Finnar sort of has no idea what constitutes being gentle enough! He will look very serious and hold perfectly still! 

After a minute of that, Fanthim clears her throat. 

(She is feeling really terrible about screwing up on the judgement call of, one, probably to let Finnar in the room at all? Nerdel was the one who asked and she was fine. And if Finnar insisted she should at least have given him more explicit instructions on what constitutes acceptable behavior in a hospital room during a medical crisis, because clearly he does not have any common sense about that – and he shouldn't have to, he's dealing with enough, the entire point of her job existing is that this entire family is dealing with more than enough already and should not additionally be required to have common sense. She is half-expecting to be taken off the case and replaced, and sort of vaguely hoping she will be, except it's not clear who would replace her, they really need someone with clearance to know about the Basement and there are really not very many trained Family Support Workers who are cleared to know that!

...Even after the fact, though, she is not sure if and how she could have predicted this, because WHAT. Just WHAT. At least she remembered to warn them explicitly not to tell Merrin she was special, which is apparently super important for some reason? And not to quote numbers on her performance incentive, Personnel added a warning about that.) 

"...That's probably enough, they need to get started in here. We can watch from your suite." 

Finnar reluctantly removes his hand. Clears his throat as well. 

"You'd better do a good job. We're paying a lot for you."

He is not quoting any numbers which in Finnar's mind means this cannot possibly be a problem. 

THIS TOO WAS PROBABLY FORESEEABLE and Khemeth really hates feeling this stupid about social interactions. He's supposed to be good at this. 

Um. This is really awkward??? What are you even supposed to SAY to that?????? 

"I'm...going to try really hard," she says, and is immediately mortified because that sounded so stupid out loud. "I, um. I know he's - I don't actually know him, he's not my... Just. I - it's important to me - I really want him to be okay." 

"We know." There are tears running down Nerdel's face again, but silently. "It's - what he means is, we're lucky to..." and she has to spend a few seconds pausing and racking her brain to find some sort of compliment that doesn't imply specialness, "...we're lucky our son has someone looking after him who cares so much and has so much determination." 

Wow???? Merrin doesn't know what emotion she's feeling about that but she sure is feeling some sort of emotion!!!! 

"I - do you -" Her arms start lifting half of their own accord, and she's half trying to stop herself because what if this is an enormous social faux pas, but she really wants to give Nerdel a hug actually. 

"Would you–" Nerdel is saying at almost the exact same time, while frantically trying to catch Fanthim's eye to try to get some sort of cue on whether offering the lead opper a hug is, like, allowed. 

Fanthim thinks this is probably allowed? Merrin has been successfully keeping up on responding to alarms despite much worse distractions; she can afford to take her eyes off for, like, ten seconds. 

She gives a fractional nod. 

"- like a hug?" Nerdel finishes. 

Merrin is not sure if this is allowed! She is, however, confident that the machines will be fine if she ignores them for literally ten seconds.

"Yeah." 

Hug. 

Hug okay wow she was not expecting that hugging Kalorm's mother would cause her to start crying that's awful aaaaaaaaaaaaaaaaaaaaaah she is on camera what if everyone thinks she's too emotionally immature to be a rank-5 medtech, that's way worse than them thinking she's just not very good at it - 

Fanthim clears her throat, and Nerdel lets go of Merrin, and Fanthim escorts the parents out of the room. 

They have, in fact, offered multiple times that Merrin has support people on standby if she needs a quick break before they dive into the rewarming. 

It is still utterly awful to have to ASK. 

It's actually quite convenient that the ICU is a five-minute walk from the Family Room(s), because it means that by the time Khemeth's parents are back, there is absolutely no hint of evidence that Khemeth was crying too. 

Finnar rolls his eyes. "I don't need you to yell at me," he says to the air, and stomps off to his room full of mirrored command-center screens. "You. Crisis Liaison person. Tell me how the settings on that opper's machine work." 

Merrin can get covered for a five-minute break, during which nothing bad happens!

She goes to pee, cries in the bathroom for the duration of a one-minute timer, and then splashes water on her face and does a two-minute timer of a concentration exercise with a soundtrack to follow, and eats a meal bar, and then she's back and ready to go. 

She feels...better, actually. Looser, less wound into knots inside. There's an optimal level of stress and adrenaline for alertness and performance, and she was kind of above it, and now she isn't. Also, there's a sort of relief in having already made a complete fool of herself, and somehow worrying less about whether she's going to 

WHY are they paying her a lot it feels sort of mean to think "because they're desperate" or "because they're not medical experts and don't have a good baseline to assess opper skill" but, like, that probably does explain it.

Also! Guess what Merrin does not actually have to think about right now! She has so many more interesting things to think about instead, like sodium levels! 

The protocol is very thoroughly specified. It's insanely complex, but Merrin's part of it isn't really more complicated than what she was already doing before. Only a handful of the peptides and other biomolecules being administered are continuous variable-rate dosing which Merrin has to control, or 'as needed' bolus doses, intended as a fallback measure if something else slips outside parameters.

