The patient is unconscious again but in fact getting more oxygen now! Saturation is creeping back up!

...Okay. That's not ideal, unconscious people cannot protect their airways, but Marian is still pretty worried that if they try to reintubate her she will just self-extubate via BITING AND COUGHING again. They could use a bite block but Marian is sort of suspicious that the bite blocks aren't rated for, uh, that. 

"She bit her tube off," Marian informs the nurse who's finally arrived to help. "Also she's really fucking strong and, like, basically impossible to sedate and she might just do it again if we reintubate her. I - think if she wakes up a bit more once her sats are back up, she could be okay on BiPAP? Uh. Maybe help me get her in recovery position to start..."

Honestly it makes no sense that just oxygen by facemask is enough to help at all. Given the visibly awful condition of her lungs and the disaster of her chest X-ray, it doesn't make sense how well she was coping even on maxed ventilator settings. But, sense or not, Marian is not complaining if it turns out that noninvasive ventilation support is enough, since high ventilator pressures are going to risk fucking up her poor lungs even more. 

...She is still really suspicious that the O2 saturation number is FAKE - maybe the lack of skin is messing with the calibration??? - and once they have the patient propped on her side, where her airway will stay open better and she's at least less likely to aspirate if she vomits, Marian is going to draw a blood gas and stick it on the iStat machine. She should have a result in five minutes. 

It's going to be really long and really stressful five minutes. 

...She restarts the fentanyl. At 200 mcg/hour, she doesn't want to risk going higher when she's already expecting an unconscious patient to breathe on her own. 

The oxygen mask does seem to be sufficient to help at least a little, though it's not doing as much as the ventilator. As does the fentanyl; she stops doing quite as much anguished tossing and turning, and continues breathing. 

And, after a little while, is conscious. She's in agonizing pain and her head is gluey and she has no idea what's going on. 

Lay on Hands.

Help, through the permanent Telepathic Bond.

Doesn't work. 

...Yeah that looks like consciousness approaching. Also the woman's flailing around has dislodged a lot of her hastily-done bandages, which is not great, though the burns look...less bad than Marian would have expected??? 

Also, the doctor must have agreed with her assessment, because the respiratory therapist is now here with a BiPAP machine and mask. Also looking at the woman with some trepidation; word has apparently spread. 

Marian puts her hand very gently on the woman's arm, and tries to keep her voice calm and soothing and not at all hinting that there's an emergency. "Hey. You're okay, but we're going to put a tighter mask on your face to help you breathe better. Can you try to hold still for me, please?" 

She doesn't speak the language. She does remember that she injured a random woman. She will hold still and try not to do that. 

Lay on Hands?

Doesn't work.

Why isn't it working. What is happening? She's not thinking clearly. If she was thinking clearly she'd have thought of that question earlier. What is the last thing she remembers happening?

Arazni died.

That is not a sufficient explanation for this though it's probably a necessary one.

What happened more recently than that?

- negotiated assassination. There was a negotiated assassination, and she is out of Lay On Hands because she's far from home, and she is probably being tended to by poor otherworldly healers, and she punched one. 

She can't apologize until she can talk. She can hold still, though.

Marian already has the beginnings of red finger-shaped bruises visible on her arms where Iomedae grabbed her, but she's not actually very injured. She's fine. She will keep talking soothingly to her patient while trying to reposition her in ways that hopefully won't hurt too much, and then making sure to pad her poor burned face with hydrocolloid dressings on the mask pressure points, BiPAP is uncomfortable enough even when you aren't missing a whole lot of skin. She's mostly hoping the woman will be more coherent in a little while and they can have a conversation about reintubating her. 

The mask is indeed pretty uncomfortable but it's by far not the thing that hurts the most, and Iomedae will notice that it takes substantially less work to draw air into her lungs. 

Iomedae is ignoring the agonizing pain. She won't die unless someone decides to kill her while she's helpless, and being in pain is not a novel experience or an interesting one, and is somewhat less bad of one when you cannot be scared about the prospect it'll continue. There are a bunch of people who might kill her while she's helpless, but presently very little she can do about it except wait to recover and try to figure out how to communicate. Greater Angelic Aspect will get her Tongues - no, she tried that and something went wrong, what went wrong - the gag - no, even without the gag, there wasn't enough air and her throat didn't work -

She needs a new plan. That doesn't rely on being able to talk. 

She had something - 

- oh, right. 

Iomedae can cast Telepathic Bond. It's not a paladin spell. She thought at first when she learned the knack that it was a fifth circle paladin spell, and asked for something else like Breath of Life instead the next day, but Aroden didn't cooperate and she figured out eventually it was something else. 

Importantly, Iomedae can cast Telepathic Bond without speaking or moving. 

She'll do that.

I'm disoriented and don't remember anything more recent than the assassination attempt, she reports briskly, and injuring a woman at some point, which I apologize for.

???????????????????????????????????????????????????????????????????????

Marian is, uh, on the one hand incredibly confused and startled and slightly wondering if she's hallucinating right now?????? 

- on some other level, though, she's less confused than she was ten seconds ago. There are a lot of individual observations that keep not quite making sense and 'the patient is some kind of alien telepath' at least condenses all of that down into one impossible observation. 

She can figure out if she's having a psychotic break later, once her patient is okay. 

...uh, okay, can she answer - she tries to think back at the patient. You're in the ICU in Reno, Nevada. You were very badly burned and your lungs were damaged but you're recovering. We - don't really have any idea what happened, someone found you beside the road. - you sort of grabbed me before but I'm okay, I'm not injured, I was just really stressed about you. 

