Oh no is that part not self-evident? Marian isn't sure how to convey in drawings that it's actually really common for very sick patients to get disoriented and pull out tubes even when they knew better and didn't really mean to, but she has even less idea how to convey "it's kind of hospital policy that I'm not supposed to go to the bathroom if you're not restrained" and also, honestly, expects this guy to be unsympathetic to that and kind of have a point. 

(She really wishes she knew his naaaame, it's super awkward not knowing how to address him except for "Hey" and only calling him "the patient" in her head, but while she could introduce herself fine, she can't think how to get his name when he can't talk and they don't share an alphabet– ...actually, wait, did she successfully introduce herself? She's definitely said her name to him a few times but, like, maybe not since she realized he didn't speak the language and wouldn't be able to pick it out from all the other words she was saying? She should maybe re-introduce herself more simply, but like, after this.) 

...She draws a stick figure on the bed with a head big enough that she can detail features and show that its eyes closed, and then an arrow to one with eyes open but with the irises sort of half rolled back, and stars around the head - does that convey "waking up kind of dazed"? Just in case it doesn't, she points at it and tries to act out someone waking up looking very bleary and groggy. 

She draws the bleary and groggy figure's hand reaching for the breathing tube, and a frowny face on it. Then she'll (more quickly) draw two other versions, one where the figure tries to reach but can't because of a restraint, and one where the Marian-figure is instead going over to talk to him? 

That part is so incredibly not self-evident!!  Karal's experiences with people being tied up all point in an entirely different direction, and he gives her such a boggled frown once he gets it.  Really it... makes sense of several things... but it's also such a bizarre thing to do to a confused person and expect them to react well!

He... feels too shaky to do useful drawing at the moment, honestly (and at least he now recognizes that as probably another backlash problem), but this part he can act out, it's simpler that way anyway.  He points at the paper and shakes his head first.

His free hand far away from the restraints.  Asleep Karal with his eyes closed... Confused sleepy Karal looking around uncertainly, moving around a little, not pulling at any tubes.  (He is telling the truth that he's not inclined to violently interfere with incomprehensible things when confused.  It's... apparently much less true about Leareth... but putting them in restraints is not going to do anything about Leareth's panicked reflexes.  ...Karal should maybe do something about Leareth's ability to act on his panicked reflexes, but they would both hate that so much, and he's not sure it would even work.)

His free hand laid over the restraints.  Asleep Karal, confused sleepy Karal trying to move around, confused sleepy Karal noticing he's tied up, scared upset Karal pulling hard at the restraints and then violently waving his arm around (briefly, and well away from her), an Empathy-push of danger-fear-hostility, a calmer and less confused Karal still looking afraid and suspicious and scanning the room for danger.  (All of this is less acting and more remembering how he felt a moment ago, and comes through very clearly even just in gestures.)  He's not inevitably going to be that bad about it - he's not incapable of waking up as a confused prisoner and not immediately trying to do something about it - but it's likely enough to count as true under the circumstances. 

He goes back to calm (or at least as calm as he can manage under the circumstances) and looks at her intently.  She doesn't seem to understand that tying someone up is an obviously hostile action, which... he has no idea what it implies about this world because he can't understand how it could possibly be the case... but he tried to convey it as clearly as he could, because nothing about them will make sense to her if she expects people not to worry about being trapped by their enemies.

Marian is so appreciative of how good her patient is at acting things out in an evocative way! He's conveying quite clearly that he - has PTSD about being restrained, or something? And will react especially badly about it when he’s confused? Which does match with how she saw him react just now. 

...She doesn't love the idea of not restraining him. She's pretty worried about his respiratory status, and it seems like it might go...pretty badly...to be trying to sedate and reintubate him if he's confused and freaking out because he can't breathe. Buuuuuut it definitely seems like putting restraints on him might actually increase the risk that he ends up going after the tubes if he wakes up disoriented and she isn't there, not to mention the risk that he makes his injuries worse in the process of trying to wriggle out of the restraints in the first place. 

Mrrrrg. Whatever, she just won't pee today.

She nods seriously. Points at the drawing of him unrestrained with her nearby and smiles reassuringly, then - in case that doesn't convey it - she's going to untie his other hand and take the restraints entirely off the bed and fold them up on the counter. 

(Maybe-fortunately, Leareth thinks that his initial reflexes don't actually include moving their body? When waking up in unfamiliar and presumed-hostile surroundings, his immediate response is going to either be Gating out or trying to scan the area with mage-sight and neutralize any threats, and in the meantime he thinks he's inclined to hold still so as not to give away that he's conscious? And the compulsion against voluntary actions seems likely to kick in before that changes. He's not at all happy about this, obviously, but it - does maybe make their current situation safer?) 

He goes very deliberately still when she leans close again - he thinks he knows what she means, but he's still feeling on edge and thinking is hard and he's going to let her do whatever she wants and not make her feel threatened, even if he hates it.

