Introvert

I suspect that I’m about to step into something I would be wisest to keep well away from. But what the hell, it’s that time between Christmas and New Year’s. And nobody’s yelled at me over the internet since I said that the TV Aziraphale doesn’t use a cell phone. *

Canonically, which is to say using the text in the book, you don’t get any description of Crowley’s sex life. The only thing the book says is “angels are sexless unless they specifically make an effort”.  You can infer, and (more to the point) you can imagine, and lots of people have chosen, not unreasonably, to ship him with Aziraphale, but you are still Making Stuff Up. It could be Making Stuff Up that happens between paragraphs, or Making Stuff Up that isn’t mentioned at all, but it’s still Making Stuff Up.** (And using the kind of eagle-eyed textual analysis that Bible scholars used to decide exactly what a piece of four thousand year old verse definitely meant also counts here as Making Stuff Up.)

Which is the fun of fanfiction, and part of the tradition of fanfiction. As is, I’m afraid, grumbling at people who do not see that your ship is the only true ship, and choose to ship anyone else with anyone else.

If anyone decides that The Relationships in Their Fanfiction Are the Only True Fanfiction, it seems to me they are missing the point. The point is Fanfiction exists so that you can imagine, enjoy and fill in the gaps. The point is that you can change things and have fun with them. And the stories are absolutely true… for you.

The TV series gets deeper into Crowley and Aziraphale’s relationship. It’ll be canonical for the TV series, and not canonical for the book.*** 

If I were to Pronounce on things that are not explicitly stated in the book, I still wouldn’t be telling you if Crowley was Canonically Gay. I would be telling you what I think, because it’s not canon unless it’s in the book. It won’t be TV canon unless it’s on the screen.

So, do not worry what other people think, and do not worry about what they say. These are not things on which people can be right or wrong, or on which anything can be “settled”. 

Make fun fanfiction. Enjoy yourself. Make things up. Share them. That’s the point.

*People would only bother him on it. And if anyone gave him one as a present, it would be still be in its box, on the same shelf as the still-unboxed Kindle.

**Which was what Terry and I did when we wrote the book. And what I had to do for the TV scripts when I needed to take the story into places the book hadn’t covered.

“It asked ‘Do you really know yourself’ and asked for men to take part in a social science experiment to be shown on TV. It warned that the research would be a challenge and involve ‘hardship, hunger, solitude, anger’.

In the case of the BBC Prison Experiment, the mock prison did not devolve into the torturous, abusive hellishness of the Stanford Prison Experiment–even though the experimenters very deliberately attempted to create conditions that would destroy cohesion among the prisoners and encourage authoritarian behavior from the guards. Prisoners were told that they might be able to be promoted to guardhood in an effort to keep them divided, shaved upon entry to the prison, and the guards were encouraged to create the rules of the prison and enforce them in any way they saw fit. 

It’s important to note that one of the very first things the experimenters noted was that the guards were, at the very outset, uneasy about the status differences between themselves and the prisoners and conscious of their power. 

Because food–both quantity and quality–were very salient and powerful status treatment differences in the prison, there was almost immediately a showdown over food. (Prisoners were fed much, much smaller and worse-tasting food than the guards, and indeed prisoners were made to serve the guards their meals and watch them eat in part so everyone would be aware of these status issues.) 

The guards almost immediately felt guilty and attempted to share their sausages with the prisoners by giving them the guards’ leftovers… and the prisoners immediately go “not until we consult with the other prisoners,” and then collectively decide to refuse absolutely to take small rewards from guards in lieu of the right to good food. 

Guards tried repeatedly throughout the study to get prisoners to see them as basically equal, bar the circumstances of their current positions; prisoners instead repeatedly pointed out the actual circumstances of their current situation placed them at very different power levels indeed and insisted that guards actually change the system in order to make the conditions fair and equal. In general, prisoners quickly and collectively exploited the guards’ shame at the unequal conditions in order to receive fair treatment. 

At this point, out of curiosity, the experimenters introduced a new prisoner into the system, one who had been trained as a trades unionist… 

….and this unionist prisoner quickly chose to approach a disaffected guard, empathize with his unhappiness, and turn the blame for the situation at the unequal and unfair conditions set in the prison. Those conditions, of course, were set not by the guards–they were set by the experimenters. The very first thing, then, that this unionist does is build bridges to unify all the people in the prison. 

