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Chapter 1: the event
It was the fall of my intern year as I bean my off service trauma rotation. This month was ubiquitously notorious for being the most labor intrusive and least productive rotaion of our emergency medicine program. Knowing this I entered with the intention of simply surviving the month.
Another intern and I let’s call them A for sake of ambiguity, we’re the first emergency medicine residents to roste on the trauma services that year. A shaky start would be an understatement. In the words of chance the raper “like my grama with the Parkinson’s playing operation.” Would better describe it. Medically we did well. We were very competent and completed our work daily, but communication and coordination was non existent. Our Cheifs had informed us that Tuesday was our day of and the Trauma cheif residents had minimum communication with us, or our Cheifs as it seams when A and I did not report on Tuesday they sternly made their dissatisfaction known.
I have struggled with insomnia sense the age of 10. Had 2 sleep studies by this point in my life and been prescribed nearly every sleeping aid on the market. The 80-94 hr work weeks of our trauma rotaion only worsened my insomnia. My lack of sleep likely contributed to a less than prime adaptive immune system and 2 days out of my trauma rotaion I contracted strep like symptoms with associated nausea, requiring me to call for a sick day the next day. No the first day that I felt too ill to work. I was not fully aware of the reporting process. I reported to my Chiefs, but I did not believe I could come to work tomorrow with amble time and notice, however I was somewhat delayed in letting their Cheifs know, because the surgical chiefs rotated every few days and I did not know who my was going to be the next day. The second day which I had to call out sick I was able to locate the cheif for the next day and reprot according to our university’s protocol, which requires that if a resident feels they are not fit for work they must not come in and the university must have staff coverage without any fear or implementation of punitive actions.
I had finally survived to the last week of my trauma rotaion and I could see the light at the end of the tunnel. What I could not see was the pile of stress, shitty diet, lack of mental well ness and sleep deprivation which I was pushing down to reach the light. By this time I had seen a psychiatrist regularly for sleep medication. I had mentioned to him that I had been experiencing more stressed lately and feel that I might be depressed. he reassured me that it was likely only due to my circumstances, given the difficulty of the trauma rotation and wish to reassess once the rotation was over. Looking back I had to fill the habit of drinking more than I usually do. My only on nights before I have days off became 1-2 beers every other night. All of this repressed unhealthy shit finally pushed bad on September 23rd. That night I was at work even later than usual, I stayed up later than usual and couldn’t seem to fall asleep. With the stress of only having minimal sleep and knowing I only had 2 more days of trauma left, I took an extra dose of my sleeping medication.
I opened my eyes to the fighting sight of sun beaming in my window and I instantly knew I was late. (Sense I hadn’t seen the sun in a month) . Due to my need for scrupulous sleep hygiene I have been sleeping with my phone of and away for me. I rushed to grab it and watched as the little Apple logo seamed to glow on the screen for an eternity. Then in conjunction with its fading I saw 3 missed calls from my director, a text from college A and 2 missed calls from the surgical director. Still, I was able to calm myself, knowing that resident A had been late to this rotation by a few hours 2 other days and nothing came of it. I called my director back and he asked me to report to his office where I was greeted by my director, my coordinator and another emergency medicine facility.
With the only explanation of: “we just want you to get better”, I was handed a letter, to my relief it did not entail my termination, but a declaration of administrative leave and a requirement to undergo an evaluation at a well known university in Florida.
Lake any other savvy millennial, I did my research. By research I mean numerous google searches and screeches thru the depts of redit. To my dismay I discovered that in order for a residency program to fire you, they must first initiate an administrative suspension. I would soon find out however, being terminated would have been a delightful outcome compared to what ensued.
I spend the next few weeks in the wallos of regret and depression. I indulged in higher qualities of alchohol then I ever have before. I all but ceased communing with peers, and abruptly stoped any physical activity I had once enjoyed. Frightened as I was I was ensured, it will be ok “we just want you to get better”
Chapter 2 The evaluation : guilty until proven innocent I did exactly as instructed and scheduled an evaluation, I supposed that this was either a mental evaluation to assess if I’m fit for work with plans of termination or it actually was an evaluation to better treat my insomnia. To this day I regret my ignorance, and wish I had researched the process more. The Hindi / sand-skrt idea of Hamsa 🪬 is that in order to do any good you must have full knowledge or else good intentions can result in harm. I truely believe my director had good intentions, however but him and I did not have full knowledge of the nature of this evaluation.
Looking back see how easily I could have avoided my troubles by asserting legal aid at this point or even by researching this evaluation process more in depth. If one searches impaired practitioner program which I now know this evaluator works for, the search entire will populate 5 or 6 layferms along side their home website and there is a valid reason for this.
If one every finds themself in this process I employ you to bring a DSM to your evaluation or at least be familiar with the most common use disorders in the DSM-5, because your evaluation will turn into a dance of questions where the evaluator attempts to trap you in a round about way to stating something that may qualify for one of the diagnosis. I have provided an image from the DSM-5 below outlining AUD, which the evaluator concluded that I had the most severe from:
Image
Example***** Here are 10 examples of how he fraudulently assessed me taken directly from his assessment note.

Evaluator: Have you ever stoped drinking in the last year.

Me: yes I stoped every week day, I was only drinking on the weekends, until two weeks ago.
-Evaluator uses stoping and starting every week to qualify for 2 or more unsuccessful attempts to stop in the last year “There is a persistent desire or unsuccessful efforts to cut down or control alcohol use.”

Evaluator Have you ever had withdrawal symptoms

Me no
Evaluator Well Have you ever had a hangover? You know that’s a from of acute withdrawal
Me: yes in college, I had a few but that was years ago and I’m pretty sure the pathophysiology is different.
Evaluator uses this to count for withdrawal symptoms even tho is was more than a year ago

Evaluator: Have you even taken your sleeping medication on a day or night which you drank? Me: Yes, I took my prescriptions are prescribed but I never drank close to bed

Evaluator: qualified this as dangerous behavior with alcohol (where the DSM gives examples such as unprotected sex and drunk driving). The sleeping medication I was on is not a benzodiazepine therefore it is not deadly with alcohol. I personally have seen many patients in the ED who have taken their entire bottle of the medication and drank copious amounts, we just monitor them over night and rehydrate them

Evaluator Has anyone told you you drink to much or been worried about you Me: No I drink much less than my friends

Evaluator what about your girlfriend? Me: well she actually doesn’t drink at all she doesn’t like it. She often buys me beer for The Weeknd’s tho. One time we went to a movie and she got a little irritated because I waited for beer then complained about them not having any craft beer. So she said, “you couldn’t have just said no” and drank something else. However, she apologized after and said it’s worth waiting if it’s my only day off.
Evaluator said this qualifies for continued drinking despite causing significant relation consequences, ie divorce.

Evaluator : you have sleep issues I hear, and your chart says you’ve had depression in the past, don’t you know that alcohol can effect your sleep and mood Me: yes that’s why I never drink within 3 hours of sleep.

Evaluator but you knew this and still drank
Evaluator: qualifies for drinking despite unwanted physical or psychological effects (this should be recurring to effects the alcohol is causing, I have had insomnia sense the age of 10 long before I took my first sip)
7 evaluator you were late for work and told my you had a drink the day before
Me: Yes but I was late because I didn’t sleep and took double my sleeping meds, I will never do that again
Qualifies for 2 significant work or school issues in the past year ( a therapist and other psychologist ensured me that being late on or a few days doesn’t count they typically are getting fired or failing) ( moreover, this would assume I was late do to drinking it’s self and also assume if happened more than once)

• Alcohol is often taken in larger amounts or over a longer period than was intended

He never once asked anything related to this question yet said I qualified in his final report 9. A great deal of time is spent in activities necessary to obtain alcohol, use alcohol, or recover from its effects. The evaluators logic here was sense I was late for work and I had 2 beers the day before I must be taking long to recover from it (this is assuming I missed due to alcohol)

Tolerance drinking more to require the same effect: this he checked as true in his final note however it was never even discussed in our evaluation. I did mention to him that I’ve been drinking more than I had earlier in the year frequency wise, but they said nothing to do with quantity or needing more.
Wanting to drink so bad you can not think of anything else: this is the only qualification of SAUD my evaluator said I did not have.

Moreover, without legal help I was not aware that I could obtain a second evaluation or even oppose going to get evaluated at all, but that wouldn’t have mattered seeing I still thought this was for my health and wellbeing as seen when I was asked why do you think you are here to today, to which I replayed “so that I can be evaluated to see what is needed to get back to work”.
To maks the ordeal more infuriating the evaluator continues to ingratiate himself and lie through the process telling you, “it will be fine as long as you are 100% honest”, “anything you say in here is between you and me” or “you slipped up once with your meds, I know your residnecy program they will probably just want a few more out patient tests”
Two weeks later I received a phone call right before I left for an out of state vacation to visit my nice for her birthday. During the call I was informed that I would be required to complete a partial hospitalization program (PHP) lasting “6-10 weeks” which would coast from 15-50 grand not including doctor visits or housing which is billed separately. I suppressed this inconvenience, enjoyed my vocation and reported when I returned, knowing that I must complete this soon so I may return to work with due to the fact that my payed time off would soon be diminished. At this time I had not yet heard of the organization PRN.
Chapter 3 Guilty till proven innocent: The diagnosis
Shell shocked I arrived to a in patient psychiatric unit and was rapidly cleared to progress to treatment without detoxification. During my 90 day of forced rehabilitation I met a few other individuals who were unjustly and fraudulently forced into treatment. I began to look up to one of these such members of the men’s community, who I will refer to as patient X for ambiguity sake.
Unlike me patient X did have alcohol use disorder. He spent many clinic days drinking to avoid alcoholic withdraws. The curious component of his story is that he admitted his depravity, saught help and through his own journey became sober. The bodies at be, namely his local physician, Health monitoring program, rejected his personal path to sobriety and forced him to undergo 90 days of in patient treatment before he could practice medicine again. When he checked in to rehab he had been sober for over a year.
Ask for Stories of people from online
As for me I spend many sleepless nights pondering how consuming a legal substance in a moderate amount could throw me into significant legal financial issues. My labs my toxicology, my story and my collateral from colleagues from colleagues all indicated light to moderate alcohol use but my evaluators word stood as the word of God.
More frightening was the director of this rehabs acknowledgment of this. The director who happens to also coincidentally be the evaluator, stated to me as well as to staff on multiple occasions: “ I suggest inpatient treatment for everyone who is reported”. “This is safer for me not to miss anyone who could harm patients, and I figure there must be a reason someone reported them.”
I am still elucidating the reason why I was determined guilty and proven innocent, however I can say from my 90 day stent that the majority of the patients at this rehab needed to be there. This program is saving lives of both providers and patients, however it is destroying the lives of those wrongfully accused.
Chapter 4 your lisense rehab or jail : Upon arivil I was sent to a detox hospital underwent a medical examination and was “one of the lucky ones” who required no detoxification and could report directly to PHP. Like everyone else, I spent 90 days in a PHP, being as 6-10 weeks is simply a lie they tell patients to decrease the change of resisting the treatment. When discussing the topic one therapist sated “if we told patients 90 days they would never come.” She then attempted to justify the treatment by outlining the story of a patient she had called who “didn’t make it to treatment” and killed themselves”. It is my belief that it is not the lack of PHP which impelled such professionals to take their life, but them realizing that they now will be obliged to undergo 90 days of PHP, 5 years of PRN monitoring with a loss of autonomy and hundreds of thousands of dollars taken from them that induced their hopelessness. For even if these professionals were truly mentally unstable in their addictions, in every case it was only following a phone call where they were informed they must undergo treatment that they took their life’s. By this time I still haven’t the slightest clue what PRN was.
Despite the security these programs provide for many my 6 main issues with them can be summarized in : 1. Kick backs: evaluators are directors of treatment clinics 2. The reported are guilty till proven innocent 3. The price, the overflow of money these places drag in from both patients and state universities is appalling, they charge separately for every visit and test 4. Although they make the claim that they are individualized, they are anything but. Every patient gets the same stay and treatment from the doctor drunk on the job and the one who was late to a shift 5. They force voluntary treatment. remember that friendly evaluator who promised he had your best interest at heart, so you opened up and told him everything about your substance use/ developmental / family history, well if you don’t stay for 90 days he will be “normally obliged” to tip the board of medical off to you.

