"That was a cute top you had. Anyway, girl, go take fifteen, I've got this for now. Get us some more coffee and some pastries, maybe? I'm starving, all I've had since dinner yesterday is crackers from the patient fridge." 

"Uh. Sure. All right. I'll be back at...eight-twenty? For the next sugar." 

"You look wiped." Emmy leans closer, lowers her voice. "Want some of my Ritalin? It helps." 

"Umm." Are they really having this conversation. Is that even legal. This is so weird and awkward. "...Sure?" 

Which is how Marian ends up acquiring half a pill of someone else's drugs, and then traipsing to the bathroom with her stolen toiletries. 

She splashes water on her face, then looks at herself in the mirror. God. She still has last night's eyeliner on and it's smeared. Did she look like that in front of everyone for the last hour and a half? 

She brushes her teeth and takes a paper towel birdbath in the sink, hastily, and then jogs to the Tim Hortons. The line is mercifully only three people long and moving quickly. 

By the time she gets back, Dr Prissan is on the unit, standing outside her new admission's room, talking to Dr Beckett. He's wearing his usual blazer with the shoulder patches, over jeans and high-top shoes. (Dr Beckett, as always, wears OR scrubs and her white resident coat.) 

He slaps Dr Beckett on the shoulder. "Stop overthinking this. You're doing all the right things. Now let's get that line in so we can run those bags into him faster." 

Marian tries not to grimace. She likes Dr Prissan, in general, but he definitely is what some of the ICU nurses like to refer to as 'a bit of a cowboy.' 

"Want me to set up the line kit?" she says instead of voicing that thought. "Uh, and we should give him a little extra sedation. He's responsive to pain and he gets agitated." 

"Ha! I heard he's got a mean elbow hook. Sure, go ahead and pull up some propofol for it, it'll wear off fast." 

Emmy fidgets. "I'd feel better if we had the crash cart nearby. Low magnesium and sticking a guidewire in him isn't a comfy mix." 

Dr Prissan mostly looks amused. "Sure, if it brings you some peace of mind. But let's move, or we won't manage to start rounds until ten." 

Marian sighs and absently pats her pocket. Nope, she has no idea what happened to the syringe of leftover propofol from before. With a sigh, she logs back into her EMR account, puts in the order, checks for new lab results - nope, still pending - and then goes to pull the meds from the Pyxis. 

When she gets back, the crash cart is blocking her computer desk, Dr Prissan is indulgently watching Emmy set up her sterile field, and the patient's blood pressure is hanging out at 132/78. His heart rate is above 60, even. The temperature reading is 32.1. 

His eyes are a crack open. 

Oh fuck she forgot to follow up on the blood sugar. 

Marian decreases the norepinephrine drip again, first, then reaches and squeezes the patient's hand, on the side with the art line. "Hey. You with me?" 

Ma'ar opens his eyes fully, with some effort, and tries to focus on her. 

"Good! Listen, we need you to sleep again for a little bit, so we can - put in a big intravenous line, right here," she pats his neck, "to give you the medicines you need right now. We're going to numb your skin and you'll be asleep, so it shouldn't hurt. All right?" 

Ma'ar isn't at all sure it's all right! He's really confused about what exactly they're intending to do to him! 

He tugs at the restraints, reflexively, and remembers that he doesn't exactly have much choice. Also the movement does - something - that makes him cough. His throat hurts. 

Oh no she just scared him more. "I'm sorry! It's okay, I promise - it sounds scarier than it is, but it's not dangerous, I've seen it done dozens of times." And since it seemed to reassure him before: "I'll be right here when you wake up. Okay?" 

Ma'ar is having trouble following her thoughts - she's only half paying attention to what she's saying, the rest of her mind is distracted - but he manages to parse that there's a question. Sort of a question. He's not naive enough to believe that, with the others right there, the girl - Mary? no, Marian, that was her name - is going to disobey orders and stop this.

He doesn't like it at all but he also doesn't want to risk upsetting his only ally here. Or getting her in trouble. He tries to nod. 

"It's okay. You're doing really well." Marian squeezes his hand again, and then gets the propofol and pushes in... "Uh, Dr Prissan? I'm giving him two to start, four almost made him code before." 

He chuckles. "Well, as long as you've got the rest right there." 

The drug is fast-acting and the effect on his blood pressure is almost instantaneous, the waveform faltering and dropping almost off the screen before the monitor recalibrates the gain on it. His MAP goes down to 60, an alarm pealing, but then starts to recover. 

He's really sensitive to the cardiovascular side effects, Marian notes. At least right now, maybe the low electrolytes aren't helping. She watches him worriedly. 

Emmy goes through the preparation slowly but smoothly; she's done half a dozen lines before, albeit usually on less unstable patients. She finishes draping Ma'ar except for his neck and upper chest on her side of the bed, then swabs his skin before carefully pulling up some lidocaine and injecting it in several spots. 

No reaction. 

Tongue between her teeth, she squeezes the packet of sterile gel onto the end of the ultrasound probe, this time managing NOT to get it all over her gloves, and then starts hunting for the patient's internal jugular vein. 

"Nice work. More pressure on it, we want to check it squishes down and there's no pulse - there we are, that's the carotid over there. See how easily the jugular flattens down? You're right, he's hypovolemic. We'll bolus him another litre once this is in. All right, remember your spot and get the needle set up..."