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ScriptMedic

@scriptmedic / scriptmedic.tumblr.com

An Archived Medical Consultancy for Writers. Personal Blog: @xoxoauntscripty Also posts general writing advice.

I was thinking about how my position on medical realism in storytelling has changed.

When I started this blog, all the common mistakes/tropes/myths really got inder my skin, because life/medicine/the human body usually doesn't work the way it does in movies or TV.

Or rather, movies and TV like to ignore how things really work in service of telling a better story.

And when people think life works like the movies, it adds real difficulties by way of unrealistic expectations. It makes the real world harder.

Then my pendulum swung toward, "tell a good story with enough detail that it feels real enough for the world you're building." Basically, I loosened up a bit, and recognized that stories are meant to be fantasies.

Then I watched the first few episodes of E.R. for the first time the other day courtesy of Mrs. Scripty, and realized that when a good writer gets the medicine right, you can have both incredible storytelling and pinpoint accuracy. (I spotted one tiny error in the first 4 episodes of ER, which, all else being equal, is an incredible accuracy rate. Even the characters' mistakes are completely appropriate based on specialty and experience).

I think you're still better off deciding how real you want your story to be, and what you want the impact of a given injury/illness to have on your character, and what you want it to reveal about them, and back-building from there.

But damn is it good to watch a show really fucking nail it.

I know this is a super duper longshot. But. Do any of my GIFmaster friends have either of the following?

• The line "Tricky fish! Tricky fish!" from Lilo & Stitch

• The moment from the Invader Zim Christmas special where Santa ignores a question and just.... shoves a little girl under the bed

• The line "Naaaaah... eh-eh" from the Muppets Christmas Carol

I would be eternally grateful if any of these things existed, but my GIF-fu is weaksauce.

PS, love you all ❤️

xoxo, Aunt Scripty

Hi I’m new here idk know the ‘about books only’ part of asks works, but does it count if I ask for book recommendations? Because I was wondering if you knew (or had written) any books about eating disorders and how to write and/or support someone with one.

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Hey! Sorry, I don't know any books on the topic, but for the overlap of mental health and storytelling, try @scriptshrink !

Ref Recs for Whump Writers

Violence: A Writer’s Guide This is not about writing technique. It is an introduction to the world of violence. To the parts that people don’t understand. The parts that books and movies get wrong. Not just the mechanics, but how people who live in a violent world think and feel about what they do and what they see done.

Hurting Your Characters: HURTING YOUR CHARACTERS discusses the immediate effect of trauma on the body, its physiologic response, including the types of nerve fibers and the sensations they convey, and how injuries feel to the character. This book also presents a simplified overview of the expected recovery times for the injuries discussed in young, otherwise healthy individuals.

Body Trauma: A writer’s guide to wounds and injuries. Body Trauma explains what happens to body organs and bones maimed by accident or intent and the small window of opportunity for emergency treatment. Research what happens in a hospital operating room and the personnel who initiate treatment. Use these facts to bring added realism to your stories and novels.

10 B.S. Medical Tropes that Need to Die TODAY…and What to Do Instead: Written by a paramedic and writer with a decade of experience, 10 BS Medical Tropes covers exactly that: clichéd and inaccurate tropes that not only ruin books, they have the potential to hurt real people in the real world. 

Maim Your Characters: How Injuries Work in Fiction: Increase Realism. Raise the Stakes. Tell Better Stories. Maim Your Characters is the definitive guide to using wounds and injuries to their greatest effect in your story. Learn not only the six critical parts of an injury plot, but more importantly, how to make sure that the injury you’re inflicting matters

Blood on the Page: This handy resource is a must-have guide for writers whose characters live on the edge of danger. If you like easy-to-follow tools, expert opinions from someone with firsthand knowledge, and you don’t mind a bit of fictional bodily harm, then you’ll love Samantha Keel’s invaluable handbook

So so honored to get THREE separate mentions in this list! (I haven't read the first few, but the first one sounds fascinating!)

To differentiate the last 3, which are mine:

10 BS Tropes: this is how not to piss off medical folks in storytelling. It is short, and it was free the last I checked.

Maim Your Characters: this is a guide to injury as a plot structure tool. As in, how and when do you make the most out of a good character thrashing, from a plot perspective?

