Chapter Text
Grace Harper's body has undergone both mechanical and chemical augmentation to help her fight Terminators. In addition to her strengthened bones and muscles, protective subdermal mesh, and enhanced senses and reflexes, her metabolism has been adjusted to provide a powerful burst of energy in combat in order to improve her odds of surviving an encounter with a Rev-9. Grace’s augmentations do come with some serious drawbacks, however. Because of how her body has been altered to optimize her for brief, intense battles, she experiences severe physiological consequences and requires medication and cooling to survive the resulting post-combat “crash”.
In this write-up, we’ll take a look at what happens to Grace’s body during a crash, the medications she requires and what each is used for, and what kind of ongoing care she’s likely to need both immediately post-combat and in day-to-day life for managing the complications that might come with having a heavily medicalized body that is both enhanced and disabled.
Grace, Crashing
So what exactly happens to Grace during combat that messes her up so badly? There’s a couple factors at play:
- Rhabdomyolysis is a dangerous condition in which skeletal muscle rapidly breaks down after intense exercise or crushing injuries, both of which Grace is likely to sustain. Damaged muscle tissue releases high levels of myoglobin and potassium into the bloodstream, which can cause permanent injury to the kidneys and heart along with tissue necrosis. Symptoms include muscle pain, an irregular heartbeat, weakness, and confusion, and most of the medications Grace takes from the pharmacy actually do correspond to first-line treatments for rhabdo.
- Grace’s nervous system has been partially rewired to improve her reflexes and interface with her mechanical components and HUD, and she may experience a form of dysautonomia after combat due to many of the functions of her autonomic nervous system like her heart rate, respiration, blood pressure, and adrenaline production being artificially modulated during a fight to optimize her body’s performance. There are many different subtypes of dysautonomia, but common symptoms relevant to Grace include dizziness, fainting, low blood pressure, rapid heart rate, and an inability to regulate body temperature.
- Grace also seems to have trouble with thermoregulation: her body overheats dangerously in combat, leading to symptoms of heatstroke. Intense exertion in the hot climate of northern Mexico and the southern US are likely also exacerbated by those aforementioned tweaks to her metabolism and nervous system, leading to difficulty cooling down. Symptoms include rapid heart rate, difficulty breathing, disorientation, seizures, and unconsciousness.
Medication List
In addition to needing a lot of water and ice packs to rapidly cool herself down, Grace requires a set of medications to treat her crash symptoms, which she mostly manages to grab at the pharmacy before passing out. I’ve bolded the meds she lists aloud in the movie, and have added additional recommended ones in italics below.
- A nonspecific anticonvulsant: used to prevent the heatstroke- or glitchy-augmented- nervous-system-induced seizures she’s facing in short order. Gabapentin in particular is also good for managing nerve pain. She also lists off benzodiazepine, which is a type of anticonvulsant with sedative and muscle relaxant properties.
- Sodium polystyrene sulfonate: used to treat hyperkalemia (excess levels of potassium in the body), which is caused by rhabdomyolysis from her damaged muscle tissue.
- Insulin: a first-line therapy used to protect the heart from the effects of acute hyperkalemia – surprisingly not for blood sugar regulation in this case! However, for it to be administered safely, it would need to be supplemented with the additional medications listed below.
- Dextrose, calcium gluconate, and sodium bicarbonate should all be administered alongside the insulin to protect her from dangerously low blood sugar, counterbalance elevated potassium levels, and treat acidosis in her blood, respectively.
- If Grace has trouble getting her heart rate and blood pressure back under control in a crash, a beta blocker will reduce both by reducing the action of adrenaline in her system.
- A non-steroidal anti-inflammatory (NSAID) isn’t listed, but is probably a good idea as both a pain reliever and fever reducer. Naproxen is very helpful stuff. In extreme circumstances, opioids work well for managing nerve pain, but they’re not recommended long-term for a whole host of reasons.
Symptom Management (Post-Movie Fix-It Fic Edition)
Even when Grace isn’t dealing with the immediate aftermath of battling a homicidal robot, life as a cyborg is not unlike life with a chronic illness. Despite the superhuman strength and senses her augmentations afford her, her ongoing need for medication and other forms of symptom management means she’ll need to get by with more than a little help from her friends in post-movie fix-it fics.
- Getting to know Sarah Connor’s network of off-the-grid, no-questions-asked, back-alley allies is going to be essential to keeping Grace alive and healthy, since she can’t really get medical care in any sort of above-the-board context. Now’s the time to break out your retired combat medic, veterinarian, disbarred surgeon, street medic, and former-nurse-turned-weird-hippie OCs.
- Finding a consistent source of medication will be an ongoing challenge: there are plenty of pharmacies to be robbed, but it might be even better to have our heroes meet a sketchy doctor who’s willing to write a prescription, a hacker who’s willing to forge one, or even an anarchist biohacker group who manufactures their own medication (look up Four Thieves Vinegar Collective for some real-life inspiration).
- Let’s actually have our heroes spend some time getting Grace’s appropriate medication dosages and forms of administration figured out! Some of these drugs metabolize best when injected intramuscularly and some work best injected into a vein, while others are best ingested orally – mixing all of them together in a water glass to load emergency syringes is definitely not the most effective option.
- Gas station snacks are Grace’s friend. After a fight she’s likely to have burned through a lot of her body’s energy reserves and could use some junk food to get her blood sugar stabilized, especially if she’s just had to take some insulin. Sarah Connor’s predilection for potato chips might also come in handy – increased salt intake is a regular treatment for dysautonomia-induced low blood pressure, and Lay’s Salt & Vinegar or Dill Pickle flavors come highly recommended in particular.
- Water works well for rehydration, but Pedialyte is even better, and Gatorade can be used in a pinch, especially if Grace could benefit from the extra salt and sugar.
- A high-protein diet is beneficial for healing damaged tissue as well as maintaining a buff physique: I get the sense that Grace would be all over a Waffle House t-bone steak and three-egg omelette special at any available opportunity. Lots of opportunities here for bonding at grungy diners, or moments of Dani and Sarah looking on in mild horror as Grace single-handedly consumes a family-sized bucket of KFC when left to her own devices.
- Like anyone living with chronic illness or disability, Grace is likely to have good days and bad days health-wise. She’s been through a lot of extremely invasive medical interventions and survived a lot of physical and mental trauma, and it would not be unexpected for her to deal with chronic pain or other inconvenient side effects from her augmentations, which won’t magically go away even if she does survive the events of the movie and our heroes get a break from being on the run all the time. This in no way precludes having a good and well-lived life.
- Allow for rest: all three of our heroes will be much better off if they get a little time to recover in between missions. Go forth and, armed with this knowledge, write as much h/c and fluff fic as your hearts desire.