...Yeah. Exactly. This whole not-sharing-a-language this is really frustrating, and it's got to be worse for him than it is for her. 

(He really shouldn't be turning over in bed unsupervised even if he can do it unassisted strength-wise, he's attached to a lot of things. Marian should probably try to convey that to him at some point.) 

She does feel like it might reassure him to know that they're following up on the problem that caused his scary heart problem? If she can figure out how to draw it...

Okay. Maybe she can do a simplified slightly metaphorical explanation like she would for a kid? He's obviously not a kid, and it feels weird, but - probably better for him to understand something of what they're doing, and it - does feel like he's somehow missing a lot of the things that adults normally know. (Like clocks? She's still confused by that. She really would have thought that even very poor countries have analog clocks.)  

She marks a line at - okay, actually she's due for repeat labs basically now, but she should finish this explanation first, and anyway it doesn't feel urgent he's clearly doing better on potassium levels - she'll draw a line at juuust slightly past the 'now' mark and then three times during the night. She draws arrows from those marks to a spot at the top of the page, where she draws a lab tube full of blood, and then circles a spot on it and draws an arrow to a zoomed-in circle, with, uh, a picture of an eye on it? And beside that another sketch of a heart (and makes the heartbeat gesture again for clarity when she's done, though hopefully he'll start to recognize her hasty anatomical-heart sketches?) 

- and since he doesn't necessarily know what a lab tube is, and also she's actually due to draw labs now anyway, she points at that part of the drawing and then goes and gets a yellow tube for electrolytes, and does all the steps to draw blood from his art line, slowly and clearly where he can see what she's doing? 

His first guess about the tube-of-liquid is that he's supposed to drink it (or, well, get it poured down the future second tube, he supposes).  There are... eyes it in??... No, that can't be right...  Luckily Empathy lets him tell that she's not done with the explanation, so he waits patiently instead of making faces about his obviously ridiculous guesses.

Oh!  She's putting his blood in a tube (luckily he's not one of the people who are at all bothered by this process - he's seen plenty of his own blood, and he peers curiously at her doing it), and then... looking at it close up?  He can't say he's ever gotten anywhere that way, but presumably she means closer up than that.  He still doesn't know what that tells her, but it's easy to believe it tells her something useful.  He nods, although doesn't look like he entirely gets it.

Leareth thinks that appropriately trained Healing-Sight could get something useful off blood even once it was outside of a patient’s body. …It would admittedly be easier to just look at the patient directly with their blood still in their body, but - these people are clearly doing something that isn’t using Healing-Gift.

….He thinks Marian means that the problem with their heart was caused by something in their blood, and she can look at his blood close up to - see things related to that? 

It feels like this should be enough information to let him guess at what the problem could have been, but even if he did at some point know that much Healing lore, he doesn’t remember it now.

…Marian needs to actually go send this blood to the lab now! Or maybe she’ll flag down her podmate instead, since she doesn’t incredibly feel like leaving her patient alone even if he seems stable and oriented right now.

Also she’s sort of run out of ideas for what she can definitely say about the next day in picture form. 

(...Does Leareth just know everything about everything?  He doesn't give the impression of personally having been a Healer, and he really is like that about basically every subject...  Karal wonders if he'd know this much after however many lives, but he suspects not.)

It makes sense that Marian can't tell him much more about what will happen, because people need to come here and talk about him and presumably make those decisions - he points to that part of the drawing and then vaguely sweeps his finger over the rest of it with a nod, in an attempt to indicate he gets that. 

He does, in the meantime, have a question.  He remembers her being briefly upset with him earlier, when she came back and he nearly died - he knows she didn't really mean it, but he's also sure he did do something wrong, and it would be good to know what, so he can maybe avoid doing it again, or just understand more about how to think about things here.  Now how to draw that...

He points to where she drew many figures coming into the room at that point on their timeline, and draws it again larger, with most of the figures faint and one of them clearer - he points to it being Marian, and gives it an unhappy face with an angry frown.  ...He looks reassuring and unworried himself, he is not trying to make her feel guilty (and he bets she will anyway), but he makes a questioning gesture and projects calm-curiosity-for-practical-reasons.

Marian is pretty confused about what the question is! Is he asking why she was upset when he was almost dying on her?? Obviously she was upset and stressed about that! 

(She would - kind of have preferred he not notice? It feels like if she had been succeeding at professionalism then she wouldn't have been memorably upset at him? Also most patients in the middle of doing scary runs of V-tach are not, like, paying enough attention to their surroundings to notice if she's stressed?) 

