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I read 17/18 on my last board, overall had a good time. :D
Avatar:
Conan
Skill: Beat the trap tile once, roll a prompt
Roll #1:
A 4, prompt: enemies to lovers - BASARA .
Roll #2:
A 2, prompt: sword & sorcery. I'll go ahead and read my new volume of Crimson Spell.
Roll #3:
A 3, prompt: based on a webnovel - Men of the Harem.
Roll #4:
A 5, prompt: crossdressing - Ai ga Aru Kara Osu!.
Roll #5:
A 2, prompt: published between 10'-'15 - Jackass!.
Roll #6:
I swear I have some kind of superpower? curse? because when I think 'I just know it's going to be a one' right before the trap tile...I get a 1. I'll go ahead and use my skill because why not. Prompt is read a manhwa - Chess Isle.
Roll #7:
A 6, vers/switching - Love Love Reversible Couple Heart Beat Anthology.
Roll #8:
A 2, generate from CR list - #51, I guess it's about time I read more Meitantei Conan: Zero no Tea Time...
Roll #9:
A 1, prompt: opposites attract - BoiGyaru.
Roll #10:
A 6, prompt: weapon on the cover - Kimetsu no Yaiba.
Roll #11:
A 2, prompt: longest titled - Touken Ranbu Anthology - SquEni no Jin .
Roll #12:
A 6 and the end. Shortest board in a while! Reward is Wind Breaker.
~Manga TBR List~
[Adventure/Fantasy] BASARA
[BL/Fantasy] Crimson Spell
[Reverse Harem/Politics] Men of the Harem
[BL/Romance] Ai ga Aru Kara Osu!
[BL/Romance] Jackass!
[Action/Mystery] Chess Isle
[BL] Love Love Reversible Couple Heart Beat Anthology
[Slice of Life/Detective] Meitantei Conan: Zero no Tea Time
[GL/Romance] BoiGyaru
[Action/Supernatural] Kimetsu no Yaiba
[Slice of Life/Fantasy] Touken Ranbu Anthology - SquEni no Jin
[Action/Slice of Life] Wind Breaker
x2 shoujoi/josei, x3 shounen/seinen, x4 BL, x1 GL, x1 other
It's mostly been because I've never had any PokéStops or gyms that I could access from home/work. On the days when I'm out and about, I could walk around and visit them, but that's definitely not something I could do every day. Especially now that my job is hybrid. I only have so much capability to deal with people in a given week, so on days when I'm working remotely it's not unusual for me to avoid all human contact whatsoever.
And, well, the game intentionally punishes you for that. Outside of a brief period during the height of the pandemic where they extended the range of PokéStops and gyms, you miss out on things if you don't actually go outside and spin those regularly as that's where you get a lot of items that can be used in the game to do things like catch new Pokémon.
Anyway, I do have a point! There's a PokéStop that I can access from anywhere in my new apartment. I've been playing the game significantly more the past month or so because it's so much more rewarding when I can easily access new items (including Poké Balls).
+ Listened to More Everything Forever: AI Overlords, Space Empires, and Silicon Valley's Crusade to Control the Fate of Humanity by Adam Becker.
WHAT A BANGER! I anticipated that this would be about how fucked up our tech overlords' worldviews are from a moral and public policy perspective, and that certainly played a large part in it. But it ended up being more about why they're wrong about the very tech they're hyping--why the claims they make are not actually possible given, like, physics and the nature of the universe. Which is not an angle I'd seen explored before, and I would have expected it to all be over my head. But Becker is absolutely fantastic at explaining complicated tech and science-y things in a way that I could understand--at least enough to know that these Silicon Valley guys are full of shit.
The moral arguments are woven into all of this; Becker has a lovely humanist approach to the world and a deep appreciation for the humanities. He's clearly repulsed by the perspectives and priorities of the people who are running our digital world (and, increasingly, our physical one as well), so I felt safe in his hands. I often feel alienated from STEM subjects both because math doesn't come easily to me and because the current discourse around it seems so anti-human to me. But Becker reminded me that there's really no boundary between the humanities and STEM and that if you appreciate both, you better serve whichever one you're focused on. Life, nature, the universe is one interwoven textile and needs to be understood as such.
