into atria

in June, a night
that clings
to my marrows
—wet, quiet

bone silence & soft
wanings—an ache
that splits the being:
part-heart
part-head

collapse inside
the atria of my own
chest: i vibrate
in the blood &
dreams of me,
oozing past layers
of ontologies

turn a page of
tender unweavings:
my heart, a garden
my heart, my own
Gethsemane

enfold all in the humidity
of thoughts & prayers;
heavy atmosphere—

go lightly,
therefore &
breathe water.


j. p. berame // no. 061117

My heart skip skips a beat

HEARTBEATS!!

The pause is to allow the atria to fully empty into the ventricle.

Heartbeat on an ECG trace

P Interval (Ventricular Diastole)

  • Atria and ventricles are relaxed
  • blood is flowing into the atria from the veins. 
  • Atrial pressure increases above that of the ventricle, AV valves open allowing blood to flow into the ventricle

P Wave (Atrial Systole) P-Q

Signal transduction from SA to AV nodes. 

  • SA node fires 
  • Atria contract causing atrial systole 
  • which forces all blood into the ventricles
  • emptying the atria.

Q Interval (End of Ventricular Diastole)

Depolarisation of interventricular (IV) septum 

  • AV valves remain open - all remaining blood squeezed into the ventricles. 
  • impulse from the SA node reaches the AV node 
  • which spreads the signal throughout the walls of the ventricles via bundles of His and Purkinje fibres
  • R peak is the end of ventricular diastole and the start of systole.

R Interval (Ventricular Systole)

Ventricular contraction

  • All blood is now within the ventricles
  • so pressure is higher than in the atria - AV valves close
  • ventricles start to contract although pressure is not yet high enough to open the SL (semilunar) valves

ST Segment (Ventricular Systole)

Ventricular contraction

  • Pressure increases until it equals Aortic pressure,
  • SL valves open
  • blood is ejected into the Aorta (and pulmonary artery) as ventricles contract
  • At this time the atria are in diastole and filling with blood returning from the veins.
  • plateau in ventricular arterial pressure

T Wave (Ventricular Diastole)

T= moment of Ventricular repolarisation immediately before ventricular relaxation

  • Ventricles relax
  • ventricular pressure is once again less than the aortic pressure 
  • so SL valves close
ECG: quick and dirty

I’ve had countless sessions and lectures on ECGs. I don’t know how many websites I have bookmarked, or how many times my eyes glazed over reading Dubin. I’m also terrible at cardiology. I was on my way to accepting my fate of being horrible at ECGs forever, until I had a life changing session on ECGs taught by a great ER doc. I want to post it here because it was probably the most useful thing I learned in med school, and it will stick with me for the rest of my career. 

WHEN LOOKING AT ECGs FOR THE FIRST TIME:

1. One ECG is never enough. Always get old ones for comparison. If none available, do another one. Because. One ECG is never enough. 

