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#FRIDAY is truly a strategy queen
idk-bruh-20 · 8 months
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Irondad fic ideas #155
Tony can be... a bit overbearing with his helicopter parent tendencies. To combat this, Peter sets up a small protocol with FRIDAY. 
Any time Tony wants to do something paranoid or invasive, FRIDAY is to send him a helpful article first, with titles like "Excessive Surveillance Can Harm Adolescent Development, Study Finds" and "Why Teens Need Privacy From Their Parents"
Peter leaves the choice of articles up to FRIDAY, trusting her to send ones that fit the situation.
While this protocol does get Tony to reconsider some of his more... extreme impractical requests, in most cases it fails to change his mind. Being hands-off about Peter's safety is not something he can do -- not when he knows the kinds of dangers this particular kid could face.
He's grateful for the insight that the protocol has given him, though. So instead of removing it, he decides to add to it. He asks FRIDAY to make it a two-way street. Now, whenever Peter complains about one of Tony's safety protocols, FRIDAY will send an article to help him understand
However, Tony doesn't anticipate the kinds of articles FRIDAY will choose. While she continues to send Tony studies and editorials, to Peter she sends news reports from Tony's past
Peter's mad that Tony has put trackers in everything he owns? -- "Tony Stark Still Missing: Inside Month Three of the Harrowing Search"
Peter hates the constant health monitoring that FRIDAY does when he's in the tower? -- "Death Wish or Death Sentence? Stark Behavior Tied to Secret Illness that Almost Cost Him His Life"
It goes on and on. For every seemingly insane overreach, there's a story, an experience Tony is trying to protect Peter from. 
They both still disagree about how much protection is too much, but at least they understand each other better now
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Lila Rossi: I’d Say She’s a Good Villain, but Then I’d Be Lying (300 Follower Special)
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Deception and cunning are easily two of the most important traits an antagonist could have. It shows that even if they don't have the strength to overcome obstacles, their wit is more than enough. This kind of trait is why characters like Lex Luthor, David Xanatos, and Princess Azula are so beloved, simply because of how intelligent they can be as villains and pose a real threat to the heroes.
It's clear that the Miraculous Ladybug writers want Lila to be seen as this, but the writing seriously fails to back that claim up.
Easily one of the most controversial characters in Miraculous Ladybug is Lila, mainly for the writing surrounding her. But there was a time where she was actually more of an ambiguous character, mainly for the lack of screentime she had until Season 3. But unfortunately, the more appearances she's had have painted a very poor portrait of an antagonist.
Lila's Tragic and Sympathetic Motivation for Hating Ladybug
Lila's first appearance was at the tail end of Season 1, “Volpina”. She was a new transfer student from Italy, and quickly made friends with a lot of her classmates for the lies she told, including being friends with Ladybug (which Alya blindly believed without doing any research like any excellent journalist). But because of how close she was getting to Adrien, Marinette, in a rare act of selfishness, transforms into Ladybug just to chew out Lila for lying about knowing her, humiliating her in front of Adrien. And this is the only motivation we get for what Lila does afterwards.
I'm not saying that it's wrong for Lila to get upset at Ladybug for doing this, and I like the moment of weakness Marinette has, but this is literally the only explanation we get for Lila deciding to side with Hawkmoth, a literal terrorist. As much as I hated the way the arc turned out, I could still understand Chloe siding with Hawkmoth, as it was clear that Hawkmoth was manipulating her and taking advantage of her ego. Lila? Ladybug's mean to her one time, and that inspires her to conspire with a complete stranger who brainwashes people to attack the city, which endangers innocent people and causes God knows how much in collateral damage if not for Miraculous Ladybug fixing everything.
I just don't get how a single negative interaction with someone is enough to conspire with a literal supervillain. Even in Season 3, when Marinette and Lila truly became enemies, it was because she risked exposing all the lies she told, which could damage her reputation. Sure, it's petty, but it makes sense for Lila to want to keep up the illusion. If she was simply an antagonist to Marinette in her civilian life like Chloe was before “Miracle Queen” , I'd be fine with that, but the writers clearly want her to be seen as on the same level of evil as Hawkmoth. I'll get into why that doesn't work later on.
