She can't help almost laughing. Kalorm is so incredibly himself. 

"Yeah, I know. I wasn't enthused either. Anyway, the really effective option here would be to do a bronchoscopy. That's a procedure where we go down into your lungs with a probe that has a camera and lots of other functions, and it would let us actually rinse everything out and administer drugs, especially the anti-inflammatory and surfactant-boosting mix, directly in your lower airways. When you just inhale them, even as a mist, your lungs generally don't want anything except air to reach your alveolae, so most of the drug gets trapped in your upper airways and doesn't make it to the places that most badly need it."

Kalorm looks intrigued. He lifts his eyebrows, and nods to show that he's following. 

"Well, um, the issue is that it's very uncomfortable, lungs aren't super designed to have things touching them. So it's normally done under heavy sedation, pretty much anesthesia-level. The procedure itself wouldn't take long - ten minutes, maybe fifteen - but the drugs would take hours to wear off, so that would actually mean delaying the minimum settings trial by a lot. Does that make sense?"

She pauses to check that he still looks like he's following. 

"...Anyway, um, the thought I had - which is not necessarily a good idea, you absolutely don't have to try this, we can do the vibrating vest and that's fine - but, um, I know you're pretty tough, and maybe you can tolerate it with lighter sedation? We would obviously load you up with pain meds, and stop if it's intolerable, but it's only ten minutes and then it'd be done." 

Obviously he wants to do the fast version! 

...On the other hand, his most recent experience of weird breathing therapy stuff was awful. 

Kalorm starts gesturing. He points at Kerrin. Taps the suction tubing. Points at Kerrin again. Gestures at his chest. Makes a questioning face. 

....Merrin blinks helplessly at him. 

"Um, Kalorm, I'm sorry, I don't know what you're asking. Ummm. Do you need suctioning again?" (Headshake.) "- Oh, did something go wrong when she suctioned you - is something hurting or bad -?" 

Kalorm scowls and shakes his head! 

This is terrible! Merrin is here SPECIFICALLY because she knows Kalorm and is supposed to be good at communicating with him, but she is a tired Merrin, and her brain is not moving very fast right now and refuses to even give her any wild guesses of what he wants, if it's not the obvious. 

"Uh. Do you want the picture board? Or something to draw on?" 

Khemeth is yawning and blearily glancing between the video-footage screen and the live-updating Treatment Planning markets, and sort of desperately wishing it was somehow okay for Dekan to come here because he wants to cuddle his boyfriend but really doesn't want to move. 

However slow his brain is right now, though - and he's certainly a lot more impaired than Merrin seems to be, relative to his baseline - it's really not hard to read Kalorm. 

He sends a text message to the control room. Message for the oppers, check if he wants to know how experienced and skilled Kerrin is with this procedure and whether she can aim to make it less unpleasant, like with suctioning.  

Personnel will pass this along to Merrin and Kerrin. 

....Right, okay, that's obvious in hindsight and Merrin is an idiot. 

"Kalorm, are you asking about Kerrin's experience with this?" 

(Emphatic nodding!) 

"Uh, right - Kerrin...?" 

"I haven't done it as many times as I've done basic suctioning - that's something that comes up multiple times in a shift, whereas a full bronchoscopy is just a once-in-a-while procedure. I can look it up to be sure, but my estimate-from-memory is that I've done over a hundred total. I've also redone the training and certs every time new equipment comes out, and there's quite a customizable range at this point, so I can select the equipment that'll be most comfortable for you." 

Kalorm nods. Frowns. 

Merrin squeezes his hand. "Why don't you take a minute to think about whether you're up for trying it? I know it's a really big ask, I wouldn't even bring it up with most patients, just - I expect you're impatient and it being fast would be a benefit." 

Kalorm is trying to think about it! Thinking is really hard! 

...Merrin seems to think it's unpleasant enough that she wouldn't even offer most patients the choice. That may or may not be saying very much, though, since most people really suck Merrin, however, sucks surprisingly less than most people. 

He would really like his lungs to stop feeling like someone dripped glue directly into the deepest parts. Wearing a vibrating full-torso vest seems like a really weird solution to this problem! Like, he can sort of see why it would work, but it's so...indirect. And it sounds pretty obtrusive, actually - if it's on his whole torso, it's going to end up vibrating his stomach too, and auuuuughhh apparently even imagining that is a bad idea. And they'll need to make him inhale a bunch of drugs, too, which will mostly get stuck further up. He doesn't want weird mucus drugs stuck to his trachea. It's presumably fine, or it wouldn't be a standard treatment, but the concept is kind of icky. 

He believes Merrin, that having complicated equipment shoved down really far into his lungs is going to be torture. But it's ten minutes. Merrin said that they'll stop if it's too bad – rather than give him more drugs until he's unconscious and do it anyway – and...he believes her, he thinks. Though he should figure out for sure whether they can stop right away if he changes his mind about it being better than a weird vibrating torso vest. 

