true winner, and yet now he sits at the top of the pile under the mantle of Marxism-Trotskyism. Smirnov will honor his predecessor by continuing the Permanent Revolution, and bring revolution to the west as he did to the east.
"First, Kolchak. Next, the Kaiser."
Defender of the Peasantry (Syndicalism) - With Stalin finally removed from power, Bukharin can begin the process of De-Stalinization and directing the Revolution onto the right track. Under Bukharin, the well-being of the working class and peasantry shall come first, as will their liberation and empowerment and the only way to achieve that, as shown in the west, is through the Syndicate. Lenin once called Bukharin the 'Golden Boy of the Party', and though Lenin did have his criticisms of the man none could ever deny his well-earned popularity. He will ensure the people of the Soviet Union do not run the risk of other autocratic Stalin's or ambitious Trotsky's taking the reigns. He will mend the gap with the Internationale not because he is a sycophant of some would-be dictator with a funny moustache, but because all of socialism must come together to challenge the warriors of reaction. He will build a new Soviet Union, not one born out of his blood, sweat and tears alone, but by the blood of soldiers on the field of battle, the sweat of factory workers on the production line, and the tears of mother and fathers. Not because Bukharin ordered them to do so for the 'Greater Good'... but because they united as one to stare the dragon of reaction in the face and tell it that its time was past.
"Democracy of the People, by the People, for the People, Shall Not Perish from the Earth."
The Fading Star (Radical Socialism) - Once, Rykov was not too dissimilar to the likes of Stalin or Trotsky, who championed 'the end justified the means'. They were not one of the architects of War Communism, and the blood that policy, however necessary and effective, stained Rykov's hands to this day. He is not Bukharin, he does not have his drive nor his charisma. But what he does have is experience and focus. Perhaps the Soviet Union will not become as revolutionary or radical under Rykov. Perhaps Rykov cannot be Bukharin. But what Rykov can do is ensure the Soviet Union he leaves behind is strong, united, and ready for a younger man to take into a new age. This will be the second time Rykov has acted as Premier of the Soviet Union, and he will not let it slip out of his fingers like the last time.
"The Reaper now Sows the Seeds of Tomorrow."
Other Snippets

• If Trotsky fails to return to the Soviet Union or survives assassination attempts, members of the Third Internationale will have events involving Trotsky. In particular, he will visit the Combined Syndicates of America and, depending on choices made by the CSA and how close the CSA is to being defeated, stay to support the revolution. This can range from either acting as a National Spirit and possible Advisor to actually acting as a Field Marshal/General for the CSA. His presence also increases the popularity of Totalism. He can provide similar buffs to either the SRI, The Commune, or the Union of Britain.
• If Stalin is exiled from the Soviet Union, he will eventually end up in Mexico. Trotsky or Smirnov can choose to send assassins after Stalin where upon he will be found murdered in his study, killed by an ice pick and becomes a Martyr for anti-trotskyite/Smirnovite socialists. If he is not assassinated, Stalin eventually suffers a stroke in the late 50's, but is saved by the quick actions of local doctors but was rendered mentally impaired, and fades into relative obscurity.
• If Stalin is not exiled, he will merely be removed from the party and retires to his villa on the black sea. Again, Trotsky or Smirnov can have him killed much to the same effect, but if not Stalin spends his days living a relaxing and peaceful life, writing books and essay's in both Russian and Georgian and on all manners of subjects including Stalin's views on Christianity, and acting as the Patriarch of a growing family. His daughter, Svetlana, eventually joins the Communist Party.
• While Stalin, Trotsky, and Smirnov can all turn the Soviet Union Totalist, their flavors vary somewhat wildly. Stalin turns the Soviet Union down its OTL path of Stalinism of course. Marxism-Leninism-Totalism is rather similar to Stalinism but much more zealous and aggressive in doctrine. Marxism-Trotskyism is essentially bog-standard Marxism-Leninism but more heavily militarized, and Smirnov takes on Stalinist and Trotskyist attributes eventually culminating in a Cult of Personality forming around the Siberian Lenin.
• Bukharin's paths will either end with Bukharin ceding power to the Supreme Soviet/Congress of Soviets of which he will remain a prominent voice, or one where Bukharin accidently forms a Cult of Personality around himself, though one that's more benign in nature. Both endings are seen as positive but radical. Rykov is still a positive ending, though more pragmatic and moderate compared to Bukharin's radicalism.

Hey, figured I'd share my tonsillectomy experience because this sub was a great resource for me leading up and after my surgery.
I had surgery on May 2, after quite a bizarre experience with my tonsils. I've had tonsil stones for as long as I can remember, but as everyone here can attest to, ENTs and doctors don't really treat stones. Also, at about the base of my left tonsil, the tissue had hardened a bit, and I suspected that I had a tonsil stone wedged deep that I could feel. After seeing about four ENTs and two oral surgeons, they all gave me the same recommendation: get those suckers yanked out.
I still wasn't convinced so I asked about getting some imaging done (I'm in the US with good private insurance, so relatively easy to schedule, but still decent $$$). I got an MRI and it didn't show anything nefarious, but interestingly enough the tech noted a "lesion" on my right tonsil, the one that felt perfectly fine. Given this new information my ENT suggested a tonsillectomy because it was really the only option I had left and every other doctor suggested the same.
I scheduled my surgery and soon enough the day came. I've had surgeries before (2x ACL, 1x meniscus over a 30 year soccer 'career') so I knew what to expect. I didn't anticipate being in the surgery center with 6 year olds as I was the only adult getting the procedure that day!!
Day 1: They wheeled me back and knocked me out, and when I woke up I remember being surprised that the pain I was in was probably a 9/10. My second ACL surgery was like an 11/10 when I woke up (interestingly enough my first ACL surgery was like 3/10) so I was initially surprised how uncomfortable I was.
They fed me ice pops and gave me ice water and tried talking to me, but before I knew it, I was on my way home. In the US, if you go to a private surgery facility, they generally wheel you out within 10 mins of waking up.
The rest of the day was pretty brutal as swallowing was uncomfortable, but my mouth kept filling with saliva so I essentially had to keep drinking water and swallowing, which wasn't great. Eating was completely out of the question, but I had stocked up on some ready to drink protein drinks that kept me relatively satiated. I kept to a pretty strict medicinal schedule which helped me sleep a bit.
Day 2: Still uncomfortable but the pain was significantly less, maybe a 5-6/10. I took about 5ml every 4-5 hours of liquid oxycodone and caught up on Vanderpump Rules. I kept a large cooler by my bed stocked with ice from Sonic, Alo Water, protein drinks, a million water bottles and ice packs. I had a couple of ice pops, but honestly, I just didn't have any appetite for ice cream or ice pops or the like. Ice cold water and the Alo Water were great.
Day 3-4: Pain was about a 4/10 and getting better. I kept to the same schedule for medicine, trash TV shows, and water + ready to drink protein. My wife made me some pastina pasta with butter and although it took me 45 mins to eat a couple of spoonfuls, it did a lot for my mind. I also ate one scrambled egg, but it took me a while. I also had my bowel movement! This is very important after surgery!! Please take some stool softener!!!
However, on Day 4 right before bed around midnight, I "spit" (aka let drool fall out of my mouth) and noticed blood in my saliva. My doctor just said to call if you see any bright blood in your saliva and I noticed it more and more, but not a lot of volume. Of course I freaked out and called at 1am, but my understanding is that a little blood is ok and should resolve itself with ice water and ice gargling. It's really only if your mouth is filling with blood rapidly that you should head to the hospital.
Day 5: I woke up out of a decent sleep at 4am not in pain, but seriously uncomfortable, like my throat and mouth were incredibly sore. The painkillers really helped and I felt like I had taken a step back in the recovery. I could start to talk a little bit more, but nothing more than a couple of whispered sentences at a time.
Day 6: Still sore, but I remember feeling like I turned a corner finally.
Day 7: Back to work! I work hybrid so I was home to recover and didn't have any problems concentrating or typing or anything. I had only been taking the painkillers maybe once a day, usually at night.
I'm a little over 2 weeks now and I feel as though I'm completely back to eating normally and speaking normally, though I can't talk too loud or for too long. After living with tonsil stones for so long, my mouth feels a lot cleaner if that makes sense.
No regrets on the surgery. Looking back, spending time in front of a mirror pushing calcified food particles out of crevices in your mouth is a wild way to spend your time. The recovery was tough I'm not gonna lie, but it is relatively short.
I found myself just like drooling saliva out of my mouth over a sink because I didn't want to swallow anymore. Ice cold water makes swallowing way more tolerable so try to always have ice cold water on hand at all times. I drink water like a psychopath so I was super hydrated, to the point where I was peeing every 45 mins the first two days. I couldn't imagine being dehydrated and trying to recover.
If I could do it over again, I would brew more tea with plenty of honey and let it cool down and then drink it cold. Honey is basically a wonder drug but I didn't utilize it enough in the beginning.
I found and downloaded a text to speech app, which was pretty handy. My kids loved it.
Here are some essentials that other people have mentioned here but I'll list them below. Good luck!!
Pillow Wedge for elevated sleep - I actually still use this as I enjoy sleeping a bit elevated now
Alo Water with Honey - I didn't realize there are clear pieces of aloe vera "pulp" in the drink, which was a super weird experience. I wound up straining the pulp out. Also, try to cut this with water, there's an insane amount of sugar in the huge bottles and you don't want any unnecessary discomfort while you're trying to recover.
Warm and Cool Mist Humidifier - I already owned this and I had it running basically 24/7. I still woke up with a dry mouth which is kind of miserable, but I think it would've been worse if I didn't have this.
Fairlife Core Power Protein Drinks - 26 or 42 grams of protein is amazing when you're recovering. They are a bit expensive, so I picked up a case of the Fairlife Nutrition Plan from my local Costco.
Sonic Pebble Ice - Pebble ice is so much better than regular ice from a freezer or if you're freezing a tray. I don't know why. It's so much easier to chew and it's so much more satisfying to put in your water, especially recovering from a tonsillectomy. If you don't leave near a Sonic, try to find pebble ice somewhere!
Miralax, 7 Once Daily Doses - You NEED a stool softener. The opioids will back you up. The worst part of my ACL recovery was that first bowel movement. I didn't stay on top of my stool softener game. You gotta get that first BM out of the way ideally within like 2-3 days.
RTIC 52 QT Cooler - It's not necessary to have a $200 cooler next to your bed, but if you already have a nice one like a Yeti or RTIC, I'd definitely recommend keeping it near where you are recovering.
Tongue Scraper - I didn't brush my teeth for like 3 days and I felt awful about it. I'd recommend at least a tongue scraper to keep up on the hygiene.
Ice Pack Head Wrap - I thought I would use this more, but it came in handy on days 5-6. I didn't need it, but I'm glad it was around.

