A Hospital Room

<Optional hospital background ambience. Heart monitor should be very fast if added>

<Hazy sound distortion; listener is only just coming to and fading in and out>

—Heart Rate at 150bpm, elevated but stabilizing. Beta blockers proven effective with no adverse effects—

—Issuing second IV bag, fluid levels stable—

—Benedict, please issue another fill of—

—Woah there! Patient is coming to. Easy now, easy...

Good evening, lucky patient of ours. How are you feeling?

{Pause for mumbled response}

Still coming back to us, that makes sense. You are waking up from a small dose of anesthesia, so if you are feeling groggy or confused, that would be the reason.

<writing sounds>

[Muttered; note taking] —Slurred speech, shortness of breath, high pupil dilation...

Dr. Thorsten is just taking some notes about your state from waking up. Nothing to be concerned with thus far.

{Pause}

Out of curiosity, do you know why you might be here tonight?

You don't? That's okay, that's okay! You're not in trouble for not knowing or anything like that.

Please do take your time to answer, if you feel capable and comfortable. There is no rush to respond if it is difficult, and if you don't wish to answer our questions because of discomfort then it is more than alright to skip them.

That's right. We are just here to help you.

{Listener starts to move}

Woah—

Hold it there! Please don't shift around too much. Your heart rate is already extremely high, and moving that quickly may raise it back up again. 

Right! Right...

Are you willing to try some deep breathing exercises with me? It might help with the tightness in your chest and dizziness.

Awesome! While I lead you through that, Doctor Thorsten is going to administer some special fluids into your IV. It might be a bit tingly, but it shouldn't hurt, okay?

If you do feel pain, or it becomes too uncomfortable, please ask us to stop. We can move at your own pace right now.

{Pause for listener answer}

Okay hun {honey}, we're going to do what's called Square Breathing. Have you ever tried it before?

That's okay! We can go over it together. What we are going to do is take a deep breath in, hold it, slowly release it, and then hold our lungs empty for a short bit. I'll count to four each time we change. I'll be your guide through it!

We'll move nice and slow. If you can't hold the whole time, or it becomes too challenging, that's a-ok! We can make it shorter and work our way up or take a break as needed.

{Authors note: This works best at about 62 BPM in my experience. State out the beats when you're counting. I genuinely do use this as a therapeutic practice—sometimes having a metronome or snapping out the "beats" to the square also helps guide people, if you choose to add that. You can lead this exercise as much as you want for the sake of the script, but please do it at least six times to be semi-effective. A guided video can be found here}

Release everything first for me...

We'll go in...2...3...4...

Hold...2...3...4...

Out...2...3...4...

Hold...2...3...4...

Almost got it there! Let's go again.

In...2...3...4...

Hold...2...3...4...

Out...2...3...4...

Hold...2...3...4...

{Repeat as desired, at least 4 more times}

There we go! You've done an excellent job!

And your heart rate has gone down quite a bit. 135 is much more stable. The electrolytic compounds and breathing exercises have helped relax the tension in your body pretty significantly.

{Pause}

So now that we're a little bit more relaxed, we would like to go over why you are here in the hospital now, if that is alright. 

You were admitted to the hospital at 12:14pm today after losing consciousness in your student lounge. Several students drove you here very quickly, which played well into your treatment and recovery.

At time of arrival, you had a heart rate of 190 bpm, severe hypokalemia, severe dehydration, irregular rapid eye movements, and no conscious response. 

Post blood-tests, we have deemed that you were experiencing a significant overdose on caffeine.

We prompted some of your study partners if you had consumed any high-caffeine beverages. They confirmed that you consumed several different sources in rapid succession at the start of and during your study session.

{Listener gets dodgy/dejected}

Hey, hey...no need to feel embarrassed. We've all felt the need to put in the extra muscle for class work and staying on top of assignments before.

We've both been in medical school! Trust us, we get it.

But...it can be easy to overdo it. We measured you with a caffeine content around 950mg. While most people go through about 100mg a day naturally, or perhaps 3-to-400 over the span of a day with coffee or similar stimulants, yours seemed to be a sudden concentrated spike.

That much caffeine in general is dangerous. It can cause a variety of issues, both in the short term...like today, and in the long term with prolonged heart health or even cognitive function. 

Having that much so concentrated in a short duration most likely resulted in extremely high blood pressure and possibly even caused a very brief stroke. It might have even resolved itself before you hit the ground, but that is still a long enough period to cause severe damage.

We are still running tests to determine if your blood pressure caused a full stroke or if it just blocked consciousness—both are equally possible. We will probably set you up for a few types of therapy to make sure things are back on track: Physical, Cognitive, and Speech. Pass all of those with no problem, and you should be back in business soon enough.

If we catch any abnormalities, then we can work on treatment moving forward from there.

Before we get to those therapies, though, we are probably going to keep you here for a couple of days. You've been through quite an extensive series of treatment, and it's going to impair your function for awhile.

{Listener complains}

Your school work is very important, but your health should come first. We will happily provide extensive documentation for your school to excuse absences. I'm sure they will push back any deadlines that might have been coming up.

My name is Ainsley—I'll be one of the nurses that checks in on you over time. If you have any questions or things I can do to make you more comfortable, please don't hesitate to ask.

I am Dr. Thorsten, and will be your leading source of care in your recovery along with Dr. Krings, who will be in later tonight. 

Moving forward...I'm going to really suggest dropping energy drinks entirely. While I'm not necessarily saying you need to go "cold turkey" on caffeine as a whole, consider looking into other, safer alternatives like black tea. If you do choose to still have energy drinks, do not exceed one per day. Having that much caffeine re-introduced to your system will probably lead to a similar outcome to where we are right now.

If you need larger amounts of energy, please consider trying to take naps or even engage in simple meditation. A healthy break can clear your mind far more than you'd expect.

Water is always something we tend to not get enough of. Having more in you isn't going to hurt. If not that, high-electrolyte beverages or sports refreshments may be a good substitute.

As your doctor, I feel it necessary to state that while I can provide medical advice, it is ultimately your decision whether or not to follow it. I cannot force you to make changes in your life. That said, by not following the lifestyle changes we suggest, you are likely directly going to negatively impact your long-term lifespan and general wellbeing.

We are going to prescribe you two medications in the short term. The first is simply Tylenol, which will help to regulate your blood flow. The other is potassium chloride, which will help return your body to normal production of potassium. You'll feel much healthier with both in no time! They'll be under the name Dr Cedar Thorston or Dr. Angelo Krings from your pharmacy.

Like Dr. Thorsten said, we are going to enroll you in several simple therapies to ensure there has been no prolonged damage to your motor function, speech, or cognitive ability. They're super easy! Two sessions across four weeks.

For now, though, please get some rest. Feel free to sleep if you'd like—you've gone through a lot today, and I'm sure it's a lot to take in emotionally.

Hang in there champ! If at any point you feel like you need to talk with someone, no matter how small it may seem, please let us know right away. It's our job to make sure you are in the best shape: mind, body, and soul.

Have a good night.

Have a good rest!

<Fade out with hospital ambiance, if present>

END.