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Merrin working in Exception Handling
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Well, Kalorm isn't immediately yelling at him to leave, soooooooo maybe he'll tolerate another two minutes of back and forth? 

He lowers himself down beside the floor mat. (Makes a mental note to go nag Personnel about increasing his performance incentive for the ergonomics side of things; he's too old for this and his knees are feeling it, and 18 hours off between shifts isn't really enough of a break to recover fully.) 

"Hey. Think you could cope with a quick dialysis run before that? Your magnesium is getting high again, which is a risk factor for nausea and could be contributing to the problem with your blood pressure. It's not incredibly urgent, so it's okay to wait until later if you're feeling tired and don't want to handle another unpleasant thing, but we can get you the noise-blocking headphones again."

Pause.

"...And I predict Merrin will be much less stressed about giving you an enema if your electrolytes are normal and she trusts that not to be a factor in making your body react badly to it." 

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One the one hand, he is ABSOLUTELY being managed into agreeing to more horrible things right now. 

...On the other hand, it wasn't even all that horrible last time, and his head feels better today. And he doesn't want Merrin to be stressed or sad! Also, you know, he doesn't want his body to ""react badly"" whatever that's supposed to mean. 

 

"- Want. Lights. Off," he croaks. "Alone. And - relax -" 

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Tharrim looks puzzled for a moment until someone from the command center helpfully murmurs to his earbud that Kalorm probably means he wants the muscle-relaxant drug again. He seemed to respond well to that before; apparently it's relieving some sort of unpleasantness for him. 

He considers it for a moment. "...Okay. I may have to run in suddenly if there's a problem with the machine." And he's not delighted about leaving Kalorm unsupervised in the dark where he might pull out his dialysis line and bleed everywhere, but - it seems like a risk they probably just have to take? "There's less likely to be a problem if you try to hold still and stay relaxed. And of course you should call me right away if you start feeling any worse. Okay?" 

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Fine. Kalorm nods. GRUMPILY. 

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Great! Tharrim will efficiently set up the dialysis circuit and hook it up, and double-check everything with Kalorm's patient-controlled pain medication console - 

 

- and then remind him that he's not getting anything for pain at baseline right now and should feel free to either give himself doses early if he notices that the pain is getting worse, or ask for a baseline rate, if that sounds too hard to remember. He notices that Kalorm hasn't pressed the button for a dose at all, yet? It's only been 45 minutes since they stopped the continuous infusion, and that was a longer-acting drug, so it's plausible that some is still in his system, but it's pretty likely that at some future point it'll wear off entirely and he will be in more pain again. 

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He's not STUPID. Glare. 

...Kalorm should maybe actually try to communicate this? It sounds hard but he takes a few deep breaths. "Pain...drug...bad. Relax drug. Helps. More." 

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"Huh! Is that more in how effective it is, or side effects?" 

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That question is too hard to answer right now. 

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Sigh. "Okay. Just, please either use the button or let us know if you're in more pain, being in pain puts stress on your body. Noise-cancelling-headphones now?" 

And he'll get that set up, and the lights dimmed (not fully to pitch-darkness, but Kalorm apparently doesn't object) and and then he'll somewhat reluctantly step out and watch intently from the other room. 

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It goes okay? Kalorm, fairly predictably, dozes off again once the lights are dimmed, so he's definitely holding still.

...His oxygenation holds steady, but his cardiovascular system is noticing the extra strain of having some of his blood outside his body. His baseline blood pressure drops to 95/60 again. And the random brief dives are less frequent, and shorter, but worse - on the worst one, he dips as low as 75/30 now before recovering. 

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- Tharrim has a remote console for his IV pump setup and can give him the standard reactive vasopressor dosing from outside the room.

This is hardly unexpected; it's a little additional Bayesian evidence toward a worse and more fragile underlying condition, but really not very much, it's very common for patients to get blood pressure fluctuations during an intermittent dialysis session even if they don't have any other organ dysfunction. 

Tharrim still doesn't like it. But running in and hovering will do the opposite of help, and right now he's at least achieving 'Kalorm is voluntarily accepting dialysis and isn't abjectly miserable about it'. So he'll instead hover and be hypervigilant from a distance! 

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Merrin is in a weird and perhaps-not-ideal emotional state this morning, it turns out! She's having trouble figuring out what the details of it are? It's at least not a motivational issue, and definitely not a motivational issue specifically related to Kalorm, who is very good and who needs her to fix the results of her past mistakes of her past reasonable tradeoffs nevermind.

It's maybe related to - some other element of this whole situation? Being in Default for weeks is weird. She feels guilty-or-something that she isn't keeping up on her sim training; Irris assured her that she's getting paid more for this, which means Civilization finds it more valuable, but that feels very fake right now. Kalorm's family members are all kind of intimidating and she can't shake the feeling that Finnar could show up whenever he likes and be smart and scary at her. Also Merrin sort of feels like Khemeth has unfinished business with her? She can't pin down why she thinks this and, presented with the standard engrained mental motion of 'put probabilities on that', her brain throws up its metaphorical hands and wails in despair. Which isn't great! That's a super critical cognitive function! 