i've been doing jury duty since the end of april, and this coming week is my last. i missed 4 days total due to being burned out and mega anxious (it feels like a job and im notorious for quitting jobs because of anxiety/feeling trapped), and i'm due to go back tomorrow but i lost my juror id and the keys to my apartment, so now i'm double fucked because i already missed a bunch of days, and i could very well possibly miss one more day because i stupidly misplaced my things. i'm at my wits end right now and i'm already scared of getting in trouble or getting yelled at, not quite sure what to do at this point. is it possible for me to be excused for the rest of jury duty with a note from a doctor about my anxiety? or do i just have to suffer the consequences and end up in federal prison?! 😭😭😭😭😭😭

I posted this in /tirzepatidecompound too, but just wanted to share here, too!
I was incredibly nervous - not so much for the side effects, as like, going into anaphylactic shock or having an adverse reaction (not a founded fear - just my brain running down the rabbit hole). My provider came to my house and showed me how to do everything, did it with me, and chuckled kindheartedly when I told her my fears. She herself lost 50 lbs with compound and has maintained that loss for a year, and assured me that I will most likely have minimal side effects if any, and if for some reason I do have a reaction: "take a Benedryl, call me, we will monitor together, and most importantly, don't panic!" Side note - I am doing this for weight loss, but I have had the suspicion for a few years that I have PCOS and/or IR.
I've been to three doctors, all of whom l've liked a lot and have done their best to be helpful but ultimately have had no answers. I showed my provider my most recent lab work, from December, when she came over tonight. She took one look and said, you have BOTH PCOS AND IR and I started crying because I felt so validated. She was like, I'm glad I looked at these labs, because you know your body and just because a doctor tells you there's nothing wrong doesn't mean that's the truth. I hugged her, for sure.
Anyway - it's been about an hour, I'm still pretty anxious, but l've had some water and been keeping busy. I have OCD and anxiety, and I'm worried this drug will exacerbate both. If anyone has experience with that...let me know?

I was incredibly nervous - not so much for the side effects, as like, going into anaphylactic shock or having an adverse reaction (not a founded fear - just my brain running down the rabbit hole). My provider came to my house and showed me how to do everything, did it with me, and chuckled kindheartedly when I told her my fears. She herself lost 50 lbs with compound and has maintained that loss for a year, and assured me that I will most likely have minimal side effects if any, and if for some reason I do have a reaction: “take a Benedryl, call me, we will monitor together, and most importantly, don’t panic!”
Side note - I am doing this for weight loss, but I have had the suspicion for a few years that I have PCOS and/or IR. I’ve been to three doctors, all of whom I’ve liked a lot and have done their best to be helpful but ultimately have had no answers. I showed my provider my most recent lab work, from December, when she came over tonight. She took one look and said, you have BOTH PCOS AND IR and I started crying because I felt so validated. She was like, I’m glad I looked at these labs, because you know your body and just because a doctor tells you there’s nothing wrong doesn’t mean that’s the truth. I hugged her, for sure.
Anyway - it’s been about an hour, I’m still pretty anxious, but I’ve had some water and been keeping busy. I have OCD and anxiety, and I’m worried this drug will exacerbate both. If anyone has experience with that…let me know?