Her patient also seems like he's trying to be - deliberately calm about it, like it's a fraught question he wants to navigate carefully? Marian still doesn't get it, though.

Oh no, she doesn't know what he means and he made her uncomfortable.  She doesn't... like when he can tell what she feels?... Oh no.  That is in retrospect entirely reasonable, but if he stops doing it he will lose half his ability to understand anything around him!  He... thinks he knows her well enough to tell that she wouldn't want him to.  He hopes he'll have the opportunity to explain and apologize, but he's not sure of even that, given Leareth's more important priorities that probably don't involve staying in this world and having normal human conversations with people.

(Karal thinks wistfully that he might like to stay in this world and learn the language and have a normal useful human life.  Not that this matters much.)

... Back to the actual topic he was trying to communicate - which he is half regretting embarking on right now, but he doesn't want to leave her confused - and it does seem important to be able to make the distinction between "an upsetting thing happened" and "you did something wrong", for the future.  Probably he should draw more little pictures.  (They make his hand ache.)

A Karal sitting up in bed (he points to the same drawing in the timeline to clarify that he means that time he sat up, not the idea in general, which she sounded like he was going to be allowed to do at some point).  Next to it a sad face and an angry face.  (He makes the appropriate expressions in case his little face drawings aren't obvious, which they probably aren't.)

A Karal lying in bed with an ineptly drawn heart-wrongness symbol over him.  A sad face but no angry face (after a moment he draws one and crosses it out, to make it clearer that this is the important part), because he isn't doing anything wrong (he thinks).

A Karal lying in bed with the mask over his face instead of a tube, and he mimes breathing really hard and points to that spot in the timeline.  A sad face and a happy face, because she thought he was doing well.

He's not sure if he's ever done something that deserved an angry face but not a sad face, or if Marian even... has that as a mental category for her patients... Probably she does but he's not going to start drawing any guesses at the sort of thing he'd have to do to get there.

Does this look like it's making any sense to her so far?

Why is her patient polling her on how she felt about everything that’s gone on with him today??

- ohhhh does he want to know if she was mad at him about getting himself out of the restraint and sitting up? And - right, the original question was about the emergency earlier, and - whether she was mad as well as stressed and worried about him?

God, was she? That’s - this guy is incredibly perceptive, if he thinks she was angry then maybe she was in the moment and just retconned her memory of it to be less horribly immature! (Or, well, she mostly wasn’t - registering - much about what emotions she was having, given how there were clearly other priorities, but apparently it bothered her patient!)

…Though his affect about it doesn’t really match with “he’s upset that she was angry”, and he seems like he has an actual question…

Oh. Maybe it’s not really about her feelings and he just - wants to know what he should do differently if he has another emergency while alone in the room? Which Marian mostly wants to avoid being an issue by not leaving him alone but that may not be tenable, especially not overnight. So he should know how to use a call bell, and - conveying that there are alarms that will go off if something is wrong also seems relevant?

The call bell cord is wrapped around itself and tucked into one of the wire stuffbaskets on the column behind the bed. Marian unfurls it and loops it around the bed rail with a couple of feet of it trailing, so it’s within easy reach. 

She - honestly could just demonstrate by pressing it and showing how someone comes to the room, actually? Her bag of norepinephrine is running low again and she’s run out of the stash of supplies to mix new bags of it without leaving the room, so she can incidentally ask whoever answers it to bring her more.

She picks the button up, holds it where he can see it, and presses it firmly, trying to obviously telegraph what she's doing. 

A light goes on on the call bell itself, there's an audible slow beeping, and the call bell light flashes on the column behind Karal's head, though this may not be super visible to him. 

Kasey comes over about thirty seconds later. "What - oh, you're here. Marian?" 

"- Sorry, yeah, I'm just demoing the call bell for this guy so he knows how to use it - he doesn't speak English. Though I do need more norepi, when you have a minute? I think I'll run out in half an hour." 

Does her patient seem to have followed that pressing the call bell will summon someone to the room? 

Oh!!  He looks so happy and relieved that she figured out what he actually wanted, which was several steps removed from what he was drawing because he hadn't really known what the problem was let alone the intended solution, without requiring him to draw all the rest of his complicated question.  He nods when she figures out that he wants to know what he did wrong rather than just worrying about her being briefly angry, and then again when she shows him the button.  He's not sure what the button will do except that it'll solve his most likely problem in some way, and calling a person does seem the most straightforward option, so he's already half-watching the door when someone comes in.  He smiles at the new person, points at the button and then the door, nods.