Prisoners steal the guards’ keys; guards choose instead of “cracking down” or punishing the prisoners to ask politely for the prisoners to help them find the keys, and cheerfully accept them when provided. This gives prisoners leverage for a negotiation, which is then deftly picked up by the experienced negotiator (although not without some pushback from another charismatic and decisive prisoner). 

Here’s what the negotiator had to say:

Negotiations begin. pDM outlines the forum proposal. One of the Guards points out that the Prisoners are asking to be rewarded for stealing the keys. pDM responds by outlining a stark choice. Certainly the Guards can refuse to accept his plan, but the alternative is a return to conflict: “It’ll not be the keys tomorrow, it’ll be something else. It’s a game. All I’m saying is that there is a way to resolve that game”.

pDM is confident. He knows he speaks for the Prisoners. The Guards, even in their own mess, are despondent. They know that they can’t handle the Prisoners. And so they accept the new order. Even if they have given up much of their power, at least this system might work and offer them some respite:

gTM: I’m in high spirits after that. gBG: It actually went alright. This geezer is alright. We can all deal          with him.

At this point, experimenters withdrew the negotiator to see what would happen to the egalitarian vision he set out. As it turned out, the prisoners peacefully overthrew the rule of guards (by, effectively, mounting a sitdown protest in the guard’s sanctuary) and decided instead to organize an egalitarian commune for the remainder of the experiment. 

IDK IF YOU KNOW ABOUT THIS WEBSITE YET, BUT I DON’T EVEN CARE IF YOU DO.

CHARAHUB BASICALLY ALLOWS YOU TO MAKE A DIRECTORY OF ALL YOUR OCS.

LIKE SO

AND SO (they let you get super detailed)

It lets you store 100 characters (you gain 2 extra slots whenever someone uses your referral code) and 10 images per character. You can even make GROUPS to organize them a little more— per RP or something. Image files can’t be too big either.

BUT if you want more file size, more character slots, and more other stuff, you can get a subscription! Don’t worry, subscriptions are super cheap (take notes, deviantART)!

So you’ve exsanguinated your 400 guys to get the iron for your sword. Cool. But now you have 400 bodies lying around.

Why not put those to good use and cremate them. Use the carbon from those 400 bodies (you won’t need all of them) and now you can make a nice mid-high carbon steel sword.

tenitchyfingers:

Anyway the LGBT community is for anyone whose identity is outside of the heteronormative rule (heterosexual, heteroromantic and cis, all three of these) and any “older” LGBT person is gonna confirm BECAUSE THEY BUILT THE DAMN COMMUNITY. Try asking them. Ask a 40-50 year old (or older) gay man or lesbian what the community is for. Ask them. Do it though. Learn some of your own history from them, and then come back to me then try and tell me I’m wrong. 

You’re wrong.

I’m a 59 year old gay man and I’m telling you in no uncertain terms, You. Are. Wrong.

Here’s a history lesson from someone who both lived it and has read extensively about LGBT issues, as well as being involved in many different organizations. I realized what I was when I was very young. I first came out in the late 60s. I was an activist during the 70s, 80s, and early 90s.

This is long, but history is long. It’s important. I tried to break it down into smaller paragraphs for easier reading. But it’s long. I debated not putting this under a cut, but holy hell it’s long. 

If you’re actually interested in WHY you’re wrong, OP, I hope you’ll read it.

TUMBLR 101: HOW TAGS WORK! (May 2017)

Tags vs. Search

The tumblr search function will search the tags and captions of all new (i.e. not reblogged) posts that do not contain an external link. 

EXAMPLE: www.tumblr.com/search/perioddramaedit returns posts that mention perioddramaedit, either in the body of the post or in the tags

The tumblr /tagged/ function returns all the posts in a tag in reverse-chronological order. Popular tags on tumblr may have years worth of posts in them.

EXAMPLE: www.tumblr.com/tagged/perioddramaedit returns posts tagged perioddramaedit in the first 5 tags.

Read more about Tags vs Search

The first 5 tags!

The first 5 tags are your best bet! 

Only the first 5 tags show up in tracked tags. Tracked tags are more reliable than search if you want your content to be seen and / or reblogged.

Put the important tags (ex. show name, actor name, artist name) in the first 5 tags.

Only the first 20 tags show up in search.

Only the first 20 tags will cause the post to show up in the tag on your blog (i.e. asoiafuniversity.tumblr.com/tagged/resources)

So start with the important tags for tracked tags / search, then add tags like “my edits” or “mine” for your own blog organization, and then add FEELINGS and TAG COMMENTARY at the end. 

Only new posts will show up in public tracked tags or search. Reblogs will not show up in tracked tags or search.

