#I SPENT YEARS IN PAIN UNABLE TO GET A DIAGNOSIS BECAUSE OF THIS FUCKER

[laughslikeaseagull]

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#jesus fucking christ the DCP tag on here is dogshit #there is ONE relevant post and it’s telling DCP to leave the donors alone? #excuse me but fuck you #my donor was fully aware of EDS in his family when he donated #I know he was aware of it because I’m in contact with his family #THEY ALL HAVE EDS #I SPENT YEARS IN PAIN UNABLE TO GET A DIAGNOSIS BECAUSE OF THIS FUCKER #he’s lucky I can’t sue him but if I ever see him I’m spitting in his fucking face #and all his donor conceived children have it #we all have EDS #AND HE’S A DOCTOR! HE WAS IN MED SCHOOL WHEN HE DONATED #how does anyone think it’s okay that this asshole knowingly produced sick kids #I have to live with a debilitating connective tissue disorder for the rest of my life #thanks dad

[oforamuse]

i had a dream (i got everything i wanted) chapter 2/?

mickey milkovich hasn’t seen ian gallagher in over 9 years, not since the day he broke his heart and they shipped him off to prison for a crime he didn’t technically commit.

the last place he expects to bump into him is new york fucking city.

or, the one where two broken puzzle pieces find a way to fit themselves back together.

au from 5x12/6x01 onwards.

read and comment on ao3 / CHAPTER ONE 

Living with Mandy definitely isn’t like the fucking Brady Bunch, or whatever you’d expect between two siblings. They get by mainly because they stay out of each other’s crap and each other’s way. Mickey will go out if Mandy brings home some guy she wants to fuck (and vice versa), Mandy will leave Mickey dinner if she’s cooked enough and he’s getting in late from work, and they both surprisingly take turns in the cleaning jobs - it’s simple and it works. They operate more like convenient roommates than two people from the same childhood home and bloodline. They’ve never been particularly close and they don’t really pretend to be. Sure, they have their moments where they laugh and crack open a beer a few nights a week but they don’t come crying to each other about their problems. Mickey can count the number of times Mandy visited him over 6 years on one hand, which he pretends doesn’t hurt, but it does.

He knows he could've been a more supportive brother when he was younger too. They both kind of failed each other in that respect.

By the time Mickey pulls himself off the floor, the kitchen is dark, and he must’ve been lying on the floor hours. He thinks he fell asleep at some point but he can’t be sure, everything is confusing and everything aches.

He stumbles into his room and switches on the light, his eyes taking a moment to adjust. He finds his phone on the side, still plugged in where he’d left it this morning on what he thought was a quick grocery store trip. His stomach swirls at the memory, which is quickly followed by an angry growl and Mickey remembers he hasn’t eaten anything all day. He checks his phone to see the time and there’s a text on the screen from an unknown number a few hours ago.

4:41pm: from UNKNOWN SENDER

‘Mandy gave me your number, I just want to talk.’

‘Fuckin’ traitor.’ Mickey mutters, weighing up whether or not to respond or to throw his phone into the East River. He can claim that on insurance, right?

His stomach growls again and his fingers itch to type out a reply.

Ian’s always been a persistent fucker. Unfortunately for Mickey, he's always ended up giving in to the younger boy. Whether it was putting up with him even when Mickey tried his hardest in the beginning to act like he didn’t want him around or suggesting community college or pushing and pushing and pushing until Mickey grew a pair and came out, Ian always seemed to be nagging about something. Up until those last few months where his mania was getting out of hand, he’d always been the one with the steady plan and expectations, or so Mickey thought. Reluctantly, he knows Ian won’t give up until Mickey gives him a straight answer or hears him out properly, his persistence used to be endearing but now it’s just fucking inconvenient. He sighs, the phone as heavy in his hand as the feelings in his chest and suddenly he feels 19 years old again.

They agree to meet an hour or so later at a bar Mickey frequents a few blocks down, a smaller slightly less sticky version of The Alibi run single handedly by this woman born and raised from Brooklyn. Mickey spent an embarrassingly long time choosing an outfit to wear (which he'd argue was because of having not done his laundry), swapping his shirts multiple times before he just gave up and chose something random. Heck, he even put some cologne on, though he’d never actually admit it.

When he leaves his apartment is tension is palpable and he's somewhat worried he might even break a sweat. Mandy didn't show her face for the rest of the evening, hr door remaining firmly closed, so luckily he didn't have to avoid any suspicious questions.

