The procedure goes fine! 

...There is no reason to think that the very-low-dose magnesium sulfate is doing literally anything, at least not based on a few very approximate proxies, like CO2 readings from the venous blood directly draining from the brain versus everywhere else. 

His blood pressure is fine though. 

They could try - 

No! That is back to sounding like an uncomfortably high risk of killing the patient! Who is currently 95% (96%, actually, updated based on the fact that they're barely an hour away from Default now) likely to still be alive at the end of the rewarming treatment, and honestly it's going to be pretty hard to push any lower on the brain-damage outcome predictions, they're at the point now when most of the probability mass there is from damage that already happened.

(That happened before Merrin even got to him, in fact, and the Exception Handling liaison is being so good about not pointing out how the best way to avoid that would have been if Kalorm had radioed for help right away instead of an hour later. It does not seem likely to help.) 

Anyway. ....Still no on that suggestion too, they're not - seriously that research was done on frogs– 

FINE then, Finnar will go back to his original Plan A, which was to figure out a way to FIX BRAIN DAMAGE. Which, you know an actually competent Civilization should ALREADY HAVE SOLVED, surely, nobody is denying this is a really important problem! But how much can you expect of people, really. 

To the family groupchat: plane is an hour out, time to start thinking about relocating to the hospital. 

Do they all have to be there? Hospitals smell weird. And they're so intense about ""noise pollution"" so she can't sing. Mallor does not feel like it is in any way her comparative advantage to hang out in a hospital while Kalorm is, like, definitively unconscious for at least the next 12 hours. 

Technically they are going to be keeping Kalorm in a medically-induced coma for probably a lot longer than that! Finnar did not know this three hours ago but now he has read all of the usual protocols. Kalorm will 99%+ not be conscious within the next 24 hours! Even if he does super well and they want to reduce the sedation earlier than usual, it's currently around 4 am local time in Default, and they're going to prefer trying to wake him up when they have daytime personnel on hand, there are studies showing that medical personnel working night shifts in their local timezone have mildly reduced performance even if you reduce their shift length by 25%. (Yes, Finnar also found and read all of those studies within the last 3h. He's a fast reader.) But anyway it'll probably be more like 48-72 hours given Kalorm's injuries from the boat incident and ensuing near-drowning, they're going to lean toward keeping him under sedation until he's medically stable. 

(Finnar has learned so much about critical care medicine in the last few hours. It turns out it's really fascinating! He is maybe going to have to invent some new medical equipment after this because he keeps thinking of ideas.)

Anyway, sure, Kalorm will in fact not give a superheated pool of feces whether Mallor is there this morning. 

Though has Mallor considered coming and just singing anyway? Finnar doesn't mind, nobody in the family minds, probably a lot of people won't mind as long as she doesn't do it literally in Kalorm's room or the on-site command center while they're in the middle of high-stakes procedures, and they can just compensate anyone who does mind.

If the weird smell is a dealbreaker by itself they can find a scented product that isn't banned in hospitals, or just pay a lot of money to break the rule where a lot of scented products are banned in hospitals because sometimes people are allergic to them.

(Finnar sort of wants a full show of family solidarity, here. It feels important even if Kalorm won't know until later. And, on some level, he wants to have his other children where he can see them.) 

...It's perhaps not so much a smell per se as just a general indefinable way-that-hospitals-feel. Mallor thinks this is mostly about the fact that hospitals have a lot of sick people in them, even if they're behind closed doors she still knows they're there. Mallor is really not sure if that is the kind of thing you can fix even with a lot of money. 

She'll come, though. 

Nerdel, three hours ago, was faced with the major logistical-planning question of: when one is bringing together one's entire very large, very stressed-out family to camp out at a hospital for an unknown length of time, what does one pack? 

(Besides the obvious course of having their nearest family-vacation-house-module transported over to dock with the hospital. That's actually a pretty good step-one plan - but also she has seven children, some of whom haven't joined in on a family vacation in multiple years, and so this isn't a complete solution. What if Ranthir no longer likes the same model of pillow? What then?) 

She did the obvious thing, and funded some prediction markets about it. 

She also called ahead and was promptly put through to the Medical Crisis Liaison department at the hospital, to discuss in advance some of their family's circumstances and support needs. 

