My PALS 2018

This post is basically gonna by my notes after reading the pediatric advanced life support, because I'm going in for the update tomorrow and I'm really nervous. Even though I don't really think I'll fail it or anything, it's not material I review a lot. So I've been going over it casually over the past two weeks and I did the little test on line I'm supposed to do. And I'm realizing what a crapload of information it covers, and definitely has me on my toes.

Comparatively, I'd say, Adult cardiac life support and neonatal resuscitation are a bit more straightforward in strategy: you kind of just follow the flow sheet and it tells you exactly what to do. There's a lot more to consider in the pediatric population. For one thing there's the age and size variations: some kids will need to be treated more like neonates, and others will need to be treated more like adults.

There are also medical problems that are a lot more common in the pediatric population than in other populations. For instance: if you find an unresponsive kid out of the blue, you operate under the assumption that what's causing the kid to be unresponsive is respiratory in nature. This is the total opposite of what you do in an adult cardiac arrest, because most kids don't suffer from heart disease. So unless you know the kid has some sort of congenital cardiac condition, or is being hospitalized for sepsis or something, you begin with respiration and you can call out for help but you don't want to leave the patient's side until you've done 5 cycles of CPR. If it hasn't been too long since the collapse, and the problem is respiratory in origin, ventilation support may even be sufficient, so we wanna try that first.

They also go into a lot more detail about specific respiratory problems, and the different types of shock, and none of the medications are, like, a standard dose...they're all based on the patient's weight. So you have to calculate pretty much every dose before you give it.

It's a LOT to remember, and it's so friggin deceptive because the PALS book is, like, the smallest of the AHA books that I've read.

Anyway...I'm just gonna go over my notes one more time. Please forgive the typos and misspellings, but if I'm wrong about instructions or dosages you should comment and let me know.

PALS BLS

CPR with AED and 1 or 2 rescuers:

1) Ensure scene safety
2) check for response, send someone to call 911/get AED
3a) for sudden witnessed collapse and single rescuer: call 911 and get AED
3b) for unwittnessed collapse and single rescuer: activate after performing 5 cycles of CPR
4) Open airway (head-tilt-chin-lift or jaw thrust if suspected neck injury), and check breathing for less than 10 seconds
5) Give 2 breaths that cause the chest to rise and last over 1 second each.
6) check pulse for less than 10 seconds Brachial in infants carotid in kids.
7a) if pulse felt provide rescue breaths at 1 breath Q3 seconds (unless for some reason the patient has an advanced airway, then you'll wanna give them at 10-12 times per minute, which ends up being about once every 6 seconds)
7b) if pulse not felt, begin compressions at a rate of 100-120 per minute, compress to a deapth of 1/3-1/2 and allow to recoil. If there is one rescuer 30 compressions: 2 breaths, use two finger technique for infants or 1-2 hands for older kids.
If there are two rescuers 15 compressions: 2 breaths, use hands encircling technique for infants or 1-2 hands for older kids.
8) If not already done after five cycles/single rescuer: call 911/get AED
9a) If patient is <1 acls="" continue="" cpr="" move="" old="" or="" over="" p="" responders="" starts="" take="" to="" until="" victim="" year="">9b) if patient >1 year old use AED /defibrillator after 5 cycles.
10) Check rhythm if patient > 1 year old.
11) if Rhythm is shockable: give 1 shock and resume CPR x 5 cycles
12) if rhythm is not shockable: resume CPR x5 cycles and recheck rhythm until ACLS providers take over or victim starts to move.



ACLS/PALS providers will need to perform several assessments very quickly:

1) General Assessment:

 Visual and auditory, taking in patient's appearance and work of breathing as well as how well blood circulation seems to be working. This one is very quick and probably the most simple.

2) Primary assessment:

 A rapid hands on ABCDE, cardiopulmonary and neurologial function assessment
A=airway patency.
Positioning, suctioning, airway adjuncts (nasal airway or one of those things to keep the tongue out of the throat) or intubation.

