Kalorm is slightly less annoying at 28 C than at 27 C. Slightly. His body is still kind of a mess. They are managing to keep everything reaching his brain very tightly regulated, but various other organs are grumpy, either about the original anoxic injury or the multiple hours of profound hypothermia and reduced circulation. His blood sugar will be totally fine for a while and then crater for no reason. (Well, presumably a reason, but not one that is scrutable to Merrin or anyone else.) Fluids are trying to shift around between the intracellular and extracellular compartments; his hands and feet and face are visibly puffy, and Merrin has given him like three ampoules of albumin just to try to keep the osmotic pressure up in his bloodstream. 

But they're managing to mostly filter out or process all the other organ-damage inflammatory byproducts before enough of them hit his brain to set off a panic cascade among those fragile, precious cells. They are, in fact, still picking up on expected spikes in the cell damage markers that show some degree of reperfusion injury, but have no reason to think the protocol is working any worse than they expected. Ultrasound shows reasonable bloodflow; sensors resting on the surface of his brain think the same. On their intermittent scans (less often now that the chance of sudden deterioration is much lower, making the small but present risk of cancer loom larger), his brain looks...mostly structurally normal.

Their limited pool of 'neurology experts who have not, already, looked at his last six scans' - but do have a pretty good idea that his is one of the scans in the pool, it's at this point hard to be a neurology expert in dath ilan and not know about this case, even if you haven't been personally betting on the markets - are staring at it for a while and eventually diagnosing 'maybe low-level inflammation' and 'probable recent electrolyte shifts' but definitely not jumping to the assumption of '11 minutes without oxygen.'

Final decision point before they rewarm him all most of the way to normal! 

(They are almost certainly going to rewarm him to 32 C. He is in some ways less stable at this temperature than he was at 25 C, and based on the readings, it's unlikely to buy them more than a percentage point or two on improved neurological outcome, at the cost of a lot of risk and an inevitably longer recovery.) 

They...are again mostly expecting 'mild bad news'. 80% likely, this time. The 20% is if the final protocol tweaks were a lot more effective than they're really expecting them to have been, and they managed to actually reverse some components of the inflammatory cascade that they had failed to block upstream. If the protocol worked that well, it's very good news, and earns them a whole 40 percentage point drop in the probability of any permanent cognitive deficits, back down to 15%. If they get the expected result, it's a 10% increase. (Other outcome probabilities are still low and mostly unaffected.) 

Merrin will definitely cheer if there is an unexpected absence of spiders! She is almost too tired to flinch about the prospect of expected spiders, though. It'll be okay. They'll get him really good rehab and he will recover more than anyone expected and it will be okay. And more importantly in two more hours he will be at 32 C and hopefully actually stable and Merrin will be able to mostly stop stressing about something catastrophic happening and costing them all of their progress so far. 

though actually an absence of spiders would be really good, can she have that one if she asks the universe nicely

Final tests come back. 

There is basically the quantity of spiders cellular damage markers that you would expect, extrapolating from the last set of results, if the protocol worked about as well as they were hoping it did. 

Probability of mild but persistent damage: 65% 

Merrin is a sane adult with reasonable expectations and she is NOT mad at Kalorm and only a little bit mad at herself. 

65%. Merrin is having to remind herself that when they got the first round of brain-damage-indicator sensor data, back in the helicopter, the markets gave him a 62% likelihood of moderate, significantly disabling brain damage, and then she worked very very hard for, no, with him to reduce that, and it's now 3%. And in one of three worlds, he walks away from this basically fine.

She worked so hard for that 1 in 3 chance. They all did. Probably thousands of people fought for Kalorm to have a 1 in 3 chance of suffering literally no long-term negative consequences from his INCREDIBLY QUESTIONABLE BOAT DECISIONS.

All clear to start bringing him up to 32 C? 

Yeah. Trying more things at this temperature is not going to buy them very much. (Also, a relevant factor is that it's clear Merrin has another two hours in her and definitely not another six, and it will predictably go much better if she can hand over a vaguely stable patient.) 

