Leareth was fully aware that it was a gamble, and that in some worlds it would be the wrong one. 

Maybe it turned out fine in most worlds. He's never going to know that now. 

In this world, the thing that happens next is that a Blackrobe priest - having half a candlemark ago received a vision from his god that was rather confusing in its particulars but not exactly ambiguous - Gates to the keep (he's never been there before but the vision was really quite impressively clear) with a party, several of whom are also mages. 

He's pretty sure that their instructions weren't to kill the...demon...spirit...? The whatever-it-is, which will look like it's wearing a human face. Unless it seems like the alternative is that it gets away, killing it would be better than that. 

He was also warned not to actually try to enter the room they were directed at before attempting to incapacitate the spirit, because it would see him coming. 

If Leareth had been less disoriented, or less exhausted, he might have laid better and more thorough wards. 

- as it is, the thing that wakes him is a spectacularly sloppy compulsion - apparently cast by someone who's never done them before, overpowered, and with the flavor of blood-magic to it - it's sufficiently sloppy that he can't tell what exactly it's for, but it's definitely getting in the way of - a lot - it might be an attempt at a block on taking volitional actions, which is actually very hard to do with a compulsion but maybe they don't know that - 

- fortunately flinging himself out of bed is not, exactly, a volitional action, and neither is flinging a fireball through the wall. 

(He almost gets as far as Gating out. He would have, if he were less newly in this body. The problem is that he has yet to visit any records caches, so none of them are Gate-locations, and he doesn't quite manage a purely instinctive Gate when he isn't sure where to.) 

- this successfully takes out more than half of the attacking party, but the Blackrobe priest has a shield-talisman. It's one of the last ones produced by their best Adept, before his death at the hands of the Butcher in White. 

He doesn't know what's wrong but it's not complicated to order an attack, and he's very prepared for powerful casting, right now, thanks to the executed prisoners. 

Where is he - 

Leareth would have been fine if he had any of his own talismans, or even if he had been able to deliberately raise any shields rather than just the ones that went up instinctively. 

He's - pretty sure he's not fine - 

- also, right, he - wasn't alone - at least apparently thinking loudly rather than clamping down doesn't count as whatever the compulsion was intended to block him from - 

Karal - under attack - 

(They're in a heap on the floor, having been smashed into a wall, which is now on fire. Leareth is still seizing control of the body - that's not volitional either - but he seems to be unable to actually move, whether because of the injuries or the sloppy compulsion is unclear. 

Karal is unaffected by the compulsion.)

The war did not leave Karal unused to being woken up in the middle of the night by attacks or orders, but nothing during the war had been like this.  It felt almost like another dream at first, his body moving without his volition and - what - flinging fire through the wall--  No, something is wrong, where is he--

Why is there a voice in his head--

The war also did not leave him with a habit of spending more than a split second searching for answers before acting.  It's not long enough to drag any clarity out of yesterday's exhausted pain and confusion, but he knows where he is and that there's something wrong with him, there's fire in his lord's hall and it's his fault, he shouldn't be here--

- why can't he move, gods, everything hurts but it doesn't hurt that much - maybe he's dying and just can't feel it yet - maybe it's good that he's dying, if he's dead then whatever is wrong will be over, and it would be so much easier than any of the other ways to not be here...

No, there was... something else, a promise, or almost one...  He doesn't remember what, but it's still enough to make him force his thoughts and his body a step further, to make him throw himself into another attempt to move and at least see what's happening - purely on instinct, he still doesn't understand what's keeping him from moving, but sheer force might be enough.

The voice can make him be elsewhere, he remembers in a flash - the effortless intricacy of the magic that took them here, stepping over the threshold home.

Can you get us out -

Leareth is still pretty thoroughly blocked from taking actions on purpose in full generality, but can he - yes, he can apparently just - make all his surface thoughts visible to Karal -

(which isn't going to add that much clarity, since Leareth is also incredibly disoriented and having trouble thinking especially clearly, but some things are sufficiently cached from when he was last conscious) 

- they're under attack, almost certainly by agents of Vkandis, that being what Leareth was worried about when considering whether to stay here or go. He doesn't actually know it for sure, and he's -  surprised and confused - this must be expensive and why do that just to kill him - 

- oh, the plan...probably wasn't to kill him...the first thing they did was the compulsion, which is why he can't - do things - they're probably also badly injured but either one of them is very capable of pushing through that temporarily to get out.

Leareth cannot, right now, get them out. ...He feels like there's a solution to this somewhere but the sloppy compulsion is also affecting his problem-solving ability, unless the problem is that they hit their head in which case Karal is also affected and they might just be. Stuck. 

(There's a faint note of apology. It's absolutely not productive to dwell on it and Leareth isn't, but - this is his history and his business, and he wouldn't have chosen to drag Karal into it, let alone Balthin's keep.) 

Karal can think fine but he doesn't know anything.  If he was on his own, he'd surrender or die, or likely both - and he doesn't even want to fight Vkandis or his priests, not without knowing why.  But... seeing Leareth's thoughts makes him remember Leareth as a person, someone who he had conversations and the beginnings of cooperation with, not just the first second's memory of a bewildering voice and a Gate, and that is reason enough to try to do more than he would by himself.

What, though?  First, he needs his body if he's going to do anything at all - and it feels awful to lie here unable to move.  He wants it back, and reaches for it, forcefully and with more of an understanding of what he's doing - he knows that on some level it's Leareth he's fighting, but it's not as if Leareth wants to lie here without moving either, it's really the compulsion he's pushing against, whatever exactly one is...  It doesn't matter - it's his body, by birth and use and instinct, and he will have it back.

As he tries to push his way in, he thinks about what to do once he has it back.  He still doesn't want to fight these people, but if only they could disappear from here - Leareth does know how, he just can't do things, or even think clearly...  Can he show Karal how?  Or the opposite, do it if Karal prompts him enough?  Last time he just didn't know where to go until Karal showed him a place (why doesn't Leareth know any places? not the time to wonder about that) - here's the main gate of the capital, no that is the last place Leareth will want to be, here's a forest in Hardorn with a rock formation that looked like a door...

He has no idea if any of that will help. But if nothing else works, he can certainly find a way to kill them both.  Leareth's thoughts make it sound like the better option than whatever would happen otherwise.

It's definitely the better option. For Leareth and Leareth's goals. Leareth can find a moment for half-awed gratitude, that Karal is putting that first - Karal isn't the one they want to hurt - though, no, it's unlikely the priesthood of Vkandis has a plan for how to imprison Leareth separately, so one way or another they're - trapped in this together - 

The compulsion doesn't make him fight Karal for control, but it's incredibly disorienting - not quite enough that he instinctively attempts a Gate to get away from it, though, it's not the right kind of thing - 

And then there are footsteps – and, abruptly, rather clumsy ropes of magic trying to pin them down. 

If Karal, who's now in control of the body and also the only one of them who can reliably take any actions, manages to turn and look, he'll see a Blackrobe priest emerging from the pall of dust and smoke where the thoroughly demolished wall of his bedroom used to be. He's wearing - to mage-sight it's beautiful, and Leareth's thoughts it's obvious that it's a rather well-made shield-talisman - but not an exceptionally powerful one, and possible to get around - 

Oh. 

They want to take us prisoner, Leareth thinks. I think - need to make it - not worth their while - but he's not going to be able to cast offensive magic again, he could only do it because he was sufficiently startled that it didn't even count as voluntary. 

(They are trapped in this together, and Leareth is the only one of them with goals that can still be accomplished.  And - Leareth is right that this isn't the time to dwell on these things, but - Karal is the reason they were still here tonight.)

Karal can definitely turn and look, trying to twist out from under the invisible ropes in the same motion.  It hurts, but distantly, the way all pain is distant in the middle of a battle and it's a surprise to look down and see yourself bleeding.

He still isn't sure he wants to hurt a priest of Vkandis, but even if he did - the fight likely isn't a winnable one, they don't have a real plan for how to get out, and he doesn't think he can even make it imprisoning them not worth it, when one more compulsion would be the end of their ability to resist. 

But there's a long knife at the priest's belt, close enough to reach when he takes another step forward, and Karal knows where his own heart is.

…The priest was sufficiently not expecting THAT form of resistance that he doesn’t manage to stop Karal in time. (He’s confused, the compulsion is definitely right there, he’s not a Thoughtsenser but it seems like it should work why is it not working.)

He raises his arms to defend himself when he realizes that the demon spirit wearing a man’s face now has his knife. His threat model is not one that includes defending Karal from himself.

Leareth was also really not expecting that! He can’t defend against it; he’s shielded against physical blows but Karal is him, and is inside his shields - there’s a shock of confused betrayal, what, why - 

The pain blots out most of his remaining thoughts, before he can fully process that Karal is doing it to help him. There’s only the desperate reflexive need to get out when he’s clearly in no shape to fight.

The Gate-threshold goes up under them while he’s still skidding off his own thoughts flailing for a destination - oh, there was that anonymous rock that he has a mental image of for some reason, but he doesn’t want to go there he wants to go somewhere safe…

The Gate-spell bends and twists around itself and does something that even Karal can tell is not how Gates are supposed to work, and then they’re somewhere else.

Not a forest, though! If Karal is still capable of processing anything, after the burns and broken bones and self-inflicted stab wound and now overwhelming backlash, he might notice that the light is neither sunlight nor torchlight, the ground under them is cool and white and seems like it should be stone but isn’t - the surroundings are incredibly strange - 

Also a janitor is screaming in surprise at the bleeding man on the floor of the downtown Reno Walmart, who he swears wasn’t there five seconds ago!

Karal is sorry, he didn't mean it as a betrayal, he thought Leareth knew that...

He does not understand any of the strangeness that happens after, but he wasn't expecting to, and for the first few seconds isn't really trying.

The backlash is... confusing, why would it still be there if he's dead... but it's also too awful to let him take much notice of his surroundings, beyond the fact that nobody is doing anything he urgently needs to react to.  Just screaming really doesn't seem urgent enough.  He will close his eyes and try to ignore it pass out.

Even then he doesn't let go of the knife.

Leareth thinks it’s very important to understand where they are - even in the blur of confusion, he's pretty sure he successfully cast a Gate, but he somehow has no idea where to - but he's unable to do anything except think, and very impaired at that. 

(They're not dead. He - realized what Karal was trying to do, a second after the Gate was already happening, and he's - grateful - and also it was in fact enough to startle him into Gating. And maybe this is a better place to be, even if he has no idea whether it’s safe and no reason to expect that he’s among allies -)

This is approximately all the coherent thoughts he can manage before the backlash drags him under.

The early shift supervisor (it's still only 5:50 am, they open at six) is alerted that there someone unconscious and covered in blood holding a bloody knife in aisle six??????

Well. Reno. He calls 911. 

The paramedics dispatched are told that someone seemed to have stabbed themselves in the Walmart. At least it's the Walmart closeish to the hospital. 

Sometimes Marian makes questionable choices.

Like, for example, staying at the bar with the day shift staff from yesterday until 11 pm and only realizing when she got home and it was too late to go shopping that she was out of coffee, and had to be back again in the morning, and the hospital cafeteria doesn't actually open until 7 and she is absolutely not doing 6:45 am shift report on no caffeine and a bit less than six hours of sleep.

Which is why she's up and dressed in scrubs and locking her bike outside the Walmart at 5:57 am, when an ambulance passes her in the deserted parking lot, lights and sirens on. 

...Yeah okay she should probably go see what's going on. 

She and the paramedics will find a man unconscious on the floor! He's bleeding from what appears to be a stab wound in his chest (with a stressed-out Walmart employee using a random T-shirt from the clothing section to try to control the bleeding), he is in fact still holding a bloody knife, and he also looks - generally pretty banged up? To the extent that it's unclear how he could have ended up that way in this freshly-mopped aisle where absolutely nothing has recently been on fire. 

Wow!! That looks pretty bad! Marian is not technically at work yet but she does have her badge on her and it sure seems like the kind of situation that could use more hands. "Um, hey - I work in the ICU, I just happened to be here - can I help with anything?" 

Absolutely! Can she put the patient on the monitor and get vital signs while they place an IV and get him immobilized on a backboard just in case? 

She can definitely do that! And a neuro assessment while she's at it. 

He's not in great shape. She's getting a heart rate of 156 and a blood pressure of 73/54. Breathing shallow and unsteady, oxygen saturation on room air 86%. (One of the paramedics is setting up the oxygen cylinder now, but getting fluids into him was the priority, there's kind of a lot of blood now forming a pool under him.) 

The man seems pretty deeply unconscious! Pupils are reactive, but she can't get more response than a twitch in response to a painful stimulus. 

(Leareth is a long, long way off. He's distantly aware of a new source of pain that might be startling if he were closer to consciousness, but it barely registers next to all the other things that hurt, and it's not like he has the ability to do anything about it anyway.) 

(He's... alive, apparently?  For some reason?  And it's important to know where he is, but he's too out of it to even keep his eyes open, or process much of what he sees when someone briefly does that for him.  He tries to drag himself closer to consciousness, but it's so hard, with nothing to hold on to...)

The painful stimuli do get rather lost in all the other pain, but if someone tries to do something that matters, like move him somewhere or take the knife from him, Karal will struggle, ineffectually, and might manage to open his eyes for a moment.

The paramedics are absolutely going to pry the knife out of his hand and also - once the IV and oxygen are in place and they've confirmed that he's not imminently dying - log-roll him onto the backboard. 

When he struggles, Marian dives in. She's mostly focused on securing the IV site, but she'll try to make eye contact with him during the second or two his eyes are open, and smile reassuringly. "Hey, hey - it's okay - just try to relax, we're going to look after you -"

Possibly this person does not actually want to be looked after given how he seems to have STABBED HIMSELF IN A WALMART, seriously, who does that??? ...Also unclear how he, like, got in, Marian doesn't think they would unlock the doors until it's actually 6 am. Not actually useful to spend any mental cycles mulling on that right now. 

She continues to be an extra pair of hands, and can stay close to him and try to be reassuring while the paramedics heft him onto the stretcher and wheel him out to the ambulance. 

He is so very unhappy about being rolled and restrained!!  He can't do much about it, but the increased stress is very obvious.

He does focus when the woman says something to him - he has no idea what, in that dreamlike way where she might be speaking an entirely different language or he might just be too out of it to understand her, but she looks like she means well.  That's enough to make him try, for a while, to remember not to struggle - it might make things better rather than worse? - but he's not very good at remembering, clearly still upset, and remarkably indifferent to causing himself more pain.

...she should probably peel off here and ride her bike to the hospital, there isn't a ton of space in the back of an ambulance and also she doesn't super want to leave her bike locked outside Walmart until such time as she manages to have the energy to retrieve it. And, like, her fresh scrubs are now pretty covered in blood (usually patients reach her in the ICU with significantly less uncontrolled bleeding than this!) and if she goes straight to the hospital from here she'll have to borrow ill-fitting OR scrubs all day and those have way fewer functional pockets. Also she didn't even get her caffeine

But. Uh. The patient seems really confused and combative, and it might be only a six-minute drive to the hospital but she wouldn't want to be alone in the back of the ambulance with him while the other paramedic drives. Also she might be imagining it but it seems like the guy is maybe a little calmer when she's right there and talking to him? 

