Elizabeth Barrette (ysabetwordsmith) wrote,
Elizabeth Barrette

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Poem: "At the Subtlest Levels of Function"

This poem is spillover from the September 18, 2018 Poetry Fishbowl. It was inspired by a prompt from [personal profile] readera. It also fills the "optimism" square in my 9-1-18 card for the Cottoncandy Bingo fest. This poem has been sponsored by a pool with [personal profile] ng_moonmoth, [personal profile] fuzzyred, and [personal profile] mama_kestrel. It belongs to the Big One thread of the Polychrome Heroics series.

WARNING: This poem contains intense and controversial topics. Highlight to read the warnings, some of which are spoilers. It features earthquakes, mass casualty incidents, graphic injuries, messy medical details, life and death decisions, self-care in emergency circumstances, and other angst. Please consider your tastes and headspace before reading onward.

"At the Subtlest Levels of Function"

[Sunday, May 29, 2016]

When the President asked Dr. Infanta
to help with disaster aid for the earthquake
over in America, she readily agreed.

Her Guardians weren't thrilled,
but they didn't try to interfere.

"The supervillains will send
the hospital ship Restitution,"
she said. "Find Nautilus and
ask her to transport it wherever
it will do the most good."

"On it," said Aquariana.
"She doesn't like humans
much more than Steel does,
but I'll try to talk her into helping."

"As for me personally, I'll head over to
the Indira Gandhi Memorial Hospital and
take care of the casualties," said Dr. Infanta.
"Send me the most hopeless cases."

"Thank you, that's very helpful
of you," the President said.

So Dr. Infanta went to Indira's
and commandeered a triage room
in the Emergency Department.

Grabbing a roll of duct tape, she
marked off one corner with a square
and fastened a GPS beacon in the middle.
She was taping a prayer rug over the beacon
when Dr. Moosa Aalif Thakurufaanu
walked into the triage room.

"I heard about the earthquake,"
said Dr. Moosa. "I am so sorry.
This is a terrible loss for America."

"Yeah, most of my California properties
are probably ruins by now," Dr. Infanta said
with a philosophical shrug. "Done is done.
Now it's time to save what we can."

"Yes, of course," said Dr. Moosa. "We've
already put the hospital into crisis mode and
called in extra help from off-duty personnel.
All elective procedures are canceled. We'll
take as many soup casualties as we can, since
few places are equipped for those. We're also
taking Muslim refugees who may not feel
comfortable in some other sanctuaries."

"Good plan," Dr. Infanta said as she
smoothed down the last of the tape. "Okay,
that's done. Pass the word that we have
a teleport pad right in the triage room."

Dr. Moosa sent the message. "Done,"
he said. "This will speed things up."

"How much help do we have here?"
Dr. Infanta asked. "It's about to get busy."

"In addition to myself, Nurse Munavvar Shaiha
and Nurse Sayeed Rafi will be helping you
here in the triage room," Dr. Moosa said.
"We have a surgical team standing by for
each operating room, and we're calling in
as many healers as we can get."

Dr. Infanta looked around the room.
There were twenty beds in here,
twenty treatment cubicles and
five trauma rooms just beyond,
plus another ten treatment beds and
ten treatment chairs in urgent care.

They probably wouldn't be enough.

Dr. Infanta had seen more than her share
of disasters, both natural and unnatural.
She was all too aware of how quickly
the casualties could overwhelm the care,
even when spread out over a wide area.

A sharp bang sounded as the first teleporter
arrived with three bleeding passengers in tow.

The nurses scooped them onto beds as
the teleporter disappeared again, and
Dr. Moosa joined the examinations.

Dr. Infanta hung back until Nurse Rafi
beckoned to her, saying, "This one
shows signs of severe spinal injury."

"We'll see a lot of that," Dr. Infanta said
as she stepped forward to heal the damage.
"During an earthquake, people crouch down
and put a hand over their head. If they can't
find cover, it leaves their back exposed."

