i can't lie to you i loveee bad endings sometimes. what if nothing worked out. what if the characters gave into their worst instincts. what if they became worse. what if there's truly no hope left. what will they do out of desperation? who will they become as their worst selves?
For the most part, my approach to prescribing hormones is âsure,â but I will note that the one thing I lean HARD on patients about is smoking. If youâre transgender, and youâre on hormones, the number one thing we want to protect is your cardiovascular health. Thatâs frankly the number one thing I want to protect in all my patients, but anyone taking exogenous hormones is at higher baseline risk. And the best thing you can do for your heart is DONâT SMOKE. Itâs a bitch to quit, and I didnât even smoke much or long before I quit in my late teens, and I STILL didnât enjoy quitting and had smoking dreams for years. Itâs harder to quit than just about anything else up to and including crack and heroin, and thatâs coming from a patient of mine who recently passed in her early 60s whoâd done all of those thingsâfor years and yearsâbut eventually was able to quit everything except smoking. And that killed her. She developed severe COPD and eventually called to say her blood oxygen saturation was dipping into the 70s, which is incompatible with life. She was lucid enough to decline medical care, including refusing to call 911 or go to the ER. A week later, after both I and one of our outreach nurses had contacted her to ask her to please go to the ER, I got a notification that sheâd been found dead. She had been so frustrated that she wasnât a candidate for a lung transplant.
One of my oldest trans patients is in her late 50s. Sheâs had blood clots that went to the lungs. Repeatedly. Smoking raises that risk. Estrogen raises that risk. Sheâs a veteran with PTSD; of course she smoked.
These arenât theoretical. These are humans Iâve cared for over years of their lives. I have been rooting for themâmy beloved former addict, who spoke without shame about her years of homelessness and drug use in the city; my queer elders, who are slowly trading in their motorcycles for power scooters. I want everyone to live their fullest, best life.
Smoking doesnât fit into that. Please donât smoke. I donât want you to die like thatânot now and not later. I want you to have the future that you may not be able to see yet, but exists.
Since I moved home as an out queer, word got out, and thereâs a whole apartment complex of lesbians in their 60s to their 80s who come see meâsitting next to their wives in the office, nagging about blood pressure meds, tattling about not having gotten the shingles shot they said they would. To be clear, when I was growing up in town, I knew no lesbians. Not one. I knew one gay kid in my class, which eventually turned into two. We were it. To see these women living decades with their wives and being able to squabble like any couple in my office over who was supposed to bring their home blood pressure cuff in for us to check it⊠it means the world to me.
In addition to the fact that it kills you and the people around you, you should quit because Big Tobacco are smug, queer-hating assholes who named their campaign to hook gays âOperation SCUMâ and, cross my heart, I am not shitting you. They also made the playbook used by Big Oil and antivaxx conspiracy theorists.
So, just a reminder that spite is a great reason to quit smoking.
Also, I keep hearing people RAVE about the book The Easy Way to Quit Smoking by Allen Carr. You can do this - other people have done this! Thereâs help out there. And spite.
Good addition! Quit smoking to stand against capitalism!
going absolutely insane because this is one of my favorite quotes from the book
'so pretty'
final commission from my batch! Don for XXVeil. this one was a doozy
charles when edwin is being mean for no fucking reason:
was thinking since transformers have sparks instead of hearts it'd be cute if they used stars as iconography for love
choices made in anger is such a crazy image. if you know what i'm talking about
i'm gonna thrup
we have to help. even if it's scary, and the odds are bad, and we might die horrifically.
I had to
dazzled
Dead Boy Detectives 1.02
Detail of Falling Cherry Blossoms, by Tatsumi Shimura, 1953, Japan.