The more I learn about the decision-making class in Silicon Valley, the more I believe that they hate all the things that make us human--art, care, struggle, nature, bodies, again, death, humility, the mutuality of relationships. All of these people are absolutely terrified of death and yet, if they did succeed in their (futile) endeavors to live forever, what would they do with all that time? They're certainly not investing in learning about the world as it is or getting to know other people or creating beautiful things or just enjoying nature. So what would be the point of living forever? They have no answer to this and if they weren't doing such terrible, terrible things to our society and nature, I would feel profound pity for them. As it is, I'm just angry. It's baffling to me that we allow the most morally vacuous people in the world to make consequential decisions about the fate of humanity.
My one complaint is that I wish Becker had read the book himself. Judging by his new podcast Dreaming Against the Machine, he's got the voice for it, and I always, always prefer to have the writer read the book if it's possible. The guy who read it did fine, but there's just no replacing the personality of a writer.
+ Read The House of the Patriarch, the 18th Benjamin January series. You may ask yourself, "Is 18 simply too many books in this series?" And the answer is "NO!!!!" There can never be too many books in this series!
For those of you who are new to my favorite currently-being-written series of books: these historical mysteries follow Benjamin January, a free man of color, in 1830s-40s New Orleans and beyond. The mysteries are good, but they're really an excuse to explore Ben's world: the complicated and colorful people he knows and loves and fears and hates, the vivid and singular and meticulously-researched world of antebellum New Orleans. These are books about power and oppression, about resisting it and not being able to resist it, about building relationships with people who are very different than you are, about how those relationships are really the only thing worth anything in a world of darkness and cruelty. I love them with all my heart.
This is one of the not-in-New Orleans books; Ben is searching for a young white woman who disappeared in upstate New York's "burnt over district" in a time of weird religious groups. A favorite topic of mine! My first thought was, "We're going to get a Joseph Smith cameo!" but no, we're a few years after he left for Illinois, so while he's mentioned a time or two he does not show up. The historical cameo we do get is much more unexpected and made me laugh. The cameos are always such a fun part of the not-in-New-Orleans books, and Hambly's writing is grounded enough that Ben never quite turns into the Forrest Gump of the antebellum US (and Mexico and Cuba and France and wherever else he goes!).
The mystery itself is engaging--I was very invested in Eve Russell, who became one of my favorite one-off characters--and, as usual, Hambly makes fantastic use of a period of American history that doesn't get a lot of fictional attention. I especially appreciated that palpable danger that the non-white characters were in even in ostensibly "free" New York--there are traffickers everywhere just waiting to capture free black people and sell them into slavery down south. No one can breathe easy because everyone is in danger all the time. Of all the fictional media I've encountered, this series as a body of work is one of the best at communicating the totality of the chattel slavery system--how it affected every single thing about life for black people, every moment of every day. How no one was ever, ever safe and how hard people had to fight for even the relative safety that a few were able to find. How it tainted the whole society, how it curdled souls. I always come away with an understanding of just why the Civil War had to happen, why the abolitionist movement probably never would have succeeded without violence. Slavery had to be ripped out at the roots.
Anyway, since we weren't in New Orleans, I missed Rose and Hannibal and Livia and Dominique and Shaw and Olympe and everybody back home, but we did get some excellent Chloe scenes, which are always a bonus! (Chloe!!!) As usual, I spent the whole book going, "When will Ben get to go home? When will he get to have a bath and a good meal and a full night's sleep and see his wife and children???" because nobody whumps their main character the way Hambly does.
But somehow no matter how dark the subject matter of these books are, they never make me feel hopeless. Heavy with the reminder of all the things that people do to each other, yes, but also fiercely grateful for all the ways we find to take care of each other. Gah, I love these books!
+ Listened to Culture Creep by Alice Bolin, a collection of essays at the intersection of feminism and pop culture. Your degree of enjoyment will depend largely on how willing you are to read personal essays that dive deep into things that most people would say "it's not that deep" about (Animal Crossing, wellness tracking, teen magazines, the Playboy Mansion). Most people's eyes would probably glaze over, and honestly I'm not sure if I would have kept up with this if I was reading it, but listening to it while working was enjoyable enough. I don't care for memoir as a genre unless the writer is really freaking fantastic, so when things are too person, I tend to check out, but this managed to be rooted enough in the texts themselves for me to never do that, and Bolin has some really sharp insights throughout. All in all a fine audiobook experience.
