#Practitioner Doctor ✦ Cinder

[magicnights]

“I DIDN’T TEACH AMIYA THOSE TERMS!!” 

#Whispers in the woods. ✦ Dash commentary #Practitioner Doctor ✦ Cinder #YET I VOW WITH MY LIFE ON THE LINE. ✦ ARKNIGHTS

[drxnknhxgh]

@jxggedlittlepill​

Limp fingers curled around a metal latch, the barest of pressures exerted to release the mechanism but enough to swing the locker open. The sigh that sounded was a signal, not of her resolve leaving but of the level her tension had reached. She was more like an old fashioned kettle - still full even when some steam forced its way out. Being on call for long stretches of time was standard practice for residents but it never seemed to get easier. When Hana wasn’t in an operating room or checking in with patients her life was a litany of aching bones from spending her nights curled up on the sofa in the on-call room. Cycling through the three or so decent meals from the cafeteria and praying for just an hour to take a proper shower. The layer of grim slicking her skin and coating her auburn tresses into a oily mass was reaching a height of discomfort sure to drive her insane. But that was the job. Hana may not have felt much more than a useless sack of flesh at the present but she wouldn’t have traded professions for all the restful nights sleep in the world. Though she wouldn’t complain about at least one. 

As far as her patient were aware, their only visage of the woman was the spring in her step whenever she entered their room and the easy smile of one visiting a dear friend. She spoke with a practiced serenity, with each word her slim fingers would flourish into the stagnant hospital air like birds, then settle as she listened to the answer like she had all the time in the world. Like nothing could interest her more than what her charged had to say. They didn’t need to know she’d just downed her fifth cup of coffee and that the caffeinated sludge was the only thing maintaining her facade. She couldn’t begin to instill peace in her patients if they could read the exhaustion in her weary gaze. Being a practitioner was similar to performing, you were always on stage. 

Hana barely registered the second presence entering the room. She rubbed at her tired eyes with the heel of her palms and proceeded to drag her fingers through her flaccid locks. It was only when the colored rubber entered her peripheral did she direct a simper thick with fatigue in greeting to her colleague. That is until she fully processed who she was addressing and her smile faded into a thin line of discontent. Fucking rainbow crocs. Had she been more alert she would have recognized the ridiculous footwear sooner, as it were she was face to scowl with Doctor Evan Bishop. Of the incessant korean proverbs her Halmeoni loved to preach she remembered; Hate was the devil's path, and we shall leave its ash-strewn surface without a single footprint. Hana couldn’t say she hadn’t dirtied her soles in the cinders of loathing when Evan was involved. From the instant he refuted her theory in first year Biology, to the dreaded realization they’d be interning at the same hospital and now as they transitioned to residents. Hana felt nothing but malice whenever he dared entered her thoughts. Which was admittedly far more often than she cared for. 

Hana and the man remained locked into a tense standstill until she eventually relented. “You look like shit” now the smile that graced Hana’s lips was less enthusiastic and more demeaning. It seemed even in her current state flinging a biting remark was instinctive. No matter how lame the caliber. Hana wasn’t usually so forbidding. Conceited, yes, but understandably so. When you breezed through medical school in half the time you were allowed to be a little cocky. But she typically didn’t overly flaunt her genius unless the situation called for it as she felt this one did. The first time she met Evan Bishop she might have even considered him a friend. But they’d only lasted as ‘pals’ for a total of two weeks before egos and rivalry pitted them against each other and made the two years they spent as John Hopkins’s youngest and brightest attenders nothing but a bloodthirsty battle of wits. The years that followed did nothing to salve the hostility between the two. In fact, seeing each other every day only seemed to transport them back to their young selves, arguing in the John Hopkin’s courtyard about surgical procedures. 

