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#every practice piece i do i try and squeeze as many experimental ideas in as possible lol not gonna lie this one kinda worked out
emmybeearts · 9 months
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Soundwave superior
i just think hes neat :)
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edelwoodsouls · 3 years
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like real people do - ch.1 [fic]
It's nothing but screams of static and fire- And then Jon wakes up next to Georgie, in his Oxford dorm room. And then Martin wakes up alone in his flat. Shit.
[AKA Time Travel Fix-It]
Word Count: 3,595 | Also on Ao3 | Other Chapters: Not Yet
chapter one: sunrise
He's falling.
Through an endless age of darkness. Down, and down, the wind tearing past skin he no longer has, tugging at limbs he no longer feels. He is a shapeless form of web and tape and eyes, and yet he sees nothing, and hears nothing, and the world is nothing more than pain.
But he can feel a hand. Fingers digging into his skin, fingers he recognises, that he's held close for months, that he could recognise in darkness and fire and the end of everything.
He clings tightly to those fingers, to the feeling of them squeezing back, squeezing hard. Those fingers are alive.
As alive as anything can be, here.
They fall forever. Until time has no meaning and sense has no place, and he finds it so very hard to remember where he came from, where they're going, who they are.
And the sound begins to reform itself - because it's not that there is nothing to hear, but rather that there's far too much. A shrieking of static and reeling of tape, the echo of fire chewing hungrily at brick and sky.
Screams of countless voices, ending or in pain. Those have been an undercurrent to his every waking moment for months now, as constant as the beat of his heart in his chest used to be, before it stopped. But now they are everything, everywhere, and there is no sense of self to anchor to.
He is adrift in the suffering. He could exist here forever, in this waterfall of fear so pure it's painful, like cold air dragging across an exposed nerve. Electric. Alive.
And then, all of a sudden, the hand clutched in his vanishes. He panics, flailing out with his not-limbs, desperate to hold on to the one thing in this insanity that has some sort of meaning.
His fingers brush against nothing but tape, sharp and cold against his skin. He opens his mouth to call out, or to scream, and all he hears is static. He tries to cling to himself, and feels that self unravelling further.
And then, just when he thinks that he'll be lost to the chaos, when the fear rises so strong and bitter in his throat that he's sure he must be on fire-
Jon shoots up from the bed, panting.
He's drenched in sweat, his t-shirt clinging to him. The duvet is thick and stuffy against his skin, heavy against his body.
He has a body. He feels as if he's been nothing more than a thought, an idea, for years. All of a sudden, there is skin, and flesh, and fingers, and arms. There is a chest and a head and a heart-
His heart. Beating like a drum against his ribcage, pumping blood around his body, keeping him alive.
He's alive. His heart speeds up at the mere thought. He'd forgotten what his own heart felt like, what the relief of breathing was. Nothing more than a mechanical function, these past few months, he takes a moment to just... breathe. To let the oxygen flood his lungs and sink into his cells, as if blowing away cobwebs strung inside the unused passageways of this body.
He hasn't been alive, truly, since he first brushed against the End.
His chest feels tight with the weight of - everything. He feels the ache of his head, suddenly light and thankfully empty and closed. He feels the ghost of a knife between his ribs, cold steel sliding through flesh like butter, mixing his blood with the sticky, drying flakes of Elias'.
The loss of Martin's fingers, wrapped in his.
The pressure in his chest increases as he stares at his hands. Uncalloused, unburnt - there isn't a single pockmarked worm scar up his bare arms. His flesh is smooth, and clean, and- naked. It feels alien.
Something must be wrong. He's dead, or dreaming. He's in a dimension that's pure dream logic, or the fears have already begun their work and torn him away from the only thing that might stop him from joining them.
Maybe this is the centre of the eye. A final, peaceful vision to keep him occupied as his body spools into tape and his mind unwinds.
And Martin is... where?
He looks frantically around. The room is dim, but it's practically blinding bright to his eyes, adjusted as they are to the pitch of a collapsing world. He can make out clothes strewn over every surface and object. Books, left face down to keep them open, on the desk and the floor.
Something shifts beside him in the bed, and he jumps a mile high. Flinches away and rips the covers back, to reveal...
His newly restarted heart stutters.
"Jon?" Georgie's voice is soft and sleep-laden, and she rolls over in the bed to look up at him through a cloud of dark hair. "You okay?"
"I..." His throat fails him, closes up like a hand held fast against his skin, squeezing. He puts his own hands up to it, to feel it, to be certain his body is his - and finds it smooth. Unblemished by the scarring Daisy gave him.
He lets out a sob. Clings to his throat, as if he might be able to protect it, keep it safe.
He's never been safe, not once in his entire life.
Strong arms wrap around him from out of nowhere, and Jon flinches at the touch of skin on skin. But Georgie just curls tighter around him, pulls him close to her. Runs her fingers through his long hair, and its such a familiar gesture, such an old one, that for a moment he lets her do it. Sits in the quiet and the peace.
"Hey, hey," Georgie says quietly. "What's wrong?"
Jon tries to think of what words to say. To explain to her that she is nothing more than a figment of fear and dreaming. That any moment she will grow a hundred eyes or limbs, or melt away to wax, or grin in fractal patterns that ache his eyes to see.
It's the only explanation that makes sense. This is one of his few good memories, a final gift from the Eye before he disintegrates.
He is nothing more than a dream, too.
"Just a bad dream," he murmurs, unsure if he's reassuring himself or Georgie. He's longed for his world to end for a long time now, but he'd expected - half wanted - it to be crueler. Painful. He's been holding onto a vision of blood and fire. Of throwing his body in the path of something, saving someone, making all his wrongs right.
His decisions, finally given positive meaning.
He wasn't expecting the end to be this soft. Wasn't expecting it be the scent of Georgie's cheap laundry detergent, and a slow sunrise, and a warm embrace. The last few months - the last few years - have been a revolving door of ache and exhaustion.
This is nice.
Perhaps too nice.
It makes sense that the End would show him Georgie, though. That, at least, he understands. The girl who cannot fear. The woman who saw the End and, instead of flinching, managed to continue on.
Nothing to be afraid of, this vision says. You've done enough. You can rest.
Just let go.
But Jon has been afraid for too long to let it go just yet. He's been afraid, in one way or another, since he was eight years old. It's the electricity in his veins and the pump of his blood, the very thing that keeps him standing, keeps him going.
And he hasn't survived this long only to trust the first sign of kindness, or warmth.
"What's going on?" Jon whispers, expecting the question to disappear into the air like so many of his enquiries have before.
Georgie pulls away and looks him in the eye, still keeping her hands resting on his shoulders. He'd forgotten, how tactile Georgie used to be. How both of them, so starved of contact, had held each other constantly.
"What do you mean?" she asks, the softness beginning to bleed out of her voice. There's a hint of worry, so subtle he could almost believe it was genuine.
"Why am I here?"
Georgie's eyebrows knit into a frown. "Why wouldn't you be?" Her eyes search his face, the worry ebbing away faster now. "What did you dream about?"
He laughs, a bitter and broken sound. "Who says I'm not dreaming now?"
"You're starting to worry me, Jon."
"Am I? Can dreams feel worry?"
Georgie's frown resolves into a grim line of pursed lips. "What did you take? And how much?"
"I'm not high, Georgie," Jon scoffs. "You're just not real. A very convincing facsimile, I must admit, but I'm not an idiot."
She sighs, frustrated - already giving up on him. "Well, I'm going back to bed. Wake me up if you feel sick, or something. There's water on the bedside table."
And she burrows back under the blankets, faced away from him.
Jon frowns. This is not how dreams tend to behave. If this is a final act of kindness, it isn't very- kind. Surely the dream should continue to comfort him, or fade into something awful and twisting and logically insane.
He pokes Georgie experimentally, to see if she'll burst into a thousand worms or spiders or flies.
"What, Jon." She rolls back over, peering up at him from a blanket cocoon, unamused.
"You're..." he searches for words, "you're not going to..."
"To what, Jon?"
"Try to kill me? Burst into flames?"
"Why would I do any of that?" she asks, but her tone is edged with something sharp and wary, now.
"Because you're..." he shrugs helplessly. This is getting him nowhere. "Because that's what the fears do."
"The fears?"
A sudden thought strikes him. "The moment you die will feel exactly the same as this one."
Goergie flinches. No, that's too tame a word. She recoils, staggering out of the bed like Jon's just struck her with electricity. "What the fuck did you just say?"
"You told me that," he says, as his mind stumbles over itself to attempt to fit the pieces together. "Maybe a year ago, before everything went to hell. You told me about the End."
Goergie's voice is shaky when it comes. "I've never told anyone about that," she spits. Jon can see her inching towards the desk, the stack of dirty plates which is a staple to any university dorm room, and - more importantly - one of the knives among the pile.
"You did- or, you will- oh god, I think-"
It doesn't make any sense. It doesn't make any sense. When he'd promised Martin that maybe, possibly , there was a chance they'd both live- it wasn't exactly a lie, but he'd been pretty damn certain it wasn't true. Maybe for Martin, maybe he'd wake up in some other world to face the fears alone.
But Jon shouldn't have made it, too. Not with the knife buried in his ribs, not with fourteen fears pouring themselves down his throat and tearing him apart from the inside. He's been a dead man for months, and this should've been the closing chapter. A peaceful oblivion.
And maybe he should've felt bad for lying to Martin, for deciding to abandon him. But Martin would get to live on, maybe even prevent the fears from gaining a foothold in their new dimension. Maybe he could be that positive entity Jon always wished for, of love and hope and a hundred other silly things.
This, though. This is not a new dimension. This isn't possible, in any sense of the word - and Jon's had to expand that definition countless times in recent years.
But here he is, in a body that still needs a heartbeat and breath. Here's Georgie, hair loose around her head in an afro, instead of the tight cornrows she favoured later. Here they are, in their university apartment, before their relationship began to tear at the seams.
Georgie's hands close around the knife, and Jon flinches despite himself, a phantom pain in his side.
"Wait, Georgie," he holds his hands up in surrender, slipping out from the bed. "I need you to hear me out. I'm not- this is going to sound crazy, but I need you to listen. I think-" he takes a breath, "-I've travelled in time."
The words hang in the air, strung among the dust motes beginning to catch in the morning sun filtering through the curtains.
"Explain," Goergie says slowly, tapping the knife against her bare arm, apparently oblivious to the dregs of hot sauce or ketchup still stuck to the blade.
"I- wait, you're not going to tell me I'm crazy?"
"You just told me not to."
Jon blinks. He's so used to being dismissed, he's forgotten how pragmatic Georgie is. How she used to humour his long rambling with a soft smile and patience.
How he slowly, but surely, lost that privilege.
"Okay. Hang on, what year is it?"
"2008. March."
That makes sense. The university dorm - third year, when he and Georgie had pooled their resources and lived together, despite all advice to the contrary.
He takes a slow, steadying breath. "Before I woke up here, I was in 2018. Well, probably 2019, but it's not as if time made much sense anymore, and we weren't really counting the days- I mean, there weren't really days, because the sun wasn't exactly-"
"Jon," Geogie cuts him off with a raised eyebrow, and a vague wave of the knife in her hand.
"Right. Okay, so: monsters are real. You know that much, you've met them. And you told me about it, because I was on the run from them. Have been for all my life, I suppose."
He never really escaped Mr Spider, did he? He was never supposed to knock on the door, only witness it, as he would come to witness countless horrors.
"And then the world ended," Jon continues. He can fill in any gaps later, perhaps - they aren't the most important thing right now. "And you and I, and... some other people, we turned the world back. Or we were supposed to. I have to hope that you survived."
"And you?" Georgie asks. She's still clinging to the knife, but her hands are down by her side, unvigilant. If there's anyone who'd believe his stories, surely it would be Georgie. "How'd you end up here? Assuming you're telling the truth."
"We were making a portal to another dimension, to throw the monsters through."
Georgie lets out a sharp bark of a laugh, which cuts out quickly when she sees Jon's expression. "Oh. You're being serious?"
"Deadly, unfortunately. Things went... wrong. Martin and I... we ended up going through the portal too."
His hand flutters to his side, imagining blood slick on his fingers.
"So you've brought monsters with you," Georgie says. "Where are they then?"
"I don't... I don't know," he shrugs helpelessly. "I wasn't really expecting to survive the trip, if I'm being honest. I definitely wasn't expecting to wake up-" he waves his hands around their flat, "here."
He watches the emotions flitter across Georgie's face, as she attempts to settle on how she feels.
Something brushes against Jon's ankle, and he flinches back, expecting for a moment to see tendrils of darkness, or spider web. Instead he sees a small bundle of orange fuzz rubbing agaist him.
He bends down and scoops the Admiral up in his arms. He's barely more than a kitten, tiny and vibrating as he purrs and buries himself close to Jon's chest.
Something like calm, and certainty, settles inside Jon.
Georgie sighs loudly, watching the interaction with half-concealed fondness. She casts the knife aside on the desk with a clatter, opens a drawer and digs out a half empty bottle of shitty Tesco vodka.
"Tell me everything," she says, taking a swig and handing him the bottle.
"It's not even nine am."
"It's five pm somewhere," Georgie rolls her eyes and throws herself back onto the bed. "And I have a feeling we're going to need it."
[linebreak]
Martin wakes far more softly. A steady fade into being, like the sunrise beginning to wash across his floor. He blinks for a moment, trying to remember why the feeling of a mattress beneath him feels so wrong, why his body feels out of sorts with itself.
His memory cascades in too fast, in a flashing halo of green eyes and the scream of tape unravelling, and the weight of a blade in his hands. He rolls over to the side of the bed and is unceremoniously sick onto the floorboards.
He sits there, head held in shaking hands, for what could be hours, but is likely just seconds. Brings his hands in front of his eyes, expecting to see them slick with blood, or whatever fluid doesn't run through Jon's veins these days.
But there's nothing there.
He glances behind him, and is barely surprised to see no one lying beside him.
His feet remember the route to the bathroom, even if his mind hasn't caught up with his location, and he stumbles there quickly. Spins the tap open and scrubs at his fingers until the skin is raw and red and aching beneath the scalding water.
He still feels Jon's blood on him. Still smells smoke and flames.
Eventually, he looks in the mirror.
He hasn't seen his reflection in months, or however long it's been since the world ended, but he's certain he wasn't this clean. Certainly hadn't shaved in a while, for one, though it's hardly his clean-shaven face that makes him doubletake.
His hair is ginger. Martin runs a careful hand through his curls, testing them to be sure. They don't fall away in his hands, or turn into worms or psychedelic spirals; he feels the tug of his fingers catching and pulling at his scalp.
There isn't a single strand of white. He'd almost gotten used to the pale, bleached colour the Lonely had cast upon him, before the end of the world, but-
He isn't crying. He isn't. It's just hair.
His fingers grip the sink so hard he's sure something will break.
Logic. Calm. That’s what he needs right now. Obviously something has gone wrong, if he and Jon have been separated. Finding him is the first priority.
He refuses to consider the alternative.
But where has he ended up? He’d half expected to be scattered to the wind of a thousand dimensions, divided into tiny fragments of consciousness.
But this appears to be a singular universe. A reality of ideals, perhaps? Where Martin has his hair back, has a body that doesn’t yet ache or go hazy at the edges when he panics.
Except Jon isn’t here, so that can’t be true.
Martin emerges from the bathroom, still a little shaky, but with resolve, and it’s only now that he realises where he is. It’s been a long time since he was here, thank god - this apartment was hardly a good part of his life.
Freshly moved to London. Scrambling to find any sort of job that would take him, ultimately having them slip through his fingers. The walls are too close and the ceiling too low, the paint crumbling and the damp stains getting ever wider. It’s cold, with exorbitant heating bills and no double glazing, and now it makes a little more sense to him why he was wearing three jumpers in bed.
He was in this apartment when he applied to the Magnus Institute.
For a moment he stands in the doorway, frozen, as the realisation begins to connect dots in his head with absurd leaps of logic. It doesn’t make any sense at all for him to have ended up here, and yet- he can’t really deny the evidence of his own eyes.
So its 2009. 2008, at the earliest. The past.
Maybe this is an alternate world. Maybe the fears have no foothold here, and he has a chance to try again.
Would that be a good thing? Can he honestly say he enjoyed the life he had before the Institute? He hates Jonah Magnus with everything he has, hates what he and his colleagues were put through in those years.
But they were hardly worse than the endless grey of his earlier years. The Loneliness that lapped at his ankles long before he knew the name Magnus and that, if he’s honest, would have consumed him if the Eye hadn’t set its sights on him first.
And without the Archives, he never would’ve had Jon.
The world seems dangerously small and cold to Martin. The walls are leaning in to press against him, to put pressure on his lungs. If he thinks about this too quickly, too long, he might shatter into pieces and never move again.
He grips the doorway to steady himself, takes a deep and slow breath.
He needs to stay calm. He can panic later, when Jon is in his arms again, when they've figured out what's going on, when they march into Elias' office ten years too early and sink the knife where it truly belongs.
Maybe then he won't feel Jon's blood on his hands anymore.
Everything in time. Martin smiles through gritted teeth, as if to convince himself he's decided. Everything is fine, until proven otherwise.
He throws open the curtains to a fresh, sunlit morning, no eye in the sky or bruise-like clouds bearing down on him, and gets to work.
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cj-jacobs · 6 years
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The Sex Elf
(Bechloe one-shot, 10k words)
Merry Pitchmas, awesome nerds! I didn’t do the official Secret Santa thing because I was so paranoid I wouldn’t get this done in time and didn’t want to disappoint anyone, but I’d like to gift it to the Bechloe fandom in general, and most especially as a surprise gift to @annakendrick4ever , because she’s been so supportive of my fics and is just an all-around sweetheart. I hope everyone who celebrates Christmas had a great holiday!
Not for the first time tonight, Beca finds herself wondering if it’s wrong to be this horny on Christmas Eve.
Because it feels wrong. Dirty, somehow. Not seasonally appropriate. After all, Christmas is supposed to be about wholesome, childlike, non-sexual things. Family things.
But then, the whole notion of family is precisely what’s put her into this situation, Beca muses, as she clumsily wields a screwdriver in an attempt to secure the wheel onto a doll stroller intended for her four-year-old daughter. Family, and the fact that in approximately five months theirs - hers and Chloe’s - is set to expand by two. And, most crucially, the fact that she’s the one carrying those two, and thus the one dealing with all the crazy, out of control hormones that pregnancy has brought in its wake.
For the ninth or tenth time in the past fifteen minutes, Beca finds her gaze drawn against her will to the other side of the master bedroom, where Chloe is wrapping presents, using their king size bed as her table. She’s got all her materials laid out on it; shopping bags full of gifts, ribbons, bows, tags, scissors and tape, boxes, and half a dozen rolls of wrapping paper, chosen specifically for color variety. But it’s not the paper or the presents that are drawing Beca’s attention, it’s Chloe herself. From here, Beca can only see her from the back. She’s dressed in a dark green romper printed with tiny red and white candy canes. In addition to this, she’s sporting fuzzy Christmas socks, dangly snowflake earrings, and a headband with a pair of perky cloth reindeer antlers. The fact that in spite of this ridiculous ensemble, Beca finds herself gazing at her lustfully says a lot about the current state of her libido.
Because no matter how hard she tries, her mind keeps sliding right back to sex. Her entire body is suffused with a kind of sensual energy like nothing she’s ever felt before, and it’s never satisfied for long. The fact that she’s already partaken of some afternoon delight today means nothing, because that was hours and hours ago, and these days the urges cycle back around continuously, with no let-up, multiple times every day.
Idly, she finds herself wondering, Is this what Stacie feels like all the time? Is that why she-
No. Picturing Stacie’s sex life is not going to help. Dolls. Strollers. Christmas. Wholesome family things. That’s what she needs to be thinking about. Focus, she commands herself.  
“How’s it goin’ over there, Mrs. Claus?” Chloe calls to her, as if sensing her distraction.
Beca surveys her work. “You know, I’m pretty sure the only reason my mom sent an unassembled toy is because the thought of me doing this in the middle of the night was hilarious to her.”
Chloe smiles. “Or,” she suggests tolerantly, “maybe it’s because that kind is cheaper, and that’s all she could afford.”
“Nah,” Beca rejects this idea. “This is payback, for all the Christmas Eves she didn’t get any sleep. See, every year she tried to get us to celebrate Hanukkah instead, and we never would take the bait. I’m telling you, this is a revenge gift. She is one sadistic woman.”
Laughing a little, Chloe reflects after a few seconds, “I think it’s just, like, a law of parenting, though, right? That we have to spend at least one Christmas Eve trying to assemble a toy?”
“Maybe. Except we aren’t assembling it. I am.”
“Hey. I’m busy over here, too,” she chides her.
Indeed she is. Beca finds herself trying and failing once again not to look as Chloe bends over the bed to cut another segment of wrapping paper, the tightness of the romper clinging to and perfectly accentuating her curves. Beca watches as she runs a pair of scissors down the middle of a sheet of glittery silver paper in a straight line. Normally this sound is one that for no particular reason grates on her nerves, like fingernails on a chalkboard. But tonight it sounds almost lewd. At the moment everything seems specifically designed to work on her hormones, not her nerves.
The funny thing is, she’d never wanted to be pregnant. In fact, until just a few months ago, she would have been adamant that it was the one life experience above all others she was determined never to go through. But then she’d changed her mind. She’s still not entirely sure why.
Because after Violet, she and Chloe had basically accepted that they’d never have another one. The pregnancy had been difficult; Chloe was sick a lot in the beginning, then the end had come abruptly, six weeks early, and Beca had spent a harrowing few days at the hospital with a premature baby and an unconscious wife, wondering if her life as she knew it was about to end. By some miracle, everything had turned out fine. Fine, that is, except for one small thing. Chloe had been warned by her doctor that another pregnancy wouldn’t be a good idea. At the time, it had seemed like a small price to pay.
But yet, here they are. Expecting not just one, but - in the most shocking news of their lives - two more.
And to everyone’s surprise, no one’s more than her own, Beca has found that pregnancy agrees with her. Not only has she not been sick, not even once, and not only is she possessed of more energy and a better mood than usual, but her sex drive has shot through the roof. Actually, one might even say it’s starting to be a bit of a problem. Needing sex so many times a day has its downsides. It’s convenient that her studio is located here on the property, which means it’s easy to duck in for a brief tryst, but having a four-year-old who’s not yet in school makes things more complicated. Violet’s three mornings a week at daycare and her daily two p.m. naptime have become blessed interludes of carnal indulgence.
Beca finds her thoughts wandering back to this afternoon’s session, her body remembering just how it had felt to be pinned under Chloe and clinging to the headboard as she…. No. That’s not going to help either. Shaking her head a little to clear the lust fog, she forces herself to focus on the damn doll stroller. It takes every ounce of her concentration to make sense out of instructions like Squeeze the metal bracket on the wheel to open it, slip the wheel onto the end of the rod, and release the bracket. She’s not even one hundred percent positive she knows what the hell a bracket is, and the words squeeze and slip look like porn in her current state of mind. But she’s doing her best.
Finally, the last wheel seems to be locked into place. “Okay. Moment of truth.” She practically holds her breath as she gives the pink stroller an experimental push forward, then pulls it back, making sure it rolls properly. “I think it’s finished. Thank God.”
“No pieces left over?” Chloe asks.
Beca looks into the box. There are approximately nine pieces left over. “Nope.” She strategically covers them with the instruction sheets. “We’re good.”
Wincing as her stiff muscles protest, she pulls herself up from the floor. “But, um, just to be on the safe side, let’s make sure we never put an actual baby in this thing.”
Chloe has also paused briefly in her assembly-line gift wrapping. She’s sipping from a glass of red wine, looking at the bed as if measuring how much is left to do. Beca approaches behind her and presses herself up against her back, wrapping her arms around her. Chloe sighs a little and leans back into her, bringing her free hand up to squeeze Beca’s arm.
Though her stomach is only just beginning to pop out, the roundness subtle enough that if she wears a baggy shirt it’s not even that noticeable, standing like this, Beca can feel the difference. Odd to think that in another few months, she won’t be able to stand like this at all. She presses herself even tighter against Chloe, to take advantage of it while she can. Nuzzling up into the spot just behind her ear, she murmurs, “Have I ever told you how sexy you look in those reindeer antlers?”
“What reindeer antlers?” Then Chloe gasps, her mouth forming an O of surprise. She suddenly reaches up and yanks the felt antlers from her head. “Oh my God, I forgot I had these on!”
Beca gives a loud laugh. “Seriously?”
“How long have I been wearing these?”
“Like, all day.”
She marvels at the antlers, amazed. “No wonder the Fed Ex guy was giving me such a weird look.” She tosses them aside, jokingly accusatory. “Why didn’t you tell me?”
“I thought you knew. It’s not like it’s the strangest thing you’ve ever done on Christmas Eve. Remember the year you put jingle bells in your bra?”
Chloe giggles a little at the memory as she takes another sip of wine. “That was a good Christmas.”
With her arms still wrapped around her from behind, and using the subject as an opportunity, Beca now unfastens the top few buttons of the romper and slips a hand in, wondering, “Anything in there this year? Oh, wow. Not even a bra.”
“I know what you’re trying to do, and it’s not gonna work,” Chloe informs her with a grin, although she leans back against Beca and makes no move to stop her.
“I’m trying to feel you up. And, I think it already did work.”
“You know what I mean. I’m not gonna let you distract me. Not tonight.”
“Can’t you take a break? I need you,” Beca whines, trying to make it sound like joke begging instead of actual begging, which it is.
“Babe, look at the time. Santa’s on the clock, here.”
Beca glances at the digital clock next to the bed, shocked to see that it’s almost three in the morning. “We shouldn’t have waited until the last minute to do all this,” she mutters petulantly against Chloe’s shoulder.
“I know, but everything’s been so crazy. And a lot of my spare time lately has been taken up by someone demanding sex.”
“Really?” Beca asks. “Who?”
“That would be the person whose hand is currently in my shirt.”
“Oh, her.”
“Yes, her. And she’s not gonna be too happy about this, but I have to get back to work now,” Chloe sets her wineglass aside on the trunk at the foot of the bed and delicately removes the hand from her shirt, over Beca’s sad-sounding protests. As if to compensate her for the loss, Chloe turns to kiss her.
Sensing her opportunity, Beca tries to make the most of the kiss, but she’s distracted by another, non-sexual craving.