Yeah, okay, she's ditching her bike at Walmart and going with them. Assuming the paramedics seem cool with that? 

They are SO cool with that. 

Okay, great, Marian will ride in the back with them and mostly focus on reassuring the patient (and holding him down if necessary), since she doesn't know where anything is in an ambulance. She can keep talking out loud to him if this helps, though it's going to involve a lot of inane repetition even over the six minutes or so that it takes to reach the hospital. 

- she's obviously still watching his vital signs. How do they look? 

The oxygen mask seems to help and his oxygen saturation is up to 96%; it seems like he probably didn't puncture a lung by stabbing himself. 

His blood pressure isn't doing great, though. The fluids might be helping a little, but his next reading is down to 67/49 and his heart rate is now at 169. 

Leareth is vaguely aware that things are happening. He's - 

- confused - 

- why can't he do anything...? 

(He fights Karal for control of their body, because that's an instinctive rather than volitional action. He isn't very good at it and wouldn't be able to do anything with it regardless.) 

He usually calms down at the the young woman's voice, and almost always stops struggling when she holds him down (he doesn't want to hurt her), he just keeps starting again when he loses the obvious reminder that he shouldn't.

He pushes the strange other presence back, just as instinctively - he's not very good at it either but he's better than that - but it too feels reassuring or at least familiar, so he tries to be gentle, and to extend his thoughts toward it, blurry as they are.  Vague reassurance, I know you, I won't hurt you, and please don't, it won't work - he doesn't remember why it won't work - wait...

It calms him down, really, all the trying to calm someone else who's panicking more than he is.  The young woman can see him relax and lie more easily, after a while.  Which only makes it harder to stay awake - he'd like to, to know what's happening, but he's not sure he can...

(Leareth can pick up on some of the attempted reassurance, even though it's coming via a deeply unexpected channel, he’s not at all used to someone being in his head, but - there’s some vague cached sense that he should feel reassured, here…)

The patient is in and out of consciousness, that’s not surprising. Marian keeps talking, and - either it’s helping or the patient is sliding further toward unconsciousness again, she’s not sure, the important part is that so far he hasn't yanked out his IV or tried to remove the oxygen mask. 

He's continuing to breathe on his own and maintain an oxygen saturation above 95%. His blood pressure and heart rate are at least not getting worse, the IV fluids seem to be doing that much. 

They make it to the hospital! The patient is still alive, and the paramedics have radioed ahead about the guy who STABBED HIMSELF in the WALMART HOME DECOR AISLE, so there's a huddle of ER staff waiting for them. 

(Leareth and Karal will notice the light changing - it's brighter now - and jostling as their gurney is wrestled out into the ambulance bay and pushed down the hall toward the trauma bay.) 

Marian stays close and - she was honestly running out of things to say in the ambulance and starting to repeat an incredibly inane loop about how they're en route to the hospital and it's going to be okay, and now she can at least swap that out for "we're at the hospital, we just need to get you to a bed." 

The paramedics are going to have to slide him from the ambulance stretcher onto the ER gurney. It's going to involve a lot of jostling. 

The movement and inevitable resulting pain wake him up.  He's more awake than he's been at any point since the Gate, for some reason - maybe just because he rested for... he has no idea how long, but it couldn't have been very long, surely... 

He manages to open his eyes properly, and take in something of his surroundings beyond a vague impression of strangeness and a woman's face.  He tries to make sense of it, but it's incredibly difficult, nothing here looks familiar, or even made of familiar materials, and there's just - so much of everything - maybe it would help if he was thinking more clearly, but he's not sure even about that -

There are people, the young woman he remembers - who keeps repeating something and he still cannot recognize any of the words - moving them from... the small confusing place that was shaking before... to a larger confusing place that at least registers to his mind as a building and isn't shaking?  That seems better, but he's having trouble figuring out where to even start answering the question of where they are or why.

It was the voice in his head that said it was important to know this, so he tries to make sure it can see, pushes an unformed question, does any of this make sense - 

(He's making no attempt to keep his thoughts off his face.  He does not look like someone who has any comprehension of where he is or what he's seeing or hearing - and not because he's too out of it or isn't trying.)

None of this makes any more sense to Leareth than it does to Karal! He manages to form the though that the lights look like they should be magic but they aren't, mage-sight is not working very well but he can at least recognize the near-absence of mage-energies here...

(It's very very difficult to form anything like a coherent thought -) 

Leareth thinks that - unless Vkandis sent them here on purpose, and that seems hard, and unlikely?? - there's no...particular reason to think...that the people here are enemies? They’re not necessarily safe but they’re probably not actively in danger? 

…that’s all he can manage before his thoughts come apart into fog.

The ER staff are going to swap in new monitor wires, and hold down his arm to place another IV and his other arm to draw labs. The ER attending doctor is asking for an intubation tray.

Presumably because the dude seems pretty close to crashing and they’re going to have to rush him to the OR to deal with the STAB WOUND.

"- We need to give you some medication that will make you go to sleep, and then put a tube in your throat to help you breathe," Marian tells him, even though she's really not sure that he can understand her or if he's just reassured by her tone of voice. 

The people don't seem like enemies, they just... keep making no sense... which Karal becomes much more unhappy about when the making-no-sense manifests as holding him down and doing more strange things to him!  Why won't they stop doing that when he clearly doesn't want it!

All the brief struggle accomplishes is a wave of exhaustion that makes him fade faster.

(He wonders if now he's going to be dead.)

Nope! Just thoroughly unconscious from the 50mg of propofol that just went into the IV, which would have had scarier effects on his already deeply questionable blood pressure if not for the fact that the ER nurse was anticipating that and rammed a half-syringe of epinephrine right after it.  

The patient's next blood pressure still drops as far as 54/35, which is moderately alarming, but the reading after that is back above 60 systolic. 

And his airway is now secured and - Marian can probably stop hovering now, given how she doesn't in fact work on this unit and really needs to track down clean scrubs and some source of caffeine in the 25 minutes before she needs to be in the ICU taking report.

...if she gets there early then she can offer to take the new admit, given how she has some context on him already? She's pretty sure it's still Dr Hulka on call and Marian is not that scared of her, as the trauma surgeons go. 

Normally they would take the patient for a scan first, since it's pretty clear he has a lot of broken bones and they haven't actually ruled out a spinal injury, but he's still doing his best to bleed out and that's the highest priority. The non-life-threatening injuries can wait until he's more stable. For now, they have just enough time to get more fluids and vasopressors running before the OR is ready for him. 

Karal did, in fact, manage to aim correctly at his heart. He wasn't actually able to apply enough force to push all the way through the heart muscle (or he and Leareth wouldn't have survived more than a minute or two) but there's significant damage to be repaired; it would in fact have been a lethal injury within ten minutes, without treatment by a well-trained Healer.

(Or by an ambulance crew and fully stocked ER and OR. That will also do.) 

Some two and a half hours later, the OR calls over a report to the ICU charge nurse.

Male, probably early 40s, no ID on him (he's in the system as Eighty-Six, Orange), found down with a (suspected self-inflicted) stab wound to his chest and - as they discovered later once they had him on the operating table - significant internal bleeding from apparent blunt force trauma (significantly more mysterious given where he was found), multiple broken ribs, and burns (mostly second-degree, some third-degree) over a large fraction of his torso and arms. Though he at least doesn’t seem to have a spinal injury or head injury. He lost a lot of blood; they transfused six units of packed red blood cells and a bunch more plasma. 

Also - as was unpleasantly discovered an hour into surgery when the initial labs came back - critically low on potassium and phosphate for deeply unclear reasons (burns tend to cause high potassium in the immediate acute phase), and also severely hypoglycemic?? They treated the latter and IV supplementation for the former is in progress but it's going to take kind of a while to normalize his potassium, you can't administer it that fast. 

He's - semi-stable, now? He's maxed out on both phenylephrine and norepinephrine to maintain a systolic blood pressure over 90, but he has at least been maintaining that blood pressure for the last hour (before that, not so much.) He has some surgical drains in place, and a chest tube because it turned out he was slowly filling up his right pleural space with blood. They're sending him over intubated; he hasn't woken up from the anesthesia yet. 

Marian has spent the last 90 minutes finalizing the transfer to telemetry for her patient in room 103 so she can take the admit in 104! She does actually have some context already - which is how she successfully bid for taking this assignment - but, wow, she did not know about the internal bleeding and broken ribs and she has questions about how that happened in a Walmart. 

...not the point. She's here and ready.

They have him on a fentanyl drip for pain control, but no other ongoing sedation, and the anesthesia still in his system is already starting to slightly weaken its grip by the time they wheel him into the ICU and carefully slide him across into the bed. 

…There’s too much fog in Leareth’s head to think. It feels like he’s floating in a void. - he’s alive, though, he can feel distant pain -

- where is he -

Whatever motion would normally come after forming that question is not working at all.

He doesn't feel worse than before, exactly, but everything feels more wrong - he can barely feel his body at all, he can tell that it should hurt but it feels so far away - he hates that more than almost any amount of pain -

- he wonders again if that's just what being nearly dead is like, but... he remembers thinking it before and it keeps not happening, so it's probably something else, what are these people doing to him that feels like being nearly dead - 

- no point in guessing at incomprehensibly awful things when he doesn't know anything (and the other one doesn't either, so Karal's barely-awake thoughts ignore him in favor of things that he might be able to do anything about) - where is he, is anything different - 

It feels like an upsettingly long time before he can even manage to drag his eyes open.  There's... the non-mage lights, again... the young woman from before, he thinks?  He gives her a miserable look, and tries to say something - discovers in the process that there's a strange thing down his throat that makes it impossible to talk or swallow and deeply unpleasant to even try - looks even more miserable.

Marian has been focused on getting him settled, charting her initial assessment, and reading the OR notes (which she really appreciates being in the system so promptly, Dr Hulka is efficient.) She also double-checked the wrist restraints, because earlier he seemed pretty inclined to fight everything they were doing except when she was right there and continually reassuring and reorienting him. She can't stay right there all the time when she also has to do everything else; it's unfortunately not hard to predict that he's probably really going to hate being restrained, but he now has a lot more tubes in him that would be a very bad idea to pull out. 

...oh, he's waking up. That's honestly really impressive! ...He looks so unhappy about the endotracheal tube and Marian is tempted to just start the sedation now, but it would be nice if she can get a better neuro assessment first.

"Hey." She leans in close where he can definitely see her, and reaches for his hand. Ugh it would be really nice if she knew his name. "I'm Marian. You're in the ICU, at Renown Hospital. Can you squeeze my hand?" She'll squeeze his first, as a hint, since he's looking at her like someone having a lot of trouble processing anything. 

He tries to shake his head when she talks - he doesn't understand - but when she squeezes his hand, he does his best to find the way into his body enough to return the gesture.  It's easier to find that one movement in the fog, when he can feel her touching him - and it's a natural human reaction, when she's talking to him in a tone that clearly means reassurance, even if he doesn't know what she means or what she wants.

(Does the other voice understand?  Is this just a language Karal doesn't know?)

There's a question...? 

Leareth drags himself toward awareness, which mainly has the effect that he’s abruptly very distressed about the extent to which he can’t seem to wake up fully or form coherent thoughts. It feels like most of him is…missing…and he can't quite dredge up the memory of how or why or what happened before this, which makes it particularly upsetting to be in a place he doesn’t know or understand, helpless, with things happening to him that he can't make sense of let alone do anything about. 

- he doesn’t understand the language, or even recognize it as related to a language he speaks.

Marian, however, lights up when the patient squeezes her hand. "Good! That's really good!" 

Karal does not think moving his fingers a little is an accomplishment to be this pleased about!  He frowns at her in frustration and tries to move his arm.  Which he is apparently not allowed to do!  That gets her a betrayed look - why is she keeping him prisoner if she's so happy about him?

(He sends a half-apologetic thought at the other one's sharp distress - he didn't mean to hurt him, but he can't really apologize for calling him up, where it might be useful and he thinks the other one would want that, if he was... anything like all right... 

He really isn't, is he.  Karal doesn't know why - he half thought there was just something wrong with them both, because they were wounded and dying, but it's not that...  Something else happened...  He'll remember later, maybe?...  But he's sorry about all this, it's his fault even if he only half remembers why.)

Leareth also only remembers a hazy sketch of what happened - under attack, Vkandis, tried to get out - something else went wrong but he's not remembering it either...

He does manage to form the thought, very effortfully: not your fault. He doesn't need to remember exactly what happened to feel on priors that the risk assessment of - whatever led up to being attacked - was his responsibility, and his decision. 

Oh no, poor guy!

...He seems confused and upset about the restraints more than in agonizing pain, Marian thinks? She's kind of unsure how much he's processing what she's saying. He's on 125 mcg/h of fentanyl, which is a pretty high dose (the order parameters let her go up to 200 mcg/h in total). It sounded from the OR notes like the anesthesiologist found it hard to keep him all the way under, at least once the hypoglycemia had been corrected, but now that he's out of surgery it's probably better for him to be more awake, and it might well be making him really groggy. (Also probably dropping his BP; he's still needing a lot of pressors.) 

"You have restraints on your hands so you don't forget and pull out your breathing tube," she says anyway. "I'm going to go down a bit on your pain medication - I'll go back up again if you seem to be in too much pain." 

She eases it down to 75 mcg/h.

(And stays right there to watch closely, restraints or not. He got some midazolam as well as propofol in the OR, probably because propofol was too hard on his blood pressure, but that's also longer-acting and takes hours to wear off. She doesn't want him to start panicking as soon as he wakes up more fully.) 

The other one gets a soft mental laugh, because it feels very like him to say that, but it's... warm, that he would.

The young woman gets another slight headshake and frustrated look, but he does stop trying to move, since it's clearly not going to work and she's... doing things... which might be better or might be worse?  He's not sure, but he can... wait and see?...

He lies there, trying to watch her as much as he can, and does feel better after a short while.  Less strange and far away.  Oh, everything hurts more now, but of course it would, and there's no point in minding that.  He gives her a tentative smile?  And might drift off to sleep again, if she doesn't do anything else.  He'd like to stay awake and... do something more useful than this... but he has no idea what that should be, and everything is very exhausting.

Marian absolutely doesn’t need anything from him! After a bit she’ll draw followup labs (and take a drop of blood for a repeat blood glucose) but she can do that from the arterial line, he won’t even feel it. She peeks at dressings and drains for signs of new bleeding and checks his urine output in the Foley bag and watches his blood pressure closely. Eventually she’ll have to wake him to reposition him in bed but she’s inclined to wait the full two hours for that, it’s going to be pretty unpleasant for him given his injuries. 

(She’s pretty curious what’s going on in his head? In particular, whether he’s upset because he was trying to kill himself and didn’t want to be saved. But there's no benefit to be had in asking him, right now; he needs to rest.) 

Leareth drifts. He dozes for a while when Karal does, but it's starting to feel easier to form thoughts. ...Enough to notice that there's something else in the way, not just exhaustion and weakness, or even just how fragmented his memories are. 

