While we wait for Liv’s foundation website to be completed, we’ve had so many people reach out asking how they can support Liv’s foundation. This feels like a beautiful, personal way to get involved right now. ❤️ We’re starting work on Joy and Hope Boxes to deliver on her birthday in July. These boxes are filled with so much love and meaning. The Patient boxes contain items that were Liv’s absolute favorites — the little things that brought her joy during hard days. We know how much siblings like our Abby often feel left out, so the Sibling boxes are designed to make them feel seen, loved, and special too. And as a mom who spent endless nights in the hospital with Liv, I know how draining and lonely it can be — the Mom boxes are meant to bring a little comfort, love, and a moment to breathe. We’ve chosen Geisinger and CHOP because they are the two main hospitals where Liv was treated. We hope to expand to more locations in the future. Our goal is to donate: • 20 Patient boxes • 20 Sibling boxes • 20 Mom boxes …to each hospital — that’s 120 boxes total. It’s ambitious, but we’re going for it with full hearts! If you’d like to help us assemble these boxes, here’s our Amazon wishlist. Every item counts and makes a difference. We’ve filed for our 501(c)(3) status, so purchases will be tax-deductible once approved. Thank you for helping us carry forward Liv’s light by spreading joy and hope to families walking this same road. 💛🎗️

Let's consult the historical record to see what the Aztec society was up to when the Spanish conquered it. First, from Cortes: “They have a most horrid and abominable custom which truly ought to be punished and which until now we have seen in no other part, and this is that, whenever they wish to ask something of the idols, in order that their plea may find more acceptance, they take many girls and boys and even adults, and in the presence of the idols they open their chests while they are still alive and take out their hearts and entrails and burn them before the idols, offering the smoke as sacrifice. Some of us have seen this, and they say it is the most terrible and frightful thing they have ever witnessed… not one year passes in which they do not kill and sacrifice some fifty persons in each temple; and this is done and held as customary… not one year has passed… in which three or four thousand souls have not been sacrificed in this manner.” And now Bernal Diaz del Castillo: “The dismal drum of Huichilobos sounded again, accompanied by conches, horns and trumpet-like instruments. It was a terrifying sound, and when we looked at the tall cue [temple] from which it came we saw our comrades who had been captured in Cortes’ defeat being dragged up the steps to be sacrificed. When they had hauled them up to a small platform in front of the shrine where they kept their accursed idols we saw them put plumes on the heads of many of them; and they made them dance with a sort of fan in front of Huichilobos. Then after they had danced the papas [priests] laid them down on their backs on some narrow stones of sacrifice and, cutting open their chests, drew out their palpitating hearts which they offered to the idols before them.” ... “Every day we saw sacrificed before us three, four or five Indians whose hearts were offered to the idols and their blood plastered on the walls, and their feet, arms and legs of the victims were cut off and eaten… Every wall of this chapel and the whole floor, had become almost black with human blood, and… the stench was worse than in a Spanish slaughter-house.” ... “When we arrived at the great market place, called Tlaltelolco, we were astounded at the number of people and the quantity of merchandise that it contained… Let us begin with the dealers in gold, silver, and precious stones, feathers, mantles, and embroidered goods. Then there were other wares consisting of Indian slaves both men and women; and I say that they bring as many of them to that great market for sale as the Portuguese bring negroes from Guinea…. They brought some of them tied to long poles by means of collars around their necks so they would not escape, and others left loose.” ~~ This is what the Spanish conquered in the name of Christendom - a Stone-Age society consumed with ritualistic human sacrifice, cannibalism and slavery.

