Kalorm drowses for a while without quite falling asleep, and eventually finds himself more back-in-his-body. And surprisingly not in much pain? Merrin usually suctioned him way less gently than that, and the inside of his chest would feel faintly achy for like twenty minutes afterward.

He sort of wants to know if Halthis can teach Merrin to do it like that, but this seems Difficult To Communicate.

When the short-acting drugs finish wearing off and he wakes up more fully, Halthis is parked in her floor chair (she specifically requested it, and should perhaps consider making sure that Merrin knows this is an available option), looking at his most recent set of labs. 

“Hey,” she says, once she notices that his eyes are open and on her. “To me that didn’t look too uncomfortable. Was it better?”

Kalorm nods. 

“I would still like to turn you in a minute - I know that’s uncomfortable for you, Treatment Planning suggested a quarter-dose of the same painkiller combination, which we think will take some of the edge off without causing as much drowsiness. Aside from that, if you’re tolerably comfortable right now at rest, I would like to see if I can wean down the continuous painkillers, so you don’t have to put up with as much of those side effects the rest of the time. Any objections to either of those?”

That was TWO questions, which is unfair. Kalorm has no specific objections, though, aside from how she keeps mentioning Treatment Planning this, Treatment Planning that, and reminding him that probably several hundred people are currently poring over his test results and having OPINIONS about bodily functions which are HIS OWN BUSINESS.

….Was he supposed to nod or shake his head to indicate that he’s not going to stop her from doing whatever she feels like here? Kalorm does not currently seem to be very able to retain anything in verbal memory while thinking about a different thing, and he can’t remember how it was phrased. He makes an “okay sure” hand gesture instead. 

“Great!” Call that one more question, that’s…seven, total? And Kalorm seems bleary, but not visibly frustrated or overwhelmed. 

“Last set of questions for now, okay? I was looking at your lab results and your magnesium is way up. I know you found the dialysis hard to deal with, and - this is really up to you, it’s not medically dangerous and shouldn’t go high enough to be before tomorrow - but it is within a range that’s known to be associated with some symptoms, and getting it back down should relieve those. So I’m going to list out the usual symptoms, and - based on how many you’ve noticed and how much they’re bothering you, you can decide how badly you want to prioritize addressing this. Okay?”

His stupid flaming magnesium levels are his OWN BUSINESS Kalorm rolls his eyes and makes a “whatever” sort of wiggly hand gesture.

(Kalorm does have enough metacognition online to notice that he wouldn’t be mad at Merrin for bringing this up. Somehow Merrin doesn’t come across as being all up in his business when she tells him about results or even prediction market updates.)

…Okay, maybe kind of frustrated. Halthis thinks that counts as Kalorm assenting, though. She’s going to assume it does and go ahead. 

“So, a lot of overlap with the painkiller side effects, with some extras. Brainfog and trouble thinking. Dizziness. Definitely nausea. It interferes with smooth muscle function, so could be preventing your bowel from recovering, if you’re still having abdominal pain it could be aggravating that. That plus your blood urea being high - waste product that your kidneys would normally deal with - could even be causing itching or increased thirst.”

Does he seem to be keeping up? She waits a bit. 

“…And one additional effect is generalized muscle weakness. There are multiple other reasons to expect that, so I doubt the magnesium is responsible for all of the weakness and difficulty with fine motor tasks that you’re having, but it won’t be helping. And in particular, your muscles are likely to get tired faster, including your respiratory muscles when we do the minimum-settings trials. Does that make sense?”

Individually yes but that’s so many things. Why are there so many things. One measly abnormal lab test shouldn’t be allowed to cause that many problems. 

…Yeah that facial expression looks like “information overload, please stop.” It was tempting to list everything in one go rather than use up like six questions on it, but this way may not have been less overwhelming for him. 

She waits a few beats to give him time to refocus.

“Are you noticing that you’re physically getting tired faster than you usually would?” she asks gently.

Emphatic nodding! He IS and it’s TERRIBLE.

“I’m not surprised. I can’t claim that just addressing the magnesium will get you back to normal, there are still a lot of other things wrong - and prolonged immobility will mean you lose some strength before you’re medically stable enough to properly start rehab exercises. But basically nothing is going to be working exactly like it should when your electrolytes are outside parameters - it’s not just the magnesium, that one just stood out to me as associated with an awful lot of the symptoms you’ve reported.”

Pause.

“Does that make sense?”

Sort of??? Current medtech (he has absolutely not retained her name) continues to be weirdly hard to understand, and to somehow be deeply annoying when doing the exact same sort of thing Merrin would do.

Kalorm is pretty sure he’s being CAREFULLY MANAGED right now and he hates it? Somehow with Merrin he never feels like he’s being STEERED, even when she’s visibly trying very earnestly to understand what he needs and make sure he gets it — and even though, you know, obviously she’s going to have opinions about her area of expertise which is also very clearly the shiniest thing in the entire world to her. 

(That might be part of the difference? Kalorm is too foggy to fully articulate the thought, but - well, he’s used to people who have a shiniest thing in the world. Everyone in his family does. The way Merrin sounds when she explains medical stuff to Khemeth is exactly how thirteen-year-old Ranthir used to eagerly expound on prediction market infrastructure, and he could never quite manage to be irritated about it even if he wishes that prediction markets as a social institution would go away and leave him alone. Ranthir didn’t want to use them to craft a perfect world for him, she just wanted to grasp for and understand and touch her shiniest thing in the world…)

Thinking about thirteen-year-old Ranthir is making it infuriatingly hard to maintain the appropriate degree of indignance about Treatment Planning trying to perfectly craft his physiological systems

Kalorm sighs (which it turns out is really not very satisfying when one is on a ventilator). He nods.