- he died recently, and came back, that’s why everything is in pieces in his head -

- he’s sharing the body, that’s why there were thoughts that aren’t his -

He’s…having trouble putting together the rest. Clearly something went very badly wrong - Vkandis, he thinks - he wasn’t careful enough, again, but that still doesn’t explain…this…whatever “this” is…

The pressure of Leareth's thoughts is enough to pull Karal into wakefulness after a while.  (And he remembers Leareth's name now, which doesn't matter in the large scheme of things but feels so much better.)

His mind and memories still feel blurry, but he remembers enough for each question to bring back several pieces that can connect together into something approximating an answer.  He lies still and spends a while slowly doing that, starting with what happened before they were suddenly in this strange place.

The priest did some confusing magic, I think?  He attacked us, but you-- couldn't move, or do anything, or think clearly, and I don't think it was because you hit your head.  So I moved instead, and - tried to kill us (he remembers the sudden wave of Leareth's distress and fear more clearly than anything else about the brief fight) - I thought it was all right, you'd come back...

And then, because clearly he remembers Leareth better than Leareth remembers him, and the entire situation must be incredibly confusing to a man only now realizing he's sharing someone else's body:  I don't know you very well.  It's only been - a day or two?  But I liked you.  ...You said you might kill me. 

(He remembers Leareth's honesty, the lack of even an attempt at excuses, the way he obviously didn't want his death.  It's strange to like someone for the way they said they might kill you, but he did - for that, and other things that he can't clearly remember yet, but he can tell they were there.)

That's - well - Leareth is confused (and no longer particularly trying to tuck away any of his thoughts or feelings where Karal can't see them; what's the point, now, they're stuck in this together, but also he's - glad, or some positive emotion in that direction. 

(His thoughts are moving slowly and oddly disjointed; it's not just the fogginess, it's also impossible to take actions on purpose and that's not not affecting his thoughts; he can still react to things, including in Karal's thoughts, and work around it that way, but it's clearly effortful.) 

Karal made the right choice, probably, trying to kill both of them? Leareth isn't angry, it would have been worse to be taken prisoner - it was a compulsion, that was the magic they did, and it's still on him - not going to panic about that, if only because he's too tired...

Anyway, he - can't actually remember for sure but he thinks he panic-Gated out; the compulsion seems to be a very clumsy one, overpowered and very broad, he can't volitionally use mage-sight to get a closer look at it (this is incredibly upsetting) but it seems to, at least, not affect actions that count as sufficiently instinctive and involuntary, and Leareth - has a lot of survival reflexes. 

...He does not have the slightest idea where he Gated them to. 

Karal could probably use the mage-sight, but he doesn't know how...  He might be able to learn?  But that seems complicated, and... probably not urgent?  He's still unhappy and confused about what the strange people here are doing, but they don't seem like they mean them harm, however little sense that makes.

He should probably open his eyes and see what's happening now.  But he... doesn't really want to?... there have already been so many confusing changes even before all this started, and he's so tired, and... on some level he just doesn't think anything he'll do will get anywhere...

He opens his eyes anyway.  Maybe this time it'll be a less miserable experience - and if it isn't, then eventually they'll think of something to do about it.

(Karal will notice that it's at least easier to open his eyes and focus on things in the room.)

Marian has been hovering, refreshing the chart, and generally considering whether it's time to nudge her patient awake so she can do another assessment and reposition him. She does notice almost immediately when his eyes open, and moves over to him, trying for a reassuring smile. "Hey. How are you feeling?" 

Another frustrated headshake.  He doesn't look like he's in pain, and isn't even tugging at the restraints - he sees that he can't do anything about the situation he's in at the moment, but he'd like to at least understand what it is, now that he finally feels more up to thinking about it, and he has no idea how to do that when he can't understand her or talk to her. 

... Does she even realize that?  He's not sure.

He tries to say something again, which he knows is both impossible and unpleasant, but maybe she can recognize the attempt.

Marian reaches for his hand. “Hey, it’s okay, don’t try to talk - there’s a tube in your throat to help you breathe - uh, do you want to try writing something?” She mimes writing in the air with her other hand, half out of pure habit and half because this guy still looks really - confused? It’s not obvious if he can hear her.

He thinks that's writing?  He nods, hoping that gesture at least carries over, and gives a single tug at the restraints on his right hand, because if she means her doing the writing then it's really not going to help.

Yeah, he seems calm and she’s right here and being able to communicate is important. …She’s still going to go get a clipboard and pen first, and raise the head of the bed just enough that he’ll be able to see what he’s writing, before she actually unties the restraint from the bed (leaving it on his wrist so she can grab the trailing end if necessary.) She holds the clipboard steady for him.

What is she so afraid of him doing with his one free hand?  She doesn't seem scared of him, so he doesn't understand why she's acting so cautious.  But he doesn't make any sudden movements, just in case.

Writing is - harder than he expected... (he doesn't know why he had any sort of expectations, he's never been this close to dead before...) but he can more or less manage.  'I don't understand your language', he starts writing laboriously in large shaky letters, although it's enough effort that he rather hopes she'll get the idea within the first couple of words.  (If he's very lucky, she'll understand what he's writing and will be able to switch to Rethwellani for him.  Probably instead she'll just see something as incomprehensible as her words are to him, but knowing that should still help.)

Wow. Okay. Marian doesn’t know that - alphabet? presumably that’s what it is - at all. 

She shakes her head apologetically. Ugh. Maybe her patient seems confused and miserable because he doesn’t speak English, in which case - wow, it’s not obvious if he even knows where he is, she’s tried to reorient him but not in whatever that language is and it’s really quite plausible he doesn’t remember the ambulance, he was in bad shape.

She could try drawing it for him? Which is kind of embarrassing, but - okay, she’s going to take the clipboard, turn the paper over, and where he can see it, draw:

- a stick figure with lines forming a pool to indicate blood

- then an arrow to a sketch of an ambulance (truck shape, wheels, lights and sirens with spinny rays and stylized sound-semicircles, the Star of Life caduceus symbol sketched badly on the side) with a stick figure in it

- then another arrow to a building outline with a Red Cross symbol and, inside it, a bed with a figure on it with the chest wrapped in bandages.

She points at the bleeding person drawing, the stick figure in the ambulance, and the bandaged person-figure in turn, then at the patient? 

(It’s going to be super mortifying if she just did all that and it turns out he can understand English fine.)

He nods at the first figure, which seems reasonable enough (except for his deeply unreasonable impulse to grab the drawing and somehow superimpose a second little man on the first one, which would be unhelpful on so many levels).

He doesn't... have any idea what the next odd shape is... except that there's a person in it which is apparently supposed to be him, so probably it's the small noisy shaking room he vaguely remembers?  He makes an unhappy face at it.  Nods at the more recognizable building, somewhat less unhappily, and again when she points at him.

The problem is that none of this answers any of his questions!  And he's not at all sure how to convey any of them in the format of little drawings.  (Honestly she's doing really well, he wouldn't have thought of most of that at all.)

He thinks for a moment before gesturing at the paper.  If she gives it to him, he'll draw another arrow from the bandaged person to an empty spot on the page, then point to all the figures in order, and to the empty spot, and make a questioning gesture.

Is he asking what’s going to happen after this? That’s such a reasonable question! Unfortunately she can’t tell him because it super depends on how his recovery goes! (Nothing is incredibly concerning so far, his followup labs weren’t worse and his blood sugar is for the moment stable, but there’s a lot of opportunity for complications.)

She can draw a sort of diagram of a sunrise and arrow up and over and down to a sunset - a day passing? - and then point at it, count on her fingers up to one, two, three, and shrug - she doesn’t know how many days - and then draw a sketch of a person sitting up in a chair. Then another arrow, count some more, and a person standing? 

Leareth is trying to follow but it doesn’t look like anything familiar to him either. 

…They’re going to expect him and Karal to be up and functional in a few days? Is his best guess for what the second drawing means. Still doesn’t answer what comes after that.

Apparently!  And, well, a lot of things hurt but Karal doesn't think there is anything that would technically prevent him from standing up in some number of days, if he lives that long at all.  Which the young woman apparently thinks he will, and he finds that he believes her.  He does feel better - rather miraculously so, he realizes, if his memory is correct.  So it's a strange kind of Healing that all the tubes are doing?  That... does make sense, maybe.  (Does Leareth think it does?)  He has no idea why they would be spending all this time and effort on it, but that's not a question he has any idea how to ask with little drawings, and not quite the main thing both of them want to know anyway.

He gestures for the paper, draws another arrow from the standing person to, well, the edge of the page, having run out of room.  Questioning gesture?  What are they going to do with him once he can stand up?

Marian thinks the guy is asking what happens once he's discharged from the ICU? Which, man, she has no idea. It seems like it depends on the answers to some pretty awkward questions, like 'did he in fact stab himself in a Walmart and if so why', because if he's actively suicidal they are presumably not going to let him go home? Which is a question Marian would prefer not to get into with any patient while they're intubated and on a lot of pain meds, even leaving aside the language barrier. 

...She probably should not give him the maybe-misleading impression that he gets to go home after this. She'll just - shrug, awkwardly, and try to convey via eyebrows that she's very sorry and wishes she could tell him but she doesn't know. 

Leareth is blearily unsure what to make of that, except that he doesn't like it. It's not her job to decide what they want to use him-and-Karal for? She's unhappy about it but she doesn't have the authority to make them any promises? 

- Karal should probably not weigh Leareth's interpretation too heavily, Leareth is - badly impaired - 

Karal agrees that seems worrying!!  He was expecting - what, exactly - he wasn't really expecting her to be able to tell him much, there's too much confusion in the way of reasonable explanations of most things people might do in a world that looks this incomprehensible - but he was expecting her to know.

And, even more importantly - given how friendly she seemed and how positively she felt about him getting better, he expected her to think whatever would happen to him afterward would be obviously good, not... unclear and vaguely sad...? 

Is she as friendly as he thought she was?  Does she really want him to get better, or does she just want to do her job right?  (Is she okay, or is she being odd about all this because she's threatened somehow?)  He might just be completely off in how he's reading all these people...

Apparently he has gotten used enough to having magic that his instinctive response to this much interpersonal confusion is to reach for Empathy.  Is he going to have to fight Leareth for it, or is it still his since last night?

Leareth is not fighting him for anything, right now.

The young woman’s main surface-level feeling is something between apologetic and embarrassed; she seems to wish she could be doing something better, though it maybe feels more like wishing she could navigate it more skillfully than wishing she had better options or more freedom to act?

She’s partly distracted from the interaction by - there’s a feeling that she’s tracking a lot of things. There’s a sense of deep immersion in some territory she understands and can master but not without ongoing attention. There’s a positive emotion there, satisfaction and relief maybe, the sense that in the immediate moment things are going somewhat better than she had anticipated?

…Behind all that, it seems like she’s deeply worried about him? Most of the depth of her emotional valence is there. Some of the worry feels sharp and immediate and short-term, but some is a lot more diffuse and uncertain. 

…She thinks like a Healer. Leareth is pretty unsure what to make of the rest.

Oh, he likes her.  He liked her already, but there's something so good and familiar and grounding about the shape of her emotions and about that instinctive skill at a complicated task, even if few of the details make immediate sense.

He wants to tell her he also constantly wishes he could do things better.  But he has no idea how to draw that, so he just smiles a bit ruefully, shrugs a little, and - it's not even really a decision, it's just that he's trying to communicate his feelings and already using Empathy - he pushes a little of his emotions at her, gently.  They will both of them do as well as they can, and be as fine as they can, and she really shouldn't worry so about him.

(There is some worry there, but a lot less of it, at the moment, than she's feeling on his behalf, and there's an underlying calm.  What it seems like to him now is that nothing deeply wrong is likely to happen - nothing that, in the worst case, he can't fix by doing a better job of dying - although he couldn't explain why in words, and even Leareth's clear view of his thoughts may have trouble tracing the quick instinctive jump to this conclusion.  The brief mental contact gave him an impression of a society there's nothing awful about - otherwise this clearly good and caring and thoughtful person would have concerns of a different shape, would feel worried about something more general than just Karal.  He knows what people feel like, when fundamentally wrong things are happening around them, and she's not... twisted up inside, she's worried but she doesn't hurt.  And she's not worried about herself, which is important and reassuring, both about her personal safety and about a range of possible complicated things that could've been going on in this place.

So, there may of course be some risks, but not of the sort Karal feels instinctively distressed by on his own behalf - nothing awful, just the normal and sometimes deadly problems of human existence, magnified when you're hurt and confused in an alien place.  And likely a lot of it is just that she's the sort of person given to worrying about others - professionally, Leareth is right, which makes sense and isn't a bad mental habit to have.  She is, he suspects, reacting something like he would when guarding someone in peacetime, when everything will very likely be fine but it's still his job to think about how it might not be. 

He does want Leareth's opinion on whether he's missing anything, but he doesn't feel like he is.)

What about the other people here?  He's fairly certain there are more of them, he can hear what sounds like human noises when he focuses on that, and he knows he has the range.  It might be informative, to know who else is here and what they're like.

Leareth...is not sure he can assess at all whether Karal is missing anything, it's still very hard to form complex thoughts. (He does manage to form the thought that Karal's more intuition-based way of thinking is - less degraded by being tired and foggy - and he’s grateful for that, even if it’s hard for him to put much emotional weight on Karal’s conclusions.)

Marian's patient is making a surprisingly evocative facial expression at her and she has feelings about it? Apparently? ...Marian is an adult and a professional and she can handle her feelings, it's not like it's the first time she's had surprisingly intense and confusing feelings about a patient. 

She smiles at him and squeezes his hand.

Karal can sense:

A handful of minds nearby that feel mostly - very out of it? Drowsiness, confusion, some amount of pain. 

Another handful of minds that feel - busy, more than anything else? One mind-source is frustrated, in a way that feels like it's not about the immediate surroundings and rather about some broader situation. 

So, more people like him and Leareth, and more people like this young woman except not as good, she's clearly the nicest one.  That makes sense and doesn't really add much new information.  He holds on to the Empathy but stops trying to sense everyone in range, because he's already given himself a bit of a headache and he's for once in a calm enough situation that he can notice it and stop it from getting worse.

He returns her smile and hand-squeeze, and lets himself relax.  Now that he thinks their situation is broadly all right, he can slow down and take some time to get his own mind in order, instead of spending every clear-headed moment trying to get more information.

Well, his own mind, but first the more urgent internal problem.  Leareth is - very much not all right, that much is obvious.  Karal has been more than half ignoring his distress, because knowing what's happening seemed more important for them both, but - he's sorry about it, even if it was the right choice, and he does care about it.  (This is clear in his emotions, for all that they barely know each other and their relationship so far hasn't been uncomplicated.  Karal doesn't like seeing people hurt, and he's fond of Leareth despite all the complications and separately from feeling that he owes him.)  Can he do anything to help?  Is there anything he should stop doing, such as asking Leareth questions he has to struggle painfully to answer?  He does appreciate the input - Leareth clearly thinks in a very different way and notices different things, and that is valuable, especially in a place as strange as this - but it's not urgent, any more.  He tries to just... feel calm, and help Leareth feel calm, and give him space to consider their mutual situation and how it could be made easier.

(Leareth - is grateful and also deeply confused and does not at all have enough mental capacity to chase down what’s confusing here. It doesn’t actually matter, not concretely, when he can see Karal’s thoughts and tell that he’s sincere. It’s just very baffling that he is, apparently, sincere?)

