It's a really abrupt and notable change, reversing a trend that's held for many hours, and no matter how exhausted she is, Merrin is going to notice immediately with a jolt of panic.

Merrin's first thought is in fact "what did she just dooooooo?" It's definitely occurring to her that maybe removing the belt was the causal factor here! Since that's what she was doing a moment ago! But her initial hypothesis is going to be "she jostled something wrong and now he's bleeding internally" and not necessarily include "and putting belt back would fix it again."

(If her reaction times were in better shape, she might have done it entirely on instinct before she thought about it and, if she saw an improvement, would have been inclined to Leave It Like That. But she's been awake for 22 hours straight, now, and it's been almost 40 hours since her last long sleep, and it's been more than four dath ilan months since she last treated a patient, and in short, she is perhaps not at her very best.) 

...She still hasn't figured out how to remove his stupid ??costume?? torso armor in a way that doesn't involve pulling it up over his head and arms when he has a FRACTURED SKULL, and that makes it hard to get an ultrasound of his abdominal cavity. 

Umm. ...She'll do another set of labs, because she can, and start another liter IV fluids, because she still has that option, and then she's going to somewhat more urgently try to figure out how to remove the armor so she can get diagnostic imagery and figure out what's wrong in there. 

(She's confused! It doesn't actually make very much sense that she could drag him over limestone rocks for seven hours without causing a problem and then cause a problem by gently removing a belt! But Merrin is very, very tired, and she's noting the confusion but she's too frazzled to multitask and think about it while also doing all of the obvious other things first.) 

Well, the labs are now going to say whatever they'd say about a patient who was getting their water and nutrients supplied by whatever she's doing with IV instead of by Magic Ring; and will also correspond to somebody who's now in generally below-average rather than above-average health.

That's....really really weird....? 

Like, Merrin flat out does not have a hypothesis for why removing a belt would drop his blood sugar and screw up his magnesium and make his kidney function worse! It doesn't look like sudden massive internal bleeding, it just looks like "he was in remarkably good shape, considering the circumstances, and now he's not"! 

She's going to keep doing what she was already doing - examining the armor - while in the back of her mind she gnaws on the confusing observations like an animal gnawing at the bars of a cage. 

(She can add some dextrose to his IV fluids, she didn't use all of her supply on growing cultures of her own gut bacteria as control samples against local biomass.) 

Esta is wearing +1 deathless studded leather armor.  It's not 'go personally punch a Balor in the face' armor but that's not really his role.  It's the sort of 4000gp armor you buy when you figure you ought to spend at least 4000 gp on armor, basically.

Without going into details of 'hardness', even the enchanted version is not quite as 'hard' as mundane steel.  Powered tungsten carbide wins, if that's the sort of eldritch capability the Far Tapestry is bringing.

It is going to be mysteriously way harder to damage than the studded leather it looks like, but--

This is no doubt some random synthetic material which is around that tough to cut; practically nobody on the entire planet would be wearing leather in the first place.  Nobody would even be able to identify by sight what it's pretending to be, unless they'd been running weird Exception Handling scenarios involving animal hides.

Merrin is not the sort of Exception Handling specialist who has done those kind of weird training scenarios, and she doesn't recognize what the armor is made of but whatever, she has too many more centrally medical things to be confused about right now. 

(Halfway through very carefully sawing it off him, it does occur to her to check his head again for new intracranial bleeding, even though that doesn't explain the timing at all, she was nowhere near his head when the sudden deterioration happened. He does seem to have stabilized again at the current point, she doesn't think he's ongoingly looking worse...) 

Okay. Stupid flaming ??costume armor?? is OFF.

Anything blatantly wrong with his abdominal organs? Or his lungs, though he's still not really having an oxygenation problem - that wouldn't be entirely explained by the atmosphere of this stupid horrible planet with its stupid horrible tidal bores - so that's not her main theory for what suddenly changed... 

(She's still, in the background, chewing on the confusion. Is the belt some kind of medical device? Sometimes people have medical devices that don't look like medical devices, and she's not sure what exact problem it would be addressing and doesn't remember Estha having anything like that but she doesn't know how long it's been...) 

This is the complete list of hits for "abdominal organs" on the Archives of Nethys for the Pathfinder 1e rules.  It returns 1 hit, to Child of Yog-Sothoth, which is actually talking about abdominal tentacles.

His abdominal organs look however all that internal goop looks at CON 9 after a bunch of lethal and nonlethal bludgeoning damage.

(ADDENDUM:  It has been pointed out that if you search on "abdomen", it looks like all that goop in the abdomen apparently has something to do with the Constitution ability score, since targeted shots at it can deal Constitution damage.)

....Which shows up to ultrasound as a lot of bruising and some hematomas that don't seem to be getting actively worse. 

Sometimes, in weird Exception Handling scenarios, the thing to do is EMPIRICISM even - especially - when you have literally no idea what's happening or why.