As soon as Mickey turns the corner and the bar comes into sight, his hands uncharacteristically clam up, instantly regrets giving into the Gallagher’s request. He stops underneath the Heineken sign in the window, basking in the green neon glow as he fishes out a cigarette. He’s already a few minutes late and he figures Ian can live with waiting an extra few minutes whilst he has a smoke to calm his nerves. Mickey had to wait 9 fucking years, the guy can deal with Mickey taking a minute. The smoke fills his lungs, warm and familiar, it’s the only thing normal about this weird fucking day. When Mickey Milkovich woke up this morning he did not expect to come face to face with the guy he’s spent so fucking long trying to move on from, it was absolutely at the bottom of the list of possibilities for the day. He smokes right up to the end of the filter, squeezing out every last moment of peace he can before he flicks it to the ground and stomps on it.

It’s now or never, Milkovich.

He takes a deep breath and pushes the wooden door open, stepping into the busy dimly lit bar.

‘Mickey!’ Rosa calls from behind the bar when she sees him, her smile huge and her hand is already pulling down a pint of Mickey’s usual beer.

Great, announce my fucking presence to the whole room.

He winces, maybe he does come here a little too regularly.

Mickey throws her a forced smile and scans the room for Ian, spotting him sitting in a back corner booth looking at his phone. As if he'd called his name, Ian's eyes flicker up just as Mickey catches him and they meet, Ian holding his hand up awkwardly in greeting. He takes a deep breath and goes over to the bar to get his drink, Rosa throws him a questioning look.

She gestures her head towards Ian’s table. ‘First date?’ She asks innocently, handing him his pint, ‘You meet him online? He’s hot.’ She wriggles her eyebrows suggestively and Mickey wants this all to be over.

‘Stick it on my tab.’ Mickey says steadily, swallowing down a biting response. He ignores her prying questions and chooses to flip her off as a thank you instead. He walks over to Ian’s table, his eyes pinned to a point on the wall above his head so he conveniently doesn’t actually have to look at the guy on his journey over.

His heart thumps. Thump, thump, thump.

He gulps.

There's a moment of blink and you'll miss it hesitation before he slumps down into the booth opposite, then Ian looks up from where he’s been fiddling with the label on his beer. His eyes get drawn to Ian’s slender fingers picking at the paper and he notes that the beer has an incredibly low alcohol percentage, barely even being able to call itself beer.

‘The fuck you drinking that piss for?’ He asks, unable to let the opportunity to poke at the other man pass him by. It's a good icebreaker apparently, because Ian smiles shyly. Mickey's never been one for small talk, especially not when he’s nervous.

‘My meds.’ Ian says simply, his forehead creasing ever so slightly, ‘It took a while getting used to it, but it basically tastes the same.’

He remembers the conversation they had with the doctor, Ian sitting opposite him with dead eyes and not saying a word. Falling further and further away from him with every single description of meds he had to take, or things he couldn’t drink or do because of his diagnosis.

‘Fuckin’ doubt that.’ Mickey grunts casually, taking a swig of his very alcoholic beer. He stares at Ian from over the glass. The other man shifts and reaches a tentative hand out on the table between them. There's a beat.

‘I-, uh, I’ve missed you.’ Ian offers hesitantly, his voice low and uncertain.

‘No you haven’t.’ Mickey says bluntly, his right hand gripping his glass tightly. Ian sighs, sitting up properly from where he’d been slouched over.

‘I have, Mick.’ Ian replies, and there it is again, that fucking nickname.

‘Miss me enough to come visit me, yeah? Or how about even a fuckin’ call?’ Mickey says bitterly, running a hand through his hair. ‘Miss me fuckin’ enough to leave me high and dry for 6 years?’

Ian scrubs his hands over his face, ‘I’m sorry’ he offers. ‘I shouldn’t have done that to you. I shouldn’t have left you there.’

‘Why did you?’ Mickey asks, and it falls out awkwardly. He's got to know. He's got to know why he wasn't enough.

‘I was a kid and I was fucked up.’ Ian says, pulling his arm back into his lap. Mickey is momentarily shocked at the honesty - he thought Ian would’ve put up more of a fight like he did when he was younger. ‘I was a kid in over his head and I thought I knew best…I thought you were better off without having to deal with me.’

‘Bullshit.’ Mickey spits, anger and hurt beginning to simmer in his belly. Nothing about what he had to go through left him better off.

‘I know that now.’ Ian says, meeting Mickey’s eyes. There isn’t a hint of blame in Ian’s eyes, but his face is held tight with regret. ‘It was bullshit.’

His words rolls over him like a cascading landslide.

God, Mickey can’t even count the amount of time he spent wishing those first few years of being locked up that he’d hear Ian say those words. Mickey rubs at his eyes, breaking their eye contact. He sits there for a second, letting his vision go black and spotty. It kinda looks how he feels. He wishes he could fall right into that dark pit and blink out of existence.