Blood on the Page is the book that tells you how long a specific injury might take to heal, what the character would go through, and details about their treatment.

Also, if cash is an issue, most of Blood on the Page and Maim Your Characters is available in my blog archives if you can navigate the hellsite. (The #masterposts tag is your best bet). And 10 BS Tropes was free the last I checked!

(Since I've had people ask: I priced the books so that, last I checked, I earn equivalent royalties whether you buy paperbacks or digital.)

xoxo, Aunt Scripty

P.S.: While I no longer answer asks about specific scenarios or injuries, I'm happy to answer questions about the books themselves via DM or ask box. Including the "hey I want this but REALLY can't afford it could you PDF me?" ones.

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Okay, as a nurse with an advanced cardiac life support certification for adults and a neonatal resuscitation certification, I feel like this is a question I can answer.

First, understand that the blood moved by cpr is much less than that moved by a normal heartbeat. Our goal with cpr is to maintain brain and critical organ perfusion until ROSC (return of spontaneous circulation) is achieved. The number of beats per minute recommended is based on what we know about about basically the maximum speed of cpr that can a) be achieved by an average person, b) be sustained by an average person, and c) (this is the most important) allow full chest recoil. Chest recoil is the chest getting back to full thickness after you release pressure on it. This is extremely important because that allows the heart to fill back up with blood so you can push it out with your next compression. Faster cpr doesn't move blood efficiently because there's not enough blood returning into the heart to push back out. We also compress in adults to a depth of 2-2.4 inches (5-6 cm) in an adult to ensure that we're emptying the heart sufficiently. This depth is smaller in children because they have a proportionately smaller chest cavity. The key is we want to compress to a depth around 1/3 the total depth of the chest.

Second thing to understand is that the movement of oxygen is via a gas gradient. Oxygen wants to move from where there's the most oxygen to the last oxygen until all fluids present have the exact same amount of oxygen. So we need to get oxygen into the blood. In one rescuer cpr this is achieved via compressions only because when you compress the chest you compress the lungs as well, which means that chest recoil also moves air into the lungs and this air allows for gas exchange which removes some CO2 and adds some oxygen. Chest recoil isn't as good at this as ventilation, which is why if there are two rescuers we prefer to have one ventilate and one compress (ideally you'll have more than 2 rescuers because best practice is to change compressors every 2 minutes). This will move more oxygen into the lungs.

Thirdly, we're trying to maintain a minimum blood pressure (we probably won't measure this during cpr until ROSC is achieved). In order to maintain brain, heart tissue, and kidney perfusion, we need enough blood pressure to move oxygenated red blood cells into the tissues and remove spent ones. Because we don't measure this, I can't remember the exact values, but I think in nursing school they said we needed a minimum of 80/40 to prevent kidney failure in sepsis, so I assume it's somewhere around there.

Fourth, every time you pause compressions to change compressors, a gap in compressions of more than roughly one second plummets that blood pressure we're trying to maintain down to zero. Your next 3 or so compressions won't move oxygen. They'll just be working to 'pump up' blood pressure to where we're properly moving oxygen again.

So now that we know what cpr does, let's talk Witcher physiology versus human physiology a little bit.

Now, in the shows, fan films, and games, witchers have roughly the same chest circumference as a human. This implies that the organs in the chest are roughly the same size as those of a human. So that means we should be keeping that compression depth of 2-2.4 inches or 1/3 the total chest depth to move blood.

We should also compare human pulse rate to Witcher, right? Well, a normal pulse rate for a human is 60-100 bpm. 1/4 that is 15-25. CPR is done at an ideal rate of around 120 bpm, meaning it's clinically tachycardic for a normal human. We also need to know that normal pulse range doesn't mean every human's resting pulse lays in that range. For very fit people, like say marathon runners and cross country skiers with excellent cardiovascular health, they often have a much lower resting pulse. I once looked after a marathon runner whose resting pulse rate was 30. What's the resting rate for a Witcher again? Up to 25? Pretty close, right?

We do not taper the rate of our cpr for marathon runners. A couch surfer like me with a resting pulse of 80 gets the same 120 bpm cpr as a marathon runner who is well oxygenated at 30 bpm.

Given this, I believe that the Witcher should receive standard human cpr.

