ME M Es and Fandoms

Hospitals and injury are always such a staple of angst fics, but 9 times out of 10 the author has clearly never been in an emergency situation and the scenes always come off as over-dramatized and completely unbelievable. So here’s a crash course on hospital life and emergencies for people who want authenticity. By someone who spends 85% of her time in a hospital. 

Emergency Departments/Ambulances.

Lights and sirens are usually reserved for the actively dying. Unless the person is receiving CPR, having a prolonged seizure or has an obstructed airway, the ambulance is not going to have lights and sirens blaring. I have, however, seen an ambulance throw their lights on just so they can get back to the station faster once. Fuckers made me late for work.

Defibrillators don’t do that. You know, that. People don’t go flying off the bed when they get shocked. But we do scream “CLEAR!!” before we shock the patient. Makes it fun.

A broken limb, surprisingly, is not a high priority for emergency personnel. Not unless said break is open and displaced enough that blood isn’t reaching a limb. And usually when it’s that bad, the person will have other injuries to go with it.

Visitors are not generally allowed to visit a patient who is unstable. Not even family. It’s far more likely that the family will be stuck outside settling in for a good long wait until they get the bad news or the marginally better news. Unless it’s a child. But if you’re writing dying children in your fics for the angst factor, I question you sir. 

Unstable means ‘not quite actively dying, but getting there’. A broken limb, again, is not unstable. Someone who came off their motorbike at 40mph and threw themselves across the bitumen is. 

CPR is rarely successful if someone needs it outside of hospital. And it is hard fucking work. Unless someone nearby is certified in advanced life support, someone who needs CPR is probably halfway down the golden tunnel moving towards the light. 

Emergency personnel ask questions. A lot of questions. So many fucking questions. They don’t just take their next victim and rush off behind the big white doors into the unknown with just a vague ‘WHAT HAPPENED? SHE HIT HER HEAD?? DON’T WORRY SIR!!!’ They’re going to get the sir and ask him so many questions about what happened that he’s going to go cross eyed. And then he’s going to have to repeat it to the doctor. And then the ICU consultant. And the police probably. 

In a trauma situation (aka multiple injuries (aka car accident, motorbike accident, falling off a cliff, falling off a horse, having a piano land on their head idfk you get the idea)) there are a lot of people involved. A lot. I can’t be fucked to go through them all, but there’s at least four doctors, the paramedics, five or six nurses, radiographers, surgeons, ICU consultants, students, and any other specialities that might be needed (midwives, neonatal transport, critical retrieval teams etc etc etc). There ain’t gonna be room to breathe almost when it comes to keeping someone alive.

Emergency departments are a life of their own so you should probably do a bit of research into what might happen to your character if they present there with some kind of illness or injury before you go ahead and scribble it down.

Wards

Nurses run them. No seriously. The patient will see the doctor for five minutes in their day. The nurse will do the rest. Unless the patient codes.

There is never a defibrillator just sitting nearby if a patient codes. 

And we don’t defibrillate every single code. 

If the code does need a defibrillator, they need CPR.

And ICU. 

They shouldn’t be on a ward. 

There are other people who work there too. Physiotherapists will always see patients who need rehab after breaking a limb. Usually legs, because they need to be shown how to use crutches properly.

Wards are separated depending on what the patient’s needs are. Hospitals aren’t separated into ICU, ER and Ward. It’s usually orthopaedic, cardiac, neuro, paediatric, maternity, neonatal ICU, gen surg, short stay surg, geriatric, palliative…figure out where your patient is gonna be. The care they get is different depending on where they are.

ICU.

A patient is only in ICU if they’re at risk of active dying. I swear to god if I see one more broken limb going into ICU in a fic to rank up the angst factor I’m gonna shit. It doesn’t happen. Stop being lazy. 

Tubed patients can be awake. True story. They can communicate too. Usually by writing, since having a dirty great tube down the windpipe tends to impede ones ability to talk. 

The nursing care is 1:1 on an intubated patient. Awake or not, the nurse is not gonna leave that room. No, not even to give your stricken lover a chance to say goodbye in private. There is no privacy. Honestly, that nurse has probably seen it all before anyway. 

ICU isn’t just reserved for intubated patients either. Major surgeries sometimes go here post-op to get intensive care before they’re stepped down. And by major I mean like, grandpa joe is getting his bladder removed because it’s full of cancer. 

Palliative patients and patients who are terminal will not go to ICU. Not unless they became terminally ill after hitting ICU. Usually those ones are unexpected deaths. Someone suffering from a long, slow, gradually life draining illness will probably go to a general ward for end of life care. They don’t need the kind of intensive care an ICU provides because…well..they’re not going to get it??

Operations.

No one gets rushed to theatre for a broken limb. Please stop. They can wait for several days before they get surgery on it. 