What I'm currently reading:
+ Listening to God, Human, Animal, Machine: Technology, Metaphor, and the Search for Meaning by Meghan O'Gieblyn. Well this is a unique book! It's philosophy and technology all tangled up together, at once personal and universal, about the past and the future, meaning and consciousness and nature. O'Gieblyn is incredibly smart and the book is very challenging in a way I appreciate. I also appreciate that she grew up fundamentalist and went to a Bible college before becoming an atheist; there's this one moment where she talks about how a process that took society centuries of bloody struggle (moving from Christian to secular societies) is something that those of us who were raised in rightwing Christianity have to do on our own in the course of a few years, and I have never heard anyone talk about it that way. But yeah, it's really hard to go from "the world is 6,000 years old" to "the universe is billions of years old" and all that those things imply in a short period of time! It's a lot for an individual human being, and she does an incredible job of evoking the disruption of that and also how things linger even when you don't want them to.
+ Reading Hunting Shadows by Charles Todd, 16th in the Inspector Ian Rutledge series of historical mysteries. This series is set in the UK just after WWI and has a shell-shocked Scotland Yard inspector as its protagonist. These are suitably engaging and twisty mysteries for when that's what I want. They kind of all blur together in my head, but that's fine--I don't need everything to be Benjamin January. I don't like cozy mysteries, and these are not, but they also don't lean too far into the gritty darkness either. It's a good balance, well written, and I continue to enjoy this series as I dip in and out of it.
Books
Read T. Kingfisher's Paladin's Grace for the first time, and found it soothingly undemanding.
Listened to the audiobook of Rick Morton's Mean Streak, about Robotdebt, on the strength of how excellent Morton's livetweeting was during the Royal Commission.
I found Mean Streak initially a bit hard going not just because of the awfulness of the subject matter (which I'd factored in) but because of Morton's extended literary riffs (in the first seven chapters, he draws detailed analogies with Heller's Catch-22, Kafka's The Trial, Borges' entire body of work, and Piranesi's Carceri.
Reading this as I was over Easter, I began to anticipate that any moment now he'd go "According to the Christian gospels, Jesus of Nazareth was crucified by an uncaring bureaucracy. Do you know who else was crucified by an uncaring bureaucracy? Welfare recipients under Robodebt!" like a reverse youth pastor, but he never did, and eventually I came to understand the analogies as not an excessive and unnecessary stylistic choice but rather the last defences of a mind besieged by Lovecraftian horrors.
There was some levity, though: Morton and his publisher were obliged to allow some of their subjects to exercise their right of reply. He provided space for this as an appendix at the end of the book. There were no real surprises in the politicians' responses, just some unpleasant reminders for readers, e.g. Stuart Robert exists and is presumably the same species as us.
Kathryn Campbell's reply, however, was the funniest part of the whole (admittedly deadly serious) book. It was amazing.
Just knowing she paid her lawyers, plural, to draft and send this document to Morton's publishers for inclusion in his book, is such a wonderful reminder of the wide variety of people in this world.
Morton could not possibly have condemned her as harshly as her own self-defence did.
One of the allegations Campbell disputes, in this rebuttal which took 57 minutes 56 seconds for Rick Morton to read (the whole audiobook being 15 hours 32 minutes) is that she is a micromanager.
Another is that (as Morton stated) the commissioner said she "failed to address in any manner concerns about the illegality of income averaging, despite being aware of concerns about the illegality of the scheme".
Having already argued that Commissioner Holmes was wrong; and then that Commissioner Holmes' above finding was only the commissioner's opinion, not a finding of fact; she then felt the need to stipulate that Commissioner Holmes' wording was not "failed to address in any manner," it was "did nothing of substance".
She didn't say I didn't do anything at all, she said I did fuck all. Unless you correct the record to reflect that the Royal Commissioner's report into the worst public service fuckup of the century (so far) said that I did fuck all, not nothing at all, I'll sue you.
Ms Campbell either has never read Much Ado About Nothing (act IV, scene 2), or she did, and she took it as personal advice and unlike Dogberry had the power to ensure she was writ down an ass.
Currently reading: Sax Brightwell's Low Dawn and the audiobook of Rachel Neumeier's Tuyo.
Fandom
Posted a thing.
Crafts
Got around to packing up and sending another Sekrit Project.
Tech
Started watching a five hour YouTube video about data structures and algorithms, then (half an hour in) spent the evening making a number guessing game in Twine Harlowe, using binary search.
