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#not so new nursing student
chryblossomjjk · 2 months
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i keep gettin degrees to procrastinate :3
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atissi · 7 months
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if you are 1) currently in a university where your student healthcare covers hormone therapy, and 2) in a good financial, emotional, and social position to start hormone therapy, i would recommend pursuing it. because in my experience, it's a huge pain in the ass to get an endocrinologist once you're on your own
#unless you live near a planned parenthood or another equivalent to that#but in general you might as well take advantage of the mandatory student health insurance while you have it#it's also cheaper than you might expect. my vials cost $40 CAD for 4 months and then the injection materials are like a couple dollars each#for me i got a therapist with the university and asked them to recommend me to one of the uni's doctors#so i got to skip some of the waitlisting process yay#and then even after getting access to hormones i went to the clinic maybe 5 or 6 times because i needed a nurse to help me with injections#all of which was 'free' because it was with the university#now that i'm graduated though i need to find a new endocrinologist and it turns out the process is WAY more complicated on your own 🤡#of course your mileage may vary depending on how based your school is but it's definitely worth checking imo 🤷#beepbeep.txt#wanted to say this because i basically didn't use the uni health services until my last year and i was like 'wow#'i'm actually getting so much shit for free right now'#like i was seeing a therapist and a dietician and the endocrinologist and a nurse simultaneously at one point#and i might've missed out on all that if i didn't have someone tell me how easy it was to get help if you ask the right questions#so there's my word of wisdom for anyone who might benefit from it.......#also going to post tips about injections later because i think that would also help people out 👍
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xenon-demon · 10 months
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med student steve and nurse eddie who is sick of his shit please <3 from wip wednesday i know it's not wednesday anymore but plz
yessssss i love this AU so much because it's just me projecting onto steve and daydreaming about Eddie Munson, Certified Hot Nurse™
also don't worry i have very little free time and am also australian so for me, WIP wednesday is a state of mind, not an actual time frame lmao
Snippet for you under the cut!
Shaking off the black cloud currently hanging over him, Steve finally lays eyes on the person trying to get his attention. A nurse is leaning over the desk of the nurse’s station a few meters away to look straight at Steve, and– wow, okay. Steve knows damn well what his type is, the kind of person and style he goes weak in the knees for, but this guy is aggressively punching every single one of Steve’s buttons. He’s got dark, curly hair that’s done up in a bun, some small strands of hair hanging out to frame the guy’s face. It gives Steve an eyeful of the guy’s killer jawline and the jewellery glinting in his ears – studs, of course, they are on the job, but at a glance Steve can see at least a couple in each ear. The guy’s arms are spread out on the desk in front of him, and Steve can feel his brain freeze at the sight of dark ink poking out from under the guy’s scrubs. He forces himself to look up and away from those (tempting, deliciously tempting) arms and into the nurse’s face – and okay, that’s not much better. The way this guy is looking at him, big brown eyes locked onto Steve’s face, he feels like he’s getting sucked in.
“Sorry?” Steve says, taking a moment to blink and regain his composure. He hopes to God he doesn’t look as flustered and distressed as he feels. “Are you talking to me?”
“Yup,” the nurse says, popping the p. He gestures at the sample bag Steve’s holding, with a few different vials and one syringe of blood inside, as he continues. The smile he gives Steve is almost apologetic as he says, “Pathology isn’t going to take those bloods from you, sweetheart. Not like that, at least.”
“Excuse me?” Steve instinctively bristles at the pet name, the way it just drips off this guy’s tongue. Just like that, the black cloud is back. He crosses the distance over to the nurse’s desk. “What’s wrong with them? They’ve all been labelled properly, and signed.”
“Well…” The nurse says, drawing out the word. Steve feels himself start to frown, just the tiniest bit. “You left the needle on your blood gas.” With a couple of fingers, the nurse points to the offending syringe in Steve’s sample bag. Sure enough, the needle is still attached to the syringe full of blood, the sharp end embedded in a small piece of foam.
Steve frowns even deeper. “My intern told me it’s fine like this.”