It is far easier to lose herself in the theatrics of her mind, casting herself the victim and leading lady, than it was to swallow even an ounce of the truth. Evan was the only persons she feared surpassing her in the field. Naturally competitive, she’d spent years engaging in tireless combat with his stupid smug smile. “By the way, the next time you want to call me out in front of the interns you’ll find a tack in your stupid shoes” she hissed, slamming her locker shut. “Let’s not forget who got the higher marks in anatomy, it was the thoracic that was cracked, not the lumbar” 

#〈 thread I hana&evan 001 〉

[oddnub-eye]

25 Days of RWBY Shipping:Day 8

8.Character A and Character B meet in the ER on Christmas Eve.  (Gauntlets and Greaves)

Modern AU, warning, Cinder is not a good person.

Yang slumped into the seat of the ER. She felt like shit. She knew the accident wasn’t her fault, but she still felt shitty. Looking down at her prosthetic, Yang cringed. She knew Ruby wouldn’t need one of those, but it still served as yet another reminder of her recklessness.

“Hey there blondie.” A familiar voice said, subdued.

“Mercury.” Yang scoffed, looking up at her frequent sparring partner. The capoeira practitioner had deep bags under his eyes, and his gray jacket was rumpled, likely from sitting in one of those uncomfortable ER seats for hours.

“What’re you here for?” Mercury asked, handing Yang a bag of cheetos. The gray haired teen slumped down into the seat next to her.

“Ruby got hurt. My fault.”

“Was it?” Mercury asked.

“Yes.”

“Why?”

“Because I convinced her to go out. If she hadn’t come with me, she wouldn’t have gotten hurt.”

“Ya can’t trap her in the house forever,” Mercury pointed out, “You can’t live without the risk of getting hurt.”

“Why are you here?” Yang demanded, forcefully changing the subject. 

“Cinder finally went overboard. Emerald’s here with 1st degree burns.”

Yang cringed, she knew Cinder’s behavior towards Emerald wasn’t healthy, but no one’s efforts could convince Emerald to get out.

“That is my fault.” Mercury sighed, “I could see the signs, but I couldn’t convince Emerald to leave, and now…”

Yang rested a hand on Mercury’s shoulder, whispering, “I guess we’re both screw-ups.”

Mercury turned his eyes towards the dull fluorescent lights, “Yeah.”

The duo leaned into each other, just absorbing their company as they waited for the doctors. Eventually, they drifted off to sleep, slightly comforted by each others presence, even as they worried over the health of their friends.

Constructive Criticism is always Welcome! I hope y’all have a great day!

#rwby #yang xiao long #mercury black #rwby gauntlets and greaves #gauntlets and greaves #disabler #combat boots

[newstfionline]

In a place of need, an unhealthy contradiction

By Jessica Contrera, Washington Post, March 11, 2017

Northfork, W.Va.--Another morning, another list of patients and problems in the hands of 35-year-old Keisha Saunders. Diabetes, depression, heart disease. Robert needs lower blood pressure. Buffy needs prescriptions filled. Mary needs to lose 50 pounds, so she can get what she really needs, a new hip.

Again, the list extends to the bottom of Keisha’s notepad, as it has so many days since the Affordable Care Act mandated that everyone have health insurance. Unlike in Washington, where health care is a contentious policy debate, health care where Keisha is a nurse practitioner is a daily need to be filled. The high rates of chronic diseases in McDowell County have made it the county with the shortest life expectancy in the nation.

It’s also a place that voted overwhelmingly for President Trump, whose promise to repeal the ACA will soon affect nearly every patient Keisha treats at the Tug River health clinic in Northfork, including the one waiting for her in exam room No. 2.

“How are you doing?” she asks Clyde Graham, who is 54 and has been out of work for four years.

“I ate a sandwich from Arby’s,” he says. “And it jumped me out for like, three days. I mean it just burnt.”

Heartburn is just the latest problem for Clyde, a patient Keisha sees every three months. Like so many in this corner of Appalachia, he used to have a highly paid job at a coal mine. Company insurance covered all of his medical needs. Then he lost the job and ended up here, holding a cane and suffering not only from heartburn but diabetes, arthritis, diverticulitis, high blood pressure and high cholesterol.

