And then he's falling. 

- what, this doesn't make sense at all, that is not how dying in a conflagration of magic works - he felt himself die - 

His confusion is interrupted by a canopy of pine and fir branches breaking his fall, and then he lands sprawling on...something soft? Soft-ish. Also incredibly cold. 

He is apparently not wearing any clothes. 

Snow falls gently, heavy fat flakes, joining the white carpet that muffles everything. It's a bitterly cold January night in eastern Canada, not that the local geography would mean anything to Ma'ar. 

If he spends much longer lying here in deep snow then he's going to die, this time of hypothermia. 

...This thought is much less motivating than it ought to be. Everything feels numb. Unreal. He died, he remembers dying, and - 

- oh. 

There were contingencies. Measures laid in place decades ago. He had hoped that he might wake up again, he just really wasn't expecting that to take the form of falling from thin air into a snowbank. 

Well, that was a LOT of magic he sensed, at the end. Who knows what sorts of weird interactions could happen? None of his methods were supposed to do this, but of course, it's not like he tested any of them before. 

Focus. One thing at a time, and the first step is not dying. Not dying again. Whatever. 

If he thinks about how much damage he was just responsible for, in Tantara and Predain, he might never move again. So he isn't going to think about that yet. 

Ma'ar drags himself to his feet, already shivering, and - reach for his Gifts - his magic still works, at least. The pattern of energies around him is strange, less than he would expect, but maybe that's just the climate. Where is he worry about that later. 

...And then he is, yet again, tempted to sit down and curl up and not move for a long time. 

He needs shelter, though. Which means he needs to orient to his surroundings. He can sleep later.

Thoughtsensing? 

No human minds within a mile - 

- wait, no, there's a mind over that direction. Moving closer. Moving much faster than it has any right to. Horses can't move that fast; horses can't move a quarter of that speed. 

The mind is near and then it's moving further again. The speed makes it hard to focus on surface thoughts. The ones he can pick up are - definitely words in a language he's never heard of. He can get some of the content anyway but this fails to make it much less baffling. 

What. 

He can answer all his many unanswered questions later. Right now he's learned the most important piece, which is that wherever he's ended up is inhabited, and he should keep moving and try to find a man-made shelter rather than making do in the middle of the forest. 

A cursory look around with a mage-light shows deep snow and dense undergrowth in the direction he sensed the fast-moving mind. He could cut his way through with magic but it would cost him precious strength, and he doesn't have much to spare. 

In the other direction, though, he can see glimpses of open space. And a sky which is...the wrong colour. Too bright for night and almost orange-hued. 

His mage-senses aren't warning him of any dangerous magics, though, so he can worry about what that means later. 'Later' is a constant litany in his thoughts. It's getting to the point where it doesn't feel like a real word anymore. 

He struggles through the snow, his bare feet numb and aching despite the heat-spell. 

He emerges into what is recognizably a cemetery. 

There are paths. They seem to have been cleared of snow recently; there's less than an inch of new-fallen flakes. 

There are also orange-hued lamps or lanterns on the tops of enormous metal poles? They have the impossibly steady glow of mage-lights, rather than the flickering quality of oil lanterns, but they give off no hints of magic. 

He's even more confused now!

Also still at risk of freezing to death. Keep moving. He can see brighter lights in the distance. Walk towards those. 

He emerges from the quiet cemetery into - well, it's recognizably a city, but little else about it is familiar. There's a road, again mostly cleared of snow; the snow that remains is oddly slushy and melted, and also almost black with grit. 

There are houses. They have glass windows; some are made of brick, some of less familiar materials. The architectural design is strange as well. All of them have lanes in front; most of these hold strange wheeled metal contraptions, like wagons or carriages but perfectly sealed. And without anywhere obvious for horses to go, but they're just as unmagical as the strange lights... 

Not all of Urtho's inventions were based in magic - 

- and it's a bad idea to think about Urtho right now. There's a well of grief and guilt there that he doesn't dare touch, not yet, because he isn't safe here, in this incredibly foreign place. 

...Or foreign time? Could one of his spells have flung him into the distant future? The most confusing part is that he appears to have the same body that he died in. 

Later. Walk, now. 

Ma'ar walks. 

There are lights in some of the houses' windows, but the street is silent. 

One of the metal wagons whizzes past, making a surprising amount of noise, and Ma'ar has to jump out of its way. It slows, and a face peers out through glass. 

The driver sees the expression on the naked man's face, decides he does not feel like dealing with a homeless man clearly high on something at 10 pm on a Tuesday night, and keeps driving. Someone has probably called the cops already. He doesn't feel like pulling over for it. 

Oblivious to this, Ma'ar keeps walking. 

The smart thing to do would be to bang on some doors, beg the help of the locals. He isn't sure why he's failing to do that, actually. It just feels impossible. He's not sure he could bear it, looking into another human being's face right now. Let alone answering their inevitable questions. 

He does, however, desperately need clothing. 

Walking mostly in a straight line eventually brings him to a bigger, brighter-lit street. One where there are still people around. He gets a couple of alarmed looks, and ducks back onto the smaller side street, spending five minutes and energy he can't afford to give up and covering himself with a sketchy illusion. It wouldn't hold up in daylight, or against real scrutiny, but it should do for random passersby on a snowy night. 

In the better lighting, he can see that the buildings, for all their strange materials and impressive height, look...kind of decrepit? Around a quarter of the not-mage-lights on poles are broken. The road is visibly potholed. 

There are shops. Many of them have metal bars pulled across in front of the glass windows, evidently a measure against theft. But through one such set of bars, he can see racks of clothing. 

...Well. Starting off with theft isn't ideal, but at this point Ma'ar is mostly too exhausted to care. He doesn't have any money, local or not, and he really doesn't want to answer questions about himself until he has some vague idea of where - and when - he is, and either way, approaching one of the locals is going to go much better if he's wearing clothes. 

Bars over windows and doors are not actually very effective at keeping a mage out. 

He waits until no one is within twenty yards in either direction, and hopes that the not-carriages speeding past aren't going to be paying much attention. It's a quick matter to raise one Gate on the nearest outer doorway, and a second on the inside of the doorframe that he can see through the bars. Five seconds and he's through. 

He dares a small mage-light, so he can actually see the clothing he's stealing. 

Nothing happens for about five seconds, and then a loud shrieking sound is inexplicably coming from somewhere nearby. 

Ma'ar has not had a good day. Or week. Or year. He is especially jumpy even for him; he startles, flinging up shields, and barely manages to restrain himself from throwing a levinbolt at the source of the sound. 

...No minds inside. Some sort of non-magical wards? Clearly within the capabilities of this bizarre place. 

And he doesn't know what other capabilities they have, or how quickly the ward-alarm will summon whoever's keyed to it, so he had better be fast.

He risks a brighter light. There, those look like coats. He grabs one. Those are...skirts? He can't find tunics and he's only guessing at the gender norms for clothing anyway; probably the long skirts are for women, but they have the advantage of a more forgiving fit, compared to trews. He goes for the warmest-looking one, with a stretchy waistband and in red-and-black checkered flannel. 

- oh, blankets, even better. He grabs two, folding them over his arm. They're thin but very soft to the touch, the fabric with a nap almost like fur. And beside them are...robes? He's suspicious that they're for sleeping in, but this one at least is made of fairly thick cloth, with sleeves. It'll keep him warm. 

He finds the shoes. Finding shoes that fit in the next thirty seconds is a lost cause, but he can shove his feet into oversized bed-slippers, that will help at least a little. 

Robed and beskirted, trading his bundled blankets between hands as he stuffs his arms into the sleeves of his heavy coat, Ma'ar raises another Gate - this one using the gate outside one of the side-street houses as a threshold - and escapes into the night. 

He waits for thirty seconds, holding perfectly still, for any signs of pursuit. There are none. He keeps walking - or shuffling, at least, he can't lift his feet too much without losing the slippers. He returns to the bigger road, but walks in the opposite direction, head down. 

He gets a very odd look from a teenaged couple who pass him, but they don't try to talk to him. 

Shortly after that, a few of the not-carriages scream toward him, making not-dissimilar shrieking noises and flashing coloured lights. 

Caught off guard, Ma'ar half-instinctively flings himself to the slush-coated sidewalk, his reflexes screaming that he needs cover needs to be out of the line of fire needs to shield -

The bored cops responding to an apparent break-in at a Salvation Army store fail to see the probably-homeless man wearing a skirt and bathrobe flinging himself down.

An older couple on the other side of the street do see, but it's not that weird for the neighbourhood, which is really going downhill these days. None of their business, anyway. 

Ma'ar stays down for a while, Othersenses extended fully, until it seems clear that whatever THAT was, it wasn't an attack targeting him. 

His body finds this hard to believe; his pulse is still racing, his breathing coming short. Distantly, Ma'ar is aware that he isn't exactly thinking clearly. Shock, probably. He died, after all. He just lost a war, paid a higher price than he could ever have imagined, and now somehow he's here but it still feels fake. It's impossible to think past the next step. 

It would be a good idea to have a plan. In his current state, he's clearly not capable of that. He'll settle for walking, then, until he finds...some reason...to stop... 

He can follow this road for a long time, if he wants, toward the taller and denser lights in the distance. He crosses a bridge at one point, over a medium-sized river, frozen over. 

Here there are more people. Most of them avoid his eyes and step away; nearly all the women he passes actually cross the street to avoid his path. 

In another place, at another time, it's possible that this would bother Ma'ar. 

Right now, to the extent that he manages to feel anything at all, it's a relief. 

If he keeps walking this way, he's eventually going to hit downtown Ottawa. Which is fairly trafficked and loud, even at close to midnight; mostly students, out to enjoy the nightlife, Tuesday or not. 

He's getting a lot of uncomfortable looks. 

Apparently he's incredibly not ready for this. 

He tries anyway. After two men duck their heads and ignore his attempts to greet them, he tries for one of the bigger groups - very young faces, but their surreptitious stares seemed more curious than alarmed. 

They don't speak any of the languages he knows. And by the fourth try, even the apparent leader of the group is starting to look cornered and like he would really prefer to run away.

Ma'ar isn't sure if the problem is just that he can't stop looking scary. He doesn't know what his expression looks like, right now, but he certainly feels haunted. 

Best to give up before he scares the kids badly enough that they escalate to violence. Ma'ar shakes his head and tries to look apologetic and then backs away while looking at the ground. 

No one follows him. 

He really needs a plan. Almost any plan would be better than wandering around in the dark and cold. 

At this point, though, he's too tired - and too numb with grief, and too overwhelmed by the lights and sounds and metal carriages moving too fast - to do anything more than keep putting one foot in front of another. 

The area near the bridge over the river is quieter. Almost peaceful. There's a small wooded area along the waterfront. 

He can't sleep here, but maybe he could just sit down. Only for a few minutes. Collect his thoughts, figure out who he should talk to and where in order to get a place to sleep.

There's a bench just before the sideway turns onto the bridge. Ma'ar sits down. Tries to cast a weather-barrier, but he can't seem to maintain concentration long enough to finish the more complicated spell. 

The heat-spell gutters in his hands as he pushes in a little more mage-energy from his reserves. There's not much left there, and even his basic control is faltering. Why did the stupid spell have to bring him back somewhere in winter. Without clothes. Is any of this even real. He's definitely starting to feel like he could be dreaming. 

A few cars drive past, but no one glances at the man on the bench. 

Tomorrow morning Marian is going to regret tonight-Marian's life choices so much. 

Really, she could have guessed that when midnight came and went and she hadn't yet left the house party. (In her defence, it was a really excellent party.) It's now almost two am, she's still a little tipsy, and the very very latest she can possibly get away with setting her alarm for work is 6:30 am. And that's if she skips showering, which her colleagues might possibly have some opinions about, and also assumes that by morning it'll have stopped snowing and the snowplows will have done their work enough that she can ride her winter bike. The studded tires help but she's learned the hard way that riding in an inch of unplowed snow is...a dubious proposition. 

It's nippy, but she's warmly dressed, with leggings under her jeans; Marian's never been one of THOSE girls, who wears skimpy outfits in Canadian winters. With a hat and scarf and gloves and good waterproof boots and her hands in her pockets, she's comfortable as long as she keeps moving. She's got headphones in and Pink Floyd playing and, despite her anticipations of an unpleasant tomorrow morning, she's in a good mood. 

Crossing the Rideau River, she almost fails to spot the person slumped over on the bench.

Oh for fuck's sake she's so close to being home. And she's getting sleepy. 

She could keep walking... 

...she really cannot do that, apparently. 

With an irritated sigh, she disentangles headphones and removes a glove in order to pause her playlist. And then hesitates, because whether or not checking on the stranger who might need medical attention is morally obligatory, it's agonizingly awkward. 

"...Uh. Hey. You all right?" 

Ma'ar isn't exactly asleep, but the foreign syllables slide past him. He's very far away, and he's finally stopped feeling cold. He doesn't try to answer. 

Maybe he's deaf. (She? No, despite the inexplicable horrible skirt, Marian is pretty sure the figure on the bench is male.) This isn't definitely an emergency. Probably he's just sleeping deeply and she's about to get yelled at. 

She has to check, though, no matter how mortifying it is. Gritting her teeth, she sidles closer, and taps the stranger's shoulder. "Hey!" She raises her voice louder. "Wake up!" 

The touch is startling, and Ma'ar tries to raise a shield, but for some reason this isn't working. 

He reaches out with Thoughtsensing, and gets - earnest worry, underlaid with impatience and frustration, some guilt - there are concepts behind the foreign words but he's too bleary to parse them. 

"Leave me alone," he tries to say, but on top of the language barrier, his lips are numb from the cold air and the words emerge slurred. He instinctively swaps to Mindspeech, bleary enough to forget that most people don't have the Gift and outside of Urtho's Tower those people tend to find being Mindspoken to startling and frightening. He's drained, but it doesn't take a lot of power at this range. :Leave me alone: 

"Eeek!" Marian jumps back. Okay, probably she imagined that? Maybe she's more drunk than she realized. Which, unfortunately, does NOT reduce the awkwardness of this situation at ALL. That seems unfair, she thinks, alcohol is supposed to make you less socially anxious. 

"I'm sorry to bother you but you can't sleep here. It's going down to minus twenty. Do you have anywhere to stay?" 

Ma'ar got some of that from Thoughtsensing, at least. Apology, concern, night getting colder, a question about sleeping indoors...? 

It's not like the young woman is wrong, he thinks dully. And she's trying to be kind. She's the first person he's seen here who's offered him any kindness, and it - matters, more than he realized. 

He tries to sit up. 

...This goes less well than he was expecting. He's dizzy, and his limbs feel like jelly; he has to grip the bench with both hands to stop from falling over, and his fingers aren't working very well either. 

He looks drunk. Well. More drunk than she is right now. And cold. He's conscious, which is good, but he must be very hypothermic. ...Also what is he wearing. That's a bathrobe. And bath slippers. One of them seems to have slipped off, unnoticed, and in the dim orange streetlamp-light she can't tell if the dark stuff on the sole of his foot is dirt or blood. 

- his hand slips on the icy bench and Marian reflexively dives in to support him before he slumps over. To her eternal gratitude, this doesn't earn her a punch in the face. 