Sometimes that's even the case in non-sim real life situations! Like, less often, because there's no active optimization for the situation to be weird, but it happens. 

Like, you don't follow that logic off a cliff, you wouldn't do something that would kill the patient under normal circumstances on the grounds that maybe these are some other kind of Weird Circumstances where medical logic is totally reversed, but a lot of things are pretty low-cost to just...try...and see what happens. And in fact, if everything else here were normal, Merrin would not be particularly nervous about disturbing his injuries if she were to gently putting the belt back on. 

So she'll try that and see what happens? 

Conceptually, Esta has a maximum amount of hit points, and an amount of damage.  His current hit points are equal to his maximum minus the damage.

This in fact makes Bear's Constitution a much more dangerous buff than granting proper temporary hit points, for example via the also-second-circle False Life spell.  Temporary hit points are first to receive damage; they cancel that damage when they vanish.  If you remove Constitution, all the damage is still there and your current hit points drop accordingly.

On the plus side, if you put the Constitution belt back on, Esta's current hit points go right back up, and the damage he's taken is a correspondingly smaller fraction of his maximum!  He'll immediately start doing better, including on the general-health-related portion of measurements in Merrin's labs.

(She's not going to notice improving labs for a while; she has limited test strips for her analyzer, and if he's improving rather than deteriorating then it doesn't seem as critical to know right away.) 

...Merrin does not understand what's happening here at all. 

She's at this point assigning quite high likelihood that the situation is, in some way or other, ""not what it looks like"". She...is kind of flailing wildly for specific theories. 

What does she actually know?

...Rather, what does she think she knows, and based on what concrete sensory input that she thinks she perceived? 

She died in a plane crash about four dath ilan months ago, and did not at that time expect she could or would be successfully cryopreserved. 

Instead of ceasing to have any experiences, she experienced being on an exoplanet, accompanied by all her gear, which had been "with her" on the plane but not with-with her in the sense of being in arms' reach or anything, it was in the cargo hold. 

The horrible exoplanet turned out to be just, barely, possible to survive on until now, and it's unclear how much longer she can manage. 

This afternoon she saw a man appear who looks and sounds exactly like Estha, one of her boyfriends from dath ilan, except for inexplicably not speaking Baseline to her. 

She was very luckily in the right place at the right time to see him and rescue him, but...not, quite, lucky enough to come out any earlier and warn him to get out of the river channel before he was injured.

He survived the tidal bore. Barely, but - she still feels like what she observed was in the best 5% of possible outcomes. Not a physically implausible outcome, necessarily, just - she would have assigned most of her probability mass to much worse outcomes. Same deal with the danger cave - like, it's not physically impossible that he went in there and got lucky, but she would mostly have expected him to show, like, more than literally zero sign of radiation-related lung damage from inhaling cave air that contained radon and also dust with its still-radioactive decay byproducts, and she's seen literally zero sign, on top of the startlingly minimal apparent lung damage from aspirating a bunch of seawater. 

In addition to his improbable luck in the tidal bore, the man who looks like her boyfriend is weirdly good at climbing up steep limestone rocks, and is in weirdly good metabolic health for his age. Except when she takes off his belt??? 

Also he seems to be immune to heatstroke AND hypothermia. His body temperature hasn't budged the entire time. 

...Nope, she still has no hypotheses.  

Except...it feels like trope logic, and not real life logic?

Like, when you string together all the specific points where a thing happened that she would have assigned 5% probability to, it's not that any of the individual events were physically impossible, it just...starts to look really weird if one is assuming a normal physical model of Reality, and...it has the feel of something where this was the best narrative? 

What is she even supposed to do with that theory, though. 

If Reality is messing with her, that doesn't actually indicate any specific way that she should be altering her medical treatment plan?? She doesn't think??? Possibly she doesn't need to be as stressed about it as she is, but the stress is keeping her AWAKE so Merrin is not, actually, going to invest much cognitive bandwidth in trying to convince her mind to stop that. 

She'll just...keep monitoring her patient and doing obvious medical care - she'll splint his broken legs too, and figure out a way to awkwardly stick one of her armor pee-absorbers in the correct place because, uh, she does not want him to pee all over her sleeping bag while he's unconscious and she miiiiight have turned all of the urinary catheters from her medical supplies into freshwater-still-related tubing - and then she'll zip him back into the sleeping bag, since it's now down to a brisk 11° C in her cave, and wait for something else to change? 

Well, it sure looks like she's investing the 8 hours it takes to do a Heal skill check for Long-Term Care!  Which would let Esta recover a total of four times his level in HP, so 48 hit points, after 24 hours pass...

Oh.  Um.

The Far Tapestry Entity's 'alien common sense' probably says that processes like that should be... continuous... rather than instantaneous... doesn't it...