Because of the ACA, Clyde’s visit is covered by Medicaid. Before the law, most West Virginians without children or disabilities could not qualify for Medicaid, no matter how poor they were. The ACA--better known here as Obamacare--expanded the program to cover more people, such as Clyde, who can depend on Keisha to fix his heartburn without having to worry about the cost.

As for the other problems in his life, he has put his hopes in Trump, who came to West Virginia saying he would bring back coal and put miners back to work. When Trump mentioned repealing Obamacare, Clyde wasn’t sure what that might mean for his Medicaid. But if he had a job that provided health insurance, he reasoned, he wouldn’t need Medicaid anyway, so he voted for Trump, along with 74 percent of McDowell County.

Tug River Health Association treats about 8,700 patients, resulting in some 20,000 visits a year to its five clinics. In 2016, 12,284 of those visits were from patients on Medicaid, up from 5,674 in 2013, before the ACA took effect here. Without the ACA, many of those patients wouldn’t be able to afford care. Will they soon lose their coverage? Will they stop coming to the clinic? Lately, Tug River’s chief executive has been telling his staff, “The key word going forward is uncertainty.”

To Keisha, all is uncertain beyond this moment, in which she prescribes Nexium for Clyde’s heartburn, examines him from head to toe and sends him to the lab across the hall for blood work.

“I’ll see you in three months,” she says, hoping that will be true, and heads to exam room No. 1, where another patient is waiting. “What’s going on today?” she asks, and walks in the room to find out.

Meanwhile in the front of the clinic, more patients are coming in through the heavy doors and up to a glass window where a receptionist is waiting.

“Hi honey, how are you?” Tammy McNew says to each one. Over the past four decades, McDowell County has lost 60 percent of its population, so she rarely needs to ask their names. Instead, she asks what seems like the most important question in health care these days:

“Got your insurance card with you?”

If the answer is no, she will send them back to Keisha anyway, and the clinic will depend on federal grants to make up the cost. But more often in recent years, the answer is what a middle-aged woman with springy curls says as she passes her Medicaid insurance card through the window: “Yes, ma’am,” she tells Tammy, who slides it into a scanning machine.

In other parts of the country, the primary impact of the ACA has been requiring people to have private health insurance, but in poor and sick communities like McDowell County, the law’s dominant effect has been the Medicaid expansion, which has given more people access to the kind of health care that wasn’t widely available or affordable to them before. With an insurance card in her pocket, the patient at Tammy’s window can venture into the realms of medical care that are typically out of reach to those without one: blood work, immunizations, specialized doctors, surgery, physical therapy.

If she needs medication, the nurses won’t go digging in a closet of samples left by drug reps as they used to do for the uninsured. The medication will come from a pharmacy and cost no more than a few dollars.

“All right sweetie, I got you,” Tammy tells her, and the patient retreats to a chair to wait for her name to be called. The routine is repeated dozens of times a day as the phone rings behind the front desk. “For appointments, press one,” the callers hear. “Black lung, two.”

This clinic is in Northfork, a community of a few hundred people along the railroad that carries coal through the mountains. Keisha, who is black, was raised in this predominantly white county, in a home overlooking the cinder-block church where her father, a coal miner, serves as pastor. She attended the middle school beside the clinic parking lot, which now has busted windows and gaping holes in its brick facade. There weren’t enough children to fill it, as every year the closing of more mines drove job-seekers out of the county.

Eventually, Keisha was one of them. After graduating high school and becoming a mother at 18, she realized that if she wanted to become something more for her daughter, she would have to leave.

She moved 45 minutes away, to Princeton, W.Va., where she got a nursing assistant certification and a job in a nursing home. But every Sunday, she strapped her daughter Kiana in her car and drove back to McDowell County, checking in on her always-fading town. Bulldozed, shuttered or abandoned: the grocery store, beauty salon, florist and furniture store. Still open: the dollar store, medical equipment store, funeral home and her father’s church, where Keisha would usually sit with her brother Derrick.