“Mmm, I can taste the wine on your mouth,” she murmurs against Chloe’s lips.
Chloe seems bemused. “You don’t even like wine.”
“No, but I like alcohol. And I miss it.” She pulls her back in for another deep kiss. She can feel Chloe actively trying to resist letting things heat up beyond a certain level, but at the same time Chloe is such a good kisser that it’s hard for her to fight her natural instincts. Beca tries to take advantage of her internal battle, using her tongue in a precise and practiced way that draws Chloe into being the aggressor. It works for a few seconds, but then Chloe seems to realize what she’s doing, and she uses all her willpower to pull back and break the kiss.
“Really?” Beca asks.
“Really.” Then Chloe cups Beca’s face in her hands, briefly leaning forward and pressing their foreheads together. “But maybe later, okay?”
Beca sighs, apparently giving in.
But just then Chloe jumps a little, turning to glance behind her and down toward her ass. “What was that? Did you just pinch me?”
“What? No. Why would I- ?” Beca makes a face of exaggerated innocence. Then she seems to think of something. “But, oh, you know what I bet it was? I bet it was the sex elf.”
Chloe tilts her head. “The what, now?”
“You’ve… never heard of the sex elf? For real? That’s insane. I thought everyone knew about this.”
Crossing her arms, Chloe plays along, waiting for her to explain.
“The sex elf is that little creature that goes around on Christmas Eve, pinching people. And when you get pinched, you become overwhelmingly aroused. And you have to get laid, like, right then. You have no choice.”
“Really. This is fascinating.”
“I can’t believe you didn’t know about this.”
Chloe narrows her eyes in mock seriousness. “Are you sure that’s not leprechauns you’re thinking of?”
“What? No.” Beca makes a disgusted face. “Gross. Leprechauns are, like, ugly little Irish dudes. Who care way too much about the color green. The sex elf is hot. And, frankly, she prefers it if you’re not wearing anything.”
“Oh, so the sex elf is female?”
“Well,” Beca shrugs. “Yeah. Obviously.”
“Obviously,” Chloe agrees. She smiles and then leans forward for one more light kiss, getting Beca’s hopes up. “Well, it was really sweet of her to pay us a visit. It’s too bad she couldn’t have stuck around to help with some of this.” She gestures at the gift-wrapping mess.
“Yeah.” Beca grimaces. “I think she’s really just… more about the sex?”
Chloe nods, amused, but then looks regretful. “Beca?”
Beca waits, giving her an expectant, somewhat pleading look.
“It’s not gonna happen,” Chloe whispers, dashing all her hopes.
Momentarily accepting defeat, Beca sighs heavily and drops onto the bed, stretching out directly on top of Chloe’s present-wrapping workshop. “Fine,” she sulks.  
“But, you know, if you’re bored, you could help me finish this up,” Chloe suggests.
“Uuhhh,” she moans. “You know I hate wrapping presents, dude. I’m carrying your children! Isn’t that enough?”
“Oh my God,” Chloe laughs at her. “Enjoy that excuse while it lasts.” But she doesn’t insist.
Beca tries to relax and coerce her body into a zone of patience, but now that she’s actually lying on the bed, the urge to touch herself is nearly overpowering. It hasn’t been this strong since she was sixteen and puberty finally slammed into her with the finesse of a car crash. She sits up again, crossing her arms and tucking her hands away to keep them out of trouble. Not that Chloe would mind. But she has a feeling that trying to get herself off while her wife ignores her and wraps presents for a four-year-old would be not so much sexy as pathetic.
Instead, she watches Chloe work, pondering the absurdity of being awake in the middle of the night wrapping gifts in paper that’s going to be torn off and thrown away in less than six hours. Being a parent is strange. But it’s pointless to question it.
Chloe has her own distinctive manner of wrapping presents, a way of folding the paper which is like nothing Beca has ever seen any human being do before. Somehow, the packages always end up looking great. But like so much else that she does, Chloe goes about it using a bizarre method she seems to have invented on her own, as if no one ever taught her the normal way to do it. Momentarily distracted from her lust, Beca finds herself watching with amused fascination as she finishes taping up the paper on one gift, then with a flourish adds a stick-on bow - not in the center, but in one corner.
Shaking her head with a fond smile, Beca mutters, “You’re so weird.”
Turning to set the package on a pile of already-wrapped boxes in a chair beside the bed, Chloe lets out a breath of relief. “There.”
Beca perks up, hopeful. “That’s it? You’re done?”
“Well, I’m not done done. I’m done with the big stuff. There’s still all the stocking stuffers.” She lifts a plastic bag from the floor near the side of the bed and turns it upside down over the comforter. Approximately thirty small items tumble out.
“What?” Beca looks at her like she’s crazy. “You’re not gonna wrap all those, are you?”
“Yeah, of course.”
“Chlo, they’re stocking stuffers. The stocking is the wrapping. That’s the whole point.”
Chloe shakes her head. “No, because then when she dumps it out, she’ll be able to see all of it at once. Where’s the surprise, where’s the anticipation? I want her to have to open each one, individually.”
“Oh my God, that’s-” Beca digs her fingers into her own hair and vigorously shakes her head, making a clenched-teeth sound like “Mrrrmmm.” It’s the sound she makes when she’s trying to keep herself from saying something she’ll regret. After restraining her worst impulses, she drops her hands and settles for, “You know that’s gonna take forever, right?”
“I don’t care how long it takes,” Chloe says stubbornly. “We’ve got all day.”
Beca lifts one of the items from the pile. “You’re gonna wrap these socks?”
“Mm-hm.”
She picks up another item. “This roll of Sweetarts?”
Chloe nods. “Yep.”
“You’re gonna wrap this lip balm. This one, individual tube of lip balm.”
“That’s right,” Chloe confirms, and because there’s a slight edge to her tone now, Beca decides she should probably back off. She carefully sets the lip balm back onto the pile, suppressing an eye roll like a good girl.
While Chloe starts in on the stocking stuffers, Beca reaches over and grabs her phone off the nightstand to check her messages. There’s a handful of Merry Christmas texts from the Bellas, nothing out of the ordinary. The one from Aubrey, however, makes Beca narrow her eyes in suspicion. It reads Merry Christmas Beca! Hope this one leaves you satisfied ;) ;)
Setting the phone back on the nightstand, she ponders the meaning of this for a few seconds.
“Hey,” she says casually. “You didn’t tell Aubrey about my whole… horniness… issue, did you?”
“Of course not.” But Chloe doesn’t look at her.
“Because I just got a weird text from her. And, now that I’m thinking about it, I’m pretty sure I overheard you on the phone earlier saying something about a… what were the words? Crazy little sex fiend.”
Chloe shakes her head slightly and frowns, but still doesn’t glance up. “I have no idea what you’re talking about.”
Beca studies her face for a few seconds, taking note of how hard she’s now trying not to laugh, and the continued lack of eye contact. “You did!” she suddenly gasps, letting her mouth fall open in pretend shock. “Dude, you told her?!”
“Beca,” Chloe protests, finally looking up at her. “Come on. Aubrey’s my best friend. I tell her everything!”
“About our love life?”
“It’s not like she’s gonna judge you. She’s been pregnant before, she knows about the hormones.”
“Okay, wow.” Beca plays up her mock outrage, a hand on her heart. “I can not believe that you would betray the sanctity of our marriage like that. Honestly? There’s only one way that you could ever make this up to me.”
“Hmm,” Chloe muses, snipping off a length of ribbon. “And what way would that be?”
“I’ll give you a hint,” Beca tells her. “It involves you taking off your clothes. Right now.”
Attempting to tie the ribbon around one of the stocking stuffers, Chloe responds only with a slightly pitying look.
“No? Damn it,” Beca mutters. “I thought the guilt trip was the way to go.” She thinks for a few seconds, trying to come up with a more effective angle. Then she suddenly asks, “Is it just me, or is it really hot in here?” As she says these words she slowly pulls off her shirt, leaving her in nothing but a pair of sweatpants and a lacy black bra.
“Nope.” Pressing her lips together to try to stifle a smile, Chloe shakes her head and concentrates on her battle with the ribbon. “I’m ignoring you.”
“Really? You can ignore this?” Beca cups her own breasts and pushes them together and up, trying to create some amplified cleavage.
As if to prove her right, Chloe glances up at her, again trying not to laugh.“Why are you wearing one of your sexy bras under your pajamas?”
“Because a girl needs to be prepared. Especially when her wife is resisting her seduction attempts.”
“Oh, is that what this is?” Chloe teases her. “A seduction? See, I didn’t get that.”
“Well, now you know.”
She snips out a small rectangle of paper, just big enough to wrap a toothbrush in. “You know what this is, Beca?” she says reflectively, pointing at her with the scissors. “It’s karma. For all those years I tried to get into your pants in college, and you wouldn’t let me.”
Beca widens her eyes with pretend dismay. “That is so twisted! For most of that time, I didn’t even think you were serious, I thought you were just messing with me.” She’s quiet for a second, as if considering how much she wants to reveal. A little awkwardly, she admits, “It’s not like I never thought about it. I had some pretty inappropriate dreams over the years.”
“Really?” Chloe looks intrigued. “You never told me that.”
Pursing her lips, Beca nods. After a pause, she adds, “First one was after the shower thing.”
“What? That was only the second time we met! Even I didn’t have a sex dream that early.”
“Yep. What can I say?” Beca shrugs. “Guess my dream self is kind of a slut.” She considers. “And, now, apparently, so is my awake self. Which could end at any time. So���” she holds her arms and gives a little shimmy of invitation, “you might want to get on this, while it lasts.”
“Well, that is hard to resist, when you put it so romantically.”
“Right?”
“But I think I’m still gonna have to finish these presents.”
Beca gives a dramatic groan at yet another failure. “You are killing me, lady.”  
After another few minutes of watching her, Beca decides to try some props.  She picks up a long tubular roll of wrapping paper and holds it so that it springs up from between her legs. “What about this? Does this do anything for ya?”
Chloe looks over at her, teasing, “If it did, it would be bad news for you.” She reaches out and snatches away the roll of paper. “Give me that, I need it.”
As it’s yanked away Beca hisses sharply and stares down at her left hand. “You bitch. You gave me a papercut!”
“Aww. Poor baby.” But she doesn’t sound particularly sympathetic.
“Ow.” Beca stares down at the shallow cut between her fingers, musing, “Why is this making me even more turned on? Am I into this? Maybe this is my kink.” She looks up at Chloe and asks in a flirtatious tone, “You want to give me another one?”
“Don’t tempt me,” she smiles, picking up her wine glass and draining what’s left of it, as though dealing with Beca’s current mood requires all the alcohol available. “Although…” she says after a few seconds, biting her bottom lip as an idea occurs to her. She sets the empty wine glass aside. “Speaking of kinks.” Now she bends forward over the bed, balancing herself with one hand on the mattress, her face coming tantalizingly close to Beca’s. She lets her voice drop into a breathy, lascivious register. “You know what would make me really, really hot right now?”
Beca watches nearly hypnotized as she approaches, staring first at her eyes and then at her mouth, only inches away. She tries to say the word “what?” but isn’t quite sure it comes out.
“The sight of you, in this bra…” Chloe coos seductively, actually running her fingertip down the bra strap and then along the edge of one of the cups as Beca follows its progress with rapt attention. Chloe pauses for dramatic effect, waiting until Beca looks up at her again, then concludes in a whisper, “Wrapping some of these stocking stuffers.” Then she leans back and straightens up, punctuating the performance with a quick wink.
“Hm.” This is the only response Beca can immediately manage as she tries to remember how to breathe. After seeming to consider the proposition, she says doubtfully, “See, I feel like that’s not one hundred percent true? I feel like I might be getting used, here.”
“Well,” Chloe tosses her a roll of tape, “guess there’s only one way to find out.”
Realizing there’s no point in continuing to fight it, Beca decides to give in and help. Even if it doesn’t actually make Chloe hot, it’ll at least mean they’ll be finished with everything sooner, which will still, hopefully, bring her closer to sex. It’s a no-brainer. So they divide the pile of remaining items up and get to work.
Wrapping things that aren’t in boxes turns out to be easier and more fun than Beca would have predicted, since it’s okay if it looks messy and there’s almost no way to get it wrong. Eventually, Chloe gets tired of standing and climbs onto the bed, sitting across from her. They trade the tape and scissors back and forth, losing them both every few minutes under the growing drift of wrapping paper scraps covering the bed.
At one point Beca seems overly amused with herself, and Chloe looks over to find her wrapping Scotch tape around the paper covering a plastic My Little Pony toy, over and over and over again, essentially mummifying the poor pony.
“What are you doing?” Chloe giggles.
“You wanted the anticipation factor. Let’s see how long it takes her to open this one.”
The piles of gifts keep diminishing until finally, finally, the very last box of sidewalk chalk is wrapped and added to the bag of finished items, ready to be crammed into the jumbo-sized stocking waiting downstairs.
Beca hardly dares to believe her own senses. “So, that’s it then? We’re done. With everything.”
Chloe looks around, considering. “What about the doll stroller?”
“Okay, we are not wrapping that,” Beca says firmly. “I’ll throw a sheet over it or something.”
“Then… yeah.” She looks back at Beca. “I guess that’s it.”
Trying and not succeeding very well at keeping her eyes from gleaming with pure lust as she stares at her, Beca offers, “Sooo, do you need like a bathroom break, or…?”
Chloe seems amused by this. “No, I’m good. I- “
But before she can complete this thought, Beca has pounced on her, with a kiss so forceful and bruising that both their mouths will probably be sore tomorrow. But she’s past caring. She pushes her back toward the middle of the bed, angling for the pillows, the wrapping paper crackling loudly underneath them. Chloe squeals in laughter, breaking the kiss to say, “Let me clear the bed off first!”
“Nope, it’s fine,” Beca gasps. “Leave it. We can knock this out in, like, five minutes.”
“God, that’s so sexy,” Chloe breathes against her ear. “Tell me again how fast you can be, it’s such a turn-on.”
“Shut up,” Beca laughs.
With Chloe now up against the pillows at the top of the bed, Beca climbs onto her lap, straddling her, almost undone by the instantaneous pleasure of even the light friction of this much contact. Oh God Oh God Oh God. She hasn’t even progressed as far as taking her sweatpants off yet, but even through the fabric the welcome pressure of Chloe’s body has her eyes rolling back in her head. In the past this would have been barely enough to register on her, but she’s so excruciatingly sensitive that any touch at all is already like a mini-orgasm. Immediately she begins rocking against Chloe in slow waves, trying to keep her movements sensual instead of desperate.
At the same time, she unbuttons the front of Chloe’s romper for the second time tonight and peels it off her shoulders, ducking down to return to the bare skin with her lips. She feels Chloe’s expected shiver as she tilts her head back to allow Beca easier access. Her collarbone is her secret erogenous zone, in the same way Beca’s ears are hers. It’s a surefire way to kick her passion up a few notches. As she kisses down the ridge of her shoulder and then along the top of her chest, she feels Chloe’s fingers working at the bra strap on her back. Without too much effort she unhooks it and Beca shrugs it off.
She continues working her way along Chloe’s collarbone and then back up her neck on the other side, but the fact that her breasts are now free is making her antsy, and she straightens her spine and lifts herself higher against Chloe’s body to put them nearer her mouth, hoping she gets the hint. She does.
The sensation of Chloe’s tongue tracing circles over one breast, followed not too long afterward by the enveloping warmth of her mouth clamping down on the other one sends a surge of heat blooming upwards from between Beca’s legs, and her thighs lock around Chloe’s hips in a preliminary spasm of pleasure. This in turn causes Chloe to press up against her and then to nip at her with her teeth, a feedback loop that jolts Beca with an even sharper stab of ecstasy and an increased frenzy to her writhing.
Suddenly she realizes that she’s too close. Way too close, for this early in the game. To try to slow herself down, she grasps Chloe’s head in her hands and physically pulls it up and away from her chest, signaling that she wants to kiss her. Chloe looks a little surprised, since Beca isn’t normally the type to want to go back to the preliminaries, after they’ve already gotten down to more serious business. But she happily obliges, sliding her hands up Beca’s bare back and pulling her even closer as she angles her head up and into the kiss.
As Chloe has gradually shifted further back into the pillows, Beca has worked herself lower down her body, and now Chloe’s pelvic bone is positioned directly between her legs, up against the precise spot that’s been begging for attention for hours. Still, this shouldn’t be enough contact, she knows it shouldn’t. And yet her lower body is behaving as if it is, almost as if it has a mind of its own, her squirming becoming more deliberately rhythmic, her hips rotating with purpose while her kisses gradually lose focus and then break off completely as her breathing grows more ragged.
Because it’s happening. All of a sudden she knows it’s happening, and either she can slam on the brakes completely or she can help it along and make sure it’s as satisfying as possible. She’s already past the point of no return. No sense in wasting it. So instead of fighting it she doubles down shamelessly, using every ounce of her strength to grind herself against Chloe’s lap, while Chloe assists her along by pushing herself up against her while simultaneously tugging downward on Beca’s hips.
Then she shudders and her back bows into a taut arc, her head practically upside down, and if Chloe wasn’t hanging onto her around the waist she would definitely fall over backwards. She hangs there suspended, waiting for it to spasm itself out. Every day the orgasms seem to be getting bigger, somehow. They’re more powerful, they take up more space inside her, and they last longer than she would have once thought possible. The bliss that floods through her now is so piercing that it brings actual tears to her eyes, and she has to make an effort to keep from screaming. Instead she makes a noise that probably sounds more like pain than pleasure, but it’s the most restrained she can manage.
Finally, feeling shaky and a bit lightheaded, still breathing hard, she steadies herself and rises back to vertical. The force of her grinding has pushed Chloe all the way back into a nearly reclining position, with Beca still straddling her midsection. Taking in gulps of air, mortification gradually settling in with the slowing of her pulse, Beca now looks down at her beautiful wife, at her messy hair splayed around her on the pillows, one strand caught in a snowflake earring, her lips swollen from the force of their brief but intense make-out session.
Chloe stares up at Beca, her eyes sparkling with mirth, stunned but also a little impressed. “Was that- ?”
Beca now covers her face with her hands as she realizes exactly what she just did. “Yep,” she confirms in a small voice.
“Wow. You weren’t kidding. That was fast.”
Beca only winces and shakes her head a little, hands still covering her face.
Chloe is enjoying this way too much. “I didn’t even touch you yet.”
“I know.”
“You’re still wearing your pants.”
“Oh my God, I know. Stop talking about it.”  
Chloe giggles and pulls her down, and Beca allows herself to fall against her, laughing into the side of her neck, glad to hide her burning face.
“Jesus,” she whispers. “I’m so sorry.”
“Don’t be sorry,” Chloe tells her, stroking her back. “It’s sort of flattering, in a… weird way. Also kinda hot,” she admits.
Beca takes a deep, shuddering breath, releasing it and feeling most of the tension drain out of her body as her pulse finally slows down. “I really needed that.”
“I shouldn’t have made you wait so long.” Chloe’s still rubbing slow circles on her back. “You need some time to recover, before the second half?”
She hesitates, but then accepts the offer. “Maybe just a few minutes.” Shifting off Chloe and onto her side, they lie facing each other, separated by only a few feet.
“Your face is all red,” Chloe smiles. She places the back of her hand against Beca’s cheek, as if checking for fever.
“That’s the color of shame,” Beca informs her, only half joking. She likewise reaches over and carefully extracts the hair that’s tangled in Chloe’s earring, then strokes it to smooth it out.
Inching closer to her across the pillow, Chloe nuzzles into a slow, lazy kiss. For a long while she seems content to keep it at this level, as if they have all the time in the world, and from the way she’s seeking out cuddles even in the midst of what’s supposed to be sex, Beca senses that she’s not in any big hurry, physically. Waiting for her energy reserves to return, she finds herself drifting into a kind of dreamy, hazy post-orgasm euphoria as they continue making out like teenagers. Beca’s fine with letting her set the pace, she just hopes she doesn’t fall asleep before Chloe decides she’s ready to kick it into high gear.
But suddenly Chloe stiffens and raises her head, like she’s listening.
“What?” Beca asks drowsily.
“I thought I heard something. In the hallway.”
“Maybe it’s Santa. Maybe he wants to watch, that old perv.”
Chloe gives her a distracted smile.
“That didn’t turn you on, did it?”
“Beca, shh. I’m serious, I hear something.”
Beca raises her head to listen as well, and confirmation shortly follows; there’s what sounds like a faint, feeble knock at the door, almost more like a scratch than a knock. Maybe one of the cats, Beca hopes. Please let it be one of the cats.
But then they hear just outside their door the one sound that no parent ever wants to hear in the middle of the night, especially while attempting to do what they’re attempting to do.
“Mommy?”
They stare at each other.
“What the hell?” Beca hisses. “Why is she awake?” Suddenly paranoid, she asks, “I wasn’t that loud, was I?”
“No,” Chloe assures her. “Maybe she’s sick.” In a loud, upbeat voice, she calls, “Just a second, sweetheart!”
Beca sits up and searches for her shirt under all the wrapping paper on the bed, then yanks it back on, not bothering with the bra. She starts toward the door but then suddenly remembers they have a bigger problem than just incomplete sex.
“Shit, the presents,” she whispers. “What do we do?”
“Um,” Chloe casts around for a solution. “Blankets!”
As fast as they can, they tug the comforter from the bed and cover the piles of presents on the floor. Beca grabs a knitted afghan to drape over the stack of gifts in the armchair in the corner, while Chloe snatches a spare sheet from a nearby laundry basket, tossing it over the doll stroller.
“Hold on, we’re almost there!” she calls again, trying to sound normal. She looks around, asking Beca, “Is everything covered?”
Beca smirks. “Not quite everything.”
Chloe looks down at where Beca’s gesturing, realizing that she’s still topless. “Oh.” She laughs and yanks the romper back up onto her arms, and is just finishing the last button when Beca reaches the door.
Checking to make sure Chloe is ready, she pauses, then swings it open.
On the other side, waiting in the hallway, they’re confronted with the face of tragedy. Violet stands there in her brand new blue and white snowman-printed Christmas pajamas, the one gift she’d been allowed to open tonight before bed, but the expression on her face is anything but festive. She looks wretched.
“Sweetie.” Chloe’s voice is drenched in pre-emptive sympathy. “What happened?”
“Did you puke?” Beca asks, getting right to the point.
Shell-shocked, Violet stares into the middle distance as if she’s barely aware of their presence. In a quiet tone of disbelief, she says, “He didn’t come here.”
“What?” They look at each other, uncomprehending.
Repeating herself, Violet emphasizes each word for the benefit of their challenged adult brains. “He. Didn’t. Come. To. Our. House.”
“Who didn’t?” Beca demands.
Violet finally looks up at her, her mouth a tiny O of surprise, flabbergasted that her mother could be so stupid. “Santa Claus!”
“Wait, did you go downstairs?” Chloe looks dismayed. “It’s not even morning yet.”
Ignoring this question, Violet shakes her head and walks a few paces into the room, then spins around and comes back, then repeats the process, wringing her tiny hands and looking distraught.
“Uh-oh,” Beca mutters. “She’s pacing. Where have I seen this before?”
“Violet, oh my God, this is just a misunderstanding, please don’t freak out,” Chloe begs her.
Without seeming to hear her, Violet continues her pacing. “I can’t believe this!” she rants. “This is the worst Christmas of my life!”
“Oh, man,” Beca winces. “Out of all four?”
“Beca.” Chloe shoots her a warning look. Then she takes Violet by the shoulders and gently guides her over to the trunk at the foot of their bed. “Honey, come over here, and listen to me for a minute.” She sits down and pulls Violet up to sit next to her, telling her, “Santa Claus is going to be here, I promise. It’s still early, there’s plenty of time.”
“No. He’s not coming. And I know why. It’s because I did something bad.” She’s really playing up the melodrama, sticking out her bottom lip in a pout that she must have learned from a sitcom kid.
“What? No, you didn’t,” Chloe tries to comfort her. “You’ve been really good this year.”
“I wasn’t good yesterday.” Violet looks at her, saying pointedly, “You don’t know, Mommy.”
“Ohhh.” Now Chloe’s catching on. “I see.”
Beca approaches, lowering herself to the edge of the bed a few feet from Chloe. Trying to sound as if she’s taking this seriously, she offers, “Is there something you want to tell us?”
It takes only a few seconds for Violet to decide that she does want to tell them, since she’s obviously suffering from a guilty conscience. “Okay.” She hops down from the wooden chest and comes to stand in front of them both, then takes a deep breath. “Yesterday…” she stares mournfully at her socks, looking for all the world like she’s about to deliver a eulogy. “I peed in the plant.”
Chloe and Beca glance at each other, baffled.
“What plant?” Beca asks.
Violet sighs, miserable but determined to press forward with her confession now that she’s started. “The big one. In the living room. With the red flowers.”
“My poinsettia plant?” Chloe asks, her voice strained as if she’s already trying to hold back laughter.
“In the dirt,” Violet specifies. “Not the flower part.”
“Oh.” Chloe nods slowly, but then clamps a hand over her own mouth.
“Because the Grinch was on,” Violet adds, warming to her narrative now. “And I had to go real bad. But I didn’t want to miss it, so I didn’t go yet. But then I couldn’t wait any more. So I went in the plant.”
Pressing her lips together hard, Beca glances once at Chloe and then looks quickly away before they make eye contact, certain that then they’d really lose it. Because they both know that their daughter is sensitive about being laughed at, it would be a bad idea. But this is one of those times when it’s practically torture to fight it.
Beca manages to master herself first. To buy Chloe some time to get it together, she comments, “I can see how that might be tempting. That white pot does sort of look like a toilet.”
This apparently doesn’t help Chloe, because now an odd stifled snort comes from behind the hand she’s holding over her mouth.
Beca adds, “And, I mean, who wants to leave the room when the Grinch is on, right?”
Violet nods, glad somebody gets it. “But it was still bad,” she points out.
Finally, Chloe regains her composure. She lowers her hand, saying sympathetically, “Sweetheart. That’s… I mean, yeah, okay, that’s definitely not a good thing. We don’t want to make a habit of… peeing in plants.” She’s forced to stop again, still avoiding meeting Beca’s eye. “But it’s good that you told us.”
“No,” Violet shakes her head tragically, refusing to be consoled. “It doesn’t matter. Because Santa already knows. Like in the song.” Suddenly she face plants onto the bed between them, uttering a muffled, plaintive wail. “I ruined Christmas!”