B=breathing
Rate and effort, tidal volume, airway/lung sounds, pulse ox etc.

C=circulation (both cardiac & end organ)
Skin color, temp, HR, Rhythm, pulses (peripheral and central), capilary refill time, BP and pulse pressure, mental status, skin perfusion, renal output.

D=disability
AVPU pediatric response, glascow coma scale, response to voice/touch/pain, pupil response

E=Exposure
remove clothing and examine s/s hypothermia, burns etc. check temp

3) Secondary assessement

identify S/S, allergies, medications, past medical history, last meal, events leading to presentation.  This usually involves asking a lot of questions for the parents if they are present.

4) Tertiary Assessment:

Laboratory tests, radiography tests, and other advance tests that take a lot of time to do so order them stat

Cardiac Arrest Algorithm

If the patient is having cardiac arrest, regardless of whatever else might be going on, you definately will want to treat that fast. I'm not saying if, say, the caradiac arrest is being caused by sepsis that you won't want to treat that too. You'll need a lot of people to kinda do both at the same time. But we're just gonna talk about the cardiac arrest right now.


You'll wanna start with BLS, attach oxygen to the thing giving respiratory support, but once you get the equiptment put on all the electrodes and the defibrilation pads and do a rhythm check.

1) if the rhythim is shockable (VF/VT): give 1 shock manually at 2 J/KG or AED if  patient is > 1 year old. Use a pediatric system for 1-8 years old. then restart CPR x5 cycles and give epinephrine 0.01mg/KG IV/IO or 0.1mg/kg ET and repeat this dose every 3-5 minutes.

 Recheck Rhythim after the five cycles and if it is still shockable give another shock, but this time at 4J/kg, or AED for 1-8 Y/O, and resume CPR x5 cycles.You will probably give epinephrine again about this time.

At the next rhythm check, if it is still shock-able deliver 4J/kg or pediatric AED and also consider amiodarone 5mg/kg IV/IO or lidocane 1mg/kg IV/IO.
Consider magnesium 25-50mg/kg IV/IO max 2grams for torsades de pointes.
After 5 more cycles do another rhythm check and continue defibrillation with the 4J/kg if indicated.



2) if at any point the rhythim is not shockable (asystole/PEA): Resume CPR x5 cycles, give epinephrine 0.01mg/kg IV or IO or 0.1mg/kg ET. Repeat Q3-5 minutes. and Recheck rhythm after the five cycles. If rhythm is now shock-able: start with the 2J/kg dose.

You will also want to consider the Hs and Ts while you're doing all of this (which I did a whole other series of posts about a few years ago)

Bradycardia (with cardiovascular compromise) Algorithm

1 Support ABCs-give O2, attach monitor/defib. and get 12 lead EKG
2a) if compromise resolved, continue to support Airway, Breathing, Circulation and consider expert consultation
2b) if symptoms persistent and HR <60 cpr="" p="" start="">
3) give epinephrine 0.01mg/kg iv or 0.1mg/kg et. if elvated vagale tone or primary AV block is noted give atropine 0.02mg/kg, may repeat to max dose 1mg.

 Tachycardia with pulsses and poor perfusion

1) 12 lead EKG
2a) If narrow QRS (<0 .08="" a="" and="" causes.="" constant="" correlate="" for="" history="" in="" infants="" interval="" is="" normal="" p="" pr="" present="" probable="" r-r="" search="" sec="" sinus="" st="" tacycardia="" treat="" usually="" variable="" waves="" with="">220, and in children it's >180.
2b)  If narrow QRS and probable SVT (correlate history: vague nonsepcific h/o abrupt heart rate changes, P waves present/abnormal, HR not variable) consider vagal manuver. if ineffective establish IV access and give adenosine 0.1mg/kg to a max of 6 mg rapid IVP, may administer a second time with twice the amount of drug dose (max 12mg).
If ineffective, perform syncronized cardioversion at 0.5J/kg. if not effective may increase to 2J/kg please sedate pateint if possible but dont delay cardioversion.