(They aren't likely to have more information on Kalorm's odds of brain damage for at least 24h, so anyone obsessively checking the market updates can probably take a break from that.)

Odds of surviving rewarming - and the 24h after that - are very nearly a sure thing. Down to less than a 1 in 1000 chance of anything going really wrong, and probably 1 in 10,000 of short term death since they are, you know, pretty well set up to immediately troubleshoot anything that goes wrong. 

Survival to hospital discharge, or next [30 days/90 days/300 days] is less so, but it mostly depends on, well, idiosyncratic factors about Kalorm, such as 'will he try to check out of the hospital as soon as he can walk, but while still in poor health' or 'will he be grumpy enough about being rescued to attempt to truicide over it, without anyone managing to stop him'.

NOT THAT THIS SEEMS LIKELY, to be clear!!! However, it's not like ANY of Kalorm's decisions make any SENSE and so pretty much everyone other than Khemeth (who thinks this outcome is very unlikely but will not categorically rule it out) is holding SIGNIFICANT UNCERTAINTY. And the market on Khemeth's current effectiveness is placing high odds that he is significantly impaired and performing well below his usual, which is, well, it would be kind of shocking if that wasn't the case – completely apart from the emotional involvement, he's been working just as long as Merrin and is not a stamina monster to nearly the same extent. 

Anyway they're giving Kalorm 95% on 30-day survival, and most of that 5% is on "something ridiculous happens", subcase: "Kalorm does something ridiculous when he wakes up." 

Nerdel watches, blinking away tears again and unsure why. She's not even actually upset!

...Not very upset. She is maybe a little bit upset. She, too, had been hoping for an unlikely-but-not-THAT-unlikely small miracle, even while knowing exactly what the numbers predicted, and "ruling out an unlikely miracle" is, still, a negative update, if a smaller one. 

(Also she, too, is pretty exhausted at this point. It's midafternoon in Default now, and her circadian rhythm is so confused.) 

At this point, her children are mostly sleeping. The lovely support worker, who said she should be good for the full 12 hours, is also starting look a bit the worse for wear, but tiptoed in to warn her that Finnar was asleep. Good. Finnar is a bit like a toddler - when he runs out of energy, he runs out hard, but he tends to just fall asleep wherever he is and wake up totally fine after the requisite number of hours. A five-hour nap will probably mean he's good to go all night (not that this is necessarily a good idea, but he totally will.) 

She nudges Khemeth. "Hey. It's nearly over. Everything on schedule. Two more hours."  

(Khemeth was having a confused disjointed dream where Kalorm had somehow dragged Merrin out to climb an especially dangerous mountain, and was trying to convince her that this totally counted as sim practice and so she could skip work for it, and they kept getting into fights about mountain-climbing safety precautions and whether they had packed enough food, and also there were about four layers of conversational subtext, mostly accidental miscommunications, half of which were in no way actually depicted in dream-sensory-input and were instead just dream-hallucinated sourceless truth. Also not entirely plausible since Kalorm has never done a conversational subtext in his entire life, though 'constantly managing to say things by accident that Merrin reads things into and is hurt' is certainly in character enough.

Also his dreaming brain is pretty sure that this is somehow a perfect metaphor for whether or not Civilization is, in some metaphysical sense that doesn't seem to correspond to anything that could be confirmed or ruled out either with logic or with empirical observations, good.) 

...He wakes up with a start, slippery layers of dream-subtext crumbling. 

The question in his eyes doesn't really need to be said out loud. 

"Sixty-five percent."

After a moment, when she realizes that perhaps this number is more ambiguous if, like Khemeth, one is horizontal in her lap and doesn't have a good angle to see the market screens. "- Two-to-one odds on minor permanent damage, love. It's - it's very unlikely to be worse than minor damage, at this point." 

Khemeth blinks a few times. Wow. He feels spectacularly awful. He has a pounding headache, either from sleep deprivation or maybe just not drinking enough water. There's...you're supposed to do things with numbers...but the numbers things are not working right now. His head feels full of glue. 