Ian pulls him back.

‘I wanted to come see you.’ Ian confesses and Mickey drops his hands. ‘I really did.’

‘Why didn’t you?’ He asks and Ian looks away, ashamed.

‘I figured you didn’t want to see me.’ He says, quietly, his fingers going back down the ripped up label. ‘It was hard picturing you there…’

‘Bullshit.’ Mickey repeats, this time with more obvious anger. Ian looks up at him, pained.

‘No, Mick, I-’ He stops and swallows. ‘By the time I had managed to sort my shit out, it had been a while. I figured you must’ve hated me.’

‘I didn’t.’ Mickey says firmly, his eyes threatening to well up with unwanted tears. He scrubs them furiously away.

The silence hangs between them, only broken by a bar full of bustling noise.

At least everyone else was having a normal night, Mickey thinks, at least everyone else doesn't have to deal with their entire everything being turned upside down and thrown out for the entire world to see-

‘You should’ve.’ Ian says, finally, breaking Mickey's internal dialogue.

‘Yeah.’ Mickey says, not meeting Ian’s gaze. ‘I probably should’ve.’

He’s exhausted, this is exhausting. He wants to tell Ian that he hated him, that he still hates him. Mickey knows it would be a lie. He wants to tell Ian to fuck off, to get the fuck out of New York and leave him alone.

He can’t. He won’t.

Because try as he might, and he’s tried so fucking hard, everything always comes back to Ian.

‘I’ve never hated you.’ Mickey says subconsciously, finally bringing his eyes up to meet Ian's desperate gaze, ‘Could never hate you.’

And it's true. He never could, never in a million years.

They look at each other. Their years and years of history spread on the table between them. Souls bared and vulnerable.

‘Why didn’t you come find me?’ Ian asks, so quiet Mickey almost misses it. Ian’s gaze shifts awkwardly as he explains as Mickey can feel himself scowl. ‘When you got out?’ Why didn’t you come find me?’

Ian looks at him so earnestly and Mickey almost bowls right over. He can’t fucking believe what he’s hearing.

‘Are you- are you fucking kidding me?’ He bites, jaw clenched so tightly he thinks he might break a tooth. ‘Are you seriously asking me right now, why I didn’t come find you after waiting six motherfuckin’ years for you to come find me?’

Ian shrinks back, ashamed and wounded. He doesn't even try to fight it. ‘I guess I deserve that.’ He says after a while and Mickey raises his eyebrows, surprised once again at Ian’s lack of self defence. ‘I know I fucked things up.’

‘Yeah.’ Mickey breathes, ‘You did.’

He puts his beer to his lips and drinks. It stings.

‘I’m on meds, have been for the last few years.’ Ian confesses. ‘It took awhile to sort out, I, uh, had a rough time at first, but I’m good now.’

Mickey’s heart twinges. He remembers Ian’s mania, him bringing in all kinds of shit into their home, running miles every morning and fucking Mickey long into the night. Fucking other guys between that too. He aches at the thought of Ian barely wanting to get out of bed, going days without food or showering. Not saying a word to anyone for hours.

Mickey runs a hand through his hair, unsure of what to say. He wants to take Ian by the shoulders and apologise for how he acted back then, he wants to slip his arms around his neck and breath him in, pull him close. He settles for a small smile.

‘Good.’ He offers, ‘Better than havin’ your crazy ass running around.’ and Ian laughs weakly.

There’s a bitter taste in his mouth that’s not from his beer. It’s the realisation that Ian got himself better without Mickey’s help, that perhaps Ian was right after all and that one of them was better off without the other.

Fuck, he needs a smoke. His hand comes down to feel the packet in his pocket and he lets it ground him. He'll get through this, he'll get through this and go to the bodega and get his pack of smokes. He just needs to make it through this conversation without completely breaking down.

There’s a pregnant pause, neither man sure of where to step next. He takes a sharp breath and jumps.

‘What the hell are you doing here anyway? Didn’t think they let Gallaghers leave the fuckin’ state.’ Mickey says plainly, shifting the subject. It's been nagging on his mind since their first encounter - what the fuck is Ian doing in New York City of all places?

‘Didn’t think they let Milkovichs either.’ Ian quips back, the corners of his mouth twitching upwards.

Mickey rolls his eyes, ‘Fair enough.’

‘Fiona’s, uh, Fiona’s actually getting married here.’ Ian explains, ‘She met some rich guy from upstate a year ago and they’re tying the knot.’ Mickey snorts, remembering the string of guys Fiona would always have trailing after her like lost fucking dogs, it’s surprising that one has finally managed to pin her down.