Just an unsteady look, dark eyes not quite focusing, expression impossible to read. 

Ma'ar is thinking that it's good someone woke him when he still had the strength to move and use his Gifts. The river, the trees... There's a faint ley-line there, he thinks. If he can get out of sight, he can tap it for energy, make himself a little camp. In the light of day tomorrow, maybe he won't come across to the locals as quite so threatening. 

Marian can practically see him thinking. And swaying, head bobbling a little as he struggles to stay upright. She doesn't think he realizes he's doing that.

"Uh, you don't - seem in shape to walk home right now. Do you have a friend I could call for you, to come pick you up?"

Honestly at this point she's close to calling an ambulance for him, but she knows how busy the ER is at this time of year. And how badly some of the staff treat the 'intoxicated homeless men' category of patients.

Ma'ar follows the gist of that. He shakes his head. No, he has no friends here. No friends, no allies, no acquaintances. He doesn't even know where 'here' is. 

...He could ask? Ma'ar isn't an incredibly strong Mindspeaker, and he's pretty sure the young woman is un-Gifted, but she's at least trying to talk to him. Her mind is held open and receptive, much more than the earlier huddle of strangers who he tried to approach, and right now she's also physically touching him. And - he has a bleary sense that he tried Mindspeaking her before, forgetting where he was, and she didn't panic? 

He meets her eyes, or tries to; there are two of her wavering in and out. 

:What city is this?: 

Marian doesn't jump this time. Mostly because she's too absorbed in trying to find a non-horribly-awkward way to check the man's pulse. 

"Uh. Ottawa? ...You didn't know what city you were in?" That's, well, concerning. More concerning. "Do you remember how you got here?" 

He doesn't recognize that place-name at all. The young woman is clearly concerned - for his health, Ma'ar thinks, she seems to be under the impression that he's sick or maybe just intoxicated - the reality isn't any less worrying, and it's both hard to explain and something he has no desire to talk about. Or think about. 

He just shakes his head. 

Aaaaaaaaaaaaaaah. Why. 

She's tired and the four-and-a-bit remaining hours of sleep time before her alarm are ticking away and why did she get herself into this situation. She can't leave now. 

"Can I...get you a motel room for the night? There's a place not far." 

Sober Marian, tomorrow morning, will probably have some raised eyebrows about this plan. Marian's mother would definitely have Words to say about it. Right now, though, it seems less wasteful to the medical system - and probably less socially awkward - than calling an ambulance. 

She wants to...pay for a room at an inn for him? 

That is so much more kindness than Ma'ar was expecting, from anyone. His eyes are suddenly stinging, and not just because of the icy air. He nods. 

All right. Okay. She can DO this. It's on the way to her apartment, anyway, and it means she only has to have ONE awkward conversation with a motel clerk rather than SEVERAL awkward conversations with a 911 operator and paramedics, and also drunk guy seems cooperative with it. 

"Can you walk?" She stands up, offering her arm. "Uh, your shoes - here..." After a moment's hesitation, she retrieves his slipper and shoves it on his foot for him. "C'mon." 

He can walk. He's not very steady on his feet, apparently, and he finds himself leaning on her for support more than he had expected to need to, but he can move. 

Awkward!!! Awwwwwkward. Why is this her life right now. What would her mother say. How did she end up where she is, half-carrying a homeless man wearing a bathrobe and constantly threatening to trip on his stupid plaid flannel skirt. Why is he wearing slippers. Tonight is really taking the cake for 'most surreal experience of her life.' 

They make it about ten paces toward the nearest intersection, and then Marian loses her footing on an unseen patch of black ice, and they both go down hard. 

"Eeep!" That's it she is never living this down ever. "Sorry sorry sorry! Are you okay? Let me - here...?" 

Ouch. Ma'ar blinks up at a sickly orange sky, not quite sure how he ended up on his back in the slush. He manages to focus on a face. Oh. There's a hand being offered. Right. He should probably... 

Without the bench, she has to get way more up close and cozy to get the man onto his feet again. Marian grits her teeth and tries to block out the voice of shoulder!Mom loudly disapproving. She is a GROWNUP she can do this and no one can stop her. 

Unfortunately, they're right under a streetlight, this process is rather conspicuous, and even at 2:30 am on a Wednesday morning, there's some traffic on Montreal Rd. 

A car stops. 

"Miss! Do you need help?" The voice belongs to a man in his thirties, wearing a uniform that screams 'private security company', though it's too dark to read the logo or his nametag. "Is this man bothering you?" 

That's it. Her life is over now. She is dead of sheer mortification. 

"I'm fine! Just getting him, uh, uh, home..." 

The man in the security uniform does not seem reassured. "Miss, listen to me, it's all right - I won't report it, you're not the one who's getting in any trouble tonight." 

Oh god what does he think she's doing. Does he think she's a prostitute. Does he think she's...selling homeless bathrobe guy drugs? Marian doesn't actually want to know she just wants this to NOT be HAPPENING. 

Ma'ar, on the other hand, can tell when someone means him harm and he needs to be elsewhere. 

:Sorry: he tells the young woman, the only person so far who's tried to help, and he shakes loose of her grip and runs back toward the bridge. 

...Or tries to, at least. He can manage to stay on his feet but he is definitely not moving in a straight line. 

"Hey! You! Where are you going? No you don't -" Security uniform guy leaves his car diagonal to the sidewalk where he stopped, door open, and goes in pursuit. 

Aaaaaaaah. 

"Please don't!" Marian calls out, though it comes out strangled and not loud enough for either of them to hear. 

In hindsight, the bridge was not the right direction to flee. Because now he's out in the open, he doesn't have time for a proper illusion, and the man who's wearing proper shoes and hasn't been out in subzero temperatures for hours can move a lot faster than Ma'ar can. 

A hand falls on his arm, gripping hard. 

Ma'ar is trained in hand-to-hand combat. He twists, jerking free - and stumbles right into the bridge railing, barely staying on his feet. 

"Oh no you don't." And apparently this stranger also has combat training, because suddenly he has Ma'ar's arm twisted behind his back. "You're staying right here until the cops arrive." 

Okay she has to do something before random guy gets arrested when he hasn't even done anything illegal. Unless being drunk in public is illegal on its own? Marian isn't sure, she doesn't think so, but she's never actually read up on the laws... Being disruptive in public is probably the sort of thing that gets you arrested, but he wasn't, he was just sleeping on a bench until she stuck her nose into this situation... 

"Hey! Stop! Please don't call the cops - he didn't do anything, I was just trying to help out - if you're calling anyone call him an ambulance, please -" 

Ma'ar is less than half following their exchange from surface thoughts. The man wants to...have him imprisoned by the local authorities for hurting the young woman? The woman is defending him, but claiming he needs to...be brought to a Healers' centre? 

Most of his mind is elsewhere, caught forever in the moment he saw the horizon flash white, and knew. Urtho.

It's all a confused nightmare and Ma'ar can't think when both of the others are yelling at each other. He wants it to be quiet and peaceful like before. He wants to be alone, without the pressure of their upset minds... 

If Ma'ar were thinking any more clearly, he would have come up with a better plan. This is very much not one of his better plans. But he feels trapped, cornered - pinned up against the memory of a world burning - 

He gets a grip on the bridge railing with his non-pinned arm, and starts swinging his leg over. 

"What are you - just hold still, motherfucker–" 

"Leave him alone!" Marian is vaguely aware that she must sound hysterical, which can't be helping her cause, but she hates fights and this is awful and it's her fault. 

He gets his leg over the railing. 

He jerks with his full body weight - the torque nearly breaks his wrist, but his attacker, startled, lets go first, and Ma'ar falls. 

He lands on his side, hard, there's only a few inches of snow over the ice and after a three-metre fall, the impact knocks all the air from his lungs. Something creaks alarmingly. 

No time. Under attack. 

He struggles to his feet and runs, or staggers, and makes it four paces before the river-ice gives way. 

Security guy stands helplessly at the railing, staring at the man now floundering in chest-deep freezing water, trying to grab at the edges of the ice. "I didn't, why did he...?" 

"Because you were hurting him and you scared him! Why did you DO that? I told you, I was just trying to help! You fucking idiot! He's just sick! He needed help! He didn't do anything to me and also I'm not a fucking prostitute thank you!" 

Normally yelling all of that at a stranger in the middle of the night would be mortifying in itself. But Marian is on the other side of embarrassment now. Her heart is hammering in her ears and her stomach feels like a lead weight, but in a sense, she's back on familiar ground. Emergencies are simpler, in a way. 

Bathrobe guy is still conscious, but it doesn't look like he's going to get himself out of the water, and he's already struggling more weakly. Damn it. She should have just called an ambulance in the first place. He clearly wasn't okay before, and now... 

She takes a breath. "Just call 911 and then catch up with me down there."

At least she wore her good winter boots. This would be so much worse in heels. Marian takes another steadying breath, and then starts scrambling down the snowy embankment towards the side of the river. 

Cold cold coldcoldcoldcoldCOLD - 

Yelling in the distance. Ma'ar is too busy floundering to track it. He's not about to drown, at least, the water isn't that deep and he can mostly keep his footing on the slippery, rocky bottom - though he's already slipped and scraped his ankle, he can't tell how badly, every part of him already hurts. 

He can't get himself out, though. There's no leverage and the ice just gives way, widening the hole, whenever he tries. 

This is bad. This is not a good situation. It was a bad plan. 

(Someone is yelling again, less distant now, but Ma'ar is facing away from the source, and his vision is starting to go hazy anyway.) 

...Focus. He's being stupid about this. Are you a mage or not? 

It's the hardest Gate he's ever attempted. His reserves are almost gone, he's so tired, and it feels like he's flailing around in a tub of razor blades, and he doesn't have a scaffolding to build on... 

But if he doesn't do this, he's going to die. 

The stark clarity of it helps clear his head, a little. There, if he puts it there in front of him, he can step through - along with half the river, but it'll do... 

It still takes an endless thirty seconds to build the threshold. 

Marian is screaming her throat raw, trying to extend a stick she found to the man, but he's facing away from the riverbank and he doesn't seem to hear her. 

There's a bluish glow? For a moment she feels a wave of relief, it must be an ambulance's lights, but the angle is wrong and it's not flashing and nevermind maybe she imagined it. 

Ma'ar puts the other end of the Gate on the snowy embankment beside the river. He got a decent look at it, before, and he doesn't think it's more than ten yards away. 

Finishing the spell is still the hardest thing he's ever done, and when the Gate snaps into place, it drains away the last dregs of his reserves and he feels the pull of blackness as it drinks deep of his remaining life-force... 

It only needs to hold for an instant, and Ma'ar throws himself through, along with several thousand gallons of icy river water, and collapses on the hillside. 

"What the fuck?" Marian twists around, craning her neck to follow the sound of cascading water. "How - what..." 

Bathrobe guy is gone from the water, which is now sloshing around the ice-hole.

She rolls away from the ice, struggling up on her knees; great, now her entire body is covered in snow, whatever, nevermind.

There's a dark hummock in the snow. It's not moving. 

The security guard runs over, phone in hand. "How did you get to him that fast?" 

Marian opens her mouth, realizes she has no idea what to say, and closes it again. Telling the asshole security guard that she might be hallucinating is not going to help anything. Clearly the guy got himself out of the water, one way or another. 

"Is an ambulance on its way?" she says instead. 

"Y-yes. Ten minutes. ...Are you, uh, going to...?" 

"Am I going to report you to the cops for harassment? No. Whatever. Just fuck off. ...Uh, after. Need your help right now. You got a coat or blankets or anything in your car?" 

"Huh?" 

"We're not letting him lie here in wet clothes for ten minutes! He can probably help us, he was conscious thirty seconds ago..." 

He does not, however, appear to be conscious now. He's breathing, but his body is deadweight, limbs rag-doll limp and floppy as Marian reaches him and rolls him onto his back. 

Marian spends a while trying to get a response from him and failing. 

That's weird? Sometimes patients on drugs do have sudden changes in mental status, but she's still confused. Also this makes it about a thousand times more awkward to try to get him out of his waterlogged coat and sodden bathrobe. She has to do it anyway but she really wishes she could do it not in front of Mister Creepy Security Guard's dubious frown. 

At least he eventually, sheepishly, lends her a jacket. It's not a very thick one, but she can roll unconscious homeless guy onto it, once she's wriggled him free of the coat and bathrobe, and then add her own much heavier winter coat as a blanket. Where she can quickly retrieve it once the ambulance gets here. She finds that she doesn't especially care if Security Creep gets his jacket back. 

The ambulance arrives, sirens screaming. Security Creep skulks nearby while the paramedics jump out and unfold the wheeled stretcher from the back. 

"...It's you?" one of them, a young man, says in disbelief. "It's -" he rubs his forehead, "- Mary, no? What are you doing here?" 

Making terrible life choices, Marian thinks but doesn't say.

"Guess he's lucky I happened to be around," she says, a lot more lightly than she feels.

"You know him?" 

"What? No, sorry. No clue who he is. I was, uh, walking home," and hope he doesn't ask why she was walking home at TWO O'CLOCK IN THE MORNING on a TUESDAY, "and I saw him sleeping on the bench, so I tried to, uh, help. He...was confused. Didn't know what city he was in. Think he's high or drunk, not sure what he's on. I should've called an ambulance but..."

Shrug. She waves a hand vaguely. "You know. Anyway. He...got freaked out when this guy," gesture at the security guard's car, "stopped to, uh, to see if we needed help. There was some - confusion - and he, uh, jumped over the bridge railing to try to get away. Fell through the ice. We called 911, I tried to help him get out of the water, he...got himself out but then passed out." 

There are raised eyebrows. 

"Also I have work in, uh, four hours. So can we hurry." 

This gets her a laugh and eyeroll from the second paramedic, a slightly overweight older woman. "Oh, to be twenty-one again. What's his GCS now? Bill, let's start getting him packaged up..." 

"Uhhhh...." Wow, doing this in her head at three am while not totally sober is embarrassingly hard. "Six or seven? Better than a few minutes ago, he was totally unresponsive at first but I was getting some movement and sounds in response to pain. Uh, some of his clothes are still wet, I think we'd better address that. He's not shivering and given everything else I don't think that's a good sign." 

Because Marian is a COWARD and a bad person and could not bring herself to remove a man's skirt in front of Security Creep. 

"I'll get him on the monitor if you pass it over?" she offers. "Bill knows me, I work in the ICU over at Montfort." 

The machine can't get a temperature reading at all, and the SpO2 probe waveform fades in and out - his hands are freezing - but when it does manage to get a reading, his sats are above 95%. His blood pressure and pulse are lowish but surprisingly tolerable. 

"Chop-chop, Bill," the older woman mutters. "Let's get this show on the road. We don't know what he took, he could start crashing fast."

"I couldn't get a temp," Marian adds, plaintively. "I think he's below...whatever your machine can measure." 

"Yikes. Thirty-two." (Degrees Celsius. This is Canada, after all.) "He's a popsicle." 

The jarring motion as the paramedics get him onto the stretcher, and then navigate it over the icy sidewalk and around to the back of the truck, eventually penetrates the blackness around him. 

Drifting through haze, Ma'ar can't remember where he is or how he got here. The war... He has a vague recollection that it was going, well. Badly. 

