Marian would have been inclined to transfer her on the slidey board regardless of her preferences if the radiology tech had been giving her indications of the scan showing something horrifying that could be made even worse by too much exertion and movement on Samora's part, but when she tried to make eye contact they just shrugged at her.

(Which doesn't mean it's not horribly concerning, it mostly means that abdominal CTs are kind of hard to interpret compared to, say, "one entire lung full of blood" on a chest CT, and they'll have to wait for the radiologist to review it to know much about how bad it is.

...Possibly she shouldn't be letting Samora move around much because it might still be really bad, but it - if anything feels more important to respect her patient's dignity while she can if she's about to have a spectacularly undignified next twelve hours? Ughhh or maybe Marian is rationalizing it because she doesn't want to have an awkward interaction where someone is frustrated with her. Whatever. It's done now.) 

She'll check a blood sugar and treat it with her last syringe of D50 if it calls for it and then they can book it back to the ICU, how about that. 

Yeah, she's going to need that D50. And then back to the ICU and not doing anything for a while sounds good. Possibly she should ask Marian to wheel her around casting Stabilize on anyone else who needs it, but she doesn't know how many injured people are here or how to explain what Stabilize is good for or how to indicate in a drawing that she understands the concept of prioritization, so it's going to take a bit of sketching and she'll wait until she's not on a moving thing to start.

When they get back, the patient in room 101 is - looking kind of okay, apparently? The blood transfusion is done and from this distance his vital signs look basically okay to Marian. She feels sliiiiightly less bad about being absolutely in no way available to help any of her colleagues today. 

One of the residents is already in Pod Two with the CT scan imagery pulled up on the computer screen. 

If communicating required less exhausting pictorial back-and-forth, Marian would totally consider showing Samora what her insides look like! She's not going to bother, though, it's not like it's very easy to make sense of for a layperson. She'll get Samora's bed back where it belongs, plug in her IV pumps again (they have like six hours of battery life but it's still rude to leave them unplugged until the night nurse gets a low battery alarm) and put her back on the big monitor, and then she'll stick her head out of the room. "How does it look?" 

He glances up. “Uh, I paged the radiologist to look at it, but - not that bad? The repairs all look fine and I don’t see any free air or signs of a new perforation. There’s some fluid accumulated behind the incision, but I thiiiink it’s just exudate that the drains aren’t getting?”

“Oh. Huh.” That’s definitely good and maybe they won’t have to rush to the OR after all, but Marian is definitely a little confused about how it got so bad so quickly. “Uh, her fever did come down with IV Tylenol, her other vital signs haven’t changed. Let me know what the plan is once you hear back, I guess—”

The charge nurse is hurrying over for some reason. “Is Marian - oh, good, you are back. Lab on the phone for you, line two, critical results.”

Oh no. Wait, what labs is she even waiting on right now? - nevermind. She dives for the nearest unit phone and hits the button for line two. “Marian speaking, this is for 104?”

"For Eighty-One, Violet in room 104, yes." The woman on the phone sounds - stressed. "You sent a sample for a wound culture, right? Some - green stuff - where exactly did you take the sample from -?"

Marian does not get the feeling that she's going to like where this conversation is going. "Yeah. She's post-op a few hours for bowel repair, I got the sample from her surgical drains but it's, like, the same stuff leaking out of her incision. We weren't sure if it was bile...?" Presumably it's not, though, if there's no new hole in Samora's guts that it could be leaking out of. 

“Doesn’t seem to be. But it’s full of - some sort of bacterial pathogen - it doesn’t match anything we’ve seen before - it’s remarkably fast-growing, doubling time must be less than ten minutes. It behaves like - a slime mold, almost, when you put some of the fluid on a slide it moves—  Please tell me the patient is in isolation?”

OH SHIT Marian is a terrible person - she had kind of already been treating it like Samora was a contact iso room, except for the part where she took her out of the room to Radiology and it completely slipped her mind to warn the tech that they should clean the room, like, more thoroughly than the standard between-patients precautions. In fairness to her, “surgical wound infection” doesn’t usually indicate isolation unless it’s an antibiotic-resistant organism - to be less fair, the patient was LEAKING HORRIFYING SLIME - 

“Uhhh. Not - officially ordered - I was treating it that way on the unit but I should call Radiology, we were just there -”

“Oh. One sec.” The voice goes muffled. “Joanne, call radiology now and tell them they were exposed to the thing - looks like it was a CT - find out which patients have been seen since, we should alert those units too—”

Aaaaaaaaaaaaah Marian feels terrible about everything!!!!!! 

The voice is unmuffled and directed at Marian again. "We're on it. - it's not your fault, this is really out of left field." 

no you don't understand it should have been obvious how it smelled like bog death and I could smell it

Melting down about how it's all her fault is unproductive. Marian takes a deep breath and clears her throat. "We'll put her in - uh, does it need to be airborne iso, the room she's in isn't set up for that -" 

"No indication it's airborne at all, thank god. And it looks like the standard disinfectants do kill it. Just, be really careful - we may want to lock the whole unit down, if the patient hasn't been in iso - the report will be through in the system in a few minutes." A pause. "Would you mind transferring me back to the charge nurse, actually? I'm sorry, I know this is a lot to throw at you and your patient needs all your focus -"

The lab person is being so nice and Marian still feels teeeeeeeerrible even though she's fully aware that she needs to stop that and focus. 