Chloe and Beca trade dumbfounded looks over her back, neither having any immediate idea of how to fix this mess. Beca still really wants to laugh, but she can read the Don’t in Chloe’s gaze as easily as if she’d said it out loud. Shutting her eyes for a second, she considers their options in this supremely ridiculous situation. She feels responsible, since if it wasn’t for her raging sex drive, they probably would have already had the presents under the tree. But there’s clearly no way to explain that to their daughter.
She opens her eyes again with an idea. It might not work, but it’s worth a shot. “All right.” She takes a deep breath. “Hey,” she nudges Violet. “Would you sit up, please? And stop being such a drama queen? There’s something we need to tell you. About Santa Claus.”
Though she drags out the process, Violet does finally pull herself up from the bed and turn around to face them, intrigued.
Chloe, however, looks confused, and more than a little concerned. She pulls Violet into her lap, as if to protect her from whatever Beca’s about to say.
“It’s a big secret,” Beca adds, “so you have to promise you’re not gonna tell any other kids.” She shoots Chloe a look over Violet’s head that she hopes conveys Trust me, but Chloe still seems nervous, obviously wondering where on earth she’s going with this.
But Violet is now hanging on every word. “I promise,” she says solemnly.
“Okay. Here it is.” She lowers her voice to a discreet level. “Santa Claus?” Here Beca takes a long pause for maximum dramatic impact, starting to enjoy herself a little. “He doesn’t actually care whether you’re good or not.”
She can sense the relief washing over Chloe as she realizes what Beca’s up to.
“Yes he does,” Violet insists petulantly.
“Nope,” Beca shakes her head. “He doesn’t. Parents just want kids to think that, so they’ll be good. But the truth is, Santa doesn’t give a crap. About anything you do. He’s gonna bring you stuff no matter what.”
“It’s true,” Chloe chimes in. “He really doesn’t care. The song is a lie.”
Mulling this over, Violet seems to want to believe them, but she’s not quite there yet.
“In fact...” Beca looks around as if she’s about to impart even more confidential information. “Did I ever tell you about the Christmas Eve when I stabbed my brother in the shoulder with a pencil?”
Violet looks shocked. “Why did you stab Uncle Chris?”
“I had to.” In her most serious tone, Beca explains, “Because he called Nicole Scherzinger a skank.”
Thinking about this, Violet wants to know, “Who’s Nicole…” she struggles to pronounce the name, “Scherrrr...zinger?”
“She was a Pussycat Doll,” Chloe supplies helpfully.
“Yeah,” Beca agrees. “Well, I mean,” she shrugs, compelled to add, “not just a Pussycat Doll.  She was, like, the lead Pussycat Doll.”
Still seeming deeply confused, Violet asks, “Who were the- ”
“You know what, that’s not important,” Beca quickly interrupts her. “The point is, she wasn’t a skank. She was a superstar. And a very important part of my childhood. And I’m pretty sure that I was trying to kill my brother with that pencil. He still has graphite lodged under his skin, to this day.”  
“He does,” Chloe confirms. “I’ve seen it.”
Looking back and forth from one to the other, Violet considers this.
Now Beca pauses, waiting until she’s sure her daughter is listening to every word. “But you know what? Santa didn’t even blink at that attempted murder. He still brought me every single thing I asked for that year.”
After processing this new information, Violet does finally seem to be reassured. But then another flicker of worry crosses her face as she glances at the clock. “But it’s almost morning. Maybe he just forgot.”
“He didn’t forget, I promise,” Chloe tells her. “Actually,” she throws out impetuously, “he’s on his way to our house, right now. We know that for sure.”
“How?” Violet demands.
“Because…” Unprepared to provide evidence, Chloe casts a desperate glance at Beca, but Beca gives her a tiny shrug; she’s all tapped out on bullshit. “Because, he just texted us!”
Beca bites the inside of her cheek, hard, just as Violet turns to her for corroboration. She nods, saying carefully, “Yep.”
“No, he didn’t,” she sulks, but it’s clear she wants them to prove her wrong.
“Yes, he did,” Chloe insists. “Right before you came in. He texted to say he’s almost here. What, you don’t believe me?”
“Let me see it.”
“You want to see the text from Santa? All right.” She seems to be racking her brain for inspiration. “Bec, give me your phone.”
Beca squints at her, dubious. “O-kayyy.” With an expression of You sure about this? she nevertheless retrieves her phone from the nightstand and hands it over.
Navigating easily to her message app, Chloe at first looks frantic as she taps through the threads, but then her face lights up with triumph as she reads something on the screen. She angles the phone toward Violet, pointing at a received message bubble in the left column. “Here it is. Right there, see it?” She reads it out loud. “It says, Almost there! Don’t give up on me ;)”
Violet studies the words for a minute, twisting a lock of her hair around her finger as she concentrates on trying to sound out the letters.
Chloe isn’t lying, this is precisely what the text says. Of course, what neither of them tells Violet is that this is actually a text from Chloe herself, sent yesterday afternoon during Violet’s nap, in response to one from Beca which reads How close are you to home? I’m in bed about to start without you.
After a few more seconds of scrutinizing, Violet reaches her verdict. “Kay,” she finally says, accepting their word for it.
“Okay?” Beca reiterates, trying not to look as relieved as she feels. “You believe us now?” She snatches the phone back before Violet can change her mind.
“See, silly? There was nothing to be worried about,” Chloe squeezes her reassuringly.
At long last, they’re rewarded by their daughter’s smile, which breaks over her face and lights it up with joy, like the proverbial rainbow after the storm. “I know,” she tells them, as if she’s been fine all along and they’re the ones who’ve been freaking out.
Unfortunately, now that her inner peace has been restored, Violet for the first time seems to notice the odd condition of her parents’ bedroom. Taking in her surroundings with perplexity as she slowly looks around her, she asks, “Why is there blankets on everything?”
“Um, because the roof was leaking,” Beca says fast, knowing that out of all the nonsense explanations they’ve cooked up in the last ten minutes this is surely the lamest. “And we didn’t want the furniture to get messed up.”
“Oh.”
To keep her from dwelling on this long enough to remember that it hasn’t rained at all in the last few weeks, Beca hurriedly changes the subject. “You know, you should probably get back to bed.  The thing is… Santa might be a total pushover when it comes to the naughty thing? But he really does want you to be asleep when he gets here.”
“Yeah, it’s true,” Chloe nods. “That part is actually pretty important. We shouldn’t take any chances.”
“Okay,” Violet agrees immediately.
But Chloe doesn’t release her just yet. “So, do you feel better about everything now?”
“Yeah.”
“Are you excited about tomorrow?” She gives her a gentle shake.
“Uh-huh.” Violet is now beginning to squirm to get out of her lap.
“You’re gonna have so much fun,” Chloe promises her. “I bet you’re gonna get every present you asked for, and probably some that you didn’t even think of.”
“Yeah. But, Mommy,” she finally runs out of patience. “I have to go.”
“Oh, okay,” Chloe laughs, finally letting go of her. “You’re right, you should go. Kiss first!”
After she accepts the kiss with barely-concealed haste, Violet starts to run right out of the room, but Beca interjects. “Ah-ah-ah! Hey. Are you forgetting something?”
With a heavy sigh, Violet turns and comes back for yet another goodnight hug and kiss. “We already did this, before,” she can’t help pointing out to Beca.
Beca laughs. “Yeah, well, if you’d stayed in bed we wouldn’t have to do it all over again.”
Violet has no desire to argue, since time is of the essence. Released from Beca’s hug, she heads back to her bedroom at a sprint. Chloe waits in their doorway while Beca follows their daughter down the hall to her room, where she watches as Violet springs into bed. Giving her a last wave and a reminder to go to sleep fast, she gently closes the door. Then she comes back toward Chloe, smiling, both hands raised in the air for a soft and soundless high-five.
Chloe hangs onto her hands and tugs her back into their bedroom. After the door is shut behind them, they both lean against it, finally allowing themselves to laugh, but not too loudly.
“Did that really just happen?” Chloe asks in a low voice. “Oh my God, I thought you were gonna tell her about Santa Claus.” She gives Beca’s shoulder a playful shove. “I would have killed you.”
“I know,” Beca smirks. “Sorry. Nice save with the text, though. We should have just started with that.”
“Oh, yeah,” Chloe says modestly. “I guess it’s a good thing she can’t read too well yet.”
Beca laughs, then both are quiet for a few seconds as they bask in the relief of pulling the whole thing off.
“So, I don’t want to sound cocky,” Beca says, sounding deliberately cocky, “but I think we’re nailing this parenting thing.”
“Totally,” Chloe concurs. Then she winces a little. “I mean, except for the part where she might be traumatized for life after seeing a Christmas tree with no presents under it.”
“Right. Except for that,” Beca agrees. She looks around the room at all the mounds covered by blankets. “We should probably get this stuff downstairs. Before she wakes up and has another existential crisis.”
Chloe nods, taking a deep breath and looking ready for action. “Let’s do it.”
It takes five trips to get everything to the living room, five excruciatingly slow trips as they tiptoe down the upstairs hallway and the stairs, trying to make as little noise as possible. Beca makes a special detour out to her backyard studio to retrieve her own presents for Chloe, because it’s the only place that’s safe to hide them from her wife’s snooping habits.
On their last trip from the upstairs bedroom, as she sets her final load of presents down on the floor, Chloe suddenly asks, “So, I have to know. Did you really stab your brother to defend Nicole Scherzinger’s honor?”
“I mean…” Beca maneuvers a large rectangular box into an armchair next to the tree and then lifts her hands in a hapless gesture. “He called her a skank. What was I supposed to do?”
“Aw, baby,” Chloe gives her a sympathetic pout. “I can’t believe you thought you were straight for so many years.”
“I know,” Beca mutters sheepishly. “I’m an idiot.”
Once all the gifts are finally unloaded in front of the tree, they work on arranging them. But every time Beca puts a present in a particular place, Chloe moves it to a different spot. So she gives up and lets her handle the fine-tuning of the visuals, standing back to watch while eating the cookies left out for Santa. She’s earned them.
Eventually, her attention drifts over to the large, nearly tree-sized poinsettia on the floor near the window, in its gleaming white pot. “I don’t think I’ll ever look at that plant the same way again.”
Chloe gives a loud laugh, remembering the cause for this assertion, then claps a hand to her mouth to stifle it. She glances toward the doorway, as if to make absolutely certain Violet is nowhere in evidence, saying in a low voice, “God, I thought I was gonna lose it. She looked so guilty.”
“I know. That’s why I was trying not to make eye contact with you, dude. I knew I wouldn’t be able to keep it together.”
Coming to stand beside her and examining the plant, Chloe muses, “I guess I should probably change the potting soil tomorrow. But I mean, it could have been worse, right? At least she didn’t poop in it.”
They both stare at the flowers for a few seconds in silence.
“We have a weird kid,” Beca remarks.
Chloe smiles, nodding a little. “True. But I wouldn’t want any other kind.”
Unconsciously, Beca rests a hand on her stomach. Only after she’s noted her own gesture does her mind catch up, and she finds herself wondering what these two will be like, whether they’ll resemble Violet or whether they’ll have totally different personalities from their big sister, or even from each other. Wondering what kind of trouble they’ll inevitably get into, what they’ll be afraid of, what they’ll love, what kind of people they’ll become. Thinking about it makes her feel dizzy and out of her depth, so she stops herself. One day at a time.
She looks over to find Chloe watching her, a soft, thoughtful expression on her face, as if her mind is on the same track.
After a few seconds Chloe looks around, making sure the job is totally done. “Oh, hey, come over here a minute.” She draws Beca toward the doorway, positioning her so that she’s facing the room. “This is the best part.” Then she turns the lights out, leaving only the Christmas tree lights on.
Chloe comes back to stand beside her, and they look out at the room.
“Wow,” Beca breathes.
They gaze silently at the spectacle of their own living room transformed, the presents spilling out from under the tree, covering a large section of the floor, even stacked in the chairs nearest the tree. Violet’s stocking is too heavy to hang on the mantel, so it’s laid in front of the gifts, bulging and overflowing, some of the items scattered on the floor around it because they literally wouldn’t fit inside. Near the fireplace is the doll stroller, which Chloe has covered with a Christmas-themed tablecloth, so it mostly blends in with the other wrapped gifts. The effect of the entire room is impressive, to say the least. It looks like something from a magazine.
“Isn’t it pretty?”
“It’s beautiful,” Beca says in all sincerity. “She’s gonna freak out when she sees all this.”
“That’s the idea.” Chloe smiles with excitement. “Don’t let me forget to take some pictures, before she rips into everything.”
“You have to admit, though,” Beca can’t help pointing out, “that’s a lot of stuff for a four-year-old.”
“Some of it’s for us, too,” Chloe offers in her defense. “It’s not all hers. But yeah,” she acknowledges, “most of it.”
“You don’t think we’re spoiling her too much?”
“I hope not.” She concedes, “I know I might have gone a little overboard. But I just really wanted this Christmas to be special, for her. Because...” Chloe hesitates, almost as if she’s not sure she wants to say the next words out loud, or maybe she just needs a second to get her emotions under control. “Because it’s the last one with just the three of us.”
Somehow, as implausible as it seems, this is the first time such an obvious fact has occurred to Beca. Maybe, on some unconscious level, she’s been avoiding thinking about it. Staring at the Christmas tree, she’s stunned into poignant silence by the emotion that hits her as she contemplates this truth.
Chloe continues in a quiet voice. “Next year is gonna be so different. We’ll have a five-year-old, and two infants.” Noticing that Beca still hasn’t said anything, she adds quickly, “And it’s not that I’m not excited. I am. So beyond excited, and, just, over the moon. But at the same time…” she pauses. “It won’t ever be like this again. You know?”
“Yeah. I guess that’s true,” Beca admits softly, marveling, “She’s not gonna be the baby anymore.” Struggling to find the right words, she adds, “I mean, she’ll always be… our baby.  But…”
“I know. I know what you mean.” Chloe takes a slightly shaky breath and lets it out. “So, anyway, that’s why I maybe overdid it, a little. I just wanted this one to be special.”
Beca finally looks over at her, then reaches out and takes her hand, lacing their fingers together and squeezing hard. “It will be.”
Chloe raises Beca’s hand and presses a kiss to the back of it, her eyes bright with unshed tears, thanking her without needing to say the words.
Looking back at the tree again, Beca shakes her head, just a bit overwhelmed. “God, it really is gonna be crazy, isn’t it? To go from one kid to three.”
Chloe starts to speak, stops herself, then forges ahead. “Are you scared?”
Not entirely sure how to answer, Beca thinks about it. She wants to be honest, but she can also feel a kind of vulnerability radiating from Chloe as she waits for her reply, as if she needs something from her.
“Nah,” Beca finally says, looking over at her. “We got this.”
The grateful, beautiful smile which lights up Chloe’s face pierces straight into Beca’s heart, and somehow makes her believe in the absolute truth of the words she’d just uttered.
“Yeah,” Chloe agrees, sounding as if she believes it too.
Drawn by an impulse too powerful to fight, Beca turns to her and pulls her close, holding her face with a reverent touch as she moves in and presses their lips together, slowly and softly. This time it’s not a lustful kiss, but one of pure love. They’ve been together long enough that Chloe instinctively knows the difference, and she lets herself melt into it with her eyes closed. There’s no mistletoe in this particular doorway, but they don’t need it.
After a few seconds Beca tastes salt, and realizes with mild surprise that Chloe is crying. She pulls back a little. “Hey.” Reaching up, she uses her thumbs to smudge away a few of the tears. “I’m the one with the hormones, here.”
“Sorry.”
“What’s wrong?”
“Nothing. That’s just it.” She looks down and places her palms over the subtle roundness of Beca’s stomach, in the same reverent way Beca had just touched her face. “I’ve never been this happy in my entire life, Beca. After last time, I honestly didn’t think we’d ever be doing this again.” She looks up and meets her gaze, but doesn’t move her hands. “I hope you know this is the best Christmas present you could ever possibly give me.”
As usual, this level of emotion makes Beca a bit uncomfortable. “Well, good,” she jokes with a little shrug. “Because I didn’t get you anything else.”
Chloe leans closer, grinning. “I know that’s not true, but even if it was? I wouldn’t care.”
Beca smiles too, wrinkling her nose into another kiss.
“I love you,” Chloe mumbles against her lips.
Now, as if her hormones are indeed living up to her comment from a minute ago, Beca feels an unexpected surge of emotion. She wraps her arms around Chloe and pulls her into a hug, since that at least allows her to hide her face. Waiting a few seconds until she trusts her voice not to break, she speaks directly against her ear. “I love you too. So, so, so much.” She swallows hard against the knot in her throat. “Like, it’s honestly disgusting, how much I love you.”
Over her shoulder Chloe makes a sound that’s halfway between a laugh and a sob, and squeezes her tighter. They hold each other like that for a while, barely moving except for hands stroking over backs or kisses pressed into hair.
Leaning her head against Chloe’s shoulder and closing her eyes, Beca loses track of time. She’s drifting in a pleasantly euphoric trance state, wishing they could somehow just teleport straight to their room and go to sleep, without actually having to walk up the stairs. She summons the energy to mutter, “We should get to bed.”
“Good idea,” Chloe agrees, sounding sleepy as well.
But then suddenly, out of nowhere, Beca feels a tiny but sharp twinge of pain on the bottom of her ass. “Ah,” she jerks a little. “What the hell was that?” Finally they separate, and she leans back and peers at Chloe. “Did you pinch me?”
“What?” Chloe’s face is the picture of innocence. “No.”
At first Beca’s genuinely confused. But then Chloe adds, as if just thinking of it, “Oh, you know what I bet it was? I bet it was that sex elf, again.”
A slow grin now replaces Beca’s puzzlement. “Really? You saw her?”
“Does she look a little bit like a miniature Pussycat Doll?”
“That’s her,” Beca widens her eyes. “Oh my God, you did see her.”
“Then, yep. She was here.” Chloe bends closer and whispers, “And I bet I know why.”
“You think?”
“Mm-hm. I bet she’s a little miffed that we didn’t quite... finish the job, earlier.”
The erotic tone of Chloe’s voice acts as a trigger, and in an instant Beca’s libido wakes from near-slumber and she’s flooded once again with a tidal wave of desire. It hits her with such unexpected force that she feels her toes clench on the rug under her feet. The orgasm from half an hour ago is suddenly as irrelevant as if it never happened. So much for going straight to sleep.
“Wow, those pinches really work,” she murmurs.
Chloe giggles and kisses her again. “I’m counting on it.” Now she takes Beca’s left hand and lifts it, staring down at it and turning it over, palm up, as she strokes a spot between her fingers contemplatively. “You know, I was just thinking, maybe I could get into that whole papercut kink of yours.”
Beca smiles, but then pulls back a bit and regards her with a curious look. “You do know I was kidding about that, right?”
Chloe only raises an eyebrow mysteriously and kisses the precise spot where the papercut had occurred, then turns in a seductive manner and begins leading her toward the stairs.
“Right?” Beca repeats, allowing herself to be pulled along.
Still no answer, aside from a coy smirk.  
Beca teases, “Okay, see, now you’re scaring me a little.”
Chloe laughs as they start up the stairs, and then laughs even harder when Beca admits, “Still really turned on, though.”
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clarasjournal · 4 years
Text
The process
After reading the articles we got together to discuss the topic of smell elements in games, and started brainstorming on this (17/11):
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We experimented with this first idea instantly while talking about it, so we body stormed as well as brainstormed. I believe this really helped us generate more ideas and iterate on our initial thoughts.
GIF of the actual game “akta väggen” or “watch out for the wall”:
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Video of me trying to find a scented piece of paper:
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It was hard for me to know where exactly the smell was coming from. I caught a whiff of it sometimes and I was close several times but even though I was right at it I didn’t think I was because I confused that concentrated smell with a whiff. I think that was because my olfactory system adapted to the smell and made me less sensitive to it throughout time. I also think I struggled so much with this this time because it was my very first time trying to pin-point where a scent came from, so my sense of smell wasn’t trained in any sense for this. I felt as though it was harder to sense the scent when I was actively searching for it, and that I could only comprehend the whiffs. I’ve experienced this before, when I for example bike past a rapeseed field in the spring (I love the smell of those), and I actively try to drag in as much scent as I possibly can. When I do this, drag in as much as possible, I don't smell it as well as I do when I just bike past without actively smelling for it... I pondered over this and my peers didn’t seem to understand this experience, maybe they haven’t experienced this themselves. I thought that maybe this is because I get “too tense”, and that my olfactory system needs to be relaxed in order to take in scents? Either way, during this week I realized that my sense of smell got better and better throughout the process, which must mean I trained this sense throughout exposing myself to this kind of practice of actively smelling for something. This connects to the workshop of “luktträning” (https://www.lukttraning.se/), through smelling citrus and animalis each day of this week I eventually got better at distinguishing between them and navigate to or from them. I believe that if we were to continue using these smells for several more weeks we would get even better at detecting them, discriminating between them and navigating with the help of them.
Then we continued brainstorming:
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We concluded our brain and body storming session with agreeing on that we found it interesting to use the sense of smell to measure distance or proximity. The following day (18/11) we brought in more scented material to work with, such as oranges & lemons and detergent. We also had a cloth to drain with citrus juice, two small computer fans to vaporize/send out the smell and we used a plastic container to fill with detergent. We also continued using some of the essential oils left for us in the ioio lab and attached the oils to pieces of paper. During this day we experimented a whole lot with all of these mentioned materials above and tried to find our way to explore distance sensing through the sense of smell. 
Essentail oil “animalis”:
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Very strong and produced a repulsed physical response from us. We deemed it as starting to smell 3 meters from the fan. In my sketches I refer to it as “boss” since Axel mentioned something about it resembling a Hugo Boss perfume.
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Citrus-drained cloth with fans:
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This fanned out the smell well, but we could feel the breeze it produced and decided to keep the cloth in front of only one fan:
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This way we couldn’t feel the breeze anymore but it didn’t emit the scent as well as previously. So we loosened the cloth a bit from the fan to allow for more airflow and hung it up from the ceiling instead:
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After doing this we conducted several experiments to see if we (the players) could sense the orange scent and be able to localize it while blindfolded. So we wanted to see if we could complement the loss of vision with the sense of smell instead. One of the video footages:
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We found this very interesting, because the scent almost came and went. You could catch a whiff of the citrus scent but then it was gone almost as quickly as you caught it. We realized that it helped to smell contrasting scents every once in a while, I smelled my clothes now and then to present a change within the olfactory system that allowed me to be more sensitive to the scent I wanted to catch - in our case: citrus. We also realized how challenging it was to measure distance to where the scent was coming from. It got slightly more concentrated the closer you got, but as I mentioned, the olfactory system adapts and what felt more concentrated a second/minute ago doesn’t seem so concentrated anymore, so you search in other places instead. It’s a slow sense, and I think we really took that into account in our experimentations.
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We also realized that we inevitably train the sense of smell through removing our vision. We actively try to get whiffs and smells of the orange scented cloth, and I believe we got better at it throughout the process. Since we worked in the classroom this particular day we were also presented with a lot of other smells and scents. Through this we eventually became better at discriminating one scent from the other, and to actively search for our scent. After this quite long day of experimentation and learnings of, among others, how different material emit different smells, how different smells are stronger or vaguer, that you can get whiffs of one scent 3 meters from it and 2 meters from another scent, we decided to squeeze a few more lemons and oranges into a cup and really cover the whole cloth with the juice and peel, and leave it there over night. To marinate.
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During this phase we discarded four other games that we had brainstormed on, such as hide and seek and “catch”. We did this because we felt as though they would take up a lot of time and eventually even be a safety risk if we decided to remove vision in these games. So we combined a few similar aspects of the games and settled for a variation of “watch out for the wall” (the first idea) where we replace the wall with the fan & citrus-cloth, and the players are supposed to walk towards the scent and stop when they think they’re as close as they can get without walking beyond it. If they happen to walk beyond it we wanted to indicate this by waving a piece of paper scented with “boss” (animalis), which we deemed to be an opposing scent from citrus.
The following day (19/11) we brought out the citrus marinated cloth from the cup and cut a few holes in the cloth for the air to flow better and make the scent emit stronger. Then we hung it up in the ceiling attached to the fan with a 9V battery.
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We realized that the “boss” scent quickly filled parts of the room even though it was only coming from a strip of paper. At first we saw this as an issue but as we progressed we realized that this was an opportunity for us to practice discriminating scents. This day we performed the game many times and it was fun each time to see how well we could measure distance and proximity through our sense of smell. Sometimes you lost, sometimes you got really close and sometimes you were just really far off. But the more we practiced the better we got. We once again realized how powerful the “whiff” is and how challenging it is to actively search for what could be a more concentrated smell of the whiff.
The final prototype looks like this:
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This week has been great fun and very insightful. I’ve never paid much attention to smell in general, and even less within interaction design. I now am a believer of that involving this sense in interaction design has much potential for allowing for presence, immersion and greater realism. The more senses we involve in our designs the more we take advantage of our human experiences. I think I fell most for using smell as an indicator, much in the same way we currently use music and sound as indicators in e.g. movies and games. Hearing an ominous sound when danger is nearby is not very realistic in the sense of our physical world in which we live, but in movies it makes perfect sense... What if we start evolving our sense of smell instead of devolving it as we have lately, for the ability to start using smell as indicators in digital medias? In our final prototype we experimented with using smell to indicate proximity to an object (cloth and fan up in the ceiling), and I think our experimentations lead to very interesting insights that proves the potential that lies in this notion of smell as indications. It would be a delight to keep working with this, but next week is all about AI, which I’m looking forward to equally much.
I believe the presentation went well as well, we got to explain e.g. our purposes of using citrus as attraction and animalis as repulsion, as well as demonstrate how we can use smell as an indicator of proximity to an object. 
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sastiells · 6 years
Text
pick up the broken pieces
“What do you have to lose, except your worst nightmares?”
Sam knows there is no way in hell he can ever bring himself to trust these people, even with one of them standing on the opposite side of the room extending a tentative so-called ‘olive branch’. It’s preposterous, he thinks, the idea that he could ever work with them - with her - after all that had happened. Even if Mick, as he called himself, said he didn’t mean them harm, Sam wasn’t drinking the koolaid. He was adamant on his feelings, and no time he needed to “cool down” would change that.