Next time I'll use Python or Javascript or something. I don't care that I don't know Javascript.
The problem is, I keep telling myself I'll just do a quick snack-sized learning activity on my phone, and Twine (or another thing I've tried recently, jsdares.com) will seem so convenient and then I'll be in a self-made hell of how unsuited their web-based interpreters are for mobile, ugh.
Garden
Bought some calendula seeds to sow.
Cats
Their previous favourite toy, the Mousie, is on stress leave: after some gastric issues it was eventually diagnosed with disembowelment.
I'm happy to say that Ash and Dory are welcoming the Mousie's substitute, the Birdie, with full lethal force.
How are you all?
Read On Doorstep and rated it 7.5/10. 
Read ch. 19-24 of Men of the Harem! Dropped Kashikomarimashita, Destiny, I was not feeling it by chapter 3 and it probably would've only got like a 6 out of me if I'd continued. Read Fuck Buddy and rated it 8/10! Read ch. 5 of Chess Isle. Read ch. 77 of Blue Exorcist! Read Brand-new ♡ Start, rated it 6.5/10. Read Mine and rated it 3.5/5. Read 2 ch. of Junjou Romantica. Read A Room with No Windows, rated it 9/10!! Read ch. 8 of Shugo Chara! Read Kimetsu no Yaiba ch. 182-183. Read ch. 7 of Witch Hat Atelier! Finished volume 2 of BASARA. Read ch. 7 of Touken Ranbu Anthology: SquEni Formation! Read volume 1 of Otoko ga Otoko wo Aisuru Toki, rated it 6.3/10. Read ch. 11-13 of Wizardly Tower. Read chapter 175-176 of Wind Breaker!Why someone would import this (in 1848 from Ancient Greek psithurisma, from psithurízein, to whisper) when we already had the clearly much better word susurration is beyond me. What's not beyond me is why it never really caught on, except in lists of obscure words.
---L.
Lest We Forget the Horrors: An Unending Catalog of Trump’s Cruelties, Collusions, Corruptions, and C
Early in President Trump’s first term, McSweeney’s editors began to catalog the head-spinning number of misdeeds coming from his administration. We called this list a collection of Trump’s cruelties, collusions, corruptions, and crimes, and it felt urgent to track them, to ensure these horrors—happening almost daily—would not be forgotten. Now that Trump has returned to office, amid civil rights, humanitarian, economic, and constitutional crises, we felt it critical to make an inventory of this new round of horrors. This list will be updated monthly between now and the end of Donald Trump’s second term.
These lists, along with everything McSweeney’s publishes on this site, are offered ad-free and at no charge to our readers. If you are moved to make a donation in any amount or subscribe to our website’s Patreon, please do. This will help support this project and our other work.
ATROCITY KEY
February 2026
Main Index
Trump’s first term
March 2026
Melania Trump Chairs Historic UN Security Council Meeting (Sky News Austrailia)
Justice the American Way (The White House)
Trump Joins Families During the Return of US Soldiers Killed in War (AP)
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April 22nd, 2026: Beats me why some dudes make mistakes. Sure as hell ain't my scene!! – Ryan | ||
Can the salvation of the Literature Club be something as simple as blackmail?
O Maidens in Your Savage Season, volume 2 by Mari Okada & Nao Emoto
Circleville, OH · Sun, 19 Apr 2026. 10pm
After a couple of hikes today— which I'll catch up on later, per (LINK) my change of tempo in blogging about this trip— we came back to our hotel in Circleville. Again we called it an early-ish day, tired out from hiking already. But this evening, unlike the past three evenings in Circleville, we were hungry for dinner here. So we checked out local restaurants.
It turns out Circleville is kind of Chicken Wing-ville. Just within 1/2 of our hotel are three restaurants that specialize in chicken wings. We picked the one that's fast food. It was genuinely good, with very tender chicken and lots of sauce options.
Speaking of what you can find when you check a map of the area around our hotel, "Chicken Wing-ville" isn't the only sobriquet you might come up with for Circleville. You could also start wondering if Circleville is actually.... Hitler-ville. Multiple place names in Circleville are Hitler-this or Hitler-that. There's a Hitler Park, a Hitler Pond, and at least one business named for Hitler. These are just what I happened to notice on Google Maps when I was browsing for restaurants nearby.