But here's where it gets weird. Marathon runners and witchers live at a lower heartrate and (probably got witchers, definitely for marathon runners) blood pressure than your average human. Their body uses perfusion or efficiently. Which means that with good quality cpr, in marathon runners we sometimes achieve consciousness before ROSC. Which is great because it tells us we're achieving perfusion of the brain. We do not want to slow down just because they became conscious. We want that perfusion.

But most people who wake up disoriented with someone bouncing on their chest and cracking their ribs become combative. So fun fact, you're going to do cpr on your Witcher at normal human speed and then convince him to fucking stop fighting you until ROSC.

Now, we also use drugs and electricity to help restart the heart in ACLS and achieve ROSC. We probably don't have electricity, so let's consider drugs and run a 'chemical code'. Two big ones are atropine and adrenaline. If we want to be really nerdy, based on the ingredients and effects in the Witcher video games, Cat should have a decent amount of atropine. Maribor forest and Blizzard both generate adrenaline points so let's assume those are artificial adrenaline at least in part.

So depending on what you think caused your Witcher to go down, when he wakes up from your excellent human speed cpr, have him drink Blizzard, Maribor forest, or Cat and hopefully you'll achieve ROSC!

Tldr: it should be human speed.

From a former critical care paramedic with 15 years experience: absolutely flawless.

I would add one bit of nuance about chest compression rates, because the recommended rate has changed over time.

It was 100bpm for a long time (to the beat of "Staying Alive" or, if you're a twisty little cruller like me, "Another One Bites the Dust"). It's faster than resting human heartbeat, but on the low end of human heart rates during critical illness (can go up to 200bpm depending on age).

When the standards were raised to 100-120bpm, I remember the logical justification being that it was raised for 2+ rescuer CPR, because if you're going 100 beats per minute solo you're good, but if you stop to add breaths you actually decrease the heart rate waiting for 2 breaths every 30 compressions. So 120/min, minus breaths, = 100.

But once you intubated the patient, you didn't have to increase heart rate to accommodate breaths, because those breaths were given asynchronously, i.e. the breaths go in without stopping compressions.

So the new guideline was originally sold as -

1 rescuer = 100bpm = Another One Bites the Dust

2 rescuer = 120 bpm = boring, no song, boo

2 rescuer intubated = 100bpm, Another One Bites the Dust but with more tubes

I honestly haven't renewed my CPR since leaving health care, but I believe the 2020 AHA guidelines were still like this, but they framed it as "100-120 bpm" to not confuse people?

Anyway yeah, solid agree, hump the corpse to the beat of Another One Bites the Dust and all will be well.

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Hey! Are there blacksmiths in your story? I'm a hobbyist blacksmith and I'm here to help!

Blacksmithing is one of those things that a lot of people get wrong because they don't realize it stuck around past the advent of the assembly line. Here's a list of some common misconceptions I see and what to do instead!