The programs have overstepped their intended jurisdiction. -these programs work well if they function how they were intended at their inception. Cite original purpose. Originally these programs were designed to protect physicians and civilians from impaired practitioners; being healthcare workers who were impaired at work. Over the years, these organizations have extended their authority to encompass individuals with substance use disorders When not at work and also those who are in training to become healthcare professionals. Take for example myself compared to a physician who is impaired at work. A doctor who arrived for duty under the influence would surely benifit from the extensive testing, therapy and accountability enforced via these programs. In accordance the 20,000$ per year cost is appropriate when only making up roughly 7% of their yearly salary vs nearly half of a residents. In my case with my loss of income from employment, coast of treatment and monitoring, this year I will be required to pay 20,000$ to work. Yes, I will be losing money to work. Even if did indeed have a substance use disorder this level of monitoring wouldn’t not be considered appropriate.

Dispite all of the miscomings of this System My time spend in PHP was indeed helpful, as I believe it would be for anyone. Time for exercise, a reprieve from work and weekly counseling. A sample structure of my day to day schedule is provided below for insight:
Structure The general structure of these rehabitation centers is as follows: 1. One week of orientation phase, where you are not allowed in electronics or contact with the outside world world. Therefore, if you’re going, bring some things you would like to read or study. 2. In phase 2, you can use your phone however you cannot leave campus. You must stay in the dorm on campus. These shitty 1 room run down apartments with two other roommates will cost you about $1000 a week, they are required for at least four weeks and they are billed separately, no insurance will help you out here. 3. In phase 3 you can commute to campus if you beg your therapist and live very close. Whether you’re on campus or living off-campus, you are allowed to leave up to four hours per day. If you commute, you’ll be required to take a sober link decide you must Breath, alcohol test into every 6 hours. Like everything else in this program you must pay for this separately, a few hundred dollars a week. You advanced to other phases by completing assignments, however, assignments are limited by required built-in time, intrusive, scheduling, and reviewing. Therefore, if you do everything as rapidly as possible phase 1 will take one week phase 2 will take three weeks.
Every day schedule:
7:30: wake up, report to the front desk to inform them that you haven’t ran away yet and take and prescribed medications. They keep all your medications and require that you report to take them; for me this was antidepressants in an attempt to dispel the depression I contracted from being forced into treatment and whatever off label medication they were attempting to treat my ADHD with, since control medications were forbidden.
8 am: community group assessments This consisted of other patients presenting their assignments amongst the large group, on the weekends this was often an hour later and 12 study regularly took the place of assignment presentation.
10 am: process group. This was a two hour group therapy session with 6 to 12 other professionals in a therapist and training or occasionally a licensed mental health therapist.
1 pm: recreation This was generally about an hour of some sober themed craft or activity. Once a week this time slot was used for yoga.
2 pm: this was another time slot used for patients to present assignments as well as for individual therapy sessions. Each patient had one individual therapy session lasting 30 minutes per week.
3pm: This was time allotted to work on assignments or go to the gym on your sex specific scheduled gym day.
5pm: this time was used for guest speakers or another 12 step study group.
6 pm : this was generally an off-campus 12 step group
10 pm: report to the front desk and let them know you still haven’t ran away and take and Medication which are prescribed to take at night, then return to your cot bed in your room with 1-2 other roommates.
I found the community to be one of the most beneficial aspects of the PHP program. I was in a cohort of chill ass professionals of the same occupation who were always there to help each other.
Assignments The curriculum of the PHP consisted of assignment based on every step of the 12th step program. Generally, a patient would be required to complete an assignment on their own, review it with other patients, then faculty and finally present the assignment in front of the whole treatment group. You’re only given one assignment at a time and there are multiple steps to each which all requires scheduling this ensures that no matter how determined a patient is a full 90 days of treatment is required to complete all the assignments.
AA structure -the obsolete nature of AA has been verified in numbers studies, but I will refrain from divulging here and lend that endeavor to Dr. Lance Dodes very thorough discussion on the subject,in “the sober truth “
In all sincerity, if I truely did have a severe use disorder this experience could have been life saving. I only wish I could have used my 50 grand for someone who has spent their life time In addictive without reprieve. My first conversation when I was given my phone back was how I wish my father could be able to attend this PHP.
Chapter 5 reporting and PRN Self reporting What they ask you What you should tell them
There’s a third-party agency called professional resource network. Every state has their own. This agency works as a liaison between you and whatever credentialing service your occupation requires. Essentially they ensure your monitoring after treatment. Stake governments and licensing boards trust them, mainly because they monitor with the highest level of intrusiveness. This alleviates much work for state governments and licensing boards because once an individual is being monitored by a professional resource network, then they are deemed appropriate for duty and no further investigation/litigation needs to occur, as long as the monitored individual completely complies.
Because I was never impaired at work I was never reported to this agency. The general workflow of things someone would report you to professional resource network, then the resource network would contact you, and then you would be required to report for an evaluation at a treatment center, which would inevitably result in a suggestion I’ve treatment at that given treatment center. In my case I was sent to the treatment center without PRN being involved. Thus, two weeks into treatment. I was notified by my therapist that I needed to call PRN and self report. I attempted to resistance given that I did not have a problem and was not individually seeking help. I asked what happened if I didn’t self report. I was told that in order to stay in the treatment program I had to report to PRN. This meant either I report to PRN or I get kicked out of the treatment program and lose my job.
When you report to PRN they will ask you why you are in treatment. They will then list off every substance imaginable, asking you if you have ever tried the substance and when your last use was. Ultimately, they will obtain your discharge information from your treatment center, so it is in your best interest to report only what was found in your biochemical testing. If it wasn’t in your hair, I would argue that you don’t have a use disorder regarding that substance and it’s not relevant. I don’t believe it’s important for them to know that you smoked weed when you were 12.
Chapter 6 The contract:
Before being discharged from a treatment facility, a professional resource network will have you sign a contract. A little known fact which I was oblivious to is that contracts can be negotiated. Though this isn’t it possible, it is highly improbable that you can negotiate your contract since PRN has a power to delay your clearance to return to work.
Contractor almost never personalized, and I have not heard of a contract which is not a five-year agreement. You will sign releases of information so that PRN has access to all of your information which was gathered at the treatment facility. You must have a therapist, psychiatrist, primary care, doctor, and a addiction, medicine psychiatrist. You assign releases of information for all of them. You will be required To commit to: 1. three mutual aid meetings a week which you must log. I log smart recovery meetings. 2. Weekly therapy sessions with an approved mental health therapist from their list 3. Monthly doctors appointments with an addiction medicine psychiatrist 4. Yearly appointments with a primary care physician 5. Monthly appointments with a psychiatrist 6. Daily check-ins on a random drug testing app ( you will agree to weekly urine tests, a peth test 4 times a year, a hair test twice a year and a little caveat that says anything else they deem, clinically reasonable) 7. Quarterly update reports which you are required to obtain from a workplace monitor, therapist, addiction, medicine, psychiatrist, primary care physician and any other doctor you are seeing. 8. You must upload all of your prescriptions into a mobile application every single time you get them refilled and are not allowed to take them until they are approved. 9. Attendance of a PRN group via zoom. This is a local group you are assigned along with other monitored practitioners. There is a fee of roughly 130$ a month to attend this required group. For me all of these requirements coast around 20,000 a year. If you ever have a positive test even if it is the result of contamination from rubbing alcohol or unintentional ingestion of alcohol/ allergy medication your contract will rest to 5 years from the time of positive test. Once your five year contract is completed, you must ask to be released from monitoring. At that point they will search for any reason to keep you under monitoring. This could be dilute urines, daily check ins or a week where you did not attend mutual aid meetings. Every certification and license which you apply for will likely ask you if you were under a monitoring program/ have been treated for substance use. You must give an explanation and check yes. As far as licensing programs are concerned, if you were under the monitoring of PRN, you are safe, however they group practitioners who have had behavioral issues with practitioners who were diverting drugs from work. Therefore, keep in mind that you will be labeled as a sever addict.
7 Back to work and only work. During treatment your only goal is to return to work, however when you return your experience will be drastically distinct from what you remember. For me, I was now working in isolation. Missing six months of my training meant that no other Resident was on the same rotation as me. My coworkers at all formed friend groups. When I returned I was greeted with much concern for my well being. No one would speak to be about my absence, however everyone knew there is only one reason a resident would leave for 6 months then return. My Accdeemic meetings were consisting of attending telling me “I have a target on my back now” and “ I have to preform even better than others” in the light of my time missed. If this wasn’t alienating enough, the majority of Resident events, sponsored by recruiters and my university revolved around alcohol to which I had to give some excuse to why I can not partake with others. I’m fortunate that I do not have an addiction, because these stressful conditions along with the daunting amount of dead and requirements imposed by PRN are enough to make any addict relapse. While I was at treatment, I was in the dative with Samyr stories a physicians whose addictions got the best of them. Physicians who did not make it to treatment, often taking their own life. These stories were presented as a warning. Your addictions will kill you without our treatment was the message. When, in reality I did not hear one story in which the addiction killed physician. Every physician who didn’t make it to treatment took their life after being told they must report to a treatment facility. Perhaps they knew what this entailed and it was not their addiction or getting caught which caused them to end their lives, but the unmanageable and often unreasonable burden that treatment would put on their lives.
9 How to escape So your fucked your in PRN and should be or you should and now your recovered and want to terminated your contract.

You ask to be released early done at 1/2 time ( good luck)
You have “good reason” (no one has ever been let out of contract because of this reason, the verbiage is far too vague)
You serve all your time and they let you out(maybe, as discussed earlier, they would do everything they can to keep you in your contract as long as your practicing)
You can’t practice medicine anymore