‘She pregnant?’ He asks, both as a genuine question and a jab. Given the Gallagher parent’s rep for popping out a kid every other year or so, he wouldn’t be surprised.

‘Nah.’ Ian replies, ‘In love apparently.’ He chuckles wistfully before his eyes catch Mickey’s for a moment and they shift pointedly away.

‘Good for her.’ He says uncomfortably, and he somewhat means it. There’s a pause and Mickey wonders if it’s time to call it a night because he can not deal with this right now because God. fuckin’. damn. he needs a smoke. Apparently his mouth hasn't caught up with his nicotine addiction, ‘How’d she meet the dude?’ He finds himself asking.

‘He’s some business man or something, he was in town on some job and I dunno, they hit it off.’ Ian shrugs, ‘Lip’s got a kid now, though.’ Mickey’s eyebrows shoot up in genuine surprise. He knows that Lip used to be an important part of the Gallagher household but fuck, Mickey would never give that man a kid of his own.

‘Who the fuck gave him a kid?’

‘A broken condom.’ Ian says bluntly, ‘Debbie’s got one too.’

‘A broken condom?’ Mickey quips back, somewhere between confused and somewhat disgusted at the idea of Debbie actually having sex considering the last time he saw her she was practically an infant.

Okay, like 14, but whatever.

‘A kid.’ Ian rolls his eyes almost fondly and it throws Mickey back ten years, as if they were back underneath the bleachers at the dugouts. It’s easy to forget that literal years have passed between them.

‘Jesus Christ , you Gallaghers have been fuckin’ reproducing like rabbits. There’s enough of you in the world as it is.’ He swallows uncomfortably before continuing, ‘You got a kid hiding somewhere?’

‘Fuck no.’ Ian laughs and something uneven in Mickey’s gut he didn’t even know was there settles pleasantly.

He glances quickly down to Ian’s left hand, no ring.  

Interesting.

No kid, check. No ring, check. Boyfriend?

‘So the entire clan is back in town then?’ Mickey asks in an attempt to distract his thoughts away from Ian and other people.

‘Yeah, we’re all here.’ Ian replies.

‘Fuck, I’m not gonna be able to leave my apartment without bumping into one of you goddamn Gallaghers.’ Mickey jokes, taking a swig of his beer. There’s a beat and Mickey takes a moment to simply enjoy being back in Ian's company. He's missed him so fucking much he feels like he could drown in it, it rolls over him like waves. Over the years he's barely let himself admit it - he's always gotta be the cool and unbothered one, never the one to harp on the past. He doesn't think he's even mentioned Ian to anyone except Mandy since moving to New York, his name always painful and heavy whenever he does rarely come up. Neither one of them mention the Gallaghers or Chicago really, for that matter. They both silently agreed to leave it behind them.

‘Come to the wedding.’ Ian blurts out. It slams Mickey right back into reality harshly and he almost falls out of his seat, his beer spilling everywhere. Ian looks at him uncomfortably, painstakingly waiting for a response. Neither man moves to grab a napkin.

Is he about to vomit? Are they both about to vomit?

‘What?’ He mutters, Mickey must’ve heard him wrong cause there’s no fuckin’ chance he just asked him to-

‘Come with me to the wedding.’ Ian breathes, offering a hand out on the table. ‘I can have a plus one, I mean it’s Fiona.’ He shrugs self consciously.

Mickey can’t actually believe the words coming out of Ian’s mouth right now. He just told Mickey that he’s on his meds right now, his mania should be under control, did he fucking lie?

He must be on crack, he’s drunk, he’s high out of his fucking mind. That’s the only explanation.

‘Are you-’ Mickey starts, but Ian stops him with a protesting hand. Mickey swallows hard, what the fuck is going on?, ‘Are you out of your mind?’

‘Hear me out, I know it sounds fuckin’ insane.’ He levels, his eyes pleading and is face so fucking earnest and open.

‘Yeah, it fucking does.’ Mickey says incredulously, really hoping that Ian his catching his clear message of what the FUCK.  

‘It’s been years, Mick.’ Ian presses, ‘I’m sure everyone would be surprised- love to see you.’ He corrects himself.

Mickey literally has to hold himself back from laughing in Ian’s face, he barely succeeds and he knows his face must be a picture of absolute surprise. He takes a moment and regroups himself, all the humour gone. He knows why they'd be surprised to see him.

‘Years because I was in fuckin’ prison and none of those bastards came to see me.’ He bites, and Ian looks like he’s been slapped.