To start this off with a little backstory. Around the time our newborn hit 3 weeks old we moved her to formula because she wouldnt latch, i wasnt producing enough, she wasnt gaining weight, and it was taking a tole on my mental health. We started her on the liquid form of Similac 360 total care and after about a week we found it was more price efficient to get the powder kind. Well when we did she began spitting up a lot. While being fed and even an hour after being fed she would be laying down and spit up formula. We brought it up to her pediatrician and they first suggested keeping her upright for 20 minutes and said she was starting to gain weight which was great.
A thing to note is our girl is really good at refusing a bottle. she has been bottle fed since we left the hospital and if she isnt hungry she will not open her mouth for the bottle nor drink from it.
Her spitting up continued even after keeping her upright for 20 minutes. We continued to bring it up weekly (she was going weekly for her weight) and at one point they put her on Famotidine. Its hard to say if it worked or not but eventually it stopped working and we were right back to the same issue. So then the pediatrician put her on Similac Alimentum and she got excessively fussy and had dark green diarrhea. The only thing that would get her to calm down was being put in her swing with white noise and her paci. Even then sometimes she wouldnt calm down. It lasted maybe 4 days. So then we moved her to Enfamil Gentlease because we had a can that was given to me when i was pregnant. Within 4 hours of starting that every single bit of fussiness was gone. However, we were back to the spitting up issue and diarrhea. It just so happened that when i took her in for an appointment she had a dirty diaper and the pediatrician decided to test it for blood. They also told us to put her on enfamil nutramigen and they upped her dosage of famotidine. We were told wed be given a call if there was blood. So a week goes by and we dont hear anything. On Saturday she vomitted 3 times during a feeding and we decided to move her back to the gentlease because we hadnt heard back and it didnt seem healthy for a baby to vomit 3 times in one feeding. I call that monday about her still spitting up and she vomitted on the nutramigen and the doctor finally calls back to tell me that there was blood in her stool and to put her back on the nutramigen. Keep in mind the doctor knows at this point that she vomitted on it. They also switched her medicine to Nexium. So we put her on that again and that night her stool had went from runny dark green to clay like and greenish white. We went to the ER because that worried us plus she vomitted again. They told us to call her pediatrician the next day and get a recommendation for a gastroenterologist. We get a recommendation and i go ahead and call them instead of waiting for them to call me. The earliest appointment anywhere was june 3rd which at the time was 3 weeks out. Well the lady at the front desk went above and beyond and mentioned to the doctor about the blood and they decided they could fit her in the next day. So we go and were expecting maybe some blood tests to see what caused the blood. Nope. They asked us a few questions looked at her body and said she needed to gain more weight (at this point she has been steadily gaining weight at every single appointment) So they sent in the nutritionist told us to make the formula a different way and said we could give her the medicine twice a day instead of once. We were also told for the hundredth time that it can take up to 3 weeks for a babies body to adjust to new formula and clear out the old. After every single formula change her stools have changed within 48 hours and been consistent after that. We decided we would stick with it for those 3 weeks and if nothing changed then we were going to get answers. well her stools moved to diarrhea again, her diapers became to where they barely had any pee in them (she would fill diapers before), and she started eating less. So we went back to how the formula was before and now she is spitting up clear liquids, she vomited 2 times during a feeding, has diarrhea, and spit up a few times.
We are at our wits end with this merry go round that feels like no one is listening. i understand that there are steps to this but everything in me is telling me she has something wrong with her. whether it be an allergy we dont know about or something else. Has anyone experienced anything like this or any advice from your experience with it?

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

To start this off with a little backstory. Around the time our newborn hit 3 weeks old we moved her to formula because she wouldnt latch, i wasnt producing enough, she wasnt gaining weight, and it was taking a tole on my mental health. We started her on the liquid form of Similac 360 total care and after about a week we found it was more price efficient to get the powder kind. Well when we did she began spitting up a lot. While being fed and even an hour after being fed she would be laying down and spit up formula. We brought it up to her pediatrician and they first suggested keeping her upright for 20 minutes and said she was starting to gain weight which was great.
A thing to note is our girl is really good at refusing a bottle. she has been bottle fed since we left the hospital and if she isnt hungry she will not open her mouth for the bottle nor drink from it.
Her spitting up continued even after keeping her upright for 20 minutes. We continued to bring it up weekly (she was going weekly for her weight) and at one point they put her on Famotidine. Its hard to say if it worked or not but eventually it stopped working and we were right back to the same issue. So then the pediatrician put her on Similac Alimentum and she got excessively fussy and had dark green diarrhea. The only thing that would get her to calm down was being put in her swing with white noise and her paci. Even then sometimes she wouldnt calm down. It lasted maybe 4 days. So then we moved her to Enfamil Gentlease because we had a can that was given to me when i was pregnant. Within 4 hours of starting that every single bit of fussiness was gone. However, we were back to the spitting up issue and diarrhea. It just so happened that when i took her in for an appointment she had a dirty diaper and the pediatrician decided to test it for blood. They also told us to put her on enfamil nutramigen and they upped her dosage of famotidine. We were told wed be given a call if there was blood. So a week goes by and we dont hear anything. On Saturday she vomitted 3 times during a feeding and we decided to move her back to the gentlease because we hadnt heard back and it didnt seem healthy for a baby to vomit 3 times in one feeding. I call that monday about her still spitting up and she vomitted on the nutramigen and the doctor finally calls back to tell me that there was blood in her stool and to put her back on the nutramigen. Keep in mind the doctor knows at this point that she vomitted on it. They also switched her medicine to Nexium. So we put her on that again and that night her stool had went from runny dark green to clay like and greenish white. We went to the ER because that worried us plus she vomitted again. They told us to call her pediatrician the next day and get a recommendation for a gastroenterologist. We get a recommendation and i go ahead and call them instead of waiting for them to call me. The earliest appointment anywhere was june 3rd which at the time was 3 weeks out. Well the lady at the front desk went above and beyond and mentioned to the doctor about the blood and they decided they could fit her in the next day. So we go and were expecting maybe some blood tests to see what caused the blood. Nope. They asked us a few questions looked at her body and said she needed to gain more weight (at this point she has been steadily gaining weight at every single appointment) So they sent in the nutritionist told us to make the formula a different way and said we could give her the medicine twice a day instead of once. We were also told for the hundredth time that it can take up to 3 weeks for a babies body to adjust to new formula and clear out the old. After every single formula change her stools have changed within 48 hours and been consistent after that. We decided we would stick with it for those 3 weeks and if nothing changed then we were going to get answers. well her stools moved to diarrhea again, her diapers became to where they barely had any pee in them (she would fill diapers before), and she started eating less. So we went back to how the formula was before and now she is spitting up clear liquids, she vomited 2 times during a feeding, has diarrhea, and spit up a few times.
We are at our wits end with this merry go round that feels like no one is listening. i understand that there are steps to this but everything in me is telling me she has something wrong with her. whether it be an allergy we dont know about or something else. Has anyone experienced anything like this or any advice from your experience with it?

I'm a newly 3rd year med student who just completed my medicine rotation and soon to be starting a new rotation. So I've never been the best at time management and my attention span has been holding on for dear life. If not for anki and videos, I would have been able to get through preclinical.
I'm sure I domt have ADHD even though I have similar symptoms because I never really had issues focusing as a kid.
I've kind of just lost passion for medicine as a whole and I'm just trying to graduate and match at least. I'm not even sure what I want to ask. I'm just struggling to juggle a lot of things. I'm barely studying except uworld when I feel a bit good. But I can't read these Aquifer cases, clinical cases we're required to do.
Half the time I'm just studying mindlessly, adding notes to anki as that's the only way I can even take any notes. It's mostly when I compare myself to other enthusiastic classmates, and just people who understand concepts differently, are more eager to learn about cases. Whereby, I'm just skipping through and passing by these cases. Showing up to the clinic because I just don't want to be seen as irresponsible but not even caring enough to study anything I learn or be eager.
Or maybe I just don't want to be a doctor but there's nothing else I could even do because I would be affected either way.
I know I'm depressed and I've been seeing a therapist once a while and maybe it works sometimes but I can't help when the wave of negativity just hits. Everything I've been doing for the longest is just so surface level. The impending doom of knowing I will be exposed when I'm asked questions but I can't even think deeper because I'm just trying to keep my mind in place aside all the other things I have to try hard to focus on.
Anyway, always come here to find someone going through the same thing or has gone through the same thing so I don't feel as bad I guess :).