Then Esta will probably wake up after around 8 hours total, maybe?  Not healed, obviously; but with his nonlethal+lethal damage total going underneath his maximum HP of 87.

1 current hit point means you're ready for adventure!

Ugh.

Vicar Esta requires coffee.

It's about 58:30, local time.

Merrin has, at this point, been awake for more than twenty-eight hours, and it's been more than forty-five hours since her last sleep of more than three hours at a stretch.

This does not actually enormously affect her ability to notice changes in her patient's condition! All that is really automatic! She was kind of expecting him to start waking up soon, she was seeing gradual signs of improving responsiveness, and so she notices within less than ten seconds that his eyes are a little bit open. 

She'll slip off her stool and move into his field of view. "Hey. It's Merrin. We're back at my shelter." She's speaking slowly and clearly and trying to stick to simple grammar, on the assumption that he's going to be pretty groggy, but she's also, obviously, doing it all in Baseline. "Try not to move, okay? You have a skull fracture and you broke a lot of bones. What's your pain level right now?" 

The person now talking to Esta in a foreign language sure looks like Mariona! That is, if Mariona had cut her hair really short (Merrin has been cutting her hair regularly as it grows, otherwise it's uncomfortable in her power armor and, just, she's worn it like this since she was in her teens and she's used to it), and had lost a bunch of weight, and was also showing about 5000% more emotion in her facial expressions (relief, mostly, and she seems really happy that he's awake) than the Chelish Mariona ever has in her entire life. 

What part of his telepathic instruction to BRING COFFEE did Mariona hear as SPEAK GIBBERISH?

Esta tries to lift his hands to perform the somatic component of the spell to Heal himself.

Hm.  Somebody has bound his damaged arms and fingers, as opposed to, say, healing them.

This situation is not making a tremendous amount of sense.

He does remember that altered-Mariona no longer speaks Taldane after her encounter with Yog-Sothoth.  Either that, or he doesn't speak it any more and his memories of her are what got altered.

"Does your incompetence and failure extend to forgetting even the simplest Infernal?" he says in that language, idiomatically.

….Okay. He’s still speaking to her in some non-Baseline ??conlang?? (Merrin did not catch enough of it before to particularly notice if it’s the same or a different language in terms of how the phonemes sound. She's not that much of a conlang person anyway.) 

He - seems to recognize her? At least that's the vague vibe she gets, that he's confused about his surroundings but not specifically by her presence? ...He doesn't seem happy to see her, like Merrin had kind of hoped he would be - especially when he must have spent the last few months believing she was permanently gone?? - but it's really stupid to have hurt feelings about that right now, and even in her current incredibly exhausted state she can set them aside. The situation is objectively pretty upsetting! 

She shakes her head and taps her ear with an apologetic expression. As well as saying "I can't understand you" in Baseline but, like, she is getting the impression that he can't understand her either in which case that will not really help. 

Right.

He will attempt again to lift his arms, while saying, slowly and clearly and in tones of command -- the tone may carry even if the meaning doesn't -- "FREE MY HANDS."

He...seems...really really upset about the splints...? Are they painful - no, she doesn't think it's that - does he want to write something, since they're inexplicably failing to communicate verbally??? 

Well. He's not going to cause himself life-threatening injuries if she frees just his hands - he might mess up the bone healing, but she's just going to hope he has the common sense not to move them in ways that are horrifically painful? and anyway the worst damage with all the loose bone shards she spent forever trying to get lined up again was in his forearms, and she can take apart the splint so his hands are free below the wrist without undoing those hours of work - and Merrin would probably ALSO be upset if she woke up unable to move important body parts? And she's always had the policy of "when it's not actually medically dangerous, try to de-escalate by giving the patient some of the thing they're really upset about not having"? 

She can free his hands, carefully and trying to clearly telegraph all of her movements. And then offer him pen and paper, on the remote off-chance he can somehow actually muster enough strength and coordination to use it? 

(He does have broken bones in both hands, and a bunch of tendon and muscle and nerve damage in his arms, and will probably not be able to use them all that effectively.) 

Esta sees.  Not hostile, then.  His hands indeed cannot be used to heal himself this way.  She only bound them to protect them from further damage, maybe awaiting her own ability to pray for spells -- if she still remembers Asmodeus, and not only things of the Dark Tapestry.  She is not garbed as one of His, and wears no unholy symbol that he can see.

After a few abortive attempts to move his fingers as they would need to move to cast Heal or even Cure Moderate, Esta will acknowledge the futility of trying to do this thing, for now.  Soon enough, if she continues to treat him, he will recover all damage taken.

"Never mind," he says, as she tries to offer him what seem like obvious Dark Tapestry writing implements.  His tone is never apologetic, but there is no more command in it.  "You were Wise enough."

His Mariona would recognize the tone as the way Esta sounds when he is as close as he ever gets to complimentary.