He feels rather than sees that Toni has risen back to her feet, but doesn’t give her the satisfaction of reacting to her presence. He’d given the bitch enough of him already. Despite himself, the hair on the back of his neck stands up, sensing her eyes boring into his back.
“Now then, I’m assuming you lads would like to get out of here, especially you,” Mick continues, nodding at Sam. “Once again, I would like to deeply apologize for your regretful mistreatment at Lady Bevell’s hands. We’ll make sure she’s punished sufficiently.” He turns his attention to his operative. “Come along, Toni. We need to gather your belongings, and I’ve ordered us a private plane back to London.”
He heads up the stairs, pausing in the doorway, waiting for her. Toni obeys slowly, moving like a snake about the room, leveling them all with a cold stare. She roughly shoves past Castiel, and a disdainful sneer curls her lips when her gaze lands upon Sam, who averts his eyes, unable to look at her.
“Oh yeah, you know what, back to you too, sweetheart,” Dean fires back. “You’re lucky your little friend was here. We ever see you again, your ass won’t be so lucky.”
Toni glowers hatefully at him, but says nothing as she retreats up the landing, and slams the door shut behind her with a loud bang that makes Sam cringe. Seeing his brother's distress, Dean places a comforting hand on his arm.
“Hey, hey, Sammy, it’s okay. She’s gone. You’re safe.”
Sam breathes evenly through his nose to relax his hammering heart, and looks over at his big brother. His brother who he thought was dead and is now somehow here, somehow alive, along with his mother. “Sorry, it’s just that I’ve, uh… I’ve heard that sound a lot for the past two days," He mumbles. “Or you know, three days, however long it's been.”
“I’ll tell ya how long it’s been, too damn long,” Dean grumbles earnestly, slipping an arm underneath Sam’s taller frame to support him. “You have nothing to apologize for, man. Come on, let’s get the hell outta here. Cas can fix you up when we get back to the car.”
The promise of being pain-free in a few minutes is blissful, but the reality of the fact that he’ll be getting out of this putrid, moist basement is somehow even better. “Yeah, sounds good,” Sam says, relieved. “I can deal with the pain for a bit. I just don’t want to be down here a second longer than I have to be.” He shudders, scanning the room that for the past few days has been his prison.
In a heartbeat, Castiel is over at Sam’s other side helping Dean support his weight, and Sam smiles weakly at the angel, even though it feels as if it’s taking every last ounce of his strength to manage his facial muscles. “Hey there, Cas.”
Cas’s expression is soft, but pained. Guilty, Sam realizes. “Oh, Sam,” He sighs, taking in his friend’s numerous injuries. “I’m so sorry she did this to you. I was supposed to keep you safe.”
Sam shakes his head. It was no good for Cas to blame himself. “It’s not your fault, man. She was already waiting for us. There was nothing you could’ve done.” The angel doesn’t look convinced, but he doesn’t press the issue, either. But Sam knows Cas well enough by now to know that it would take more than a pep talk to make him stop feeling guilty about it. He’d have to talk to him more about it later, once they’d all had their rest.
“All right, tiger, you ready?” Dean asks him, and Sam almost laughs because Dean hasn’t called him that in years, instead he manages a tight nod. As soon as he places his burnt foot forward, he lets out a pained shout and stops, gripping the chair for support. The pain is worse than he’d anticipated. He can barely hear Dean over the hollowness in his ears, and he worries he might be on the verge of passing out. “Sam?! You hearing me? You all right?!”
Sam groans, squeezing his eyes shut against the nausea and dizziness. He knew he didn’t have anything in his stomach that would be worth throwing up, but he’d still rather not add that on top of everything else. “I’m okay,” He assures the room at large once the feeling passes. “I just stepped too hard on it.”
“What the hell did she do to you?” Dean snarls angrily. “And what did she do with your shoes?”
Sam shrugs. “I don’t know, they’re around here somewhere, I guess.”
“I found them.” He hears Mary pipe up from behind him, and guiltily, he remembers for the first time that she’s there.
“Mom.” The younger Winchester turns his head to stare at her breathlessly, suddenly all too aware of her presence again. “How in the world are you here..?” He had so many questions that his head was swimming. Or maybe that was just the fatigue. For a long moment, he wonders if he’s hallucinating again, because this had to be some kind of dream.
Then his mother smiles, brushing a stray lock of hair out of his face, her touch so very real that he’s sure it’s better than anything his imagination could conjure up. “We’ll tell you everything on the ride home, Sam, I promise. Let’s get you out of here and mended up first, okay?”
He nods, emotion stuck in his throat, and it’s her presence that prompts him to keep going. Taking a deep breath, he signals his assent to Dean and Cas to continue and moves. With each step, he can’t help but cry out, the pain growing worse than before and it takes longer than necessary to reach the damn stairwell. By the time they reach the front yard, Sam is half-collapsed and it is only by the way of Dean and Castiel dragging him forward that he is able to move at all.
Once they reach the Impala, they lower him into the open passenger’s side. Cas crouches in front of him and pushes Sam’s greasy hair out of his face, getting a good look at the wounds marring his flesh. Gingerly, the angel places the tips of his fingers to Sam’s tender cheek, using only his thumb to swipe the damage away. Sam closes his eyes in relief at the feeling of warm, healing grace flowing through his body, like the rush of a gentle wave. He looks down and sees that the cuts on his upper body have closed up. Experimentally, he flexes his leg, finding no pain from the gunshot wound. Even the labored breathing from his broken ribs has mellowed out.
Even after the abrasions fade though, Castiel does not immediately pull away, providing a momentary gentle caress that Sam can’t help but sink in to. It feels good, a comforting touch after the days of torture. The angel takes the opportunity to hone in on any other damage Sam may have suffered. Underneath the physical damage, he detects the emotional turmoil coming off the younger Winchester in waves, an injury that only he as an angel can see. He is in sync with Sam’s emotional suffering better than perhaps anyone alive, except for Dean. Their shared suffering of Lucifer’s Cage had connected them in that way. It takes the angel a moment to identify the source of the heaviness weighing on Sam, remnants of residue from a toxin inside his bloodstream. He furrows his eyebrows, searching. And then Sam cranes his neck just a bit, just enough to expose the needle’s entry point and Castiel sees red. The hunter watches as Cas’s tender expression shifts to realization and then an absolute, carnic rage. A snarl forms on the edge of his lips, and the angel has to stop himself from making the headlight above the car explode.
“Was it not enough that she tortured your body?” He growls, “She had to go and vilify your mind?”
“She did what?” Dean angrily prompts, but Cas ignores him, looking back to the dreadful house.
“I should go back in there and smite her while I still have the chance.”
A hand comes upon his shoulder and he turns back expecting to see Dean, but it’s Sam, and the look on his face makes Cas’s ire lessen just a bit.
“Don’t, Cas,” He whispers. “Just… leave it.”
Sam looks so tired suddenly, as though the hell of the past few days has finally caught up with him. Cas decides to take a raincheck on killing the horrible woman just yet. He sighs.
“I’ve healed your numerous cuts, bruises, the broken ribs and the gunshot wound, but you still seem to be suffering from other afflictions like immense dehydration, hunger, and of course this.” He inclines his head at the wrapped foot. “I need to get a good look at it to be sure, but I sense some kind of damage to the dermis and the nerves. What did she use?” He begins unwrapping the wound. It sticks to Sam's flayed skin and he gasps, writhes, and practically howls as it comes undone.
“A blowtorch,” Sam says when he can finally breathe again, raising his foot slightly to give Cas better access. “Her friend or whoever she was did it.”
“Yeah, well, that bitch is dead now.” Dean says proudly. “Mom got her. Saved me and Cas doing it, too.”
Sam raises his eyebrows impressively at his mother, who shrugs although her lips twitch with the hint of a smile.  
With the wound now exposed to the daylight, it looks even worse than it had back in the basement. Cas’s nose wrinkles in disgust when he sees the extent of the damaged foot, scorched ugly and bright red. “This is extensive. I’ll try to be as gentle as I can.” He looks up at Sam for permission to continue, who nods. The hunter can’t help the hisses even though the angel is barely touching him at all, wiggles his toes in discomfort, but a moment later Cas’s grace comes and the pain lessens. The wound practically vanishes before his eyes, except for a lingering redness and slight blistering.
“I’m sorry, Sam, but we’re going to have to do another session when we get back to the bunker.” Castiel says regretfully. “The broken ribs, gunshot wound, and your other injuries were not as hard to heal, but this -” He gestures again down to the burnt foot, which was starting to at least resemble a normal foot now, in Sam's opinion: not quite as bad, “- is proving to be difficult. She caused significant flesh and nerve damage, and my grace seems to still be recovering after she banished me.”
Sam smiles in understanding. “That’s all right, Cas. It’s already starting to feel a lot better, thank you.”
Cas watches him skeptically. “Are you sure? I can keep trying if you’re still in a lot of pain.”
“It’s okay, really,” He insists gratefully. “I can handle a little bit of burning and redness. Besides, you need to heal Dean and Mom, and you’re going to need to recuperate too. This is enough for now.”
Castiel looks like he wants to argue, but after a moment, sighs and gets back to his feet with a curt nod. He heals Dean and Mary and then they head off. The ride back to the bunker is one of the best  - if not slightly bizarre - things Sam has ever experienced. They stop at a gas station, fuel up, get Sam a ton of sustenance and liquids (“Hey, Doctor Cas’s orders,” Dean had joked much to Cas’s annoyance) and after all explanations are had, and everything makes sense again, he feels calm enough to fall into an easy, but slightly restless sleep.
-
So, was it good for you?
When Sam wakes again, it is abrupt and panicked and he is greeted by darkness. For a long horrifying moment, he’s terrified that he’s back in that basement, still strapped to the chair. It takes longer before he realizes he’s in the Impala and it’s parked outside the bunker. Dean is at his side in a instant, pulling the car door open. “Sam, it’s okay, relax, we’re home.” Still a bit delirious from sleep, Sam isn’t aware that he’s breathing heavily and his hands are shaking until Cas informs Dean that Sam’s having a panic attack. He feels like he's been robbed of all breath. The small space of the Impala feels confining suddenly, and he hurries out of the car, needing to be out in open space, fresh air.
So, was it good for you?
Her voice is so clear in the crisp chill of the night, making a shiver unrelated to the weather run down his spine. “No. No.” He remembers the feeling of warmth pooling at his groin, the way it clung to the fabric of his boxers. The  overpowering smell of his own odor, the urine, sweat, and blood that he’d been covered in for the past couple of days reaches his nostrils and he gags. He feels dirty, so incredibly dirty. His legs buckle and he falls to his hands and knees, retching violently. The stomach acid hurts his throat as it comes up. Mary comes to sit beside him, pushing his hair away from his sweaty forehead, soothing him with gentle whispers.
Worst of all, Sam realizes, is that he can still feel the crusted semen in his jeans, sticky and hard and painful. He’s sure that if shame was something one could throw up, he would, and plenty of it. Toni’s words continue to echo around him, drowning out his mothers', as if they had become a part of the night. And then Lucifer’s voice joins hers, cackling and overbearing. Wow! I didn’t know you had that in you, Sammy! Solid B on the tongue action! And the rest of you, well, that wasn’t bad, either. How about another go?
It takes twenty minutes for his mom and brother to coax him inside, and when he finally goes, the first thing he does is take a long, hot shower and throws his disgusting clothes in the trash.
He doesn’t feel clean even after that.
-
Cas is true to his word.
As soon as Sam’s been able to keep some sustenance down, the angel goes back to work on healing up the rest of Sam’s foot. By the time he’s done, there is no evidence left of the third-degree burns, and all nerve function has been restored. It almost feels like being back to normal, but Sam knows better. It was going to take more than a quick angel fix and a resurrected mom to ease him through this. Not that he was ungrateful - he was so happy his family was here with him, his mother was here, that he could barely stand it. And while Toni had been no Lucifer, he still couldn’t bring himself to easily shake off the whole ordeal.
He realizes he won’t be able to take a step forward, any step at all, if he doesn’t tell someone.
He recalls Castiel’s last words to him before the whole ordeal with the British snob started, how he’d be there if Sam wanted to talk, or needed anything. He finds that now is as good a chance as any to take the angel up on his offer. Dean and Mary are out in the control room and Cas inclines his head with a smile, about to leave Sam to rest when the hunter speaks up.
“Hey, Cas, before you go, can I uh…” He stammers, but presses on before he can lose his nerve. “Can I maybe talk to you for a second?”
“Of course,” Cas turns his full body towards Sam, expression curious but open, receptive. Sam takes that as a good sign and exhales deeply. This wasn’t going to be easy to talk about, but now that he’d already started, he couldn’t bring himself to stop.
“I just wanted to, uh, well… look, I know this might be painful for you to talk about, but…” He swallows down the last of his hesitance. “When you were human, you and April had sex, right? But she did it under false pretenses, so she could torture you.”
“Yes. She did.” A confused furrow appears between Cas’s eyebrows. “Why do you ask, Sam?”
Sam opens his mouth, tries to get the words out, and promptly closes it again, shame rising in his throat like bile. He fidgets, eyes lowering to the floor. His heart is racing so hard it’s as though it’s going to leap out of his chest, knows that Cas can probably hear it too. His palms suddenly feel clammy and his chest is rising and falling rapidly. A gentle hand on his shoulder shakes him from his reverie, calms the panic rousing inside him. The touch startles him at first and reflexively he almost shrinks under it, because it’s unexpected and he’s not quite readjusted to tender contact yet.
“It’s all right, Sam,” Cas coaxes him, and Sam feels like he can breathe again.
Slowly, he raises his eyes to meet Castiel’s concerned, but patient gaze, watches the way his face scrunches up.
“Are you saying that woman - ?”
“Sort of, not really,” Sam explains. “She didn’t exactly force herself on me or anything, but… during the time she was torturing me, she put me under some kind of spell, I guess. Physically, I was still strapped to the chair but mentally, she had me believing I was in bed… with her.”
Realization dawns upon Castiel’s face. “A sexual hallucination.”
“Yeah. She wanted information from me and when torturing me and trying to break my head didn’t work, she – well, she went another way. The thing is, though… my body didn’t realize it was just a trick, and uh…”
Cas looks, for lack of a better word, absolutely pissed. “She forced a sexual experience onto you and your body believed it was actually happening. You had physical responses when you were unaware and unable to consent. So you unintentionally climaxed. I could smell it on you, but I thought it was just your body’s response to the stress it was under. She raped you.”
“God, Cas, don’t…” Sam lowers his head in shame, the full gravity of what it was hitting him. “Don’t say it like that.”
Cas lowers himself to sit beside him on the bed, sitting a respectful distance away, but close enough to still be comforting. “There is nothing for you to be ashamed of, Sam.”
“No, but Cas, you don’t understand. She..” He exhales a shaky breath, hands folded in his lap, struggling to choke the words out. “She made me want it, want her.” And when he’d roused himself from the spell, with nothing but the evidence of his orgasm drying in his underwear and the sneer on her face as she mocked him, he'd never felt so dirty. With Lucifer, it had still been rape but it had been different; he hadn't been made to want it. Lucifer took, tore, inflicted. Toni had violated even his perception of reality. “She was watching me, smirking, and asked if it was good for me.” The shame washes over him like a physical sensation, building in his chest. Who knew what kind of noises he had made, chained in that chair, what kind of buckling came with his hips? Had he moaned her name upon his release, the stain covering the crotch of his jeans before her very eyes?
“It still isn't your fault. Sam, look at me.” Cas says sternly, and Sam unwillingly meets his eyes. He is taken aback by the intensity in the angel’s expression. “The only one at fault is her. She's an atrocious human being. I regret that we didn't kill her when we had the opportunity. If Dean and your mother knew, I think they would go and kill her right now and I can't say I'm not tempted to do the same.”
“I know they would,” Sam says, voice barely above a whisper. “And that’s why they can't know. Not yet. Please, Cas... keep this between us for now. I can’t tell them yet.”
Castiel looks pensive, but agrees. “If that’s what you want, I won’t tell them. But if you decide that you need to do so, you won’t have to do it alone. Your brother and I are here, and your mother. We won’t let you deal with this by yourself.”
A little bit of the tension lifts off of Sam’s shoulders at the angel’s response, and he finds he’s able to breathe a bit easier. The first, real smile he’s had in days curves his lips, even if it doesn’t quite reach his eyes. “Thank you, Cas.”
The angel returns the gesture, and for what feels like a long time, they just sit there, and Sam takes solace in the companionable silence. When Cas decides at last to try and leave Sam to rest, the hunter finds he has another - if slightly more embarrassing - request to make.
“Wait, Cas, um,” He fumbles his words, inclining his head at the TV. “Can you... er, do you want to maybe see what’s on Netflix for a bit? I was about to turn it on until I fall asleep, since the noise will probably help me relax.” He explains it quickly, not wanting to keep the angel there longer than necessary if he wanted to go do something else. He just found that he didn’t want to be alone right now, not with the noise raging in his head. It was likely true, in any case -- he didn’t think he could sleep in silence ever again. He’d always be waiting for the next blow, the next time he’s forced awake with cold water and a violation of his very reality.
Cas, fortunately, seems to understand. He sits back down in Sam’s armchair, his features soft. “You never need to ask, Sam. I’d be happy to join you.”
Sam ends up selecting one of the few nature documentaries that he’s not sure he’s seen, and this time, he is the one who allows himself to move just a little bit closer the angel. One day soon, he'll close that gap again, but for now, this is enough.
He falls asleep with Castiel’s gentle fingers combing through his hair.
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Day 10-our first day in the theater!!
*note* sorry this didn't post sooner! Wifi gets spotty here sometimes. Day 11 coming soon! Hiya! I'm currently writing while backstage at the National Theatre of Taiwan....ahhhh! So so cool! All dancers grow up with a profound respect for theaters and this is the biggest theatre I've performed in. We are dancing on what's called the experimental stage. The National Theatre houses several stages so multiple productions can happen simultaneously. I could hardly believe it when they gave me my backstage pass at the stage door today--I'm going to be performing professionally in Taiwan in just 2 short days! I spent the morning before the theatre bopping around Taipei. After my full night of sleep I was in a great mood so I was more chatty than normal (sorry Kelly, Christina, and Michael) and despite my hyperactive tendencies they let me come along with them on their outing to the dance store. The ladies found cute leos and Michael got a pair of rockin sweatpants. Yay Taiwanese dance clothes!💃🏽 Still filled with lots of energy, I split off from the group to do a couple of Taipei things that I wanted to squeeze in before being in the theatre for the rest of the trip. First, I took the MRT to city hall and tried lots of yummy samples in the schmancy underground food court. One bakery had this wine quinoa walnut bread that was ahhhhmazing (it also had squid ink bread which I didn't try due to my vegetarianness but it certainly piqued my interest!). Next I went to the Discover Taipei exhibit on the 3rd and 4th floors of city hall to learn a bit more about the region's history. This island has been through so much! The Sino-Japanese war of 1894, declaring itself the Republic of Formosa, Japanese colonization, and many years of complicated relationships with China. Since it was just around the corner, I walked to the famous Taipei 101 building and checked that off the must-do tourist list. I didn't want to pay to go the top of the 8th tallest building in the world (I already got a pretty killer view of Taipei from elephant mountain) but I did want to learn more about it! It is shaped like a tower with 8 sections, and every section is supposed to look like a traditional Chinese money box to bring prosperity to the city. The money boxes are stacked up to look like a bamboo shoot, which represents growth and learning. How cool to make a skyscraper that's so meaningful! I walked around the Taipei 101 mall for a bit (more samples yusss) then I walked over to Sun Yat-Sen Memorial Hall. On my way, I passed a block filled with small stores and food trucks. One store was entirely dedicated to toilet paper that smelled of different flavors--they kept giving me samples even as I was trying to walk away! I love the idea, but unfortunately I'm not at financial level where I'm able to budget for nice smelling toilet paper. Haha maybe one day! Sun Yat-Sen memorial hall had a surprising amount to do! I was expecting a nice walk around a park, but in addition to pleasant greenery I experienced multiple art galleries, a musical performance, a mini museum, a calligraphy lesson, and a cow themed cafe. What's not to love?! My favorite art gallery was made by adults who had had disabilities from birth or had developed them later in life. The docents spoke to me about the program, which in works to make beauty from potentially ugly situations. How smart! Ugh I love it!The pieces were incredible and the artists' quotes were inspiring. We can all work to make the best situation with the hand we're dealt! I MRTed back to the hotel to meet up with the company and we all walked to the National Theater. After getting our swanky backstage passes (still can believe it😸) we set up in our dressing rooms and took company class onstage. We didn't have barres so we had to use chairs that were a little too short...time to get on your leg! Getting on your leg is what dancers refer to when talking about finding your center of balance. Richard, our rehearsal director, gave a tough but good class. I love that we get to continue working on technique even as professionals. Then it was time for a long night of rehearsal. The experimental theatre has some of the most technologically advanced production capabilities I've ever seen (or danced in). It's equipped with every type of lighting you can imagine. Strokes of light shoot through the air, waves of color glimmer across the stage with a 3D quality, fog bends light in all directions...the possibilities are limitless. These production qualities make for a very ambient stage but also for some disoriented dancers on tech night...oof again. My stamina felt better today but there were several occasions where I had no idea which way the front was (the audience, the back wall, and all 4 corners of the stage all appear to be pitch black from an on-stage perspective) so I was frequently turned around and consequently not on my leg😑 The main purpose of a tech rehearsal is for the light and sound people to coordinate with dancer cues, but it is also a chance for us dancers to learn where to anticipate particularly disorienting parts so we can find a visual anchor for the next run (i.e. a piece of glow type or light fixture). I have some serious anchoring to do! I am writing this while watching rehearsal for the last piece, "Arrival from Departure" which Ming (BodyEDT's director) set on Verb last season. It's 9:30pm so almost time to head home for the night and get some rest for another theatre day tomorrow! Update: I wrote my last post from the theatre, but I had one more adventure on my way home. As Michael and I were passing the main entranceway to the theatre (imagine a grand stairwell and vast roof over a terrace), I heard some funky music playing from above. The stairs are so high that we couldn't see what was happening from below, so we ran up to check it out. OhMyGosh!! Jackpot! We found a street dance crew practicing their moves in three rings--one circle for practicing flying, one for popping, and one for breaking. When you're a dancer, it's practically irresistible to withhold from dancing when there's a sick beat and bunches of other people dancing around you, so I went over to the popping group and introduced myself. They were super excited to have michael and I join! They explained that they were experimenting with slow movement accented with popping on counts 1 and 5, so we played along and improved with them. I love how dance can build relationships among people of all backgrounds and languages, ultimately people want to move together! One woman named Cynthia was especially good at English. She offered to introduce us to the dance captain so he could teach us some of his moves. Before we knew it, Michael and I were on the stone ground learning how to swing our legs around our body for a breakdance move. I was terrible, but it was super fun to learn! Their dance captain was a great teacher and very accommodating to our balletness. He kept reminding us not to point our feet...Haha. Street dancing with the "90s breakers" was definitely one of my favorite moments from this trip! Now bedtime time for meeee! 😴Kate☺️
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little-murmaider · 7 years
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Fic: Autoclave
Anyway America is coming apart at the seams and my coping mechanism for this new HIGH-KEY CONSTANT ANXIETY is writing goofy fanfic. This was actually the first scene I wrote after I jumped back into fandom last year. I’ve lost interest in the fic this is attached to, but I still have affection for this bit. I’ve edited and modified it so it better stands on its own. Also I almost posted this at 1 AM Saturday when I was drunk and panic-scrolling through Twitter and I am very glad…….I did not do that………
I am this great, unstable mass of blood and foam And no emotion that’s worth having could make my heart it’s home. My heart’s an autoclave. As they cross the threshold to Skwisgaar’s bedroom, they both hesitate. It was as through a tectonic plate had shifted beneath them, and they were left clutching each other, trying to find their footing.
The night of Toki’s rescue, as the four of them paced treads into the hospital’s waiting room tile, Pickles had asked if any of them felt different. Like all the ugly parts of them had been muted, replaced with something new. Something better. In this moment, Skwisgaar feels the blazing heat of all those new parts, searing and uncomfortable and satisfying. He sees this white hot newness in Toki, too. He wants to stick his hands in it, burn his fingerprints off.
When he touches Toki now, it’s not like any other time they’ve touched. This body that was once so familiar to him is now a tangible mystery. He reaches up to touch his face, but that feels too bold, so he touches the inside of his elbow. The skin is cool, slightly damp with sweat. Toki has similar reservations: he initially grazes Skwisgaar’s cheek, then withdraws as if shocked. His hand settles on Skwisgaar’s ribs, jutting and prominent from his position. He pretends they’re piano keys, taps out a melody only he can hear, giggles at his own joke. They stay like that for a while, experimentally exploring the new terrain.
He ghosts his fingertips over Toki’s bicep, running the length of the muscle down to the bend of his elbow, doubling back up to his shoulder. He tries to tell him like this, the only way he can say anything. He presses down on the raised veins of his forearm, wills the words into his fingers, a physical morse code.
Toki shifts, lets out a short breath through his nose. “Ams tickling mes.”
“Sorries.”
Toki’s gaze blasts craters through the back of Skwisgaar’s skull, but he can’t bring himself to meet it. Doesn’t know what will meet him there.
“Why comes you stares?” he finally asks.
“Yous just so pretty, how cans I nots?” He’s teasing–-an insult disguised as a compliment is a familiar tactic-–but beneath the bite is a flicker of something Skwisgaar can’t place. Something about the way he says the word “pretty.” Skwisgaar squeezes Toki’s bicep a hair above the point of pain. Releases. Outside, he hears the distant howl of the yard wolves, the faint shrieks of a Klokateer meeting his untimely demise.
“De worst dreams ams about yous,” Toki whispers. At this Skwisgaar does look up, but Toki’s gaze is roving. “I’ve seen you dies so many times, so many way. Dat first nights back, when you wake mes up, I sees you gets yous throat slit.”
He traces a line across Skwisgaar’s neck with his pointer finger, just above his Adam’s apple.
“Ams covers in yous blood. You tries to tell me somet’ing. Bloods come out yous eyes, yous ear, yous mouth.”
Without breaking contact from the skin Toki’s touch glides upwards, along the length of Skwisgaar’s jaw, settles hardened fingertips softly on Skwisgaar’s lips.