And now he seems to be tied down, too weak to fight the restraints, and his Gifts aren't working. 

This is not good, this is very not-good, but for some reason it's hard to summon the will to care. 

"Mary, you want a ride?" Bill asks Marian. "I don't feel great about you walking around this late at night." 

Usually Marian hates it with a passion when people say things like that. Right now, though, she's exhausted. And also Bill's partner seems to have stolen her winter coat to add to the (fairly pathetic) ambulance blankets. The thought of walking home without it is incredibly unappealing.

Also, Security Creep is STILL THERE and what if he follows her to try to ""help"". 

"Uh, sure, thanks." Maybe she can even grab a nap in the clean utility room behind the ICU, borrow some OR scrubs, and get away without trekking to and from her apartment at all. She could sleep until 6:45 am. Maybe 6:55 am. Right now that sounds like heaven. 

Bill offers her a hand up into the back of the ambulance, patting the bench next to him. 

"Selfish agenda is that I'd rather not be alone back here if he starts tanking on us." He grins. "You had a good night?" 

"Great up until the point that all this happened. How're your classes going? I haven't seen you in a while." 

Bill is a nursing student, in the community college program at Algonquin, working nights to cover tuition. He and Marian once transferred a trauma patient to the Civic hospital together. They're not friends exactly, but there's a certain kind of bonding unique to 4 am in a hospital. 

"Pharmacology's the worst." The monitor beeps. Bill whacks it. "Fucking sat probe." 

Marian feels vaguely offended on behalf of the poor machine, which is trying its best. "His hands are cold, that's all. You don't have the peds kind?" 

"Dunno. ...Oh, there we go. Ninety-three, we're fine." Bill's eyebrows rise, almost vanishing into his mop of hair. "What was the deal with that guy in the uniform? You were giving him the death glare." 

"I wasn't!" Marian can feel her cheeks flaming. "...Maybe I was a little. He's a bully, is all. I don't want to talk to about it. Bill, please focus on your patient." 

Marian has a suspicion that Bill is, perhaps, not one of the most conscientious or detail-oriented people in the world. Also not one of the brightest. He's told her before that he wants to work ICU as well, and she's never had the heart to tell him outright that she wouldn't want him as a coworker in a million years. 

"Chillax, girl. He's fine. And we're nearly there." 

Marian stretches out and hits the monitor for another blood pressure anyway. The guy's chest rises and falls slowly, but not that slowly. His heart rate is in the fifties, a little irregular Which isn't objectively worrying - her resting heart rate looks like that, fit healthy young adults tend to have sinus arrhythmia timed to their breathing - but somehow she doesn't like it. 

Blood pressure comes in at 92/49. Which is also technically acceptable - he's not a big guy, and he's drunk - but the systolic was in the 100s before. And she doesn't like his colour, which she can see a lot better under the bright ambulance lights. Under his golden-brown natural skin tone - what ethnicity is he, anyway - he's pale, with a hint of grey around his lips and eyes. And...are those beads of sweat around his hairline? He could just be wet from the river, she can't tell. 

Still, her instincts do not like it at ALL. 

"Bill, hey. Did you get a sugar on him?" 

"What? No. You're thinking he's a diabetic?" 

"I don't know." It could be another explanation for an apparently-healthy man falling asleep on a public bench in the middle of winter, though. If she's right then she feels TERRIBLE about failing to think of it earlier. "Just check his blood sugar, please." 

Ma'ar drifts in the darkness behind his eyelids, intermittently close enough to the surface that he tracks the nearby minds with Thoughtsensing and glimpses fragments - baffling fragments - but mostly not. 

...He feels the stabbing pain in his finger, though. (Bill used the biggest needle for the lancet.)

He jerks away, trying to shout and making a wordless guttural noise instead. Opening his eyes fails to help much; everything is a too-bright blur. 

A hand falls over his. "Hey, it's okay, we're not going to hurt you. I promise. I'm really sorry about that other guy, he was a stupid bully." This is not the most professional speech Marian has ever given, but whatever, it's now past three am and she is out of fucks to give. 

The words don't parse, of course, but the tone reaches him, and her surface thoughts swim into brighter focus. 

She's trying to tell him that he's safe. Which doesn't mean he is safe, but...is more reassuring than it could be. He may be a prisoner, but they don't want to hurt him right now. 

...A flicker of memory, the bridge, the young woman screaming at the man grappling with Ma'ar and pinning him - 

- he's so confused, he doesn't understand any of what's happening, but the young woman was kind to him. And there's very little else he can hold onto, right now, so he might as well cling to that. 

He seems calmer, at least. That's something?

She wonders where he's from. The handful of times he tried to talk, it didn't sound like English, and he seems to understand some but not all of what she's saying. He doesn't quite look Inuit, but he could not-implausibly be Native American. It seemed like he didn't know anyone in the city... Poor guy. 

The glucose monitor beeps. 

"Huh." Bill makes a surprised sound. "Marian, you're a genius sometimes. Glucose is 51." 

The normal range in mg/dl would be 70 to 110. So, low, but not critically low, probably not enough by itself to explain his decreased level of consciousness? Marian can't remember off the top of her head how hypoglycemia interacts with hypothermia. 

"Can we treat it before we get there?" The ambulance appears to be stuck behind a truck, which is technically breaking the law by not getting out of the way. 

"If we get an IV. I figured best not to wait for that." 

"I can have a go." She addresses the patient again. "I'm sorry, I need to poke you again. ...Can you tell me if you're diabetic? You can just not or shake your head." 

     (No answer. His eyes are open and trying to track her but he seems not to understand the question.) 

"I just need to look at your arm..." 

He has decent veins, she thinks, or normally would - he looks fit, his forearm muscled - but right now he's cold and hypotensive and his veins are not popping up at all even when she finds the tourniquet. And also it's three am in a moving ambulance and she's mostly sobered up but the sleepiness is hitting now in waves. 

"...Ugh. Nevermind. Sorry, Bill, I shouldn't - but make sure the ER nurses get on it ASAP, please." 

The ambulance reaches the ambulance bay, sirens and lights switching off. Bill radios ahead, and by the time he has the back door open, a couple of annoyed-looking night shift ER nurses are reaching them. 

The conversation immediately lapses into the usual Montfort Hospital staff dialect, of Quebecois French full of English loanwords. Bill gives a terse, bored report covering the gist of what Marian told him. 

One of the nurses peers in. "Marian? Qu'est-ce que tu faites ici?" [What are you doing here]

"C'est compliqué. Pas important. J'était proche quand..." She gestures vaguely at the patient. "C'est pas mon shift maintenant, je veux simplement cacher et dormir, je travails le jour."

[It's complicated. Not important. I was close by when... It's not my shift now, I just want to hide and sleep, I work days.] 

Judging by the looks she gets, this is considered a little odd but not especially.

Marian says a few more reassuring platitudes to the poor patient, and then escapes before someone fails to notice her completely-non-scrubs attire and starts giving her work to do.

She's halfway to the ICU when she realizes she left her coat behind. Whatever. It'll probably end up in a bag with drunk bathrobe guy's other possessions, and she can retrieve it before she goes home. 

The ICU is dim-lit and peaceful and Chantal, at her desk, doesn't even blink at Marian coming in wearing damp jeans and the sequined bright purple sweater-top she wore to the party earlier. 

     "You're early," she says in French. 

"I'm not here yet. Want to hide and sleep." 

     "Eh. I'll ask you in the morning then." Chantal goes back to her charting.  

Lights. Movement, jarring him, pain jabbing his shoulder... Voices, strange syllables that slide past him without resolving into words. 

...where is he...? 

Staying conscious at all is a struggle; holding onto a thread of thought, impossibly hard. Ma'ar drifts in shadows, trying to sink away from all of it. He's cold, but in an abstract way. Distant. 

...Until something STABS him in the crook of his elbow, and the pain of that isn't distant at all. He struggles and finds that his wrists are pinned in place. Panic rises. He reaches for his Gifts but there's nothing there, no energy to be had, he's an empty cracked vessel... 

"Fuck!" the nurse attempting to place an IV snarls. "I almost had it and then he fucking had to move. Chelsea, hold him - hey, you," (to the resident, whose name she forgot), "can we sedate him, he's getting combative on us." 

     "Did you send the tox screen? I'd rather know what's already in his system before we starting piling on more." 

"I intend to do that as soon as I've got blood from him, which I don't know if you've noticed but we're having some trouble here!" 

    "All right. Hmm. Five of Haldol, that shouldn't hit his respiratory drive too much - do we have a sat reading yet...?" 

"He fucking took it off again. That's a big dose, can I start with two? And I want to give it IM and then get the stupid IV." 

None of the people present are talking to him, which makes it harder to focus on surface thoughts even when he can maintain enough concentration for passive Gifts, which is only in snippets. 

Frustration. Tired, busy, he's an inconvenience - they want to keep him immobilized - they think he's sick, no, they think he's...a drunkard? Or drugged? They have some way of checking but can't do it yet - maybe they don't have many Healers with true Sight, wherever this place is... 

...he remembers being under attack, running, trying to get away - a river - icy water - he doesn't remember anything after that, he doesn't know what happened, but the obvious sequence is that the attacker caught up with him. And now he's a prisoner. What happened before that is a blur as well, but - the war - death and destruction bearing down on him... 

Wherever his immortality spell brought him, however far it is from Predain, it wasn't far enough. Someone must have caught up to him. Recognized him. And now he's a prisoner. 

He just hopes the young woman is all right, the one who tried to help. It seems likely she had no context on who he is, so with luck she won't be implicated... 

Ma'ar is incredibly tired, but he gets his eyes open, at least for a few seconds, and manages to turn his head. There are metal bars inches from his face. A restraint firmly tied around his wrist. 

A lot of people, and he has to assume that they know who he is and what he's capable of. There will be precautions against his mage-gift. 

He's trapped. 

Oddly, the moment when that realization sinks in, he feels more relaxed than he has in weeks. Months. 

He's lost. The war is over and he lost it. He's been overpowered, he has none of his allies, he's too drained to fight with either fists or magic... 

For the first time since all of this began, there's no longer any reason to keep pushing forward. 

Urtho. 

Gone. 

What is this guy ON. Why is he suddenly sobbing uncontrollably. Did he just flip from being an angry fighty drunk to a morose drunk. Maybe he'll be less work this way, at least. Though he's managed to lose his sat probe again, damn it. 

At least she finally has the Haldol pulled up. And she's just remembered that if she's giving it IM instead of IV, due to the lack of an IV because her patient keeps fighting her, she probably can't - or shouldn't - keep the rest in the syringe and use it later. Whatever, she'll give him five, he clearly needs to chill out. 

Something is STABBING him again, this time in his upper arm. Ma'ar can't flail very far, with his wrists pinned, and he catches himself and tries forcibly to relax. He's a prisoner. Helpless. And he was injured during his capture, probably, judging by how awful he feels? 

He lets it happen, whatever 'it' is, and after a little while, a grey gluey blanket seems to settle itself over his thoughts, muffling everything. He still feels it, when they stab him again in the arm, but he doesn't bother to fight it. 

He drifts in grey fog, and cries. For Predain. For Tantara. For Urtho, who paid the highest price of all for his pupil's mistakes... 

Eventually even the grief is muted behind greyness. When the sticky fog swallows him entirely, it's almost a relief. 

Emily Beckett, third-year medical resident currently halfway through her critical care rotation, stands at the foot of the narrow gurney with her arms folded, frowning at the monitor. 

This patient should be a pretty simple case, well within her skills. Male, a John Doe, at a glance in his thirties or early forties but in good shape for it. She can't quite pin down his ethnicity, but - Hispanic, maybe, or he could be Native. Brought in after he was found intoxicated in public, sleeping on a park bench, and tried to run away from a security guard. The kind of story that's amusing to tell later at rounds, but not interesting. 

...So why is he giving her such an uneasy feeling? 

The patient lies with eyes closed and does not enlighten her. 

The monitor pings gently as his heart rate drops to 49, then back up above 50. The oxygen saturation probe is barely picking up a waveform, and there's a question mark by the number it's giving, but the number itself - 93% - is fine. Last BP 90/47, perfectly tolerable. 

Patricia, the nurse for Resus 1, is currently hanging more fluids for Resus 2, their elderly lady with urosepsis who's waiting on an ICU bed. 

Emmy crosses over to her. "Hey, Pat. Did we ever get a temp on your other guy? The paramedics couldn't get one, right?" And, right, the report mentioned he ended up in the river during his attempted flight. Not for long, and apparently he made it out on his own so it can't have been that deep, but - still. 

     Patricia looks up. "Hmm? Kelly tried but he wouldn't hold still for it. I'll give it another go when I'm done here, one sec." 

"Did you give the D50? He had a low sugar on the way in." 

     "...Crap. Sorry, I got the IV in and went to send off his tox screen and then her bag was empty." 

Sigh. Emmy hates it here. It's not like she can blame the nurses, when this place is chronically understaffed. 

And she's not too proud to push a med herself. "It's fine, I'll get it. And the temp. You focus on her, I know she's sicker."

Ma'ar doesn't even notice the syringe of 50%-dextrose solution in water going into his IV, or the saline flush following it. 

The thermometer under his tongue is unexpected enough to penetrate the fog, but it doesn't hurt, and he's very tired. He tries to turn his head away and then doesn't resist further. 

Up close he looks...well. Bad. She doesn't have better words for it. There's an ashen-grey undertone to his brown skin. His lips are greyish-purple. He's not hypoxic - at least, if that's an accurate O2 sat reading, which given the dubiousness of the waveform she's less sure of than she would like - but his breathing is steady and unlabored. Shallow, though. And slow. The heart monitor leads are picking it up fine, now that he's calm and holding still, but the current reading is 9 breaths/minute. 

Emmy does not like this. 

She glares at the thermometer. It still has the flickering bar that means it's trying to get a reading. It's been saying that for nearly a minute now. 

Eventually the screen blinks, almost apologetically, and changes to LO READING. 

...Well. That is...somewhat less reassuring than 'we couldn't get a reading'. There are lots of ways to fail to get a reading, especially on a combative patient. But this one sure looks like the patient is colder than whatever minimum temp this thermometer can pick up. She's personally used it and seen temps in the 34s, so it's...lower than that. 

Yikes. 

"Patricia?" Emmy calls out. "Pat, hey, do we have a better thermometer than this one anywhere? It's reading LO. I need one that goes lower than, uh, than whatever this one does." 

"...Right," Patricia mutters as she presses a button on the IV pump. "Paramedics said something about that. I figured user error, that they'd gone for axillary when he was in wet clothes or something - they said their machine goes down to 32, and that's got to be wrong, he looks too okay." 

Emmy bites her lip. "...No, I'd buy it. He looks sick to me." 

     "His vitals are all right, though?" 

"We don't have all his vitals. Ask the charge nurse for me, please? You guys should have a low temp thermometer - if not, maybe ICU does...?" She would offer to go ask herself, but right now her instincts feel that staying NEARBY is important. 

There are voices...?

Mostly what Ma'ar feels, right now, is very very far away. Numb, floating.

It's a relief, to leave behind everything that hurts. He's so tired. He remembers urgency, no time to rest, not now, because– he can't remember what was so urgent. But it would be so, so good, to finally rest. 