  • Not all blacksmiths are gigantic terrifying muscly guys with beards and deep voices. I am 5'8, skinny as a twig, have the muscle mass of wet bread, and exist on Tumblr. Anybody who is strong enough to pick up a hammer and understands fire safety can be a blacksmith.
  • You can make more than just swords with blacksmithing. Though swords are undeniably practical, they're not the only things that can be made. I've made candle holders, wall hooks, kebab skewers, fire pokers, and more. Look up things other people have made, it's really amazing what can be done.
  • "Red-hot" is actually not that hot by blacksmith terms. when heated up, the metal goes from black, to red, to orange, to yellow, to white. (for temperature reference, I got a second degree burn from picking up a piece of metal on black heat) The ideal color to work with the metal is yellow. White is not ideal at all, because the metal starts sparking and gets all weird and lumpy when it cools. (At no point in this process does the metal get even close to melting. It gets soft enough to work with, but I have never once seen metal become a liquid.)
  • Blacksmithing takes fucking forever. Not even taking into account starting the forge, selecting and preparing metal, etc. etc. it takes me around an hour to make one (1) fancy skewer. The metals blacksmiths work with heat up and cool down incredibly fast. When the forge is going good, it only takes like 20 seconds to get your metal hot enough to work with, but it takes about the same time for it to cool down, sometimes even less.
  • As long as you are careful, it is actually stupidly easy to not get hurt while blacksmithing. When I picked up this hobby I was like "okay, cool! I'm gonna make stuff, and I'm gonna end up in the hospital at some point!" Thus far, the latter has yet to occur. I've been doing this for nearly a year. I have earned myself a new scar from the aforementioned second degree burn, and one singe mark on my jeans. I don't even wear gloves half the time. Literally just eye protection, common sense, and fast reflexes and you'll probably be fine. (Accidents still happen of course, but I have found adequate safety weirdly easy to achieve with this hobby)
  • A forge is not a fire. The forge is the thing blacksmiths put their metal in to heat it up. It starts as a small fire, usually with newspaper or something else that's relatively small and burns easily, which we then put in the forge itself, which is sort of a fireplace-esque thing (there's a lot of different types of forge, look into it and try to figure out what sort of forge would make the most sense for the context you're writing about) and we cover it with coal, which then catches fire and heats up. The forge gets really hot, and sometimes really bright. Sometimes when I stare at the forge for too long it's like staring into the sun. The forge is also not a waterfall of lava, Steven Universe. It doesn't work like that, Steven Universe.
  • Welding and blacksmithing are not the same thing. They often go hand-in-hand, but you cannot connected two pieces of metal with traditional blacksmithing alone. There is something called forge welding, where you heat your metal, sprinkle borax (or the in-universe equivalent) on it to prevent the metal from oxidizing/being non-weldable, and hammer the pieces together very quickly. Forge welding also sends sparks flying everywhere, and if you're working in a small space with other blacksmiths, you usually want to announce that you're welding before you do, so that everyone in a five-foot radius can get out of that five-foot radius. You also cannot just stuck some random pebbles into the forge and get a decent piece of metal that you can actually make something with, Steven Universe. It doesn't work like that, Steven Universe.
  • Anvils are really fucking heavy. Nothing else to add here.
  • Making jewelry is not a blacksmithing thing unless you want jewelry made of steel. And it will be very ugly if you try. Blacksmithing wasn't invented to make small things.
  • If there's anything here I didn't mention, just ask and I'll do my best to answer.

If anyone has some fiction questions for a blacksmith, perhaps this kindly Tumblr could help?

TO THOSE MAKING NATIVE OCS

I see this a lot, no one has actual names, or any reference for names, that are legit Native American, varying among the tribes, for their characters.

Babynames.com and shit like that will give you names made up by white people.

However, I’ve got your solution.

Native-Languages  is a good website to turn to for knowledge on a lot of native things, including native names. If you’re unsure about the names you’ve picked, they even have a list of made up names here!

Please don’t trust names like babynames.com for native names, they’re made up and often quite offensive to the cultures themselves.

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shishitsunari

Thank you!

Native Languages is a great website. I use it for my fact-checking since it always has reliable links to tribal sites.

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things people do after having a nightmare that isn’t crying

  • struggle to catch their breath
  • grab onto whatever’s close enough to ground themselves in reality
  • become nauseous / vomit
  • shake uncontrollably
  • sweat buckets
  • get a headache

things people do to combat having nightmares if they occur commonly

  • sleep near other people so they can hear the idle sounds of them completing tasks
  • move to a different sleeping spot than where they had the nightmare
  • leave tvs / radios / phones on with noise
  • just not sleep (if you want to go the insomnia route)
  • sleep during the day in bright rooms

things people with insomnia do

  • first, obviously, their ability to remember things and their coordination will go out the window
  • its likely they’ll become irritable or overly emotional
  • their body will start to ache, shake, and weaken
  • hallucinate if it’s been long enough
  • it becomes incredibly easy for them to get sick (and they probably will)

add your own in reblogs/comments!

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common myths about migraines (AKA if you get headaches regularly, please seek treatment for migraines)

"i don't have migraines because while i get them several times a week, it's only when i am hungry or dehydrated."

those are probably migraines. thirst, hunger, sleep disturbances, or any disruption to routine are common migraine triggers.

"my headaches are specifically barometric related, i get them when the weather/altitude changes."

those are probably migraines. barometric pressure is a common migraine trigger.

"i get headaches all the time but ibuprofen gets rid of them so they can't be migraines."

that's not true. ibuprofen works great at relieving migraine pain for many people.

