What's this? More automail meta? Pinako backstory? Yes!
Warnings: Medical talk, injury
Characters: Pinako, mentions of OCs
Timeline: Early series
People died during automail surgery. It wasn't a common enough occurrence to truly drive people away, but it also wasn't rare enough to be ignored as an accident of fate. Pinako had death on her record- two had died on the table, and another half dozen were lost to complications after the surgery. She remembered them all and when Edward declared he wanted automail, they were all she could think about.
Gerald had an artery that wouldn't close, no matter how much she cauterized and wrapped it. Loretta's heart gave out during the initial port installation and Pinako hadn't been able to get it beating again.
Edward made it through surgery. He had a hell of a time with it, but he made it. It was more than some people got.
The rehab was every bit as messy as Pinako had predicted. Ed pushed too far too quickly and the strain left him laid out for days. Balancing Ed's drive with her own caution was a true challenge, but Pinako couldn't bring herself to outright deny his efforts. Especially with Alphonse quietly lurking around, trying to pretend he wasn't as big and empty as he was. She let Ed push himself till he collapsed or vomited or bled and she hated every minute of it.
So she doubled down where she could. Sanitizing and cleaning went under extra scrutiny- even to the point where Winry was frustrated with having to change and wash the sheets again. But Pinako wasn't risking it; she wasn't going to let Ed go the same way Wilhelm or Abigail or Brun had gone. They'd been fine one day, feverish by the evening, and dead in the morning. Infections came quick and they weren't gentle by any means. And that meant she had to be just as aggressive, even if it meant losing sleep.
She checked his wires daily. It drove Ed up a wall, both because getting hooked up to the machine took time and having electricity shot through your nerves was far from pleasant. But Pinako didn't budge. Maud's wires hadn't sat quite right and when Pinako had connected her leg for the first time, the electrical burst had shut down her brain and that'd been that.
Maud had been Pinako's first death- first failure. It was also the first time she'd gone and gotten blackout drunk. It hadn't helped. When she'd come out of it, Maud was still dead and Pinako still hated herself.
She'd spent weeks after that, holed up in her shop, going over every blueprint, every plan, every step, trying to figure out what had gone wrong. Why had it been Maud's wires that went bad? The wires weren't torn, the port had been secure. But the angle had been just a little off, the wires connected to the nerves just a little too loosely. Half a centimeter of difference had been all it taken to kill a perfectly healthy woman.
Edward, at eleven years, had a veritable minefield of potential disasters and deaths to navigate through. His drive to do it all in a year was something of a relief: the quicker they got through the surgery and the recovery and the rehab, the sooner those dangers passed.
But danger never really passed when you had automail. It was a constant strain, even years and decades after the fact. It could make you sick in a dozen different ways, wreck your body temperature, and warp the muscle and bone it cut through.
Improvements to automail- usually in the shape of better materials- would normally be seen as an all-around good thing. But bringing in a new metal was a risk all by itself. The only real way to effectively test for allergies was the use it and hope for the best. Rashes and nausea were the obvious tells and easy to catch. Sometimes it was quieter, deadlier. Wilhelm had had a headache he couldn't shake after she swapped out his connectors with a new design (and a new metal). He'd died not even a week later, the reaction having spread through the nerves in his shoulder port to his brain.
And sometimes, the automail just straight-up fought back. Port rejections were a nightmare, the boogeyman of the automail industry. There was no true rhyme or reason to them, but they were almost always lethal. If someone survived with nothing more than further amputation, they were lucky. Louisa had not been lucky. She'd spent three days in and out of surgeries before she'd lost that battle.
Pinako watched for it all. Any time Edward so much as winced, her mind was going a hundred miles an hour, trying to pinpoint what exactly the problem could be, how much time she'd have to fix it, and what she needed to do. It was exhausting. If she hadn't already been grey, she would have been by the time Ed waltzed out her door to go sell his soul to military.
"Granny?" Winry asked from the doorway. "You need a break?"
Pinako glanced up from her knitting. It was nearly midnight and Ed was snoring away on the bed, exhausted after a day spent going up and down the stairs. He was past the point of needing someone watching him all night. Pinako had decided to sit up with him the past couple nights; the fever he'd developed was low, but it was enough to catch her attention. "No, I'm fine. Go to sleep."
"I'm not tired. I can watch him." When Pinako shook her head, Winry went doggedly on: "You've stayed up with him all week, you need a break. You're always telling me not to wear myself out!"
She was right. Pinako did need a night off. But she definitely wasn't going to take one that night. Maybe tomorrow. Or the next week. She leaned back further in her chair and pointed to the half-open door across from her. "Since you're not tired, you can go scrub down the bathroom."
Winry puffed out her cheeks. "I did that this morning."
"Do it again."
"Why?"
"Just in case."