It was 2003 when Derrick started to feel pains in his back and groin, and Keisha, then a 22-year-old licensed practical nurse, started to understand what insurance could mean. Derrick was 24--too old to be covered by his father’s insurance but unable to afford his own. He thought his only option was to go to an emergency room. His parents remember him returning home, having been told there was nothing wrong with him. When the pain didn’t go away, Derrick tried a different ER. Keisha would later learn that doctors thought her brother was seeking pain pills. Months passed.

All the while, a tumor inside his kidney was growing. A few months after the cancer was finally discovered, Derrick died at 25.

Keisha didn’t allow herself to wonder what might have happened if he’d had insurance. She focused on remembering their last days together, when the doctors said the cancer was too advanced to be stopped by treatment, so she treated him with chocolate instead. M&Ms by his bedside.

She kept working at the nursing home and then in hospice care, raising Kiana and taking classes at night. When she was 30, she completed a graduate degree and became a nurse practitioner. She made the drive back to McDowell County again, this time to ask for a job.

At first, some patients at Tug River were wary of her loud laugh and big hoop earrings. Others had known her since she was a little girl. She cared for them all, and her schedule grew busier as the ACA came to McDowell County and made more people eligible for insurance.

Now Trump is in the White House and Keisha is pressing her fingers into the stomach of 24-year-old Ruby Thompson. Nearly every patient Keisha sees has been impacted in some way by the ACA, and in Ruby’s case, the ACA’s Medicaid expansion is the reason she has insurance.

According to the list on Keisha’s notepad, Ruby is just here to refill a prescription, but Keisha checks her as if they are meeting for the first time. She tries to feel for anything abnormal around Ruby’s stomach, which is a little too thin, but Keisha knows cigarettes can cut into a person’s appetite.

“Are you still smoking?”

“Yeah,” Ruby answers, tugging at a gold necklace that spells MOM.

“Do you want to stop?”

“I will eventually, I guess.”

Ruby is another patient who voted for Trump because of his promise to bring back jobs. She hasn’t yet lost hope that she can become a secretary, but for the past two years she’s been working at KFC. She has health insurance only because she was fined on her taxes for not having it, at which point she found out that because of the ACA, she qualified for Medicaid. It is insurance at its most tenuous, though, because if Medicaid reverts back to a program only for the neediest people, the working poor will be most at risk of losing their coverage.

“Go ahead and sit up,” Keisha says after checking Ruby’s ankles for swelling, a potential sign of diabetes. She writes a prescription and sends Ruby to the front desk to make an appointment for November, when she is due for a breast exam and cervical cancer screening.

Another patient comes in: Carolyn Hodges, 68, who tells Keisha that she’s been feeling dizzy. Carolyn has Medicare, the public health insurance for the elderly. Medicare doesn’t cover all health-care costs, which is why Carolyn is as worried about the price of her medications as the fact that she’s been bumping into walls.

The last time she went to pick up her husband Roger’s insulin, Carolyn tells Keisha, the pharmacist said it would be more than $600, instead of the $100 or so they usually pay. That was when she learned Roger was in the Medicare prescription “donut hole,” which means that the cost of his medications had exceeded his limit for the year, and he would be forced to pay far more for prescriptions until the year ended and the tab started over. One initiative of the ACA has been to close that hole incrementally, but Carolyn, unaware of that, sees the bills piling up and thinks she knows who must be to blame.

“Thank you, Obama!” Carolyn says, throwing her arms in the air.

Another patient: Andrea Easley, 50, who has struggled for so long that there wasn’t much more the ACA could do to help her. She already had Medicaid, which she depends on for her health care, and disability payments, which she uses to pay her rent, support her 70-year-old mother and send checks to her son who is in prison in Charleston, W.Va.