WTF? I wondered. Did I accidentally book us into a hotbed of racism like when I picked a hotel near the headquarters of an overtly racist, white-supremacist organization in Arkansas?
No! The Circleville Hitlers are the good Hitlers, numerous other blogs tell me. 🤣 It's the name of an influential pioneer family that helped settle this area in the late 1700s and early 1800s— well before the bad Hitler was even born. Example reference: All That's Interesting blog from 2018 (retrieved April 2026).
I get it that a name is just a name, and the good Hitlers had theirs first. But when a name is held by a singularly awful world leader who declared war on democracies around the world and committed the worst genocide of the modern era, it's time to think about changing. Anybody living in the current time line since, say, 1943 should be able to figure this one out. Changing your name is a legitimate choice. Thus not changing a name, particularly not renaming public landmarks and businesses— which are not like asking a person to change the name they and their parents and grandparents were born with— is also a choice.
My sister's been hogging the washing machine since Saturday and it seems like it may or may not rain this or that day over the next few days, so I probably need to steel myself for doing a quick load when she leaves later, so I'm sure to have clothes to wear (that I like and are comfortable... if you looked at my closet you'd be like, what the fuck, but unfortunately my cold/cool weather rota does not encompass even half of that, and it is still cool enough indoors for long sleeves) on Saturday. If I can, I'd also like to start individually washing that winter blanket, the charcoal gray blanket I'm currently using, my green winter coat, and my house shoes. Either pair. Though I may throw the one I haven't been wearing in the trash at this point, god knows how many times Ciri's peed on them by now.
Ciri was in heat last week and I was exhausted the whole time, to the point that I felt drunk when I went to the store Saturday morning. It was kind of funny because my mom had been hypocritically side-eying my picking up 5% abv cocktails in a can the day before, but also: not pleasant. I'm slowly recovering from that, but the nightmares aren't helping. Neither are the bouts of depression.
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I've been experimenting with extremely low-grade alcohol for a couple of weeks -- and by low I mean "I don't think this counts as breaking sobriety," because the tipsiest I've felt has been 'unexpectedly happy,' twice -- to see how my body takes to it now it's been off it for three years, and also so I could try a drink I saw at Primaprix that looked right up my alley except for the 5% abv. It was delicious. They no longer stock it, of course. ( More chatter about this. )
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Three episodes behind on The Pitt, caught up on 9-1-1 (Buck ;__;) and decided to finish 9-1-1 Lone Star for some reason. I have two episodes left and I assume they're gonna make me cry again so I've been putting it off a bit. This show is a telenovela. For all the NDEs in 9-1-1, at least you can kind of assume things will turn out okay, with one glaring exception. Season 4 of Lone Star was just melodramatic hit after hit, and Judd has been depressing in season 5. Carlos, too, to some extent. I do still really love Nancy and Marjan though. And TK and Carlos's relationship. And Paul. ( Ramble/rant, with spoilers. )
Anyway. I am trying to convince my brain mice to let me do things. I just wanna make maps and edit pictures and the mice are like, "what's that? We don't know how to open an editor suddenly." I'm halfway through Trespasser on Dragon Age: Inquisition, where I am missing most of the trophies for some reason? I'm pretty sure I did the DLC last time, but who knows. It was 2020. I accidentally locked myself out of a bunch of companion quests, but I'm just not putting myself through this game again. It would be so goddamn replayable if combat wasn't so tedious. I have it on easy! It should not take this long to defeat a bunch of bandits! At this point if they had an accessibility 'one-shot enemies' option I would take it. Goddamn. Let me shoot them in the head. Let me shoot them dead in the head, specifically. At least Veilguard let me aim.
I'm very pleased I made a guy and experienced the Dorian romance, though. He is just delightful.
In the last months, weeks, and days of his life, “I will not go to the emergency room” became my husband’s mantra. Andrej had esophageal cancer that had spread throughout his body (but not to his ever-willful brain), and, having trained as a doctor, I had jury-rigged a hospital at home, aided by specialists who got me pills to boost blood pressure; to dampen the effects of liver failure; to stem his cough; to help him swallow, wake up, fall asleep.
