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scientia-rex · 8 months

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Because my most popular post is about weight loss and how it's a crock, I get a lot of questions about various things, including bariatric surgery--just posted the link to the post I did about that--but also Ozempic/Wegovy, the once-weekly injectable semaglutide medication that was developed for diabetes but was found to have independent benefits on weight loss.

I always said that weight loss was like Viagra: when a medication came along that actually worked, it would explode. We'd all hear about it. Fen-phen in the 90s worked, but it was bad for your heart. Stimulants, like meth, may cause weight loss, but they do it at the cost of heart health, and raise your likelihood of dying young. Over the counter weight loss supplements often contain illegal and unlisted thyroid hormone, which is also dangerous for the heart if taken in the absence of a real deficiency. Orlistat, or "Alli," works the same way as the Olestra chips Lays made in the 1990s--it shuts off your ability to digest fats, and the problem with that is that fats irritate the gut, so then you end up with fatty diarrhea and probably sharts. Plus Alli only leads to 8-10lbs of weight loss in the best case scenario, and most people are not willing to endure sharts for the sake of 8lbs.

And then came the GLP-1 agonists. GLP stands for glucagon-like peptide. Your body uses insulin to make cells uptake sugar. You can't just have free-floating sugar and use it, it has to go into the cells to be used. So if your body sucks at moving sugar into the cells, you end up with a bunch of glucose hanging out in places where it shouldn't be, depositing on small vessels, damaging nerves and your retinas and kidneys and everywhere else that has a whole lot of sensitive small blood vessels, like your brain.

Glucagon makes your liver break down stored sugars and release them. You can think of it as part of insulin's supporting cast. If your body needs sugar and you aren't eating it, you aren't going to die of hypoglycemia, unless you've got some rare genetic conditions--your liver is going to go, whoops, here you go! and cough it up.

But glucagon-like peptide doesn't act quite the same way. What glucagon-like peptide does is actually stimulating your body to release insulin. It inhibits glucagon secretion. It says, we're okay, we're full, we just ate, we don't need more glucagon right now.

This has been enough for many people to both improve blood sugar and cause weight loss. Some patients find they think about food less, which can be a blessing if you have an abnormally active hunger drive, or if you have or had an eating disorder.

However, every patient I've started on semaglutide in any form (Ozempic, Wegovy, or Rybelsus) has had nausea to start with, probably because it slows the rate of stomach emptying. And that nausea sometimes improves, and sometimes it doesn't. There's some reports out now of possible gastroparesis associated with it, which is where the stomach just stops contracting in a way that lets it empty normally into the small intestine. That may not sound like a big deal, but it's a lifelong ticket to abdominal pain and nausea and vomiting, and we are not good at treating it. We're talking Reglan, a sedating anti-nausea but pro-motility agent, which makes many of my patients too sleepy to function, or a gastric pacemaker, which is a relatively new surgery. You can also try a macrolide antibiotic, like erythromycin, but I have had almost no success in getting insurance to cover those and also they have their own significant side effects.

Rapid weight loss from any cause, whether illness, medication, or surgery, comes with problems. Your skin is not able to contract quickly. It probably will, over long periods of time, but "Ozempic face" and "Ozempic butt" are not what people who want to lose weight are looking for. Your vision of your ideal body does not include loose, excess skin.

The data are also pretty clear that you can't "kick start" weight loss with Ozempic and then maintain it with behavioral mechanisms. If you want to maintain the weight loss, you need to stay on the medication. A dose that is high enough to cause weight loss is significantly higher than the minimum dose where we see improvements in blood sugar, and with a higher dose comes higher risk of side effects.

I would wait on semaglutide. I would wait because it's been out for a couple of years now but with the current explosion in popularity we're going to see more nuanced data on side effects emerging. When you go from Phase III human trials to actual use in the world, you get thousands or millions more data points, and rare side effects that weren't seen in the small human trials become apparent. It's why I always say my favorite things for a drug to be are old, safe, and cheap.

I also suspect the oral form, Rybelsus, is going to get more popular and be refined in some way. It's currently prohibitively expensive--all of these are; we're talking 1200 or so bucks a month before insurance, and insurance coverage varies widely. I have patients who pay anything from zero to thirty to three hundred bucks a month for injectable semaglutide. I don't think I currently have anyone whose insurance covers Rybelsus who could also tolerate the nausea. My panel right now is about a thousand patients.

There are also other GLP-1 agonists. Victoza, a twice-daily injection, and Trulicity, and anything else that ends in "-aglutide". But those aren't as popular, despite being cheaper, and they aren't specifically approved for weight loss.

Mounjaro is a newer one, tirzepatide, that acts on two receptors rather than one. In addition to stimulating GLP-1 receptors, it also stimulates glucose-dependent insulinotropic polypeptide (GIP) receptors. It may work better; I'm not sure whether that's going to come with a concomitantly increased risk of side effects. It's still only approved for diabetes treatment, but I suspect that will change soon and I suspect we'll see a lot of cross-over in terms of using it to treat obesity.

I don't think these medications are going away. I also don't think they're right for everyone. They can reactivate medullary thyroid carcinoma; they can fuck up digestion; they may lead to decreased quality of life. So while there may be people who do well with them, it is okay if those people are not you. You do not owe being thin to anyone. You most certainly do not owe being thin to the extent that you should risk your health for it. Being thin makes navigating a deeply fat-hating world easier, in many ways, so I never blame anyone for wanting to be thin; I just want to emphasize that it is okay if you stay fat forever.

