"So, in Exception Handling, we finally find out what's going on, at this point, and we start coming up with a treatment plan.  We don't already HAVE a treatment plan, or so I am informed, for this exact circumstance.  And this, you know, this really bothers me, people.  It's a common misconception that being Chief of Exception Handling means you're supposed to think of every possible and probable contingency in advance.  In fact my job isn't to do that, it's to ride herd on the people who are supposed to do that, which, given their general fractiousness and wild-ranging creative imaginations, is a full time job that leaves me very little time to imagine events myself.  Which is to say, I had ONE JOB, and today it became apparent that I must have FAILED at that one job over an EXTENDED PERIOD and in a very wide-ranging way.  Because while my employees had devised over 144 advance plans for different kinds of alien invasions, on the excuse that rehearsing those would 'increase general robustness', they were so busy 'increasing general robustness' that we had zero advance-tested plans or advance development work for the case of 'what if somebody with a really valuable brain falls into cold water'."

"I try, generally speaking, to be pessimistic enough that I am ever pleasantly surprised, and sometimes I am, so I cannot say with confidence that I am still ill-calibrated on how bad things really are in Civilization.  But I was nonetheless, on an emotional level, deeply and unpleasantly shocked by the STAGGERING lack of advance work I found, that had NOT been done by Civilization generally and Exception Handling specifically, on the case of averting anything more than the bare level of brain damage from rewarming an ischemic patient.  Which, you might have thought, you might PREDICTABLY encounter as a problem across a wide variety of imaginable cases, if for some reason you wanted to save someone even THOUGH - this being a level of weirdness apparently beyond our tiny intellects to envision - we would USUALLY have put that person straight into cryo.  Which we did not want to just do here, due to other conditions being NOT TOTALLY PERFECTLY NORMAL, but who would ever think of THAT possibility in advance of it ACTUALLY HAPPENING?  Not us, apparently."

"But we at least had, apparently, some general contingencies for what would happen if there came about a medical case of very high value to Civilization under conditions of mild secrecy.  We spun up those social connections and those pseudo-markets - as would seem to work at least TEMPORARILY - and obtained an initial stabilization plan that was at least a tenth as good as an actual market could have provided.  And we staggered on ahead, usurping the target hospital's computer systems - which worked unexceptionally, you'll note, because THAT part had been envisioned in advance and ACTUALLY THOROUGHLY TESTED - and transmitting our treatment plan, including fallback contingencies for if their emergency certs were not in sufficient order."

...You know, that's kind of a good point about the lack of any existing protocol. This does seem like a problem that will sometimes, predictably, come up! And sometimes even come up in circumstances where you want to try to revive the patient! 

Oh no was there drama about emergency certs. Merrin missed it if so? She's pretty sure they were fine on them, though, she checks regularly if new weird ones got added. 

"And here, of course, another random unearned heroic saviour begins to become important to this story, because the local hospital has someone who possesses the exact five certs needed for five different emergency protocols to be implemented simultaneously.  Sheer improbability?  Meddling aliens?  No, it just turns out that she has all of the emergency certs.  Why, it's hardly improbable at all, when you look at it from that perspective!  And she's done roughly twenty times as much emergency sim time as her general career cohort and can interoperate all five protocols adequately from the moment those are called in."

"There's two problems with this, people.  The first problem of course is that we could not possibly have relied on this happening, as part of any ACTUAL PLAN, which means that no part of this performance can be properly credited to Exception Handling as such, and our earned performance on this scenario is whatever the patient's survival probability would have been without that quality of medical care being delivered immediately.  Which a counterfactual market-grounded-nonmarket-prediction places at 15%.  One quarter of our total success probability was delivered by this one stroke of sheer, unearned luck."

