Okay. Strategize. 

…Main constraint is that he is, in fact, feeling pretty close to running out of energy, at which point he's pretty sure his arm will collapse no matter how much willpower he applies to it and he'll lose all the effortful progress he made. So. His hand isn't that far from the bar thingy. Maybe thirty centimeters. He can reach thirty centimeters. He just has to TRY HARDER. 

- he manages to sort of flail at the bar, whacking his hand on it - ow - and setting it swinging. His entire shoulder is burning and his fingers aren't really listening to him; he is totally unable to regain control of his arm's momentum, it's just going to do what it's going to do now. 

Merrin manages to gently catch his forearm just before Kalorm whacks himself in the ventilator tubing with it. 

She is trying so incredibly hard not to laugh. It is probably the most effortful non-laugh of her entire life. "Good job!" she says, her voice coming out high-pitched and chirpy as a result of the suppressed giggles. 

This is ridiculous. This is possibly the silliest situation anyone has ever been in in the entire history of dath ilan. Kalorm gives Merrin a deeply dubious look. 

....Help this is one thing too much and Merrin's giggles are breaking free. She is still trying incredibly hard to bite down on them and as a result mostly silent, just making a high pitched clicking-squeaking sound in the back of her throat. 

"...I...sorry...not...laughing...you..." she manages. 

Kalorm cannot even slightly blame Merrin for laughing at what is objectively the silliest and most absurd situation a human being has ever endured. He would maybe laugh at himself too except he thinks it would make him cough, and also he's incredibly out of breath and overheated. 

Merrin turns up the ventilator pressure and O2 concentration, Kalorm looks really winded. 

"I'm actually very impressed!" she says, once she's gotten herself under control. "You're amazing and deserve at least two cookies for that - sorry, for later, once you can eat - and I think Diagnostics will be updating downward on the predicted intervals for you hitting various mobility milestones. But, uh, also there's a reason why we were planning to break it down into a progression. It's really normal for simple things like that to be hard right now, especially when you're still on a lot of drugs. I propose you take five minutes to rest and catch your breath, and then we try assisted bar-gripping?" 

...Yeah, okay, fine. Kalorm is going to keep his eyes open the whole time, because he's pretty sure that he's one too-long blink away from involuntarily dozing off again. 

His heart rate and respiratory rate slowly drop, until he's back to a heart rate around 100 and no longer breathing above the ventilator set rate. (His oxygen saturation never dropped below 90%, and by the time he's fully recovered from the exercise, it's up to 99%.) 

Well, he is on 60% oxygen right now, but Merrin is sort of planning to leave it there while he's exercising. He could use the extra boost. 

"Ready? Okay, how we're going to do this is I want you to save your energy and not try to help me when I lift your arms up, okay? Just stay relaxed. Okay. There we go. - Is your arm okay? It should be healing well but please tell me if a particular motion hurts. Good. Here we are. Just try to grip the bar, okay? ...If 'grip' doesn't feel like a simple motion, focus on pressing your fingertips against it, like so..." 

Kalorm has NO INTENTION of letting Merrin know that his arm hurts. Then she'll probably not let him do things with it and it will take EVEN LONGER before his arms learn how to be less stupid than this. 

He can grip the bar! Not very hard, nowhere near enough to support his body weight even if his shoulders and biceps were willing to let him lift himself, which he is almost certain they aren't. But enough that he can keep his arms raised and hanging from the bar even once Merrin lets go. 

...This is tiring. Merrin counts off in ten-second increments, and by thirty seconds his fingers are trembling and his forearms are burning. But he is NOT LETTING GO until Merrin makes him. ...Maybe. He can't remember how long she said he was supposed to do it for. If it was ten minutes he is not sure that's physically possible for him to do.  

It was one minute!

After counting off sixty seconds, Merrin gently unwinds Kalorm's shaking fingers from the bar and lowers his arms to rest on the pillows. "That was really good. It looked like it was kind of challenging? We're going to keep doing a couple repetitions of it whenever you're awake, I want to aim for every two hours. And we'll add in some isometric muscle exercises, but I think one more repetition of that one in five minutes once you're rested will be enough for this hour, yeah?" 

She starts massaging his hands. 

That is the best thing in the entire world. 

