His heart rate is still at around 120 even with him asleep and mostly looking comfortable; his blood pressure has been veeeery slowly creeping up and is pretty good, 115/82, but he's still maxed on both pressors, Marian hasn't touched those yet.

He's on 35% oxygen on the ventilator and his O2 sat is...actually worse than it was when he arrived? Not enormously, 93-94% rather than 98-99%, but enough to be slightly suspicious. There's a moderate amount of bloody drainage both in the chest tube receptacle and in the surgical drains in his mediastinum.

His urine output is okay. Not amazing given that he's getting a lot of fluids, but acceptable. 

The last bag of IV potassium is running now (the phosphate can be run faster and finished ages ago), so Marian is probably due soon to check electrolytes and see if that's back to normal? 

Yeah she'd better do that; she's got orders to follow up on his hematology and blood gas too. And she'll check a blood sugar, she didn't have specific orders to follow up on the hypoglycemia - in the OR notes it looked like they had to give him a surprising amount of D50 to get it back up but once it was up it stayed there? - but it seems like a good idea. 

Blood sugar 74, on the lower end of normal but still, in fact, normal. His blood gas is fine except for a mildly elevated PaCO2; he’s breathing about the ventilator set rate but he might be taking shallower breaths than ideal, what with the broken ribs.

Everything else goes off to the lab and Marian will have to wait.

Marian can do that. 

Marian is not very good at sitting still. She ends up puttering seeing if her pod-neighbor needs anything that she can help with without taking her eyes off her guy for too long - she did loosely retie the restraint once he was definitely asleep, and he's probably not going to try to pull any tubes out anyway, but she's still paranoid - and then, out of things to do, going in to try to rearrange her patient's IV pumps more efficiently and get them all onto one pole. 

...Marian is perhaps not the most coordinated person in the world, and she's running a sleep deficit today. She manages to trip over the chest tube drainage box, attempts to catch herself, and instead manages to also knock the now-pumpless IV pole over into the sink. 

Leareth is deeply asleep, but enough of the sedation has cleared Karal’s system now that he’s fully capable of startling awake at an unexpected loud noise and attempting to panic-Gate out.

This fails on several levels! He’s reaching for reserves that aren’t there, and also he apparently doesn’t even have a destination firmly in mind, and when he wakes up enough to actually think about this problem, he’s quite abruptly no longer to take actions, and the half-formed Gate-spell collapses and backlashes on him, sending a searing pain through his - and Karal’s - head.

(There’s also a very brief glow that Marian would maybe have noticed if she were less distracted by trying to scramble up from the floor and catch the stupid IV pole before it falls the rest of the way over. The floor shakes, which is noticeable and briefly panic-inducing, did she just manage to knock something over hard enough to cause an earthquake -) 

The noise did startle Karal awake as well.  His instinct upon waking is only to be very still and figure out what's happening - but in this case what's happening is panic in his thoughts and then sudden sharp pain--

- he tries to lift his hands to defend himself against whatever this is, but he's tied down--

- he fights hard against the restraints, which turn out to be loose enough that he manages to pull one hand out.  Before Marian gets off the floor, he manages, somehow, to sit up on the bed - this is really not helping with the amount of pain he's in - and is throwing panicked looks around the room full of bizarre and suddenly threatening objects, his one free hand held defensively in front of himself. 

At least he hasn't pulled out any tubes, unless some didn't survive the sudden change of position.

Holycrapfuckohno— …okay it’s fine everything is FINE he hasn’t pulled anything out and Marian can set the IV pole back upright and then go in and gently but firmly hold his free hand just in case he changes his mind about going for the ET tube, she’s honestly really impressed that he didn’t. Wow this is utterly mortifying.

“Hey. It’s Marian. Shhhh.” He doesn’t understand English so there’s not much point in further verbal reassurance, but she’ll put a hand on his shoulder and try to gently ease him back down onto the bed. He must be in so much pain, wow, in addition to the broken ribs he just had open-heart surgery to fix the damage from a stab wound like four hours ago.

Leareth is - really not succeeding very well at calming down, actually, he’s trying but he’s not in control of their body and he’s trapped here in unfamiliar surroundings, he tried to Gate to safety and couldn’t, and it apparently doesn’t really matter that, now that he’s closer to awake, he’s remembering that this isn’t actually new information… 

It's good that he recognizes her, even confused as he is, because if anyone else got that close to him right now he would have hit them.  Between the noise and the pain, his first obvious assumption was that they were attacked - now that he doesn't see anyone who looks hostile, he's slowly starting to consider the option that one of the machines did something wrong, but he would like that question resolved before he lets anyone near him.