The spine was cracked in several places,
the spinal cord bruised and swelling,
but not ruptured. She healed it before
the damage could get any worse,
ignoring the lesser injuries.

"Take him away," she said, and
Nurse Rafi wheeled the patient
to whomever was in charge of
finding room for the stable ones.

By then, two more teleporters had
arrived, each carrying several casualties.

The first few weren't too bad -- that is,
bad enough that ordinary medicine couldn't
prevent permanent damage, but nothing
Dr. Infanta couldn't fix one way or another.

After that, though, they got steadily worse.

Less than ten minutes in, she found
the first fatality, a man with a crushed skull.

"Expectant," she said quietly. "There's
major brain damage. I could probably
save him, but he wouldn't thank me for it."

Even with her ability to bend time,
head injuries could be dicey things, and
rewinding the brain necessarily erased
some memories. She had learned
the hard way not to try too hard.

"I'll take him to Palliative Care,"
Nurse Munavvar said as
she wheeled him away.

One nice thing about working
in an Islamic culture was that
they had no shortage of people
to care for the poor and the sick.

As soon as the President's call
had gone out, volunteers had
poured in, including imams
and chaplains of other faiths
to attend the departing souls.

There were more after that,
many whom Dr. Infanta could
save and others she could not.

A few begged her to let them go,
and when she whispered to them
what she could still do for them,
most of those gladly gave over
their unwanted lifeyears for her
to use in saving other lives.

She was still running out of
energy, but slowly. It gave her
a sense of dogged optimism.

Dr. Infanta was washing
her hands when Rambler
showed up with someone
obviously walking-wounded and
said, "You want to take this case."

"What the hell for?" she snapped,
waving a hand at the real casualties.
"The people in here need me."

"Shut it, Ethan," Rambler said to
the man who was arguing with him,
then turned back to Dr. Infanta.
"Just ask him how it happened."

Then he disappeared.

"Jackass," Dr. Infanta said,
rolling her eyes at the stunt.
"Okay, show me your boo-boo."

"My name is Ethan Wheeler. I'm
a healer. You don't have to help me,
I can wait. It's not that serious," he said,
but he lifted his right hand anyway.

She'd heard of him, she realized
as she examined the injury, and
he was known to her allies.

The bones were clearly broken
in at least two places, the flesh
around them already swelling
and turning purple. Bone shards
through a blood vessel, probably.

Well, maybe Rambler had been on
the right track after all. A healer's hand
wasn't something you wanted to leave
at risk of any permanent damage.

"If you wait, you're out of commission
for the rest of the crisis," Dr. Infanta said.
"Or I can fix this now. Decide quickly."

Ethan's resistance crumpled.
"Okay, fix me now," he said.

"Get your ass on a bed,"
Dr. Infanta said. One
had just opened up.

As soon as he sat down,
she cupped his hand in hers
and turned off the nerves.

Then she set the bones and
patched the ruptured vessels.

She was smoothing away
the horrific bruises when she
finally remembered to ask him,
"How did this happen, anyway?"

"I uh ... punched someone,"
Ethan admitted, looking away.

Her eyebrows went up.

From the feel of the breaks,
he had thrown it correctly;
the force had just exceeded
what his bones could withstand.

"Some punch," said Dr. Infanta.
"You want to tell me why?"

"Bastard kept arguing with me,"
Ethan gritted. "I was up in Rain City,
what's left of it, helping the medics.
The triage team sucked, and one of
the paramedics bitched every time
that I made a status change."

"Well, you're fine now," she said,
pushing his hand back. "What else?"

Ethan sighed. "There was one guy
hurt pretty bad, but still fighting, and I
pulled him off the Expectant tarp," he said.
"Another might've made it but didn't want to,
and I had to push for his right to bug out.
So when that bastard got on my case
about it, I lost my temper and decked him."

Dr. Infanta gave him a sharp look. "You
can do enhanced triage?" she demanded.