Why Lila is an Excellent Liar
In my Master Fu analysis, I had pointed out that despite all the flaws he had, the narrative insisted on portraying him as an incredibly wise mentor. The same problem applies for Lila as well. We're supposed to see Lila as an expert manipulator and liar, but her lies are insultingly obvious. She always claims to be friends with celebrities and does all these awesome things, and in an age where we can have almost any question answered thanks to the internet, nobody ever stops to question her.
It's even more frustrating when you hear Lila talk about saving Jagged Stone's cat, when Jagged Stone is established to be very fond of Marinette (evidentially more than his own daughter), and nobody ever points that out. I think if Lila's lies were more stories about her travels around the world than outright lies about real people, it could have worked. It'd still be hard to believe, but it's something.
But this is a problem with writing shows aimed at children. As much as we hate writers who need to spell out things to kids, sometimes, they just don't understand some of the media they consume. Seriously, I never got this joke in SpongeBob as a kid, and I can't believe Nickelodeon actually approved this.
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So the dilemma when writing a show with children in mind is finding that sweet spot between assuming your audience can figure it out, but not being too vague in your details. It's even harder when you need to find a way to convey the fact that someone is lying without being too obvious. Unfortunately, the show clearly fails to do that
Okay, this is going to sound like an incredibly weird thing to cite, and I only know about it because I used to know someone who was a huge fan of the franchise, but the movie Monster High: Friday Night Frights does a better job of subtly explaining to the audience that a character is lying. Please, just hear me out.
The movie follows the main characters competing in their high school's roller derby for the season after everyone on the usual team gets injured, and the championship match is against another school whose team tends to cheat to win matches. How they manage to do this without getting caught is anyone's guess. While the main characters are practicing, their coach, Clawd, notices a spy for the enemy team taking video of them to study their moves. In response, he calls over one of the athletes, Operetta, to chew her out for her showboating attitude. In reality, he's alerting her to the spy. Only using facial expressions, he clues her, and by extension, the audience, in on the fact that they know what the opposing team is trying to do.
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This soon leads to Operetta pretending to tell the enemy team about their secret plan for the championship match, which was really an attempt to outsmart them to gain the advantage in the final stretch. The brilliance of this is how the audience is informed of this with no dialogue, and there's no scene afterwards spelling it out for those who don't get it. It manages to convey deception without being too obvious that Clawd and Operetta are being deceitful.
I think if there were more subtle hints to show the audience Lila was lying, she would be seen in a better light. As it is, Lila's lies are just pathetic, and it's ridiculous that everyone believes her. Which leads me to...
Lila, the Master Manipulator
I once read a Star Trek: Voyager fanfic that poked fun at the series by claiming that the reason a lot of the dumber episodes like “Threshold” and “Twisted” happened was because one of the crew members was an alien who unintentionally produced mood altering pheromones, with Captain Janeway actually realizing they were all high because of said pheromones, while two of the unaffected crew members were wondering what the hell they were doing before they found out the cause. Why do I bring this up? Sometimes, it feels like Lila is an unintentional parallel to the alien in that story.
Like so many characters, it's clear the show desperately wants the audience to view Lila in a certain way, but her actions do very little to actually back up that claim. When she's not using lies to tell stories about so many famous people she knows like her uncle who works for Nintendo, Lila is using strategies to manipulate everyone that are so obviously deceptive, the Thermians could pick up on them. Everyone and their mother knows how ridiculous a lot of what Lila does in episodes like “Chameleon” and “Ladybug” are, and I've talked about them before, so I'll try to be quick.
First off, as someone who had access to accommodations through high school and has had assistance in college so far, there is no way in hell that Ms. Bustier should take Lila's tinnitus at face value in “Chameleon”. If a student has a disability that could interfere with the education process, physical or developmental, not only does the school have to evaluate their performance, and determine if they're eligible for an Individualized Education Program, or IEP, but her teachers would have to be notified in the first place. As her primary educator, Ms. Bustier would be part of the team to oversee Lila's IEP and determine what accommodations she needs to help her learn better with her tinnitus and arthritis. But because the writers don't know what Google is, they just ignore it,  assume that Lila can just say she has a disability, and have everyone believe it. Even when Eric Cartman pretended to be disabled to compete in the Special Olympics, he put in more effort to look the part, even if he looked like a caricature.
