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#garr-bear
dukeoftheblackstar · 16 days
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[6] 'Father Duty' Pt. 2 || Castis Vakarian
I, II, III, IV, V, by scent.2002 || Meta
Here we have:
Little Garrus stuffing dad's drawers with his blankie because someone has been bring home work a little too much. Needless to say, Castis feels equally touched as he is troubled because Garrus has thrown his stuff away to make room for his blankie.
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Itty, bitty Garr-bear sharing his desserts for dad but ends up taking a huge bite and is now in the dilemma of whether dad would notice or he'd have to take one for the team and eat all of it.
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Hydration is very important. Specially if you're a very young Turian caught in the adventure of making sure dad's OK. The drink was supposed to be Castis'.
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And so was the sandwich — or what's left of it. Castis is not a fan of saliva-soggy bread. [ I wasn't sure if there's an equivalent of sandwich for Turians.]
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Dad's way of saying he's both proud and love the itty, bitty monster baby.
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I'm having dad withdrawal. This may be a little too wholesome for Castis, but I'm pretty sure he did his best. With how Garrus turned out. I know most of his personality is more from mom as per the comics, but I'm also sure that he's got a lot of Castis in him too.
Anyway, have some fatherly sweetness from husband #3, Castis Vakarian.
Tagging my fellow thirsty Turian friends @eyecandyeoz @yuku78
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bestfurryhusband · 3 months
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20th-century-man · 2 years
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Frankie Avalon, Teri Garr / production still from the unaired pilot for Where the Action Is (ABC 1965–67)
This pilot was taped at the Big Bear Mountain Resort in California in February 1965 for CBS but the show ended up on ABC starting in June 1965.
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wingsy-keeper-of-songs · 11 months
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WIP Whenever
I was tagged by the very lovely @kirschewine and I figured "why the hell not?" So I have a bit of a Shakarian fic coming up, provided I can find the right voice for my Shep and Garre-Bear. I also like doing bits and can't write chronologically so hear y'all go. No warnings as of yet.
"Vi veri universum vivus vici" ("By the power of truth, I, while living, have conquered the universe.") - Faust
"You were dead." Vakarian said as if this were explanation enough.
"I got better," Shepard cracked as she leaned against the viewfinder of the Citadel beside him. "What does my untimely demise have to do with you putting down someone you used to call a friend?" Cerberus had been generous enough to upgrade her hearing to such an extent that she could hear the fine-tuning of turian subharmonics. She had no idea what they meant, and had no intention of embarrassing her friend by asking him to translate, but she could hear them. Right now, Vakarian made a quiet noise between a tiger's chuff and the bellow of a crocodile.
"Because your death was what brought me to Omega, and to him, in the first place." He replied without tearing his eyes from the skyline. Shepard said nothing after the fact. She waited for him to continue if he wanted. "I tried to do things the way you taught me," Vakarian began after a quiet sigh. "And for the most part, things were going well. Pallin didn't have to lecture me, we were doing good work by cleaning up Saren's mess. But then, the Normandy went down. After you were gone, all anyone wanted to do was forget what happened and move on with their lives. Things got...tense. The Council wrote the Reaper threat off despite being right there. They were right fucking there and they just dismissed it, dismissed you." His voice, both tones, trembled with anger. "I'd had enough. So I left and I headed to Omega and I formed a team, just like you did. We wanted to bring at least a little bit of hope back to the galaxy, but you saw how that ended." Shepard continued to keep silent, but lifted a hand to rest on her friend's arm. He didn't acknowledge the touch, but he didn't shy away from it either. He sighed again, deeper than before, a low and mournful keen thrumming in his sub-vocals. "Ten good people dead and gone, and all of it because I pushed them too hard." His mandibles clicked to his jaw and his head bowed. "All because I tried to be what you were to all of us, and failed." Shepard didn't know why, but something urged her to grip his shoulder and make him look at her. When he did, she surprised not only him, but herself as well by wrapping an arm around the nape of his neck and tugging him down to hug him.
"You goddamn idiot," she muttered into his throat. "You goddamn reckless, idealistic seven feet of dumbass turian." Vakarian wasn't sure why she was hugging him or calling him an idiot, but he wasn't about to question her either. "You didn't fail shit, Garrus. You had a bitch ass coward sell you out and then you nearly died with your team. Sounds like you got me down perfectly, buddy."
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thecreaturecodex · 2 years
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Deepspawn
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Image by Rafa Garres, © Wizards of the Coast.
[Commissioned by @tar-baphon​, who wanted the deepspawn from Forgotten Realms amped up to a CR 17 monster (previous 3rd edition versions were a CR 10). That’s fine with me; they’re logical “dungeon boss” monsters, and I’m happy to slot them in at a higher CR. In keeping with this advancement, I gave them a few more spell-like abilities to support their minions, and Craft Wondrous Item so they can stock their dungeons with magic traps. ]
Deepspawn CR 17 CE Aberration This horrific thing appears as a spherical mass of meat roughly ten feet in diameter. It has six large tentacles, three of which end in snapping maws, and the other three seem to serve as limbs. More than a dozen smaller tentacles grow from it, extending and retracting into its mass, each tipped with a scrutinizing eye.
A deepspawn is a foul, bizarre creature of the subterranean realm. They can reproduce a variety of monsters based on the creatures they have eaten. These are vomited up from one of its toothy maws, and are fully grown from birth. A single deepspawn can populate an entire region with horrors of all kinds, which are fanatically loyal to the deepspawn and serve it unto death. The deepspawn itself lairs in the middle of a dungeon protected with these minions and traps that the creature constructs. Some deepspawn spread rumors of the riches these dungeons hold, the better to lure more adventurers, kill and eat them, and add their skills and abilities to its army.
Deepspawn fight with a combination of their natural weapons and weapons collected from their treasure horde. They may distribute some of these as tools to their tool using spawn, but keep the best for themselves. A deepspawn can charge weapons and shields with magical energy if they don’t have any with particularly interesting magical properties on hand. A deepspawn uses the terrain to its advantage in combat, attacking from odd angles, inside pools or partially buried in a pile of coins.  They usually are accompanied by several of their minions, whom they empower with their magical abilities. A deepspawn always saves its healing magic for itself, however.
Because deepspawn are seemingly sexless, and hate other members of their own species, their origins and reproduction are obscure. Their aberrant appearance and monstrous fecundity suggest a link to the qlippoth of the Abyss, and their combination of a spherical body, eyestalks and tentacles specifically is reminiscent of the esoteric beholders. Deepspawn themselves do not talk about their origins. They are happy to talk about other things while tormenting their enemies—every deepspawn is deeply arrogant and vain, and they have a tendency to monologue.
Deepspawn           CR 17 XP 102,400 CE Huge aberration Init +4; Senses all-around vision, darkvision 60 ft., Perception +23 Defense AC 32, touch 12, flat-footed 28 (-2 size, +4 Dex, +14 natural, +6 shield) hp 275 (19d8+190); fast healing 5 Fort +18, Ref +12, Will +16 Immune poison; SR 28 Offense Speed 20 ft., climb 20 ft., swim 20 ft. Melee +4 longsword +23/+18/+13 (2d6+13/19-20), +4 handaxe +23/+18/+13 (1d8+13/x3), 3 bites +19 (2d6+4) or 3 bites +21 (2d6+9), 2 tentacles +19 (1d8+4 plus grab) Space 15 ft.; Reach 15 ft. Special Attacks constrict (1d8+13), spawn Spell-like Abilities CL 17th, concentration +20 At will—detect magic, detect thoughts (DC 15), water breathing 3/day—greater magic weapon, hold monster (DC 18), magic vestment, true seeing 1/day—heal, mass bear’s endurance, mass bull’s strength, mass cat’s grace Statistics Str 29, Dex 19, Con 30, Int 23, Wis 20, Cha 16 Base Atk +14; CMB +25 (+29 grapple); CMD 39 Feats Combat Reflexes, Craft Wondrous Item, Double Slice, Greater Two-Weapon Fighting, Improved Two-Weapon Fighting, Multiattack, Power Attack, Skill Focus (Stealth), Stand Still, Two-Weapon Fighting Skills Climb +32, Craft (traps) +21, Disable Device +18, Knowledge (dungeoneering) +24, Knowledge (arcana, local, nature) +21, Perception +23, Sense Motive +23, Spellcraft +23, Stealth +20, Survival +23, Swim +32 Languages Aklo, Aquan, Common, Draconic, Undercommon, telepathy 300 ft (spawn only) SQ martial training, trapfinding, undersized weapons Ecology Environment underground Organization solitary or brood (1 plus 3-6 spawn) Treasure double standard (Large masterwork longsword, Large masterwork handaxe, Large heavy steel shield, other treasure) Special Abilities Martial Training (Ex) A deepspawn is proficient in all simple weapons, martial weapons and shields. Spawn (Su) As a full round action, a deepspawn can give birth to a spawn. This creature is an aberration, animal, dragon, humanoid, magical beast, monstrous humanoid, ooze, plant or vermin of Large or smaller size that it has previously eaten. This creature is the same alignment as the deepspawn, is friendly towards it, and can only be convinced to attack it via magical compulsion. Creatures retain all of their skills, class and racial abilities, but only have dim memories of their lives before becoming spawn. A deepspawn can create spawn in a day of a CR equal to 3+ its Constitution modifier (CR 13 for the average deepspawn). Trapfinding (Ex) A deepspawn can detect and disable magical traps as if it were a rouge. Undersized Weapons (Ex) A deepspawn can use weapons sized for Medium or Large creatures without penalty.  
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nathangarries04 · 4 months
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Unloading Nathan Garries' Ruler Monetary Heading
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In the stunning universe of individual accounting, looking for course from specialists can have an awe-inspiring effect in making cash related progress. Nathan Garries, a carefully arranged monetary master, has gotten thought for his shrewd course on investigating the complexities of cash the managers. This article bobs into Nathan Garries' cash related information, researching key standards and tips that can engage people on their outing to monetary achievement nathan garries edmonton.
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n8bitg · 5 months
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My DnD character for an upcoming session. Garr is a half orc barbarian who is searching the next thing to kill. Also he has polar bear boots with the fur.