He remembers an attacker, though the details fade into mist. 

...He remembers someone there, surface thoughts bright and clear and promising he was safe. 

The last thing seems better. Maybe he's going to pick that one, and go to sleep. 

A more urgent pinging from the monitor grabs Emmy's attention.

Heart rate 46. No, 44. The smooth valleys between each spike stretch out longer. 

Down to 39, and the pinging changes to an attention-grabbing RINGRINGRING - and stops a moment later as the patient's heart rate stabilizes around 42. 

Blood pressure - how often - for fuck's sake the monitor is set to take it every HOUR. 

Emmy also doesn't think she's too important to change monitor settings herself. She finds the button for a manual blood pressure and then, with some effort, hunts and pecks her way into the settings menu and changes the frequency to Q5MIN. 

...The automatic blood pressure cuff inflates, and starts to deflate, and loses signal and tries again. 

Something is squeezing his arm really hard, enough to hurt kind of a lot. But Ma'ar is too far away to care, now, and the soft grey fog waits to cushion him, to muffle everything that hurts... 

The monitor eventually gives up and settles on displaying a blood pressure of 71/39, which it immediately starts screaming about. 

Emmy really hates it when her bad feelings are accurate. 

"Pat!" she yells. "Get back here– HEY! I need some HELP in here!"

She does her best to imitate the calm yet commanding voice that some of the older ICU nurses can pull off. She's not them, though, and it instead comes out sounding panicky and hysterical, which she also hates, it makes her sound like a twelve-year-old. 

It does successfully summon a few nurses, though, including Matt, the charge nurse on shift tonight. 

"Dr Beckett. What's going on here?" 

He sounds calm, maybe a little bored. 

Emmy could kiss him for that. 

"It's our ETOH patient." ETOH: medical shorthand, based on the chemical formula for ethanol. Translates to 'drunk as a skunk'. "Paramedics never did get a temp on him. I couldn't either. He did manage to fall in the river, and he was outside for who knows how long before that, I think he's more hypothermic than we realized. And he's looking pretty crashy." 

Matt, to his credit, nods seriously and rubs his hands together and doesn't make any quips about men in skirts. "Right. I already sent Pat over to grab the low-temp thermometer kit. The standard ones go down to...thirty-two, I think–" He breaks off. Scowls. "Can someone silence that motherfucking alarm, I can't hear myself think." 

(One of the newbie nurses does, looking somewhere between excited and sick to her stomach.) 

"Anyway. Other orders?" 

Emmy hasn't gotten that far yet and she could cry. 

She's a big girl, though. She can say some incredibly obvious things while she tries to think of clever things. 

"- Er, right. Prep an intubation kit - get an arterial blood gas for me, I want to know if he's acidotic, given the low resp rate and all..."

She can't remember off the top of her head how hypothermia interacts with blood pH. Presumably in a way which is...bad. How helpful of her brain to produce that information. 

"- get another blood sugar too. Uh. Give him some IV fluids– uh, warm fluids, don't want to cool him down any more -" 

People are hurrying to do this. 

There are voices. 

Far away, there's another pinprick of pain. The grey fog lies heavily over him, though, and Ma'ar doesn't care much. 

Emmy watches the monitor, then turns as Patricia finally makes it back. "- Hey, was he throwing that many PVCs before?" The monitor is binging plaintively again; in between the neat spikes of a normal-but-slow heart rhythm, there are frequent wide, ugly ventricular beats. 

     "I don't think so? Uh, I found the low-temp thermometer, should I...?" 

"Please. And let's get the warming blanket on him, what's-it-called, the Bear Hugger one?" 

     "I think ICU has it?" 

"Well, send someone to get it ASAP." 

This time, Ma'ar doesn't respond at all to the thermometer under his tongue. 

He was more responsive before. Emmy has an uneasy feeling about this new convenient calm. "Pat, how much Haldol did you end up giving him?" 

     "I gave him five, like you ordered." 

Emmy nods. She can't exactly get annoyed about orders being followed exactly; she'll have to settle for being annoyed at herself for not thinking it through. "Well. I don't like how sedated he is. Can you try to -"

     Patricia interrupts her with an alarmed sound. "Uh. Temp is...I don't know if that can possibly be accurate, it's reading 29.3?" 

"God." Emmy takes a deep breath. "God. Maybe he wasn't drunk. If he's really that hypothermic, it'd explain the mental status changes." And if that's the case then she's going to be so embarrassed when she has to explain it to the attending in a few hours. "Guess we'll know when the tox screen comes back. Is someone getting that warming blanket right now?" 

Patricia is still staring blankly at the thermometer. "Uh. Not sure. Matt?" 

     "I'll call them, maybe they can send someone over with it." 

"Right." Patricia sets down the thermometer. "You wanted fluids? Matt, can you put saline bags in the microwave?" 

     "...Honestly I have no idea. I think the OR has something for it? Maybe ICU knows, I'll ask them too." 

This conversation - or maybe just the fact that it's 3:30 in the morning and excluding catnaps she's been awake for thirty hours - is making everything feel so surreal. Emmy's brain is helpfully remembering to her that the blanket-warming cabinet has a sign on it mentioning saline bags. Except it explicitly says NOT to put them in the cabinet.

"Civic had a rapid blood transfusion machine that came with a warmer? It was a bitch to set up though, and I'd rather get a move on this, I don't love that BP. Umm." She's tempted to just Google whether you can microwave IV fluids– actually, that's a good idea. If the Internet thinks this is safe then it might also have directions... 

...The Internet rapidly answers her question: yes, someone has thought of this before and tested it for emergency situations, you can, 2-3 minutes recommended. 

She relays this to Patricia while Matt waits for someone to answer the phone, and conveys his request, then confirms that the ICU can send someone over in a couple of minutes. Which probably means ten minutes. 

"Pat? In the meantime let's at least get some heated blankets from the cabinet on him? Maybe, like, five of them?" 

Ma'ar is having a nightmare. He knows it's a nightmare, and yet for some reason it's impossible to wake up. 

In the dream, he can't move. The reason for this keeps shifting. Now he's in a coffin, about to be buried alive; no, he's in a giant grey spider's web; now he's on a frozen lake and his limbs are iced in place... 

There are voices, and in his nightmare the voices belong to Urtho's armies, as he evacuates his Tower. Because Urtho was willing to sacrifice his own life to keep his works out of Ma'ar's hands, but not the lives of those loyal to him... 

He knows it's too late. Some part of him remembers that Urtho is already dead. That even if he could free himself, he couldn't stop it. 

Still, he tries to call out - a warning, an apology, a final farewell, he isn't sure which. He tries, but his throat doesn't obey him, and Urtho isn't listening, any more than he listened to Ma'ar's letters during the war. 

He watches Urtho die, and he tries to scream but can't, and the horizon is flashing to fire but somehow it's cold. So cold. 

Emmy shakes out the final blanket from the stack, fresh from the heating cabinet, and drapes it over the patient, tucking it in around his chin and then checking that the IV line from his now-buried arm isn't kinked. The freshly-warmed bag of half-saline half-5% dextrose is flowing well, but she absentmindedly gives it a squeeze anyway, frowning at the patient's face and trying to decide if she thinks he looks dehydrated. 

...Wow, she really isn't liking this guy's complete lack of reaction to anything being done to him. She doesn't think 5mg of Haldol should be hitting him this hard? And she's uncertain enough that this calls for consulting Doctor Google again, but she doesn't think a temperature of 29 C should result in complete unconsciousness? And he was responsive before... 

She replays the brief report from the paramedics again in her head. He had a loss of consciousness on the scene. Very suddenly, it sounded like, if right before that he'd climbed out of the water on his own. 

A head injury? He did supposedly jump from the bridge - come to think of it, it's possible she ought to check for broken bones or internal injuries, she doesn't know how long a fall that was - and he could have slipped and hit his head when he was climbing out onto the ice. Maybe this calls for a head CT. Not that she especially wants to take him off the unit right now. 

...Well, she can do a more thorough neuro exam, at least. 

She checks the patient's pupils with her penlight. Dilated, and reacting sluggishly to light, but they're equal sizes and do react at all. 

In Ma'ar's drifting semiconscious-semi-dreaming state, the sudden blinding light is a world on fire. The fire swallows him - oddly, without pain - and he remembers dying and why is he dying again? 

- no, this isn't real - 

- was the war real? He can't keep track anymore. Maybe that was all just part of the same nightmare - 

Emmy watches the patient grimace, his muscles tensing. That's...some sort of a reaction, at least? 

"Hey! Can you hear me? Please open your eyes! Can you squeeze my hand?" 

There's a voice calling to him. Shouting, demanding, almost pleading.

In the dream/nightmare, it becomes his mother's voice. He can't see her face, and he can't move to look around, but he can see the blood. So much blood. If he could go back, then maybe he could save her. But he can't. He's caught in a grey spiderweb of mistakes he can never undo, and it's too late, and he's lost everything. 

I'm sorry, he tries to say, but his throat isn't obeying him either, and all he can manage is a sort of croaking exhalation. 

Was that a response? Technically, Emmy supposes, but not a very reassuring one. 

"I'm sorry about this," she says on reflex, and pinches the patient's nail against her penlight. 

Ow? 

For a moment Ma'ar confusedly thinks that he's under attack - one of the combat mages on Urtho's side must have gotten past his shields - but then the grey fog recedes a little, and awareness of his body returns. 

He's still tied down, and almost too weak to lift his head, and someone is talking to him and hurting him. He manages to lift leaden eyelids, just a crack, and the world is a painfully bright blur but he can make out her face. 

The pain stops, and more meaningless words slide past his ears. The woman looking down at him looks more worried than angry. 

Well, if they're attempting an interrogation, they haven't even bothered to figure out what language he speaks. And there's no point hiding anything, now, but he also can't think of anything he would want to say. 

"Hey there. That's really good. I'm sorry about that. Everything's fine. You're in the hospital but you're going to be just fine." 

Wow, sometimes it's really embarrassing how her voice comes out when she's trying to do the reassuring-bedside-manner thing. She sounds like her grandmother on the phone with a salesperson. 

The man's eyes are open and sort of looking at her, but he looks disoriented and terrified. And miserable.

She repeats her reassurances on autopilot while she glances back up at the monitor. Alternating English and French, just in case. 

He's so cold. Maybe his captors are doing that on purpose, hoping he'll break and talk, but right now he's far too tired to bother. 

He closes his eyes and lets the grey fog swallow him. 

Emmy gently tucks his hand back under the blankets, giving his fingers a final squeeze. He's responsive enough that he probably doesn't need to be intubated for airway protection right now? But the blank, helpless, scared look she saw in his eyes is still bothering her. 

"Pat?" she calls out to the nurse. "Do we have, uh, any reason to think this guy speaks French or English?" 

     "Huh? Oh. Paramedics' report didn't say." Patricia shrugs. 

"Nevermind." She frowns at the patient, whose eyes are closed again. She still doesn't like his colour, or the irregular wide-complex ventricular beats invading the ECG reading on the monitor, but at least his latest blood pressure is back up to 95/50. "Is there any way we can get a continuous temp on him? I want to know if we're making progress here." 

 "Hmm. Rectal probe, I guess? Dunno if he'll let us–"

Patricia breaks off at the urgent ringing of a monitor alarm. It takes both of them a few seconds to realize that it's not hypothermic John Doe's monitor. It's the lady in the bed over, still waiting for her transfer to the ICU. 

Patricia bolts over. "Fuck, fuck fuck fuck, that's not artifact -" 

The ECG tracing is...rather more exciting than what anyone wants to see at 4 am. 

Emmy stomps on a moment of med-student-like excitement. "Crash cart in here right now please! That looks like torsades. Do we have a magnesium on her yet? ...Okay she's not coming out of it. Pat, call a code, please."  

There's shouting. Some sort of loud horn-like sound. Drifting through underwater spiderwebs, Ma'ar wonders vaguely if there's a battle happening. Why would anyone bother, though, the war's over... 

Maybe his people are trying to rescue him. 

He probably ought to do something, or at least try to orient, but he can't even concentrate enough to extend his Othersenses, so he lies and shivers in his bonds, and waits, and eventually drifts back into the grey. 

WOW she was ASLEEP and the fucking code alarm on the intercom woke her. 

Marian flops over in the reclining chair and manages to check the time on her phone. It's 4:02 am. Amazing, that means she has almost three more entire hours to sleep... 

Code bleu, Urgence... 

Nope. Nope nope nope even if that is her guy she's not working right now and she's going to stay right here and go back to SLEEP. 

...After a couple of minutes, Marian groans and sits up. She might as well admit to herself that sleep isn't going to happen until she confirms whether or not the code is that guy. It's dumb, he's not even her patient, but - well, in a sense she's almost more invested. She's never rescued someone and called 911 for them before. 

Chantal is still at her desk when Marian emerges, blinking and yawning. "Chantal? Savez-tu c'est quoi le code a l'urgence?" 

Chantal doesn't bother to look up. "Aucune idée." 

FINE she will WALK back to the ER and see what's going on. 

...The Bair Hugger hot-air warming blanket machine is by the doors. "Chantal?" Marian calls back. "Pourquoi c'est ici?" She has a suspicion. 

"...Oh. J'ai oublié - ils l'ont demandé a l'urgence - tu peut l'emporter pour moi?" 

"D'accord." Although she's going to stop on the way and grab scrubs. She does not feel like strolling into the Resus bay wearing a sparkly sweater-top. 

The man she rescued from the riverbank isn't the code; the huddle of medical staff is around the bed next door. 

Mystery bathrobe guy is lying still and quiet, covered in a shocking number of blankets, an almost-empty IV bag hanging from the gurney's pole. The monitor is occasionally beeping once or twice, when his heart rate drops below 40. His O2 sats are hanging out at 91%, which for some reason isn't setting off an alarm because the threshold is set to 88%; probably the monitor was last used with a COPD patient and wasn't reset to its default alarm limits. He's shivering a little, now, which is probably a good sign overall. 

His mystery bathrobe, and the awful plaid skirt, are crumpled up in a wet bundle on the chair in the corner.

For the first time, Marian notices a Salvation Army price tag on the neck of the bathrobe, and chokes down an incredibly inappropriate giggle. 

Very self-conscious of the bright red long sleeves sticking out from the armholes of her oversized OR scrub top - she didn't want to just strip in the middle of the hallway - Marian plugs in the forced-hot-air blanket system, and unrolls the disposable blanket component from its package. 

"Hey - I'm so sorry, I need to take off these other blankets just for a moment - this one will be warmer, I promise..." The Bair Hugger is supposed to be directly in skin contact, though some of the ICU nurses always put a sheet under it. 

For a moment the air is cold against his bare skin, but mostly Ma'ar tenses up because he's exposed and he desperately wants to run away or hide or something, anything, but he's bound and helpless and he can't. 

At least he's awake enough to notice? Marian winces, though, and hurries to drape the warming blanket over him. 

This particular model of heated blanket works by pumping hot air through a hose from the machine, and out through tiny holes in the basically-made-of-paper blanket part. 

It feels very strange. But it is, in fact, warm, and he feels less exposed, and despite everything else he's grateful. 

Marian reaches under the blanket and squeezes the man's hand. "Better? Are you comfortable - do you need anything else...?" 

