#children's pediatricians email list.

[gilbertdb]

7 Fascinating Facts Regarding Pediatric Gastropathy

PEDIATRICS EMAIL LIST:

You may contact the top kid specialists by using our pediatric email list, which has been thoroughly validated. To market your offerings to pediatricians, you'll need a thoroughly tested advertising strategy and a robust client database. There is tremendous competition in the market. Without a strong campaign approach at the outset, you cannot establish your reputation. As a top-tier source of medical data, GILBERT DATA offers highly flexible pediatrician mailing lists to assist marketers in connecting with the appropriate pediatric decision-makers with their healthcare products, equipment, and other services. In order to reach out to and offer your medical solutions to as many potential consumers as you can, we will give you access to a broader network.

With birth rates in the millions each year, pediatricians are among the busiest doctors in the United States. Pediatricians provide excellent targets for marketing initiatives involving continuing education invitations, medical equipment and supplies, drugs, and other healthcare-related products. Since we value the confidence of our customers, we only supply datasets that don't result in bounced or rejected emails or messages.

You have undoubtedly started learning about gastroparesis and have more questions if your child has recently been diagnosed with it. Here are some further details on the condition:

7 ADDITIONAL FACTS ABOUT GASTROPARESIS IN CHILDREN

1. THE FUNCTIONS OF THE STOMACH

The heart, fundus, body, antrum, and pylorus are the five main components of the stomach. When all of these components are working properly, food can be accommodated, stored, compressed, digested, and pushed into the small

intestine. However, any combination of these five areas may be faulty and result in symptoms in a child with gastroparesis. Additionally, foods or liquids may be to blame for the symptoms.

We now lack a good test that can identify which one or more of the five components is malfunctioning, though we can perform a four-hour gastric emptying scan to see if the stomach empties slowly and can discriminate between liquid and solid emptying. We do, however, have drugs that target certain aspects of the stomach. Therefore, based on which medication helps reduce some of the symptoms, we can figure out which section is the issue after some trial and error. To treat the symptoms, we may occasionally need to take many drugs.

2.AN INCIDENCE

While not particularly prevalent in youngsters, gastroparesis is common in adults. It usually occurs after a viral infection in children. But frequently, the reason is unknown, which is referred to as idiopathic. It does occur when there is diabetes or a neurologic issue present, although it is less common in children. In addition, certain children may experience joint hypermobility, a disorder that can have an impact on various body systems, including the digestive system, and may result in gastroparesis.

3.In children of various ages, IT SEEMS DIFFERENT

Because children can't express their pain, gastroparesis manifests differently in infants and toddlers. They frequently have a feeding issue because they abruptly stop eating and become cranky and vomitous. The diagnosis is simpler in older children because they can express their feelings and report symptoms like bloating, nausea, and feeling full.

4.THE DIFFERENT GRADES OF SERIOUSNESS

Gastroparesis can range from minor to severe. Gastric failure is the term used to describe the severe variant. Children who have it stop eating and constantly throwing up, which causes them to lose weight and get dehydrated. In order to acquire nutrients, they frequently need to be fed through a feeding tube that skips the stomach. Sometimes they can't handle it either, therefore they may need to receive whole parenteral nourishment intravenously (TPN). Thankfully, this is a rare variation of the illness.

5.CONDITION OF LIFE

Many kids might get relief from their symptoms with the correct care. The process of receiving the proper diagnosis and subsequent therapy, however, can be drawn out and have an influence on a child's quality of life. These kids miss a lot of school and extracurricular activities as a result of their stomach pain, nausea, and vomiting symptoms. Most are taught at home. Furthermore, they may improve gradually over a period of several years. Some of them won't get better, and some of them will live with their symptoms for the rest of their lives. In most cases, post-viral gastroparesis gets better in three months to three years. After puberty, gastroparesis typically improves in patients with hypermobility.

6.The best treatment options

Every child will respond differently to treatment for gastroparesis, but alternatives may include prescription drugs, dietary changes, and medical and surgical treatments. A GI-focused psychologist can instruct children in certain methods to lessen the feelings of nausea and abdominal pain and to increase appetite. These methods for coping with pain and nausea can enhance everyday functioning, school attendance, nutrition, and weight growth. Multiple professionals are needed to meet the needs of children with severe forms. We advise patients to work with a team that consists of a neuro gastroenterologist, nutritionist, psychologist, and social services to assist children with their academics.

7.WHEN TO CONSULT A SPECIALIST

I advise having another discussion with your primary care physician if your child has experienced an acute sickness, such as the stomach flu, and if the symptoms, such as bloating, fullness, and pain, have not subsided. Your pediatrician could suggest referring your child to a pediatric gastroenterologist if they have been treating your child's symptoms with medication but they aren't improving.

#pediatrician mailing list #list of pediatricians #pediatrician database #pediatrician marketing data #buy email lists #pediatricians database #pediatric physician email addresses #pediatrician direct mail lists #pediatric specialists marketing lists #telemarketing lists #email marketing lists #best pediatrician email list #pediatrics associates email list #preferred pediatrics email list #pediatrician doctor email list #children's pediatricians email list.

[the1975attheirverybest]

10 things Matty does as a dad

A/n: the brain rot will not stop so….

Warnings: none

————

Freak out at the hospital when the nurse hands him his newborn baby for the first time. “Oh gosh what if I drop her.” “Oh she’s so small. How can a person be so small.” “hi little one. I’m your daddy it’s so good to meet you.” “I love you already.”

Gets up every single time the baby does. Even though he and the wife have a schedule and it hinges upon one of them being awake and alert when the other isn’t. So it defeats the purpose for him to wake up every time but he insists he’d just feel guilty if he kept sleeping while his wife and child are awake at night.

Takes a year off from work. No producing. No writing for other artists. No 1975 stuff. He might scribble stuff down or try ideas if something comes to him. But he’s not like actively trying to make a record at all. So, he stays with the baby at home all day when the missus gets back to work and gets really into baby nutrition. Reading books on obscure health benefits of rare oils and extracts. Tries to buy a bunch of them online.

Oh the online shopping. When it’s late at night and he’s rocking the baby back to sleep and he’s kinda sleep deprived, he makes questionable decisions. Buys every toy that markets itself as “educational.” Or important to kids cognitive development or whatever. His missus has to institute a rule where they need to donate 2 old toys for each new toy they purchase.

The pediatrician tells him that talking and reading to the baby is important in order to make sure they acquire the strongest vocabulary by age 3. So he starts to read to her regularly. First, it’s children’s books. But then it progresses to whatever he can find around the house. Grocery lists, the blender manual, song lyrics, emails. He even does different voices and sound effects to keep things interesting.

He asks his baby girl for her input on music even before she’s old enough to understand what she’s really saying. “Come here, daddy wants to show you something. What do you think? You like it?”

Let’s her design tour posters/ album cover/ merch graphics

Establishes a regular dad-daughter date. Even when she’s an infant. A whole day of just the two of them. It starts out as just him needing to prove to himself that he could take care of her all day without asking for help from anyone. But he just keeps doing it as time goes by. It becomes a bonding experience. As she grows up, they start to use this time to talk about school, what she’s into, her friends, etc.

Cries when she’s sick. The missus will be like “matty, children get the sniffles sometimes. She’ll be okay. This is fine. Necessary even! For her immune system.” But he’s just like “she’s so miserable and can hardly breathe poor girl.” He’s practically a mess when she gets the chickenpox. All his memories of getting it or watching his brother get it mean nothing to him. He acts as if his kid is the first and last one to ever get sick on parent earth.

He watches YouTube tutorials to learn to do various hair styles just to impress her by offering her options when she asks him to help her do her hair for school in the morning.

[pipthebadger-blog]

The Crimew Email Leaks: My Notes on the First 100 Pages

So, all of these are unedited notes of my first 100 pages of the Crimew Email leaks. For those unfamiliar, the Crimew Email Leaks are leaks of emails from Republican lawmakers across the country who are pushing anti-trans bills. Quick notes before we begin. First, I am somewhere between gay and bisexual, but I am not trans myself. Second, my notes aren't going to focus too much on the fact that the republicans use detestable language to talk about queer people behind closed doors. Frankly, we already know that because they do it in public too. In my opinion, it's more beneficial to point out the political horse-trading and message-crafting that happens behind the scenes to make these kinds of fascist bills pass. With that said, here are the rough notes.

(LIST OF KEY PLAYERS:

-REP JULIANNE YOUNG (R, IDAHO)

-SOCIETY FOR EVIDENCE BASED GENDER MEDICINE, A CONSERVATIVE THINK TANK OF BOUGHT MEDICAL PRACTITIONERS.

-AMERICAN COLLEGE OF PEDIATRICIANS, A SMALL SPLINTER GROUP OF LICENSED PEDIATRICIANS WHO ARE AGAINST GENDER TREATMENT IN CHILDREN, DESPITE THE FINDINGS OF THE LARGER PEDIATRIC COMMUNITY

-WOMENS LIBERATION FRONT (WOLF), TERFS

-THE KELSEY COALITION, A HATE GROUP DISGUISED AS PARENTING ADVICE FOR PARENTS OF TRANS CHILDREN. ANTI-TRANS. -THE EAGLE FORUM, A LEGAL HARASSMENT GROUP ORIGINALLY CREATED TO OPPOSE THE EQUAL RIGHTS AMENDMENT OF 1972. NOW ASTROTURFS ON CULTURE WAR ISSUES. END KEY PLAYERS) -They're gameplanning the wording of bills very carefully, and are generally very conscious of optics throughout (see Email pg 12).

-A lack of understanding/education among “moderates” is key to the trick of oppression (Email pg 14, “Not a single legislator I’ve spoken with so far has a clue about what’s happening with transgender advocacy nor affirmative therapy. All of this is new to them," phrased in a context that implies that this lack of information gives the Republican extreme maneuvering room). The fact that they know this is telling, and it comes up later.

-Role christianity has to play in the radicalization (Email pg 17, from Margaret Clarke of the Eagle Forum, a group originally created to oppose the Equal Rights Amendment of 1972) -Using WOLF for feminist cover (Email pg 19)

-Use of Detransitioner Amicus Brief (argument is trying to allow businesses to discriminate against trans people by claiming the following: Gender = Sex, Sex = “reality,” “you can’t force people to accept a denial of reality”. Never mind the massive complexities of primary & secondary sex characteristics, the many documented cases of people with one set of sex chromosomes with primary & secondary sex characteristics that do not match, & the fact that allowing kids to try social transitioning before they’re eligible for surgical change will actually prevent people from rushing into being trans by letting them try non-permanent gender experimentation that is reversible, thereby reducing the amount of detransitioners) -Citing “fact checking of American Association of Pediatrics (AAP)” but only really coming up with the fact that articles from the very early days of trans conscious study used sources that weren’t specifically related to trans identity, but Gay and Lesbian identity instead. As if they wouldn’t fucking string gays and lesbians up by a tree if they had the fucking chance, and as if torturing trans people back into the closet is going to magically fix that too, somehow (Email pg 21) -Throwing out gender identity research because it was written by Trans people. Because they don’t understand the concept that people sometimes work on things that are very close and personally affecting to them. (pg 24) -All above points are referencing the “Vulnerable Child Protection Act” - “We will need to respond to the Suicidal Thoughts quote, who’s the best on our team?” (pg. 29) Specifically referring to the statistic that gender affirmation by family in trans youth drops their fucking rate of suicidal thoughts by 52% and suicidal actions by 48%. So, yes, the right knows exactly what they’re doing. -Lawmakers are “pissed” at having to hear from actual trans people and their lived experiences (no surprise, lawmakers aren’t people) (also, pg 36) -Citation of a “Daily Signal” article saying that “surgeon admits that nobody truly transitions.” What the article actually provides is a transition surgery doctor’s physical examination of a trans woman which marks that, yeah, sure, certain physical secondary sex characteristics did not, in fact, change, because she was fucking born with them. But no trans person I've talked to ever denies the fact that certain biological secondary sex characteristics will survive the transition, they all acknowledge that and it isn’t much of a problem because secondary sex characteristics are already not a black and white issue. (pg 36) -An admission that, ultimately, they want to stop all transitioning, regardless of social/medical/adult/adolescent on pg 37 (also some generally concerning language, but that’s a given with republicans). -Failure to understand that children (in the relation sense, not the age sense) have their own agency at some point and deserve to make their own decisions, page 39.

-Reference to christianity being their main driving force on 41.

-Republicans ACTIVELY removing “expert” testimony that is prejudicial to their anti-trans bills from their findings. Not passively, actively. As in they saw it, literally said “this makes us look bad,” and struck it from the record. (43) The “expert” was SEGM, an anti-trans farce of an agency, and even THEY said that “the society of evidence-based gender medicine has declared that the conflation of sex and gender in health care is alarming, subjects hundreds of thousands of individuals to the risk of unintended medical harm, and will greatly impede medical research.” This is their anti-trans farce agency, seeing the evidence, acknowledging the evidence, and then ignoring the evidence because they want to do damage.

-Arguing about using the word Cisgender in the SEGM’s findings because it “lends an air of credence to gender research” (46) -Evidence of collusion w/ Child & Parental Rights Campaign, a legal harassment front (79) demonstrating a direct effort from republican senators to provide aid and comfort to the legal harassment of trans constituents. Not a surprise, if we're being honest.

- “the society of evidence-based gender medicine has declared that the conflation of sex and gender in health care is alarming, subjects hundreds of thousands of individuals to the risk of unintended medical harm, and will greatly impede medical research.” Remember this line from earlier? Well, the lawmakers (not the SEGM) decided to amend it to “the erasure of biological sex negatively impacts the health and safety of all individuals,” which is the opposite of the original quote. The quote was changed by Julianne Young, a woman who is not a medical expert of any kind, but instead, an Idaho state rep. Republican, obviously.

-Page 86, on Feb 4 2020, Julianne Young talks about INSERTING IDEOLOGICAL LINES INTO THE FUCKING CENSUS CODE IN ORDER TO JUSTIFY THEIR POINTS IN A LATER PLANNED DEBATE ABOUT TRANS RIGHTS. All of the points she adds (highlighted in red on the page,) mention some strain of ideological instead of statistical interest. Also, god help them, they cannot get over the appeal of using segregation terminology like “separate but equal” because they just HAVE to let the mask slip off sometimes. -ACP’s leader, Michelle Cretella, calls herself “techtarded” on page 91, which is an interesting choice of language in a professional setting. -“embrace reality and christ” on page 91 is fucking comedy gold.

-GIRL or “Gender is Real Legislative Act,” using language to wrap fascism in feminism (not an uncommon tactic). They're using a similar tactic with Women's Liberation Front, or "WOLF," which is just a TERF organization.

-Discussion of fabricating information in briefing papers to state legislators in order to sway votes on page 92. Specifically claiming that inconsistent legal/historical definitions of gender bolsters their argument (somehow?)

-Robert Sullivan, esq, discussing how his faith plays a role in his anti-trans crusade. Most interestingly, if you swap “Christ” and “Christian” terms with “Allah” then it would sound like it was written by the fucking Taliban (98-99)

-Kaiser Permanente study is cited by Dr. Mirriam Grossman, a bought rag for the Republicans, and she specifically heard it from the Society of Catholic Social Scientists. A longitudinal study found that, basically, youth diagnosed with gender dysphoria were often comorbid with other mental health issues before their diagnosis, which, yeah, no shit, being vilified by society will tend to do that to a motherfucker. Plus, I think that non-queer people who are on average far more repressive and image-conscious are just more hesitant to get diagnoses about mental health issues in general, which definitely skews the stats. But, there are other things here that are important to note: 1, this study is being misrepresented to paint trans identity as “a malformation” in that creepy, eugenicist feeling way. 2, full on tinfoil hat speculation, but I’m convinced that Kaiser Permanente shared this information with the republican party (albeit indirectly) in order to use the culture wars as a cudgel to legally cut costs by denying medical coverage to trans people, which, sans anti-trans legislation, could be prosecuted as discrimination. (100).

[ourlittledinosaur]

From Baby to Toddler

New Post has been published on https://www.ourlittledinosaur.com/from-baby-to-toddler/

From Baby to Toddler

My Big Ole One Year Old!

My son turns 1 year old here in a couple weeks. As my husband said today, “I’m in denial.” Watching him grow up from a newborn to this newfound toddler stage has been such a joy, even though sometimes it makes me tear up. Time is just passing so quickly!

As I often do, I have been reminiscing about those first days. Lately, I’ve been thinking about his very first day, in his very first few hours. My husband and I were sitting on the bed in the birthing suite, watching the midwife do his newborn testing. We noticed that his feet were flexed upward and laid all the way against his tiny shins. My midwife mentioned that if we didn’t see a change to take him in to his pediatrician in a couple days.