She can see his whole body relax when she takes the restraints away.  It's not that he didn't trust her about the intention behind them, but... trust is one thing and fear is another.  He puts his hand over his heart with a grateful expression, and then over the unpleasant tube in an exaggeratedly calm definitely-keeping-it-here gesture.

... And now that there's nothing he urgently needs to focus all of his mind on, he notices how awful he feels.  Dizzy and shaky and vaguely nauseous, and the headache is getting worse again (and the way he suddenly relaxed probably did not do good things to his blood pressure).  His attempt at a smile ends up much more confusedly unhappy than he intended.  Probably he should just... sleep more...?

(And really hope Leareth doesn't wake up scared again.  It's true that he doesn't try to move, but trying to Gate is... not exactly a good thing either... and Karal could maybe prevent that by preemptively holding on to the mage-gift, but - especially after all of his own distress about the restraints - the idea of depriving Leareth of the last thing even theoretically under his control makes him feel sick.)

Marian doesn't miss the part where he holds still in a tense-seeming way when she approaches. Oh nooooo he's scared of her, she hates that.

(Also, what the hell happened to this guy? He really does seem - well, incredibly traumatized about something. Unfortunately, conveying that she wants him to draw the answer to "what do you have PTSD about" seems even harder than asking him to draw how he ended up in Walmart with with burns, broken ribs, a stab wound, and a bloody knife in his hand that might or might not be related to said stab wound she genuinely has no idea at this point. - probably not urgent to find out, though it does feel important to make sense of what the fuck.) 

...She watches him fall asleep almost instantly again, and then hovers - not near any equipment she could possibly knock over - and frets about him.

He looks - actually pretty terrible? She thought it was probably just the being upright when he's clearly not ready for that, plus breathing ineffectively while he was panicking - and the breathing part does seem better, he's still at 97% - but his heart rate is higher than before, and his color is worse. And when he was awake and trying to communicate, he’d seemed - not exactly more out of it, but - less capable? He was definitely having more trouble using his hands than he did previously. 

Is he bleeding internally again? It wouldn’t be shocking if all the exertion tore something. There's more in his drains and chest tube, but - it looks like the recent stuff is more blood-tinged serous fluid than frank blood, and just the effects of gravity would explain that too. Also his blood pressure is actually fine - well, fine on two pressors, but not worse than his previous baseline... 

She should maybe get an order to re-check his blood counts - or, you know what, put in a verbal order without asking, Dr Hulka is the kind of impatient where she hates being asked for routine orders like that but importantly not someone who will get mad at you for putting them in under her name without asking. 

- oh, right, she hasn't actually rechecked whether the last set of labs is back. Maybe his potassium is still low and that's making him feel off, though it doesn't exactly match the expected symptoms–

...or maybe his weird hypoglycemia problem is back. (She's mostly reminded because those problems happened at the same time in the report she got, they don't seem related.) Actually that would kind of fit? Pallor, tachycardia, weakness and shakiness... 

She'll go get a glucometer and check his blood sugar. 

52 mg/dL. 

Okay wow yeah that's not great! Marian isn't sure why it's abruptly so low - his last sugar was marginal and he did exert himself a bunch just now but still - but, you know, it does explain a lot of why he looks like crap right now. 

He still looks pretty asleep, great, she'll run out of the room again - this is still a bit nails-on-a-chalkboard for her brain, when he's neither sedated nor restrained and she hasn't specifically detailed someone to watch him, but it's literally thirty seconds and she's pretty sure that even if he does wake up he'll be fairly chill as long as he's not restrained - anyway she can bring back a few boxes of D50 and give him one. 

It only occurs to her afterward that she isn't sure if she even has a standing order for treating low blood sugars, given that the patient isn't diagnosed as diabetic and just had a weird one-off blood sugar problem in the OR? - and indeed she doesn't have such an order, but whatever, she's going to stand here and see if he seems to look better immediately once she's given him some dextrose.

Maybe! His vital signs don't change enormously much, but his heart rate drops a little - though maybe it would have done that anyway? - and his color might be better. 

His last set of labs are in fact back. As of - well, like an hour or more ago - his hemoglobin is stable, his white count is mildly elevated but not more than you would expect from the initial inflammatory response to an injury, and his phosphate and potassium are back in normal range.

Marian isn't super sure if it's worth unilaterally rechecking hematology? Probably not just yet?

...Honestly he might just need more fluids, he doesn't have an order for maintenance fluids apart from what he's getting incidentally with his pressors, and his urine output is okay-but-not-great - he got a lot of fluids and blood products in the OR but that sort of thing is so hard to judge, he might still be dry... 

She's going to strategically plan her moment for exiting the room when she sees one of the residents actually within eyeshot and can go ask him about giving her patient another 1L saline bolus, nothing is looking terrible it just seems like maybe he'd benefit from it? 

Yeah, seems good, she should do that. 

Great, she'll do that and then hover nearby - she can bring in a chair so she can sit at her computer-on-wheels and hover, she feels less bad not being available to help anyone else given how hard it was earlier to get help with repositioning him - and wait for him to wake up. 