The young woman, who he does not want to hurt without clearer cause than this, is still not going to get to do anything resembling holding him down unless she decides to get in a fight with him about it.  (A fight he might well lose, under the circumstances, but he is not processing things well enough to think of that, and likely wouldn't change his mind even if he was.)   He shakes his head when she comes too close, moves to avoid her hand if she does try to grab him, and will do his best to push her away if she keeps trying.

(There is... something better he could be doing about all this... but Leareth's trapped panic makes it hard to think, and it's difficult to be reassuring about it when he's not even sure Leareth is wrong.)

Oh no poor guy!! Marian feels really extra bad about startling him by being a klutzy idiot!! 

Marian does actually think she could probably win a wrestling match with him, he's clearly strong and able to push through things hurting but he's not, like, "on way too much cocaine and PCP" levels of strong and impervious to pain, he was able to roll over in bed but had a hard time with it. She's pretty worried about hurting him, though, or about him getting even more panicked and hurting himself. She'll take a step back and give him space and try to look very nonscary, unless he goes for the endotracheal tube or seems to be having an urgent medical problem.  

His vital signs in fact aren't coping incredibly well with the very sudden transition to sitting up; his heart rate is abruptly over 150, which makes sense given how freaked out he clearly is, but his blood pressure - the arterial line is fortunately well secured - is also down to around 90/50. (The pulse ox probe is less well secured and has gotten lost somewhere in the bed.) 

...Okay, Marian is still not going to risk getting into a physical fight with the guy whose sternum was recently sawed open and then wired back together, buuuuut she is going to be very ready to dive in if he starts looking like he's going to collapse. 

He does feel fainter - yes, sitting up is not good for him, but her looking like she's just waiting for him to collapse is not maximally reassuring...

He wants to know what happened!  He makes an attempt at a noise, then an abortive half-movement toward the tube which he'd absolutely pull out so he could talk except he knows she couldn't understand him anyway - 

Questioning gesture??  With accompanying Empathy sensing, although that makes his headache even worse...

Oh, right, he probably didn't actually see her whole incredibly mortifying incident and might think there was an actual earthquake? Oh no. Marian makes an apologetic face, points out the IV pole, tries to mime out "it fell over and smashed into the counter", and looks even more apologetic and embarrassed. 

(Her emotions show no hint that she saw or is anticipating a threat or attack, she's mostly dying of embarrassment over here and feels terrible that she scared him.) 

(Leareth is still not really succeeding at tracking his surroundings or becoming less upset, but he is at least forming the thought that they have a backlash headache, if Karal is paying enough attention to notice that.)

The thing fell over and... hit him in the head?...  No, now that he's focused on trying to understand instead of on the possible threat he manages to connect Leareth's thoughts to his own and notice they don't match - a backlash headache?... oh, from the Gate, he did notice Leareth thinking about that, but...  He can't quite figure out everything that happened, he needs Leareth to help him with that, and first he needs Leareth to calm down...

It's all right, I think we're safe, nothing wrong is happening, it just hurts because I moved--  He should... lie down... everything will probably feel less awful when he's lying down, and then they can figure this out...  He nods at the explanation, starting to look apologetic too, and tries to get himself back down onto the bed without making anything worse.

(Marian would be SO MUCH MORE ALARMED if she had managed to hit her patient’s head by being an idiot; as it is she’s not particularly alarmed, just embarrassed and background-worried; possibly Karal isn’t calibrated on this, though.)

She spots Karal on the various tubes, and temporarily raises the head of the bed a bit so he doesn’t have as far to lean back, but will otherwise let him do it himself unless he indicates wanting more help than that.

Leareth is -

- miserable, trapped, not in control, possibly lost in another world where his people won’t know to look for him, unable to take any actions toward changing this, unable to use magic - in short, approximately everything about his situation and surroundings is practically designed for him to hate it…

…but after a few seconds he can mostly think around the distress. There was - something startled him, probably just a loud noise, and he woke up in unfamiliar surroundings and had the obvious reflex to Gate to safety. Which didn’t work, obviously, and now they have a reaction-headache. He thinks a mental note of apology at Karal.