…He’s inclined to agree with Karal’s assessment of his safe this place is in general. It fits with his own sense that it’s something like a House of Healing, with - the sort of people who Healers are, and maybe they even got a bit lucky with their particular Healer, though of course he’s instinctively suspicious of anything that looks like luck…

Either way, that’s - not the main reason he’s scared?

It doesn’t - matter - if most people would be safe here. He doesn’t know where he is and he’s probably still be within reach of the gods and that means he’s not safe unless he’s in control, which - is going to be impossible for a long time, it seems.

(He wishes this didn’t mean putting Karal in danger…)

Ah.  Yes, Leareth is right about that, and that's what Karal has been missing (and will probably keep missing for a while, until his instinctive reasoning learns it) - Karal is a normal person who a normal degree of safety is enough for, and Leareth is very much not.  And... this is why they're here - because Karal thought they would be safe to spend one night in the place that's always been safe for him, and he was wrong.  He should try not to make the same mistake again, though he has no idea how. 

(He doesn't mind that their entanglement puts him in danger - on some level he finds it confusing that Leareth minds it, although he appreciates the thought.  He minds that it makes him do badly at keeping other people safe. 

...He can see, through Leareth's eyes, that he is fundamentally a somewhat baffling person.  He has no defense to offer, except maybe that Leareth is deeply baffling himself.  That thought, too, is tinged with fondness.)

Neither of them is in control of much, here.  After that... Gods, it's a hard question, isn't it.  Does Leareth want to - think more about what the two of them will do with each other, once they're out of here and have actual decisions to make?  Or should they go back to finding out more about what that will be like, first?  Karal is not sure either of them is thinking clearly enough for binding decisions quite yet.  He knows there will be many of them to be made, but... he has to admit it's a relief, on some level, to have a little more of his own life even in this strange place.  To be forced to wait and think about what he wants, rather than having to go north with Leareth with much less choice about anything that happens next.  He swears he was not aiming for this, and so perhaps shouldn't feel anything positive about it, but here it is.

Leareth does not at all think that Karal was aiming for this! And isn't sure how he could have even in theory. He - agrees that they shouldn't make binding decisions right now - it's confusing that Karal would even have been contemplating that? 

(Below the surface: Leareth is aware that he has zero leverage with Karal, right now. He's the one who is - more impaired, helpless, dependent. It's not unsurvivable - the worst case here is that he dies again and wakes up somewhere else - but on a deep emotional level, he doesn't at all feel like it makes sense here for Karal to be asking what he wants.) 

Karal does not think in leverage and is not about to start.  Yes, he's also aware that he has Leareth stuck helpless in his head right now, and that he could likely keep him that way, and... they did both just say they shouldn't make binding decisions, so this isn't one, but... he is not going to do that.  He can imagine a future in which he gives himself a week, maybe a month.  He cannot imagine one where he just leaves things this way forever.  Even if he can easily predict Leareth telling him he has every right to, and trying not to make his obvious misery his problem.  Gods, the thought makes him shudder.  No.

In the meantime, the fact that Leareth is so dependent on him right now is more, not less, reason to ask what he wants.

(And on a practical level, it makes sense to ask what Leareth wants because Leareth is better at this, better at being the required degree of careful.  But it's not for his own sake that Karal wants to be careful, either, so it still comes back to the same reason.)

Well, in that case, Leareth is (still confused but the confusion doesn't matter right now) inclined to think that it would make sense to prioritize learning more about where they are? Since it - matters a lot, whether they're still in the territorial remit of the gods who have a grudge against him, and if so where exactly. And Karal is definitely better at orienting, given their current constraints, so - he should do that.

Karal thinks he can manage to make himself less confusing, but - it can be later, yes.  And in the meantime he's happy enough to fold the large questions and the attached emotions away for later and focus on something practical.

The problem with asking where they are is that he has no idea - not just how to ask the question, but how to recognize an answer.  He can... draw Karse on a map, and name the neighboring countries and some beyond that... He knows about the Pelagirs, something about uninhabitable ice mountains in the north, and more vaguely that there's the sea somewhere in one - or maybe all - of the other directions?...  They are clearly not anywhere he knows anything about, and he doesn't know what places there are that could possibly be this.  Does Leareth?  If Karal can get the young woman to show him a map, will that tell Leareth anything?

(He also worries for a moment about whether it's a good idea to ask questions that make it obvious how entirely not from here they are.  But it's obvious enough already, between the language and the circumstances, that it's probably not worth trying to hide.  Although he finds himself oddly unable to guess what these people will think about it.)

... Starting with the gods rather than the place seems like it might be easier.  Can he get the young woman to let him draw again?  What has she been doing, while he's been lying here having a conversation in his head?

Leareth would normally be able to mentally pull up a map of the entire continent. He…can’t, right now. He has his core memories and a few dozen intact episodic memories of his past life and - there's probably more, procedural memory transfers better, but he can't call it to mind unprompted. He does think it would help if Karal can communicate that they want to see a map.  

...It would really help if they could talk; place names spoken aloud might be recognizable even if they don't share an alphabet. Leareth's awareness of their body isn't great right now and he's sort of blearily confused about why talking isn't working. 

Marian assumed he had fallen asleep - it seems like a pretty reasonable thing to do, he's got to be exhausted and probably still has some sedation in his system. She's been trying to flag down someone to help turn him, without actually leaving the room because she's not yet super comfortable leaving him unrestrained but doesn't want to upset him by retying it. 

Oh he's awake again! She'll bring him the clipboard back, since he seems to want it. 

Leareth may be better off without clear awareness of their body!  They have a bizarre tube down their throat for some reason!  Karal hasn't even tried to pull it out and he thinks that's a better demonstration of self-control than stabbing himself was.

He'll... start with something he has any idea how to draw, because if he started by attempting a map he expects he'd end up with an unrecognizable blob.  He draws a few small houses, and a much larger temple building in the middle, with some vague squiggly decorations and a conspicuously blank circle in the center over the door, where he would automatically draw a Sun-In-Glory. Gesture at the blank spot, at the young woman, question?  He gives her the pen.

Marian has to stare at it for a while trying to guess at what the question could possibly be! She doesn’t think the large building is meant to represent the hospital. Some kind of large public building? "Large public building" could be a lot of things...she supposes it looks sort of mosque-like, maybe? Is the guy asking if she’s a Muslim? That would be a really weird question in addition to being absolutely none of his business.

Maybe he wants to know whether it’s a religious hospital? That’s still an odd question but at least it’s significantly less personal and awkward? 

What else could he mean? The big building could be a…courthouse? Library? Something with fancy architecture, though it's not quite fancy enough to be, like, a palace or something. She can’t think why he would be asking about a courthouse or library, though, or whet the conspicuous blank spot would be for given that it doesn’t seem likely he can read English text.

It - does overall seem like “what religion?” fits best with the drawing, and it’s, like, confusing but not completely insane that someone would have that question? The answer to "is Marian religious" and "is this hospital religious" are the same, and if he's asking about the city, it's - multicultural? Honestly, she should maybe try to answer all three of those questions, given how she doesn't think she has a way of narrowing down which one he means assuming she's even on the right track at all. 

She nods at his drawing, but then takes a new piece of paper and draws a bunch of small houses interspersed with a church (tower in the middle, sloped roof on either side, cross on top of the tower and, for congruence with the original drawing, inside a circle on the doors), and - smaller because probably it's a smaller percentage of the population - a mosque (a couple of domes with pointy tops and, uh, the Islam symbol is a crescent with a star in it, she thinks?) and - wow she's drawing a complete blank on whether there's a standard architectural style for synagogues, so she just draws a square building with a door that has a Star of David on it. 

...and then the hospital is over here - she draws a blocky building and gestures at the room around them - and it gets a circle on the door that's scribbled out and a headshake, which she hopes conveys "none of those are applicable"? And then she'll draw a figure to be herself and put a scribbled out circle on it too. 

So, they have gods - none of the symbols are obvious to to him, although they might have different ones this far away, and the stars could be the Star-Eyed or maybe Astera - but this House of Healing is opposed to them?  And so is the young woman personally, which warrants a separate drawing, because... they do allow god-worshippers here but they just don't like them?

That's... well, Karal is still not sure how he feels about all this opposition to the gods, but Leareth should get along with these people - and given what happened at home, he's probably right that it makes them safer.

Does Leareth recognize any of these gods?  The cross shape is particularly odd, it doesn't even look like anything.

Leareth doesn't, which is bizarre - maybe he's just forgotten, but it's the kind of procedural memory that should stick better. It's not impossible that some third group other than the Tayledras worships the Star-Eyed and uses one of the star symbols. He's fairly sure that he would recognize any symbol affiliated with Astera, though. His top theory, now that he's managed to eke out a few more thoughts, is now that they're on Velgarth's other continent, somehow. That doesn't make a huge amount of sense, it's an order of magnitude too far to Gate even when he's not dying, but it's less confusing than somewhere like this existing without his knowledge on the continent where he's spent centuries operating. 

He's not sure if he thinks the woman's affect obviously means opposition to the gods, as opposed to her feeling it was important to communicate that the House of Healing isn't affiliated with a specific temple? Karal could probably get a better sense with Empathy, though. 

Karal did not know there was a second continent!  (...Also he only knows what a continent is because Leareth's thoughts carry that information.)  That does seem like the sort of place that might be this strange and alien - and have different gods as well, he supposes.  Does Leareth have a guess about whether they hate him too?

Empathy, yes, all right.  How does the young woman feel about these gods?

The woman's feelings are mostly that this is really awkward! She's still not sure she interpreted the question right and it would be so embarrassing to give that whole elaborate answer if he actually wanted to know something about the courthouse! 

There's not particularly a sense of hostility in her emotional reaction to what she drew? Mostly the sense is that she thinks of the whole topic as a sensitive and fraught one- and a private one, there's definitely a sense of feeling-exposed in a way she doesn't expect to encounter usually and that's throwing her off-balance - and a feeling that she's worried about his reaction and whether he's going to be uncomfortable with her. 

Oh no!  He's... not exactly sorry about asking her apparently private questions, this is important, but he's sorry that she feels awkward about it, and definitely doesn't want her to be worried.  He gives a serious nod and... how can he make this right...

He nods, then draws another figure and points to himself, and on it both a sun and a scribbled out circle - not even referring to Leareth, he himself is... really not sure about anything, right now.

There, now they have both shared private and somewhat vulnerable information, is that better?  She can't think he'd be uncomfortable with her given this, surely, but he adds a small friendly-calm-apologetic-appreciative Empathy push just in case.

So, this place has some sort of complicated god situation where... multiple gods are worshipped but people dislike each other based on this and try to keep it secret?  It seems like a difficult thing to keep secret to Karal, when the temples obviously aren't, but perhaps he's missing something.

Marian supposes this is marginally less awkward than her patient demanding a Muslim nurse, which probably isn't even a request they could accommodate on this shift. She’s…not sure why it was worth it to him to put what must have been quite a lot of effort into conveying this question, given that it’s not clear how he’s planning to act on the answer? 

He did seem - surprised about it, or confused, or something. She’s not sure what to make of it, or of his own drawing - that he deconverted from a religion that uses the sunburst symbol, maybe? But that’s still not an answer to why he brought it up at all…

She tries to smile reassuringly at him anyway, even though at this point she has no idea what she’s reassuring him about.

(To Empathy, her affect is - not upset or stressed, but definitely bemused.)

Yes, there are confusing things going on with him and he cannot (and possibly shouldn't) explain them.  He gives her an apologetic smile, nods, and switches to a topic he hopes will make more sense.  (Although this is so much drawing, his hand is starting to cramp, he's not used to holding a pen for very long and he's weak and uncoordinated on top of that...)

He takes the earlier sheet with his drawing of a town, and adds the Sun-In-Glory to the temple building.  Draws the borders of Karse on the empty half, as best he can remember them, and some reasonable guesses at the borders of the surrounding countries.  Labels a few in small Rethwellani letters (rather crookedly given how much effort all this is, but it's not as if she can read them anyway, it's just important that it looks like writing).  Draws a dot in Karse, circles the town, points to the town and the dot and himself.  Then points to her drawing of this town, to the building around them, and a few blank areas outside the drawn map.  Questioning gesture?

It’s pretty clear what he’s trying to communicate, and it might be a more successful communication if Marian…sucked less…at geography… Maybe she could track it down on Google Earth but that sounds time-consuming and she’s not incredibly hopeful.

Also she can tell he’s tiring himself out - it’s actually really impressive he had the stamina to draw this many things - and she should probably encourage him to rest soon. (And either make a bigger effort to find someone to help turn him, or just do it herself and tank the lower back injury risk.) 

It's pretty reasonable of him to want to know where they are, though she's...confused...how he ended up in a Reno Walmart with a stab wound while not knowing he's in Reno. She's starting to feel like there must be a weirder and more complicated story here. 

She is absolutely not going to try to draw the United States borders. She'll pull up Google Maps on her phone and show him that way?

Leareth is missing a lot of memories and context but he’s still fairly sure he’s never seen an artifact like that before.

(He can’t sense any magic from it, which is a little confusing, but he’s groggy and not in control of the body and can’t poke at his mage-sight on purpose, so probably it’s just not working properly.)

What is that??

Why does this kind young woman whose really very normal-feeling emotions he's been sensing have an incredibly complicated mage-artifact sitting in her pocket?

...And even more confusingly, why is she not acting like that's what she has??  She very obviously isn't - she pulled it out and did some intricate and unbelievable things to it and did not at any point look like she thought this was at all out of the ordinary or like she expected him to think so.  Is magic so common in this place?? 

Karal's shock is very obvious.  He's definitely making no gestures in the direction of touching this thing, but he isn't taking his eyes off it.  He wishes he could figure out mage-sight right this second, but he almost certainly shouldn't be piling more new factors onto an already unbelievable situation...

It takes him a moment to realize the thing he's looking at is - of course, that's what he asked for - a map.  He... really doesn't know what to do with the information that they use mage-artifacts instead of maps here.

It’s a map that can zoom in and out to different scales, even! Marian starts at the dot for her current location, points out the hospital on the map and gestures at the room around them, and then uses her fingers to zoom out until she can point at the city and say “Reno”, and then zoom zoom zoom out to the state (“Nevada”) and finally the country with both coasts visible (“America”).

That…is not the other continent Leareth is aware of, the shape is wrong. Is there a third major continent that he’s somehow missed the existence of for two thousand years?? One that has zero outside trade but internally has impossibly advanced mage-artifacts…???

Marian can pick up on the patient’s surprise and awe. Has he never seen a touch screen smartphone before? Wow. 

He absolutely hasn't!

He's never seen "America" before either, although at this point it's probably hard for her to tell what specifically he's having that wide-eyed reaction to.

But she does such a good job with her clear map demonstration that, when she pauses, he manages to copy her repeated zoom gesture in a request to show him more of the map instead of stopping at the still-unfamiliar continent outline. 

…Sure, okay, she can do that. She’s not sure why he wants that - has he never seen a map of the world before, what is this dude’s deal - it’s not like he’s illiterate, she saw him writing in whatever that language is…

Fully zooming out doesn’t work great on a phone, she has to pan back and forth to view all the continents, but: here’s Europe, here’s Asia, here’s Africa, here’s Australia…

…Leareth is so incredibly confused.