"That's what I was doing, trying to do,
in Rain City," Ethan said. "Didn't
go over well with the civvies."

"Well, they're idiots," Dr. Infanta said.
"I'm not, and you are so drafted."

"Me?" Ethan said. "But -- but you're
way more powerful than I am!
I do recognize you, ma'am."

"Power isn't everything," she said.
"The greatest leverage for healing is
found at the subtlest levels of function.
I can't always find the fine lines there,
between the dire but survivable injuries
and the ones that I should just let go."

"Not everyone can," Ethan said. "I've
gotten very good at sensing who wants
to stay and who wants to go. So if that's
any use to you, then put me to work."

Dr. Infanta lowered her voice.
"On a battlefield, I take my reload
wherever I can get it," she said.
"In a civilian hospital, I'm not willing
to take such risks over survivability
or consent. I just need you to tell me
which way the casualties are headed,
so I can make it happen for them."

"I can do that," Ethan said evenly.

So she introduced him to her team
and put him at the end of the triage line
where he could swap out any misses
before she got down to them.

Unlike whatever idiots he had been
working with in Rain City, her people
knew what they were doing, and it was
at least a dozen cases down the line
before Ethan made a switch.

"Jesus, lady, let go, if you want
to live I need to pass you along,"
Ethan said, then looked up at
Dr. Infanta. "This one's a fighter,
but be careful, she's grabbing energy."

"Not a problem," Dr. Infanta said,
and dumped a heavy stream into
the woman whose battered body
was barely even breathing.

It worked, though.

"Okay, she's stable for
the moment, send her up
to surgery to pick out all of
the debris," Dr. Infanta said.

Ethan gave her a tired smile.
"Thanks for listening to me."

"Thanks for saving her bacon,"
Dr. Infanta said, turning to
the next casualty in line.

A while later, it happened again,
but this time Nurse Rafi said,
"I think I see what you mean.
There's almost ... a tension there,
like he's holding onto something."

"He is," Ethan said, pushing the man
toward Dr. Infanta. "That's his soul
clinging to his body for dear life."

"Is that what that is?" Nurse Rafi said.
"I thought I was imagining things!"

Ethan reached over and touched
the back of his hand to Rafi's neck.
"Nope," he said. "It's for real.
Congratulations, you're a soup."

"Shuffle the team," Dr. Infanta said.
"Ethan, you're with me and Dr. Moosa
on patchwork. Nurse Rafi, you're on
final triage. Somebody get me
another nurse for early triage."

"What if I make a mistake?"
Nurse Rafi said, hesitating.

"Then I'll catch it and fix it,"
Ethan said. "You won't get
any better practice than this,
though, so get to work on it!"

Nurse Rafi stopped arguing and
took over Ethan's role as Ethan
joined Dr. Infanta and Dr. Moosa.

He sure boosted her optimism.

Casualties rolled through
the room in a steady stream.

Now that they had three people
on patchwork, two of them healers,
Dr. Infanta could devote more time
to repairing each patient's injuries.

Thanks to the enhanced triage,
she also had fresh energy arriving
in surges every time a departing soul
willed her their remaining lifeyears.

That made a big difference in
how many people she could save.

"Ethan, help!" Nurse Rafi called.
"I can't read this one. I mean, I can,
but I keep getting mixed signals."

Dr. Infanta glanced over at them.
It was a pregnant woman on the bed,
so no wonder the kid was dithering --
nobody wanted to make that call.

"Damn," Ethan said. "They're split."

"So cut the kid free and let the lady go,"
Dr. Infanta said. "Hurry up, because
we don't have all day to do it in."

"I can't," Ethan said, shaking
his head. "The baby is too young,
he'd never make it on his own."

"I can fix that," Dr. Infanta said.

She put a hand on the forehead
of the unconscious mother. "Shit, I
can't get through to her. Ethan, you try,
you're better at this than I am. Tell her
if she gives me the life that she doesn't
want, then I can save her baby and
a bunch of other people with it."