The heart-lung bypass machine has very complicated controls, but Merrin has like three hundred hours of sim time on it, and a huge library of semi-automated scripts she can trigger, and it's substantially less complicated overall than juggling interactions between ECMO and the mechanical cardiac pump. There will likely be periods of relative stability where it's mostly running itself, leaving her free to focus on the hemodialysis circuit. She no longer has to wrangle the liver machine - they switched Kalorm to the full Complicated Liver Replacement Module, with a team in the adjacent room, a swapover that went uneventfully because the heart-lung bypass machine is WIZARDRY and gives Merrin a ridiculous degree of control over the patient's circulation. 

Over about an hour, they'll rewarm him by 4 degrees, to 22 C. 

This will be the first of many points, over the next twelve hours, where the patient's body will start to give them more information about which of the outcome worlds they're in.

(Though they won't know for sure until days later, if and when he wakes up - and maybe not until months later whether cognitive deficits are going to be temporary or permanent.) 

At 22 C, even as they gradually raise the patient's blood pressure and the oxygen content of his blood, there is not yet a lot of cellular activity. Only relatively simple biological processes are happening; parts of the cascade that involve upstream changes in gene-expression regulation are still going to be very sluggish. 

If they're in one of the relatively luckier worlds - and the markets think they probably are - they'll see some damage markers increase, but limited, a bump that levels out and maybe even trails off. 

If they're not - if the underlying damage, impossible to assess directly while he was cold, is severe - then they'll see a spike that doesn't level off. There are a few protocol adjustments to try, but not, really, very many options. 

There were small moves in the outcome probabilities during the rest of setup. They're currently at:

Minor damage 60%

Moderate damage 20%

Severe damage 5%

The markets think it's 20% likely that they'll see a large spike.

This doesn't determine for sure that they're in the 'severe brain damage' world. It doesn't even shift them above 50%. The markets are calling a 16 percentage-point increase, to 21%. Still only 1 in 5. (There's guesswork involved in how well initially-severe damage can and will heal, and some uncertainty in how much "redundancy" Kalorm's brain has, how many neurons and supporting cells actually have to die to entirely disrupt function in a way that can't be routed around. There's significant weight being placed on the hope that even "severe" initial damage can partly repair itself, and significant function can eventually be regained, during a long, slow, grueling recovery.)

Irreversible moderate damage - permanent disability - would start to look pretty likely, though. Not 100%, but the markets are predicting a 56 percentage point jump to 76%, three in four worlds. 

If they only see the small spike, though, they can almost rule out the severe-damage world. Not entirely, but the remaining probability mass is mostly on something going catastrophically wrong and causing new damage. The risk of that might be below 1 in 100, but the markets are pretty confident it's not higher than 1%, which is almost safe. Predictions on (permanent) moderate damage and disability would see a dramatic decrease, by 14 percentage points, down to 6%. 

Failing to observe a large spike is not especially strong evidence against minor damage. It maybe drops the odds to 50% - but a spike being observed brings the prediction of at least minor permanent cognitive deficits to, not quite 100%, but pretty flaming close. 

The atmosphere in the Family Room is VERY TENSE. Finnar is pacing. Kurthim and Khemeth are quietly MISERABLE, occasionally exchanging looks with each other about it. Nerdel is fidgeting. Ranthir is having a surprisingly hard time focusing on trading, weird, nothing has ever been sufficient to distract her from that before. 

The Family Support Worker was not replaced. The consensus is that while she could have done better - and this will be reflected in the lack of a higher performance incentive that she could hypothetically have earned by handling this perfectly - she did not in most people's eyes make a predictable mistake, because Finnar reacting in that way was SUPER WEIRD. She should of course not let it happen again, but she seems as well-equipped to do that as anyone - better equipped, even, she has some sort of rapport with Finnar and he doesn't seem to be angry with her. 

Personnel almost certainly made a mistake in her decisionmaking around whether to let the ask through to Merrin. A little because she was probably underweighting how much internal pressure Merrin would have felt to say yes - significantly more than most dath ilani, and yes they know she's neurodivergent but it's hard to fully account for that in one's intuitions. Mostly, though, she was overweighting the scenario where Merrin was predictably upset with Personnel later, and underweighting the risk of something going disastrously now, a time when it matters a lot more that Merrin is not unnecessarily upset. 

(That being said, it's a recoverable mistake. Merrin was certainly embarrassed, and was in fact distracted, but not at a critical moment, because they had chosen the timing so it wouldn't be. They had to pull in backup to cover her, but they had that backup available, it was fine, and Merrin's performance recovered adequately afterward. Better than adequately, even.) 

Merrin is admittedly currently having a PROBLEM, but it's not one for which Finnar bears any responsibility. It's just that, see, the LAST time she was in a situation like this, repeatedly refreshing a screen of sensor data for updates, she was expecting METAPHORICAL SPIDERS, and her expectation was PROVEN CORRECT, and Merrin's brain has concluded that this is just a spider-containing sort of situation. And is responding to this by dumping a whole lot of adrenaline on her, in case she has to run away or fight off spiders. 

This is a super inconvenient thing to apparently have some sort of trauma about! It's especially frustrating that apparently hundreds of hours of drilling this in sims didn't help! 

...Well. The sim time did help with the most important aspect, which is that although Merrin's heart is pointlessly racing and she keeps visibly startling at alarms that aren't even related to the neural cell damage sensors, she has the basics of the protocol down really solidly, and enough cognitive capacity to handle the tweaks. 

That being said: STRESSSTRESSSTRESSSTRESSSTRESS