Apparently Khemeth can make sense of it, maybe just via having strong priors on his brother’s likely objections.

He sighs. “I’m not sure what you want me to say, Kalorm. Yes, we spent a lot of money on saving you - and I spent a lot of preparation and favors on making that possible at all - because you’re my brother, and you can choose not to live within Civilization but you don’t, actually, get to opt out of the fact that your family cares about you. I’ve never tried to stop you from - living the life you want, or at least the best option for avoiding what you don’t want.

“I know that if this goes on, we’re going to lose you at some point. I’m not even going to try to convey how much I hate that, how long I’ve spent wondering if there were anything I could say that would matter - how badly I wish that I could make the world different for you until it’s one you’d want to live in forever, because until we’ve done that for everyone we’re still failing as a Civilization. I also know you hate that way of framing it. And - my feelings are never your responsibility and I’m never going to argue with you about your preferences or try to change your mind. Just, you don’t get to argue with mine either, and I preferred not to lose you this year.”

Nerdel is quietcrying.

Oh no Merrin has a bad feeling about how this is conversation is going to go.

Kalorm glares at his brother, frustratedly mouthing words, of which the subvocalization microphone is not successfully parsing more than one word in three, and which going by his face, he would probably really prefer to be SHOUTING.

Merrin is sure that Khemeth has some sort of reason for doing this right now, but being in the room with (one side of) what’s clearly a long-delayed family argument is AGONIZINGLY awkward. Also, she’s the one who has to listen to the ventilator alarm. 

“Can you—” she starts.

“I’m nearly done,” Khemeth says, and turns back to his brother. 

“Kalorm, I - there are a lot of conversations I wish we’d had years ago. Unfortunately there are topics that are really hard to get into with you, for reasons that mostly have nothing to do with me. I apologize for leaning on the fact that, for once, I can finish a sentence without you shouting at me and storming out of the room.

“But. I love you and I want you to be okay. I don’t want to coerce you into being a different person who Civilization would find more convenient, because I think the world is richer for having people like you in it. There are a lot of things I can’t change, and some things I shouldn’t try to change because you wouldn’t thank me for it, but I don’t regret saving your life. I’m not going to tell you what to do with the rest of it.”

Kalorm wrenches his working hand free of his mother’s - Nerdel is, perhaps, distracted - and makes a grab for the breathing tube. 

Yeah, that was really predictable. Also NOPE. Merrin, who has been watching him for the last ten seconds and anticipating exactly this, is faster. 

“Kalorm calm down - I realize it’s frustrating not to be able to communicate better, but if you pull it out yourself you will hurt yourself—”

Kalorm is super not going to calm down! Especially not because a medtech asked him to! He’s now fighting her with all his strength.

Is Merrin, minus any kind of powered wetsuit or power armor, actually stronger than a full-grown man who - while admittedly injured, still somewhat drugged and pretty uncoordinated, and weakened by two days of critical illness - also has at least twenty centimeters of height advantage on her and does intense physical labor on a daily basis! And is really really determined! 

Why is she wrestling with her patient????? Why is this the thing happening right now?????

Merrin is not entirely caught off guard - she did get a lot of warnings about Kalorm as a person - she’s just appalled. Who DOES that??? …Although, honestly, she’s impressed. If he can direct this sheer degree of effort into productive activities contributing to recovery, he’ll be out of here in days.

Only one of his hands is actually working, and Merrin is not the only one in the room.

[Khemeth get his other hand] she subvocalizes, because this room does not need more yelling. [Control I need someone to remotely bump up sedatives - can someone one-minute-silence the ventilator alarm I can’t hear myself think -]

Kalorm is fighting the ventilator and not really getting enough oxygen right now to have much endurance for wrestling. Also he is in fact in quite a lot of pain again, and stubbornness only gets him so far.

The bolus dose of short-acting sedatives - someone who wasn't Merrin and had more mental capacity to think about that chose it - hits, and he sags back, flushed and sweaty, gasping for air and maybe actually looking kind of panicked about this. 

No wonder, his oxygen saturation is suddenly at 75% and he's breathing at, like, fifty a minute. 

This is fine. Everything is fine. He can breathe 100% oxygen for a couple of minutes and have a dose of the short-acting beta blockers and this is not a scary medical emergency, Merrin is in control of the situation, it'll be fine.

(She is still holding pretty firmly onto his wrist.) 

Khemeth holds his other arm. Gently, because it has the cast on it, but he doesn't put it past Kalorm to figure something out anyway. 