Welcome back once more, for our final discussion of Armadale. I apologize again for the discussion being late. Last week, my excuse was that I had to spend time with my sister's family, including a labradoodle. This week, I am dog-sitting my mother's beagle, who has separation anxiety and gas. I am horribly sleep-deprived because this dog insists on sleeping next to my bed every night, snoring loudly and farting. Speaking of people breathing in poison in their sleep, let's get to the recap:
Allan has just set off for the Adriatic, with his cash converted to gold, obviously the result of Manuel's suggestions. Lydia and Ozias have been transferred to Turin by Ozias's employer, and Lydia pretends to have gotten a letter from her mother, asking her to come home, so she has an excuse to go back to London. Once there, she checks the newspaper for any articles or obituaries indicating that Allan has died. She also finds Mother Oldershaw's new address, but decides not to visit her.
After a few days, she finally gets the news she's been hoping for. Allan's yacht sunk off the southern coast of Italy, and everyone on board perished. Her next step is to write to Bashwood:
My dearest Bashwood,
I desire you... I mean, I desire to *meet with you... to apologize for my previous behavior towards you. I have foolishly made the mistake of marrying an immature child. If only I had married a real man (realness not necessarily extending to his teeth and hair)!*
Please, do not show this letter to anyone. Let us meet clandestinely.
Sincerely,
Lydia Armadale (note the last name)
Lydia then considers the marriage certificate, and realizes a glaring flaw in her plan: Ozias's handwriting looks nothing like Allan's. In a panic, she decides that her only option is to get advice from Mother Oldershaw. Unfortunately, Mother Oldershaw appears to have found God, and no longer wants anything to do with Lydia's plans. (Of course, she refuses to give Lydia the signed paper that she was going to use to extort money from Lydia if her plans succeeded.)
While leaving Oldershaw's, Lydia runs into Dr. Downward... excuse me, Dr. Le Doux, totally legitimate sanitarium owner. She realizes that he may be able to advise her, and asks to meet him later at the sanitarium. The sanitarium is basically what you'd expect a 19th-century sanitarium to be: creepy old house with shelves containing jars of preserved "creatures," a "galvanic apparatus" for providing electric shocks, etc. No patients yet, though.
Lydia tells the doctor her story, leaving out the worst details (he doesn't know that she's the reason the yacht sunk, or that her husband goes by the fake name "Ozias Midwinter"). Downward agrees to assist her by claiming to be a witness to the marriage... for a fee of six hundred pounds. Lydia agrees, and he assists her in sending a letter to Thorpe Ambrose, claiming to be Allan's widow.
The next day, Lydia gets a visit from Bashwood, who delivers the news that Neelie is beside herself with grief, and Mr. Darch is handling the matter of the inheritance, which was going to go to Allan's cousin, before Lydia announced her claim.
Bashwood returns a few days later with a shocking letter from Yugoslavia: Allan is alive! This is where I'd normally try to write a funny version of the letter, but nothing I could possibly write would be funnier than the actual letter's opening line: "I have been the victim of a rascally attempt at robbery and murder." Yes, "rascally." Oh, Allan, never change. One of the would-be murderers took pity on Allan and didn't securely board up his cabin, so he was able to escape instead of sinking with the yacht.
Lydia turns to Downward for help.
Downward: What if we trap Allan in the sanitarium?
Lydia: And murder him?
Downward: WTF, no. We get him to agree to not press legal charges against us.
Lydia: And then we murder him?
Downward: I have so many regrets about teaming up with you
Lydia: How do we catch him?
Downward: You could get Bashwood to lurk around the train station and intercept him before anyone else sees him. Have him tell Allan that Miss Milroy was sent here because she was driven insane by her grief for him.
Lydia: Can we murder Allan and Miss Milroy?
Downward: I am running an unlicensed sanitarium under a false name, and even I think you're unhinged.
Lydia: Gwilty as charged
Downward: But wait, what if he doesn't agree immediately, and we have to keep him here for months? What if I have actual patients at the time, and they report us?
Lydia: What if...
Downward: ...please don't say "murder"
Lydia: ...what if he had an accident?
Downward: Oh. Well, if it was an "accident," that would be okay. I don't know how an accident could happen, though, if you aren't an inmate here.
Lydia: I'll think about it
Meanwhile, Bashwood keeps vigil at the train station, until one day he sees... Ozias, who is searching for Lydia because she's stopped writing to him. While they talk to each other, Bashwood can't contain his shock at hearing that Lydia is Ozias's wife, and accidentally calls her "Mrs. Armadale," which understandably makes Ozias suspicious, so he follows Bashwood to see where he goes, which of course leads him straight to Lydia. Lydia pretends she was never married to Ozias, and Ozias faints from the shock.
Lydia heads straight to the sanitarium, tells Downward she's going to be an inmate, and asks for a sleeping draught. Downward prepares the draught, but first places yellow liquid in a purple flask. He then informs Lydia of what he thinks they should say at the inquest after Allan dies: The two of them knew he hadn't drowned, but when he arrived in England, they decided to trap him in the sanitarium because, shortly after his marriage to Lydia, Allan had starting having a delusion that he was engaged to Neelie. Once in the sanitarium, Downward diagnosed Allan with an incurable and fatal brain ailment, and that's what killed him.
Downward has scheduled a "Visitors' Day" so that people will witness Lydia as an inmate in the asylum. The visitors are mostly women, because life as a woman in Victorian England was so boring, they had nothing better to do than go to sanitariums to gawk at the mentally ill people and see where they will eventually live when the hysteria finally drives them mad. (I am only barely paraphrasing. The actual quote is "In the miserable monotony of the lives led by a large section of the middle classes of England, anything is welcome to the women which offers them any sort of harmless refuge from the established tyranny of the principle that all human happiness begins and ends at home.")
Downward shows them around the sanitarium and explains how it will be run, including only allowing novels that make people feel comfortable. (I assumed this was an intentional satire of Wilkie's critics, and the notes in the Oxford World's Classics edition confirmed this.)
But then Downward gave a sales pitch that damn near sold me on his sanitarium. "I throw up impregnable moral intrenchments between Worry and You. ... Will ten minutes’ irritation from a barking dog or a screeching child undo every atom of good done to a nervous sufferer by a month’s medical treatment? There isn’t a competent doctor in England who will venture to deny it!" Considering I almost couldn't post last week's discussion because of a few hours' exposure to two loud children and a labradoodle, I'm about ready to self-diagnose with hysteria and deranged lunacy.
He also explains that while the bedrooms lack fireplaces, they're heated with hot water. This impressed me because I've read about Victorian insane asylums not having fireplaces in the bedrooms (since the inmates might burn themselves), but I always assumed this meant that the inmates were cold in the winter. But wait... the bedroom also has secret controls that let him open, close, and lock the window and door from the outside, and a vent that lets him pump gas into the room. Whaaat? I rescind my diagnosis of hysteria and deranged lunacy. I want nothing to do with this.
After the tour is finished, Downward demonstrates to Lydia how to prepare the poison, and then breaks the bottle so that his assistant (who doesn't know about the purple flask) will think there's no more of that chemical in the house.
Meanwhile, Ozias is stalking Bashwood at the train station. He thinks Lydia is cheating on him, and Bashwood is waiting for Lydia's lover. But then he sees Bashwood with Allan. After confronting the two of them, he learns Bashwood's story about having to take Allan to Neelie in the sanitarium. Realizing that Lydia is probably still behind Bashwood's actions, Ozias insists on going with the two of them. On arriving at the sanitarium, Allan is informed that Neelie cannot see him until the morning, but he and Ozias are welcome to spend the night: Allan in Room Four, and Ozias in Room Three.
Lydia sets Bashwood up to spy on Allan's door from a room with a grate in its door. She tells him to make sure Allan stays in his room all night. Later, watching from the grate, Bashwood observes Ozias leave his room and examine the fumigating apparatus connected to Allan's room. Then Ozias stuffs his handkerchief in the grate, blocking Bashwood's view, before going into Allan's room and convincing Allan to switch rooms with him.
Later that night, Lydia returns and asks Bashwood if anything happened. Too afraid to tell her about the handkerchief, he tells her nothing happened, and she dismisses him to bed. After almost convincing herself to not go through with it, she then starts the process of pouring the poison at five minute intervals. While waiting for one of the intervals to pass, she notices Ozias's handkerchief and realizes that Bashwood lied to her. She checks in Room Three, and finds Allan asleep where Ozias should be.
In a panic, Lydia rushes into Room Four and drags the unconscious Ozias out. She then continues to pour the poison, writes a last letter to Ozias, and locks herself in the room.
We end with an epilogue that rapidly ties up all the random loose ends. Lydia has been buried in a nearly unmarked grave. The doctor is apparently still running his sanitarium. Allan and Neelie will be married in the spring. Mrs. Milroy doesn't have much longer to live, but she's undergone a personality change for some reason and she and the Major are happy for once. Ozias is recovering and living with Allan. Mother Oldershaw is a religious speaker, apparently. Bashwood has gone insane. Manuel drowned.
But wait, one last thing: Wilkie has something to say to us. He wants us to know that he intended the dream to be left up to interpretation. Thanks for handing me a discussion question like that, Wilkie. He also shares a weird-ass story about how, after he'd finished the rough draft and while the story was in the middle of serialization, several people were poisoned in their sleep on a boat called The Armadale. Okay, Wilkie. Thank you for that incredibly weird anecdote.