10 Layer up butter cup : I cannot emphasize the extent to which legal help is required in this process. You much seek it and seek it early. Lawyers can provide many avenues to you early in the process. Once you have committed to treatment, gone for evaluation or are in a PRN contract , this is very little that you or legal help can do. Spend a few thousand dollars when you are accused and save the 20-30,000 later.
After you have been evaluated if you disagree as I did, then this is the process you must undergo. 1. Hire a occupation, defense, lawyer 2. Prove you don’t have an addiction, this is done by having an alternative evaluator with similar credentials state that either you don’t have an addiction or that PRN’s level of monitoring is not medically appropriate ( this will need to be a multi day neuropsychological evaluation, which will cost about $5000). 3. Your lawyer must draft in writing that the medical level of monitoring is not required such as another medical professional and send this to PRN 4. PRN will tattle on you to the board of medicine. 5. The board of medicine will conduct an investigation. 6. At the end or when they believe they have enough reasonable evidence to the board of medicine will suspend your license or claim, you must comply with the PRN contract to practice. 7. At this time your lawyer will defend you in the state court against the board. This is costly but much less than the coast of a 5 year PRN contract 8. If you win you will likely suggest an alternative level of care such as gonna get therapy every week. If you lose, than you wasted a fuck ton of money and are still bound by your PRN contract.
Overall this entire process has coast me Over all coast:
My finances for this year only including PRN and rent are as follows:
120-200$ every week for testing 480-800/ month
65 every week for therapy 195/month
125 every month for PRN group
About 50-69 every month for 2 doctor apts
So at least 745$/month at the lowest
Treatment at the recovery center coast 20,000 for me out of pocket and
I wasn’t payed for 6 months with no FMLA because I am a first year. At the 1 year mark I will have made 26,000 this year after taxes And payed About 29,000 on PRN alone
Rent is 1,000 so that’s 12,000 a year
Just in rent and PRN alone I will be at 26,000- 41,600 -15,600.
I will be in debt by at least 18,000 at the 1 year mark
Coast of treatment center 20,000 (with insurance) For each year of PRN roughly 20,000 Add that to 6 months of attending salary which was delayed due to my treatment time: at least 150,000 Layer coasts along with other evaluations 25,000 Missing 6 months of residency pay 30,000 Coast of 1 year in monitoring: 245,000 Coast of 5 years 325,000
If my case progress to a trail I will require an extra 20,000 in court coasts
Chapter 11 My secondary eval: Dr sushi After I arrived at my treatment center I challenge my evaluation multiple times. Each and every time I was discharged and often accused of alternate mental health/ substance abuse issues to discourage my advances. I was never given the opportunity to undergo alternative assessment, however PRN guidelines state that you can obtain a second option within 7 days of your first. This is a mute point, however, because you will not receive the results of your evaluation until over a week after it is conducted and the second evaluation must be conducted by another PRN hired evaluator of their choosing. During my stay in rehab I contacted PRN multiple times to attempt another evaluation/ legal help. They warned against both stating they were a “waste of money” and “pointless”.
After completing my treatment with the guidance of many addiction, experienced physicians, mental health counselors and psychiatrists recommendations I sought in a secondary evaluation. I chose a highly qualified professional with over 30 years of experience to conduct an extensive neuo psycho social evaluation of me. One that I was sure would be more extensive than the evaluation I received at treatment and more importantly an unbiased evaluation.
The results from my evaluation not only showed that I did not have a substance abuse problem warranting PRN level monitoring, but also that PRN was falling to allow adequate treatment of other conditions such as my ADHD. My evaluation showed my ADHD was not only untreated by PRNs attempt at using non controlled medication, but also in the top 3% most severe presentations of ADHD. My evaluator went on to explain my results by questioning why my treatment center even mandated I undergo neuro cognitive evaluation. The only neurodiverse findings were my IQ, my dyslexia and my ADHD. However, a neuo cognitive examination can be billed separately by treatment centers, therefore they always recommend one.
Chapter 12 Amongst its greed, intrusive nature and faulty accusations, professional recourse network function highly proficiently at the task they were designed to; protective physicians and patients from physicians who are impaired at work. In this domain they save lives, offer second changes and protect the public. When they act beyond their intended jurisdiction by imposing unnecessary monetary demands on practitionersin training, accuse practitioners without proof or act on behavior exemplified outside of a work setting they unjustly and inappropriately attack the week and innocent.
Proposed reform: As a trainee my universities malpractice insurance covers me for mistakes made at work. If a learner mistakenly harms a patient, then the university stands on their behalf. If the learner does something wrong under a teachers direct guidance, then the teacher is at fault. This makes sense logically as well as pragmatically. The state entrusts large amounts of money to hospital systems and universities to train resident physicians. A portion of this money is allocated to malpractice insurance. This should extend to accused impairment.
Suppose a training university was required to cover rehabilitation and monitoring of a resident of whom they claim is impaired. Alternatively they have the option of firing the trainee. This would reduce the number of innocent trainees being accused of impairment, make the process of rehabilitation more fair and provide a better use for tax payer derived dollars, which hospital systems are given to train residents. The truly impaired could still seek help, less false accusations would be made and with the employers having the ability to fire at the moment of impairment, there would be less chance of impairment at work.

So I've got a scene with a simple cube and a sphere both with rigid bodies, but the cube is passive so that it remains stationary, the sphere slowly rolls off the edge because a vortex force field is slowly pulling it towards it. Then the sphere falls onto a plane below that is being distorted by the displace modifier using a generated cloud texture, however I've set the coordinates to global in the displace modifier and animated the rotation of the plane so that it's constantly rotating, this combined with the displace modifier being set to global causes the displacement to constantly change.
What I wanted to achieve with this is have the sphere start getting pushed around by the constantly changing geometry, but all it does is roll around a bit and then it simply stops.
Here's a quick render of the scene: https://i.imgur.com/AEZHQbP.mp4
I'm completely new to the physics portion of blender, so I'm probably just missing something really simple

i’ve been dating my bf for the past two years and it’s been great for the most part. in the beginning, i considered him my soulmate and i was so eager to tell him i love him first but now im not really sure what to think.
i feel like i constantly have to tip toe around him because he’s so sensitive/emotional plus he has anger issues that result in ugly tantrums (he yells, gets physical with stuff and is overall aggressive). he literally makes such a huge emotional deal over things so small and meaningless. for example i gave him @dvice to charge more on work he offers because he was lowballing himself and he went on this rant about how i think he’s stupid and how i don’t appreciate him. all i wanted to do was help him and he just completely flipped it. i didn’t smother him like he wanted me to so he faked an anxiety attack/started crying to force me to hug him….. yelling that all he wants is my “support” …. if something doesn’t go his way he either throws a fit or makes himself the victim and i end up feeling bad over something he caused.
i think a lot of it has to do him him being an only child to keep it real. he always wants to be nurtured if not him, his emotions. he wants to be babied and i think it’s extremely unattractive for a 21 year old man. he has this idea that he isn’t capable of doing wrong so his lack of self awareness is of course baffling. hes pretentious in a subtle way that it could pass off as him being smart/charming but that’s not the case… he’s seriously a completely different person when he doesn’t have it his way its almost unbelievable how someone that’s so sweet can go to THAT.
one time i was talking to him about geminis (he’s a gemini) and how my sister shits on that sign and he took it so far up the a$$ he gave me an ultimatum. “your sisters just trying to get you to break up with me, you’re over there with your sister listening to her, stay with your sister then see how much she cares, i would chose you over my family but that’s just me i guess now i know how much you care about me” and yadayada you get the gist. another example, i came back home it’s 2 am because he has to be up by 530am for a trip. he expected me to stay with him and he got upset when i said i wouldnt. we met up at 9 and once i told him i was going back home he started frowning and pouting and just RUINED the last hour of me being there with his moody self. what’s lame is that he doesn’t even say what’s wrong i have to constantly ask and he denies when it’s CLEAR as day he wants me to notice he’s bothered. it’s funny because he said we didn’t even hang out because it’s wasn’t “just us” mind you we were together … alone … playing video games. what he wanted was my attention 100% and that’s how he always wants it to be. it’s overbearing draining and just UGHHHH. he can’t take any criticism to better our relationship without him getting offended and immediately getting defensive. i’ve talked to him about this already but idk what to do anymore. everyone tells me he’s immature and emotionally abusive and SUPER manipulative but everytime i try breaking up with him he makes me the bad guy and i just stay to repeat the same old cycle

I want to create a lil’ group of people that love to play duos but don’t have IRL friends to play with to fill an 8-man lobby or in general don’t have a homie to play with and constantly playing with strangers
Being competitive is wanted, but don’t want someone that truly gets “heated” when their teammate either doesn’t follow your advice or get upset that you are losing
Just looking for a chill group of players who like to play a lot and a chance to meet some new friends
The ideal “dream” is to have a group of 8 who play together and get along with some friendly banter via a groupcall through snapchat or whatsapp

My stepdaughter (26) always visits her father(57) and I (48)F in the US. My husband’s 4 kids are very self entitled and very condescending to me and my daughter(20). I have dealt with a lot of uncomfortable situations and my daughter has been patronized by her step siblings a lot. My daughter and I are both humble and we both have been through a lot which caused us both to have very low self esteem, this doesn’t help us to deal with people like my stepdaughter.
It is very uncomfortable being around her and trying to maintain a good relationship as she takes over the space, literally and physically. She is constantly patronizing and behaves as superior to everyone. She is British and so she will make comments such as “oh my gosh you are so American” and she will roll her eyes and laugh.
My daughter and I have always been quiet but always feel very insulted when she comes and I’m to a point that I feel I need to stop trying to please everyone around me including my husband.
Most recently we went to see my husband’s kids and they did not receive my daughter and I well. They treated us with very poor courtesy and respect so this is why I got to this point of enough is enough. I have told my husband I feel disrespected and as if my feelings don’t matter and I have always received them in my house with all the love and respect, I’m trying to win them over and to please my husband.
I am not sure how to handle this situation but I feel I need to set boundaries. I just feel bad for having to change and maybe even ask my husband to not let her come here due to the recent events that were very unpleasant when we visited them.
TDL; DR: I seek some advice on how to handle this situation because I worry about my husband being upset about my request.

Chapter 1: the event
It was the fall of my intern year as I bean my off service trauma rotation. This month was ubiquitously notorious for being the most labor intrusive and least productive rotaion of our emergency medicine program. Knowing this I entered with the intention of simply surviving the month.
Another intern and I let’s call them A for sake of ambiguity, we’re the first emergency medicine residents to roste on the trauma services that year. A shaky start would be an understatement. In the words of chance the raper “like my grama with the Parkinson’s playing operation.” Would better describe it. Medically we did well. We were very competent and completed our work daily, but communication and coordination was non existent. Our Cheifs had informed us that Tuesday was our day of and the Trauma cheif residents had minimum communication with us, or our Cheifs as it seams when A and I did not report on Tuesday they sternly made their dissatisfaction known.
I have struggled with insomnia sense the age of 10. Had 2 sleep studies by this point in my life and been prescribed nearly every sleeping aid on the market. The 80-94 hr work weeks of our trauma rotaion only worsened my insomnia. My lack of sleep likely contributed to a less than prime adaptive immune system and 2 days out of my trauma rotaion I contracted strep like symptoms with associated nausea, requiring me to call for a sick day the next day. No the first day that I felt too ill to work. I was not fully aware of the reporting process. I reported to my Chiefs, but I did not believe I could come to work tomorrow with amble time and notice, however I was somewhat delayed in letting their Cheifs know, because the surgical chiefs rotated every few days and I did not know who my was going to be the next day. The second day which I had to call out sick I was able to locate the cheif for the next day and reprot according to our university’s protocol, which requires that if a resident feels they are not fit for work they must not come in and the university must have staff coverage without any fear or implementation of punitive actions.
I had finally survived to the last week of my trauma rotaion and I could see the light at the end of the tunnel. What I could not see was the pile of stress, shitty diet, lack of mental well ness and sleep deprivation which I was pushing down to reach the light. By this time I had seen a psychiatrist regularly for sleep medication. I had mentioned to him that I had been experiencing more stressed lately and feel that I might be depressed. he reassured me that it was likely only due to my circumstances, given the difficulty of the trauma rotation and wish to reassess once the rotation was over. Looking back I had to fill the habit of drinking more than I usually do. My only on nights before I have days off became 1-2 beers every other night. All of this repressed unhealthy shit finally pushed bad on September 23rd. That night I was at work even later than usual, I stayed up later than usual and couldn’t seem to fall asleep. With the stress of only having minimal sleep and knowing I only had 2 more days of trauma left, I took an extra dose of my sleeping medication.
I opened my eyes to the fighting sight of sun beaming in my window and I instantly knew I was late. (Sense I hadn’t seen the sun in a month) . Due to my need for scrupulous sleep hygiene I have been sleeping with my phone of and away for me. I rushed to grab it and watched as the little Apple logo seamed to glow on the screen for an eternity. Then in conjunction with its fading I saw 3 missed calls from my director, a text from college A and 2 missed calls from the surgical director. Still, I was able to calm myself, knowing that resident A had been late to this rotation by a few hours 2 other days and nothing came of it. I called my director back and he asked me to report to his office where I was greeted by my director, my coordinator and another emergency medicine facility.
With the only explanation of: “we just want you to get better”, I was handed a letter, to my relief it did not entail my termination, but a declaration of administrative leave and a requirement to undergo an evaluation at a well known university in Florida.
Lake any other savvy millennial, I did my research. By research I mean numerous google searches and screeches thru the depts of redit. To my dismay I discovered that in order for a residency program to fire you, they must first initiate an administrative suspension. I would soon find out however, being terminated would have been a delightful outcome compared to what ensued.
I spend the next few weeks in the wallos of regret and depression. I indulged in higher qualities of alchohol then I ever have before. I all but ceased communing with peers, and abruptly stoped any physical activity I had once enjoyed. Frightened as I was I was ensured, it will be ok “we just want you to get better”
Chapter 2 The evaluation : guilty until proven innocent I did exactly as instructed and scheduled an evaluation, I supposed that this was either a mental evaluation to assess if I’m fit for work with plans of termination or it actually was an evaluation to better treat my insomnia. To this day I regret my ignorance, and wish I had researched the process more. The Hindi / sand-skrt idea of Hamsa 🪬 is that in order to do any good you must have full knowledge or else good intentions can result in harm. I truely believe my director had good intentions, however but him and I did not have full knowledge of the nature of this evaluation.
Looking back see how easily I could have avoided my troubles by asserting legal aid at this point or even by researching this evaluation process more in depth. If one searches impaired practitioner program which I now know this evaluator works for, the search entire will populate 5 or 6 layferms along side their home website and there is a valid reason for this.
If one every finds themself in this process I employ you to bring a DSM to your evaluation or at least be familiar with the most common use disorders in the DSM-5, because your evaluation will turn into a dance of questions where the evaluator attempts to trap you in a round about way to stating something that may qualify for one of the diagnosis. I have provided an image from the DSM-5 below outlining AUD, which the evaluator concluded that I had the most severe from:
Image
Example***** Here are 10 examples of how he fraudulently assessed me taken directly from his assessment note.