Still incomprehensible. The tone is gentle, though, and Ma'ar can hear the question in it. 

He can't focus quite well enough to make out surface thoughts - his head still feels full of glue, which is worrying, actually, or would be if he could muster any real emotion - but he still recognizes the earnest flavour of her mind.

...It's her. The young woman who found him. Who, not knowing who he was, tried to offer help. He can't think what she's doing here - he wants to tell her to get the hell away, she shouldn't be here - and at the same time he's alone and helpless and he doesn't want to lose that one note of familiarity and comfort. 

He forces his eyes open a little, shakes his head, tries to smile to show his gratitude. 

Huh, the guy seems really out of it? His response was very delayed and he's barely able to keep his eyes open. Then again, he's better off than he was when the paramedics arrived. 

"You're doing great," Marian says, if only because The Bedside Manner Script calls for her to say something at this point; she honestly doesn't know how he's doing. At least his O2 sats are back up to 95% now that he's awake. She's a little tempted to put him on a couple litres of O2 anyway, but he's not her patient and she's not even technically working and the responsible thing right now is to get more SLEEP. 

She pats his shoulder again and leaves. 

- and, a few steps down the hall, remembers that her coat is probably in here somewhere and she'd better find it before shift change risks its disappearance. It's not on the chair with the wet clothes...oh, there it is, hanging over the back of that other chair behind the desk. 

She retrieves it and heads back to the ICU. 

And Ma'ar is alone again. 

He understands why the young woman didn't want to risk untying him, but despite himself he resents it. 

He stays conscious as long as he can - the muffled voices and other sounds from nearby help, it doesn't actually sound like a battle at all, he doesn't have the faintest idea what it is. But the fog is waiting for him, and eventually he succumbs to it. 

Two shocks from the defib, a few minutes of CPR, and a frantic infusion of magnesium get the lady next door back into sinus rhythm, but even a brief cardiac arrest is very tough on someone over 75, and she was sick to begin with. Her blood pressure is all over the place. 

And to make her night EVEN WORSE, just after they get confirmation that the ICU can take her, Matt gets a radio alert from another paramedic team. 55-year-old morbidly obese man coming in with severe chest pain and shortness of breath. Great. Exactly what she needed right now. 

She doesn't have the chance to even think about their John Doe hypothermia victim until Matt taps her on the shoulder, nearly an hour later. 

     "Dr Beckett? Lab just called about bed one's tox screen." 

"And?" 

     He shrugs. "Negative on the whole panel." 

"Huh. I...was wondering." She rubs her eyes. Right now her deepest wish in the entire world is for things to stop happening for one. single. hour. so that she can grab a nap before shift change. "Anything on the rest? ...You know what, damn, I should've sent the full panel on him. Pat! Hey! When you're done with him can you get a full rainbow on your other guy?" Sending off all the colours of lab tubes is often colloquially called 'the rainbow.' 

     "Sure. On it." 

"Any change otherwise?" 

     "Not really." 

"Latest temp? ...Oh, crap, did we ever get the continuous probe, we didn't, did we." 

    "I'll grab another temp now." 

"He's still pretty brady." The patient's heart rate is hovering between 35 and 45, not totally regular. "Why don't you just get the rectal probe?" 

Ma'ar was asleep, mercifully without dreams this time. 

Hands untying the bonds on one of his wrists is enough to half-wake him. He stays limp, though, keeping his eyes closed. It gives less away and is also less effort. 

Someone else is grabbing him by the shoulder and hip and rolling him onto his side. They're not doing it all that gently and it hurts; his skin feels bruised and tender everywhere, and his bones ache.

And now there's cold air against his bare skin again, making him shiver harder. Which somehow manages to be painful as well; every muscle in his body is sore. 

- and then something VERY STARTLING, which wrecks all chances of pretending to be asleep, he was not at all prepared for...whatever they're doing to him...and he yelps involuntarily and tries to fling up a shield, while at the same time flinging his free arm backward in hopes of striking whoever's responsible. 

Patricia, busy trying to place the rectal temperature probe while the resident holds her patient on his side, starts to squeak as her hands suddenly lose purchase - almost as though he pushed her, but he didn't - 

- she's just starting to lean in and retrieve the dropped probe, when the patient elbows her almost right in the eye socket. 

"Ow! Ow motherfucking OW." She hops back from the gurney. "What the fuck. He hit me." 

"I'm sure he didn't mean to! He's just confused - I'm so sorry, though, are you all right - let me have a look, can you see out of that eye...?"

Whoever was holding him on his side is now distracted as well; they've let go. Good. 

Ma'ar fumbles at the ties holding his other wrist. It's soft cloth, somewhat to his surprise, and feels padded. He can't figure out how the knots work, especially given that he can still barely feel his fingers, but with some effort he manages to loosen it. Enough to pull his wrist free. 

...Right. That leaves the problem of the bars. He seems to be in some sort of cage? But it's a very odd cage. Normally it wouldn't challenge him at all; the walls are only about a foot high. Right now, though, he's still as weak and uncoordinated as a kitten - what did they do to him - and it's going to be a serious challenge. He needs to plan this out, before he gives himself away to the guards.

Ma'ar tries to breathe deeply, fighting against the gluey fog. If he grabs the bars with both hands, he's pretty sure he can pull himself into a sitting position, and then he can probably get his opposite leg over...

Unfortunately, escaping is going to mean leaving behind the warm blanket, he can't carry it. This is almost enough to tempt him to stay. But he might not have another chance. They drugged him before, he's pretty sure, that must be why he can't stay awake - it seems to be wearing off a little now but they'll do it again... 

On the count of three, two, one– 

- and he hauls himself into a sitting position, which works roughly as planned. Getting his foot over the bedrail goes less as planned; he's even weaker than he realized, and also for some reason the blanket has a hose attached and he manages to get himself tangled in it. And he seems to be tangled up in something else, as well, he can't tell what but one of the somethings is pulling painfully at his arm - 

- he gets his foot hooked over the railing and tries to vault himself over it and this does not work at all, because his limbs are about as strong as noodles and he's incidentally restrained by monitor wires and the blood pressure cuff. 

- and then hands are there, pushing him back into the cage, and he doesn't have the strength to resist. 

"Mister, listen - hey - just please calm down, I'm sorry we surprised you - we're not going to hurt you, you're in the hospital, you need to stay in your bed and rest -" 

...Well. He didn't really expect it to work. 

Panic does give him at least momentary strength to extend his Othersenses, and he doesn't need to reach far, the woman is touching him. Holding him firmly, rather. (He really wishes she wouldn't. Everything hurts.) 

He can't pick up all the concepts with her words, but he gets some of it - apology, they want him to hold still - she's claiming he's in a Healers' centre? It doesn't look much like one. They're claiming that they won't hurt him. 

He lets himself go limp, and doesn't even try to resist the woman's grip on his shoulders. 

"Pat! Shit, he just - I've got him for now - can you pull up some, uh, not Haldol, that knocked him out too much - let's try 1mg IV Ativan? Can you put in the verbal order and get it now I don't want to let go of him." 

...Ma'ar is vaguely following that. Confirmation that they want to keep him drugged and complacent. If they bring him something to drink, maybe he can pull off pretending to drink it - though now that he remembers the concept of drinking, he's noticing that he's very thirsty, his lips and throat parched...  

Patricia puts in the order, glancing worriedly over at heart attack guy in the bed over, and then heads for the Pyxis meds dispenser. 

"...Goddamnit. Ativan's out of stock. Can I just give him some midazolam?" 

That feels a little doomy, but the man can probably handle it, if he's with it enough to elbow a nurse in the face. (She feels so bad about that, even though it's not obvious how it could be her fault.) 

"Sure. Uh, start with point five though, we'll go carefully." 

Ma'ar does not have a chance to pretend to drink, since the drug is given through his IV and he doesn't even notice it. He does notice that he's suddenly a little dizzy, though. He grasps for the bars of the cage. 

"...Give him another point five and then let's hope he lets us restrain him again." 

The world is spinning and Ma'ar is no longer at all capable of holding onto Thoughtsensing. The hand gripping his wrist is unexpected, and despite knowing it's not strategic in the least to fight right now, he can't help it. He does not like having his hands tied down. And he might be seeing double right now and too weak to sit up unaided, but he can still lash out with his fingernails at the hands trying to bind him. 

"Jesus Christ, man, what the fuck is wrong with you!" Patricia jumps back. 

"- I'm starting to think he doesn't understand a word we're saying," Emmy says quietly from the other side of the gurney. "He's disoriented and scared, all right?" 

"If he doesn't calm the fuck down he's going to pull his IV out and then where will we be?" Patricia flings up both hands. "Can I give him another two mg." 

"- I don't want him over-sedated. You can give him another one mg. And again in five minutes if he's still antsy." 

...He's not. The additional dose is enough to leave Ma'ar floating. It's less a feeling of fog-and-spiderweb, this time; he just feels outside of his body, like nothing is real, it's just some child's doll whose limbs are being tied with padded wrist restraints. 

Emmy rests a hand on the patient's shoulder for a second. "I'm sorry, sir. I know you're scared and confused. And you probably don't understand this. But - we're trying to help, I promise. You're really sick and we can't risk losing your IV. But everything's going to be all right." 

Patricia gets another pack of restraints and ties his ankles too. He might kick her otherwise. 

And in five minutes, when Emmy is over assessing the heart attack patient and making the call on whether he needs an urgent transfer to the cardiac cath lab over at Ottawa General Hospital or can wait until morning, she gives the sleeping patient another milligram of midazolam, because she is incredibly over him fighting her and maybe this will keep him quiet until it's day shift's problem. 

Emmy glares at the printout for heart attack patient's 12-lead ECG and eventually admits, grumpily, that there's definitely an elevated ST segment on at least four of the leads and this calls for shipping him out. His vital signs are mostly stable but three doses of nitroglycerine plus supplementary oxygen and the usual meds on the protocol didn't fully resolve his chest pain. 

She calls Ottawa General and is almost immediately put on hold. 

"Pat?" she calls out while she waits, twirling the phone cord around her finger; her cell doesn't have the best signal in here. "Did you ever end up getting another temp on him?" 

     "...Right. I'll do that. Uh, okay if we skip the rectal probe for now? I can try to check more often, just..." 

Emmy sighs. "Yeah. Figure we'd best wait until we know for sure we can communicate with him. Day shift has access to that virtual interpreter service, no?" 

     Patricia just shrugs, and retrieves the low-temperature thermometer. 

Ma'ar floats a long way away, but manages to open his eyes - which feels oddly like opening curtains at arms' length - when he hears a voice and then feels them shove something in his mouth. Why do they keep doing that. It's not painful but it's uncomfortable. 

Patricia glares at the thermometer. "...Huh, he's only up to 30.6. I would've thought he'd warm up faster." 

Emmy scowls as well. "Shit. Well, he didn't get that warming blanket until...what, during the code earlier? And we only ever gave the one litre of fluids. He could probably do with a few more, his BP's still soft. And check it every thirty minutes, please -" 

The hold music changes to a man's gruff voice, and Emmy breaks off, lifting a hand apologetically, and ducks behind the desk to negotiate the patient transfer. 

This time her voice doesn't disturb Ma'ar at all. He's a long, long way away. 

Emmy haaaaates transfers. She always manages to forget quite how much she hates transfers. After calling the cath lab and arranging a spot, she has to wrangle a transport team and ambulance to pick up the patient, and find a nurse willing to accompany him, and fill out endless paperwork - literal, physical paper, like some kind of peasant, the Ottawa General doesn't share an electronic medical record system with Montfort. 

And then there's another unstable patient to assess, and forty-five minutes pass before she has a chance to do more than glance at their John Doe's monitor and check that he's calm. 

She checks the vital signs in the chart, and is a little miffed but not surprised that Patricia is hours behind on charting. It's been a hectic night. 

"Pat? What's our last temp?" 

     Patricia glances up from her computer. "Hmm? Oh. Thirty point eight. That was ten minutes ago or so." 

"Thanks." Emmy adds it to the chart herself, since she has it open right there, then checks the med record. That's...not as much improvement as she'd hoped for. "He got another litre of the saline-D5?" 

     "Yeah. Alicia hung it for me, I was grabbing a break." 

Emmy frowns, suddenly suspicious. "...Did she warm it?" 

     Patricia's head jerks up. "Christ. I'm - not sure. I think I mentioned it but she might not've." 

Emmy shakes her head. "At least it firmed up his BP a little. Look at that, systolic above 100 again." Then she frowns at the chart. "...You've only been getting BPs every half-hour?" 

     "He was a little restless when it was taking, before. Given, uh, earlier, I didn't want to push things." 

"Mmm." Understandable, but Emmy doesn't love it. "Hmm. Sats are... Not sure." 

     "Crap, right, he lost the probe again. Rude. I thought he was finally out and staying that way." Patricia stands up, with a grunt of reluctance, and heads over to remedy this situation. "He was satting fine last I checked, though." 

"Get another BP for me, too?" 

Ma'ar doesn't stir when Patricia replaces the O2 sat probe on his finger. (It's been off for a while.) His breathing is even, but shallow and slow. 

The reading comes up as 86% and the monitor pings in complaint. 

"...I don't love that. How much midazolam did he end up getting, total– You gave him three doses? I guess that'd explain a bit of respiratory depression. ...Oh, and that BP's not filling me with delight either." The monitor is claiming 85/57, which is technically fine by ICU standards but probably not this guy's normal range.

He's mostly stable, she thinks, he's just...not bouncing back as fast as she feels that a young, apparently-healthy man, apparently not on any drugs at all, should be. "What am I missing..." 

She runs down the list of complications-from-hypothermia in her memory. And then admits that she should probably consult Google, and pulls up a US National Library of Medicine paper, watching Patricia unspool the tubing for nasal cannula and hook them into the patient's nose. 

"...Cold diuresis, right. Uh, we - should probably be monitoring urine output, we're putting a lot of fluids in. And he'll be losing electrolytes. Let's give him another litre of fluids, but switch it to lactated ringer's - and make sure it's warm. Three minutes in the microwave– actually, I'll just do it myself and, uh, probably I can check the temperature of it somehow...? And I want a Foley catheter." 

"Are you kidding? You want me to drop a catheter in mister 'I have a black belt in judo and will punch you in the face'?" 

"...We can't just not treat him. I guess maybe that's less urgent and possibly it could wait until day shift has an interpreter. Unless he drops his BP again, if that happens I want it done ASAP."

She vaguely recalls that the ICU stocks those neat catheters with temp probes, which would kill two birds with one stone, but also it's all the way over there. And she's pretty sure they cost three times as much. The patient is concerning her some, but he's not that sick. Yet she is not going to tempt fate here. 

She clicks around the chart. Labs: a whole slew of them pending, sent about thirty minutes ago. The only ones that are back yet are the blood counts; hematocrit is at the high end of the reference range, whether because he's an active male or from hemoconcentration because they weren't keeping up with fluids, she can't say. White count a touch elevated.

Arterial blood gas from hours ago: back, PaO2 low end of normal, PaCO2 the same, pH slightly acidotic, bicarb below the reference range but not marked as a critical result. Metabolic acidosis, which Doctor Google informs her is to be expected. 

...And then, inevitably, she's pulled away by a ringing monitor next door, before she can finish her mental checklist of what she might have missed.