“Whens I wakes up I still t’inks I dreamings, dat yous dead. But it not reals. Yous alive.”
His eyes are trained on Skwisgaar’s mouth, his thumb finding the small dip in his chin.
“Dreams about yous, too,” he mumbles, then clears his throat. Some ancient leftover douchebag doesn’t want to give Toki the satisfaction of knowing what a sap he is. “Whens yous gones. De dreams makes me so happies, whens I wake up it feel likes…you knows about hows dey used to punish ladies whats dey thoughts was witches? How dey woulds puts dem under a bunch of rocks, so de ladies gets crushed? Dat how I feels.”
“How you feels now?”
He blinks. Drawing a sharp breath, he leans in close, tangling his hands in Toki’s hair. Why did he find this so impossible before? It’s the easiest thing he’s ever done. It’s playing a solo in front of 500,000 hysterical fans. It’s exhaling. “I loves you.”
Toki lay motionless. Panic spiderwebs through Skwisgaar’s abdomen. Oh no. He tries to think of a way to spin this, to turn it against Toki, a wacky practical joke. He opens his mouth to backtrack, lay some groundwork for recovering his dignity. But then Toki’s hands are on his face and his mouth is on his mouth.
He kisses him like he’d never been kissed in his life. He kisses him like he’s dying of thirst and Toki is an endless stream of cool water. Skwisgaar always thought all those songs about love were the result of childish, lazy fantasies but oh God he gets it, he gets it now. He’s never felt more exhilarated, more terrified, more desperate, more alive. His body is a supernova, destroying all he was and recreating him into something resplendent, something deserving of feeling this way. He is nothing. He is everything. He loves Toki so much.
Toki is crying, ha ha, what a baby. Maybe they’re both crying. Who cares. It doesn’t matter.
Toki pulls away–it hadn’t even occurred to Skwisgaar they would eventually need to stop kissing–and straddles Skwisgaar’s hips. Skwisgaar leans up but Toki widens the distance, rocking back on his heels and wearing a lopsided grin.
“Says it again,” he says. He’s enjoying this, the little shit. Skwisgaar coils Toki’s hair around his fist, his fingers grazing the back of his skull.
“I loves you.”
“Says it again.”
Skwisgaar narrows his eyes. 
“I loves you.”
He tries to make it sound like an insult, like how dumb am I, if I love you, you idiot, but his annoyance can’t make a dent in the words’ sincerity. Toki hovers over him, just out of reach. When Skwisgaar reaches for another kiss, Toki lays his arm across his chest, his forearm sitting heavily on Skwisgaar’s solar plexus.
“Says it again.”
“Fuck YOUS.”
He yanks Toki’s hair hard, drags him beside him and kicks a leg across Toki’s. He hoists himself on top, trying to sink his full body weight into him. Skwisgaar has both Toki’s wrists in one hand, digging his knees into his ribcage. His grip isn’t that strong because Toki easily breaks it and shoves Skwisgaar dead in the chest. He’s on his back, braced, but instead of attacking Toki languidly crawls toward him. There’s a flash of anxiety when Skwisgaar almost asks him to say it back–-just for confirmation–-but looking up at Toki he realizes how unnecessary it is. Toki radiates love; every piece of him glows with it. He brushes some of Skwisgaar’s hair out of his eyes, cups his cheek and kisses him again. Skwisgaar feels lit up from the inside, like he swallowed the moon, light shooting out of his fingers and toes and the ends of his hair.
Toki smiles against his mouth and giggles, and whatever scrap of vanity Skwisgaar had left evaporates and he giggles, too, the both of them tittering like teenagers, nearly silent so their bodies shake. He’s so giddy, he’s never felt this happy in his life. Toki breaks away, still laughing, takes Skwisgaar’s hand and holds it flat against his chest. Skwisgaar feels Toki’s riotous heart beneath his palm, the beat so thunderous and sustained it gives him an idea for a new baseline. He feels like if he removes his hand, Toki’s heart will tear straight out of him, like this is his job now, to hold his heart, keep it safe. He can think of worse ways to spend a life. “Says it again.”
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bmwilla · 7 years
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The China King Massacre
WARNING!!! THE FOLLOWING STORY FEATURES A MIXTURE OF MACROPHOLIA, GAINERISM, AND VORE. DO NOT CONTINUE READING IF YOU DO NOT ENJOY THESE THEMES. At 3:57 p.m., on April 8th of 2017, Justin Rounder entered the China King Buffet on 169th in Lanesville, TX. Justin Rounder was a 21 year old, dark haired, caucasian, Male, standing at 7'4" tall, 687 lbs, and wearing size 20 1/2 shoe. He squeezed himself through the front doors of the building by ducking down and turning to the side. His shoulders were just a little too wide for the door frame and his midriff not far behind. The suspect made his way to the front podium, his gate wide and waddling, his shadow broad and deep. At the podium was little Greg Mouse (21 years old, 5'1", 112 lbs, blonde, caucasian male). Greg felt as well as saw the shadow fall over him. Instinctually, he froze, like a small animal cornered by a larger one. He knew that shadow well. It had grown wider since high school but he would never forget it, because it had been present at all of his most embarrassing moments, following him around like a dark cloud of humilation. Greg took a deep, steadying breath before looking up at Justin. The larger man was looking down at him with that same smug smirk. It didn't seem possible but Justin looked even bigger today. His enormous belly hung high practically level with Greg's head and pretty much the same size at Greg himself. Greg eyed that enormous belly with trepidation. He had many nightmares growing up of being trapped in that belly. "Hey runt," Justin said in greeting. The muscles in the big man's thick arms buntched and notted. They were increadibly strong, as Greg knew all too well, and the biceps were almost the size of Greg's head. This had been demonstrated through forced comparison several times. "You better tell the kitchen to get to work, cause I'm feeling extra hungry today." Greg quickly lead Justin to a large booth. The latter had to pull the table out to get behind it and seat him self. Despite it being a serve-your-self buffet, the big man always made Greg bring him his food. Greg loaded a tray with 4 plates each piled high with food and brought it to Justin's table. The latter wasted no time in getting started. True to his word, Justin seemed extra ravenous today. He finished off the entire tray and 3 more after it barely stopping to breath. His big mouth seemed like a bottomless pit, he just kept shoveling huge scoops of food into it over and over again. He paused after the first four to chug an entire pitcher of coke in one draft. After that he was back at with full gusts. It was all Greg could do to keep food on the table. It seemed like only minutes after he would drop off a try the big man would be finishing the last bites. On and on it went, for hours, and something very strange started happening. Justin was getting bigger. Greg didn't know how or why, but every plate seemed to make Justin expand more. And it wasn't just fat, he seemed to be getting taller with each plate too. Each time Greg dropped off a new tray, Justin seemed to be looking down at him from a greater height. But of course his upward progress was minimal compared to his expanding waist line. The table was being pushed further and further away by his swelling belly, and his ballooning ass was just barely able to clinging to the booth seat. Justin's clothes made a valiant effort to stay whole but they never really had a chance. As the hours passed his shirt steadily made its way up his expanding bulk and his pants became tight and too short. His shoes too seemed to be fighting a losing battle too as Justin's feet grew and expanded. Before long his shirt was a thin strip of fabric across his  big full chest and his pants were more like short, that seemed to have mostly disappeared under his expanding bulk. All of this and still Justin continued to eat. In fact he seemed almost unaware of his growth, until the plates and fork in his big meaty hands started to feel very tiny. He looked around at the diminished world around him, and smiled. He noticed a tightness around his chest, middle and around his feet. Just as he became aware of them though, the tension seemed to have become too much and all three broke off. First there is a pop as his shirt snaps off and falls to the floor, followed by a muffled pop from under his belly from his shorts, and lastly an angry ripping sound from down by his feet as his shoes split open. Justin sighed with relief and wiggled his enormous toes experimentally. Justin flexed his HUGE arms, pleased at the new mass added to them. He looked around and saw the other restrant patrons looking at him with expressions of shock and awe. His grin widened. He didn't know what was going on but he liked it. He patted his belly with both hands feeling distinctly smug. Just then Greg came up and dropped off the next tray of food. Justin looked down at the little runt with even more satisfaction. He was even smaller and more pathetic now. Justin just wanted to pin the little runt under his belly and watch him squirm, but the runt was serving a purpose at the moment, one that Justin wasn't ready to loose, so he let the little runt scurry away unharrassed and went back to eating. The next hour brought on the most drastic change in Justin yet. Encouraged by his sudden growth, he doubled his pace and started dumping the entire contense of each plate into his mouth at once. Each plate bringing on a surge of growth. By the end of the hour Justin was truely enormous now. He was easily 10 ft tall siting and appeared to have taken on the combined weight and girth of 3 bull elephants. His belly alone took up half the dinning floor and was still expanding. His ass look wide enough to legitimately crush a tank and was starting to block the exit. The entire restaurant staff and patrons were huddled at the opposite corner of the building watching Justin examine himself. Glancing up from admiring his newly engorged body and it's bare enormity Justin saw Greg trying to sneak by him. The runty bitch looked tinier then ever. In fact, it looked like... an idea struck him and a wide grin spred across his round face. He lifted one of his ENORMOUS fat feet. Greg glanced over just in time to see Justin looking at him with a scary smile stretching his HUGE face, followed by the bottom of Greg's huge bare foot coming towards him. Greg only had time to let out a little squeak of shock and terror before the foot collided with him, sending him sprawling to the floor. He rolled over to his back and looked up just in time to see the meaty under side of Justin's foot decending over him. To his dismay it looked bigger then his torso. Greg gave another terrified squeak as Justin pinned him under his foot like a mouse. Laughter rumbled up from Justin's belky as his foot covered up almost all of the pathetic little rodent. Only the little bitches scrawny arms and legs stuck out from underneath, flailing frantically. He could feel the way Greg's tiny little body struggled and squirmed against his sole. "Ha," Justin barked smugly, "I knew it. Your almost as small as my foot." Greg spluttered against the fat meaty sole pressing him down. It felt like he was slowly being squished flat. "Your like a mouse. I could crush you under my foot. Listen, you even sounds like one." Justin pushed down a little harder and Greg gave a squeaky cry. The sound made more laughter rumble up from Justin's belly. Right after came a second rumble this one was followed by a feeling of more hunger. Justin glanced around hungrily looking for food, Greg still squirming under his foot. There didn't seem to be any food left, which was increadibly frustrating. Then he spotted a thin athletic looking guy trying to sneak past him. Before the guy could do much more then cry for help Justin scooped him up in one hand. He squirmed just like Greg but Justin's thick pudgy fingers wrapped around most of the guys body and he wasn't going anywhere. Justin's belly growled again and he got another idea. That same smug grin spread over his face as he started to pealed the clothes off of the guy. "Wh- what are you doing?" The guy asked in a paniced voice. "Let me go! Stop! STOP!" Once the guy was naked Justin eyed him closely while rubbing his big belly and linking his lips. The guy seemed to figure out what was about to happen and started to squirm more frantic then ever. "DON'T! PLEASE DON'T! PL-." The man's cries were suddenly muffled as Justin stuffed him into him mouth head first. The guys legs kicked frantically, as Justin pinned his arms to his sides and force him deeper in. First his head and shoulders disappeared then his chest, torso, legs and finally just the guys feet sticking out between Justin's lips and wiggling erratically. The guys muffled cries could still be heard from inside Justin's mouth. With two plump fingers Justin pushed the guy the rest of the way in. At first Justin let the guy sit in there. Heseeming to find the guys pathetic cries amusing, then with a final swallow the guy went silent. Justin licked his lips contented for a second. Then his body started to expand again. His belly inched further across the floor. His head slipped a little higher up. He looked down smugly to watch his foot swell to cover up more of Greg's squirming form. On the other side of the room the rest of the dinner patrons were looking utterly horrified. Justin smirked at thier tiny quivering forms and licked his lips. The next 20 min was total chaos, as the rest of the people attempted to evade Justin, only to fail. One by one Justin caught them, stripped them, and stuffed their protesting little bodies into his mouth. With each one he grew and with each one it became easier and easier to fit them into his mouth. By the last three he was poping them like large pieces of candy. After the third to last however his head hit the ceiling. His belly had met all for walls and he was getting really cramped. With minimal effort he ripped through the roof and his belly collapsed three of the four walls. He held the last two people in each hand, and ate them one at a time, enjoying the growth surges brought on by both. Looking around he realized he had eaten everyone. Wait... a tiny squirming sensation against the bottom of his foot catches his attention. The widest grin yet spreads across his face. With a bit of adjusting Justin manages to extricate Greg from the bottom of his foot. He holds the little bug boy by his legs with only his index finger and thumb. Greg gasps at the freash air with relief until Justin brings him up in front of his titanic face. Then Gregs eyes take in the latter's enormous lips, which are big enough to fit a mac truck into it easily. Looking down, Greg sees Justin's building sized belly and nearly wets himself. "I'd had almost forgotten you were down there," rumbles Justin. "Your so pathetic now I don't even know if it's worth keeping you around." Justin licks his lips. "I think, I have a better use for you." Greg's heart does a summersult in his throat. "WAIT!" he speaks. "USE ME! USE ME HOWEVER YOU WANT! JUST PLEASE DON'T EAT ME!" Justin let's out a rumbling chuckle. "And what use could I put you to? You don't even qualify as a mouse, your just a little bug. Actually your not even a bug, your food!" "NO! NO! NO! PLEASE NO!" Justin chuckles again, "You were always destined to be my snack runt. Face it you have always been a weak little bitch, and now you've found your rightful place in life." Justin tilted his head back and lifted Greg high over it. "NO PLEASE! NO! DON'T!" Justin gave one last rumbling chuckle before opening wide. Looking down into it was like looking at bottomless hole the size of a bus. Greg's panic reached an all time high. He tried to reach up and cling to Justin's beefy finger but he had started to sweat and his grip slipped. With genuine satisfaction Justin dropped Greg and the latter fell into his open mouth, where he was swallowed. THE END
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dawnajaynes32 · 6 years
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Don’t Fear White Space: Oliver Jeffers on Work, Process and Building a Creative Career
  Oliver Jeffers is the author and illustrator of 15 (and counting!) picture books for children, including Lost and Found, The Heart and the Bottle, and Here We Are. He has topped the New York Times Bestsellers list with multiple works and has won numerous awards, including the Children’s Book Council Children’s Choice Award and the ALA Notable Book Award.
But Oliver Jeffers’ work spans far more than picture books. He is also an artist with breathtaking emotional nuance. In his latest book, a monograph published this autumn by Rizzoli, Jeffers includes never-before-seen pieces as well as reflections on his personal life and career. It’s a treasure chest of quirky curiosities and distinctive charm.
After reading his monograph, I remembered what Holden Caulfield said in J.D. Salinger’s The Catcher in the Rye—that often, when you finish a really good book, you wish you could just call up its author to talk. Every book by Oliver Jeffers has made me feel that way, but none more so than his monograph. So, after roughly 14 years of following Jeffers’ work from the shelves of bookstores and libraries, I reached out with some questions. Jeffers generously shared his thoughts on his work, his creative process, and advice on building a creative career—and did so with his characteristic sense of humor.
On the Monograph
What did you learn or discover while putting your monograph together?
That there were a lot of holes in my archive. There were certain images I wanted to include, but couldn’t as we didn’t have a high enough resolution image. WA few pieces we were able to track down the original and rephotograph some of the pieces, but a lot of stuff has simply gotten away, as not enough due diligence was applied at the time of creation. before I had simply moved onto the next project.
One of your chapters in your monograph is called “Don’t fear white space.” Fear of the blank page cripples many aspiring artists. Did you ever fear blank canvases?
This was written as one of several things I’ve learned since leaving art college. It was more of a metaphor than fear of a literal white page, more about the slow rolling of the beginning of any project. I never really did fear blank canvases, simply because everything in my work is concept- driven, rather than craft- driven— – in that I don’t paint things just for the sake of painting them. and I never have bought or made a canvas not knowing what was going to go on it.
You’ve including a pie chart of an average day, and the second largest slice of the pie (after airport security) is feeling pleased with yourself! What helped you to gain confidence as an artist? How did you learn to handle the inner critic?
I think a big part of this came down to being asked, quite brutally in art college one day, who I was trying to please. When I dissected this, I realized that, when making work that was ultimately aiming to garner the approval of others, not only was my work less interesting, but it was disingenuous.
My dad once told me that looking at motivation, rather than action, was a truer path to understanding another person. It occurred to me that the same lesson could be applied to my art. There were double benefits in this. Firstly, I was making work that I wanted to make, and therefore enjoying myself more, and secondly, I cared less and less about what other people thought.
These things combined led to confidence, and I was fortunate that I got to that point in my practice relatively early. It strikes me how many people don’t believe in themselves. There is really only one alternative to that—which is NOT believing in yourself, and that just seems like such a burden to carry around. So f***uck it. Why NOT believe in yourself? You’ll get more done and have more fun!
Your pie chart also mentions lists. What are some of your lists about? Can you list some items off of one?
Mostly they are to-do lists and shopping lists. A recent shopping list included “‘Guinness,”’, “‘matches,”’ and “‘rubber gloves’.” Can’t remember what I was planning, but it sounds dangerous. Random things from a recent to-do list include “‘find old pencil drawings”’ and “‘charge bike battery’.” Sometimes I’ll add something to a list that I’ve already done, just so I can cross it off!
On the Creative Process
How do you decide that a story idea is one worth turning into a book?
There are lots of half- conceived, then discarded, book ideas littered throughout my sketchbook. It’s rare I know right away something will fully work as a book concept. In fact, it’s only happened twice. Once with The Incredible Book Eating Boy, which sort of just popped into my head fully formed, and the second one is the book I’m in the middle of completing. I woke up from a nap, on a solo car journey up the north coast of Antrim (in Northern Ireland), and the story was just there in my head. Maybe I’d dreamed it. I don’t know.
I’ll sketch all ideas down, and squeeze out any potential.
Sometimes I’ll start off fairly confident, and realize, after sitting with it a while, or coming back with fresh eyes, that it doesn’t hold itself up. For it to work as a full book, there needs to be a solid beginning, / middle, / and end. Often two of those come quickly, and the third takes some enticing. Sometimes the third aspect never comes at all, and the idea stays in my sketchbook. Though that is how I came up with Once Upon an Alphabet—a clatter of not quite big enough ideas to work as a solo book, but bundled together as a collection of short stories.
Do you ever get in a creative rut? When you get stuck (hopefully not in a tree with a whale), what do you do to get unstuck?
If I’m creatively stuck on a problem, I move on to another project — the answer normally comes when you’re not thinking about it. If I’m motivationally stuck, I remember I’ll be dead soon.
What happens to you if you go some time without drawing?
Not much, to be honest. I’m not one of those sorts who has to draw every day. I suppose because my output is so varied, even if I’m working full tilt, I rarely draw every day. Sometimes I’m painting, writing, building, fund raising, wall-breaking, planning, thinking, designing, reading, looking. Drawing actually takes up relatively little of my actual output.
You often mix handwritten words with typeset words. What’s your writing process like? How do you decide on this balance–choose which words to handwrite? When writing by hand, how do you decide which words to emphasize? And how do you decide on the balance of words with graphics?
For my handwriting process, it’s as simple as going with my gut. Intuition rather than a formalized and laborious design process. Does it look good? Then, that’ll do the job.
On Building a Creative Career
You have a distinctive illustration style. Is having a distinctive style important? What do you advise to someone trying to figure out their style? How did you find your style?
I think having style is important. But so much of this goes back to my earlier answer of authenticity of motivation. If you’;re imitating someone else’s work, then that’s not your style. Very early on you’ll go through the motions of imitating people whose work you admire, but the hope is that you then move on from this, once you’ve figured out what your hands and eyes can do.
So much of finding your style is about listening to yourself about what you enjoy making, and listening to the way your hands want to work. See the tweaks and quirks in your visual handwriting, then turn up the volume on it. So it’s not really you finding your style, as it is your style finding you.
Are you picky or particular about your tools? What’s indispensable or special? What’s something weird you’ve used? How do you choose your tools? Have they changed over the years?
I use a lot of different materials, for different end goals. Most mediums are regularly in circulation. With water colour and oil, so much of it is about the right brush for the right job- so keeping the brushes clean and in the right place is important. I work quickly, and fairly spontaneously, so something has to be where it’s supposed to be when I go to lay my hand on it. The right type of paint is important too. I have a few go-to colorscolour’s for specific things. I found all of my favorites throughHow I got there with all of it was experimentation—. Eexploring to see what worked for me and what didn’t, then sticking with what did.
I also use paper towels a lot with painting. Realizing that taking paint away was as valid as applying it was an interesting lesson.
These days, I’m a fan of attacking a delicately produced oil painting or collage with an oversized oil or pigment stick. There’s no going back with those things, so you only get one crack at it.
They say that success is the tip of an iceberg and under the surface is a lot of hard work, persistence, and struggle. Can you share a story about rejection or failure, and how you worked through that? Do you agree? How do you advise confronting rejection and failure?
This is absolutely true. For every success I’ve had, there have probably been three times as many rejections or failures. The important thing is to not sit or dwell on those moments and just move past them. Either try a different approach, or move on to a different project. So much so, that I can barely recall what any of the rejections actually were. Mostly they’re project ideas that can only come to fruition with the permission and funding from someone else. The important thing is to not sit or dwell on those moments and just move past them. Either try a different approach, or move on to a different project.
The last page of your monograph reads “And on we go…” What’s next for you? What are you looking forward to?
I’m currently working on two exhibitions; one in NYC and one in London, both of which will occur before spring., I’m also working on a large- scale installation concept (though at the time of writing, this may end up being chalked up to one of those frustrating rejection / failure moments), and there are two story books. I’m trying to complete (booth of which are well-started), and I’m aiming to get all of this done before next summer. Then I am looking forward to taking a year off and traveling around the world with my family.
Read more HOW Design illustration coverage now, ranging from icons and emojis to turning hand-drawn doodles into digital art. 
The post Don’t Fear White Space: Oliver Jeffers on Work, Process and Building a Creative Career appeared first on HOW Design.
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kin-collective · 6 years
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By Essence Harden -- 8.8.18
(An edited version of this interview  originally appeared in Performa Magazine, August 2018)
keyon gaskin is an artist at the inter- of disciplines and positions. Corporeal poetics, gestural manipulations, and discursive shouts inform gaskin’s take at performance art, black social/dance, sound, and theatre. The tentative arrangement of gaskin’s time-based work shatters relationships not merely between perceived audience and artist but curator and gallery, land and architecture, trust and supposition. Preferring to not qualify their work (gaskin’s artist statement reads “keyon gaskin prefers not to contextualize their art with their credentials”) the assertion of what it is gaskin does is informed by the experiential spectatorship within gaskins work. gaskin is not here for entertainment (though they do entertain) rather their performative based art is a blustery and fervent trip where those echoes of the subjective experience reverberate in the room with them and after.
gaskin and I sat down to talk about their artistic practice on hot Los Angeles summer evening. This conversation begins with our discussion of my first experience attending gaskin’s piece “this is an interactive experience for you/.you are a community/.you are my material/.this is your prison/.leave when you want” part of the Hammer Museums weekend-long exhibition “At night the states” in January of 2017. In this work gaskin moved between the formal stage and the audience floor, arranging and rearranging furniture and people by gesture and voice. Wearing all black, gaskin would form lines of folks reminiscent of a tribunal, rings of people squeezing every closer together, and masses of bodies shifting and swaying to where gaskin seemingly desired. At times reciting prose or direction, at times tossing chairs or placing people, gaskin wound, bent, and graced his body throughout the ever-shifting space. Ending and beginning without fanfare (simply gaskin emerged and began movements at the pieces start time and said it was over when finished) gaskin spun a narrative between and with the audience, the Hammer, the room, and himself for close to an hour.
Our conversation begins here and explores the contents of gaskin’s work, probing moments, and his thoughts on artistry, mastery, and defiance.
Essence: My first experience of seeing you perform at the Hammer Museum in 2016 for “At Night the States.” Not only did I not know what to expect because you don’t qualify what you do with program text or curatorial statements, but once there I found myself simultaneously rolling with laughter and near tears. I think part of it was the intensity of the audience not knowing what to expect and how you moved around the room and engaged with the stage (in this performance you had chairs on the stage that we’re being moved around erratically at times and had audience members sitting on them at times). There was this great force with your movements throughout the room- asking and gesturing for our bodies [the audience] to be closer in proximity while you ground through the new, dense mass of people. There was an older white couple, some kids, and a lot of folks who I would not, in general, find myself sharing such tight and hectic quarters with which made me laugh and feel uncomfortable at the same time. The experience was really one of a collapsed space wherein expansion and intimacy seemed bound up in it.
What is your process with this kind of work? What was the process for this piece? It’s not black social dance, but it is absolutely black social dance, It’s not performance art but it’s absolutely performance art, it’s not theater, but it absolutely is.
keyon: i like that. Initially, i go back to when i started making solo performance pieces—i say “solo” which is funny because, while I’m the initiator, instigator, and primary performing figure, it's important to recognize the active role of the audience in my work. Early on, i realized that i like to center what's happening in that room at that particular moment; we can look at it as a microcosm—if not of the world then at least of art scenes or institutions. In performance, what's happening in the room is always indicative of larger social, political, historical ways of engagement.
i try to use the information in the room to highlight how those social structures are present. i think that my role is important, but it's also important just to have the space to be in tune with, and very much listening to, the room. With that older white couple, i didn't want to move them from the front row, and i made a point not to disturb them, but there was really violent action going on around them. They were a little shook, and everybody else moved farther away from them. It was this thing of seeing that couple, seeing where they were placed, seeing that there was space around them that i could engage in an action, and how that will bring something to light. And i think we all became aware of us differently. We became aware that they were sitting in the room, that they chose to sit in the front row. We became aware of the absence of bodies around them.
Essence: In my memory, they were on the stage, by virtue of the activity around them. 
keyon: It highlights them no matter where they were in the room. you know, the stage is so not tired but also tired in a way. I’m not one to be like anything is dead necessarily, i think everything has space to be enlivened and the stage is doing work in whatever vein that it’s in. I don’t think theater has nothing to offer but the stage is so easily trope-ish, problematic, and indicative of oppressive systems of power. i also think a lot about how the stage centralizes focus, as opposed to a softening or opening of focus, what i think of as feminist gaze. What are you choosing to look at? Is it the most interesting thing in the room? Or is the thing that’s actually happening what’s happening on the stage or is it actually the person breathing heavily and making comments under their breath two rows back that you barely hear that are hopefully influencing your experience. i think I’m often trying to just highlight these other things.