Also his eyes land on Merrin on the screen, the camera footage is visible from a horizontal position, and his social-modeling is still online enough that he reads a dozen cues from the angle of her shoulders and the faint concentration-line between her eyebrows and the way she keeps tapping her foot and the noticeable startle reaction - noticeable to him, at least - every time that, presumably, an alarm rings in her earbuds.

He concludes that Merrin is currently in a foul mood, and never wants to hear another filter pressure alarm in her ENTIRE LIFE, and is trying really very hard not to aim any of her frustration at Kalorm but starting to struggle with that. 

Grab the remote control for the LCD screens, tab from the camera footage to the page of Merrin-related stats - her performance is degrading a little, reaction times are slower, her attention span is shorter, she is more easily distracted, it's less that her abstract reasoning isn't working and more that explicit reasoning about complex concepts starts to be deeply aversive for her at this point and she looks for every excuse to instead not do it - but she does have the basic tasks deep enough in muscle memory to still be performing basically adequately. Everyone who's seen Merrin through to the end of a sixteen-hour sim agrees that she won't slide much more in the remaining two hours. It's an awfully delicate time for a handover and will be much less so when Kalorm is at 32 C, and Merrin has so much intimate context on his physiology.

...The fact that her basic performance is still adequate does not mean that she is a happy Merrin, this many hours in, while juggling a situation as annoying as Kalorm's. 

Khemeth's mental Kalorm is defensive and snapping that if Merrin didn't want to do this then she could have just not gone after him, really he feels like she was asking for this. 

....His mental Khemeth, the one which is coping and functional and only having emotions which are helpful (e.g. not very many of them), is NOT back online yet. He is a dozen fragmented half-asleep mental processes which are not quite cohering into a sense of self yet, his goal-oriented processes are really up to speed, and he is blearily aware that there are exactly two people right now who are VERY IMPORTANT to understand and predict. And the one of them who he loves, the one of them he grew up with and has spent the last decade worrying about from a distance, is also the one behaving (in Khemeth's head, at least, though arguably also in real life albeit not on purpose) in characteristic yet deeply socially inappropriate and frustrating ways, and Khemeth has secondhand embarrassment. 

He wonders if having mild brain damage will make Kalorm more Like That, or less. 

His head hurts. 

His mental Merrin, already on the raw edge, is...mostly indignant and offended, actually, even angry - which is interesting - but apparently her reaction to anger is also to burst into tears, and there is no calm stable imaginary Khemeth on hand to respond to this by shutting down that mental process, and so Merrin's anger escapes its mental sandbox and blends with Kalorm's anger since childhood at a Civilization that tries very hard to carve out space for its Exceptions but does not, really, have room with it for someone like him.

And Khemeth is angry - with his brother, with the world for not being good enough, with the stupid boat manufacturing company because who even makes boats with large metal pieces that can come loose and sink, maybe with nothing at all really it's just a modeled-emotion leaking - and now he's sobbing. 

Nerdel...is pretty surprised, actually! 

She knows her son well enough to realize that it will do the opposite of help to let on that she's surprised, or show any sign that it hurts to see him in pain, or even hint that this situation calls for any sort of action from her. But just refusing to acknowledge it in any way also seems bad? 

She strokes his hair. 

Fanthim is feeling pretty out of it at this point, but she tries to catch Nerdel's eye and mouth do you need help? Does he need anything? 

Nerdel really doesn't want to have an entire conversation via lipreading and facial expressions. She has a hand free, and her cellular texter in reach. 

[It's okay. Delayed reaction to all the everything. Don't make a fuss about it.]

Pause. 

[Maybe get him a glass of juice and a snack?] 

She can do that, and unobtrusively put it on the side table within Nerdel's reach. 

Nerdel pats her son's shoulder. "Come on. Up you get and have some juice. I shudder to think what we'd see if we had your blood sugar up on that screen." 

Khemeth is honestly still half asleep and is not entirely functioning as a person right now, but he is apparently capable of sitting up and drinking juice even though his brain is mostly white noise. 