"my consistent headaches are tension headaches. i feel them originate in my neck/shoulders."

those are probably migraines. muscle tension is a common migraine trigger.

if you are regularly getting headaches (once a week or more), you are likely getting migraines. in fact, a good rule of thumb if you're consistently getting headaches is to treat them as migraines until you can rule out migraines. that's how common "chronic headache = migraine" actually is.

migraines are a neurological disorder wherein pain is one symptom. pain is often the MAIN symptom, and the most noticeable symptom, which can make diagnosis tricky. other symptoms of migraine include:

  • fatigue
  • nausea/vomiting
  • digestive issues
  • visual disturbances (auras)
  • sensitivity to light and/or sound
  • mood changes
  • brain fog/cognitive changes
  • ringing in the ears
  • dizziness/vertigo
  • numbness/weakness on one side of the body

this list is NOT complete, but is a starting point. i really like the comparison to a hangover. if you generally feel hungover when you get a headache (without having consumed alcohol), that's a classic migraine presentation.

so many people suffer from migraine and don't even know it, so they aren't able to advocate for themselves to get treatment. there are great new migraine treatments on the market! if you're able, please seek treatment for your migraines. a better quality of life is possible.

here's some more myths! brought to you by the most frequent comments i get on my migraine posts.

"but migraines are extremely painful/debilitating and i can push through my pain."

migraines certainly can be debilitatingly painful. the pain can also be mild/easily treatable. it depends on the person and it depends on the day. regardless, your ability to live with chronic pain does not mean your pain isn't a problem!

"my headaches always have a direct cause/trigger so they can't be treated/they're my fault."

wrong! migraine is a sensory disorder in many respects. most/all migraines are triggered by something. avoiding triggers is good but isn't the whole story, and migraines with triggers can be treated effectively!

"i feel pain in (x) area of my head so it's not a migraine."

migraines can hurt in a specific area of the head/one half of a person's head. but this is not universally true for every person. please forget every silly infographic you've ever seen about areas of the head equaling different kinds of headaches. that's just literally false.

Seems like this could be useful to some of y'all

HEY ARTISTS!

Do you design a lot of characters living in not-modern eras and you’re tired of combing through google for the perfect outfit references? Well I got good news for you kiddo, this website has you covered! Originally @modmad made a post about it, but her link stopped working and I managed to fix it, so here’s a new post. Basically, this is a costume rental website for plays and stage shows and what not, they have outfits for several different decades from medieval to the 1980s. LOOK AT THIS SELECTION:

OPEN ANY CATEGORY AND OH LORDY–

There’s a lot of really specific stuff in here, I design a lot of 1930s characters for my ask blog and with more chapters on the way for the game it belongs to I’m gonna be designing more, and this website is going to be an invaluable reference. I hope this can be useful to my other fellow artists as well! :)

Did you find this helpful? If you’re able, maybe buy me a coffee please? :D

Aaaaand could maybe be helpful for writers too!

If I were to do something Very Stupid and mildly unretire to write ONE (1) post about storytelling + health/injuries/trauma/diseases/...

....What would you want it to be about?

(NOT a promise)

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Sincerely: This is 100% not true! Donations to science have a lot of positive upsides. There are a lot of things cadavers can be useful for, including testing new treatments or surgical procedures, providing valuable training and education for students, and more!

You can also register to become an organ and tissue donor if science isn’t your thing! One donor can save up to 8 lives (depending on what’s healthy enough to donate). Even if you have significant organ damage, your corneas can help others see again, and your skin can help a burn victim survive.

Your body has worth, both when you’re alive and after you’re gone ❤️

This is genuinely something I think about somewhat frequently. I am an organ donor. When I pass on my body will be useless to me and if it can help other people then I want them to have it.

But I had covid last year and now I wonder about that. See, I had covid in January then later that year I was diagnosed with long covid and still apparently struggle with some symptoms.

It’s made me wonder about all the talk of how long covid can hang out in the body. If it can be passed on through the organs donated. It sounded far fetched, but there have been stories of people having new memories after organ donation (which is another thing I’ve become weary of know that I know more of my trauma), why not covid?

A friend of mine who is a nurse, looked it up and actually did find a story of a woman who was organ donor passed a long after she’d had covid and the recipient ended up with covid after no known exposures.