‘Mickey…’

‘Your family fuckin’ hated me.’ He states plainly, and it’s true, he knows they weren’t his number one fans. In their defence, Mickey found them fucking annoying too. ‘I ain’t wasting my time in a place where I ain’t wanted.’

‘That’s a lie!’ Ian protests, ‘Carl has always liked you, Debbie too, I know Lip can be a dick- and Liam you have to see Liam-’

‘You’re crazy.’ Mickey mutters in disbelief, but Ian holds up a hand in protest. The idea of being thrown back into that... It makes him feel sick.

‘I want you there.’ Ian admits, and it hangs there heavily as he tries to gage Mickey’s reaction. Mickey’s heart pounds inside his chest and he feels like he might vomit on the table between them. ‘I just want to spend some time with you Mick, it’s been…’

‘I want you there.’ Ian repeats, holding his uncomfortable gaze and Mickey really thinks he’s going to vomit this time.

‘You don’t owe me anything, Gallagher.’ He bites back stiffly, attempting to swallow down the lump that’s building slowly in his throat. His hands start to slightly shake and he wraps them around his empty glass to steady them. Ian’s eyes catch onto the quick movement. ‘And I sure as hell don’t owe nothin’ to you.’

This is too much, this is all too much.

‘I want you there.’ Ian says for a third time, his fingers coming to rest hesitantly on top of Mickey’s hands and Mickey surprises himself by not instantly pulling away. The touch blazes like fire, sending sparks through his hand and up his arm.

‘Heard you the fuckin’ first time.’ Mickey mutters, ‘Like a goddamn broken record.’

His gaze shifts down and fixes on their point of contact. Ian’s slim fingers lightly tracing the dark angry ink on his knuckles. He can feel his resolve chipping away, years and years of shutting everything out comes falling to the floor, like his heart is a fucking piñata. He always found it difficult to say no to Ian, even when he was a closeted asshole kid it didn’t come as easy as it must’ve seemed. Even in the most terrifying moment of his life, when Ian asked him to put everything on the line and jump quite literally headfirst out of the closet, he couldn’t say no.

‘Mickey.’

‘I, I just don’t know, okay?’ He pulls his hand away and pinches the bridge of his nose. He really should fucking run, go back to his apartment and book a flight to somewhere fucking far away. His breath hitches. ‘It’s been nine fuckin’ years, I can’t just…’

‘I know.’ Ian breathes, ‘and that’s why I want you there.’ Mickey looks up at him and his eyes are sad, his eyes are so so beautifully sad. ‘Please give me the chance to make it up to you.’

The brick fortress around his heart crumbles around him and comes tumbling to the floor.

‘When is it?’ He sighs, exasperated, and Ian’s eyes light up in disbelief, like he’s just handed the guy a million bucks.

‘Tuesday.’ Ian answers, grinning that same fucking smile. His fist bumps the air playfully, and Mickey’s heart clenches because he looks so young.

‘Tuesday? Tuesday like two days from now?’ Mickey says, scowling and he cannot actually believe he is buying into this shit. ‘You are giving me two days to prepare to see your fuckin’ family? I’m gonna need at least another five years.’ And he’s being 100% serious.

Ian laughs and something warm in Mickey stirs. He doesn’t know what to do with it.

‘It’s gonna be fine.’ Ian says, ‘once they get over the shock of seeing you again.’ He takes a swig of his piss beer and grins at Mickey from over the bottle.

‘Fuck off.’ Mickey says, but there’s zero bite behind it. It's casual and warm, like the old days. He flips him off, ‘I’m gonna get so fucking drunk.’

‘What else is there to do at a wedding?’ Ian says breathlessly, ‘You’re gonna get to meet all the kids!’

‘Whoop di fuckin’ do.’ Mickey sing-songs unenthusiastically, raising his eyebrows at the other man. ‘You’re supposed to be sellin’ this shit to me Gallagher, not makin’ me want to run for the hills.’

Ian laughs, throwing his head back which exposes his pale neck and Mickey gulps. The amount of kisses he has pressed into that very skin, he knows the exact point that drives Ian crazy. They used to spend hours just going at it, Mickey going to town on his neck, licking and biting. His hand comes down to shift himself uncomfortably in his pants as his crotch responds like an inexperienced teenage boy. He can’t fucking believe this is happening.

‘Fiona won’t mind?’ He asks, trying unsuccessfully to shift his focus away from the blood stirring in his groin. Thinking about Fiona Gallagher should definitely make him go soft. It works.

‘Nah’ Ian dismisses easily, ‘I’ll tell her beforehand, so there are no surprises.’

‘Good.’ Mickey finds himself saying, the last thing he wants to be is an unwanted surprise - much like the ones the Gallaghers have apparently been racking up. They find themselves, for the first time since they bumped into each other earlier, in a comfortable silence which neither one of them know what to do with.