2. RATE. Look at the number on top of the printed ECG. It’s stupid not to use that number. Yes, you should know the rule, 300-150-100-75-60-50. People say you shouldn’t trust the machine because… well, it’s a machine, and it can make mistakes. This is true. I don’t like to look at their “diagnosis” until I have gone through it myself. But the rate is just a number. Plus you should be able to eyeball it and be able to tell if it’s tachy, brady, etc. If the machine is telling you it’s 200 and if it looks tachy, then it’s probably the right number. 
3. RHYTHM. Is there a p-wave for every QRS and a QRS for every p-wave? Is the p-wave upright in lead II and down in aVR? Good. Done. BOOM. It’s sinus rhythm. ***if you cannot clearly see the p-waves then you cannot call sinus. move on.
4. AXIS. Again, look at the number at the top of the page. If it’s between 0 and +90, then it’s normal axis. If the number isn’t provided, or if your preceptor doesn’t believe in the convenience of machines/technology, look at the QRS complex of lead I and lead II. 
  • up in lead I, up in lead II: normal axis
  • up in lead I, down in lead II: left axis deviation (most common causes are left anterior hemi block and left ventricular hypertrophy)
  • down in lead I, up in lead II: right axis deviation (most common causes are right ventricular hypertrophy…PE)
5. did someone say HYPERTROPHY?
  • look at V1
  • is the R wave tall? (greater than 7mm?) right ventricular hypertrophy.
  • is the S wave tall? (greater than 11mm?) left ventricular hypertrophy.
  6. P-waves
  • look at lead II
  • is it wide? left atrial enlargement.
  • is it tall? right atrial enlargement.
7. PR interval
  • should be between 0.12 sec and 0.2 sec (3-5 small boxes). I used to always get this interval and QRS complex (less than 0.12 sec) mixed up. Think: atria depolarizing + shit getting to ventricles is gonna take longer than ventricles depolarizing. [2 things happening] versus [1 thing happening]. [0.12 sec-0.2 sec] versus [<0.12 sec].
  • long PR interval means there’s some sort of block at the AV node. 
  • 1st deg block. PR interval is long. everything else is normal. cool. 
  • 2nd deg block
  • type I: PR interval progressively gets long. eventually a dropped QRS.
  • type II: PR interval is constant, but randomly dropped QRS. 
3rd deg block “complete block”
  • there is no association between P waves and QRS. they run separately. **QRS does NOT have to be wide. Just look for P wave/QRS complex disassociation. I sometimes get this and 2nd deg type II mixed up. The only difference I try to remember is that PR interval is constant in 2nd deg type II, but is variable in 3rd deg. 
8. QRS complex
  • narrow or wide? 
  • narrow: good. signal coming from somewhere above ventricles. 
  • wide: think BBB (bundle branch block)
  • LOOK AT V1 ONLY.
  • if the last deflection of QRS is DOWN, then it’s a left BBB
  • if the last deflection of QRS is UP, then it’s a right BBB. super easy. no more of this bunny ears crap. 
9. ST segment
  • always look from J point, and compare with the isoelectric line of T-P segment (NOT PR interval). 
  • elevated/depressed… STEMI… duh. indicates ACUTE ischemic changes. 
  • look for reciprocal changes of the heart. if ST elevation in lateral leads, could see ST depression in the septal leads. PAILS:
  • posterior up, anterior down
  • anterior up, inferior down
  • inferior up, lateral down
  • lateral up, septal down.  
LBBB can look like STEMI. How to tell?
  • disconcordant changes is normal. (QRS and STEMI on opposite sides of the isoelectric line.)
  • concordant changes is abnormal. 
  • massive discordance is abnormal. (STEMI is greater than 5mm)
  • this isn’t that important. Moving on. 
Inferior STEMI. Could right ventricle be involved? 
  • DO NOT GIVE NITRO DO NOT GIVE NITRO DO NOT GIVE NITRO.
  • order a 15 lead
  • is STE in lead III > lead II? likely RV involvement
  • INFERIOR MI? 15 LEAD NO NITRO
  • INFERIOR MI? 15 LEAD NO NITRO
  • INFERIOR MI? 15 LEAD NO NITRO
10. T waves
  • is it inverted? indicates recent ischemic changes. 
11. Q waves
  • is it significant? indicates old ischemic changes. will likely be present if followed rule number 1 of reading ECGs. (1 ECG is never enough= look at old ECGs). 
I literally go through this list of 11 points in my head when I’m reading an ECG, regardless of whether or not I have an atrial flutter jumping at my face or if I see a massive anterolateral STEMI. Obviously I needed background knowledge on ECGs and the physiology of the heart before constructing this list, but this basic checklist has been very, very useful to me so far. It might look lengthy, but it doesn’t take a lot of time at all- a patient is not likely going to have all these issues with their heart.    Anyway. I still don’t love ECGs, but it feels pretty wonderful to be able to be able to evaluate it in a systematic manner, and get the theory behind interpreting the scribbles of an ECG reading. I don’t get these moments as much as I would like to, but it’s that crosspoint where my classroom learning actually meets real-life applications that gives me happy brain-gasms for days. I love knowing things and more importantly, knowing why.

Sea cucumbers can eviscerate themselves as a defense mechanism.

When using a microscope to study particularly small organisms, placing a drop of immersion oil on top of the slide cover will focus the light from the microscope and further magnify the specimen.

Rosalind Franklin died of ovarian cancer six years after using x-ray diffraction to identify the physical structure of DNA. Other people were awarded a Nobel Prize for her discovery; there is a very strict rule that a Nobel Prize cannot be given to someone who is dead. It isn’t like the Oscars. Her cancer was probably caused in part by excessive exposure to radiation.

A sound occuring below the frequency of twenty Hertz–the lowest sound usually detectable by the human ear–is referred to as infransound. Infrasonic noises may cause pain in the eardrum, and/or inexplicable feelings of dread.

When trying to identify which chamber of a human heart you are observing, it is helpful to know that the atria have smooth walls, whereas the ventricles’ are textured, and that the walls of the heart are much thicker on the left side than on the right.

Eels have not been observed spawning in nature.

The oldest confirmed wild bird is approximately sixty-six years old; her name is Wisdom and she has flown more than three million miles.

Human beings can also eviscerate themselves as a defense mechanism, but this is often called an Emotional Disturbance.

anonymous asked:

In the absence of normal cardioversion resources, would it be possible and/or useful to lower someone's heart rate by ducking their face in cold water (i.e. activating the dive reflex)?

Yes, but only for one specific circumstance (and maybe not exactly how you’re thinking).

May I introduce you to my favorite arrhythmia: Paroxysmal Supraventricular Tachycardia (PSVT). I like it because its not too deadly, can be utterly terrifying, and there’s a lot of cool ways to treat it. One of the more common first line treatments for PSVT is the use of a vagal maneuver, one of which involves dunking one’s head in ice water.