#the attending dr. kristophine

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riondisease · 19 days

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been a shit year for my health, i got diagnosed with ehler’s danlos, chronic illness came out of remission, my mobility issues got worse and i limp now, brain damage, asthma, liver and kidney issues.

it’s hard but i’m trying not to let it get me down because i’ll just fucking die before i let all the people that talk like my life is all suffering and worthless get what they want out of me.

i might only live to be 40. i might be shit at most things. i might feel like shit all day but i go outside and play the guitar and talk to my friends. i make art and i listen to music and i watch the sun come up.

disabled pride. don’t let anyone make you feel like your life isn’t worth living. shit sucks a lot of the time but you’ll find things you love.

#disability #disabled pride #disabled joy #chronic pain #mobility issues #ehlers danlos syndrome #screen reader safe

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olderthannetfic · 8 months

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/726864398686240768/

LMFAO this ask knocked me flat on my ass because anon. Dear sweet anon. I would LOVE to know what it is about Remus or Tonks that you think is 'queer-coded' beyond Tonks having colorful hair (and I'd be willing to bet that most people if they could change haircolor at will would happily sport more wild colors than they will when it's a time commitment and risks actual damage to their hair) and Remus having lycanthropy which is treated as a clumsy metaphor for AIDs in the story.

Neither of those things, particularly by themselves, actually equate to queer-coding, especially if you go by what queer-coding actually, originally meant, which is "these characters are queer but we can't actually say that, so we're just going to make it seem as obvious as possible without offending the censors". (It isn't queerbaiting, either, since as OTNF pointed out, I would bet both my kidneys and my spleen that Rowling never gave any thought to potential queer readership, and she certainly wasn't trying to bait them with comparatively minor side-characters who only have a handful of pages collectively.)

But even if you're trying to claim that the queer-coding happened unintentionally... what about either of their characters actually seems like they are queer that came from the text and not from popular fanon that got so deeply entrenched people forgot it wasn't actually in the books (which is what happened with WolfStar lmfao)? (And like, sure, 'fuck the text, jkr sucks' and whatever but in that case why are you even trying to argue the characters were queer-coded in the first place since canon clearly does not [and shouldn't, I agree!] matter.)

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whumpshaped · 4 months

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How do you write gore? I am interested in this process.

alright okay so. this got long and i also mention some brief examples of gore in there. i hope its somewhat helpful?? or at all?? im not sure. im not great at giving advice im sorry

gore is something very precious and intimate to me. i feel like i approach it in a way people would approach a tender smut scene. because its the same to me. its being able to peel back someones little layers. to be inside them. to know them. to know them better than they know themselves, because honestly, when was the last time you took a peek at your own kidneys? yeah i thought so. gore too takes two or more people because whatever gore you can inflict on yourself is Nothing compared to the tender intimacy of someone else digging around in your stomach. its vulnerable. its beautiful.

as for literal descriptions, i always try to get very visceral with it, because i feel like it deserves detail and long drawn out paragraphs of description. there are so many sensations and sounds and sights and smells to describe. i cant write super detailed smut but i can write the exact way someone would reach inside someone else's ribcage and slide their fingers under the bone to caress their lungs. its just so much more comfortable to me. it feels like home.

i look at tons of images of specific elements of gore i want to write, real images, drawings, medical illustrations etc. when i can, i watch surgery videos on it. i want to know what it's like so i can write it as best as i can.

i like to relate it to my own life too. shout out to my 5th grade literature teacher who said "whenever i think about being burned at the stake, i like to imagine how much it hurts when i accidentally burn my hand on the clothing iron or stove. and thats just a moment, and a small surface." she was so real for that. breaking every bone in someones body? think back to that time u broke the tiniest bone in your wrist at age 11 and your entire arm went numb. putting needles in someones fingers? blood draws, or pricking yourself while sewing, but times ten or a hundred. and if you really cant relate it to yourself, read about it, read the symptoms, read the accunts of ppl who HAVE gone through it, try to really imagine it.

and dont forget about shock. shock is one of the best parts of gore to me. because you will probably go into shock when you see your severed arm (shout out to the medical instructor who taught us first aid on my drivers course).

idk. gore is something so precious and important to me. it just sucks me in, it feels like writing a long unhinged love letter as an obsessive lover. every time.

and that doesnt mean i condone gore or think its morally awesome to dismember someone. but you can write it that way from a whumper's perspective. but you can also write whumpers who dont really like it but have to do it for whatever reason. whumper pov is good if you dont want to try and explain how itd feel. some things i like to consider: is this the first time whumper does this? does it make them giddy with excitement? or is this the thousandth time and its just work to them? do they like what theyre doing? is it a means to an end or is it for fun? do they have any medical knowledge?

then of course you can write it from whumpee's perspective, which might be good for not going into anatomical detail. whumpee doesn't really see whats going on, most likely. and there's so much blood! it's their blood! theyre not thinking about anatomy, theyre thinking pain pain pain pain PAIN PAIN PAIN. some things i like to consider: has whumpee ever gone through something like this? is this the first time they're seriously hurt? is it the thousandth? and if it is the thousandth, how does it compare to the previous times? how is whumpee's pain tolerance? are they afraid of dying? do they have any medical knowledge, can they kinda gauge how bad the damage will be?

you can bring in a third observer, write it from their pov. itll be vastly different every time based on that character's own feelings towards gore, towards the two or more people involved, etc. there are so many ways to depict and explain what gore looks and feels like.

when i write gorey stuff, i like to just get it all out in a first draft, then go back and do some "realism checks" (this might not be smth you want at all and thats okay :) ). not medical accuracy or anything, but i like to go back and think okay, this character is getting their eyes plucked out, would they really be snarky during the process? maybe not! lets take that out. gore is smth that is usually rly far removed from your life/experiences, so it takes effort to write it in a way that feels authentic.