Evaluator: Have you ever stoped drinking in the last year.

Me: yes I stoped every week day, I was only drinking on the weekends, until two weeks ago.
-Evaluator uses stoping and starting every week to qualify for 2 or more unsuccessful attempts to stop in the last year “There is a persistent desire or unsuccessful efforts to cut down or control alcohol use.”

Evaluator Have you ever had withdrawal symptoms

Me no
Evaluator Well Have you ever had a hangover? You know that’s a from of acute withdrawal
Me: yes in college, I had a few but that was years ago and I’m pretty sure the pathophysiology is different.
Evaluator uses this to count for withdrawal symptoms even tho is was more than a year ago

Evaluator: Have you even taken your sleeping medication on a day or night which you drank? Me: Yes, I took my prescriptions are prescribed but I never drank close to bed

Evaluator: qualified this as dangerous behavior with alcohol (where the DSM gives examples such as unprotected sex and drunk driving). The sleeping medication I was on is not a benzodiazepine therefore it is not deadly with alcohol. I personally have seen many patients in the ED who have taken their entire bottle of the medication and drank copious amounts, we just monitor them over night and rehydrate them

Evaluator Has anyone told you you drink to much or been worried about you Me: No I drink much less than my friends

Evaluator what about your girlfriend? Me: well she actually doesn’t drink at all she doesn’t like it. She often buys me beer for The Weeknd’s tho. One time we went to a movie and she got a little irritated because I waited for beer then complained about them not having any craft beer. So she said, “you couldn’t have just said no” and drank something else. However, she apologized after and said it’s worth waiting if it’s my only day off.
Evaluator said this qualifies for continued drinking despite causing significant relation consequences, ie divorce.

Evaluator : you have sleep issues I hear, and your chart says you’ve had depression in the past, don’t you know that alcohol can effect your sleep and mood Me: yes that’s why I never drink within 3 hours of sleep.

Evaluator but you knew this and still drank
Evaluator: qualifies for drinking despite unwanted physical or psychological effects (this should be recurring to effects the alcohol is causing, I have had insomnia sense the age of 10 long before I took my first sip)
7 evaluator you were late for work and told my you had a drink the day before
Me: Yes but I was late because I didn’t sleep and took double my sleeping meds, I will never do that again
Qualifies for 2 significant work or school issues in the past year ( a therapist and other psychologist ensured me that being late on or a few days doesn’t count they typically are getting fired or failing) ( moreover, this would assume I was late do to drinking it’s self and also assume if happened more than once)

• Alcohol is often taken in larger amounts or over a longer period than was intended

He never once asked anything related to this question yet said I qualified in his final report 9. A great deal of time is spent in activities necessary to obtain alcohol, use alcohol, or recover from its effects. The evaluators logic here was sense I was late for work and I had 2 beers the day before I must be taking long to recover from it (this is assuming I missed due to alcohol)

Tolerance drinking more to require the same effect: this he checked as true in his final note however it was never even discussed in our evaluation. I did mention to him that I’ve been drinking more than I had earlier in the year frequency wise, but they said nothing to do with quantity or needing more.
Wanting to drink so bad you can not think of anything else: this is the only qualification of SAUD my evaluator said I did not have.

Moreover, without legal help I was not aware that I could obtain a second evaluation or even oppose going to get evaluated at all, but that wouldn’t have mattered seeing I still thought this was for my health and wellbeing as seen when I was asked why do you think you are here to today, to which I replayed “so that I can be evaluated to see what is needed to get back to work”.
To maks the ordeal more infuriating the evaluator continues to ingratiate himself and lie through the process telling you, “it will be fine as long as you are 100% honest”, “anything you say in here is between you and me” or “you slipped up once with your meds, I know your residnecy program they will probably just want a few more out patient tests”
Two weeks later I received a phone call right before I left for an out of state vacation to visit my nice for her birthday. During the call I was informed that I would be required to complete a partial hospitalization program (PHP) lasting “6-10 weeks” which would coast from 15-50 grand not including doctor visits or housing which is billed separately. I suppressed this inconvenience, enjoyed my vocation and reported when I returned, knowing that I must complete this soon so I may return to work with due to the fact that my payed time off would soon be diminished. At this time I had not yet heard of the organization PRN.
Chapter 3 Guilty till proven innocent: The diagnosis
Shell shocked I arrived to a in patient psychiatric unit and was rapidly cleared to progress to treatment without detoxification. During my 90 day of forced rehabilitation I met a few other individuals who were unjustly and fraudulently forced into treatment. I began to look up to one of these such members of the men’s community, who I will refer to as patient X for ambiguity sake.
Unlike me patient X did have alcohol use disorder. He spent many clinic days drinking to avoid alcoholic withdraws. The curious component of his story is that he admitted his depravity, saught help and through his own journey became sober. The bodies at be, namely his local physician, Health monitoring program, rejected his personal path to sobriety and forced him to undergo 90 days of in patient treatment before he could practice medicine again. When he checked in to rehab he had been sober for over a year.
Ask for Stories of people from online
As for me I spend many sleepless nights pondering how consuming a legal substance in a moderate amount could throw me into significant legal financial issues. My labs my toxicology, my story and my collateral from colleagues from colleagues all indicated light to moderate alcohol use but my evaluators word stood as the word of God.
More frightening was the director of this rehabs acknowledgment of this. The director who happens to also coincidentally be the evaluator, stated to me as well as to staff on multiple occasions: “ I suggest inpatient treatment for everyone who is reported”. “This is safer for me not to miss anyone who could harm patients, and I figure there must be a reason someone reported them.”
I am still elucidating the reason why I was determined guilty and proven innocent, however I can say from my 90 day stent that the majority of the patients at this rehab needed to be there. This program is saving lives of both providers and patients, however it is destroying the lives of those wrongfully accused.
Chapter 4 your lisense rehab or jail : Upon arivil I was sent to a detox hospital underwent a medical examination and was “one of the lucky ones” who required no detoxification and could report directly to PHP. Like everyone else, I spent 90 days in a PHP, being as 6-10 weeks is simply a lie they tell patients to decrease the change of resisting the treatment. When discussing the topic one therapist sated “if we told patients 90 days they would never come.” She then attempted to justify the treatment by outlining the story of a patient she had called who “didn’t make it to treatment” and killed themselves”. It is my belief that it is not the lack of PHP which impelled such professionals to take their life, but them realizing that they now will be obliged to undergo 90 days of PHP, 5 years of PRN monitoring with a loss of autonomy and hundreds of thousands of dollars taken from them that induced their hopelessness. For even if these professionals were truly mentally unstable in their addictions, in every case it was only following a phone call where they were informed they must undergo treatment that they took their life’s. By this time I still haven’t the slightest clue what PRN was.
Despite the security these programs provide for many my 6 main issues with them can be summarized in : 1. Kick backs: evaluators are directors of treatment clinics 2. The reported are guilty till proven innocent 3. The price, the overflow of money these places drag in from both patients and state universities is appalling, they charge separately for every visit and test 4. Although they make the claim that they are individualized, they are anything but. Every patient gets the same stay and treatment from the doctor drunk on the job and the one who was late to a shift 5. They force voluntary treatment. remember that friendly evaluator who promised he had your best interest at heart, so you opened up and told him everything about your substance use/ developmental / family history, well if you don’t stay for 90 days he will be “normally obliged” to tip the board of medical off to you.

The programs have overstepped their intended jurisdiction. -these programs work well if they function how they were intended at their inception. Cite original purpose. Originally these programs were designed to protect physicians and civilians from impaired practitioners; being healthcare workers who were impaired at work. Over the years, these organizations have extended their authority to encompass individuals with substance use disorders When not at work and also those who are in training to become healthcare professionals. Take for example myself compared to a physician who is impaired at work. A doctor who arrived for duty under the influence would surely benifit from the extensive testing, therapy and accountability enforced via these programs. In accordance the 20,000$ per year cost is appropriate when only making up roughly 7% of their yearly salary vs nearly half of a residents. In my case with my loss of income from employment, coast of treatment and monitoring, this year I will be required to pay 20,000$ to work. Yes, I will be losing money to work. Even if did indeed have a substance use disorder this level of monitoring wouldn’t not be considered appropriate.

