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#maybe someone will correct me on that but
scientia-rex · 1 day
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Saw a patient today who had been through a series of medical visits that epitomizes what I hate about multiple different kinds of care providers. Their VA dermatologist took a scoop out of them to remove a basal cell cancer. Fine. I’m not a dermatologist, maybe it needed those wide margins. (If it didn’t, going that deep should mean it was an excisional biopsy and they put in sutures to close it.) They gave the patient and his wife confusing instructions about wound care. They didn’t provide guidance around keeping it covered or moist. It got infected. His wife took him to Urgent Care. The UC doc took a swab of the wound and started antibiotics. They came to see me for a visit we scheduled ages ago for something else.
Here’s the thing. Wounds need to be kept at what I call the Goldilocks moisture level: not too dry and not too wet. If it’s pruny/white/mushy like it’s been in a bathtub, it’s too wet. If it’s cracking, it’s too dry. This is why you can’t say “cover it for X days and then leave it out.” That would be like telling someone with heart failure and lower extremity edema “take the diuretic for a week and then stop” without any instructions around dry weight, dizziness, etc. It’s more complicated than that.
This wound was too dry. No one had talked to them about keeping it moist. No one had even mentioned Vaseline.
No, they got a wound swab. Want to guess how good a wound swab is for an open wound exposed to the world? Pretty terrible. You can improve it a little bit by making sure you’ve removed some kind of layer and then expressing fluid directly from the wound with the swab, but it’s still bad. The only time I give a shit about what grows from a wound swab is when it was a) collected in the OR (as when the podiatrist gets a sample of osteomyelitic bone in a sterile environment) or b) when it grows pseudomonas. Everything else? I can figure out by looking at it. If it’s skin it’s probably either staph or strep. If it’s staph, it’s either MRSA or MSSA. If it’s MRSA, it’s making a lot of pus, it’s red, it’s hot, it’s painful. This wasn’t. So it was either MSSA or strep. So what are we going to do for systemic antibiotics? Probably the same thing we would have done anyway—Keflex.
And what’s the utility of systemic antibiotics in a skin wound? Not a lot, most of the time. This wasn’t cellulitis proper. It wasn’t red or hot or angry enough. A red border around the wound does not a systemic infection make. And if you don’t care properly for the wound itself, there’s no point in antibiotics, because it still can’t heal. Antibiotics can get where blood goes. Blood does not go into the slough that is the bacterial biofilm covering a wound.
So I sat there with gauze and saline and gently debrided the 100% slough off the wound. It’s yucky and it takes time and attention. It doesn’t get compensated. That’s why no one else had done it yet. The derm had blown it off as “it’s healing, it’s fine.” It wasn’t healing. It was developing rolled edges, where the wound edges couldn’t heal across the slough and so they started to curl back under themselves. If taking off the slough (and keeping it gone by MAINTAINING PROPER CONDITIONS) doesn’t let it heal, I’ll need to get him back in and rough up the edges with a Buck’s curette until it can heal.
Multiple professionals who should have known better tried to make my patient just go away, rather than heal him.
I’m pissed. I’m tired. I think I have a cold. I shouldn’t be doing the work the dermatologist or the UC provider should have done. And because of everything they’d told her, his wife was pissed at me for doing what was correct. “We’ve heard a lot of different things!” Yes, and I’m right. You’ll find out when the wound actually starts healing when we care for it properly.
The value of a model is in what it can predict. Wounds are great about making it clear when your model sucks.
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nattblacklupin · 2 days
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Blood and Ice
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Pairing: Hockey player! Cassian x Fem! Reader
Warnings: fluff and smut (so mdni 18+), possessive Cassian, Cassian fights someone, people flirting with Cassian, p in v, little bit of overstimulation, praise kink, dirty talk
Summary: headcanons about dating hockey player! Cassian
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Cassian totally gives off offence vibes, not scared to get into fights (most of the time, it's him who provokes his opponents until they give in). It was quite the opposite. He loves getting into fights.