She only realizes several minutes later that she told Patricia she would prep the warmed fluids, and she has absolutely not done that, and also Patricia is nowhere to be seen.

"Matt! Hey, I'm sorry, could you microwave some Ringer's for bed one?" 

The charge nurse shakes his head. "I still can't believe you can do that. Sure." 

"And a blood sugar while you're over there?" Emmy adds thirty seconds later, calling out so he'll hear her at the nursing station. "I'm not sure we ever followed up after we treated the low sugar that the paramedics got." 

Matt sighs, but doesn't frown where Dr Beckett can see. "Sure, of course." 

He passes her again a few minutes later. "Fluids are running. Sugar was 81, he's fine. I grabbed another temp for you, too, he's up to 31.2. Oh, and I bumped his O2 up to 3 litres, his sats were dipping a little." 

"Thanks for the head's up." That's a little worrying? She's not sure how worrying. Probably it's just that Patricia, well, got overenthusiastic about the midazolam order. It'll wear off soon, it's not that long-acting a drug... 

She makes a mental note that they'll want another blood gas, and returns her attention to the other patient. 

Ma'ar drifts through confused nightmares, voices and lights and other miscellaneous sounds of an understaffed ER at six-thirty am reaching him from a great distance, blending with memory of battle and fire and a child's flight through a violent country. 

Eventually he sinks into deeper sleep, where there are no dreams at all. 

His blood pressure rises briefly after the fluids go in, but creeps back down to a systolic in the 80s. His heart rate is consistently between 45 and 50, now - that one degree of body heat made a difference - but it's more irregular than before, the ugly wide-complex ventricular beats coming more often and sometimes joining up into couplets. 

His breathing is still unlabored, and not that much slower than normal - 10 breaths a minute, sometimes 9 or 8 - but it's less regular than before, and his chest only rises a little. 

Shift change is approaching and most of the nurses are doing their very best to catch up on a night's neglected charting, even as the first dribs and drabs of the morning rush start. Patricia is stuck in an isolation room helping clean up a, well, mess, which would be very embarrassing to leave to the arriving nurses. 

One of the others at the nursing station notices the monitor pinging sadly on the central display, glares at it for thirty seconds to see if the sat reading will come up by itself, and then groans and briefly interrupts her charting to go increase the patient's oxygen. Might as well go to 6L and let day shift sort it out later. 

6:35 am. 

Ma'ar's sats pop up above 92% again, but the reprieve is short-lived. By the time Patricia extracts herself, washes her hands thoroughly, and heads back over, he's slowly dropping through the mid-80s. 

He looks calm at least. She taps his shoulder. "Hey, man, take a couple deep breaths for me? Through your nose." 

No response. The alarm shifts to a faster, shriller ringing as the number slides down past 85%. 

"Jesus. Why now." It's 6:45 am. Staff huddle and shift report is at 7:15. 

Patricia squeezes his shoulder harder, repeats the instructions much louder, then winces and rubs her knuckles up and down on his sternum. When this doesn't get a noticeable response beyond, maybe, a faint frown-line appearing on his forehead, she starts to genuinely worry. 

"Matt! Lila, get Matt here now - find the resident, I need her ASAP - uh, call the lab, see if they can move on results." She whacks the button for a blood pressure. 

76/41. 

Sats down to 84%. 

Ma'ar's features are slack, his expression almost peaceful for the first time. His skin feels clammy to the touch as Patricia wrestles an oxygen facemask into place, turning it up all the way - better to overreact and correct later.

By the time Emmy Beckett arrives at a jog with Matt, he's maintaining his sats at a fairly cheerful 95% - but it's a less cheerful sign that that's on 100% oxygen. His blood pressure is back up to borderline-acceptable, probably because Patricia keeps repeatedly causing him pain. She can get some response - an eyelid flicker, a faint tensing of his limbs - but not more than that. 

Emmy stands at the foot of the bed. "Shit. What's up with him. Matt? Anything obvious we're missing here? ...Labs, right, his electrolytes could be whacky and they're not back yet–" 

"Lila's calling the lab. Sorry, if I'd expected," vague handwave, "this, I would've put them down stat in the first place. Anyway, right now I'm worried about his BP." 

A terse nod. "I don't want to dump more fluids in him til we've seen that bloodwork and I know I'm not making anything worse. Can you prep some norepinephrine? I don't love running it peripherally, but it is what it is - if he doesn't stabilize we can do a central line. Maybe we should prep for one anyway. He seems fragile."

At which point she actually turns her attention on the patient and looks at his face, rather than the monitor. "...God. I do not like how he's looking right now."

It's hard to put into words. She remembers her first attending saying something like that, 'I can't say why I'm worried except she just looks sick'. 

"- Right. Let's prep to intubate him as soon as we've got some support for his BP. Matt, call the ICU and make sure they've got a room for us? If we can get him stable enough for transport before day shift..."

6:48 am. 

Marian feels a lot better than she expected to, even with the interruption to her few hours of sleep. The pre-shift-change bustle and lights being switched on in the hallway woke her, and she emerges, yawning, and heads for the end of the hallway, there's an empty patient room there and it's a way nicer bathroom than the staff one. She stole a mini deodorant and one of the disposable patient toothbrushes from the clean supply room; the mini tubes of toothpaste are awful, but at least she can make herself very slightly more human before 7:00 am. Which is when the Tim Hortons in the front lobby opens. 

Chantal's desk is empty. Judging by the lights being on, she's in the closer patient room in this side hall. 

The phone at her desk rings. Rings again. 

After the third ring, Marian grumbles under her breath, sets down her filched toiletries, and picks it up. "Soins intensifs, c'est Marian?" 

She listens for a while.

When the ER night charge nurse gets to the patient details on their requested admit, her stomach seems to drop out the bottom of her feet. 

"...Oui, je penses qu'on a une chambre libre? On peut envoyer quelqu'un pour aider. ...Non, je suis jours, j'ai...arrivé tôt. Je m'en viens, deux minutes..." 

It's not that unexpected for the ER to ask for help, for an unstable ICU-bound patient this close to their shift change. Marian...would probably have volunteered to go anyway, she's here and might as well, but it does make a difference that it's her dude. 

She pauses outside the isolation room, yells an update across to Chantal, runs back to the clean utility to retrieve some entirely different medical supplies, and then books it down the hall. 

Emmy is glowering at the thermometer. "What the fuck do you mean his temp's gone down?" Not a lot, 30.9, and it's not impossible that the high-flow oxygen mask messed up getting an oral temperature, but STILL. 

...The patient isn't shivering. He was before, she's pretty sure. Now he's very, very limp.

She lifts his arm. Clammy skin, his nailbeds are dusky purple - no wonder the O2 probe is having trouble getting a good signal - and completely floppy, no muscle tone to speak of. 

She doesn't think this could be just from giving the guy too much midazolam hours ago. Well, that may not have helped, but something else is wrong - what is she still missing... 

"Where're we at with that norepi? Matt, can you get us another peripheral IV line, we've got a lot to do and I'd rather ship him to the unit and then fuss with a central line if he's still needing it." She looks around. "Damn it, guys, we need more hands in here." 

     "ICU's sending someone over to help out," Matt offers. "Day shift, too, starting early." 

"Excellent. We could use someone fresh." Emmy's forehead is aching from the combined exhaustion and tension. She massages her temples. "Well. Get me that IV - we'll need meds for intubation - oh you know what I can pull those myself." Another thing that Emmy considers it important not to be too proud to do. 

Matt is having a hard time with this stupid IV. The patient is hypotensive, and peripherally shut down, his hands purplish-grey and cold to the touch despite the blanket blasting him with warm air. You would THINK that three litres of fluids dumped into his veins would help, but in fact it's mostly made his hands and forearms slightly puffy, apparently without plumping up the veins much at all. 

Matt is an experienced ER nurse who has placed, at the very least, over a thousand IVs. He does not normally have to stoop to digging around for a vein that might if he's lucky be there. 

After the second poke fails to get even a speck of blood return, he resorts to digging. 

Ma'ar drifts below a dark quiet sea. Something keeps intermittently hurting, somewhere above the surface, but it's not exactly him, and it's hard to care. He feels very, very tired. 

- until the STABBING PAIN yanks him closer to the light and air, close enough to his body that he notices he feels incredibly dizzy and sick and he can't move he can't even pull away from the agony, let alone fight back, he barely has the strength to curl his fingers slightly and he's not actually sure whether or not he's succeeding. His feet are entirely outside his range to control. 

He manages to get his eyes open and slightly turn his head, though. And immediately regrets it. His head hurts and the gently spinning blur of too-bright lights is making him motion-sick. 

Something makes a whimpering sound. Maybe it's him. Then his body starts trying very hard to vomit, a process he has approximately no control over. 

"- Jesus Christ, could he have picked literally any other time?" Patricia snarls, dropping the trailing IV line that she was about to connect and grabbing the patient's shoulders to roll him towards her instead. 

Marian arrives at a breathless run, temperature-probe-Foley-catheter package in hand. "What is it?" 

"Get the suction tubing - the last thing we need is for him to aspirate on us - oh, hey, Marian!" A brief and harried smile. Marian is...well, a kid, really, less than nine months out of school, and it shows, but she's a decent kid, at least. And she has ICU discipline. "Matt, buddy, maybe torture our patient after he's sedated." 

The suction tubing is not hooked up to the wall, because SOMEONE didn't do their ROOM PREP, but Marian keeps the grumbles in her head and rushes to plug everything together and pass it to the nurse. "Here." The leg of her scrubs catches on something– oh, tubing, trailed over the gurney railing. "...This meant to be running?" 

"Yes. Start it at two, please." 

More than half of the patients she's ever had were on blood pressure-increasing drips. Marian has the ccs per hour to actual dose conversion memorized. She makes a mental note to program the pump properly anyway. Later. 

Something stings, but after a little while the dizziness recedes somewhat, and Ma'ar's mostly-empty stomach stops trying to turn itself inside out. He coughs, and tries to spit, except that someone is shoving something in his mouth again. Why do they keep doing that. 

...The familiar mind is back. The one person who, as far as he can tell, hasn't tried to hurt him at all. He doesn't understand why she's here now, right in front of all the other guards-or-whatever, but - maybe - if he can stay conscious and concentrate for just a few more seconds... 

Her hand is on his arm. She's saying incomprehensible words; comforting ones, he thinks, though he doesn't understand the content. Her mind is focused on him, trying to communicate, and so unconsciously holding herself open. It's hard, incredibly hard, like lifting a massive boulder - but he can reach her with a whisper of Mindspeech. 

:Help: 

Marian doesn't jump this time. She's busy taping the precious IV line in place more thoroughly, and looking for other veins though she's not hugely hopeful, and she's not looking at the patient's face when she hears - not-hears? - the word. But he's obviously freaked out, understandably so, and this is a situation she's been in before. Lots of times. 

She wraps her hand around his and squeezes. "You're going to be okay. You're very sick right now, but we're here to help." He remembers her, she thinks; his eyes are fixed on her now, desperate and pleading. "Listen to me. I work here and I'm not going anywhere. These nurses need to give you some drugs to put you to sleep, for a while, so you can get better. But I'll be there when you wake up. Okay?" 

Even with the young woman - scarcely more than a girl, really, now that he can see her face in better light - holding her mind open, Ma'ar can only grab onto fragments of her surface thoughts. 

She says he's ill. Well, something definitely feels wrong. Maybe the other guards hurt him worse than they had meant to? The girl is saying that she's allowed to be here. That he has to sleep, but...she's staying. 

It's a slim thread of hope, but right now it's the only one he has. 

Marian considers asking if she can have her hand back, but she's really not sure the guy is lucid enough to follow, and besides, she feels too bad about it. She has good access to his IV line, here, and she can push meds one-handed. 

The monitor dings. 

"BP up to 120 systolic, think that's enough wiggle room. Sats at 98%, we're not going to get better than that. Marian, maybe bump the norepi drip up to four before you push the propofol, just in case? Where's respiratory therapy - are we waiting for them?" 

     "Probably in shift report," Matt mutters, looking over at the clock. "Which I need to be in in fifteen minutes. I can bag him." 

Emmy nods. She almost asks Marian what the deal is, how she can get this patient to chill out - at least a little - but now doesn't seem like the time. "Right. Let's go." 

Marian manages to one-handedly - and only slightly using her teeth - alcohol-swap the port in the IV line, and screw on the propofol syringe. "...Uh. How much. I don't think he needs all of it." 

"God, no! Start with 4 ccs, we'll go from there. He's already got some midazolam in his system." 

One is not technically supposed to push propofol through a line running norepinephrine, but probably it'll be fine, and Marian has other worries right now. She holds eye contact while she pushes the drug in and, rather than re-capping the syringe, shoves it in the opened saline-flush package in case she needs the rest later. She manages to get the saline pushed through as well before anything terrible can happen to the two drugs mixing in the short length of tubing. 

She keeps talking to the patient until his eyes close. Not really saying anything with content, she suspects he isn't parsing most of it anyway, just...reminding him that she's there. 

It doesn't feel like falling asleep. It doesn't feel like anything, really. Just - one moment the world is there, and then the curtains close and there's nothing. 

The phone picks this exact minute to ring. 

"It's probably the lab! Someone needs to answer that!" Emmy's hands are very busy right now. 

     Matt gets it. Listens for about three seconds. "- Got some critical results for this guy." 

"What a big surprise." Emmy's voice is flat; she's trying to concentrate. "What ar– Marian, I don't have a good position here, help me wedge this pillow further down? ...What are the results." 

     "Magnesium and phosphate critically low. Phosphate is...zero point nine. I didn't know that was possible. Potassium's pretty low but not quite in critical range. Calcium's low too." 

Marian doesn't swear out loud but she's doing it a lot in her head. 

"Shit. We need another line - I think mag's one of the ones you really shouldn't run with propofol. Matt, call the pharmacy and get IV supplements as fast as you possibly can." 

     "What dose?" 

"- I don't have a clue and I'm a little busy." ...Did she say that out loud. That's mortifying. "They're pharmacists, they should know– Got it! I think! Marian, mind listening for air entry?" 

Marian feels pointlessly for her stethoscope around her neck, before remembering that she wasn't actually done getting ready for her shift. "If I can borrow your stethoscope? Thanks. ...Got bilateral air entry. I think. Sats are - crap what happened to the sat probe, sorry -" 

Emmy looks down at the patient's face. 

"Marian." 

She finishes swapping the sat probe to another finger. "What?" 

"Can you check if we've still got a pulse. He looks..." 

It's not a dead person colour - yet - but it's not exactly an alive-person colour either. Emmy would check but she's having that inconvenient and horribly embarrassing problem where her hands are shaking and she's not sure she would be able to tell. 

Marian nods and does this, with the same sort of distant matter-of-factness she would if Dr Beckett had asked her to pass the tape. 

"...I think so?" She glowers at the monitor tracing, trying to decide if the faint fluttering that she maybe feels under her fingertips matches the rate of those too-slow spikes. "Uh. I'd like it if I were...more...sure of that..." 

She has one hand free, at least, if she awkwardly cranes around she can bump the norepinephrine up to its maximum rate without otherwise moving.