‘I’ve missed you.’ Ian admits again, just as Mickey is about to open his mouth to say how he should go get more beer. He tenses, pressing his back into the booth. ‘I- I know I don’t get to say that.’

‘You don’t.’ Mickey mutters, his fingers reaching down to trace the seam of the booth’s fabric. Ian winces, but nods sadly.

‘I’m sorry.’ Ian whispers, ‘I-’

‘Ian.’ Mickey says firmly, and he takes a deep breath, he feels like he’s on the edge of a cliffside about to jump, ‘I’ve missed you too.’

They hold each other’s gaze. Now that’s out in the open. It’s heavy, daunting and too much to handle. His breath hitches and he feels like he could scream. Or cry. Or both.

‘I should go.’ Mickey says, cutting off their eye contact by moving to shift out from their table. Ian’s shoulders drop down.

‘Yeah.’ He says, bringing his hands down to wipe his palms on his thighs.

Is that disappointment Mickey can sense in his voice? Is Ian allowed to be disappointed?

Ian pulls himself out of his seat to meet Mickey standing, making them much closer now than they had been with the table between them. Without that safety distance, Mickey can smell his cologne, it’s not too strong and smells delicious. Mickey wants to bury his face into it.

Fuck.

‘Thanks.’ Ian says, awkwardly bringing up an unsure hand before deciding to place it on Mickey’s shoulder.

‘Yeah, whatever.’ Mickey says as he shakes it off, unable to deal with the closeness right now. ‘Text me the wedding details, if you still want me there.’ He waves his hand dismissively, unable to look Ian in the eye. His throat constricts at the thought of Ian changing his mind on him, again , and Mickey needs to get out of there before he really does scream.

‘Yeah, Mick.’ Ian breathes, ‘I do.’

Mickey nods, and steps backwards, ‘I’ll see you then, I guess.’ He says awkwardly, turning away quickly before Ian can respond. He walks straight out of the bar, onto the sidewalk and right around the block before he doubles over, attempting to get his wrecked breathing under control. He feels like he just ran a marathon or hiked up fucking Everest.

His breath comes out in shaky stutters, his chest hurts. He just wants to go to sleep, or drink, or find some twink to fuck. Anything to get his fucking mind off of the last hour’s conversation. He spits onto the sidewalk then leans his full weight against the brick wall as he pulls out a cigarette and lights it.

A shaky hand brings it to his lips, and he breathes it in.

#shameless #gallavich #ian gallagher #mickey milkovich #gallavich fic #shameless fic

[braindamageforbeginners]

Intent/The First 120 Hours

Cycle 8, Day 11

Everyone always wants to know what chemo (technically maintenance chemo) is like, and I try to give an accurate portrayal, However, the truth is, even with the lighter touch and my new Hunter S. Thompson drug-fueled lifestyle (actually, after reading “Gonzo Girl,” even at my most heavily-medicated, I’m not in the same league), you’ll feel physically and mentally funky (and there’s always that nasty injection site pain from the Marizomib). The good news is, with Marizomib, fatigue is the most-noted downside (I wrote about that previously, but fatigue, I’ve learned, isn’t really exhaustion, it’s when consciousness is painful), so I usually get a full night’s sleep. Thanks to a quasi-legal medical substance, the chemo hangover is cut down significantly, and you wake up feeling, almost too good. So, yeah, in my false sense of recovery, I did push myself a little too hard and sprain something in the bad leg, so I'm spending today on the couch, thanks to that nasty rubbery leg of mine. I try to keep active and fit, but it isn't always a reasonable goal. So, today; rest; tomorrow, more-achievable goals, like going up and down stairs without a deathgrip on the rail.

Anyway, the point of this writing project is to provide some sort of useful data in an easily-digested form, so I thought I’d give a few pointers on surviving the first 120 hours after a terminal (we'll discuss it) cancer diagnosis (with the warning that it’s from my perspective, but what works for me may well be fatal for you; use your own judgment). I’m not talking about self-care or organizing your prescriptions - that’s later in the process. I’m going to tell you what I wish I’d known to survive the first four or five days after the diagnosis (non-medically). This is about how to subtly shift your thinking from "I'm gonna die" to "I'm going to scream into the gates of the Underworld like I own that fucker," which, based on personal experience, might be the necessary attitude to putting off that particular scenario.