He made a reputation of someone you don't wanna meet on the ice, and totally not have a fight with him.
After every fight, he looked your way and waved at you, making everyone jealous cause how you managed to get Cassian, who was known for his playboy personality.
Sitting in the family section as close to the ice as you could be would be a dream come true for many people. But for you, it was truly a nightmare right now. Your boyfriend was on the ice having a fight with some other buff player from the other team. They were shit-talking each other even before the game started, the tension getting higher as the other player kept crosschecking and hitting players on Cassian's team. With bated breath, you watch them circle around each other, occasionally throwing punches that did little to no damage - when suddenly Cassian took his jersey in his hand and threw him on the ground. Fans got notably louder, and you let out the breath you didn't even know you were holding. Cassian turned to you while leaving the ice and sent you a kiss.
Don't even think about going to any of his matches without a jersey with his name on it. Not just that, it made him especially horny - but it gave him an incredible boost of energy.
He always called you his lucky charm. That's why you had to go with him on every game. He strongly believed he would lose without his favourite girl there.
"Cassian baby, you know I have to do things for work. I will come on the next game, " you said with head buried in his chest, nearly suffocating because of his muscled breast.
"Nono, this is the most important game of the season, plus I already said that I can financially take care of both of us" his lips leaving butterfly kisses on your neck, slowly breaking you and bending you to his will.
"So will you go with me, please?" Seeing his puppy eyes, you just left out a sign and went into your shared bedroom to take out his jersey.
Sometimes, other players would use you to rill up Cassian. Most of the time, it was winking at you or even throwing their own jersey at you with words that it would be prettier on you than Cassian's.
Cassian has a ritual routine after every game in the playoffs. It includes you, him, and an empty locker room. By now, his whole team knows to get away as fast as possible and to not be in the locker room alone with you two. It still didn't save him from teasing coming out of Azriel and Rhysand, but he didn't care that much. Not with you on his cock.
"Faster, come on show me what you got princess" Bouncing you up and down on his cock while he laid on beachers they had there. "I-I can't it's too much Cass," your whole body was sore after the third orgasm he gave you in thirty minutes. "One more, I will cream your pussy. Fill you up for good, never going to let you go. " his fingers found your pearl playing with it, making you moan his name. "That's how I like it, good job, love." He was kissing your neck in a gentle yet rough way. Marking you up so everyone knew to whom you belonged. "I-Im close," Cassian's thursts became sloppy and faster as he himself was close. "Come with me, baby."
Everybody by now knows that you two are a thing, and sometimes fans even come to take photos with you as if you were Cassian himself.
Situations like these always make you smile, especially when little kids come to you saying how they wish to be like your husband (you couldn't make yourself correct them - maybe cause you too wish it was true).
That brings on the spotlight Cassian propose plan. Poor baby planned it for nearly half a year before he even was somehow satisfied, forcing Rhysand and Azriel to do a presentation about what was good on his plan and motivation that you won't say no to him.
That finally calmed Cassian down, and he could put his plan in motion. The first step was to win the Prythian league.
You rushed on the ice to hug Cassian. Incredibly happy and proud of him and his team for winning the playoffs and becoming the best team in the history of the Prythian League. "You did it!" You couldn't contain your happiness screaming into Cassian ear while hugging him. He was spinning you in his arms with an iron grip on your waist. "I wouldn't do it without you, babe." He kissed you roughly on the lips before going down in front of you. Tears welled up in your eyes, already knowing where this is going. "Y/N L/N, will you marry me?" You started jumping up and down while nearly slipping on the eyes."Yes! One hundred times, yes!" Both of you now crying tears of pure joy while everyone cheered for you and Cassian.