He leans against his mother's shoulder. It is really stupid how he's physically too exhausted to even want to think about standing up, despite the fact that basically all the effort of the last fifteen hours was mental. 

She rubs his back. It's...sort of nice, actually. There are fewer opportunities to offer physical affection to her adult children, Khemeth especially. 

"No more decisions for a while, love," she murmurs. "We won't know much more before tomorrow. We should get some sleep." 

Can they do that right here? Khemeth does not look super up for moving. The twins are curled up like hamsters at one end of the sofa, having managed to sleep through the whole crying interlude like only exhausted teenagers can, and Kurthin is a person-shaped bundle under a fuzzy blanket at the other end of the sofa. 

Via cellular-texter conversation since that seems to be Nerdel's preferred communication medium right now: They can totally sleep here! This was an anticipated need and the sofa device can somewhat disturbingly transmogrify into a full-fledged bed. (The Medical Crisis Liaison will be on hand for the next two hours, but is being unobtrusive in the room over.)

Does she think Khemeth would like a weighted blanket? Maybe an electric heated one with a temperature-control remote? The room temperature is very comfortable but Fanthim notices that he's shivering, which is a normal stress reaction for a lot of people but also exhaustion does make people more cold-sensitive. 

....Sure seems fine. (Nerdel is, herself, also kind of too tired to form original thoughts right now.) 

Fanthim nudges Ranthir, who is sort of melted into her chair in front of the computer screen and occasionally twitching awake just enough to refresh the markets, and is maybe not actually processing the fact that further updates are unlikely for the next day, and would now prefer to be horizontal and asleep? 

(Mallor's singing stopped a while ago, but she locked the door of her room, so Fanthim is assuming she fell asleep and is fine and will call if she needs anything.) 

hnnggggg what that isn't an odds ratio what is she supposed to do with that

...yeah ok sleep good. sleep is all the way over there though. that's bad. too far away.

You do not get certed as a Family Support Worker without having substantial practice in maneuvering very tired people to new locations. The chair has wheels. Ranthir can be deposited on the sofabed furniture device without having to make much effort, or any decisions. 

Nerdel tucks Khemeth in under a weighted blanket, setting it to what seems like a reasonable temperature and then putting the temperature remote control in his hand and gently wrapping his fingers around it. She strokes his hair until his breathing evens out, and then she lies down beside him, with most of her children literally within arms' reach, and falls asleep. 

(It would be nice if Finnar were also within arms' reach, but Finnar working up until the point that he involuntarily passes out at his workstation is not exactly a rare occurrence.) 

Merrin continues to show no signs of collapsing in exhaustion!

She was coming into this well-rested (yes, her last full night's sleep was closer to 20 than 15 hours ago, but she is pretty good at napping in helicopters at arbitrary times of day.) She's natively higher stamina than Finnar-and-family, who are still outliers by dath ilan standards, but not by as much and especially not on very cognitively-intense tasks. In some sense the work Merrin has been doing is less cognitively demanding for her than what Finnar or Khemeth were up to – especially during the six-hour block of Nothing Much Happening, she was actually having a fairly easy time of things.

Merrin is also very physically fit. She likes exercising until it hurts, has known since childhood that it's great for her mood and emotional stability (and she does have enough likely genetic risk for depression that she is somewhat careful about that), and also fitness is a job skill for her, and not so much for anyone in Kalorm's family except for, perhaps, Kalorm himself. By her own standards, except for the actual water-rescue component, today hasn't even been physically strenuous. She got to spend most of it sitting down if she wanted to! 

Merrin saves her stimulant tolerance for occasions like this one, and she is SO AWAKE right now.

....It's more hit or miss whether the stimulant effect lands on lowkey euphoria, or higher-key irritability. At the 10h checkpoint (14.5 hours into her shift), everything was very frustrating and complicated and her dopamine reward system was getting a lot more negative than positive signals, and so she was pretty solidly landing on intense irritability. 

However! The next degree of rewarming to 29 C, in just 30 minutes, is making a surprising amount of difference!