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ar-rc · 1 year
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Dictionary of Roe
Modifying Grammar Noun -> Adjective Noun+i Ais (Ice) + i = Aisi (Icy) Ex: Aisibhir (Icy Ale)
Verb -> Noun(er) Verb+a Braen (Break) + a = Braena (Breaker) Ex: Aisbraena (Ice Breaker)
Verb -> Noun(ing) verb+n Floer (Lead) + n = Floern (Leading) Ex: Floernmann (Leading Man)
Spelling Rule Always remove doubled letter when combining a word that ends in the same letter the following word begins with. Rostn + Noez = Rostnoez (Rusty Walnut)
Words classified as both adjective and noun, including those under Minerals and Colors, will not change in structure when they are used as an adjective. For example Agat (amber) will NEVER become Agati.
Misc Jho……………… And Oebb…………… Above
Numbers Aerst…………… First Agynn………….. Beginning Helb……………. Half Jarr……………… Year ---- Eyn……………… One Does……………. Two Drys…………….. Three Foer……………. Four Pfym…………… Five Saes……………. Six Syvin…………… Seven Aht……………… Eight Nyun…………… Nine Zaen……………. Ten Eynli……………. Eleven Zwelf… ……….. Twelve Ahtza…………… Eighty
Colors Bloe……………. Blue Broen………….. Brown Fhil……………… Yellow Gryne………….. Green Hast/Hastal…… Hazel Keim…………….Violet, Purple Kest…………….. Chestnut Rhot……………. Red Swar……………. Black Thosin…………. Gray Wyzn…………… White
Animals Aent……………. Duck Ahl……………… Eel Ahr……………… Eagle Bhar……………. Bear Born……………. Boar Elak…………….. Elk Falk…………….. Falcon Farr…………….. Bull Fhis/Fhisk……. Fish Floh……………. Flea Fohc……………. Fox Folg…………….. Bird Frusk…………… Frog Gaez……………. Goat Hund/Hundr…..... Dog Hwab…………… Hawk Khra……………. Crane Kilb…………….. Calf Koel……………. Coeurl Lahz……………. Salmon Lorh……………. Rabbit Loug……………. Leech Mhar…………… Horse Mhol…………… Salamander, Eft Mhus…………… Mouse Rael…………….. Doe Ramm………….. Ram Skapf…………… Sheep Skrat……………. Goblin Spaer…………… Sparrow Thuv……………. Dove Troeg…………… Monster Urs……………… Auroch Uwil……………. Owl Wilf…………….. Wolf Wyrn…………… Snake
The Body Ahrm…………… Arm Baen……………. Bone Benn…………… Leg Broes…………… Chest Foet……………. Foot Fyst…………….. Fist Gara……………. Skin Gybal…………… Skull Haerz…………… Heart Hanth………….. Hand Harr…………….. Hair Krepf…………… Claw Maga…………… Stomach Mynd………….. Mouth Oeya…………… Eye Oura…………… Ear Pfyn……………. Finger Zagyl…………… Tail Zant……………. Tooth Zeh……………… Toe Zoeng………….. Tongue
Seasons Bryn……………. Spring Some/Soemr… Summer Hyrt…………….. Autumn Wint……………. Winter
Food/Nature Ahct………………………. River Ais………………………… Ice Bera………………………. Berry Berk………………………. Mountain Bhir……………………….. Ale Bhrat……………………… Meat Bluom……………………. Flower Blyss……………………… Blossom Brem……………………… Bramble Brot………………………. Bread Byrm……………………… Tree Cwaen…………………… Pine Cwin……………………… Wine Doen……………………… Thunder Dornn…………………….. Thorn Eyha………………………. Oak Eyhil……………………… Acorn Faeld…………………….. Field Fedar…………………….. Feather Frut……………………….. Fruit Fyr………………………… Fire Hana……………………… Hemp, Hempen Himal…………………….. Sky Hylt……………………….. Forest Isil…………………………. Island Kyrss……………………… Cherry Laent……………………… Land Loef……………………….. Leaf Merl………………………. Sea Myst………………………. Mistletoe Opyl………………………. Apple Orn……………………….. Maple Pfef……………………….. Pepper Noez……………………… Walnut Pfrym…………………….. Plum Roegan/Roega…………. Rain Saelb/Sylbei……………. Sage Saelz……………………… Salt Saem……………………… Seed Seik/Sfiek………………. Lake Snoe…. ………………….. Snow Swaen……………………. Mushroom Synt……………………….. Sand Tu………………………….. Dew Tyl…………………………. Valley Ulm……………………….. Elm Weitz…………………….. Wheat Wolk……………………… Cloud Wurt/Wurth……………. Herb Wyda……………………… Wilow Wyta……………………… Water Wyrst…………………….. Sausage Zedyr… ………………….. Cedar
Nouns Abyl……………. Rage Alyr…………….. Alder Anka…………… Anchor Ansa……………. Scythe Aren……………. Harvest Ask……………… Ash Bhaln…………… Plague Blaet…………… Blood Borg……………. Castle Brytt……………. Bridle Byrt…………….. Axe Ceig…………….. Sail Ceil…………….. Rope Dhem………….. Dusk Dorpf…………… Village Dyn…………….. People Dyrf…………….. Farm Eidin……………. Oath Ent……………… End Garr…………….. Choir Geim…………… Jewel Geiss/Geyss….. Ghost Glac…………….. Bell Graeb………….. Grave Hyll…………….. Hell Hyml…………… Heaven Hyr……………… Army Ingil/Inghil…… Angel Itar……………… Knight Gybet………….. Prayer Haemr…………. Hammer Halp……………. Side Khezl………….. Kettle Kirz…………….. Candle Klet…………….. Burdock Liht……………… Light Lleid……………. Pain Lora…………….. Laurel Mhas…………… Scar Moen………….. Moon Moht…………… Mind Murl……………. Wall Myna…………… Love Myrgan………… Morning Nagl……………. Nail Nahct………….. Night Nort……………. North Nyst……………. Nest Oefyr………….. Sacrifice Ost……………… East Pfrew………….. Joy Raen/Raen…… Circle Raet……………. Chariot Ronn…………… Current Ruht……………. Smoke Ryhhe………….. Empire Rymm…………. Frost Sald…………….. Luck Sath……………. Knife Satz…………….. Dance Skaet…………… Shadow Skoef………….. Poetry, Poet Skyf…………….. Ship Skylt…………… Shield Spyr….. ……….. Spear Stral……………. Arrow Stymm………… Voice Styr/Styrn……. Star Styrm………….. Storm Sund…………… South Sunn…………… Sun Sweig………….. Herd Swerd.. ……….. Sword Sygg……………. Victory Syng……………. Song Toum…………… Dream Trach…………… Dragon Twyr……………. Dwarf Tyrn……………. Tower Tyrb/Terbin….. Cyclone Und…………….. Wave Waek………….. Battle Waen/Waent… Wind Ward…………… Watch Warg…………… Truth Wein…………… Woad Wist……………. West Woerd…………. Word Wyrk…………… Work Zahr….. …………Tear
Titles/Professions Ahtyn…………………….. Judge Blyda……………………… Maker Broda…………………….. Brother Bryda…………………….. Bride Daeg……………………… Soldier Draga……………………… Carrier Fatyr………………………. Father Fian……………………….. Enemy Froe/Froa……………….. Lady Fryn………………………. Friend Germa……………………. Conjurer Goht………………………. God Gohta……………………. Goddess Klin/Klind………………. Child Koen……………………… King Koena/Koenyb………… Queen Kympf……………………. Champion Kynd………………………. Virgin Leita………………………. Bringer Lon/Lona………………… Gatherer Mann…………………….. Man Skal……………………….. Servant Smyd……………………… Smith Swys/Swysta…………… Sister Syn………………………… Son Thota… ………………….. Daughter Thuba…………………….. Mage Waht……………………… Guard Wyb………………………. Woman Wykra……………………. Worker Zwyn……………………… Twin
Adjectives Abar………………………. Lone, ALone Aerg………………………. Ambitious Aerm…………………….. Poor Ahld………………………. Old Awyr……………………… Absent Bara………………………. Bare, Naked Bhald…………………….. Bold, Brave Blei……………………….. Pale Blyn………………………. Blind Bylg………………………. Fertile Caer………………………. Sad Dani………………………. Narrow Denkyr…………………… Thinking Denn……………………… Thin Doer………………………. Dry Dyrst……………………… Thirsty, Thirst Eifa……………………….. Bitter Elil………………………… Exiled, Foreign Erna………………………. Earnest Ewan……………………… Even Eyri……………………….. Wandering Faez………………………. Fat Fhruh…………………….. Early Flaz……………………….. Flat Flekk……………………… Spotted Frae……………………….. Free Fyril……………………….. Lost Ganz………………………. Perfect Ghim……………………… Modest Greh………………………. Calm Grym……………………… Cruel Guht………………………. Good Guol………………………. Glorious Hael………………………. Healthy Haer………………………. Grand Hald………………………. Kind Herl……………………….. Elder Hezz………………………. Hot Hint……………………….. Behind Hirsk………………………. Agile Holas……………………… Bald Holl……………………….. Hollow Holsk……………………… Fast Horsk/Horsam…………. Obedient Kelt……………………….. Cold Khus………………………. Chaste Klyn……………………….. Small Kneh……………………… Near Kroem……………………. Bent Lamm…………………….. Lame, Injured Loet………………………. Loud Loetr……………………… Pure Loez………………………. Short Lyna………………………. Linen Lyng………………………. Long Maeti…………………….. Mighty Moeg…………………….. Able Nazz………………………. Damp, wet Nedyr…………………….. Low Niu………………………… New Nortyr……………………. Northern Ostyr……………………… Eastern Ofan………………………. Clear Pfar……………………….. Walking Phati……………………… Late Rhen……………………… Clean Rheti……………………… Straight, Lawful Rhit……………………….. Right Rhyl………………………. Plentiful Roeh……………………… Rough Rostn…………………….. Rusty Skaen…………………….. Beautiful Skarn……………………… Horrible Skoen…………………….. Shining Slae……………………….. Dull Slaf……………………….. Sleeping Slett………………………. Plain Solk……………………….. Blessed Stael……………………… Still Sterr………………………. Strong Sundyr…………………… Southern Swoz……………………… Sweet Swyg……………………… Silent Swyn……………………… Round Swyr………………………. Big Syhr………………………. Fearless Syk………………………… Sick Syngi……………………… Singing Syzn………………………. Sitting Thor………………………. Torn Toff……………………….. Deep Trachyn………………….. Dragon Tragg……………………… Slow Trahg……………………… Lazy Troe/Troeb……………… Confused Tymb……………………… Dumb Ubyl………………………. Evil Unsyn…………………….. Innocent Unta………………………. Other Usyn……………. …………Ashen Waem……………………. Warm Wakk……………………… Awake, Woken Wann…………………….. Empty Wast……………………… Sharp Whei……………………… Soft Wilt……………………….. Wild Winst…………………….. Left Wistyr……………………. Western Wunt……………………… Under Wuot……………………… Berserk Wyss……………………… Wise Ybolg……………………… Enraged Zaes………………………. Right Zoer………………………. Sour
Minerals (work as nouns and adjectives) Agat……………. Amber Blau……………. Lead Caepf………….. Slate Glaz…………….. Glass Grein…………… Bronze Guld……………. Gold Iyrn…………….. Iron Kryd……………. Chalk Kryst…………… Crystal Kupf……………. Copper Loh……………… Cloth, Clothes Lydir……………. Leather Marm………….. Marble Sthal……………. Steel Sylb…………….. Silver Webb………….. Silk Whaz…………… Wax Woll……………. Wool
Both noun and adjective Blan…………….. Darkness, Dark Fryd…………….. Peace, Peaceful Keten………….. Chain, Chained Knod…………… Knot, Knotty Lubb/Lubd……. Poison Myte…………… Middle Ryss…………….. Giant Thubyr………… Magic Toeg……………. Secret Zirn…………….. Fury, Furious
Verbs Braen………….. Break Byld…………….. Make Byrg……………. Protect Draeg………….. Carry Edz……………… Eat Fhet……………. Fight Firk……………… Explore Floeg…………… Fly Floer…………… Lead Gheb…………… Give Grina…………… Howl Gyft…………….. Sell Hwyz…………… Know Jaeg…………….. Hunt Khan……………. Laugh Lago……………. Lament Moer…………… Kill Ronth………….. Run Skrib……………. Write Sthan…………… Stand Sweig………….. Herd Syz……………… Sit Waeb………….. Weave Wall……………. Boil Wegg………….. Provoke Wezzn…………. Punishment Zent……………. Send
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vickiabelson · 2 years
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Can you top this? Yes, we can. How the hell is it possible that this sitdown with The Sopranos Richie Aprile aka David Proval, will go down as one of the most entertaining shows yet? It shall. WOW. What fun. Great stories. Crazy coincidences. More great stories.