in any case, just have fun and remember fantasy gore hurts no one :)

#asks

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polyhexian · 8 months

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God I'm so glad that ych sold. That's two problems resolved, one big one to go, and then one... Huge one I need to get help from my parents for

Not being able to work sucks. Like. If I was working I would be making money and then I would be paying off medical debt every month- but that debt would quickly outpace what I can actually make so even though it would SEEM like I was better off because I could buy groceries like. I'm just locking myself into debt I can never escape. Legitimately my last hospital visit was nearly half of what I made in a year at my last job. And God knows what the next will be. I'll probably need another MRI at some point and I WILL have to do another five day study since the last failed to see results. Again, like another 20k. My epilepsy medication alone is like $350 a month without insurance. And I am constantly getting myself hospitalized or sent to the doctor for dumbass shit. In the last year I went in five times in ten days for kidney stones and had a billion tests, I scratched my cornea, I got smoke inhalation, I had a seizure, I thought I broke my hand, I had a UTI, I've had the flu like three times, I've needed a physical to get my license back AND needed to see my neurologist for approval, I've needed blood drawn approximately five hundred times, I have to see my psychiatrist every month, and I had a root canal. Like come on. I am stupid and clumsy and I take poor care of myself. And also I have epilepsy and minor brain damage. It's expensive being sickly and disabled!!

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skeezpyuff · 1 year

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Hey you, yes you! (Side note: this down here is how I'd design Casey Jones' hair omigosh-)

Have some pizza, you deserve it ^^

#treat yo self #I'm tired #kidney damage sucks #sorry if i seem a bit less active lol #just not feeling well #type 1 diabetes struggle BOIIIIIIIIIIIIIIII

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tomwambsmilk · 2 years

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I think that in season 4 Greg should have to get a tooth removed bc no way does that boy brush his teeth regularly and he asks the dentist if he can take it home with him and the dentist says 'yes' and then he shows it to tom and then tom steals it (but he feels a bit bad so he leaves money in its place like the tooth fairy). And then this sparks something in him so he starts going to Greg's hairdresser and paying them an absurd amount of money to collect Greg's hair clippings and give them to him. Greg comes over to visit and he pretends to be disgusted by the length of Greg's nails and makes Greg clip them so he can keep the clippings. Then Greg gets appendicitis and tom goes and pays off the doctor to give him Greg's appendix and now this is definitely getting out of control because he's just got pieces of Greg in jars in his apartment but he can't stop because how the fuck do you dispose of that kind of thing without it looking extremely suspicious, and also he doesn't really want to stop. So instead he starts playing in a rec hockey league with the hope of sustaining kidney damage and he pays a guy to slam him into the boards so hard he passes out and he *does* need a new kidney now so he goes to Greg (as this was his plan all along) and gives him a whole sob story about how he doesn't have any functioning kidneys (not true because his other one is fine but its more dramatic this way) and he'll die if he doesn't get a new kidney because he thinks this will prompt Greg to offer his kidney (so he can have Greg's kidney inside him) but Greg just goes "aw man that sucks :("

Tom starts hinting more and more at Greg offering his kidney and Greg knows exactly what he's doing (just that he wants Greg's kidney, not the rest of it) and keeps playing dumb while trying to figure out whether or not he's in Tom's will and if he can get added and how long Tom has before he's going to die anyways, and also whether any of the fly guys might be the type of develop a psychosexual corporate sugar daddy obsession with him

#tomgreg i guess???#idk they're like clowns to me

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mcclainwilla · 1 year

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Writing Fight Scenes, Part 3 - Being Hit

Today's topic kinda made me giggle. We're gonna talk about Being Hit.

If your character is hit in a squishy spot, they're going to react very differently than if they were hit in a non-squishy spot. Also, if your character has no fight experience, they will react very differently than if they've been sparring since they could walk.

It has occurred to me that not everyone has had the pleasure of being punched! So don't go do irl research; I have already done it for you!

Edit: Holy shit I forgot to mention that I did martial arts for about five years, so don't worry about me! Everything is fine!

Getting hit in the face

On either side of your face, curving from your temple down your jaw, is a C-shaped zone. 'C' stands for 'consciousness'. This is the knockout zone. There are two main knockouts (I named them myself):

Teleporting - you only lose consciousness for a moment. From an outside perspective, a character that teleports will get hit, fall, wake up upon hitting the ground, and probably deny that they passed out to begin with. From the first person perspective, the character will be standing, and then they'll be sitting with no memory of how they got there

Actually passing tf out - your character will take longer to wake up and when they do, they will be disoriented and have a hell of a headache. Both kinds of passing out are an indicator of brain trauma, but if your character is out for a hot sec, they almost def have a moderate concussion

Observe both of these in action by watching UFC fighting. Not kidding. It is very informative

Getting hit in the c-spot (I'm sorry. No I'm not) isn't the only way to have your day ruined tho

Getting punched in the eye is the Worst Thing Ever I don't care how much experience your character has, if they get punched in the eye they will have to take a moment. It doesn't always hurt too badly, your brain just goes 'hey what the Fuck was that'

Getting hit in the nose does hurt. I know you've heard that it can kill you (nose bone -> brain) but that is sooo rare, so. Don't worry about it <3

If your character gets hit in the mouth, they might lose teeth. They will almost definitely cut their lips/cheeks on said teeth

Getting punched in the ear hurts a surprising amount. Getting punched behind the ear is 1000x worse. There's a soft spot right behind your earlobes/jaw (that's where your eustachian tubes are. If you even care)