“I will not go to the emergency room”—emphasis on not—were his first words after passing out, having a seizure, or regurgitating the protein smoothies I made to pass his narrowed esophagus. He said it again and again, even as fluid built up in his lungs, rendering him short of breath and prone to agonizing coughing spells. He had been a big, athletic guy, but now, in the ugly process of dying, he was looking gaunt. Ours was a precarious existence, but I understood his adamant rejection of the emergency department. Most prior visits had morphed into extended trips into a terrifying medical underworld—to a purgatory known as emergency-department boarding.
I managed to keep Andrej at home while we planned for hospice, until one dreadful night at 2 a.m., when I ran out of hacks. We got into an ambulance and headed together to the hospital.
We had already learned the hard way that if you need admission to the hospital, you can remain in the emergency department—in the hallway or a curtained bay on a hard stretcher or in a makeshift holding area—for more than 24 hours, even for days, while waiting for a real hospital bed. In this limbo state, you’re technically admitted to the hospital but still located in the physical domain of the ER. And the rules governing acceptable care and safety measures become much less clear.
In the summer of 2024, still being treated to keep his cancer at bay, Andrej had suddenly become somewhat delirious, requiring hospital admission to rule out the possibility of infection or, worse, of the cancer having spread to his brain. After we went to an emergency department near our home, in New York City, he lay trapped on a hard stretcher, with its rails up, for more than 36 hours, amid the alarms and calls for the code team, without any clues of whether it was day or night, and with access only to the few toilets shared by the dozens of patients and visitors in the emergency room. None of this helped his mental state. By the end of day two, he knew me—kind of—but had become convinced that the doctors were “the enemy” and that I was their paid accomplice.
After I pressed to move him to a bed “upstairs”—I meant to an inpatient ward—he was transported to a bed five floors higher. I realized too late that this was an “ED overflow area,” according to the paper sign attached to the entrance’s swinging door. A plaque in the hall identified it as a former labor and delivery floor. It had been kitted out with some of the trappings of an actual ward, such as real beds and bathrooms, but not the most important one: adequate personnel.
The space was by turns eerily quiet and wildly cacophonous. Although patients there were undergoing intimate, embarrassing procedures, rooms were gender-neutral. That first night, Andrej’s roommates were a man in a coma and an elderly French woman in a diaper and boots (no pants), who marched around her bed singing like a chanteuse. In the morning, I pestered a harried nurse and got Andrej moved to a quieter room with three beds, where two people died in three days.
The overworked staff did the best they could, but that was far from good care. My husband—who needed protein and calories but could consume only soft foods—was served chicken cutlets. When I noted to one nurse that Andrej’s soiled sheets hadn’t been changed for several days, she directed me to a linen cart so I could change them myself.
That first time, one of several extended ER stays Andrej made as a boarder, I thought perhaps we had just hit a busy time at a busy hospital. When I worked as an emergency-medicine doctor a few decades ago, the ED was mostly empty at the beginning of my 7 a.m. shift. A few patients might be lingering from the day before: alcoholics who would sober up and leave, patients with a severe burn or a bad case of pneumonia who were waiting for a bed in intensive care.
In the decades since, EDs have doubled or even tripled in size. Even so, patients are piling up. When I started asking around, I quickly discovered that ED boarding has become commonplace in the past five or so years and is getting worse, more or less omnipresent in hospitals. “Everyone knows about this problem, and no one cares enough to do anything about it,” Adrian Haimovich, an ED doctor at Beth Israel Deaconess Medical Center who studies ED boarding, told me. “It’s barbaric.”
Measuring the problem has been challenging because data on ED-boarding time are limited. Only this past November did the Centers for Medicare and Medicaid Services finalize a rule that would require hospitals to collect data on ED-boarding times, starting in 2026. Using what other data he could find, Haimovich has shown that boarding for more than 24 hours has increased dramatically for people 65 and older since the coronavirus pandemic.
Once they enter ED boarding, patients exist in a gray zone. There has been a national push to establish “safe staffing” nurse-to-patient ratios in EDs. Even with that, if an ED boarder has a medical complaint that needs quick attention, it’s easy for them to fall through the cracks, Haimovich said: In some hospitals, an admitting team of doctors from upstairs is responsible for the boarders stuck in the ED (but not the associated floor nurses); in others, overstretched ED medical staff must take full responsibility to care for boarders until a bed opens—and that in addition to seeing new patients. Some EDs now routinely hold more boarders—many of them quite ill—than patients being actively evaluated.
