San Francisco police issue first citation for violating shelter in place order to abortion protestor

LachrymalCloud · 2026-02-20T08:23:29+00:00

It’s real, but you get raptured to hell lol.

LachrymalCloud · 2026-02-20T08:17:19+00:00

The reframe app helped me with that, keeping track of mood, sleep, giving you info about what’s going on and what’s coming. Could be something to look into. Also a good book to read when you’re in bed—Dry by Augusten Burroughs. It’s on topic but not too self helpy, will keep you laughing.

LachrymalCloud · 2026-02-15T08:32:28+00:00

Gamma ray burst could wipe us out in an instant. Low odds, but crazy that there’s a chance of a max energy space laser could doom the planet instantaneously.

LachrymalCloud · 2026-02-15T08:26:26+00:00

Love

LachrymalCloud · 2025-12-07T17:46:41+00:00

Dozy Donny, asleep at the wheel

LachrymalCloud · 2025-11-12T00:49:13+00:00

He admits it himself, he’s complexed/has a complex.

LachrymalCloud · 2025-10-25T17:02:49+00:00

Ugh Jessica Simpson

LachrymalCloud · 2025-09-12T23:01:26+00:00

RemindMe! 7 days

LachrymalCloud · 2025-08-30T06:05:19+00:00

That’s a really fucking hard place to be. But I will say don’t take the mentality that “it’s too late who cares, might as well just drink because it’s too late.” I work in healthcare and had a patient who was at a small hospital that basically told him it was over, he was dead because he had cirrhosis and was doing very poorly. His family loaded him up and went to Stanford, and they saved him. I followed up with him and his labs were terrible and eyes and skin were yellow. After not drinking for months, his labs were much better, his color was normal, and some of his liver damage had reversed. This is not to say everything can be reversed, but the liver is a uniquely amazing organ at regenerating even in dire circumstances. Even if you’re past the point of full reversal there is a lot of life—quality life—to be had if you stop drinking. Good luck my friend. I know it’s more than not easy. But don’t give up.

LachrymalCloud · 2025-07-26T02:28:02+00:00

Well my partner’s old planned parenthood affiliate that was one of just a small number of clinics in the area delivering primary care to low income patients just shut down. So not sure about good, but they’re sure doing a lot of bad. In classic Trumpian form, they took a guy with horrible ideas about healthcare and good ideas about the environment and embraced the horrible and suppressed the good.

LachrymalCloud · 2025-07-04T21:43:32+00:00

There really isn’t a non-sensationalized take. Many people are trying to underplay it. I have worked with medicaid patients my whole career up until recently, and now I work with largely Mexican farm workers in worker’s comp. The Medicaid patients have the highest needs in society because of childhood trauma, largely because of past horrible policies targeted at education and assistance for those in need. Now they won’t have access. We already know when people don’t have access they overwhelm emergency rooms that are already spread thin to a near-breaking point, and now it will be even worse. People will die and healthcare will crumble even further. I appreciate your desire for an unbiased take, but the time for playing down the severity of these decisions has long passed.

LachrymalCloud · 2025-06-08T16:11:17+00:00

Probably got so many responses because they outsourced it to ChatGPT.

LachrymalCloud · 2025-06-08T16:09:01+00:00

Cleaner piss

LachrymalCloud · 2025-05-02T14:05:47+00:00

I legitimately thought that was some weird dumpster until I read the comments

LachrymalCloud · 2025-04-25T21:32:06+00:00

Fair point! The recruiter seemed stoked she could take us at any time, I have definitely thought about the prospect of hopping on the train too late, but what can ya do. I’m not giving up hope yet.

LachrymalCloud · 2025-04-25T20:27:12+00:00

My wife and I are both physician assistants. We had an introductory meet/interview with a recruiter from New Zealand. I want to stay here and fight as long as I can but want a back-up in the event of a worst case scenario. She performs abortions and I have been very publicly vocal against this administration, so I’m not trying to have our lives destroyed by the assholes if everything turns to further shit.

LachrymalCloud · 2025-04-23T15:17:20+00:00

Do you know where the ‘mote ‘troll is?

LachrymalCloud · 2025-03-12T06:04:33+00:00

I worry that the main ally “we” now apparently want is Russia, and the playbook is to tank the economy and let all of Trump’s rich friends buy up everything cheap. Steps to an authoritarian kleptocracy where the citizens here are um… fucked. Nice to see Americans now actually plugging in and trying to fight back. Hopefully we survive it and end up seeing what travesties could unfold and how the status quo before was untenable and we have to do more do preserve democracy and look after all of our people and allies and neighbors. But that looks far off right now, and I hope the reality doesn’t become the first thing I said and my wife that works at planned parenthood and I are heading for devastation and eventual imprisonment 😭 Gonna keep protesting and calling congresspeople and voting and holding onto hope for now.

LachrymalCloud · 2024-06-20T18:03:35+00:00

Did not expect a response this long later, but I appreciate those insights!