As if it wasn’t enough that David’s mother and I share the same family name,    and she has the same country of origin as my grandma with the same name, we’re both New Yorkers, David went to Yeshiva, my father taught Yeshiva, our paths crossing about a decade ago while filming Henry Jaglom’s The M Word with Michael Imperioli, post their work in The Sopranos, pre ours at Women Who Write and Game Changers. 
Thanks to the suggestion of my new good friend, Mark Metcalf, who also middled last week’s stupendous sitdown with Tim Matheson, I know David’s extensive body of stellar work, Mark added technicolor. I jumped at his suggestion to invite David. My gratitude to both of them is boundless. What fun! I know I said it before, but it bears repeating.
From his grandma and the Yiddish theatre, school plays, Uta Hagen, to Scorcese and Mean Streets, thanks to his friend, Jon Voight, how he got it—DeNiro, Keitel, Pavlo Hummel, again thanks to Voight, which led to Nunzio, a hysterical story about filming with Jack Gilford, Elliot Gould, and James Caan, which included more great stories about James, to the other James… Gandolfini. David’s audition(s) for The Sopranos, so much great stuff there, moving from mobster Richie Aprile to a Rabbi in The West Wing, Teri Garr, Richard Dreyfus, coaching Eddie Murphy, an insanely great story there, a Drama Desk Nomination, Innocent Blood, John Landis, Don Rickels, hysterical stuff there, meeting Sinatra, and sitting down with him, a fan, wow, Everybody Loves Raymond, Italy, and his personal discontent… all straight talk, with loads of laughter and a few tears. I loved every single second, especially when his wife of 46 years, Cheryl, joined the conversation from the other room. 
Forget cowbell. More David Proval! 
David Proval Live on Game Changers With Vicki Abelson
Wednesday, 8/10/22, 5 pm PT, 8 pm ET
Streamed Live on my Facebook
Replay here:
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romespulse · 5 years
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have this because it makes me laugh
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qqueenofhades · 3 years
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The Green Knight and Medieval Metatextuality: An Essay
Right, so. Finally watched it last night, and I’ve been thinking about it literally ever since, except for the part where I was asleep. As I said to fellow medievalist and admirer of Dev Patel @oldshrewsburyian, it’s possibly the most fascinating piece of medieval-inspired media that I’ve seen in ages, and how refreshing to have something in this genre that actually rewards critical thought and deep analysis, rather than me just fulminating fruitlessly about how popular media thinks that slapping blood, filth, and misogyny onto some swords and castles is “historically accurate.” I read a review of TGK somewhere that described it as the anti-Game of Thrones, and I’m inclined to think that’s accurate. I didn’t agree with all of the film’s tonal, thematic, or interpretative choices, but I found them consistently stylish, compelling, and subversive in ways both small and large, and I’m gonna have to write about it or I’ll go crazy. So. Brace yourselves.
(Note: My PhD is in medieval history, not medieval literature, and I haven’t worked on SGGK specifically, but I am familiar with it, its general cultural context, and the historical influences, images, and debates that both the poem and the film referenced and drew upon, so that’s where this meta is coming from.)
First, obviously, while the film is not a straight-up text-to-screen version of the poem (though it is by and large relatively faithful), it is a multi-layered meta-text that comments on the original Sir Gawain and the Green Knight, the archetypes of chivalric literature as a whole, modern expectations for medieval films, the hero’s journey, the requirements of being an “honorable knight,” and the nature of death, fate, magic, and religion, just to name a few. Given that the Arthurian legendarium, otherwise known as the Matter of Britain, was written and rewritten over several centuries by countless authors, drawing on and changing and hybridizing interpretations that sometimes challenged or outright contradicted earlier versions, it makes sense for the film to chart its own path and make its own adaptational decisions as part of this multivalent, multivocal literary canon. Sir Gawain himself is a canonically and textually inconsistent figure; in the movie, the characters merrily pronounce his name in several different ways, most notably as Sean Harris/King Arthur’s somewhat inexplicable “Garr-win.” He might be a man without a consistent identity, but that’s pointed out within the film itself. What has he done to define himself, aside from being the king’s nephew? Is his quixotic quest for the Green Knight actually going to resolve the question of his identity and his honor – and if so, is it even going to matter, given that successful completion of the “game” seemingly equates with death?
Likewise, as the anti-Game of Thrones, the film is deliberately and sometimes maddeningly non-commercial. For an adaptation coming from a studio known primarily for horror, it almost completely eschews the cliché that gory bloodshed equals authentic medievalism; the only graphic scene is the Green Knight’s original beheading. The violence is only hinted at, subtextual, suspenseful; it is kept out of sight, around the corner, never entirely played out or resolved. In other words, if anyone came in thinking that they were going to watch Dev Patel luridly swashbuckle his way through some CGI monsters like bad Beowulf adaptations of yore, they were swiftly disappointed. In fact, he seems to spend most of his time being wet, sad, and failing to meet the moment at hand (with a few important exceptions).
The film unhurriedly evokes a medieval setting that is both surreal and defiantly non-historical. We travel (in roughly chronological order) from Anglo-Saxon huts to Romanesque halls to high-Gothic cathedrals to Tudor villages and half-timbered houses, culminating in the eerie neo-Renaissance splendor of the Lord and Lady’s hall, before returning to the ancient trees of the Green Chapel and its immortal occupant: everything that has come before has now returned to dust. We have been removed even from imagined time and place and into a moment where it ceases to function altogether. We move forward, backward, and sideways, as Gawain experiences past, present, and future in unison. He is dislocated from his own sense of himself, just as we, the viewers, are dislocated from our sense of what is the “true” reality or filmic narrative; what we think is real turns out not to be the case at all. If, of course, such a thing even exists at all.
This visual evocation of the entire medieval era also creates a setting that, unlike GOT, takes pride in rejecting absolutely all political context or Machiavellian maneuvering. The film acknowledges its own cultural ubiquity and the question of whether we really need yet another King Arthur adaptation: none of the characters aside from Gawain himself are credited by name. We all know it’s Arthur, but he’s listed only as “king.” We know the spooky druid-like old man with the white beard is Merlin, but it’s never required to spell it out. The film gestures at our pre-existing understanding; it relies on us to fill in the gaps, cuing us to collaboratively produce the story with it, positioning us as listeners as if we were gathered to hear the original poem. Just like fanfiction, it knows that it doesn’t need to waste time introducing every single character or filling in ultimately unnecessary background knowledge, when the audience can be relied upon to bring their own.
As for that, the film explicitly frames itself as a “filmed adaptation of the chivalric romance” in its opening credits, and continues to play with textual referents and cues throughout: telling us where we are, what’s happening, or what’s coming next, rather like the rubrics or headings within a medieval manuscript. As noted, its historical/architectural references span the entire medieval European world, as does its costume design. I was particularly struck by the fact that Arthur and Guinevere’s crowns resemble those from illuminated monastic manuscripts or Eastern Orthodox iconography: they are both crown and halo, they confer an air of both secular kingship and religious sanctity. The question in the film’s imagined epilogue thus becomes one familiar to Shakespeare’s Henry V: heavy is the head that wears the crown. Does Gawain want to earn his uncle’s crown, take over his place as king, bear the fate of Camelot, become a great ruler, a husband and father in ways that even Arthur never did, only to see it all brought to dust by his cowardice, his reliance on unscrupulous sorcery, and his unfulfilled promise to the Green Knight? Is it better to have that entire life and then lose it, or to make the right choice now, even if it means death?