That makes it easy enough to work backward through the rest of his original question: he should have used the button instead of shouting for help, which means he shouldn't have pulled the tube out, since she told him not to, and that's what she was very understandably upset with him about. 

Except that he... didn't know about the button... Maybe she did show him and he was too out of it to remember?  Or maybe there are more solutions than that.  These people seem the sort to have solutions for everything.  He'll wait and see if Marian goes on to any more explanations.

(That's on Marian, she really should have explained the call bell sooner, she's just - not in the habit of ICU patients being with it enough to use one even when there isn't a language barrier making it more effortful to explain. Also, in fairness, it feels like even an hour or two earlier the call bell wouldn't have helped with the problem she was worried about, which was him waking up disoriented and startled and forgetting he was supposed to leave the uncomfortable tubes alone, rather than being alert enough to know he had an urgent problem.) 

It would also be pretty reasonable of him to be worried that he might not be able to press the button if he has a serious enough problem, or if it happens in his sleep. So: alarms! 

She draws a sketch of him in bed, with some lines trailing from him and up to a square with an ECG tracing on it to represent the monitor; to make it clearer, she points at the lines and then taps one of his monitor leads, and then points at his chest and slides her finger along the ECG drawing while making what she hopes is clearly a normal-heartbeat gesture. She adds a square outline for the room and then draws another square across the page to be the nursing station, and a rough grid for the bank of monitors, and fills in one of them with the same ECG tracing and adds an arrow connecting the one in the room to the one outside. 

Then she moves over to the remaining empty space on the page and adds a drawing of him in bed with his eyes wide and mouth open in alarm and a hand clutching his chest - hopefully that's clear enough? - and this time the monitor square gets an ugly spiky line and rays around it to indicate flashing light, and she points at it - and at the drawing of the nursing station monitor bank - and imitates the rapid high-pitched beeping for a critical alarm. She adds a stick figure in the nursing station box and an arrow pointing from there to the room-box, and uses her fingers to mime running in. 

Oh, the wiggly lines are... counting his heartbeats somehow...??  He has no idea how (he wonders if Leareth is going to be able to make sense of it), but Marian is very clear about that being what's going on.  (She's so good at explaining things! He smiles, and projects admiration and gratitude.) 

And that means they can just tell whether he's dying without him needing to do anything at all about it, and someone was watching for that even if they weren't there, and he should've just waited for them to notice.

(... For all he knows there were alarms beeping and he just wasn't paying attention - he hasn't been paying attention to almost any of the confusing artifacts in here, there are so many that he feels like it'd only make him dizzy to try.  Probably they weren't really expecting him to pay attention to all the complicated things and they were just... also not expecting him to do anything about his confusion... which is not unreasonable of them, it's just that if he was not inclined or able to do things while panicked and confused he'd be dead already, and Leareth is even more like that.  Most people are much less like that, and probably most people in this world are also much less confused in the first place.)

He nods, and gestures for the paper so he can make extra sure they're talking about the same thing.

He draws a panicked Karal like she did, and points to that point on the timeline.  Draws an arrow from that to a flopped over unconscious or dead Karal all alone in his room, and from that to another identical scene to show that he didn't think anything would change quickly.  Another arrow from the first panicked one to one that pulled his tube out and is shouting for help (there are lines coming out of his mouth), and from that to people coming in.

He looks up at her, points to one and then the other option a few times, crosses out the alone-dead-Karal one - this is what he thought he was doing, and it made sense to him at the time.

Then he pauses, looks at her again, shakes his head, and draws a third option where the Karal doesn't do anything but there's a spiky line on a monitor outside the room and then people are coming in.  He points between the three options, circles that one, crosses out the shouting-for-help one.  Looks at her for confirmation, but he's fairly sure he got it right.

Yeah! Marian had been pretty sure that he extubated himself because he was scared and thought he was dying (and that he would have followed her instructions to leave the tube alone otherwise), but it’s good to have confirmation that it was - actually a deliberate attempt on his part to solve a problem? (Not that she thinks he was able to get out a particularly audible shout for help when he was struggling that much to breathe - if he managed any sound at all, it wasn't one she could hear over the multiple screaming alarms - but it makes sense that he felt like it was his only option.)

She nods and pats his arm reassuringly. It's okay, she's not mad at him for realizing he needed help and trying to problem-solve - he scared her, it meant he was suddenly having a respiratory emergency as well as a cardiac emergency - but they handled it and he's okay(ish) now and if anything else does go that badly wrong overnight, now he knows that someone will be there quickly. 