There’s a lot of background I have to go through to explain it though, so bear with me:

Heart Electrical Stuff:

The heart rate and rhythm are controlled by structures in the heart capable of sending electrical signals (pacemaker nodes). When those nodes send out an electrical signal, it travels through the heart muscle across specialized fibers. As the electrical signal passes them, cells that are sensitive to that signal contract in sequence. This results in a coordinated beat.

If this electrical signal is discharged inappropriately or interrupted, the result is an abnormal heart beat, rate, or rhythm. Some of these abnormal heart beats, rates, and rhythms, especially ones that start in the lower part of the heart (the ventricles) can be deadly.

PSVT Especially:

Fortunately, PSVT starts in the upper part of the heart (the atria), and is not deadly on its own. It occurs when one of the pacemaker nodes in the upper part of the heart (the SA or AV node) get “stuck” discharging signals too fast- sometimes as many as 250 times per minute.

Even though this likely won’t kill the person, it’s still a problem because when the heart beats too fast, it does not have time to completely fill with blood in between beats. This means not enough blood gets out to the body and brain, causing dizziness and shortness of breath (because enough oxygenated blood isn’t getting to the brain and body tissues, causing a slight lack of oxygen throughout the body). Some people can feel their heart beating abnormally fast, and some have chest pain with this too.  

Treating PSVT (what you’re actually here for):

One of the first ways to treat PSVT is the use of vagal maneuvers.

Vagal maneuvers are different actions that can stimulate the vagus nerve- a nerve that connects the heart and lungs to the brain. When triggered, the vagus nerve releases neurotransmitters that can slow the heart rate set by the SA and AV nodes. In the case of PSVT, this might be enough to “break” the ultra fast heart rate and reset to a normal one.

Some vagal maneuvers include:

  • Bearing down (as though trying to poop)
  • Coughing forcefully
  • Gagging
  • Carotid massage (massaging the area of the carotid artery just below the jaw- this should only be done by trained professionals, though, as a last resort before moving on to more invasive treatment)
  • Submerging the face/head in ice water

See, told you we’d actually get to this. The dive reflex (which I should really do a whole post about, cause its super cool, uh, literally) is a trait that allows aquatic mammals to conserve oxygen and stay under water longer by significantly decreasing their heart rate and shunting blood into their core. Hitting one of the nerves in the face (the trigeminal nerve) with freezing water mimics this reflex in humans, which in turn triggers the vagus nerve, which is what helps treat the PSVT. Here’s my favorite PSVT home video about vagal maneuvers.

Just for funsies, I’m going to keep going. If vagal maneuvers are ineffective, the next step up is to use a medication called adenosine. Adenosine is given IV, where it is pushed as fast as possible into the vein. When it hits the heart, it briefly stops it. The hope is that it starts back up in a normal rate. Think chemical defibrillation. Here’s another one of my favorite PSVT video about adenosine administration.

If adenosine doesn’t work, the next step up is cardioversion. This is like defibrillating someone, but with a lower dose of electricity. Here’s another one of my favorite PSVT videos about cardioversion. This usually works.

People can have episodes of PSVT frequently or just once or twice in their whole lives. If it becomes a problem, certain parts of the heart can be cauterized to prevent future attacks.

Personal note: I’ve had four runs of SVT in my life, the longest one lasting a little over an hour. All were eventually treated with vagal maneuvers and I never had to be hit with adenosine or cardioversion, but if I ever do, I’ll certainly share my experience with you all.

I’ve been having just the worst mental block ever lately. It’s strange, sometimes making art or models of other people’s work is much easier than of your own original characters, since there’s so much reference work to go off of rather than just what’s in your head.

So to that end, I’m going to kick off the new year with a slew of fanart! I’m going to be doing a few models of characters from some of my favorite artists, and hopefully that will help me burn through this art block and realize my own characters better.

First up is a model of Atria Vixx, one of the stars of @blogshirtboy‘s awesome comic series Hijacked!. I draw a lot of inspiration from BSB’s artsyle and colors, but it’s tricky trying to recreate it in 3D. I like to think if Hijacked was a Playstation game, Vixx’s model would turn out like this. 

For my next model, I won’t be “clowning” around, he he~

deepseasleepy  asked:

okay but like when jin first started to make puns in rm's presence rm stopped dead and immediately fell even harder for him because holy shit that was the cUT EST thing he's ever seen and heart eyes please make puns forever and keep talking to him and looking pretty and he low key cannot handle it, just barely keeping himself composed

nOOOOOOOOOO MY  hollow muscular organ that pumps the blood through the circulatory system by rhythmic contraction and dilation. In vertebrates there may be up to four chambers (as in humans), with two atria and two ventricles IS GOING TO BURST OH NO THIS IS SO DAMN CUTE 

anonymous asked:

Could you do RFA+V+saeran react to MC passing away? You can choose how or to leave it out. Up to you but I am curious to how they would react