Then there's the fact that that in “Chameleon”, everyone just believes Lila when she says Marinette stole her grandmother's necklace when not only is said necklace from the Agreste line of jewelry, but Alya, who is Rena Rouge, can't pick up on the fact that it's a fake. All she does to justify these lies is come up with a sob story about how nobody believes her, yet nobody ever tries to defend Marinette except Alya one time, and it was after she got expelled.
Or what about in “Oni-Chan”, where Lila thinks having Kagami kill Ladybug while claiming she'll back away from Adrien is a good idea? Let's say Oni-Chan does kill Ladybug or at least take away her Miraculous, what then? We know Lila wouldn't go through with this promise, and as soon as Kagami sees her harassing Adrien, she'll be ripe for akumatization again. Overall, not a great plan.
And yet somehow, this last example is what made her worthy enough to become one of Hawkmoth's most trusted agents. I'm just going to say it: Lila is not a good fit for the power of illusion. Whenever she's Volpina or Chameleon, she always goes out of her way to make a big show instead of being subtle with her deceptions. “Chameleon” is the worst offender, as even though Lila gets the power to shapeshift into someone else, instead of being discreet and cornering people into kissing them and gaining their appearance, she just runs around to get Ladybug's attention instead of being subtle. Even Felix had the bright idea to pretend to be Adrien to catch Ladybug off guard. How do you lose to something that happened in “Felix”?
Despite all of these screw-ups, we're still supposed to see her as this master of deception worthy of allying with Hawkmoth in both his supervillain and civilian form, when really, she's a terrible liar on the schoolyard and on the battlefield.
Why Lila is an Important Character
In the grand scheme of things, Lila just isn't as important of a character that the show loves to parade her around as. She's nothing more than a plot device used to raise the stakes in an episode, given how much reality seems to bend over just to accommodate for her lies. Even when the show alludes to her being part of bigger things, like her deal with Adrien, or her rivalry with Marinette, they don't even go anywhere.
She just feels pointless when you remember Astruc's brilliant idea to force Chloe into being the final Akuma for the season while Lila isn't even mentioned once. She only really makes appearances whenever the writers feel like it, which is why it’s hard to take her seriously. Why should I take this character seriously as a threat if the writers refuse to take her seriously as a threat? Why build Lila up as a big threat and not give her a major role in the finale? Why even include her in the show in the first place when you could show Chloe being more manipulative to fill in the plots Lila plays a big part in?
As of the time I am writing this analysis, four episodes of Season 4 have aired, three of them have been about lies or deception, and Lila hasn't been mentioned at all. It honestly seems like she won't appear unless the writers need a easy way to drive up the conflict, so they can justify it by saying that Lila's “superpower” of lying is more powerful than the common sense of everyone else.
I'm sorry this post was shorter than the last one, but compared to Master Fu, there's not that much to say about Lila that I haven't already said. Even the show barely gives her any attention, so it's hard for me to really find a lot to talk about.
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gypsydanger01 · 4 years
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THE STORM - Part one
Fandom: The Boys (Amazon prime tv series)
Pairing: Black Noir x OC
A/N IMPORTANT: Hey folks! As you can see, I’ve REVIEWED the first four parts of this series! The changes I’ve made are important because they set everything up for the rest of the story.
Something to note is that this series is au and explores the fight against Vought from a completely different point of view. The story will reference certain episodes from S1 and S2, but diverges on many other aspects. The Black Noir here depicted is au as well, and while I’ve tried to portray the darker side of him, I’m reevaluating other aspects of his personality. THIS BLACK NOIR IS NOT TAKEN FROM THE COMICS! I don’t think I could even write about that character.
Disclaimer: I do not own The Boys, only my OC and some of this story’s plot line.
                 Posting new chapters every Wednesday and Friday! 
            Night at the gala
It was a requirement for the Seven to attend the string of galas that Vought organized. It could easily be considered a marketing strategy as it was an easy way to display their product, their heroes, to some of the most powerful and influential individuals in the country. During the first few years, the team’s excitement was real. Their personalities showed and they engaged in deep conversation with guests. But as the years went on, that curiosity and pride turned to arrogance, and those hearty laughs morphed into tight-lipped smiles, hiding clenched teeth. 