Doctors and nurses have complained bitterly about the situation, which forces them to provide inadequate care. Gabe Kelen, the director of emergency medicine at Johns Hopkins University, told me that it’s creating a moral hazard for emergency-department staff. But doctors and department heads such as Kelen are not in control of admissions. Generally, a hospital’s administration parcels out inpatient beds, and emergency-department boarding is in many ways a result of today’s business models and pressures.
When I worked as a doctor, if an ED was overwhelmed beyond capacity, the attending (that was me) typically called in to ambulance dispatch to request “diversion”—ambulances should take patients to another hospital. If a hospital got too full, the admitting office canceled elective admissions. Today, hospitals run like airlines and intentionally overbook, Kelen said. They also have fewer beds than they did a few years ago—in part because nurse (and executive) salaries have risen since the pandemic. An empty, staffed bed is a money loser, so the institution has an incentive to keep beds full and make new patients wait.
“The problem isn’t inefficiency—it’s the way health-care finance is structured,” Kelen said. “Hospitals typically run on thin margins. Elective admissions are prioritized because they tend to be for lucrative procedures like heart catheterizations and joint replacements.”
Admitting patients through the emergency room has business advantages too, even if it means that patients wait for a bed. The evaluation generates charges that typically run many thousands of dollars; once admitted, my husband was still billed the inpatient rate even for a stretcher in the hall. Old, sick, and dying patients are more likely to linger there in part because, after they’re in a real bed, they may take up that spot for days or weeks at a time while waiting for a bed in rehab or hospice, requiring nursing time but not the types of interventions that generate revenue.
Hospitals have tried Band-Aid fixes, such as bed-tracking software and discharge lounges where patients can wait for paperwork or transport home. Many do hire more doctors and nurses and orderlies in the ER to confront the overflow. “Long ED wait times and boarding have root causes that extend far beyond EDs and hospitals themselves,” Chris DeRienzo, the chief physician executive at the American Hospital Association, told me in an email. He listed the high cost of opening beds and the shortage of rehabilitation facilities, and emphasized the precarious financial situation of many hospitals.
But while Andrej waited in the overflow area, we were not thinking of any bigger picture: He was sick, desperate, and still waiting for care. He lingered in boarding for four days before he got a bed. Each time he had to return to the ED, each time he faced a painful wait, he hardened his resolve to never go back.
Thunk. Crash. “Elisabeth, help!” Those were the sounds that woke me at 2 a.m.
I had fallen asleep in our bed, next to Andrej, his head raised with a foam wedge to ease his breathing and make sure food would not come up. Before I dozed off, I listened to his breathing—30 times a minute, two times faster than normal—a sign that he was struggling to get sufficient oxygen. And that racking cough. This was not good.
Now his bruised body was twisted, lying on the floor with his head against the bed frame. He’d attempted to use his walker to go to the bathroom. He was complaining of chest pain, coughing and short of breath. But he managed to get out those words: “I will not go to the ER.”
I knelt by his side in tears, telling him that I loved him but that I could not do anything more right now at home. Carlos, our super, helped me get him into bed and called EMS. I promised Andrej (against hope) that, given his condition, he would surely be quickly assigned to a real room and bed.
What happened next was a blur. I have a vague memory of paramedics arriving, putting him on the stretcher, sliding him into the ambulance, giving him oxygen. I mechanically grabbed his “do not resuscitate” form from under the refrigerator magnet and buckled myself in beside him.
Then he was in the ED, which was thrumming with activity, under the fluorescent lights, with oxygen in his nose, wearing a hospital gown, looking gray and sick. The staff asked what was, for them, the operative question about a guy with widespread cancer: “Does he have a DNR?” Andrej asked me what was, for him, the operative question: “Did you bring my shoes?” He already wanted to leave.
An X-ray showed possible pneumonia, more tumors, and a buildup of fluid in his lungs. A medical team that covers oncology patients wrote an admitting note—he was now a boarder, again—and then retreated upstairs. They started antibiotics and gave him something to help him sleep amid the alarms and shouting. He didn’t.
When I came back the next morning—and two mornings after that—I was alarmed to see him still there on a hard stretcher, his feet dangling off the end, exhausted and in pain. “When will he be admitted to a bed?’’ I implored. If some of the stuff in his lungs was infectious, maybe he could be treated and get home.
Likely soon and I hear your frustration—I came to detest those two phrases.