... Is Leareth very sure they're not dead?

He said he's been dead before, so surely he would know, but Karal is back to feeling like that's the best explanation for how they ended up in a different world entirely.

... No, if this was what happened to the dead then all these people would know it, and wouldn't act so surprised about everything.

Well.  Karal is also incredibly confused - and too confused, or maybe just too tired, to think of any more questions.  Maybe things will make more sense after they've slept?

Leareth is pretty sure this is not what being dead is like, and that "being dead" is probably not the best explanation for apparently ending up in another world. (He's not certain of that, thinking is so hard and he feels so agonizingly disoriented, it feels entirely possible that he’s somehow catastrophically failing at reading maps.)

…anyway it doesn’t seem like there are any decisions to be made right now, they're almost certainly not in acute danger and Leareth is deeply badly placed to evaluate and mitigate any longer-term danger, and the exhaustion is starting to feel intense enough that Leareth wouldn't be surprised if sleep happens at some point regardless of whether they're planning on it. 

Marian is now burning with curiosity about this guy's deal, but also he looks so tired and she wants to leave him be to rest but doesn't want to leave him flat on his back for another two hours. 

She tries to mime "helping him roll over" - honestly, he can probably contribute enough that she's not putting her back at risk? - and then points at him, pillows her head on her hand and closes her eyes? 

If Leareth might be catastrophically failing at reading maps then they definitely should just sleep and try to think about all this again when they're rested.  But this place scribbling out all the gods should be a good sign about not being in acute danger, yes?  So they can probably afford to take some time.  ... Not that they necessarily have much choice about it.  The young woman miming sleep makes him feel so tired.

And she... needs him to not be on his back first?  ...Yes, that does sound really nice.  He didn't realize it was allowed, since most other comfortable things aren't, so he'd just been ignoring that entire category of problem.

The idea of having a young woman help him roll over in bed fills him with vague mortification.  Can he just do it himself?  Maybe he's enough of an invalid that he genuinely can't, but he's definitely at least going to try.  He does feel very weak, and it becomes immediately obvious that he shouldn't be using his core muscles for much, but his legs and arms more or less work, the side of the bed has something he can hold on to and pull, and he is very willing to ignore any pain that doesn't feel like it's doing him real damage.  (His intuition for what counts as real damage might use a higher bar than Marian would like.)

...Ah, he's that type of guy. (Also some other more complicated type of guy, she really doesn't know what's going on here, but "youngish previously-healthy man who has his pride and absolutely does not want help with anything basic" is absolutely an archetype of patient she's seen a lot of in the trauma ICU.)

It's fine??? She's not totally un-stressed about it, but she'll settle for helping him only by managing the various tubes and by tucking a row of pillows behind his back so he has something to lean against. 

He is absolutely that type of guy, yes. 

He gives her an apologetic look about the extra stress (and about wanting so much confusing information earlier), smiles tiredly, maybe touches her hand if she puts it close enough for that to be a reasonable gesture, and is out like a light the moment he stops trying to stay awake.

Awww. Marian will definitely squeeze his hand reassuringly and smile back, and then feel quietly pleased with herself when he's clearly asleep less than thirty seconds later and even looks mostly comfortable. 

...She's really quite confused about what happened just now?? "Guy who stabbed himself in the aisle at Walmart before it was technically open" was already bizarre enough, and that was before they identified all the injuries that look neither self-inflicted nor possible to pick up in a Walmart aisle. And that was before he woke up, proved not to speak English, cared a weird amount about communicating something related to his religious background, is from a country she definitely doesn't recognize on a map (not that this is saying enormously much), and also acted like he had never seen a smartphone before and was having his mind utterly blown by Google Maps. 

She's at least a lot less worried now that he's actively suicidal, unless he's doing a very good job of hiding it, but that just means his serious injuries are even more inexplicable. He didn't show any sign of a head injury, so it seems implausible he has complete amnesia over how he ended up in Nevada (it would be implausible even with a head injury, unlike in fiction it's pretty rare for someone to have retrograde amnesia and no other problems.) 

How much are the many questions she has actually a priority? She needs to think more about how she would draw the question "what happened to you?" and isn't 100% sure he wants to answer, and she kind of wants to give him a break from drawing complicated things, he was managing it remarkably well but it pretty clearly wore him out. 

...If he's confused about that many things, he plausibly doesn't really understand what they're doing treatment-wise, which must be stressful and scary. It's maybe a higher priority for Marian to convey to him, like, what all the tubes in him are for? 

Also, obviously the highest priority here is making sure he stays stable. How's he looking? 

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.

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.

...Yeah. It's really inconvenient and it's bugging her too! Unfortunately she's worried about his respiratory status - his sats are fine now but he's been lying still - so probably he's not going to get the tube out that soon. Maybe she can find on Google what that alphabet is from and figure out how to use the stupid phone translation service to read a written note and then this isn't actually a worthwhile use of time, probably. Marian nods and shrugs and looks apologetic.

- does he seem like he might be persistently awake and feeling a little better? Because she does still have a lot of questions for him, if it seems like it might be a good time and she can think of how to draw pictures to ask. 

He does look persistently awake!  Not very much better - or, he still looks physically uncomfortable and a bit unhappy about that, but he does seem to be more clear-headed than before.  Or at least he's focusing on her and doesn't look like it requires deliberate effort.

Oh good. She might as well try conveying that she's confused and has a question? He may or may not be up for actually drawing the answer but it's a start. 

She finds the bit of paper where she originally drew the sequence of how he ended up in the ICU, and - points at him where he is now and then walks her finger back along the page, from the hospital-drawing to the ambulance-drawing to the bleeding-stick-figure drawing. And then moves her finger further left, off the paper, and makes a questioning face, and then offers him the clipboard with a blank sheet on it...? 

It's very understandable that the Healer has questions about how they ended up wherever they are! Leareth is...deliberately not having an opinion on whether Karal should try to answer, actually, that seems like it should be up to Karal. 

Oh no, that is such a reasonable question, and he knows neither how he wants to answer it nor how to draw whatever he decides on.

(He squints mentally at Leareth's lack of opinion, but decides he should take it at face value, if they're going to try to trust each other.)

Well, he could refuse to talk about any of it, but that just seems unhelpful to the goal of figuring out where they are and why?  These people may know something they don't.  They seem to know so much, in general.

But he would prefer not to have to explain Leareth in small drawings, and that doesn't feel like lying, when Leareth doesn't want to be talked about.  So...

A little scene of Karal sleeping in a bed, in a room with a wall. 

Next, a group of shadowy figures outside, a large jagged hole in the wall, a net thrown over a flailing Karal-figure on the floor. 

Next, the Karal figure, half out from under the net but surrounded by enemies, stabs itself with a knife.  He adds abstract scribbles to the scene - some from Karal's head, some from the other figures, some from above - a circle underneath, faintly drawn and then half scribbled-out - he makes a complicatedly confused gesture.  Points to the three pictures in turn, gestures confusion again, and then points to Marian's bleeding-stick-figure page.

....Wow that's really confusing. Uh. Marian is - kind of struggling to come up with a less stupid interpretation than "something involving Spider-Man attacking her patient"? 

Ugh. She shouldn't punish her patient for being bad at drawing having a weird complicated history whatever.

She tries to smile gratefully at him even though none of that makes ANY SENSE.

Yes, it's confusing, he knows!  But... she seems even more confused than he expected?  He helps himself with Empathy, but really most of it is clear enough from her body language - there's no recognition there at all, not "what a bizarre magical accident, I have no idea how that happened or what sort of place you're from" but "I don't understand what any of this is at all". 

... He has noticed that her world is very unlike his.  They... do magic completely differently?  Don't have Gates?  Something else he isn't thinking of?  Or maybe he's just very bad at drawing and it would all make sense to her if he did it differently.  All these are possible, and he doesn't feel up to trying to disentagle them with more little drawings, especially when it seems unlikely to help - he had hoped she might have some idea of what happened to them and why, but if the concepts are so alien to her then she probably doesn't.

The important part is - he points to his last drawing, makes an exaggerated confused gesture, points to her first one - he doesn't understand what happened either.

They can both be confused then!!! 

...Also Marian is maybe getting distracted by the baffling Spider-Man part and neglecting to focus on the more important part, which is that the figure in the last panel is definitely stabbing himself! Why! He's not even acting like this is incredibly concerning! 

She points at the figure with the knife and makes a questioning face, trying to convey "why did you do that?" matter-of-factly without looking like she's upset with him over it; if she acts like she thinks he did something wrong, she's worried he won't want to tell her. 

(Inconveniently for Marian, Karal has Empathy and will be able to tell just fine that she's upset.) 

Being upset about all of that makes perfect sense!  If it wasn't an incredibly upsetting situation he wouldn't have tried to kill himself to get out of it!  She seems upset in a... different direction than that... but probably it's just because everything is confusing.

It's also, once again, a really complicated question, with parts he doesn't want to answer and probably couldn't even if he wanted to.  But it's a reasonable thing for her to want to know, when she's been putting so much effort into keeping him alive.  He cannot exactly promise he won't do it again, but he can try to show that he did it for good reasons?

He circles the earlier scene, where he's trapped under a net.  Draws a line from that to a version where he lies down and doesn't do anything as one of the figures grabs him - another line from that to a scene where he's chained to a wall - and he draws that one a second and third time, pointing to them in turn and then in a circle with a distressed look on his face.  Imprisoned forever.

He draws another line from the net scene, to one where he stands up and stabs one of the other figures with the knife.  A line from that to a confusing and very scribbly larger scene - a big building, explosions, many figures lying around bleeding.  He looks even more acutely miserable about that one.

He draws a third line from the net scene to the original one of him stabbing himself.  Circles that one, emphatically crosses out the other two, looking a little sad but mostly deeply relieved.

Okay, he - thought he didn't have better options than trying to kill himself? Fair enough, she supposes, just. What even are the other options he's trying to draw here??? 

- okay, ignore the Spiderman webs, that's a distraction. He was asleep and - got cornered by some unfriendly people who intended him harm, that much is clear. Some sort of fucked up gang thing, maybe? He could have fought back, but this would have...escalated to someone blowing up the building? Baffling that that would happen but valid not to want it to! And he could have not fought back and they would have - kidnapped him and chained him up in someone's basement? 

There's a notable lack of any of the options being, like, calling the cops. ...Honestly all Marian can think of is that maybe her patient is also a gang member who was up to something shady and didn't want the authorities involved. Not that it actually matters, he's her patient and he deserves the best care she can give him regardless of what brought him here and it's not actually her business. 

Did this all happen in the fucking Walmart where she does her grocery shopping??? (Is this guy homeless and breaks into stores to sleep there? That might explain not wanting to call the cops though, uh, trying to kill himself seems like an enormous overreaction if the alternative is getting in trouble for breaking into Walmart.) Or possibly it happened somewhere else and the unfriendly gang dumped him there and left him for dead. For some reason. It seems like the guy who was opening the store would have to be in on it and Marian suddenly has so many concerns about ever going to that Walmart again. 

- it's also pretty unclear how he ended up with burns? Maybe the reason he thinks that a fight would have escalated to blowing up a building is because the Spiderman web was a baffling way of depicting that the unfriendly gang would-be-kidnappers tried to incapacitate him with a bomb, and he reasonably thought they probably had more of those? In that case it presumably didn't all happen in Walmart unless the guy opening the store was in on it and cleaned up the evidence before calling 911. 

NO FUCKING WONDER this man has some sort of PTSD! 

...How is one supposed to respond to one's patient confessing that they were ??involved in some sort of horrific gang kidnapping incident?? Should she be explaining this to the charge nurse so they can make a police report? 

Probably first she should, like, be sympathetic and understanding to her patient who just went through an incredibly awful experience. Marian nods seriously, making eye contact, and - not moving quickly and trying to telegraph everything she's doing - will reach to squeeze his hand comfortingly if he allows it? 

She's... worried and confused about pretty much everything, which is entirely reasonable of her... uncertain about him, briefly, and concerned for her own safety, also briefly - she is absolutely entitled to both of those reactions, and he nods with an apologetic expression - and... despite all that she resolves to focus on being kind to him...

Oh, she's so good.  He gives her a heartfelt sad smile, squeezes her hand for a long moment, projects gratitude-regret-trust-safety very lightly.

... He may be clinging and tearing up a little. 

Awww. Marian is so glad that he seems to trust her and be comfortable with her even though she probably gave him a PTSD flashback by being an enormous klutz and somehow causing a miniature earthquake. She can stand here holding his hand as long as he seems to want that. 

(She feels like she has a way better sense of why he hated being restrained so much! He might even have thought that the kidnapping had succeeded and he was chained up in someone's basement after all, during the worst disorientation. 

...She does not have any idea how the "gang activity" theory fits with the thing where he doesn't speak English, is from some country she doesn't recognize with an alphabet she doesn't recognize, and seems to have never seen a phone before? But it's not, like, incredibly decision-relevant to figure that out right now. Maybe it'll at least mean that the police can not bother trying to question him until he's recovered enough for extubation? If the police want to harass her patient they'll have to get through her first.) 

She is so good.  He will in fact close his eyes and spend a few minutes crying in mixed horror and relief, and not let go of her hand unless she does it first.  It was all a terrifying experience, and truly awful things could have happened, that he didn't predict and wasn't prepared for - and then different confusing things kept happening and he hasn't had time to have emotions about it for... he has no idea how long he's been here...  But in the end the worst didn't happen, and he's still alive and surrounded by kind people and they will... probably be all right? 

It's a little worrying that she seems to expect some sort of conflict over him - and she should not put herself at risk for his sake even though she's absolutely considering it!  But she isn't very worried, so probably whatever it is will be fine, and in any case he can deal with it later.  Everything will be easier then - or at least Marian thinks so, and he believes her.

Leareth doesn't relax just in response to what Karal is picking up with Empathy, but Karal's reaction to it is - Leareth thinks he's right, probably, that they're - that whatever the remaining complication is, it's not physical danger. There's no point in - well, there was already no point in trying to hold himself tense in a shape ready to respond to unexpected danger, since he can't do things, but now it feels like it's also no longer justified.  

...he's not sure what to do with that. Usually this is where it would make sense to focus on resting and processing what happened, and work toward being - okay. Which would involve actually letting himself fully feel all the emotions he's definitely going to have about the situation as soon as he leaves space for them in his head, but it feels impossible to get anywhere on being more okay given the...everything...

Yes - Karal can lie here and cry and feel better, because for him the worst part is already over, but for Leareth it's not.  No wonder he can't see how he can possibly feel more okay until things get at least a little better.  Karal imagines hugging him, for all that he's not sure Leareth will find that anything but baffling.

He tentatively thinks it would be good for Leareth to try having some of his inevitable emotions now, when he at least feels safer and more relaxed - and when Karal is relaxed and taking the time to feel his own pain, because it seems like Karal's reactions help Leareth figure out the right way to feel about things?  Which makes sense, with how he can't really do much figuring out on his own.

And then they'll work on finding something that can be made at least a little better.  Karal is clear-headed enough now that he can promise him at least that much.  It... wouldn't be fair, to ask Leareth to let himself feel things with no prospect of having different feelings afterward.