“Yeah, that doesn’t surprise me.” The guy grins and rolls his eyes before giving Steve a ‘what can you do’ kind of expression. “It’s a common mistake to make, actually, since they don’t really explain this stuff officially, but-”
“Listen,” Steve interrupts, gritting out the word between his teeth. He’s sure this nurse, whoever he is, has more important things to do than patronize him. Steve sure as fuck isn’t going to stand here and be made fun of while this guy takes his sweet-ass time to get to his point. “I’m pretty sure my intern knows what they’re talking about, seeing as they’re, you know, a doctor. If you really want to be helpful”–Steve’s eyes flick down to read the nurse’s name badge–“Eddie, then you can point me in the direction of the specimen drop-off.”
Eddie actually rears back at that, straightening up and pulling his arms back so he’s holding on to the very edge of the desk instead of casually leaning over the top of it. If Steve were having a better day, he might feel bad about it. As it is, all Steve feels is a sick sense of satisfaction at the way Eddie’s face has shuttered off, his eyes no longer shining the way they were a moment ago.
“It’s that way,” Eddie says bluntly, pointing back in the direction Steve came. His voice has lost all the character, the theatricality that he spoke with a minute ago. “Turn left once you step out of this ward and follow that hallway straight down.”
“Thanks,” Steve says, trying very hard not to feel like an asshole. He almost succeeds.
Eddie just grunts in acknowledgement. He gives Steve a quick once-over and says, “Good talk,” in a tone that clearly states it was anything but.
As he strides off towards the specimen drop-off, Steve can’t help but agree.
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queerofthedagger · 1 year
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i don't think i should have to choose between burnout or barely scraping at the poverty line and yet. here we are
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pansyfemme · 8 months
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the truth is im not sure if any other towns with ivy leagues in them tend to have the hatred and resentment for the school that ppl from new haven often have for yale. id love to just sit down and chat with someone from another ivy league town bc like. is it just the combo of a school full of very rich prep school kids in one of the poorest areas in the state where our public schools literally does not have the funding or curriculum for a lot of students to qualify for the college in their own fucking town or is this a wider issue in other places
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renee-mariposa · 5 months
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Nothing in my day-to-day job shows me the limits of modern medicine like vancomycin does. And it makes me insane.
(extremely long, somewhat incoherent nerd rant below the cut)
See, vanc is really good at, like, three things: treating MRSA (when given IV), treating ampicillin-resistant enterococcus (when given IV), and treating c diff (when administered orally ONLY). Most every use outside of that, like when it’s used to treat methicillin-susceptible staph aureus for “penicillin allergic patients” (don’t get me started on PCN allergies), actually has data that it increases risk of morbidity and mortality (i.e. harm and DEATH).
Unfortunately, due to the prevalence of multi-drug resistant organisms, vancomycin is empiric therapy for a lot of presumed infections. And it's a lot more difficult to actually tell if someone has an infection than you'd think. A lot of medical conditions imitate each other and when time is of the essence to identify what's going on, the most ethical thing is to start an antibiotic and rule out infection as the hospitalization continues. Lab techniques have gotten a lot quicker: I can remember 8 years ago, it would take 3 days just to identify what microbe the patient had in their presumed infection. These days, anno domini 2023, PCR comes back in a matter of hours, identifying gram positive/gram negative staph/strep/bacilli/etc, and it's the sensitivities that take 2-3 days. (Don't get me started on contaminated cultures.) But even with improvements in lab technique, we might not culture any microbe at all or the provider might keep vancomycin on "just in case" because we don't know IF the patient is infected, WHAT they're infected with, or if the infection will get better with a different drug.
And vancomycin is terrible on kidneys. Extremely nephrotoxic. It isn’t as bad as the 80s when the drug first came out and was called Mississippi Mud colloquially, but it will fuck the patient up if not monitored closely.
But finding the correct dose for each patient in a timely manner is nigh impossible. This is because vancomycin is renally eliminated. We have to mathematically estimate how well the kidneys are working. Unfortunately, our mathematic equation is next to useless if you are:
-Less than 50 kg
-Shorter than 5 foot tall
-Have a BMI of more than 40
-Are an adult younger than 45 (twenty-year-olds get astronomical doses that would be destructive in an older patient)
-Are older than 65 (the official definition of 'geriatric', i'm relatively sure)
-Are female (this is really only applicable if the patient is less than 50 kg or older than 65 - think: little old frail lady - we have absolutely no fucking idea how their kidneys are doing until we order the serum drug level. It is next to impossible to accurately dose vancomycin in little old ladies on the first try.)