Awwwwwwwww. Having cranky eye-rolling Kalorm back was amazing just by itself, but smiling happy Kalorm is even better. Merrin can keep massaging his hands and forearms for the entire five-minute rest period. 

Oh no he has to do it AGAIN Kalorm will not complain. This "exercise" is incredibly stupid, but having arms that are this bad at being arms is even stupider. He will try very very very hard to hold the bar for a minute, even though his stupid fingers are sweaty and slippery by the end. 

Afterward, he falls asleep mid-hand massage. 

Awwwwwwwwwwwwwww. 

Merrin will keep massaging and gently stretching his hands and arms for the next ten minutes. 

Kalorm has, by any reasonable standards, an incredibly good day.

His endurance for fighting the sedation to stay awake is about ten minutes at a stretch, and he’s pretty irritable every time he’s nudged awake, but if Merrin does it, he can usually be coaxed into a round of some kind of exercise. His retention and memory-consolidation of previous conversations is clearly impaired; Merrin has to re-explain the physical therapy plan about eight times before it sticks at all. She’s picking items from the list that are very straightforward to explain and where she can easily guide Kalorm through them - including by literally holding and moving his limbs into the right position - when he proves unable to remember more than two steps. 

(Kalorm is also having a pretty hard time remembering things like “what exactly went wrong such that he's on a ventilator again now", "how many days it’s been” or “where his family is”, but this doesn’t seem urgent to know anyway, and communicating anything is exhausting, so whatever.)

His oxygen needs continue to be fairly high, and for his exercises he does a lot better if Merrin goes up to 60% or 70% on the ventilator, but his blood pressure holds up fine and his vasopressor needs are gradually decreasing. By the end of Kerrin’s shift at 8 pm, he’s down to 20% of the maximum, and tolerating 2-hour periods supine without increasing O2 needs or shortness of breath.

He’s definitely more limited on coordination than strength. With his knees bent and Merrin holding his feet in place, he’s strong enough to lift his buttocks a little off the mattress (though it takes him ten minutes to fully catch his breath afterward, at which point he instantly falls asleep), but he is completely incapable of touching his own fingertip to Merrin’s in a controlled way. 

He is slowly but steadily making progress on the basics of using his muscles on purpose, even when he isn’t yet strong enough to do anything unaided. By 8 pm, he’s managed to figure out how shoulders work enough that he can actually get his good hand up to the trapeze bar. (Though the effort wears him out enough that he ends up having to let go almost immediately.) 

From Kalorm's perspective, he can't do ANYTHING. (He doesn't feel like it counts as him doing it if Merrin is doing half the work. It's incredibly stupid how quickly he gets tired, how little exertion it takes before he has to spend the next five minutes catching his breath and waiting for his heart rate to drop to something reasonable. His hands are weird and puffy for some reason and they look incredibly stupid and also his wrists and ankles are so itchy and Merrin won't let him scratch them. He's so frustrated. He's feverish on and off and his skin hurts and his bones are achy and he's not going to COMPLAIN or even ADMIT to it but most of the exercises are pretty unpleasant?

He wants things to be NOT LIKE THIS and he's starting to wish Merrin would go away. 

But every time she gently wakes him and eagerly suggests a new weird horrible stupid exercise, he ends up doing it. 

By 8 pm, Merrin has covered every exercise that she thinks Kalorm can both physically do and understand the instructions for at least once. That's probably more than enough for today, honestly, especially when she can tell that Kalorm still isn't feeling great. He can have 8 pm - 8 am off – well, except for repositioning and some passive stretching, that's not optional. 

Moving his body around has helped a bunch with the lingering tissue edema; his feet are still water balloons, but his hands are only a little puffy by evening, and pressing a finger against his skin no longer leaves an impression. And he's stronger than she had expected, and clearly a lot stronger than the rehab team had expected, because the diagnostic market spreads are narrowing toward the optimistic side. She's so pleased and proud of him and he's earned, like, another eight cookies by the time Kerrin goes home. 