"I'll try," Ethan said, and
the next minute the woman
was practically throwing
energy at Dr. Infanta.

"Get ready to catch him,"
she said as she spun power
into a twirl of time, pushing
the pregnancy to conclusion.

As soon as the mother
snapped free of her body,
Dr. Infanta swiped a scalpel
over the swollen belly, spilling
the baby into Ethan's hands.

Ethan passed the squalling boy
to Nurse Rafi, who murmured
a reverent prayer in Dhivehi.

Dr. Infanta was wondering where
the sunbeam had come from when
Ethan said, "Nurse Rafi, don't
look now, but you're glowing."

"What?" Nurse Rafi said,
staring down at himself.
He really was giving off
a faint gilded aura.
"I suppose I am."

Then the baby rooted at
his chest, which of course
had nothing to eat there.

"I need to take him to be fed
and checked," Nurse Rafi said.

"Huh, I guess this makes him
a Maldivian citizen," Dr. Infanta said.

"His mother's American," Ethan said,
"or at least I assume so, since they
came here from the West Coast."

"Yeah well, being born here gives him
local citizenship," Dr. Infanta said. "If
his American relatives want him back,
they can argue about all that later."

"I'll take little Mohammed up to
the Maternity Ward and tell them
where he came from," said Nurse Rafi.

"Mohammed?" Ethan said, frowning.

"If you have a hundred sons,
name them all Mohammed,"
the Muslims chorused.

"It's what we call baby boys
who haven't been named yet,"
Dr. Moosa explained. "It can be
just a nickname, but Muslim parents
often stick with it, as a sign of faith."

"I guess that works," Ethan said.
"Your country, your rules, anyway."

Not long after that, someone
came by urging the workers
to stop for a meal break.

"In the middle of this?"
Dr. Moosa protested,
looking around the room.

"If you don't refuel, you'll
fall on your face, and then
you're no good to anyone,"
Dr. Infanta pointed out.

"We've been working
for over four hours,"
Nurse Munavvar said.
"It's past time for lunch."

"All right, you win,"
Dr. Moosa said, letting
her nudge him toward
the sinks to clean up.

They had a whole food cart
to themselves. The top held
beverage cups and the middle
held platters of finger foods.
The bottom held cartons of
food, fruit cups, and silverware.

"I smell food," Ethan said, diving
for the cart in the break area.
"Oh god yes, give me the food!"

He grabbed the first carton
that he could reach and started
shoveling it into his mouth.

"Blargh," he said, making a face.
"Who puts tuna in rice?"

"Oh, you got the mas bai,"
Dr. Infanta said. "Here, trade
with me. This is handulu bondibai,
sweetened sticky rice with coconut."

Ethan seemed to like that a lot better,
or at least, he didn't complain about it.

"There's masala chai instead of coffee
if you want caffeine -- that's spiced tea,"
Dr. Infanta said, reading the labels.
"Karaa fani is watermelon juice."

"Spiced tea, please," Ethan said,
holding out his hand for it.
"I really need a pickup."

Dr. Infanta passed him a cup,
then took watermelon juice herself.
She needed sweet things right now.
So she got more handulu bondibai too.

"What else is there?" Ethan asked.

"Mince wraps, those are beef,"
Dr. Infanta said. "Aluvi hiki riha
just means fried potatoes. You
should like both of those."

"There are fruit cups too,"
Nurse Munavvar pointed out.
"Just look for things that you
recognize, like bananas and
pineapple and coconut."

There were various mixes,
and that was one of them.
Ethan took a cup of it.

"Do you like falafel?"
Nurse Rafi asked. "It's
chickpeas and herbs."

"Yeah, I do," Ethan said,
and Nurse Rafi passed him
a platter of the little balls.

Dr. Infanta backed away
from the food cart, because
the other staff members wouldn't
come near it until she did.

"Nurse Rafi, you've worked
hard today," Dr. Infanta said.
"You may need more calories
than you're used to eating."