-Are missing limbs (lots of leg amputations in the older and impoverished diabetic population!!)
-Have a lot of muscle mass (think bodybuilder or really tall guys)
Fun fact: we estimate renal function by looking at height, weight, age, birth gender (few, if any, studies on trans patients taking HRT), and a lab value called serum creatinine. Creatinine is a byproduct of muscle metabolism, I don't know the fine details, but we can generally estimate how well kidneys are working by seeing how much creatinine is in the blood: low creatinine usually means kidneys are excreting it as they 'should' be. High creatinine means there's something wrong, the kidneys aren't able to excrete it as efficiently as they 'should' be. But the effect of low muscle mass and high muscle mass haven't been studied enough to be able to adjust our mathematical equation to compensate for them. And with high BMI: we often overestimate their renal function because we don't know how to estimate their muscle mass vs their body fat.
(I work out in the boonies. ~70% of our patients have diabetes. ~80% of our patients have a BMI of greater than 35. So what I'm trying to say here is: we are shooting in the fucking dark when we're estimating the renal function of the vast majority of our patients.)
Complicating this: vancomycin is useless until it reaches steady-state concentration in therapeutic range. On one side of this problem: a lot, if not most, medical providers assume that vancomycin starts working its magic from the first dose. So we sometimes get orders for "vancomycin 1 gram now and see how the patient is doing in the morning". That isn't going to solve jack shit! That's just going to increase the incidence of microbial resistance!!
OR, like in the multiple situations I dealt with this afternoon, you make an educated guess on what regimen is going to work for the patient. You get a level 48 hours after the dose starts. And you find out that you fucking guessed wrong and the patient is subtherapeutic. It has been two fucking days and the patient hasn't started being treated for their (presumed) infection yet!! And we've increased the possibility of microbial resistance! *muffled screaming in frustration*
So what I'm trying to say here is: on almost every presumed infection that comes into the hospital (which we're guessing like 30%? 50%? of the time), we're starting an extremely toxic drug, oftentimes 100% guessing what regimen will be therapeutic, only finding out in 2 days that it is not therapeutic, and it can sometimes take days and days to titrate the dose sufficiently to find a therapeutic regimen. And sometimes we're really fucking unlucky and we destroy the patient's kidneys temporarily (or permanently! but kidneys can be very resilient so that's thankfully rare) because we guessed a regimen that's too high!! This is a fucking nightmare!!!!!!!!
And if all of this wasn't bad enough, we don't really have any drugs that do what vancomycin does therapeutically. We have things that can be used to cover some of what vancomycin does, but nothing that's equivalent AND less toxic.
Like, to fix this situation, we need:
-Better education to providers on what drugs are appropriate empiric therapy for different presumed infections (we're working on it, we are working on it)
-Better ways to estimate kidney function (there needs to be more research on kidney function in patients with BMI greater than 35!! And little old ladies!! And patients with low body weight and high body weight and amputations and...)
-Better prognostic tools to tell 1. when the patient is infected (looking at you, sepsis!!!) 2. what they're infected with
-Less-toxic antibiotics AND/OR better ways to treat infection (this would be the evolution of medicine as we know it)
And I want to be clear: vancomycin isn't bad. It's an extremely effective tool when used correctly but we often either don't have enough data to use it correctly or the provider doesn't understand that this tool is fucking useless for the job they're trying to perform.