The Treatment Planning team is indeed surprised in a positive direction! He came in under the 20% interval for starting bed-based exercises. His cardiovascular system is tolerating exertion fairly well, and it's not great how much his oxygen needs increase for it but they can, in fact, give him high O2 concentrations for five minutes at a time without causing problems. His core and leg strength are surprisingly decent already, though the lack of coordination does not bode well for balance. At this point he clearly does need a rest and recovery period, and overnight is good timing for it, but he might in fact be able to handle sitting up on the side of the bed - with appropriate assistance to avoid falling over - by tomorrow morning? The prediction spread for that is now 10 hours / 22 hours / 40 hours.

For assisted standing, the new intervals are 30 hours / 48 hours / 4 days. He's still on vasopressors, but they're hopeful that this will stop being true before morning, and if he's otherwise ready, it's probably worth attempting even if he's still needing ventilator support and high oxygen concentrations. 

To actually walk, even a short distance with a lot of help, his coordination needs to be a lot better than it is right now, and he definitely needs to be breathing on his own and needing less than 50% oxygen at rest. They're hopeful that just getting him off sedation will help with the clumsiness, but it definitely looks like some of it is neurological, and will take a lot of therapy to resolve fully. They're now predicting 60 hours / 4 days / 6 days. 

Predictions on when he'll be able to walk >50 meters unassisted are less optimistic, because even if his cardiovascular system does well, the lung damage is going to seriously limit his endurance, and at this point looks like it will take a while to resolve. The spread is now at 6 days / 9 days / 11 days. 

Dalthem is back! 8 pm-2 am isn't his favorite shift, but it's better than 2 am-8 am, and Kalorm is probably going to be awake for at least some of it. 

...He got in report that Kalorm had a very thorough bath yesterday, but he sure looks sticky again today! Does Merrin think she can convince Kalorm to tolerate another bed bath tonight before they get him settled? (The plan is to let him stay in prone position for the 8-hour block between 10 pm and 6 am, with the lights dimmed and as undisturbed as possible, unless he wakes up on his own and requests something else.) 

...Sure, she can try to have that conversation with him once it's time to nudge him for his final round of lying on his back, which they're planning for around 8:30. 

Waking up is, at this point, slightly less difficult and unpleasant? Kalorm is finally less confused about opening his eyes to find himself staring down at the floor (and a Merrin sitting on it, looking up at him.) He still feels very dislocated-in-time; he’s completely lost track of how many times he’s now woken up like this, and he would honestly be equally unsurprised if Merrin said it were noon or midnight, and not very surprised if she informed him that he lost a week somewhere.

He blinks at her.

“Doing okay in there? It’s about 8:30 pm." She reminds him of the date. "Your medtech for the next six hours is Dalthem, but I'll be here. I do need to get some sleep in a few hours, but I can wait until after you're settled for the night. For right now, we want to turn you onto your back again for about 90 minutes. Ready?" 

Kalorm isn't really sure what the difference is here between him being ready or not! It's not as though he really participates in the process! He nods.

They get him turned, uneventfully. 

Merrin lifts his arm to put a pillow under it, then squeezes his hand. "Just to go over where we're at– sorry, wave your hand or something if I'm just repeating stuff you know, but you were really out of it earlier today and you seem more alert now. It's been nearly seven days since the boat accident. You first woke up around five days ago and came off the ventilator a bit more than 24 hours after that, and then the next day - three days ago - you had an infection from your gut that got into your bloodstream, and you ended up being very sick before the antibiotics kicked in. You were unconscious for two and a half days, but you're doing way better now - you're doing really well - and we were able to reduce the sedation and let you wake up again this morning, around eleven hours ago now. Your lungs took a hit and you're still needing a lot of help breathing, but your heart is doing really well. Are you confused about any of that, or do you want more detail on anything?" 

He kind of does? Merrin hasn't really told him what HAPPENED when he apparently just...missed...two and a half days. That's multiple days! Multiple things must have happened! 

He nods.

....In hindsight that was two questions and now it's ambiguous. 

"Do you, uh, just want me to - explain more concretely all the medical problems you had and the treatments we did?" (Nod.) "Uh, from the start?" (Headshake.) "Do you think you remember okay things that happened while you were off the ventilator?" (Uncertain nod.) "Do you want more detail on things that happened in between when you started getting really sick and when you woke up today? ...I should maybe go over some of the things while you were still technically awake, you were getting pretty out of it."