"The second problem is that this particular bit of good luck should actively not have happened because somebody like that should not be working at a small regional hospital.  It should have reliably been the case that this hospital had nobody like that, because they should not have found it profitable to spend the amount of money it should take to afford that level of talent and put it to that particular use.  I am not an expert on labor markets, people, but I know what they are supposed to do.  Labor markets are supposed to offer people financial incentives to go work where their work will be most valuable, such as, say, Default Hospital, where they on a weekly basis encounter strange patients who could benefit from somebody simultaneously versed in all protocols, practiced in synergies of their simultaneous operation; who could benefit further from someone able to do the work of five people for six consecutive shifts, at an emergency tempo, accumulating additional facts and practices and procedural skills about the particular patient."

"Does Harkanam regional hospital pay to employ second-rank Keepers as medical personnel?  No?  Because my understanding is that by the time we had our second-rank Keeper medtech in place to replace Merrin, she was doing adequately enough and was enough of a known quantity of adequate performance that policy-prediction-markets declared it a bad idea to replace her, especially after taking into account that the second-rank Keeper in question in fact had less total emergency sim time.  People you can't replace with second-rank Keepers should not, as a general rule, be paid the same amount as tier-three hospital medtechs."

"I am not an expert on labor markets, people, but I have read theorems about them.  I know what sort of equilibria correctly functioning labor markets are supposed to have.  In a functioning labor market in equilibrium, you should not be able to trivially predictably generate a massive profit by moving labor from one use to another.  So, while I don't know what to call whatever Civilization has instead of a labor market, we apparently don't have one.  We simply do not have a labor market, people.  We are not actually paying people according to their opportunity costs and the marginal value they generate, but paying them according to some entirely other mysterious principle.  Somebody who acquires several dozen emergency certs should not be paid for emergency-cert maintenance a quantity that is linear per emergency cert, because their value is not, in fact, LINEAR.  If that DOES happen and furthermore the way in which it came about is that somebody did twenty times as much emergency sim time as the rest of her cohort, including multiple runs of consecutive hours at emergency tempo on a practically daily basis, you would think there would be some sort of VENTURE CAPITALIST who would see a misplaced labor source and try to MOVE HER SOMEWHERE MORE PROFITABLE in exchange for MONEY.  But this did not happen because of a MISSING REQUISITE detected by the software, a requisite for the supposed fluid intelligence levels to easily acquire the crystallized skills she ALREADY HAD."

"Civilization did not simply profit from Merrin happening to be present, today, it profited from Merrin being present somewhere she was underpaid.  We profited at Merrin's own expense, and that's just entirely unacceptable."

"Why did nobody notice the entire stamina monster affair?  It's valuable generally and in medicine specifically.  We know extended endurance is valuable in medicine.  Default Hospital bids more for their tier-five and tier-six operators who have that property.  So why don't we measure that capability, run competitions about it, and award status for it?  If it's valuable to society, why doesn't society try to detect it and reward it somehow?  Are we just hoping that we'll get nice things for free?  There should be, I don't know, Endurance Medical Technician rankings, if that's a useful property worth competing on, and that way society can actually notice excess talent there and move it where it can generate the most value."

What.

Merrin is aware - on some level, not necessarily the level that most of her conscious mind is attending to - that Catchall is saying nice things about her. 

Normally, she would have some sort of emotion about that. Probably. Right now she mostly just feels like swerving to calling people 'random unearned heroic saviours' is a weird tonal shift, she thought this was supposed to be the villain monologue section of the weird TV show. It's just a bizarre narrative choice. 

(The grandmother-gendertrope lady who spotted their patient in the river deserves it, though. Merrin sort of wants to give her a hug at some point. It would have been scary for her and she's seen way more bodies.) 

IS THAT WHY THE KEEPERS ARE WEARING SCRUBS???

HOW DID THEY POSSIBLY THINK IT WAS A GOOD CALL TO USE MERRIN INSTEAD?????

PREDICTION MARKETS ARE SUPPOSED TO BE RIGHT ABOUT THINGS AND NOT LUDICROUSLY WRONG???????? You know, just, maybe someone could have noticed that and flagged the whole secret pseudomarket setup as dubious way earlier if they had put together how little sense that conclusion makes? 