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killu · 22 days
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i left my internship back in february and i feel soooo much better
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I have a pharmacology exam on Wednesday and I would love nothing more than to slip into the abyss (cool weather and cozy blankets, candles and soft rain) and still get an A on the exam tbh
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heartapnea · 6 months
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nurses love me for my paper-mache skin and entirely visible cardiovascular system
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samsterham · 1 year
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I'm actually disappointed that hospitals aren't haunted by benevolent spirits. Spirits that have no qualms about interacting with patients & staff. Spirits who know a living patient is gonna start circling the drain before any of the staff, and alert them. Spirits who died from a medical mistake warning nurses & doctors if they're going to make that mistake again. Spirits who show up to help hospice and dying patients transition without fear. And hell, even the curmudgeonly but harmless ghost of ol' Mr. George still occassionally setting the bed alarm off in one specific room & grumbling about having to pee even though he always had a Foley.
I just think that would be nice. As long as we don't have the ghost of Karen or Kyle hitting the call bell every 60 seconds & screaming they're out of ice while throwing the pitcher at you
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loose-leafstudy · 1 year
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3:18pm
sunday, jan 29
happy sunday! 
online school isn’t going too bad, i've only had one all-nighter so far lol. i’m really enjoying my pathophysiology class though! and my goal for this week is to get most of my assignments and quizzes done by wednesday, fingers crossed 
wishing everyone a great week ✿
+ important biology lesson below
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(don’t ask me how many times i've learned the cell parts for a class lol)
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vibinwiththefrogs · 8 months
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You ever have a roommate that the longer you live with them and get to know them the less you trust them
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so much happened today! I went to my first spin class! I received my schedule for clinical placements next month! i finally know where I'm being sent to work this summer! I found out I am 5.5 hours behind in lectures for a class I have a final for on Monday! phew, what a day 😪
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aqpippin · 7 months
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besties pls it’s my first day as acting educator and our regular educator sent me this i’m 🥹🥹
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tteokdoroki · 6 months
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☆༉ — SATORU GOJO. a flicker of a flame.
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about. when satoru notices the flicker of cursed energy within your unborn child, he starts to feel the weight and nerves of becoming a father.
warnings. minors, blank and ageless blogs do not interact! sfw, fluff, expecting parents, reader is pregnant, hospitals, nerves about being parents, listen idk how gojo’s cursed technique works so here u go >:( canon verse, expecting father!gojo, fem!reader.
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“i can see it…like…flickering inside of you.”
satoru carries an expression of intrigue, like a child who’s just discovered a new sensation.
you flip the page of your magazine, not bothering to spare your husband a glance while you instead choose to admire the many strollers and their offers that decorate the page. “don’t be weird, satoru.” you tap a perfectly manicured nail against the one you like most, leaning over to show the item to him.
“but it’s there… like actually there.” the sorcerer replies, keeping his voice low despite the loud ambience of the maternity ward’s waiting room. people crying, people celebrating, families already full of children gathering around to hear more exciting news. “i like that one. it’ll fit in the hallway too. do you want it in grey or in black?”your husband passes you a pen from the depths of your tote bag in his lap, letting you circle the stroller in the magazine so you know to come back to it.
this time, you do him the honours of looking up at him — a fresh glare settled on your glowing features. “satoru gojo please stop referring to our baby as an ‘it’.” you sigh in exhaustion, watching him slump in his seat because you know he hates it when you’re irritated with him. “i thought you were excited about having a baby girl. and the grey one, it goes with your eyes.”
that seems to perk him up enough, earning you a kiss to your cheek that has you smiling like a fool in the nurses office. “sorry, sorry…” satoru starts to coo warmly, a soft tone that’s usually reserved for you and his students. “it’s just that… every time i look at you, i see two vessels of cursed energy instead of one. there’s a flicker of a flame there, right where she would be. it’s blowing my mind.” he points to your bump, nestled away under the layer of his clothing since they’re the only thing that makes you feel comfortable right now.
you close your magazine slowly, fighting the flutter of your heart and the warmth that spreads through your body. you know that your husband is being cautious, overly observant and extremely over protective — being pregnant and having a baby in your line of work was dangerous. scary, even. but you knew that satoru wanted this with you, and you him. that he cared a little too hard or worried slightly too much because while he was the strongest, you’d become every target and every weakness to him.
you and your daughter.
an unborn child who may possibly have the powers of a god among men.
so, instead you tuck away the irritation that comes with your hormones and let your gaze slink over to the large man squished into the abnormally small seat of the waiting room — just to be by your side. “do you need me to explain how pregnancy works, satoru?” you quip and rest your head on your knuckles, just to make him laugh and ease up a little.
a wiry smile starts to tug at the corner of his soft, pink lips. “i’d rather you show me but i think we got the fun part nailed.” gojo’s face splits into a wide grin, making you roll your eyes. “we made her, yanno. she’s alive in there because you’re keeping her safe.”
