The shift change huddle isn't actually mostly about Karal! The charge nurse is just going to briefly go over the assignments and unit census. It's also when announcements would be made if there were any, but there aren't today. Marian does not seem very worried - maybe a little stressed in a way that feels more about logistics than about Karal's wellbeing specifically. (The unit is still particularly full and high acuity, and they're not short-staffed exactly but more patients are 1:1 than usual, which leaves other nurses with unusually heavy two-patient assignments. It's a good thing her patient can turn himself in bed if she's spotting him; she expects help with that will be hard to come by today.) 

- Also, the nursing station is halfway across the unit from Karal, which is further than he's tried to reach with Empathy since they were injured. It's within his range, and might be comfortably so if he were in better shape, but as it is there's more strain than he was noticing trying to reach people in the same room.

...Leareth notices, and reaches out with a gentle mental nudge. It might not be the best idea to push it too hard? 

Leareth is a very sensible man.  In that case Karal will lie there patiently, re-read his notes, and not do anything unreasonable until Marian comes back.  (Unless it takes long enough that he will instead fall asleep.)

He wants to poke at one of the mage(?)-lights until they can tell whether there's magic in it or not, but that really seems like something they should leave for a more predictably long stretch of time alone.

It's not going to take that long. Five minutes, maybe, before Marian comes over with Lisa to get a more detailed bedside report on how the night went, including pulling up the gnarly X-ray from the middle of the night. 

...Marian definitely winces at the X-ray and gives her patient a sympathetic look when Lisa describes how poorly he coped with being laid flat (it's fairly clear from Lisa's gesticulation what she's referring to). Her affect isn't actually particularly worried, though? If anything she seems maybe slightly relieved, in a "no longer waiting for the other shoe to drop" way. She had a suspicion something was more wrong with his breathing than they had been explicitly taking into account, and now they know what, and it's a problem that fits with the rest of what they did already know, and - obviously not a good sign, but it's treatable and something he should still recover fully from.

Also he's responding fairly well to the dobutamine and his other pressor needs are way down already, yay! They're still only getting around 100-150ml of net fluid loss per hour even with diuretics, and it's taking longer to get his oxygen needs back down, but he already seems to be feeling an improvement in his breathing. 

(She's not particularly stressing about the social work consult, though Lisa does mention it briefly in her report. It'll be annoying with the language barrier but they'll do their best.) 

And this conversation happens right here where he can pay attention properly without giving himself a backlash headache!  Great. 

He's very glad all of this makes sense to Marian and makes her feel like things are better rather than worse.  He'd really like it if she could make it make sense to him too, but even without that, it's very good to know that from the viewpoint of someone who understands what's happening he isn't just developing random new unpredictable problems.  (He still appreciates the sympathetic look about them.)

And she's... slightly unhappy but not upset about the outside person?  Something like that.  It makes sense - Karal wouldn't be happy about a conversation as confusing as this one will no doubt be, in her position.  (He wonders if she'd even like knowing the truth. It's not as if it's much less confusing, or likely to be less disturbing than whatever she guessed about him.)

They check all of his tubes and equipment together, and then - since it's 7 am - Lisa checks his blood sugar. 

72 mg/dL. 

Okay that's not actually below the normal cutoff but he's getting 10% dextrose at 50cc/h right now. WHERE IS HE PUTTING IT.

"- You're due to check lytes at 8," she reminds Marian. "I'd - be a bit tempted to run those early, I feel like the low sugars and the low K go together. His 4 am check was 4.1, fucking finally, so he should have a bit of wiggle room…”

…Yeah, Marian’s going to do that. And also listen to his lungs and offer suctioning while she’s here.

He cannot tell her where he's putting it, because she hasn't asked and he wouldn't understand the question, but if he could try it probably wouldn't come out very reassuring!

Lisa did suction him pretty recently, but if Marian thinks doing it again will help then Karal is the last person who would say no.  He would like to be as far from suffocating as he can possibly get!

Also he does wish he knew what that brief spike of confusion/worry was.  It didn't feel serious or, hmm, even new - is it the same confusing thing Lisa explained earlier?  He tries to remember what that one was about...

(He doesn't desperately need suctioning, probably, but she's here anyway, he's awake, and she can definitely hear some secretions rattling around in there. If she gets ahead of it now then maybe she can leave him to nap for longer later.) 

...There was the confusing explanation about the blood tubes and the graph of blood-related numbers going down a lot? Leareth wasn't paying attention, though, and isn't sure if the little burst of concern coincided with them having removed any blood to study it. 

Karal has gotten so used to them doing a lot of complicated mysterious things while he was too out of it to wonder about them that he's now only slowly getting back into the habit of consciously noticing everything of that sort, but when he thinks back on it, yes, it did!