"Tak'r usual 'n'one thing more
f'starters," Ethan mumbled
with his mouth full. "G'back
f'seconds if y'still hungry."

Dr. Infanta sat down and
watched her people pick up
the fragrant cartons of food.

She felt grateful for the supplies,
as well as for everyone's help.

In the end, things like this
often made the difference at
the subtlest levels of function.

* * *


Dr. Moosa Aalif Thakurufaanu -- The first name is his family name. The second is his personal name. The third is a Maldivian title. He has toffee skin and brown eyes. His dark hair is showing silver on top and in his mustache, while his beard is nearly white. His heritage is Maldivian. He speaks Arabic, English, Dhivehi, Greek, Hindi, Latin, and Sinhala. Dr. Moosa lives in Malé, Maldives. He works at the Indira Gandhi Memorial Hospital as a liaison between the superpowered heatlh workers and the conventional departments, helping to integrate both forms of treatment within the health care system.
Qualities: Master (+6) Doctor, Expert (+4) Compassion, Good (+2) Healer Liaison, Expert (+4) Organized, Good (+2) Muslim, Good (+2) Stamina
Poor (-2) Sense of Self-Preservation

Munavvar Shaiha -- The first name is her family name; the second name is her personal name. She has caramel skin, black eyes, and long straight black hair. Her heritage is Maldivian. She speaks English and Dhivehi; she is learning Esperanto. Shaiha lives in Malé, Maldives. She works as a nurse at the Indira Gandhi Memorial Hospital, currently in soup care.
Qualities: Good (+2) Dexterity, Good (+2) Emotional Intelligence, Good (+2) Gentle, Good (+2) Reputation, Good (+2) Soup Care Nurse
Poor (-2) Broke

Sayeed Rafi -- He has caramel skin, black eyes, and wavy black hair cut short. He wears glasses. His heritage includes Indian and Maldivian. He speaks Dhivehi, English, and Hindi. Sayeed enjoys cooking and likes to blend Indian and Maldivian cuisine, along with inspiration from foreign cultures. He lives in Malé, Maldives. He works at the Indira Gandhi Memorial Hospital as a nurse assisting the healers in the new integrated health system.
Origin: He discovered his abilities shortly after the Cascadia Cataclysm.
Uniform: On duty, he wears a white coat over practical clothes or scrubs. Off duty, he likes men's beach clothes. Sayeed also gets a kick out of mixing Indian and Maldivian garments, and he doesn't hesitate to throw on things from other cultures.
Qualities: Good (+2) Cosmopolitan, Good (+2) Constitution, Good (+2) Fusion Cook, Good (+2) Healer Assistant Nurse, Good (+2) Observant, Good (+2) Trustworthy
Poor (-2) Eyesight
Powers: Average (0) Enhanced Triage, Average (0) Visible Aura
He can sense information about the body, mind, and spirit which allows him to sort patients more accurately than ordinary triage nurses can. Sometimes when he's working, his power spills over and he glows with a golden light.
Motivation: To help people.

Rambler (Riggs Worden) -- He has tinted skin, brown eyes, and curly chestnut hair to his shoulders. He wears crystal stud earrings. After his parents died when he was 13, he bounced around the foster system for two years before running away at 15. A high school dropout, he soon fell in with supervillains, who were happy to pay him handsomely for teleporting them places. He travels widely and makes friends easily, but it's almost all casual. He has difficulty deepening his ties with anyone. He likes healers, though, and he's willing to jump into and out of hot spots for their sake.
Origin: His parents were firefighter-paramedics who were fatally wounded on duty. When he heard about it, he teleported to the hospital where they were. He got there in time to say goodbye, but he couldn't save them.
Uniform: Rambler typically dresses in blue-collar men's clothes regardless of the context. He loves khakis and blue jeans, hoodies and long-sleeved flannels and t-shirts with rude sayings on them.
Qualities: Good (+2) Dancer, Good (+2) Friends All Over, Good (+2) Tolerance for Danger, Good (+2) Traveler, Good (+2) Visual-Spatial Intelligence
Poor (-2) Attachment Damage
Powers: Expert (+4) Teleportation
Motivation: Money.