That makes sense. It's not like Leareth isn't already experiencing a lot of distress, and looking at how he feels about the situation in more detail will probably make the misery easier to bear even if it doesn't precisely make him any less miserable. 

What is the situation? Start by trying to think about that. 

He died. He doesn't remember how he died, which is unusual and bothers him. He might have been unusually disoriented even for having just died and come back, though it’s hard to be sure since he doesn’t remember the other times.

He landed on a battlefield in Karse, in circumstances that seemed carefully arranged by Someone to nudge him toward not immediately killing Karal. He judged it was worth the small risk of staying in Karal’s keep for longer, to avoid the different risks of sleeping rough and - because it was something considerate he could do for Karal, and he thought he could afford that.

He clearly misjudged that gamble.

Probably the godplot was in fact to take them prisoner, and Vkandis wasn’t specifically steering Leareth into somehow messing up a Gate in a way that might have landed them in a different world and has at least almost certainly landed them out of normal Gate-range of any of his people or records.

And, of course, he wouldn’t be able to Gate himself back anyway; he doesn’t remember any safe Gate-locations, he’s badly injured, and he’s under a compulsion not to do anything. If Vkandis was actually trying to trap him in another world where he can’t complete his work in Velgarth, this is a highly effective way to do it.

- though now that he’s trying to lay it out, it’s occurring to him that the compulsion was a sloppy one. Overpowered, so it won’t fall apart in days, but it probably won’t stay stable for months.

That’s…an enormous relief, it doesn’t make the current situation less unpleasant but he’s unlikely to be trapped indefinitely…

Also he's sharing his head with Karal, which - to the extent Karal can be modeled as an ally, is actually very fortunate? Karal isn't affected by the compulsion, and - possibly that's something Vkandis wasn't expecting or counting on? It's the only reason why he's not a prisoner, and now that they're - elsewhere - it's also the only reason he has avenues to learn more about their situation or gain any control over it. 

...It's also very stressful because Karal barely knows anything about him and might prefer not to treat him as an ally if he did know. And it's not fair to Karal to keep that information from him, even if Leareth is very very scared about where that might lead. 

Karal said he wasn't going to keep Leareth trapped indefinitely!  ...But Leareth doesn't trust people, so that didn't count.  No, that's unkind - even if he did believe him, there's an enormous difference between believing someone that something will happen and knowing that you'll be able to do it yourself, and Karal cannot at all blame Leareth for feeling relieved for not having to rely on him.

And Leareth is right that they don't even know each other very well.  For instance, Karal did not realize he had been at that much risk of being killed immediately!  He's not sure how he feels about that for a moment, then gives a mental shrug - that is the nature of battlefields anyway, so he hardly has much room to complain, and it's not as if the short rest of his life without Leareth's appearance would've meant much of anything.

Leareth got him home, and Karal owes him for that.  He knows everything is complicated and probably awful - just that killing Karal wouldn't have been much of a loss doesn't mean it's all right that Leareth apparently regularly does this to people - but he would pay a debt even to an enemy.  And, more than that... Leareth is not treating him as an enemy, Leareth keeps trying to be fair and kind to him when he can, and Karal is not going to repay that with hostility.  (He just isn't - that is a fundamental fact about him that he cannot prove or explain, but the unshakeable certainty in his thoughts is difficult to doubt.)  He is not going to let Leareth be worse off for having let him live, or for letting him spend a night at home, or for any of the small cooperative gestures he clearly expected no advantage from.  (A memory of Leareth, helpless and confused, pushing through his distress to tell Karal what happened wasn't his fault.  It hurts, that he could do that for someone and yet had no expectation of being treated well in turn.)  Even if Leareth has done awful things, which must be the case if he's so worried about telling Karal more about himself, he is clearly not an evil man, and it would be a deep wrong to punish him for his better impulses and push him toward becoming one.  Karal will not let a man be trapped because he chose to be kind, not even if the gods intended it.

And Karal doesn't insist on knowing whatever it is Leareth's keeping from him.  That is Leareth's choice, and it should be a free one.  He doesn't expect it to change much of what he does, only how he feels about it.

Well, there’s also the fact that Karal currently can’t fix it, and it might well take him longer than a few weeks to learn enough control of his mage-gift to safely cut a compulsion without hurting them. But, no, Leareth’s life - many lives - have generally not rewarded him for trusting strangers thrown into his life by circumstance. And this particular set of circumstances was almost certainly steered by Vkandis, who Leareth would expect want Karal not to be someone who he could trust and work with. 

There’s a note of mental apology - he doesn’t mean to offend Karal by implying that he must be lying about his intention to try to help Leareth - the prediction that this ends badly for him isn't really about Karal at all, just - broader priors. 

Anyway. For better or worse, they're in this together for the foreseeable future, and Leareth is glad that Karal isn't treating him as an enemy, and grateful that he wants to help make this easier if he can. 

He thinks telling Karal - well, not hiding in his thoughts from Karal - the truth about his life and plans is a necessary step toward it being any easier. As long as Karal doesn't know who Leareth really is, his intention to help feels - like it might be based on false premises, and therefore Leareth can't put any emotional weight on it. Though he maybe needs...some more time...to get his thoughts and fragmented memories into enough order that he can show Karal in a way that makes any sense. 

...also he's paying a little more attention to the sensory input of having a body right now, even though this is distressing because he can't move it, and - he's noticing that Karal's body feels really quite terrible? To an extent that might be concerning, and is almost certainly impairing for both of them. 

He's not sure if the Healer can do anything about that, but it's plausibly the sort of thing she would want Karal to communicate? 

Karal is not so much offended as just baffled - he's led a simple life in which people mostly believed him when he said things, and he's having trouble imagining the thought process that leads someone to see all his thoughts and not trust that they aren't somehow false - but he can understand what Leareth is saying, even if that entire way of thinking is deeply alien to him.  (It hurts, of course it does, to offer someone that much of himself and have it ignored.  But that is not Leareth's fault any more than Karal's side of all their misunderstandings is his.  They will just have to do it the long way around.)

Yes, then, Leareth should take the time to think about how to tell Karal more about himself - Karal is not good at thinking through bizarre complicated situations, and Leareth's existence has clearly been that, so he would be grateful to have it simplified, but he would very much like to... know enough for Leareth to be capable of believing that he means what he says.  And in the meantime Karal should... see if Marian can do anything about the vague terribleness?...  He thought vague terribleness was the expected state of things when he should really be dead, and so he's been ignoring it, which he's really remarkably good at.  But maybe Leareth has a point - he has been feeling better and worse, or at least different types of bad, over time, in ways that might possibly depend on something all these strange objects are doing, rather than just being the inevitable result of his choices?  The objects are doing something, after all.

He opens his eyes, waves his hand to get Marian's attention - he does feel really weak - makes an unhappy grimace?  Cups his head in an 'it hurts' gesture, squeezing his eyes closed for a moment.  Picks up his arm and half flops it to indicate how exhausting it is to move, although that's... probably normal...?  Points at his chest, where it feels like his heart is doing something strange and wrong, but that's probably also expected after having stabbed it, and he has no idea how to differentiate it from any of the other obviously wrong things with his chest.

Aww poor guy. He does look like he's feeling pretty terrible! ...It's moderately worrying, actually, he still looks - off, sick, in some way Marian can't pin down but she doesn't think it's just the expected blood loss and pain. 

He doesn't have a fever, though she should be keeping a close eye on that, he's at high risk of infection from the burns. And at risk of dehydration - which would also explain a headache - but his urine output is all right. He's pale, but less sweaty and clammy than before she treated his low blood sugar. 

Something about his chest is clearly bothering him, and proooobably it’s not just pain? He knows he’s injured and already expressed that he still prefers a lower dose of pain medication.

….His sats are down at 91%. That’s not great, hmm. Marian points at his chest, attempts to act out someone trying to catch their breath, and makes a questioning face?

He... has been ignoring anything going on with his breathing even more thoroughly than he's been ignoring everything else... because there's a tube in there and that really seems like it makes it not his responsibility to consider whether the right things are happening!  But yes, now that she asks about it, he would like to feel like he can breathe properly.

He attempts to also act out trying to breathe, grimaces at the tube making it feel weird, nods.

Marian swings down her stethoscope and listens to his lungs.

- okay, yeah, he’s in fact filling up with fine crackles, whoops, she hasn’t suctioned him - at all, actually, his lungs were clear right after the OR and then he was awake and refusing sedation and she didn’t want to be mean.

It seems like she’s now going to need to be mean! Normally she would consider giving him a bit of extra sedation for it, but she doubts he wants that.

She nods, then picks up the in-line suction tubing where he can see it, and mimes pushing it into the tube, then points at him and fake-coughs. Does he seem to follow this?

She's going to put a thing into the tube and wants him to cough?  That's... well, not reasonable, but not more unreasonable than anything else going on... except he worries he won't be able to breathe at all while there are things in there?  He mimes breathing again, mimes putting a thing into the tube and then failing to breathe?

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.

Marian starts another liter of saline. "...I'm checking his blood sugar again just in case, he had the weird hypoglycemia problem again and it didn't go up as much as you'd expect." 

72 mg/dL. 

Technically still within normal range! It's very borderline and making Marian nervous but she doesn't see how it could possibly be causing whatever problem he's having. 

She watches his vital signs closely and refreshes the computer repeatedly for labs. 

His heart rate does come down a little, to around 125, and his blood pressure is a more comfortable 110/60. His sats are holding up fine, still at 96%, and his breathing looks slow and steady and fairly unlabored.

He's if anything doing even more irregular beats, though. 

(Leareth has gone back to mostly trying not to be aware of their body; there's nothing he can do, so feeling worse in some way isn't decision-relevant, and trying to drift somewhere far away makes it easier not to be stressed, which is important, he needs to be calm so Karal can be calm...) 

Also he looks like crap, for someone whose vital signs are technically fine. 

Marian should probably go check with Dr Hulka if, given his current heart rate and BP, she wants to do anything else while they wait for the labs? 

One of the premature heartbeats lands at exactly the wrong moment, and the monitor switches from still mostly reading sinus tachycardia, to a very fast wide-complex ventricular pattern. 

- for about three seconds before breaking out of it, but there are only a handful of normal beats before it happens again. The blood pressure waveform almost instantly dropped to below 70 systolic, and doesn't have time to recover in between. 

Marian is at the nursing station, waiting for Dr Hulka to be off the phone. 

Someone's alarm is going off. She should see who has– WAIT SHIT 

"I need help in 104!" she yells, and runs. 

They're... doing things but none of it feels like it's helping... do they know that... Marian seems to know, good, he can stay calm if someone knows what to do... Leareth is doing the right thing in not being there, Karal is definitely better at being helpless and still and not trying to do any things...

Marian is going somewhere, clearly for good reason given how worried she is (he's relying on Empathy more and more as worrying and confusing things keep happening without a good opportunity for communication) and Karal will not protest but he is starting to feel less happy about being left alone like this...

--a sudden spike of pain and wrongness, he can't breathe and he thinks he really is dying, somehow, for no reason-- what happened-- 

--Marian's not here, he tries to find her with Empathy but he can't, it's like the whole world is shrinking around him, he can barely see anything-- (he's projecting distress in all directions, but his range is shrinking fast enough that it may not have anyone in it)

--he needs help, he needs to breathe, he has no idea what's wrong but if he pulls the tube out he can shout for help, and if he doesn't he may be dead before anyone knows what's happening--

He's incredibly weak (because he's dying) but he does still manage that.  It does not let him breathe.

(He manages to - briefly - hit the patient next door, who’s less than fifteen feet away on the other side of a thin wall, and who is actually conscious - and now very confused! Did someone just - yell for help -? …He’s going to hit his call bell, which is unfortunately a much lower priority for anyone to answer than the multiple alarms already screaming next door.)

Marian reaches the room and

WHAT

HOW

That’s not fair she was gone for less than a minute and he said he wouldn’t pull any tubes out if they left him unrestrained

She's going to be in so much trouble 

- focus. Airway/breathing/circulation and then she can have feelings.

He’s - still conscious, somehow, and at least making a valiant attempt to breathe unassisted, despite being in rapid V-tach on the monitor with a systolic blood pressure in the 50s - though at least there’s a waveform at all - his color is greyish and either he's lost the sat probe or it's failing to get a reading because his peripheral circulation is no longer happening. 

Marian whacks the code button - he appears to technically still have a pulse but she's unconvinced that's going to last much longer - and drops the head of the bed to flat, which won't make it any easier for him to breathe but his blood pressure feels like the bigger problem right now - she'll dive for the non-rebreather oxygen mask tucked behind the head of the bed, turn the flow up all the way and desperately hope he's not going to fight her about it because he's disoriented and terrified, or at least that if he does he's not strong enough to put up actual resistance - 

(At some point during that, the patient snaps out of the fifteen-second run of V-tach and back into an unsteady sinus rhythm. His blood pressure recovers slightly.)

Leareth is - still there, but honestly significantly less conscious than Karal at this point; there's less of him that can run on physical reflexes alone, and it feels like there's maybe not enough energy left in their body for both of them to be awake. He's confused and distressed and not incredibly aware of what's happening, but he does, on some level, just barely remember that he shouldn't be fighting Karal for control of the body... 

Karal makes a faint unhappy noise at the sudden drop but doesn't fight Marian about anything - she's here, that's really all he wanted - and she's upset with him, oh no, he's sorry for almost dying whatever it was and he will definitely not do any more things!

also doing things would be so hard right now, it's so much better that she's here and he doesn't have to

(He is still using what Empathy he can manage - after so long it feels like just another sense he has, more than something he's deliberately doing, so it never occurred to him to stop.)

Dr Hulka reaches the room within another twenty seconds, looking harassed, at around the same time as Marian's podmate arrives with the crash cart. "Okay, what's happening here - did he just self-extubate, why wasn't he -"  

     "He has PTSD about being restrained," Dr Cabat jumps in helpfully. "Uh, he did seem calm before." 

This is POSSIBLY THE WORST SHIFT OF MARIAN'S ENTIRE LIFE and she wants to disappear through the floor. "I wasn't restraining him because it made him really panicky and combative, and he was basically calm and cooperative otherwise - I think he must have felt it when he went into V-tach, that was the monitor alarm, and got scared -" She's trying to find the stupid sat probe. "He's conscious and - I think he's trying to be cooperative.” 

She gets the probe back on his finger; his blood pressure is struggling its way back to 70 systolic, which might be enough to get a reading on his finger, though also she thinks the crash cart should have some of the neonatal ones that work on an earlobe…

84%.

"Well, that could be worse," Dr Hulka says matter-of-factly. "We'll have to reintubate but I reckon he'll tough it out a few minutes while we stabilize his rhythm. - get the defib pads on him, please, let's do front and back rather than yank off more dressings - run amiodarone 150mg over ten minutes - and let's prep an epi drip in case his BP doesn't recover or the amio drops him more - we sent labs, right, do we have those back, what were his last lytes -?" 

     Dr Cabat is pulling up the chart on the computer. "Uh, last K was back up to 3.6. Most recent set is still marked pending." 

"Show me the ECG again - this looks like it could be hypokalemia, but I can't think what would drop him that fast - he definitely didn't get diuretics, right?" 