Avoid unnecessary punctuation. Apostrophes ’ are ok to use, but tags with a slash / or a hyphen - or a plus sign + or an equal sign = will NOT show up in tracked tags. 

External Links

Posts with external links will NOT show up in search. 

See a list of sites that tumblr no longer allows linking.

Posts with external links WILL show up in tracked tags. So use tracked tags and put the important tags in the first 5 tags!!

Tagging Etiquette

Don’t tag your hate; it’s considered rude

If you use anti tags like #ANTI SHIPNAME, everyone who is searching for SHIPNAME will see your anti post. Don’t use SHIPNAME when creating your anti tag if you don’t want people to get upset about it. 

Don’t put something that isn’t an edit in an edit tag. People are going into the edit tag to look for edits and if your post isn’t an edit, it defeats the purpose of the edit tag. 

Don’t spam the tags. 

Reblog; don’t repost

The OP (original poster) will often read your tags when you reblog a post, so if you say something nasty in the tags, the OP will (probably) see it. Say something nice instead!

Other useful tips:

Install new-xkit-extension to improve your tumblr experience

How to go to a specific date/time in any tag

More info on tumblr’s search and discovery

Popular ASOIAF fandom edit tags

I used to work for a call center and I was doing a political survey and I called this number that was randomly generated for me and the way our system worked was voice-activated so when the other person said hello you’d get connected to them, so I just launch right into my “Harvard University and NPR blah blah blah” thing and then there’s this long pause and I think the person’s hung up even though I didn’t hear a click

And then I hear “you shouldn’t be able to call this number.”

So I apologize and go into the preset spiel about because we aren’t selling anything, etc. etc. and the answer I get is

“No, I know that. What I mean is that it should be impossible for you to call this number, and I need to know how you got it.”

I explain that it’s randomly generated and I’m very sorry for bothering him, and go to hang up. And before I can click terminate, I hear:

“Ma’am, this is a matter of national security.”

I accidentally called the director of the FBI.

There was no MS Dos involved. Instead, there was a proprietary type-based OS and an actually-uses-transistors refrigerator-sized computer with switches I had to trip at certain times during the night as I watched the data flow from six pm to six AM on Fridays and weekends. If things got stuck, I reset the server. 

The company handled everything from low-end data (hotel and car reservations) to flight plans and tower information. I was weighed every time I came in to make sure it was me. Areas of the building had retina scanners on doors. 

During training. they took us through all the procedures. Including the procedures for the red phone. There was, literally, a red phone on the shelf above my desk. “This is a holdover from the cold war.” They said. “It isn’t going to come up, but here’s the deal. In case of nuclear war or other nation-wide disaster, the phone will ring. Pick up the phone, state your name and station, and await instructions. Do whatever you are told.”

So my third night there, it’s around 2am and there’s a ringing sound. 

I look up, slowly. The Red phone is ringing.

So I reach out, I pick up the phone. I give my name and station number. And I hear every station head in the building do the exact same. One after another, voices giving names and numbers. Then silence for the space of two breaths. Silence broken by…

“Uh… Is Shantavia there?”

It turns out that every toll free, 1-900 or priority number has a corresponding local number that it routs to at its actual destination. Some poor teenage girl was trying to dial a friend of hers, mixed up the numbers, and got the atomic attack alert line for a major air-travel corporation’s command center in the mid-west United States.

There’s another pause, and the guys over in the main data room are cracking up. The overnight site head is saying “I think you have the wrong number, ma’am.” and I’m standing there having faced the specter of nuclear annihilation before I was old enough to legally drink.

Seriously, this is legit.

In December 1955, Sears decided to run a Santa hotline.  Here’s the ad they posted.

Only problem is, they misprinted the number.  And the number they printed?  It went straight through to fucking NORAD.  This was in the middle of the Cold War, when early warning radar was the only thing keeping nuclear annihilation at bay.  NORAD was the front line.

And it wasn’t just any number at NORAD.  Oh no no no.

Terri remembers her dad had two phones on his desk, including a red one. “Only a four-star general at the Pentagon and my dad had the number,” she says.

“This was the ‘50s, this was the Cold War, and he would have been the first one to know if there was an attack on the United States,” Rick says.

The red phone rang one day in December 1955, and Shoup answered it, Pam says. “And then there was a small voice that just asked, ‘Is this Santa Claus?’ ”

His children remember Shoup as straight-laced and disciplined, and he was annoyed and upset by the call and thought it was a joke — but then, Terri says, the little voice started crying.