My husband and I spoke about it in the days afterwards, when my son’s feet started to look more normal. Both of us had the thought, though we didn’t verbalize it in those early hours that our son may never walk.

Aaaaaand He Walks!

I am happy to share with you that as of this past week, we have a happy, brave, and fully WALKING child. He is no longer a tiny, helpless baby, but a waddling, mobile toddler. (Ok, ok, he’s still my baby.) Remembering those scary moments in the beginning has made us all the more grateful for his progress and health in both mind and body.

We have truly loved each stage with our son more than the last. Looking forward to all the many moments, milestones, and stages to come.

“Children are a heritage from the LORD, offspring a reward from him.” Psalm 127: 3

What about you?

Share your parenthood story with us!

Like this post? Help us and others by Sharing!

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#Milestones #Parenthood #Teaching and Guiding our Children

[blairmelendez93]

Essential Points to Keep in Mind When Looking for an online pediatrician Service

Pediatricians are the specialist doctors to diagnose and treat ailments deteriorating children's health. Parents approach these specialist doctors to seek medical consultation when any issue arises. The most convenient way of seeking quick consultation is by choosing an Online pediatrician from the top telehealth portals. Before making any consultation, here are a few points parents should keep in mind.

Points to ponder for online pediatric consultation

1.                  Approved portal for healthcare consultation

Ensure the respective authorities approve the portal you have chosen for online consultation. It is necessary to abide by such rules to avoid discrepancies and improper treatment.

2.                  Board-certified pediatricians

All the pediatricians in the online telehealth portal should be certified by the medical association board of the USA. The online portal must cater to displaying the academic excellence and experience of doctors of all categories. It enables the parents to trust the doctors at a glance and choose specific doctors for online consultation.

3.                  Preparation with the history of vaccination and other details

Parents should be well aware of the information related to birth, vaccination, history of illnesses, physiological traits, etc., of the concerned children beforehand. It enables the doctors to seek information better and make well-informed decisions considering all the facts and figures.

4.                  Nothing should be hidden from doctors

Another critical factor is telling every detail of the ailment to the doctors. Make sure you reveal the correct information as asked by the online pediatrician. The parents will also have to monitor the children's physical and mental growth and provide information accordingly. Identify all the changes, including behavioral changes, beforehand and tell the doctors. Any discrepancy in providing information may lead to improper diagnosis and treatment.

Choosing the right online telehealth portal

Now that these points are clarified, you will have to choose the telehealth portal for proper consultation and care. Parents should check the authenticity of the online portals offering a medium for online medical consultation. The pediatricians must be credible enough to provide consultation.

Check the experience of the Online pediatrician you want to choose for consultation. Find out how the online portal operates. Online portals will ask to register and create an account. Evaluate these plans beforehand, considering the services you can get.

After a proper evaluation, select a plan on a provided list to seek consultation. These online portals will send the digital prescription generated to your email ID. Make sure you have provided information to all sections appropriately. Register today and enjoy the convenience of pediatric consultation.

#onlinepediatrician

[snelbz]

Life As We Know It {Chapter 9}

Summary: After the sudden deaths of Nesta’s sister and Cassian’s best friend, they gain guardianship of their nephew, Nyx.

Based on Life As We Know It (2010) and a prompt sent in by anonymous for our Nessian fanfic contest. This is a modern au.

Instead of doing a tag list for this story, we have decided to have a set posting schedule. Chapters will be posted weekly on Mondays and Thursdays. Chapters will be posted on both my and Shelby’s blogs! >> @snelbz​

Life As We Know It Masterlist

Shelby’s Masterlist

Tara’s Masterlist

A/N: SURPRISE. Enjoy this chapter a day early. I had my days wrong and legit thought it was Thursday, but since it was ready…. Y’all get to enjoy the spoils of my frazzled brain. 😘

Nesta waited with Nyx in the waiting room of the pediatric office.

His rash didn’t seem to be bothering him much, but she wanted to get ahead of it before it became a problem. He was absolutely enamored with the TV playing a bright children’s show in the corner, and Nesta couldn’t help but smile down at him as she checked her email.

The usual stuff greeted her, some open catering order invoices for the restaurant, a few wayward resumes from high school kids that had managed to get her personal email, and, of course, spam.

“Nyx?”

Nesta’s head shot up, and Nyx began looking around, wondering who had called his name. Nesta was instantly on her feet, pushing Nyx’s stroller toward the door that the nurse held open.

She smiled. “Hello, Nyx.”

Nyx babbled in greeting.

The nurse chuckled. “Such a cute little guy. You’re Nesta, I assume?”

“I am,” Nesta confirmed. “I’ve not been here before. It’s a nice office.”

The small talk went on. Nesta had never been a fan of small talk, of polite pleasantries.

It just made her feel awkward.

Nyx didn’t seem to mind. He just kept babbling and babbling and babbling, without a care in the world.

The nurse led them into a room and she checked Nyx’s height and weight before telling them that the doctor would be there shortly.

Nesta had picked Nyx up, looking around at all the educational posters on the walls, when a quick knock sounded on the door and a man cracked open the door.

Nesta blinked once as he stepped inside, not expecting the tall, muscled man that appeared in front of her.

“You must be Nesta,” he said, extending his hand. “I’m Dr. Kamaras.”

This man was Nyx’s pediatrician? She had known that Nyx’s doctor was male, Feyre had mentioned him in some stories a few times, but Nesta had always pictured an elderly man.

Not this sculpted, handsome man, who could easily graced the cover of one of the ridiculous smutty books she kept well hidden in her bedroom.

She shook his hand, finally remembering how to speak. “Yes, I am, it’s nice to meet you.”

Very nice to meet you, she added in her head.

His face sombered. “I was very sorry to hear about Rhys and Feyre. They were great people.”

And just like that, Nesta was back on earth, holding her sister’s son in her arms, standing where her sister should have been. She tried to keep her smiling from dimming, but she cleared her throat. “Thank you. It’s…been an adjustment.”

As if they both remembered why they were here, Dr. Karamas blinked and said, “Yes, Nyx, right. You told the nurse he has a rash of some sort?”

“It’s just a diaper rash but it seems to be getting infected,” Nesta explained. “I’ve tried a few different things but nothing seems to be working.”

“Ah,” he said, nodding. “Well, let’s take a look.”

Dr. Karamas took one glance and whistled. “Definitely infected. I’m going to give you a steroid cream. Put it on after every diaper change. It should clear up within the week.”

Nesta let loose a breath. “Oh, great, thank you.”

“Absolutely,” he smiled.

He had a nice smile.

He scribbled something down on his clipboard, signed it, and handed it to Nesta. “The number on the bottom is my office number. If you have any other concerns, no matter how small, give it a call.”

Nesta looked at Nyx’s prescription and the number that was beneath it, along with his name.

Balthazar Karamas.

“Thank you, Dr. Karamas,” Nesta said, and she meant it. She was still new at this, and every little medical thing concerned her.

If it wasn’t normal, she was freaking the fuck out.

“Bal, please,” he said, taking her hand again, shaking it. At the look on her face, he added, “I work with kids. They do better on a familiar name basis than with titles like doctor and mister.”

She nodded, smiling. “Bal, then.”

Nesta was getting Nyx resituated in his stroller in the waiting room, about to head back out into the bright sunlight, when she felt someone approach. She wasn’t expecting to find Balthazar standing a few feet away. She quickly checked the stroller, making sure she had her purse, the diaper bag, and, of course, Nyx himself. “Did I forget something?” She asked, finding everything exactly where it was supposed to be.

“No, no, it’s not that,” he said, pausing in front of her. “I just…can’t shake the feeling that I know you from somewhere.”

It was strange, since Nesta felt the same way.

“You’re not Illyrian,” he said, and it wasn’t a question, nor was it rude. Just an assumption. She only knew of a few other Illyrians in the area, and Balthazar definitely had the same coloring as Cassian and Az. And Rhys used to have. She, pale skinned and blue eyed, certainly did not.

“I’m not,” she said, at last.

Bal chuckled.

That smile, yet again, had her toes curling.

“Interesting,” he said, that smile remaining. “Well, maybe we can figure out just where we’ve run into each other before...over lunch this weekend?”

Nesta blinked. A date?

“Not a date,” he said, quickly, reading her mind. “I would never ask the aunt of my patient on a date. That would be incredibly unprofessional.” Nesta laughed. “Just…two acquaintances figuring out where they were previously acquainted.”

“Lunch sounds nice,” Nesta said, unable to shake her own smile. “Saturday, then?”

“Saturday,” Bal agreed.

They set up a time and place and then Nesta was out the door.

*

Cassian’s day had been as long as it was the day before. It seemed that the teenagers visiting Velaris had gotten the message from their friends that Cassian’s bar was checking every single ID of every single drink that was ordered. So instead of being slammed and busy and frustrated the whole day, he had been bored out of his mind.

He’d gone through his inventory sheets twice, ordering anything they might remotely run out of in the next few weeks.

It didn’t help that Kallias had the day off, covering the evening shift tonight, leaving him alone with his thoughts all day.

And those thoughts constantly reminded him that he’d been an absolute dick to Nesta the night before.

As he drove home, he contemplated the apology he needed to make.

Although Cassian believed his intentions were typically good, apologizing wasn’t one of his strengths. He ran through what he’d say a hundred times, had come up with an unbearable amount of ways in which he could apologize, but everything he thought of wasn’t good enough.

He knew Nesta well enough to know when she would laugh in his face.

He’d come up with about fifteen different scenarios of how this could go by the time he pulled into the driveway, parking next to her little car. He took a deep breath before unlocking the front door and letting himself in.

The house was quiet, neither Nesta or Nyx were anywhere to be found. It was barely six-thirty, but he knew Nesta was taking Nyx to the doctor earlier in the day, which may have tired him out so thoroughly that he was already down for the night. A peek into his cracked bedroom door confirmed it, his little hand curled next his face as he slept.

When he finally tracked down Nesta, on the back patio, her feet propped up in a lounge chair, he definitely hadn’t expected to find her with a bottle of wine. Or what was left of it, at least.

The mostly empty bottle of wine sat next to the baby monitor.

He cleared his throat, announcing his presence.

Nesta’s sigh was the only acknowledgement she showed.

“Everything alright?” He asked.

She shrugged and took a sip from her glass.

“Bad day?” He continued.

She shrugged again.

“Is this the silent treatment?” He asked.

“I assume you’d know,” she said.

Cassian began rubbing his temples. “Look, Nesta-.”

“I’m a little busy if you don’t mind,” she continued. “I prefer to relax alone.”

“This is my house, too,” he said, shutting the sliding door behind him as he made his way onto the patio. “What if I want to sit out here with you?”

“Then I’d suggest continuing the silence,” she said, not looking at him, her face tilting back up to the sky, where it had been when he’d come outside.

So he sat down on a nearby lounge chair, and didn’t say a word.

Or he tried, but he didn’t last five minutes. The words that had building inside him all day needed to come out. He’d rehearsed different things he wanted to say, with reasons for why he was such an asshole, and promises to try and be better from now on. But as he looked over at her, the starlight on her face, all he could get out was, “I’m sorry.”

For a moment, Nesta said nothing. “About?”

“The way I acted last night,” he replied, keeping his eyes on the lawn. “It was uncalled for, and I’m sorry.”

“I have no idea what you’re talking about,” she said, draining her glass.

Cassian’s eyes shot her direction. “I’m trying to apologize. You can at least accept my apology so we can move on.”

“Apologies mean nothing,” Nesta said, shrugging. “Words are meaningless.”

“Not mine,” Cassian argued. “I mean what I say.”

“Then you meant what you said last night?” Nesta pushed.

Cassian’s lips snapped shut and his jaw hardened. “No.”

“So, you’re a liar, then?” Nesta asked.

He groaned in frustration. “You’re infuriating.”

She didn’t deign to reply to that.

He took a deep breath. “I’m sorry I was an asshole last night. I was…embarrassed about how you found me the night before. I don’t… I don’t like to be seen like that.” He paused, but then he held a hand out in between them. “Not- not that that happens often. I mean, I don’t make a habit of having emotional breakdowns.”

She didn’t say anything. Just stared at him.

He cleared his throat again, remembering little things he had felt badly about through the day. “Nesta, I’m sorry I acted like an ass. I’m sorry I didn’t appreciate the dinner you made me. I was rude as hell and you did nothing to deserve it.”

After a second, she glanced away, out over the pool. He figured she wasn’t going to reply, and he stood, heading back for the back door.

He had slid the door open and was halfway inside when she said, “If you’re hungry, I made lasagna for dinner. It should still be warm on the stove.”

He turned back and found a hint of a smile on her face. “Thanks, Nes.”

*

A continuation of his apology, Cassian had told Nesta he'd be on baby duty for the rest of the night, waking Nyx up for his bottle, granting her leave to do whatever she wanted. She elected to finish off the bottle of wine, open another, and relax in the bathtub with a book.

The book of choice was definitely not appropriate to read in front of Nyx.

Or Cassian, for that matter.

She had appreciated his apology, even though a part of her still wanted to be pissed. There were very few things that agitated her more than male bravado, and Cassian was the spitting image of it. Embarrassed because he was emotional? Please. Get the fuck over it.

Then again, she could say that all day, but in honesty, if the positions were reversed, she would have reacted very, very similarly.

If not worse.

Nesta had always felt too much, far more than either of her sisters. It wasn’t like they were robots, of course. Elain had a bigger heart than anyone Nesta had ever known, and Feyre had been a light to be around.

But, Nesta…

She felt it all, and she felt it far too deeply. She had learned long ago to shut those emotions off, to let them go, to not let her emotions show. They could just be used as a weakness.

And she found life worked better that way.

There was a soft knock on the bathroom door.

Nesta sat up straight, even though the door was locked, in a sudden panic over the fact that she was nude and reading smut.

“Yeah?”

“Nyx is going to bed,” he said. “Just thought you’d want to say goodnight.”

“I- Ah- Just a minute,” she called, setting the book down and reaching down to grab for her towel. She was out and damn near opened the door in just her towel again, but remembered their agreed upon rules. She snatched her robe, wrapping it around herself, towel and all.

She opened the door, Cassian standing just by her bed, and Nyx had his head resting on his shoulder, rubbing his little eyes.

The image was so pure and innocent that Nesta couldn’t stop herself from taking a few steps towards them, reaching out to brush her fingers down Nyx’s soft cheek. “Sweet dreams, buddy,” she breathed, leaning up to press a kiss to his forehead.

She regretted it almost immediately, as bringing herself that close in Nyx also inadvertently brought her to Cassian. His heady, nutmeg-and-campfire scent enveloping her, reminding her of the morning she’d come downstairs and found him as naked as she was now. She stepped back quickly, clearing her throat. “And goodnight to you, Cassian,” she murmured. She pointed back behind her towards the bathtub, towards her book, and said, “I’m going to read a little longer and then go to bed myself.”

He nodded. “Alright, I’ll see you in the morning. Goodnight, Nes.”

The nickname didn’t bother her as much as it previously had, she realized as he made his way back out of her room, shutting the door behind him.

She didn’t let herself think about that, did her best not to think about him, as she sunk back into the warm water.

*

Nyx had gone down easily for Cassian, for the first time ever, thanks to the frozen toy he’d gnawed on to relieve the pain of his incoming tooth. He’d decided he deserved a treat, too, after that, and had sat down to watch the hockey game, a beer in hand.

Fifteen minutes later, there was a knock at the front door.

Cassian paused, glancing down at his watch, seeing that it was pushing nine o’clock. He stood, after a second knock sounded, making his way to the door. He opened it to find a woman dressed in a suit on the other side. “Can I help you?”

“Mr. Nazari, I assume?” She asked, extending her hand.

He took it, on instinct, shaking it, but he blinked. He repeated, “Yeah… Can I help you?”

Her brows twitched together. “My name is Alis Birch. I’m with social services.”

Cassian continued to shake her hand, staring.

“The courts told you we’d be making random visits to check in on Nyx,” she continued.

Oh, fuck, Cassian thought. Oh, fucking hell.

They’d completely forgotten about those random visits, in the past few weeks they’d been doing this, distracted by getting used to not only being parents, but getting used to each other as well.

“I see,” Cassian said, nodding. “I… I’ll…be right back.”

“I’d like to come in-.”

Cassian shut the door, quickly set his beer on the table in the entryway, and hauled ass upstairs.

He threw open the door to Nesta’s bedroom, only to found it empty, so he continued on, throwing open the bathroom door.

Where Nesta was still in the tub, completely nude, a book in hand, one hand disappeared beneath the water. Her head was thrown back in utter ecstasy.

Until Cassian barged in, anyway.