- she should not leave the room to go get isolation stuff. She may have been kind of mentally treating it like Samora was in contact iso, but she probably wasn't being careful enough - for example, she super wasn't putting on a gown and should assume her scrubs are now Contaminated - and also it might have been contagious before she actually noticed all the slime. 

"Kristy! I need help - uh, my patient has an infection of something the lab's never seen before and they want her in isolation but I don't want to leave. - also can you let Dr Harrison know? And tell Alison the lab is still on line two and wants to talk to her?" 

Aaaaaaaand then she should go figure out how to explain to Samora that she has something wrong with her that they've never dealt with before and also all the staff treating her are going to be in isolation gear from now on. 

(It's going to be pretty obvious to Samora that Marian has been getting increasingly alarmed and upset about whatever conversation she was having.) 

It's very obvious and Samora is worried too! She holds up the picture of her praying at dawn and healing herself and other people again, because that's the most reassuring thing she knows how to communicate.

Marian nods and smiles distractedly but is, honestly, not really in a headspace right now where "reassurance from her patient, the one with the horrifying fast-spreading infection" is particularly landing. 

She puts on gloves and takes the clipboard and - hmm - she'll draw a bandaged stick person on a bed, and circle the stomach area and draw an arrow to a circle where she draws some bacteria-shapes again, except this time she also adds lots of angry-eyebrows faces. 

How to convey 'it could spread to other people'...? She adds another stick figure standing beside the bed - points at herself to convey that she means who it is - then gives the Marian-figure hands and makes another zoomed-in-circle of one hand and draws some squiggly-bacteria on it. She puts all that in a box and draws another box further down with another bed in it, and draws a long arrow going to that room and the Marian-figure beside it with bacteria-shapes beside her, and then some bacteria on the patient in the other room, and a sad face. 

They want to put her in isolation because as far as they know it hasn't spread yet and they want to stop it. Hmm. ...She gets a new sheet of paper (ugh she needs to ask someone for more printer paper since she is officially not leaving this room to go touch things at the nursing station for the rest of her shift) and very quickly sketches the same scene, except this time the Marian figure has a bathroom-figure-dress style sketch of a gown on, and gloves drawn as an outline around the stick-hands, and the bacteria are only on the outside of that? And she'll draw the arrow to a Marian-figure dropping a bacteria'd dress into a cylinder to indicate the trash can, and then walking out with no bacteria with a smiley face beside her? 

Marian . . . caught her dungeon fever? Marian is worried she might catch dungeon fever. Well no wonder she's worried! Civilians getting dungeon fever is way worse than her getting it! She tries to communicate that she understands and that Marian should do whatever she needs to do. Hopefully there's some kind of backup plan for whatever they wanted her to be able to do in a hurry, now that they're not going to want her going anywhere until tomorrow.

Marian is preeetty sure Samora followed that? She feels like they're getting really good at communicating in pictures! This doesn't actually improve the medical situation and so doesn't really make her feel better, but it does feel like it matters that Samora is - probably more willing to extend her the benefit of the doubt, if they do need to do some sort of unpleasant and confusing emergency treatment in a hurry? Hopefully? 

- her vital signs still aren't worse, that's something - 

Kristy brings an isolation cart and slaps signs on the door, and Marian dons an isolation gown, which doesn't actually do anything about the feeling that her entire body is Contaminated and she desperately wants to shower and scrub her entire body with chlorhexidine soap and throw her scrubs in the laundry on the Sanitary setting, or possibly just throw them out as not worth salvaging. This is not a feeling Marian gets very often and she doesn't like it. 

Ugh she's late on the blood sugar check again and also completely out of boxes of D50 in the room, the last two went with her to CT and were used up - she'll ask Kristy for a bigger stash and poke poor Samora's finger again, god, at this point it almost feels worth getting her on board with another art line just for the glucose checks (and of course it's always not a bad idea for someone maxed on norepinephrine, even if they've been like that for like the entire day and seem to be stable like that...) Marian is also starting to feel very fried again, though, and drawing a picture of what an art line is for feels hard, and also that requires Dr Harrison or at least a resident and she has no idea where any of them are. 

It's coming up to 6 pm. Marian is simultaneously incredibly ready for her shift to be over, and also feeling pretty aaaaaah about handing Samora to someone else who she doesn't know, but in any case there's still an hour to go. 

The resident comes back again five minutes later. "No OR for now, the radiologist said everything looks intact. There are inflammatory changes that look like peritonitis and there's a lot of free fluid accumulated, probably the same stuff coming out the drains. Dr Harrison wants to see if he can drain it with a paracentesis kit, if she's stable enough - is she?"