Here she is! Gowned and masked and so so so carefully carrying their precious bowl of purified diamond particles over to Samora!

(Wow her patient looks concerningly awful! Marian isn't entirely sure if he's actually gotten worse in a visible-at-a-glance way or if it's just that she was desensitized before and has now spent an hour outside of the room and forgotten how bad he looked, but it's definitely punching her in the eyeballs now.) 

Samora has seen worse but only on ghouls. She takes the cup of diamond dust, picks up a pinch and sprinkles it back into the bowl, and smiles in satisfaction as she starts adding more in a careful pattern of lines and curves on Leareth's chest. After the first line is complete she starts chanting in Celestial, a prayer of healing and life and the steadfast endurance that overcomes all ills in time.

When the last graceful S of diamond dust is complete and the last "by my will and Yours" falls into silence, all the diamond dust on Leareth vanishes.

And abruptly Leareth looks enormously less like he's inches away from dying!

The ECG tracing on the monitor transitions from the bizarre ventricular rhythm to something almost normal. His blood pressure bops up to a beautiful 118/73 and then...keeps going up, probably because he's getting a suddenly-totally-unnecessary amount of pressors and also an extra 3.5L/min of oxygenated blood squirted back into his descending aorta. 

He doesn't move, and his breathing doesn't change, because he's sedated and paralyzed and on a volume-control mode on the ventilator. But there's some indefinable sense that he would breathe okay on his own. 

Wow shit okay he does not need to be maxed on norepinephrine and in fact possibly he needs to be on zero of it! And they should start weaning the ECMO flow rate because it sure does not super look like he needs it! 

...This is not a stressful problem. Like, it's mildly suboptimal for his blood pressure to be rapidly approaching 150/100, but Marian is having a very hard time getting worked up about it when her entire subconscious mind is feeling deeply soothed by her patient being healthy-person-colored with great peripheral circulation. 

....Clarice draws labs. 

Most of them will need to be sent off - along with the "pre" labs already bagged on the table - and take twenty minutes to come back even if they're processed at the very top of the queue, but the iSTAT blood gas is almost immediate. 

Before, they were getting moderately worse numbers than the last one threeish hours ago: pH 7.04, pCO2 39, pO2 288, HCO3 9. Lactate on its way up again and now hitting 17.2.

Now it's...very close to normal? pH 7.32, pCO2 38, pO2 285, HCO3 19, lactate...only down to 6.8, which is still pretty high by any objectively standard, but that's still a completely physically impossible decrease to happen in two minutes. 

It's not very dignified to grin and bounce slightly while she decreases and documents decreasing the pressors, but Marian is doing it anyway!!!!!

That's a really impressive difference!

:It definitely didn't get all the damage, but I think it might actually have gotten nearly all of the - diffuse metabolic failure type problems? Exactly the kinds of things that I would expect Endurance to include: Shavri tells Samora and also literally everyone in range. :...The underlying problem is definitely still there. The life-force leak. And there's quite a lot of non-life-threatening but...sticky...damage, I think downstream of all the inflammation? The muscles and nerves in his extremities are in pretty bad shape. But the - cells not properly able to use fuel - that problem is gone, for the moment.: 

"Well, it sounds like we'll have some pretty dramatic data to send Dr Chen," Dr Harrison says. 

"I'm glad it helped a lot! That one was targeted at Endurance so it makes sense that his muscles are still damaged. I can do another one for Strength tomorrow if there's more diamond dust."

"Well, good news!" says Catherine when this gets translated. "I just ordered another two castings on McMaster Carr! They'll be here tomorrow and they won't be paste!"

Bounce bounce bounce their patient is going to SURVIVE and NOT DIE and BE OKAY and this might be the best shift of Marian's life even if she really doesn't get to claim credit for almost any of it. 

She's gotten him entirely off the norepinephrine and now it's time to help Clarice and Dr Chadra document the 'weaning off ECMO' steps. This is objectively speaking a lot of work and kind of stressful but Marian is downright cheery about it. 

They do not quite have him off ECMO by the time the lab calls with their results – both sets at once, the "before" and "after" bags processed as a batch with draw times two minutes apart – but this isn't because there's a problem, 

Dr Chadra listens to the lab tech checking off the box "I read the critical results to someone" on the phone, his grin widening, while Clarice hurriedly pulls up the lab results page in the chart and refreshes it repeatedly until the numbers show up there. Everyone crowds in, except for Shavri who will just stay at Leareth's side and mindread people for the latest. 