     "No..." Dr Cabat looks speculative. "He does have that weird recurrent hypoglycemia thing - uh can someone check his sugar again? - right, anyway, I know giving insulin and D50 is a firstline treatment for hyperkalemia - if whatever's going on with him has a similar mechanism, could it be doing the same thing, pulling too much K into the cells and dropping his serum levels..." 

"That's certainly a theory. - okay, I want his BP up faster than this, let's start the epi -" 

Marian is trying to half-listen to everything going on but most of her attention is on making eye contact with her patient and keeping him calm while they mess a bit with his dressings again to make enough room to attach a defibrillator pad - some of it's going to be over blistered skin but she can at least manage to avoid the third-degree burns - and then they also have to roll him all the way onto his side to stick the other pad on his back, both of which have to hurt like hell. He keeps doing little runs of V-tach but at least nothing that lasts more than two or three seconds, and with enough time in between for his blood pressure to straggle back up again. 

(Her affect is actually significantly less alarmed and upset now; she's stressed but focused. Her team is in the room with her and it feels at least more like whatever happens they'll be able to wrestle the situation back under control.)

Marian is very good.  All these people are doing so many strange and uncomfortable things, but he knows he's supposed to let them, and it's easy to remember that when she keeps looking at him and thinking calming thoughts.  His chest hurts whenever they do anything, but it's surface pain, it's fine, they can do that-- he still feels faint and just generally horrible, but... maybe a little less so?...  He tenses up whenever his heart does the Wrong Thing again, but he tries to relax and wait it out and it keeps not killing him, so maybe it's not as bad as he thought--

And he can breathe now - it takes so much effort but it's good to have something he can usefully apply effort to, and Marian clearly wants him to keep trying, so that's not one of the things he shouldn't be doing.  He focuses on keeping it up for as long as he can manage, looks at her, and tries to let these people keep him alive. 

(He thought it wasn't that important to be alive, but Leareth was so scared, and he thinks Marian would be upset...)

He's doing so well! Marian is so proud of him! He's managing to maintain his sats at 90%, which is really impressive given the broken ribs and lung damage and obvious muscle weakness. It's also actually pretty reassuring that he looks alarmed again every time he does another short run of V-tach, it means he's with it enough to notice. 

"Dr Hulka, uh, his blood sugar is, like, fifty-nine -" 

      "Seriously, again? Let's deal with that - labs still aren't back? This really feels like something is up with his lytes. ...I think let's run another 10 mmol of potassium without waiting, even if I'm on the wrong track it shouldn't send him high. - repeat lytes again first, if something is going on with that it's worse than it was an hour ago -" 

"I'm going up to 0.2 on the epi - amio's half done, I can't tell if it's helping but -"

     "Well, he hasn't actually coded, that's something -" 

It seems like he's going to keep not coding! The amiodarone bolus finishes after ten minutes and it's clearly not fixing the underlying problem but it does maybe seem to be helping, he's now mostly back to sinus tachycardia with a lot of ventricular beats and is only occasionally doing short runs of V-tach. It also clearly would be tanking his blood pressure, but the epinephrine drip is managing to keep up with that. 

And Dr Hulka is now prepping an intubation tray, which is such a reasonable plan - he's clearly going to exhaust himself soon - but they'll have to give him sedation and Marian feels really bad about just - doing that without indicating it to him in any way. 

She takes his hand and tries to get his attention, then - points at him, mimes closing her eyes and letting her head flop in a way she hopes looks more like "drugs to fall asleep" than "deciding to go to sleep on purpose", and then gestures to try to convey "the tube will go back in." 

Does it look like he's following any of that? Does he seem upset about it? 

He doesn't look happy about it, but seems oriented in an exhausted way.  He nods - Marian is probably right that he can't keep breathing this hard for very long, especially if he ever wants to sleep, and in any case she knows better than he would. 

He's not entirely clear on how the falling-asleep is supposed to happen, or whether that gesture even means falling asleep and not just relaxing and trying not to think about what's happening (which would be a very reasonable way to go about having the unpleasant tube put in! and might be what they mean if they expect it to happen very soon, which it looks like they do?), and he will in fact close his eyes and try to relax once she's done talking to him.

Oh good. Marian isn't sure if she thinks he understood, but she feels better for having tried. 

And someone is handing her a syringe of propofol, so she'll find an available bit of IV tubing going into the central line - the one just running IV fluids, you're not really supposed to mix propofol with most things - and squeeze her patient's hand reassuringly while she waits for Dr Hulka to indicate that they're ready. 

A minute or so later, she gets a nod and pushes in 50mg of propofol (at which point Karal will feel an overwhelming wave of sleepiness for several seconds, followed by feeling the world spinning - a little like being very drunk - and then nothing.) 

Oh, is that what she meant!  He had no idea that could happen!  If it had happened with no warning he'd probably think he was dying again, but as it is he just wonders vaguely if they're doing it by magic, and then he's out.

Unsurprisingly, it does drop his blood pressure, but they have room to go up on the epinephrine, which one of the nurses maxes out immediately when the art line trace starts to fall off a cliff, and it only gets down to 83/49 before starting to turn around. 

His SpO2 also drops all the way to 79% during the brief interval that he’s no longer able to put in maximal respiratory effort but isn’t yet back on the ventilator, but it also starts to recover almost immediately.

And he’s totally out for at least the next 5-10 minutes, so Marian doesn’t feel bad about suctioning him while he can’t yet feel it. Unfortunately he also doesn’t have much cough reflex, but you can’t have everything.

…He’s approximately stabilized now, right? Dr Hulka will strip off her gloves and leave. 

She ALWAYS DOES THAT and it’s great when you’re the one waiting on routine medical decisions while a dozen emergencies happen across the unit - or refreshing the chart to see if notes are in yet - but when you’re instead one of the emergencies, it’s really stressful.

(At least it sounds like Marian has probably avoided any further dressing-down for the circumstances that led to her patient self-extubating while in V-tach…)

…She considers restraining him again now just in case, before remembering the miserable betrayed expression the first time he woke up and realized he was tied down. He was probably almost kidnapped and only avoided it by stabbing himself and being left for dead! She’s not doing that to him. She’s going to stand RIGHT HERE within arms’ reach, watching him, until he shows signs of waking up.

Within five minutes, before he’s shown any sign of stirring, her podmate is at the door. “Marian? Lab for you.”

“…Uh, right, critical results?” Marian doesn’t really want to go even as far as the phone. “Would you mind taking them down and letting the resident know? If it’s his potassium we are already treating that…”

And she’ll go back to hovering.

Karal slowly drifts closer to consciousness.  He's... scared, like something might go wrong at any moment and he doesn't know what to do about it...  That pushes him to wake up faster and try opening his eyes, maybe he can see if anything is wrong, although probably he can't...

He's more awake, and so tired.  He hurts - more than before?... but the thing he's scared of isn't happening, although he can't quite remember what it is.  He does manage to drag his eyes open and focus on Marian with an uncertain look.

“Good! That’s really good.” Marian leans in immediately, reaching for his hand and squeezing it in a way that hopefully doesn’t feel like restraining him even though she is, totally, thinking about her ability to stop him making a grab for any tubes if he's so inclined. She smiles reassuringly. 

...He looks stressed and she's not sure how much of the recent events he remembers. She makes the hand-squeezing heartbeat gesture he was doing before and then smiles and makes a thumbs-up gesture in a way that will hopefully convey that his heart is (for the moment) doing better. 

He doesn't seem at all inclined to grab anything!  He's in fact not moving at all.  (It was important not to do any things... and right now the awful thing isn't happening but if he does anything it might start??...)

... Oh that's what the scary thing was--  He makes a reflexively distressed face as her motion brings back the memory, but once he gets the rest of her meaning (from Empathy, not the unfamiliar thumb gesture), he nods a little to confirm that it's not happening any more.

Leareth is dragging himself to full consciousness as well. He’s - aware that he shouldn’t fight for the body or mage-gift, that much he actually managed to engrain as a temporary instinctive-level habit, during the minutes he was reminding himself of it over and over.

…It’s approximately the only thing he remembers for the first few seconds, other than the distressing fact that he’s trapped and can’t do things. (It’s still clearly harder for him to track down recent memories on waking than it would be for Karal - his mind is still fragmented,  nothing is “where” he expects it to be - and his basic orienting reflexes are getting tangled up because he can’t volitionally use mage-sight.)

Also there’s an enormous amount of pain - though more distant for Leareth than it is for Karal - and he remembers danger and wrongness - where, what -?

(He’s not yet panicking but his stress levels are clearly rising quickly.)

He catches Leareth's distress almost immediately.  It's all right - or at least things are more stable now!  Their heart was... not working right... but the healers fixed it.  That was most of the danger and wrongness, he thinks?  But he should find out whether it's completely fixed or not, it's just that he doesn't know how to ask that, and he's so tired...

The enormous amount of pain is-- fine, he thinks?  Probably?  Maybe he's wrong about that.  He should probably check that too.

... First he'll lie there for a moment, try to catalogue all the various unpleasant sensations, and see if anything feels better once he gets used to being awake.  And if Marian has more communication ideas.  It would be so much easier if she could tell them what the important things are.

Breathing is back to being weird with the tube - and of course the tube itself continues to feel deeply uncomfortable - but it’s not especially effortful, especially compared to before; it feels like he’s getting enough air within too much difficulty.

Once he pays closer attention, he can tell that his heart is beating quite fast, thumping in his chest as though he's engaged in some sort of moderate exertion like a hike and not lying perfectly still in a bed. He's no longer especially faint or lightheaded, though; there's some lingering dizziness but it feels maybe more like the remnants of the being-drunk dizziness that happened immediately before he fell asleep, and it's getting better rather than worse. 

He does feel appallingly weak, his limbs heavy and floppy, as though he just marched for days without food. Drawing anything right now is going to be very difficult. Also, though it barely registers next to all the other, worse pains, there's a dull achy stiffness in his back and in the muscles of his arms and legs. 

Marian is definitely thinking about ways to communicate, since she's definitely getting the feeling this is a patient who wants to know what's going on! (As a general rule Marian always tries to explain to patients what's going on if they seem up for it at all, but some people actively find it reassuring.) She'll have more to explain once she knows for sure if the problem was his potassium - oh, actually, she can check that, now that he's awake she thinks it's okay to duck to the other side of the room and haul the computer-on-wheels over so she can log into his chart and see the new lab results. 

...Oh dear, that is indeed a potassium level of 2.4 mmol/L. And this is the older set of labs - if it's some sort of bizarre progressive potassium-loss problem, it probably went lower during the interval between when he started seeming a bit off and when he started actively doing potentially-lethal arrhythmias. (Is there some sort of syndrome that causes excessive loss of specifically potassium in urine or something, without causing weirdly high urine output? Maybe related to the hypoglycemia? Ugh, Marian has no idea, that is in fact a doctor question not a nurse question.) 

At least his troponin is - well, mildly elevated, but to an extent fully explained by damage incurred during the surgical repair of his stab wound - which is really good! Low potassium is treatable - if not as fast as she'd like - but much moreso than a MI or other structural cardiac problem. 

Uh. Okay. She needs to think about how to draw someone...having a mysterious electrolyte deficiency? Ugh. That's going to take some thought. In the meantime she'll make sure she's where he can see her and smile reassuringly some more. 

When she first looks at Karal after seeing the results, he looks surprisingly reassured for someone who was clearly scared a moment ago and hasn't been given any new information! 

(The information wouldn't do him any good anyway, he's absolutely not going to understand the details, but he can tell that now Marian knows why things were so bad, and it's an easily-fixable thing rather than a hard one - which is all he really wanted to ask about, and he didn't even have to figure out how!)

He makes the awful-heart-thing motion, points to the strange large artifact she was looking at and then at her, and draws an X in the air over his chest to show the thing no longer happening?

This guy is impressively good at reading her face!

His problem isn't entirely fixed, but - it seems pretty likely he won't do any more scary arrhythmias, the amiodarone certainly looked effective - at the cost of increasing his vasopressor needs a lot, his contractility and thus cardiac output are plausibly even worse now, but also he's back to only the occasional premature ventricular contractions. And meanwhile his potassium will at least be trending upward, and even if it's going to take, like, four to six hours to normalize it, it should take less than that to get him definitely out of the lethal arrhythmias danger zone, for most people that's only a risk below 2.5 mmol/L.

(Also possibly they can get him up faster if there's any way at all he can tolerate it enterally. Though giving the potassium elixir down an NG tube risks just making him throw up, there's a reason one usually avoids giving it to patients on an empty stomach and he's additionally pretty shocky and recently had major surgery.) 

- anyway it seems close enough that she's happy to nod and smile at his gestures. 

Leareth still thinks he would like to know the details, but - at some point, if they survive this, later once they're recovered and he can do things and there's maybe been an opportunity to learn the local language. (It's significantly more frustrating not having Mindspeech potential in this body than it was when he just thought it would be a minor inconvenience and require relying more on people in his organization.) Right now if they at least know the emergency is over, that's fine. He's very tired. 

Karal is very much looking forward to watching Leareth figure out how all the bizarre local artifacts work!  But yes, definitely later.  (For now he shows him some memories of the two strange machines he probably wasn't paying attention to at the time.) 

In the meantime, now that they've established the problem where they nearly died is getting fixed (even if Marian is frustrated about how long it'll take), maybe he could find out about fixing some of the other problems?  He really is incredibly tired and weak, but he's mentally feeling better, which makes it more frustrating how difficult it is to move.

He holds up his arm in an exaggerated floppy way, and makes a questioning gesture?

Hmm, why is he feeling so weak? …Honestly it seems pretty normal and expected for any critically ill patient, but in his case it seems…worse than before…when he was able to roll over in bed unassisted and even sit up (however ill-advised it might have been.)

He’s anemic, but not low enough to necessitate any more transfusions, and his hemoglobin was stable across a couple of checks. He’s on a lot of pressors in addition to his body’s natural shock response, both of which will be redirecting blood flow and oxygen away from his extremities to prioritize vital organs, but that can’t explain all of it, surely.

…Honestly that might also be a direct effect of a potassium level that low. She wants to Google that really quickly - okay, yeah, she was right and hypokalemia totally causes fatigue and muscle weakness.

She points at the computer again, makes the heartbeat gesture and also imitates his floppy-arm gesture, then points at the IV tubing, taps her watch and mimes clock hands turning, and then makes the X gesture over her patient’s chest and also adds a bicep-flexing gesture.

Hopefully that conveys “fixing the heart problem will also help with the weakness and fatigue” and also that he should expect it to take a couple of hours?

Oh!  That's very good, if the two problems are somehow really one problem.

He has no idea what the wrist gesture was, but he can get from her emotions that it's about time, long but not days?  That's not bad at all, really, but it is going to be frustrating to spend that much time unable to draw reasonably.  Moving his hands is hard enough!  He would maybe like to be done with that for a little while, since everything seems to be all right.  (Well, relatively speaking.)

He mimes sleep, questioning gesture?

That’s an excellent idea! Marian nods and smiles and repeats the same “sleep” mime-routine back to him. …And then points at him and mimes rolling over, because he’s now flat on his back again after the reintubation and might be more comfortable in a different position? …She’ll also point outside the room, and make a walking gesture into the room with her fingers and count to 2 on her fingers while pointing to herself and across the bed, to convey that they’ll help him? He might assume she wants him to roll over by himself again but not feel up for that in his current condition.