“Shit!” he yelled, just as Nesta gasped and sent the water sloshing out of the tub, over the porcelain edges.

Cassian quickly shut the door behind him, closing them into the bathroom together, and put his face in his hands. “Sorry!”

“What the fuck is wrong with you?” she yelled, and he could hear her pulling the plug.

“It’s important, I swear,” he said, his voice muffled by his hands.

“If the house isn’t on fire or Nyx isn’t dying, it’s not important,” she cried, ducking behind the walls of the tub.

“It’s pretty fucking important,” he said, turning to give her a semblance of privacy. He heard her stand up, water moving and quiet dripping, before her feet landed on the rug outside the tub. “The social worker is here.”

She froze and he dared a look back at her. Thankfully, she was wrapped in her towel again, one arm pushed through her robe. “The social worker is here? Now?” He nodded, and she looked at the nearly empty bottle of wine next to the glass on the small table by the tub. It was the second one she’d had that night. “But it’s late,” she protested.

“It’s a random, surprise visit,” he replied. “I left her outside, but-.”

“You didn’t let her in?” Nesta demanded, eyes widening. “Cauldron, Cass, that makes us look so guilty.”

He blinked. “Of what?”

“I don’t know,” she said, throwing her hands in the air. “But it doesn’t make us look good.”

“Well, I didn’t know what to do,” he sighed, exasperatedly. “I sure as hell wasn’t expecting to come up here and find you doing that.” He gestured to the tub.

Nesta’s cheeks heated. He figured his own were going to permanently be the shade of red they were now.

No, that was the last thing he ever expected to catch Nesta doing.

“Just… Go let her in and stall her while I get dressed,” she sighed, crossing her arms, waiting for him to leave.

Cassian hesitated, then nodded, and hurried back down the stairs. When he reopened the front door, Alis Birch stood there. Her expression was hard, intimidating.

Cassian could feel himself sweat.

He prayed that Nesta somehow sobered up and got the fuck downstairs, because there was no way in hell he could do this without her.

#snacmc lawki #life as we know it #nessian #nesta archeron #cassian #acotar #acomaf #acowar #acofas #acosf #snelbz tacmc collab #snacmc

[a-very-fond-farewell]

The forbidden crack! Untamed prompts: 25/?

Gaming Chat AU [xuexiao + songxiao = ?]: “Lie to Me”

[tw cyber bullying; tw use of slurs; tw fake suicide mention; there’s a redemption arc, but it starts with 15yo Xue Yang being... well, himself I guess. so be warned.]

[attn!: I don’t know shit about playing games and going to quests with strangers on the internet so bear with me. if you feel inspired by this please, by all means, feel free to use this prompt and write something and then tag me so I can read it and reblog it!]

[enjoy!]

*

It’s been 15 years since that idiotic intern at the school counseling center suggested him to... what did he say? “Channel his anger in something productive”. And then tried to talk Meng Shi into purchasing a fucking computer to let him “get off some steam” by killing fictional people instead of smashing actual valuable objects like, say, the principal’s Mercedes with a stolen golf club, or, the nurse’s desk with a fire extinguisher back in middle school.

Good thing Su She had disappeared under mysterious circumstances after Xue Yang had surreptitiously let the intern’s uni professor know in a detailed email how the aspiring counselor had suggested him (a sweet innocent 15 year old) to use his new computer to watch porn instead of focusing on his studies. Song Lan was much better than him, and bitchier too, which was fine by Xue Yang anyway. Not that he cared.

What good had that stupid glorified television brought him in the end? Most of the computers at school had become intimately familiar with many a malware and virus already with how frequently he used to browse through the deep web. The ones at the local library had let him in on the secrets of 4ch*n since the tender age of 8. Hell, even his pediatrician had made the glorious mistake to leave him alone in her office one merry day of winter when he discovered the wonders of x-rated videos.

But Meng Shi had tried to cheer him up anyway, buying him that stupid thing. Working her ass off at the bar trying to make social services forget she used to be a stripper back in the days. All to provide a place for children in foster care to feel safe, the stupid hag. Xue Yang wasn’t fucking stupid, he knew she was collecting money for every kid ever stepping inside her ratty flat. He knew that she would have never adopted anyone for real because she already had a son and she was working to send him to university anyway.

Yet, she had come home one day with a big smile on her youngish and bland face, hoisting up the heavy computer in a box, and told Xue Yang to share it with his siblings. Yeah, fuck that. That little bitch A-Qing was even worse than him, and she probably used to sell feet-pictures recycled from the internet to disgusting men online. To this day Xue Yang is none the wiser and he doesn’t need to know what that fucking witch had been up to at 14. XuanYu would have used the computer to stream and torrent shit nonstop to sell at school even if he was only, like, 12. Qin Su was 15 like him and she would have been tempted to set up a fucking YT channel and subject him and XuanYu to whatever scientific experiment she would have come up with. And Meng Yao had too much embarrassing blackmail material on Xue Yang already, he didn’t need to have access on his erased search history after digging gods-knows for how long.

Ahah no. No thanks.

But detention got him occupied for so long by cutting library books pages down to papermen without getting bored out of his mind. And he did have his fun that one time when he caught a pervert with a hand down his pants when they chatted on Om*gle after Xue Yang had catfished him good by pretending to be a girl. Got everything on tape and published the whole interaction on the school website for everyone to see. Which had been appropriate at the time, given that the man had been part of the board of directors. Fittingly hilarious too.

Still, boredom loomed over him like a quilt of sadness on summer break and he had been tempted to log in and play games in the end. Nobody wanted him in their stupid ass teams anyway, with him having higher kill counts than them and all, not following tactics and so on. Whatever.

Until one day user shuan_ghua naively trusted Xue Yang when the other assured him that “teabagging“ was just a fancy slang for ordering a cup of jasmine tea. The 17 year old boy named Xiao XingChen had thanked him for teaching something new to him and then proceeded to ask him to join his one-man-party out of fucking nowhere.

Everything changed after that.

[more under the cut. it’s long long tho]

XXC family!:

XXC is 17 at the beginning of the story and he used to live with his mother Baoshan [i know that “Sanren” and “Daoren” are titles, but in absence of a real surname I will use them as such for this prompt. feel free to change that if you take inspiration from this post to write your take on the story] and the rest of their family on a mountain before they moved back to the city in Gusu.

XXC’s mother was barely 20 when she got married the first time and her first son Daoren YanLing was born. two years later her husband died and she travelled a lot afterwards, adopting 4yo CanSe when she was 25. then she married again at 41, had XXC at 44, and then divorced at 48.

CanSe eloped with ChangZe when she was 18 and got WWX at 20, the same year her own mother got married again (at 41).

BaoShan got XXC three years later (at 44).

hence, WWX is 3 whole ass years older than XXC despite being his nephew. both boys find the thing absolutely hilarious.

YanLing and CanSe are only 1 year apart and they still bicker nonstop. both of them went to school with Lan QiRen and his older brother and frequently got in fights back in the days at Gusu.

(if YanLing had a thing for Lan QiRen, well, nobody has to know)

XXC, being the baby of his family, is doted on by YanLing and brought to mischief by CanSe until XXC’s father divorces their mother and they move on the mountain along with ChangZe and 7yo WWX.

up on the mountain BaoShan works as a tour guide and she takes baby XXC and WWX on hikes along with tourists to admire the beauty of the scenery.

XXC’s sight starts deteriorating when he is 12 and WWX is 15. they have been homeschooled until then, so when it gets clear XXC will not improve much so far away from proper healthcare, the whole family moves back to the city in Gusu.

XXC is not comfortable leaving his new home, not with all those new noises and flashing lights. WWX is drawn to them instead, more than happy to enroll in school, where he meets JC and he realizes the boy is the son of CanSe’s middle school boyfriend. WWX declares them to be almost-brothers and is perfectly fine with adopting even JC’s older sister in the family and CanSe can only laugh at that. JC and YanLi visit XXC often as a result and they help him make sense of the new environment without stressing him too much.

YanLing finds a job as a cook in WWX’s school and he is back to making Lan QiRen’s life impossible after learning the man is a teacher there.

LWJ and LXC’s mother is a music teacher there as well and YanLing bonds with her to make Lan QiRen life’s an absolute nightmare.

LWJ and LXC make friends with the mountain gremlins and they are initially horrified by their manners: XXC would pick food from the ground and eat it, it doesn’t have to be his for that to happen to begin with; WWX doesn’t realize he should cut his nails (both for his feet and hands) until he is forced to wear shoes outside and not climb up trees, for he assumed nails simply never grew bc he used them constantly, wearing them down; etc.

LWJ hates himself for falling for WWX but he cannot care less.

LXC notices how lonely XXC feels when wangxian becomes a thing, so he buys him a computer to better gather more information about the world and adjust the settings to maximum accessibility whenever XXC wants to read something.

by the age of 17 XXC is mostly left alone in the house: WWX goes to uni; his mother BaoShan works at a local museum; his brother YanLing is trying to not get fired at his job; and his sister CanSe has started to travel with her husband selling the delicate dizi flutes ChangZe makes as an artisan.

XXC is also on the waiting list for an important eye surgery and he figures he has a couple of years to go before he will either lose his sight or be granted a second chance at life altogether.

XY’s family!:

Meng Shi had Meng Yao at 19 and started stripping the following year in Yunmeng. 

her friend SiSi helped her both financially and emotionally, spending time with A-Yao while she worked at night. after four years she can move out of her flat and finds a job as a bartender downtown. she would have kept her old job, if SiSi hadn’t convinced her to think of A-Yao first, who was painfully shy and didn’t know how to socialize with other kids his age.

at 24 she starts the paperwork to become a foster parent and has to child-proof her entire apartment before the first kid arrives. at 25 she welcomes Qin Su, who is only 5, and initially A-Yao doesn’t want to share his mother with anyone. the situation gets bad to the point social services have to take Qin Su away one year later, because she tried to set A-Yao’s hair on fire in retaliation once, but two years later Meng Shi gets her back.

A-Yao, now 9 years old, has thought about it and reasoned that having a sister wasn’t so bad after all. Qin Su is only one year younger than him and she will not take up much space, right? wrong. but they bond over their shared nerdiness and while A-Su likes to blow things up, A-Yao helps his mother with taxes every year.

at 29 Meng Shi takes in XuanYu, who is not an orphan like A-Su, and still misses his birth mother fiercely. she had to give him up for adoption when he was 3, because she had been only 15 when XuanYu was born and her family threatened to disown her. 

being profoundly deaf on top of that, no foster home wanted to have him and he was kept in the system for three years after his mother had to let him go. the woman had tried to be present for him while he waited for a family to pick him, teaching him sign language and reading lips, but she had been forced to eventually let go.

XuanYu arrives at Meng Shi’s when he’s 6. A-Yao (10yo) and A-Su (9yo) try their best to involve their new brother, but they don’t know how to communicate with him. SiSi takes the children to sign language classes at the community center after school and XuanYu warms up to them. he teaches Meng Shi what they learned the previous day every morning, before going to school. teachers don’t really pay attention to him, but he manages by reading lips when people face him properly, which is a rare occurrence, but he tries his best.

when A-Yao and A-Su realizes A-Yu is being bullied, they start to get nasty, setting backpacks on fire and terrorizing the other children at school. even when they move to middle school one after the other nobody picks on A-Yu, fearing what his siblings could do.

XY arrives at Meng Shi’s when she is 32 (A-Yu is 9, A-Su is 12, A-Yao is 13) and XY is 12. A-Su initially gets jealous bc they are the same age, but XY doesn’t talk to anyone for a year and ignores her attempts to rile him up. Meng Shi had been warned about him: his father had killed his mother and then failed to kill himself afterwards... and XY still believed the man was out there, looking for him to finish the job. XY had lived on the street for years before social services could find him, but he had felt trapped like a dog, not wanting to be touched, frequently running away.

XY doesn’t remember much of his life before entering foster care. he only knows everything is a bother, that his nightmares give him constant migraines, and that he doesn’t care how he lost one of his fingers. but anyone who makes fun of him for that gets kicked, that’s for sure.

it’s only when A-Qing (12) comes one year after XY’s arrival that things get a bit better... so to speak. 

she is even less well behaved than him, thrashing around at night, screaming at the top of her lungs, saying that she doesn’t want to be there. that she’s better than the rest of them combined. 

her anger issues trigger something in XY and the two of them get into fights with each other constantly.

A-Yao (14) and A-Su (13), reminiscing of the 2 years they spent apart because they couldn’t stop hitting each other up, take the issue seriously and convince Meng Shi to ask for help. SiSi is the one taking A-Qing and XY to therapy two times a week and they are followed through by professionals who know how to tackle their issues, an elderly woman who goes by the name of Lan Yi (LWJ and LXC’s paternal grandma) and her assistant Wen Qing, an intern working there for uni credits.

one year later XY is 14 and A-Qing is 13 and they... don’t really love each other, but at least they can talk to one another without trying to kill anyone in the process. they spend a lot of time with A-Yu (11) and learn sign language to keep him entertained.

by the age of 35, Meng Shi has 5 kids and can barely afford food for herself but she is happy like never before. A-Yao (16) is already considered smart enough to attend advanced math classes in high school. A-Su (15) has won a science competition sponsored by city hall. A-Yang (15) is trying to work on his anger issues with video games, making friends online. A-Qing (14) doesn’t let anyone make fun of her for her dyslexia, asking adults and classmates to take her issue seriously for once. And A-Yu (12) wants to learn how to sign in different languages to maybe travel the world one day.

Meng Shi is very happy indeed.

now, the plot: (tw fake suicide mention; tw use of homophobic slurs)

XY (15) and XXC (17) meet online every night before bed, playing video games together. XY made a mistake first time they chatted, saying he was 17 instead of 15 bc he didn’t want the other to look down on him.

XXC trusts him a little too much and doesn’t question if his new friend is lying to him or not. he’s the funnies person he has ever met, after all.

WWX (20) notices something is wrong by the way XXC starts speaking around others, using inappropriate language when he has never been anything but polite and gentle. even if, technically, XXC is WWX’s uncle, the latter sees the other more like a cousin than anything else given that he’s older. so he takes the matter in his own hands and one day asks him to let him play games with him.

XY doesn’t like his only friend not telling him someone else would have joined their party, and initially he covers XXC in insults and threatens to leave. but then WWX is really good at killing fictional people and XY reconsiders. he makes fun of WWX for being the older one AND the other’s nephew at the same time, but aside from that he doesn’t try to run away like a caged animal anymore.

WWX trust XXC when the younger says XY is 17 like him, but he still supervisions most of their sessions just to be sure XY cannot teach too many horrible things to XXC. WWX wants XXC to make more friends and maybe one day leave the house to attend university if the other will feel inclined to do so, but he doesn’t pressure him.

in the meantime, XY changes counselor at school and it is Song Lan (23) who tries to make a better human out of him. SL is deaf and occasionally uses cochlear implants to hear, but only because his family made the choice for him to have surgery when he was only a child. he can speak if he feels like it at times (not frequently, he’s very adamant about reminding others he doesn’t owe them anything. he’s also trying to make a change at the school where he works by organizing classes on Deaf culture and sign language for the students to take as an elective)

XY already knew of SL thanks to XuanYu, bc A-Yu had seen the counselor at the community center where SiSi usually takes the kids to for sign language classes. counseling at school doesn’t really happen one-on-one, detention kids being too many to follow one at a time and all, but when SL comes by to chat with them he’s always funny as fuck and XY (who will never admit it) feels good about being the only one in class able to understand SL only through sign language.

SL forces himself to talk to the kids and read their lips only bc... well, they’re young and did nothing wrong to him. he occasionally asks XY to help him translate, but aside from that there are really too many kids to look after and he doesn’t treat XY differently from the others, nor he notices him much.

two years pass and XXC (19) announces to XY (17) that wangxian (22) is having their wedding. since XY has learned all about their family, he asks XXC if it’s a common thing to get married super young in their household and XXC laughs... but it’s a sad and brittle thing and XY gets a bit worried.

XXC reveals then that soon after the wedding he will have a surgery to (hopefully) fix his sight and he’s very anxious. he timidly asks XY if he wants to go to the wedding with him, because he would like to see his face at least once before the surgery.

XY panics: he knew XXC’s eyesight was bad, but he never knew to what extent exactly; he’s not really of age yet, so he cannot move on the other side of the country just to attend a wedding; he has never talked specifically about XXC with his family and Meng Shi is working a lot and A-Yu should get his hearing aids soon and A-Qing needs help for her finals and... and...

...and he’s not ready to meet XXC.

XY lied to him and told him they’re the same age. he had never told XXC his name, even if the other had revealed his own, always going by his username jiang_zai. he called him and chatted with him and made fun of his own family and the other had been nothing but kind and amazing and... and... and XY realizes he’s been in love for a while and he abhors the idea to the point where he openly laughs at XXC and calls him a sap.