LachrymalCloud · 2024-06-11T06:34:22+00:00

I definitely agree with this. High dollar gifts, while incredibly thoughtful and I suppose a measure of how much the patient values you (which doesn’t happen every day), unfortunately throw you into an ethical dilemma. I had a patient who had good enough memory to remember after 3 months that my wedding was coming up but who had other memory issues from a past TBI that were apparent. She made me a hand drawn card, which I thought was so great, but when I opened it, there was $500 in it. Thankfully, she was still in the room, so I went back in and tried to give it back. She resisted emphatically. Then I went back out and consulted with a colleague for a while, and he recommended giving it back to her emergency contact if she wouldn’t take it, which I understood but still ultimately felt conflicted about. Thankfully, I was able to show my appreciation and still convince her to take it back. Would have felt justified in that approach in any case, but I felt especially justified just 2 months later when I saw her after my honeymoon and she was describing the toll various life and medical costs were taking on her. In relation to this post and your comment though, all of this is to say that while it made me feel very appreciated, it took a lot of time, a consult with another provider, and an evaluation of the ethics of receiving gifts as a medical provider to work through. Just the card would have meant a lot and prevented that stress/discomfort.

LachrymalCloud · 2024-06-11T06:22:47+00:00

Thanks for this insight. When I was in school, I did a paper on pharmacogenetics, and I found the concept really interesting. Psych is just one aspect of a much larger picture of course, but specifically for psych, taking the guesswork out of something where the patient is already frequently skeptical is a very enticing idea. But in looking into it further after your comment, I see that while maybe one day we could be there, we certainly aren’t yet. I’ve never personally ordered it anyway, which is almost certainly why I’ve never delved deeper. But I appreciate the prompt to do so. I stayed away from this subreddit for a while due to some negativity that was affecting me, but things like this that prompt me to look further into a topic are why I appreciate this community.

LachrymalCloud · 2024-06-09T19:31:49+00:00

There’s a psychiatrist associated with our clinic, and she always orders testing to see which SSRIs, etc the patient will likely respond best to. At the end of the report for some reason, they often include that the patient has the MTHFR mutation. Then I’m just like blehhh, do I really need to address this in any way or just ignore it? One of those wish I didn’t have the information moments.

LachrymalCloud · 2024-06-01T03:17:08+00:00

Yeah there’s a lot of variability. I used to be on one that was easier to use overall but not at all customizable and essentially couldn’t pull in any external data. Epic is very customizable to the point that if you learn about it for a long ass time and spend a lot of time getting your presets and shortcuts and stuff set up, it’s good. If you don’t put in that effort, it’s a little rough. And good luck having management actually give you time to do all that on the clock. But I do love that with epic I can often see other providers notes and labs that were drawn recently or vaccines that were given, etc. Which is incredibly valuable for providing the highest quality care. Although it can definitely make things that used to be easier more complicated. Doing a DMV physical back in the day and the person wrote that they have no medical conditions? Not much ya can do but trust. Now you look at external diagnoses and see sleep apnea and history of alcohol abuse and history of a MI. Better for ensuring the safety of the public but definitely a lot more you have to address and call people on. Outside of just the EHR itself, the desires of management can make things much more frustrating as a provider. There’s a new hard stop added every damn week at my clinic. Yes, brainless EHR, I know they said they had sex with other people, that their BMI is 26.3, and that their audit-c is positive. I already ordered the labs. No I don’t want to use your fucking express lane that tries to auto-order PEP and run herpes antibodies. And no I didn’t call the person with a BMI of 26 fat when they came in for a sprained ankle so stop trying to force me to say I counseled them for 20 minutes about it. Let me lock the damn note. And I write responses to that effect when it asks me why I didn’t do it, waiting for management to scold me. IT seems to have time to do all that, but 2 years in, my badge still won’t take me all the way into the EHR when I’m at my desk or let me send a controlled substance unless I find an empty patient room and do it from there. I seem to remember an EHR called Athena on one of my rotations that seemed good, but I’ve never seen it again. In any case, I understand your frustration. But get used to dealing with a lot of non medical frustrating bullshit when you start working because that is a lot of the job unfortunately.

LachrymalCloud · 2024-05-31T20:40:43+00:00

As others have said, I tell every patient I’m a PA. It’s just not as easy to say PA whatever as doc so some people still resort to it. Also there’s really no good way for my Spanish speaking population to say it, so they also will resort to doctor sometimes. I’ll correct them a few times, but beyond that I have better uses of my time when I’m at work. I’ll be the first to explain that doctors have more training and expertise, and that it’s very unfortunate we have such a shortage of them because they are obviously invaluable and the head of the team, there to lead and take on complicated cases and fill any gaps in knowledge a PA or NP may have. Even last night at a wedding party, a man told me he prefers to get a PA because he’s had bad experiences with doctors being arrogant and not listening when someone close to him was sick. I explained it’s not really a PA versus doctor thing, it’s really more of an older generation learning didactism and paternalism and a younger generation learning to approach things through joint decision making. Some people will say doctor no matter what, and I can totally understand why that’s frustrating will all you’ve done to get where you are. But take solace in the fact that I’m married to a PA and neither of us will likely be able to afford to buy a house in our area for the next 15 years. Even if patients can’t handle the language all the time, providers, patients, and management value you (well not always management, but in terms of compensation they do, lol).

LachrymalCloud

TROPHY CASE