Now I have a mornid curiosity about it every time I get on my car.

It is 100% better to be alive with a COVID exposure than to die of organ failure ¯⁠\⁠(⁠◉⁠‿⁠◉⁠)⁠/⁠¯

Yes, risks. Yes, screening procedures. But the alternative for most recipients is a pine box.

Pine Box Prevention is one of the highest good deeds one can do IMO. So stay curious, look at the science based evidence, but don't let the what-ifs of donation make you change your mind on giving someone else a chance to live.

Sincerely: This is 100% not true! Donations to science have a lot of positive upsides. There are a lot of things cadavers can be useful for, including testing new treatments or surgical procedures, providing valuable training and education for students, and more!

You can also register to become an organ and tissue donor if science isn't your thing! One donor can save up to 8 lives (depending on what's healthy enough to donate). Even if you have significant organ damage, your corneas can help others see again, and your skin can help a burn victim survive.

Your body has worth, both when you're alive and after you're gone ❤️

Every movie makes it look so easy to snap someone's neck by twisting their head really fast and hard, and it's used all the time, but it can't possibly be that easy or effective can it? It's not like every Joe Schmoe on the street can start going around snapping necks can they? They also love to have people snap necks between their thighs, I imagine that's even harder and less likely to work.

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So, breaking someone's neck with your bare hands basicallyisn't a thing. Actually breaking your neck doesn't take a lot of force, but the whole neck snap thing takes an absolutely comical amount of force to work, and even if it did, it wouldn't necessarily be lethal. The idea is that it severs the spinal column or the brain stem, but in practice, all you'd be able to do is abuse some dense muscles and ligatures.

This is a real risk in auto accidents, particularly if the victim isn't properly belted, but the version you see in films is pure fiction.

Choking someone out is a lot more viable. This can either come from asphyxiation, or from obstructing blood flow to the brain. The former is slow, and is likely to cause the victim to panic while they slowly lose consciousness. The latter (sometimes called a blood choke, or triangle choke) can quickly lead to death, as you starve the brain of oxygen by cutting it off after it's been absorbed by the body. You do sometimes see these in film, though the amount of time needed to subdue someone is hilariously abbreviated. If you're just choking someone, that will take minutes before they'll lose consciousness, and they're going to seriously start to freak out once they realize they can't breath. Blood chokes, as mentioned earlier, are faster, but you're still looking at a long time in a fight.

Neck snapping with the thighs is about as plausible as the neck twist. Choking someone out with the thighs is slightly more credible. Legs can be used in submission holds while grappling. But, if we're being honest, I think we all know that this isn't used because it's realistic, it's the sex appeal. Without speaking from personal experience, I suspect thigh chokes are harder to get out of, simply because your legs are significantly stronger than your arms, but I'm speculating.

Also, importantly, suffering a broken neck isn't (usually) going to be immediately lethal. As mentioned earlier, unless the spinal chord is severed or the brain stem is damaged, they'll survive. This may result in a life altering injury, but it's not going to be an, “oh, they're instantly, and quietly, dead.”

I remember running across a news report, when we last covered this, where a couple of teens had decided to kill someone by snapping their neck. The victim ended up with some soreness in their neck, and the teens went away for attempted murder. Moral of the story, this doesn't work.

-Starke

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Flawless as ever from @howtofightwrite !

For some extra goodness....

Keep in mind, when someone tries this, they're looking to overcome some of the strongest muscles in the body (the strap muscles, AKA SCM or sternocleidomastoid, and the trapezius muscles where they connect to the skull, AND levator scapulae), break the vertebrae, and then also break the spinal cord itself.

Also, the first two vertebrae (C1 and C2, Axis and Atlas) are literally designed for rotation. There's a limit, but the neck turns pretty far just fine.

For reference, when someone is being executed by hanging, a good hangman will make the drop up to 3 meters (9 feet+) to make sure enough force is applied to break the neck and sever the spinal cord. Generally it takes 1,000 - 1,250 foot-lbs of torque to do this - an amount of force it's almost impossible to generate by hand.

Hey. Why isn’t the moon landing a national holiday in the US. Isn’t that fucked up? Does anyone else think that’s absurd?

