No! Or, like, fine, if he insists, but it’s been less than two minutes, they’re not even up to the goal flow rate yet, it won’t have changed very much! 

FINE he’s going to harass Shavri instead for Healing-Sight updates in real time. 

If he desperately needs to feel busy he could consider helping the nurses but he’s a resident so he’s not going to do that, is he

Shavri is staring intently.

….It’s really incredibly cool that they can do this and it does, in fact, look like it’s doing a vaguely successful job of artificially replacing the essential vital functions that Leareth’s body cannot handle right now. But that’s not the same as actually getting back any coherent life-force patterns that Shavri can hook her Gift into properly.

She’s going to keep trying, it currently feels very stupid to her that she doesn’t actually…know how…to solidly anchor a Healing-link to anything except the “loop” of a heartbeat, surely there’s got to be something she can link to. There’s getting to be a reasonable amount of life-force brightness! Well, a tiny fraction of what he should have but compared to before. Just, still completely fragmented and not at all operating as a coherent system.

(Shavri includes Samora in her update and also the other young woman she met first whose name she never successfully got, she seems to be responsible for writing things down. It would never have occurred to Shavri to assign a specific person to just doing that but it’s actually kind of brilliant, especially when things are this spectacularly complicated.)

Marian and Eleanor are currently working through yet another checklist which was, uh, supposed to be completed and signed off before they went ahead and connected the circuit and definitely not five minutes later. 

:Thanks: she thinks back at Shavri, but she does not have any boxes in the electronic medical record flowsheet to put any of that so what exactly is she supposed to do with it.

Samora is frowning contemplatively about the difficulty of getting Earth medicine to Golarion. It's not just the number of giant machines, it's that there are multiple different types of trained people involved in operating each one, and even if Samora was confident in her ability to absorb one person's worth of training and willing to stay on earth long enough for it she definitely can't absorb ten. (Stabilize.) And then building and maintaining the machines takes yet more people. And the closest thing she has right now to a plan for getting back to Golarion at all is only one way. (Stabilize.) Even if she founds a church here and enough other clerics get picked that someone will probably get Plane Shift eventually, that won't be enough for the kind of regular trade she's expecting to need for Absalom and Vigil to have hospitals like this one. (Detect Evil. Stabilize.) Iomedae, this is a point where a small change can shift the course of many things; help me find the decisive blow that breaks the stalemate and shifts the equilibrium. Abadar, there is so much value here that can be exchanged, make straight the road so that traders may walk it and reach each end richer than they set out. (Stabilize.)

Shavri discusses with Dr Chadra and during a pause in compressions (the fancy artifice is indeed not really generating enough circulation by itself but it makes pauses less costly) she gets herself aimed and whacks Leareth’s heart with as much Healing-energy as she can cram into a single split-second bolt.

It gets a blip on the monitor and someone actually squeaks and then…nothing happens, to the deep disappointment of everyone who was actually paying attention to that specifically.

….You know what else has a kind of cycling energy-loop! Lungs! And this doesn’t actually depend on the patient providing the breathing impetus themselves, it’s pretty intrinsic in the pattern of filling and emptying the lungs.

Shavri can get a link to it!!!! It’s a very tenuous link and it’s not really in the right place but she can squeeze some slightly more targeting Healing-energy into him, and it doesn’t all instantly fall out the bottom, and maybe there’s a trace of catching in his blood and reaching his heart….

10:15 am.

10:20 am. It’s now been more than thirty minutes. It’s a really good thing that Samora’s magic is so good at injuries, Marian thinks, this poor guy probably doesn’t have a single intact rib left.

She documents the results of another blood gas. It’s…less…horrifying…? They’ve probably done incredibly concerning things to his sodium levels by giving him like ten amps of bicarb, but his blood gas level is up to 11 and his CO2 is down to 69 which, like, Marian sees that number all the time with COPD patients, and his pH is about 6.8 now.

Stabilize doesn’t land and it doesn’t land and it doesn’t land and then it DOES!!!!

:Stop something went through I need to—: Shavri sends to the nurse doing compressions.

They have an electrical rhythm! It’s extremely fucked-looking and really looks like it should decay back to a non-rhythm in five seconds, but it…doesn’t somehow.

Samora saw that right!!!! It worked it worked it worked it might not stay working very much longer he’s kind of continuously being injured from the inside by whatever is horribly wrong with him - 

Cure Moderate Wounds!!! He probably has room for a Serious but she wants to hang on to  that last Remove Disease as long as possible.

It lands!!!!

Shavri has the simultaneous realizations that: 

One: she really should have thought to warn Samora that the thing where clerics in Golarion - and, she's inferred from Blai, other spellscasters - gain an absurd amount of extra life-force as they get more experienced, is not a thing in Velgarth, and Leareth can't benefit from the extra positive energy in anything stronger than the weakest Cure spell. 

Two: she should have thought!! about what to do!! if it worked!!! She did not think to warn anyone of the obvious thing Leareth might do if this works well enough to get him conscious and he abruptly wakes up in an unfamiliar and kind of terrifying place, which is to GATE OUT. She knows this because it's the source of their ENTIRE PROBLEM and she still forgot!! 

Then arguably it's fortunate that the spell doesn't work incredibly well!

It lands. It gets...a substantial amount...of the most acute-injury-like damage, including everything that's imminently life-threatening. But it's...not just that the metaphorical 'cup' for holding life-force is too small to capture all that positive energy, it's also still badly cracked enough that most of the remaining energy doesn't even have a chance to do anything before it spills away. 