And i’m not into mastery either. i’m always in that space of defiance when it comes to regulations, regimes, and boundaries. i have a multidisciplinary background in theater, art, and dance. All of these things are things that I have at some moment been much more invested in their “pure” form. i definitely studied theater, studied dance, and for years i was invested in learning as much art history, color theory, etc. as i could. i feel like it’s cool to invest in things and then be able to not hold that preciousness and allow these art forms to integrate into my experience and my body.
Essence: Yeah, because preciousness is precarious, right? And I don’t believe in, the notion that one does one thing for the entirety of their existence.   You hit so many things I want to follow-up with so I’m going to work a little bit backward. You mentioned the troubling of spectatorship, macro, and micro-engagement, disentangling of borders and boundaries within disciplines and rupturing the seams that form them. Like the stitches in a pillow, you show us the binding that holds this discrete structure together, and then you rip it up and leaving us, including yourself, with the mess of what it means to create a kind of comfort in this disarray. And I’m so interested in how we think about going to something that’s being marketed as a performance, as spectators, and you being in their actively dispelling that.  
I would love for you to talk to me more about that idea of troubled spectatorship, wherein the audience members and the institution are both implicated. 
keyon: Well, first of all, everything is site-specific. i feel like it’s more of a thing in dance and theater where the stage is seen as this somehow universal or neutral space that you can take these things that you’ve made in a box somewhere else and just plant them and it just magically works with her. i don’t believe that because of all the things around space and place… what else was this building used for? Whose things inform what’s happening.  
With making this abstract, experimental sort of work i can’t wholly know or predict what every person coming is bringing, and i’m not giving (via a curatorial or artist statement) a specific narrative for folks to follow so i know that everyone’s subjective experience is totally influencing whatever “it” is. This goes to the thing with spectatorship for me. It reminds me of something that i’ve been thinking about lately, which is objectivity is not real. As a theory or concept, i get it, and perhaps there are non-human being/s that are objective. i don’t think it’s humans. Everything we receive comes from the subjective and we can’t think beyond our own existence. So that layer of how i know that everybody’s coming with their subjective thing and everybody’s going to read what they read into it, especially because this is kind of abstract, experimental thing. Even if i am working in specific concepts, i’m not necessarily interested in folks needing to take note of those things. Which is why I don’t give a lot of language before my performances because i think that the experience that we have in that room, which is based on all of our subjective experiences, is what is informing the work as well. And though i understand that as the artist who’s invited people here, it’s my role to initiate, instigate, engage and provide an offering, and that offering can look as many different ways as there are different people, plus the multitude of ways as to do what we will with that material after we leave that room.  
And that to me is the juice or the meat of it. That possibility, the potential that this thing that we’re engaging within this room right now can snowball or turn into or amalgamate or slip and leak into something else through our engagement with it, through having been in that room and now talking about it. Or sleeping on it and having some sort of dream that arises from that. Or having that experience inform how you tell your little cousin something three years down the road. That’s really the potential of anything that we’re doing.  
Essence: Yes! It really feels like you’re remarking on the world. Being in the room with you, you, Keyon, are the initiator, but we in attendance are also the initiator for even coming to the performance in the first place. There’s a level of autonomy happening because you came.
keyon: Right! Exactly. Also, there’s this thing of responsibility. As though, “i’m responsible for you and what you receive now because you made a decision to come here tonight?” Whether you spent money or not, you made the decision to be here as well, and i am here offering something, whether you read it as an offering or not.  
To get back to spectatorship and experimental abstract work, …this isn’t entertainment.  
Essence: You will not be sitting here passively with your popcorn.
keyon: Exactly.
Essence: Try to have that popcorn, it’s going to get snatched out of someone’s hands!  
keyon: Exactly. And now i will be having some, and we can talk about what it means for me to take your popcorn. i’m so here for those things coming up. i also love when something that happens that i didn’t expect. i work in improv, i set up structures—the score of that piece from The Hammer you’re talking about is actually the title of the piece. At that time it was called “this is a performance.” Now it’s called “this is an artwork/this is for you/you are a community/you are my material/ this is a prison leave/leave when you want.” That’s the only text that i give for the work. That poem is the score that i’m working from. i used that poem to come up with physical ways to engage those things. i’m starting with a specific thing, and it shows up with me moving bodies around and emphasizing other bodies. i’m highlighting the prison of the institution, the prison of us being here, the prison we trap ourselves in, and with each other.  
i don’t like to talk about stuff too much because i feel like saying “this is a prison” to me leaves it open enough without trying to make these direct correlations between our institutions and the prison industrial complex, which feels absurd in some ways to make. i’m not saying that’s what’s happening here in the art industrial complex, but i am saying that having that word in your head and being in this space together thinking through or feeling that that can do something, can open us up to how we think about the space we’re in.
Essence: I think it’s interesting to think about the use of not only a poem as a score, or as a type of corporal reality which is so brilliant, but also the way of language. I’m thinking of Kristina Sharpe’s book, In the Wake: On Blackness and Being, and the many ways of “wake” in thinking on and of black ontology– the space between and collapsed into a word.
I notice with your titles you have that forward slash spacing between groups of words (this is for you. / you are a community. / this is my performance. / you are my material. / this is a prison. / leave when you want.), and I’m thinking about that break, and the space in between language and the multiple meanings of a word like “prison”– to be in jail, to be imprisoned in your mind, a type of physicality. It’s a multitude of beings, and while we assume language to be particular and universal within many contexts, it’s actually your own assumptions that guide that assumption.  
keyon: Thank you! That’s your own assumption. i’m talking about a de-centering of objectivity or objectivity as an impossibility. We need to deal with the fact that we’re coming to this world through our subjective experience. The more we can say, “okay, maybe i’m seeing it this way,” and acknowledge that we are seeing it one way and that it may not be the way it is, then we are more available to engage with one another across boundaries. 
 Essence: Even our colonizer language.  
Keyon: Yep.
Essence: Or black folks constantly signifying and re-mapping language–from “kink” to “funk,” to “nasty”—meaning is remade.  
keyon: Ha that part too! i mean i’m black and i love it. i like a lot of theorizing, black theory, and the critical race theory that’s happening now. i love that so much theory or the things that have come to me through theory are talking about the expansive nature of blackness. i just read Dawn Lundy Martin’s “A Black Poetics: Against Mastry,” and it was a trip. What i took from it was the correlation between blackness and the impossible, blackness to nothingness, and equating that to creativity.  Mastery is to be bored. To know something so completely is to be bored. Creativity always comes out of a place of not knowing anything, and I don’t think that means being unfamiliar or wholly ignorant of it. 
Essence: Right, but it does mean being uncomfortable.
keyon: Without a doubt. It means not knowing what the outcome is going to be. For my work, i may come in with a certain score but it’s important for me not to know who is going to be there. i have specifics that I’m working for, but it’s super important that i, as the person who has invited us here, do not know how this thing is going to turn out. That thing in my work you pointed to “is it this or is it that?” i don’t even know what it totally is. i often feel like i’m pulling from all of my experience, a lot of times from all of our experience–including the experience of the room–in ways that i couldn’t have known.
Once i was performing in a theater that used to be a horse stable, and i swear to God so much horse shit came up that night. It was the piece “it’s not a thing” that i’ve been doing forever, but i always adapt to specific spaces. It’s one of the pieces that i tap dance in, and i had this other collaboration with Sidony O’Neal called “Dead Thoroughbred,” so there was all this wild corollary coming up. Between horses and blackness, being sold, tamed, and broken, these sorts of things came up in the work that night. It wasn’t just me holding that either—i talked to other people after that didn’t know the history of the space, that had experienced things around horse-ness. i think that the room influenced that, and when i do that piece in other countries, there’s a part in that piece at the beginning where i talk to the audience and hire a translator in front of everybody. i bring $10 with me, and i’m like, “who’s willing to translate for me for $10?” The translator tends to have so much influence as well—these ways in which to work also escape me— to be able to throw all these things out, but also wrangle it all as well.  
My friend visual/sound artist Adee Roberson talks about me being the trickster or the fool, and i identify with those roles. We think of the fool as cunning, and i think that coming at things from the side, you can get at something without holding the full responsibility of it. You’re like, “Oop, yep i said that” and now what happens, now where does that go? There’s something to that archetype that resonates with me.
Essence: Absolutely. The Fool is also the first card in the Tarot deck and has this primary social presence. I think of The Fool as the person who can talk trash to the King and remain in grace. And then the trickster through black folklore with this crafty genius level of intelligence—to be able to live, survive, and even thrive in a world where you’re abject. To survive by virtue of not being seen and holding up various mirrors, offering a reflection for someone else, society, or for a room. But then here you are gesturing, dancing, and performing beyond it, behind it, remaining just out of reach. One can try to pin you and your work down but you’re going to be wrong, and when you find yourself being wrong, you’re going to find yourself being seen and seeing your own reflection in that dance of mirrors.  
keyon: Something else about The Fool is that it’s also someone who positioned as such, but makes the best of that position. i think about this so much about being “burdened” and overdetermined when it comes to black folks, queer folks, but primarily with black people, especially in America.  Like, “oh, okay, if you want me down there then i’m going to not only make the most of that space, but i supersede what you even thought that was possible.”
Essence: And I’m unpinnable. Try as you may, you always fail.  
You mentioned the exhibition I curated “black is a color” and your performance for the closing, which was beyond anything I could’ve ever hoped for. We had toured the gallery the day before, (the gallery had the main floor with artworks arranged on the walls with three smaller installations by artist Adee Roberson, Kenyatta A.C. Hinkle, and Texas Isaiah and a smaller, room behind it with a single installation by Azikiwe Mohammed. Upstairs were the administrative office and downstairs, in the basement, was another show (Alexander Rebe, Wax Chromatic) and you touched a few things and scanned the room asking if some areas like the stairwell or the desk were sturdy and that was that. I had no idea what you were going to do…only that I had faith in your artwork. Then the night of the performance hits and we’re all here and it’s happening and I’m like, “Oh, keyon is about to climb down the rail of this 15 or 17-foot high staircase,” and after that, it was just on. One of the first things that resonated for me was how blackness appeared in these disembodied forms—there was the cast iron skillet you were wielding, the black sweats you were wearing, and your black high heels—the way that blackness appears as a color.
keyon: And that’s that piece too. It’s also a rumination on the color black. So when you invited me to “black is a color,” i was like, “i have the perfect piece!”
Essence: I would love for you to talk specifically about it in the context of the Charlie James Gallery, but also, how has it formed at other locations?  
keyon: That piece is called It’s not a thing. i should say that the piece develops through performance—i do a lot of performing of a thing; i think about a thing, i start with a concept or idea or something, etc. So it actually started with doing things that i didn’t want to do in performance or things that i have contention within performance.
Essence: Like what?
keyon: Like drag, dancing to music, using race as a specific material for making, using personal trauma or experience as material for making. These are all things that i have contention with, not to say that they’re tools that i don’t use, but they are things that i have contention with, primarily in contemporary art and performance. There’s a whole list of things that come out of the opening monologue… 
Working with race as a material was one of the things i didn’t want to do that i started to trip out on and landed me with blackness— thinking about blackness, thinking about this thing of using personal material, lived experience, which i think we all do always. That’s the thing about subjectivity– everybody is making identity work. Damien Hirst is making very white male informed work, you know what i’m saying? This is the thing: we’re all making from our subjective lived experience, so my contention with it isn’t necessarily that i don’t want to be it, but that i don’t want to be pigeonholed.
Essence: In recognition of what tends to happen to black folks making work, when you say (or don’t say) anything about black people or being black, you’ll only be put into conversation with blackness as a ceiling, a limit, an unfixed homogeneous experience.  
keyon: Exactly. And so yeah, i was on this trip on and about blackness. i started thinking about what we do culturally with the color black—black magic, black snow, black space, black holes, etc. i like minimal things, minimal aesthetics. i prefer to walk into the room with just my body and in it’s not a thing, it’s the literal hammer i walk in with. If i use objects, they all need to hold weight and have multiple layers of access. So the cast iron, for instance, is, to me, a literal black hole if you look at it. But i also think of it as a feminist weapon. i think about my grandmother threatening folks with hot grease out of the cast iron, or it being the first weapon she’d pick up if somebody came into the house.  
i also think about movement a lot in that piece and the way that the movement affects my body and takes my body out of control.  When i start with the cast iron skillet way up above my head and then swinging this thing down i’m at once handling it but it is simultaneously handling me. That’s just to say that all the objects i bring in need to have multiple layers of access and have a life or experience that can be witnessed– that i could just walk in and put the cast iron down and be like, let’s consider this skillet. We could go hard on it, there could be a lot to come out of that, you know?  
Essence: Especially a cast iron for some reason, right? It feels like slavery and present life…it’s past/present and it has this multiplicity of use-value. When you were talking about your body being led by it as you also were leading it, I was thinking of earlier in our conversation when you spoke about moving chairs around the older white couple and the sense of discomfort that’s built in a room around brash movement.  
When you hit the window at Charlie James Gallery with the cast iron, I assumed it wasn’t going to break. But, after I thought about it, I questioned myself about the security of your actions, like “why do I think keyon thinks this won’t break?”  
keyon: i love messing with that relationship. We immediately give trust and respect to spaces by virtue of their existence, without asking why. Years ago i used to talk about the rules of engagement in art. What are these rules that we’re all agreeing to? But especially when we’re coming from a radical, queer, black perspective, and we know that we don’t trust this shit, so why don’t we challenge these rules? Why do we not challenge that when we come into a theater, we sit down and allow for whatever the person onstage is going to do? And trust that we won’t be harmed?  
Why? Because the institution told you that you should? Because we assumed that this person wouldn’t do anything? So that role in challenging and questioning those norms (did i know the window would not break?) with people trusting me, without challenging what i was doing, since no one grabbed the skillet out of my hand. i’m always interested in troubling and challenging.  
Essence: So much of your practice, what i’ve experienced at least, is about what you get out of the tension between bodies and space? And even in your biography or curatorial statement, or lack of them, the tension produced in a limited space, the possibility of productivity. i just love how much you mess with our senses, sensibility, and space that you offer via discomfort. How it’s a real opportunity for engagement.
i wanted to ask what, for you, is the purpose of an exhibition title, artist biography, or artist’s statement? i’ve been thinking about an earlier conversation we had where you described using a black box in lieu of an artist statement when responding to a galleries request.  
keyon: My sister recently told me that she’s been coming into her own more, speaking up rather than staying quiet. She’s seen my work, and she  knows me (I am a contrarian, I have no problem saying, “nope”) and she’s like, “it does feel good and empowering to use my voice and not to be so hurt when people are offended.” But she did ask me, “how do you do it? How do you keep holding that space?” I know it feels hard for her (and other folks especially black womxn) to make the room uncomfortable because it is truly uncomfortable feeling. It’s hard for people to disagree. But I’m not into group think. I was the president of my college Student Government Association  and went in on them on my second week, and let them know, “people need to think for themselves and we’re not here to collectively agree with one another.”
Essence: This is what democracy looks like.
keyon: Yeah. And i do think that more voices, multiple voices taking the time to consider, to sit with things, and be uncomfortable actually reap a more holistic space. But i realize that part of my training and part of how i am is that i can hold that space…i can be the person who makes it difficult and uncomfortable, and i can sit in that and with that, and it doesn’t throw me. i think it’s generative, and i don’t think it gets offered enough. i do feel like since i can, and since i have the inclination to, i do. And again, i’m a contrarian, i am not one who’s here for someone saying, “this is the way it is because i said so.”  
Essence: So the way that you use your artist bio or if you are curating your curatorial statement is a way of pushing back?   
keyon: Exactly, they’re ways of challenging and pushing back at that thing.  When i first did the bio thing i got so many artists being like, “Oh shit, that’s dope!” or “i wish i could do that” or “How do you do that?” For me, that felt super affirming that people needed that. People need to know that we don’t have to take the shit that they give us on their terms. For example, in institutions’ bio samples, they tell you flat out how they want you to present yourself, and there are no bones about it. People rarely question it? That’s wild.  
This new piece is a self-portrait, but the title is the color lavender. Literally, i want it to be a block or swatch of the color lavender, or the title of the pieces is a swatch of lavender. Everybody gets a book when they come in the room with a little bit of lavender painted on the cover, and this is the title. It’s been difficult to make that happen with institutions, who say, “well we use words,” but in the age that we’re in, do you really? And even if someone has to put “a swatch of lavender” in brackets my having to fight with institutions about that, i feel like, is doing some work. Why are titles necessarily that way?  
Institutions also ask, “well how are we going to get people here?” Those are rules you’ve made imagining how and why people attend shows. People come to things for a lot of different reasons. There are so many ways to get people to a thing. i’m not super invested in capitalism, i’m not invested in your organization making whatever amount of money tonight. i’m going to get paid the same amount, which sometimes that’s nothing or sometimes that’s the amount that you’ve agreed to pay me, which you already wrote that grant to get, baby. i don’t necessarily care if this house is packed right now. But I’m very invested in what’s happening in the room. i care about who comes to the room that night.  
Essence: There are people who see a strip of the color lavender in the space of the exhibition title and say, “I want to go to this.”   
keyon: Exactly. The black box thing, i’ve had several people who were not in the arts—a couple from Switzerland, quite a few people from Berlin and  New York—who came up to me after that and said, “I didn’t know you, I didn’t know your work, but when I saw a program description that was a black box and no words, I knew I had to come to this.” And that’s what i’m talking about.
Essence: Right, who do you get? Who do you engage with? And how do you also respect your audience? To think that people might have some inkling of desire outside of the words you’ve written down. I think so much of what you’re talking about goes back to the idea that you will not get better or different things if you keep accepting what you’ve been given and imagining it as permanent.  
keyon: Exactly. You helped me a little moment ago with a piece that i’ve been working on. It started with Alf actually, the show about the alien, and then it was about Alf and Jesus.  
Essence: I always thought Alf was black.
keyon: i have a whole thing around Alf being black. They kept Alf in this backhouse where he would not come out if anyone else was over and while he wasn’t helping out necessarily he was around for the family’s morale. He was like this pet that was brown and an immigrant. i was thinking about it as these figures that actually do provide a lot, but that are also subjugated, oppressed and objectified. i think that’s why Jesus as a historical figure came up for me. Jesus was a savior of people and murdered for such beliefs, and then what we do posthumously, right? It’s crazy. Anyways this conversation is helping me gig through that more.
But getting back to what i was saying, i’m thinking about something Fred said in reference to Fannie Lou Hamer, which was that her practice was her statement and the statement is “refuse that which has been refused to you.” i think of this a lot when doing my bio.
i haven’t always had access to this world, being in my body, being how i am and not into professionalism. It has everything to do with being a radical punk, anti-professional, anti-capitalist and these sorts of things. So i’ve been refused this level of access the whole time, and now you want to access me. So no, you can get it how i decide to give it to you, but you can’t get it like you want it. Now what? You’re gonna have to take it as is or you won’t get it.  
But i’m also not invested in my success, and this is also a big part of my practice that i feel like i have to hold onto. Look, i can die poor and nobody can know my work. i like living, i like my friends, i like eating, i am a very resourceful person, and I’ll be fine. i don’t need your institution to validate me.  
Essence: Absolutely. People say that they don’t care, but the reality is that 90% percent of us do care, and I’ll put myself in there. I have to remind myself that if I want to do something quite outside institutional norms, then I will likely not be able to garner success economically in relation to an institution. 
 I think that we’re in a moment where the term radical, as in someone existence or in an image they take or the superfluous language they use to describe themselves/practice is in a particular type of vogue. However, there are no guarantees that one’s mere existence as black or queer person is somehow a project towards or of liberation. I’m much more interested in what is practiced, challenged and active in our existence. Not in Fannie Lou Hammer as a mere symbol but in her actual radical practice. I think the desired recklessness in your work, the way you engage with what it looks like to “not care” is such a profound move towards disinvestment.  
It’s risky and uncomfortable, but still, the risk is necessary, and it’s actually something one can do. And the punishments vary for deciding to not belong or to pretend to belong, or to desire to belong, but there is a type of worth in it. It’s encouraging to my spirit to really ask, what does success look like?  
keyon: i’m glad you asked the question because i’ve been grappling with the art world’s investment in failure which makes me wrestle with what we mean when we talk about success. If this idea of “failure” exists in a binary relationship with success, then this means that there are measures of success, which I don’t know if I really believe. i think this is the thing about making work and performance, that every time i make work, it’s not going to be something that everybody wants.
Essence: But is that then successful?
keyon: Is it or is it not? i don’t know. Or is it just what happened? And do we have to assign measures of value to things? i don’t judge this thing—this thing happened. That’s all I know, that it happened, and i feel all sorts of ways about it all of the time—whether it was well-attended or made money or black people were there or not. We can talk about things i desire out of a performance, and i don’t even know what that entirely is. i am about what happened and what is happening right now.  
Essence: Presence.  
keyon: What is supposed to be happening and what needed to happen right now. So i would never say it was a success or failure because it happened. It is what it was and i don’t need to judge it.  
Essence: They do feel like moral qualifiers —one imagines their life trajectory bending towards justness and non-inherent values like economic wealth and capitalistic acceptance. If it’s not doing that, then we can lean on the hope of success a failure contingent upon the eventual success of the thing. What then does it look like to take up the task of living without a qualifier?  
keyon: Because if it, one’s life, one’s work, is being measured on a scale of success or justness, then i’m so hopeless. This is also a big part of what i’m doing, i don’t have hope—i don’t think “success” is ever possible. The world we live in is so violent and heinous all of the time in everything that we do and have is born of it. We are sitting here with our phones and Apple computers to make this conversation happen, which i love and i’m so joyful about that, but it’s contingent upon various forms of abusive labor practices, including children in central Africa. How can that be a success?   
And if you’re performing anywhere in the United States, guess what? You can never have a successful event because it’s happening in relation to Indigenous Americans genocide and displacement. Whether we acknowledge it or not in our daily lives, and i know it’s impossible to do that every moment of every day), but it is there. It just is.  
We get these boxed in ways of looking at the world based on our society, and we make up ideas of success based on a limited version of what’s happening, and that’s just false to me and it feels foolish to do so. If i was judging on those scales, then i would have to talk about all of the ways that there’s no way the work could succeed because of all of the ways that it’s failed, outside of my control. 
Photo by Iris Alonzo
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kristinsimmons · 6 years
Text
The EBM Wars: Manufacturing Equipoise (Part 1)
By ANISH KOKA
The phone rings.  It’s not supposed to be ringing.  It’s 2 am.   The voice on the other line is from an apologetic surgery resident.
Resident: There is this patient..
Me: Yes, go ahead. Please.
Resident: He’s tachycardic.
Me: How fast?
Resident: 160 ?
Me: What’s the blood pressure?
Resident: 130/90
Me: Rhythm?
Resident: An SVT I think.. I gave adenosine.  Nothing happened
Me: Audibly groaning.  I’ll be in..
Forty five minutes later I’m at the bedside of a decidedly ill appearing man.
I want to be triumphant that his heart rate is only 145, and a quick glance at the telemetry monitor above his bed uncovers juicy p waves in a cadence that suggests this is no primary electrical arrhythmia.
Something is very wrong somewhere – the heart in this case is an innocent bystander being whipped into a frenzy to compensate for something.
At the moment the whip is a norepinephrine infusion being used to keep his blood pressure up.
I ask the nurse if the amount of norepinephrine infusing has been stable.  She replies that his dose has been slowly escalating.
Eureka! I think – the heart rate response in this case is being driven by the norepinephrine – a powerful adrenaline that acts on beta receptors and alpha receptors within the body that increase heart rate and constrict the blood vessels to raise blood pressure.  Fix the cause of the low blood pressure, come down on the norepinephrine, and perhaps the heart rate would be better.
But it turns out this particular post surgical patient doesn’t have a medical cause of low blood pressure I can find.  I cycle through cardiac ultrasounds, blood gases, steroid and volume challenges, and try inching down on the norepinephrine.
All of it is to no avail.  I’m growing more and more convinced this problem is surgical in nature. Perhaps an infarcted piece of bowel?  All I know is that the man acts like he has no peripheral vascular tone.
An interesting thing happens shortly after.  The norepinephrine drip runs out.
As one nurse runs to get another bag from the pharmacy – a quick cascade of events unfolds.
The brisk upstroke from the arterial line that marks the pressure wave generated with every beat of the heart starts to dampen.  The color seems to visibly drain from the patients face, and he begins to complain that his vision is getting blurry.  His systolic blood pressure is 70 – an almost forty point drop within a minute of the norepinephrine running out.
I call for help.
I try to keep a level tone.  Project control, not panic.
“Open the code cart, I need a half a milligram of epinephrine”
“You’re going to be ok, sir.  Hang with me.”  I squeeze his hand.
He closes his eyes
The code cart – a fully stocked cabinet on wheels with almost everything you need for resuscitation efforts – is wheeled into the room. The epinephrine vial is handed to the nurse, and hurriedly pushed.
Within seconds, I can see the blood pressure and heart rate rise.  The patient’s grip on my hand relaxes.  Or maybe its my grip on his hand.  I forget which.  His vision returns to normal as his blood pressure ‘normalizes’.
Of course nothing has been fixed.  Why his blood pressure remains low continues to be a mystery.  The bag of norepinephrine soon isn’t enough even at its maximal dose.  The same scenario (hypotension -> pallor -> vision loss ) recurs 30 minutes later, and another bolus of epinephrine aborts a rapid spiral towards pulselessness.
This case is an anecdote, the weakest possible form of evidence apparently.  Yet there are powerful lessons learned that night. Blood flows in pulsatile fashion with a certain pressure head.  Below some threshold of pressure, the end organs of the body stop functioning.  Agents that are active on peripheral vasoconstrictor receptors (norepinephrine, epinephrine) raise blood pressure.  Epinephrine was keeping this patient alive while a team worked to understand why his blood pressure was so low.  My suspicion was that he was in something called distributive shock – a catastrophic life threatening syndrome that requires a furious hunt for cause to save the patient.  Overwhelming infection and an even more aggressive immune response renders normally relatively impervious vasculature to be a sieve.  At the present time the therapy is directed towards replacing the fluid lost in the intravascular space and using medications that act on peripheral vascular receptors that increase peripheral tone.