Dispite all of the miscomings of this System My time spend in PHP was indeed helpful, as I believe it would be for anyone. Time for exercise, a reprieve from work and weekly counseling. A sample structure of my day to day schedule is provided below for insight:
Structure The general structure of these rehabitation centers is as follows: 1. One week of orientation phase, where you are not allowed in electronics or contact with the outside world world. Therefore, if you’re going, bring some things you would like to read or study. 2. In phase 2, you can use your phone however you cannot leave campus. You must stay in the dorm on campus. These shitty 1 room run down apartments with two other roommates will cost you about $1000 a week, they are required for at least four weeks and they are billed separately, no insurance will help you out here. 3. In phase 3 you can commute to campus if you beg your therapist and live very close. Whether you’re on campus or living off-campus, you are allowed to leave up to four hours per day. If you commute, you’ll be required to take a sober link decide you must Breath, alcohol test into every 6 hours. Like everything else in this program you must pay for this separately, a few hundred dollars a week. You advanced to other phases by completing assignments, however, assignments are limited by required built-in time, intrusive, scheduling, and reviewing. Therefore, if you do everything as rapidly as possible phase 1 will take one week phase 2 will take three weeks.
Every day schedule:
7:30: wake up, report to the front desk to inform them that you haven’t ran away yet and take and prescribed medications. They keep all your medications and require that you report to take them; for me this was antidepressants in an attempt to dispel the depression I contracted from being forced into treatment and whatever off label medication they were attempting to treat my ADHD with, since control medications were forbidden.
8 am: community group assessments This consisted of other patients presenting their assignments amongst the large group, on the weekends this was often an hour later and 12 study regularly took the place of assignment presentation.
10 am: process group. This was a two hour group therapy session with 6 to 12 other professionals in a therapist and training or occasionally a licensed mental health therapist.
1 pm: recreation This was generally about an hour of some sober themed craft or activity. Once a week this time slot was used for yoga.
2 pm: this was another time slot used for patients to present assignments as well as for individual therapy sessions. Each patient had one individual therapy session lasting 30 minutes per week.
3pm: This was time allotted to work on assignments or go to the gym on your sex specific scheduled gym day.
5pm: this time was used for guest speakers or another 12 step study group.
6 pm : this was generally an off-campus 12 step group
10 pm: report to the front desk and let them know you still haven’t ran away and take and Medication which are prescribed to take at night, then return to your cot bed in your room with 1-2 other roommates.
I found the community to be one of the most beneficial aspects of the PHP program. I was in a cohort of chill ass professionals of the same occupation who were always there to help each other.
Assignments The curriculum of the PHP consisted of assignment based on every step of the 12th step program. Generally, a patient would be required to complete an assignment on their own, review it with other patients, then faculty and finally present the assignment in front of the whole treatment group. You’re only given one assignment at a time and there are multiple steps to each which all requires scheduling this ensures that no matter how determined a patient is a full 90 days of treatment is required to complete all the assignments.
AA structure -the obsolete nature of AA has been verified in numbers studies, but I will refrain from divulging here and lend that endeavor to Dr. Lance Dodes very thorough discussion on the subject,in “the sober truth “
In all sincerity, if I truely did have a severe use disorder this experience could have been life saving. I only wish I could have used my 50 grand for someone who has spent their life time In addictive without reprieve. My first conversation when I was given my phone back was how I wish my father could be able to attend this PHP.
Chapter 5 reporting and PRN Self reporting What they ask you What you should tell them
There’s a third-party agency called professional resource network. Every state has their own. This agency works as a liaison between you and whatever credentialing service your occupation requires. Essentially they ensure your monitoring after treatment. Stake governments and licensing boards trust them, mainly because they monitor with the highest level of intrusiveness. This alleviates much work for state governments and licensing boards because once an individual is being monitored by a professional resource network, then they are deemed appropriate for duty and no further investigation/litigation needs to occur, as long as the monitored individual completely complies.
Because I was never impaired at work I was never reported to this agency. The general workflow of things someone would report you to professional resource network, then the resource network would contact you, and then you would be required to report for an evaluation at a treatment center, which would inevitably result in a suggestion I’ve treatment at that given treatment center. In my case I was sent to the treatment center without PRN being involved. Thus, two weeks into treatment. I was notified by my therapist that I needed to call PRN and self report. I attempted to resistance given that I did not have a problem and was not individually seeking help. I asked what happened if I didn’t self report. I was told that in order to stay in the treatment program I had to report to PRN. This meant either I report to PRN or I get kicked out of the treatment program and lose my job.
When you report to PRN they will ask you why you are in treatment. They will then list off every substance imaginable, asking you if you have ever tried the substance and when your last use was. Ultimately, they will obtain your discharge information from your treatment center, so it is in your best interest to report only what was found in your biochemical testing. If it wasn’t in your hair, I would argue that you don’t have a use disorder regarding that substance and it’s not relevant. I don’t believe it’s important for them to know that you smoked weed when you were 12.
Chapter 6 The contract:
Before being discharged from a treatment facility, a professional resource network will have you sign a contract. A little known fact which I was oblivious to is that contracts can be negotiated. Though this isn’t it possible, it is highly improbable that you can negotiate your contract since PRN has a power to delay your clearance to return to work.
Contractor almost never personalized, and I have not heard of a contract which is not a five-year agreement. You will sign releases of information so that PRN has access to all of your information which was gathered at the treatment facility. You must have a therapist, psychiatrist, primary care, doctor, and a addiction, medicine psychiatrist. You assign releases of information for all of them. You will be required To commit to: 1. three mutual aid meetings a week which you must log. I log smart recovery meetings. 2. Weekly therapy sessions with an approved mental health therapist from their list 3. Monthly doctors appointments with an addiction medicine psychiatrist 4. Yearly appointments with a primary care physician 5. Monthly appointments with a psychiatrist 6. Daily check-ins on a random drug testing app ( you will agree to weekly urine tests, a peth test 4 times a year, a hair test twice a year and a little caveat that says anything else they deem, clinically reasonable) 7. Quarterly update reports which you are required to obtain from a workplace monitor, therapist, addiction, medicine, psychiatrist, primary care physician and any other doctor you are seeing. 8. You must upload all of your prescriptions into a mobile application every single time you get them refilled and are not allowed to take them until they are approved. 9. Attendance of a PRN group via zoom. This is a local group you are assigned along with other monitored practitioners. There is a fee of roughly 130$ a month to attend this required group. For me all of these requirements coast around 20,000 a year. If you ever have a positive test even if it is the result of contamination from rubbing alcohol or unintentional ingestion of alcohol/ allergy medication your contract will rest to 5 years from the time of positive test. Once your five year contract is completed, you must ask to be released from monitoring. At that point they will search for any reason to keep you under monitoring. This could be dilute urines, daily check ins or a week where you did not attend mutual aid meetings. Every certification and license which you apply for will likely ask you if you were under a monitoring program/ have been treated for substance use. You must give an explanation and check yes. As far as licensing programs are concerned, if you were under the monitoring of PRN, you are safe, however they group practitioners who have had behavioral issues with practitioners who were diverting drugs from work. Therefore, keep in mind that you will be labeled as a sever addict.
7 Back to work and only work. During treatment your only goal is to return to work, however when you return your experience will be drastically distinct from what you remember. For me, I was now working in isolation. Missing six months of my training meant that no other Resident was on the same rotation as me. My coworkers at all formed friend groups. When I returned I was greeted with much concern for my well being. No one would speak to be about my absence, however everyone knew there is only one reason a resident would leave for 6 months then return. My Accdeemic meetings were consisting of attending telling me “I have a target on my back now” and “ I have to preform even better than others” in the light of my time missed. If this wasn’t alienating enough, the majority of Resident events, sponsored by recruiters and my university revolved around alcohol to which I had to give some excuse to why I can not partake with others. I’m fortunate that I do not have an addiction, because these stressful conditions along with the daunting amount of dead and requirements imposed by PRN are enough to make any addict relapse. While I was at treatment, I was in the dative with Samyr stories a physicians whose addictions got the best of them. Physicians who did not make it to treatment, often taking their own life. These stories were presented as a warning. Your addictions will kill you without our treatment was the message. When, in reality I did not hear one story in which the addiction killed physician. Every physician who didn’t make it to treatment took their life after being told they must report to a treatment facility. Perhaps they knew what this entailed and it was not their addiction or getting caught which caused them to end their lives, but the unmanageable and often unreasonable burden that treatment would put on their lives.
9 How to escape So your fucked your in PRN and should be or you should and now your recovered and want to terminated your contract.

You ask to be released early done at 1/2 time ( good luck)
You have “good reason” (no one has ever been let out of contract because of this reason, the verbiage is far too vague)
You serve all your time and they let you out(maybe, as discussed earlier, they would do everything they can to keep you in your contract as long as your practicing)
You can’t practice medicine anymore

10 Layer up butter cup : I cannot emphasize the extent to which legal help is required in this process. You much seek it and seek it early. Lawyers can provide many avenues to you early in the process. Once you have committed to treatment, gone for evaluation or are in a PRN contract , this is very little that you or legal help can do. Spend a few thousand dollars when you are accused and save the 20-30,000 later.
After you have been evaluated if you disagree as I did, then this is the process you must undergo. 1. Hire a occupation, defense, lawyer 2. Prove you don’t have an addiction, this is done by having an alternative evaluator with similar credentials state that either you don’t have an addiction or that PRN’s level of monitoring is not medically appropriate ( this will need to be a multi day neuropsychological evaluation, which will cost about $5000). 3. Your lawyer must draft in writing that the medical level of monitoring is not required such as another medical professional and send this to PRN 4. PRN will tattle on you to the board of medicine. 5. The board of medicine will conduct an investigation. 6. At the end or when they believe they have enough reasonable evidence to the board of medicine will suspend your license or claim, you must comply with the PRN contract to practice. 7. At this time your lawyer will defend you in the state court against the board. This is costly but much less than the coast of a 5 year PRN contract 8. If you win you will likely suggest an alternative level of care such as gonna get therapy every week. If you lose, than you wasted a fuck ton of money and are still bound by your PRN contract.
Overall this entire process has coast me Over all coast:
My finances for this year only including PRN and rent are as follows:
120-200$ every week for testing 480-800/ month
65 every week for therapy 195/month
125 every month for PRN group
About 50-69 every month for 2 doctor apts
So at least 745$/month at the lowest
Treatment at the recovery center coast 20,000 for me out of pocket and
I wasn’t payed for 6 months with no FMLA because I am a first year. At the 1 year mark I will have made 26,000 this year after taxes And payed About 29,000 on PRN alone
Rent is 1,000 so that’s 12,000 a year
Just in rent and PRN alone I will be at 26,000- 41,600 -15,600.
I will be in debt by at least 18,000 at the 1 year mark
Coast of treatment center 20,000 (with insurance) For each year of PRN roughly 20,000 Add that to 6 months of attending salary which was delayed due to my treatment time: at least 150,000 Layer coasts along with other evaluations 25,000 Missing 6 months of residency pay 30,000 Coast of 1 year in monitoring: 245,000 Coast of 5 years 325,000
If my case progress to a trail I will require an extra 20,000 in court coasts
Chapter 11 My secondary eval: Dr sushi After I arrived at my treatment center I challenge my evaluation multiple times. Each and every time I was discharged and often accused of alternate mental health/ substance abuse issues to discourage my advances. I was never given the opportunity to undergo alternative assessment, however PRN guidelines state that you can obtain a second option within 7 days of your first. This is a mute point, however, because you will not receive the results of your evaluation until over a week after it is conducted and the second evaluation must be conducted by another PRN hired evaluator of their choosing. During my stay in rehab I contacted PRN multiple times to attempt another evaluation/ legal help. They warned against both stating they were a “waste of money” and “pointless”.
After completing my treatment with the guidance of many addiction, experienced physicians, mental health counselors and psychiatrists recommendations I sought in a secondary evaluation. I chose a highly qualified professional with over 30 years of experience to conduct an extensive neuo psycho social evaluation of me. One that I was sure would be more extensive than the evaluation I received at treatment and more importantly an unbiased evaluation.
The results from my evaluation not only showed that I did not have a substance abuse problem warranting PRN level monitoring, but also that PRN was falling to allow adequate treatment of other conditions such as my ADHD. My evaluation showed my ADHD was not only untreated by PRNs attempt at using non controlled medication, but also in the top 3% most severe presentations of ADHD. My evaluator went on to explain my results by questioning why my treatment center even mandated I undergo neuro cognitive evaluation. The only neurodiverse findings were my IQ, my dyslexia and my ADHD. However, a neuo cognitive examination can be billed separately by treatment centers, therefore they always recommend one.
Chapter 12 Amongst its greed, intrusive nature and faulty accusations, professional recourse network function highly proficiently at the task they were designed to; protective physicians and patients from physicians who are impaired at work. In this domain they save lives, offer second changes and protect the public. When they act beyond their intended jurisdiction by imposing unnecessary monetary demands on practitionersin training, accuse practitioners without proof or act on behavior exemplified outside of a work setting they unjustly and inappropriately attack the week and innocent.
Proposed reform: As a trainee my universities malpractice insurance covers me for mistakes made at work. If a learner mistakenly harms a patient, then the university stands on their behalf. If the learner does something wrong under a teachers direct guidance, then the teacher is at fault. This makes sense logically as well as pragmatically. The state entrusts large amounts of money to hospital systems and universities to train resident physicians. A portion of this money is allocated to malpractice insurance. This should extend to accused impairment.
Suppose a training university was required to cover rehabilitation and monitoring of a resident of whom they claim is impaired. Alternatively they have the option of firing the trainee. This would reduce the number of innocent trainees being accused of impairment, make the process of rehabilitation more fair and provide a better use for tax payer derived dollars, which hospital systems are given to train residents. The truly impaired could still seek help, less false accusations would be made and with the employers having the ability to fire at the moment of impairment, there would be less chance of impairment at work.