"His cardiac output is probably shit right now, with everything that out of whack. Can someone who has their hands free right now please look up whether, uh, 31 C is cold enough that epi might not work. Also it's past seven can someone please page Dr Prissan right now that holy crap that got bad faster than I'd expected. And we should get a blood gas and a lactate. ...Also I think I'm just going to assume he's really acidotic and would benefit from an amp of bicarb before we have results. Uh is someone writing that down...?" 

Marian kind of wants to tell Emmy to take a deep breath, but it feels too patronizing to say in front of everyone else standing around. She cycles the blood pressure again instead. 

The machine considers this with bemusement for a while, deflating and re-flating a few times, and eventually settles on 67/39, which is honestly a lot better than it could be. The sat probe is still picking up occasional ripples but not managing to settle on a waveform. 

"You're pretty sure there's a room ready?" Emmy asks Marian quietly. "How would you feel about we push some epi and then run like hell down that hallway? Because I would much rather be there and not here." 

"...There's a room that I'm pretty sure is empty. I, uh, haven't checked if it's fully set up, it probably isn't. I guess if we steal the suction canister from here then we'll have a backup plan at least. Oh, and I don't know if admissions is going to, uh. Have a snit if we just decide to stick him there without telling the computer. If he's not properly admitted then I don't think the Pyxis would let us get drugs and I would rather be somewhere we can get drugs." 

"I suppose we're waiting for some phosphate and mag and I don't want those getting lost."

Emmy remembers to take a deep breath. It helps. 

Marian takes another blood pressure. "We're up to 72/45. That's...any better, I guess. Uh, want me to try for another IV while we're here anyway? Guessing you'd rather do a line over on the unit." 

"Mmm, sure?" 

It's 7:05. As the minutes tick forward to 7:15, various things happen. The respiratory therapist belatedly arrives, obtains a blood gas sample, and asks Emmy if she wants a ventilator set up here or to wait. Emmy, who's been manually ventilating the patient this entire time and almost forgot she was doing it, shrugs and says they might as well set it up on the ICU end. Matt pushes an ampule of bicarbonate and spends a couple of minutes googling the effects of significant hypothermia on how well epinephrine works, but by the time he's concluded that it's "probably fine", the patient's blood pressure is struggling back up toward something tolerable. Matt, on Marian's suggestion, also hunts for and digs out the neonatal O2 sat probe, which wraps and sticks on like a bandage and, while it's meant to go on babies' tiny feet, also works surprisingly well on adult earlobes. This gets them an easily-disrupted but much more robust waveform, and a number very solidly at 100%. In hindsight, probably manually bagging the guy with 100% oxygen is overkill. 

Marian hunts for veins. 

She's not, actually, all that good at IVs. But she's often a lot more patient than busy ER nurses are willing to be. 

She gets an instant heat pack, cracks it open, and heat-packs the patient's forearm, below the existing IV. She flips down the railing and unties his wrist - keeping a careful eye on him - and lets his arm dangle off the side of the bed. She only ties the tourniquet in place after a minute of that, and gets out her penlight for extra vein visibility. 

There, that one on the side of the wrist, she can probably get a small 22G needle in there... 

Ma'ar is oblivious to these manipulations. He's trying to breathe a little on his own, now, occasionally fighting with Emmy's timing for squeezing the bag, but that's the only change. 

Marian heat-packs the vein some more while she preps materials, makes sure the lighting is good, reties the tourniquet, swabs his skin... 

...if she misses it then they're kind of screwed. Practicing every opportunity she can get is all good, until the stakes are 'maybe her patient dies.'

Marian swallows her pride and straightens up. "Patricia? Are you good at IVs? I found a vein but I'm - not sure I can get it." 

Patricia has a go. It's a lot easier now that his blood pressure is back up above 100 systolic and he's also, conveniently, totally out and holding still for it. 

7:14 am. Marian is thinking sadly that she missed her chance for a no-line wait at Tim Hortons, at least until after 9 am when the rush quiets down. And she's going to miss shift report too. Probably someone got the message that it's because she's trapped in the ER with an admit? 

...They'd better let her keep this patient. Marian is feeling kind of possessive. 

Without an obvious next action, Marian putters. She transfers the norepi pump to the gurney's pole for easier transport, programs it properly, and then hunts down another pump and primes a bag of saline so she can hang the electrolyte replacement in piggyback. (Can you run mag and phos in the same IV? She actually has no idea, she'll have to look it up.) 

Matt ducks off for shift report and huddle, but returns thirty seconds later with two plump little bags, neatly labeled for John Doe, supposedly born on Jan 1st 1900 is that some kind of default setting. 

The phone rings. 

Marian answers it, since Dr Beckett is still breathing for their patient. 

She bounces. "Room's assigned! We can head over! ...I don't really want to wait for transport, do you?" 

"Oh, phew. No, I don't. I do want a syringe of epi in my pocket. Just for my peace of mind." 

"It's, like, thirty seconds down the hallway," Marian points out, but lets it slide. "I'll find us an oxygen tank. Might as well start the phos and mag once we're there." 

And then they're underway. Packaged fairly neatly for transport, the oxygen tank lying beside the patient's legs. Marian takes the handles of the gurney, and Dr Beckett holds the ambu bag and grips the railing to help steer. 

...She doesn't have her badge. Oops. Also, Marian only just remembered that she meant to put deodorant on. After removing her sparkly red sleeves. And then she was interrupted. She just did all of that in her party outfit... 

"I got it," and Emmy swipes them in and taps the wheelchair-access button. 

There's a room. The lights are on in it. There's even suction set up properly.

There is not...a bed. 

This was not a problem Marian was expecting and, pre-caffeine, it sort of sends her brain into a tailspin. "Um," she says to no one in particular. 

"That's awkward. We'll have to...call supply and order one, I guess? Does central supply do beds? Don't worry about it, just get him settled, I'll go ask the charge nurse to deal with it." 

Getting her John Doe transferred from the portable monitor brick - it pops right out of the ER monitor and has a teensy screen of its own - onto the ICU system, is a pain. Mostly because she has to count to ten in her head repeatedly and remember to squeeze the ambu bag; he's breathing spontaneously now, but not that often. She gets a new blood pressure - it's actually up a bit, 110/70, maybe the jostling did it - and checks that his sats are still 100%. 

And then, because she is an idiot, she spends nearly a minute waiting for the thermometer to read, and stares stupidly at it when it times out and settles on LO. She didn't think to grab the one that the ER was using and she's not sure if the ICU has its own. 

...no, wait, she is triply an idiot, she brought the fancy catheter for exactly that reason. Unless she left it behind, that would be - kind of hilarious in a mortifying way - but no, it's there, stuffed at the foot of the gurney where she must have dropped it. Right, she left the Bair Hugger machine behind, she'll need to grab a new one - should she heat up his phosphate and magnesium bags, are they going in fast enough to matter either way, is it even safe to do that - can she put them in the IV bag - damn it she forgot to ventilate the patient for the last thirty seconds, his sats don't seem to have noticed but still. 

One thing at a time. She will call RT and get them to do their JOB and then she will check med compatibility and hang the mag and phos and then she will place a catheter and THEN she can retrieve the Bair Hugger. Or hopefully at some point someone else will show up and she can delegate. Shift change is such an awkward time. 

More hands thankfully arrive soon, in the form of RT and Anne-Marie, a fellow new grad, who agrees to grab the blanket-warmer machine. 

Anne-Marie also has a much more sensitive nose. She sniffs. "...I smell pee." 

Marian lifts the deflated blanket. 

"...Oh. Awkward. Uh, can you get me another blanket pack too, this one's... Gross. And, uh, a towel. Maybe two towels." She is slightly wishing that someone had made different choices early about when to place a catheter, though it was admittedly less urgent than many other things. She's guessing he lost bladder control when he nearly coded, and no one was expecting that.

Anyway, whatever, they're waiting on an actual bed, she'll just sort of sop it up for now instead of trying to change sheets on the gurney. 

Her patient, at least, has the excellent qualifications of being: 
- not ancient 
- not obese
- not a woman
- not struggling wildly 

Finding the right cable to hook into the monitor and the other end of the temp probe is actually more time-consuming than the placement itself, but after that she has a NUMBER right there on her SCREEN. Which immediately sets off the alarm because she didn't think to customize the settings. 

It's a better number though! An entire 31.8 degrees! She could dance. Now they just need to get him blanketed again before they lose ground they've gained here... 

He's starting to shiver again, presumably as the sedation wears off. His pupils, under Marian's penlight, are equal-sized and only a little bit sluggish to react. He very weakly tries to pull his arm away when she pinches his nailbed, though neither that nor politely asking gets him to open his eyes. 

She is going to do an ASSESSMENT no nevermind she is going to make a very hasty trip to the staffroom to collect her stethoscope and - while no one is looking - skin out of her stupid shirt. On top of looking absurd, it's too hot. 

By the time she gets back, Dr Beckett and the day shift charge nurse, Amélie, are wrestling a full-size ICU bed through the door. 

"Marian? What happened to the warming blanket?" 

"Uh." 'It got peed on' feels weirdly like maligning her patient, even though it's literally what happened. "Anne-Marie's getting the machine from the ER and bringing a clean one. ...If we're going to transfer him, can we get him on something for sedation first, that would be really bad timing for him to wake up and freak out."  

"It really would be! Are we still maxed on the norepi, though?" 

"For now, I might be able to come down." Marian cycles the blood pressure, then remembers to switch it to every 5 minutes. It won't drive him up the wall right now, when he's unconscious; if his BP keeps being this all over the place, though, she should remember to nag about an arterial line. 

She squints at the number. 105/52. "C'mon, buddy, you can do better than that. I can probably come down a tiny bit?" 

"Don't. Let's put him on midaz, he didn't tank nearly so hard when he got that before. We can start it at, like, 1 mg an hour, I want to go gentle on him - if he's agitated you can bolus 0.5 mg, let's say q30min and bother me later if that's not enough, and up the drip to a max of...I'm going to put down 3mg an hour, we can reassess later but I really don't want to oversedate him right now when he's got so little cardiovascular reserve. He scared the piss out of me earlier." 

"He scared the piss out of himself too," Marian says before she can stop herself, and then feels her cheeks turning crimson. "Um." 

Emmy ignores the comment. She paces. 

"...So. What did I miss, earlier. Am I still missing something critical here. - Oh, snap, we should replace potassium too. I'd lean toward getting a NG tube down him and giving him the liquid, so we can give him 40mg in less than four hours, except I dunno what was up with the vomiting earlier, and...probably that's not a great idea when he's still this cold, he won't be absorbing it well. I guess we've got time, that one wasn't a critical result. Pharmacy gave you a max infusion speed for the others?" 

Marian's brain was already overloaded enough and now Emmy is thinking-in-circles out loud and her head hurts. "Yeah. Two and four hours, they're running - together, I checked and I think it's fine and these concentrations. Uh, right, and sure. I can put in the order for that and for the sedation and get that going before we move him? Ugh, I need a cosign on midazolam though..." 

"We really need that central line. Mel, can you bring us a kit once we've moved him? ...Fuck, I don't get it. Why is he this crashy? We deliberately cool people almost this much for the post-arrest protocol and they don't pull this crap. And they're usually old with janky hearts, he's young and - well, look at him, he's clearly fit."  

Oh are they brainstorming out loud now, is that what's happening. Usually Marian loves doing this sort of thing, especially with Emmy, but right now she can't think because she hasn't had her coffee. 

"Ummm. I mean, sometimes young people have heart problems too? He could have some condition that - makes him less able to handle stress on his heart?" 

Emmy snaps her fingers. "Right. The attending can get a bedside echo just to see - I don't know what I'm doing enough. I...still feel like we're missing something, though. He wasn't improving like I'd expected, that was what I noticed first - his lowest temp was actually still just 'moderate' hypothermia according to the Internet, patients supposedly do fine usually with external rewarming only and we did that and the warmed fluids and it seemed like it just wasn't helping that much..." 

This does seem like important speculation to be doing, even if it's a little late for it, but also Marian is too tired and un-caffeinated to multitask, and so she hasn't put in orders for sedation or potassium yet, and minutes are ticking by. 

     "Marian? I pulled the midaz for you - cosign?" 

Marian could hug Amélie right now. "Thank you!" 

Ma'ar isn't awake. Or asleep. For a time, he isn't anywhere. 

...And then he's somewhere, again, just - far away, floating. 

There are voices, fading in and out. And then movement. Discomfort, but not really pain. 

He's so very tired, and the girl he at least provisionally trusts a little said he needed to sleep, which makes sense because he's so tired - and she's still there, he feels the glow of her mind, so far what she said would happen hasn't been falsified (yet).

For now, he succumbs to the inevitable, and sleeps. 

They get him moved across into the bed, and Marian runs off to collect all the spare pillows she can find and get him tucked in, he's been flat on his back for - well, presumably ever since she arrived at the hospital with him in the ambulance - and some vague tickle of a thing she read once informs her that hypothermia increases the risk of bedsores. Which checks out, less perfusion to the skin, whatever. They need him in an appropriate position for central line placement, so she doesn't turn him very far, but she tucks one of the flatter pillows under one side, arranging it so that she can turn him further on her own later. The upside of being down the side hallway like this is that it's quieter; the downside is that helping hands are a lot harder to come by. 

And then Anne-Marie is finally back, wheeling the Bair Hugger machine along by kicking it because her hands are full. Which also shows why she took so long; she's carrying an entire tray of Tim Hortons coffees. 

"Marian? You want black, no?" 

"Anne-Marie I love you," Marian says, with force. "Thank you so much." 

The phone rings. She answers it. 

"...Uh. Uh. Wow. Just a sec, I need paper..."

Where the hell is her clipboard. Oh right she doesn't have it, because unlike her stethoscope, she took it home in her backpack last night. Which is now in her apartment. She doesn't have a single thing written down right now. She doesn't have a pen on her. 

It's hard to have too many regrets, though, because if she hadn't been irresponsibly walking home from a party alone in the early hours of the morning, this guy might be dead on a park bench by now. 

"God, what is it now?" Emmy offers Marian her own pen. 

"Blood gas results, from before." Marian, hunched over the unused bedside table, finishes scribbling a vertical row of numbers on the napkin that came with her coffee. "Not pretty. pH is 7.12." Alarmingly below the normal reference range of 7.35 to 7.45, which by this point Marian just has memorized. "Partial pressure of O2 is 59, that's...low but honestly could be worse. I guess we were ventilating him by then. PaCO2 is...54? That's high but could be worse. Probably was before we tubed him. Bicarb is, holyfuck, it's 13. I hate this blood gas." 

"It's not a great blood gas! Let's get a repeat - god, we should just drop an art line in him at this point, shouldn't we, we're going to be doing a fuckton of repeat labs until his lytes are stable."

Emmy takes a breath. "And I can do that. I'd rather wait for Dr Prissan before I risk a central line, I - I still don't feel confident I can keep the guidewire from going in too far, and if I send him into an arrhythmia right now I'm worried he won't come out of it." 

Marian lets out her breath in a puff of relief, though she remembers to do it quietly. This is one of many reasons she likes Dr Beckett. She's not a cowboy, like half the residents - okay, fine, mostly the male half of them - who would jump on the chance to put in a line unsupervised.

"Right. Want me to get you the kit?" 