Likewise, Arthur’s kingly mantle is Byzantine in inspiration, as is the icon of the Virgin Mary-as-Theotokos painted on Gawain’s shield (which we see broken apart during the attack by the scavengers). The film only glances at its religious themes rather than harping on them explicitly; we do have the cliché scene of the male churchmen praying for Gawain’s safety, opposite Gawain’s mother and her female attendants working witchcraft to protect him. (When oh when will I get my film that treats medieval magic and medieval religion as the complementary and co-existing epistemological systems that they were, rather than portraying them as diametrically binary and disparagingly gendered opposites?) But despite the interim setbacks borne from the failure of Christian icons, the overall resolution of the film could serve as the culmination of a medieval Christian morality tale: Gawain can buy himself a great future in the short term if he relies on the protection of the enchanted green belt to avoid the Green Knight’s killing stroke, but then he will have to watch it all crumble until he is sitting alone in his own hall, his children dead and his kingdom destroyed, as a headless corpse who only now has been brave enough to accept his proper fate. By removing the belt from his person in the film’s Inception-like final scene, he relinquishes the taint of black magic and regains his religious honor, even at the likely cost of death. That, the medieval Christian morality tale would agree, is the correct course of action.
Gawain’s encounter with St. Winifred likewise presents a more subtle vision of medieval Christianity. Winifred was an eighth-century Welsh saint known for being beheaded, after which (by the power of another saint) her head was miraculously restored to her body and she went on to live a long and holy life. It doesn’t quite work that way in TGK. (St Winifred’s Well is mentioned in the original SGGK, but as far as I recall, Gawain doesn’t meet the saint in person.) In the film, Gawain encounters Winifred’s lifelike apparition, who begs him to dive into the mere and retrieve her head (despite appearances, she warns him, it is not attached to her body). This fits into the pattern of medieval ghost stories, where the dead often return to entreat the living to help them finish their business; they must be heeded, but when they are encountered in places they shouldn’t be, they must be put back into their proper physical space and reminded of their real fate. Gawain doesn’t follow William of Newburgh’s practical recommendation to just fetch some brawny young men with shovels to beat the wandering corpse back into its grave. Instead, in one of his few moments of unqualified heroism, he dives into the dark water and retrieves Winifred’s skull from the bottom of the lake. Then when he returns to the house, he finds the rest of her skeleton lying in the bed where he was earlier sleeping, and carefully reunites the skull with its body, finally allowing it to rest in peace.
However, Gawain’s involvement with Winifred doesn’t end there. The fox that he sees on the bank after emerging with her skull, who then accompanies him for the rest of the film, is strongly implied to be her spirit, or at least a companion that she has sent for him. Gawain has handled a saint’s holy bones; her relics, which were well known to grant protection in the medieval world. He has done the saint a service, and in return, she extends her favor to him. At the end of the film, the fox finally speaks in a human voice, warning him not to proceed to the fateful final encounter with the Green Knight; it will mean his death. The symbolism of having a beheaded saint serve as Gawain’s guide and protector is obvious, since it is the fate that may or may not lie in store for him. As I said, the ending is Inception-like in that it steadfastly refuses to tell you if the hero is alive (or will live) or dead (or will die). In the original SGGK, of course, the Green Knight and the Lord turn out to be the same person, Gawain survives, it was all just a test of chivalric will and honor, and a trap put together by Morgan Le Fay in an attempt to frighten Guinevere. It’s essentially able to be laughed off: a game, an adventure, not real. TGK takes this paradigm and flips it (to speak…) on its head.
Gawain’s rescue of Winifred’s head also rewards him in more immediate terms: his/the Green Knight’s axe, stolen by the scavengers, is miraculously restored to him in her cottage, immediately and concretely demonstrating the virtue of his actions. This is one of the points where the film most stubbornly resists modern storytelling conventions: it simply refuses to add in any kind of “rational” or “empirical” explanation of how else it got there, aside from the grace and intercession of the saint. This is indeed how it works in medieval hagiography: things simply reappear, are returned, reattached, repaired, made whole again, and Gawain’s lost weapon is thus restored, symbolizing that he has passed the test and is worthy to continue with the quest. The film’s narrative is not modernizing its underlying medieval logic here, and it doesn’t particularly care if a modern audience finds it “convincing” or not. As noted, the film never makes any attempt to temporalize or localize itself; it exists in a determinedly surrealist and ahistorical landscape, where naked female giants who look suspiciously like Tilda Swinton roam across the wild with no necessary explanation. While this might be frustrating for some people, I actually found it a huge relief that a clearly fantastic and fictional literary adaptation was not acting like it was qualified to teach “real history” to its audience. Nobody would come out of TGK thinking that they had seen the “actual” medieval world, and since we have enough of a problem with that sort of thing thanks to GOT, I for one welcome the creation of a medieval imaginative space that embraces its eccentric and unrealistic elements, rather than trying to fit them into the Real Life box.
This plays into the fact that the film, like a reused medieval manuscript containing more than one text, is a palimpsest: for one, it audaciously rewrites the entire Arthurian canon in the wordless vision of Gawain’s life after escaping the Green Knight (I could write another meta on that dream-epilogue alone). It moves fluidly through time and creates alternate universes in at least two major points: one, the scene where Gawain is tied up and abandoned by the scavengers and that long circling shot reveals his skeletal corpse rotting on the sward, only to return to our original universe as Gawain decides that he doesn’t want that fate, and two, Gawain as King. In this alternate ending, Arthur doesn’t die in battle with Mordred, but peaceably in bed, having anointed his worthy nephew as his heir. Gawain becomes king, has children, gets married, governs Camelot, becomes a ruler surpassing even Arthur, but then watches his son get killed in battle, his subjects turn on him, and his family vanish into the dust of his broken hall before he himself, in despair, pulls the enchanted scarf out of his clothing and succumbs to his fate.
In this version, Gawain takes on the responsibility for the fall of Camelot, not Arthur. This is the hero’s burden, but he’s obtained it dishonorably, by cheating. It is a vivid but mimetic future which Gawain (to all appearances) ultimately rejects, returning the film to the realm of traditional Arthurian canon – but not quite. After all, if Gawain does get beheaded after that final fade to black, it would represent a significant alteration from the poem and the character’s usual arc. Are we back in traditional canon or aren’t we? Did Gawain reject that future or didn’t he? Do all these alterities still exist within the visual medium of the meta-text, and have any of them been definitely foreclosed?
Furthermore, the film interrogates itself and its own tropes in explicit and overt ways. In Gawain’s conversation with the Lord, the Lord poses the question that many members of the audience might have: is Gawain going to carry out this potentially pointless and suicidal quest and then be an honorable hero, just like that? What is he actually getting by staggering through assorted Irish bogs and seeming to reject, rather than embrace, the paradigms of a proper quest and that of an honorable knight? He lies about being a knight to the scavengers, clearly out of fear, and ends up cravenly bound and robbed rather than fighting back. He denies knowing anything about love to the Lady (played by Alicia Vikander, who also plays his lover at the start of the film with a decidedly ropey Yorkshire accent, sorry to say). He seems to shrink from the responsibility thrust on him, rather than rise to meet it (his only honorable act, retrieving Winifred’s head, is discussed above) and yet here he still is, plugging away. Why is he doing this? What does he really stand to gain, other than accepting a choice and its consequences (somewhat?) The film raises these questions, but it has no plans to answer them. It’s going to leave you to think about them for yourself, and it isn’t going to spoon-feed you any ultimate moral or neat resolution. In this interchange, it’s easy to see both the echoes of a formal dialogue between two speakers (a favored medieval didactic tactic) and the broader purpose of chivalric literature: to interrogate what it actually means to be a knight, how personal honor is generated, acquired, and increased, and whether engaging in these pointless and bloody “war games” is actually any kind of real path to lasting glory.
The film’s treatment of race, gender, and queerness obviously also merits comment. By casting Dev Patel, an Indian-born actor, as an Arthurian hero, the film is… actually being quite accurate to the original legends, doubtless much to the disappointment of assorted internet racists. The thirteenth-century Arthurian romance Parzival (Percival) by the German poet Wolfram von Eschenbach notably features the character of Percival’s mixed-race half-brother, Feirefiz, son of their father by his first marriage to a Muslim princess. Feirefiz is just as heroic as Percival (Gawaine, for the record, also plays a major role in the story) and assists in the quest for the Holy Grail, though it takes his conversion to Christianity for him to properly behold it.
By introducing Patel (and Sarita Chowdhury as Morgause) to the visual representation of Arthuriana, the film quietly does away with the “white Middle Ages” cliché that I have complained about ad nauseam; we see background Asian and black members of Camelot, who just exist there without having to conjure up some complicated rationale to explain their presence. The Lady also uses a camera obscura to make Gawain’s portrait. Contrary to those who might howl about anachronism, this technique was known in China as early as the fourth century BCE and the tenth/eleventh century Islamic scholar Ibn al-Haytham was probably the best-known medieval authority to write on it extensively; Latin translations of his work inspired European scientists from Roger Bacon to Leonardo da Vinci. Aside from the symbolism of an upside-down Gawain (and when he sees the portrait again during the ‘fall of Camelot’, it is right-side-up, representing that Gawain himself is in an upside-down world), this presents a subtle challenge to the prevailing Eurocentric imagination of the medieval world, and draws on other global influences.
As for gender, we have briefly touched on it above; in the original SGGK, Gawain’s entire journey is revealed to be just a cruel trick of Morgan Le Fay, simply trying to destabilize Arthur’s court and upset his queen. (Morgan is the old blindfolded woman who appears in the Lord and Lady’s castle and briefly approaches Gawain, but her identity is never explicitly spelled out.) This is, obviously, an implicitly misogynistic setup: an evil woman plays a trick on honorable men for the purpose of upsetting another woman, the honorable men overcome it, the hero survives, and everyone presumably lives happily ever after (at least until Mordred arrives).