Karal wakes up slowly - mostly he notices that he's still feeling shaky and just... generally awful... he'd like to sleep more but something about the awfulness woke him up and he's not sure he can fall asleep again... He keeps his eyes closed just in case he's wrong about that.

Leareth wakes up and -

- unfamiliar surroundings, pain, he’s probably in danger -

- instinctively attempts to Gate out.

What, no, they are not in danger--

Karal grabs at the mage-gift and wrests it away from Leareth, roughly and without pausing to worry about the obvious awfulness of what he's doing, because he knows how fast Leareth is at Gates and Karal is not putting any of them through all of that again--  (he's not quite awake enough to remember what exactly it is that doesn't want to do again, just that he doesn't want it)

Stop, we're all right--

He opens his eyes, but doesn't really focus on anything in more detail than to register the room still looking as familiarly incomprehensible as before, and still having the kind young woman in it.  The look on his face is one of sudden exertion, for all that he's not moving at all.

AAAAAH— 

- nothing is actually any worse than before but he still hates being here - 

He doesn’t look like he’s going after specific tubes? He just looks - briefly startled - which is exactly what he warned her about…

Marian is going to - go stand nearby with her hand near his, in case he needs anything…?

Karal looks at her, but shakes his head a little and ignores her for a moment (and definitely doesn't go after any tubes, or move much at all) while he tries to convey to Leareth that he's sorry about doing that but - he thinks the other option would be even worse - (he remembers more of how it went now, although it's still not exactly a clear memory) - does Leareth know where they are now - does he disagree, once he can calm down and think, assuming that happens--

Leareth can calm down and think, though it takes more than just a few seconds. 

He doesn’t disagree that Karal made the right choice, to - suppress Leareth’s access to his mage-gift or whatever it is that he did. He’s grateful, even.

(This doesn’t especially reduce how distressed he feels about - about, well, all of the everything.)

Of course it doesn't.  It's as if the young woman had decided to just keep Karal tied up, and kindly and truthfully explained why - it might be right but it wouldn't make it any less awful, and he hates that he's doing something even worse.  (And that Leareth is grateful even through all that misery. Gods...)

But it does seem that things will likely get better, and Karal is the one of them overall more suited to these circumstances, he suspects.  So if Leareth can... manage to trust him that he will do his best to make things better for both of them... that might be easier?

... Not that Leareth has any choice, he realizes, even if Karal wanted to give it to him.  So perhaps it's a stupid and unkind question to ask.

Leareth agrees that it would be convenient if he could manage to implicitly trust Karal! (And therefore not try to reflexively Gate out if Karal thinks he shouldn’t.) Karal is absolutely better at handling these circumstances, he's already noted that.

He just - doesn't think that, at this moment in time, he has the ability to deliberately decide to trust Karal, even if it's worth it in expectation? 

Of course he doesn't, that is really not how trust works!  Well, maybe it is for Leareth.  Leareth is a very strange person.  But Karal doesn't think almost anyone can just decide to trust someone because it would be convenient and probably work better than the alternative.

He'd... like to be someone Leareth would feel safe enough with not to have that escape reflex.  (He'd like it rather a lot, it turns out, now that the idea occurred to him.  His feelings about it are definitely not Leareth's problem, and he makes half an instinctive mental motion toward figuring out how to hide them - if Leareth can hide from him, it should work the other way too, shouldn't it? - before realizing he would rather not have the ability.  If Leareth knows he can see all of Karal's thoughts, he can trust him at least that far.)

He does appreciate his confidence, still.  (Leareth is clearly extremely good at many things, so it means something, when he says it.)  And should... probably go back to handling the circumstances, and stop ignoring the poor Healer, who's clearly worried about him again.

Who he really can't - well, shouldn't, he thinks - explain any of this to.  (Unless Leareth would prefer to be explained?  Karal suspects not.)  He gives her a rueful smile and makes a vaguely confusion-indicating gesture at his head, touches the throat tube with his fingertips in an attempt to confirm that he knows it's supposed to be there, and waits to see if she has any ideas for what should happen next.  He does not really feel up to asking more non-urgent drawing questions, although it's not as if he doesn't have them.

...Leareth is pretty deeply confused about the entire thread of thought around Karal - wanting it to be the case that Leareth trusts him - but that seems not important to resolve right now in any case. He's working on getting himself the rest of the way to actually calmed down, which is difficult given how half of his usual thought-patterns apparently DON'T WORK when he can't use mage-sight or any of half a dozen other orienting reflexes he seems to have, but he'll get there eventually. 

- and, no, he would prefer that the Healer not know about him. Not like it's likely to make any difference - and also it seems pretty hard to explain in pictures - but still.

Her patient seems okay now? 

- oh, also, Marian still hasn't re-introduced herself, has she. This feels very awkward, especially given that maybe he did get her name the first time or several times and it's reductant, but... 

She smiles at him and then points at her own chest. "Marian." 

Oh!  He smiles at her, and certainly looks like this is new and valuable information to him.

Points at himself and makes a rueful gesture at the tube.