And to the RT, quietly dying of embarrassment, "- Krystal, did you hear that?" 

Krystal is adjusting settings on the BiPAP machine and kind of busy. "- hear what?" 

Oh dear. Okay maybe she is just having a psychotic break. 

- still gotta focus on her patient though. How are her O2 sats with the BiPAP. 

Clinging to 90. 

I am unfamiliar with those place names. Has Urtho or his representatives contacted you? Or Ma'ar, or his? Or the Shining Crusade's? Do you have Aroden here? Iomedae feels stunningly dizzy and her thoughts keep flitting away on her and she's in agonizing pain but none of that is a reason not to communicate like a normal person. And did you remove my armor and possessions?  I need those back, conceivably urgently. 

What. Okay great her patient is PROBABLY FROM ANOTHER PLANET. 

...I don't recognize any of those names. We had to remove all the armor because you're burned badly over your entire body. I think most of the armor is still in the OR - uh, another room where we took you to treat the burns - but there's some stuff here, I have a shirt and cloak and some jewelry, and...it looks like a gauntlet and - whatever arm armor is called? - came with you from the ER, they'd taken that off earlier to have somewhere to put an IV. Also I put your belt back on because your condition mysteriously got worse without it. 

- uh, you're also having more trouble breathing without the tube to help you. I think it would be a good idea to put it back, but I want to explain it first so you don't panic and bite it off again, that was bad. 

- the belt makes me healthier. Please don't take it off. I will recover from the burns and I prefer being armored for the next time someone tries to kill me.

The tube makes it hard to speak and it's fairly inconvenient being unable to speak, I think if you give me back my necklace of adaptation it'll probably solve the breathing problem.

The belt just...makes...her healthier? Just like that? ...Okay, fine, that did kind of look like exactly what happened, it helped with a bunch of disparate vital signs not all of which made any sense with the theory 'it was doing something to intra-abdominal pressure or lower limb circulation'. Though of course the obvious explanation is still that Marian is hallucinating. But she's pretty sure she's not currently doing anything that would be insane, and, uh, if she's sufficiently out of touch with reality that what she thinks she's doing is uncorrelated to what she's actually doing, then telling someone isn't going to help anyway and she'll just have to count on someone, like, noticing and sitting on her. 

Great. 

Okay. We can try the necklace, if you tell me which one it is. ...Nobody's going to kill you, you're in the hospital. 

It is not my intent to impugn the honor of your healers but I am at war with a god right now and I while I think He is too honorable to try to kill me in a hospital I am not sure, and in any event would not in reliance on that be more vulnerable in a hospital.

????????????????????????????????????????????????????????????????????????????????????????????????????

...Focus. Okay. 

Simplest explanation: Marian is in fact having a psychotic break.

Alternate explanations: her patient is telepathic and also insane? Her patient is an alien from another world in a fight with a more powerful alien and her weird telepathy is translating it as 'god'? Both of those seem like MORE likely explanations than 'God exists and is the sort of entity that goes to war and randomly tries to assassinate injured people in hospitals.' 

Uh. 

I can get you the necklace and see if it helps. Where is it? And if it indeed causes the woman to have decent sats and a decent blood gas on room air, that's sufficiently whatthefuck that she can, like, probably just ask the resident to come look and confirm? And if other people are seeing the same thing as her then either she's not crazy or all of them are crazy. 

She is kind of mostly not thinking about the "war with a god" part because she has no idea what to make of it and it's also sort of terrifying. 

It's in the gauntlet but the gauntlet only opens to my touch. Can you bring it here? I think I'm not yet very able to walk.

I can bring it. Please don't try to walk. You're attached to a lot of things and I think you might lose consciousness again if you pull the oxygen mask off. 

She'll carry the gauntlet over. She's sort of past asking questions about bizarre shit, such as how exactly a gauntlet 'opens' to reveal a necklace. (Why it does it to only the patient's touch seems less weird, Star Trek is full of DNA-activated tech.) 

(The respiratory therapist is watching her with a weirded-out expression, but she has like five other patients to see before she can have a break. She'll leave Marian to it, whatever 'it' is.) 

Iomedae taps the back of the gauntlet and it opens to reveal a jewelry box larger than you'd expect to fit in there but not obviously-impossibly larger, and takes out the Necklace of Adaptation, and with some concentration makes her hands behave normally so she can slip it over her head. 

I do need to breathe oxygen, she agrees with Marian absently. If I were healthy I could do without for quite a while but I am in poor health at the moment and am probably going to have to convalesce the slow way.

The patient indeed does not look like she's particularly having an easier time with breathing, and her sats are still at 90%, though at least they're not dropping below that. 

Yeah, I think you still need some help breathing. I am kind of worried that if you put on armor it will put a lot of weight on your chest and make it harder to breathe. 

I have never had that problem before but I rarely survive being injured this badly. If the problem is not that this world has different air I am actually confused about why I am having any trouble breathing.

Marian's brain is making a quiet mental checkmark about the 'if this world has different air' part, yep, alien. ...Five seconds later she runs into a mental stumble, what the fuck is "I rarely survive being injured this badly" to mean?????? 

- probably not the point right now. 

Obviously I don't know anything about the air on your, uh, world, but I am pretty sure you breathe oxygen like humans because it does help and also I think our equipment wouldn't work if your blood wasn't carrying oxygen. I think you're having trouble breathing because you inhaled a lot of steam or boiling water and your lungs are really horrifically burned. I am actually pretty surprised you're not having more trouble breathing, you - didn't seem to be dying without supplementary oxygen, you just weren't getting enough to be conscious.