 

She wants to do a plank for five minutes straight, until the point when her entire body hurts and the world suddenly feels simpler and clearer and more beautiful. She really shouldn't do that right now, though! Kalorm is very good and deserves a Merrin who hasn't just turned her arms into jelly for no good reason. 

 

It's fine. She'll be fine. She tested it and she can definitely at least manage to finish thoughts, including thoughts with numbers on them, if they're about Kalorm. 

Message to Personnel: today would be a really bad time for Finnar to show up. Uhhh. Unless Kalorm asks for his father? But Merrin thinks he won't, and that probably it would be stressful for him, given how they're going to need to put him through some particularly uncomfortable and undignified medical procedures. 

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(Currently-on-duty Personnel does, in fact, have basic common sense! Also there are several notes on the chart that Finnar and Merrin should never be in the same room at the same time, unless and until Khemeth manages to somehow resolve the tension there.) 

The reply is much easier! [Acknowledged. Agreed high priority to minimize stress for the patient] 

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Merrin makes herself eat some food, and then mentally shrugs helplessly, and has some caffeine. She can worry about stimulant tolerance LATER, and - it sort of feels like she might need it, today. 

She's over at Kalorm's ICU room area by 10:55 am. 

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Tharrim is in the monitor room right next to the actual patient area. 

"- He's asleep right now. Think it's worth letting him rest until either we're done this dialysis run, or he wakes up and calls for us– or if there's a worse complication. He's having some blood pressure irregularities, but it responds to vasopressors and the frequency is decreasing as we get further into this dialysis run..." 

Tharrim takes his time giving a careful and thorough report, making sure to cover the Vague Concerns noted on his end and by Dalthem. 

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Kalorm sleeps through it. He does two blood pressure drops over a 20-minute period, but with Tharrim watching and triggering the programmed vasopressor dosing as soon as he notices a problem, he never actually drops below a systolic blood pressure of 80. 

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Once he's answered all of Merrin's questions, Tharrim is going to duck out. 

(....But stick around nearby, because he's only been on-shift for three hours and isn't especially tired yet, and Merrin might need backup.) 

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........It turns out that not being in the same room as her patient is THE LITERAL WORST THING for Merrin's current emotional state. And the EEG thinks he's in - okay it's not obviously stage III slow-wave deep sleep, but it's pretty deep sleep?? Probably if she's very very careful and very very quiet, she can sneak in and sit nearby and not disturb him???? 

- okay it's maybe going to be an issue that the light from LCD screens will disturb him. But maybe someone can relay any important changes to her by earbud? 

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- in that case they do want an actual ICU-trained medtech, with context on Kalorm, available to watch the monitors and also close enough to be in the room inside of 30 seconds. Tharrim is available for that, though, he'd originally been intending to do a 6 hour shift anyway. 

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Merrin would appreciate, that, honestly? Merrin should register that she would feel more comfortable if Tharrim is on-site and available to make comments to her via her earbuds - or physically jump in if something goes wrong - through the end of his usual shift end-time. 

(Unsaid thoughts: Tharrim is neat! He's almost certainly smarter than her, for one, which means he can make way more effective use of being in a room of screens with numbers on them. Merrin is pretty sure she's just not smart enough to work with that! Which is probably why she's so stressed about not being able to physically lay eyes on her patient! Also, like, Tharrim just has vastly more patient experience than her, and it's pretty deeply reassuring to have backup for the next few hours, given how Merrin's brain is still throwing a lot of unspecified doomfeelings at her.) 

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- yes, of course, Tharrim's available for this. He'll slip back into the room. 

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Aaaaaaaaaand Merrin will very, very cautiously open the soundproofed door to Kalorm's area, and tiptoe in and shut it behind her, and then walk so carefully because even with the dim lights on she isn't that sure that she would spot anything she might trip over - not that there should be any random debris on the floor to trip over but still - and if she trips and falls on her face right now she will DIE of HUMILIATION about it. 

She can't see where her floor chair ended up. Whatever. She'll just, like, lower herself to the ground and sit and watch Kalorm sleep?

 

 

....While, uh, possibly slightly internally panicking about the fact that she can't directly watch the trend in his vital signs? She has all of the alarms set to max sensitivity and to send audio tones to her earbuds, but STILL. 

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Kalorm looks okay, at least? It's 11:03 am. He's about 45 minutes into the dialysis session. His breathing is deep and even and he looks reasonably relaxed and comfortable. 

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...Okay. This is okay. Her eyes are adjusting to the dimness; she can see her patient well enough now to feel mostly oriented. And one of the admin staff in the command center can repeat vital signs and dialysis parameters to her every 60 seconds. 

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The dialysis run is going smoothly; Kalorm's magnesium is now beautifully mid-range, and his blood pressure does seem to be less variable as a result. They're just still working on getting his urea down as low as possible, but an hour should be plenty of time. 

(Kalorm is still lying still with his eyes closed, but his EEG is showing lighter sleep, with occasional bursts of closer-to-wakefulness activity.) 

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