I made a cosplay of my D&D character Vasiliel - elven swordmaiden whose blood remembers the god of flame, but whose heart chose freedom ❤️‍🔥 *this is the lingerie version

Friends… we lost Sharpie. It’s been emotionally heavy over here. We all knew from the beginning that this outcome was still a strong possibility, even with all the work I’m doing to try and avoid it, but this news still feels devastating to have to share. Even though intakes like Sharpie are wild animals who are only with me for a few short weeks, the loss of these hydro babies always breaks my heart. I think part of what makes these losses so difficult emotionally is that these babies are often some of the sweetest patients. You wouldn’t normally want to encourage a rehab patient to bond to you, however, these babies don’t process the world quite the same way as a typical fox kit. Their lack of normal fear - which is always part of how a human was able to get their hands on them in the first place - and their inability to really distinguish friend versus foe means they seek out comfort and affection and express excitement in a way that makes it almost impossible not to become attached. Sharpie was arguably our hardest hydro baby loss yet, because he was SO “good”. He was so much more like a “typical” kit than most cases. I really thought he might “be the first one” because of his encouraging mentation and ability to function. His sudden decline was a blow to the chest, to say the least. Some of you may remember the hydrocephalic baby we named Coconut from a few years ago; he wasn’t with us long, as usual, but that loss really stung for my daughter, Ella. I still remember coming home from the vet without him in the carrier and watching her young, knowing eyes instantly fill with tears. Well, Ella has been more involved than ever assisting where she safely can with my wildlife rehab work this year, prompted both by her maturing and showing genuine, personal interest in my work, and also by my fractured foot forcing me to heavily rely on loved ones for help. Her true involvement this year led to Ella really viewing Sharpie as “her intake” in a way. Even though she understood from the beginning that this outcome was still likely - because we haven’t quite “figured it out” yet, & because I’m VERY transparent with my children about the realities of this line of work - it still shattered her heart. So, grieving Sharpie’s loss while simultaneously empathizing with my own blood and mini-me as she experienced her first truly excruciating rehab heartbreak, seeing silent tears fog her glasses when I acknowledged that it was time… that was a very unique kind of pain. Sharpie was playful, curious, and full of personality. He happily ran around carrying toys in his mouth, activated his little “Porsha ears” every time he heard someone approaching, loved cuddling with Apple, and genuinely just seemed happy to exist. He was also able to stay with us a couple weeks longer than most (and again, he was not just “alive” - he appeared comfortable and maintained the ability to perform most normal functions), which was very encouraging. And that’s exactly why I will continue pushing back against the idea that every one of these babies should automatically be euthanized upon intake. Because Sharpie’s life mattered, and I have absolutely no doubt that he ENJOYED life right up until his sudden turn for the worse - which, unfortunately, is a spontaneous reality that can occur with the delicate brains of these babies, especially in these early stages while we’re still fine-tuning medical management and seeing if they may someday become appropriate candidates for surgery. But because of all of you, his story became bigger than just another loss. We were able to officially confirm severe obstructive hydrocephalus via MRI. We gathered advanced imaging while he was still with us, more data, & more firsthand experience managing this condition than we’ve ever had before. We learned from him, documented it all, and even though his loss feels like a smash to the heart, his life ultimately moved this mission another step forward. CAPTION CONTINUED…

I am the Health Services Contract Administrator for U.S. Immigration and Customs Enforcement and on October 3, 2025, I stopped paying for medical care, and the system has been working better ever since. I need to be specific about what "working better" means in this context because I am a contract administrator and specificity is my entire professional identity. It means: fewer invoices. Fewer reimbursement disputes. Fewer pharmacy reconciliations. Fewer appeals from providers who claim they provided urgent care and want to be compensated for having provided it. The workflow is cleaner. My inbox is lighter. The VA Financial Services Center, which had processed our medical claims since 2002, twenty-two years of pharmacy invoices, specialist referrals, hospital transports, dialysis authorizations, and oncology treatment plans, terminated its interagency agreement with us after a lawsuit from a nonprofit called the Center to Advance Security in America. They filed suit. The VA pulled out. Our entire claims processing pipeline vanished overnight. I posted a notice on on November 12 describing this as an "absolute emergency" that required resolution "immediately" to "prevent any further medical complications or loss of life." That was seven months ago. The replacement contractor, Acentra Health, had not achieved notice to proceed by the April 30 period of performance deadline. As of today, no entity is processing medical reimbursement