(They have some sort of artificial Healing-Sight that works from a distance? That's - incredibly useful - Leareth has no particular hypothesis for how it could work but he's very impressed that it apparently does! And it's also very reassuring, both directly but also because of what it implies about their capabilities in general.) 

As usual, Karal somehow manages to look like he both understands all of Marian's emotional reactions and agrees with them.  He smiles at her and projects (rather complicatedly, but it really is a single emotion in his mind) the feeling of safety because of understanding what he's supposed to do and why.  He can do very hard and confusing things if he's just confident that he knows what the right things to do are.

And now he should really lie still for a while and let his hand rest...  But he's not tired enough to sleep again, he only just woke up.  He spends a while relaxing and reminding himself about the button and the alarms, then experiments with reaching for the button (without pressing it) to be sure he can do it if he suddenly needs to.  He does have more questions for Marian, but they're all about the further future or the larger scale, and he gets the feeling that at least for the rest of today they should focus on orienting to their immediate situation and recovering.

Leareth agrees that this seems reasonable.

In the slightly longer run he thinks it would be a good idea to try to learn some of the language - which will be more relevant once they can talk, but even in the meantime, recognizing a few basic words might make it easier when they're being cared for later by other Healers who aren't Marian and might be less inclined to put what's clearly a huge amount of time and effort into communicating their intentions. He's not sure how far they could get tonight, it might not be worth trying, but it seems plausible they'll have the tube for multiple days, given that there’s no indication these people are using any actual Healing-Gift to speed up recovery.

In the longer longer run, he wants to know more about this place’s gods. They're probably in another world where the gods have no reason to dislike him specifically, but it's still - a pretty key part of the landscape they'll be operating in. They must be very different from Velgarth's gods. That doesn't obviously mean that They're entirely friendly. 

...Also he and Karal still need to have. A conversation. Leareth isn't sure if tonight is a good time but he feels substantially closer to capable of it. 

(He's getting more used to picking his way around the mental traps-spells of the compulsion, avoiding the parts where it sloppily impinges on his thinking as well as his actions. It’s slower and more effortful than thinking usually is for him, and it’s going to be difficult to have to unlearn those habits later, but - again, it’s obviously what he needs to do now, and there’s no point in finding it frustrating.)

Learning the language without the ability to speak sounds immensely frustrating, and hopefully later tonight or tomorrow they can at least get an estimate for when the tube can come out, but Leareth is right that they could ask Marian for some basic words that other less drawing-inclined people might want to use.  She'd probably know better than them what those would be, although Karal isn't immediately sure how to prompt a list.  ...Probably she'll guess right if he just draws talking, she's really good at figuring out what it would make sense for him to be asking for.

What... sorts of things... does Leareth want to know about the gods?  Karal is still deeply confused by how one could possibly end up an enemy of the gods in full generality, and doesn't have any idea how one would tell whether the local gods felt the same way.  Possibly the ominous conversation will explain some of this?  (He's a little apprehensive about the ominous conversation, but if Leareth needs to have it then they obviously should.  They should wait until everyone comes here to talk about them and Marian goes to sleep, and then they can decide if it looks like a good time.)  In any case this doesn't seem like a good place to learn about the gods from, since it doesn't allow them and Marian was uncomfortable with the topic, so Karal suspects it'll need to wait until they're either out of here or capable of reading or at least having normal conversations, but once any of that happens he's happy to go looking for the information.  (... Leareth should be warned that Karal might end up liking some of the local gods, and it sounds like that might be awkward, but he's fairly sure they have bigger problems than that.)

Karal's main problem is... he doesn't even know how to word it in his own thoughts... something about magic here is off and he doesn't know what to do about it so he's been defaulting to nothing?  They carry mage-artifacts in their pockets, not to mention all of the strange healing devices, but they don't act like people who know much about it, and he's finding himself oddly reluctant to just ask them outright.  He thinks... because of how Marian reacted to his first drawing with various, admittedly ineptly scribbled, magic use - there was no comprehension there at all, so now he instinctively expects trying to talk about it to end up too confusing to be possible by drawings.  (His thoughts are even more vaguely apprehensive about having that conversation once they can talk.)

... If he could have mage-sight, maybe that would tell them something useful.  He's not sure if tonight is a good time for that either, but he expects mage-sight to be the sort of thing he could try learning without much risk of making things explode?

Something is strange about magic here. Maybe related to the thing where they have dozens of powerful artifacts for Healing but he has yet to see any sign of standard Healing-Gift being used. They could have very few mages but methods for crafting artifacts in large quantities, that un-Gifted people can use? Or even that might still be - assuming too much similarity to Velgarth - they might have a different set of Gifts entirely? 