I had a call with my doctor last week about my mental health, and I had a bit of a breakdown about how much my pain is affecting me. It has just passed a year since I started feeling constant, debilitating pain that has left me pretty much housebound. I’ve been really hesitant when asking for prescription pain medication for the past year as I was hyper aware of what it could come off as as a 20 year old uni student asking, so I have just never brought it up and just asked for scans and checkups etc, and took over the counter meds daily. I was given codeine at an A&E visit during a horrible episode, and it helped although made me incredibly tired and stupid, so I wasn’t interested in asking for any more opioids.
Last week I think something in me snapped and I realised I didn’t have to live this life that is making me so anxious and depressed and I have the right to request my pain be managed, and I pretty much told him “I can’t imagine living like this for the next however many years until my surgery. I’m not functioning and it’s killing me”. He faffed about for a bit, telling me “well I’m not really sure what to do to be honest” and “I’m not sure there’s much I can do for you to help in this case” and “When you phoned today what were you hoping I’d say” and I just persisted with “I want advice on the best route for me to take to get this pain under control until I get the surgery”, and finally he offered me tramadol to take as needed (despite sounding very unhappy about it). I’ve only taken one in the past week as I’ve decided only to use them when my pain is affecting my ability to complete tasks, but when I did, oh my God. Within an hour my pain was down to a 2 (a number I very rarely feel), and after 7 hours or so it climbed back up to its usual non-flare up level. I was able to just skip a quick flare up until the baseline pain reached a level I can deal with. It doesn’t make me feel drowsy (in fact I feel a little more energised), it doesn’t make me stupid and stoned like codeine, maybe just a tiny bit more chilled out than usual.
Just knowing that I have this to fall back on when I know I’m going into a flare up has reduced my anxiety tenfold, and knowing that if I have an event or a class to show up to and I’m too sore, there’s now a chance I could make it is a security that I haven’t felt in years. I hope I won’t need them forever, but knowing I have something to pull me over until the next step is such a relief on both my mind and my body.
In conclusion, doctors who say controlled drugs are not appropriate treatments for chronic pain need to go back to school. I am so grateful toward myself for making this choice and standing up for myself.

For the past few months, I've wanted to change my job, because I couldn't “grow” in my current one. It hasn't been easy; many companies either didn't respond at all or I received automated replies. Sometimes I had interviews, but then all contact stopped, or they ultimately chose another candidate. It wore me down, making me feel like there was something wrong with me, even though I'm only 21. The only person who lifted me up and genuinely helped me was my husband. He helped me improve my CV, talked about things that could benefit me, did mock interviews with me, and cheered me on after every CV I sent out. It was mainly thanks to him that I didn't give up and changed my mindset about it not being my fault.
I found a company that was very interested in hiring me. I went through their entire recruitment process, and yesterday they called me to say they want to start working with me. Moreover, it's the offer I liked the most, related to my field of study, and I'll be the only person in my year already working in the profession. I was literally jumping for joy like a little child, extremely proud of myself, just like my husband, who didn't take any credit for himself. Even though I thanked him probably a million times, every time I heard that it was solely thanks to me and that I should thank myself.
The joy lasted until I called my mom. Initially, she said she was happy for me and congratulated me, but then the conversation quickly took a turn. She started asking me if I planned to pursue a master's degree after my bachelor's (she brings this up regularly every few months; her attitude towards my education and career was the beginning of all our problems and my current life difficulties). She wants me to have that title so she could boast about it among her friends and convince herself how wonderfully she raised me, that I achieve such successes. Here we come to the worst part for me. Even though she didn't have even 1% of a share in my job change, she said she was proud of herself. OF HERSELF. Surprised, I asked "why?" and in response, I heard (more or less, I don't remember exactly because of nerves) that she's proud of herself because she raised me and now I'm succeeding in life, so her methods weren't that bad. She labeled the harm she caused me with constant arguments and bans when I got a grade other than what she thought I should, as mistakes, and again attributed credit to herself.
I'm just sad. For the past 2 years, I've worked hard to start living my own life. I moved, changed jobs twice, changed my studies, started a second therapy, I'm finally happy, and yet it's not acknowledged, and there's always something that could have been done bettedifferently. I know that for her, any method other than her own is not good enough, but does it really require so much just to sincerely congratulate someone, someone who you say you love and are proud of?

I am ftm and my gf is mtf. She constantly is upset by her facial hair and it's starting to get thicker and darker as she shaves daily to try and alleviate the dysphoria it causes. I thought I'd get her some session of laser hair removal for her birthday in a few months as I'd have to save up to buy it. However, this may not be the best as I don't want to hurt her feelings by getting her this present. Any advice would be appreciated.

My stepdaughter (F26) always visits her father(M57) and I (F48)in the US. My husband’s 4 kids are very self entitled and very condescending to me and my daughter(F20). I have dealt with a lot of uncomfortable situations and my daughter has been patronized by her step siblings a lot.
My daughter and I are both humble and we both have been through a lot which caused us both to have very low self esteem, this doesn’t help us to deal with people like my stepdaughter. It is very uncomfortable being around her and trying to maintain a good relationship as she takes over the space, literally and physically. She is constantly patronizing and behaves as superior to everyone. She is British and so she will make comments such as “oh my gosh you are so American” and she will roll her eyes and laugh.
My daughter and I have always been quiet but always feel very insulted when she comes and I’m to a point that I feel I need to stop trying to please everyone around me including my husband. Most recently we went to see my husband’s kids and they did not receive my daughter and I well. They treated us with very poor courtesy and respect so this is why I got to this point of enough is enough.
I have told my husband I feel disrespected and as if my feelings don’t matter and I have always received them in my house with all the love and respect, I’m trying to win them over and to please my husband. I am not sure how to handle this situation but I feel I need to set boundaries.
I just feel bad for having to change and maybe even ask my husband to not let her come here due to the recent events that were very unpleasant when we visited them. ———
***TDL; DR: I seek some advice on how to handle this situation because I worry about my husband being upset about my request.

When my now partner and I started talking, we messaged each other all day everyday. It was intense and we opened up to each other about a lot of things.
This is something I’m used to and I was expecting it to continue since all of my past relationships tend to be volatile. A lot love bombing and then withdrawing and codependency.
Currently, my partner and I have moved past the infatuation stage. We’re not messaging each other every second. We update each other throughout the day but we live independent lives.
I’ve felt a little bit taken aback by how chill everything is. It’s so chill that I’ve been feeling kind of ignored lately and my partner insist they’re not ignoring me and they’re not bored at all and feel very happy with everything.
They told me that I’m just used to toxic relationships full of drama and it’s not healthy to constantly be messaging.
I think maybe they’re right. Idk what a healthy relationship looks like. I’m not sure what the difference is between someone losing interest and someone who is stable and doesn’t need constant attention.
Also, I want to know everything they’re doing. I’m constantly resisting the urge to make sure they still like me because I’m afraid of being abandoned.
I feel like my current relationship is bringing out all these insecurities I have. I’m used to someone needing me and me needing them. And if I’m not needed then I feel like they don’t care about me.
Am I just messed up?

I (19 **) work as a direct support professional for children in residential care due to IDD and/or behavioral issues. I am a full-time college student while independently supporting myself by working full-time. I typically work 32-36 hours a week while taking 4 classes (16 credits) with 3 of them being STEM, so you can only imagine how extremely busy my schedule is and the amount of stress I am constantly under.
I took a week off from work to ensure that I could solely focus on my finals. I returned to work the Saturday right after finals, first day of spring break, and worked a 12 hour shift at a house that I have only worked at about 4 times prior to that shift. This house has a 1:1 staff to client ratio so there is typically 3 staff to the 3 clients, except when it is the overnight shift. On the last hour of my shift, one of the clients ran away during bed time hours and none of us realized until 20 mins later. You're probably wondering how the hell we didn't notice a kid was missing. All of the clients were in bed and all 3 of the staffs were in the staff office finishing up the necessary paperwork to complete the shift. About 10-15 mins after the last kid was put to bed, we heard the slightest chirp from one of the alarms. It was completely silent but we still barely heard the alarm. There is supposed to be alarms on every door and window leading outside, but this house in particular had an alarm on one of the bathrooms.
We assumed that it was bathroom door slightly swinging open, but Staff 1 (client is the one who ran away) walked out of the office and I assumed that they went to check out the rest of the house. My client's room is right across the office door with their door wide open due to personal preference. The office door was never fully shut and I was sitting by the door to ensure that I could keep visual/audial supervision for my own client practically at all times. Staff 2 (client is in the other side of the house) was at the desk working on their paperwork and peeked out the window that shows the front lawn. They didn't see anything or say anything, and resumed their paperwork. About 20 mins later, Staff 2 goes out to warm up his car since it was almost shift change and the overnight staff was supposed to be coming soon. Overnight staff pulls up as Staff 2 was out there and the two had a conversation before Staff 2 drove off without being relived from duties. Overnight staff walks into the office and says "Y'all didn't notice you were missing a kid?" Staff 1 and I are obviously confused and thought that they were joking but they tell us how the kid got out and that Staff 2 left to drive around in search of the kid. Staff 1 walks around the neighborhood while I stay in the house because atleast one person needed to be in the house and the overnight staff was still clocking in and doing shift change duties. The kid is found at a park down the street and brought back to the house within 15-20 mins. All three of us were relieved from our shift and informed that we would be suspended pending investigation. This is because the company policy is to maintain supervision with 15 minute checks, at minimum, even if the clients are in their room. In other words, we realized that the kid was missing 5 mins late.
HR contacted me 4 days later and said that they filed a report of child abuse and that the investigator will be reaching out. I don't hear anything from anyone for the next week and a half. I then reached out to my manager and informed that I haven't been contacted yet and they responded that they will reach out to HR. I get contacted by the investigator 3 days later and find out that they weren't able to reach out because they had spelled my name wrong on the email. I was under the assumption that cooperating was in my best interest if I wanted to return to work as soon as possible and so I told the investigator my perspective of the events and was very detailed and included timestamps. This is something that I have picked up while working there to provide the most accurate information relating to tracking client's behavior. At the end of the interview, the investigator stated that they didn't really find incriminating evidence but that was still up for debate until the investigation has been concluded. The investigator mentioned that it may be possible for me to be brought into court as a witness if it reaches that stage.
I don't hear anything else after this for another 2 weeks before I reached out to HR and left the investigator a voicemail. HR informs me that I am still employed but that they didn't have any other information. Another week or so goes by and I still haven't heard from the investigator so I sent them a text message. I got a reply the following morning stating that there was no new information at the time. At this point, I have been suspended for 8 weeks and applied to a former minimum wage job to have a source of income. A few hours ago, I got a text from a coworker checking in on me and I find out that Staff 1 got fired immediately and that Staff 2 returned to work after 1 week. I am now trying to look for a legal aid or a lawyer for low-income people but I am not really sure how to go about this situation. I am looking for advice because I have no family and no connections to guide me through this foreign situation. I maintained supervision on my own client the whole time and I assumed that my fellow coworkers did their duties in ensuring their clients' safety. I do not think that I am implicated in this situation at all.
What should I do?
** Side note: Specific details have been simplified due to the sensitivity of this situation and any identifying characteristics has been anonymized and may cause confusion. I apologize for that.