XXC notices the change in his tone immediately and wonders if he’s overstepped, if he’s asked too much by inviting the other over to celebrate with the rest of the family. XXC apologizes to XY and begs him to not step away like he usually does when he feels cornered.

XY feels absolutely cornered and attacks XXC by asking him why he’s so keen on asking him out (“are you a f*g or something?” etc.). the other doesn’t even know what that means but hearing XY so scared hurts, bc he doesn’t want to make the other uncomfortable in any way.

XXC does like XY romantically, but would never dream to say anything and hinder their friendship. yet, it hurts more to hear his only friend so afraid and angry. he apologizes profusely and promises him not to bring the subject back.

after that, XY doesn’t log in much, avoiding XXC. A-Yao (18) notices he’s sullen and tries to spend more time with him, but the younger doesn’t budge and talks less and less. even SL (25) sees XY less and less, but he doesn’t thinks the younger one is actually skipping classes or anything.

but XY is, in fact, skipping school and Meng Shi covers for him saying he doesn’t feel well enough to go to class. she knows something’s up and she also understands the need to have days off in order to take care of yourself when everything goes to shit.

wangxian wedding happens and XXC is both happy and sad. they made him the official photographer of the day, which is both sweet and incredibly hurtful, because he’s the one taking all those beautiful pictures... and maybe he will never be able to look at them ever again after the surgery. WWX and LWJ already had to organize the wedding earlier than what they originally planned to accommodate XXC and the date of the surgery. XXC feels bad but he’s very happy for them.

YanLing and CanSe worry about him and they ask their mother to help them figure out what’s going on. BaoShan agrees with WWX that XXC had a fight with a friend, alright, but that cannot be all, surely...

it’s the week before XXC’s hospitalization and WWX takes the issue in his hands. logs in pretending to be XXC and plays until he takes XY’s place in the rankings of his and XXC’s favorite game.

XY receives notifications about it and initially fumes at the idea of being outranked, but then he understands what XXC is trying to do and doesn’t know how to react.

he does something horrible instead.

WWX waits to be contacted by this jiang_zai boy who broke XXC’s heart, but when it finally happens... it’s not the familiar, high-pitched voice he expects to hear in the chat. it’s a girl (A-Qing), who tells him her brother had died and that he won’t be playing games anymore. she sounds too serious to be joking and WWX tries to ask more about it... but she just tells him her brother killed himself before ending the call.

WWX doesn’t have the heart to tell this to XXC, not before the surgery and not until he has properly recovered (one year later).

XXC had wondered about XY in silence, not trusting himself to reveal all about his crush to his family, worrying about making the other boy uncomfortable. 

XXC misses XY, but he is patient. he can wait.

A-Qing had agreed to lie for XY only because he lied to her first: he told her a creep on the internet had tried to meet with him and he needed a way out; outraged, A-Qing had helped him without a second thought and answered the chat in his place. 

this spurs her to take more seriously what she and her siblings had been doing on the Internet and reconsiders some of the things she herself posted in the past. she will take this topic so much at heart that she will pursue an academic career to become a social worker.

XXC’s surgery goes well, but he still loses his sight after a while. WWX ends up telling him what happened to his online friend and XXC is so heartbroken he doesn’t even blame WWX for keeping the secret from him for so long. 

after some time BaoShan makes sure he goes to therapy and takes better care of him, helping him figure out what to do. she fears people will look down on XXC and, as a blind person, he will probably be hindered by the system to pursue a career, so she retires from her job at the museum and focuses all of her attention on him.

XXC feels guilty for XY’s passing, but he doesn’t think the other had been triggered to commit suicide bc of him: XXC simply fears XY had hid a different type of sorrow from him; a pain so deep that XXC had failed to see while they were playing silly games. so, three years after the surgery, when he’s 21, he enrolls in uni to study psychology to help kids who are struggling to ask for help.

15 years after XXC and XY had met online:

XY is 30 and a professional carer. he studied to become a nurse, of all things, after what happened. he got a lot of time to think about the horrible thing he had done to XXC and considered helpings others to atone for that.

he is the first to say such a choice was very out of character for him, and even if he has to bite his tongues at times he doesn’t mind his job: it keeps him occupied and exhausts him well enough... but after working in the hospital for 5 or so years he decides to become a carer and trains to help disabled people in particular in his late twenties.

A-Su (30) has become a chemical engineer and married a man working as a lawyer (who happens to be LXC), while A-Yao (31) ends up moving in with his best friend (NMJ). A-Qin (29) doesn’t find romance interesting enough to give up on her career as a social worker, so she doesn’t really move out of Meng Shi’s old flat and everyone is fine with that. A-Yu (27) has graduated from uni and travels the world as an interpreter. Meng Shi and SiSi have lived together since the first has adopted all the kids and they opened a B&B near the seaside. they are wives and very in love.

XY lives with A-Qing in Yunmeng until his late 20s and they fight a lot for stupid things (like when A-Qing makes fun of the boring people her brother hooks up with on the regular, or when XY tries to coerce her to do the fucking laundry by tickling her into a pulp of pain and tears), but otherwise they work well together.

A-Qing is working at the community center as a social worker to help the kids find purpose in life and use the internet safely. she still believes a creep had tried to mess with her brother and doesn’t want anything to happen to the kids under her care. XY knows this, but never got around to tell her the truth, believing it would have been pointless to reveal her how everything she knew had been a lie. even her own purpose on top of that.

A-Su’s husband (LXC) rarely got to speak with XY in person, the latter busy with his job as a nurse most of the time, but during a dinner party LXC has to suddenly leave because of an emergency: his brother-in-law had been brought to the hospital after a car crash and lost the use for both of his legs.

one year later, XY (29) coincidentally becomes WWX’s personal carer and decides to move closer to the man’s house in Yiling since it would be troublesome to help him as efficiently otherwise. XY does not recognize WWX (34) from his voice or name (he did play games with him in the past, sure, but he knew him as XXC’s nephew by the name of Wei WuXian, not Wei Ying, which is the name LWJ uses around him) and helps him around the house and out of it.

WWX’s husband (LWJ) is frequently out of the house to work as a lawyer like his older brother and entrusts WWX to XY, even if begrudgingly so. 

WWX pretends to be fine, but he has a tendency to try to sneak out and walk on crutches without anyone noticing, so LWJ has asked for a carer to come to their house every day. XY doesn’t have to bite his tongue as much around WWX, their interactions easy enough for the both of them to work together despite bickering about the stupidest things.

XY discovers WWX is friends with Wen Qing (37) (the same intern who helped the psychologist take care of XY and A-Qing while they sorted their shit out in the past). 

he meets her and learns from her how WWX’s family had moved in Yiling to help him recover after the crash. her brother Wen Ning is the physiotherapist helping WWX regain control of his legs, but there are basically no chances for him to go back to be a professional athlete even if he were to walk once more.

this new information spurs XY to force WWX to rest more and take his situation more seriously. they work together to find possible solutions and WWX decides that he would much rather have his legs cut off from the knee down that suffer through the pain of having multiple fractures splitting him apart day after day. the surgeons had done their best to save his legs, but the fractures had compromised his nerves maybe forever and the pain is now unbearable.

LWJ trusts his husband but he’s weary at the idea of having him evaluated for amputation. XY refuses to feel responsible for the tension in the house, since this is clearly what WWX wants. XY knows WWX is secretly considering running again on prosthetic legs in the future, but he doesn’t want to anger LWJ more by mentioning it. it’s too soon to know anyway, and who is he to tamper down what little hope WWX has managed to harbor for himself after an entire year drowning in grief?

one year later WWX (35) gets permission from his physician to get prosthetic legs fitted for his needs and he couldn’t be happier. his family visit him more frequently now to congratulate him, even his grandmother who has descended from the mountain where she retired to in order to celebrate him.

XY (30) has already met WWX’s parents and his oldest uncle, but he never suspected them to be related to XXC, because he had never knew them by name. 

yet, one day Song Lan (38) comes in with a huge backpack on his shoulders and recognizes XY immediately. XY doesn’t know why his old counselor is there: he knew WWX’s other uncle was coming over, but he never imagined it was SL they were talking about. 

SL is beaming at him, signing he met XY’s bother A-Yu during one of his travels as a tour guide and that they kept in touch. SL has come to know XY is the reason behind WWX’s recovery and he tells the younger man that everyone in their family is happy XY has appeared in their life.

XY doesn’t have time to answer, overwhelmed with this sense of belonging, this sense of being finally, finally accepted somewhere outside of his own family... that someone else enters the house with a backpack on his shoulders.

XY doesn’t know the man and SL enthusiastically guides him over to meet the newcomer. XY is surprised to hear SL speak out instead of using sign language as the older man asks “A-Chen” to come meet “his nephew’s savior”. based on the pronouns SL has just used, XY recognizes the newcomer to be WWX’s actual uncle and he smiles at the beautiful man in front of him...

...only to be filled with horror the minute the other speaks.

XXC (32) greets XY without knowing who he really is, smiling at him without even recognizing the younger man’s voice. the two of them had never seen each other, playing games only through chats and calls... but XY recognizes XXC immediately, aware that his own voice has changed drastically over the years.

XY is still transfixed and petrified when XXC asks him if it would be okay for him to touch his face to have a better idea of who he’s interacting with. XY doesn’t even register himself voicing his consent when he feels XXC’s hands on his face. only then he understands the infamous surgery had failed and that XXC did not regain his sight after his nephew’s wedding.

overwhelmed with grief, guilt and longing for what never was and never could be, XY is unaware of the tears rolling down his cheeks as XXC gently trails his features. XXC apologizes when he feels his palms dampening and he asks XY if he overstepped. next to them SL is distressed, not understanding what’s happening in front of him.

XY shakes his head and simply says... that he lost someone and that XXC reminded him of that person. then he excuses himself looking for WWX, to ask him to give him something... anything to do. he gets himself a task to accomplish and leaves the house brimming with relatives that he will never be able to call his own.

1 year later:

XXC and SL do not leave the city as they originally planned. they have travelled long enough for the time being and they decide to get a house close to WWX and his husband. they spend the following year after their return looking for stability and peace.

XY (31) didn’t stop working for WWX (36) and doesn’t plan to. not now that he got his new legs finally fitted. the recovery takes long, but it’s already been two years since the amputation now and WWX tries his best every day. he believes to be a handful and doesn’t dare ask for things he needs after receiving the prosthetics. XY is there to loudly remind him to stop being an idiot and that he is paying XY to boss him around however the fuck he wants. LWJ is very grateful to hear WWX laugh more and more these days thanks to XY.

XXC (33), however, is frequently around his nephew’s house, keeping him company. before his three-or-so years of traveling with his boyfriend SL, XXC has briefly worked as a psychologist with Wen Qing, of all people and the two of them have applied for a position at the community center in Yunmeng at the same time. there isn’t one available in Yiling and the commute shouldn’t be too bad. during that first year after his return, XXC has met A-Qing multiple times to inquire for a place at the center in Yunmeng and they are quickly becoming more involved with each other because of their shared passion for the job.

XY feels the end nearing, time ticking away. it had been an agonizing, brilliant, terrible year the one he had spent so close to XXC... and it is now coming to an end. knowing that A-Qing will eventually tell XXC how and why she became a social worker, spilling everything about how “her pitiful bastard of a brother had been molested by a pervert online” and so on. he only hopes A-Qing will never get to meet WWX... she would absolutely recognize the other man’s voice and accuse him of being the pervert in question and XY... XY will die.

XY feels trapped and he will most certainly have a stroke the moment XXC will realize that he lied to him, that he is still alive, that his reason to become a psychologist to help troubled kids was not a real thing... XY will die and Meng Shi will cry.

only because he lied about being 17 when he was 15 one day of 16 years ago.

XY disappears the same night XXC tells him he invited A-Qing over. SL (39) is overjoyed at the idea of meeting the girl once more after the time she and her step-siblings used to go to sign language classes at the community center in Yunmeng. WWX is interested as well, having heard all about A-Qing from XY along the years.

but XY disappears anyway.

2 years later:

it’s XuanYu (30) who finds him, but doesn’t ask him to go back home. A-Yu takes XY (33) with him in his travels for some months to hide him. he doesn’t ask him what he did in those two years, but he does force him to call Meng Shi and SiSi at least.

XY complies but still feels empty inside. the single year he had spent with XXC while the other visited WWX will be permanently engraved in his memories and he cannot stop thinking about it. about how gentle XXC had always been with him, how sad he had looked and sounded reminiscing an “old online friend who had died many years back”, how generous he had always been towards him and everyone and... and XY cannot do this anymore.

A-Yu may be younger than him, but he protects him well for those months... waiting for XY to tell him the truth. so one winters night finally XY does, starting from the beginning.

the following week, close to New Years, XY realizes A-Yu had betrayed him.

someone rings the bell of their shared apartment and A-Yu asks him to go open the door. XY does and it’s A-Qing (32) and WWX (38) who greet him with tears in their eyes. A-Qing tackles him on the ground and tries to hit him they way they used to do as kids, fists getting the point across faster than any word ever could, but WWX pries them apart and hugs them instead.

somehow, XY had not been notified of having acquired a new sibling, but WWX clearly considers him a brother of sorts and he had missed him greatly. A-Qing explains that A-Yu had sent her an email with XY’s version of the truth, sure... but she also tells him that she and WWX had solved the mystery soon after XY’s disappearance already, after talking extensively on the matter.

A-Qing had recognized WWX as the person she had talked to in chat all those years ago, that is true, but she also realized WWX was not, in fact, a bad person and that something didn’t add. when she understood who XY’s online friend actually was... she had felt sick to her stomach for having let someone as kind as XXC presume XY had killed himself bc of him.

hurt and confused, XXC’s family and even A-Qing’s one had initially blamed XY for the pain he had caused, the lot of them filled with anger and grief. especially BaoShan, who had felt guilty for not supervising and protecting her younger son better when he was still too naive to understand the ways of the world.

but then, seeing XY was not coming back, Meng Shi and SiSi insisted for XXC’s family to help them with the search instead. after two years the lot of them missed him. yes, even those who still berated him for his poor choices in life.

XXC now knows the truth and only wants XY to come back home.

some days later:

XXC opens the door after hearing the bell and he knows, he knows who the person in front of him is. he already had his suspicions back when he used to visit WWX every day two years back. WWX’s carer reminded him so much of his friend that... that he may have hoped.

but now XY is back and he has a name and a face and is alive and XXC greets him with a smile as the other hugs him and never lets go.

XY has never been happier in his entire, miserable life.

and XXC will never lose sight of him ever again.

the end.

[now imma go weep for fucking ages. also fuck typos.]

#mdzs #cql #songxiao #xuexiao #wangxian #the untamed #mo dao zu shi #(possible songxuexiao ?) #mdzs/au: modern #mdzs/au: gaming chat #tw suicide mention #tw homophobic slurs #the forbidden crack! untamed prompts #sorry for the horrible pun at the end

[altabrisa1]

Your Pharmaceutical Sales Interview - How to Get Connected, Get Organized and Get That Interview!

