Marian accepts the syringe and a handful of saline flushes and alcohol swabs from Anne-Marie; she dumps the latter on Ma'ar's lap, for lack of another surface. "Anne-Marie, you can steal the piggyback line for the magnesium or phosphate, they're done." And probably by now some more bags fresh from the pharmacy are waiting in the pneumatic-tube receiving tray, but she can't exactly check right now. 

Ma'ar, eyes squeezed tightly shut, doesn't seem to be tracking anything around him. Marian talks to him anyway, as she finds an available port of the central line and hooks in her syringe and sloooooooowly eases the plunger down. 

"Ma'ar, I'm still here. Your heart is beating really fast right now and we need to slow it down a bit. I'm going to be giving you a drug to help with that, it shouldn't really affect your head, but hopefully you'll feel less anxious or scared."

She unscrews her metoprolol syringe, caps it, flushes the port and clamps it. Anne-Marie is fiddling with the pump beside her, clamping and disconnecting the magnesium piggyback line and replacing it, reprogramming the pump. Marian traces the tubing with her hand, quickly making sure it's running to a different, un-clamped port of the central line.

He can't breathe. 

Ma'ar is vaguely aware that he's causing this problem himself, but he can't stop. It's not even so much the overwhelming grief and guilt and loneliness, now, it's that his body keeps insisting that he's choking. He tries to draw a breath and then involuntarily coughs against the pressure of the ventilator and he KNOWS if he could just calm down it would be fine but he can't. It feels like an incredible weight is resting on his chest, his heart is hammering painfully and his head throbbing along with each heartbeat and he can't hear anything but his own pulse. He feels hot and sick and dizzy. is 

And all of that is terrifying. It feels like he's dying. Probably he isn't dying, he doesn't think you can die of being upset, but nonetheless. 

...Marian is there. The world is closing down to a narrow box, his Othersenses unable to reach past the invisible walls holding him prisoner, but Marian is there. 

"Ma'ar, we're giving you a bit of medicine for pain," Marian says. "I bet you've got a really bad headache again, yeah? And it'll help you slow down your breathing. ...Can you try to do that? Just breathe out, nice and slow - and in - and out..." 

She can't tell if he's hearing her. His heart rate is down to 139 but his eyes are still scrunched shut. 

She sees Amélie in her peripheral vision. "- Don't stick him for it! Art line, right here..." She shoves the tubing and blood-draw port at the charge nurse. "Thank you. ...Ma'ar, can you hear me? Look at me?" 

Dr Prissan, standing on the other side of the bed, shifts from one foot to another and rubs his hands together. "I think we're seeing some effect, but lots of room to go still. Marian, push another 2 mg. Over at least a minute, please." 

Ugh. Marian hates doing IV push drugs that have to go slowly. It's so tedious and she's always worried about accidentally doing it too fast. 

She thinks Ma'ar is looking more relaxed, though? His face and neck are slick with perspiration, but his features are relaxing, and his blood pressure is back down to a much more reasonable 125/88. 

Amélie grunts. "Dr Prissan? We sure got a problem." She shows him the screen of the glucometer. 

     "- Jesus. Marian, you guessed something right. Sugar's at 47. Once you're done pushing that metoprolol, let's give him an amp of D50." 

Marian, tongue between her teeth, doesn't look up from her syringe and her sloooooow progress down the plunger. "...Right. Got it. Uh, I bet he'll end up needing two, last time it took a lot to raise his sugar much." 

Dr Prissan chuckles. "Then why don't we just start with two? If we send him hyperglycemic then whatever, at least we'll be giving him a different problem." 

He feels better? Maybe? 

More time passes, counted only by his breaths. 

No, Ma'ar decides, he definitely is feeling better. He's dizzy and nauseated still, and he's so hot, but the knot in his chest is loosening, he's able to breathe. His head still hurts but it's just an ache, it's not stabbing him with every heartbeat. 

He can hear Marian's voice in his ear. And he passively senses her mind, bright and nearby - and a couple of other minds, further off? He's quickly dissuaded from trying to read surface thoughts, though; sickening emptiness rolls underneath him, he overextended himself and his reserves are gone. 

Instead he lies still and focuses on breathing. 

Marian pushes dextrose straight into Ma'ar's jugular, and watches his numbers. Blood pressure hovering at 102/69 - they definitely don't want to send him any lower. Heart rate 97. Resp rate about 25, still a little fast but he's getting good tidal volumes on the vent screen and satting at 100% again. Temp is...actually dropping again, 36.6. Probably because she took the blanket off and also he's sweating like a pig. Which seems like it could be either a panic attack thing or a hypoglycemia side effect.