The single most important part is that, three seconds ago, Leareth's heart had an electrical rhythm but was having a bit of a time actually moving blood. There was an enormous amount of direct injury to the heart muscle, and Stabilize somehow got it to beat anyway but not well. The Cure gets...some amount...of that. Not nearly all, less than half, even of the damage that looks like the same 'kind' to Shavri, maybe because the untargetable-by-a-Cure damage meant he couldn't absorb enough of the positive energy. But his heart is beating and seems like it's going to keep doing that!

It's not a normal electrical rhythm. The spell seemed to only target some of the Leareth's-body-poisoning-itself problem, and of that it only hit a fraction, and meanwhile the unaddressed injury means that the electrical conduction in his heart would be screwy even with perfect electrolytes and blood pH. He's still in some kind of horrible wide-complex ventricular escape rhythm, just...a surprisingly functional one. He has a blood pressure! They can get a pulse oximetry reading! Neither of them are incredibly delightful numbers but they are, at least, "this patient is alive" numbers. 

He doesn't move or show any sign of waking up. 

Shit what if that means the damage to his brain is somehow the wrong kind and Samora won't be able to fix it! 

Shavri gets her Sight over there as fast as she can and...oh, that could definitely be worse. She pushes it at Dr Chadra. The structure is mostly normalish-looking and there's circulation. There's a lot of something wrong, some kind of low-level generalized damage just like everywhere else, and there's inflammation and some swelling from it. He's not imminently dying of it and it looks like a lot of what's wrong should, in theory, be targetable if they can get his body to hold onto life-force or Healing-energy or positive energy or any of the things, but it's not at all surprising he's still unconscious. 

They should try Lesser Restoration? But, uh, possibly first Shavri should explain the Gate thing. 

She includes Samora and Marian. :He's still unconscious, so we don't need to worry about it yet, but - Samora's healing is instantaneous, which means he might at some point go straight from unconscious to Gate-capable. Last time he woke up injured and disoriented he Gated out on instinct. If he does that now it would be....bad.: 

How in the planes do you end up with combat instincts for Gate. 

Well, she already knew Shavri was a very strange and impressive type of caster from somewhere not Golarion.

"Is he the kind where tying his hands and sticking something in his mouth will stop him from casting? Also whether we do that or not you should stand where he can see you so he doesn't think he's been taken prisoner by  necromancers." Ask her how she knows.

Taken prisoner by what– nevermind. 

:Unfortunately that doesn't stop our mages: or else it would be a nonissue because he already has a thing stuck in his mouth that will thoroughly prevent him from speaking. :I can make sure I'm where he can see me but he doesn't actually know my face and he might not recognize the Healers' robes if he's disoriented enough. I'll be Mindspeaking him to explain, obviously, but we've never met and it's possible it would just alarm him more.: 

If they're worried he's going to wake up combative they should just sedate him first???? Like, there are risks to doing that when his blood pressure is kind of crap already, but they're hoping more Samora-healing will fix whatever's causing that to still be the case, right, and at the very least Stabilize should work again if he attempts to die on them. "Guy who tries to portal himself out while attached to an ECMO machine" is not specifically a genre of fighty patient Marian has encountered before, but lots of people are fighty about the whole being-in-the-ICU-with-tubes-in-them situation and there's a known solution to this problem! 

She still isn't sure how to properly telepathy-reply but she'll try to shove that at the telepathic healer. 

Shavri has managed to pick up that they have some kind of bizarre separate-chains-of-command situation where Marian cannot just make decisions about what to do without consulting the trainee-senior-Healer. She can bounce their discussion to Dr Chadra. 

Yes obviously if they're considering doing any healing that might cause their guy to suddenly wake up then he should be sedated and paralyzed first. Hopefully they'll conclude he doesn't need to be on ECMO anymore and they can wean him off it in a controlled fashion and then let him wake up. 

...They can do what. Is that...safe...? 

What, chemical paralysis? Yeah it's totally safe as long as someone's already on a ventilator, they do it all the time. 

Okay but is is strictly speaking necessary if he's not conscious anyway, because that sounds incredibly terrifying Shavri is not going to argue.

She conveys to Samora that they have a plan to make sure Leareth doesn't wake up and do anything he shouldn't, and she should wait until then to cast - how many Lesser Restorations does she have? And how many remaining spells that can be turned into Cure spells? Shavri's inclination would be to hit him with everything they can, Lesser Restorations first and hope it lets him hold life-force better and then another Cure once he can benefit more from it. But if Samora is running low on those, then - he's still steadily leaking life-force, and she knows Lesser Restoration didn't fix that for the other patients, so he's going to keep leaking and it sounds like dawn was not that many hours ago and they have a lot of today and tonight to get through before Samora can get more spells and they might need to keep it to, like, the bare minimum he needs to stay alive. 

"I have four Remove Sickness and a Comprehend Languages I can convert to Cure Light. Two Lesser Restorations and a reserved slot I can prep a third one into in fifteen minutes, any of those can swap to Cure Moderate. One Remove Disease that I'd like to hold onto and try to use on an actual disease, but if we need a Cure Serious it's there. And then one reserved fourth circle slot I can use for Cure Critical Wounds, or for another Remove Disease, or for Restoration if there's diamond dust available which we hadn't fully figured out yet. And three channels but those would ideally be arranged to get multiple people. I can do a Lesser Restoration now but it's not even noon yet I don't think, so if we want to space them out evenly I could do now dusk midnight and then an hour after dawn tomorrow?"