He tries to catch Merrin's eye and nod. 

That was somewhat longer than a minute; Kalorm does seem to be following explanations, and this one wasn't trivially simple, but he's definitely processing things very slowly. 

Also, nodding is ambiguous. 

"You're done thinking about it?" she guesses. "Uh, is it– can you nod if you do want to try the bronchoscopy with only light sedation and pain meds, or shake your head if you'd rather go with the default plan and use the chest therapy vest?" 

Kalorm nods, but then waves his hand in a vague attempt to convey that actually he has some other things he wants to communicate. 

Ugh. If he has questions or things he wants to clarify - which of course he would - it's going to be so hard to do that whole conversation by mime and picture board. 

"Ummm, do you want me to just go over everything that's going to happen, in order, and if you have questions hopefully it'll cover that, but you can interrupt if you're confused or you object to a specific thing?" 

That does sound way easier and probably Merrin will explain in in a way that isn't incredibly confusing? He nods. 

"Right." Merrin smiles reassuringly at him. "So, uh, if we go ahead with this, we'll need about five minutes to get set up and ready. Kerrin will request the equipment setup that she thinks will be most effective and comfortable for you in particular, and we'll find out if Treatment Planning has any updates on the plan. Once it's all ready to go, I'll check with you again that you want to try this and you're ready, and we'll give you the drugs for it – uh, that's one of the things Treatment Planning will probably clarify, but if we're aiming for only light sedation, my guess is that we'll give you the short-acting pain medication bolus, with the nausea medication to prevent that side effect, and probably also a dose of the short-acting sedative. Maybe the beta blocker too – uh, we've been trying to keep your heart rate and blood pressure in normal range, since your body went through a lot and we don't want to strain your heart." 

She pauses, waits to make sure she's given him enough time to process that. 

"Uh, Kerrin will wait until everything's taken effect. I'm guessing that the dose we'll need to get you through a bronchoscopy at all will hit you pretty hard at rest, so you may fall asleep briefly until we actually get started. But I'll be right here the whole time, and I'll keep talking to you and explaining what's going on, in case you're out of it enough to be confused about that. If you're obviously fighting us or your vital signs go outside parameters, we'll stop – uh, turnaround time on stopping is a few seconds, maybe up to ten or fifteen seconds, since if we just squirted a bunch of saline rinse fluid down there we need to get that out first. But hopefully it'll be tolerable."

Merrin frowns. Thinks. "Ummm. We should maybe agree on some hand signals to communicate during it? To help distinguish if you just need a quick break and a little extra pain medication, or if you want us to stop entirely. Uh. My hands will be free, so - maybe if you need a short pause, squeeze my hand once? And if you need that plus more pain drugs, squeeze it twice? And, uh, if you need us to abort entirely, you can...slap the ground with your other hand? That should work?" 

Kalorm was following FINE up until the point when she started telling him things he's going to have to REMEMBER even when he's simultaneously half-asleep from all the drugs and also being tortured! 

He glares at her and makes a frustrated gesture. 

Oh noooooooo is he mad at her for something she said??? ....Or, right, maybe she forgot and talked too fast. 

"Sorry, should I repeat some of that?" (Nod). "The whole thing?" (Headshake and eyeroll). "Uh, just the last part about hand signals? - Right." 

Merrin can repeat that, very slowly and clearly. 

Kalorm is still mostly expecting that he won't succeed at remembering that if he's confused and sleepy and in horrible pain. He can - maybe at least try to remember TWO things, though - he's supposed to squeeze Merrin's hand if it's horrible but not horrible enough that he wants to give up entirely, and slap the floor if it IS horrible enough that he absolutely cannot cope with any more. 

(He's grateful to Merrin for clarifying that it might take another ten seconds of horribleness even once he communicates that he can't cope with any more horribleness. He....is still going to stick it out as long as he can, even if he has to give up at some point, that's still more time for them to wash the stupid lung glue out of his lungs. Which does seem like a much better solution than whacking his chest to make him cough up the glue.) 

He nods. And clumsily flails for Merrin's hand and tries to squeeze it, to convey that he understood that part. 

How is that so adorable???? Also why is Merrin sort of almost crying about it??? Apparently Merrin's tired brain is ridiculous. 

....She squeezes his hand back, since this is a response that probably isn't stupid and also doesn't take much thought. 

"...Right. Good. Do you want us to start getting ready? Um, I'll keep checking the Treatment Planning updates and tell you what drugs they're suggesting once that's up." 

Kalorm makes a face at her. He's pretty sure that at this point he's already made it pretty clear that he wants to try the horrible-but-fast plan? He's not sure how many times he needs to nod to agree to that? 

He can nod YET AGAIN for it, though.