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Merrin working in Exception Handling
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Kalorm does not look like he considers this a reasonable solution to his problems.

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Sigh. Discreet sigh, but despite all her efforts to be sympathetic, Merrin is in fact feeling slightly frustrated at this point.

”Kalorm, I am here to figure out which things are wrong and then help you fix problems, but we need to go through that one thing at a time. I know you must be pretty impatient. I am completely not surprised that you feel terrible. We can help with some of it, I think, but you went through a lot and it’s not going to be an instant recovery.” 

Does he seem to be following? 

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His eyes are on her, but he’s gesturing emphatically again.

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Apparently Khemeth can pull off the uncanny mindreading thing this time, despite the fact that Merrin has no idea what that gesture is, and honestly might not recognize a gesture even from a known code, Kalorm’s movements are still very weak and clumsy.

“Yes, Kalorm, I'm aware you would like to leave this place as soon as possible. This fact is incredibly unsurprising to me. You're still going to have to wait until you can at least walk.”

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The next gesture is very recognizable even to Merrin.

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Oddly, this is taking the situation from frustrating to sort of endearing! Not that Merrin is going to let on in any way whatsoever to Kalorm that she feels that way! 

"I wish I could give you news you would like better," she says mildly. "I do want to work as hard as we can to make this tolerable for you, but - at this point I am not sure you're especially ready to breathe on your own, let alone walk out of here. Your kidneys are not in amazing shape and you're going to need dialysis for a few days. I will be incredibly delighted if you make it out of here faster than we're expecting, and I am happy to strategize about that with you, but the median estimate for needing ICU-level care is about a week." 

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Kalorm looks SO INDIGNANT about this! He makes a gesture which is obviously meant to indicate 'want breathing tube out NOW'. 

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Well, it's...better than him trying to yank it out himself? She is actually pretty amazed by his self-control on that front. 

"How about," she says levelly, "we address some of your other complaints, get you a little bit more comfortable, and then if you want, I can dial down the ventilator settings so it's helping you out less, and we can see how that goes?" 

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Tired eye-roll. 

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Honestly that's an understandable reaction and also kind of adorable.

All right. They can go down the list of symptoms that are bothering him, and see what's doable to mitigate them. 

Dizziness and headache: super unsurprising, will likely improve over the next few days, for now she will consult Treatment Planning on whether they have ideas for painkillers that might help if none of the ones he's currently on are really doing it (- yes, they have some ideas, and there's a drug that sometimes helps with vertigo). And she can get him a cool damp cloth to put on his forehead, which may make the symptoms more tolerable even if they can't get the headache down to zero. Resting and not making too much cognitive effort will help. 

Cold: that one's easy! As long as he's not spiking a fever, Merrin can just turn up the bed temperature for him. 

Thirsty: that's an incredibly common problem! He cannot actually drink water right now and is also on a fluid restriction, but there's a moisturizing mouth spray (it comes in like eight different flavors) and he can have swabs dipped in ice water - they also come in a range of flavors - to swish around his mouth at regular intervals, and it might help if she brushed his teeth for him, does he want that? 

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Kalorm is DEEPLY UNENTHUSED at the concept of someone else brushing his teeth! Also looks pretty offended about the fluid restriction. (It is fairly easy to predict that he will not feel like cooperating with their "restrictions" once he's capable of swallowing, though his stomach and gut are in bad enough shape that he might not be able to keep fluids down anyway.) 

He will RELUCTANTLY settle for flavored swabs dipped in ice water. 

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Merrin does not need him to be gracious about it; as long as he is in fact more comfortable, she's happy with that.

Itchy: they have skin cream for that? Getting his back will be mildly inconvenient, Merrin isn't sure how well he'll maintain his oxygenation all the way on his side, even on the good side. 

Whatever's up with his feet: well, he does plausibly have some peripheral nerve damage. Merrin's top guess is that he's experiencing some sort of peripheral-neuropathy-related badness, and request that Treatment Planning give her some suggestions for drugs that might help with the symptoms. 

Stomachache: very unsurprising, they can maybe trickle some oral drugs down his nasogastric tube to more directly soothe his irritated stomach lining, though she's a little worried that if they take the tube off low suction drainage for too long, even to give a treatment time to take effect, he's going to end up a lot more nauseated and maybe vomit – not as risky for aspiration with the breathing tube in place, but she predicts it would really hurt given that, yeah, the treatment that saved his life did kind of involve getting his chest cut open and being on full cardiopulmonary bypass for like eighteen hours, it's not surprising it feels like he was stabbed. They can keep trying to optimize the nerve block but Merrin is not sure how much better they can realistically get it without risking paralyzing his respiratory muscles and definitely requiring him to stay on the ventilator longer. 

