Aaaaaaaaaaaaaaand coming up on the point where they should expect to see one of two things on the display...

STRESS

Only a small spike! 

KALORM IS THE COOLEST MOST IMPRESSIVE PERSON ALIVE AND HE IS GOING TO STAY ALIVE AND BE OKAY BECAUSE HE IS JUST THAT GOOD AT NOT DYING!!!!!!!!!!!!!

....All right, Merrin's brain, chill. There are still eleven entire hours of this to go. Kalorm is more likely to be okay but it's still not a sure thing, and in particular, he is not okay yet and he will only get there if Merrin is very very diligent and very very conscientious about executing this protocol perfectly. 

Finnar is not so restrained. He is bouncing around the Family Room beaming and speculating out loud on whether his proposal on adding this particular peptide is why it worked so well. 

Markets update! The patient's odds of surviving rewarming are now up to 99.8%, 2 in 1000 chance of a complication that could even theoretically be fatal; the most risky part, in terms of Kalorm's basic physiological stability, is now behind them. 

Updated outcome probabilities:

Mild deficits 50%

Moderate damage 6%

Severe damage 1%

To Merrin, who has been hyperattuned to every single aspect of Kalorm's physiology for coming up on six hours, the difference is huge! His blood pressure is less randomly variable, as capillaries start to respond just a little bit more consistently to drugs. His hands and feet are still blue and mottled, but his face is less grey. The hard-working dialysis circuit is even giving her fewer high-pressure alarms. 

(For which Merrin is soooooooooooo grateful. She's worried that she was starting to hallucinate high pressure alarms, and/or mix up which machine was which.) 

The next part....is going to be pretty boring, actually, at least as an observer. Now that they're most of the way out of the scary danger zone of hypothermia where Kalorm's organs are mostly not functioning and the system is incredibly fragile, they are going to slow down massively on rewarming, to buy themselves more time for tweaks. 22 to 25 C is a delicate and critical interlude, so they'll do half a degree per hour, taking a whole six hours to cover those 3 degrees. 

Once there, seven hours total into the protocol, they'll still have almost 10 degrees before they even start to approach a normal body temperature, but they aren't going to get to a normal body temperature today. 25-28 C is almost but not quite as critical; they can afford 1 degree of rewarming per hour. Three hours of that. 

If, at 28 degrees, things look good, they'll speed up again, hit 32 C within the remaining 2 hours, and stabilize the patient there for the next 24-48 hours before they actually start letting him wake up. If things don't look good, they have the option of keeping him at 28 C while they try other things for a while. It's not preferred – it's cold enough that his heart will be irritable and prone to arrhythmias, his electrolytes will require constant management, and taking him off either the dialysis or bypass circuit will be fraught. They can probably keep him on the bypass for 24 hours without problems, and will if it looks like it might make a critical difference to his neurological outcome, but they'll need to hand off to another opper, and there just aren't that many people who can handle even the current reduced number of machines for longer than 4 hours.

Really, they're hoping they can get him to a nice stable 32 C, a temperature at which – if his lungs are capable of it, which looks hopeful – they can expect his heart to beat unaided and the ventilator to be more than sufficient for oxygenation, and then they can finally do something about his injuries. If his physical condition is good enough, they'll reduce the sedation and let him wake up 24h later, and....find out for sure how well they succeeded. 

There will be additional panels of tests at 25 C and at 28 C. Additional key points for, if not decisions at this point - there are mostly past the stage when decisions could be made differently - at least belated information on whether their early decisions were the right ones. (Though, of course, it's possible they were in a world where no possible set of perfect decisions could have been enough.) 

The main remaining risk is that, as long as they're keeping the patient below 28 C, Something Might Go Suddenly And Catastrophically Wrong. They don't know what; it's a number of possible risks, all low, all minimized as far as they can, but not zero. A machine breaks; a blood vessel bursts in the patient's brain; or, maybe, Merrin makes a mistake (she will after all be 14 hours into her shift by the time they hit 28 C).

The estimated total per-hour risk of Something Catastrophic for the next 6 hours, while they cross the gulf from 22 to 25 C, is about 1 in 50. From 25 to 28 C, one in 200, and they won't spend as long there. Even summed over 9 hours, it's not a very big total risk. 

Still. 