claims for ICE detainees in the United States. When I say "no entity" I mean that structurally. A person held in a GEO Group facility in Georgia who requires dialysis three times per week is receiving dialysis from a provider who has not been paid since October. The provider continues to provide care because the alternative is that the confined person dies in their facility and the facility is then liable for a death that could have been prevented by a treatment that the facility was contractually obligated to provide. The treatment continues. The payment does not. The provider absorbs the cost. The cost is eventually written off. The write-off appears in the provider's quarterly financial statements as "uncompensated care, federal detention." It does not appear in our budget. It does not appear in any ICE financial disclosure. The care happened. The cost was real. The payment was imaginary. The system is working better. In fiscal year 2024, the VA processed $246.42 million in clinical reimbursement claims on our behalf. In fiscal year 2025, despite an 82.5% increase in our daily detained headcount, the VA processed only $157.2 million before the October termination. The delta between what was needed and what was processed is approximately $300 million. That $300 million represents medications not reimbursed, specialist consultations not paid for, emergency transports not covered, prenatal visits not compensated. It represents chemotherapy sessions where the drugs were administered and the oncologist submitted an invoice and the invoice entered a system that no longer exists. I have a filing cabinet in my office — three drawers, GSA-standard, beige, the kind with the lock that everyone has the same key to — that contains printed copies of the final VA-processed claims from September 2025. The bottom drawer has a jar of Tums that my predecessor left when she transferred to FEMA in August. I eat them daily. Not from stress. From the cafeteria. The cafeteria serves a chili that the facilities contractor, Aramark, describes as "Southwestern-inspired." It is inspired by the Southwest the way our medical payment system is inspired by the concept of paying for medical care. The death rate is the number people ask about, so I will provide it with the precision my role requires. Historical baseline, 2018 through 2024: 8.9 deaths per year in ICE custody. Calendar year 2025: 33 deaths. Twelve of those occurred after October 3, after the payment freeze. January through April 2026: 17 deaths. That is one death every six days. Annualized, the current rate is 51.7 deaths per year. 5.8 times the pre-October baseline. A study published in JAMA on April 16 calculated the per-capita rate: 88.9 deaths per 100,000 person-years in partial fiscal 2026, compared to 13.0 in fiscal 2023. Nearly seven times. The JAMA authors are epidemiologists. I am a contract administrator. We are counting the same bodies with different denominators. Emmanuel Damas was 56 years old, Haitian, confined at an installation I am not authorized to name. He had a tooth infection. The on-call clinical staff treated the infection with ibuprofen. Ibuprofen is an anti-inflammatory. A tooth infection is a bacterial event. These are different categories of medical problem requiring different categories of intervention. The infection progressed to septic shock. Emmanuel Damas died. The ibuprofen was on our formulary. Antibiotics were on our formulary. The difference between the two was a reimbursement claim that would have been submitted to a payment processor that no longer existed. The detention center chose the treatment that did not generate a claim. I cannot tell you whether that decision was made consciously. I can tell you that it was made consistently. Across multiple facilities. Across multiple months. The ACLU reviewed deaths in ICE detention between 2017 and 2021, before the payment freeze, and determined that 95% were preventable with adequate treatment. I do not know what the percentage is now. I suspect it is also 95%. The category "preventable" has not changed. The category "payment" has. At Fort Bliss, a military installation in El Paso repurposed as a detention facility under a $1.24 billion sole-source contract awarded to Acquisition Logistics, a firm with no prior detention management experience, three people died within 44 days. One death was ruled a homicide by the El Paso County Medical Examiner. ICE reported it as a suicide. Those are different words describing different events with different legal implications. The Medical Examiner's ruling generates an investigation. A suicide generates a compliance review. An investigation involves law enforcement. A compliance review involves my filing cabinet. I am not qualified to determine which word is correct. I am qualified to tell you that the words produce different paperwork, and the paperwork determines which systems activate, and the systems that activate determine who is accountable, and in this case, the system that activated was the compliance review, and the compliance review found that all protocols were followed, and all protocols were followed because the protocols do not include "pay for medical care." Rodney Taylor was a double amputee detained at Stewart Detention Center, operated by CoreCivic. He was forced to crawl on floors covered in feces and mold because the center did not provide adequate mobility assistance. CoreCivic reported $2.2 billion in revenue last year, up 13%. Their profit was $116.5 million, up 70% year over year. Their ICE revenue nearly doubled between Q4 2024 and