Instead, by plunging the outcome into doubt and the hero into a much darker and more fallible moral universe, TGK shifts the blame for Gawain’s adventure and ultimate fate from Morgan to Gawain himself. Likewise, Guinevere is not the passive recipient of an evil deception but in a way, the catalyst for the whole thing. She breaks the seal on the Green Knight’s message with a weighty snap; she becomes the oracle who reads it out, she is alarming rather than alarmed, she disrupts the complacency of the court and silently shows up all the other knights who refuse to step forward and answer the Green Knight’s challenge. Gawain is not given the ontological reassurance that it’s just a practical joke and he’s going to be fine (and thanks to the unresolved ending, neither are we). The film instead takes the concept at face value in order to push the envelope and ask the simple question: if a man was going to be actually-for-real beheaded in a year, why would he set out on a suicidal quest? Would you, in Gawain’s place, make the same decision to cast aside the enchanted belt and accept your fate? Has he made his name, will he be remembered well? What is his legacy?
Indeed, if there is any hint of feminine connivance and manipulation, it arrives in the form of the implication that Gawain’s mother has deliberately summoned the Green Knight to test her son, prove his worth, and position him as his childless uncle’s heir; she gives him the protective belt to make sure he won’t actually die, and her intention all along was for the future shown in the epilogue to truly play out (minus the collapse of Camelot). Only Gawain loses the belt thanks to his cowardice in the encounter with the scavengers, regains it in a somewhat underhanded and morally questionable way when the Lady is attempting to seduce him, and by ultimately rejecting it altogether and submitting to his uncertain fate, totally mucks up his mother’s painstaking dynastic plans for his future. In this reading, Gawain could be king, and his mother’s efforts are meant to achieve that goal, rather than thwart it. He is thus required to shoulder his own responsibility for this outcome, rather than conveniently pawning it off on an “evil woman,” and by extension, the film asks the question: What would the world be like if men, especially those who make war on others as a way of life, were actually forced to face the consequences of their reckless and violent actions? Is it actually a “game” in any sense of the word, especially when chivalric literature is constantly preoccupied with the question of how much glorious violence is too much glorious violence? If you structure social prestige for the king and the noble male elite entirely around winning battles and existing in a state of perpetual war, when does that begin to backfire and devour the knightly class – and the rest of society – instead?
This leads into the central theme of Gawain’s relationships with the Lord and Lady, and how they’re treated in the film. The poem has been repeatedly studied in terms of its latent (and sometimes… less than latent) queer subtext: when the Lord asks Gawain to pay back to him whatever he should receive from his wife, does he already know what this involves; i.e. a physical and romantic encounter? When the Lady gives kisses to Gawain, which he is then obliged to return to the Lord as a condition of the agreement, is this all part of a dastardly plot to seduce him into a kinky green-themed threesome with a probably-not-human married couple looking to spice up their sex life? Why do we read the Lady’s kisses to Gawain as romantic but Gawain’s kisses to the Lord as filial, fraternal, or the standard “kiss of peace” exchanged between a liege lord and his vassal? Is Gawain simply being a dutiful guest by honoring the bargain with his host, actually just kissing the Lady again via the proxy of her husband, or somewhat more into this whole thing with the Lord than he (or the poet) would like to admit? Is the homosocial turning homoerotic, and how is Gawain going to navigate this tension and temptation?
If the question is never resolved: well, welcome to one of the central medieval anxieties about chivalry, knighthood, and male bonds! As I have written about before, medieval society needed to simultaneously exalt this as the most honored and noble form of love, and make sure it didn’t accidentally turn sexual (once again: how much male love is too much male love?). Does the poem raise the possibility of serious disruption to the dominant heteronormative paradigm, only to solve the problem by interpreting the Gawain/Lady male/female kisses as romantic and sexual and the Gawain/Lord male/male kisses as chaste and formal? In other words, acknowledging the underlying anxiety of possible homoeroticism but ultimately reasserting the heterosexual norm? The answer: Probably?!?! Maybe?!?! Hell if we know??! To say the least, this has been argued over to no end, and if you locked a lot of medieval history/literature scholars into a room and told them that they couldn’t come out until they decided on one clear answer, they would be in there for a very long time. The poem seemingly invokes the possibility of a queer reading only to reject it – but once again, as in the question of which canon we end up in at the film’s end, does it?
In some lights, the film’s treatment of this potential queer reading comes off like a cop-out: there is only one kiss between Gawain and the Lord, and it is something that the Lord has to initiate after Gawain has already fled the hall. Gawain himself appears to reject it; he tells the Lord to let go of him and runs off into the wilderness, rather than deal with or accept whatever has been suggested to him. However, this fits with film!Gawain’s pattern of rejecting that which fundamentally makes him who he is; like Peter in the Bible, he has now denied the truth three times. With the scavengers he denies being a knight; with the Lady he denies knowing about courtly love; with the Lord he denies the central bond of brotherhood with his fellows, whether homosocial or homoerotic in nature. I would go so far as to argue that if Gawain does die at the end of the film, it is this rejected kiss which truly seals his fate. In the poem, the Lord and the Green Knight are revealed to be the same person; in the film, it’s not clear if that’s the case, or they are separate characters, even if thematically interrelated. If we assume, however, that the Lord is in fact still the human form of the Green Knight, then Gawain has rejected both his kiss of peace (the standard gesture of protection offered from lord to vassal) and any deeper emotional bond that it can be read to signify. The Green Knight could decide to spare Gawain in recognition of the courage he has shown in relinquishing the enchanted belt – or he could just as easily decide to kill him, which he is legally free to do since Gawain has symbolically rejected the offer of brotherhood, vassalage, or knight-bonding by his unwise denial of the Lord’s freely given kiss. Once again, the film raises the overall thematic and moral question and then doesn’t give one straight (ahem) answer. As with the medieval anxieties and chivalric texts that it is based on, it invokes the specter of queerness and then doesn’t neatly resolve it. As a modern audience, we find this unsatisfying, but once again, the film is refusing to conform to our expectations.
As has been said before, there is so much kissing between men in medieval contexts, both ceremonial and otherwise, that we’re left to wonder: “is it gay or is it feudalism?” Is there an overtly erotic element in Gawain and the Green Knight’s mutual “beheading” of each other (especially since in the original version, this frees the Lord from his curse, functioning like a true love’s kiss in a fairytale). While it is certainly possible to argue that the film has “straightwashed” its subject material by removing the entire sequence of kisses between Gawain and the Lord and the unresolved motives for their existence, it is a fairly accurate, if condensed, representation of the anxieties around medieval knightly bonds and whether, as Carolyn Dinshaw put it, a (male/male) “kiss is just a kiss.” After all, the kiss between Gawain and the Lady is uncomplicatedly read as sexual/romantic, and that context doesn’t go away when Gawain is kissing the Lord instead. Just as with its multiple futurities, the film leaves the question open-ended. Is it that third and final denial that seals Gawain’s fate, and if so, is it asking us to reflect on why, specifically, he does so?
The film could play with both this question and its overall tone quite a bit more: it sometimes comes off as a grim, wooden, over-directed Shakespearean tragedy, rather than incorporating the lively and irreverent tone that the poem often takes. It’s almost totally devoid of humor, which is unfortunate, and the Grim Middle Ages aesthetic is in definite evidence. Nonetheless, because of the comprehensive de-historicizing and the obvious lack of effort to claim the film as any sort of authentic representation of the medieval past, it works. We are not meant to understand this as a historical document, and so we have to treat it on its terms, by its own logic, and by its own frames of reference. In some ways, its consistent opacity and its refusal to abide by modern rules and common narrative conventions is deliberately meant to challenge us: as before, when we recognize Arthur, Merlin, the Round Table, and the other stock characters because we know them already and not because the film tells us so, we have to fill in the gaps ourselves. We are watching the film not because it tells us a simple adventure story – there is, as noted, shockingly little action overall – but because we have to piece together the metatext independently and ponder the philosophical questions that it leaves us with. What conclusion do we reach? What canon do we settle in? What future or resolution is ultimately made real? That, the film says, it can’t decide for us. As ever, it is up to future generations to carry on the story, and decide how, if at all, it is going to survive.
(And to close, I desperately want them to make my much-coveted Bisclavret adaptation now in more or less the same style, albeit with some tweaks. Please.)
Further Reading
Ailes, Marianne J. ‘The Medieval Male Couple and the Language of Homosociality’, in Masculinity in Medieval Europe, ed. by Dawn M. Hadley (Harlow: Longman, 1999), pp. 214–37.
Ashton, Gail. ‘The Perverse Dynamics of Sir Gawain and the Green Knight’, Arthuriana 15 (2005), 51–74.
Boyd, David L. ‘Sodomy, Misogyny, and Displacement: Occluding Queer Desire in Sir Gawain and the Green Knight’, Arthuriana 8 (1998), 77–113.
Busse, Peter. ‘The Poet as Spouse of his Patron: Homoerotic Love in Medieval Welsh and Irish Poetry?’, Studi Celtici 2 (2003), 175–92.
Dinshaw, Carolyn. ‘A Kiss Is Just a Kiss: Heterosexuality and Its Consolations in Sir Gawain and the Green Knight’, Diacritics 24 (1994), 205–226.
Kocher, Suzanne. ‘Gay Knights in Medieval French Fiction: Constructs of Queerness and Non-Transgression’, Mediaevalia 29 (2008), 51–66.
Karras, Ruth Mazo. ‘Knighthood, Compulsory Heterosexuality, and Sodomy’ in The Boswell Thesis: Essays on Christianity, Social Tolerance, and Homosexuality, ed. Matthew Kuefler (Chicago: University of Chicago Press, 2006), pp. 273–86.
Kuefler, Matthew. ‘Male Friendship and the Suspicion of Sodomy in Twelfth-Century France’, in The Boswell Thesis: Essays on Christianity, Social Tolerance, and Homosexuality, ed. Matthew Kuefler (Chicago: University of Chicago Press, 2006), pp. 179–214.
McVitty, E. Amanda, ‘False Knights and True Men: Contesting Chivalric Masculinity in English Treason Trials, 1388–1415,’ Journal of Medieval History 40 (2014), 458–77.
Mieszkowski, Gretchen. ‘The Prose Lancelot's Galehot, Malory's Lavain, and the Queering of Late Medieval Literature’, Arthuriana 5 (1995), 21–51.