(Merrin is vaguely background aware that there's some sort of wrongthought in there, the part of her that flags that is still working, just...not the part of her that goes on to do anything about it and try to have correct thoughts instead.) 

...Oh phew here comes the criticism, he...thinks she should have gone to work somewhere else? Great! Now she feels bad about not having done that years ago! And somehow simultaneously very aaaaaaaaaah about the prospect of having to do it now. Convincing people to hire you is stressful! She knows everyone here! She had sort of expected she would keep working this job for, like, at least a decade. 

Now apparently she needs to move to Default because that's where Civilization can make the most use of her talents??? Aaaaaaaaaaaaaaaah that feels so fake and also badwrong but what is she going to do, ignore the Chief of Exception Handling? 

- ok definitely wrongthought, Merrin is pretty sure that's not what he means. It's usually not what people mean. 

That being said, if a venture capitalist shows up to try to recruit her after this she might actually cry. She so incredibly does not have the emotional bandwidth for this level of weirdness right now. 

None of the rest is really emotionally registering compared to the part where, not just Hospital Administration, but also the absurdly well-funded prediction markets and top world experts, decided she was going to outperform a second-rank Keeper. 

Merrin is staring woodenly ahead, sort of half trying to disappear into her bathrobe, and would be turning bright red, but conveniently she's already green and maybe no one can tell. It's tempting to hide under the table but there continues not to be very many available under-table spots and it won't help anyway. 

(Personnel is frantically trying to text Catchall and tell him to stop saying things that imply Merrin is special but in fact it's not actually that easy for a random dath ilani citizen to text Catchall directly.  It's not that hard for many high-ranking people, but Catchall specifically is the one whose address gets frantic texts from people who just went schizophrenic, so it's a bit harder to contact him directly than usual.  Catchall isn't going to get Personnel's advice until thirty seconds after it's too late for him to benefit.)

"Merrin was a hero, and anybody who thinks that puts Civilization in a good light ought to be flung out the nearest window before they drag down the average sanity in the room any further.  Correctly designed social systems do not rely on individual heroes.  Especially heroes who, on a planet that actually had a labor market, would not be working as tier-3 medtechs in the middle of nowhere.  Merrin wasn't there because Civilization has a great hospital system and educational system, she was there because our labor allocation system is a flaming fragrant failure fart.  We had no right to that piece of luck, and we gained it at the expense of Merrin being severely underemployed for a quarter of her life."

"We turn now to a bright spot that was, I suppose, slightly more earned, if you count it as skill that we contacted a large group of people one of whom was the right person; the venture capitalist Ashre, who did a quite impressive job of frantically improvising around Exception Handling's total failure to have done the right research or even gathered the right information more than five minutes in advance.  I won't call him a hero, because he was doing his actual job and was approximately where Civilization thinks somebody like that should be, but he was, beyond reasonable doubt, the most valuable player of this entire affair, above even Merrin..."

(This next section is about complicated proteins and possibly of less direct personal interest to Merrin.)

Oh, good, he's done ??using her as a character in some sort of parable to make Hospital Administration and the rest of Exception Handling feel bad about their lack of preparation?? Which is sort of valid, they were unprepared, not that Merrin herself would have thought of those contingencies ahead of time even if she had a million years of it being her only job.

Merrin would have preferred not to be used as an example in a villain monologue but it's fine, she's fine. 

Normally she might be interested in complicated proteins, but it's not of direct personal relevance to her right now, and her brain is tired. She half-listens, but goes back to watching the various patient screens, flicking through to hunt for any change in vital signs or various other sensor data. 

He'll get noticeably louder when he talks about the CATASTROPHIC FAILURE OF THEIR PREDICTION MARKET SOFTWARE and how he is not TOO UPSET because HUMAN BEINGS FLATLY CAN'T PROGRAM COMPUTERS and this state of affairs does reflect a deliberate, considered choice by Civilization not to go too far into genetic engineering or even systematically breed their best current programmers together, but it is still ANNOYING.