“and you too, mister six eyes.” you tap his skull, brushing against pure white locks, as gojo leans over you affectionately — probably in demand for a kiss (which you give).
the receptionist calls your family name from the front desk — no doubt to call you in for your neonatal appointment. another set of scans to help confirm your little girl is nice and healthy before you tell the rest of your friends and family later today.
gojo wanted to hand out copies of your scans to everyone at dinner. show off.
but as you stand, satoru goes quiet, offering you his hand as aid. “do you think…do you want…” pressing his lips into a thin line, your husband mulls over his words whilst guiding you down the hall to the doctors office — nodding to the receptionist to thank her as you pass. “i hope she doesn’t have what i have. i wouldn’t wish this burden on anyone.” he looks you straight in the eye, blue eyes piercing your soul. you feel your baby move and kick, forcing you to wonder if she’ll have the same mind blowing eyes as her father. “i hope she’s like you. beautiful and strong and—“
“ours. she’ll be ours and the best parts of both of us. her daddy’s strength, bravery, good looks and her momma’s wits, pretty ‘get me what i want eyes’ and smarts too.” you laugh, bright and loud as you cut gojo off — turning to look at him with a happy smile. “if she turns out like that, the best parts of both of us she’ll be perfect. i’ll love her because you gave her to me, we can figure out the rest later.”
that seems to reassure satoru, who sags in relief by your side as he wraps an arm around you, his large palm splaying across your baby bump. “you’re right, you’re right,” he grins again, feeling her little feet mercilessly kick at his palm. “as long as she’s healthy, we’ll be fine. i love you.”
“we love you too.” you swoon a little too much.
satoru gojo will be a great father, you think, your baby girl is so lucky — she has the strongest daddy in the world and he loves her a little too much already.
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꒰ end. — all rights reserved © tteokdoroki 2023. do not copy, repost, translate & recommend elsewhere.
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Simon Riley crying and praying for the first time in years bc you're hospitalized
(self indulgent as fuck, based off of personal medical history bc it'll be more accurate)
You hadn't ate or drank for 5 days, unable to keep anything down. You thought it was the flu at first. Fevers, puking, extreme fatigue. It didn't seem like anything out of the norm. Except for when your fevers started casing full body convulsions that made you look possessed. Chills and cold sweat turned to groaning and crying, muscles all over cramping and clenching, breathing becoming difficult. You figured it was because you hadn't had the flu in years. How wrong you had been.
Once your puke turned green, which was later found out to be bile from your kidneys, Simon rushed you to the hospital. Unable to stand, he pulled a wheelchair from the entrance and pushed you everywhere. Within 2 hours, the nurses had you admitted and on IV meds. Pain meds, IV Tylenol, and bags of fluid were hooked up to you, rehydrating you being high priority. Your body is in shock, resting heartrate being 140. He sat by your side the entire time, holding your puke bag in one hand, and your hair back in the other. The doctors drew blood, running blood cultures, searching for a more accurate answer.
The night you were admitted, they informed you that your kidneys were so infected that one got injured. The bile that was thrown up was caused but how hard you were puking, pulling it up from your kidneys.
He stayed the night, sleeping in the rocking chair, right next to your bed. He woke up when your fevers came back, holding your hand and telling you how good you're doing, calling in a nurse. The morning that followed, he had to go back to the house to make a bag of your immediate needs, clothes, deodorant, hairbrush, and anything else he could think of. When he came back, a doctor and a couple med students came in with important news.
"We ran blood cultures to see if there was possible an infection in your blood due to your symptoms leaning towards that. They came back positive. We are going to give you antibiotics and run cultures every 12 hours to track if the antibiotics are working" The doctor says as gently as possible.