I was 8 weeks and a few days. I opted for the medical abortion
I went through Kaiser. I took the mifepristone at the doctorson Thursday. Friday I took 4 misoprostols into my cheek and swalloed after 30 minutes.After the misoprostol, I cramped terrible and passed HUGE clots for about 4-5 hours. At least 3 were about palm sized
My doctor said because I was over 8 weeks I should do a second round of the misoprostol. Because of how bad I cramped (I literally had contractions), and the large clots. i didnt take the 2nd round of the first pills.
It is 2 days later and the bleeding is a lot lighter but im cramping heavily. I wanted to know if I could still take the other 4 tablets to help. And how bad is the cramping during the 2nd round. I had 800 Ibuprofen, promethazine, and extra strength Tylenol and nothing helped the pain I went through.
This is my second abortion and it is about around the same gestational age. My first abortion was intense for the first few hours but I didnt have heavy cramping after just heavy bleeding. And I only did one

I’ve been seeing my doctor for about 2 or so years now for ADHD and an anxiety disorder. There is an issue/person/event that intermittently affects my mood, and I know i mentioned it when I first met my doctor and we were doing the intake, but I can’t remember if I’ve mentioned this since then. I don’t like to talk about it—especially in a clinical setting because I fear it could be seen as some kind of drug seeking behavior. i.e. my doctor notices I needed more Xanax than last month, and asks about it. I’m worried it will sound made up or she won’t believe me. Plus, this event is infrequent, and varies in intensity, and I only see her every 3 months or so…it just hasn’t come up/I haven’t connected the dots until now. However…I am seeing that when this event occurs, I do need more anti-anxiety medication to cope, and legally, I do want to document that this issue has caused distress and has interrupted my life. Is my doctor able to make a note stating that this issue has impacted my life and is not a NEW concern? That I’m just an idiot and was too embarrassed to tell her? —just said more professionally than that?

I am a mid 20s professor. I have been full time in academia for 2 years at a D3 SLAC, and I am not going back.
Becoming a professor was my dream. I had always wanted to have thoughtful, provoking discussions with students about intriguing topics. As one of my professors put it, academia is about “having smart conversations with smart people”. My experience has been anything but.
The students have been worse than I could have ever expected. They want A’s, but don’t come to class or do work. Then, they have the audacity to fight for a grade appeal— and admin grants it. No one takes notes during lecture. No one knows the material. It’s all just too much. I am washing my hands clean of this batch of students and not turning back. It has completely destroyed my image of academia and my faith in future generations of higher ed. For every ~50 students, maybe 1 tries or just even reads the material. It is so draining on my mental and physical health, even my doctor has advised I switch careers.
I’m heartbroken, but after everything that’s happened, I can’t say I’m surprised. Hoping some can offer messages of support.

Warning this is a very long read without a TLDR
I left this sub and joined the ryerson sub in 2021. Leaving behind my big drive of notes which is what I assume keeps driving these posts talking about grade inflation to my feed. My last few comments were very similar to everyone’s posts as of now - grade inflation, unfair admissions, feeling close to your goals and it being taken away. 3 years later here’s where I came from and what I’m doing now, why it’s not your fault and to offer a bit of hope if it helps. :)
In grade 12 (end of 2021) I had an 89 average, I was rejected from the majority of life sci and health sci programs (if a school had both I applied to both of them) - mac, u of t, queens, western. I got into York psych, health, TMU bio, undeclared arts and psych (waitlist), Laurier health sci and ottawa health sci. (some of my programs might be off if it’s wrong, the overarching field is what I mean). My goal was U of T life sci and to go to medical school. Laurier and Ottawa were off the table after my family and I came to the conclusion that we don’t have the money for me to move away, removing my last two life/sci options. I honestly wasn’t a big fan of York leaving TMU as my last option. I really wanted a life science or health science program because the curriculum after first year was not simply bio, chem, physics so I veered from biology at TMU.
So I ultimately ended up accepting undeclared arts as I was waitlisted for psychology. At the end of June, I got off the waitlist for psychology and accepted that. At the time, I was seriously unhappy with myself I was angry at the fact that people were getting opportunities that I wanted that didn’t deserve them due to inflation and lack of standardization of monitoring of tests during online schooling and just overall how poorly my high school experience ended. I’m talking full breakdowns about how I worked so hard and got nothing in return. I had teachers who genuinely believed that I was one of the best students that they had in years and told me that I would go far. I had a teacher go as far as writing a letter for no reason other than to just say how proud they were of me and how they knew that I would do great - which at the time I truly didn’t believe after not achieving any of the goals that I had set for myself at the beginning of grade 12.
My first year of psychology was online for my first semester where I did decently well I got a 3.0 my second semester, ended up being entirely in person because the online sections of classes were full. At the time I wanted to do medicine this dream quickly got away from me when second semester in person classes left me with a 2.67 gpa for the semester. I had a realization looking upon my peers who were still completely online at TMU or at other universities had much much better GPA than me and I wouldn’t be able to get into medicine with my GPA. So again I felt let down by systems that ultimately led to further inequality in education. I let go of the idea of medicine and had no idea what I wanted to do after my undergrad.
After my first year, I decided to join the course union at my school, which was one of the best decisions I ever made. I met amazing people who encouraged me to do better, peers who were higher years than me and gave me advice when needed and from there, my grades got better. after joining the course union I joined the liberal arts union and from there I worked on about five more different positions over the next two years. TMU is generally not seen as the best school and it’s not necessarily “competitive” but that can work in your favour because there’s so many positions available whereas at other schools where people may be more inclined to take these these positions making them more competitive. Joining these course unions gave me so many opportunities and so many things that are now on my CV that continue to provide more opportunities, for example I was offered a job at the school based on all my experience. My CV is now what I would consider amazing with all the work that I’ve gained that is applicable to the field that I want to work in and because of my experience on my CV I got a research assistant position where I have a great academic relationship with a prof. And I got my gpa up enough it’s not near a 4.00 or anything crazy but it’s good enough for me to get into grad school.
I always knew that I didn’t want to stay in psychology after I graduated so I completed my degree in three years rather than four. I also want to mention you do not need to complete your degree in three years. There’s no need for it. Had I stayed for an extra year I would’ve had so many more opportunities with extracurriculars. It’s just I did not love the psychology curriculum enough to want to stay in it for another year. I had taken summer school courses before coming to this conclusion, and I had so many credits that I didn’t want to switch programs so I fast tracked. All that being said, do not rush your degree unless for example, you don’t like it and have plans to do something unrelated afterwards - for me it was a masters in a different field that the only requirement was a bachelor’s degree so I didn’t see the point in switching. Having gained all of the research experience and extracurricular experience in the field that I want to pursue is what made my degree nonetheless beneficial even though I wasn’t doing what I had originally planned.
As of now, I will be beginning my masters at U of T in the fall (not in psychology). I feel very accomplished and fulfilled with everything I’ve done and I feel like the person that all those teachers said that I was back in high school. While I didn’t go to U of T for life sciences, and become a doctor like I had thought I would I am going to U of T nonetheless for a field I didn’t even know existed. I found and great community and something I genuinely love by continually working hard after feeling like I was ripped off by grade inflation and online school. All of which is so minuscule to everything I’ve gone on to do.
Moral of my story is you might feel ripped off right now, that your hard work went unnoticed and you might feel like you’re never going to accomplish your goals. But the truth is, it's very minuscule to the potential that you have. And as long as you continue to use your work ethic and potential wherever you go, you will be successful. You don't need big fancy school. You can do just as well if not better at schools that are seen as less prestigious or competitive as long as you continue to put in the hard work that you did in high school. So please don't feel like you have lost something but feel that you have gained the potential to do more. If you’re truly uncertain about accepting a program, take the time off think about alternate fields and try applying again, it might be better than toughing it out in a program you don’t really care about. If you’re dead set on going to university this fall, don’t wanna take time off and want to apply again and didn’t get into the one you planned, join extracurriculars meet new people and keep putting in work and it will pay off.
And I’m not saying you’re wrong in anyway for complaining and feeling the way that you feel because I felt the same way. You’re all valid asf. All I’m saying is don’t beat yourself up and don’t feel like you’re the problem because there’s so many opportunities for you so long as you seek them out and take them and you will end up in a much better position in the end.