There is, of course, much that isn’t known about this process.  Hopefully it will come to pass that we will arrive at a better understanding of what specifically creates this mileu so our therapies may be more directed.  But for the time being, our solutions are limited by our current, always imperfect understanding of the world.
The culprit in this case was a leak of intestinal contents into the peritoneal space from two pieces of bowel that should have been exactly apposed.  The body had attempted to tell us this very thing with that high heart rate post-operatively.  It took us, the clinicians, some time to translate.
The uninformed prior: Unlearning what has been learned.
For many, medicine has for too long been an imperfect science.  The history of medicine is replete with physicians acting with certainty in a manner that – in hindsight – was ineffective, or even worse – harmful.  Blood letting to allow the release of bad humors is believed to have hastened the demise of the greatest American – George Washington.  The disconcerting part of this is that the physician players were not motivated by anything but the best intentions.  They relied on their experience, intuition and judgement to deliver exactly the wrong prescription.   Intuition fails.  No matter how many patients died soon after blood letting, operating biases didn’t let physicians link the two events.  After all, the patients may have died even sooner if blood letting hadn’t been done.
The idea that medicine had progressed – by the 1980’s – to the point that doctors were not engaged in the equivalent of blood letting came under heavy fire when it was demonstrated a number of standard practices of the time could indeed be ineffective.  Extra beats (also known as ectopic heart beats) after heart attacks were noted in cardiac units to portend a higher risk of dying suddenly.  The obvious approach to this was to use medications that effectively suppressed ectopic heart beats.  Testing this in a double blind randomized control trial did not just demonstrate ineffectiveness, but harm.  More people randomized to suppression of ectopic beats actually died.  It turns out the anti-arrhythmic drugs being used were actually proarrhythmic as well.  The attack on ‘expertise’ that relied on intuition and experience was on, and it was a rout.
Glue ear – a condition that developed in the middle ears of little kids after ear infections  was treated with insertion of a tube to drain that space.  The trial to determine efficacy using a randomized trial to blindly allocate patients to surgery or no treatment?
Negative.
Many of the children turned out to do just fine if you left them alone.  Given the fact that all procedures have a certain complication rate, the lack of efficacy here was no small matter.
And so it went – the populace had to be on guard not just against the afflictions of disease, but against the intuitions of its doctors.
Uncertainty reigned, and in search of certainty, the field fled to the warm embrace of ever greater empiricism.  In the early ’80s from the McMaster University in Canada, David Sackett gave voice to a new sheriff – Evidence Based Medicine (EBM).
“EBM de-emphasizes intuition, unsystematic clinical expertise, and pathophysiologic rationale . . . and stresses the examination of evidence from clinical research. In 1960, the randomized trial was an oddity. It is now accepted that virtually no drug can enter clinical practice without a demonstration of its efficacy in clinical trials. Moreover the same randomized trial method is increasingly being applied to surgical therapies and diagnostic tests.” (Sackett et. al, Evidence Based Medicine)
The premise as outlined is simple – don’t believe anything that hasn’t been tested in a randomized control trial.  The only real evidence is that found within RCTs or in reviews that amalgamated RCTs.
The usual response from EBM experts can be found below in the response to the statement that real evidence may come from outside an RCT.
It is quite possible Professor Francis is right on here about the specific subject being discussed, but the point is that there is an established hierarchy of evidence on display.  The RCT is king, everything else is no better than the court jester.
While an RCT may certainly be better than anything cobbled together at a pub, the conventional parallel group RCT certainly isn’t always King of the Hill.   As nicely expounded on by the prolific statistician Stephen Senn, there are plenty of potential errors the conventional RCT finds itself humbled by.
The clinician may thus feel somewhat mollified about conclusions drawn about the effect of epinephrine in the earlier anecdote.
The idea that real evidence may live outside the confines of RCTs was also countered by none other than the godfather of EBM, David Sackett:
“Evidence based medicine is not restricted to randomized trials and meta-analyses. It involves tracking down the best external evidence with which to answer our clinical questions. To find out about the accuracy of a diagnostic test, we need to find proper cross sectional studies of patients clinically suspected of harboring the relevant disorder, not a randomized trial. For a question about prognosis, we need proper follow up studies of patients assembled at a uniform, early point in the clinical course of their disease. And sometimes the evidence we need will come from the basic sciences such as genetics or immunology. It is when asking questions about therapy that we should try to avoid the non-experimental approaches, since these routinely lead to false positive conclusions about efficacy. Because the randomized trial, and especially the systematic review of several randomized trials, is so much more likely to inform us and so much less likely to mislead us, it has become the “gold standard” for judging whether a treatment does more good than harm. However,some questions about therapy do not require randomized trials (successful interventions for otherwise fatal conditions) or cannot wait for the trials to be conducted. And if no randomized trial has been carried out for our patient’s predicament, we must follow the trail to the next best external evidence and work from there. (Sacket et al, Evidence based medicine: what it is.. )”
Sackett also noted that there were therapies whose ” ‘face validity’ is so great that randomized trials were unanimously judged by the team to be both unnecessary, and, if a placebo would have been involved, unethical”.
In effect, there was always an escape clause to let common sense prevail over EBM.  But as frequently happens in movements, the second generation of followers moves in directions unintended by the founders.  If the safeguards in place involve only areas where equipoise exists, but equipoise is itself determined by fallible judgement, the range of unacceptable experiments becomes very narrow.  This especially applies to new therapies where members of the community not involved in design and development have skeptical prior beliefs.  This is, of course, not a bad thing – it is entirely possible that the usually overoptimistic prior of the developers of a new therapy are farther from the truth than the skeptics.  But it is a major problem if we ask doctors to discard their prior beliefs that are not based in RCTs.  In doing so, we are manufacturing equipoise.  This means travel in dangerous ethical waters for physicians and their patients that is at best unwise, and at worst willfully foolish.
The EBM Wars: Manufacturing Equipoise (Part 1) published first on https://wittooth.tumblr.com/
0 notes
getfoundfastblog · 6 years
Text
7 Ways to Increase the Effectiveness of Your Email Marketing
Email Marketing Strategies
Email marketing has come back in full force, and brands that know their way around best practices can reap huge returns.
According to a survey of marketers conducted last summer, the average ROI from email campaigns was over 100 percent! This ROI beat out other marketing channels by over four times, including social media, paid search, and direct mail.
One study from 2015 even found that email marketing could generate as much as $38 for every $1 spent, which equals a mind-blowing 3,800% percent ROI.
For anyone trying to squeeze more out of their email marketing or turn around their lackluster campaign success, here are 7 pointers for increasing the effectiveness of your email efforts.
Segment Your List (Or Risk Being Irrelevant)
Talk to people about topics, products and ideas they are interested in.
According to an infographic by Mailigen, using segmented, relevant messaging more than doubles your open rate while driving 18x more revenue for your campaigns.
This approach makes a lot of sense if you have ever been to a party where someone is droning on and on about something you just don’t care to hear about or have any interest in. “Have you seen how expensive jogging strollers are these days?” they ask, not bothering to remember you don’t have kids and haven’t jogged since high school.
While the person talking may feel like they aren’t being terribly rude, to the recipient it can feel a bit more personal. “I don’t care what you are actually interested in” the person communicates. “Everyone is equally interested in what I have to say.”
Not having email segments is the same thing. Ensure your list is segmented by buyer persona so that every message is as relevant as possible.
For people who self-subscribe, you can even give them a chance to customize the content they receive by interest, product category and other choices from a pick-list. Just don’t count on them to do all the work of segmenting for you!
Using an email automation system like Constant Contact or Mailchimp is critical to keeping these segments organized, but you can also potentially do-it-yourself by just separating your mailing lists into separate content buckets.
Once you have segments established, take a moment to strategize the difference between each segment based on consumer traits, progress through sales pipeline and other situations. Then, outline the type of content that would be most relevant to each segment as well as what would be least relevant and should not be sent.
Taking a moment to get to know your audience can dramatically increase your open rates while lowering the amount of frustrated subscribers.
Use Personalization to Make Recipients Perk Up
When we hear our names — even if we know it’s someone else with the same name being called — we tend to take notice. Chances are good that your parents were pros at this technique. When they said your name before a sentence, you knew they meant business!
We have the same reaction when we see our names in an email. Personalization with a name and other details increases open rates by 26 percent, and it can even help drive brand affinity.
Note that personalization involves more than just adding a first name to an email. The entire message should be framed as if the recipient is having a 1:1 conversation with the sender. LinkedIn has become a pro at this tactic. They use personalization in a way that makes you sit up and listen.
Looking at moi? Go on, I’m listening!
The above message not only includes a name but signals that an exciting activity has happened. It says people are looking at your profile. Think of ways to mirror this effect so people get excited or intrigued just from looking at a subject line.
Segmenting your user base by the products they have bought (or expressed interest in) is another way to connect more deeply right from the subject line. “New Jeep Anniversary Fog Lights” can be a way for a Jeep Wrangler owner to have immediate interest, for instance.
Data shows that this type of personalization is table stakes for marketers with successful email programs. “88 percent of those that exceeded revenue expectations have personalization measurement systems in place,” says Inc.
Test Subject Lines Rigorously
A lot of marketers mess up promotional emails right from the moment they begin creating the subject line. You should scrutinize your subject line, get in-house feedback from a fresh set of eyes, and A/B test different subject lines before rolling out massive campaigns.
The first step is to make sure you are using some sort of subject line preview tool, like this one. Seeing your subject line visually helps you better-imagine how a recipient would react to it in their inbox.
Take special note of how the email looks on mobile devices since over half of email opens come via mobile. People tend to filter out what emails to read by the subject line alone. 69 percent of email recipients will report a message as spam based solely on the subject line.
Worst words to use include:
FREE
$$$
Earn
Guaranteed
Whitepaper, journal, report
Some of the best words include:
[Recipient Name]
You/Your
Thank you
Account
Monthly
Subject 1 | Subject 2 | Subject 3 (e.g. “Bid Bonds | Liability Insurance | Worker’s Comp”)
Note that not every “common marketing knowledge” pointer like this list may work for you and your audience. Always test to be sure!
Promise to Not Waste Their Time by Always Signaling Value
Thinking like a recipient means coming up with ways to offer something they might actually want. For sales and promotional offers, think of the hottest product they might want or the best offer possible. Don’t just tell them there’s a “sale”; tell them what that means.
Humble Bundle, which offers discount video game bundles, leads with its most popular game in the package.
When offering something non-material, like information, explain clearly how the contents of the email benefit the user. It could be something deep/important like “Want More 5 Star Reviews☆☆☆☆☆?” or even the promise that “You’ll Laugh Way Too Hard at These Marketing Puns”.
Many email marketers find great results by telling their audience how they can get more out of the products or services they already use.
The New York Times has gotten this down to an art. Since there is a million different pieces of content on their site other than what you see on the homepage, they take it upon themselves to inform subscribers about how they can learn and do more on NYTimes.com.
Get more from my subscription while spending less time? Sure, why not?
Use Powerful Images and Video to Get a Reaction
HTML-based email templates have transformed inboxes from a boring wall of text to a gorgeous place for showcasing compact content or well-designed advertisements.
Images are especially important for mobile since they make messages more colorful and intriguing as well as easier to read. Since 80 percent of email users are expected to access their inbox via mobile at least some of the time by 2018, thinking about their needs is vital.
Using human-centered images like this stock photo can invoke emotion and draw the eye to certain email sections.
Make sure you have text-only alternatives for image blockers, and try not to get too overboard with the images you use. Using images in a sloppy or unappealing way can sometimes hurt rather than help.
Using video embedded within email or as a link can likewise help you improve open rates and click-throughs. According to one source, just using the word “video” in a subject line can boost clickthroughs by 65 percent and opens by 19 percent.
Tell People What to Do with a Single Call to Action
This one is simple: every email should have a call to action (CTA).
Your CTA can be nearly anything, including:
Go buy this product
Take advantage of a limited-time offer
Try our tips
Go learn/read more at this page
Attend our event
Upgrade your current service package
Book a free consultation
Ensure that your CTA is crystal clear and compelling. Every recipient should know exactly what you want them to do and how to do it.
Providing a landing page after clicks to direct them more linearly to an offer can help simplify the process further. That way, your real CTA is just “Click Here,” and then you can drive more complex conversions from the landing page.
Avoid conflicting CTAs or multiple messages. No matter what you say, your ultimate conclusion leads the audience down ONE possible path. This practice will help your clickthroughs thrive.
Study Email Marketing Analytics Like You Have a Test Coming Up
Lots of email marketing strategies tend to work well across the board for a majority of industries, but there is no single set of hard-and-fast rules. Instead, every company has to study their own data in order to find what their audience seems to like/dislike about their emails.
Learn how to learn more from your email analytics, and use the lessons to optimize your approach over time. Trial-and-error is the only way to truly get better at something, and luckily email gives you plenty of lessons in the form of data.
Stick to Best Practices to Drive Success in Email Marketing
Mastering email marketing takes a lot of experimentation, practice, trial-and-error and attention to detail, but by following the best practices mentioned above, you can be well on your way towards greater success.
Just to recap your keys to success:
Use segmentation to maximize relevance
Personalize emails to get attention
Test subject lines, mind your length and think like a recipient
Promise true value to the recipient through your word choice and messaging
Use emotional images in your layout
Direct people to act with a single strong CTA
Use analytics data to optimize your approach over time
Pay attention to what your data tells you, and keep up with the latest email marketing trends and advice on our blog to learn best practices that make you an email genius over time!
For more information on how our Denver SEO agency can help you market you business effectively contact us today!
Article Source over here: 7 Ways to Increase the Effectiveness of Your Email Marketing
0 notes
kristinsimmons · 6 years
Text
The EBM Wars: Manufacturing Equipoise (Part 1)
By ANISH KOKA
The phone rings.  It’s not supposed to be ringing.  It’s 2 am.   The voice on the other line is from an apologetic surgery resident.
Resident: There is this patient..
Me: Yes, go ahead. Please.
Resident: He’s tachycardic.
Me: How fast?
Resident: 160 ?
Me: What’s the blood pressure?
Resident: 130/90
Me: Rhythm?
Resident: An SVT I think.. I gave adenosine.  Nothing happened
Me: Audibly groaning.  I’ll be in..
Forty five minutes later I’m at the bedside of a decidedly ill appearing man.
I want to be triumphant that his heart rate is only 145, and a quick glance at the telemetry monitor above his bed uncovers juicy p waves in a cadence that suggests this is no primary electrical arrhythmia.
Something is very wrong somewhere – the heart in this case is an innocent bystander being whipped into a frenzy to compensate for something.
At the moment the whip is a norepinephrine infusion being used to keep his blood pressure up.
I ask the nurse if the amount of norepinephrine infusing has been stable.  She replies that his dose has been slowly escalating.
Eureka! I think – the heart rate response in this case is being driven by the norepinephrine – a powerful adrenaline that acts on beta receptors and alpha receptors within the body that increase heart rate and constrict the blood vessels to raise blood pressure.  Fix the cause of the low blood pressure, come down on the norepinephrine, and perhaps the heart rate would be better.
But it turns out this particular post surgical patient doesn’t have a medical cause of low blood pressure I can find.  I cycle through cardiac ultrasounds, blood gases, steroid and volume challenges, and try inching down on the norepinephrine.
All of it is to no avail.  I’m growing more and more convinced this problem is surgical in nature. Perhaps an infarcted piece of bowel?  All I know is that the man acts like he has no peripheral vascular tone.
An interesting thing happens shortly after.  The norepinephrine drip runs out.
As one nurse runs to get another bag from the pharmacy – a quick cascade of events unfolds.
The brisk upstroke from the arterial line that marks the pressure wave generated with every beat of the heart starts to dampen.  The color seems to visibly drain from the patients face, and he begins to complain that his vision is getting blurry.  His systolic blood pressure is 70 – an almost forty point drop within a minute of the norepinephrine running out.
I call for help.
I try to keep a level tone.  Project control, not panic.
“Open the code cart, I need a half a milligram of epinephrine”
“You’re going to be ok, sir.  Hang with me.”  I squeeze his hand.
He closes his eyes
The code cart – a fully stocked cabinet on wheels with almost everything you need for resuscitation efforts – is wheeled into the room. The epinephrine vial is handed to the nurse, and hurriedly pushed.
Within seconds, I can see the blood pressure and heart rate rise.  The patient’s grip on my hand relaxes.  Or maybe its my grip on his hand.  I forget which.  His vision returns to normal as his blood pressure ‘normalizes’.
Of course nothing has been fixed.  Why his blood pressure remains low continues to be a mystery.  The bag of norepinephrine soon isn’t enough even at its maximal dose.  The same scenario (hypotension -> pallor -> vision loss ) recurs 30 minutes later, and another bolus of epinephrine aborts a rapid spiral towards pulselessness.
This case is an anecdote, the weakest possible form of evidence apparently.  Yet there are powerful lessons learned that night. Blood flows in pulsatile fashion with a certain pressure head.  Below some threshold of pressure, the end organs of the body stop functioning.  Agents that are active on peripheral vasoconstrictor receptors (norepinephrine, epinephrine) raise blood pressure.  Epinephrine was keeping this patient alive while a team worked to understand why his blood pressure was so low.  My suspicion was that he was in something called distributive shock – a catastrophic life threatening syndrome that requires a furious hunt for cause to save the patient.  Overwhelming infection and an even more aggressive immune response renders normally relatively impervious vasculature to be a sieve.  At the present time the therapy is directed towards replacing the fluid lost in the intravascular space and using medications that act on peripheral vascular receptors that increase peripheral tone.
There is, of course, much that isn’t known about this process.  Hopefully it will come to pass that we will arrive at a better understanding of what specifically creates this mileu so our therapies may be more directed.  But for the time being, our solutions are limited by our current, always imperfect understanding of the world.
The culprit in this case was a leak of intestinal contents into the peritoneal space from two pieces of bowel that should have been exactly apposed.  The body had attempted to tell us this very thing with that high heart rate post-operatively.  It took us, the clinicians, some time to translate.
The uninformed prior: Unlearning what has been learned.
For many, medicine has for too long been an imperfect science.  The history of medicine is replete with physicians acting with certainty in a manner that – in hindsight – was ineffective, or even worse – harmful.  Blood letting to allow the release of bad humors is believed to have hastened the demise of the greatest American – George Washington.  The disconcerting part of this is that the physician players were not motivated by anything but the best intentions.  They relied on their experience, intuition and judgement to deliver exactly the wrong prescription.   Intuition fails.  No matter how many patients died soon after blood letting, operating biases didn’t let physicians link the two events.  After all, the patients may have died even sooner if blood letting hadn’t been done.
The idea that medicine had progressed – by the 1980’s – to the point that doctors were not engaged in the equivalent of blood letting came under heavy fire when it was demonstrated a number of standard practices of the time could indeed be ineffective.  Extra beats (also known as ectopic heart beats) after heart attacks were noted in cardiac units to portend a higher risk of dying suddenly.  The obvious approach to this was to use medications that effectively suppressed ectopic heart beats.  Testing this in a double blind randomized control trial did not just demonstrate ineffectiveness, but harm.  More people randomized to suppression of ectopic beats actually died.  It turns out the anti-arrhythmic drugs being used were actually proarrhythmic as well.  The attack on ‘expertise’ that relied on intuition and experience was on, and it was a rout.
Glue ear – a condition that developed in the middle ears of little kids after ear infections  was treated with insertion of a tube to drain that space.  The trial to determine efficacy using a randomized trial to blindly allocate patients to surgery or no treatment?
Negative.
Many of the children turned out to do just fine if you left them alone.  Given the fact that all procedures have a certain complication rate, the lack of efficacy here was no small matter.
And so it went – the populace had to be on guard not just against the afflictions of disease, but against the intuitions of its doctors.
Uncertainty reigned, and in search of certainty, the field fled to the warm embrace of ever greater empiricism.  In the early ’80s from the McMaster University in Canada, David Sackett gave voice to a new sheriff – Evidence Based Medicine (EBM).
“EBM de-emphasizes intuition, unsystematic clinical expertise, and pathophysiologic rationale . . . and stresses the examination of evidence from clinical research. In 1960, the randomized trial was an oddity. It is now accepted that virtually no drug can enter clinical practice without a demonstration of its efficacy in clinical trials. Moreover the same randomized trial method is increasingly being applied to surgical therapies and diagnostic tests.” (Sackett et. al, Evidence Based Medicine)
The premise as outlined is simple – don’t believe anything that hasn’t been tested in a randomized control trial.  The only real evidence is that found within RCTs or in reviews that amalgamated RCTs.
The usual response from EBM experts can be found below in the response to the statement that real evidence may come from outside an RCT.
It is quite possible Professor Francis is right on here about the specific subject being discussed, but the point is that there is an established hierarchy of evidence on display.  The RCT is king, everything else is no better than the court jester.
While an RCT may certainly be better than anything cobbled together at a pub, the conventional parallel group RCT certainly isn’t always King of the Hill.   As nicely expounded on by the prolific statistician Stephen Senn, there are plenty of potential errors the conventional RCT finds itself humbled by.
The clinician may thus feel somewhat mollified about conclusions drawn about the effect of epinephrine in the earlier anecdote.
The idea that real evidence may live outside the confines of RCTs was also countered by none other than the godfather of EBM, David Sackett:
“Evidence based medicine is not restricted to randomized trials and meta-analyses. It involves tracking down the best external evidence with which to answer our clinical questions. To find out about the accuracy of a diagnostic test, we need to find proper cross sectional studies of patients clinically suspected of harboring the relevant disorder, not a randomized trial. For a question about prognosis, we need proper follow up studies of patients assembled at a uniform, early point in the clinical course of their disease. And sometimes the evidence we need will come from the basic sciences such as genetics or immunology. It is when asking questions about therapy that we should try to avoid the non-experimental approaches, since these routinely lead to false positive conclusions about efficacy. Because the randomized trial, and especially the systematic review of several randomized trials, is so much more likely to inform us and so much less likely to mislead us, it has become the “gold standard” for judging whether a treatment does more good than harm. However,some questions about therapy do not require randomized trials (successful interventions for otherwise fatal conditions) or cannot wait for the trials to be conducted. And if no randomized trial has been carried out for our patient’s predicament, we must follow the trail to the next best external evidence and work from there. (Sacket et al, Evidence based medicine: what it is.. )”
Sackett also noted that there were therapies whose ” ‘face validity’ is so great that randomized trials were unanimously judged by the team to be both unnecessary, and, if a placebo would have been involved, unethical”.
In effect, there was always an escape clause to let common sense prevail over EBM.  But as frequently happens in movements, the second generation of followers moves in directions unintended by the founders.  If the safeguards in place involve only areas where equipoise exists, but equipoise is itself determined by fallible judgement, the range of unacceptable experiments becomes very narrow.  This especially applies to new therapies where members of the community not involved in design and development have skeptical prior beliefs.  This is, of course, not a bad thing – it is entirely possible that the usually overoptimistic prior of the developers of a new therapy are farther from the truth than the skeptics.  But it is a major problem if we ask doctors to discard their prior beliefs that are not based in RCTs.  In doing so, we are manufacturing equipoise.  This means travel in dangerous ethical waters for physicians and their patients that is at best unwise, and at worst willfully foolish.
The EBM Wars: Manufacturing Equipoise (Part 1) published first on https://wittooth.tumblr.com/
0 notes
kristinsimmons · 6 years
Text
The EBM Wars: Manufacturing Equipoise (Part 1)
By ANISH KOKA
The phone rings.  It’s not supposed to be ringing.  It’s 2 am.   The voice on the other line is from an apologetic surgery resident.
Resident: There is this patient..
Me: Yes, go ahead. Please.
Resident: He’s tachycardic.
Me: How fast?
Resident: 160 ?
Me: What’s the blood pressure?
Resident: 130/90
Me: Rhythm?
Resident: An SVT I think.. I gave adenosine.  Nothing happened
Me: Audibly groaning.  I’ll be in..
Forty five minutes later I’m at the bedside of a decidedly ill appearing man.
I want to be triumphant that his heart rate is only 145, and a quick glance at the telemetry monitor above his bed uncovers juicy p waves in a cadence that suggests this is no primary electrical arrhythmia.
Something is very wrong somewhere – the heart in this case is an innocent bystander being whipped into a frenzy to compensate for something.
At the moment the whip is a norepinephrine infusion being used to keep his blood pressure up.
I ask the nurse if the amount of norepinephrine infusing has been stable.  She replies that his dose has been slowly escalating.
Eureka! I think – the heart rate response in this case is being driven by the norepinephrine – a powerful adrenaline that acts on beta receptors and alpha receptors within the body that increase heart rate and constrict the blood vessels to raise blood pressure.  Fix the cause of the low blood pressure, come down on the norepinephrine, and perhaps the heart rate would be better.
But it turns out this particular post surgical patient doesn’t have a medical cause of low blood pressure I can find.  I cycle through cardiac ultrasounds, blood gases, steroid and volume challenges, and try inching down on the norepinephrine.
All of it is to no avail.  I’m growing more and more convinced this problem is surgical in nature. Perhaps an infarcted piece of bowel?  All I know is that the man acts like he has no peripheral vascular tone.
An interesting thing happens shortly after.  The norepinephrine drip runs out.
As one nurse runs to get another bag from the pharmacy – a quick cascade of events unfolds.
The brisk upstroke from the arterial line that marks the pressure wave generated with every beat of the heart starts to dampen.  The color seems to visibly drain from the patients face, and he begins to complain that his vision is getting blurry.  His systolic blood pressure is 70 – an almost forty point drop within a minute of the norepinephrine running out.
I call for help.
I try to keep a level tone.  Project control, not panic.
“Open the code cart, I need a half a milligram of epinephrine”
“You’re going to be ok, sir.  Hang with me.”  I squeeze his hand.
He closes his eyes
The code cart – a fully stocked cabinet on wheels with almost everything you need for resuscitation efforts – is wheeled into the room. The epinephrine vial is handed to the nurse, and hurriedly pushed.
Within seconds, I can see the blood pressure and heart rate rise.  The patient’s grip on my hand relaxes.  Or maybe its my grip on his hand.  I forget which.  His vision returns to normal as his blood pressure ‘normalizes’.