Obtain expert consultation and administer amiodarine 5mg/kg IV over 20-60 minutes or procainamide 15mg/kg over 30-60 minute BUT DO NOT ADMINISTER THEM TOGETHER....

Respiratory Emergencies

There's no real algorithm for this one. Differental treatment is based on how bad the symptoms are and whether you determine its an upper airway, lower airway, lung tissue, or disordered control of breathing problem.

People with breathing problems are generally anxious in the early stages and lethargic in the later stages, tachycardia is an early symptom but it progresses to bradycardia as breathing function deteriorates. Infants and young kids may often have a distinctive head-bobbing or seasawing breathing pattern in the abdomen.

Upper airway problems often present with inspiratory stridor, a seal like cough, and hoarse breathing.
(ex: croup- give nebulized epinephrine and corticosteroids, anaphylaxis-give IM epinephrine, albuterol 0.5mg/kg/hr with a max of 20mg/hr, antihstamine benadryl 1-2 mg/kg iv Q4-6 hours, Corticosteroid Dexamethasone 0.6mg/g IM/IV max 16.

Lower airway problems often present with expiratory wheezing, prolnged expiratory phase breathing (ex: aspiration-position to comfort and specialty consult. Bronchoiolitis-nasal suction and brinchodilator trial. Asthma-albuterol with or without ipratropium, corticosteroid, SQ epinephrine, mag sulfate, terbuttaline.)

Lung tissue/parnecymal problems often present with Grunting, crackles, and diminished breath sounds (ex; pneumonia/pneumonitis-albuterol 0.5mg/kg/hr with a max of 20 hr. and start ABT. Pulmonary edema-ventilatory support with PEEP vasoactive support, diuretic lasix 1mg/kg max 20)

Disordered control of breathing presents with normal lung sounds but a disordered breathing pattern.
 (ex: incresed inacranial pressure, avoid hypozimia, hypercarbia, hyperthermia...which makes it really hard to do things like provide ventilatory support...basically this person needs an ET tube and if possible and ICP line. Poison-antidote/poison control. neuromuscular disease-ventilation support.

 PALS Septic Shock Algorithm

 1) Recognize ALOC and decreased perfusion-give o2 and support venntlation, start IV, begin advanced life support if needed.
2) consider VBG and ABG, lactate, glucose, ionized calcium, BC, CBC.
3) Within the first our Bolus 20ml/kg NS or LR (probably more than 1 bolus will be needed, if the patient has an underlying cardiac problem or if cardiogenic shock is suspected give 5-10ml/kg), correct hypoglycemia with D25W 2-4ml/kg or D10W 5-10mlg/kg (0.5-1g/kg) DO NOT GIVE GLUCOSE FLUID TO CORRECT HYPOVOLEMIA, correct hypocalcemia 20ml/kg slow IVP calcium chloride 10%, give first dose ABT and consider vasopressors and hydrocortisone

4) monitor response:

 a) if symptoms resolve-consider transfer to IC
 b) if no change or worstening begin vasoactive therapy, iv/arterial access

•   if BP nrmal give dopamine 2-20ug/kg/min
• if hypotensive/warm shock-give norepinephrine 0.1-1ug/kg/min
• if hypotensive/cold shock-give epinephrine 0.1-1ug/kg/min

Cold shock refers to vasoconstriction peripherally, warm shock refers to dilation of the blood vessels.

