mr. ryan

There was an Off Topic Podcast where they talked about Ryan over-reacting dramatically to small things in GTA lat’s plays, mostly through the influence of Gavin. It got me thinking of like, super paranoid Vagabond. He’s been in the business for so long, that he’s become super cautious. He doesn’t want to lose a(nother) crew. If there’s even a whiff of cops being nearby when they’re trying to kidnap someone, their would-be-victim instantly get a bullet to the head and the crew is forced to retreat. If someone fires a bullet at any of them, Ryan’s pulling out a machine gun, or on a memorable occasion, a fucking flamethrower and going to town on the dude. Everything is an over-reaction, and Gavin, little shit, knows this. He knows that if he yells, or acts scared, or shoots his gun at nothing, Ryan will come flying in, giving all he has to remove the danger. 

This is all fun and games until Ryan catches on, and he starts ignoring him. Gavin shoots the wall next to Ryan, and he just turns to look at him, eyes cold behind the mask as he stares at Gavin with disapproval. Gavin screams ‘They’re coming!’, and Ryan doesn’t even bother to ask who, just keeps piling money into the bag. It’s like the boy who cried wolf. It ends the same way. 

Weapons deal, Golden Boy goes in, told to leave his guard dog and all weapons at the door. Ryan doesn’t like it, but remembering that Gavin’s with him makes him refuse to act on his paranoia, to retain his pride. They people they’re dealing with don’t take their coms, either through laziness or lack of noticing. Ryan stands by the closed door, waiting for Gavin to come back. He’s listening to the conversation and kind of zones out. He just barely notices the other man in the room say ‘I’ll be right back.’ There’s a few seconds pause then Gavin starts sounding alarmed. 

‘What have you got that out for? This is just a weapons deal, not a demonstration.’ Ryan shakes his head. He knows Gavin’s alone, the guy just left the room, it’s a stupid prank. 

‘Mate, come on, you really want to shoot me? You’d have the entirety of the Fake AH Crew chasing you down.’ Gavin is starting to sound a little more alarmed, but Ryan still refuses to move. Golden Boy is a convincing actor, but Ryan refuses to be a part of this play. He shuffles, content to let Gavin play it out until the weapons dealer comes back, when he finally hears the voice of the man Gavin is talking to. 

‘The Fake AH Crew isn’t gonna do shit. The Vagabond won’t hear a thing and by the time he thinks to check on you, we’ll be long gone. Say goodbye Boy.’ Ryan recognises the voice of Mr. E. Everytime he hears it, he’s flooded with thoughts of putting him in the ground, preferably in a casket. 

‘Don’t do-’ There’s a gunshot, and Ryan hears a sound like a bird. 

‘Don’t move so much. It’ll hurt more, the more I shoot you and miss the vital bits. Do you wanna go quick or bleed out?’ Mr. E’s voice imitates that of a kind friend offering food, but is spoilt by the obvious joy he derives from watches Gavin squirm like a headless chicken.  

Ryan busts open the door, with one good, solid kick next to the handle. Before Mr. E or Gavin even have time to scream, two shots ring out. One hits Mr. E solidly in the chest, where he dies on impact. The other hits Gavin in the shoulder. ‘Shit.’ Ryan tucks away his gun and moves to Gavin who’s desperately trying to hold the blood inside himself. Ryan is quick to notice the blood on the left calf of his pants. Making a decision, he picks Gavin up and sets him on his shoulders in a fire mans carry, Gavin squeaking in pain all the while as Ryan carries him to their car and plonks him in the passenger seat. There’s an awkward silence only broken by the occasional groan as Gavin tries to wrap fabric around his ankle and hold his shoulder at the same time. 

‘I’m sorry.’ Ryan stares resolutely forwards, focusing on getting them to Caleb as soon as possible to get Gavin patched up.

‘Me too.’ Gavin gives up on his ankle and just leans back in his seat.

‘You know, if you hadn’t tried to trick me all those times, I would have trusted you, and not let you get shot.’ Ryan tries to crack a joke but it falls flat.

‘… Shut up Ryan.’

Dear Trump Administration

Hello Mr Ryan, Mr Trump, and whomever else this may concern.

(And, if you are an American of any stripe, then as it turns out it also concerns you.)