“And Dad realized that it wasn’t a joke,” her sister says. “So he talked to him, ho-ho-ho’d and asked if he had been a good boy and, ‘May I talk to your mother?’ And the mother got on and said, ‘You haven’t seen the paper yet? There’s a phone number to call Santa. It’s in the Sears ad.’ Dad looked it up, and there it was, his red phone number. And they had children calling one after another, so he put a couple of airmen on the phones to act like Santa Claus.”

“It got to be a big joke at the command center. You know, ‘The old man’s really flipped his lid this time. We’re answering Santa calls,’ ” Terri says.

And then, it got better.

“The airmen had this big glass board with the United States on it and Canada, and when airplanes would come in they would track them,” Pam says.

“And Christmas Eve of 1955, when Dad walked in, there was a drawing of a sleigh with eight reindeer coming over the North Pole,” Rick says.

“Dad said, ‘What is that?’ They say, ‘Colonel, we’re sorry. We were just making a joke. Do you want us to take that down?’ Dad looked at it for a while, and next thing you know, Dad had called the radio station and had said, ‘This is the commander at the Combat Alert Center, and we have an unidentified flying object. Why, it looks like a sleigh.’ Well, the radio stations would call him like every hour and say, ‘Where’s Santa now?’ ” Terri says.

For real.

“And later in life he got letters from all over the world, people saying, ‘Thank you, Colonel,’ for having, you know, this sense of humor. And in his 90s, he would carry those letters around with him in a briefcase that had a lock on it like it was top-secret information,” she says. “You know, he was an important guy, but this is the thing he’s known for.”

“Yeah,” Rick [his son] says, “it’s probably the thing he was proudest of, too.”

So yeah.  I think that might be the best wrong number of all time.

Your body is an incredibly bizarre machine.

The best of Tumblr: Avengers part 3

Highways are usually two-to-four (at the widest) lane roads that meander the US landscape. Think Route 66, dinosaur statues, mom-and-pop diners, southern gothic. There are state-level and national-level highways. Some run for a 100 miles, some, like US HWY-17, run most of the East Coast:

That red line is US HWY 17. If you follow it, you will go through tiny towns. You may hit stoplights. I kid you not, you will see spinning cows on poles. Businesses exist along highways that you are encouraged to pull over and visit. They were designed to let you see America.

Yeah.

Now, interstates were made in the 50s and were made to get people from Point A to Point B. These suckers range from four lanes to eight lanes around big cities. They cut through everything. If you want to get to a business, you have to take an exit ramp and detour. They are great for getting places fast. You can still have weird experiences on them, but usually at night, when your eyes start playing tricks on you. Or there are deer.

I-95 is a massive corridor that runs from the Florida Keys to the Canadian Border. You can see the difference just looking at the maps.

As far as writing goes:

If you want quirky character development inside the car, you’re looking for an interstate. The majority of Americans take interstates to go on road trips.

If you want mysterious and/or supernatural hijinks, you’re looking for a highway. They are weird, weird places, and they’re surprisingly easy to wind up on if you leave the interstate.

Hello, Vampire Chronicles fans.

Sit down. We need to have a chat.

You see, while some people are very much excited for a new show about our pompous king of the assholes (and I say this as a term of endearment, having loved Lestat since I was a depressed teenager living in New York, shuffling through my mom’s fiction section) we need to pause and remember this:

Anne Rice does not support fan fiction or anything that is not glowing praise.

Read it again, slowly.

Anne Rice does not support fan fiction or anything that is not glowing praise.

This is difficult for younger fans to understand, but let’s take a walk down memory lane.

She has threatened to sue writers in the past. She is one of the most prolific writers of our generation, and she does not support people using her characters for their own work.

In fact, in 2000 she went on a binge-attack against her fans. She threatened legal action against fans who wrote or drew her characters, but especially those who wrote with them. She sent them weeks of harassing letters and doxxed them on the internet.

Let me repeat that.

She doxxed people who wrote fan fiction.

She harassed them online and threatened to contact employers.

She used her fans to outright attack other fans.

This isn’t even something she can just shake off now, with the comment of “It was so long ago” because she did this to a writer who wrote commentary on her story in 2013.

In 2013.

While it was not that she wrote fan fiction, she still shows that she has no respect for people who are in fandom.

Remember those disclaimers used in fan fics, at the beginning? “I do not own …. ”? Yeah, a lot of that has to do with the fact that Anne Rice and others like her would attack fandoms and threaten them, and was in hopes that they would just leave us alone. She didn’t.