Moss, Rachel E. ‘ “And much more I am soryat for my good knyghts’ ”: Fainting, Homosociality, and Elite Male Culture in Middle English Romance’, Historical Reflections / Réflexions historiques 42 (2016), 101–13.
Zeikowitz, Richard E. ‘Befriending the Medieval Queer: A Pedagogy for Literature Classes’, College English 65 (2002), 67–80.
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sleepykittypaws · 3 years
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Mother’s Day Movie Favorites
What better way to celebrate mom than by watching a mother-centric movie with her or, if that's not possible, while thinking about her, or her memory? 
We've all got a mother, heck, some of us even are mothers, making motherhood extremely fertile, movie-making subject matter for everything from tear-jerking melodrama to slasher flicks. There are hundreds, probably thousands, of movies exploring the bonds of mothers and their children, both sweet and sour, but below are my Top 25 favorite mom movies…
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Updated: July 29, 2023
Steel Magnolias (1989) - This Southern-friend Schmaltz-fest is near and dear to my heart, having lost my own mother in a way not all that dissimilar to Julia Roberts' character. And, while much of Steel Magnolias is over the top, the cast is, indisputably, top-notch. This is one that never fails to make me laugh, cry and think about my mama.
Lady Bird (2017) - Probably the best mother-daughter movie of the last 20 years, this Greta Gerwig classic is a perfect watch on Mother's Day, or any time. It nails teen angst and the push pull of mother-daughter relationships perfectly.
Mr. Mom (1983) - While the premise—A dad being the primary caregiver? How novel!—may be dated, the comedy in this Teri Garr-Michael Keaton comedy still holds up remarkably well, give or take a moment or two. A great, whole family watch, and a wildly under-rated '80s comedy.
Petite Maman (2021) - This simple, sweet, but never cloying, French story of a daughter who magically meets and befriends her mother as a child, leading to greater love and understanding between them is the absolute perfect mom-centric movie, on Mother’s Day or anytime.
Postcards from the Edge (1990) - Based on Carrie Fisher's roman a clef about her own relationship with actress-mother Debbie Reynolds, this Meryl Strep-Shirley MacLaine movie is one of my very favorites.
Freaky Friday (2003 or 1976) - Whether you prefer the Jamie Curtis-Lindsay Lohan remake, or the Jodie Foster-Barbara Harris original, this Disney classic is fun, funny and an absolute hoot of a mother-daughter romp.
Terms of Endearment (1983) - As you can see, Shirley MacLaine looms large on this list. MacLaine really cornered the market on over-the-top, yet-loving mom roles, and there are few better mother-daughter dramas than this absolute classic weepy that co-stars Debra Winger.
The Mitchells vs the Machines (2021) - This Netflix-original animated movie, starring Maya Rudolph as the mom, is a pretty perfect Mother’s Day watch. Funny, all-ages humor that packs quite an emotional punch, amidst all the silliness, and the Mama Bear fierceness Rudolph provides in the climax is epic.
Philomena (2013) - As an adoptee, another very personal watch for me (even if this situation is nothing like my own), this story of a woman searching for the child she was forced to give up is incredibly well done, and funny as well as heart wrenching, with absolutely incredible performances from both Judi Dench and Steve Coogan.
Overboard (1987) - This goofy ‘80s comedy features real-life loves Kurt Russell and Goldie Hawn at their most charming. It’s also about found families in a way that feels very modern Mother’s Day appropriate, and is a whole family watch that holds up better than you'd think given it’s a story about a man who convinces a rich lady with amnesia that she’s the mother of his three rowdy boys all because she stiffed him on a contracting job. But, whatever you do, don’t watch the dreadful 2018 remake (shudder).
Mamma Mia! (2008) - This Abba-jukebox musical has a star-studded cast—Meryl Strep! Amanda Seyfried! Christine Baranaski!—and a heart of gold. If you're not singing and dancing along with the mother-daughter wedding hijinks, you're doing it all wrong.
Baby Mama (2008) - This Tina Fey-Amy Poehler comedy is not only a “stealth” Christmas movie, it’s also a great Mother’s Day watch that’s funny and has a little something to say about society’s vision of who is “worthy” of being a mom.
Dumplin’ (2018) - Based on the great book by Julie Murphy, Dumplin' is honestly Jennifer Aniston's best work in years. Aniston plays the pageant queen mom to the less lithe Willowdean. Lots of love and some messy family business make this a relatable, yet lovely, watch.
Mother (1996) - Though I slightly prefer the movie about Debbie Reynolds as a mom, see Postcards from the Edge above, this movie with Reynolds playing Albert Brooks' mom is also a classic. Brooks is at at his absolute driest wit in my second favorite of his movies, after Defending Your Life. Just don’t confuse this Mother with the controversial 2017 Jennifer Lawrence horror movie, because that would be a very different holiday viewing experience.
Juno (2007) - This story of a pregnant teen making choices feels especially poignant in 2022. The balance of so many iterations of motherhood—from Juno’s own mostly absent mom, to Allison Janney as her fierce and flawed stepmom, potential adoptive mom Jennifer Garner and teen-mom Juno herself make this absolutely perfect Mother’s Day viewing.
Blockers (2018) - This teen sex comedy is neither about sex, nor the teens, but instead focuses on a ragtag group of parents, including mom Leslie Mann, who are struggling to let their kids grow up. A truly funny R-rated romp.
Wonder (2017) - This under-seen, sweet and gentle story stars Owen Wilson and Julia Roberts as parents of Auggie, a kid who is a little bit different, and a whole lot special. Will definitely give you all the mom feels, and also has some stealth Christmas moments.
Little Women (1933, 1994 and 2019) - Take your pick from the myriad adaptations of Louisa May Alcott's classic, but whichever Marmie you prefer, this story of three sisters and their stalwart matriarch stands the test of time.
The Parent Trap (1961 or 1998) - Both versions of this twin-swapping story are equal parts ridiculous and joyful. Don't think too much about what kind of parents would willfully give up one of their children just because they looked alike (I mean, what in the world?!?), and instead enjoy the cute, cupid-y machinations of multiple Hayley Millses or Lindsay Lohans.
Baby Boom (1987) - This Diane Keaton comedy is usually remembered as a rom-com with Sam Shepard, but it’s really the story of a woman falling in love with being a mom, and what could be more appropriate Mother's Day viewing?
A Simple Favor (2018) - If you're looking for something a little less gushing, and a lot more deadly, check out this Paul Feig black comedy/thriller that features Blake Lively and Anna Kendrick as epic mom frenemies.
It's Complicated (2009) - Not sure whose movies feature in this list more often: Meryl Strep or Shirley MacLaine. This Strep-led, Nancy Meyers romp is a grown-up family dynamic farce that still holds up, despite the somewhat unfortunate inclusion of Alec Baldwin.
Bad Moms (2016) - Kathryn Hahn, Mila Kunis and Kristen Bell make a heck of a trio in this R-rated comedy about moms going kind of, but not too, wild.
The Guilt Trip (2012) - This guilty pleasure road trip comedy stars Barbara Streisand and Seth Rogan, and the very fact that such a combo exists at all gives me great joy.
Hope Floats (1998) - This Texas-set, Sandra Bullock divorce story didn't get a lot of love upon release—the soundtrack was a bigger hit than the movie—but it's better than you remember, and is also a pretty great portrait of a multi-generational mother-daughter relationship. Plus, it features a baby Mae Whitman.
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Mum (2016-19) - This gentle BBC series, which checks in on a newly-widowed, working-class mother in the first years following the death of her husband (the first two seasons feature monthly check-ins, the last takes place over a single week) is a delight. Mum originally aired on PBS in the U.S., and is now available via Britbox. Just a really lovely portrait of motherhood, love at a certain age, and how adult children learn to live and grow on their own—or don’t, as the case may be.
Motherland (2016-22) - The Sharon Horgan-created BBC series, available on AMC+ on the U.S., is a very funny look at modern motherhood starring Anna Maxwell Martin, and includes a smashing season three Mother’s Day-centric episode—the eponymously-named “Mother’s Day”—that’s both terrifically funny and touching.
The Middle: Mother’s Day II (2011) - This season two episode of the long-running ABC series, currently available on HBO Max, is probably my favorite episodic take on the holiday. The depiction both of how “me time” is never all it’s cracked up to be for moms, and how trying to recreate a perfect moment never works out, is spot on.
Snoopy Presents To Mom (and Dad), with Love (2022) - The Peanuts gang is eager to celebrate Mother’s Day in this new, Apple TV+ original special, all except for Peppermint Patty, that is, who grew up without her mom. It’s a rare special centered on the holiday with a sweet, family-comes-in-all-forms message.
Mothering Sunday (2022) - A stellar cast—Olivia Colman, Colin Firth, Josh O'Connor, Odessa Young—populate this Mother’s Day-set period drama that is far from a fun romp, but impeccably acted.
Mother's Day (2016) - This movie is bad. Really bad, yet I feel obligated to include it, since it actually takes place on the holiday, but must stress it should only be watched for ironic mocking, with a generous amount of wine.
Mother’s Day (2018, BBC) - This British TV movie, available in the U.S, on Britbox, couldn’t be more different from the stinker that shares its name. Vicky McClure and Anna Maxwell Martin play mothers who use their own tragedies to help bring peace to Northern Ireland, with key events taking place on the British version of the holiday.
Mother’s Day on Walton’s Mountain (1982, NBC) - This reunion movie follows up on the family from the long-running CBS series.
Otherhood (2019) - This otherwise mid-tier Netflix empty nest/road trip comedy benefits from its very strong cast—Angela Bassett, Patricia Arquette and Felicity Huffman—as well as its liberal references to the holiday itself. 
Mermaids (1990) - This Cher-led single mom story is another under-rated gem. Featuring Winona Ryder and a baby Christina Ricci, with the very odd (but it works) choice of Bob Hoskins as the eventual love interest, this is definitely one worth checking out.
Incredibles 2 (2018) - While both of these Pixar flicks are some of the best superhero movies ever made, the second is particularly mom-focused in a way that feels both realistic and touching—not an easy feat for a cartoon about a family with superpowers.