He'll get suctioned, with his usual level of cooperation and strange lack of aversion to the obviously painful process, and then find the graph of things-in-tubes and point at it questioningly.

Marian blinks at the graph, trying to figure out what – oh, that's clever! ...She thinks it's of his potassium, not the blood sugar, given the frequency of the measurements, but - oh, he must have noticed her drawing a tube of blood from the art line? And wants to know whether she's worried about it? 

It feels like it should be feasible to convey the concepts of "checking blood sugar" and "treating low blood sugar by giving him IV sugar", that's, like, not super complicated? Marian is still slightly blanking on how to draw it. 

- she can show him the glucometer, though, and mime taking a tiny bit of blood from the art line to put on a strip, she's sure he's seen her do that before and just presumably wasn't that sure what she was doing it for. And she'll sketch a different graph and draw lots of spiky ups and downs - more frequent changes than the potassium levels, though she's not going to bother looking up the exact history - and put the graphs side by side. The spikes downward don't line up exactly, but - she'll gesture at the two graphs, point at one of the unexplained big dips in the potassium levels, and point at a spike downward in the blood sugar tracing. Wiggly hand gesture - they don't know if it's related but it feels like it could be? 

She points at one of the upward spikes and picks up one of the not-yet-used boxes of D50 from the counter (there's a bit of a stash), mimes putting it to the IV tubing - again, he's almost certainly seen her doing that before - and, uh, points at it and mimes eating and smacking her lips as though it's something delicious? 

Karal had been noticing a lot more about people and the basic practicalities of life than about confusing artifacts, because he finds it much easier to think about those.  He's probably seen her do that on some level and it just... sank into the undifferentiated murk of "people doing strange things he can do nothing about and has no hope of understanding" without him noticing.  He wasn't even particularly distressed by this - he's used not to understanding important areas of life, when he trusts other people to take care of them.  (Leareth was very distressed, but also too out of it to do much about this.)  But it seems like he really should try to do better.

So, this is another Healing-Sight artifact that tells her something about how his blood is doing, and it's doing... very variably, in a separate way from the previous thing Lisa showed him, but probably related?  (It's great how having the numbers drawn like this makes it easy to see when they match even just somewhat.)

And they have another thing to put in his blood to fix whatever this is.  Lisa already showed him the other one, that they can put in his blood or more unpleasantly in his stomach, so that makes sense.

... And the thing they're putting in his blood, that looks like water, is-- food??  Why are they putting that in his blood instead of his stomach??  Karal does not feel like having food in his blood is a good idea at all!!  Probably they know what they're doing, or he's confused about something, or both, but - it's just such a bizarre thought.  Does it make sense to Leareth??

…Well, the contents of food do eventually end up in your blood? It would be incredibly unsafe by any known method in Velgarth to try to put them directly there, but - clearly this place is more advanced, and it would actually solve a lot of problems? It's a recurring problem for Healers that Healing requires a great deal of the patient's own life-energy, which needs food to replenish, and sufficiently badly-off patients can't eat? 

It's presumably only some components of food, since it looks like water. Leareth is now trying to think of things-that-are-in-food that he knows dissolve in water and leave it looking unchanged. Maybe salt? It's confusing to him why how much salt they need would be so wildly variable, though...

Karal has no Healing knowledge and did not in fact know what sorts of things end up in blood!  But if Leareth says the important parts of food do, then Karal will take it as a given and skip over how it works and how one would get them in water in strange bags, in order to focus on the question Marian and Lisa keep being confused about.  They're giving him something-like-food and confused that he needs more of it than they expected--

... Oh.

He and Leareth have been doing exactly one thing that takes a lot of effort and that the Healers don't know about, haven't they.

Karal is not good at hiding his emotions, especially when he's starting from a mindset of not trying to do it at all.  From Marian's perspective he looks first briefly alarmed, then thoughtful, then figures out something important, and immediately realizes he's conflicted about telling her what it is.

- actually that makes perfect sense, including of some of the sudden drops - actively moving magic around, or projecting with Empathy, is a lot more draining than passively using Sight. (And, on brief consideration, it is known that sweetened tea is one of the best things to give a mage suffering from backlash if they're feeling too ill to eat, and sufficiently pure sugar would be clear in water.) If Leareth had been tracking things better, he might have noticed before this that it's odd how much stamina for magic they have despite having given themselves serious backlash barely a day ago. 

They - should probably minimize actively using magic, and maybe projecting with Empathy as well? Leareth isn't sure if they should additionally try to explain it; that seems like something Karal is better placed to think about, he has a much clearer intuitive understanding of how Marian might react. 