"I promise to buy you chicken nuggets every day from now"
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hbmmaster · 9 hours
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Correct me if I'm wrong, but "Twitch chat" is akin to "Swedish Person", adjective noun, maybe adjective proper noun, in what case would someone assume chat is a pronoun?
someone would assume chat is a pronoun if they don't know how people use "chat", what a pronoun is, or both
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its-avalon-08 · 12 hours
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hearts intertwined (hamilton x sister! driver!rosberg) p9
chapter 9: don't let your guard down
warnings - none at all
series masterlist
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As the warmth of the coffee spread through them, so did the conversation. They delved back into their childhood, sharing forgotten memories with easy laughter. Lewis spoke of his surprise and (secretly) delight when Y/N began showing up at his and Nico's racing practice sessions, her bright personality a welcome change to their competitive intensity.
Y/N, in turn, confessed her childhood crush on him, a secret she'd harbored for years. "I used to sneak peeks at you during races," she admitted with a blush, "just waiting around with cold bottles of water and hoping you'd notice me cheering you on from the stands."
Lewis chuckled, a genuine smile warming his features. "Believe me, I noticed." He felt a warm feeling bloom in his chest
The conversation grew more serious as they touched upon the rift between Lewis and Nico. Y/N listened intently as Lewis spoke of the crushing pressure to win, the constant need to prove himself. "It's frightening. I turned into a totally different person and I wasn't able to recognize myself after everything with-with.. Nico," Lewis's voice broke towards the end truly giving away how hurt he was. He admitted his fear of commitment, not just on the track but in his personal life.
"Dating is… complicated," Lewis confessed, running a hand through his hair. "There's never enough time, and the fear of failing… it spills over into everything. I am not able to enjoy the simple things like movie nights because I'm always checking my phone to see if Toto sent me something. I forget anniversaries because I'm occupied with all the other overwhelming things."
Y/N nodded in understanding. "I totally get it," she said softly. "I had a serious relationship a few years ago with this guy called Aaron. We were together for a year but it crashed and burned because of his.. inability to stay away from his ex's bed. We just weren't right for each other. I wanted my career and he wanted someone who stayed at home and didn't travel as much. I just could never be that person for him."
A shadow crossed Lewis's face. "I'm so sorry to hear that."
"It's okay," Y/N forced a smile. "I learned a lot from it, mostly that I deserve someone who can be honest and true."
Suddenly, a playful glint returned to her eyes. "Speaking of which, I'm actually seeing someone casually right now. It keeps the pressure off from being permanently held to someone and just allows me to have a fun time. Just to keep things interesting, you know?"
Lewis's smile faltered, a flicker of something akin to jealousy crossing his features. He quickly masked it, but Y/N caught the shift in his demeanor.
"Oh," he said, his voice a touch colder. "That's… nice. yeah, that's good."
The conversation stalled, a heavy silence settling between them. Y/N's phone buzzed insistently in her pocket. Glancing at the screen, she saw it was her brother calling. Her face paled considering she had just spent over an hour talking to Nico's rival.
"Well," she said, standing up. "This has been… nice. Unexpected, but nice. I should probably get going."
Lewis rose as well, a strange mixture of emotions swirling within him. "Yeah, of course. See you around, Y/N."
"Yeah," she echoed, feeling the awkwardness return. "Bye, Lew- Lewis." She corrected herself from muttering his nickname. Lewis noticed and he felt his heart freeze.
With a mumbled goodbye, Y/N exited the apartment, leaving Lewis alone with the lingering scent of her vanilla perfume and a tangled web of emotions. He watched her disappear down the hallway, a strange ache settling in his chest. He hadn't expected her to be seeing someone, and the realization stung more than he cared to admit.
Lewis sank back into the chair, the worn leather a stark reminder of a simpler time. Maybe, just maybe, there was a chance to rebuild the bridges that had been burned. But first, he had to confront his own fears, both on and off the track. As the afternoon sun streamed through the window, Lewis knew his journey to redemption had just begun.
credits for gif - @lewishamiltongifs
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taglist: @laura-naruto-fan1998 , @xoscar03 , @torossosebs , @jajouska , @lindsayjoy444 , @barcelonaloverf1life
🏎️🏎️🏎️🏎️🏎️🏎️🏎️🏎️🏎️🏎️🏎️🏎️🏎️🏎️🏎️🏎️🏎️🏎️🏎️🏎️🏎️🏎️
leave a like! leave a comment! reblogs are appreciated!
