Huh. 

Is she...done?

Merrin's brain is really confused about this. Her brain seems to have been under the impression that this was just, like, going to be the rest of her life. She's so ready to hand over, though. 

Most dath ilanis would not recognize someone by face who they have handed patients to twice in the last two and a half years. 

(Merrin might not either, if the first time hadn't been quite so incredibly memorable.) 

"Avarris!" Merrin bounces. "Hi! It's so good to see you again!" 

How can Merrin possibly see her nametag from– oh, right, face recognizer. Avarris' greeting is significantly more dignified. 

"I'm really sorry to leave you with the dialysis filter change but in my defense it has been such a day. Anyway, uh, I'm guessing you're basically up to speed but I should explain the weird thing I need to do when I get high pressure alarms on the bypass circuit - it's mostly fine and maybe it'll stay fine but you need to -" 

It is possibly the least coherent Merrin has ever been in a handover. Her verbal processing is so fried and she's starting to lose the ability to multitask on the level of "manage the machines and also talk at the same time." Fortunately, no one is expecting her to be perfectly eloquent, Merrin is too tired to be self-conscious anyway, and Avarris is self-onboarded enough that she can practically just hit the ground running without requiring Merrin's explanations. 

The patient remains stable throughout, looking about a thousand times better than he did during the worst parts of the interim stabilization protocol. 

And then, sixteen hours and forty minutes after the water rescue (which was already 45 minutes of flight time after multiple hours of being on standby, but she totally napped during the 45 minutes), Merrin is actually done. 

Kalorm is very good. Today was a good day. Maybe tomorrow will be a bad day, they don't know exactly what to expect when they start waking Kalorm up, but tomorrow's Merrin can worry about that. 

She...is not really sure what to do with herself now. She is apparently too tired to task-switch from "making decisions about her patient" to "making decisions about her downtime" and, when queried, her brain keeps offering her suggested setting changes and nothing else. 

This is incredibly unsurprising and Personnel (Merrin's Personnel, who she knows and who knows her) is here to collect her. They took the liberties of moving her Default apartment to the hospital's nearest housemodule section and her mom is there. They've been supplying her with calories during the endless day, but she can have a proper sit-down meal if she doesn't want to just go straight to sleep. 

Merrin doesn't think she can go straight to sleep! She had so much caffeine. Also her brain is having a hard time setting down all of the things she just spent an entire day juggling, and because she no longer has input data or feedback, her brain is instead just stuck in a permanent loop of feeling disoriented and like she forgot to do something important. 

(She is honestly a little bit - a very little bit - jealous of Kalorm for getting to be asleep without trying because he's sedated.) 

Normally she would watch Exception Handling TV sims if she was in that state, but she actually really doesn't want to do that right now for some reason. 

Can she...maybe have a massage therapist come? Maybe if she gets a massage, and enough momhugs, then she'll be able to fall asleep. 

Of course! (Merrin can have just about anything she asks for, right now. Personnel is relieved that she did ask for something instead of just staring at him awkwardly.) 

Irris is there to hug her daughter! She made a lot of money on Merrin-related prediction markets today and she's in a good mood about it. 

Also she's still kind of seething at the patient's father for his BIZARRE INEXPLICABLE CHOICES and for upsetting her daughter. She was not actually going to do this but she was super tempted to go march over to the Family Room and yell at him. She has instead spent the last many hours perfecting her rant about Finnar's terrible qualities as a human being. 

(Now that her daughter works in health care and Irris is reasonably often at the hospital, she is actually, herself, retraining as a support worker - though in rehab cases, not really the sort of work Merrin usually does. Though this might be both! Irris is considering actually asking to be assigned to the case, at least as a student shadowing the main support worker, if the patient does end up staying in the hospital for rehab. That would be really cool. She is vicariously attached to Kalorm now and also if the dad is mean to Merrin again then she can tell him off.) 

MOM NO THAT'S EMBARRASSING STOP. 

(It turns out that Merrin is perhaps not entirely out of the capacity for embarrassment.) 

A very skilled massage worker is at Merrin's suite in about two minutes. 

Incredible!!! This is amazing. Happy Merrin. 

Actually, slightly frustrated Merrin! This is a good massage but she wants more massage. Can it be harder than that? 

...harder than that too? 

- no, still harder. Like a lot harder. Like, maybe she just would like her muscles to be straight-up punched. 

....does that not hurt???? The massage therapist is now sort of concerned that Merrin has some kind of weird reduced-sensation thing from sheer fatigue, or something. 

No?? Merrin is pretty sure she has totally normal sensation and proprioception. She would like a massage that hurts more than that. 

???????? 

Well, that's a weird preference but sure. 