Bound by their contracts, they were to swallow their disgust for these events, and act personable around the attendees.
Only one team member was allowed to refrain from the conversation: Black Noir. Since mutism is a defining aspect of his persona, all that was needed was his silent, mysterious presence. He would choose to sit at a small, vacant table towards the margins of the room, somewhere out of the spotlight. And then he’d just pass the evening alone and in silence, watching people’s movements with a careful eye.
He didn’t mind the stillness, so much as the fact of it being used as a prop. Already two people had walked up to him and tried to elicit a response. When they realized that he truly wouldn’t speak, they left satisfied. Content and laughing, they had no idea he could disembowel them in a blink of the eye.
Scouring the area, he saw elegant women walk and hang off politician’s arms; he watched Homelander talk to different people, who were gathered around him and listening intently to his every word. The superhero laughed and patted one man on the back. Sure, he had everyone fooled, but Black Noir saw through it. His jaw was clenched, and if you looked hard enough, the forced smile and dark look in his eyes could easily be read as murderous. 
But then a sweeping dark blue caught his eye. To his left, off towards the center of the room and under the bright lights, he saw a woman.
In a long, blue dress, she walked over towards a group of co-workers who greeted her with big smiles and compliments on the simple, yet elegant look she’d chosen for the evening. Her hair was pulled up, letting Black Noir get a glimpse of the radiant smile that graced her face. Stunning. 
Fixated on her face, he memorized every detail.
At a first glance, she seemed simple enough like someone who could easily blend into a crowd. She was beautiful but didn’t flaunt it. What really captivated Black Noir, though, was the energy surrounding her. Her thick, chocolate curls. The slight skip in her step. The sway of her hips. That smile. She was magnetic.
It was as if something moved in him, something shifted out of place. For the first time in his lifetime, he felt like he wanted to speak. Like he needed to. After a moment of careful calculation, he stood up and smoothly crossed the room towards her. Once he thought he was close enough, he sat again and listened to the bright woman speak excitedly to his right. She was positively radiant. That’s all he could think, radiant. He looked forward, his eyes trained on Homelander as the man crossed through a crowd, shaking hands. But his mind stayed focused on her. He sensed her movements, how her hands become a part of her speech. He inhaled deeply and relaxed. 
“Come on, try to understand,” she said with mirth, “you would’ve been late, too, if that had happened to you.” She paused, only to continue, “In fact, seeing as how you’re the drama queen, I’m convinced you wouldn’t have shown up at all.”
The whole group started laughing except for one young man who sputtered in fake indignation. Soon, he too joined in with a laugh of his own.
When she laughed, he had to train his focus on a point of the room in front of him, or he thought he might shift in his spot to gaze at her. 
But then she moved away, and finally, he saw her glide onto the dance floor with one of the young men, maybe the one she had just been teasing. Were they together? It was gnawing at him, and he could feel the blood rush to his brain, pumping hard through his veins. They weren’t dancing very close, but nonetheless, they both looked comfortable in each other’s presence. He got a glance of her face amid the crowd, her features framed by two long, elegant earrings. She was smiling, content. The man pulled her closer. Black Noir gripped the arm of his chair hard and let go only when he realized he’d crushed the metal. He took a few breaths, knowing he needed to leave before he lost control. 
And more importantly, he needed to find out who the woman was.
As he moved away from the noise and up to his living quarters, her eyes were blazed into his mind.
 PART 2  PART 3  PART 4  PART 5
Giulia
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phroyd · 4 years
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HOUSTON — Over the past week, Dr. Aric Bakshy, an emergency physician at Houston Methodist, had to decide which coronavirus patients he should admit to the increasingly busy hospital and which he could safely send home.
To discuss questions like these, he has turned to doctors at hospitals where he trained in New York City that were overwhelmed by the coronavirus this spring. Now their situations are reversed.
Thumbing through a dog-eared notebook during a recent shift, Dr. Bakshy counted about a dozen people he had treated for coronavirus symptoms. His colleagues in Houston had attended to many more. Meanwhile, friends at Elmhurst Hospital in Queens told him that their emergency department was seeing only one or two virus patients a day.