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elgatt0 · 18 hours
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The day was stressful, but drawing this boy was therapy.
Hope you don't mind me making this xd
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Also low on detail because it's 3 a.m and I still have homework xd (and maybe even not that correct (sorry))
But WOW it surprised the level of detail you put in this, you're a master in details!!!
Your references were P E R F E C T. They really helped a lot!!
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This was my favourite part of the drawing. Specially his hair and eyes. (tried to give his hair the effect of being underwater)
And it was REALLY fun defying all that I know about anatomy and mixing it with a lobster!!!
I see why you love drawing the boys as mermen!!
And remember about the "creepy" eyes?
I did this too!!
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(yes it is a latam joke (sorry xd)) But I can's stop imaging him like in those cartoons were someone gets too surprised that their eyes jump off of the eye sockets.
Thank you for creating these designs. I love them!!!
OMGGGGGGGGGGGGGGGGGGG
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Many thanks ;v;
AAAAAAAAAAAAAAAAAAAAAAH
I LOVE IT
HE IS PERFECT!!!!!!!
if you think Wind is super detailed, it's because you haven't seen Wilds design yet *screams in despair*
I hope your day is getting better now, because after this wonderful art mine definitely got better 💕💕💕💕💕
@indigoartistqueen LOOOK!!!
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Tsc spoilers (CW: SA)
I saw many people talking about how Riko made Ravens SA Jean to punish him for being gay (bi, actually) or to create a bad association with men in general because "is easier to be straight". But they forget that those weren't Riko's words.
Riko is a twisted individual, that's what we know for a fact. He was a sadist and enjoy taking his rage on Kevin and Jean and having them under control.
But he was also the same man that spat in Neil's mouth and made him swallow it. The same man that keeps Kevin's room as a museum and practically only interacts with other men in all 3 books (excluding some exceptions you can count with one hand).
Jean said that Riko needed someone (5 people) to "help him break in" Jean and you can analyse those words how you want but it's a very interesting wording if you ask me. Not to mention that Jean doesn't wanna talk about Riko or the extent of his abuse.
That man was a monster, but he wasn't moved by homophobia, maybe by some weird amount of repressed homosexuality, but he didn't suggest this "punishments" to "correct" Jean, just to make him submit more.
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lolliepops-rox · 7 months
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This is my petition for people who create pins/stickers/other things with "she/they" & "he/they" to also include "she/he". I'm kind of sick of being excluded, and I'm sure there are plenty of others who feel the same.
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canisalbus · 5 months
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Hi!! I don't know if anyone has drawn this before (sorry if they have!! I couldn't find any evidence of it) but I have recently been plagued with the question of "what if Machete and Vasco were in Bluey?"
Well. Now we know.