Questioning face - does he want that? (It’s not urgent, he’s fine to lay on his back again for a couple of hours, but she thinks he seemed comfier before on his side.)

Shrug?  It seems like a lot of effort to go to for something that doesn't matter, especially if he'll be able to do it on his own in not too long, but if she thinks it's important he's not going to argue with her.

Well, it’ll help Marian feel better so she doesn’t mind if it’s more work! Also he’s spent a lot of hours on his back today, but if she puts him on his other side she’ll be happier about leaving him be to sleep for two or three hours. And the unit seems less hectic now, she thinks she can get someone to help without too much time elapsing. 

This proves correct, and she’s able to nab Elliot, one of the other travel nurses, to help gently slide her patient up to the top of the bed again - people always slide half down to the bottom when the head is raised - and then turn him and tuck him in with a nest of pillows. He can have a blanket from the warmer too. (Marian feels that making patients comfortable in small ways is especially important when they feel awful in big ways that she can’t immediately fix.)

And now he can sleep, if he wants! She’ll stay nearby (though maybe after asking Elliot to keep an eye on him while she pees and gets water.)

Healers have very strange priorities, but it is really comfortable, so he gives her a sleepy smile and closes his eyes.

He has no idea what time of the day it is, but with everything that's happened in the last days, it hardly matters to his ability to fall asleep within a minute.

It’s early afternoon. Marian is actually really hungry, but getting anyone to cover her for a lunch break - even just long enough to bolt down the stew in a container in her backpack without heating it up first - would require actually explaining to someone why restraining this guy is a really bad idea and they need to instead park themselves next to him for the duration. 

Ugh. She needs to...do something about that. She's not behind on charting in the sense of vital signs and assessments but she's arguably very behind in the sense that she hasn't even tried to figure out where to document any of the tenuous facts she knows-or-is-guessing about her patient's history. And waiting for rounds is starting to seem less tenable. Dr Hulka tends to round on new admits last rather than first - which Marian minds a lot less given how she actually does her notes in a timely manner and puts in standard admission orders - but it does mean that rounds on him may not happen until like 4 pm. (Also, explaining what she knows about his deal in front of the entire medical team sounds way more awkward than having it already in the chart.) 

She manages to flag down Kasey, her podmate today, and ask if she can send over the charge nurse when she has a chance. 

Alison is the charge nurse today. She looks tired when she comes over, which is really unsurprising because Marian knows for a fact that she was also out at the bar last night and showed no indication of being ready to leave at the point when Marian left. 

"'Sup?" 

...Marian brings over the clipboard of drawings, and maybe they can talk standing in the doorway in hopes of not waking her sleeping patient? 

"So, uh. He's the Walmart stabbing guy, right, and we had no idea what went down before they found him? There's - a bunch of stuff - uh, he doesn't speak any English, that's one thing. He wrote this," she shuffles through to find the relevant bit of paper, "and I don't even know what alphabet that is. And then later he drew a map..." 

Also had a weird amount of interest in Marian/the hospital's religious affiliation, she had kind of forgotten that, but it seems less important to go into right this second.

She finds the map. "I think it's meant to be the country he's from? Also I tried to show him Google Maps and he was, like, astounded, like he'd never seen a smartphone before. Anyway, later I think I tried to ask him what happened and he drew this, uh, incredibly confusing picture, and I tried to ask why he stabbed himself and he drew - this. I'm guessing here but I think what happened is that maybe people were - trying to kidnap him? Maybe some sort of gang thing? And he was worried if he fought back there'd be, like, some sort of shootout or they'd set off a bomb or something and a lot more people would get hurt? I don't know why he didn't call the cops..." 

Ugh she's definitely rambling at this point. Focus. 

"Anyway, he has, like, serious PTSD about stuff like being tied down - I tried to explain why we usually put wrist restraints on intubated patients and he - wait, that one wasn't a drawing, but I think he pretty clearly acted out that he would be was more likely to get combative if he woke up restrained. So I think it's a better idea not to, but - we really shouldn't leave him alone. He's usually really cooperative when he's awake, but I left for like a minute right before he started doing runs of V-tach and he panicked and self-extubated - I mean, he probably thought he was dying, which isn't even wrong, and no one was there..." Shrug. 

A slight sigh. "Marian, you're not in trouble." 

Oh. ...Was it that obvious she was stressed about that, significantly more than she's stressed about the decision itself or the next several hours? 

"Can we make him officially 1:1 so we can do that safely? He's actually really pleasant and cooperative as long as he's not scared." 

"...I'll see what I can do. Can't promise anything for tonight, but we can at least not give you anyone else for this shift." Another sigh. "This seems complicated. We should probably consult social work?" 

"Mmm. ...I was wondering if we should, like, make a police report? Since it seems like there was probably a crime committed? - I don't think it's a crime to stab yourself but, like, the people kidnapping him, if that's what happened." 

Alison makes a face. "Let's just put in a social work consult and they can figure that out, I have no idea." 

"Okay. Seems like a good plan." Somehow Marian feels like this conversation should have involved a lot more of her being asked pointed questions, but she's not actually sure what additional questions Alison - who's clearly busy and juggling a whole unit worth of patients - should be asking. Probably Alison also doesn't want to make it her problem if their patient was involved in criminal activity. It's not like he has a knife or illegal drugs on him now. 

"...Uh. I do kind of want a lunch break. At some point." 

“Sure thing, girl.” Alison glances at her watch. “I can give you ten minutes now, rounds is on pause again while Hulka’s dropping a dialysis line in 109. - lines, drips, anything else I need to know -?”

Oh thank god that’s long enough to pour some stew into her face. “Triple lumen central line - subclavian - he’s maxed on norepi and phenylephrine and I’m trying to wean him down on the epi drip - he’s on fentanyl for pain, no sedation, I wouldn’t say he’s comfortable but he didn’t like the higher dose - uh, if the lab calls about a critical K, we already know and he’s getting IV replacement - defib pads are on him in case he does V-tach on us again, he’s on the 24 maintenance dose of the amiodarone now…” This was probably in fact more detail than Alison wanted but Marian is more comfortable when people know stuff about her patients.

Aaand then she can bolt to the staff room and eat?

Her patient does not wake up during this interval.

It’s not long enough for any kind of mental reset but Marian will survive. It is long enough to eat most of her (cold) stew, chug more water, and pee again so she’ll be set for as long as possible, which are the important things.

Alison has done a bunch of cleaning up the inevitable post-emergency mess in her patient’s room, and reports that he hasn’t budged. “Oh, and I checked his chart a bit - it looks like you only had the one bag of potassium ordered, but he came back at 2.4?”

“- Oh, right, that’s because Dr Hulka was kind of guessing, the labs hadn’t quite come back when he almost coded. He does probably need more than that…” And rounds is on pause so who knows when they’ll make it to her, it might even end up being one of those days when rounds trail into night shift. Though probably not, it’s Dr Hulka who has actual time management skills.

“I’ll bug the team for orders,” Alison promises. “Text me if you need anything, yeah? …And try to find time to write up a narrative note on everything you told me, and I’ll get a social work consult in.”

Sure, Marian can do that. She watches her patient sleep and wishes she knew his name - though it wouldn’t at all have been reasonable to ask him to talk and tell her during the 10 minutes or so he wasn’t intubated - and hangs the next bag of potassium when the first one finishes. 

The lab does call with more critical results! His potassium during the almost-code was down to 2.1 mmol/L.

Well that’s alarming! It would admittedly be more alarming if they didn’t already know about the problem. Marian is kind of stressed about where he’s putting it and whether the max safe IV rate is even sufficient to keep up, but she now has orders for serial labs every four hours, plus a standing order to repeat labs in case of suspicious ECG changes or worsening hemodynamics.

She double checks the time for her next lab - 4 pm, less than four hours after the last set but Alison clearly put the order in so it would end up falling on a standard easy-to-remember schedule - and then settles in to work on her narrative note some more and be right there when her patient wakes up.

(His sats are slowly dropping - he clearly isn’t keeping up with clearing secretions while he’s asleep - but as long as he’s managing to stay above 90% it’s not worth waking him for.)

He has one of those vague stressful dreams - there's something wrong with him, the details keep changing, and everyone at home's too busy to help - no, he blurrily realizes as he wakes up, he's somewhere completely different...

... And he feels all right?  Well, not by any reasonable standards, he'd be no use with a sword like this, but he thinks he could at least hold up a pen.  (He had no idea his expectations could get that low, but the prospect of being able to move without immediately getting exhausted feels too good for him to get morose about it.) 

He opens his eyes, smiles at Marian, and stretches carefully to test the feeling. Yes, definitely better, although he wishes he could breathe more than this.

He sends Leareth calm-safety-feeling-better in case he's waking up anxious again.

Leareth is actually waking up a lot calmer this time! The new mental habits he’s ingraining, of - helplessness, and resignation to it, the implicit expectation that none of his usual survival reflexes will work or help the situation - are going to be obnoxious to unlearn once he’s no longer in circumstances where they’re necessary. (Especially because it seems like he’s ramming through a sense that he’s utterly dependent on Karal and that frustration about this is unproductive, rather than actually feeling secure and safe in Karal being someone he can rely on as an ally.)  But it seems like this is the shape he can be where he’s mostly likely to survive to have better options later, given how tenuous their situation is and the fact that his panic-responses have definitely made things worse.

He appreciates Karal thinking to reassure him, though, and he’s glad it seems like Marian guessed right and the weakness is in fact improving in response to her dealing with the heart wrongness.

Oh good he’s awake, and looks so much less miserable! Marian watches him stretch out with obvious delight.

His sats have been at exactly 90% for a while now, though - and he’s on 50% oxygen now, the respiratory therapist must have left it on higher after the near-code and reintubation, so he does seem to be doing a little worse than when she first got him. 

Marian swings down her stethoscope and clearly telegraphs what she’s doing before listening to his lungs - yup, fine crackles everywhere again, and significantly decreased air entry to the lower lobes, though it’s symmetrical so it’s probably just that he was taking shallower breaths while deeply asleep for hours and not something wrong with the chest tube on the right. 

She taps the 100%-oxygen-for-two-minutes button on the ventilator, then picks up the tubing and mimes suctioning him. Questioning face?

He sends sorrow that Leareth's situation so obviously goes against all his instincts and needs, but - he's not wrong, that he's nearly helpless and struggling against it makes things worse, and Karal cannot yet do anything about it.  (It's impressive, how well Leareth is dealing with something clearly so awful for him.)

It visibly takes him a moment to remember what Marian means, but - yes, she can do the unpleasant thing that lets him breathe better, and he can cough through it like he's supposed to, and only make a bit of an unhappy face about it.  He doesn't mind this nearly as much as most of the other things that have happened here.

He notices how easy it is to trust that she's doing the kind and helpful thing, and how used he's gotten to her being right here when he wakes up...  How long has it been?  Once the they're done with the tube, he points at Marian, gestures sleep, question?

Huh? Clearly her patient thinks his question is obvious but Marian isn't actually sure what he means. He...did sleep...but it's not like he wouldn't already know that? 

He's pointing at her, though, maybe he wants to know if she was here the whole time? She wasn't but someone was - who Marian trusts would have taken good care of him if he did wake up needing anything - so it doesn't feel too much like lying for convenience to find the picture she drew from earlier, of him not-restrained with her there, and point at herself and then point at it? 

That's... good to know, actually, he nods at her with a grateful look, but it's not answering his question at all!  (Except to clarify that she hasn't gotten to sleep so far, but he didn't think she had, and Empathy tells him that's not what she meant to communicate.)

Luckily he's pretty sure he can draw now, and he might as well start with this reasonably easy thing.  He gestures for the pen, draws Marian sleeping in a bed (the figure has long hair and a dress, which isn't really very distinguishing given that both of them have long hair and Marian is actually the only one who has trousers, but he at least thinks to point to her for clarity).  Questioning gesture?

Aww, is he worried she’s tired? That’s actually really sweet! Marian is - honestly doing surprisingly fine given the early start to her day and less than full night of sleep, not to mention the lack of breaks, and also it’s not even that late yet, not quite 4 pm.

...Plausibly he has no idea what time it is or how long it’s been, actually? And now is a good opportunity to try to explain to him that she has to leave in about three hours and someone else will be taking care of him. - oh and she should explain how to use a call bell, and that there are alarms that will alert someone right away if he has a problem, even if they’re not in the room with him. 

That’s a lot of drawing! She’ll start with “what time is it”. 

…If she draws an analog clock, does he seem to recognize that? 

He watches it expectantly with what might be recognition, but looks confused about something.  (The thing he's confused by is that it looks like a sundial, matching the Empathy feeling that it has something to do with time, but then why does it cast two shadows? Do they have two suns here??)

If she lets him have the pen, he'll tentatively draw a sun above the top of her circle and some stars below the bottom of it, and look to see if she agrees with that?  (... Or if she at least recognizes the concepts. If he's seen the sky here at all, it was only when he was too nearly dead to remember it.)

…They are definitely having some kind of mutual confusion over how clocks work??? His drawing would maybe make sense if days were twelve hours total and hours were twice as long but...okay, fine, Marian doesn't actually feel like trying to resolve that confusion. 

She nods, then shakes her head, then shrugs, to try to convey that he seems to have correctly understood something about what she was trying to draw but she's now also confused, and then she's going to give up and flip the paper over and just draw...a timeline. The start of it can have a sun on the horizon with an up-arrow to indicate that she means sunrise, and a whole sequence of suns at various places in the sky until she gets to sunset at the other end of the page.

She draws a figure lying on the ground bleeding with a knife in its hand at around the sunrise point, and a Marian figure beside it. Then moves her finger along to about 3/4 of the way through the day, makes a mark, and gestures at the room and both of them.

They do have one sun, which goes its normal way through the sky!  He's relieved.

And surprised that it's all been less than a day, but... he supposes there's no real reason why it wouldn't have been, except that he slept so many times and so many confusing things happened, but of course those are not unconnected, and it's not as if there's very much time he actually remembers.

He wants to arrange all the other things that happened on that line, to have a better idea of what his sense of time is doing and where it all went, but he's... not entirely sure he can remember all the things in order, let alone draw them, and in any case it's not actually important.

Instead he points to Marian, mimes sleep, points to the sunset mark or a ways after it?

(Marian is absolutely intending to fill in the line with all the points that her patient probably remembers! It seems pretty important! But she can answer that question first.

She nods and - hmm she’s not actually sure what time sunset is right now, it's at least still light out for some time after she leaves the hospital, but she's inclined to make sunset also represent shift change for simplicity. She draws Marian and then some footprints wandering down the page to a simplified house-drawing with a bed in it. She adds an incoming arrow and a different stick figure, to try to convey that someone else will be coming in and he won't, like, be alone overnight. 

He smiles at the little footprints!  It's good that Marian has a house with a bed in it.  (He's suddenly tempted to ask who else lives in her house, but he should probably leave her personal life alone - just that he feels like she's his friend doesn't mean she agrees.)

He nods at the different person.  And she seemed like she had a lot of other things she wanted to try to explain, so he should probably let her do that...