As Houston’s hospitals face the worst outbreak of the virus in Texas, now one of the nation’s hot zones, Dr. Bakshy and others are experiencing some of the same challenges that their New York counterparts did just a few months ago and are trying to adapt some lessons from that crisis.
Like New York City in March, the Houston hospitals are experiencing a steep rise in caseloads that is filling their beds, stretching their staffing, creating a backlog in testing and limiting the availability of other medical services. Attempts to buy more supplies — including certain protective gear, vital-sign monitors and testing components — are frustrated by weeks of delays, according to hospital leaders.
Methodist is swiftly expanding capacity and hiring more staff, including local nurses who had left their jobs to work in New York when the city’s hospitals were pummeled. “A bed’s a bed until you have a staff,” said Avery Taylor, the nurse manager of a coronavirus unit created just outside Houston in March.
But with the virus raging across the region, medical workers are falling ill. Dr. Bakshy was one of the first at Methodist to have Covid-19, getting it in early March. As of this past week, the number of nurses being hired to help open new units would only replace those out sick.
Methodist, a top-ranked system of eight hospitals, had nearly 400 coronavirus inpatients last Sunday. Nearly a week later — even as physicians tried to be conservative in admitting patients and discharged others as soon as they safely could — the figure was 575. The flagship hospital added 130 inpatient beds in recent days and rapidly filled them. Now, administrators estimate that the number of Covid-19 patients across the system could reach 800 or 900 in coming weeks, and are planning to accommodate up to 1,000.
Other Houston hospitals are seeing similar streams of patients. Inundated public hospitals are sending some patients to private institutions like Methodist while reportedly transferring others to Galveston, 50 miles away.
“What’s been disheartening over the past week or two has been that it feels like we’re back at square one,” Dr. Mir M. Alikhan, a pulmonary and critical care specialist, said to his medical team before rounds. “It’s really a terrible kind of sinking feeling. But we’re not truly back at square one, right? Because we have the last three months of expertise that we’ve developed.”
Houston’s hospitals have some advantages compared with New York’s in the spring. Doctors know more now about how to manage the sickest patients and are more often able to avoid breathing tubes, ventilators and critical care. But one treatment shown to shorten hospital stays, the antiviral drug remdesivir, is being allocated by the state, and hospitals here have repeatedly run out of it.
Methodist’s leaders, who were planning for a surge and had been dealing with a stream of coronavirus patients since March, pointed to the most important difference between Houston now and New York then: the patient mix. The majority of new patients here are younger and healthier and are not as severely ill as many were in New York City, where officials report that over 22,000 are likely to have died from the disease.
But so far, the death toll has not climbed much in Texas and other parts of the South and West seeing a surge.
“We are having to pioneer the way of trying to understand a different curve with some very good characteristics versus the last curve,” said Dr. Marc Boom, Methodist’s president and chief executive.
But he cautioned, “What I’m watching really closely is whether we see a shift back in age — because if the young really get this way out there and then start infecting all of the older, then we may look more like the last wave.”
Dr. Sylvie de Souza, head of the emergency department at Brooklyn Hospital Center, which on Friday reported no new coronavirus admissions and no current inpatient cases, said that she was receiving distressing text messages from doctors elsewhere in the country asking for advice. “It’s disappointing,” she said. “It sort of brings me back to the end of March, and it’s like being there all over again.”
One of the most worrisome trends, hospital administrators said, is the increased politicization of public health measures against the virus. The hospitals in Houston are operating in a very different environment now compared with during New York’s peak in the spring, when federal, state and local leaders agreed to a national pause.
Here in Texas, political leaders have been at odds with one another, and residents sharply disagree about the danger the virus poses and what precautions are necessary. At some Houston hospitals, visitors and patients have refused to wear masks, creating conflicts with security guards at entrances.
As the Fourth of July holiday approached, Methodist spent hundreds of thousands of dollars on a public information campaign — including full-page ads wrapped around a local newspaper, social media efforts and billboards. “Stay Safe and Stay Home This July 4th,” the signs say. Methodist also sent a text message to about 10,000 patients providing safety tips. In response, the hospital system received some angry phone calls and texts. “How about you stay at home and quit telling me what to do,” was how one hospital official described them.