The Sound of Music (1965) - Because this is a movie about motherless children and their nanny/eventual stepmom, didn’t think I could put this in my main list of mom-centric movies, but as a motherless child myself, with several stepmoms far less magical than Julie Andrews, this is definitely a fantasy film for me, and another whole-family pleasing watch.
Muriel’s Wedding (1994) - One of my favorite movies of all-time, this one isn’t quite mom-centric enough for me to include on my main list, but the tragic mother-daughter relationship in this otherwise lighthearted, Aussie coming of age tale is indelible.  
My Big Fat Greek Wedding (2002) - This one is more about family bonds, than motherhood in particular, but if you need a dose of how loving even the most cloying clan can be, this is a great example that will make you want to reach out to relatives you haven't seen in years. And Lainie Kazan as the lovingly overbearing mother is a standout.
Secrets and Lies (1996) - This adoption story is about the reunion of a mother and daughter who don't share much beyond DNA. This British Best Picture nominee isn’t a lighthearted romp, but it is poignant and powerful, and just missed making my Top 25 above.
Lion (2016) - Yes, yet another adoption story. Based on a true tale of a man searching for a his biological family, it takes a different tack than many similar stories, and Dev Patel’s performance is incredible
Parenthood (1989) - Not on my top 25 list mostly due to the fact that Steve Martin’s multigenerational father-son relationship is probably the more central story, but still one of my all-time favorite family life films and if you’re looking for something for Father’s Day…
Imitation of Life (1959) - Sure, it lacks some of the nuance a 21st century telling of this story would have, but the performances, and prejudice, seen through the eyes of two mothers, remain all too relatable.
Stepmom (1998) - Another mom movie that also qualifies as a stealth Christmas flick, this weepy tale of Susan Sarandon and Julia Roberts battling over the kids’ affections isn’t my personal fave, but a lot of people love it.
Mom’s Day Away (2014, Hallmark) - This Bonnie Somerville-led family comedy is set around the holiday, and cuter than your average Hallmark joint, with a stressed out mom taking a day off from her family.
Mom’s Night Out (2014) - Almost a Hallmark film, this very gentle, PG-rated comedy, starring frequent Hallstar Sarah Drew, is one of those “crazy night out” comedies that is low on actual crazy, and big on family feels. 
The Adam Project (2022) or Yes Day (2021)- Not sure how an actress whose breakout role was as a sexy super spy morphed into the ultimate Hollywood mom, but Jennifer Garner has seemingly cornered the market on loving but exhausted and/or somewhat tightly wound mom roles, which is why so many of her movies already appear on this list. Neither of these are spectacular, but both are perfectly fine, ultimately innocuous, all-ages, family viewing that also happen to be easily available on Netflix for at-home, anytime viewing.
The Joy Luck Club (1993) - This adaptation of Amy Tan’s novel is all about mothers and daughters. I wholeheartedly recommend the book, but am a little less enthusiastic about the movie, which is why it didn’t make my main list.
Room (2015) - Definitely dark, but a searing portrayal of what mothers endure for their children, and how strong those bonds are. Alison Brie won an Oscar for this mostly grim, but ultimately hopeful, mother-son story.
This is 40 (2012) - Judd Apatow isn’t everyone’s cup of tea, but that this sort-of sequel to Knocked Up features his real-life wife and daughters, with Paul Rudd as Apatow’s martial stand in, adds some interest to an otherwise just so-so story.
Tully (2018) - This dark and twisty Charlize Theron movie is a relatable portrait of an exhausted mother…right up until it most definitely is not.
The Kids are All Right (2010) - I didn’t love this story about how two moms relationship changes when their son meets his sperm donor, but there’s no denying the acting chops in this Julianne Moore-Annette Binning-Mark Ruffalo movie.
Auntie Mame (1958) - Make sure you watch the Rosalind Russell original and not the Lucille Ball remake (shudder) but this delightful comedy about non-traditional mother figures has been a favorite of mine since childhood.
Serial Mom (1994) - This dark (very dark) comedy about a murdering mom played by Kathleen Turner is not for everyone, but for those in the right (a.k.a. wrong) mood, it could make a perfect Mother’s Day watch. 
Mommie Dearest (1981) - Perhaps the ultimate anti-Mother’s Day watch, this camp classic starring Faye Dunaway as Joan Crawford is unforgettable and way, way over-the-top.
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unicorndads · 3 years
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I know Garrett gives off golden retriever energy but he gives of teddy bear energy to☺🧡💙
Imagine Andrew calling Garrett teddy bear off the random
One can daydream 🧡💙
Aww he really does. It would be super cute if Andrew did call him that haha. And it's not too far off from Garr-Bear. (Also, did he say at one point that his high school friends or something used to call him that when someone else called him that recently, or did I dream that??)
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Callie’s yeoman thinks she and Garrus would be a cute couple.
Well I’m TRYING Kelly. It’s a little difficult when he just got half his face blown off. 
(Seriously, Garr-bear, can you change your armor? You’re making me nervous.)
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fugitivehues · 3 years
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DNcember 28 - Cursed Weapon art by @fugitivehues​ & writing by @keikotwins
His eyes pensively scanned the list of names and pictures of the latest museum acquisitions, until something in particular caught his attention, making him straighten on his chair. Donated anonymously, artist unknown… Among the foreign paintings and various pieces returning from exchanges with other museums, the item undoubtedly stood out. He didn’t like its design in particular, but he felt something, even from a mere picture on an online catalogue.
For days, he kept the artwork in mind, whether he wanted to or not. A mixture of fascination and dread returned each time, making him hesitate between seeing the piece in person and avoiding it like some cursed, rotten amulet. If he had been affected that intensely by an image and a few empty lines of text, he couldn’t fathom what the real thing would unleash within. Some days, morbid curiosity won, and he made plans to see the artwork, which was now part of the Le Garre museum’s collection, for himself. Others, he retreated back, unsure of its powers and dangerousness, unwilling to fight such a monstrosity.
However, with passing time, it soon became obvious that, no matter its threatening aura, no suspicious accident occurred in the museum after the item joined its permanent exhibition. He knew well: he had paid particular attention to any report related to this part of town. No specialised newspaper had cared writing about it either; this artwork was, at best, forgettable by the general public. This indifference pushed him to make a decision: he finally bought a ticket to the Le Garre, put the ticket on the living room’s console, and glanced at it several evenings in a row before he couldn’t bear with it anymore and took a Saturday afternoon off.
It could be a nice occasion to see old pieces he enjoyed, after all. He didn’t have to focus his energy on that one hideous creation whose author’s name had been lost in age. While climbing the main stairs of the museum, he listed his favourite artworks, in order, then determined which path would optimise his visit. He almost changed his mind to execute this new plan as he reached the room where his original target was exhibited, but determination overcame expectation. He barely slowed down, and, hands secured in his coat’s pockets, entered in the large, circular area.
He recognised some of the items from previous visits, even if the room was modified regularly due to the size of its artworks. Decorative arts could encompass pots, cutlery, and even pieces of furniture the tapestry museum hadn’t absorbed in its eternal expansion, however, what had his interest rested on the wall, between an ornate panel and what resembled a wrought iron gate.
As long as an arm, its anthracite grey handle contrasting with the two-tone metal of the blade, a hatchet shone in the tired light. Its knob shaped like an orb, the throat chiselled in patterns that matched the cross that crawled on the head, the claws that sharpened its poll all gave it a grisly, brash appearance. It wasn’t Kei’s first time in front of a distasteful artwork, but this one in particular did make him uncomfortable. He forced himself to breathe slowly, steadily, all his senses focussed on the item. Was it sentient? Was it trying to intimidate him? If it was, then he could question it.
The man raised an arm, and approached his hand cautiously, ready to react in case of aggression. Why did this foreign artwork seem so familiar? And why, why did it fill him with dread? Fingers brushed the handle on its smooth part, slowly, steadily. If a guard was to come up to him, he would deal with it.
Nothing. This repulsive thing did not think by itself. Kei’s hand ran towards the blade, that remained cold and unresponsive under his touch. The picture, the anticipation, the fear, everything had only been his own emotional response? A long-term, disruptive aesthetic shock? He recognised the weapon, despite having never laid its eyes on it before, from deep, unreachable memories. Why an axe? Why this axe?
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lupinepublishers · 4 years
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Lupine Publishers | Two Rare Cases of Monostotic Paget’s Disease of Bone in Adult Female
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Lupine Publishers |  Orthopedics and Sports Medicine
Abstract
Introduction: Paget’s disease of bone is a metabolic bone condition characterized by increased bone resorption by osteoclasts with simultaneous new bone formation. The result of which is bone appears expanded with both lytic and sclerotic areas. The bone eventually becomes weak and starts producing symptoms such as pain, difficulty in walking if it involves the weight bearing bones, pathological fracture and systemic symptoms related to increased bone turnover.
Case presentation: Here we are reporting two adult female cases of monostotic Paget’s disease involving tibia. A 58-year-old female and a 47 year old female who presented with complaints of pain in the leg with history of fever. Blood investigations showed elevated alkaline phosphatase with normal serum calcium and phosphorous. X ray of tibia showed lytic and sclerotic areas. MRI showed features of Paget’s disease of tibia. Biopsy of tibia confirmed the diagnosis to be monostotic Paget’s disease of tibia. They were managed conservatively with oral bisphosphonates.
Conclusion: Monostotic Paget’s disease even though is a rare disease it is encountered now and then in Indian population. It has to be differentiated from other lesions producing similar clinical picture such as secondary osteosarcoma, sclerosing osteomyelitis and metastasis. Early diagnosis and appropriate treatment will reduce pain, deformity and the need for surgical intervention with good symptomatic and radiological recovery.
Keywords: Paget’s Disease; Monostotic Type; Tibia; Rare Condition; Indian Population
Introduction
Paget’s disease of bone was first described by Sir James Paget as early as in the year 1877 [1]. This disease is also known as osteitis deformans. It can either involve a single bone (monostotic) or can involve many bones (polyostotic). This is a type of metabolic bone disease characterized by increased bone resorption and formation of new bone which is consistent with the presence of both lytic and sclerotic areas on radiology. The excessive remodelling makes the bone enlarged , weak and deformed. This disease commonly affects elderly white adults of age above 50 years. The prevalence of Paget’s disease increases with age and is slightly more common in men. Paget’s is rare under 25 years and unusual before 40 years of age [2].
