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Merrin working in Exception Handling
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Kalorm didn't quite follow that. He keeps holding rigidly still and waits to endure more stabbing pain. 

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Merrin squeezes his hand. "Kalorm, that's it. We're all done." Kerrin is really good at this, and did the entire thing in, like, seven or eight minutes. "You can relax, take some nice deep breaths, I expect it'll feel much better now! ...You're probably really sleepy. It's okay to sleep. Kerrin's stopping the extra pain medication now and the sedatives should wear off in ten or fifteen minutes. Um want me to wake you in twenty minutes if you haven't woken up on your own then, so you can try the minimum settings trial?" 

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Kalorm got as far as 'it's okay to sleep' and stopped putting in the effort to particularly parse words. There...might've been a question? It was a question-y tone of voice. He squeezes Merrin's hand, that's the response to being asked questions, right. (At least he thinks he squeezed her hand. Everything is very floaty and far away and he's most of the way to asleep already.) 

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Merrin isn't super sure how to interpret that! Possibly it means that Kalorm doesn't want to be nudged awake and would rather she wait and let him wake up on his own. Possibly it just means that he wasn't really parsing the question. 

 

...Wow. She's so relieved that's done and it's possible it was more stressful for her than for him? She's sort of all shaky now. 

[You're so good at that!] she tells Kerrin, fervently, but subvocalized rather than out loud since their patient is sleeping. [That was so fast. And still pretty gentle. Uh, what sorts of things were you taking into account when you picked your specific equipment and customizable bits? I've never seen that kind of probe tip before]

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Sure, if that's what Merrin is curious about, Kerrin can discuss it while she flips through Treatment Planning updates.

(They want another scan. Scan is indeed much improved but they expect they can get more improvement if they bump up the positive end-expiratory pressure really high for ten minutes while Kalorm is asleep and won't mind. Kerrin does that.) 

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Merrin will ask questions while absentmindedly doing mouth care, because all the Kalorm-torture that went on has definitely caused a saliva disaster. 

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[Want me to show you some of the tips I got from Halthis?] Kerrin offers. [It's a pretty convenient time while he's still knocked out] 

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Aaaaaaaaaaaaaaaaah Kerrin is probably JUDGING her for being terrible at mouth care. 

 

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[Sure!] Merrin says - or subvocalizes - brightly, smiling at Kerrin. 

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Then they can pretty easily fill the time until Kalorm wakes up. 

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It takes him about twelve minutes.

(He spends the first five minutes sedated enough that he'll breathe at 8/minute if they don't leave the ventilator on a set rate – but with the positive pressure bumped way up, he's getting excellent breath volumes, and Kerrin is able to ease him down to 25% oxygen concentration on the ventilator. They're not going to do another X-ray just for this - it's still some radiation exposure - but the latest ultrasound checks show really good lung expansion.) 

He doesn't wake up all at once. He stirs a few times, makes faces while still half-asleep, every so often takes a deep sigh-like breath - 

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- and then at some point he's close enough to awake that he notices the lingering achy twinge deep in his chest, which prompts him to pay attention to his surroundings and try to remember what happened last to explain it. 

Oh right. They were going to do a horrible procedure. Kalorm...isn't sure whether or not they did? He doesn't remember anything??? He's not even sure he remembers them giving the drugs, though he does - hazily - recall Merrin talking to him about what drugs those would include. His lungs do feel different? He thinks it's a better sort of different, even if everything feels slightly tender in there, but that does seem like something you would expect after having your lungs washed. 

Another minute or two later he's actually awake enough to drag his eyelids apart and try to see what's happening. 

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Merrin notices immediately, of course, even though she's listening to Kerrin subvocalize commentary while gesturing at an LCD screen set to display sims of a bronchoscopy. She lights up. 

"Kalorm! Hey! That wasn't long at all. We finished the bronchoscopy a bit over ten minutes ago. How are you feeling? Are you in pain?" 