Your brain stem (back of the skull, right above your neck) is a second, more deadly knockout zone. If your character is just friendly sparring, do not let them hit to the back of the head

Conversely, it's pretty okay to get hit in the forehead. It'll maybe make your character's eyes water, give them a headache, but it won't end a fight. There's lots of bone (armor) there

Getting hit in the body

I'm just going to go down the line

Throat - bad. Chances are, it'll do some damage, but even if it doesn't, it's kinda like getting punched in the eye, where it just feels Wrong. (Also there's two main regions, the neck part (larynx) and the collarbones part (trachea). Both suck)

Ribs - it's not great, but it's better to get hit in the ribs than in the things those ribs protect. There are twelve ribs on each side, but only ten of these wrap from the spine to the sternum. The bottom two, called the floating ribs, do not attach to the sternum; they're easier to break and hurt way more when hit

Diaphragm (squishy bit right in the middle of your chest, where your ribcage ends) - hurts so badly. Your character will probs get their breath knocked out (their muscles spasm, preventing them from drawing a breath. They can only make wheezing sounds. Very undignified)

Liver/kidney - the liver is in the front right side of the body, underneath the lower part of the ribcage. The kidneys are in the back of the body, underneath the lowest part of the ribcage. Your character doesn't want to get hit in either one - they'll make a loud 'hnnnk' sound and it will be embarrassing

Stomach - like the ribs, it's not great, but there are worse places

Groin - take this with a grain of salt, I don't own a ballsack. Reportedly, getting hit in the loverman hurts immediately, but getting hit right where you sit will knock your character to the ground - then, after about three seconds, it starts hurting

Newbies Vs. Pros

There's not a ton for me to say on this one

For a newbie, getting hit in a squishy spot is (understandably) the Worst Thing Ever. It's not unreasonable for your character to end up crying, less from pain and more from surprise/fear

For pros, getting hit in a squishy spot still hurts, they're just able to tune it out more. And, characters with more experience may entirely filter out the pain from hits to places like the shoulders/hips/other not-so-sensitive areas. They may only realize they were hit a day later, when the bruise pops up!

I'll probably cover things like nerve bundles in another post, this one is already too long as is. Whoops. I hope y'all are able to make use of all the times I was hit during my adolescence

#writing #writing advice #wip #wip stuff #fight scene #martial arts #willa mcclain

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alyosiuscreightonward · 10 months

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Dear Diary. Talk about people who actually suck.

Recently my late husband’s dog passed away at 14 years old.

So…His kidneys shut down and he was sneezing and urinating blood all over the house. Plus he was 14 years old. It happened in a matter of days. I first thought he had lost another tooth and I went on about our lives. Then he just started to decline. He wandered around the house, just staring out and pee blood. Which leads him to start sneezing blood. I waited a day and told Childzillah we had to make that informed decision…

That’s what happened. I texted my dad on Father’s Day and wished him a happy Father’s Day but I was in a bad situation but I didn’t get into it with him.

Of course my sister had gotten those aforementioned texts just to shut the fuck up about it and leave me to grieve his passing. BUT NO!!!

My baby, my life, my heart, Harrowgate Broadchurch Cunningham Rogers has lost his pack. First was, The Emperor of Quail Village, Augustus Caesar Cunningham Rogers; he passed away due to neurological damage, he was 6 years old. Then there was, His Holiness, The Brother Levi Reddy Gudipally, he was 21. Now, CoCo Monaco Veronica Louise Ciccone Penn Ritchie Corleone The Third. However in between all this bullshit, my husband had passed away.

It was a trigger for me and I was dealing with it as best as I could. It reminded me of the days of yore when I had 8 friends die before I was 30 because of complications from AIDS/HIV. Okay. Not a fucking great time in my life. Granted my idiot sister wouldn’t fucking understand that pain since she’s 7 minutes younger than me and she’s constantly saying fucking shit like, “I’m the baby, gotta love me!!” Bitch. Please. Go ahead and have your Walmart Temper Tantrum elsewhere. No Sale here. I’m not feeding into it. “He’s picking on me!!” Fucking twat. Change your own fucking diaper.

As of this writing, I had every intention of calling my dad and telling him what happened BUT NO!!!

My sister fucking ratted me out. She put me on Front Street. She put that landfill on my dad’s property. Thanks a lot for that you stupid fucking idiot. “I’m SO going to TELL!!!”

I’ve been working on myself for years and now I’m dealing with shit better than before and the Lexipro is helping me not to feed into other people’s bull-fucking-shit. I’m of the mindset that if you tell me something, I believe in the sanctity of the confession and what you tell me, I’ll deny everything. “My name is Oliver North and I have no record collection of that memory.” I loathe telling folks that I’m dealing with my own bipolar depression, manic episodes of hypomania and suicidal ideations. I’m making progress. It’s a moment by moment thing.

Regardless of my rant, my sister will never understand how much she hurt me, again.

She’ll then claim I’m being so secretive about my life. Motherfucker, if I am able to tell you, then I would tell you and not put it in The National Enquirer or on TMZ. Nacho Bizness. Nunya Bizness. Not your story to tell. I have therapists who I confide in and not my family. They have a tendency to throw it up back in my face because they can and they will.

The love for my family is real and not just conditional. However I know that they don’t like me as a person because I’ve done shit and I’m not going to judge them but I’m going to say very clearly, that my dachshund and I WILL talk shit about them, but I’m not going to tell the world what I think because I’m irrelevant.

CoCo is going to rest in power but I will talk shit about him and not you.