Khemeth was almost certain his brother was going to do something like this at some point. But probably only once, at least until he's recovered enough to walk, because Kalorm is not actually out of touch with reality and is capable of noticing, after trying it, that plan "fight his medtechs" is unlikely to succeed, especially with Merrin, who couldn't beat him in a fair fight but can certainly handle him in an unfair one. Honestly, knowing Kalorm, he might well end up with grudging respect toward Merrin. Kalorm doesn't like other people having control over him, but he's actually in some ways less bothered if they try it with direct force rather than patiently arguing that the convenient-for-their-purposes thing for him to do is also clearly optimal and what he should want for himself. The second thing happened way more often during his childhood. 

All else being an equal, it's sort of a relief to get it out of his system while it would definitely immediately be obvious that fighting his medtech is a doomed plan, and while he's still too weak to really hurt himself or anyone else. Khemeth hadn't confidently predicted that Kalorm would react like this to being lectured, if he had he'd have warned Merrin, but it had seemed like a possibility and not a disastrous one. 

...He still probably owes Merrin an apology, though.

Merrin is not actually annoyed with Khemeth now. If Kalorm were her brother, she too would probably be really tempted to take an opportunity to lecture him while he couldn't argue back. 

"Take deep breaths," she keeps telling Kalorm over and over, as matter-of-factly as she can manage, which is a lot because her mind is mostly on machine settings and so her verbal loop is running on memorized scripts. "You're fine. Your oxygen levels are coming back up. Just breathe." 

Kalorm is calming down! It's hard not to calm down on this many drugs. His O2 saturation is back at 100%. He's evidently still feeling short of breath, this is more a CO2-levels thing, and he's breathing at 25/minute, and visibly using accessory muscles to suck in more air despite the inspiratory support from the ventilator, but - as a result - he's moving excellent volumes per breath. His heart rate is slowly decreasing, finally falling below 100 again. 

...He is also very clearly having a LOT of trouble staying awake. 

Who knew that a wrestling match was such effective deep-breathing physical therapy 

"Kalorm," Merrin says carefully, "we are not going to keep you sedated just because you were frustrated and tried something dangerous. We did give you a drug because it was not super safe for me to sit on you, given how we recently cut a hole in your chest, but it's very short-acting. You can sleep and you'll wake up in about five minutes." 

Whatever objections Kalorm has to the entire institution of hospitals, he doesn't expect medtechs to lie to him. 

He closes his eyes, and is promptly very thoroughly passed out. And drooling again. 

He's...probably...deeply out enough that he won't notice and freak out if she cleans that up? Ugh...

She takes the opportunity to wipe Kalorm's face a bit; he's damp and sweaty from his intense exertion and subsequent probable-panic-attack over feeling unexpectedly short of breath, and the tears from coughing fits are mixed with the gunk that ends up at the corners of your eyes after two days of unconsciousness. 

...She sort of wants to ask Khemeth if he saw that coming and didn't warn her on purpose, because really as a psychological modeling expert he should have. That sounds incredibly awkward, though, and besides it was fine, since Merrin also saw it coming. 

By the time Kalorm does start waking up again, his vital signs are gloriously normal and Merrin has the ventilator setting back down to 40% oxygen concentration. 

He opens his eyes, sleepy and - briefly - confused, but he sees Nerdel and Merrin and Khemeth, and seems unsurprised about this. 

His EEG is unchanged, deeper sedation turning to light sleep and then wakefulness, and Merrin grabbed a quick ultrasound, confirming that their wrestling interlude and his resulting blood pressure spike didn't do any damage to possibly-weakened blood vessels in his brain. 

"Hey," Merrin says calmly. "If you try to talk right now, I think you'll probably start coughing and maybe feel short of breath, your lungs are going to be irritated. And we mostly can’t understand you anyway. You can try if you want, obviously, but to give you a second option, I’m going to ask some questions and you can nod or shake your head. Do you remember where you are?" 

Drowsy nod. 

"You're doing fine, your breathing is fine right now and you're not needing that much help from the ventilator, but it earlier it looked like you were having trouble and that was stressful. Do you remember that?" 

...Nod. 

Merrin nods as well. "It makes sense that being unable to speak normally is also pretty distressing. I predict that we can minimize the total amount of distressing things by slowly doing this transition, and making sure that you're managing on really minimal ventilator support, so both of us know you’ll manage without it. Does that make sense?”

Kalorm nods. And must be feeling better or at least more alert, because he starts trying to point in what’s clearly the direction of the picture board.