You will want to evaluate SCVo2:

if it is > 70% with low BP/Warm shock -NS at 20ml/kg, norepinephrine with or without vasopressin

if SCVo2 is < 70 with normal PB but poor perfusion: PRBC to HGB>10g/dl, NS or LR at 20ml/kg optimize arterial O2, consider milrione 50-75ug/kg over 10-60minutes, consider nitroprusside 1-8 ug/kg/min, consider dobutamine 2-20ug/kg/min,

if SCVo2 <70 and="" blood="" cold="" hgb="" low="" perfusion="" poor="" prbc="" pressure="" shock:="" to="" until="" with="">10g/dl, optimize SPO2, NS or LR at 20ml/kg, epinephrine 0.1-1ug/kg, or dobutamine and norepinpeprhine

Consider hydrocortisone approx 2mg/kg max 100mg if adrenal insufficiency is suspected (due to all the stimulants we've been giving)

Saidin and Saidar: An Overview of Gender Division in Robert Jordan's "The Eye of The World"

One of the most interesting aspects of Robert Jordan's "The Wheel of Time" is his depiction of the balance of power between the sexes, both in interpersonal relationships and society at large. I don't think I've ever read a story that handles this topic quite the way this series does; and I really appreciate the the level of thought and consideration that must have gone into it. It really made me consider femininity and masculinity as concepts in a way I hadn't before.

I kind of have the feeling that a lot of people today might take issue with this series because the story itself, even down to the worldbuilding, does convey a very strong distinction between a masculine identity and a feminine identity. But I think it's something you could learn from even if you feel like it doesn't capture the entire spectrum of gender identity.

The story starts out in this small town called Emond's Field, which is run by two governing branches: The Town Council (comprised of men) and The Women's Circle (made up of...ya know...). Even though it seems a bit like these two groups kinda bicker and don't always see eye to eye, you get the sense that they're keeping each other accountable. Like there is tension, but it's the kind of tension that is supposed to be there in a balanced society so that everyone is represented fairly.

Anyway...

In the story, the people of Emond's Field are about to celebrate their annual spring festival: Bel Tine (Which is Medieval Fun-Time Land's version of the Celtic festival Beltine...May Day...which commemorates the mystical union between the male and female aspects of divinity. They never go into this in the story, but it stuck out to me as pretty significant symbolism...) 

So far, everything seems fairly balanced between men and women...

Then Moraine comes into town:

(With her beefy bodyguard/personal assistant, Lan, in tow.)

Moraine is a member of an order of very powerful female magicians who are generally distrusted by rural folk due to their penchant for enchanting men and taking them as their Warders (personal assistant/bodyguards). 

Men are apparently defenseless toward these magic users, because 1) most men a can't use magic and 2) Men who can use magic are "tainted" or corrupted in some horrible way, causing them to be systematically hunted down and imprisoned by those in power. Eventually they have their power (along with their will to live) severed from them and most of them end up committing suicide. 

(Interestingly, this is not presented as oppression

 but as an unfortunate necessity.) 

So slowly we start to gather that life out there in the wide world is not nearly as balanced as it would at first appear to be. Generally speaking, the balance of power in the world at large is slanted to favor women. (Now, this is not unanimously the case... The world is a pretty big place and every country and culture kind of deals with the situation a bit differently, but in general this holds true.) The country Emond's Field is nominally a part of is lead by a matriarchy: Women are Queens, men are their consorts. This is the way the world works, and it's the way the world is meant to work, and the main characters, 3/5 of whom are male, do not question any of this.

Not surprisingly, the Bel Tine celebrations are disrupted and order within the community devolves into chaos when they are attacked by the NOT ORCS. And it emerges that the male 3/5ths of the POV characters are magic-destiny boys who are fated to change the world in some significant way. And so the Emond's Field boys (Rand, Mat and Perrin) are ushered off on to their adventure.

I think it's interesting that the female Emond's Fielders are actually the ones who are who are given agency in this scenario: Nynaeve and Egwene (the female 2/5ths of the MC's) go along on the adventure of their own free will (out of a moral imperative and as an opportunist, respectively), while the Male MC's are forced into it.