Honestly? No one gets ‘rushed’ to theatre at all. Not unless they are, again, actively dying, and surgery is needed to stop them from actively dying. 

Except emergency caesarians. Them babies will always get priority over old mate with the broken hip. A kid stuck in a birth canal and at risk of death by pelvis is a tad more urgent than a gall stone. And the midwives will run. I’ve never seen anyone run as fast as a midwife with a labouring woman on the bed heading to theatres for an emergency caesar.

Surgery doesn’t take as long as you think it does. Repairing a broken limb? Two hours, maybe three tops. Including time spent in recovery. Burst appendix? Half an hour on the table max, maybe an hour in recovery. Caesarian? Forty minutes or so. Major surgeries (organs like kidneys, liver and heart transplants, and major bowel surgeries) take longer. 

You’re never going to see the theatre nurses. Ever. They’re like their own little community of fabled myth who get to come to work in their sweatpants and only deal with unconscious people. It’s the ward nurse who does the pick up and drop offs. 

Anyway there’s probably way, way more that I’m forgetting to add but this is getting too long to keep writing shit. The moral of the story is do some research so you don’t look like an idiot when you’re writing your characters getting injured or having to be in hospital. It’s not Greys Anatomy in the real world and the angst isn’t going to be any more intense just because you’re writing shit like it is. 

For example, I do ICU transfers for a living. In the hospitals I do transfers between, nurses don’t stay IN the room of a vented patient. They typically have a seat at a desk or rolling work station outside.

don’t show up on camera

can fly/scale walls

immune to bullets

can break into any safe by turning into fog or some bullshit

could probably hypnotize security guards as needed

they enter the museum while it’s open to the public (and the Welcome sign is on display). they turn into bats and hide in the rafters until the museum closes. the only hiccup is when the overhead announcement comes on and politely requests all visitors leave for closing. the vampire are forced to flee, but come back the next day with tiny bat-sized earplugs.

downside: this requires going out in daylight, leading most of the team members to show up in long black victorian formalwear, complete with lacy parasols, which they insist on carrying with them throughout the entire heist (much to the frustration of the team leader, who just wore sunscreen and a raincoat).

depending on how invitations work, it is possible any random human can invite them in. one of the vampires gets their Ultimate Frisbee buddy Oakley to tag along and invite them in after closing.

downside: the gang spends the rest of the heist gently mocking the idea of a vampire playing association ultimate frisbee (“so what, you turn into a bat and catch it with your fangs? do they make you crawl up the wall when it gets stuck on a roof? if you turn into a cat to get it down from a tree, do you end up stuck in the tree?”) this ends in a Climactic Twist Ending when Oakley reveals they don’t play ultimate frisbee, just dog park frisbee. In the sense that they met when the vampire transformed into a wolf to gatecrashed a game at the local dog park.

(Bonus points if Oakley is a werewolf. extra bonus points if this is revealed in a post-credits epilogue where, on the next full moon, the entire gang transforms into creatures of the night and joins Oakley at the park for a frisbee game of Bats vs Wolves)

Final option: to gain legitimate entry, an invitation is needed from a museum employee. this presents two possibilities:

the vampires pretend to be incredibly rich eccentric patrons who want a private nighttime tour of the museum. (this is convincing due to the fact they are rich and incredibly eccentric.) the vampires get inside, planning to hypnotize the Curator supervising their tour.

downside: they immediately discover the Curator has been left immune to hypnosis by years of post-grad exposure to droning history lecturers. the vampires leave their least competent member to distract her while they carry out the heist–in the ensuing 90 minutes, the vampire and the curator accidentally Fall In Love after bonding over their shared fury about british archeological theft.

(In the sequel they get married and spend their honeymoon robbing the British Museum in order to return sacred objects to the cultures from which they were stolen. this is made more complicated comical by the fact vampires are unable to interact with holy objects. also, they are lesbians.)

alternatively: the gang simply bribes a security guard into letting them in after closing. the security guard then tags along, offering helpful advice for disabling alarms and transporting antiques. it turns out Security Officer Greer only applied for the job bc they too were planning an Elaborate Acrobatic Burglary, but then their partners quit to join Cirque du Soleil and “I can’t exactly perform a Double Cartwheel Birdie Flying Trapeze Boomerang Special without a partner.”

downside: the gang becomes too attached to ask Greer to leave. They carry out the heist as intended, but this time pretending to be circus performers to explain their vampire powers. Turning into a cloud of smoke to bypass locks? Magicians never explain a trick. Spider walking across ceilings to bypass alarms? Contortionist. When it comes time to fly from roof to roof, they decide turning into bats would give away their secret, so instead they help Greer, in a sparkling moment of triumph, execute the perfect Double Cartwheel Birdie Flying Trapeze Boomerang Special!