Yoosung

  • You’d found out in December that you were pregnant and Yoosung was so excited
  • He wanted this baby so bad, and you were due any day now.
  • He didn’t know how to act, he just made sure that you never had to be on your feet and he’d massage your back and feet and feed you because that’s what Google had told him
  • When you’d gone into labor he didn’t think anything was out of the ordinary and nor did you because you didn’t know what was in the ordinary
  • You were puking and constantly looked ready to hurl again
  • Your legs and hands had swollen too, swollen to the point where they looked like they actually kind of hurt?
  • In the hospital room as you were giving birth Yoosung noticed that your face was extremely pale, did pregnant women always get so pale when going into labor?
  • You’d had the baby and they’d taken her out to get cleaned up and checked so Yoosung was brushing your hair back off your forehead.
  • He had kissed your forehead, allowing you to close your eyes and rest
  • “We had a baby Yoosung.” You were smiling but suddenly your face contorted
  • Doctors were running in the room, pushing Yoosung out as a rush of more doctors ran in
  • He could hear the doctors’ rushed words as they were trying to save you. But the loud, piercing sound of a heart monitor going flat hit him as if there was no other sound there to compete with it
  • Yoosung fell to his knees shaking as he sobbed
  • The ringing didn’t stop, no matter what the doctors did
  • He saw feet in front of him and then when a hand rested on his shoulder he choked back a sob
  • “Mr. Kim, I’m so sorry but-”
  • “Don’t say it. Please don’t say it.”
  • The doctor paused for a moment before taking a large breath
  • “Your partner had a condition called eclampsia. It can normally be treated but because their previous doctors hadn’t noticed it we couldn’t do anything to help them. It causes an onslaught of seizures in it’s worst form. The baby is okay though, she’s healthy and she’s beautiful. Would you like to see her?”
  • Yoosung had to see the baby of course but when he did he broke again. She looked just like you.
  • Yoosung became hollow without you. He only managed to stay alive because he had to take care of the baby, the one thing he had left of you
  • He missed so much work that he was visited by one of his assistants at home to see if he was okay
  • She’d found Yoosung sitting on the couch crying as he’d told the baby about you
  • He hadn’t been eating much so his body was all skin and bone
  • But he kept a happy face for everyone, for the baby as she grew up into a child
  • The aching and emptiness he felt when you’d first died had never left him, never dissipated and every night he let his arm rest where your body should be, and he cried
  • He sobbed because you promised him you’d be with him forever but you’d barely made if five years before you’d left him
  • The part that tore him up though was that he couldn’t remember what it felt like to hold you, how your voice sounded, how it felt to have you as his and him yours

Zen

  • It had been all his fault
  • He’d been practically unharmed. Other than a broken arm and a gash on his leg, Zen was fine. You though, he couldn’t say the same
  • He’d crawled over to your body sprawled on the road, your helmet had fallen off and was lying a fair distance away now
  • Your eyes were unblinking and looked up at the sky unfocused, your body already turning cold
  • Zen didn’t notice at first though, he’d thought you were looking at him, he heard you speaking to him as he’d laid his head on your chest to try and comfort the both of you
  • He didn’t feel your sticky, warm blood soaking into his clothes
  • Nor could he hear the screams of people as they saw your body
  • Only when paramedics were there pulling him off of you did everything start crashing down on him.
  • He still refused to believe you were dead though, he was confident that you would pull through in the end and come home. No matter what.
  • Of course they’d taken Zen to the hospital as well and stitched up the large cut through his leg and put a cast on his arm.
  • He kept asking about you, whenever anyone came into the room. You were his top priority
  • After two days the doctors finally told him your state, you’d only just been alive when they’d brought you to the hospital. You had no chance so they drugged you up until you could feel no pain and let you slowly pass away
  • They’d found you always seemed most serene when a friend of yours had played music from Zen’s musicals
  • Jaehee and Yoosung had been visiting him when they’d told Zen the news, as moral support, and to this day they say that when Zen was told you’d died his heart skipped four beats.
  • “MC isn’t dead.” He’d convinced himself of it, these doctors were joking right?
  • “They wouldn’t just die on me, they promised to never leave.”
  • He was hysterical
  • The doctors actually kept him in the hospital for mental problems after he was due to be released for his physical injuries
  • Even after being dispatched Zen believed you hadn’t died, he’d even started seeing hallucinations of you. He’d think he’d eaten with you earlier that day so he wouldn’t eat after that which ended up in him becoming too weak to work for a long time
  • Slowly he became unable to know the difference between reality and fantasy
  • He was put into a mental institution for three months before they deemed he’d be okay to stay home if he was routinely checked up on so the RFA all took shifts to be Zen’s nanny
  • It took two and a half years for him to mentally recover from your death, and when he did he buried himself in work and refused to date or marry or anything because he knew you were his soulmate and no one else would be able to compare