I don't think it would be quite fair to think of Rand, Mat, and Perrin as passive figures, but they are being manipulated by forces outside of their understanding and control. This, compounded by their "Special" status, kinda makes them seem a bit like an inverted princess archetype with Nynaeve and Egwene as the traditional adventurers. 

Towards the end of their adventure in this book, Rand meets a NOT ENT called "The Green Man". who's this kind of male nature-guardian, holding the last bit of uncorrupted Saidin (male-magic), which Rand gets to experience before it is extinguished. 

Overall I think it's a really clever inversion of gender inequality as we normally think of it. You get to see this kind of benevolent sexism, and the rationalization for it, as well as an inkling of what a genuinely feminist culture might look like in Andor. The exploration continues in the subsequent books where we see a fuller exploration of female hierarchy, female leadership, as well as the power of a well-balanced relationship.

Year of Epic Fantasy Reading 2017: Day 31 (The Children of Hurin)

Title: The Children of Hurin
Author: John Ronald Reuel Tolkien
Themes: Humanity
Quotes: "Others of the House of Hador bear themselves otherwise, and Tuor among them. For they use courtesy, and they listen to good counsel, holding the Lords of the West in awe. But you, it seems, will take council with your own wisdom..."
Reading/Listening Time: 7 hours, 51 minutes

Review:

This one is a little bit cheating, because I had read this one back in 2009, but I decided to listen to it in 2017 because I found out Christopher Lee performed for the audiobook.

For this review I want to focus on the particular things that stood out to me on this second reading. If you're only familiar with Tolkien's work through "The Lord of The Rings", or even "The Hobbit", this book may take you by surprise. It's written in a similar narrative style to LOTR, but it's a tragedy rather than a heroic tale. (If LOTR is about persevering through adversity with hope, this book is about persevering through adversity when there is no hope.)

We as the readers watch everything that could possibly go wrong, go wrong for our protagonists. Yes, it is a bit of a downer, and I can understand why it might not resonate with most people the way Mr Tolkien's more traditionally heroic offerings do.

However, for me this story is extraordinarily meaningful in the way it explores human nature: thematically, it's willing to go places "The Lord of the Rings" isn't willing to go and because of that it can say things that LOTR couldn't.

(I also think it adds a lot to the whole mythology and background of Middle Earth as a fantasy setting without reading like a D&D guidebook.)

What stood out to me most on my second reading was how the main character's journey was kind of an affirmation of the human identity. In the story, Turin and Nienor have a choice: They can stay with the elves and be safe, or they can venture out into the world and face life on their own terms.

If you're a fan of Tolkien, this story shows us a significant turning point in Middle Earth history. Humans are still a pretty new race in the world and a lot of them like to see themselves as a shorter-lived, weaker versions of what Elves are. Through the course of the story we ultimately see the two kindred races diverge into culturally distinct, separate societies with very different interests and outlooks on life.



Just as a WARNING rest of this post is going to have significant PLOT SPOILERS




What kicks it off is this monumental change is this horrific military defeat: There's this big-bad guy, decides to go to war against an Elvish city (yes, elves had cities back then). The Elves call for help, and their human neighbors take up the call. One of these guys is named Hurin, he's a chief and he leaves behind his pregnant wife and two children. They're the focus of the story because, of course, Hurin's army (along with everyone else...elf and human...who goes to fight) gets decimated.

Oddly enough, Hurin is captured alive. Even though he won, the big-bad guy is so epically pissed at Hurin for helping the elves and making his job harder, that he decides to keep him alive and perform a uniquely cruel form of psychological torture:

The big-bad guy is going to curse Hurin's family, and have Hurin watch how the rest of their lives play out with absolutely no chance of escaping or helping them an any way.

From here the perspective shifts to Hurin's family, but we know Hurin is watching the story unfold alongside us (the reader).