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To my knowledge, the only Bluey dogs who wear clothes are the ones in uniforms. TECHNICALLY Machete's outfit could count, but I left it out because it's not typical of a main character. He must be naked 😔
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#oh GEEZ they're so cute uaugh#no you're the first to make this crossover!#once someone told me that my dogs and Bluey could exist in the same universe#and even though I'm getting my Bluey lore from second hand sources I think that might be correct and feasible#so you know#take that and eat it with your breakfast#it's great how it's almost justified to let Machete keep his outfit but in the end he must be naked 😔#while everyone is on board with Vasco wearing only a smile#like yeah that tracks he doesn't seem to mind#I like how you managed to translate Vasco's gradients to a form that works with the art style#including the lighter chest/abdomen#also maybe this is an odd thing to say but I suddenly realized how monochrome they are#like their designs have very little contrast and are essentially just different hues of a same color#weird moment to notice that#thank you! this was so sweet#they're adorable#gift art#stafell#own characters#Machete#Vasco#I had sort of a rough day so this cheered me up a lot#cw needles#I had to go get blood tests done and this specific lab person had been really heavyhanded with me before so I asked her to be gentle#and she jabbed the needle into a nerve and I full on screamed in pain and sweated and shook and passed out for a couple of seconds#worst medical experience this far I never knew routine stuff like that could potentially hurt so immensely#I've never been scared of needles before and that has been sort of a point of pride for me#like at least I can do this one unpleasant thing effortlessly#but now I'm just terrified of that happening again#been feeling really weird/exhausted/nauseous all day and the arm still feels weak and tingly so I'm going to bed early tonight
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Idk I just think it’s so interesting how Hickey uses names and titles as a tool to manipulate the people around him (especially the mutineers). Calling Tozer “sergeant” when he’s first convincing him to mutiny, to play into his desire to follow his rank and protect. Switching to “Solomon” when he’s trying to get Tozer to open up more about the Tuunbaq. Intentionally not calling Jopson “Lieutenant” after his promotion as a subtle dig. How often he says Billy’s name, especially during the ring scene and when Billy’s entertaining the idea of a mutiny before the walk out (“speak your mind, Billy”). Smugly directing his story about kidnapping Silna to “Captain Crozier” and only Captain Crozier, then after kidnapping him only referring to him as “Mr. Crozier” and making the mutineers do the same (but Hodgson, who’s not loyal but is at least complacent to Hickey, stays “Lieutenant Hodgson”). Calling Tommy, who’s always Tommy or Mr. Armitage, “Private Armitage” when he’s ordering him to brutalize Crozier, because Hickey knows he’s always wanted to be a marine, so in his camp he’s given him the rank of one. It adds an such an interesting layer to Hickey’s “reconfigure, reinvent, rearrange” speech.
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okkalo · 1 month
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best big brother ever.
rindou x reader
genre(s): fluff, crack
hi, this is a tiktok trend for anyone wondering
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“if you wanna get to him, you gotta get through me first,” your possessive and bold words immediately drew rindou’s attention towards you. his lilac eyes narrowed as he confusingly tried to make sense of the situation.
rindou had been minding his own business on the couch, listening to some songs out loud. when you had come over to sit next to him, which was just a second ago, he paid it no mind. but, now you were threatening your phone camera?
as if he wasn’t already in a confused state, you turned to face him with that mischievous smile he’s come to dread. then, your hand clawed around his chin, pulling him closer to smash your lips against his.
now he was in complete shock.
before he could even comprehend what the hell was happening, you pulled away just as swiftly as you came and turned back to your phone.
“best brother ever,” you enunciated, a proud smile adorning your lips. rindou’s heart stopped. his hand immediately flew to snatch your recording phone away from you, throwing you a disgusted glare at the same time.
“what the hell is wrong with you?” his question made it hard not to just burst out laughing then and there.
“what do you mean, big bro?” you innocently asked, your tone much softer as you tilted your head at him. he hated the way his heart fooled him to feel a pang of guilt at the sight of your obvious act.
“i’m not your big bro!” he hurriedly replies, giving your shoulder a small shove. unlucky for you, he was quick to move his attention back to your phone, obviously about to delete the video.
“rindou, it’s a prank! don’t delete the video!” you hastily beg, moving to try to claim your phone back from his hands.
“i’m not letting you make people think we’re siblings,” he grumbled, practically jumping over the joke and continuing to hold the phone out of your reach. his fingers were quick to delete the video, much to your dismay. his reaction truly would’ve gone viral.
“rin, that’s a whole trend. no one’s gonna believe we’re siblings,” the whine leaves your lips, upset that he deleted something so funny. in his eyes, he couldn’t believe that you were the one pouting. still, he couldn’t help but feel a tinge of guilt.
he huffed, tossing your phone back to you. “don’t care, that was probably the stupidest thing you’ve ever said. i’m saving you face,” he claimed, moving his arm around your shoulders to pull you closer. despite his words, he was obviously trying to make you feel somewhat better.