Check with your doctor immediately if any of the following side effects occur:
Rare Coughing difficulty in swallowing hives or itching of skin swelling of face, lips, or eyelids wheezing or difficulty in breathing Check with your doctor as soon as possible if any of the following side effects occur:
Less common Skin rash Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
More common Diarrhea headache Less common Abdominal pain irritability muscle pain nausea trouble in sleeping Note: If the above side effects occur in patients with mastocytosis, they are usually only temporary and could be symptoms of the disease.
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Obligatory English is not my first language and writing this on Mobile notice. Warning reproductive system is involved in not so flattering ways. Don't read if rancid things make you feel nausea. Also don't read if you get mad easily, unless you're into that then you do you bubu.
Medical terms and definitions some people might not know:
Ovarian cyst- when an ovum decides it doesn't want to go down the fallopian tube and be a total jerk by hanging out in your ovary and suck up nutrients to grow indefinitely or until it pops creating the same pain as if a cyst popped inside testicles.
PCOS- condition that makes you have said ovarian cysts but for some reasons multiplied times too many. One ovary can easily have 8 cysts so imagine when both ovaries have it.
Dermoid Cyst- same as ovarian cyst but the composition is actually made of hair, teeth, bones, skin, etc. it's really gross to look at.
Struma Ovarii- an extremely rare type of dermoid cyst who's composition is mainly thyroid tissue. It makes up only .5% of dermoid cysts.
Ovarian torsion- when your ovary twists on itself or with the fallopian tube, often times cutting off blood supply if not caught on time.
Sepsis- when a part of your body starts to decay and releases chemicals into your body causing life threatening shock that need immediate medical treatment. Most can recover from it but takes a long time to recover, sometimes years.
Cystectomy- surgery that removes cyst(s)
Ooftarectomy- surgery that removes ovary
Bilateral- both sides
Hey everyone from the Two Hot Takes team, hope you're all doing well and have your seatbelts buckled in as this is one heck of a medical story doozy.
Back story: I had always suffered PCOS. The irregular yet heavy periods, the extra hair, and the multiple cysts. The problem was that I was a teen and apparently PCOS is not a big deal if it's on a teenager. It's also not a big deal if it's on a young adult that doubles over in pain from periods and wears overnight pads that need to be changed every 4 hours because thats not heavy enough to be of concern. Sometimes even doubling over on times when there is no period because those are just the cysts popping. I always did my pap smears and always went to the gyno, fully trusting them that what I had was not note worthy. So whenever I moved and got a new gyno, while it was mentioned nothing was done about it and I had assumed that was the norm.
It all started in October of 2023 when I felt a sharp pain in my right lower hip while I was at work. At that time I worked for a hospital as a host and only been working for a few months so thank goodness that I had access to the ER. Unfortunately for me my work place is a small hospital so there aren't any gyno nor obs. So the ER doctor just ordered an ultrasound and a trans-vaginal ultrasound (where they stick a dildo shaped ultrasound tool inside of you), and a CT scan without contrast due to iodine allergy. They initially said that due to the pain level I must be having appendicitis. However they instead found a 9cm (for reference a grapefruit is 10cm) cyst on the left ovary and a 4cm (walnut sized) cyst on the right. They said that while they are big and need to be removed, that a specialist needs to write the recommendation to do the surgery and that since our hospital didn't have any that I'll have to get an appointment with a gyno outside of the hospital. He prescribed me 500mg of ibuprofen and told me that I'm discharged. This was the first bs hospital policy of many that I will encounter in this roller coaster.
After getting an appointment with a gyno, I had another incident at work with the same crippling pain. I had the same double vision, nausea and fainting as the first time but this time I had fainted near a patient I was tending to. I didn't get into trouble for that as it was a medical condition that was previously recorded and I had been fine prior on that day. Just my ovaries decided to be jerks on that poor patient to which I apologized heavily to later. Instead my boss wanted answers as to why I was starting to become absent so frequently. I told her about what they found in the ER and how long it takes to get a specialist to see and how my ovaries just want to remind me that going up and down three flights of stairs daily to get to my apartment is making them more irritated.
Appointment time comes and instead of taking the findings for what they are, the gyno then decides to order the same exact tests but within his facility because that's apparently some kind of bs hospital policy that they have to do before giving the ok for a surgery.
I wait for the tests and had more time called off from work. Day of the tests and the ultrasound lady says "you have at least 8 cysts on your right with the biggest one being 7cm (peach sized) and on your left you have a massive one that is 10cm big". I told her "oh so it grew? Is it cancer then?" She calmed me down saying that ovarian cysts do grow as you get more ovulation cycles and that it doesn't mean that it's cancer. However that I most likely have PCOS and that the giant cyst is probably hiding the other cysts if not just merging with the other cysts ony left side. I told her I knew about the PCOS and that her explanation made sense as the dates between the scans had several months in-between since the specialist couldn't see me the day of the incident. (nor even the week of apparently because that's how it goes over here in the USA when it comes to specialists.) She then was surprised and said "I didn't see any PCOS medications on your chart". I told her I had no idea that there was such a thing. She told me not to worry that my new gyno will prescribe me meds.
After the tests, my gyno finally schedules a pre-op appointment, day of surgery and post-op appointment.The surgery would be performed on a second hospital where I don't work in. I arrive at pre-op, doctor tells me the exact same thing that my ultrasound lady said but he mentioned that there's a slight possibility for an ooftarectomy but that we're definitely doing a bilateral cystectomy. He prescribed me Metformin which is for preventing new cysts from forming. I was so happy thinking that I might be able to live a life free from these cursed cysts after the sury. Oh how things were going to turn out.
Turns out the day of the surgery Match 1st was my "6th month anniversary" (it's not I've been working since August of 2023) of working in the hospital. That meant that a new insurance policy was placed and the old one was replaced. I showed up on the day of the surgery and they told me that they couldn't do it because the new insurance wouldn't cover it due to no prior authorization. I had thought that the new insurance wouldn't kick in until my 1 year anniversary or until it was time for enrollment. I cried. I cried right there on the lobby in front of everyone. In front of my family, my boyfriend and coworkers that had woken up at 5 am to be there for moral support on their day off. There's so many hoops just to get treated. My boyfriend said that if a grapefruit sized cyst was on a testicle they would had treated it as an emergency but because it's on an ovary that it isn't.
I had collected myself and immediately scheduled for a new gyno appointment. Unfortunately the appointment was again several months. It was for August 28th. Luckily my cysts decided that was too far off. So I had another incident at work once again. I was rushed to another hospital instead of being discharged thankfully. However that said hospital then sent me away to another hospital because they weren't a "women's hospital" and that women's hospital said that they couldn't do anything without my gynos permission. That the best that they can do is call my gyno and claim that my appointment with her should be expedited but that my situation isn't an emergency. We told them to do what they need to do. At this point not even morphine helped with the pain.
Thankfully my gyno reached out to me stating that she was available to see me that week instead. I was able to see her and she saw that the women's hospital did some tests and the cysts were now 11cm left and 8cm right respectively. She said however that she can't use the tests from the women's hospital, that she had to schedule for the same tests to be done in her facility. I started to cry, again. It was the same dumb policy. I understand that some time had passed but it was only a few days in-between and having these tests won't show anything new other than possibly new growth. She promised that the tests will be scheduled under expedited and that it will be on April 28th. This was on March 26. At least she increased the dosage of the ibuprofen to 800mg so it would take the edge off a bit more.
On March 30 my boyfriend wanted to cheer me up by taking me to see his brother Orlando FL since he was getting married soon. We were supposed to stay there for a few days for the preparations. I had a small ache at the time so thought I just needed to take my ibuprofen and be on my way. My boyfriend noticed I was in pain and asked if I was ok, the pain was small so I said yes. His mother said "maybe we should leave her in the apartment so she can rest" to which my boyfriend said "I don't like that idea, if she can't come I'm not going". I was relieved because I didn't want to be alone if an incident were to happen again. My parents were running out of days to take off to be there in the hospitals (4 different hospitals at this point). The car ride made me sleepy as car sounds remind me of ASMR. It was a long ride but when I woke up we were already in Orlando. The pain had significantly increased. I thought if only I could just take another ibuprofen when we get to my future brother in law's place that I would be good. I.WAS.NOT.
As soon as we arrived nausea took over and I puked from the pain. The abdominal motion made the pain so much worse that I just started to scream in pain. It was so much pain I couldn't think or speak. My boyfriend knew it was the cysts and told everyone that he's going to take me to the ER. There wasn't a second I wasn't screaming in pain with tears running down my face. The hospital he tooke to said that they weren't the women's hospital however they do have a sister hospital that they will take me to called Winnie Palmer's Women's Hospital (I will forever name drop this hospital for what they did to me).
They immediately gave me medications that took the pain away, I was able to have a conversation with the doctors of what has been going on and the long history. They debated amongst themselves on whether or not to do the surgery but they in the mean time did tests while they kept calling my gyno for permission to do the surgery. The specialists in the hospital said that I don't have just regular cysts, I had a dermoid cyst and that my blood tests shows elevated levels of cancer antibodies. So they decided to go against policy and keep me hospitalized until they get permission from my gyno to get the surgery. My gyno finally reached out to them on Monday April 1st and they had me for surgery at 1pm. They found an ovarian torsion on my right size which explains why my right size hurt more than my left at times. Unfortunately the ovary was necrosed same as the fallopian tube, they theorized reason why tests showed "healthy blood flow to the ovary". The first theory was that the ovarian turn kept being undone and turned again. Which if that was the case I would have been dead before any professional would have seen me on April 28th. The second theory was that the type of dermoid I had was a Struma Ovarii which basically acted like a second thyroid glad in my right ovary. So when they saw it on the tests they thought it was my ovary when in reality it was my second thyroid getting blood supply. On the second theory I would have still died because the necrosed ovary would have eventually expanded and exploded. Spreading putrid flesh into my body's cavity on top of bleeding profusely as that would undo the knot, quickly ending my life if medical attention wasn't given immediately. They removed the large cyst on my left ovary alongside another Struma Ovarii. Turns out I hit the lottery of thyroids. They suspect that the antibodies is due to genetics since my family history is riddled with cancer survivors.
I got discharged after the surgery and when it was my April 28th testing appointment it turned into my post-op appointment lol. My gyno saw my stitches and gave me clean bill of health. However the gyno from the other hospital called and wanted to see me. So we traveled all the way to Orlando again. She wanted to see for herself how I was doing and she was concerned that since it was two Struma Ovarii that my body might have been relying on those two thyroids in addition to my OG thyroid to function. So she's worried that I might be having lower levels now. So she ordered to do thyroid test and genetic tests to see if the cancer antibodies theory can be proven.
So now I'm waiting for when I move to NC since my old job could no longer tolerate the absences and my apartment rent got higher while also not having a grace period for me to gather money to break lease. My boyfriend decided that he would quit his CNA job so that he could pull out his 401(k) and help me break off the lease and move in to his apartment in NC while I recover from surgery. I'm so glad he refused to leave me alone and he wasn't afraid to speak for me to doctors to do the surgery while I was drugged up. He's currently applying for CNA positions so that he can get health insurance ASAP and add me to the policy as soon as we get married. In mean time we also wait for thyroid test and genetic tests. Will update after all the testing.