Back at Hurin's village, another chieftain comes into his village and ransacks everything, and abuses his family. Hurin's three-year-old daughter dies of illness, and his son is sent off to live with Elves so the new guy in charge won't kill him. Then the new baby is born, and she looks ridiculously like the father she'll never meet.

Hurin's son is somewhat protected from misfortune while he is with the elves, but presumably Hurin is still watching him being raised by well meaning but emotionally distant elves. Turin does make one elvish friend, but she kind of lives on the fringe of society.

Right away, we notice a big disconnect in the way the Elves and the Humans have handled this loss:

• The elves suffer a major defeat. The bad guy won, so they decide to stop fighting and live in secret.

• As a society humans can't really do that, so they have to live under a new regime. 

Hurin's son (Turin) starts to grow up and he starts getting ticked that the elves aren't planning on fighting the big-bad guy who ruined their lives. We start to see how the races different ways of dealing with loss can cause conflict:

• Turin believes that you should try to make a difference in the world. That your life should ultimately mean something; that he (Turin) should try to make a difference-even if he ultimately fails.

• The Elves think this is stupid; they'd much rather enjoy immortality than glory.

(^^which is interesting to me because clearly if Turin stayed with them he'd have neither of those things)

Ultimately these two approaches to life aren't compatible. Even after he's come to respect their point of view a bit, he decides that he can't follow their mores. Even after he leaves and whole bunch of horrible stuff starts happening to him, he isn't really tempted to go back.

On my first reading, I kinda thought the point of the story was that Turin should have tried to live more like an elf. (This really fits because Professor Tolkien was really Pro-Elf, like, in LOTR he'll just stop the whole narrative to fanboy about how awesome they are...). There's no doubt in this story that if Turin had stayed safely in obscurity he would have avoided a lot of the horrible stuff that happened to him later on.

On my second reading, I think I have a different impression of what this story is trying to do. Tolkien may be a Elf-fanboy, but this story is  trying to demonstrate more than it's trying preach. It's not about elves, it's about how humans are NOT...and shouldn't be...like elves:

Turin has not one but TWO female elves who fall in love with him, but he can't reciprocate those feelings romantically because he's looking for something that they don't have. At one point there's this evil dragon who manipulates Turin into choose between helping his elvish friends or his human family, it's presented as a gut-wrenching choice but ultimately he chooses his family. Both of these choices are ultimately used against Turin as part of the curse, but on this reading I can't think of them as inherently wrong decisions in context of the larger narrative in Middle Earth.

 For both Turin and his sister Nienor, the elvish sanctuary is a nice place to visit but a horrible place to call home. A static paradise is not a paradise for humans because humans are made for change: to fight or fail, to challenge and redefine the perimeters of their world. 

So whether or not living life their own terms was "worth it" for Turin and Nienor personally, their attempts to do so become cemented into the collective human (and hobbit) identity.

In later ages of Tolkien Legendarium, we see the elves continue to disengage and withdraw into their comfort zone. (Which I guess is perfectly appropriate when you'll live forever and you don't reproduce very fast.) We also see humans/hobbits become more proactive force in the world. That's the real legacy of Turin and Nienor...

Rating: 4/5 Stars


End notes:

Thank you to anyone who's been reading these and sharing my journey. Again, it's kind of a solitary exercise (as much as I try to make it more social on goodreads).

I just carry these things inside me, and it's nice to write these little reviews/commentaries like going to visit a friend (and also...like saying goodbye a bit).

Since my Grandma Peggy died, I've had a really hard time with reading. I was ravenous, and now it's kinda painful because it was G.P who really got me into and encouraged my love of reading. (even though, strangely, we didn't read many of the same things! She loved romances and mysteries! I'm more into classics.)

• My goal in 2018 is 10 bilingual books.