Q4 2025, from $120 million to $245 million per quarter. They received a 70% increase in profit and Rodney Taylor received a floor. CoreCivic's annual report describes their business model as "government solutions." Rodney Taylor's experience was, technically, a government solution. GEO Group, the other major for-profit detention operator, posted $2.6 billion in revenue in 2025 and $254 million in profit, a 700% increase. They secured $520 million in new ICE task orders that year. Combined, GEO and CoreCivic spent $6.8 million on lobbying to secure access to a $75 billion funding stream from the GOP's reconciliation bill. The return on that investment is so large I had to check my calculator twice. It was not a calculator error. It was the normal functioning of a procurement system where the companies that run the facilities also fund the campaigns of the legislators who appropriate the money for the facilities. The firm-fixed-price task orders specify a per diem rate of $187.48 per adult per day. That rate includes healthcare coverage. The rate has not changed since the disbursement freeze. We are still remitting $187.48 per day per person. The clinicians are not receiving any of it. The $187.48 goes to the facility operator. The operator is supposed to allocate a portion of it for clinical services. There is no SLA enforcement mechanism to verify that they do. There is only my filing cabinet, and the filing cabinet is for contracts, not outcomes. Senator Ossoff's office conducted an investigation between January and August 2025 and received 85 credible reports of medical neglect, including untreated chest pain causing heart attacks and unmanaged diabetes complications. That investigation preceded the payment freeze by two months. The conditions it documented were the baseline. The baseline was already 95% preventable death. The disbursement freeze removed the financial infrastructure supporting the 5% of care that was being provided. I have a Gantt chart in my office, printed on 11x17 cardstock and laminated and pinned above the Tums drawer, that tracks the Acentra Health onboarding timeline. The original completion date was April 30, 2026. That date passed twelve days ago. The chart has a red line through it drawn in Sharpie by my deputy, who does this for every missed milestone. There are four red lines. There will be more. Each red line represents a period during which no payment processor exists. Each period without a payment processor is a period during which clinicians must choose between providing unpaid care and not providing care. The first option costs them money. The second option costs someone their life. I do not track which choice they make. I track contracts. Seventy-one percent of ICE deaths in 2025 and 2026 occurred in privately operated detention sites. Half of 2026's deaths occurred in CoreCivic or GEO Group facilities. The Office of Detention Oversight, the COR entity responsible for facility inspections, conducted 36.25% fewer compliance audits in 2025 than the previous year. Fewer audits, more deaths, higher profits. The three trend lines move in coordinated directions. I do not draw conclusions from correlated trend lines. I am a contract administrator. I process contracts. The contracts are technically valid. The facilities are technically operational. The reimbursement apparatus is technically being replaced. The deaths are technically being counted. The word "technically" is doing more work in this paragraph than any clinician in the ICE detention system has been compensated for in seven months. My internal memo from November 12 used the phrase "absolute emergency." It recommended resolution "immediately" to "prevent any further medical complications or loss of life." That memo was written on government letterhead, classified as internal correspondence, distributed to eleven recipients, and filed in the correspondence tracking system under routing symbol HSA-OAQ, which requires a FOIA request to access. Seventeen people have died since I wrote it. The memo was technically effective. It generated a procurement action. The procurement action generated a bridge contract. The bridge contract generated an onboarding timeline. The onboarding timeline generated a Gantt chart. The Gantt chart generated four red Sharpie lines. The red Sharpie lines generated nothing. They are decorative. Like the per diem rate that includes medical care nobody is billing for. Like the 95% preventable death rate that is not being prevented. Like the word "emergency" in a seven-month-old memo that is technically still active, technically still urgent, technically still describing a situation that requires immediate resolution. I am technically still the person responsible for resolving it. The system is technically still working. The people are technically still dying. The filing cabinet is technically still organized. The contracts are technically still valid. The word "technically" has appeared so many times in this document that it has lost all meaning. That is exactly what it was designed to do.

Hearts are on the verge of making Scottish football history as they head to Celtic for a title-deciding clash on the last day of the season, in their push for a first Scottish top-flight title since 1960. Sky's @RobHarris reports from Glasgow.

Our hearts are heavy over yet another shooting of a Black man, Daunte Wright, at the hands of police. It’s important to conduct a full and transparent investigation, but this is also a reminder of just how badly we need to reimagine policing and public safety in this country.