The lack of any FAILOVER system he is likewise not blaming on HUMAN BEINGS PER SE because this state of affairs was presumably brought about by INTELLIGENT MICE who'd somehow TAKEN OVER THAT SECTION OF EXCEPTION HANDLING and were running it to Civilization's subtle detriment.

Whatever he thinks counts as 'flatly can't program computers', Merrin is vastly less capable than that, and has been for her entire life, which is apparently enough to not feel like this is a criticism of her personally. She doesn't have any opinions on the prediction market failure aside from how it was really stressful and she hopes it never happens again.  

Oh no she asked people to review her code what if he saw it almost certainly the Chief of Exception Handling had better uses for his time than looking at her horrible sim-practice automation scripts. 

They're getting on towards initiation of the actual rewarming protocol, so Catchall will wind down and finish up, here.

"...really, the whole concept of 'exception handling' is an element of creeping fridge horror as a design pattern in computer programming.  It normalizes the idea that your ordinary code is not actually correct in general, only correct by coincidence for specific inputs, and sometimes needs to 'throw exceptions' when it reaches conditions under which the code's underlying incorrectness would be made manifest."

"Nothing in Civilization works in general, it breaks as soon as it encounters slightly unusual challenges, no organizational structure within all Civilization is actually generally correct and known to be correct.  Our approach to this as a society has been to slap Exception Handling on top of it as a patch."

"For this to be even slightly okay, it requires that at least Exception Handling work."

"And then it doesn't work."

"If we came across a computer program as poorly designed as Civilization, we'd throw the entire thing in the trash and start over and not hire anyone who'd caught a glimpse of the previous code."

"They say it's a famously hard problem to predict what the Aliens will be like, when we finally meet them, some billion years hence.  After today, I think I will dare to venture a prediction as to how specifically the Aliens might differ from us, and I'm not entirely joking either."

"When we meet the Others, they will, during their corresponding historical period insofar as their history can be aligned with ours, have had better healthcare that was more robust to out-of-distribution inputs."

"Thank you for listening to this rant, since I cannot actually rant about it on television in this particular case.  We don't have long before the rewarming protocol will be initiated, now, but I have courteously made certain to reserve at least a hundred seconds for questions, objections, and comments.  Are there any such?"

(This really is supervillain behavior, reserving so little time for objections at the end.)

Merrin does not have questions. That would requite saying words with her actual mouth, for one, and she doesn't have anything coherent, just...she's vaguely mentally poking at whether she actually expects Aliens to have better health care relative to other Civilizational infrastructure. Also what if he asks her to her face if she's a Sparashki. Merrin is too tired to ad-lib anything. 

Anyway, she is so eagerly watching the screens for the actual rewarming protocol, though she's a little curious if anyone else has questions or objections. 

There's a brief exchange of glances, and then the fourth-rank Keeper lists the top five things that Catchall said that were probably not valid inferences given current knowledge.  'The Others will have had better healthcare during their corresponding historical period' is on the list.  Nice things Catchall said about Merrin are not.

Merrin does not actually think to update from the inexplicable failure of anyone who actually knows her to point out that saying she should have been working in one of the top-worldwide ICUs in the world in Default Hospital is obviously absurd. That would require her to still be thinking about the absurdity.

She is definitely going to look very apologetically at the second-rank Keeper if at any point she can catch the woman's eye. Merrin isn't sure what she owes an apology for but it's definitely something.  

Second-rank Keeper actually has her eyes closed, at this point.  Trying to keep up with all of Merrin's data inputs for a few hours, without actually being her or actually controlling the systems, is mentally exhausting; and she's been trading off shifts with the fourth-rank Keeper and a third-rank Keeper at staying fully up-to-date on what Merrin was doing.  (That third-rank Keeper is currently busy tracking the current medtech in case she falls over.)  She's not asleep, but she's accepting audio inputs only, right now.

And the rewarming protocol goes into action, with Avarris orchestrating.