Yeah, Halthis is not blind to subtext and can tell when she’s edging closer to the limits of Kalorm’s patience and tolerance for annoying questions.

“Also, I think that the more nausea risk factors we can minimize, the less you’ll be affected by the factors we can’t avoid, like your stomach being in bad shape.” She smiles crookedly at him. “And, of course, hopefully conversations like this will be less frustrating if you feel less foggy and out of it.”

Actually this conversation is intensely frustrating for reasons unrelated to how hard it is to think! Though, yeah, if thinking didn’t feel quite so much like swimming in thick syrup, maybe Kalorm would be able to come up with a satisfying rejoinder in hand signs and eyebrow wiggles.

He rolls his eyes and sort of half nods.

Okay, good, she hasn’t totally lost him yet even though he is clearly getting pretty sick of this. It’s fine. She’s pretty much done. 

“You can think about this after, I realize it’s an obnoxious tradeoff to have to make, but it sounds like getting through a full course of dialysis might help on multiple other dimensions, if you’re feeling up for getting through an hour of unpleasantness in exchange for probably feeling a lot better afterward.”

Kalorm is ABSOLUTELY being manipulated into agreeing to the horrible dialysis machine, and the worst part is that it’s probably going to WORK. The medtech has successfully made him feel creeped out by imagining all that extra magnesium floating around in his blood, slightly poisoning everything. Ugghhhhhh. Terrible.

(The horribleness of the dialysis machine is at most half because the sound it makes eventually starts to feel like someone gently sandpapering the inside of his skull. The rest is that Kalorm really doesn’t want high-tech machines in contact with his blood, which belongs to HIM.)

Halthis doesn’t seem to be requesting or expecting an answer from him right now, so he will just sit here and fume silently. 

Merrin could probably manage to make dialysis machines sound cool instead of upsetting, by waving her hands around while telling Khemeth how wielding them makes her feel like a literal wizard

Well, that went…about as well as Halthis was going to be able to manage, at least without the social modeling expert brother on hand to help her workshop what to say. She’ll let him think about it, but she’s estimating, like, 70% odds that he agrees to it before the end of her shift. 

“Ready for a turn?” she says gently, once he looks a bit less irritated with her and more just tired.

Kalorm rolls his eyes and makes a “sort of” wobbly-hand gesture. And then points very clearly toward his right side. 

(He isn’t sure if he banged or wrenched his left hip or something, or if it’s just that he spent 50% of the hours he was unconscious lying on it, but there’s an ache deep in the joint, and lying on that side eventually results in his left foot painfully falling asleep. And Kalorm will admit, if only to himself in his head, that it’s a lot more uncomfortable on the floor. He has not tried to communicate this because it’s not on the picture board and drawing it would require so many lines.)

Halthis tries not to visibly make a skeptical face. “Okay. Last time your O2 requirements were a lot higher on that side, but if it’s only that - if you’re not short of breath and your CO2 is within parameters - and we don’t have to go above 80% on the ventilator, I think that should be fine. You must be getting pretty tired of the other positions.”

(Who knows why he prefers lying on his right side to his left! Maybe his ribs are more sore on the left. Maybe it’s just his preferred sleeping position in general. Either way, Halthis is also pretty experienced at positioning medically fragile patients with a wide range of additional comfort-related constraints, and while having to do it on the FLOOR is kind of cramping her style, she thinks she can probably set him up so he’s tilted that way but not actually squashing his right lung.)

“Note that if we have to go above 50% O2 at rest, I don’t think it’s a good time to pile a minimum-settings trial on top of that, okay?” she adds, gently. “I think it’ll go better in the longer run if we avoid setting you up for failure.” She waits for his reluctant nod.

…Halthis, unlike Merrin, is NOT used to working on a small team in remote locations with limited personnel. (And it’s perhaps relevant that, unlike Merrin, it has never once in her entire career occurred to her to feel self-conscious about asking for help with something, or socially anxious when other people are in the room with her.) She doesn’t really prefer the mechanical lift equipment at the best of times, it feels like it doesn’t give her the same fine control - and ability to turn a patient gently without hurting them - and using it for repositioning patients at floor-height is sort of outside its design constraints anyway. 

“Is it okay with you if I call in some of the other medtechs to help me?” she says quietly. “I can ask them not to talk out loud, if that would be overwhelming.”

What’s wrong with the perfectly good equipment, Merrin managed to get through an entire shift being the only medtech who had to TOUCH him Eh. Not a priority to fight about. Kalorm nods, albeit pretty noncommittally.

Then Halthis will premedicate him with a sniff of the painkiller + anti-nausea combo, get set up and subvocalize instructions to the helpers while she waits for the drugs to take peak effect, and then efficiently-yet-gently get Kalorm turned a little onto his right side, ensconced in pillows.

She spends longer on it than Merrin does, making sure his limbs are well supported in natural, hopefully comfortable alignments — and absentmindedly doing some quick ankle rotations and calf stretches on him while she’s positioning his lower legs, because, you know, usually her patients are sedated enough that she’s not in the habit of asking every time.

This is REALLY STARTLING for a moment and then - wow, that feels kind of amazing actually? Maybe she’ll keep doing it???

No…?

Kalorm waves his hand at her in a way that he hopes will indicate “keep doing that thing please”.