A really random thread (because I haven't written enough fiction today and still have words in me) about why working on a burn unit rocks and it's the best place in the hospital. Follow if interested.

First off, everyone thinks it's gory and horrible and you can do it and shit smells but fuck all that.

The true magic of the burn unit is this -- demographically, the ppl who get burned are most likely to survive.

It's pretty much all dumb 16-25 yr old boys doing dumb shit, and pedi patients with scalds.

Yes, there are sad outliers, etc, BUT...by in large people admitted into burn units for care survive.

& the ones that don't -- we generally know they're not gonna make it ASAP. There's a nifty formula of age vs % burn injury = survivability that lets us look at someone's injured grandma and say, "Let's have hard talks right now." and cuts out a ton of the wavering.

A Ton.

Your patients are generally there for awhile, a few days to few months, & you really get to know them, their families, and you really get to see them get better, live time, as their skin heals. You get to feel like part of their little hospital family, there's nicknames, etc.

You get the time and the space to really dial care in...and then when you're giving care, doing massive dressing changes with your coworkers...it's like an Amish barn raising or a ballet.

Everyone knows what needs doing simultaneously.

Doing a dressing change on an 80% burn is a thing of beauty, of coordination, expectations, just flat out getting shit done...it's so satisfying. SO SATISFYING.

Other job perks include.

Picking at scabs. (Shut up. This is fun. And you don't pull the ones that won't come mostly.)

Taking out staples.

Everyone on the floor standing and cheering when someone gets out of bed to walk the floor successfully.

it's just so nice to get the chance to know someone. You roll in there with their pain meds, and they know you, and you've got a routine, and they feel safe, and you do a good job, and then because you're both awesome their skin heals and things are good.

I don't get to do that anymore on the ICU, rarely if ever can I talk to my patients, and now for like half of my ICU career, we haven't even had visitors.

Skin's like such a nice easy metric too, to see people getting better with...it's not tricky like lungs or cardiac or neuro. You can have a different assignment for a week then come back & ooh & ahh, because they really have progressed, that you don't get on any other floor.

Sure, every once in awhile you'd see something tragic, or you'd have a patient on the cusp and their families wouldn't let go, but by and large you got to make positive change in the lives of people who were going to survive.

Anyhow, I miss the shit out of that job and that place and those people, and if I my body could hack that commute again (and the work itself, which is backbreaking) I'd be back there in a heartbeat.

You don't mind the gore and the smells and the sweat and the labor and the occasionally very sad stories as long as people survive.

If you can make 'em better, all that other shit's worthwhile.

Oh and also, your skin counts as an organ -- you should definitely let ppl harvest it after you're dead (they do so in places that won't show if you've got a funeral) -- but it makes a huge difference in the ability of burned people to heal.

A patient's own skin is a precious resource, and sometimes they may not have enough to go around--but if we can cut off the dead tissue and put some donor skin on there...

that can really, really help.

Your skin's regenerative layer is the dermis, and you can really only harvest it twice. So if you're 60% burned, and you only have 40% skin left (but some of that's scalp, elbows, fingers, etc) that's a lot of space to fill w/out much tissue

But if we can put donor skin over injured areas until we're sure that they're ready to accept the patient's skin -- or if we can mesh out the patient's skin and put donor skin on top to kinda help net everything together -- huge difference. Huge.

A lot of times ppl thing, 'oh, i'm too old to donate anything' once you're like 70+, but they can still take your skin from you, and we'll put it to good (albeit temporary -- but very good!) use.

18/18 done...for now, lol.

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More from @CassieY4

14 Sep
okay, after my tweet last night, turns out y'all are into the gross stuff, apparently especially scrotal related gross stuff, so here goes -- I won't post any pictures, what y'all google is on y'alls souls.

Fournier's gangrene is a nec fasc that effects genitalia...

Nec fasc = necrotizing fasciitis = flesh eating bacteria.

Like those things you read sometimes -- "she jumped in the lake, and went to sleep, and when she woke up we'd had to amuputate three limbs"

only this time on men's junk.

I don't really know why it sometimes happens there, people say 'oh, they're unclean' or whatever, but honestly, the incidences I've seen of it seem to be usually attributable to 1) bad luck and 2) a general desire not to go into the hospital have have ppl inspect your stuff

Read 14 tweets
13 Sep
A meta-thing in this week's What we Do in the Shadows, is them playing MUSE during the 'Twilight' kickball part, bc Stephanie Meyer is a huge MUSE fan and each of her movies got their own brand new MUSE song.

Also, that show continues to be the only good thing in this timeline.
This is the only level of fame that I aspire to, really.

Pay off my house, not have to work again, fine, but to be in a sitch where someone is, "Oh yes, to accommodate you, we'll pay Matt Goddamned Bellamy to write a song specifically for your proj."

I'd die and go to heaven.
A random thing about me, is when we did EMDR therapy for my PTSD, my therapist wanted me to come up with 3-4 deep veins of good memories to balance out the tragic covid work ones, and one of my good ones was going to @muse shows.
Read 4 tweets
13 Sep
This is the most followers I've ever gotten in a day.

I'm getting the irrational urge to say something stupid or do something dorky to scare you new people off.
I think the thing that I'm feeling here now is the awkwardness of this being a semi-professional and branded/ing 'author' space for me...but also where I whine about why the fuck hasn't Neelix died yet, I've been watching Voyager for 7 effing seasons, WHY.
I missed an episode with the girls this afternoon, and we all have a pact, if we miss the episode where he dies, everyone will either stop viewing immediately, or everyone has to rewatch it with you.
Read 6 tweets
11 Sep
Zomg, y'all are really getting the word out! Year of the Nurse is down to #108 on Amazon's free list & I've done 0 promo other than mention it here. I'mma do a Freeboosky on Tues, and my mailing list on Weds, but this is already super amazing!❤️❤️❤️

I've also gotten my first 'well at least it was free' one star spite review, lol.

One of the reasons I didn't go free sooner was because by casting a wider net, you get readers who don't like your stuff and your rating # goes down.
This is just a Known Thing, in fiction land anyways, Kara warned me about it when we got our first big exposure on Dragon Called.

But I think I've got enough of a ratings buffer to handle it now 🤞
Read 5 tweets
24 Aug
Saw someone w/a fiction revising Q elsewhere and thought I'd answer it here bc I'm clearly not going to get any 'real' work done on a release day, lolsob ;)

So -- How Cassie Edited 400k of Fiction Last Year, here we go!

First off, I'm not going to lie, it helps if you've been doing this forever (I'm like 23 years in) so yeah, experience is a magic of it's own.

But if my experience can help you, all the better, the world needs more great books!

Assuming you've gotten to the end of your book, the #1 thing ppl tell you to do is 'wait' before heading back in, which yes, totally works...but it does cost you time.

Another hack for getting around that is to switch up the way you view/feel your book....

Read 52 tweets
24 Aug
If you ever what fiction I wrote last year to stay sane(ish?) and happy(some!) and alive(woohoo!) it was writing this book here: an opposites attract sexy paranormal romance and charming as hellllllll. :D

Today is Wolf's Princess's release day! :D

And one of the things I'm most proud of in it is that it's alllllll about consent. (All of my stuff usually is, except for the things that are explicitly labeled not!)

But in this book I had the characters make a game of it...

Because they were literally too different to have a functional relationship without abundant rules and enthusiastic participation.

They both wanted to be there with the other person! But they came from, literally, worlds apart.

Read 7 tweets

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