Over the next six hours, for each hour that passes, if nothing goes wrong the odds will very slightly improve. Maybe by 0.1% for the severe damage outcome, by 0.5% for moderate damage, by 0.8% for mild deficits. If something does go wrong, it's - probably survivable (the patient's survival odds are still very high, and will drop only somewhat), and they're already probably not in the world where severe damage already happened; with the resources on hand, they can probably stabilize the patient before it does. The markets are calling only a 5 percentage point jump in that outcome – but a 25 point jump for moderate damage, and 40% for mild. 

It's probably going to be okay. But they do have to roll those dice quite a lot of times. 

"Merrin plays the heart-lung bypass machine and dialysis and prevents the carotid blood pressure from exceeding parameters" turns out to be a boring spectator sport once more than ten minutes has elapsed. Finnar is bored. He starts a debate with Kurthim about their options for later treatments that will help Kalorm recover faster.  

It may not be very eventful per minute but Nerdel is not taking her eyes off that screen. She has one arm around each of the twins. 

It turns out that "stressed, miserable, and ADDITIONALLY bored" is the worst combination! Khemeth's brain is kind of eating itself. 

He's at least pulled himself together enough to make Merrin-related recommendations, since he is in fact one of the top Merrin experts, and as proved by the ill-fated parental visit, he's not sure Personnel is entirely on top of Merrin's needs. 

This is a good protocol! Merrin is fond of it! Everything is very well specified and there are no scary decisions and she is just reacting, over and over, and she's getting it right every time, which of course mostly because Kalorm is very good and so it's not, actually, hard... 

One hour in. 22.5 C. 

No spiders. 

Yayyyyyyy! No spiders is Merrin's favorite way for things to be. 

Khemeth is idly making his mental models of Merrin and Kalorm talk to each other. He feels like there has to be some first interaction that would result in them getting along, which would be neat, but it's very much hard-mode if the context of their first meeting is "Kalorm wakes up in the ICU." Kalorm is going to hate waking up in the ICU, and probably be reflexively angry at everyone who was in any way causally involved in this. 

Two hours in. (Hour 3 of the protocol overall.) 23 C. Finally, creeping back toward the temperature Kalorm was when they got him. 

Still no unexpected catastrophes. 

Khemeth's mental Kalorm is berating Merrin for having opinions about his bodily functions which are HIS and he can do what he WANTS with them, and also for giving him encouragement in a way he interpreted as patronizing. Khemeth's mental Merrin is patiently listening and apologizing while internally dying of abject humiliation. Khemeth is not really sure why he's doing this to himself. 

Three hours. 23.5 C. No catastrophes. 

Eeeeeeeeeee amazing!!! 

Also it's now almost nine hours since Merrin fished him out of the ocean, it's sinking in that she still has another eight hours to go – it's going to be longer than sixteen, given the setup time required on arrival in Default, though if all goes as planned the last couple of hours won't be hard. 

She could go for a fifteen-minute break if someone can spot her. Literally nothing interesting has happened in the last three hours. 

Four hours. 24 C. No disasters. 

There are, at various points, random spikes in one or another of the damage markers that then level off and slowly decrease. This is approximately exactly what they were expecting. It is still, overall, an improvement in the outcome probabilities for each hour that passes. 

Five hours. 

Six hours. 

Nothing goes unexpectedly and catastrophically wrong. 

The current predictions:

Mild damage 45.20%

Moderate damage 3.00%

Severe damage 0.40%

Kalorm did SO well and Merrin is SO pleased, although of course she never really doubted he could do it, because he is very very good at not dying and at recovering better than anyone expected! 

...Merrin is not tired per se, but it has been eleven and a half hours, and she's been doing exactly the same thing over and over for the last six of them. She is a little bit in some sort of weird trance state. 

Kalorm at 25 C – and, at this stage of the protocol, with adjusted O2 sats now allowed to be in the mid-80s and a systolic blood pressure goal of 75 – is starting to look, not healthy, but no longer setting off nearly as many loud alarm bells in Merrin's head. 

He's still pale, with a purple tint to his lips, but the mottling is nearly gone from his extremities, capillary refill is only modestly sluggish, and his hands and feet just feel cool to the touch, not cold. His kidneys are putting out some urine, after multiple hours of mostly not bothering. It's still a darkish color that Merrin doesn't love, and reading positive for protein, and the various neurological and hormone systems that regulate electrolytes are not really back online, so his kidneys are just sort of dumping out whatever happens to be there, and it's actually giving Merrin a harder job of, at this point, the goal of keeping his sodium at 155 rather than letting it keep dropping and risk ILL-ADVISED BRAIN SWELLING. His heart is neither beating nor even quite fibrillating, but there's some slow, disorganized electrical activity happening.