The economy in Texas remains open, with only bars shuttered, but Gov. Greg Abbott on Thursday issued an order requiring Texans to wear face coverings in public after long opposing such a mandate.
“There is a glimmer of some optimism,” Dr. Boom told the health system’s physicians this past week, reporting that county testing figures showed some signs of improvement.
Many hospitals in New York during the earlier crisis essentially became all-Covid units and endured billions of dollars in losses.
But Methodist and some other private Houston institutions are trying to operate differently now after taking a financial beating from shutting down elective surgeries and procedures this spring.
With safety protocols and expansion plans in place, they are trying to maintain as many services as possible for as long as possible while contending with the flood of coronavirus cases. “No one’s ever done that before,” Dr. Boom said. “We were seeing all the harm from patients delaying care.”
Doctors and nurses have combed through lists of surgical patients, choosing whom to delay. The easiest surgeries to maintain are those that do not require a hospital stay, like treatment for cataracts. Some surgeons who used to keep patients overnight after knee and hip replacements are now allowing them to leave the same day.
The most agonizing decisions concern the hospital’s robust transplant program, in part because its recipients often require a stay in intensive care. Dr. A. Osama Gaber, the program’s director, spoke with a dialysis patient whose kidney transplant had been postponed from March. “She was in tears,” he said. “She almost wanted me to swear to her we’re not going to put her off again.” For now the surgeons plan to continue cautiously.
A key strategy to maintain services is increasing what hospital officials call throughput — discharging patients as quickly as is safely possible. Yet it is not always clear who is ready to leave. Alexander Nelson-Fryar, a 25-year-old treated for coronavirus pneumonia at Methodist, was discharged from the hospital this past week. Hours after he left, he said, he began laboring to breathe and an ambulance sped him back to Methodist. By the end of the week, he was in intensive care receiving a high dose of pressurized oxygen.
As cases began rising in New York, some overwhelmed emergency departments sent home coronavirus patients only to see them return gravely ill or die. “We realized there was no way of predicting which direction a patient would go,” said Dr. de Souza, the emergency department director in Brooklyn. As a result, she said, she came to believe that any patient aside from those with the mildest symptoms should be admitted to the hospital or otherwise monitored.
But doctors in Houston are tightening criteria for admission. Dr. Bakshy, the Methodist emergency room doctor, who trained at Bellevue and Mount Sinai in New York, said that he was conferring with his former colleagues.
“We all have questions about who truly needs to be hospitalized versus not,” he said. “If we had unlimited resources, of course we’d bring people in just to make sure they’re OK.”
Now, he said, a patient has to have low oxygen levels or serious underlying conditions “to really justify coming into the hospital,” although exceptions can be made.
Another challenge in New York and Houston has been determining who is infected and needs to be isolated from others. Nearly 40 percent of all emergency room patients at Methodist are now testing positive; some of them lack symptoms.
Because test results are sometimes delayed by more than a day, Dr. Bakshy and his colleagues have had to make their best guesses as to whether someone should be admitted to a ward for coronavirus patients.
Hospitals in New York tended to move patients within their own systems to level loads. In Houston, the wealthier institutions have joined together to aid those least able to expand capacity.
This past week, Methodist sent a team to a nearby public hospital to accept transfer patients. Top officials from Methodist and the other flagship hospitals that make up the Texas Medical Center, normally competitors, consult regularly by phone. They have been coordinating for days with the county’s already overwhelmed safety-net system, Harris Health, taking in its patients. The private institutions have also agreed to take turns, with others in the state, accepting patients from rural hospitals.
Better Treatments
One morning this past week, Molly Tipps, a registered nurse, brought some medications to an older patient at the Methodist ward outside Houston. “I have the dexamethasone for your lungs,” she told the patient, Dee Morton. Preliminary results of a large study, released last month but not yet peer-reviewed, showed that the drug, a common steroid, saved lives among those who were critically ill with Covid-19 or required oxygen.
Ms. Morton, 79, said she was confident she would recover. “I’m going to make it to 80,” she said. A much lower proportion of patients have been dying from the virus locally and nationally than they were several months ago.