She's known a handful of diabetics whose primary warning symptom for low sugars was 'sudden hot flash.' Or sometimes nausea. The description of it sounded so miserable. 

"Anne-Marie?" she says. "Could you wet a couple of those hand towels for me?" It might help him calm down, if it makes him more comfortable. Probably in ten minutes he's going to be freezing, but the Bair Hugger is right there.

She folds one of the damp towels and puts it over his forehead, then lays the other one around the back of his neck. 

It makes a surprising difference. There's no clear reason for a cold cloth on his head to make him less nauseated, but it seems to, maybe it's just the distraction. Ma'ar wants to thank Marian, but Mindspeech is too hard. 

When he feels her hand on his again, he squeezes it, maybe that will convey his gratitude. 

Marian isn't sure what it's trying to convey but it does, at least, communicate that Ma'ar is conscious and knows she's there. 

Dr Prissan steps back from the bed. "Well. Seems we've had our fun. Marian, you good here?" 

That is exactly what Dr Prissan would say. Marian tries not to roll her eyes. "I...think so?" 

"Stay with him until he's stable and lucid, do another glucose in fifteen minutes, yell if he does anything else funky. ...Oh, and I'm not loving that BP. He's off norepi, yeah? I'd rather not restart it if we can avoid it. Last sodium was still low... Let's give him just a little bolus, 250 ccs, and then run a maintenance drip at 100 ccs an hour. Good?" 

Marian sighs. Wipes her own slightly-damp forehead on the shoulder of her scrubs. "Good, if someone can check on 201 for me and bring me a bag of saline. Oh, and check if the mag and phos are here, he still needs another bag of each." 

"On it," Amélie confirms. 

     Dr Prissan, at the doorway, turns with a final lifted eyebrow. "Marian? Do please make it clear to this guy that he's not going anywhere. I'm still hoping we can extubate him this afternoon, but after he caused all that fuss, we're definitely keeping him in the ICU another day or two." His cheek twitches. "Oh, and do make it clear we have a policy against mind control." 

Marian blinks at him. "Uh, sure. Thanks." 

The room is suddenly very empty and quiet. 

Ma'ar seems calm and not especially alert, so she stands up, reties his restraint and puts the bedrail back up, and putters around the room cleaning up the mess. Anne-Marie has a habit of tossing packaging in random directions and leaving it on the floor. 

Ma'ar lies still, heart rate and breathing very slowly descending toward his earlier numbers, sweat drying on his skin. 

Unsurprisingly, by the time fifteen minutes have passed and Marian has run most of the 250cc saline bolus and pulled another sample from the art line for a blood sugar, he's shivering again. Or maybe just shaking. His temp is 36.2, not hypothermic, but his gown is still damp and he definitely looks uncomfortable. 

Marian puts a hand on his shoulder. "Ma'ar? Can you understand me again now?" 

(Tired nod.) 

"You look uncomfortable. Can you tell me what's bothering you, or should I ask some yes/no questions?" 

He is very tired, but he feels less horribly drained. 

:Cold. Thirsty. Tube hurts: 

"Mmm. I'm sorry you're thirsty - we're giving you water in the IV, but you can't have anything to drink until the tube's been out awhile and you can swallow okay. I can get you a wet sponge, to make your mouth less dry?"

Which is reminding her that she's done ZERO mouth care on him today, she somehow just forgot. At this point he's probably not going to be on the ventilator much longer, and she doesn't want to subject him to the awful-tasting chlorhexidine mouthwash. 

"I'll do that in a moment. Are you feeling dizzy or sick to your stomach?" 

:A little. Better than before: 

"Mmm. Any chest pain or trouble breathing?" 

(No.) 

"All right, I'm going to go grab you a dry gown and I'll put the warm blanket back." If she does it on the 'medium' setting, it shouldn't overheat him. "If that's too warm, we have normal blankets too." Well, crappy hospital flannel blankets, anyway. "I'll say more when I'm back."

The glucometer beeps, reminding her that she forgot to look at it. It's 88. Good. 

She's back thirty seconds later, nudging the door shut for privacy. "Here, let's get the new gown on... I'm putting the flannel blankets right here on the counter, if you decide you want those instead." She spreads the Bair Hugger blanket over him again and switches the machine on, toggling it to the middle setting.

"Right, and a sponge. Open your mouth a bit - sorry! - please don't bite it - there..." 

Ma'ar is finding that he really doesn't like having things stuck into his mouth even if he's forewarned, and he would much rather do it himself, but he doubts Marian would agree to untying his hands now. 

The sponge has a very weird sweet-cool flavour, but it does help with the thirst. :Thank you: he manages.