The room begins to feel like it's spinning. Sepsis has a 68% mortality rate, and knowing how deadly it is, it feels like you're already being buried. Simon looks to you with a confused look, not knowing exactly what that it, but knowing it isn't good.
"I have sepsis?" You ask in a quiet voice, throat constricting.
"Yes" The doctor says softly.
"Oh fuck I'm gonna die" you whisper under your breath, tears forming.
Simon looks to you, eyes widening. 'Not again'
"Wait, the hell is Sepsis?" He demands, but not sounding confident, more scared than anything.
The doctor explains it to him, how it when your blood is infected, how the infection can latch onto your other organs and slowly kill you from the inside out. Once it reaches your brain, it's too late. His grip on your hand tightens. The doctor tries to give hope, but she can only do so much without lying. She leaves to give you privacy.
It's silent, neither of you speaking out of shock. The only noise in the room is the quiet hum of the IV machine and Simon's shaky breathing. Your thumb softly glides back and forth over the back of his hands, trying to ground him.
"Si" you softly call.
It takes hour to get him to loosen up a little. It's only when you manage to keep down a popsicle that he feels like he can breath a little easier. Like maybe you'll be part of the 32% that pull through.
That sliver of hope is crushed that night, being woken up by his arm being slapped repeated by you in a panic. His eyes meet yours, concern instantly written on his face. Your hand is on your chest as short, sharp breaths are the only thing you can manage.
"I,, can't,, breath,," you whisper between breaths, unable to say a sentence in one go.
"Baby it's alright, jus' try to breath wit' me, hm?" he tries to demonstrate slow breathing, mistaking it for a panic attack.
"not a,, panic,, attack,, please,, nurse,," you try to tell him.
He nods in a panic, running out to the nurse station and explaining. They rush in and take your pulse-ox just to see your oxygen percentage is at 86% when it should be above 95%. They try to do the deep breathing again before Simon interrupts them.
"It's not a bloody panic attack, she literally can't breath. Get her oxygen or somethin' before she fuckin' suffocates!"
They put you on oxygen until they can get you an X-ray. The nurses try to chalk it up to a panic attack until in the morning they see you still can't breath. They give you an X-ray and when the results come back, they send the doctor in. She informs you that the nurses gave you too much IV fluid and that caused your organs to swell so much that they pushed up on your lungs, collapsing them by 3/4ths. 1/4th of your lungs are still open and they're going to take you off fluid, start you on exercises to open them back up, and keep you on oxygen.
That's the last straw for Simon. Once you fall asleep for a nap, he heads outside to the bench area and punches a wall. His knuckles split but he barely feels it, ringing in his ears drowning out the surrounding noise. With no one around, he sits on a bend, elbows on knees and face in his hands. His breath picks up as his throat tightens and tears threaten to rip out of him.
"Why would ya let this happen to 'er? Aren't you supposed to be lovin'?" He whispers into the wind, looking up at the sky, "That girl in't like me. She's the fuckin' sunshine in human form and she's on death's bloody doorstep."
Tears cloud his vision, unable to keep it in any longer. He blinks them away, falling onto his clenched fists. Years of praying, to a god he later grew to resent, for him to fix his family. A child kneeling at his bed, begging him to get his family out of his father's grasp. Once he got to his teenage years, his desperation became resentment and anger. His jaw began to clench when his drunken father would spew bible verses at him to condemn him. He realized God wouldn't save him, nor would he when Simon's family was ripped from him.
Yet here he was, back to that same god, desperate that maybe, just maybe, he'd have mercy on him this time. He believed himself a rotten man, even if it was subconscious, unworthy of the angel sent to him. His light, reparations for the mistreatment The Father had destined for him.
"You sent 'er to me, it's gotta be for a reason. You've never listened to my prayers before but just this fuckin' once, please don't ignore me." His voice breaks, openly sobbing with no sound, "You sent 'er to me and now I can't live without 'er. She's fuckin' everythin' to me. Don't take back your gift, please" The end of his sentence slips into a whisper.
He wipes his tears on his sleeve and sniffles hard, trying to erase the evidence of his vulnerability. He stands and walks to the door, looking back at the bench before turning back to the door and walking in. 'Amen'
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