• A few other fantasy books that I would definitely recommend:

-Sabriel by Garth Nix

-Norse Mythology by Neil Gaiman

-Jim Henson's Labyrinth by A.C.H Smith

and 

-The Last Unicorn by Peter S. Beagle

• Also if you have a favorite book in the fantasy genre I'd love to hear about it, feel free to leave a comment :)

Year of Epic Fantasy Reading: Day 30 (Fireblood)

Title: Fireblood
Author: Jeff Wheeler
Themes: Trust
Quotes: "Strange how people yearn to become holy only after years of depravity.” She smiled knowingly. “Give me chastity and continence, but not yet.”
Reading/Listening Time: 12 hours, 25 minutes

Review:

This was another book that I felt was pretty exciting.  It starts out with this team of wizards from Mirrowen's CDC and they're on a mission to stop this horrible plague. And they end up getting completely massacred. Only two people survive.

And then it skips to, like, 20 years later. It ends up being like you're kind of following two stories: the present timeline, and what's happened in the past 20 years to the survivors of that "CDC" team.

It's interesting because it sets up this sense of uncertainty and you're not really sure who should trust who. The main character is inclined to be obliging, and as a reader you're kinda wondering whether or not he should be like that... Like, "Maybe he's being too naive...but also there could be a really good reason why he can't know certain things yet???"

It ends up being a bit of both, I particularly loved the twist with SPOILER ALERT the sister who acted all nice, but ended up trying to use him for stuff END SPOILER

My favorite character was Paedrin. He's, like, this monk-knight helping the main character. His perspective on the world was a pretty neat contrast to the other characters, plus I thought he was pretty funny.


Rating: 4/5 Stars.


Note:

I was really excited, after I finished this one, and started it's sequel right away.

I didn't finish it, and I thought it was a lot less exciting because it introduced this really boring new character who I didn't care about. If this weren't a sequel, I could understand playing up the mystery some more, but when you're hitting literally every. single. mystery. that we've already figured out from the first book, like you expect us to be surprised all over again, I call bull.

Year of Epic Fantasy Reading 2017: Day 29 (The Golden Compass)

Title: The Golden Compass
Author: Philip Pullman
Themes: Moral development
Quotes: "And though she understood nothing, she was intrigued and delighted by the complexity and the detail."
Reading/Listening Time: 13 hrs and 7 mins (but I listened to it on 1.5x speed because it was a little boring)

Review:

For a long time I didn't want to read this book because I'd read some articles by the author and it really seemed like we didn't seem eye to eye on a couple of subjects, but that really didn't become an issue in this book. I mean, I can see how this can vaguely be construed as a reconstruction/criticism of The Chronicles of Narnia (Lyra vs Lucy, beauty in the natural world vs beauty in the "other" world) but, in this particular book, God is just a curse word. The author is dealing with some very specific religious dogma, and how dangerous it can be when it's taken to extremes.

It's about a girl named Lyra who grows up at a college in England with a bunch of old professors and her "Uncle" who's kind of a douche bag. There's some intrigue because her uncle is involved in this research and they made a discovery about wibbly-wobbly-timey-wimey, and also original sin...and then everyone from the college to the church tries to kill him...

SPOILER ALERT Lyra saves him from being assassinated and he doesn't even friggin care. Like WTH ASSriel?! END SPOILER

My biggest problem with this book was the characters. It was really hard to be invested in them when the adults are friggin cardboard and Lyra goes from like a 7 year old kid mentality to being, like, 11...to suddenly having the reasoning skills of an adult depending on what the writer wants from her at that moment.

The magic system was a little better: everything vaguely magical is described like it's a natural extension of reality, which was actually pretty cool. Unfortunately, it also kinda makes it feel like it exists mostly for aesthetics. I suppose that can be the point: that things just are and they don't have to have to serve a greater purpose, but it didn't make them particularly memorable for me.


Rating 2/5 Stars.

Year of Epic Fantasy Reading 2017: Day 28 (Wizard's First Rule)

Title: Wizard's First Rule
Author: Terry Goodkind
Themes: Truth vs Belief
Quotes: "Mice think they are in the right, but my cat still eats them."
Reading/Listening Time: 34 hours, 10 minutes for entire book, I skipped roughly 10% of it.