For a former pharmaceutical sales recruiter, my coaching clients find it odd when I state that networking with pharmaceutical reps is a key to landing their first pharmaceutical sales interview, rather than simply calling a recruiter. But let's are up against it, if a manager can hire a sales pro recommended by his/her rep at a much cheaper charge than through a recruiter, then which do you think the manager will choose? And, although networking seems to be feared just by many first time pharma sales candidates, it has become increasingly easier to do over the last few years. Why? Sheer numbers, my good friend! With over 100, 000 pharmaceutical reps in the United States alone, chances are high that someone in your network of mates or acquaintances is a fda cleared vs approved rep, or at least knows one. In my pharmaceutical sales interview coaching business, There really is that only the strong survive a career search in pharmaceutical sales. To put it bluntly, gaining your 2nd job in pharmaceutical sales is not for the faint of heart. You must be willing to "put yourself out there" and not be timid about utilizing your network of friends/family or approaching pharmaceutical reps that you do not know. Discover How to Kick-Start Your Networking Activities and Land That Pharmaceutical Sales Interview: First Step: Send out networking words to everyone in your circle of family and friends. Inform them of your fervent desire to win a job in pharmaceutical sales, and enquire of for further networking contacts. Second Step: Develop a tracking system of your network - who you've spoken using, the results of the conversation and if/when follow up is required. This is important to begin right away, as you will soon have many contacts it will be difficult to keep track of your next step. Third Step: Make a list of your physician/physician assistant contacts. Ones children's pediatrician, your personal doctor, a family friend who is also a physician - all of these are perfect networking connections. Contact they via phone, or write an informal note and leave it for them at their place of business. Fourth Step: Employ your current relationships with office personnel in local medical clinics to provide networking contacts. Ask for a copy in the local pharm rep association list, or at the very least for the names of 3-4 reps that the office personnel love and trust. Fifth Step: Visit your local pharmacy and ask the pharmacist for the business cards of reps that will frequent the pharmacy. Sixth Step: What about camping out in a busy medical clinic all day, dressed in your finest? Avoid getting shy about approaching pharmaceutical reps as they make their way out of the clinic. Only take one minute of their time, and supply a 45 second "infomercial" of your education and career history that qualifies you for a pharmaceutical sales occupation. Finally, ask if you may contact them at a future time that is convenient for them. Seventh Step: Show up for a local Pharm Rep Association meeting and ask to be introduced at the beginning of the meeting. Rattle off your "infomercial" and have for business cards, so that you may follow-up with reps at a later time. Chat with the reps afterward to determine immediate options and make dates for later conversations. What Are the Keys to This Networking System? Consistent Follow-Up: Follow-up through telephone and email with your contacts on a monthly basis to discover new openings and to keep the relationship "warm". Organized System for Progress Activities and Next Steps: Track your progress every step of the way; utilize spreadsheets and update accordingly. Generate Relationships: Develop a personal relationship with each of your contacts. Remember and track the "little things", (as inside your contacts' likes/dislikes, birthdays, names of family members, etc . ) and utilize that knowledge to build a positive bond with all your networking contacts. The above 3 tips can literally make or break your career search progress. Consider it practice for any pharmaceutical sales job you'll soon have - organizational skills, follow-up, and repoire-building skills are a huge portion of pharma sales career success. But What if You're Still Not Landing a Pharmaceutical Sales Interview? It's time for you to reflect... step back and take a look at the big picture. If you have a large network of pharma rep contacts (30-40 is good), you've passed your resume along through your contacts, and yet you're still not gaining job interviews... your resume may be the cause. Your resume must be a powerful marketing piece that showcases your skills/abilities/experience in a way that ENERGIES hiring managers to interview you! Consider a pharmaceutical sales resume writer to jump-start your interviews. Make sure to pick out a resume writer with pharmaceutical sales industry experience, as this will ensure effective use of industry buzzwords and key phrases... essential to gaining interviews! And finally, don't give up! Remember... pharmaceutical sales is not an easy career; in fact it is extremely challenging, since reflected in the high turnover rate. Today's challenge of networking your way into a pharma sales interview will sound petty, once you obtain a pharmaceutical sales job. Keep this challenge in perspective, and refuse to give up. I've possessed clients waiting in medical clinic parking lots, ready to approach pharmaceutical reps as they get into their cars! Do you want to be that determined and tenacious? Chances are... your competition will be!

[thechaseaphrodite]

Time Warp

Chapter 01

Hi guys! How are you?

First, I would like to thank you very, very, very much for all the reviews, kudos, favorites and followings that we got only with the prologue!

I would especially like to thanks: Anita, BrittneyJ2020, calzona4me, Calzonafan123, chuckechesnut, Felicity_Olicity, helenkidd1, Kels1769, koreee.95, LarisUSB, Mariz Vida, MauraIslesJr, Sisidandan, TheMikaelsonPrince, Tifenn and WitchArabella

And of course, a special thanks to my beta reader: @tiggermay

Answering Reviews: I planned to go back so far for many reasons that will be revealed throughout the story. And yes, this will impact many things, including Sofia, but calm down, we'll cross that bridge when we get there.

I got some comments saying that Callie was out of character because she was “sleeping around”. First thing, right now Callie is single, so if she wants to sleep with all of New York, it’s her right. However, Callie’s behavior was indicative of something intentional in the story. After all, you know Callie doesn't usually spleep around. Or maybe that was just Arizona's jealousy talking. You didn't EVER see Callie with anyone. So don't be so quick to judge, guys, and hold your fire.

And, take it all with a pinch of salt.

Finally, I just wanted to say that I plan to try to post a new chapter every Thursday.

I hope you enjoy this first chapter!

When Arizona opened her eyes again, she was in a bed. She sat up slowly, her hands going to her left leg, caressing her own skin, delightedly watching her own left foot move, like it hadn’t in years.

"God..." she murmured, a smile breaking out in her face. Arizona jumped out of bed, laughing as she felt both her legs move together, wiggling her toes in absolute delight. She ran to the bathroom, smiling at her reflection, ten years younger. She giggled as she saw Kai's face over her shoulder.

“We're back,” she said to him, maintaining eye contact through the mirror. “We’re really back.”

Kai laughed softly and nodded. "We’re back".

Arizona turned squealing with joy and embraced the half-naked man. "How… How are we going to do this?" she murmured, keeping her face against her guide's chest, the scent of the meadow, not having yet left Kai's skin.

Kai shrugged. “Only you can see me Arizona. I will follow you and help you with the memories, but you’re free. This is your second chance.”

Arizona sighed turning to the mirror. "This is my chance to make things right with Calliope," she murmured lovingly. “Wait, wait. What day is it?” she muttered taking out her cell phone. She frowned, thinking it would take her a while to readjust to the technology. “January 2009... Dr. Kenley will have a heart attack...”

"Tomorrow. Your main case will be Jackson Prescott. And you will meet Miranda Bailey and Alex Karev.”

Arizona nodded. “I remember that case. It was a true miracle. I think I can do better this time. But before... Before, I need...” she looked around the apartment for her laptop. “I need to talk to Nick. He needs to get proper treatment. It's been three years since he was diagnosed, I think…”

Kai sat on Arizona’s couch, throwing a small ball against the wall while the pediatrician wrote to her best friend.

 Hey Nick!

How are you? I haven't heard from you in a while... Alright, alright, I know I turned into a horror show during my residency, but now that I've finished my fellowship I should’ve a more normal life. Or as normal as a doctor's life can be.

Because I'm a doctor, remember that, Nick? Even though I'm a pediatric surgeon, I studied everything. That is, I can help you if something is wrong.

Arizona took a deep breath. Theoretically, she shouldn’t know about the tumor.

I have a feeling something is wrong. Let me help you, Nick; please contact me!

With love,

Arizona

 She bit her bottom lip before clicking send. With that done, Arizona decided to explore her old apartment. The memories were coming back little by little, like little flashes through her mind. She was so focused that she didn’t even notice Kai fade into the background.

It didn't take long for her to hear the sound of a new email. She jumped back to her laptop. She took a moment to acclimate back to the old technology. She had gotten used to the smoothness and easy access to everything the technology of her time provided. This might take a minute, she thought and waited while everything was uploading while silently longing for the digitalized easiness she left behind.

 Hey, Phoenix!

Your sixth sense is damn accurate, isn't it? I was trying a more unorthodox route of treatment for my little issue, but if you could feel something wrong all the way back to the States, maybe it isn’t working so well, after all. But don't worry M.D., I'm already buying my ticket to Seattle and I'll be a good lab rat for you.

Love,

Nick

 Arizona laughed softly, her eyes welling up with tears that start streaming down her cheeks. Nick was alive and she was going to have enough time to save him. She sniffled a few times, trying to calm down. Nick was coming home. He would be fine. Now, she needed to focus on Jackson Prescott.

Arizona pulled out her files from Hopkins and began to study her case notes of children with short bowel syndrome, so that she could figure out how she could buy enough time for Jackson Prescott, until the transplant arrived.

Honestly, she wanted to strangle Kenley. Repeating the same procedure twelve times, what the hell was he thinking?! Three years spent torturing a poor boy instead of leaving his comfort zone!

She would arrive in the OR tomorrow with a real plan and she would show everyone why she was (or rather, would become) one of the greatest pediatric surgeons in the country.

***

Arizona arrived early at the hospital so she could organize Kenley's charts. She picked up Jackson Prescott's binder and took a deep breath, looking at Kenley's notes. She'd like to just put the boy on the transplant list, right away. But Bailey would fight her every step of the way, and this was an unnecessary fight. She could save as much bowel as possible, as well as remove the most damaged part of his liver, which would give her more reasons for the transplant request. She nodded to herself, thinking that it was a solid plan. Before leaving her new office, she smiled at Kai. Her angel was barefoot and wearing only black sweatpants, his huge white wings folded and dragging on the floor as he walked a few steps behind her.

They had talked and settled on Kai always being around (even if sometimes he disappeared from her sight completely) to guide her through the past.

Arizona skated to the General Surgery Nurse Station. She couldn't contain the huge smile on her face when she saw the young - still a resident - Miranda Bailey.

"Doctor Bailey!" she called, moving toward her and extending her hand. “Arizona Robbins” she introduced herself. The future chief of surgery looked at her hand for a moment before shaking it, with obvious hesitation on her face. "I'm taking over Doctor Kenley's patients."

“You are the peds surgeon.”

"Yeah," she confirmed nodding her head, the permanent smile on her face. "I see you’re assisting with Jackson Prescott." Arizona paused a moment to breathe. “With all due respect to Dr. Kenley, he was a wonderful physician, but I'm surprised he has insisted on this course of treatment for so long. When it wasn't - you know - working.” Arizona studied Bailey's face, watching her friend take a deep breath, clearly annoyed with her. Dammit, she had offended Bailey. Again! "Oh, no I'm not criticizing you!" She quickly amended. "You didn’t make the call."

"Yeah, but I supported the call," Bailey recited, pushing the chair away from the desk. Bailey took a deep breath and began trying to explain. “We hadn't turned the corner yet, but Kenley was sure that if we kept on doing what we were doing-”

"Jackson's case is quite severe," Arizona interrupted. They had no time for these debates.

The boy is dying Bailey. Every minute counts. I need you to trust me. Arizona thought worriedly. Bailey looked at her incredulously.

"If you're suggesting we were torturing him with useless procedures..."

Arizona smiled. Bailey was still Bailey. "A lot of senior peds surgeons believe stritoroplasty works, and sometimes they're right." That was enough for Bailey to nod in agreement with her. Arizona took a deep breath. She knew she couldn't go straight for the transplant, but that didn't mean she wasn't frustrated "So, we'll go with this, today, but with his liver disease, we need to start exploring other options." She paused a moment just to smile at Bailey. "I’ve got to run." She said pulling away. “Dr. Kenley had a big case load. I will see you at the OR!” She said before taking off and skating away.

A giggle she barely managed to hold back almost escaped her mouth. If she could, she would be skating all day. Arizona had cried a little, while putting on her heelies that morning. She was skating again. Arizona stopped before entering the locker room to prepare for Jackson's surgery… Unfortunately, she doubts the nurses would let her skate into the OR.

***

Arizona smiled as she saw Karev preparing to enter the OR. She quickly began cutting, with a precision far superior to someone who had just finished their fellowship. She took a deep breath, knowing the mess that would be inside the boy.

"Karev, can you pull the retractor more?" She asked.

Her future resident obeyed the order without hesitation, knowing exactly how much more pressure to apply. "Like this?"

She agreed. "Yeah, great."

Arizona shook her head. "Look at this. It is a mess. He'll have maybe ten centimeters of bowel when we're done here.”

“Wow, wow, wow… Can't we try Bianchi's procedure to try to save some more, then?” Bailey interrupted anxiety clear in her voice.

Arizona didn't even deign to look at the resident in front of her. “The bowels are dead, and the liver is cirrhotic. There is no way to save anything.”

"Yeah, but-"

“Dr. Bailey, this kid should have been on the transplant list a year ago. It is a miracle that he’s still alive.” Arizona took a deep breath. (“Teach them Arizona. They are your ducklings.” Norman McHale's voice, her former mentor echoing in her mind.) “This is what happens when you insist on the same procedure twelve times…. All right, what we’re going to do is try to keep as much of his bowel as possible. He’ll need to go on liver dialysis as soon as this is over. I know we have some machines here for a clinical study but keeping this child alive is a priority. And we'll need a transplant… Laura.” she called the intern who was watching the surgery. “This boy goes on the transplant list today. Go get the paperwork ready. Intestine and liver.”

“I think we should ask for another opinion.” Bailey interrupted her again.

Arizona looked at Bailey. "Laura, as an order from your attendant, go get the paperwork ready."

As soon as the OR door closed again, she moved her focus to the child in front of her. “Dr. Bailey, as soon as we get out of here, I'll give you the cell phone number of Norman McHale, the head of Pediatric Surgery at Hopkins. You'll say Arizona send you, and he'll say Jackson needs a transplant two minutes into the call.”

“There is no need to snap at me-”

"Actually, there is," Arizona replied. “You're good, Bailey. You could be a great pediatric surgeon, and you have what it takes to be chief of surgery one day. But you are still a resident. Which means you are still in training and still learning. And what you need to learn today is that repeating the same procedure twelve times won't bring different results, and Dr Kenley put this boy at risk. And in medicine, and especially in peds, your focus cannot be on you, or the attendant you're working with, but on the patient. You don't know me yet, I’m the stranger in a ponytail and you liked and trusted Kenley, but that doesn't change the facts.”

Karev looked at Bailey's astonished face. The rest of the surgery was done in silence.

***

Arizona collapsed on her couch that night, grunting. "God, I had forgotten how frustrating Bailey could be."

Kai laughed hoarsely. "I think you're the first doctor who acknowledged that she's still a resident."

Arizona sighed turning her cell phone in her hand. She missed the social networks and games on her old phone (well, future phone). And the tablets, which had greatly improved the efficiency in the hospital. She didn't like working with so much paper anymore. "Do you think she'll hate me? We’ve never really butt heads like that before…"

Kai shook his head, his black curls bobbing almost childishly. "I think she'll respect you. You're fighting for this child. She sure appreciates that."

Arizona nodded absently. It had been almost a week since Jackson's surgery had taken place. No compatible donors yet. And no excuses to talk to Calliope. Or Mark. God, she'd missed Mark. And Lexie was still there. She sighed. Kai had advised her to let things progress naturally. So, she would try to focus on Jackson for now. And soon, soon she could get closer to her friends. She fell asleep, still lying on her couch, being woken up a few hours later by the sound of her pager.

"Shit, 911."

Arizona jumped off the couch, still smiling at her left leg as she put on her sneakers and bolted out the door.

***

She spotted Bailey outside Jackson's room as she straightened her white coat.

"I'm up, I'm here." she announced trying to ward off her tiredness. "What happened?"

The resident walked fast to her, preventing her from entering the room. "Jackson's BP has gone down a little since yesterday. No big deal, but if we make a few calls and be a little pushy, we might be able to pass him a little further on the transplant list."

Arizona looked at her resident, shocked. "Dr. Bailey, you paged me 911 at 2:30 in the morning. To chat?"

Bailey looks embarrassed for a second. "You like to chat. You're chatty."

Arizona closed her eyes, taking a deep breath. "Not at 2:30 in the morning!" She looked at Bailey, worried for a moment. "Look, he's young, he's almost at the top of the list. UNOS will find a donor for him as soon as it’s possible" (or Webber will do it, just like last time) "And God knows that staying up all night chatting about it won’t help. I'll try to get some sleep, and I suggest you do the same. "

"He’s running out of time," Bailey complained in a chocked-up voice.

Arizona smiled sadly. She had almost forgotten about this insecure Bailey. "They always are. Welcome to peds" she repeated her words.

***

Arizona was preparing a coffee for herself. She had forgotten that there were twenty other children who needed her care besides Jackson. And she had just sent one of them home along with her parents, because there was simply no treatment. And she was frustrated. Because there was treatment. That hadn’t yet been finalized. Anyway, she had recommended the girl for clinical research, but her parents didn't want her to be a guinea pig. She had only been taking a few minutes to compose herself when Bailey found her.

"Okay, I made a list of the best pediatrics GAs in the country. I think between the two of us, we can get one of those guys to come here and do a TIPS procedure on him."

Arizona took a deep breath. She knew how to do a TIPS procedure. She was excellent at TIPs procedures. To hell with the technicality of… You know, not actually having learnt them yet here. She didn't need another surgeon intruding into her OR and trying to tell her what to do, ordering her and bossing her around and most importantly distracting her from her job. A job at which she excels, thank you very much. "Firstly, I am perfectly capable of performing a TIPS procedure," she began. "And secondly, doing a TIPS procedure on a boy who needs a new liver is putting a band aid in a bullet hole."

Bailey looked exasperated. "Well, do you have a better idea?"

Arizona smiled, rolling her eyes. "I have. Wait for UNOS. Trust the process. Why can't you?"

That was enough to piss Bailey off. "Because I'm tired of waiting while this child gets worse! Jackson is tired! His mother is tired! The only one who is content to sit on her ass and wiggle your fingers waiting is you!"

This ignited Arizona’s temper. "Look, I've been patient with you, I've been nice, but I am really over you constantly telling me how to do my job!”