In short: Do not trust Anne Rice. I love her writing, I have read every book she has even written, but I do not trust her.

She use to threaten to sue anyone she found posting specs anywhere, and there was a whole underground network of people to share specs and fan art (which she also would threaten to sue over).

DISCLAIMER: this is not about fanfic, but it is about what she can do to you.

So, I totally idolized Anne Rice. Fully and adoringly so. One day, she shared one of my HuffPo articles with her “people of the page” and it was probably the greatest day of my entire career. 

But she has this thing where she’s OBSESSED with bad reviews. At one point, she complained about a bad review she got for Interview from the New York Times or some such thing like forty years ago. She used it as an example of how reviews can hurt authors. I was like, seriously, lady, you have how many millions of copies of your books sold? How many movies have been made from them? *People try to find your house to take pictures of themselves in front of it.* But okay, everybody has their quirks. I just kind of rolled my eyes over it.

Not long after that, she made a post about this website that was made by a writer who apparently wasn’t getting the sales numbers or accolades they so richly deserved. The problem wasn’t like, the nature of the business or anything, nay, my friends, nay, but the fact that people–BULLIES!–left mean reviews on Amazon. So these people whom Rice so admired would make posts where they would reveal Amazon/GoodReads reviewers names and home addresses and such. One post even mentioned something like, “Between this time and that time every weekday, they go for a walk by the sea wall.” Scary, scary shit. And Rice LOVED these people.

I don’t know why I took it upon myself to argue with her. I really don’t. Maybe because I respected her so much and her support of the site was so disappointing? This was the result.

So, I’m a bully. Big whoop, right? And my feelings were a little hurt, but hey, never meet (or follow on social media) your idols, right? Lesson learned, and it wasn’t like this could destroy my fond memories of how much I loved her books, right?

So, fast forward, I think it was the next year, or at least a few months later, when I wrote a post about a dumb $0.99 Kindle book about Thomas Jefferson and Sally Hemings in a BDSM relationship. A pathetic little troll with too much hair gel and not enough parenting ran to his goddess Anne Rice to tell her how mean, mean, mean I was being. She posted a link to a blog post made about me on the reviews-are-bullies site and said something to the effect of someone needing to teach me a lesson or someone needed to show me how it feels or something like that. To THREE. MILLION. PEOPLE.

As a fan of Anne Rice, I am confident in stating that many of her fans are not okay people. And they heeded the command of their “queen.” Yes, they referred to her as such, flooding me with emails, tweets, FB messages, anywhere they could reach me. They posted my address, screenshots of google earth images of my house, they threatened to kill me, they made graphic threats against my children, one charming gentleman on parole from his assault sentence offered to make a necklace of my teeth to present to “my queen.”

When confronted about the fact that she had unleashed all of this on me, her response was basically:  ¯\_(ツ)_/¯

She insisted she hadn’t done anything wrong, she couldn’t control what people were doing, and oh yes, it’s terrible that people are saying this, but she NEVER. ASKED. THEM. TO. STOP. In fact, she joined her “people of the page” in mocking my appearance, mourning the horrible lives my children must have, and continuing to insist that my “prison tats” indicated that I was a member of a gang (I have “TIME LADY” tattooed across my knuckles in the 11th Doctor era Doctor Who font). Egging them on with this coy, “Well, we shouldn’t say things like that, we’re better than that, BUT” bullshit.

Her “people of the page” also contacted one of my publishers and caused a multi-author anthology that was like, a year in the making to fold.

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. 

Also, unrelated to the lights and sirens issue, lemme add a detail about us asking a lot of questions. If you want verisimilitude in your story, remember SAMPLE:

Signs and symptoms

Allergies

Medications

Past illness/injury/disease

Last food, drink, and medication taken

Events leading up to the injury or illness

These are the questions EMTs are trained to ask every patient, though they rarely end up coming out in that order. Also, you can totally add a W to that, which is inevitably “Why did you wait so long to call us?” *sighs forever*

And for some more basic on-scene emergency care, remember CABC: C-spine, Airway, Breathing, Circulation. This time, actually in that order (except for cardiac arrest, in which case remember CAB: Compressions, Airway, Breathing). 

The long and short of CABC is: if the patient fell or was in a car accident or had any other potentially traumatic injury, start with stabilizing the C-spine (typically via cervical collar and head blocks and backboard), because if there is a fracture in the neck and you don’t manage it and end up severing the spinal cord that high up, your patient’s probably going to die, and if not, will probably be paralyzed from the neck down. 