1. Do what you need to do, emotionally. One of the shittier things able-bodied people do to new cancer patients is tell them to buck up, or be positive. Folks, if this goes South, I will experience cachexia. Most survivors are sterilized and have long-term health issues related to treatment. You wouldn’t tell someone who’s about to march into the jaws of hell to smile, especially if they’ve just had a seizure or are in pain. If you have to drink a bottle of whisky and drunkenly call an ex, now’s the time, you might not get it later. I think I spent a day dry heaving and lying in bed before I really came to my senses. Do what you have to, but do it quickly because you are now on the clock.

2. Find appropriate help. Just as not all cancers are created  equal, not all doctors are created equal. Again, according to Briish stastics, “medical misadvenure” is the third leading cause of death. Having said that, even though I insist on the very best for my glioblastoma, that’s because there isn’t much of a middle ground between “survivor” and “dead” with that. If I get lung cancer or colon cancer, I may not be quite as picky. I’ve talked previously about finding good oncologists, and, as recently noted, they’re usually not motivated by money. And be creative in where you get information; two friends from the Mesozoic contacted me to ask for help with their parents who have glioblastoma. It seemed odd to me that I’d be asked about, especially since one of these friends is a practicing physician. I try to give everyone accurate, well-researched advice, and I hope I did then, but it still feels like there’s somehing wrong in the universe when I’m somewhat knowledgeable about how to handle a crisis. We’ll ignore the self-contained, Zen koan-like irony of that statement in a guide to what to do.

3. Find new friends/join a support group. I don’t know if it’s just brain cancer patients - I don't know if it's just brain cancer patients or all cancer patients, but your previous support group (or key members of it) will be conspicuous in their absence. In my case (and another person I've read of), I heard back from a bunch of random people I literally hadn't heard from in decades (in a few cases). I get an awful lot of passing privilege, but, so far, any time I've dropped the "C" word - it's immediately changed the nature of our interactions. So far, overwhelmingly, people have been kind, or positive, which is great, but it does get grating after a while that any time the phrase "and what do you do?" comes around, there's a stilted shift. You know who absolutely could not give less of a shit about your new medical label (unless you're having a seizure)? Other cancer survivors and patients.  And - bonus - they'll actually be able to give you far more accurate and up-to-date info on your disease and/or financial or social resources that might now be at your disposal than I know about. I'm indebted to my old friends from the Mesozoic who showed up to cheer me on in my hour of need (extra kudos to Laura and Julie), but I owe an unrepayable number of favors to the Leukemia Kids (okay, that's the Young Cancer Support Group, but most cancer patients under 40 are lymphoma or leukemia patients/survivors, hence my name)(sorry if you guys don't like it, I'll think of a better one ASAP) who helped me get past that (sort of, I still need all the help I can get). I did not do that, but, in retrospect, it was a massive mistake I didn’t.

4. Prepare for drama - your life is about to become a bad Lifetime Television Special, and it does affect different people in different ways - I know one brain cancer survivor whose husband left her  - and you’re going to be doing this while experiencing an amount of fear you’d previously been unable to imagine; the full 31 flavors.  You will be - initially - completely overwhelmed by terror. I'd recommend seeing a shrink (I do); all the prescription pads will come out for this one. The bad news is, even if you beat this thing, you don't ever really get over it. I've talked to late-stage breast cancer survivors who say the same thing; even after years of clean scans, the anxiety and fear never fully leaves (it certainly hasn't for me, though, but I'm not even a year out of a five-year deal).

5. know the difference between terminal, incurable, chronic and fatal. I remember which step on the stairway I was on - the third or fourth - when Mad Scientist told me those six words, over the phone (I was traveling at the time), "I'm so sorry, it's stage IV." The world swung, because I suddenly knew not only that I would die soon, but exactly how (that's a really horrifying thing to consider, I wrote one of my fist essays - posted around here, somewhere - to try and capture that sensation). Fatal diseases are like a car crash - they'll kill you. Terminal illnesses are defined by Wikipedia (and I like their definition, since the traditional definition has involved how, subjectively, soon/quick the disease is likely to kill you) as, "an incurable disease that cannot be adequately treated and is reasonably expected to result in the death of the patient." You'll note a lot of weasel words in there that make this nice, elastic definition my favorite, but the phrase I like to hang on is, "adequately treated." Chronic diseases are the ones that last three or more months (or something like that; I did take an intro pathophysiology class that involved knowing the instructor's definition of "acute" and "chronic"). Chronic cancers - like mine and a lot of recurrent leukemias - are ones that require five consecutive years without metastasis or recurrence before you're declared "cured." It's telling of the quality of my medical team that, as far as I know, none of them have ever said the words "fatal" or "terminal" in my presence.  Instead, I've been given a series of treatments that really suck (check this blog for any examples you'd like), but, I'd so far rate as "adequate" in that they've kept the disease at bay (for those of you working out, step-by-step along with me how to save yourself or a loved one, that statistic is progression-free survival. I'd imagine, based on how a new immunotherapy has gotten to round 3 just in the nine months I've been in treatment (technically, treatment ended back in February, I'm in "maintenance chemotherapy," but since I have to be in the infusion center every Tuesday, and I have to remain wary of potential problems/side-effects/etc. it's just easier to think of myself as still being in chemo). And most cancers are, technically, incurable. We might have a definitive treatment of some sort, but since it's ultimately caused by damaged DNA, and we can't repair or zap every single rogue cell in your body, most are just genetic time bombs. And, since I've survived the first tumor, a lot of medicine seems to have swung back to reclassify a lot of very treatable (but not curable, apparantly) as either chronic or having that potential. I like to use the idea/metaphor I saw another science writer use; it's like heart disease or diabetes; it'll take a lifetime of management and monitoring,  but it may not, necessarily kill you. In other words, you've received a helluva strong first blow, but, even with the gravest prognosis, you might be around for a longer struggle (and time) than you'd thought.