Case 1
58-year-old female came with complaints of pain over the right knee for the past 2 weeks and difficulty in weight bearing over right lower limb. Pain was insidious in onset, aggravated in the night and relieved with rest and medications. No history of radiation of pain or history of pain elsewhere in the body. There was history of fever and there was no history of trauma. There was no history of loss of weight or loss of appetite. On examination there was no swelling, no scars or no sinuses, no visible pulsations or no dilated veins over right knee, there was no bowing. Warmth was present over the right proximal tibia, tenderness was present over right proximal tibia with broadening and thickening. The range of movements of knee joint was not affected and was not associated with any pain, there was no distal neurovascular deficits and distal pulses were well felt. Laboratory investigations showed normal calcium (9mg/dl) and normal phosphorus (3.7mg/dl). Serum alkaline phosphatase levels were elevated (148 IU/L). Plain x ray was done which showed sclerosis over right proximal tibia and lytic lesion over right tibial tuberosity with cortical thickening and widening (Figure 1,2).
Figure 1: X ray of right proximal tibia antero-posterior view.
Figure 2: X ray of right proximal tibia lateral view.
We had differential diagnosis as Garre’s sclerosing osteomyelitis of right proximal tibia, metastasis of right proximal tibia and secondary osteosarcoma. MRI of the right proximal tibia was done which showed diffuse cortical thickening of the involved tibia, heterogenous signal with normal fatty marrow, an intracortical cystic lesion measuring 4.2 x 1.5 x 2.3 cm noted just below the tibial tuberosity without any pathological fracture which was consistent with Paget’s disease (Figure 3). CT guided biopsy was done from the lesion to confirm the diagnosis and the specimen was sent for histopathological study which came as monostotic Paget’s disease of right tibia (Figure 4, 5). She was treated with analgesics for pain and was started on oral bisphosphonates T. Alendronate 70mg weekly along with calcium supplementation. On follow up patient was symptomatically better and is mobilising well.
Figure 3: MRI right knee.
Figure 4: CT of right tibia.
Figure 5: Needle insertion under CT guidance.
Case 2
47-year-old female came with complaints of pain in the right leg and deformity of the right leg for one month. Pain is insidious in onset , aggravated on weight bearing , relieved on rest and medication. There was no radiation in pain, increased in night. Pain was associated with deformity and the deformity aggravated on weight bearing. There was no history of fever, no history of loss of weight or loss of appetite, no history of any other limb involvement and no history of trauma.On examination there was a Varus deformity of 10 degrees, there was no visible swelling , no dilated veins or no scars or no sinuses or any visible pulsations. There was warmth and tenderness diffusely over the right leg. Varus of the right leg of 10 degrees. Range of movements of knee and ankle were not affected and was not associate with any pain. There was no distal neurovascular deficits and distal pulses were well felt (Figure 6,7). Laboratory findings were calcium was normal (9.3mg/dl) and phosphorous was normal (4.4mg/dl). Serum Alkaline phosphatase was elevated (173 IU/L ). ESR and CRP were normal. Plain x ray was done which showed lysis and sclerosis of entire right tibia with widening and thickening of cortex (Figure 8). We had differential diagnosis as Garre’s sclerosing osteomyelitis of tibia, metastasis and secondary osteosarcoma of tibia. MRI right leg was done which showed involvement of entire tibia predominantly the proximal aspect including the articular cartilage with cystic areas, subcutaneous edema and thickened cortex with features of mixed phases of Paget’s disease (Figure 9,10). Core needle biopsy of the right proximal tibia was done to confirm the diagnosis and the specimen was sent for histopathological study. The diagnosis was confirmed to be monostotic Paget’s disease of right tibia. She was started on oral Alendronate 70mg once a day weekly along with calcium supplementation and analgesia for pain. Deformity correction was planned on a later date but the patient was symptomatically better and was mobilised so did not come.
Figure 6: Clinical picture.
Figure 7: Clinical picture.
Figure 8: X ray of right leg antero-posterior and lateral view showing cortical widening with lysis and sclerosis predominantly involving proximal tibia and articular cartilage with Varus deformity.
Figure 9: MRI of right knee showing cystic areas and edema inside the marrow and subcutaneous space.
Figure 10: MRI of right knee.
Discussion
Paget’s disease of bone also known as osteitis deformans is a skeletal disease seen in elderly above 50 years of age characterized by increased bone resorption and increased bone turnover. It has a familial tendency of transmission common in first degree relatives of affected patients but it can also be caused by certain viral infections such as paramyxovirus or measles virus Paget’s disease is most common in the United Kingdom and Western Europe but is also common in British immigrants to Australia, New Zealand, South Africa, and South America. The disease is uncommon in African blacks, Scandinavia, China, Japan, Southeast Asia, and the Indian subcontinent [3]. First-degree relatives of patients with Paget’s disease have an increased risk particularly if the patient has an early age of diagnosis and the disease is extensive [4]. This suggests that there is familial trend and genetic factor plays an important role in Paget’s disease. Rural life and animal contacts are associated with a greater risk of Paget’s disease in [5,6], this suggests that animals may carry infectious agents causing the disease. The nuclear inclusion bodies in osteoclasts in Paget’s disease resemble that of viruses [7]. but if viruses play a role as a causative agent for the disease remains unclear. Classical PDB is caused due to mutations in SQSTM1 that encodes for a protein known as p62 that plays an important role in osteoclast regulation. These mutations are only in 5-10% of sporadic cases and in 40-50% of familial cases [8]. Paget’s disease is a chronic disease involving the skeletal system primarily. It is characterized by increased bone resorption by osteoclast followed by increased bone formation by osteoblasts. The osteoclasts are increased in number and size and may contain more than one nuclei. The nuclei may contain inclusion bodies that resemble viral particles [9].The initial pathology is because of increased resorption of bone by osteoclast due to abnormal activation of RANKL and increased expression of interleukin-6 ( IL-6) , the osteoblasts are also increased in number but they are morphologically normal suggesting that the main pathology is due to osteoclastic resorption of bone.
The accelerated resorption and turnover of bone causes the bone to be expanded and laying down of immature collagen fibres makes the bone structurally weak and the bone deforms In India Paget’s disease is rare [10,11].Many times the disease is diagnosed incidentally on routine blood or radiological investigations. In the musculoskeletal system the disease is characterised by pain over the involved bone , there is warmth due to increased vascularity, Deformity of the bone is present especially in weight bearing bones example bowing of femur or tibia, pathological fractures, osteoarthritis of joints adjacent to the involved bone. If the skull is involved there will be frontal bossing. If the spine is involved there will be back pain, radiating pain if there is canal stenosis or cord compression, in severe cases there can be paraplegia. The most commonly involved bones are spine, skull, pelvis, femur and tibia. Here one patient had pain, the other patient had pain and deformity with involvement of tibia in both the cases. Serum calcium, Serum phosphorous levels, Parathyroid hormone levels and Vit D levels [12] are usually normal unless the disease is extensive involving many areas. Bone specific alkaline phosphatase (BAP) seems to have the best diagnostic accuracy as a measure of bone formation, with a sensitivity of 84% and a specificity of 100% [13]. Both the patients who presented to us had normal serum phosphorous, normal serum calcium levels, normal parathyroid hormone and elevated alkaline phosphatase levels. Plain X ray of the involved site will show mixed areas of lytic and sclerotic lesions, bony enlargement, cortical thickening, increased trabeculae and bowing if weight bearing bones are involved. In the above cases we saw all findings in x rays.
Isotope bone scan shows increased uptake in affected areas. Here we did not do isotope bone scan instead we did MRI of the involved leg which showed features of Paget disease.
To confirm the diagnosis we did biopsy, computed tomography guided biopsy of tibia using trephine needle for one patient and core needle biopsy of tibia for the other patient and the specimen was sent for histopathological study. In both the cases it was reported as monostotic Paget disease consistent with our MRI findings.Our cases are unique in the sense both the patients were young female one in early 50’s and the other in late 40’s and both of them had primary involvement of only tibia without any other bone involvement such as pelvis, femur which are most common sites. Asymptomatic lesions do not need any treatment but regular follow up is necessary. In lesions producing symptoms or causing bowing of large weight bearing bones need treatment. The main goal of treatment is to prevent osteoclastic resorption of bone. Bisphosphonates or calcitonin can be used while bisphosphonates being gold standard of treatment for medical management of Paget’s disease. Bisphosphonates such as etidronate, pamidronate, alendronate, risedronate and zoledronic acid [13]. While alendronate and risedronate are given orally whereas pamidronate and zoledronic acid are given intravenously. The potency of bisphosphonates in inhibiting osteoclastic bone resorption may be related to their ability to inhibit farnesyl diphosphate synthase [14]. Common side effects with oral bisphosphonates are gastrointestinal and oesophageal disturbances which is why it advised to take the drugs early in the morning. In those with gastrointestinal problems intravenous infusion of bisphosphonates can be given but there can be side effects such as transient bone pain, headache , myalgia and nausea. Response to treatment is observed by reduction in the level of serum alkaline phosphatase, improvement in bone pain and radiological improvement of the involved bone. Here once the diagnosis was confirmed by biopsy we started both the patients on oral alendronate 70mg weekly. Both the patients had symptomatic relief of bone pain and were mobilising well two months following the initiation of treatment.In a small number of patients surgery might be indicated if there is pathological fracture for fracture stabilisation , deformity of long bones which causes difficulty in walking or if the patient feels is cosmetically unacceptable in the form of corrective osteotomy , Paget’s disease is known to cause secondary osteoarthritis hence in selected cases total joint arthroplasty maybe necessary [15]. Paget’s disease is a highly vascular condition hence surgery should be done after adequate treatment of the disease to reduce blood loss.
Conclusion
Monostotic Paget’s disease even though is a rare disease it is encountered now and then in Indian population. It has to be differentiated from other lesions producing similar clinical picture such as secondary osteosarcoma, sclerosing osteomyelitis and metastasis. Early diagnosis and appropriate treatment will reduce pain, deformity and the need for surgical intervention with good symptomatic and radiological recovery.
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