Jaehee

  • “JAEHEE!”
  • Your scream echoed in her head, followed her into her dreams, haunted her every time it became quiet
  • The two of you had been driving home from dinner one night and a drunk driver had crashed into your side of the car
  • You’d flung yourself over her in hopes to protect her and you had, but at the cost of your own life
  • With your body contorted at such a weird angle your bones snapped easier and damage to your organs was more extreme than it could’ve been if you’d just kept yourself straight.
  • Maybe you’d’ve lived if Jaehee had gone to protect you instead, but she’d been frozen with fear
  • You’d died on impact, there was no saving you, there was no hope
  • She couldn’t bring herself to even touch you, the feeling of your dead body laying over hers was enough to make her light headed, and start going in and out of a daze
  • She wanted to push you off of her but she couldn’t bring herself to
  • When the first responders showed up on the scene they’d taken you away and started to try and help Jaehee come out of her state of shock
  • Her body didn’t follow orders as she told it to move away from the paramedics, as she told herself o look away from your body
  • When she’d finally been taken home she bathed and threw away the clothes she’d been wearing
  • Even with new clothes on and half a bottle of soap scrubbed into her skin she could smell your blood clear as day
  • When she slept she dreamt of the accident over and over until it had stopped hurting her
  • She’d become somewhat mute, because when she spoke all she could think is what you’d say or do
  • And when she tried to think of your voice she’d only been greeted with your scream
  • Zen, Yoosung, and Seven had gone to visit her and when Zen rested his hand on her bare arm Jaehee jumped and pulled away
  • Just the simple touch of his skin on hers was enough to make her almost pass out and puke
  • It took her a long time to finally train herself to not jump away from the slightest touch but she couldn’t help but scrub the part of her body that had been touched when she bathed at night
  • When she prayed she spoke to you, she thought it’d make you happy to hear a familiar voice in Heaven, to know that she still loves you

Jumin

  • Everything seemed to be fine with you, your relationship was at an all time high
  • Nothing could ruin this
  • But then you collapsed clutching your heart and gasping out for breath as your heart failed
  • Jumin couldn’t do anything, he just screamed for help so the security guards came rushing in to see you on the floor with Jumin stood in shock
  • One of them had ended up calling the police who had come too late, you were dead and Jumin was being held back by two of the security guards as he tried to fight the paramedics as the lifted you up onto a stretcher and took you away
  • The doctors had gone to visit Jumin and tell him what had been wrong with you.
  • You’d had A-Fib which was irregular beatings of the heart, where your two atria beat out of sync with your ventricles. Your heart had then became useless as it couldn’t pump blood to your body
  • It was as though someone had taken out your heart and replaced it with a sack of worms, it moved randomly and uncoordinated, filling the space with the right size but ultimately useless
  • A lot of this went over Jumin’s head, but he knew what he needed to, your heart had given out on you.
  • It didn’t seem fair
  • Jumin had loved you with every ounce of his being and then some. He’d made sure you were happy, and when you weren’t he always kissed away your tears and you’d done the same for him
  • But as he cried those nights, hidden away from everyone you didn’t come to him
  • You didn’t hold him as you always had before. He had to wallow in his own sadness that he knew would only consume him as time went on
  • He’d blocked himself off from the rest of the world after your death
  • His performance at work crumbled, everything that he knew before seemed to escape him
  • Deals fell through, stocks plummeted, all because Jumin couldn’t find a center anymore
  • His father had actually had him stop working until his mental state came back to normal
  • He wore your wedding ring on a chain around his neck, kept hidden underneath his clothes and pressed tight against his chest so he would always remember you
  • Every week he visited your grave, he would crouch beside your grave stone and tell you everything that had happened over the course of those seven days and then he’d press a kiss to the corner of the stone and lay flowers in front of it
  • He never even considered marrying or dating or loving ever again
  • “You will forever hold my heart, MC.”

Seven

  • Seven knew that this would be a possibility ever since he’d fallen in love with you
  • But the years of being happy and together had let that possibility dwindle to almost nothing in his mind
  • And then he’d found you lying on the floor with a bullet wound going through your head and the window directly across from you
  • Seven’s entire life shattered right in front of him
  • He’d just gotten Saeran back and you were with him and he thought he was going to be happy for the first time in his life and now you were ripped away from him and there was no getting you back
  • He refused to believe that you were actually gone, he couldn’t, but when he would try to sleep and his night terrors struck him he wouldn’t wake to have you resting on his chest and mumbling words to him to soothe him
  • He’d wake alone in a cold sweat panting and praying that nothing had happened
  • Seven searched for months to figure out who had killed you so he could take his revenge but with the major lack of evidence there was he had to start with the people he knew wanted him dead and start from there
  • He found nothing
  • Seven had always had to keep his emotions pretty tight because emotions meant bad things were to come, as he’d just lived, in his profession 
  • This meant that Saeran witnessed his brother go on with life as if the love of his life hadn’t just died, and Saeran was furious
  • You don’t just get over someone like that. Is that what Seven had done when he’d left him?
  • But Seven hadn’t gotten over you, he was still too in love with you for his own good.
  • He refused to visit your grave or even speak your name but he made sure there were many things to remember you 
  • He’d created the deadliest virus known to man and named it after you so everyone who heard that name would fear it and that so when the person that had killed you received it they would know exactly why it had been made. 
  • Seven had also begun cooking because you weren’t there to do it and he didn’t trust Saeran with knives or fire. He named his spiciest dish after you.
  • Most days it appeared he got on fine without you but then there were some where he couldn’t move, he would just lay wherever he woke and sob silently. 
  • He wouldn’t eat those days, nor would he bathe, or drink water, or speak. He simply thought of you and prayed that God might give you back to him.
  • “I should’ve never let you love me, MC. I should’ve tried harder to push you away.”