Okay, I'm honestly confused to a huge degree so maybe you can tell me where I went wrong and if and maybe why I ATAH.
Since my brother (34) accuses me of treating him badly, here is a caption of the most recent events and most important facts.
GENERAL ASPECTS

we have a bad relationship since I'm about 12 (he was probably 15)
we had heavy arguments full of insults and physical fights.
when I was in my twenties he attacked me which resulted in permanent damage to my nose.
since I moved out we're barely in touch
he stayed mostly in his room when I visited (he still lives there).
every year he blocks and unblockes me, leaves and rejoins the family group. This mostly happens after I text my mother about something I don't think is okay, for example that he took my stuff that were presents or that there were different standards for him and me.
my mother witnessed him insulting and physically hurting me since were young but doesn't do anything and simply states that it hurts her to see our relationship being that bad.

THROWBACK SINCE DECEMBER

two weeks before our grandpas funeral he told me I should not come over after the funeral.
at the cemetery I told him to speak quieter since what he was saying was something that would cause him huge trouble. He insulted me as a result.
on my birthday he was there despite me telling our mother several times I didn't want him there. He was surprisingly nice and even had a present for me. My mother pressured me to tell him about my pregnancy. He was nice to me from then on.
my mother told people about my pregnancy and a few weeks later the gender despite me telling her repeatedly how important it was for me to be the one to share the news and experience the reactions. Therefore I let her know how very inappropriate this was and that I wasn't going to share any more information with her.
I texted my brother and told him that I hoped he wouldn't behave as egoistic as she did. He blocked me and left the family chat.
he unblocked me shortly before his bday, so I wished him a happy birthday. He replied "thank you".

NOW COMES THE CURRENT WTF MOMENT

so this morning I see that he texted me last night.
he was telling me there were two options: we'd be a normal family and acted that way or I'd keep on acting the way I do, in which case he'd stop any contact towards me and the child wouldn't have him as an uncle as it would be too stressful for the child. He wouldn't let himself get treated this way.

He did not tell me in which way I was treating him badly or in which way my behaviour was wrong. Mind you, I revealed everything that happened up front so I am honestly heavily confused.

exactly one hour later he texted again, stating that he chose the second option as expected and then he blocked me.

I am honestly heavily confused so please help me out because my first thought was: wtf, is he completely nuts now? My second thought was: wtf are him and my mother talking about me that led to this? My third thought is: I am the one that gets treated badly repeatedly and never saw any apology. I am simply sticking to my boundaries and keeping a distance. So what am I missing here??
So... AITAH for the way I treat my brothefamily?
TLDR: my brother blocked and unblocked me constantly. After telling him to not behave like my mother and spread all the baby news he blocked me. Unblocked me before his bday So I wished him a happy bday. He then send me an ultimatum and decided for himself the answer. AITAH?

26 AMAB treated for a suspected PE 3 years ago stopped Eliquis 1.5 mo ago, panic disorder, no prescription meds, less than 6 units of alcohol per week on average, former smoker, moderate use of nic vape.
About 1 week ago, I recovered from a cold perfectly normally, but still coughing up thick white phlegm. I've started using a new toothbrush and that's been knocking off a bunch of plaque.
Not sure if those are related, but over the last two days, my entire body has been super sore out of nowhere and my thighs and calves have been twitching. It's much worse when I'm sleepy, but other than that, it's pretty constant. The pain is throwing off my sleep schedule and making it hard to get out of bed, so my life is a mess because of whatever is wrong. I've tried to make sure I'm hidrated and have taken Tylenol and Ibuprofen, but that's not helping.
I've never had anything like this happen to me before and I can't afford to go to the doctors office for another thing that's just anxiety related. Is there anything serious that could be causing this, or am I good to just try to wait it out?

I'm still using the S7 active, but I will need to upgrade soon because of outdated software, broken screen, and worn-out battery. I also find I have to constantly delete apps to update them and the 32gb of storage just isn't enough anymore. I'm thinking when I upgrade my phone, I'll get the A35.
I really like the idea of having the large OLED screen. I need a decent camera. I'm not too into mobile gaming, I play Nintendo and other light-weight arcade games on my phone. Though I've heard the exynos 1380 will cause lag even for normal usage. Is it smooth and responsive enough for day-to-day use? What about the battery life? I intend to use the phone for years. I'm also an US customer and the options are quite limited compared to what's available internationally. They've dropped the A5x from the US market.

Hi, sorry if this seems so jumbled. I just want to start of by saying I am NOT diagnosed. In the future I plan on seeking out an evaluation.
But anyways, one of the reasons I believe I may be autistic is due to the fact that I don't understand a lot of things socially. I'm quiet and polite, I'm kind. Most of the time I'm genuinely just chilling. I am kind to people because I know the world and people are cruel. I don't believe I'm like "creepily" overly kind where people feel as if I'm invasive. I have never understood why people talk badly about others behind their back and I don't participate. I find no reason to because why should I? It's their life, let them live it.
I also want to say I'm a young woman in her 20s and unfortunately women can be mean and sneaky and unfortunately it seems hard to find friends who are genuine.I'm not saying that to be offensive at all or to sound like the "I'm not like other girls". I genuinely just don't understand why. In high school it was of course especially bad. I'd have girl friends that would be genuinely nice for years. And suddenly it's like a weird mask comes off and they get jealous and angry. I wouldn't even call myself conveniently attractive so I don't believe to be a threat in terms of looks. I'd always respect boundaries regarding their boyfriends, never texted them and only hung out with them when my friend was around. I'd never even sit close to them. But it seems like a weird possessiveness would take over.
I had a best friend of over 5 years. We were inseparable. We laughed and cried together. But when I finally got a boyfriend (fiancé now) that treated me kindly (both of us unfortunately have a history of unstable and abusive relationships), it's like that mask came off and jealousy came roaring in. She suddenly stopped talking to me as much. After I moved in with him I'd offer her to come over (My fiancé would as well) I'd still try to face time her regularly, I'd text her and ask how she was doing. She would constantly make excuses as to why she wasn't talking as much and coming over. Unfortunately we had a very bad falling out which included her accusing me of abandoning her despite me reassuring her and making my best efforts to remain in contact. I felt awful because I never meant for her to feel that way. My fiancé would constantly reassure me it was jealousy and that it was her own problem and that I did the best I could. When I tried to speak to her calmly about it, it seemed she would attack my character and kept reiterating that I had abandoned her. After I moved she also began hanging around this guy, let's call him J. Who disliked me for no reason. I was friends with his fiancé and I used to think he was my friend too until my former best friend informed me he would talk badly about me when I was not there. That hurt me of course because I genuinely enjoyed his company and he was friendly to me. After I moved away she began hanging out with him more and she said later on how he was the only one there for her when she would question why I abandoned her.
That was a couple years ago now and as silly as it sounds in still greiveing it and trying to understand, not just the one incident but the similar ones I had growing up. I have trouble understanding how jealousy works, because I always celebrate my friends and family's achievements. What did I do wrong? I'm really sorry if this seems weird or not for this sub. I just thought that others here would understand the frustration of not fully understanding social norms.
So, TLDR: Please try to explain to autistic (possibly) woman why NT women are jealous all the time. Thank you.

Hey there— I know what you’re thinking, why do I still have it in? Lol
Basically, despite taking my adderall as prescribed everyday for YEARS, for some reason I could never remember to take my birth control pills constantly everyday… which was scary for me as someone who is somewhat sexually active and I never wanted to put myself or my FWB at risk for pregnancy. I’ve heard terrible side effects about the shot like rapid weight gain, all over acne, etc. and the thought of an IUD freaks me out… I won’t try to explain it too much, if it’s sort of a sensory or just psychological thing, but I can’t consider it.
So, that led me to nexplanon after hearing mostly good things about it from my friends and family who have it. Some warned me about a couple months of bleeding and I accepted that, but never expected this. I got the implant early December of 2022, and have bled everyday since— so right at 1.5yrs/18mo. Every now and then I get a day or two of relief where it’s so light it’s border line spotting, but for the most part it’s heavy.
I’ve brought it up during my normal every 3 month checkups (who btw didn’t insert it, I had to find someone diff for that bc my practice didn’t do them) and none of my PCPs (practice has gone thru like 3 in the last year) have seemed concerned. I mostly get answers like, “well that’s a long time but it’s different for everyone”. I mean, I know it is diff for everyone but… damn… I’ve not heard of ANYONE bleeding consistently for that long on it.
At the end of the day, I’d rather have it in and be inconvenienced by the bleeding since the heaviness is varying at least and not be pregnant, than take it out and be forgetful with the pill. However, if these symptoms are an actual cause for real concern and it’s fucking my body up in an unknown way— then I’d bite the bullet and take it out.
Has anyone had a similar experience? If so, did ANY doctor tell you that it wasn’t normal, explain risks of bleeding that long, or insist on taking it out? If there is some critical info I’m missing that my doctors don’t know or are too lazy to look up, then I’d love to know about your experience if it is similar and can offer some perspective. TIA! 🫶🏼

So recently i have not feeling very good, mentally. Whenever i am not doing mentally good, i don't feel like talking to anyone. It's hard for me to keep up with people. I don't feel like talking to anyone. I dogde their call, ignore their texts. So the people here I am talking about are mostly those i met online. From few days i am just saying,"hey i am busy, can we talk later?" And when i don't text him after that too, they kinda tuant mee. Which gets more frustrating, then I lose my calm. Recently i ended things with someone, i met with that person online only. But i never felt anything, nor did we talk that much. Cause i didn't find it any interesting. But the constant messages from that side made me reply. Like i am not someone who will ignore people who are putting so efforts to talk to me. Just few time ago i clearly said that i don't want to entertain anything which doesn't have any meaning for me. Kinda harsh, but it is what it isss. I kinda feel guilty too, but again.... I can't do anything. And why do people start flirting like crazy after two days of talking to someone 😭 that actually gets on my nerves.
And why do people think that if someone's talking to you they are thinking of something, like uk they plan this whole stupid thing that oh now we are talking, then i will constantly flirt and then boom we will be a thing. Ugh as if it's so easy. This is very annoying tbh. So now i am kinda feeling bad how i abruptly ended things and just blocked them. Am i in wrong here? Honestly i have no capacity of talking to people and investing myself in them without any meaning. Like if i am not interested, nor finding any meaning in it, why should i continue it???? And i appreciate them trying and all, but sorry. I just can't. Specially when i am dealing with my stuff and they try to be uk be there for me and then they will talk as if they know me, c'mon not even two weeks. That irritates me. And when i say, "hey i am not feeling good, i will get back to you in few days" people can't understand it broo. They will text after two hours again, to ask how i am doing, oh please. Give me a damn breakkk.