"Well, clearly someone has to!”

"I have twenty other children-"

"And I am concerned over this one child!"

"SHUT UP"

Arizona stopped arguing with Bailey staring at the door where Karev was standing. She hadn't even noticed him there.

"Respectfully," he corrected himself, "respectfully shut up. Because we have organs," he announced with a crooked smile and a raised eyebrow.

Arizona swallowed hard. She was the attending physician. She would have to go, on a small plane, with Karev to fetch these organs.

She nodded quickly. "Dr. Bailey, you know the procedure. Go get Jackson ready. Doctor Karev we'll go get those organs."

***

Arizona was sweating cold as they boarded the plane. She sighed as she sat in the front row. Lexie had sat in the back, and she was dead, so Arizona couldn't get past the third row of any kind of aircraft.

But Lexie isn’t dead she thought, trying to breathe. Lexie is just fine. Lexie is going to be fine, if I have anything to do with it.

Since it was just the two of them, she expected Karev to choose a seat away from her, only to be surprised when he sat right beside her.

Arizona couldn't speak, fear (your leg is still here. you're safe) forming a lump in her throat.

Kai sat behind her, one hand on her shoulder. "It's fine, Arizona. You are safe." Her angel reassured her.

As the plane began to accelerate for take-off, she closed her eyes, only to be surprised when Karev gripped one of her hands, squeezing it gently. She squeezed back until the plane was high when she finally managed to breathe again. "I... Thank you."

Alex just shrugged. "Fear of flying?"

She nodded. "I ..." (I was in a plane crash. But she hasn’t. Not yet. Hopefully, not ever) "I always feel closer to death on planes than in the OR."

Karev nodded and went back to ignoring her.

"I saw Izzie the other day" (she doesn't deserve you Alex, she'll break your heart. Jo will arrive soon and she's perfect for you).

Alex nodded. "Yeah"

Arizona smiled. "It's nice. You're a beautiful couple" (you and Jo will be even better).

She let Karev spend the rest of the trip pretending to be asleep. But he took her hand again as soon as the commander warned that they would begin the descent. Arizona smiled. The golden heart was there.

***

The next time Karev spoke to her was when he saw the patient from whom they would take the organs.

"It's just a kid."

Arizona nodded, knowing what it was like to deal with the shock for the first time. "Yes. Let's get the organs."

***

Alex didn't look up during the entire procedure. Not even when she explained aloud what she was doing and the differences in anatomy between adults and children for him.

When they got back to the plane, he didn't sit next to her either.

She took a deep breath. "Spit it out Karev. Don't brood."

He glared at her. "We just got a little boy's intestine and liver out. A dead little boy! And you don't mind! You didn't even blink during the whole procedure, and now you stand there, shaking in fear of a plane, but you didn't care about that kid!"

Arizona stared at her hands in her lap shaking. "I know they unplugged that little boy. Do you think I don't get that? Do you think I don't know about the tiny coffin they're going to stick him in? I know all about the tiny coffins. I see them all the time. In my sleep.” She took a deep breath “But we move on Karev. You turn your back on the tiny coffins and move on. To the next child."

Karev turned forward still angry. But as the plane was about to descend, he reached out to her hand through the aisle.

Arizona gripped his hand tightly. Fear consumed her, but a part of her was proud. Here was her pediatric surgeon.

***

The transplant surgery was quiet and calm. Arizona took a deep breath. They had been faster this time. Jackson's treatment was more advanced.

Kai was watching over her shoulder. "Everything looks fine on my end."

Arizona smiled and nodded. "Finishing the vena cava."

Karev smiled at her. "Anastomosis looks good."

Bailey smiled. "Now all that’s left is to release the clamps."

Arizona smiled at Bailey. God, she loved how she used a stool to get taller, so she had a better view of the patient. "Do the honors, Miranda. He’s your patient."

Bailey smiled at her. "Thank you, Dr. Robbins"

She watched carefully as Bailey removed the clamps, paying attention to the dark marks, but she didn’t need to.

"Call on me!" intern Sadie Harris interrupted. "There is a spot on the duodenum."

Arizona looked at that angrily. Damn it, not again! She shook her head.

"What the hell is that ?!" Bailey snapped.

Arizona took over immediately. "Necrosis… Dammit! Get the organs out now! We'll need a new transplant, looks like we're going to do a TIPS procedure, Bailey."

"This can't be happening..." Bailey started tearfully. "Not to this little boy."

Arizona was already putting new clamps. "Dr. Harris help Dr. Bailey step away, Dr. Karev you're taking over."

Sadie immediately moved behind Bailey. "No, I can go on!" Bailey protested her eyes full of tears.

Arizona did not raise her eyes as she removed the increasingly dark organs. "That's an order, Miranda. Karev!"

Karev forcibly removed Bailey, quickly picking up the instruments. "How long to find new organs?"

"Twenty-four hours. Maybe more, since he was already on liver dialysis." Arizona warned. "Harris, Bailey, find all interns and residents. Someone in Seattle must be compatible with this boy and I want all hands-on deck, working on finding new organs. Now!”

Arizona didn't even have time to look up to see the mighty Dr. Bailey, running out of an OR to follow an order.

***

Arizona collapsed when she got home. "I did everything right!" she said tearfully to Kai. "Everything! And yet, Jackson is dying and its days earlier, which means the original donor for Jackson isn’t there!"

Kai sighed and sat beside her. "Arizona. Take a deep breath. Whatever is meant to happen will happen.”

Arizona shook her head. "He's already on the liver dialysis machine. That gives us an advantage. Still..."

And in that moment, it was as if a light bulb appeared above Arizona's head. She ran back out her door, and rushed back to the hospital, just in time to see Bailey, crying outside.

“Dr. Bailey?” she called softly.

“I want off this case.” She whispered. “Oh God, I want off this case. I want off... This little boy is going to die, and I just don’t want to be here to see it. I just don’t want… I just want off. I want off this case. I want off!”

Arizona shook her head. "Jackson is already on liver dialysis, but we can put him on peritoneal dialysis. This will delay any swelling in the brain and not require further surgery."

Bailey looked at her in surprise. "It doesn't solve the problem of..."

Arizona nodded. "No. But it will buy us time. I'll do the procedure, and don't let anyone rest until we get those organs."

***

When Arizona had set up everything to begin the dialysis procedure, Alex Karev and Izzie Stevens hurried through the door. She smiled at the two, watching as they quickly took over their positions.

"Arizona, don't let this woman work with needles. Something's not right with her." Kai murmured in her ear.

She nodded. "Doctor Stevens, switch places with Doctor Karev. He's been working with this boy for a while."

Izzie nodded in confusion, going to hold the ultrasound while Alex took over the catheter.

Arizona refocused on the boy, but she noticed Izzie looking anguished while staring at something behind her.

She began to instruct Karev in detail, on what they were doing and for what purpose.

"Shut up," she heard Izzie mutter.

"What was that?" she asked to the blonde doctor incredulously. This resident had not just told her to shut up during such a delicate procedure. She wouldn’t dare... Karev looked equally concerned.

"Nothing. Sorry Doctor Robbins" Izzie said louder this time.

Melinda Prescott entered the room. "Has UNOS said anything?"

Arizona looked at the doctor holding the ultrasound. "Dr. Stevens will call them again. And contact Dr. Bailey and see if any of our doctors were lucky." she said to the woman, who was clearly and understandably worried. Izzie was looking around anxiously and didn’t move to carry out the order. "Doctor Stevens, are you paying attention?!"

Kai shook his head. "Arizona, no. There’s something wrong with her, this doctor isn’t all here."

"Dr. Stevens, ask at the nurses' station to make the calls. And then go get some rest."

Izzie nodded, almost in a daze, propping the ultrasound on the patient's bed and leaving the room. Arizona and Karev finished the procedure in silence.

"Dr. Robbins, Izzie... She was tired. We’ve all been up all night trying to find the organs and-"

Arizona silenced Karev with a gesture. "It's okay. Just talk to her. This is a serious case, Karev."

Arizona took a deep breath, appreciating her work. "Good job here Alex." she complimented. "I'll make the rounds, try to talk to Izzie, okay?"

***

Arizona was returning from her rounds to check Jackson's PIC when George O'Malley came running toward her, Richard Webber right behind him.

"I got it Dr. Robbins!" George announced "We have the organs! OR number 3!"

Arizona looked into the room, Jackson's PIC still below the limit. She nodded. "Great job O'Malley" she said with a smile on her face.

***

The surgery went well, and Jackson's heart didn't stop. Not even once. After they sent the boy to Recovery, Arizona leaned against the wall taking a deep breath.

Miranda Bailey stopped next to Arizona. "I... I didn't think you could handle this case. After today I think you were the only person who could have ever handled it." she said softly. "I almost crossed a line today. Before O'Malley arrived... I was going to ask Derek Shepherd to let a man die so I could save this boy. But I didn't break my oath. Thanks to you."

Arizona laughed softly and took Bailey's hand. "You are an excellent doctor, Miranda. I know you, and when it comes down to it, you will always do the right thing… And thank you. For trusting me."

Arizona gave Bailey one last soft smile and turned back to staring at the walls quietly, cherishing these few moments of peace and letting the immense feelings of gratefulness flow through her, still in awe of this new chance at life she was given. She sighed softly and let her head fall back against the wall, content in the feelings of achievement and camaraderie shared between her and the woman who would one day be one of her closest friends.

#greys anatomy #arizona robbins #callie torres #fanfic: callie/arizona #timewarp

[chobimoy-interior]

All the better you can do is love them, attempt your hardest to settle on the extreme decisions that you believe are directly for them, and concede to the individuals who know superior to anything you do when you're up the creek without a paddle. Now and then, that may be your confided in pediatrician, while different occasions you'll likely wind up going to different guardians with a couple of more long stretches of understanding under their belts who have effectively explored comparable difficulties.

Sometime in the distant past, you needed to turn to your mom or grandma for exhortation. In the event that they didn't have the foggiest idea about the appropriate response, you were simply up the creek without a paddle. Presently, the response to for all intents and purposes everything is only a tick away. Regardless of whether you're searching for somebody you can identify with when you are feeling separated and alone in your child rearing excursion or you need counsel in a particular region, there are several child rearing websites offering wise counsel (or a decent snicker when you need it most) on pretty much every conceivable child rearing situation you may experience.

We've gathered together 51 first class child rearing sites beneath that do only that. Children certainly don't accompany instructional manuals, yet a decent child rearing website is the following best thing.

*Got a most loved child rearing web journal that we missed? Send an email to [email protected] – we'll keep on extending the rundown with peruser top picks.

Hop to web journals in a particular class:

Web journals Offering Practical Tips

Entertaining Parenting Takes

Wellbeing and Wellness Blogs

Web journals by Dads

Web journals for Working Moms

Web journals Offering Practical Tips

1. 5 Kids is a Lot of Kids

@Beth_Woolsey

5 Kids is a Lot of Kids

You can't blame Beth Woolsey for not having the experience to back up her recommendation. She has five children, received and natural, the two young men and young ladies, with an age go that traverses over 10 years. She made this blog to share her untidy, entertaining, genuine family experiences and all the help and counsel that accompanies them.

Three posts we like from 5 Kids is a Lot of Kids:

20 Things Every Parent Should Hear

On Not Doing All the Things

On Working Tirelessly

2. Alpha Mom

@alphamom

Alpha Mom

This blog will help those of us who don't have solid, characteristic child rearing senses (or possibly we do, however we simply haven't understood it yet). Alpha Mom means to make a sans judgment child rearing asset to walk current guardians through the pieces of the child rearing excursion that require more artfulness. The designer, Isabel Kallman, has assembled guardians and child rearing experts as supporters of the site, offering help and information to assist you with picking up certainty as a parent.

Three posts we like from Alpha Mom:

Work and Delivery Turf Wars

Taking advantage of a Hand Me Down Wardrobe

The most effective method to Help with Homework if Math is a 4-Letter Word in your House

3. Caffeine and Fairydust

@CaffeineandF

caffiene and fairydust

This child rearing and way of life blog originates from mother and style planner, Maz Halliday. She investigates her everyday existence with rousing authenticity. She is open and expected both about the not really exciting sides of child rearing and her very own battles with gloom and bipolar issue. This is a superbly enlightening web journal that is completely relatable.

Three posts we like from Caffeine and Fairydust:

My Life – Living With Bipolar Disorder – Growing up, Pregnancy and Motherhood

Pregnancy Brain… It's a Real Thing

10 Things You Should Never (Ever) Say to a Pregnant Woman (And What You Should Say Instead)

4. Cultivate the Family

@FOSTER_the_FAM

Cultivate the Family

This is the blog of Jamie Finn, non-permanent parent professional. Her family inclines toward their Christianity to see them through troublesome and cheerful occasions and that incorporates everything from encouraging, selection, and natural child rearing in every one of those parameters. She self-teaches her youngsters and has an enthusiasm for vagrant consideration, rousing her to connect give data to anybody she can motivate to open their hearts and homes.

Three posts we like from Foster the Family:

The Answers to All of Your Foster Parenting Questions

Quit Using the "Broken System" as an Excuse

Authorized and Waiting: Tips for Getting Foster Care Placements

5. Have Baby, Will Travel

@hvbabywilltrvl

Have Baby Will Travel

In case you're keen on keeping up a functioning itinerary significantly after you have kids, at that point this blog may turn into your most important asset. Since going with a stream slacked baby is hopeless (not to mention your fly slacked self!), and any tip to diminish that wretchedness gains our affection. Made in 2007 by Corinne McDormott, this blog endeavors to spur and help families with infants, babies, and youngsters to go with their children, yet without the pressure. Corinne is a movement advisor and Family Travel Specialist, so she has a lot of skill and accommodating goodies to share.

Three posts we like from Have Baby, Will Travel:

Flying with Baby: Travel Tips for Flying with a Newborn

The Mother of All Packing Lists

A Little Jetsetter really taking shape… Coping with Baby Jet Lag

6. Kristina Kuzmic

@KristinaKuzmic

Kristina Kuzmic

This is a crossover of the old blog ways and the new, including both composed and video content. Kristina Kuzmic is a mother with three youngsters who figures out how to discover balance in delightful tumult, something to which the greater part of us can relate. She's gone from a battling single parent of two to a wedded and effective mother of three like an all out chief, and she's a consistent suggestion to all guardians that it shows signs of improvement and that you are sufficient. Her blog articles are elegantly composed, yet her viral acclaim originates from her recordings, which you've most likely observed and didn't understand. (Also, some way or another, her hair consistently looks astounding.)

Three posts we like from Kristina Kuzmic:

I'm not your companion, kid! (Since I love you.)

Needs

Debilitated Mom

7. Mother Knows it All

@BrandiJeter

Mother Knows it All

This blog is from Brandi Riley, a Northern Californian who subtleties her encounters throughout everyday life and in bringing up her two youngsters. She began the blog to give herself an outlet, however the network she found has kept her here. Her commitment to the network is one of help, and from the narratives she shares, we can realize what things work and what don't, just as what may work.

[dr-calvin-hirsch]

Dr. Calvin Hirsch has been named a Sacaramentos Top Doctor for 2018-2021.

Dr. Calvin Hirsch suggested that, practices Geriatric Medicine in Sacramento, CA. He has been a physician for 42 years. In 1980, he graduated from the University of Connecticut School of Medicine. He is associated with the University of California, Davis Medical Center. This page includes citations to his publications. Continue reading to learn more about this doctor and his services to the community. Some of his publications are listed below: Calvin Hirsch, Ph.D.

Professor Dr. Calvin Hirsch joined the U.C. Davis Health System in the early 1990s as an assistant before being elevated to full professor. He remained in Davis for 31 years and achieved a number of triumphs along the road. His most recent accomplishment was being crowned Sacaramentos Top Doctor for the years 2018-2021. Despite his intention to retire in July 2021, he has been summoned to oversee medical students and continue teaching at U.C. Davis.

Prof. Dr. Calvin Hirsch concentrated on geriatric health care policy and research after finishing a two-year residency at Stanford University. He stressed the need of addressing patients' requirements in order to reduce hazards to them. He was also the medical director of the Palo Alto VA's long-term care unit. He has dealt with numerous patients from the elderly population during his career and is a real inspiration to people in the industry.

Dr. Calvin Hirsch has inspired generations of medical students since the release of his first book, El Juego educativo. His pupils have gone on to distinguished careers in academic geriatrics. Dr. Calvin Hirsch received his Bachelor of Science degree from Yale University in 1976, during his medical studies. He finished his internship and training in internal medicine after finishing his residency at the University of Connecticut School of Medicine. He has also been supervising medical residents for over 30 years. His scholarly works

According to Dr. Calvin Hirsch, a pediatrician at UC Davis, has been named the Sacaramentos Top Doctor for 2018-2021. He is a successful professor with a long history of community involvement. In addition, he is the Principal Investigator of the Cardiovascular Health Study, a 33-year longitudinal study of 5,888 persons aged 65 and older. The research looks at risk factors for cardiovascular disease, cognitive performance, and lifestyle choices. Hirsch has also co-edited two medical textbooks and authored more than 50 research publications.