* * *

"The greatest leverage for healing is found at the subtlest levels of function."
-- Rudolph Ballentine

The Indira Gandhi Memorial Hospital is a 275-bed hospital in Malé, Republic of Maldives. It is an acute tertiary care public referral hospital located at the west end of Malé. Reception includes a large waiting room. The bang room for teleporters has a quibla and a prayer rug to mark the landing zone. A tropical lounge offers a place to relax.

The Urgent Care Department has 10 treatment chairs and 10 treatment tables. Half of them have curtains as shown in the picture. The other half have glass cubicles as shown in the Emergency Department, and are equipped for patients with superpowers.

Recently renovated with superpowered people in mind, the Emergency Department now includes flowglass enclosures for privacy and safety. There are 20 treatment cubicles in this section, 10 of them equipped for superpowered patients. There are 5 consultation cubicles, 2 of them equipped for superpowered patients.

Flowglass is a quasicrystalline material that seems solid but is actually a thick fluid. It can deform and spring back under stress, instead of shattering. This gizmotronic stuff is used as safety glass in windows where something rigid like dymondine could simply tear out of its frame. Flowglass can be clear or frosted. A fancy setup can include something like a wave machine in the frame to make ripples which allow light but not images to pass through, such as used for bathroom windows or other privacy screens.

The triage room has 20 beds, with 10 on each side of the center aisle. Incoming patients are first placed here for assessment, then sent the appropriate location for treatment.

There are 5 trauma rooms for treating serious injuries, 2 of them equipped for superpowered patients and 1 of those with some gizmotronic and super-gizmotronic gear.

There are 2 scanning rooms, each with multiple types of equipment for assessing patient conditions.

The admission transit area has a wide hallway with beds for patients being admitted into the hospital.

The break room is entirely halal.

Hallways connect the sections of the hospital.

There is 1 fully gizmotronic operating room, suitable for superpowered patients. It can be manned, or for some operations, run entirely by remote. There are 4 standard operating rooms, 1 of which is equipped for superpowered patients.

In the Intensive Care Department, there are 5 private rooms on each side of the hall, each of which can be sealed to minimize risk of infection. One side of the hall has rooms equipped for superpowered patients. At the end of the hall is a ward room with 5 more beds, customarily used for surgical recovery.

The Palliative Care Ward has multiple beds in an open room.

Standard patient rooms include single and double options.

The ablution room is next to the prayer room. The Friendship Room is a relatively new addition, providing a place for people of other faiths to wait while their Muslim friends pray. It includes sacred texts from many different religions.

The quiet rooms are lined with acoustic panels to muffle sound, covered with a variety of nature images.

The reproductive health room provides space for family consultations.

A café feeds staff and visitors.

Sunday, May 28, 2016
Sunrise 5:53 AM, Sunset 6:13 PM, Day length 12:20:24, Astronomical twilight 4:38 AM

Prayer Times for Malé
Fajr 4:48a -- after the white light in the east till sunrise.
Shorook 5:57a -- the sun passes its zenith
Dhuhr 12:02p -- after sunrise till Asr
Asr 3:03p -- after when the shadow of an object is the same length as the object till sunset
Maghrib 6:06p -- after sunset till the red light in the west
Isha 7:11p -- after the red light till the white light in the east.

San Francisco, California is 12 hours earlier than Malé, Maldives. The earthquake happened at 4 PM on Saturday, May 28 in San Francisco, which was 4 AM on Sunday, May 29 in Malé.

Being a hero, or a superhero, requires understanding how to handle emergencies.