V

  • You had been the love of his life, the light in the dark abyss Rika had thrown him into
  • You were his best friend, and now you were gone
  • It had all started when a date had gone long, mostly because you had insisted on following a dog around to pet because it appeared to be the fluffiest dog you had ever laid eyes on
  • At one point you had let go of his hand so he had to follow the sound of your voice, but then abruptly your voice stopped
  • It took V too long to realize that this wasn’t a game you were playing on him and that something had happened
  • Little did he know you’d been kidnapped
  • It took a little over four months to get you back, and when Seven and Jumin had retrieved you you were immediately hospitalized
  • You were doing fine, you’d actually been getting better
  • V had gone in one morning as he did everyday to hear doctors yelling back and forth to one another in your room, but above that, clear as a bell he heard he flat line tone of a heart monitor
  • You were dying
  • V sunk to the floor and sobbed as he heard the doctors call clear before shocking you with the defibrillators, but still the heart monitor stayed flt
  • It was as if everything else in the world had stopped as he heard a nurse say, “time of death, 10:47 AM, January 15th 2017.”As the doctors left your room and saw V they stayed silent, only offering condolences before leaving him
  • He’d walked into your room to see you laying with your eyes closed, mouth slightly open. It looked as though you’d fallen asleep and that’s probably why V had found it so easy to trick himself into believing you were alive and that you would simply wake later
  • It wasn’t until he watched as your casket was lowered into the ground that the situation truly hit him. The love of his life was gone forever
  • If Jumin hadn’t been holding V back he would’ve jumped into the Earth with you
  • Out of all the awful things V was doing to himself not eating was the worst, he’d become skin and bones practically
  • He didn’t mean to not eat, he just got so lost during the day, sometimes going into dazes for hours before coming back to reality
  • V had many a house plants though, and you had always had a favorite so he decided that he would name that plant after you.
    Because of this whenever the plant began to wilt or just look sad V would tell it stories, and if you were in them would speak as if he was actually telling you the story
  • He also read the plant your favorite books and told it everything that had happened on your favorite show
  • The entire RFA was worried about his attachment to the plant and didn’t want to know what would happen when it died but no one said anything because it was his way of coping and at least he’d begun eating now.

Saeran

  • To spite you and Seven both Saeran had fallen into the wrong crowd, drinking, doing drugs, anything to make you hate him and send him away
  • But that didn’t happen and instead he fell in love with you, and for whatever reason you had fallen for him
  • But he’d gotten himself addicted to his old lifestyle
  • One night you had gone to retrieve him before he got hurt because Saeran was always picking fights
  • He didn’t know who it was, he hadn’t been looking and everyone had guns, but when the two of you had turned away to head back to the car you’d gotten shot in the back
  • Immediately he turned on them and shot them all in the legs, they weren’t going to die but they were going to hurt like hell and have quite the walk once they could move
  • He lifted you and put you in the back of the car hoping that you’d keep crying, keep saying his name because that meant you were still alive, that meant the hospital had something to work with
  • He hadn’t even made it half way to the hospital when you’d gone silent, he couldn’t even hear your ragged breaths anymore.\
  • he pulled over and climbed into the back of the car pulling you onto his lap
  • “I’m so sorry MC. This is all my fault.”
  • You’d gone slow and painfully and he’d wished that he’d ended you sooner just so you didn’t have to live through that pain
  • But what was he supposed to do?
  • His heart ached
  • Contrary to what everyone thought would happen Saeran completely pulled away from that way of living. He refused it
  • He’d stopped doing drugs and drinking alcohol because whenever he did he could only think of you dying
  • He also felt extremely alone, yes he had the RFA and Saeyoung but you were the one person he had completely opened up to the one person he’d come to rely on
  • He could hear your voice in his head ever day, haunting him
  • Telling him that it should’ve been him to die, that he deserved it more than you had
  • But then he heard you saying that you loved him, telling him you were always there, that you’re happy he’s alive and trying to take care of himself
  • He spoke to you every night, he knew you’d be listening because you always did
  • But then he’d try to sleep.
  • You’d always held him, ran your fingers through his hair to help soothe him
  • But there was none of that anymore and it led to many restless nights
  • Saeran knew though that you were somewhere, watching over him, because that’s what Saeyoung had told him and that’s the one thing he wanted to believe to be true from his brother’s mouth
  • Because you’d promised you’d never leave

~Love, Peony

anonymous asked:

i read grootmuns fic and !!! whaaaaaaat? is rockets heart implant killing him???