“geez, rin, i take what back what i said earlier. you’re actually the worst brother ever,” you mirrored his huff with an eye roll, not being able to resist teasing him.
“i’m not your brother!” he immediately replied, pushing you away from him once again. unlucky for him that he’s just so easy to poke fun at.
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urghblergh · 2 months
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"Every man needs a hobby." - by Leonard H. McCoy
inspired by this picture and this picture only
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Here's the full comic.
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It's the McSpirk brainrot, guys. I had to draw some silly old married gays. ✨🌈
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aceredshirt13 · 7 months
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as an American currently living in Japan. can’t stop thinking about modern AU Jeeves and Wooster where Bertie can’t flee from Aunt Agatha to America because she can just fly there and find him so he has to find somewhere even further away, resulting in Bertie and Jeeves taking the most sterotypically white tourist trip to Japan known to man. featuring:
Bertie saying “Konnichiwhat ho, Jeeves!” the second they get off the plane
Bertie getting complaints from the cat cafés because the cats adore him and the other customers are upset that he’s hogging them, leading to a blanket ban from every establishment in Tokyo
Jeeves (who is either inexplicably still Bertie’s valet or is an incredibly dedicated live-in PA) critiquing the technique of everyone working in the butler cafe, leading to a blanket ban from every establishment in Tokyo
karaoke night where Bertie knows all the lyrics to various anime songs but is absolutely not even close on the pronunciation (Jeeves watches him with impassive, amused fondness)
Bingo, for some reason
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moeblob · 1 month
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I am really tired of a situation rn.
#fe three houses#felix hugo fraldarius#me using felix on my angy days because he is my angersona? you bet!#anyway if you want to try to get someones money or something bc you hurt your own car banging into mine#can you try to be a bit more timely with it buddy come on you hit me on feb29 !#why am i getting your insurance company calling me today !#also i would like to point out i didnt do it and neither of us were hurt and i filed a claim with my own insurance comp#and also filed a police report bc he didnt even suggest calling the cops to the scene#so like yeah hey man maybe you and your insurance company can move a lil faster or smth#literally everything that happened the day of is - according to my dad - an intimidation tactic#i look like im 15 and he probably thinks he can take advantage of a new driver but ya know! tough luck!#im just really tired and stressed over multiple things not negative so getting this on top of it was like#bro .................... anyway my phone didnt pick up for some reason so i called back and then nothing got resolved#cause the person who actually called me wasnt around to connect the line to from the guy who answered#idk man just its a lot despite my v minimal energy#got a job interview on monday tho ! and then also next week is an eye exam#and you might be thinking isnt that a good thing to get your eyes checked? you are correct but i am horrified#there are two body parts that give me absolute anxiety and eyes are one of them#and i know my eye sight is declining and im just v anxious#its fine im going to be fine i just have to be anxious about it
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rileylastname · 6 months
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for those of you who don’t have the npmd digital ticket, the ones in High School is Killing Me who do the howls during “I’ve been thrown to the wolves of the community— *awoos!*” bit are Bryce, Jon, and Curt, in that order
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kimeoshi · 19 days
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the way I'd devour a fic of aven and ratio with your buckshot crossover, that thing has EATEN my brain
if anyone writes one 🙏🙏🙏🙏
YES!! I WAS THINKING THE SAME THING
If nobody does it I will do it myself HOWEVER that doesn't mean I wouldn't like any additions heheh
(in that case I MUST be sent a link to that fic before getting admitted to emergency care)
If anyone has the tiniest urge to write too, I implore them to join me!! Even if it's just one particular dialogue or sentiment that comes to mind, one small idea can surge much more once you end up starting it.
I really love this crossover particularly because the game's undertone themes (not saying what due to potential spoilers) deals with the exact same things Aventurine struggles with, oh, the angst potential.
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keymintt · 7 months
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bisexual, but not rly in an "i'm attracted to xyz" way so much as a "whatever the fuck happens, happens" way
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