You don't actually have to call ahead! Dath ilan does not necessarily expect people who just received unexpected and terrifying news about the medical condition of a family member or close friend, and are now frantically rushing to the hospital, to have time or be in a good emotional state to make their needs and preferences legible. (Also, it's not uncommon for people to just straight-up document what support they would benefit from, if they end up in a hospital not as a patient but as a friend or family member of a patient.)

Hospitals are mostly focused on patient outcomes, of course, but Civilization broadly prefers for things to be better rather than worse, even if the thing in question is not the primary goal of an institution. Having a loved one experiencing a medical crisis is an awful situation to be in, and dath ilan does not want any of that awfulness to be avoidable awfulness. And it's generally understood that, given the stress and also the likely accumulated exhaustion of being in an emotionally vigilant state for many hours or days, people are going to be in a weird corner of their psychological state-space, and might find apparently very random things upsetting and have unusually little emotional slack to cope with that. If you think that you'll feel a little bit safer and calmer in a room that has the exact vibe of a particular scene from an obscure amateur-TV-show-of-a-fanfic-of-a-popular-TV-show, and also does not contain a hint of the color yellow, providing this is really very cheap compared to the heroic medical interventions happening a few rooms over.

Also! Keeping the patient's support people updated - and hearing their responses - is sometimes genuinely relevant to optimizing for patient-QALYs! People close to a patient have a lot of private information about them, which the medical prediction markets cannot be assumed to have. Most of it isn't medically relevant information, but sometimes it is. The Medical Crisis Liaison caseworker assigned to a case has extensive training in communicating about the complexities of biochemical models justifying a diagnosis or treatment, updating prediction market probabilities, and cost-benefit analyses to people who may be all over the cognitive-ability spectrum and who are also having the worst day of their lives. 

If they don't have explicit directives, either verbal or written in advance, they still have public information to go on, and will spin up some policy prediction markets on their end to inform how to set up the Family Room (sometimes on literally ten minutes' notice, but the hospital has a wide variety of quickly-customizable furniture and decor in stock, that's also cheap compared to actual medical treatment) and to assign a caseworker. All of the Medical Crisis Liaison caseworkers have a minimum set of qualifications and experience, but they don't all have the same background, and different families-or-friends have different communication preferences. If they do have private information to go on, they'll usually still run prediction markets during a case, for anything that lets them avoid bothering or interrupting people who are in a strange place, probably tired, plausibly very cognitively overloaded and decision-fatigued, and definitely dealing with more than enough emotional challenges. 

It's honestly really helpful in this case to have more to go on, because dear superheated geysers this family dynamic is complicated. 

Agreed! Also, several aspects other than just the family dynamic are pretty complicated! Exception Handling is going to provide their own team. 

(All of whom have sworn high-grade secrecy oaths, and are cleared to know certain facts about this family that even most of Exception Handling isn't aware of, but saying that would itself be leaking information.) 

The assigned Exception Handling Medical Crisis Liaison is named Dathim (and will introduce herself by name if anyone seems to care, but otherwise defaults to letting them call her by her role). She is highly qualified, has over a decade of experience, and is secrecy-oath-cleared. 

She immediately reviews all publicly-available data on the patient and (even more importantly given her role) the patient's family. On the one hand, it's fascinating reading, but on the other hand she is already feeling very tired.

One of Khemeth's open text-conversation windows is with his boyfriend. He...has honestly been prioritizing it below almost all of the other realtime text conversations. Mostly because, one, Dekan trusts him and Dekan is also a sane and well-adjusted person who can handle himself and so this piece of the complex emotional puzzle is unlikely to fall apart no matter what he does -

- and two, because Dekan is going to want to interact with Khemeth's emotions.

Khemeth is currently LARPing being a person who is not having any emotions, because he can't manage to dig up any that are useful. He feels like this is sustainable at least in the short term, which is what matters in an emergency. He would prefer that his emotions continue to not be anyone's priority. He is pretty sure that he can handle this for the next 12-24 hours, and it won't be easier if he suddenly also has to navigate Dekan being sad because Khemeth is sad. 

