I’m deeply enjoying this polite and intellectual discourse re: is this physically impossible act I imagined at 14 years old docking or sounding. Please continue this and all your other weird sexual internet discourse with the same level of polite fervor. :)

When I was in middle school and first learned about gay men I thought one penis would have to open up somehow to accept the other penis as what I now know would be called sounding. Also knowing what I know now that would be pretty extreme even for sounding but I was a preteen fundie and had gotten all my sex ed from an anatomy and physiology book in the family library with 0 direction from any adult so in the absence of any better ideas that seemed like the most likely way that would work out. Anyway this is a great example of why puritans wind up so kinky; you have no idea what normal sex looks like so you just have to imagine it and sometimes the imagination comes up with some really weird shit and before you know it you’re having preteen wet dreams about stuff the human body doesn’t even do.

The worst part is that this story is so common that it’s going to be vaguely similar to about 500 different specific situations across the entire country.

Oh patients get hot potatoe’d all the time it’s just usually they’re full code violent dementia patients. OB hot potatoes are just the new fad in overly legally complicated patients no one wants to be officially responsible for when they die. The republican party is the party of the freedom to die in a ditch full of maggots when your death panel insurance review board (chaired by an eye doctor who’s been out of practice for 10 years after committing fraud) denies your chemo treatment juuust long enough that you’re better off dying quickly and getting out of their hair.

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First they came for the socialists, and I did not speak out—because I was not a socialist.

Then they came for the trade unionists, and I did not speak out—because I was not a trade unionist.

Then they came for the Jews, and I did not speak out—because I was not a Jew.

Then they came for me—and there was no one left to speak for me.

—Martin Niemöller

I have 0 kids and want them to have a good education because I find interacting with stupid people to be exhausting.

Gym doesn’t help the weight issue. You gain weight in the gym, you lose it in the kitchen.

There’s been articles written about it actually. Google “health insurance ghost networks” for more info but the short version is that you know how the only utility of a middleman is to provide convenience? They get to keep more money every time you can’t figure out which doctors they actually cover. They actually get MORE money for being WORSE middlemen.

Also executive dysfunction (fancy word for the motivation and planning it takes to do complex tasks like navigating bureaucracy) is a symptom of pretty much every mental illness ever making them the easiest population to collect a premium from then bury in paperwork and by doing so never actually have to pay out for services. When you add in having the government cut a check perr poor person to insurance companies to provide state benefits it basically becomes an infinite money glitch that churns faster the more people you force into poverty.

Yeah quitting alcohol will kill you and nicotine is still the hard one for a lot of people. My unofficial psychiatric subspecialty is violence management and nicotine is on my list of top ten reasons people will punch you right in the face along with food, perceived threats to their children, and looking like the person that diddled them as a kid. Interestingly opiate withdrawal actually won’t kill you (at least not directly), you’ll just wish it did. Benzos and barbituates totally will though they work on the same system as alcohol.

Fun fact! Nicotine paralyzes your cilia.

Your cilia are a layer of fine hairlike structures that coat most of your respiratory tract. They whip / beat together rhythmically to push debris filled mucous up and out of your respiratory tract to your pharynx where it can be expelled by coughing or swallowed and processed by your digestive tract. When you smoke, they’re paralyzed, allowing debris to build up (and man is there a lot of debris, on account of, y’know, the smoking).

About a week after you quit they wake up and yell,“WHAT THE FUCK IS ALL THIS SHIT?” Imagine if somebody came into your job and roofied you, smeared diarrhea all over the walls, then left. You’d be mad too. Give your cilia lots of water to help thin that mucous out and make their job a little easier during that stage.

Also read up on the other stages of quitting, it’ll make it much easier once you’re expecting these kinds of things.

It’s also been bred to be waaay stronger over the last couple decades. I see a fair amount of weed-induced psychosis rolling through inpatient, or at the very least weed-exacerbated psychosis. Way worse than the psychosis is the hyper-emesis syndrome. One of the characteristic symptoms is “scromiting” (Scream-Vomiting).

It’s better for you than alcohol. That’s not a high bar. A light mauling from a black bear is also better for you than alcohol. It’s waaay better for you than cigarettes but also most brain cancer starts out as lung cancer and I’ll let you follow the rest of that on your own. Most of my substance abuse patients who are hooked on shit like fentanyl and meth also tell me that nicotine is the hardest drug to quit.

Weed’s not the worst. It’s still drugs though.

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…I mean I don’t wanna be that guy but… yeah that’s HCA alright. Iirc a while back they acquired a hospital in North Carolina that subsequently unionized in record time in a part of the country that is NOT union friendly, at which point HCA suddenly pulled out and took their funding. Pretty sure it was a critical access hospital too (critical access means the only hospital for miles around, usually rural). HCA is basically synonymous with capitalism in Healthcare. Even personally they once tried to illegally charge me for emergency mental health services. I’d rather quit nursing entirely than ever work for them. They are sooooo sketchy.

The details don’t match exactly but I’m thinking this is what I’m remembering.

Oh and by the way, remember how capping travel nurse wages was a big thing around that time? So typically when nurses strike they give notice then the hospital has to fill those positions, usually with travel nurses from around the country, who they have to pay to travel, get travel accommodations, get local licenses and certifications, get new uniforms, the whole 9 yards. Then their wages are also high for going to all that trouble plus a cut for the travel agency that’s helping to arrange it all. So yes, the hospital is hiring scabs, but one of the things that made that work out alright in the end is that those scabs will bleed the hospital dry pretty quickly. “Capping travel nurse pay” is an anti-union / anti-strike dogwhistle (I think I’m using that term correctly here).

You. I like you.

My only question is how to best handle children having sex with each other. Do you ban it / try to prevent it from happening at all? Do you set limits on how different they can be in age? Is there an even younger age when it’s never ok but it’s ok if they’re both older AND of similar enough age? Is age not even the right way to do it and more importantly is there a better way? Should you have to pass a class where you can prove you know how to apply a condom and obtain consent from others??? I don’t have any good answers to any of these questions but I do think they’re important to ask and talk about. The more common discussion I wind up in is juvenile substance abuse (should you let kids do drugs as long as they’re in your house so you can keep them safe? Are kids who are raised where everybody 14ish and older can have a glass of wine at the dinner table more or less likely to develop alcoholism due to the increased daily presence but decreased taboo?) but this discussion reuses a lot of the same concepts.

ok you got me try “hairy notes” but I’m still probably gonna use my original version.

Well you do gotta give Cesar back what he done minted.

Oh god eastern religions have puritans too? jk, glad to hear you’re doing well.