Once C-spine is stable, make sure the patient’s airway is clear (this includes both foreign obstruction and the patient’s own tongue). Yes sometimes this actually involves sticking your finger in their throat to clear shit out, and yes it’s gross. It also means positioning an unconscious patient’s head in a certain way (assuming there is no chance of C-spine damage) to keep the airway open. EMTs also carry little plastic hook things called oropharyngeal airways in a bunch of sizes that keep the patient’s tongue from blocking their airway. And of course if needs be you can intubate, although this is not a skill EMTs have (paramedics do, though, and in some states there’s a certification called EMT-I [the I for intermediate] that also teaches that skill). If someone’s just come across an unconscious person and doesn’t have an airway to use, and you’re sure their C-spine is fine, you can roll them onto their left side and gently curl them; that’ll help keep the airway clear and also helps the heart pump blood a little more efficiently than if you’d rolled them onto their right side. 

Anyway, once the airway’s secure, you move on to making sure the patient is actually breathing. If they’re not, you do it for them with an ambu bag. If they are but are struggling, or aren’t struggling but may for any reason potentially go into shock or have compromised circulation (broken leg, high fever, etc.), you give them supplemental oxygen, typically through a nonrebreather mask, though the flow rate depends on their symptoms. 

Okay so once we’ve secured the patient’s C-spine, airway, and breathing, only then do we worry about circulation (unless the patient’s in cardiac arrest, remember, in which case we secure circulation first). Which in the case of trauma is generally first aid for serious open wounds and preventing or treating shock, and in the case of medical issues may be getting an ECG reading or administering medication or, if the patient does go into cardiac arrest, chest compressions and defibrillation.

Okay, that’s the end of the CABCs, but you’ll note that in the last para I said treating serious open wounds. Because a minor open wound is going to wait until after the next step after the CABCs, which is a full-body assessment wherein we meticulously assess a trauma patient using palpation from, basically, head to toe, looking for broken bones, soft tissue damage, internal bleeding, etc. Some of those things can be pretty serious, so before we treat a shallow cut, we check for, like, broken ribs that might puncture a lung.

So obviously not all of these things happen all the time. A patient presenting with an asthma attack needs neither a full-body assessment nor C-spine and circulation management. So we just jump straight to airway and breathing and forego the rest. (And then ask anyone with them our SAMPLE questions if the patient is too distressed to speak, because we still need those answers, but also if the patient is too distressed to speak you can bet we’re asking their companion in the back of a moving ambulance.)

Sometimes you spend a Long Fucking Time at a scene, either because the patient is resisting transport (this happens a lot, especially with the uninsured; we stick around and do everything we can to help them while simultaneously trying to encourage them to go to the ER anyway), or because the patient’s trapped in a smashed car and we’ve got to cut the door off and peel the roof back and get a cervical collar and a backboard on the patient while they’re still in the damn driver’s seat and lemme tell you that is a goddamn game of Jenga and can take half an hour, or because the patient isn’t critical but you want to minimize discomfort and damage so you take the time to meticulously package them while also getting all your questions answered on scene to make sure you haven’t missed anything, or because … well, you get the point. Sometimes shit just takes forever.

Other times, we do what’s called a scoop-and-go, typically with patients in critical conditions that can’t really be managed without surgery or medications we don’t carry. Like, patient bleeding out while giving birth? Not a whole lot we can do about that, so we get them in the rig as fast as fucking possible and race to the hospital while trying to get the most critical questions answered. These kinds of situations are very rare, though; it’s much more common to be on scene for 15 or 30 minutes than 5 minutes. 

OH AND, another thing. Listen. EMTs do not approach a scene that is not secured. If there’s an active shooter, or a hostage situation, or a raging fire, or a potential for something to explode (or for something that’s already exploded to collapse), or a flash flood, or a hazardous materials spill, or whatever else, we do not go in until the unstable situation has been resolved. It sucks waiting 100 yards away while a critical patient is maybe dying and you can’t get to them yet, but listen, the first thing they teach you is don’t make new patients. IOW, don’t become a victim yourself; you can’t help anyone if you get wounded in the crisis too, and in fact then you’ve just become an additional burden on the personnel remaining.

I’ve never heard of the lights-must-be-on rule. It’s gotta be one or a few specific states. Generally speaking, lights and sirens increase accident rates, and most states are actively trying to REDUCE their use, not increase them, but I don’t know where she lives, so that’s accurate in her part of the country (I’m assuming the US). But it’s inaccurate in most of the country.