For context, I do not work at Walgreens. I spent so many years in retail that I follow subreddits for retail employees, and I think that’s why I get your posts in my feed. OK, onto the story…
My 77-year-old mother called me yesterday (Saturday) to tell me that she had fallen in her yard and that her ankle was painful and swollen. I picked her up from her house and took her to a doc in the box to get her ankle x-rayed. It turned out to be just a sprain, thank goodness! The doctor called in an anti-inflammatory to Mom’s pharmacy, which happens to be a Walgreens whose pharmacy closes at 6pm on Saturdays and is closed on Sundays.
We left the clinic at 5:25pm and strategized how we would get the Rx. I told her that I knew for a fact that Walgreens pharmacies tended to be understaffed and that there was a good chance that the Rx might not be ready before 6pm. We decided that we would call the 24-hour Walgreens a few miles further from this one if she didn’t get the text before 6.
Mom decided to call her normal Walgreens location from my car at about 5:40 just to see if they had even received her prescription yet. The girl who answered the phone (yes, she answered almost immediately!) confirmed that they had received it and that it would be ready for pickup if we could get there before 6. Mom told her no problem, we are just a block away.
When we pulled up into the drive-thru at 5:45, I told the tech my mom’s name and mentioned that my mom had just called her. She nodded and went and grabbed the bag. Not only was I amazed at how quickly they had filled Mom’s prescription, but I was also impressed at how pleasant the tech was throughout the transaction.
After she handed me the bag, I said “I just want you to know that you and the rest of your team are rock stars. We figured we’d have to go to the store on Main Street to pick up this prescription, but y’all had it ready in less than 15 minutes. My mom sprained her ankle today, and now she doesn’t have to worry about getting her medication. Please thank everyone on your team for us and enjoy the rest of your weekend!"
At first her smile was a normal retail-worker smile, but soon she was beaming at the unexpected praise. I absolutely loved driving away from there knowing that she was able to end her work week on a positive note.
After reading all the stories about how much abuse the pharmacy teams have to put up with, it’s hard to fathom how y’all are still able to provide a high level of service. But that is exactly what we received yesterday, and thanks to your stories I was compelled to make sure that team felt appreciated.