Leareth is inclined to think the local gods don't have the qualities that resulted in him being opposed to Velgarth's gods, but - hmm, it'll be easier to get into that later once they're properly having the conversation. 

Trying to show Karal how to use mage-sight definitely seems valuable. They can try it later tonight if they both have the energy for it. 

(Leareth still seems to have less mental stamina than Karal in their current state, and is abruptly exhausted.) 

Karal is looking forward to trying magic!  It seems so much simpler and more productive than thinking about the hundred different things that might be going on here.  Not that it's a bad idea for Leareth to think about them, it's just that Karal finds that sort of abstract complicated thought much more tiring than most other things.  Though he can't complain, compared to poor Leareth who just finds everything tiring right now.  Whatever they decide to spend the evening doing, it should be something that can tolerate sudden interruptions due to exhaustion.

Hmm, they were already not very far from the point on the timeline when Marian will go away, and other things might happen in the meantime, so if he wants her to teach him words he should probably start soon.  If he draws her talking and then points to things, can she teach him words for... this building? breathing? the throat tube? a heart? sleep? restraints? the three future events marked on the timeline? himself?

It's not at all hard to guess what he wants! It's clearly a good idea and the only reason she didn't think of it already is that she's actually pretty surprised he has the energy and focus for learning English words, especially when he can't practice by repeating them. 

She will happily try to help, and gets as far as teaching him the words for 'hospital', 'breathing', 'ET tube', 'heart', 'reposition', 'suction', and 'sleep' before she's interrupted by rounds finally showing up (which does offer an opportunity to point at the crowd-of-people in the drawing, the crowd-of-people now outside the room, and teach him the word 'rounds'.) 

Leareth cannot do very many things but he can at least do the purely mental action of using mnemonics to try to ensure that they'll actually remember those words. 

Oh no Marian has spent, like, zero time preparing to present on her patient for rounds. About half the time on this unit the residents actually do that - and more likely if the patient was admitted that day - but usually the resident assigned to do that would, like, come in and see the patient and talk to Marian about them, and she doesn't recall that happening. 

Unsurprisingly, everyone is looking pretty tired and frazzled, except for Dr Hulka who looks exactly the same way she always does. The respiratory therapist and the dietician are having an unrelated conversation about some sort of romantic drama that Marian has no context on, and it seems like no one else except her is motivated to make rounds start Right Now. 

She clears her throat.

Dr Hulka sets down her phone, which she was responding to a message or something on. "Right, people, let's keep moving. Marian, mind giving us quick rundown?" 

Marian does not mind! 

"Right. Admitted as Eighty-Six, Orange, still no ID. Male, probably late thirties or early forties," this is to be clear an assessment Marian heard from the OR, she sucks at telling how old people look, "no info on medical history. He's the one with, uh, the really weird admit history - he doesn't speak English, by the way - I put in a narrative note about what he told me, but it's guessing a lot because he told me in drawings, anyway I'll skip that - what we know is he was found down in the Walmart with a stab wound to the chest - he did tell me in drawings that was self-inflicted - blunt force trauma and burns. He was in the OR this morning, admitted here around 9:30 am." 

Wow she really hates presenting at rounds when she hasn't prepared notes! Everyone is looking at her and, like, they're not staring at her like she has two heads and/or is making no sense, they're just politely listening, but STILL, it makes it HARD TO THINK. 

"Uh, neuro, he's - been awake since this morning, pretty alert, it's - sort of hard to assess orientation given the language barrier, he's able to communicate but he does maybe seem confused about some things," like PHONES. "He's not restrained because he has PTSD about it and he definitely gets combative if he's scared, but he's really cooperative otherwise.

"Respiratory, he's - I'm actually kind of worried about that? He's on 50% O2 and 14/10 vent settings and he starts desatting and filling up with fine crackles after more than an hour or two without suctioning, it's not terrible but it's worse than he was at admission? - he did, uh, self-extubate earlier today, but it was because he went into V-tach - I'll get to that - and thought he was dying and he didn't realize there were alarms - he toughed it out for ten minutes on 100% O2 but I'm still worried he's doing worse on that front than he was this morning."

Marian simultaneously feels like this is too much and too little detail, but Dr Hulka at least is listening attentively and doesn't look impatient. 

"Cardiovascular, he's on three pressors - maxed on norepi and phenyleprhine and I'm still weaning the epi - and, uh, yeah, he almost coded earlier this afternoon, which turned out to be from really mysterious hypokalemia, we're - still correcting it, I sent labs at four but I don't know if they're back -"