robin

a (very ad-hoc) list of butch reading and writing, (mostly) by butch authors. books I've read myself in bold; take the rest with a grain of salt. additions, addendums, and commentary welcome :)

(you can find my list of femme literature here)

general/literary fiction:

mrs s by k patrick

stone butch blues by leslie feinberg

boulder by eva baltasar

running fiercely towards a thin high sounds by judith katz

tipping the velvet by sarah waters

a crystal diary by frankie hucklenbroich

godspeed by lynn breedlove

cha-ching! by ali liebegott

the ihop papers by ali liebegott

greasepaint by hannah levene

lucy and mickey by red jordan arobateau

the bull-jean stories by sharon bridgforth

development by bryher

notes of a crocodile by qiu miaojin

america is not the heart by elaine castillo

the slow fix by ivan coyote

the swashbuckler by lee lynch

old dyke tales by lee lynch

sci-fi, fantasy, and horror:

gideon the ninth by tamsyn muir

the unspoken name by ak larkwood

vermilion by molly tanzer

metal from heaven by august clarke

scapegracers by ha clarke

the unbroken by cl clarke

fire logic by laurie marks

the seep by chana porter

these burning stars by bethany jacobs

feast while you can by mikaella clements and onjuli datta

non-fiction, memoir, and autobiography:

hijab butch blues by lamya h

gender failure by ivan coyote and rae spoon

fun home by allison bechdel

butch is a noun by h bear bergman

female masculinity by jack halberstam

burning butch by rb murtz

when we were outlaws by jeanne cordova

leaving isn't the hardest thing by lauren hough

odd girls and twilight lovers by lillian faderman

another mother tongue by judy grahn

boots of leather, slippers of gold by elizabeth lapovsky and madeline davis

the persistent desire ed joan nestle

persistence: all way butch and femme ed ivan coyote and zena sharman

I’ve had countless sessions and lectures on ECGs. I don’t know how many websites I have bookmarked, or how many times my eyes glazed over reading Dubin. I’m also terrible at cardiology. I was on my way to accepting my fate of being horrible at ECGs forever, until I had a life changing session on ECGs taught by a great ER doc. I want to post it here because it was probably the most useful thing I learned in med school, and it will stick with me for the rest of my career. 

WHEN LOOKING AT ECGs FOR THE FIRST TIME:

1. One ECG is never enough. Always get old ones for comparison. If none available, do another one. Because. One ECG is never enough. 

2. RATE. Look at the number on top of the printed ECG. It’s stupid not to use that number. Yes, you should know the rule, 300-150-100-75-60-50. People say you shouldn’t trust the machine because… well, it’s a machine, and it can make mistakes. This is true. I don’t like to look at their “diagnosis” until I have gone through it myself. But the rate is just a number. Plus you should be able to eyeball it and be able to tell if it’s tachy, brady, etc. If the machine is telling you it’s 200 and if it looks tachy, then it’s probably the right number. 

3. RHYTHM. Is there a p-wave for every QRS and a QRS for every p-wave? Is the p-wave upright in lead II and down in aVR? Good. Done. BOOM. It’s sinus rhythm. ***if you cannot clearly see the p-waves then you cannot call sinus. move on.

4. AXIS. Again, look at the number at the top of the page. If it’s between 0 and +90, then it’s normal axis. If the number isn’t provided, or if your preceptor doesn’t believe in the convenience of machines/technology, look at the QRS complex of lead I and lead II. 

up in lead I, up in lead II: normal axis

up in lead I, down in lead II: left axis deviation (most common causes are left anterior hemi block and left ventricular hypertrophy)

down in lead I, up in lead II: right axis deviation (most common causes are right ventricular hypertrophy…PE)

5. did someone say HYPERTROPHY?

look at V1

is the R wave tall? (greater than 7mm?) right ventricular hypertrophy.

is the S wave tall? (greater than 11mm?) left ventricular hypertrophy.

  6. P-waves

look at lead II

is it wide? left atrial enlargement.

is it tall? right atrial enlargement.

7. PR interval

should be between 0.12 sec and 0.2 sec (3-5 small boxes). I used to always get this interval and QRS complex (less than 0.12 sec) mixed up. Think: atria depolarizing + shit getting to ventricles is gonna take longer than ventricles depolarizing. [2 things happening] versus [1 thing happening]. [0.12 sec-0.2 sec] versus [<0.12 sec].

long PR interval means there’s some sort of block at the AV node. 

1st deg block. PR interval is long. everything else is normal. cool. 

2nd deg block

type I: PR interval progressively gets long. eventually a dropped QRS.

type II: PR interval is constant, but randomly dropped QRS. 

3rd deg block “complete block”

there is no association between P waves and QRS. they run separately. **QRS does NOT have to be wide. Just look for P wave/QRS complex disassociation. I sometimes get this and 2nd deg type II mixed up. The only difference I try to remember is that PR interval is constant in 2nd deg type II, but is variable in 3rd deg. 

8. QRS complex

narrow or wide? 

narrow: good. signal coming from somewhere above ventricles. 

wide: think BBB (bundle branch block)

LOOK AT V1 ONLY.

if the last deflection of QRS is DOWN, then it’s a left BBB

if the last deflection of QRS is UP, then it’s a right BBB. super easy. no more of this bunny ears crap. 

9. ST segment

always look from J point, and compare with the isoelectric line of T-P segment (NOT PR interval). 

elevated/depressed… STEMI… duh. indicates ACUTE ischemic changes. 

look for reciprocal changes of the heart. if ST elevation in lateral leads, could see ST depression in the septal leads. PAILS:

posterior up, anterior down

anterior up, inferior down

inferior up, lateral down

lateral up, septal down.  