Greer and the gang escape (by tightrope walking) into the night with all the plunder they can carry. Tearfully, the gang begins to say goodbye (bc they can’t keep up the pretense of being circus performers forever) when Greer casually asks how a bunch of vampire ended up working in a circus.

(Greer assumed from the beginning they were vampires, because of “how you dress, how you talk, and mostly because none of you showed up on camera back in the CCTV control room. Why did you think it took me so long to let yall in?”)

I cannot for the lives of me decide which synopsis I like best

Because their stuff isn’t all in the same museum.

It’s an entire season of heists. NONE of which go as planned, and they keep making new friends, and getting involved in more heists, and the last museum doesn’t have a SINGLE THING that belongs to them but at this point it’s become a hobby and the Curator said there’s like some really important cultural artifacts in this one and Greer was down for another round and they had a new scheme they wanted to try. 

[Yes, I had to do it. Yes, all the voices are me. Lyrics under the cut.]

Just a couple more items I put together. I really enjoy making items for my players that have limited use, or just to make them laugh (or in some cases, make them THINK that they might need them later) I also like adding in little jokes that really, only I (or other D&D podcast listeners) will enjoy. 

The ‘Me First’ Bracers of Roguish Douchebaggery These dull grey leather bracers cover the wrists and grant advantage on all initiative rolls when you start your turn in stealth. Typical Rogues…

Cloak of Sneaking This inky black cloak will give you a +2 to all stealth checks when used at night It feels like shadows… smells like midnight

Book A lovely, thick book, bound in black leather called “The Prince of Thieves”. This book takes a long time to read (30 in game days) but once completed you will understand the way of the rogue better. You can select proficiency in 1 common rouge skill: Stealth, Sleight of Hand or Acrobatics. Once read, this book loses whatever power it held to teach you this trick for 10 years. Cause magic. Oo-de-lally, oo-de-lally, golly, what a book!

Spellscroll of Oddly Specific Creature Knowledge A one use spellscroll which grants you useful information about Umber Hulks. When going up against this creature in the future you will have advantage on all initiative and attack rolls. Well this…. Is probably going to be useful at… some point? Probably?

Carnie Coin This normal looking platinum coin has an intricate stamp of a dancing circus fool on one side and the kings head on the other. This coin always returns to its owner… Does anyone have change for a platinum piece? I’ll even accept 9 gold! A bargain for all! (with this I might actually have it disappear on them after a day… it always returns to it’s owner after all!) 

Potion of Sweet Flips This bright blue potion seems light as air. Drinking this will give you advantage on all dexterity checks for 1 hour Embrace your inner cirque du soleil

Potion of Luck A golden syrup that once drunk will allow you one point of luck. You can re-roll any dice to grant yourself advantage. Will last one day, and can only be used once. Looks like a potion of golden snitch

Potion of Mr Ed A small bottle holding only a tiny drop of a deep green gel. When consumed, you can talk to animals for 1 hour. Made by a Herbalist of the name ‘Doo-leet El.’

Potion of Haggling A purple potion that seems to turn to mist and reform in the bottle. Drinking this will make shopkeepers friendlier and more likely to grant discounts or pay more for items. Only sold at Gilmores Glorious Goods! Does not work on Gilmore…

I have a lot of other potions with cute flavour text but they are more ‘typical’ items. For me, having these little cards printed out means that my players feel like they are getting something really cool or handy when… really they are just getting something that legit won’t do MUCH for them later (like potions with 1 hour duration, I like those a lot) 

Does this item kind of suck? Yup. And yet I felt the need to make it once I got the idea.

Wondrous Item, Rare (requires attunement) 

A dull and pock-marked cast iron crown with a simple maker’s mark along the inside (a pair of pliers). The metal has a slight warmth to it when handled and its presence causes excited anticipation to stir in those that relish in slaughter (either openly or secretly), akin to a child about to open a present or a dog about to go for a walk. 

This weapon allows an attuned wielder to summon a phantasmal form of any martial melee weapon. This weapon operates as a +1 version of the summoned weapon and the wielder is proficient with it. The weapon deals psychic damage instead of it’s normal damage type and counts as magical for the purpose of resistance. It is a free action to summon the weapon and a bonus action to dismiss the weapon or change its form. Whenever the weapon hits a target the target makes a Intelligence saving throw (DC 15), on a failure the target takes full damage and is stunned until the start of the wielder’s next turn, if the target succeeds the wielder takes half the damage that the target would have. Neither party may be resistant to this damage or otherwise reduce it. 

Sentience All Crowns of Pain (there is more than one) are sentient Lawful Evil, with an Intelligence of 12, Wisdom of 14, and Charisma of 18. It has hearing and blindsight out to 60 ft. The Crown communicates telepathically with its wielder and can speak, read, and understand Common and (sometimes) Abyssal.