It was a huge milestone of scientific and technological advancement. (Plus, at the time, politically significant). Humanity went to space! We set foot on a celestial body that was not earth for the first time in human history! That’s a big deal! I’ve never thought about it before but now that I have, it’s ridiculous to me that that’s not part of our everyday lives and the public consciousness anymore. Why don’t we have a public holiday and a family barbecue about it. Why have I never seen the original broadcast of the moon landing? It should be all over the news every year!

It’s July 20th. That’s the day of the moon landing. Next year is going to be the 54th anniversary. I’m ordering astronaut shaped cookie cutters on Etsy and I’m going to have a goddamn potluck. You’re all invited.

Hey. Hey. Tumblr. Ides of March ppl. We can do this

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Wait what's a buildings fire evacuation plan if you aren't supposed to use the elevator to get down

You go down the stairwell/fire escape. Is that weird?

But what if you have a walker or a wheelchair??

in america at least, in this situation, there isnt one. either your loved ones or the firemen can get you out using the emergency fire escapes or stairs, or you die 

That's fucking horrific, thank you

“fun” little story:

last summer my friend who is an amazingly talented artist and i were in this super tall building, and she’s in a wheelchair and i’m pushing her around the room. it’s an art exhibit and some of her art was chosen to be showcased there and so it’s all fine and dandy until suddenly an alarm starts going off

a FIRE ALARM

everyone starts running for the stairs and my friend just looks at me with this forlorn look on her face

“i can’t go down the stairs”

but i’m a stubborn bitch “i’ll carry you”

“what about my chair? it’s too expensive for me to be able to get another one if i can’t get this one back”

“i’ll carry that too”

and i did. we went to the stairs (by then most people from our floor were gone) and i lifted her up in a fireman’s carry over my shoulder and then lifted her chair up and used the ridiculous amount of adrenaline that was coursing through my veins to make it down approximately 20 half-flights of stairs until we met some people exiting lower floors, one of which who kindly took the chair. I changed positions so i was holding my friend bridal-style which was, somehow, easier and the person who took her wheelchair (with her permission to handle it of course) accompanied me to the ground floor and then out the doors

basically there is no real protocol for people who can’t use the stairs in an emergency. it’s up to the people with them, if anyone, to help them or the person to somehow make it down the stairs alone, unassisted

thank fuck that it was just a faulty alarm system, because if i was unable to carry her down those stairs and the building was on fucking fire???? then i don’t know what would have happened to her, but i don’t think it would have been very good.

it’s fucking ridiculous and ableist to the absolute max.

I use a cane. When I did a day-long fire safety training at my northeast American university (UMass Amherst), I asked that exact same question: “what am I supposed to do if the fire alarm goes off and I’m in my lab on the twelfth floor?” 

the fire marshal hemmed and hawed for a while and then said to take the elevator- you’re supposed to leave it free for the fire department to use and they want able-bodied people out fast not waiting for elevators. if the fire alarm has just gone off the building probably hasn’t suffered enough structural damage to make using the elevator dangerous, and modern elevator wells are heavily reinforced. many large and high-trafficked buildings on my campus have fire rated elevators that link in with the fire alarm system so they won’t let you off on a floor with a possible fire. 

if the elevator isn’t working, wait in the stairwell and call the fire department to let them know where you are. modern stairwells are also heavily reinforced- it might not be pleasant but modern building code usually requires fire-resistant stairwell doors in office and big residential buildings, also to help firefighters get in and out safely. older buildings’ stairwells may or may not be retrofitted with fire-resistant doors but a stairwell is generally the safest place to wait if you can’t get out. 

what happened to your friend was horrible, and i’m very glad you were there to help her out, but you can absolutely use the elevator to evacuate if it’s not shut down. those don’t-use-the-elevator rules are for abled people.  

This is GOOD TO KNOW. why do they not tell people this??

Okay, firefighter here. If you are not physically able to use the stairs, and the elevator is NOT compromised, use the elevator. But you MUST be ABSOLUTELY CERTAIN that the elevator is NOT compromised before you get into it, because there is always the chance that once you get into it, you may not exit it. Power could go out. The elevator may actually BE compromised and you just couldn’t tell from where you were until you were in there, and it suddenly shuts down on you. Something else could happen. 

Understand that once you enter the elevator, you could POTENTIALLY be taking your life into your hands there.