Now you see why I stay over here and mind my business and I make every effort to keep myself out of your life and business. If you want me to tell you all about yourself, there’s going to be tears and they won’t be my tears. Trust and believe. I’m sure that you are not ready for my verbal and emotional abuse. I’m very good at it. My tongue is so sharp that it can and will clip the hedges. I’m going to annihilate you into a puddle of tears. Though this requires some effort on my part and I didn’t schedule that today but now, I’m going to tell her, that she can speculate about it since I’m not going to say shit to her.

Yeah I know that my dad worries about me but if it’s my shit then let me deal with my shit and don’t interject yourself in my business.

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san--jose--sharpedos · 1 year

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i don't talk abt the fact that i have a chronic illness often, kidney disease for those curious, i had a transplant about 19 years ago, and one or two scares about 6 years ago, I've been perfectly healthy, but shit with it does fucking suck.

there's so much shit that i would love to do that i just straight up can't bc its too dangerous to do bc of anti-rejection meds like getting tattoos, then there's shit with taking meds that give me hair loss in my early 20s that I'm insanely insecure about, it's not much and just the back of my head, but I just had to buy fucking Minoxidil much to my dismay and embarrassment. And like yeah, it could be worse, I'm perfectly healthy and you wouldn't know i have it save for a handful of levels on my bloodwork, but it does suck sometimes.

Hell even things that i enjoy like going to shows I gotta be careful abt bc of where my kidney is located, bc fun fact, it's not protected by my ribs bc it's closer to the stomach area. it sucks and there's really nowhere for me to actually talk about these things bc no one in my life gets it. People will always say "at least you have your heath" yeah but i cant life the life I want to live and do the things i love to do often. I cant just jump into a pit if i want to bc i could damage my kidney bc there's no damn bones protecting it

#this is also the first time ive ever ackolwegded myself as being chronically ill

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platypanthewriter · 2 years

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Ding-Dong-Dashin’ on Heaven’s Door

My first @harringroveson-bingo prompt! BE WARNED: it contains TEMPORARY CHARACTER DEATH, though he will be brought back later! Read on Ao3

A2: Terminal Illness

Title: Ding-Dong-Dashin’ on Heaven’s Door

Rating: Teen and Up

Word Count: 3771/?

Ship(s): Harringrove

Major Tags: Temporary Character Death

Additional Tags: Terminal Illness, ghost, character brought back to life, Canon-adjacent, Billy doesn't die at the mall, But they can't save him until later, sad probably, but happy ending

Summary: They get Billy out of the mall, but even the hospital can’t save him...but even after he dies, he isn’t really gone, and strange things happen in Hawkins.

The thing with the Mindflayer was, it was stubborn.

They’d gotten Billy out of the wreckage (before he burned up, even), they even got his bleeding stopped on the way to the hospital (though he lost a lung in the process)—but if the Mindflayer was gonna die, apparently it was gonna take Billy Hargrove with it, sucking all the life out of him like it had the farm above the tunnels.

Steve wandered by Billy’s room on his way home, after they’d finished checking him over for weird truth drugs or whatever, and after he’d poked his nose in to see them stitching up El’s leg after they’d gotten the slug out. He could see Max across the hall, sitting in the chair in the corner of Billy’s room. She was gripping the seat with white knuckles, listening to all the machines keeping Billy alive while the doctors tried to find something wrong with him they could actually fix. She told Steve (in a flat voice) about Billy’s lung, and the damage to his spine, damage they couldn’t even estimate until he woke up and tried to move.

“His lung,” Max repeated, her voice gravelly with tears.

“I’ve seen damage like this before, actually,” his doctor told them, once she’d asked about Billy’s parents, and Max and Steve had stared back at her. “At the veteran’s hospital. We got a World War II vet in. He’d been hit by a sniper as he was boarding the ship home. Bullet bounced around everywhere, he lost part of his liver, a kidney, a lung, some intestine…everything in his x-rays was in the wrong place, because they just shoved everything back in, and sewed him back up. They didn’t think he was gonna live.”

Max glared at her, her knuckles whitening as she gripped Billy’s blanket.

“He made it,” the doctor stressed, gently. “He married and came in for his checkup with his wife, and talked about his children. And our medicine is better than it was forty years ago, in a war zone. Your brother’s injuries were severe, but they haven’t turned septic. The problem is…something else,” she said, using a swab to dab at the black slime dripping from under Billy’s eyelids.

“Shit,” Max whispered, as Steve bit his lips together, watching the doctor try and sound calm as they all watched Billy cough black smoke.

Steve kept visiting after that, feeling kinda weird about it, given that he’d tried to run the guy over, and he still remembered—too vividly, sometimes—the sensation of Billy’s fists connecting with his face. It was just…he kept remembering Max, sitting there next to the hospital bed, waiting for her brother to die.

Also, Steve reminded himself, Billy Hargrove was an unredeemable asshole, but he had stopped the Mindflayer from killing basically everybody. A few evenings here and there watching him gasp for breath, mumble to people who weren’t there, and puke slugs up into a bucket weren’t hurting Steve any. Lucas sat with Max sometimes, holding her hand—or Dustin tried to make her laugh��but mostly she just glared past Billy’s feet under the blankets. Sometimes she cried.

The couple nights Max couldn’t make it, she called, her voice eerily calm, to ask whether Steve would sit with her brother. “We don’t know how long he’s got,” she said, flatly. “I don’t want him dying alone.”

“Sure thing,” Steve told her, grimacing as he realized he was awkwardly giving the wall a thumbs-up. “I—yeah. I’ll hang out and, uh, I’ll—at least through visiting hours.”