The answers to your questions is both yes and no.

There is a twenty-fives percents chances that his hearts implants will breaks and makes his hearts stops, yes. Twenty-fives is ones fourths or ones quarters. It is less than seventy-fives percents or threes quarters, so that is why the answers is also no. Rocket says anything more than zero percents with life is too much. He thinks about it more when he is triggers and has intrusive thinks.

Here is a graphics of how a mammal’s hearts works.

The implants is not does damages to his hearts. His hearts might does damages to the implants attach to his hearts. It has very fines wires feeds into the sinus nodes in his hearts. It goes from there into the atrioventricular nodes and goes parts of the ways down the “bundles of His” as humies calls it. 

If those wires breaks it will destroys those nerves. It is likes frays an electrics cords so they arcs and fry anything nears. Rocket’s hearts will not gets the signals from his brains to beats. Nothing to the atria or ventricles. There will be no fibrillates to shocks with defibrillators. The electrics signals will stops. Asystole. Flatlines. No pulses. Dead.

Humies remains conscious for fives to eights seconds without a heartbeats. Rocket may lasts about the same. I doesn’t thinks he will knows what is happens. It will be so fasts he may not has times to realize he is about to gets dead. No suffers, no pains. The most he might feels is dizzy or lights-heads but that can happens for lots of reasons that are benign. 

Ones quarters is less than threes quarters. I worry a little bits sometimes, but I doesn’t lets myself lives in constant afraid because gets afraid steals today. I lives in today because yesterdays is behinds me and I can’t reach tomorrows so why wastes today worry about them? All we has is rights now, so I loves Rocket moments to moments rights now

Lots of griefs is regrets. I notices people says they wish they says this or they wish they does that with the person who is dead before they gets dead. So I tells Rocket what I feels and I treats life likes his might ends at any moments but I doesn’t dwells on the facts that it can ends at any moments. The chances is so minors but I doesn’t pretends it is zero either.

Here is a secrets: Any of us can gets dead at any times for many reasons. Hearts attacks, sudden cardiac arrests, pulmonary embolisms, hemorrhagic strokes, accidents! Oh my! Does we sits and dwells on those things? Some does, but most doesn’t. Maybe people who has terminals ills does dwells a bits because they has to gets their things in orders, but people who has goods health doesn’t thinks of all the ways a body can fails or how an accidents can happens without warns. It is a wastes of times to spends all our days afraid of gets dead.

Someday Rocket’s hearts will stops whether it is old ages, an implants, an accidents or ills. I will cry and miss him a lots and I will not regrets things I never tells him because I always tells him what my hearts feels and you should does the same for the people you loves.  

No matter how longs or shorts his life is, Rocket’s names is a loves story being writes on my hearts and at firsts I will tells it with my tears because he is physicals gone but then I will tells it with my smiles because he happens and I knows his Spirit will still touch my hearts from Forever. 

Music communicates a lots likes Flora Colossi does– it is a mix of sounds that causes emotions. It is hard to uses just words to express the promises I makes any times I looks into Rocket’s eyes, but I finds a songs that says it perfects.

https://www.youtube.com/watch?v=VxNllYdEleQ

I has accepts the facts that my lifespans is a lots more longs than Rocket’s, and if nothing bad happens to me “this” times, I could lives for a thousands years. If Rocket doesn’t wakes up tomorrow, he knows that my voices and heartbeats will says his names when I tells his story a thousands years from today and people who hears his story will says his names when they tells his story to other people who will says… you gets the ideas. Becomes a story that gets tells over and over is how you lives forever.

The NHS and the Reality of the New Junior Doctors' Contract.

I am a junior doctor who works in the Accident and Emergency department of a Midlands’ hospital.

It’s a hard job, like many within the hospital. The pressures on the staff and the department itself are considerable.

Over the past months, with the evolving dispute surrounding the contract for junior doctors, I, like my colleagues, have watched with intrigue. Intrigue has made way for indignation, disappointment and anger.

We have tried to remain professional despite the thinly-veiled attacks on our integrity and sense of vocation, our outrage cemented in false statistics and sensationalist reporting designed purely to denigrate the NHS and every single person who works within it.

The furore has dimmed somewhat since the announcement of imposition of the new contract, in the media at least. This has at least given us all time to reflect on what has happened.

I have read as many articles and posts from as many different sources as I have been able to. Many are in support of the juniors and the NHS as a whole whilst some have demonised the BMA. Others have tried to simplify this action to a pay dispute.

I’d like to try to describe my last week to you and explain why this is a dispute about something else entirely.

This is about life.

It is about providing the opportunities for patients to have their lives cared for, adequately and professionally, so that they can leave the hospital in a better situation than when they arrived.