Neighboring patients came and went 24 hours a day. Some were pleasant; some were screaming in pain or just screaming mad. Pulmonary doctors came and, in this semipublic space, used a large needle to remove three liters of fluid from Andrej’s right lung cavity.
Near the end of the Biden administration, in response to a bipartisan congressional request, the Department of Health and Human Services convened a meeting on emergency-department boarding. Its report, from HHS’s Agency for Healthcare Research and Quality, came out the same month that the Trump administration took office, not long before Andrej’s fall—the last night he spent at home.
“Emergency department (ED) boarding is a public health crisis in the United States,” the report concluded. “Patients who are sick enough to require inpatient care can wait in the ED for hours, days, or even weeks … Boarding contributes to increased mortality, medical errors, prolonged hospital stays, and greater dissatisfaction with care.”
The meeting proposal called for the formation of an expert panel to recommend solutions. In theory, a panel could have weighed in on key questions: Should hospitals—some of which are rich institutions—get paid an inpatient rate for boarding in the ED? Should they have to report boarding times and face penalties for excess? Should they be required to open more real beds, and should requirements for licensing be lessened? How can the country create more rehabilitation beds?
But since then, the Trump administration has dramatically cut that HHS agency’s staffing, as well as its grant programs. (Congress is still pushing to fund the agency.) The expert panel never formed, let alone offered solutions. The Centers for Medicare and Medicaid Services did initiate a program this year that will include voluntary reporting of boarding times in 2027, which will become mandatory in 2028. Bad marks will eventually affect Medicare reimbursement.
In an emailed statement, the Joint Commission, which certifies the nation’s hospitals, called boarding a “serious public health crisis” and “one of the most incredibly complex challenges in healthcare.” Although the organization does indirectly look at hospitals’ “ED throughput” from charts, such data are not comprehensive. Little information exists, for instance, about how many people’s last days are spent on stretchers, in hospital limbo.
None of this knowledge would have helped my dying husband. So I did what I’d promised myself I’d never do: I called a doctor friend, who called the hospital’s VIP office.
Suddenly Andrej was whisked to a real hospital room, with a bed that he could adjust to keep his head elevated, a tray he could eat from, a morphine pump, a TV, a bathroom, and a nurse call button at his side. A room with extra chairs, so his stepkids and friends could visit with gifts and mementos one last time. A room where the caring staff placed a chaise longue, where I could sleep over. That way, when he woke scared and coughing and yelling for me, I was there to hold his hand, adjust the oxygen, and push the button for an extra dose of narcotic.
Until, six days after we got in the ambulance and three days after we’d moved to this room, he woke early one morning, agitated and coughing, calling out, “Elisabeth?” I was there. But then, in a blink, he wasn’t.
Currently reading: Here Where We Live Is Our Country by Molly Crabapple. This is a weirdly dense book—like, not in terms of content but in terms of typography where it turns out to be much longer than it looks. So it will take awhile and I'll no doubt have very scattered thoughts on it. I'm up to a weird point just before WWII where Piłsudski has done a coup in Poland and provided some kind of respite for the Bund there, while Molly's great-great grandfather Sam is in the US, trying to make it as an artist. The revolution in Russia has almost immediately turned sour. The Zionist movement is ascendant in Eastern Europe but still looked on as profoundly unserious by the Bundist majority, who are like, "you're going to be farmers in the desert? Good luck with that and also fuck you."
This is just such an important book, right now in our history with what was once the biggest current of socialist thought in Europe being whittled down to a few of us hobbyists in 2026. It's not just hereness, but a lineage that I think most Ashkenazi Jews are lacking, even ones like me who know a fair bit about the Bund. The majority of Jews in the West have accepted the Devil's bargain of whiteness: give up your culture for safety and assimilation into the power structure, sure celebrate your holidays but now you're part of the dominant culture. There have been times, watching the livestreamed genocide of Gaza, that I have thought, "well, can I just not be Jewish anymore? I want no part of it, I want to wash my hands of it, I cannot participate if this is what most of us feel is okay," but you can't, can you? I mean you can but not in any meaningful way that helps even a single person. It's better to have a history, to know why and how that history has been suppressed, not because of some nostalgia or historical LARPing but because of the whole "first as tragedy, then as farce" of it all.
Which is to say that this book is giving me a lot of feels. You should read it, probably.