He manages to get down by himself, if not very gracefully, and lies there, making a variety of thoughtful faces while he tries to work out what happened and in what order (and tries to will himself to relax enough to stop feeling so awful).

Leareth is... tempting him to make inadvisably binding decisions, not that he's sure that would even help much... he wants to help him be less trapped and miserable, but everything is so hard right now.  He sends gratitude for the explanation.  Yes, there was a loud noise, the Healer says something fell over.  And then Leareth panicked and tried to Gate out and gave them a backlash headache, and then Karal panicked and tried to get out of bed and made everything else hurt...  God, he feels like such an awful idiot.  He nearly hit the poor young woman over this!  No wonder she thought he needed to be kept tied up!

He looks deeply distressed.  Doesn't really know how to convey how sorry he is to someone from another world, but he'll clasp his hands and bow his head over them while making an apologetic face.  Then... place his freed hand back over the restraints, looking miserable about it.

Inadvisable binding decisions to do what– ...not the point right now. Leareth is mostly not engaging with their body but it - really does seem like they feel awful, was sitting up that much of a bad idea? Well, Karal did stab them, it shouldn’t actually be surprising that they’re in bad shape…

His blood pressure does go up basically as soon as he’s horizontal, that’s good. Marian finds and restores the pulse ox and - oh, that’s less good, his O2 sat is 86%. She whacks the button on the ventilator to give him two minutes of 100% oxygen, and tries to encouragingly mime taking slow deep breaths.

He's - pointing out that the restraint is still off and reminding her to put it back? Despite not looking at all like he wants it on, and - well, Marian isn't sure how much it helped, he didn't go for any tubes but he did do a lot of fighting the restraints themselves and possibly waking up with his arms tied down was part of what scared him? On the other hand, it would clearly be very bad if he did manage to extubate himself - she's mostly worried about that if she's not there to quickly reorient him. He didn't in fact try to pull anything out right away, but it's possible he would if he were left there panicking for longer. 

She gets the clipboard and paper and draws two pictures side by side of a stick figure in a bed, inside a box for the room. One of them has a Marian figure in the room, and the stick figure in bed has visibly free hands. The other one has an absence of anyone else in the room, and she draws restraints. 

She shows him the drawing and then points at herself, smiles at him reassuringly, and moves the restraint to the side. 

He did stab them, and - he thinks slowly and carefully sitting up wouldn't be that bad, but all his sudden panicked effort could have torn up some of the Healers' new work. It's not a new concept, that you can reopen wounds that way.

He obediently takes slow deep breaths, ignoring the familiar pain of broken ribs that he's been told before to ignore, and gradually feels less light-headed and out of it.  He smiles at her a little, without entirely losing the upset expression.

Then looks so confused at her drawing.  He wonders if she just... accidentally switched them around?  It's a common mistake to make.  If she lets him, he'll take the drawing, change which figure has free hands and which doesn't (he's not very good at drawing right now, but this doesn't require much skill or stamina), and look questioningly at her.  (This version would make a lot more sense and would, if he's to be honest, be a lot less upsetting. He trusts her not to do anything awful, but he really doesn't want to be left alone and helpless in this strange place.)

He…probably doesn’t know what the restraints are for? 

Marian shakes her head, then takes the paper back and flips it over. She draws another figure - less stick, this time, so she can actually draw where the art line and endotracheal tube and central line with trailing IVs are. She points at the ET tube and takes exaggerated breaths, which will hopefully convey “helps with breathing”, and the other tubes can both get a pumping gesture in front of her chest (the art line is for a lot of things but “about the heart” is the simplest gloss). 

…She draws a second figure instead holding the ET tube in one hand and a bunch of leaking IV tubing in the other with drips of blood from his neck. She puts frowny faces all around it. After a moment, she points at the drawing of the tube no longer in place, points at the figure, and tries to mine “painfully gasping for air”.

Does that seem to add any clarity?

He was going to get around to asking about all that at some point, but mysterious tubes really aren't his area of competence and he doesn't think he could've done anything useful with the answer.  Which indeed he can't, but it does feel better to know what they're all for. 

... He doesn't know if this is supposed to be related to the previous topic in some way, and if it is it isn't obvious to him how.  He points to the various tubes in him and nods (although with a residually unhappy expression about the one in his throat) - then points to the restraints and makes a questioning gesture again.