Wow there are admittedly still a ton of CRITICAL RESULT flags on there given the VAST IMPROVEMENT on ALMOST EVERYTHING but that mostly goes to show how terribly he was doing before this. 

...Okay, huh, it didn't put back his ability to fight off infections nearly as much as Shavri might have hoped. She hadn't been sure off Healing-Sight alone. It did help, and she's holding out some hope that the blood they took hadn't yet 'caught up' with how drastically his underlying condition had improved. 

:I think that's the case with a lot of your numbers: she tells everyone. :...Not the ones that measure inflammation, he still objectively has a lot of tissue damage - that doesn't affect his basic metabolism, so I guess it's not strictly speaking targetable as damage to Endurance, but it's still there for his body to be panicking about. But I think there are a lot of things here that are - mostly markers downstream of a problem and not a direct problem in themselves? Like the ones for damage to his heart muscle, or the liver damage ones, I think the improvement is bigger than it looks here and the spell just didn't consider it its job to clean all the damage-flag chemicals out of his blood, since they aren't themselves harmful to him. I suppose we'll see if they decrease over time.: 

She mulls over her Sight some more. 

:I think his liver function is almost perfect right now - I mean, there's still some damage, and it's still going to get worse over time, but there's a lot of redundancy in that organ and the function is - pretty much reset to be adequate, right now. His kidneys should be working fine too, though the muscle breakdown you were talking about is still happening and that's still going to be a lot of strain and I think they'll start accumulating damage again. His clotting function should be fine for the moment...: 

Dr Harrison is hurriedly typing up another email to Dr Chen. "How does his brain look?" 

:...Structurally normal? Good circulation, no injurylike damage or swelling, the last Cure still reset all of that even if it barely helped overall. It's...kind of hard to assess when he's this deeply out, the energy-flows are all dampened anyway. I wouldn't be surprised if he still has a lot of...you know the thing where people can get pretty delirious with a fever? Not because of damage, just because all the panic-flags floating around in their blood are affecting the function of the cells in their brain? - it's possible there is damage at a very fine-grained level, if it's not injurylike and more like the kind of degeneration you get with age but - accelerated - Healing-Sight doesn't do incredibly well at catching that and I'm not a Mindhealer.: 

"...That's not ideal," Dr Harrison says absently. "If he's still got the DNA damage, I mean, I doubt a second of that spell would fix it when the first one didn't, and if it's going to take stronger magic we apparently need him functional to provide his own transport to Samora's world. - how's his gut?" 

Shavri peers. 

:...Functional? The cells that had died are alive again. For now, I think they still can't divide so he's going to have exactly the same problem in a day or two, but right now he could probably digest food.: 

Type type type. "We're not going to push it, TPN's safer, but that's excellent to know. Any reason you're seeing to wait on trialing waking him up? - the delirium won't be better tomorrow, deep sedation is a risk factor by itself." 

:- He's going to be really really scared if he wakes up and he can't move.: 

Scoff. "Obviously we stop the paralytics first. Marian, do it now, we'll need an hour or two anyway to make sure he's stable off ECMO and ideally off CRRT." Type type type. 

Okay. 

Marian does that, and feels vaguely anxious, and it takes her a while to pin down why. It's because she still hasn't said anything to the rest of the medical team about the patient being Evil. And she really really doesn't want to! It feels like it shouldn't be relevant! But if it's relevant to Samora then it could well be relevant to Dr Harrison. 

She finishes the next round of flowsheet-populating and then turns to get Samora's attention. 

"...Um. I haven't actually told anyone else or documented anywhere that he reads Evil to your alignment magic. I think I have some sort of intuition that that it's, I don't know, private and not the doctor's business – I mean, normally we would have no way to tell, right, without, I don't know, invading someone's privacy by reading all their private correspondence about crimes they'd done or something? And I feel really uncomfortable just telling Dr Harrison about it but if you think it's actually relevant and important that they know before we try to wake him up then I guess I should." Aaaaaaaaaaaa!

"I agree that it generally wouldn't be other people's business; I only mentioned it because a magically powerful Evil person with the ability to travel between worlds could cause large-scale problems I would feel responsible for stopping. Shavri thinks he's the reasonable kind of Evil person who can be cooperated with on shared goals, so I don't think he's going to attack people for no reason. I mean--when I first woke up here I was really scared, and if he doesn't know what a hospital is either he might be really scared too and attack people because of that, but I don't think he's going to attack anyone randomly? Or Shavri doesn't and I figure she's right. So I don't think you need to tell anyone unless someone is planning to trust him with something important."