6. Use statistics as guidelines, not rules. This was a big one for me. And it doesn't mean you shouldn't use statistics, or automatically dispute them, but realizing the GBM median life expectancy included both 20-year-olds and 90-year-olds who dropped dead of heart attack and people who refused (or were not candidates) for other treatment. Again, there's a lot of luck involved in this, at every single point, but you can - mentally and physically - prepare for pain, or  hardship, or potential heart problems (and react and treat such things). You can't really prepare for cancer recurring or metastasizing, apart from writing your own eulogy (which, come to it, I suppose this is a part of).

7. Decide right now if you want to live or go gentle into that good night - This is far, far more important than you might think, because both the medical industrial complex, your disease, and the basic, horrible logistics of this situation are going to be beyond exhausting. There's a lot of luck here, but, from minute 1, I have had one thing going for me:  complete, near-psychotic commitment to actually staying alive.  And that's what it'll take (sadly, in more than a few cases, much, much more will be required).  You're going to have to charm, cheer, cajole, finagle, and, in some cases, con people like there won't be any consequences, because, if you're unsuccessful, there won't be. And this will give you the required attitude to deal with some of the higher-ups you'll meet in medicine (and scream at them, if necessary).  Again, full honors to all my various clinicians and support staff over the years who have never made me feel trapped or impotent by my immediate sitaution, but, at the same time, if any of the sort of arrogance and contempt I've heard of from other folks (including doctors) was actually warranted on behalf of modern science and medicine, there would be no fatal diseases. Again, I'll happily write glowing testimony on behalf of the people treating me, but I've met too many patients who feel like refusing treatment because they're too dejected or frightened to go on, and their doctors or insurance are still charging them (why that's still allowed is largely due to the fact that modern medical insurance is an entirely artificial industry created to meet no demand, and enabled by Richard Nixon and Edgar Kaiser)(again, I'm making none of that up). I'd urge everyone to get up, remember that dead men, women, transgender, non-binary, (and anyone I'm forgetting), do not pay bills; hopefully that'll give you the sort of needed psychological boost to get off your butt and demand more. It's not a sustainable life strategy, but until the end of your illness is in sight, Malcolm X's statement, "By any means necessary" should be your mantra.

8. Don’t lose hope - Believe me, it seems weird for me to write it, and it might very well be warranted in more than a few cases, but I did ask myself, once, why I'd be on the phone the next morning ordering and organizing my prescriptions (orchestrating what substances should be in me on which day is now a more daunting logistics task than the D-Day landings), instead of just sitting quietly in a comfy chair until it was all over (that's still always a temptation), and all I can say is, I guess it was enough to motivate me through another day. And another. And another. And, in the meantime, another treatment has made it to trials, for, wait for it, recurrent GBM (which is what I'll have if the Warlocks miscalculate using the lunar calendar)(no longer a joke; each treatment period is 28 days). I'm not gonna lie, it's gonna get miserable, and not all of us will make it (Hell, measles has a death rate, which, there,  that sensation of realizing measles can be fatal, is what a TIA feels like).

9. Mourn your old life, don’t waste time trying to get it back. I made that mistake between Tumor #1 and 2. I'm not making it again. I realize I can only write for myself, which was the horrifying realization that came to define my existence - no one, as far as I can tell, has written a decent, current, useable guide to avoiding the reaper when your number's up. So I guess I'm going to have to stay alive long enough to do that. Also, I don't know if anyone out there's outlived their own life expectancy, but I've already done it twice, and there is no more amazing sensation - no matter what else your life looks like.