Of course nothing has been fixed.  Why his blood pressure remains low continues to be a mystery.  The bag of norepinephrine soon isn’t enough even at its maximal dose.  The same scenario (hypotension -> pallor -> vision loss ) recurs 30 minutes later, and another bolus of epinephrine aborts a rapid spiral towards pulselessness.
This case is an anecdote, the weakest possible form of evidence apparently.  Yet there are powerful lessons learned that night. Blood flows in pulsatile fashion with a certain pressure head.  Below some threshold of pressure, the end organs of the body stop functioning.  Agents that are active on peripheral vasoconstrictor receptors (norepinephrine, epinephrine) raise blood pressure.  Epinephrine was keeping this patient alive while a team worked to understand why his blood pressure was so low.  My suspicion was that he was in something called distributive shock – a catastrophic life threatening syndrome that requires a furious hunt for cause to save the patient.  Overwhelming infection and an even more aggressive immune response renders normally relatively impervious vasculature to be a sieve.  At the present time the therapy is directed towards replacing the fluid lost in the intravascular space and using medications that act on peripheral vascular receptors that increase peripheral tone.
There is, of course, much that isn’t known about this process.  Hopefully it will come to pass that we will arrive at a better understanding of what specifically creates this mileu so our therapies may be more directed.  But for the time being, our solutions are limited by our current, always imperfect understanding of the world.
The culprit in this case was a leak of intestinal contents into the peritoneal space from two pieces of bowel that should have been exactly apposed.  The body had attempted to tell us this very thing with that high heart rate post-operatively.  It took us, the clinicians, some time to translate.
The uninformed prior: Unlearning what has been learned.
For many, medicine has for too long been an imperfect science.  The history of medicine is replete with physicians acting with certainty in a manner that – in hindsight – was ineffective, or even worse – harmful.  Blood letting to allow the release of bad humors is believed to have hastened the demise of the greatest American – George Washington.  The disconcerting part of this is that the physician players were not motivated by anything but the best intentions.  They relied on their experience, intuition and judgement to deliver exactly the wrong prescription.   Intuition fails.  No matter how many patients died soon after blood letting, operating biases didn’t let physicians link the two events.  After all, the patients may have died even sooner if blood letting hadn’t been done.
The idea that medicine had progressed – by the 1980’s – to the point that doctors were not engaged in the equivalent of blood letting came under heavy fire when it was demonstrated a number of standard practices of the time could indeed be ineffective.  Extra beats (also known as ectopic heart beats) after heart attacks were noted in cardiac units to portend a higher risk of dying suddenly.  The obvious approach to this was to use medications that effectively suppressed ectopic heart beats.  Testing this in a double blind randomized control trial did not just demonstrate ineffectiveness, but harm.  More people randomized to suppression of ectopic beats actually died.  It turns out the anti-arrhythmic drugs being used were actually proarrhythmic as well.  The attack on ‘expertise’ that relied on intuition and experience was on, and it was a rout.
Glue ear – a condition that developed in the middle ears of little kids after ear infections  was treated with insertion of a tube to drain that space.  The trial to determine efficacy using a randomized trial to blindly allocate patients to surgery or no treatment?
Negative.
Many of the children turned out to do just fine if you left them alone.  Given the fact that all procedures have a certain complication rate, the lack of efficacy here was no small matter.
And so it went – the populace had to be on guard not just against the afflictions of disease, but against the intuitions of its doctors.
Uncertainty reigned, and in search of certainty, the field fled to the warm embrace of ever greater empiricism.  In the early ’80s from the McMaster University in Canada, David Sackett gave voice to a new sheriff – Evidence Based Medicine (EBM).
“EBM de-emphasizes intuition, unsystematic clinical expertise, and pathophysiologic rationale . . . and stresses the examination of evidence from clinical research. In 1960, the randomized trial was an oddity. It is now accepted that virtually no drug can enter clinical practice without a demonstration of its efficacy in clinical trials. Moreover the same randomized trial method is increasingly being applied to surgical therapies and diagnostic tests.” (Sackett et. al, Evidence Based Medicine)
The premise as outlined is simple – don’t believe anything that hasn’t been tested in a randomized control trial.  The only real evidence is that found within RCTs or in reviews that amalgamated RCTs.
The usual response from EBM experts can be found below in the response to the statement that real evidence may come from outside an RCT.
It is quite possible Professor Francis is right on here about the specific subject being discussed, but the point is that there is an established hierarchy of evidence on display.  The RCT is king, everything else is no better than the court jester.
While an RCT may certainly be better than anything cobbled together at a pub, the conventional parallel group RCT certainly isn’t always King of the Hill.   As nicely expounded on by the prolific statistician Stephen Senn, there are plenty of potential errors the conventional RCT finds itself humbled by.
The clinician may thus feel somewhat mollified about conclusions drawn about the effect of epinephrine in the earlier anecdote.
The idea that real evidence may live outside the confines of RCTs was also countered by none other than the godfather of EBM, David Sackett:
“Evidence based medicine is not restricted to randomized trials and meta-analyses. It involves tracking down the best external evidence with which to answer our clinical questions. To find out about the accuracy of a diagnostic test, we need to find proper cross sectional studies of patients clinically suspected of harboring the relevant disorder, not a randomized trial. For a question about prognosis, we need proper follow up studies of patients assembled at a uniform, early point in the clinical course of their disease. And sometimes the evidence we need will come from the basic sciences such as genetics or immunology. It is when asking questions about therapy that we should try to avoid the non-experimental approaches, since these routinely lead to false positive conclusions about efficacy. Because the randomized trial, and especially the systematic review of several randomized trials, is so much more likely to inform us and so much less likely to mislead us, it has become the “gold standard” for judging whether a treatment does more good than harm. However,some questions about therapy do not require randomized trials (successful interventions for otherwise fatal conditions) or cannot wait for the trials to be conducted. And if no randomized trial has been carried out for our patient’s predicament, we must follow the trail to the next best external evidence and work from there. (Sacket et al, Evidence based medicine: what it is.. )”
Sackett also noted that there were therapies whose ” ‘face validity’ is so great that randomized trials were unanimously judged by the team to be both unnecessary, and, if a placebo would have been involved, unethical”.
In effect, there was always an escape clause to let common sense prevail over EBM.  But as frequently happens in movements, the second generation of followers moves in directions unintended by the founders.  If the safeguards in place involve only areas where equipoise exists, but equipoise is itself determined by fallible judgement, the range of unacceptable experiments becomes very narrow.  This especially applies to new therapies where members of the community not involved in design and development have skeptical prior beliefs.  This is, of course, not a bad thing – it is entirely possible that the usually overoptimistic prior of the developers of a new therapy are farther from the truth than the skeptics.  But it is a major problem if we ask doctors to discard their prior beliefs that are not based in RCTs.  In doing so, we are manufacturing equipoise.  This means travel in dangerous ethical waters for physicians and their patients that is at best unwise, and at worst willfully foolish.
The EBM Wars: Manufacturing Equipoise (Part 1) published first on https://wittooth.tumblr.com/
0 notes
kristinsimmons · 6 years
Text
The EBM Wars: Manufacturing Equipoise (Part 1)
By ANISH KOKA
The phone rings.  It’s not supposed to be ringing.  It’s 2 am.   The voice on the other line is from an apologetic surgery resident.
Resident: There is this patient..
Me: Yes, go ahead. Please.
Resident: He’s tachycardic.
Me: How fast?
Resident: 160 ?
Me: What’s the blood pressure?
Resident: 130/90
Me: Rhythm?
Resident: An SVT I think.. I gave adenosine.  Nothing happened
Me: Audibly groaning.  I’ll be in..
Forty five minutes later I’m at the bedside of a decidedly ill appearing man.
I want to be triumphant that his heart rate is only 145, and a quick glance at the telemetry monitor above his bed uncovers juicy p waves in a cadence that suggests this is no primary electrical arrhythmia.
Something is very wrong somewhere – the heart in this case is an innocent bystander being whipped into a frenzy to compensate for something.
At the moment the whip is a norepinephrine infusion being used to keep his blood pressure up.
I ask the nurse if the amount of norepinephrine infusing has been stable.  She replies that his dose has been slowly escalating.
Eureka! I think – the heart rate response in this case is being driven by the norepinephrine – a powerful adrenaline that acts on beta receptors and alpha receptors within the body that increase heart rate and constrict the blood vessels to raise blood pressure.  Fix the cause of the low blood pressure, come down on the norepinephrine, and perhaps the heart rate would be better.
But it turns out this particular post surgical patient doesn’t have a medical cause of low blood pressure I can find.  I cycle through cardiac ultrasounds, blood gases, steroid and volume challenges, and try inching down on the norepinephrine.
All of it is to no avail.  I’m growing more and more convinced this problem is surgical in nature. Perhaps an infarcted piece of bowel?  All I know is that the man acts like he has no peripheral vascular tone.
An interesting thing happens shortly after.  The norepinephrine drip runs out.
As one nurse runs to get another bag from the pharmacy – a quick cascade of events unfolds.
The brisk upstroke from the arterial line that marks the pressure wave generated with every beat of the heart starts to dampen.  The color seems to visibly drain from the patients face, and he begins to complain that his vision is getting blurry.  His systolic blood pressure is 70 – an almost forty point drop within a minute of the norepinephrine running out.
I call for help.
I try to keep a level tone.  Project control, not panic.
“Open the code cart, I need a half a milligram of epinephrine”
“You’re going to be ok, sir.  Hang with me.”  I squeeze his hand.
He closes his eyes
The code cart – a fully stocked cabinet on wheels with almost everything you need for resuscitation efforts – is wheeled into the room. The epinephrine vial is handed to the nurse, and hurriedly pushed.
Within seconds, I can see the blood pressure and heart rate rise.  The patient’s grip on my hand relaxes.  Or maybe its my grip on his hand.  I forget which.  His vision returns to normal as his blood pressure ‘normalizes’.
Of course nothing has been fixed.  Why his blood pressure remains low continues to be a mystery.  The bag of norepinephrine soon isn’t enough even at its maximal dose.  The same scenario (hypotension -> pallor -> vision loss ) recurs 30 minutes later, and another bolus of epinephrine aborts a rapid spiral towards pulselessness.
This case is an anecdote, the weakest possible form of evidence apparently.  Yet there are powerful lessons learned that night. Blood flows in pulsatile fashion with a certain pressure head.  Below some threshold of pressure, the end organs of the body stop functioning.  Agents that are active on peripheral vasoconstrictor receptors (norepinephrine, epinephrine) raise blood pressure.  Epinephrine was keeping this patient alive while a team worked to understand why his blood pressure was so low.  My suspicion was that he was in something called distributive shock – a catastrophic life threatening syndrome that requires a furious hunt for cause to save the patient.  Overwhelming infection and an even more aggressive immune response renders normally relatively impervious vasculature to be a sieve.  At the present time the therapy is directed towards replacing the fluid lost in the intravascular space and using medications that act on peripheral vascular receptors that increase peripheral tone.
There is, of course, much that isn’t known about this process.  Hopefully it will come to pass that we will arrive at a better understanding of what specifically creates this mileu so our therapies may be more directed.  But for the time being, our solutions are limited by our current, always imperfect understanding of the world.
The culprit in this case was a leak of intestinal contents into the peritoneal space from two pieces of bowel that should have been exactly apposed.  The body had attempted to tell us this very thing with that high heart rate post-operatively.  It took us, the clinicians, some time to translate.
The uninformed prior: Unlearning what has been learned.
For many, medicine has for too long been an imperfect science.  The history of medicine is replete with physicians acting with certainty in a manner that – in hindsight – was ineffective, or even worse – harmful.  Blood letting to allow the release of bad humors is believed to have hastened the demise of the greatest American – George Washington.  The disconcerting part of this is that the physician players were not motivated by anything but the best intentions.  They relied on their experience, intuition and judgement to deliver exactly the wrong prescription.   Intuition fails.  No matter how many patients died soon after blood letting, operating biases didn’t let physicians link the two events.  After all, the patients may have died even sooner if blood letting hadn’t been done.
The idea that medicine had progressed – by the 1980’s – to the point that doctors were not engaged in the equivalent of blood letting came under heavy fire when it was demonstrated a number of standard practices of the time could indeed be ineffective.  Extra beats (also known as ectopic heart beats) after heart attacks were noted in cardiac units to portend a higher risk of dying suddenly.  The obvious approach to this was to use medications that effectively suppressed ectopic heart beats.  Testing this in a double blind randomized control trial did not just demonstrate ineffectiveness, but harm.  More people randomized to suppression of ectopic beats actually died.  It turns out the anti-arrhythmic drugs being used were actually proarrhythmic as well.  The attack on ‘expertise’ that relied on intuition and experience was on, and it was a rout.
Glue ear – a condition that developed in the middle ears of little kids after ear infections  was treated with insertion of a tube to drain that space.  The trial to determine efficacy using a randomized trial to blindly allocate patients to surgery or no treatment?
Negative.
Many of the children turned out to do just fine if you left them alone.  Given the fact that all procedures have a certain complication rate, the lack of efficacy here was no small matter.
And so it went – the populace had to be on guard not just against the afflictions of disease, but against the intuitions of its doctors.
Uncertainty reigned, and in search of certainty, the field fled to the warm embrace of ever greater empiricism.  In the early ’80s from the McMaster University in Canada, David Sackett gave voice to a new sheriff – Evidence Based Medicine (EBM).
“EBM de-emphasizes intuition, unsystematic clinical expertise, and pathophysiologic rationale . . . and stresses the examination of evidence from clinical research. In 1960, the randomized trial was an oddity. It is now accepted that virtually no drug can enter clinical practice without a demonstration of its efficacy in clinical trials. Moreover the same randomized trial method is increasingly being applied to surgical therapies and diagnostic tests.” (Sackett et. al, Evidence Based Medicine)
The premise as outlined is simple – don’t believe anything that hasn’t been tested in a randomized control trial.  The only real evidence is that found within RCTs or in reviews that amalgamated RCTs.
The usual response from EBM experts can be found below in the response to the statement that real evidence may come from outside an RCT.
It is quite possible Professor Francis is right on here about the specific subject being discussed, but the point is that there is an established hierarchy of evidence on display.  The RCT is king, everything else is no better than the court jester.
While an RCT may certainly be better than anything cobbled together at a pub, the conventional parallel group RCT certainly isn’t always King of the Hill.   As nicely expounded on by the prolific statistician Stephen Senn, there are plenty of potential errors the conventional RCT finds itself humbled by.
The clinician may thus feel somewhat mollified about conclusions drawn about the effect of epinephrine in the earlier anecdote.
The idea that real evidence may live outside the confines of RCTs was also countered by none other than the godfather of EBM, David Sackett:
“Evidence based medicine is not restricted to randomized trials and meta-analyses. It involves tracking down the best external evidence with which to answer our clinical questions. To find out about the accuracy of a diagnostic test, we need to find proper cross sectional studies of patients clinically suspected of harboring the relevant disorder, not a randomized trial. For a question about prognosis, we need proper follow up studies of patients assembled at a uniform, early point in the clinical course of their disease. And sometimes the evidence we need will come from the basic sciences such as genetics or immunology. It is when asking questions about therapy that we should try to avoid the non-experimental approaches, since these routinely lead to false positive conclusions about efficacy. Because the randomized trial, and especially the systematic review of several randomized trials, is so much more likely to inform us and so much less likely to mislead us, it has become the “gold standard” for judging whether a treatment does more good than harm. However,some questions about therapy do not require randomized trials (successful interventions for otherwise fatal conditions) or cannot wait for the trials to be conducted. And if no randomized trial has been carried out for our patient’s predicament, we must follow the trail to the next best external evidence and work from there. (Sacket et al, Evidence based medicine: what it is.. )”
Sackett also noted that there were therapies whose ” ‘face validity’ is so great that randomized trials were unanimously judged by the team to be both unnecessary, and, if a placebo would have been involved, unethical”.
In effect, there was always an escape clause to let common sense prevail over EBM.  But as frequently happens in movements, the second generation of followers moves in directions unintended by the founders.  If the safeguards in place involve only areas where equipoise exists, but equipoise is itself determined by fallible judgement, the range of unacceptable experiments becomes very narrow.  This especially applies to new therapies where members of the community not involved in design and development have skeptical prior beliefs.  This is, of course, not a bad thing – it is entirely possible that the usually overoptimistic prior of the developers of a new therapy are farther from the truth than the skeptics.  But it is a major problem if we ask doctors to discard their prior beliefs that are not based in RCTs.  In doing so, we are manufacturing equipoise.  This means travel in dangerous ethical waters for physicians and their patients that is at best unwise, and at worst willfully foolish.
The EBM Wars: Manufacturing Equipoise (Part 1) published first on https://wittooth.tumblr.com/
0 notes
kristinsimmons · 6 years
Text
The EBM Wars: Manufacturing Equipoise (Part 1)
By ANISH KOKA
The phone rings.  It’s not supposed to be ringing.  It’s 2 am.   The voice on the other line is from an apologetic surgery resident.
Resident: There is this patient..
Me: Yes, go ahead. Please.
Resident: He’s tachycardic.
Me: How fast?
Resident: 160 ?
Me: What’s the blood pressure?
Resident: 130/90
Me: Rhythm?
Resident: An SVT I think.. I gave adenosine.  Nothing happened
Me: Audibly groaning.  I’ll be in..
Forty five minutes later I’m at the bedside of a decidedly ill appearing man.
I want to be triumphant that his heart rate is only 145, and a quick glance at the telemetry monitor above his bed uncovers juicy p waves in a cadence that suggests this is no primary electrical arrhythmia.
Something is very wrong somewhere – the heart in this case is an innocent bystander being whipped into a frenzy to compensate for something.
At the moment the whip is a norepinephrine infusion being used to keep his blood pressure up.
I ask the nurse if the amount of norepinephrine infusing has been stable.  She replies that his dose has been slowly escalating.
Eureka! I think – the heart rate response in this case is being driven by the norepinephrine – a powerful adrenaline that acts on beta receptors and alpha receptors within the body that increase heart rate and constrict the blood vessels to raise blood pressure.  Fix the cause of the low blood pressure, come down on the norepinephrine, and perhaps the heart rate would be better.
But it turns out this particular post surgical patient doesn’t have a medical cause of low blood pressure I can find.  I cycle through cardiac ultrasounds, blood gases, steroid and volume challenges, and try inching down on the norepinephrine.
All of it is to no avail.  I’m growing more and more convinced this problem is surgical in nature. Perhaps an infarcted piece of bowel?  All I know is that the man acts like he has no peripheral vascular tone.
An interesting thing happens shortly after.  The norepinephrine drip runs out.
As one nurse runs to get another bag from the pharmacy – a quick cascade of events unfolds.
The brisk upstroke from the arterial line that marks the pressure wave generated with every beat of the heart starts to dampen.  The color seems to visibly drain from the patients face, and he begins to complain that his vision is getting blurry.  His systolic blood pressure is 70 – an almost forty point drop within a minute of the norepinephrine running out.
I call for help.
I try to keep a level tone.  Project control, not panic.
“Open the code cart, I need a half a milligram of epinephrine”
“You’re going to be ok, sir.  Hang with me.”  I squeeze his hand.
He closes his eyes
The code cart – a fully stocked cabinet on wheels with almost everything you need for resuscitation efforts – is wheeled into the room. The epinephrine vial is handed to the nurse, and hurriedly pushed.
Within seconds, I can see the blood pressure and heart rate rise.  The patient’s grip on my hand relaxes.  Or maybe its my grip on his hand.  I forget which.  His vision returns to normal as his blood pressure ‘normalizes’.
Of course nothing has been fixed.  Why his blood pressure remains low continues to be a mystery.  The bag of norepinephrine soon isn’t enough even at its maximal dose.  The same scenario (hypotension -> pallor -> vision loss ) recurs 30 minutes later, and another bolus of epinephrine aborts a rapid spiral towards pulselessness.
This case is an anecdote, the weakest possible form of evidence apparently.  Yet there are powerful lessons learned that night. Blood flows in pulsatile fashion with a certain pressure head.  Below some threshold of pressure, the end organs of the body stop functioning.  Agents that are active on peripheral vasoconstrictor receptors (norepinephrine, epinephrine) raise blood pressure.  Epinephrine was keeping this patient alive while a team worked to understand why his blood pressure was so low.  My suspicion was that he was in something called distributive shock – a catastrophic life threatening syndrome that requires a furious hunt for cause to save the patient.  Overwhelming infection and an even more aggressive immune response renders normally relatively impervious vasculature to be a sieve.  At the present time the therapy is directed towards replacing the fluid lost in the intravascular space and using medications that act on peripheral vascular receptors that increase peripheral tone.
There is, of course, much that isn’t known about this process.  Hopefully it will come to pass that we will arrive at a better understanding of what specifically creates this mileu so our therapies may be more directed.  But for the time being, our solutions are limited by our current, always imperfect understanding of the world.
The culprit in this case was a leak of intestinal contents into the peritoneal space from two pieces of bowel that should have been exactly apposed.  The body had attempted to tell us this very thing with that high heart rate post-operatively.  It took us, the clinicians, some time to translate.
The uninformed prior: Unlearning what has been learned.
For many, medicine has for too long been an imperfect science.  The history of medicine is replete with physicians acting with certainty in a manner that – in hindsight – was ineffective, or even worse – harmful.  Blood letting to allow the release of bad humors is believed to have hastened the demise of the greatest American – George Washington.  The disconcerting part of this is that the physician players were not motivated by anything but the best intentions.  They relied on their experience, intuition and judgement to deliver exactly the wrong prescription.   Intuition fails.  No matter how many patients died soon after blood letting, operating biases didn’t let physicians link the two events.  After all, the patients may have died even sooner if blood letting hadn’t been done.
The idea that medicine had progressed – by the 1980’s – to the point that doctors were not engaged in the equivalent of blood letting came under heavy fire when it was demonstrated a number of standard practices of the time could indeed be ineffective.  Extra beats (also known as ectopic heart beats) after heart attacks were noted in cardiac units to portend a higher risk of dying suddenly.  The obvious approach to this was to use medications that effectively suppressed ectopic heart beats.  Testing this in a double blind randomized control trial did not just demonstrate ineffectiveness, but harm.  More people randomized to suppression of ectopic beats actually died.  It turns out the anti-arrhythmic drugs being used were actually proarrhythmic as well.  The attack on ‘expertise’ that relied on intuition and experience was on, and it was a rout.
Glue ear – a condition that developed in the middle ears of little kids after ear infections  was treated with insertion of a tube to drain that space.  The trial to determine efficacy using a randomized trial to blindly allocate patients to surgery or no treatment?
Negative.
Many of the children turned out to do just fine if you left them alone.  Given the fact that all procedures have a certain complication rate, the lack of efficacy here was no small matter.
And so it went – the populace had to be on guard not just against the afflictions of disease, but against the intuitions of its doctors.
Uncertainty reigned, and in search of certainty, the field fled to the warm embrace of ever greater empiricism.  In the early ’80s from the McMaster University in Canada, David Sackett gave voice to a new sheriff – Evidence Based Medicine (EBM).
“EBM de-emphasizes intuition, unsystematic clinical expertise, and pathophysiologic rationale . . . and stresses the examination of evidence from clinical research. In 1960, the randomized trial was an oddity. It is now accepted that virtually no drug can enter clinical practice without a demonstration of its efficacy in clinical trials. Moreover the same randomized trial method is increasingly being applied to surgical therapies and diagnostic tests.” (Sackett et. al, Evidence Based Medicine)
The premise as outlined is simple – don’t believe anything that hasn’t been tested in a randomized control trial.  The only real evidence is that found within RCTs or in reviews that amalgamated RCTs.
The usual response from EBM experts can be found below in the response to the statement that real evidence may come from outside an RCT.
It is quite possible Professor Francis is right on here about the specific subject being discussed, but the point is that there is an established hierarchy of evidence on display.  The RCT is king, everything else is no better than the court jester.
While an RCT may certainly be better than anything cobbled together at a pub, the conventional parallel group RCT certainly isn’t always King of the Hill.   As nicely expounded on by the prolific statistician Stephen Senn, there are plenty of potential errors the conventional RCT finds itself humbled by.
The clinician may thus feel somewhat mollified about conclusions drawn about the effect of epinephrine in the earlier anecdote.
The idea that real evidence may live outside the confines of RCTs was also countered by none other than the godfather of EBM, David Sackett:
“Evidence based medicine is not restricted to randomized trials and meta-analyses. It involves tracking down the best external evidence with which to answer our clinical questions. To find out about the accuracy of a diagnostic test, we need to find proper cross sectional studies of patients clinically suspected of harboring the relevant disorder, not a randomized trial. For a question about prognosis, we need proper follow up studies of patients assembled at a uniform, early point in the clinical course of their disease. And sometimes the evidence we need will come from the basic sciences such as genetics or immunology. It is when asking questions about therapy that we should try to avoid the non-experimental approaches, since these routinely lead to false positive conclusions about efficacy. Because the randomized trial, and especially the systematic review of several randomized trials, is so much more likely to inform us and so much less likely to mislead us, it has become the “gold standard” for judging whether a treatment does more good than harm. However,some questions about therapy do not require randomized trials (successful interventions for otherwise fatal conditions) or cannot wait for the trials to be conducted. And if no randomized trial has been carried out for our patient’s predicament, we must follow the trail to the next best external evidence and work from there. (Sacket et al, Evidence based medicine: what it is.. )”
Sackett also noted that there were therapies whose ” ‘face validity’ is so great that randomized trials were unanimously judged by the team to be both unnecessary, and, if a placebo would have been involved, unethical”.
In effect, there was always an escape clause to let common sense prevail over EBM.  But as frequently happens in movements, the second generation of followers moves in directions unintended by the founders.  If the safeguards in place involve only areas where equipoise exists, but equipoise is itself determined by fallible judgement, the range of unacceptable experiments becomes very narrow.  This especially applies to new therapies where members of the community not involved in design and development have skeptical prior beliefs.  This is, of course, not a bad thing – it is entirely possible that the usually overoptimistic prior of the developers of a new therapy are farther from the truth than the skeptics.  But it is a major problem if we ask doctors to discard their prior beliefs that are not based in RCTs.  In doing so, we are manufacturing equipoise.  This means travel in dangerous ethical waters for physicians and their patients that is at best unwise, and at worst willfully foolish.
The EBM Wars: Manufacturing Equipoise (Part 1) published first on https://wittooth.tumblr.com/
0 notes