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It's more discomfort than pain per se, and he really doesn't want more drugs about it. Kalorm shakes his head. (He's relieved to get definite confirmation that the torture procedure is DONE, at least.) 

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"That's good! Your lungs are looking great on imaging. Think you can try taking some really big deep breaths - breathe out all the way, and then in as much as you can - and we'll see how impressive your numbers look on that?" 

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Kalorm manages a smile, nods, and then takes a few experimental normal breaths before he actually tries to breathe all the way out. And then in. It definitely hurts - not just his sore sternum and ribs, but a twinging, almost stretching feeling deep inside - but he can manage what feels like a pretty good amount of air before it gets too uncomfortable. 

- at which point he inevitably starts coughing as soon as he tries to exhale, and owwwwwwwww, but for once, it doesn't incredibly feel like he has stuff rattling around that he needs help coughing up? 

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Merrin makes a delighted sound. "2500 ml! That's really good for where you're at right now!" She pats his arm and sits on the urge to give him a hug. 

(It's not normal. Kalorm's ideal body weight – estimated to be a few kilograms heavier than his actual current body weight, he's mildly undernourished – is probably around 80 kg, and he's male and very fit, which means that his vital capacity should be at least 4500 ml and might have been as high as 6000 ml, six liters of air, before his accident. But it's real progress.) 

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"The procedure went well," Kerrin says, her eyes still mostly on screens of sensor data. "You were definitely uncomfortable during it, but you held still for it very well - it seems like we were able to juggle the sedation dosing well enough that it was tolerable, but without knocking you out for too long. Your lungs may feel irritated for a while, that's partly all the prodding in there and partly a reaction to the surfactant drug, people sometimes describe it as feeling itchy. Anyway, do you think you're up for the minimum settings trial now? I'd put 90% odds that the sedative hasn't entirely worn off, it might take half an hour to fully clear your system, but your lungs do look much better, so at this point I don't think the drowsiness will much get in the way of succeeding at that." 

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Yes he would like to do that!!! Eager nodding!!! Kalorm also tries to get his hand to cooperate with pointing at the wall time display, which he can't read – even if he could concentrate well enough to pick out numerals right now, his eyes aren't focusing well enough to make out details on the screen. 

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For once, it's pretty obvious what he wants! 

"It's ten-thirty pm," Merrin says, and then yawns, because apparently looking at the time reminded her brain that it does not feel like this should be work time. "–Sorry. Uh, I would normally consider whether you'd rather get an uninterrupted night's sleep and come off the ventilator in the morning, but I predict you'll be way more comfortable with the tube out, and at worst they'll have to wake you overnight every so often for breathing exercises, if you're not clearing secretions well enough. We should confirm that you're willing to put up with that, if it's necessary?" 

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Kalorm glowers at Kerrin - he definitely anticipates being annoyed if they keep shaking him awake all night - but he does nod. 

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Kerrin neither sees nor reacts to the glare, since she's busy gently easing down the pressure support settings on the ventilator, so it won't be too abrupt for him. She watches the sensor screens closely – the markets are putting >95% odds that he tolerates this fine, but she's not going to slack off on monitoring him. 

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This is fine! 

...Well, Kalorm does still feel incredibly terrible in at least eight different ways, but! He can breathe fine! It's perhaps very slightly effortful, in a way that would discourage any serious exertion, but he has multiple other reasons to prefer to lie still right now, and as long as he's resting, it's perfectly comfortable. 

He is maaaaaybe going to doze off again for another few minutes. 

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Merrin wishes she could ALSO take a nap that's not really true, she got up less than five hours ago, but she's certainly tired. She keeps craving caffeine and having to repeatedly remind herself that today is NOT A CAFFEINE DAY, and tomorrow won't be either, the two emergency shifts in a row thing was a fluke. 

 

She settles back in her cozy floor chair to watch Kalorm's beautifully normal vital signs. 

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