The ward where Ms. Morton is being treated is inside a long-term acute-care facility and is known as the Highly Infectious Disease Unit. Created to treat Ebola several years ago, it now serves as a safety valve for the Methodist system. It takes in coronavirus patients who are improving but for various reasons — from lacking housing to living in a nursing home that will not accommodate them — cannot go home. In Ms. Morton’s case, she was too weak, and after transferring to the unit, some signs of infection, including a fever, rebounded.
At Methodist’s flagship hospital in central Houston, Rosa V. Hernandez, 72, a patient in the intensive care unit, has pneumonia so severe that if she had fallen sick several months ago, she would probably have been put on a ventilator and made unconscious.
But doctors, based on the experiences of physicians in New York and elsewhere, are avoiding ventilators when possible and are maintaining Ms. Hernandez on a high flow of oxygen through a nasal tube. She is on the maximum setting, but can talk to the clinical team and exchange text messages with her daughter, who is also a Methodist inpatient with the coronavirus.
“I took it seriously,” Ms. Hernandez said of the virus. But she joined a small party of eight people for her granddaughter’s birthday, a decision she now described with regret. “Just a birthday cake. What’s a birthday cake without health?”
She is getting remdesivir, an antiviral that was tested in clinical trials in New York and Houston, among other cities, and a new experimental drug.
Methodist was part of two remdesivir trials. But because the research has ended, it and other hospitals now depend on allotments of the drug from the state. As virus cases increased, the supplies ran short, said Katherine Perez, an infectious-disease specialist at the hospital. “In Houston, every hospital that’s gotten the drug, everyone’s just kind of used it up,” she said.
The hospital received 1,000 vials, its largest batch ever, a little over a week ago. Within four days, all the patients who could be treated with it had been selected, and pharmacists were awaiting another shipment.
A new chance to test remdesivir in a clinical trial in combination with another drug may provide some relief. As cases rise, Methodist researchers are being flooded with offers to participate in studies, with about 10 to 12 new opportunities a week being vetted centrally. Without solid research, “your option is to do a bunch of unproven, potentially harmful, potentially futile, interventions to very sick people who are depending on you,” said Dr. H. Dirk Sostman, president of Methodist’s academic medicine institute.
Convincing the Public
Dr. Boom, the Methodist chief executive, said if he could preserve one thing from the New York experience in March, it would be how the country came together as it had in previous disasters.
When cases began rising again in Texas, hospital officials here spent close to a month trying to educate the public about the risks of contagion. “It didn’t work,” Dr. Boom said.
“How do you get the message out there when certain people just don’t hear it and then you’re dealing with quarantine fatigue and it’s summer and I’m done with school and I just believe I’m 20 and I’m invincible?” he asked. “We told everybody this is all about the sick, vulnerable population, which was the truth, but they heard the message of ‘Well, therefore I’m fine.’ And now we’re doing the re-education on that.”
But even some of Methodist’s physicians, like many Texans, take issue with measures promoted by most public health experts. “A lot of the masks that people are wearing in public don’t do very much,” said Dr. Beau Briese, director of international emergency medicine, contradicting studies that point to a substantial benefit with universal face coverings.
Dr. Briese, 41, believes the soundest approach is to keep opening businesses but have the population at highest risk, including older people, stay apart from the broader public. Some of Methodist’s patients find even those measures objectionable.
One patient on Dr. Bakshy’s emergency room shift, Genevieve McCall, 96, came to the hospital with a satchel full of nightgowns because her legs had swollen, a sign of worsening heart failure. Dr. Bakshy asked about any exposure to the coronavirus. She said her caregiver had been out since the previous day with a fever and a sore throat.
Born five years after the 1918 flu, Ms. McCall, a retired nurse, said that until the coronavirus, she told people she thought she had seen everything. “I question a lot of things,” she said of the safety restrictions. “They’ve been too tight about it. And every time that there is a little bit of a spike, then we’re restricted more.”
Ms. McCall, who tested negative for the virus, added: “This is a political year. I think that politics has a lot to do with the way this has been handled. And I think it’s been mishandled.”
She said that it was difficult to be stuck in her apartment in an independent-living complex that was prohibiting visitors, canceling many activities and delivering meals to rooms instead of serving them in the dining room. “It’s very depressing,” she said. “Until this afternoon, when my daughter walked in the door to come and pick me up and bring me here, I had not been able to see her or touch her for three months, more.”
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