It turns out that 'literally as hard as the massage therapist can physically manage' is legitimately really really painful! Merrin is no longer stuck in a mental loop where she feels like she forgot to respond to an alarm! She can focus all of her attention on forcing herself to hold still and relax and she should probably...at some point...communicate...when she has had enough massage-which-is-suffering...but, see, that would require having thoughts...

She can do this for a while, sometimes people do get really intense massages as physical therapy, but it's still kind of weird in this context. You would not think that someone who just worked for almost sixteen hours would be in the mood for intense physical therapy massage. Within twenty minutes her hands are going to get tired, though. 

Merrin wants more something but is not managing to figure out how to communicate it as massage instructions. 

...oh is it finished? Okay. That's slightly frustrating but she is indeed more relaxed and less feeling itchy behind her shoulder blades because she can't see the updated sensor data on her patient. Someone else's patient, right now. That's okay. Merrin is okay with Kalorm being someone else's patient because she is not work Merrin right now, she is flopped Merrin. Also the massage therapist is pretty and it would be nice if she cuddled Merrin okay, what the superheated steam explosion is that about. Apparently Merrin's brain gets weird after a seventeen-hour shift. No, Merrin's brain, she is not going to ask the massage therapist to cuddle her, that's so awkward, why would she do that. 

She does after a minute manage to communicate that a more normal non-suffering massage would still be appreciated. And then falls asleep less than ten minutes into this. 

This is way more normal and as expected. 

Even while mildly hypothermic, and with a number of his organs very unhappy, Kalorm slowly improves over the next few hours.

They take out the most invasive sensors that enter through the skull almost immediately; the information is no longer decision relevant, just outcome-prediction-relevant, and the Diagnostic experts can cope with a little less information and higher uncertainty. The infection risk is at this point no longer justified. 

The plasmapheresis is successfully preventing almost all of the inflammatory panic signals flying around in his blood from reaching his brain and panicking any of the carefully-preserved neurons. There are a few little spikes in neuron-damage indicators. But overall those are trending down. They take out that sensor after four hours. Very sensitive lab equipment can still detect major changes with a blood test not drawn directly from the brain, and minor changes are - well, what are they going to do about it? 

The plasmapheresis can also mostly prevent the existing organ damage, and resulting dead-cell-contents floating around Kalorm's bloodstream, from directly causing more organ damage. With some of the load taken off by the freshly-changed and fully functional new dialysis circuit, his kidney function is stabilizing. They're planning to normalize his sodium to 140 mmol/L (mid normal range) over 24 hours, at which point the free-floating myoglobin should be entirely cleared and his creatine kinase should have peaked and started a slow descent, and they should be able to take him off dialysis and expect his own physiological control systems to suffice for keeping his blood chemistry stable, at least with the backup assistance of some gentle drug-based nudging as necessary. (Despite being cautious about fluid balance, he's "positive" about five liters of fluid since treatment was started - some of that was making up for actual dehydration, but there is additionally a lot of excess fluid oozing into his extracellular spaces and his hands and feet and face are visibly puffy.) 

They're picking up indicators of liver damage, which are still rising, but a young healthy person's liver, again, has a lot of redundancy. And it's one of the organs with the greatest capacity to regenerate and repair damage. The plan is to keep the Complicated Liver Replacement Module going for maybe 12 hours, while damaged tissues are still dumping various waste products straight into his bloodstream; dealing with this is hard even on a completely healthy liver. But in the long run, he should be fine.  

It takes a little longer than the original estimated 50% confidence interval to get him off the bypass machine. His heart function would have been adequate sooner, but they ended up wanting to take the time to administer some immunomodulators that target lung tissue in particular, directly give him some aerosolized surfactant as well as drugs that should boost the production of more, administer other drugs that boost the production of antioxidants and should reduce oxygen toxicity to the cells, and to very slowly up the positive end-expiratory pressures on the ventilator, opening more collapsed airspaces without the pressure causing any additional trauma. (The changing intra-thoracic pressure is also doing all sorts of wacky things to his hemodynamics.) 

Five hours in, though, Kalorm's heart is beating unassisted save by medium doses of drugs regulating his heart rate and contractility (the internal pacer wires with their emergency defibrillation capabilities are still in place just in case but will be taken out if no problems arise within 12 hours), and is breathing reasonable per-breath volumes with a medium degree of ventilator assistance, maintaining a normal oxygen saturation on 30% oxygen, only slightly higher than regular atmosphere. 

Five hours in, Avarris could keep going, but is pretty happy to hand off to someone else, since Kalorm no longer particularly needs a medtech who can solo multiple life-support machines. 

A still very tired Nerdel comes in to see him again, after the Crisis Medical Liaison (a different one, their shift change was hours ago) lets her know that her son is most of the way to actually stable.