Review:

This book was like was like watching a crime drama. I don't know how you feel about crime dramas, but I think they can be pretty engaging (especially if they actually make you invested in the characters), but then inevitably it seems like they'll have these really graphic scenes that just kind of sneak up on you, and you realize you're watching torture-porn.

OK, maybe that's a bit of a strong label...what I mean is that the story can become gradually so much more graphic than it needs to be, and you hardly even notice because you're so wrapped up the tension of it all.

This story does have pretty engaging characters, I liked Richard, and Kalhan, and Zed. (And that cute little girl they kept running into, and the other wizard who was her friend and gave her the doll to let her know how much she was worthy of being loved...cuz everyone else treated her like crap and it #just #ugh #FEELS!)

I loved that each of them knew a different part of the mystery, that the other's didn't know...and how that influenced their whole group dynamic. Like, "I can't tell you this piece of information right now, because you won't understand it, or it will give you the wrong impression of me and right now we need to have each other's backs."-type thing...It's really suspenseful and engaging to read.

And I get that if you're going to have your main character weld a 'Sword of Righteous Indignation', or whatever, you're gonna need some really really horrible, universally despicable people to use it on.

But the whole depiction of someone grooming a child up for ritualistic sacrifice, conveyed using sexual euphemisms, was simply distasteful.I read most of this book on kindle, these types of scenes made me I wish I could eye-vomit that shit out of my head.

(I can't believe I paid for this book)

Rating: I was really torn with the rating, I eventually went with 3/5 Stars because I did enjoy the story. I have not desire to continue the rest of the series tho.

Year of Epic Fantasy Reading 2017: Day 27 (The Neverending Story)

Title: The Neverending Story
Author: Michael Ende
Themes: Imagination
Quotes: “When it comes to controlling human beings there is no better instrument than lies. Because, you see, humans live by beliefs. And beliefs can be manipulated. The power to manipulate beliefs is the only thing that counts.”
Reading/Listening Time: 13 hours, 46 minutes

Review:

I didn't notice until just now that the author's last name is "Ende" which is funny because in the book he makes a big point of giving his characters ridiculous last names. Like, the main character's last name is "Bux" (Pronounced "Books") and he gets a book in the story. The author's last name could be, like, a play on the title. I don't know if that was intentional, (because the story was originally written in German and I don't know the word for "End" in German) but it's pretty interesting.

All I remember from the movie version is that this kid in the real world is reading a book, and we see what's happening in the book as he reads it. And SPOILER ALERT all this crap happened to the characters in the book (like they died and everything was really sad) but in the end it was just A OK because the kid could always revisit the best bits in his imagination...

So, in his mind, he could go back to when the horse was still alive...and the little boy and the horse were just setting out on the adventure with all this enthusiasm and hope and totally ignorant of the pain and adversity they would face in the future.

(Which sounds totally healthy and appropriate to me...NOT!)

And even as young as I was (I was probably around 10 years old) I just thought it felt like cheating. Like, you're missing out on the whole picture and purpose of it if you just pretend like the bad stuff never happened.

Even though I still think it leaves a lot to be said, I can kinda appreciate where that part of the story is coming from now that I'm older.

What I appreciate even more is that the book version actually has a lot more to say about the purpose of an imagination, and the role escapist literature should play in real life.

The second half of the book could is actually more of a sequel. It gets really metaphysical and it examines the whole mechanism of imagination, and how it can gradually become a malignant force if you let it.

My favorite scene was when the book character Atreyu meets that werewolf who's chained up. It was so cool because they explain the difference between things like an imagining and a delusion, or how does a metaphor become twisted into a lie? Why the imaginary world is important to humans, and exactly why it absolutely shouldn't become "real".

It makes me wanna go back and watch the movie again.

Rating: 4/5 Stars.