“Thanks,” she rasped, and hung up without another word.

Billy was fairly lucid sometimes, though he mostly couldn’t talk—either he was throwing up stuff that horrified the nurses, or he had tubes in him to keep him breathing. Steve sat next to the bed and griped about shitty customers, and shittier uniforms, and Billy watched his face, sometimes. Sometimes he slept, but Steve stayed anyway, until visiting hours were over.

He was strong enough to lift Billy too, when he got confused and tried to get out of bed and fell, and Max couldn’t do anything except scream for help. Steve hugged her, after they got him back in bed and asleep, and she sobbed silently into his sweater, shaking.

Towards the end, Billy yanked the tubes out, over and over, until they stopped fighting him. “Fuckin’...dyin’...anyway,” he mumbled, taking a shuddery, wheezy breath between each word.

It was weird hearing his voice, raw as it was. His skin was mostly blue-black and veiny, but his eyes were still Hargrove, still the guy who’d climbed over furniture to get to Steve at a party, and then all he’d done was glare. Steve wondered what to say. “How’re you feeling,” he asked, immediately feeling stupid as Billy shook with silent laughter.

“Fff…fuck you,” he panted, his body jerking, and Steve grabbed the bucket fast, helping Billy turn to hork up the water he’d drunk earlier, black liquid, and what looked like some of a tentacle. He laid on his side with his eyes shut, afterwards. “...thought I’d…get to…do more shit,” he gasped, laughing.

Steve grimaced, nervously twiddling his thumbs. “...least you aren’t dying a virgin?” he suggested, fairly sure, and Billy choked again, turning his body as much as he could to drool and spit thick black fluid into the bucket. “Sorry,” Steve told him, feeling underqualified for the situation.

“...I’m…fag,” Billy whispered, tears dripping down across his face as he shook again, trying not to laugh.

“What?!” Steve asked, grabbing for a paper towel, and cleaning the guy’s face up a little.

“‘Z’it even count…f’never…kissed…” Billy wheezed out, and Steve thought about it.

“...maybe not, huh,” he agreed, wincing. “If you didn’t…I mean, you didn’t kiss anybody you even…kinda…wanted to kiss.”

“...yeah,” Billy gasped, his shoulders jerking with hiccuping sobs. He didn’t open his eyes.

The next day, Max was there, so Steve just popped in briefly, to tell her a story about a customer who wanted child-appropriate slasher films. Billy’s skin was sunken and grey. He didn’t seem aware—his eyes were half open, but he didn’t look over when Steve talked, even when he helped Max sponge her brother off a bit.

Steve didn’t tell her what Billy’d confessed. It didn’t seem like her business—or Steve’s, even, except that he’d been the only one there to tell. The hallway seemed silent after the rasping, uneven sounds of Billy struggling for breath, as he left Max with her book and her dying brother, wondering whether Billy would wake up again.

Max called the next day, and Steve waited, biting his lips together, to hear Billy had died. “...Neil finally said they can start the morphine tomorrow,” she said, her voice hoarse. “They said…once they do, he probably won’t wake up. E-ever.”

“Shit,” Steve said, rubbing his face. “Fuck. Uh. You…”

“I gotta go to school,” she said, sounding wet, like she was breathing through a bunch of raw eggs, or had a sodden swimsuit in her sinuses, and Steve grimaced, wondering where the hell Billy’s parents were.

“I’ll take the day off,” he said quickly, and listened to her cry. “I—I can, um, I can at least sit there. I’ll tell him…stupid shit about Hawkins. I mean, he’s not really missing much—”

She gulped a sob at that, and Steve shut up, cursing himself. “See you after school,” she gritted out.

It seemed like it was gonna be super awkward, sitting next to Billy all day on his last day alive, so Steve braced himself for listening, but he also took a book—the novelization of the Star Trek movie with the little teddy bears. He was glad he did, because when he got there, Billy was out cold, his breathing labored. Steve sat down and opened his book, then, after some thought, read it softly aloud. At least if Billy could hear anything, he’d know he wasn’t dying alone. After the second chapter, when Steve’s throat was getting dry, he looked over to see Billy’s eyes open, focused on him.

“...hey,” he said, and Billy’s mouth quirked a little.

“That…ewoks?” he asked, closing his eyes for a second and working his jaw between words.

“...yeah, that’s what they’re called,” Steve remembered. “I always forget.”

“Ewoks,” Billy rasped. His breath was gurgly, but he actually sounded…better, somewhat, more awake.

“You want some water?” Steve asked, getting up.

“...nah. You…leaving?” Billy asked, his hand twitching in the blankets, and Steve tossed the book into his chair.

“No, nope,” he said quickly, glancing at the clock—five entire hours until Max could possibly make it after school, even if somebody gave her a ride. “I’m here until Max gets out of school, you’re stuck with me.” Billy squinted at him, and Steve pointed to the bathroom with both hands, like a moron. “I’m just getting a drink. ‘Cause I was reading.”

Billy bit his lips together, and Steve took that as permission, retreating to drink several refills of the tiny paper cup on the counter. His mouth felt like he’d been breathing desert sand, and he wondered why Billy didn’t want a drink in the dry hospital air, but the nurses had told Max not to try and force anything into him.

When he got back, Billy was trying to get the hospital bed to raise behind him. Steve helped with his pillows, so for the first time in a while, Billy could sit up, a bit. He didn’t weigh enough, Steve thought, pulling him up very carefully so he could stuff pillows behind. Billy shut his eyes for a long second after Steve finished, and Steve didn’t dare move his hands off Billy’s shoulder and back, didn’t dare drop him if he wasn’t steadied out yet, in case the asshole was hurting.