(He has also been multitasking a number of conversations to a ridiculous extent for a while, now, and while that in itself is in his wheelhouse, he's ALSO having to actually read the dense technical medical papers that Finnar keeps sending him, which is NOT.) 

Dekan is not confused about any of Khemeth's recent behavior, which mostly means that it doesn't hurt. 

He would prefer if things were going differently, of course. He would prefer the hypothetical world where he could go join his boyfriend at the hospital, and maybe make some useful contributions, but if not, at least be there while Khemeth was repeatedly making agonizing cost-benefit-analysis judgement calls on behalf of someone who he loves (and who has given him so little to work with.) 

Instead, they are living in the world where Dekan shouldn't even try to be in the room, however much this would help Khemeth make critical decisions more effectively and at a lower emotional cost – because, thanks to decades of complicated emotional history, it would be net-negative-in-expectation.

Dekan is pretty sure Khemeth would also prefer that different events were happening, and that different events had happened in the past, but - given the actual history, and recent events, and the problem they now have to solve, and the resources available to solve it, and the fact that Khemeth is very much himself - well, Dekan knows his boyfriend very well, and he understands. 

He knows better than to interrupt and bother Khemeth by asking about what he needs. He is still pretty worried. 

Khemeth packs up his office. (This doesn't take long. Most of what he needs on the scale of 12-24 hours is computer-based, and he's sent that data ahead to Default Hospital. Nerdel will have handled anything else.) 

[headed to hospital now] he messages Dekan.

A pause. 

[wish you could be here]

It is vaguely tempting to retort with "well who's stopping me from being there" but Dekan does not say this, even in private text chat, because it would not help. 

[will be here and receptive next 24h if you need anything, flag any needs where I have comparative advantage to help*] he answers. 

*I am pretty sure this requires fewer syllables in Baseline but I am not sure which ones.

[noted] 

Finnar would like to check whether they can bring his wall-display-projector to the hospital? He's using it for important work. 

....Yes, Khemeth did think of that. The room being prepared for them should include an identical model. 

What if they calibrated the display settings wrong. 

Khemeth did check that and he's pretty sure it'll be fine and if not they will fix it. 

(...It hasn't even been four hours and he's already so tired.) 

30 minutes to go before landing! 

Not that Merrin's work will end there!  Just. During this particular interlude, she keeps having to be MEAN to Kalorm! For example by keeping him really cold at 18 C! And then shoving him into a tiny transfer capsule and subjecting him to the full winds of a storm!

She is super looking forward to landing in Default! Both because she will have way more backup so she can stop worrying about killing her patient because she's stupid, and because once the have everything in place for the neuroprotective rewarming protocol, she can instead be NICE to Kalorm, by letting him rewarm to a less insane temperature. 

(Merrin is having to juggle a lot of factors right now, and she can do it, she can keep up, but it's frustrating and stressful and emotionally draining. She is trying really hard not to let that slide into being mad at her patient about how he cannot flaming stop doing weird stuff with his electrolytes that forces her to run the dialysis harder, which means upping the dilutant fluid at the top of the circuit, which means that to keep overall fluid-input-to-the-system at an allowable level she has less wiggle room for dilutant in her other two circuits, which means the high pressure alarms going off CONSTANTLY and she wants to PUNCH the machines producing them for being INCONSIDERATE of her FEELINGS.) 

(Yes, Merrin is on some level aware that she is attributing agency and volition and social goals to a system which absolutely does not have them. Her brain is going to insist on doing that about something anyway, it's better than being socially anxious about all the people watching her.) 

Public announcement on treatment planning: they have everything ready on site to start phase one of the protocol as soon as they land in Default.  Some details of the treatment protocol have been blocked from the public feed at the family's request, to make use of proprietary research to be published soon. 

(This is obviously not ideal, in terms of the medical experts contributing to the prediction markets being fully informed, but it's not unheard of. The trading entities have strategies to account for that uncertainty, and it lets them keep the public markets up.) 

Separate announcement from Exception Handling, to only the people cleared for grade-three secrecy and higher (which includes everyone on the medevac plane, and at least a solid fraction of the experts betting on the markets): they're using a more complex experimental protocol that includes elements which are not published yet for reasons. 

Here is the full updated version to familiarize themselves with before landing.