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Kalorm is INCREDULOUS and ANNOYED about the cardiopulmonary bypass! He looks like he has questions! 

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Subvocalized for relaying to Khemeth without Kalorm overhearing: [is now actually a good time to tell him what happened]

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Khemeth considers this.

[I think ‘when he seems to want to know’ is the right time to tell him] he answers after a few moments. [And - don’t soften it for him. Things that alarm most people won’t necessarily be frightening for him, and - he doesn’t like feeling that people are sheltering him from the world.]

Pause. 

[I also suggest you frame it as - closer to an exciting adventure, something that gave you a great story to tell, than you'd normally find appropriate with most patients. I expect it to land better with him.] 

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It was NOT an exciting adventure it was the worst shift of her ENTIRE LIFE and she is NEVER DOING SOMETHING LIKE IT AGAIN Merrin is, at this point, experienced enough to be aware that the most stressful and awful shifts do, often, end up making really good stories. After the fact. A long time after the fact. 

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Merrin shifts her chair closer, so that her head and shoulders are comfortably in Kalorm's field of view from his current position in bed, and sits. 

"Hey. I had wanted to fill you in a bit on what happened in the last two days, and it seems like you're more alert. I'm not sure how much of the events around it you remember, but - there was a storm, a big one, waves up to 10 meters. It was hitting a pretty wide area, lots of ships potentially at risk. I'm trained as an Exception Handling emergency medtech, particularly for water rescues, and we were on standby in case anyone did end up in trouble. Your boat capsized, and according to your friends," the ones who survived, "your group spent a while trying to deal with that, and then called for help. Since we were covering just the general region, it took us around 45 minutes to arrive, at which point all of you had been in the water for almost two hours, and you were all pretty cold." 

In hindsight, Merrin wonders how much her team was on standby for Kalorm specifically. It's clear that his family cares a lot about him, and his sister is apparently heavily involved in the shipping-related policy prediction markets. And Khemeth clearly has a high grade of secrecy clearance. But that wasn't the information she had at the time - and they were, in fact, 45 minutes away, placed to minimize the average travel time to any given ship - and Kalorm is probably going to react less badly to Exception Handling responding once they actively radioed for assistance. 

“Do you remember any of that?” she says gently.

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He stares at her, frowning, looking puzzled. Eventually shakes his head a little. 

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“That’s understandable.” It’s…kind of a lot of amnesia, actually. Unsurprising for him to be hazy on whatever happened after he was already significantly hypothermic, and she wasn’t really expecting him to remember his tether coming loose, seconds or at most minutes before he lost consciousness from hypoxia. But the storm itself would have hit them hours before the boat actually ran into trouble.

“Anyway. A few minutes before we were due to reach you, the decking that your tether - fortunately, only your tether - was fastened to…came loose. Your personal flotation didn’t have enough buoyancy to compensate for the weight. We got your friends out and then I had to go on a bit of a chase. So, um, you were underwater without oxygen for a while. Eleven minutes, we think. By the time we got to you, you had no heartbeat and your body temperature was very low." 

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Kalorm turns to look over at Khemeth. He seems mostly...incredulous? 

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“You’re right that in many circumstances this would not have been survivable,” Khemeth says levelly. “Luckily for you, Merrin is an endurance EMT whose training emphasizes working solo or with a small team in remote areas, and she does sims like that for fun.”

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That is not exactly how Merrin would put it.

“We weren’t delighted about your odds of making a full recovery if we rewarmed you immediately,” she says quietly. “You were underwater a long time and there were early signs of brain damage - though the cold was on our side, you actually had much better chances, just - only with the right followup treatment, and we didn’t have it. We were on a helicopter in a storm fifteen hundred miles from Default, but your family wanted us to try anyway, so…we figured out a plan. It only worked because physically you’re very healthy and resilient.

“We put you on some invasive life support machines and lowered your body temperature even further to buy us time while we evacuated you to Default, and we got here at…around 4 am, actually, nearly two days ago, it’s around midnight now. We slowly warmed you to a more normal temperature over twelve hours, while giving you drugs to try to prevent the damage from getting any worse. That’s when we had you on the heart-lung bypass. We think it worked about as well as we hoped.” Which was imperfectly, but maybe, if they’re lucky, well enough.

“It was pretty hard on your body, though. We kept you very heavily sedated and gave it twenty-four hours until you were a bit more stable, and we started bringing you out of it about, um, seven hours ago.”

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Hazy tired frustrated-looking Kalorm is blinking at her.

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“- Sorry, that was probably kind of a lot of things for right now. We can go over it again later. Just - you are going to feel pretty terrible, and it will take a while to recover physically.”

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Kalorm does not look super happy about this! He’s mainly glaring at Khemeth, though, gesturing incomprehensibly and mouthing words again. 

 

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