I am a family physician. I interact with your constituents all day, every day. I hear about their problems, their struggles, and often the limitations they face regarding healthcare. I try to help them when I can. That’s my job in a nutshell.

So let me tell you about one of your constituents who also happened to become my patient. Let’s call him Bob.

Bob is a middle aged man who worked full time at an entry level manual labor type job. The kind of job you spend 40 hrs/wk working but still hover around the poverty line. The kind of job with no benefits. He didn’t go to the doctor and had no health insurance but as far as he knew he also didn’t have any health problems. Until one day he started feeling unwell. This persisted for a few days and he refused to let his wife take him to the doctor. He was worried about the cost and figured he’d get better in a few days anyway. Only he didn’t. He got worse and his wife called an ambulance.

Enter the healthcare system.

Actually, let’s skip ahead to the final diagnosis. Bob has type 2 diabetes. Newly diagnosed. Easy. Boring. Right? Except Bob clearly had diabetes for some time, unbeknownst to him. When he arrived in the Emergency Department he was in septic shock. He was riddled with large abscesses in his internal organs and soft tissues. Both his lower limbs were necrotic. He had osteomyelitis in multiple locations. What’s really amazing though is that he lived. He had both his legs amputated below the knees and was hospitalized for weeks. All told he had 8 or 9 surgeries. He required weeks of additional IV antibiotics. But he ultimately got better. And his diabetes is well controlled now on pretty minimal medication.

During his hospital stay he was enrolled in Medicaid which, fortunately, will pay for all this medical expense. So let’s look at this from an economic perspective for a quick minute. This is a man who very quickly racked up hundreds of thousands of dollars of medical bills for which the government will pay. He is wheelchair bound now and on disability, again on the government’s tab. He will certainly have additional complications during his lifetime including pressure ulcers, infections, chronic kidney disease, etc. All told this one individual is costing/will cost the government millions of taxpayer dollars.

For want of a couple hundred bucks of prevention.

A routine visit to any PCP would have certainly identified his diabetes earlier and, as it turns out, he only needs like $30/month of medication to control it.

This is the tragedy of healthcare in America. That few hundred bucks of prevention is the ‘entitlement’ you and your fellow Republicans want to remove. This is of course saying nothing of the great personal cost to Bob in terms of his quality of life, physical, and psychological well being. Your bill that was withdrawn on Friday was nothing short of an abomination. Now, you might say I have chosen an extreme example to make a political point. Only I haven’t. I have multiple Bob like patients. Ask any PCP, especially in rural and urban underserved America. I promise you they will all know Bob. They will all have multiple Bobs on their panel.

Obamacare is not perfect, but it is progress. You must understand that prevention is cheap and to continue to make progress Obamacare must be augmented and refined, not ‘repealed and replaced’. Anything else is a complete affront to the American people. So please, cut your political BS and draft some useful legislation with input from actual physicians and other folks who understand that yes, healthcare is complicated. Perhaps you could ask Mr. Obama for some tips.

Memento mori,

Hostile Shrubbery

6
  • March 18, 2005 - May 6, 2011
  • 6 seasons total
  • 158 episodes total
  • 3 Emmy nominations (2 Outstanding Children’s Program & Outstanding Choreography)
  • highest rated series premiere in 2005
  • Disney Channel Original Movie
  • 2 crossover specials
nytimes.com
Trump’s First Legislative Effort Fails as G.O.P. Pulls Bill to Repeal Obamacare
House Republican leaders pulled legislation to repeal the Affordable Care Act from the House floor before it could be defeated, a huge loss for President Trump.
By Robert Pear, Julie Hirschfeld Davis and Jennifer Steinhauer

WASHINGTON — House Republican leaders, facing a revolt among conservatives and moderates in their ranks, pulled legislation to repeal the Affordable Care Act from consideration on the House floor Friday afternoon in a spectacular defeat for President Trump on the first legislative showdown of his presidency.

House Speaker Paul D. Ryan conceded, “We’re going to be living with Obamacare for the foreseeable future.”

Mr. Ryan had rushed to the White House shortly after noon to tell Mr. Trump he did not have the votes for a repeal bill that had been promised for seven years — since the day President Barack Obama signed his landmark health care act into law.

Good.