“What’s going on, Miss Andrea?”

“My nose,” Andrea says, nearly shouting. “I had just come in. Sit down. Sneeze. My nose went to burning. I mean, it burned like someone gone and set fire to my nose.”

Despite taking more than a dozen medications a day, Andrea’s problems never seem to go away. Her life isn’t one where she thinks much about politics--she didn’t vote in the election--but of stomach issues, coughing, lack of sleep, fights with her mother, stress over her son.

“Have you tried a humidifier?” Keisha asks.

“What is that?” Andrea says.

“It keeps the moisture in the air,” Keisha explains. “Do you sleep with your mouth open?”

“I don’t know how I sleep. I’m not half sleeping. Now last night, it made me mad,” she says. “Them cats out there meowing, and I’m trying to go to sleep, and they’re out there doing all such things they have no business doing ...”

Looking up at Andrea from her low swivel stool, Keisha listens. She knows other patients are waiting. But she also knows that sometimes her patients need to talk, so she gives no sign that she has anyplace else to be. Only when Andrea pauses does she say, “I do think you need a humidifier. I think that will help some.”

“Where can I get that from?”

“Well,” Keisha says, knowing her answer will upset Andrea, “you have to buy it.”

Another patient, here for the first time: a 33-year-old woman who voted for Hillary Clinton. She has no insurance, by choice. She didn’t feel she needed it. Now, because of a test result in Keisha’s hands, she will.

“Hi Miss Amanda, I’m Keisha, the nurse practitioner here.”

“Nice to meet you,” Amanda says, pushing back a lock of cherry-colored hair.

Keisha asks Amanda about her symptoms, then gets to the point. She turns to face her and says, “It looks like--you’re pregnant.”

“I’m pregnant?”

“Yes. Were you expecting ...”

“That’s such good news!” Amanda says.

“I’m glad you’re happy,” Keisha says. “Good! Yay!”

Amanda lifts her palms in the air, and they double high-five. Then come the questions Keisha needs to ask for her chart.

Is the baby’s father involved? “I think he’s going to be a little apprehensive,” Amanda says.

Is she working? “Not currently,” Amanda says, explaining to Keisha that she just moved back to West Virginia after living in Ohio. So far she has put in applications at gas stations and restaurants.

Is she at all familiar with the area? With the doctors she’ll need to see? With what she needs to do now? Amanda wrings her hands between her knees. “I have no idea where to go next,” she says.

And here is another version of uncertainty in the clinic, this time a patient’s. If she signs up for Medicaid, which covers low-income, pregnant women, she’ll be covered through her pregnancy. But after that? Her access to insurance will depend on what happens over the next months in Washington, where so many plans for the ACA’s replacement are floating around.

With so much to be resolved, Keisha hands Amanda a form to sign up for Medicaid. They walk together to the front desk, where Keisha asks Tammy to schedule Amanda’s first prenatal appointment.

“Thank you,” Amanda tells her.

“You’re welcome,” Keisha says. “I hope everything goes well.”

Sometimes, between patients, Keisha retreats into her office, sits at the folding table she uses as a desk and takes a few steadying breaths. If she has enough time she also prays, and since January some of those prayers have been for President Trump.

“I just pray that he makes the right decisions,” she says. “I’m not sure what’s going to happen. All we can do is pray about it.”

She prays for others, too. Her daughter. Her parents. Her brother. She prays for her patients, that they stay healthy, that they lose weight, that they take their insulin shots the correct way, that the woman with the rotting tooth will follow up on her promise to go to the dentist, that the man whose wife died after saying to him, “Honey, do you think I’m getting better?” will find a way to ease his loneliness.

One more deep breath and a last prayer for herself--“Okay, Lord, help me get myself together”--and then she picks up her stethoscope. It’s Friday afternoon, and seven patients need to be seen before she can go home to her teenage daughter.