“Fuck,” Billy whispered, tears streaking down his cheeks, leaving oily black streaks. He shook with suppressed coughs, and more black goo dripped down his chin.

“Shit, I broke you,” Steve said, trying to look around for the “help” button without moving, and hurting Billy worse.

“Already…broken,” Billy wheezed out, trembling against him, and squeezing his hand. “S…fine.”

Steve waited a long second before moving, and then kept his arms up and ready while Billy settled back into the pillows. Steve sat on the edge of the bed, kind of…unwilling to yank back the hand Billy had squeezed, and worried about sitting too far away, in case Billy needed something, the bucket, or help lying down again.

“...why’s…Max coming,” Billy managed, his eyes closed. “Got…school.”

Not having much in the way of family meant Steve had watched other people’s so hard it was probably a little creepy. “...’cause she’s your sister, and she loves you,” he said confidently, and Billy snorted a laugh. “She does,” Steve told him. “I guess she’s got bad taste, man.”

“...gon’ get…in trouble,” Billy rasped out. “Max…”

“Look, she’s got my number, okay,” Steve told him, gingerly squeezing his arm, and trying not to tug on the IV. “I’ll be there.”

Billy glanced up at him and away, his eyes filling with the creepy black tears again.

“So,” Steve said, clearing his throat in the awkward silence, and Billy looked up, smirking a little, his eyes red-rimmed. “Uh. I got roped into going to see The Black Cauldron. It was the worst.”

“The what,” Billy grunted, coughing, and Steve dug his fingers into the blankets next to Billy’s hand, trying to keep his voice calm.

“It’s this shitty kid’s movie. There’s a psychic pig,” he said, rolling his eyes, and told Billy what he could remember of the weird story, while Billy watched his face, glancing down occasionally at his hand on Steve’s. He laughed until he cried some more at Steve’s impression of the creepy little furry monkey guy, and Steve found himself trying to remember every second of the movie, because Billy was awake for the first time in forever, and listening to Steve’s dumb rendition of an awful movie had to be better than waiting to die.

By the time he got to describing how they’d just edited in live-action actors with colored visual effects, Billy was grinning tiredly. “Wha…this shit,” he muttered, and Steve laughed, squeezing his hand.

“I know, right?” he agreed, noticing Billy was feeling better, for real, he had some pink in his cheeks, and the tops of his ears. Maybe he wouldn’t die, Steve thought. Maybe the doctors had been wrong, all of them, and Billy was going to be a pain in Steve’s ass for years to come.

“...keep going,” Billy rasped out, and Steve stopped just smiling like an idiot, and remembered where he’d been in the story.

“That’s most of it,” he said, “—but you wanna hear about dumb movies, I’m your guy.”

“Tell me,” Billy wheezed, closing his eyes tightly for a long second, and Steve waited for him to open them, squeezing Billy’s hand in both of his.

“Okay,” Steve told him, his own eyes stinging, because Billy’s hand in his felt cold. “Lemme tell you about Gymkata.”

Steve and Robin had agreed that Gymkata was the worst movie ever, every time they snuck in to see it, watching an olympic gymnast find convenient pommel horses and bars to swing on to defeat ninjas. Billy laughed silently, tears running down his cheeks as Steve got up and acted out scenes from the movie, kicking off the edge of the bed, or pretending to grip the curtain rod concealing Billy’s bed. “A fusion of ka-ra-te and gymnastics…GYMKATA,” he mimicked, as Billy wiped his eyes, shaking with suppressed laughter. “Worst movie ever,” Steve told him, delighted at the grin on Billy’s face, forgetting for a second the reason he was there—until he glanced at the clock, and realized Max’ school was out, and she’d be showing up any minute. It’d be stupid, he thought, to hang around in the way, while Max spent her last evening with her brother.

“...you…gotta go?” Billy rasped, looking from him to the clock.

“Hell no, I can wait until Max shows up,” Steve told him, sitting down on the bed again and kind of…trying to rub some warmth back into Billy’s hand. “There’s a guy in it with a rubber face on the back of his head, so when he turns around, he has to be really careful he doesn’t move his neck and make the rubber face wrinkle.”

“Jesus,” Billy wheezed, tears dripping freely out of his face.

“We snuck in and watched it all the time,” Steve told him, and Billy’s mouth quirked, again.

“...you an’...girl?” he asked, dryly, and Steve shook his head, then remembered what Billy had confessed the day before. He’d never had anyone he could tell, but a dying guy was probably the safest it got.

“No, um…Robin’s a queer too,” Steve told him in a hurried whisper, even though there was nobody else around, and Billy stared at him. “She crushes on girls,” Steve said, to be clear. “Just on girls.”

Billy licked his lips, glancing with wide eyes from Steve’s face to the open hallway door, and Steve wondered, suddenly, whether he even remembered his confession. He’d been half conscious, gagging over the side of the bed. Maybe he hadn’t meant to say anything.

“I’m here!” Max said, stomping inside to drop her backpack on a seat. Her skateboard scraped sideways across the floor as she tossed it, ducking her panting, sweaty self into the bathroom and slamming the door.

“Do you wish you got to kiss somebody,” Steve asked, in a rush. “A—you know, a guy.”

“What,” Billy whispered, blankly. He’d turtled back into the blankets a little since Steve had brought it up—the queer thing—his jaw set warily.

“You never got to kiss anybody you wanted to kiss,” Steve hissed at him, listening to Max flush.

“...fuck you,” Billy rasped out, his eyes shining with tears that overflowed down his cheeks.