This is about fuller and happier lives for the families of those patients who can build new memories, enriched by the presence of a loved one.

And it is about life for the people providing that same care.

We need the environment and the system in which to optimise the delivery of the care we are capable of giving in order to save lives, improve them and empower them. It’s what we strive for every day.

We also need the environment to balance our own working lives against our need for social interaction, rest, learning, adequate nutrition and maintenance of our physical and emotional health.

Without this, it is not possible to offer the best care that any of us can hope to provide.

And that is a travesty for patients.

From last Saturday (20th Feb) in seven days, I was Rota’d on for 72 hours. This comprised of:

Fri 19th: off
Sat: 14-0200
Sun: 14-0200
Mon: 12-21
Tues 12-21
Wed: 2200-0800
Thurs: 2200-0800
Fri: 2200-0800.

In reality, I worked nearly 85 hours.

On Sunday evening I left work at 0340, got home at 415, went to bed at 0500 and was up at 0930 before another 10 hour shift that turned into twelve hours.

I had one proper break all week- that is, half an hour to sit and eat a sandwich and have a cup of tea. I had one proper meal.

I missed my scheduled teaching for the week because I was on nights. I had a meeting on Thursday morning after my night shift to discuss why I had missed so much teaching and the extra e-learning I would need to do in order to compensate for this, as well as that already required that I was yet to complete.

I crashed my car on the way home.

That night I led the care of a seven week old in cardiac arrest due to an undiagnosed narrowing of their aorta and a hole between the atria in their heart. We were successful.

The other patients I remember from the week were a gentleman who I told required further investigation because he had a brain tumour; a lady on chemotherapy who had an overwhelming infection; a 10 year old with a life-threatening asthma exacerbation; and a lady who had been hit with a hammer in the eye.

We were so busy one evening we had someone with a supraventricular tachycardia, another with a bowel obstruction and another with a diabetic ketoacidosis in the waiting room- we just had no space to put them into a room.

These people were critically unwell and there is an energy that comes with that. This is what we are trained for. This is what we do.

The patients that turn out to be more difficult when you are tired are those inbetween; blood results unremarkable, imaging without abnormality, but distinguished clinical signs.

Send home or admit? GP follow up or medical review? Non-specific abdominal pain or appendicitis?

When you are tired, the mistakes lie here. In the grey areas. And it is so easy to miss.

For example: A man comes in with a respiratory tract infection. You treat it. He is epileptic. You refer him, and he is to be transferred to a medical bed. You are not informed there is a delay in transferring him to the ward. He doesn’t receive his regular medication because you didn’t prescribe it in your rush to see the next patient. The nurse tells you and they prevent a fit. You feel awful; but until you see his face you can’t even remember him because you’ve seen 10 patients since and numerous relatives.

1g of paracetamol prescribed; but the patient is 45kg and you didn’t check. She should have had half that. My colleagues prevent me overdosing her.

I enter the department each day and look at the bed board and hope I don’t recognise any names of patients that I treated the day before.

I’m tired when I start.

We finish late on shifts because we can’t leave these patients. We aren’t clock-watching.

It is not straightforward to hand over the details of a case to a colleague and ask them to contact intensive care. It is better for the patient that we do it ourselves; so that is what we do.

Sometimes, there is nobody to hand over to. So we stay on. Because that is what we do. That is what is right.

We don’t take breaks so we can tell your relatives your blood tests results and the likely course of a new diagnosis or life event. That is normal.

We do this in an increasingly litigious society where our mistakes are magnified and we are punished, rightly, for our errors. Twice this week my consultations have been recorded by relatives, once without my knowledge at the time.

Is that right?

Is any of this right?

Is it right I am being pushed more and more by my seniors, by my health secretary, by my government?

Is it right that I am in increasingly difficult environments that make it more likely that a patient will come to harm? More likely that I will end up in court with the coroner? More likely that my career will stall? More likely that my health will be affected?

I go on holiday in my fixed annual leave and realise it is the first time I have had to process the cries of the woman I comforted after we lost her 5 month old daughter on Boxing Day. A week after she had lost her husband in a motorbike accident.

I remember the 11 year old who tried to resuscitate her 42 year old mother. We couldn’t save her. She wouldn’t let me go when I told her and I watched her grow up in front of my eyes as she comforted her father when he arrived and was so stricken with grief he couldn’t get up from the floor for an hour.

I need to be alert, well-rested and healthy. For these patients and these relatives, they deserve for me to be at my best.

And I need to be at my best for me too.

I do this job so families and friends can share more precious moments together. My chosen career doesn’t afford me the same opportunity.

If the new contract is, as planned, imposed in August, this week will be more normal for my colleagues.

Being at my best will be impossible.

And despite not agreeing that the care I provided last week deserved the £6.54 per hour (£5.40 if calculated under the terms of the new contract) I received, that is not what our profession is concerned with.

For patients and all healthcare staff, this contract is morally, ethically and fundamentally wrong.