It is NOT LIKELY, to be perfectly honest. It’s only in a pretty catastrophic scenario - think the Twin Towers, USA, on September 11th - that the elevators will be compromised and out of service. But there is a NOT ZERO PERCENT CHANCE and you need to understand that and accept it.

As for leaving the elevators free for the firefighters, okay, here’s the deal. Unless your nearest fire station is literally right next door? Your first on scene fire truck is NOT likely to be there on scene and needing that elevator before you get to the ground. It takes us TIME to find the address, gear up, and drive to the building. Then we need to hoof it into where the elevators even ARE, so YOU HAVE TIME to use the elevator to get down to the ground floor... BUT ONLY IF THERE’S NOT A RUSH ON THE ELEVATOR! And THAT is WHY we don’t tell people this shit. That’s WHY we tell people to NEVER USE THE ELEVATOR... because every self-entitled asshole will use it because they don’t feel like walking, and then put YOU in danger by delaying the elevator’s arrival to you.

IF, however, the elevator IS compromised, or you just can’t get it to come for you, or whatever, and you either don’t have anyone with you who has the adrenaline fueled BALLS to be able to toss you over their shoulder and hoof it down the stairs with you - because, let’s face it, that is RARE AS FUCK, then HERE IS WHAT YOU DO:

You call 911 and tell the call taker that you are in the building that has a fire alarm going off, and you are not able to evacuate because of a physical disability, and you tell them what floor you are on, and EXACTLY what stairwell you are waiting at. And the very FIRST thing that the firefighters are going to do once they arrive, if it is, indeed, a REAL emergency, and not a false alarm, is come get your ass and bring you down. Whether that means carrying you down the stairs, or whether that means locking out the elevators so that no one else can override them and coming to get you themselves, they WILL come get you FIRST THING if it is a real event. And if it is a false alarm? You will probably be the first person who is not involved with the building to know, because the call-taker is going to stay on the line with you until you are under someone’s care and out of danger, or until the scene has been sorted out as real or false, and you are out of danger that way.

These are pretty standard operations in the fire service throughout the United States. There may be some minor variations based on specific municipalities, but, for the most part, this is pretty typical: LIFE BEFORE PROPERTY. So, as long as SOMEONE knows where you are - hence why you call 911 - Firefighters will come get you. You are NOT alone, and you have NOT been abandoned. I PROMISE. It’s like, our whole reason for doing the shit we do: to save lives and to break shit. Sometimes, we get lucky enough to do both at the same time.

High rise fires suck ass, and I always hated them. But the very FIRST thing I asked anytime we got one was if we had “any entrapments” - which is what we call anyone who could not self-evacuate for ANY reason. We ain’t leaving you behind. And yes, your friend who doesn’t have the stamina to carry you down can stay with you, too. Because I would never ask that of someone, honestly. 

Also, just a little FYI... MOST fire alarms are false alarms. Not to make anyone complacent or anything, but, yeah. Most of them are either system malfunctions, someone accidentally hit a pull station, or someone burned popcorn in a break room. So don’t let a fire alarm freak you out until you need it to - by smelling or seeing smoke or flames. 

i have had multiple nightmares about this very thing because NOBODY BOTHERS TO ACTUALLY TELL WHEELCHAIR USERS THIS STUFF

After 9/11, and again after Hurricane Katrina, there was movement for awhile around disaster planning for people with disabilities.  There were some grants to fund research on best practices and some guides issued and some calls for publicly funded housing and healthcare in particular and employees in general to come up with emergency planning.

In practice, it didn’t really take.  People who understand the issue tried, but ... it just isn’t even on the list of things to plan for in most organizations.

There are guides to planning:

You’ll note that many of them can only suggest that people unable to evacuate themselves either rely on a coworker who may or may not remember to come for them, or wait for emergency personnel to show up.  

For several larger buildings that I have been in, including a couple hotels and business offices, there were bagged emergency-color-coded packages on the staircase, hanging on the railing with some wording about disabled users.

I never opened one because I didn’t want to get chewed out for curiosity, but always felt like they were a “better than nothing” but shy-of-practical solution. Because the premise I got from them was something like a makeshift sling that supposedly holds someone and they can go down the railing in the stairwell if they are disabled.

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