“No! No, I just—”

Max turned on the water, and Steve just leaned in and pressed his lips to Billy’s, ignoring the taste of puke, and the awful, stale smell of dehydration, and whatever the Mindflayer had done to Billy’s body to turn his tears dark and slimy. Billy inhaled hard, coughing again, and Steve squeezed his hand, and left, because that had probably been a really stupid idea, but at least Billy’d have something else to think about, like what a fucking weirdo (and shitty kisser) King Steve Harrington was.

If Billy called after him, it wasn’t loud enough to hear.

The next day, Saturday, Max called again. “He’s gone,” she rasped out. “He, uh. He asked about you. At the…where you were. Where you’d gone.”

Steve was kind of…shocked, even though he’d known, even though the doctor had told them what to expect. Billy’d been more awake, he’d been grinning, and laughing, and Steve had thought maybe, just—maybe they’d been wrong, maybe he’d live. Max was quiet on the other end, and Steve cleared his throat. “Probably pissed I spent his last day telling him about The Black Cauldron,” he told her, grimacing.

“...I don’t think so,” she said, and then she was quiet for a bit again, and Steve paced around the kitchen.

“Want me to pick you up,” he suggested, waving his hands. “Get—uh, I’ll get you a—one of those breakfast sandwiches. At McDonalds’, you know.”

“A what,” she said, her voice as wet as Billy’s had been.

“We can drive out to the quarry and throw rocks,” he tried, because he couldn’t suggest they get high, though he put that thought aside to circle back to, in case of desperation.

“...okay,” she sighed, and he groaned internally, because how come somebody hadn’t stepped up to help who knew what they were doing, somebody with better ideas than kissing dying queers and throwing rocks.

As he hung up, he felt something cold brush his lips, and he shivered, stepping back, and frowning around.

Max didn’t want to talk. She didn’t want to hear about stupid movies, or do much more than heave rocks as hard as she could, so eventually Steve just turned the radio on, and let her be. To his surprise, when she climbed in the car again, she stared at the glove compartment, took a ragged breath, breathed slowly out, closed her eyes, and asked, “Can we do this again?”

“Sure,” he said instantly, giving her an over-enthusiastic thumbs-up, and she laughed, wiping her nose. As he looked in the rearview mirror, his heart nearly leapt out of his chest, because he stared straight into Billy’s dark blue, red-rimmed eyes. He whipped around to look in the backseat, and there was nothing, not even a bulky folded coat or a pile of trash to explain the shape, and he stared back at the rearview mirror again, seeing only the view out the back window of his car.

“...you can drop me off at home, I guess,” Max said, digging around in the wrappers from their McDonald’s breakfast and blowing her nose hard into a napkin.

“Y-yeah,” Steve said, glancing into the backseat again. “Uh,” he said, trying to remember what he’d been gonna say before he started hallucinating. “Um, you want I should drop you at Lucas’ house? Or somebody?”

She frowned, crumpling the napkin in her hands. “...I guess,” she muttered, sighing. “Mom keeps wanting me to cheer up.”

“...call me up anytime you wanna yell,” Steve told her, prepared to make excuses to Robin and his boss.

“He was a shithead, but…he wasn’t always a shithead,” she mumbled. Steve nodded, gripping the steering wheel, and wishing he had any idea what to say. “...his dad…” Max whispered, then bit her lips, shutting her eyes tightly for a few seconds. “...shit, just take me somewhere,” she bit out, with a sob, and Steve startled and hit the gas so hard gravel flew.

She didn’t call all the time, but over the next couple weeks, on Steve’s days off, he’d get a call from her little angry voice and go pick her up. She’d stare out over the quarry and tell him stories about Billy—sometimes little things, shopping for Christmas presents together, sometimes bigger things.

“He had a weird gap in his ribs,” she said one day, sipping her Coke. “You could feel the broken ends, and the gap between. Like…a couple inches, probably. He said he’d gotten it when spies broke in,” she said, snorting a laugh. “We were just…watching late night TV, y’know, I Love Lucy, all quiet after everybody else went to bed, and he had a few beers. He let me have one. It was gross,” she said softly, staring out the windshield. “I found this…hole in his rib, tickling him. He was…cussing me out, y’know, laughing, and I kept asking. He said his dad did it. Threw him into some cinder blocks.”

“...shit,” Steve muttered, grimacing.

“He was always—he’d grab Billy’s face, make him say things—make him say he was shit, or—or he’d hit him—” she cut off, her breath shuddery.

Steve didn’t know what to say to that, trying to imagine Billy allowing it.

“I know he shouldn’t’ve…what he did to you,” she said, glancing over at Steve, and glowering away. “...he was a shithead, I know he was, it’s just—it’s stupid—”

“He was your brother,” Steve said, grimacing. “I mean. I don’t have one, but…you knew him a long time. It makes sense to be sad about it.”

“Pissed as hell about it,” Max growled, sniffling, and Steve handed her his napkin.

“Yeah, that too,” he agreed, and she laughed, blowing her nose again.

Steve’s house had gotten drafty. He wore sweaters over long underwear, kind of glad he didn’t have a girlfriend, because it was not a sexy look. He’d wake to a chill feeling on his face, or pivot on his heel because he felt something tug at his sleeve, in a room colder than late summer in Indiana had any right to be.

Once, out of the corner of his eye, he saw Billy, sitting cross-legged right at the end of Steve’s bed, his mouth moving like he was talking. When Steve shoved himself up, staring around, his heart pounding, no one was there.

Chapter Two

#terminal illness #Harringrove Bingo #Harringrove #TEMPORARY character death #This is just chapter one #There will be more

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