Dr. Hirsch was not only a well-known professor at UC Davis, but he also effectively led the UC Davis Geriatrics Clinic. Dr. Hirsch won this accolade from Sacaramentos Magazine in 2020, which was also recognized by UC Davis. This is a tremendous accomplishment that demonstrates his competence and passion to improve health care for the elderly. His participation in the community

Following graduation, Dr. Calvin Hirsch joined the National Health Service Corps, where he provided healthcare to low-income seniors in San Francisco's Tenderloin neighborhood. He felt a duty to offer medical treatment to the low-income elderly population, many of whom did not have family members or transportation to medical visits. He was also a lecturer at UC Davis. He has remained active in the community, including sitting on the board of directors of the University of California, Davis Medical Center.

Dr. Calvin Hirsch is a geriatric expert, while many specialists concentrate on children and minor ailments. He thinks that by educating the community about the health issues that older persons encounter, he would be able to make their golden years more joyful and easy. His many successes have earned him the title of hero in Sacramento, where he has served as the top physician for the last 31 years. Despite the fact that he will formally retire in July 2021, he will continue to teach and oversee residents at UC Davis.

Dr. Calvin Hirsch pointed out that, a private email addressed to Hirsch in 2014 detailed the alleged rape. The doctor was not named by Olivarius, but her statement was included in McAllister Olivarius' book. Hirsch's behavior as a doctor at UC Davis has now been called into question as a result of her alleged rape. Olivarius filed a complaint against Hirsch with the Medical Board of California last year.

[charlienosheen]

#MamaMonday I get a lot of questions about what products can be used for children who have eczema, sensitive or severely dry skin. These 4 products are gentle enough for sensitive skin and can be used on kids 2+ (consult with pediatrician if you are unsure if any ingredients might cause an allergic reaction) 🛁 Bath soak can be used once or twice a week. 🧼 Soap scrub can be used every other day depending on severity of damage to the skin. 🧈 Body Butter I recommend using twice daily on affected areas. ☀️ Sol oil can be used on face & body daily. *(Some of these products do contain coconut and essential oils be sure to read ingredients list on our website thoroughly. If your child is allergic to any ingredient on the list I can accommodate you and offer a custom made product, send an email with your inquiry.) #PrettyConscious (at New Jersey) https://www.instagram.com/p/CYjlsFLLhmr/?utm_medium=tumblr

#mamamonday #prettyconscious

[xtruss]

Anti-Vaxxers Could Fuel Spike in Childhood Diseases: 'It Will Be Horrific'

— By Steve Friess | October 06, 2021 | Newsweek

A recent gathering in a Quality Inn ballroom in rural Bradley, Illinois, offered a glimpse—terrifying to most epidemiologists, thrilling to longtime vaccine "safety" activists—of America's growing political divide over vaccinations and its implications for the nation's health. Ostensibly, the meeting was a community forum about employer mandates for COVID vaccines that the organizer expected to draw 80 people in this overwhelmingly Republican exurb of Chicago. Instead, more than 300 people piled in, mostly to complain about the notion that anyone—a boss, a school, a government—could force them to take any vaccines at all. As one Libertarian county commissioner told the crowd: "I will fight for your right to believe in whatever god, medicine or way of life you choose."

The event is being replicated in some form or another in cities and towns across America, emblematic of a growing grassroots movement of people who believe that vaccine mandates—for COVID, yes, but increasingly for other diseases as well—are an affront to their personal freedom. That represents a marked shift from pre-pandemic times, when vaccine opponents typically based their reasoning on medical concerns and were largely comprised of a few religious sects and a small number of left-leaning activists seeking explanations for rising rates of autism. As the anti-vaxx mandate movement gains political traction, particularly on the right, medical experts fear it could not only cripple efforts to eradicate COVID but could also lead to a surge in long-conquered diseases, from mumps to whooping cough to smallpox.

"Those [more established] vaccines have had a long history of use, so there's certainly data that suggests that they're relatively safe. But it always has to be a choice of individuals. You can't have government forcing that on us" - Conservative group Action 4 Liberty president Jake Duesenberg

"There are some more conservative states where we are likely to see other non-COVID vaccine mandates under attack, and it is very worrisome," says Marcus Plescia, chief medical officer of the Association of State and Territorial Health Officials. "If we have some of these pediatric infectious diseases come back, it will be horrific."

Even before President Joe Biden's September 9 announcement of a litany of aggressive COVID vaccine mandates—covering an estimated 100 million Americans, including federal health workers and companies with more than 100 employees—evidence of changes in policy and sentiment toward such rules was cropping up, led by the right. This summer the Tennessee Department of Health, reportedly pushed by GOP lawmakers, directed its staffers to stop conducting "proactive outreach regarding routine vaccinations," including those for childhood diseases, HPV and influenza. Larry Elder, the top Republican vote-getter in the failed recall effort against California's Democratic Governor Gavin Newsom, told the Los Angeles Times editorial board in August, "I don't believe that the state should tell a parent whether or not a child should be vaccinated. That's an intrusion of state power." In Minnesota this month, the conservative group Action 4 Liberty, which boasts an email list of more than 100,000 recipients, began hammering a leading Republican candidate for governor for refusing to sign the group's "Stop Vaccine Mandates" pledge.

A recent gathering in a Quality Inn ballroom in rural Bradley, Illinois, offered a glimpse—terrifying to most epidemiologists, thrilling to longtime vaccine "safety" activists—of America's growing political divide over vaccinations and its implications for the nation's health. Ostensibly, the meeting was a community forum about employer mandates for COVID vaccines that the organizer expected to draw 80 people in this overwhelmingly Republican exurb of Chicago. Instead, more than 300 people piled in, mostly to complain about the notion that anyone—a boss, a school, a government—could force them to take any vaccines at all. As one Libertarian county commissioner told the crowd: "I will fight for your right to believe in whatever god, medicine or way of life you choose."

The event is being replicated in some form or another in cities and towns across America, emblematic of a growing grassroots movement of people who believe that vaccine mandates—for COVID, yes, but increasingly for other diseases as well—are an affront to their personal freedom. That represents a marked shift from pre-pandemic times, when vaccine opponents typically based their reasoning on medical concerns and were largely comprised of a few religious sects and a small number of left-leaning activists seeking explanations for rising rates of autism. As the anti-vaxx mandate movement gains political traction, particularly on the right, medical experts fear it could not only cripple efforts to eradicate COVID but could also lead to a surge in long-conquered diseases, from mumps to whooping cough to smallpox.

"There are some more conservative states where we are likely to see other non-COVID vaccine mandates under attack, and it is very worrisome," says Marcus Plescia, chief medical officer of the Association of State and Territorial Health Officials. "If we have some of these pediatric infectious diseases come back, it will be horrific."

Even before President Joe Biden's September 9 announcement of a litany of aggressive COVID vaccine mandates—covering an estimated 100 million Americans, including federal health workers and companies with more than 100 employees—evidence of changes in policy and sentiment toward such rules was cropping up, led by the right. This summer the Tennessee Department of Health, reportedly pushed by GOP lawmakers, directed its staffers to stop conducting "proactive outreach regarding routine vaccinations," including those for childhood diseases, HPV and influenza. Larry Elder, the top Republican vote-getter in the failed recall effort against California's Democratic Governor Gavin Newsom, told the Los Angeles Times editorial board in August, "I don't believe that the state should tell a parent whether or not a child should be vaccinated. That's an intrusion of state power." In Minnesota this month, the conservative group Action 4 Liberty, which boasts an email list of more than 100,000 recipients, began hammering a leading Republican candidate for governor for refusing to sign the group's "Stop Vaccine Mandates" pledge.

A group demonstrators hold signs as they protest against mandated vaccines outside of the Michigan State Capitol on August 6, 2021 in Lansing, Michigan. Emily Elconin/Getty

"Those vaccines have had a long history of use, so there's certainly data that suggests that they're relatively safe," the group's president, Jake Duesenberg, tells Newsweek. "But it always has to be a choice of individuals. You can't have government forcing that on us."

In all, some 22 percent of Americans now identify as "anti-vaxxers," defined as people who support vaccine refusal and "embrace the label as a form of social identity," according to a report by researchers at Oklahoma State University, Texas A&M University and others, published in the journal Politics, Groups, and Identities. Underscoring concerns of public health experts, the study also found identifying as an anti-vaxxer to be predictive of increased opposition to childhood vaccine requirements.

Meanwhile, signs are also mounting about the partisan nature of growing opposition to vaccines and vaccine mandates, and the shift from medical to libertarian reasoning. Asked in a survey by the Kaiser Family Foundation whether getting the COVID vaccine is a matter of "personal choice" or "part of everyone's responsibility to protect the health of others," more than 70 percent of Republicans saw it as a personal choice vs. just 27 percent of Democrats. And according to a Twitter analysis by Renee DiResta, research manager of the Stanford Internet Observatory, reported in The New York Times, even anti-vaxxers whose opposition in the pre-COVID era was focused on concerns about autism and toxins are now evolving their messaging to talk about freedom and "vaccine choice."

Paramedics transport a COVID patient in Houston, Texas, where the governor has banned vaccine mandates. John Moore/Getty

"The coalescing of previously distinct groups that are now more aligned on this issue of opposing vaccines is new," says Douglas Opel, a pediatrician at Seattle Children's Hospital and author of numerous papers on vaccine hesitancy among parents. "The politicization of the COVID-19 vaccine development and authorization process has been a concern of all of us on what that might mean for vaccine confidence and the sustainability of immunization programs generally."

The Road to Here

Until recently, mandates for vaccinations—which mostly surface when parents try to enroll their children in daycare facilities or schools—were a relatively uncontroversial, routine part of preventing the spread of mostly vanquished infectious diseases. Every state has such mandates, and all but six allow exemptions for reasons of either religious or "personal belief." In California, Connecticut, Maine, Mississippi, New York and West Virginia, only exemptions for medical reasons are acceptable.

All 50 states have vaccine mandates, typically dating back decades. Here, a young boy receives a smallpox vaccine as classmates watch circa 1967. United States Department of Health Education and Welfare/Getty

Opposition to such mandates in the decades before COVID included the likes of Robert F. Kennedy Jr. and the actress Jenny McCarthy, both liberal skeptics of vaccine science who promoted theories about widespread vaccine side effects that have been aggressively debunked and dismissed by the medical community. When the country experienced outbreaks of diseases such as measles—an illness that in 2000 was declared eradicated in the U.S. by the World Health Organization—the overall numbers were in the dozens or hundreds, which is relatively small. In California, where a 2014 outbreak was traced to Disneyland, and New York, where surges in 2019 were connected to insular Orthodox Jewish communities, lawmakers quickly voted to eliminate the ability of parents to opt out of vaccinations for religious or personal reasons.

Yet what scares epidemiologists now is that many conservatives who denounce vaccine mandates are eliding the medical questions of whether they are safe. Instead, says David Rosner, a Columbia University historian who specializes in the intersection of politics and public health, they're focusing on a political view that requiring them is wrong.

"We are at the beginning of a much more profound change that may lead to resistance to other vaccines but also may lead to disintegration of any sense of social obligation, social cohesion and social purpose," he warns. "It's part of the questioning of what the country is and what it represents. When you see this kind of breakdown and unwillingness to work together, even under the most obvious circumstances where we've had more than 650,000 people die, it feels like the beginning of a major dividing point."

Many opponents—like Elder and Ohio Senate candidate Josh Mandel, who likened vaccine mandates to the Gestapo—are themselves vaccinated for COVID-19 and aren't voicing criticism of the safety or efficacy of the shots themselves. They merely insist that it's not the government's role to force the shots on people, many of whom question the record speed of the vaccines' development, prefer to rely on natural immunity the body may develop after being exposed to COVID or believe a wide range of misinformation, from the myth that the shots contain microchips capable of tracking movement to concerns of potential harm to the reproductive systems of women of child-bearing age.

After receiving COVID shots this spring, Californians in Richmond wait in an observation area. David Paul Morris/Blooberg/Getty

"I am not against anyone getting the COVID vaccine, it's their choice," says Duesenberg, who declined to say if he is vaccinated against COVID. "From someone that's not in the medical profession, there are risky classes of individuals who, if they were to contract the COVID-19 disease, it could be very bad for them. There's a big argument for them to get the COVID vaccine. But for young, healthy individuals, that risk-reward is way different. I've heard even doctors ask why a young healthy person would get the vaccine when you don't know the long-term effects of it. Either way, it can't be the government's choice."

That notion, though, threatens to upend more than a century of bipartisan acceptance and judicial support for the government's ability to impose vaccine requirements. As recently as mid-August, in fact, Supreme Court Justice Amy Coney Barrett, a conservative, declined to block a requirement from Indiana University that all students and faculty be vaccinated for COVID. In doing so, Barrett upheld a ruling by the 7th Circuit Court of Appeals, featuring all Republican appointees, that said vaccine requirements "have been common in this nation" and citing a 1905 Supreme Court decision upholding a smallpox vaccine mandate.

Still, just because the practice is constitutional doesn't mean state legislatures must continue to mandate immunizations. Nor does it mean that local boards of health will continue to be stingy about allowing exemptions if the political winds shift in such a way as to make that position untenable. The outcome, experts say, could be significant regional differences in vaccine protections.

"It's hard to know how big that group of vaccine refusers could potentially grow, but it's very clear that they will be in pockets, that they will reside together in different communities, where then we will see increased rates of certain vaccine-preventable diseases, of whooping cough, of measles, potentially of COVID, of influenza—all vaccine-preventable diseases" as a result, says Mary Anne Jackson, dean of the University of Missouri-Kansas City School of Medicine and a former member of the National Vaccine Advisory Committee and the American Academy of Pediatrics Committee on Infectious Diseases.

GOP House colleagues look on as Maryland Representative Andy Harris, a doctor and vaccine mandate opponent, speaks at a news conference on the Delta variant this summer. Alex Wong/Getty

Factoring into the heightened risk is the very nature of viruses, which bide their time in asymptomatic carriers waiting for hosts whose defenses are down. Tara Kirk Sell, a public health expert at the Johns Hopkins Center for Health Security, says the outcome is that any drop in vaccination coverage in a locality could present opportunities for, say, chicken pox or rubella to sicken and spread to other vulnerable people in the community, including people too young or medically fragile to be immunized.

Tara Kirk Sell at a congressional testimony. House Science Committe

"There are strong reasons why we require vaccines in schools, because we want to make sure that kids don't end up with measles or mumps and we don't want them spreading disease throughout the community," says Sell. "It's extremely concerning that this whole concern about COVID-19 vaccines is spiraling out into those other necessary public health requirements."

Signs of Trouble Ahead

The Centers for Disease Control's data so far is of little use in assessing the impact of COVID politics on vaccination rates for other diseases. The compliance rate for the usual litany of childhood shots was more than 95 percent as of the agency's most recently published numbers, but that only goes through 2019—before the pandemic's onset.

Still, based on spot reports from different pockets of the country, the National Foundation for Infectious Diseases noted "an alarming decline in vaccination rates" last year that it says puts individuals of all ages at risk of contracting vaccine-preventable diseases. Miami-Dade County in Florida, for instance, saw a 60 percent drop in the number of children's vaccines administered in April 2020 vs. April 2019; in Michigan in May 2020, half of infants five months or younger were behind on their vaccines; in New York City, vaccine dose delivery fell 91 percent between March and May 2020. But experts attribute those drops in shots more to parents' fears of taking their kids to doctors at the height of the pandemic lockdown out of fear of contracting COVID than to raging vaccine hesitancy.

Anecdotally, however, many pediatricians see a baffling, troubling sea change. Joel Heidelbaugh, a physician who oversees family practice residents at the University of Michigan School of Medicine at a clinic in suburban Detroit, says he now sees parents who refuse vaccines for their children at least twice a week whereas such refusals pre-COVID occurred a few times a year.

"I saw a baby today who didn't get their first vaccine in the hospital because the parents didn't want to give it, and then I saw a 14-year-old for a sports physical who had not gotten the COVID vaccine and was due for an HPV and a meningitis vaccine but the mom declined both of those," Heidelbaugh says. "When I suggested that they get the COVID vaccine for the 14-year-old, Mom vehemently told me no and said she'd thrown out everything in her house that's made by Johnson & Johnson because she's against the COVID vaccine and thinks it causes more harm than good." (J&J makes one of three approved COVID vaccines in the U.S.)