...Okay, what?

Marian thinks she successfully communicated something to her patient, though she's not entirely sure if it was what she intended to communicate, and now he's - had a realization about something related to his blood sugar drops? And he - possibly doesn't want to tell her - oh no did he take illegal drugs?? It would maybe explain him not wanting to call the cops about the ??gang kidnapping attempt?? and deciding to try to kill himself instead, if he were high on something at the time? 

Inconveniently it, uh, is actually important? It's possible the whole reason he went into heart failure bad enough to cause pulmonary edema is because they didn't catch his potassium dropping until after it started causing arrhythmias. 

...She's not sure how to convey in Pictionary form that no matter what he took, she won't be angry or want to hurt him. (And, like, he could still get in trouble even if Marian doesn't personally report it to the police, she would have to put it in his chart and stuff.) She - can reach out and squeeze his hand reassuringly, at least? 

Marian is very good, and also worried that he did... something... forbidden and harmful to his health?  For all he knows she's right, maybe people doing magic is just against the law here and they only allow artifacts, for some reason...  (Is this another country where having some Gifts will get you killed, why does that keep happening to him...)  Or what she just thought of is something completely different - he can't be sure, with just Empathy, but the flavor of her reaction feels to him like something is off about whatever she's thinking. 

Which is not a good state to leave things in.  He should tell her.  Either her guess is right and she already knows, and deserves to be reassured about the circumstances and his intentions (and can tell him if magic really is forbidden here and why, which would be very important to know - and he suspects she'll keep their secret, or at least is more likely to keep it than they are likely to deal with it well on their own).  Or her guess is wrong and who knows what unfortunate and misleading thing she's thinking about him, even if she clearly means to be kind about it.

He gives her an apologetic look and nods, but projects - patience, the feeling of wanting to have a long conversation once everything is calm and the urgent things are taken care of.  This isn't urgent, and the explanation may well involve explaining several other complicated issues, and if there are more Healing things that need to happen in the near future then she should do those first.

(He thinks to Leareth that he doesn't think they need to be that careful about active Gift use - Marian and Lisa were both pretty clear that they can give them enough of the things-like-food to keep up with whatever's happening, they were just confused about why it was necessary and couldn't always catch the need in time.)

... How much of this interaction did Lisa notice?  He'd rather not have to explain to more than one person, and... he likes Lisa, but he trusts Marian more, with something complicated and personal and not really about healing.

(Lisa hasn't actually left yet, but she was finished with her report and is now finishing up her charting at the computer-on-wheels in the corner. She's not really paying attention to Marian's interactions with Karal, and in any case their conversation isn't happening out loud.) 

Huh. Marian is really not sure what to make of that! She suspects that her knee-jerk theory was wrong, and it's - something weirder than that? 

...And also that he's decided he trusts her with it, whatever it is, which is - surprisingly touching? 

He's probably right that this is a conversation to have in private when they won't be interrupted for a while - if only because it would clearly stress him out, she didn't miss his worried half-glance in Lisa's direction.

She doesn't actually have a huge number of urgent tasks she definitely has to do first? Social work is apparently coming by this morning but, uh, Marian would all else being equal kind of prefer to know whatever it is her patient wants to convey first. Also it's still only a little past 7 am and it would be quite surprising to Marian if they showed up before 9. 

She should plausibly go check if one of the residents will be presenting on him at rounds today, and nudge them to come do an assessment and get it out of the way; that's the most likely form of interruption before 8 am. She should finish her own quick assessment and then do that. 

(Leareth doesn't even disagree with Karal's assessment! It seems clearly better to have local advice on navigating this. He thinks Karal is right that Marian wants to be on their side, and that in expectation they'll be more rather than less in control with her help. 

He...is still instinctively feeling kind of panicky about it and having trouble getting his mind to relax. Possibly it's just the accumulated stress of feeling out of control of the situation for so long.) 

It makes sense for Leareth to feel that way!  Well, it doesn't help, but it's not as if Karal can be sure the conversation will go well.  He thinks it will, and would feel safe enough about it on his own, but that's because Karal doesn't fundamentally mind losing - and Leareth does, and cannot tolerate a normal human level of risk, or he'd have been lost many times over, in his thousands of years of being opposed by the gods themselves.  It will take Karal a long time, to get used to that.

They do still have to wait while Marian and Lisa take care of their remaining tasks.  But they might finally be able to feel more in control, after that.

It's not as though it would be better for Karal to be stressed as well, even if his reasons for not being are very alien to Leareth.

Leareth...will maybe just try to drift for the next bit, though Karal should of course get his attention immediately if there's anything useful he can contribute.