Yeah it’s going to be unpleasant! Marian points at the suction tubing again and counts to five on her fingers and mimes pulling it away, which should hopefully convey that it won’t take long? Also she’s going to give him a couple of minutes of extra oxygen again, and wait for his sats to come up to 100%.

 …It is, in fact, going to be very uncomfortable, and of course coughing is excruciatingly painful with broken ribs.

Oh!  Right, that makes sense, why didn't he think of that-- probably because he's half dead-- he feels stupid for questioning the Healer about something this simple, but she doesn't look like she minds, and apparently he's supposed to question her more than he would normally be inclined to. 

In any case, he has no further questions, nods, and appreciates the oxygen.

Marian gives him a very apologetic look and then suctions him. (She does try to keep it to less than five seconds.) 

That does feel shockingly painful!  But not in a wrong way, much like the expected pain in his ribs, so he ignores both of them and coughs as deeply as he can.  (He hopes Leareth is either all right with this or managing to ignore it...)

Something else does feel wrong though - he's not sure if it's just that he couldn't breathe and now he feels awful and dizzy because of that, but after she lets him breathe for a moment that seems fine and the general awfulness is still there...  He calmly, because he doesn't want her to think he objects to any of this if it's supposed to be happening, makes a face, gestures... at all of himself, which he realizes is incredibly unhelpful, he needs to focus and figure out what specifically is bad...  He turns his head in a slow dizzy circle (which predictably makes that even worse), then thinks for a moment... Points at his chest, makes a fist over it and tightens it in an irregular rhythm, makes a confused face?  He's not sure that's exactly right, but his heart sure is doing something that doesn't feel right.

Then he puts his hands down and watches her with a calm (if still slightly unhappy) expression, trying to make it clear that he can live with the terribleness and isn't making any demands about her treatment ideas.

Marian looks kind of worried! His heart rate shot up to 170, probably because he was kind of being tortured - that part isn’t unexpected, but his blood pressure is actually down - which is mildly alarming when she has no room to go up on pressors - and he’s doing some premature ventricular contractions on the monitor, which she hasn’t seen before. Also he just looks…not great.

He did stab himself in the chest, it’s not shocking that his heart isn’t in great shape and has limited tolerance for any additional strain, and probably the intrathoracic pressure increase from coughing tanked his venous return. 

She tries to indicate for him to relax as much as he can and take slow deep breaths, while she hovers and watches to see if the problem gets better or worse.

It gets a little better? His heart rate comes back down to 135 and his blood pressure makes it back above 100 systolic. It takes a couple of minutes, though, and he’s still doing a lot of premature ventricular contractions. 

(Leareth is trying to be far away. He can’t actually avoid experiencing suffering about it, but he can at least not experience it with a lot of details.) 

Okay. 

Marian isn't panicking but she's not delighted; she has a feeling something is wrong other than the blatantly obvious. She should go let the resident know, probably? Whiiiich means she needs to leave her patient alone for a couple of minutes. She's really not very worried about him interfering with any tubes, but she is kind of worried about stressing him out right when he least needs that? 

She smiles reassuringly at him and squeezes his hand, then points at the door, uses her fingers to indicate walking, and then makes talking-hand gestures in front of her face and also a foot away with her other hand to try to convey "I need to go talk to someone else." 

It's very sweet how much effort she puts into explaining things to him.  He nods calmly, touches the tube in a carefully-acknowledging-it's-supposed-to-be-there gesture, and waits to see if there's anything more to the explanation.  He suspects it'll involve something he won't like, or else why would she be this detailed about something completely unobjectionable like leaving for a while, but maybe he's missing something.

It's possible she's going to come back with a diagnostic or treatment plan he won't like very much! But for right now, no, she just feels bad about leaving him alone right after he expressed to her that he's feeling bad in a way that's probably kind of scary. 

She goes and tracks down one of the residents. "Hey, it's about my guy in 104. He's been looking off for a bit - I checked his glucose before and it was low again so I gave him D50 - but he's complaining of palpitations and started doing a lot of PVCs all of a sudden. Oh, and he dropped his BP pretty badly after suctioning - he's still maxed on two pressors -" 

The resident frowns. "Stab wound guy, right? Yeah, that's worrying. We should get an ECG and troponin - hmm and let’s repeat his lytes just in case - if the ECG looks abnormal I’ll page Dr Hulka about doing a bedside echo. Is there much in his drains?”

“Uh, moderate amount, bloody but didn’t look like frank bleeding - uh, he did get freaked out," because Marian CAUSED A TINY EARTHQUAKE LIKE AN IDIOT, "and try to sit up earlier," and succeed, "it's not impossible he damaged something." 

Wince. "...Yeah, I'll page Dr Hulka and find out what she wants to do. He's awake, though? That's good." 

"Yeah. Uh, he doesn't speak any English and he has PTSD about being restrained. FYI. He seems pretty oriented and calm now, I just, uh, startled him by accident at one point. - anyway I'll go get an ECG and labs." 

It takes her another couple of minutes to actually track down the 12-lead ECG machine because SOMEONE failed to put it back in its spot after using it last, but then she finally makes it back to her patient's room. How is he doing? 