To those who have long toiled in the movement to question mass vaccinations and their safety, though, such stories are encouraging. "We're seeing many more people than before the pandemic asking serious questions," says Mary Holland, chief counsel to the Children's Health Defense, a non-profit advocacy group founded by RFK Jr., son of the late California Senator Robert Kennedy, that recently organized protests around the country in response to mask and vaccine mandates. "Is it safe? Is it effective? Were the clinical trials adequate? Is there liability protection? What's happening to the people who have been injured or have died? We're certainly seeing a level of interest in the movement for vaccine safety that we didn't see before the pandemic, and we are happy to see that renewed level of interest and education."

Brian Hooker, a longtime vaccine skeptic and one of the most prominent researchers to push a debunked claim that childhood vaccinations cause autism, agrees. "It's quite astounding to have more than 20 percent" of the public say they're anti-vaxxers, notes Hooker, a bioengineer and chair of the math and science department at Simpson University, a small Christian private college in Redding, California. "And that's not just specific to the COVID vaccine. This is something that is really, really new."

US President Joe Biden give remarks on COVID-19 response & vaccinations in the State Dining Room of the White House on June 18, 2021. Demetrius Freeman/The Washington Post/Getty

Proof Is Elusive

It's more difficult to persuade vaccine-hesitant parents like those he's encountering than it used to be, Heidelbaugh says, because their political views make them unreceptive to medical information that contradicts whatever they've heard from conservative or social media.

"I try to explain what they're due for, what vaccines we recommend, I'm happy to give literature on each of the vaccines so they understand what it's for and potential side effects," he says. "Then I explain to them the risks of being unvaccinated and tell them that there's a reason we have eradicated these diseases. And there's a reason we're starting to see some of these diseases which are preventable." Does that work? "Rarely," he says.

Sell believes this is the best approach even if it is increasingly futile: "It's much harder to debate political beliefs or values. For both sides, it is about protecting kids. You can't just come in and say, 'You're wrong,' because nothing turns someone off faster than that."

Another challenge vaccine proponents face is new data showing no recent uptick in various preventable childhood diseases over the past year when many children did not get their vaccinations on schedule. While the CDC doesn't have national numbers yet for 2020, it issued an alert in June to urge parents to catch up after analyzing data from 10 areas of the country and found, for instance, that the measles, mumps and rubella (MMR) vaccination rate dropped by an average of 63 percent among children 2 to 8 years old in 2020. Yet there was no corresponding outbreak of those illnesses and, in fact, some other childhood afflictions saw declines.

An EMS medic from the Houston Fire Department prepares to transport a Covid-19 positive girl, age 2, to a hospital on August 25, 2021 in Houston, Texas. John Moore/Getty

There are easy explanations for that outcome, experts say. Just as kids didn't go to doctors at the height of the pandemic lockdowns, they also didn't go to daycare or in-person school—and many wore masks and sanitized their hands when they did encounter friends and relatives—so they were cosseted from exposure to a variety of germs.

But activists like Holland nonetheless point to these declines as more proof that the sky won't fall if kids don't get their shots or don't get them on the schedule that epidemiologists and virologists insist is necessary for peak effectiveness. "We've published articles showing that infant deaths went down, Sudden Infant Death Syndrome went down during the pandemic," Holland says. (Most public health experts see no link between vaccines and SIDS; correlation doesn't equal causation.) "There are some positive associations for lower vaccine uptake that should be researched and followed up on. But instead, there's now a lot of emphasis on families catching up on their vaccines and staying with the regular schedule."

The Pushback Against Pushback

Pro-vaccine advocates say they have one important secret weapon in this battle: parents. Jackson says the overwhelming share do vaccinate and, she expects, will become more vocal if anti-vaxxers threaten the health of their kids and other loved ones. She predicts they will clamor for data on the percent of unvaccinated children in daycares and school classes, she says, and parents will make decisions about where their children go based on that information.

"There are some pediatric practices that now refuse to have kids in their practice whose parents have refused to vaccinate," she says. "That's a trend that the American Academy of Pediatrics worries about because those children also need quality providers. But pediatricians say they can't have situations where under-vaccinated children are sitting in my waiting room and could potentially bring in measles to a vulnerable population."

What's more, the cost of more frequent disease outbreaks on local health-care systems could make medical coverage more expensive for people in under-vaccinated areas. "In states that don't want to vaccinate, the insurance companies are going to either raise the premiums for all of us or they're going to have to put those states into a higher rate bracket because the risk pools in those states will go through the roof," predicts Connecticut State Representative Stephen Meskers, who earlier this year sponsored a successful measure that repealed the ability of parents to opt out of vaccine mandates based on religious or personal views. "It's not inexpensive to put people on ventilators and to have them in hospitals. So if you want to go that route, you're either going to let the hospital overfill or you're going to have to build better occupancy, and both of those have economic costs."

A shot of hope: A COVID vaccine manufacturing site in Germany: Recent data shows the shots are more than 90 percent effective in preventing deaths from the disease. Thomas Lohnes/AFP/Getty

Health economists such as Jonathan Kolstad of University of California at Berkeley back up this notion. He says, "If there's an increase in the cost of supplying healthcare in a certain area, we would expect in a competitive insurance market that premiums would increase."

Holland of the anti-vaccine-mandate Children's Health Defense believes her movement emerges from COVID in a much different, stronger place. She's less sure, though, that they can count on unqualified support from the GOP. "It's accurate to say that the Democratic Party is very aligned with the vaccine agenda, but I don't think you can say vaccine choice is cemented into the Republican party platforms," she says

And Meskers, the Connecticut State Representative, says much will depend on whether the COVID vaccines do stem the tide of the pandemic and whether the outcome differences between the vaccinated and unvaccinated remain so dramatically different. A recent CDC study found that unvaccinated Americans were nearly five times more likely than vaccinated people to contract COVID and about 29 times more likely to be hospitalized than fully vaccinated individuals; a separate study found the vaccines to be more than 90 percent effective in preventing deaths. But that could change.

"We run the risk of a breakthrough variant where the death rate picks up," Meskers says. "Are we going to get a breakthrough where the vaccine loses its effectiveness? If we do, we're going to go into another round of 'Well, the vaccine was never going to work.' And that's scary for what it will say to people about all the other vaccines out there."

[stephenmccull]

DeSantis’ Executive Order Is Misleading About Lack of Scientific Support for Masking in Schools

The Centers for Disease Control and Prevention’s recent guidance on students and masking “lacks a well-grounded scientific justification.”

Florida Gov. Ron DeSantis in a July 30 executive order

On July 30, Florida Gov. Ron DeSantis issued an executive order stating that schools couldn’t mandate that their students wear masks, and that it should be up to parents to decide whether they want their children masked in school buildings. The order also said the state can deny funding to districts that don’t comply.

One part of the order particularly caught our attention because of what it said about masks: “WHEREAS, despite recent Centers for Disease Control and Prevention (CDC) ‘guidance,’ forcing students to wear masks lacks a well-grounded scientific justification; indeed, a Brown University study analyzed COVID-19 data for schools in Florida and found no correlation with mask mandates.”

The executive order came on the heels of the CDC guidelines for reopening K-12 schools, which recommended that everyone age 2 and up should wear masks whether they are vaccinated or not. This guidance was issued partly because of the increase in covid cases due to the delta variant, which is more contagious than other versions of the virus. It was also issued because covid vaccines have not yet been authorized for use in children under age 12.

During the pandemic, DeSantis, a Republican, has consistently taken positions contrary to public health guidance from experts and said he wants Florida to remain open.

“In Florida, there will be no lockdowns, there will be no school closures, there will be no restrictions and no mandates,” DeSantis said during a speech introducing the executive order, which drew immediate pushback. President Joe Biden criticized his position and a group of Florida parents filed a lawsuit to block the order.

But the state is currently considered a covid hot spot. New covid-19 cases jumped to 28,000 on Sunday and total covid-related hospitalizations to almost 14,000 on Monday — numbers that surpassed previous statewide records. For context, in Florida there were 2,500 new covid cases and a seven-day average of 229 hospitalizations reported two months earlier, on June 6, before the delta variant surge.

DeSantis’ executive order cites a Brown University study to support his argument that schools can’t mandate masks.

We reached out to DeSantis’ office to confirm the role of that study and to ask if any other research was involved in the development of the executive order.

Press secretary Christina Pushaw replied with a statement reiterating the governor’s position that studies have shown covid’s spread in schools is typically less than within the larger community and that science has yet to substantiate the effectiveness of masks in reducing what she said was “an already very low risk of COVID-19 in children.” She acknowledged that the delta variant has been shown to be more transmissible — which means it could increase children’s risk — “but that is only a working theory as no studies have shown that conclusively.”

That made us wonder about key elements of the executive order — specifically, whether the Brown study indeed illustrated that mask mandates didn’t prevent transmission of covid-19 and if it’s correct that “forcing students to wear masks lacks a well-grounded scientific justification.”

The Brown Study

We reached out to Emily Oster, a professor of economics at Brown University, and the lead author of the study that DeSantis’ order references. Oster became well known during the pandemic for issuing data-driven recommendations on parenting and schooling. Some experts, though, have taken issue with her being an economist and not an epidemiologist.

Oster told us she couldn’t participate in a direct interview about the study, but she sent us this statement:

“We did not consult with Gov. DeSantis on these issues. Our paper is currently a pre-print, undergoing peer review. It relies on data from the 2020-2021 school year, prior to the emergence of the more contagious delta variant. Current CDC guidance, taking into account the current virus situation and all available data on masking, suggests masking for all K-12 students and staff, regardless of vaccination status.”

The study analyzed whether mask mandates in school districts in Florida and other states influenced the number of covid cases among students and staff members by looking at mitigation strategies as well as covid case counts. The researchers found that staff rates of covid were slightly higher in districts without mask mandates, but the difference was not statistically significant. Overall, no correlation was found between mask mandates and covid cases in students.

But within the study itself, the authors wrote about the limitations of their methods.

For instance, the study looked only at whether mandates existed at particular schools — not at the mask-wearing behavior of students and staffers. The study also didn’t account for mitigation measures that might have been in place in the surrounding community, which would influence case counts.

At the end of the study, the authors offer a conclusion that undermines the executive order: “We would emphasize that in general this literature suggests in-person school can be operated safely with appropriate mitigation, which typically includes universal masking. It would be premature to draw any alternative conclusions about this question based on this preliminary data.”

Justin Lessler, an epidemiology professor at the University of North Carolina, who led a peer-reviewed study that found masking in schools was associated with a significantly reduced risk of covid transmission, said he didn’t think this Brown study showed any strong conclusions to support the governor’s position.

“I think the lack of correlation with mask mandates at the population level is pretty weak evidence,” Lessler wrote in an email. “Also, mechanistically, it is a little hard to believe masking would not have some effect.”

Other Studies on Masks in Schools and Covid in Children

Dr. Lynn Goldman, dean of the Milken Institute of Public Health at George Washington University, said masks are absolutely effective in reducing covid transmission in children.

“What the science actually shows is that for children ages 2 and above, masks are not only protective but needed,” said Goldman, who is also a pediatrician. Since “those kids who are below the age of 12 cannot yet have the vaccine so they don’t have that layer of protection.”

Goldman also said studies show masking is effective in preventing covid transmission in schools.

The CDC guidance also cites several CDC-led studies that show the benefits of masking in schools, while independent researchers have shown similar results. Masking was often combined with other efforts to reduce spread, including improved ventilation and filtration systems. 

These points counter a claim central to DeSantis’ executive order: that the CDC school-reopening guidance “lacks a well-grounded scientific justification.”

“I think this ‘whereas’ of DeSantis’ executive order is just false, it’s just patently false,” said Dr. Jeffrey Goldhagen, a pediatrics professor at the University of Florida Health in Jacksonville.

What About Infection Risks for Children?

Though studies early in the pandemic did seem to indicate children were less likely to get covid than adults, current CDC data suggests that no longer seems to be the case.

CDC data through March 2021 shows that covid infection and symptomatic illness in children ages 5 to 17 was comparable to infection and illness in adults ages 18 to 49. Studies have also shown that even if children have mild or asymptomatic cases of covid they can spread the disease to adults who may then develop more severe cases — meaning children can be significant vectors of disease.

Children also are susceptible to the delta variant, which is more transmissible than the alpha variant.

Goldhagen said he has already anecdotally heard and seen the spread of the delta variant among children in camps and in schools that have started their semesters.

Pediatric covid hospitalizations have also been increasing in Florida in the past week, likely due to the delta variant, and there are reports that some children are experiencing serious symptoms. “The increase in the number of patients that we have in our children’s hospital due to covid has increased 500%,” Goldhagen, who is also a pediatrician at Wolfson Children’s Hospital in Jacksonville, told us on Aug. 5.

Our Ruling

DeSantis’ July 30 executive order missed the mark with its claim that “forcing students to wear masks lacks a well-grounded scientific justification.”

It also cited a Brown University study as scientific evidence that there is no correlation between mask mandates and reduced covid spread. However, while that study didn’t show a correlation, its authors noted the study’s limitations and concluded that appropriate mitigation typically includes universal masking. It flatly stated it would be premature to draw other conclusions based on the researchers’ preliminary data. Multiple studies also show masking in schools does have an effect on preventing covid transmission.

DeSantis’ executive order cherry-picked a study that offers little basis for his position and includes a variety of elements that are not accurate. We rate this False.

Source List

ABC Science Collaborative, Final Report, June 2021

Bloomberg, “Florida Parents Sue DeSantis, Ask Court to Allow Mask Mandates,” Aug. 8, 2021

Centers for Disease Control and Prevention, Mask Use and Ventilation Improvements to Reduce COVID-19 Incidence in Elementary Schools — Georgia, November 16-December 11, 2020, May 28, 2021

Centers for Disease Control and Prevention, COVID-19 in Primary and Secondary School Settings During the First Semester of School Reopening — Florida, August-December 2020, March 26, 2021

Centers for Disease Control and Prevention, Trends in Number of COVID-19 Cases and Deaths in the US Reported to CDC, by State/Territory, accessed Aug. 9, 2021

Centers for Disease Control and Prevention, Guidance for COVID-19 Prevention in K-12 Schools, updated July 9, 2021

Centers for Disease Control and Prevention, Science Brief: Transmission of SARS-CoV-2 in K-12 Schools and Early Care and Education Programs – Updated, July 9, 2021

Centers for Disease Control and Prevention, Estimated COVID-19 Burden, updated July 27, 2021

Department of Health and Human Services, Protect Public Data Hub — Hospital Utilization, accessed Aug. 9, 2021

Email interview with Justin Lessler, epidemiology professor at the University of North Carolina-Chapel Hill, Aug. 5, 2021

Email interview with Jill Roberts, associate professor at the University of South Florida College of Public Health, Aug. 3, 2021

Email statement from Emily Oster, economics professor at Brown University, Aug. 3, 2021

Email statement from Christina Pushaw, press secretary for Gov. Ron DeSantis, Aug. 4, 2021

Harvard Medical School, Coronavirus Outbreak and Kids, Aug. 2, 2021

medRxiv, COVID-19 Mitigation Practices and COVID-19 Rates in Schools: Report on Data From Florida, New York and Massachusetts, May 21, 2021

The Miami Herald, “Florida Children’s Hospitals See Pediatric COVID Cases Soar Amid Delta Variant Surge,” updated Aug. 9, 2021

National Bureau of Economic Research, School Reopenings, Mobility, and COVID-19 Spread: Evidence From Texas, May 2021

NBC 6 South Florida, “‘Governor Who?’ Biden Hits Back at DeSantis as Feud Continues,” Aug. 6, 2021

The New York Times, “She Fought to Reopen Schools, Becoming a Hero and a Villain,” June 22, 2021

Office of Gov. Ron DeSantis, “Governor DeSantis Issues an Executive Order Ensuring Parents’ Freedom to Choose,” July 30, 2021

Phone interview with Katherine Drabiak, associate professor at the University of South Florida College of Public Health, August 3, 2021

Phone interview with Dr. Jeffrey Goldhagen, pediatrics professor at the University of Florida Health in Jacksonville, Aug. 5, 2021

Phone interview with Dr. Lynn Goldman, dean of the Milken Institute School of Public Health at George Washington University, Aug. 6, 2021

Reuters, “Florida Governor Blocks School Mask Mandates, Says Parents Can Choose,” July 31, 2021

Science, “Household COVID-19 Risk and In-Person Schooling,” June 4, 2021

KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism about health issues. Together with Policy Analysis and Polling, KHN is one of the three major operating programs at KFF (Kaiser Family Foundation). KFF is an endowed nonprofit organization providing information on health issues to the nation.

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