Patient ok-outcome probability drops to 18% shortly after it begins.

Oh no did the smart people now in the room just notice a stupid mistake she made in one of the earlier treatments that no one else caught from outside the room itself

You know what? Even if they did, Merrin is past caring. This is a weirdly paced TV show, and – well, would she be judging a fictional TV character in her position, with her previous established backstory, for failing to plan out a perfect response to all the cases where the patient started deteriorating on her watch? No. She would not. She definitely wouldn't judge, say, her colleague Lethan, who with six weird-emergency certs (and at least a standard deviation of thinkoomph on Merrin, and about her age but with four years rather than one in direct ICU experience), was probably next-most-likely to end up in charge here. 

...Huh. Now that she's actually picturing this in its specifics, it's obvious that Lethan couldn't have handled all five machines like Merrin did. Lethan could have handled two or three machines with a lot more skill and forward planning, of course, but...not for twelve hours. Come to think of it, Merrin isn't sure if anyone on staff would have been able or willing to tough out twelve hours of that. 

Merrin is under no illusions that she was the only option; the hospital should have had enough people with the relevant certs, who were adequately rested and hadn't just come off-shift, to cover the machines until they could bring in someone like Avarris. But coordinating within a group of multiple people all handling complicatedly-interacting functions is stressful, and handovers are stressful, and - yep, checking the prediction markets on when Avarris will need replacing, they're expecting it to be a lot sooner than twelve hours. 

Maybe - at least in this one bizarre edge-case scenario that really has no right to happen outside of a weird surreal TV show - there really is something to be said for being able to perform badly for twelve hours. The imaginary mental voice of Merrin's mom is telling her she should feel good about it. Merrin is not quite there, right now, but it feels a little more plausible that the hospital really was lucky to have her in particular on staff, not that this feels very predictable in advance. 

Does Default Hospital really get patients this interesting on a weekly basis?

(In the immediate aftermath, Merrin would, if asked outright, have said that she never wanted to deal with a shift like this EVER AGAIN, but even just twenty minutes later, she's emotionally recovered enough to start reconsidering.) 

Just, wow, in a way - a very hypothetical way that she can't actually think about as though it's a real decision without internal screaming - it might actually be pretty neat to regularly get to do stuff this intense outside of sims? By which Merrin mostly means 'it would be horribly stressful but after a year of it she would be better at things'. Maybe that's how you get to be as cool as Avarris. Hypothetically. Thinking that she could be as cool as Avarris is definitely not the sort of thought that Merrin lets herself think without flagging it as not something she can ever reasonably expect to achieve. 

...Actually, Merrin is still too off-balance for any of this to be productive to think about right now.

She leans forward in her seat and flips through screens of sensor data, including from sensors that she's never seen even in sims, and she feels weirdly empty and floaty, and at the same time she can't seem to stop fidgeting and there's a tight knot of something in her chest. It's hard to tell what emotion that is. Maybe that's just all the caffeine.

Bits and pieces of Catchall's speech keep replaying in her head, unwanted. 

- there's a restless itchy feeling behind her shoulder blades, and she wants to go to the sim room and stay up all night angrily playing the same stupid sim over and over again until she can do it right, she wants to go to the pool and swim and swim until everything hurts, she wants a hug, she wants her mother, she wants the patient to be okay so badly and it's out of her hands and was maybe never in her control at all but 18% odds aren't good enough that's not acceptable it shouldn't be allowed - 

- and it's all tangled together in her head: if Civilization were better, if they'd been more prepared, if she were smarter if she had worked harder if she were braver if she had ever really cared enough if she were a better person not the sort of person who's scared of everything all the time...

Merrin is on some level aware that she's an unhelpful degree of emotionally engaged, but she doesn't actually want to disengage, that feels like an impossible mental motion right now, and it doesn't really matter if it makes her less functional, since she's not doing anything important. The worst that happens is she cries in front of the Chief of Exception Handling on vidscreen and maybe this will convince everyone she's not cut out to work in Default Hospital