Well, his blood pressure is tolerable at the moment, but his heart rate is still up around 140 with frequent premature beats. 

He does not like the way he's feeling, but it hasn't gotten suddenly worse or anything.  He's lying there calmly and ignoring the pain in his ribs to take slow deep breaths, and smiles with only a bit of relief when he sees her.  Makes the same dizziness and wrong-heartbeat gestures from before, by way of report.

Marian reaches to squeeze his hand reassuringly, and then does a very quick mime routine of putting the 12-lead ECG stickers on him before she actually does it. She'll do her best to be gentle and avoid touching the dressings on his burns, but those cover kind of a lot of his torso and she has to put the stickers somewhere. 

Leareth is vaguely curious what the whole process is for, but - not enough to nudge Karal to try to ask when they're feeling this bad. Plausibly the Healer wouldn't want to take the time to draw an answer anyway. She seems stressed. That's - kind of concerning - he isn't sure if it implies they should be doing anything? In any case he can't. Do things. 

The ECG is definitely abnormal! There's marked depression of the ST segment after the main spike, across multiple leads, and he's still doing frequent premature ventricular contractions.

Oh no that's concerning. Karal will pick up a spike of alarm from Marian as she looks at the readout, which she mostly keeps off her face and quickly controls. 

…Okay, focus, she needs to get labs and alert the resident to the ECG changes and they’ll figure out a plan. It’s going to be really upsetting if he caused damage to his recently-repaired coronary arteries or something by sitting up because she startled him, but whatever the cause, right now she needs to focus on figuring out what’s wrong and what they can do about it now.

She even more doesn’t want to leave him alone now, but she’ll try to smile reassuringly at him again and then hurry.

Karal can theoretically do things, but it doesn't feel like much of a useful ability at the moment!  Marian's worried and doesn't know what's wrong, which is concerning, but the only way he can think of in which doing things would be useful is if he could communicate complicated concepts like "backlash headache" quickly enough to make the communication worth it when he has no idea what is and isn't relevant, and drawing is not fast enough for that. 

In any case, Marian seems like she thinks they'll it figure out and she's just going to worry in the meantime?  She worries about everything more than Karal would be inclined to, so he's guessing everything will still be fine.  He smiles back weakly and watches her go.

... If they end up dying after all, does Leareth think the... whatever he's doing to come back... will still work?  If this is a different world, or just another continent?

Oh. That’s - a good question - Leareth had been assuming yes, anywhere it’s possible to Gate to is in contact with the Void by definition and his method should work, but - he probably shouldn’t be assuming he understands what’s going on even to that extent… And of course he can’t check while he’s unable to use his mage-gift deliberately.

It’s a very awful thought. Leareth can’t really manage to panic about it while Karal is in control of the body and deliberately trying to stay calm and relaxed, but it’s a very awful thought - 

Karal should maybe think through the consequences next time he asks a question like that!  He can still hold on to the calm even while Leareth worries about the worst possible thing happening, because they can't do anything about it - except not dying, and Marian said being calm would help with that - but he thinks he's feeling worse, and the new stress is not helping. 

Distraction, think about something complicated and even slightly useful instead of worrying - how would Leareth check for that, if he could?

...Leareth is not actually comfortable thinking about the details of his immortality method where Karal can see it, that's - a very high level of trust, it's really not personal, he thinks only a handful of his closest allies have ever known the details.

But he appreciates the attempt at distraction, and - it does help, reminding himself that the most helpful thing he can do right now is make it easy for Karal to stay calm. He can wrestle the startled horror and fear under control in about thirty seconds. He's very good at doing that, and the compulsion doesn't knock out all of his ways of coping. 

And then Marian is back with another two people - an older, stocky grey-haired woman and a tall skinny young man pushing some new kind of machine. She'll introduce them quickly. "Dr Hulka, Dr Cabat." 

Dr Hulka peers at Karal's heavily bandaged chest. "Well, this is awkward," she says gruffly. "Sorry about this." Though she's not feeling nearly as apologetic as Marian would; her emotional radiation is a lot more brusque and distracted. She peels away the tape on one side of a dressing, exposing enough skin that she has somewhere to place the ultrasound head. 

"- Yeah, his ejection fraction is awful - I'm calling that 10%? Would love to get his rate down but if he's still maxed on everything..." She grunts unhappily at the IV pumps. "Let's give him another liter of fluids, he might still be dry, and if that gets his BP up we can try some IV metoprolol to settle him down." 

Ah, Karal didn't mean to pry, he was only thinking of some general simple way to check whether they're in contact with the Void, whatever that is-- and now he should stop thinking about it, he already has more information than he should.  He's very good at not thinking about things - and in any case knows almost nothing about magic and couldn't possibly get far, but it's a good habit anyway.  He appreciates Leareth's similar ability to calm himself down when it's important to do that.

He nods slightly to the new people, and watches them and their machine calmly enough, though still with a faintly unhappy look on his face.  Doesn't flinch at all when the older woman shifts his burn dressing, even though it hurts enough that nearly anyone would.  Maybe later Marian can explain what all this is doing, but for now they seem like competent people who have some idea of what's wrong and what to do next - although they aren't too happy with the situation, so maybe he shouldn't get his hopes up yet.