I’ve been teaching at the same high school for 17 years. I’ve taught government for about a dozen of those years. Normally at the end of the school year admin lets us know what we’re teaching next year. I’ve never been bothered by it. This last November I had a stroke and I was out for about 4 1/2 months, used up 69 of my sick days during the recovery time. I knew that this semester I had one world history class and two government classes, No problem. These last nine weeks, I have figured out that the work needed for two preps is too much for me. During the meeting I was informed that I would have two preps next year. I met with admin and asked if I could just teach one prep, government. Since I have all the assignments, quizzes, and tests already created. This would help me immensely as it would be low stress and I could focus on teaching and helping my students succeed. They told me to ask my fellow government teacher to take the world history class. Then proceeded to explain to me how it’s part of my job description. Blah, blah, blah. The other teacher said that they didn’t want to switch. Admin acts like it’s a huge inconvenience for them to switch classes. WTF! This assignment list was just created and I’m only asking for them to switch my name on one class and put the other teachers name on it. The other teacher has been there for 5 years and I’m the longest running teacher in my department. I’m trying to get a doctors note to get to this moving forward with me just teaching government next year. It’s funny while trying to reduce stress they add more. BFBS!🤬

So I’m a 21 years old woman, I’ve always thought of myself as “fat” I’ve been dieting on and off ever since I’ve learned what that word means, but I’ve only become medically obese in the last four years, so when the whole Covid thing happened, I gained a lot of weight because I got really depressed and I started binge eating. I’m a Covid high school graduate and that year that Covid happened was my first year at college, it was a lot of stress so I used to binge eat to deal with my emotions. I also have a family history of diabetes and as I said I’m very obese right now so I’m really scared that I might get it, like that’s actually one of the main reasons why I want to start on Ozempic. I would like to note that I went to a doctor and they said I was in my “pre-diabetes” phase so I’m allowed to take Ozempic for weight loss (that was back on march of last year, I did take it for a few months and I did lose some weight BUT due to shortage of Ozempic I had to stop so now I’m starting all over again.) My only concern is that I’ve been hearing a lot about the side effects of Ozempic, like I’ve heard about something called “Ozempic face” (and yes I do care about my health and not getting diabetes more than getting wrinkles but it’s a concern of mine and I want to address it.) Is “Ozempic face” even a thing? I’m not sure but I’m scared of that. I’m also scared that if stop using it (because I only want to lose a certain amount of pounds and then I’m planning to stop it.) So I’m really scared that if I stop I might get all the weight back.
Please share your experiences, it would be very appreciated x

Was in polaris on the flight last night that got diverted to HNL because 3 crew members were sick (i am guessing food poisoning since they took a couple of toilets offline with them), with 5-6hrs left to SFO (before the clock changed to 2hrs to HNL instead). At first it looked optimistic when we landed because they started restocking water bottles and such on the plane, ground crew came to clean the toilets, and a doctor wearing a hawaiian shirt + stethoscope (very on-brand for hawaii) came to check on the afflicted flight crew.
Then after 20-30mins they told us we wouldn't be continuing tonight and kicked us off the plane, though thought it was a bit strange since I saw what seemed like replacement crew with contractor lanyards saying goodbye to us when we got off. Official note in the email for cancellation said that it was due to the crew running out their clock of allowed flight time (so i guess there wasn't enough replacements ready?).
Airport was totally asleep since it was 1.30am when we got kicked off the plane, immigration & customs seemed like they had just been called up in the middle of the night to handle us, dragged bags all the way across to the other end of the airport to be given 2-day hotel vouchers (for HHV- surprising it wasn't a marriott given united's usual partnership) and taxi vouchers. However, since it was the middle of the night (~2.15am), there were no taxis available so they were coming 1-2 cars every 5-10min and slowly moving people across. Some smart people took ubers, i stayed behind at first to finish attempting to rebook using the chat function in the united app.
Wasn't lucky enough to get on the 7am flight out (saw a lot of my fellow biz class cabin was fast enough to rebook to it), but i still really needed to make a connection to Toronto 14hrs later from SF for a work trip so I got them to rebook me to one from Maui to SF (which would leave me with just enough time to drop off my bags at home in SF- tight but i figured i had about 10min of buffer in the plan 😅). Also booked myself a Hawaiian air flight from HNL-OGG to reposition for the OGG-SFO leg on UA. The OGG-SFO leg is in economy sadly.
After I finished like 45min later the taxi line was still super long so i gave in and took an uber out of pocket as well, but when I got to the hotel it turned out that long taxi line had just converted to a long (and unavoidable) check-in line at the hotel, since (again) it was the middle of the night and only 1-2 staff were working. A 3rd checkin person opened up a couple hours later, but it literally took 2.5hrs standing in that line to get through. 6am I finally got to my room, slept for 2hrs and then headed back out to the airport (finally using a united voucher this time).
I just landed in Maui, and im hoping everything else goes smoothly but I am curious if anyone knows if I'll be able to claim what i paid for this HA flight from United as compensation? It was only like $130 but would be nice if possible. Or if there is anything else I might be able to claim, either from UA or from my amex platinum travel insurance? Technically the app says its a cancellation (also have diversion screenshots if needed). Or if theres anything i can claim for the downgrade from Business to Economy- though im guessing not on the latter.
I did check the DOT website and their chart has united marked as giving hotels+meals+transport vouchers instead of cash compensation for cancels&delays, and technically they did that (although nearly unusable..) so I am guessing not eligible for much. I am guessing maybe can claim the HA flight from amex travel insurance but not super sure on that either.
Also in retrospect, I wish they had just decided to continue to SF, we weren't on the ground that long for the crew clocks to be off by much and im sure people would have not minded having a few bathrooms out of order vs the massive 1-2 day ordeal most are getting instead.

Hey, everyone! I recently completed my undergrad and plan to apply this cycle. Here are my stats; hope you guys can provide me with some feedback!
URM- Hispanic
Major: Biology
cGPA: 3.97 sGPA: 3.95
MCAT: 507 (126,126,127,128); I plan to retake if I do not matriculate this cycle. My financial circumstances hindered my MCAT studying, and I explained this on my AMCAS.
EC's

• Pharmacy Technician (~1,700 hours)
  
• COVID Tester ( ~2,000 hours)
  
• Medical Scribe ( ~1,000 hours)
  
• Medical Assistant ( ~3,800 hours)
  
• General Chemistry Tutor ( ~90 hours)
  
• Founder of On-Campus Martial Arts Club ( ~40 hours)
  

NOTE: Both my scribing and medical assistant experience took place in a bilingual (primarily Spanish-speaking) urgent care clinic for uninsured patients
Research

• 1 semester of Biophysics research with no publications/posters

Volunteer Hours: N/A
Shadowing

• 43 hours
  
• Specialties are ophthalmology, sports medicine, PM&R, pediatric surgery, and interventional radiology
  

Immediate Family in Medicine?

• No, first to enter medicine.

State: Tennessee
In-State Schools Applying to:

• Belmont Frist College of Medicine
  
• ETSU College of Medicine
  
• UTHSC College of Medicine
  

Out-of-State Schools Applying to:

• Albert Einstein
  
• Kaiser Permanente
  

-Chicago Rosalind Franklin

• Drexel
  
• UCLA
  
• UC Irvine
  
• Rush
  
• Pennsylvania State
  
• Virginia Commonwealth
  

NOTE: I am from California and have a family connection to the state.
I plan to apply to 8 more schools, but I am unsure which schools I would potentially matriculate to; feel free to list some school suggestions! Thanks and best of luck to everyone this cycle!