I want to have children, I want to buy a home, I want to work my job, I want to live healthy, I want to not step on others to make all that happen. It is impossible at this day and age to do all of them, maybe not even half at the same time.
The water we drink is poisoned. Whether it's waste legally dumped from factories making untested chemicals, or from the pipes it flows through or from the containers we drink from, it doesn't seem like you can drink untainted water.
Our food is poisoned. Whether it's the untested chemicals put into it to make it last longer, taste better, become more addictive and become cheaper, or from the chemicals known to cause health issues, sprayed on it to keep bugs off. If we are talking about meat, factory farmed livestock is given plastic to eat, pumped with hormones to grow bigger and faster, and all that's without getting into the torture of their short lives in the dark with no room to move, living in their own excrement.
Our shelter costs more than ever in American history, not just to own, but to borrow. Broken homes are being sold for what more than half the population could afford to "buy." Buy is a loose word because over 3/4ths of Americans live Paycheck to paycheck. We don't have money to "buy" anything. We have to borrow money from institutions that have crashed our economy, in order to hopefully, eventually own one of these broken homes. If you borrow shelter (rent), you are at the mercy of your landlord, almost guaranteed to have the rent go up every year and lose your down payments when you move out. If you refuse to buy or borrow, wherever you stay is likely illegal and the country is working on making it a crime to sleep outside. You will be productive, whether is by "choice" or in prision.
Our environment is poisoned. The air you breathe, the water you swim in, the ground you grow crops in, is it safe? Have you gotten it tested? Sure there are "acceptable" levels of everything, but who is it acceptable to? The people living in it or the people polluting it? Can you go for a swim at your nearest beach without getting tar balls stuck to your clothing or your dogs fur from the multiple offshore oil rigs crowding the sunset view? I can't. Can you swim in the lake or pond nearest to you? I can't. Its prohibited and I cannot find a specific reason, but I'm sure it has something to do with the water cooling the Power plant located there. Somehow the fish have been cleared as acceptable to eat though. If you can't find somewhere to swim, you better find a way to cool down because this summer will be the hottest on record until next summer and so on. You sure you want to live in the hottest parts of the country right now? Will they be habitable in a few years? Will even the poisoned water be available to drink?
Our medical care is so expensive we either don't have it or are so afraid to use it for fear of bankruptcy. Insurance companies are constantly denying payment for basic medical needs and death causing events. Cancer will kill you and if it doesn't, the bill at the end will make you wish you died instead. If you wanted to try and pay for it yourself, the insurance industry has caused even just basic services to sky rocket in price, it's impossible. A 15 minute checkup is $400 out of pocket at the medical office nearest me. That does not include the blood work they send you to a different facility for, or any other xrays, medicine or general care you may need otherwise.
Our jobs are so level locked that if you've got no education, you'll make enough that the government will assist you with some needs like food. Your community has been trained to judge you for it, thinking you're cheating the system because you don't want to work, when in reality it's whichever corporation your working for, actively gaming the system so they can keep their labor costs as cheap as possible. If you've got some education, you're probably living to work. Yeah you only make what minimum wage SHOULD be, but if you work 80 hours every week,, you might be able to pull off a lower middle class life style. With some education, you might even be able to sneak into a 9-5 where you don't have to work as many hours, but you're still not making enough to meet every basic need. If you have higher education, you might be doing alright, or you might be unable to find a job, while stuck in nonexpiring, crippling debt. Maybe you're somewhere in between. And even if you've got a great job... is it safe? Did the shareholders make enough so that there won't be a massive round of layoffs this quarter? Did the right political candidate get elected so the field you work in isn't shut down until the opposite party gets back into power?
Not every American is in this position, there are lucky ones who come from enough money that they'll never know struggle, never know food/wateshelteHealthcare insecurity. But the one thing that is STILL unavoidable, the one thing EVERYONE must participate in is stepping on others to live day to day. Everyday, we interact with, see, touch, feel or use a product that was made with questionable labor, if not outright slave labor and human suffering. From the people mining the basic materials to create products, to the people working the factories that products are produced in, to your neighbor that works at the shipping facilities to get it to you, the whole line is corrupted and meant to squeeze the absolute most out of the workers operating everything. The threat of losing even more of your basic needs keeps you in line, if not threat of physical and emotional torture.
I am only smart enough to see the things that are wrong in the world and recognize that it is unsustainable, but I'm too dumb to solve any of it and convince others to help.
So how do we give up without giving up? How do we get rid of our morals and act like everything is fine? How do we continue on feeling good about the systems we have in place, knowing there is so much suffering involved? How do I make a concious decision to bring another human life into this world, to experience what Im experiencing, but for it to be so much worse by the time they can recognize it? It seems that there is no way to change everything and we are headed towards inevitable collapse, so how the hell do we enjoy the ride that's left? I see people do it everyday. Not doing it is pure depression and I am so exhausted from being depressed.

So recently i have not feeling very good, mentally. Whenever i am not doing mentally good, i don't feel like talking to anyone. It's hard for me to keep up with people. I don't feel like talking to anyone. I dogde their call, ignore their texts. So the people here I am talking about are mostly those i met online. From few days i am just saying,"hey i am busy, can we talk later?" And when i don't text him after that too, they kinda tuant mee. Which gets more frustrating, then I lose my calm. Recently i ended things with someone, i met with that person online only. But i never felt anything, nor did we talk that much. Cause i didn't find it any interesting. But the constant messages from that side made me reply. Like i am not someone who will ignore people who are putting so efforts to talk to me. Just few time ago i clearly said that i don't want to entertain anything which doesn't have any meaning for me. Kinda harsh, but it is what it isss. I kinda feel guilty too, but again.... I can't do anything. And why do people start flirting like crazy after two days of talking to someone 😭 that actually gets on my nerves.
And why do people think that if someone's talking to you they are thinking of something, like uk they plan this whole stupid thing that oh now we are talking, then i will constantly flirt and then boom we will be a thing. Ugh as if it's so easy. This is very annoying tbh. So now i am kinda feeling bad how i abruptly ended things and just blocked them. Am i in wrong here? Honestly i have no capacity of talking to people and investing myself in them without any meaning. Like if i am not interested, nor finding any meaning in it, why should i continue it???? And i appreciate them trying and all, but sorry. I just can't. Specially when i am dealing with my stuff and they try to be uk be there for me and then they will talk as if they know me, c'mon not even two weeks. That irritates me. And when i say, "hey i am not feeling good, i will get back to you in few days" people can't understand it broo. They will text after two hours again, to ask how i am doing, oh please. Give me a damn breakkk.

I first had abdominal/arm weight gain (with purple striae) and hirsutism several years ago, and have been actively trying to find answers about the cause for almost the last 4 years.
Since then I’ve had (very frequent) headaches, and consistent brain fog/trouble concentrating, memory issues and trouble putting sentences together, extreme fatigue and nighttime insomnia, hot flashes/night sweats, permanent red face, joint stiffness, occasionally blurry vision, constant high heart rate, slow progression of the hirsutism, hair loss on my head, bruises/marks linger for weeks, and feelings of emotional instability. Probably forgetting some. Many of these are recent in the last year.
I have elevated glucose and mildly elevated prolactin (40s) for the last few years. Normal blood cortisol/ACTH (though only done in the afternoon) and 2 UFCs over the 4 years that were normal.
I was told the prolactin meant there could be an adenoma for the past few years and finally had the MRI done after asking if it could at least be ruled out - 3.5mm pituitary adenoma.
I’ve seen a few doctors and they have either suggested a psychological cause, or told me that an adenoma is meaningless, harmless, and very common. Nothing to monitor or look at again. Every case study I’ve read, finding the adenoma was like the final puzzle piece that brought it all together, especially in light of normal bloodwork. To hear that it’s inconsequential hasn’t been sitting right with me. Hard to ignore the brain tumor and go about my life never thinking about it again.
Am I way off base here? Is this really nothing noteworthy and just some very normal menopausal-type symptoms and the no-energy, never enough sleep of early 30s? Will an anxiety med stop my dark hair growth? All joking aside, to hear “you’re fine” over and over while I can barely stay awake through the day and my heart rate sits around 110 on a good day has been demoralizing.
I’ve lurked here long enough to know many of you have struggled with the exhausting process of diagnosis. I’m just only doubting myself and wondering if I’m on the wrong track and maybe need to pursue a different type of specialist. I know an adenoma can be nonfunctional and plenty of people have no symptoms, but is an adenoma that was searched for due to symptoms sometimes just no big deal? Does this sound like Cushings is even still a possibility? I would need a new doctor regardless because current one says no further evaluation or investigation is necessary.

I think I might be at my breaking point, and I feel like I need to rant amidst all the uncertainties in my life. At the same time I feel weird sharing about my personal life to others, but sharing a burden of such kind seems like a remedy(maybe?). I will try to be coherent. (TL;DR in the end)

I've always been someone who's struggled with his identity. Even in my mid 20s when most start to grind for their future, I'm here passively failing at almost every juncture in life. I will not lie when I dare mention I was a happy to go child back in my early teen days. Shy & introverted, but at the same time motivated, smart, and a playful kid. Had a lot of friends, no close ones tho, but used to indulge a lot in sports and other activities with them. Once I moved to a different place prior to my 10th grade, it's where life started to shift for worse. I've started to struggle a bit with academics, motivation, friendship and health. Also, I realized how alone I was, as this is the stage in school life where most kids were in strong friendly relationships already, and being an outlier was certainly not helpful. My 12th results were horrible, compared to what I had dreamt in my younger days, with my eyes once set on becoming an astronaut too. No way with such horrible grades I was gonna be able to pursue anything of that sort. I was there lost and confused, gazing outside my window during my 12th break post the results. I had horribly fucked my jee advanced, and not a surprise as my motivation and intellectual for academics had already started a steep decline. Somehow, I still fought back and found a decent college. First year was great, maybe the move to a different city was a fixer, but I thoroughly enjoyed that time. All this was just for the first year tho, as the next three especially last 2 were just horrible. I still remember crying alone in my room during festivals when I had no one to hang out with, everyone was so distant from me. I resorted to video games, and although it was a terrible phase, but I'm happy I was able to enjoy some really great games, and amidst the loneliness it was the only sort of comfort for me.

It became much worse when the corona phase struck, I was still in my last year, but it sucked so much with online because I had planned long back to enjoy my last sem, reach out to friends and go on some hikes or shit. Now, a guy who's already been lonely and depressed grew even more distant to everyone, lost much of contact with everyone. Life was absolutely shit. There was a girl in uni I had a crush on, and maybe I believe she liked me too, we were normal friends, but even she seemed not interested and I didn't felt like forcing it further. Soon, I was in a terrible state, sleeping barely 3 hours, wasted my time watching Youtube and Twitch, playing video games, and listening to just melancholic music and thinking about ending my life, but I just didn't had the courage.

Somehow through all this clusterfuck I was able to find a decent enough job, it's sort of chill on most days, but boring. The work was fine for the first couple of years, but I absolutely don't enjoy the work and the teammates, and wanna move out. Have been job hunting for a couple of months, but no luck so far. During this time, tried to bring in few changes in life, like not spending too much time on any social media, it's been great as I'm not getting constantly bombarded with toxicity online. Also, started to goto gym, it's only been almost 2 months, but already have felt so good, from being a unhealthy loser to a healthy loser is somewhat of an achievement unlocked. So, yeah for the most part my life is just me going to work, goto gym, study for a better job, and repeat. On weekends or off days I spend time with family and play video games. Sadly, there's no part where I got to hangout with friends or s.o. because I got none. I know most people say you don't need those if you got family, but I feel like you need them, since some things are better shared with friends. I've felt like I'm a patient stuck in a high security mental asylum, and with no escape, a deadlock infinite loop. Currently contemplating my life choices about finding a better job, even still not sure which field I wish to pursue in IT, and at the same time thinking about moving to abroad, no I'm not rich, would've to take loan, but thinking maybe that may motivate me again to push further in life. I seriously want some normalcy, but I'm somewhat stuck in life, absolutely hate every fucking day, I'm seeing a dark future. I wish someone could fix me (self-insert Blade Runner 2049 reference).

I know a lot of you might be busy in life and all of this may seem too much of yapping, so here's an ai summary (TL;DR) :-

I am reaching my breaking point and need to vent about the uncertainties in my life. It feels strange to share personal details, but I believe it could be helpful. I have always struggled with my identity, and in my mid-20s, I am failing at almost everything. I used to be a happy and motivated child, but when I moved before 10th grade, my life took a turn for the worse. I struggled with academics, motivation, and friendships. I felt alone and different from my classmates. My 12th-grade results were terrible, crushing my dreams of becoming an astronaut. Despite this setback, I managed to find a decent college. The first year was great, but the next three, especially the last two, were horrible. I found solace in video games during this lonely time. Things worsened during the pandemic as my plans to enjoy my last semester and spend time with friends fell apart. I fell into a deep depression, sleeping only three hours a night and contemplating suicide. Eventually, I found a decent job, but I don't enjoy the work or my colleagues. I've been searching for a new job without success. I have made some positive changes in my life, such as reducing my time on social media and going to the gym. While my life now revolves around work, the gym, and studying for a better job, I miss having friends and a significant other. I feel trapped and uncertain about my future. I am considering changing careers or moving abroad to find motivation. I long for normalcy and someone who can help me.