LBBB can look like STEMI. How to tell?

disconcordant changes is normal. (QRS and STEMI on opposite sides of the isoelectric line.)

concordant changes is abnormal. 

massive discordance is abnormal. (STEMI is greater than 5mm)

this isn’t that important. Moving on. 

Inferior STEMI. Could right ventricle be involved? 

DO NOT GIVE NITRO DO NOT GIVE NITRO DO NOT GIVE NITRO.

order a 15 lead

is STE in lead III > lead II? likely RV involvement

INFERIOR MI? 15 LEAD NO NITRO

INFERIOR MI? 15 LEAD NO NITRO

INFERIOR MI? 15 LEAD NO NITRO

10. T waves

is it inverted? indicates recent ischemic changes. 

11. Q waves

is it significant? indicates old ischemic changes. will likely be present if followed rule number 1 of reading ECGs. (1 ECG is never enough= look at old ECGs). 

I literally go through this list of 11 points in my head when I’m reading an ECG, regardless of whether or not I have an atrial flutter jumping at my face or if I see a massive anterolateral STEMI. Obviously I needed background knowledge on ECGs and the physiology of the heart before constructing this list, but this basic checklist has been very, very useful to me so far. It might look lengthy, but it doesn’t take a lot of time at all- a patient is not likely going to have all these issues with their heart. 

  Anyway. I still don’t love ECGs, but it feels pretty wonderful to be able to be able to evaluate it in a systematic manner, and get the theory behind interpreting the scribbles of an ECG reading. I don’t get these moments as much as I would like to, but it’s that crosspoint where my classroom learning actually meets real-life applications that gives me happy brain-gasms for days. I love knowing things and more importantly, knowing why.

- we are not men. we are not "basically men" or "trans men in denial". we do not experience male privilege. this goes DOUBLE for trans butches.

- being butch is not about being violent or aggressive or cruel. if a butch is violent or aggressive or cruel, that's a character flaw, not a defining feature. some of us may be strong and intimidating and use that to protect others and ourselves but the key word there is PROTECT

- a LOT of us face enormous violence for being who we are. most of us face misogyny on a regular basis, from both men and gender conforming women. many of us have had our butchness shaped by misogyny

- butch fashion is one tiny facet of what makes us who we are. a straight girl wearing a collared shirt and slacks is not Butch

The other day I came across this awesome program by accident (I don’t even remember what I was actually searching for, but on the several times I’ve looked for a program like this I’ve had no luck). It’s cool enough that I wanted to share it.

It’s called DesignDoll (website here) and it’s a program that lets you shape and pose a human figure pretty much however you want.

There’s a trial version with no expiration date that can be downloaded for free, as well as the “pro license” version priced at $79. I’ve only had the free version for two days so far, so I’m not an expert and I haven’t figured out all of the features yet, but I’ve got the basics down. The website’s tutorials are actually pretty helpful for the basics, as well. 

Here’s the page for download, which has a list of the features available in both versions.

There are three features the free version doesn’t have:

Can’t save OBJ files for export

Can’t download models and poses from Doll Atelier (a sharing site for users; note that the site is in Japanese, though)

It can’t load saved files

The third one means that if you make a pose, save it, and close the program, you can’t load that pose/modified model later. You have to start with the default model. I found that out when I tried to load a file from the day before (this is why reading is important…). Whether saving your modifications (and downloading models and poses) is worth $80 is up to you. 

But, the default model is pretty nice and honestly if all you’re looking for is a basic pose reference it should work fairly well as it is. Here’s what it looks like:

There’s a pose tag that lets you drag each joint into place and rotate body parts. The torso and waist can be twisted separately, and it seems like everything pretty much follows the range of movement it would have on an actual human.

Even the entire shoulder area is actually movable along with the joint! See, like how the scapular area of the back raises with the arm:

The morphing tag is one of the coolest features, in my opinion. It lets you pick and choose from a library of pre-set forms for the head, chest, arms, legs, etc. It has some more realistic body shapes in addition to more anime-like ones. Don’t like the options there? Mix a few to get what you want! Each option has a slider that lets you blend as much or as little as you want into the design. 

So you, too, can create beautiful things like kawaii Muscle-chan!!

The scale tag lets you mess with the proportions and connection points of different joints. This feature combined with the morphing feature not only allows more body shape variations, but it also means that you can do things like make a more digitigrade model if you want. (The feet only have an ankle joint, but for regular human poses that’s all that you really need, so whatever.)

Or you can make a weird chubby alien-like thing with giant hands and balloon tiddies if that’s more your thing.

The ability to pose hands to the extent it allows is far more than I could have hoped for from a free program. Seriously, you can change the position of each finger joint individually, as well as how spread out the fingers are from each other. Each crease on the diagram below is a point of movement, and the circles are for spread between fingers. 

And to make it a bit more convenient, there’s a library of pre-set hand poses you can pick from as well, and then change the pose from that if you like. 

In both versions, you can also import OBJ files from other places for the model to hold, like if you wanted to have them hold a sword or something.

That shaded ball on the left is your light source. You can see how moving the point changed the shadow cast.

Oh and all those other nifty looking things in that bottom bar there, yeah it’s what you think. You can change the model color to one of these presets or even customize your own palette.

Plus for all you lovely people who want something a little more simplified to use as a pose reference