Your Favorite Non-Euclidian Pistol Shrimp

in 2019 the FDA approved a drug called trikafta (which is really three drugs in one) for cystic fibrosis treatment. what it essentially does is patch up the malfunctioning proteins that cause the extra sticky mucus. trikafta is effective on about 90% of cystic fibrosis patients.

people who had spent their entire lives in and out of hospitals, on and off of ventilators, suffering from pneumonia and sometimes treated through painful procedures like intubation took this drug, got out of bed, coughed up an entire lifetimes worth of mucus out of their lungs over the course of a few hours, breathed clearly for perhaps the first time in their lives, and now go on to live well into their seventies.

My ward is the respiratory ward - CF is one of the things we specialize in.

Since this med came out we haven't had a SINGLE CF admission to the ward

There used to always be a CF patient spending a couple of months with us at a time

There's a man who is 23 years old who I was sure would not survive his next admission (aim saturations 85% is end stage lung disease)

There's a set of the local frequent flyers that we all know so well

Except

No we don't

On the CF specialist ward (with reasonable staff turnover)

Half the staff have probably never even seen a CF patient

Additionally, it should be noted that metrics like life expectancy are in no way a guarantee of... Anything. There are significant outlier CF patients who are at an advanced age now despite the odds due to a variety of different factors, having lived the majority of their lives before the development of modulators.

That is per month with the most common coupon people are likely to use.

But don't worry, there's grants and patient assistance programs you can apply for. 🤞🫠 Most people in high income countries like the USA can get it "covered" through insurance for fewer thousands of dollars. Or even less if your insurance is good or the manufacturer likes how poor and/or on Medicaid you are! A good social worker will help you with the process, and make sure your yearly reapplications and PAs are done a little early so they have time to think about it before you run out. Jesus Christ.

a foul-mouthed former gang member and accomplished flyweight boxer.

an expert swordsman and seemingly unstoppable sex machine.

*  Never allowed a crippling disease to get the better of him, and even when he was suffering quite badly, was sharp enough to tell when some people wanted to kick him out of WHO (The Celestial Toymaker) and out-maneuvered them.

*  Saw his passenger ship sunk by Nazis before he had finished growing, and instead of taking a traumatic accounting of the memory, enlisted in the Navy and manned a gunboat.

*  Dealt with more crushing personal blows from childhood to his youth than most people will see in their entire lifetimes; remained protective of the weak and helpless, and remained unbelievably generous to friends and family throughout his life.

please, please, please remember that this "hating transmascs" and "kill all TMEs" bullshit is just a few edgy weirdos on the internet who enjoy saying inflammatory things for shock value.

transfems are not your enemy, and YES, you do actually need to unlearn transmisogyny. Not because you're transmasc, but because we live in a transmisogynistic society.

transfems are not a hivemind, there's no broader transfem consensus that transmascs are Evil Privileged Abusers, but the small group of people who think that way WANT you to believe that they are representative of trans women everywhere. they're super not. they really are just a handful of angsty people online looking for someone to pick on.

all trans people have more commonalities than differences. there aren't two distinct species of trans people from two different planets, there are just trans people with a wide diversity of experiences and walks of life. we are all affected by the same systems of oppression.

I have been mulling something over for a while and have decided to share. As part of my job, I read a lot of fiction that's still in development. After a while, you start to see the same errors, misunderstandings and shortcuts crop up repeatedly with different creators and it gets me thinking what is the most elegant way possible I could explain the issues to someone wanting to improve? The one that comes up the most often and is the hardest to explain is: "Why don't people care about my characters and/or story". It's always a thorny problem and I think I have a workable answer that applies in most cases: A story is a series of revelations regarding compounding, unintentional consequences to character decisions. The further you stray from this, the less people care. It translates to: 1) characters have to make decisions otherwise there is no drama 2) Those decisions have to matter otherwise there are no stakes 2) The consequences have to interact with one another. A affects or causes B affects or causes C etc. otherwise there is no progression 3) There must be some unintended consequences otherwise there is no conflict 4) The consequences have to be revealed (even at least implied) otherwise there is no conclusion This works at the micro scale in terms of dialogue: The specific word/tone/movement a character uses affects how another character reacts in an unexpected or interesting way which in turn causes another reaction and these layer onto one another until a decision is reached and a consequence implied thereby completing the scene. It also works at the macro scale in terms of plot: The decisions characters made in a scene prompts/affects the characters and context of the scene that follows (even if we don't know it at first) and by the end those layered interactions have been revealed to us and we see the unexpected or interesting result.