Fault tolerance is the ability of a system to absorb loss or damage before it collapses completely. A surge plan details available resources, service goals, thresholds of activation, and steps to take when demand rises such as mobilizing additional personnel. Medical surge capacity appears occasionally in references to local-American facilities, but not all hospitals have a surge plan. Surge hospitals include closed medical facilities that can be reopened, nonmedical facilities that can be borrowed, and mobile units that can be deployed wherever needed. Terramagne-America requires hospitals to have a surge plan, most other emergency services do too, and so do other organizations that experience large variations in demand such as utility companies. T-Maldives is in the process of picking up the practice from their allies, so the Indira Gandhi Memorial Hospital has one. Any business that has surges of activity will benefit from a surge plan, and it also works if you have several employees absent at once, so this is something lots of folks could create and use.

(Messy medical details here.)
Triage is the process of separating casualties according to severity. This flow chart gives an example of how it works. You can see the opportunity for mistakes -- an unconscious person might seem much worse than they are, while a walking person might be quite badly hurt but too shocky to feel the pain. (Note that some groups, such as soldiers and people living with chronic pain, may obscure quite serious injuries for different reasons.) Triage sacrifices precision for speed in hope of saving as many people as possible. It mostly works. Triage tags record information on the scene for use in sorting casualties and treating them at a hospital. A simple tag such as MET is good for major disasters or nonmedical responders such as police, and is usually the kind included in disaster response kits. A more complex tag such as AIIRisk is good for local disasters or trained medics. These tags can also be paired in primary/secondary triage with large numbers of casualties waiting.

While researching conventional triage systems, I also found this empath triage system. It's aimed at everyday encounters, however, rather than disaster scenes. I have personally handled emotional first aid at a disaster scene, so I created a basic triage routine for that.

(These links are intense.)
A mass casualty incident is one where the number of casualties exceeds the personnel and/or supplies available to treat them. It doesn't take a huge number -- a handful will do it if you only have one medic and a couple of beds. This requires special planning to handle critical resource shortages. It's also important to account for sudden peaks in demand. A few local-American hospitals have a proper surge plan, but many do not. Read about how one hospital developed a surge plan and see what it looks like. Terramagne has much wider use of surge plans. T-America requires them for emergency services such as hospitals, police, and fire departments; T-Maldives has them too. An incident scene needs a number of tasks covered, and the more complicated the scene, the more personnel it needs. Here is one scale of severity in a document that explains how to handle MCIs:

Mass-Casualty Incident Levels
Level 5 MCI (3-10 patients)
Level 4 MCI (11-20 patients)
Level 3 MCI (21-50 patients)
Level 2 MCI (51-150 patients)
Level 1 MCI (over 150 patients)

In mainstream superhero fantasy, ordinary people are useless. Terramagne does much better in this regard. Those willing and able to help become citizen responders, which is at least 10% of the population in T-Maldives and T-America. Training is available for those who want it. Children, elders, pregnant women, people with disabilities, and other vulnerable folks are taught to evacuate in an orderly manner if they can or shelter in place if they can't. The difference between a tactical withdrawal and a rout is measured in lives. This is why you rarely see Terramagne folks screaming and running in a mindless mob. They're just as scared as anyone else in an earthquake, but they know what to do. That reduces feelings of helplessness and PTSD risk, as well as raising the rate of survival. The crowd scenes just look totally different.

Self-care is important for first responders. This minimizes the chance of burnout and traumatic stress. It can be hard to stop and take care of yourself during an emergency, so moral support from other responders may help.

Enjoy recipes for Masala Chai (Spiced Tea), Karaa Fani (Watermelon Juice), Mince Wraps (beef), Aluvi Hiki Riha (Fried Potatoes), Mas Bai (Fish Rice), and Handulu Bondibai (Sweetened Sticky Rice). The fruit cups are similar to this recipe for Piña Colada Fruit Salad with Kefir Dressing, but with chunks of fresh coconut instead of shredded coconut from a bag.
Tags: cyberfunded creativity, ethnic studies, fantasy, fishbowl, gender studies, poem, poetry, reading, safety, spirituality, weblit, writing

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