#West Virginia #Norfolk West Virginia #Keisha Saunders #Affordable Care Act #West Virginia health Clinic

[magicnights]

“Daniel... Are... Are you a DILF....?” 

#Whispers in the woods. ✦ Dash commentary #Practitioner Doctor ✦ Cinder

[magicnights]

“WHAT ABOUT MATING?? HI Penance, you lookin hot today.” 

#Whispers in the woods. ✦ Dash commentary #Practitioner Doctor ✦ Cinder #[ my gods. ]

[magicnights]

“Aw look! Nian && Lava are back on their movie night club.” 

#Whispers in the woods. ✦ Dash commentary #Practitioner Doctor ✦ Cinder #YET I VOW WITH MY LIFE ON THE LINE. ✦ ARKNIGHTS

[magicnights]

    They side-eye at the operator whom is complaining about the reports, “Well, why are you dealing with the complaints then?” It’s good to acknowledge them, but it’s better to learn that it wasn’t her fault. After all, not everything will be in your control. “I doubt that they are being honest, if anything.” 

#Whispers in the woods. ✦ Dash commentary #Practitioner Doctor ✦ Cinder #YET I VOW WITH MY LIFE ON THE LINE. ✦ ARKNIGHTS #[ hello hello! hope this is alright ]

[magicnights]

FUCKING

DEAD

NEVER MIND MAIDS

O H

BUTLER CLARA

H O L Y. 

NOSEBLEEDS. 

sorry kramer. 

your student is DEAD. 

#Whispers in the woods. ✦ Dash commentary #Practitioner Doctor ✦ Cinder

[magicnights]

Cinder: nothing brings me fear but that

anni3

Cinder: that brings me fear. 

#Santa Claus isn’t real. ✦ Crack #Practitioner Doctor ✦ Cinder #[ no one gets context ]

[magicnights]

Someone: Oh man, I wonder what’s the doctor thinking!

Cinder, while snacking on a sandwich:

“I want Phantom to destroy me. Make me beg for pain && mark me as his. If Kal’tist asked? I just say I am having a ‘bad’ day. It’s not like she’s gonna strip me && see the beauty that man has placed upon my body. I want to be unable to walk for a few days, && leave me in sore pain for a bit, until I get back to work.”

“NOT TO MENTION--” 

#[ i stop here bc otherwise i start doing lime on every ship possible ] #Practitioner Doctor ✦ Cinder #S support? More like Sax support ✦ lime

[magicnights]

CUE CINDER & PENANCE BANGING. 

THOSE TWO ARE IT. 

#SUGGESTIVE. #Practitioner Doctor ✦ Cinder #Whispers in the woods. ✦ Dash commentary

[magicnights]

Cinder walks in with two boxes of pizza, && holding an tray of coffee for any doctors (one of them includes Kramer), as she opens her eyes, 

“Uh. Sex dungeons huh?” 

You do you! but wow, the ark really has changed!

#Whispers in the woods. ✦ Dash commentary #hallowkeylines #Practitioner Doctor ✦ Cinder

[magicnights]

“I mean. I wish I could kick ass but...” Casually holds a clean scalpel, “Unless you are into some really concerning kinks.” 

#Whispers in the woods. ✦ Dash commentary #Practitioner Doctor ✦ Cinder

[magicnights]

“Alright fine, you can be my little pogchamp.” Wink at. 

#[ i was dared on vc i swear ] #Whispers in the woods. ✦ Dash commentary #Practitioner Doctor ✦ Cinder

[magicnights]

@endlessfrontiertrio​ from this. 

“As in my eye because it’s damaged, but not blind.” Cinder points at her scarred location, “Unless you meant you have damaged eyesight...?” Dealing with robots isn’t in the job. That was usually handed off to a co-worker, since getting familiarized was a whole new game level. 

#endlessfrontiertrio #Practitioner Doctor ✦ Cinder #[ that nickname lol ] #[ dw about images ]