     "I'll get it," Anne-Marie offers. "You stay here. Do you need anything else?" 

Marian glances around. "...Could you grab me a spare clipboard. Dr Beckett, uh, do you need your pen back or can I...?" 

"Nah, keep it." Emmy leans on the foot of the patient's bed, hands wrapped around her own coffee. Her eyes focus on the respiratory therapist poking at ventilator settings. "...Uh, set the volumes lower. I was probably overventilating him for a while, I bet we've driven his CO2 way down by now, and - hypothermic, right, lower metabolism, he won't be producing as much. Don't think we need to compensate that hard for the metabolic acidosis. Though we should get a lactate ASAP once I've got the art line in - did we get one before? I can't remember if I ordered it..." 

The room does not currently possess a computer-on-wheels and it's feeling kind of crowded anyway. Marian opens the blinds on the window, then risks ducking out to use the desk outside, so she can actually log in and assign herself the patient and orient better to what happened while she was asleep. 

...Thirty seconds of looking around aimlessly, and she's already thinking that she is very unimpressed. She handed this guy off to them and they NEGLECTED him. She's so offended. ...Probably she's mostly fuming about this because she had less than four hours of sleep and keeps forgetting to actually drink her coffee. 

She takes a large gulp and burns her mouth. 

Emmy glares at the monitor while she sets up her arterial line sterile field and starts draping and prepping the patient's arm. ...Which requires untying his restraint. 

The patient's temperature is reading 31.4. 

"Ugh, we lost almost half a degree just from not having the blanket on him for five minutes? Oh, and Marian, can you come in here a minute and be ready to grab him if he moves? I had to untie him to get at the radial artery." 

Damn. Marian takes another long swig of coffee; at this point she's already burnt all her taste buds, it won't make it any worse. "Uh, if I have to make a grab at him I'll wreck your sterile field? Maybe I can glove up too and I'll...hold onto his hand under the drapes? I can keep his wrist at a good angle for you and it'll be easier to calm him down if he starts waking up when you stick him." 

Emmy shakes her head. "Knowing my luck, he'll wake up and try to punch me in the face." 

She should not giggle that's incredibly inappropriate. Marian makes faces for a few seconds instead. "...Is there a story there?" 

"Oh, just, I wanted a continuous temp on him, but he had some objections to the rectal probe. Patricia got a black eye." 

Probably this wouldn't be hysterically funny on a normal amount of sleep. Or if Marian were less of a terrible person. She snorts despite herself. "You're serious? Wow. ...I mean, if you surprise rectal probed me, I might do that too." 

"...You know, good point. He was pretty out of it and I don't think he understands French or English? For all I know he thinks he's been kidnapped by aliens for their experiments." 

"What? No, I mean, I don't think he speaks English but I'm pretty sure he understands some?"

Oh. Right. It's very possible this information got entirely lost. Marian isn't delighted about disclosing her sleep choices, but. "...Uh, for context, I found him last night. I was walking home. ...I might not've been all the way sober. I was trying to find out if he had a friend I could call or something," maybe she'll just...leave out...the incredibly sketchy-sounding motel room plan that tipsy-her hatched, "and then some skeevy night security guard dude showed up and - I guess thought he was molesting me? So he picked a dumb fight and then...stuff. And then I got a ride in the ambulance and slept over in the ICU." 

Emmy, to Marian's eternal gratitude, doesn't roll her eyes even a little. "Wow! So you've actually got a bunch more info on him. Oh! And maybe that's why you can get him to calm down, if he recognizes you?" 

"...Maybe. Uh, and - I guess if he understands a little English but he's not fluent, maybe he can't follow as well when he's drugged, that'd fit. Uh, why did you sedate him so much in the ER anyway?" 

Ack, how mortifying to be asked outright. Especially by a new grad nurse who has a great point. 

"...In hindsight we should've gone gentler with that. But I did mention the part where he elbowed a nurse in the eye socket?" 

"You did! Weird. He wasn't like that with me at all, he seemed...sweet. I guess I didn't try to stick a rectal probe in him." And she's suddenly VERY glad he wasn't conscious for the Foley catheter and can't blame her for it. 

Emmy takes a deep breath, sets down the used chlorhexidine swab, and carefully lifts the arterial line kit from the sterile tray. 

"Marian, I'm ready when you are." 

Marian finishes tugging on her sterile gloves, twitching her nose under the surgical mask that she threw on. She didn't bother with the sterile gown, since she's not the one placing the line and also she's terrible. 

"Okay, hmm, if I stand - here?" she positions herself at the head of the bed, "and reach under - how's that?" It's not a comfortable position to hold, she has to stretch her shoulder half out of its socket to reach the patient's hand, but it does mean that her head is close to his and she'll be able to talk to him. And gently hold him down if he starts trying to flail out of bed or something. 

"All right. Here we go..." 

Placing arterial lines used to scare the crap out of Emmy, but it's not actually hard. It's a lot easier than a central line, really. She can feel the artery right there under her fingers, not as strong a pulse as one might hope but straightforward enough to aim for. 

Something HURTS.

Ma'ar was fast asleep seconds ago, and he's still very groggy. He tries to pull away from the pain, but his muscles are weak and ineffectual and something is holding him firmly in place. 

...She's there, the girl who - didn't rescue him, exactly, but who took him away from the bad, well, the worse-than-this place. The initial stabbing pain is already fading to a distant sting, and other than that he's...not comfortable, exactly, but a lot less uncomfortable than he was before. Maybe they're just needing to...clean existing injuries? It doesn't really feel like that, but then again he can't feel his body very well.

The girl's voice is nearby, he can't understand any of the words or quite make out the content of her thoughts but he can vaguely sense her intentions, which are...protective? A surprising amount of fierceness in that. Her hand is on his shoulder and it's been such a long time since anyone touched him in a comforting way. 

Marian keeps a firm grip on the patient's hand, watching him slowly relax while Dr Beckett screws in the waiting tubing. He tenses again when she adds a couple of quick stitches to keep the line in place, but Marian holds his arm still, and keeps murmuring reassurance to him, until it's done. 

Emmy finishes placing the dressing and immediately heads over to zero and calibrate the pressure line; it's usually done by the nurse but she doesn't think she's too good for it. 

"You really don't like seeing people suffer, do you?" she says to Marian. "Good plan, holding him still, I think I'd've lost the line if you hadn't been right there." 

"Mmm. I think we'd better risk some extra sedation for the central line. And be thorough with the lidocaine. Uh, want me to put in and send that bloodwork now?"

"Yes, please. ...Send some repeat electrolytes too, it's been - god, how has it been an hour?" It's now 7:45. 

Marian, for her part, feels like it should in fairness be at least nine am, how is she going to survive an entire day. 

Bloodwork gives her an excuse to duck out of the room twice, though, to get tubes and ice and then to send the pneumatic tube to the lab. On each exit and each re-entry, she sneaks a gulp of cooling coffee. 

She's barely finished this when Chantal and Amélie corner her and Dr Beckett in the room. 

"So," Amélie says, yawning. "We have a problem. We're short and we can't give you this guy one-to-one without tripling someone else up - and it'd have to be Nelly, who's all the way in the other corner. Do you think there's any possible way you can handle taking next door as well?" 

     "She's stable," Chantal adds. "Vent, sedated, feeds, all she really needs is turns and antibiotics. Would be a good charge nurse patient, except Amélie's already taking one for the team and has a full patient assignment." 

Emmy is the one who objects, before Marian can agree. "I don't feel great about this plan. Is there any way someone could...stay from night shift? Even just an hour - even just half an hour - so we can get our bearings with this guy and get all his lines and stuff done? - The nurse last night was splitting her attention and I think we missed him decompensating, I don't want that to happen a second time." 

Chantal rubs her nose. "Was worried you'd say that. I can stay an hour." 

"I can take report now if you want? And then take over on her at, uh, 8:30 or so." 

There are voices. It sounds, from the tone, like some sort of dispute is being resolved. 

Ma'ar struggles, over and over, to wake up enough that he can at least parse how many voices and which emotions are represented, but he's very foggy and he can't make sense of it. 

He's clearly a little less drugged than before, though, because when the girl approaches again, he can actually sort of focus on her surface thoughts; it hurts his head, more than he would expect, but he can do it briefly.

He even manages to open his eyes a crack, assessing wherever it is they've brought him now. 

He's lying in what is much more obviously a bed rather than a weird cage, though it does have a sort of rim or low wall on each side. The ceiling is out of focus, but there are weirdly bright lights - mage-lights? - and something is making an almost birdcall-like sound in the distance. 

And Marian. "Hey there! That's really good. See, I said I'd be here when you woke up? You're in the ICU now and - uh, right, sorry. My name is Marian and I'll be your nurse for all of today. We have a couple more procedures to do that might hurt, but we can make sure you're asleep for them, and once that's all done we won't need to keep sticking you any more." 

She speaks slowly and loudly, holding eye contact and trying to decide if she thinks he understands her. 

"Right. Uh, are you in pain right now? Just nod or shake your head. If you can." 

She said a lot of things in a row and Ma'ar understood some of it but he can't hold onto it when she won't stop saying things. 

...That's a question. He can get just enough from her surface thoughts that he can guess what she's asking. Yes, he's hurting, his head hurts a LOT now. He manages a very slight nod, surprised by how hard even this small motion is. 

"Oh. I'm sorry. Do you need more medicine for pain, right now?" 

Ma'ar isn't sure he understood that question right, but he shakes his head anyway. This feels like a reaction-headache. ...And something else as well, he feels wrong in a way he can't make sense of, but he was sleeping before, and there isn't much to be done for backlash except rest. 

He's not going to be able to get out of here unless he conserves his strength and rests when he can. Ma'ar closes his eyes again. 

Huh. Well, he definitely understood her that time, which on the one hand is good, but on the other hand he's clearly waking up more - the propofol must be close to worn off entirely, it's short-acting, and 1 mg an hour of midazolam is barely anything. 

She double-checks the patient's restraints and then ducks out of the room. "Emmy? I'm going to put him up to two an hour on the midaz. Just now he was awake enough to follow commands, and he's in pain. I think his BP can tolerate it." 

The arterial line is actually reading a bit higher than the cuff was. He's sitting at 112/58 right now. This happens sometimes and usually the arterial line is the more accurate one. The mean arterial pressure calculation is supposed more accurate as well; Marian's understanding is that it's based on the true area-under-the-curve, whereas cuff blood pressure is a simple calculation. In this case, the MAP is lower than she would expect from the approximate formula, at 69. It's above 65, though, the minimum safe number to know he's getting enough perfusion to his brain. 

Though, as Marian watches, the blood pressure curve straggles up and down within a fifteen-point range. The MAP is less variable but it does sometimes briefly drop under 65. 

Marian frowns at the variability, trying to figure out if it's correlated with the humps showing each breath on the ventilator screen. 

"...Uh, Dr Beckett? His BP is doing that thing -" fuck there's a technical term for this but she's blanking on it, "- you know, where it's changing based on the vent. That...means he might still be dry?" 

"Hypovolemic in general, but yeah. Huh. What's our urine output been?" 

"Ummmm. There was...kind of a lot that I didn't, uh. Get a chance to measure. Since I put the catheter in, it's...two hundred ccs? Very pale." 

"And that's in less than an hour, right?" Emmy slips back into the room, frowning at the straggling blood pressure waveform. 

What is time even. Normally Marian is so much better than this at writing times down. Lately she's barely had enough attention to spare to look at the clock. 

"...Half an hour ish, we didn't get here until after 7:15. I probably got a hundred ccs out right away, though, it's not all new." 

Emmy rubs her hands together. "Cold diuresis, right. Low body temperatures affect the kidneys' ability to concentrate urine, so he's losing more water and salt than he should, and I bet he was already dehydrated when he came in. Hmm. I might want to give him some albumin, just in the hopes that'll stay put in his circulation." 

"Huh. Right, I think I read about that... Is that why the low mag and phos, you think? Because he's peeing it all out and the fluids we gave him were just saline?" 

"...And diluted him even more on the other electrolytes. That's way too plausible. He's been hypothermic this whole time, he'll have been cold-diuresing and we've been pushing him lower and had no idea... Shit, that would explain the deterioration." She rubs her chin. "Although I - don't see how that gets a phos of point fucking nine. He has to have been low already." 

"Uhhh. Nutritional deficiency?" The guy doesn't look starving - he's carrying some solid muscle mass, physically he looks like someone who takes care of himself - but someone whose wardrobe consists of a Salvation Army bathrobe plausibly can't afford a reasonable balanced diet. 

"Not impossible, but it's pretty hard to get that deficient in phosphorus! Mag I could see." She rubs her arms. "I'm going to be so pissed if he turns out to have some one-in-a-million rare genetic disorder." 

"...Is there a genetic disorder that would cause low phos and mag, and, uh, worse cardiac function?" 

"No idea, I'm not a specialist in rare metabolic diseases."

Emmy sighs. "...Well, I don't know what to do differently, aside from supportive treatment which we've already got covered, and watching him like a hawk. Shit, how is he still not back up to the temp he was at before?" 

"I don't know! I did notice he's not shivering that much? If I were that cold my teeth would be rattling." 

"...Could be the low phosphate. It can cause muscle weakness and 'neurological dysfunction' which...who knows, maybe that includes shivering response? And, uh. Hypothermia by itself should increase blood sugar," according to Doctor Google an hour ago, she did NOT know this off the top of her head but it's neat to sound like she did, "but since we suspect he's doing something screwy, metabolically, possibly we should have him on q1h glucose checks?" 

"Cool, can do. Uh, the blanket doesn't go any hotter but I can...heat pack his armpits?" She's never done that before but she's done the opposite, to bring down fevers, she can't see why it wouldn't work.

"Given how unstable he is, we should maybe be thinking about active internal rewarming, not just the blanket. If he needs fluids anyway we can heat them, but I don't want to overload him - once there's a line in we can get a central venous pressure... I need to do some research." Also where the fuck is the attending doctor, Emmy would swear she asked someone to page him, it's almost eight. 

Emmy runs to the supply room and fills the front of her oversized scrub top with instant heat packs and runs back. She cracks a few of them, puts them in pillowcases just to make sure she won't burn the guy, and then tucks them into his armpits and groin. 

This is a weird enough sensation that it wakes him - well, mostly the brief gust of colder air when Marian has to flip back the Bair Hugger blanket wakes him, and then Ma'ar is vaguely bemused. It's not uncomfortable, though. He's very cold and it's actually kind of pleasant. 

Marian retrieves a glucometer and takes his blood sugar. With a drop of blood pulled from the art line, because why not, it'll be more accurate than capillary blood when he's so peripherally vasoconstricted, and it means not having to stab his finger. 

"...Uh? Dr Beckett, you still there?" 

     (Murmured affirmative.) 

"Well, he's not critically low but he's at 64." 

"...Weird. I gave him two litres of half-D5 plus the bolus, where's he putting all of it. Push another amp of D50, I guess?" 

Marian does this. 

...and, of her own accord, watches really closely for any change. 

...His colour actually looks noticeably better within five minutes? His heart rate is steadier, with fewer arrhythmic beats. His blood pressure is still variable, but the MAP is steadying at a much higher number. 

Huh. Fascinating. 

Marian relays this to Dr Beckett.