fix: escalate the symptom phrasing people actually use, and never clear a reported symptom (#21)

Deterministic escalation only fired on a narrow set of literal phrases, so real reports
like "there is blood when I wipe" or "I have tarry stools" reached the chat provider
without the fixed medical guidance. Expanding the suite found 18 of 18 checked clinical
phrasings missing.

- domain: cover bleeding reported by wiping/toilet paper/anatomy/mixed-in phrasing,
  black-tarry-dark-red stool, reported temperature and high temperature, abdominal-scoped
  severe pain in every natural word order, and past-tense/slang inability to pass gas.
  Near-miss wording that must stay quiet (paper cut, blood pressure, black beans, dark red
  wine, a normal temperature, knee or back pain, passed gas, no gas in the car) is pinned.
- domain: a symptom reported in any truthy shape (1, "yes", "true") now counts as reported.
  Reading only the literal boolean `true` silently cleared a symptom, which is the one
  direction this boundary may never fail in.
- hermes-agent-service: the gateway ledger sanitizer used the same strict check, so a
  browser-supplied ledger entry could have its symptom cleared before the escalation check.
- tests/escalation-regression.test.js: per-flag positive and negative language coverage,
  model output can neither set nor clear a symptom/urgency/discomfort/note, and the
  escalation copy is byte-identical for every flag and under a missing, throwing, or
  malicious provider. Registered in the default unit gate.
- scripts/record_release_demo.mjs: the recording now types the new bleeding and tarry
  phrasing, and seeds a fictional ledger whose note says "stool was tarry yesterday", then
  asserts in the browser that exactly one new Timmy bubble carries the app's own copy and
  that the turn never reaches Hermes. Three new captions are required release gates.

Boundary unchanged: no new inference, no diagnosis, no image claim. Escalation only ever
gets broader on user-reported symptoms.

src/domain.js

@@ -1,14 +1,58 @@
 const URGENT_KEYS = ['blood', 'blackOrDarkRed', 'severePain', 'vomiting', 'fever', 'cannotPassGas'];
 const URGENT_MESSAGE = 'These reported symptoms can need prompt medical care. Contact a clinician or urgent service now; call emergency services for heavy or nonstop bleeding, fainting, or severe worsening symptoms.';
+// Bleeding is reported in more shapes than "blood in my stool": wiping, toilet paper, or the
+// anatomy word the person actually uses. Each alternative still requires a bowel or wiping
+// context, and the near-miss wording that must stay quiet ("a paper cut", "blood pressure")
+// is pinned in tests/escalation-regression.test.js.
+const BLEEDING_TEXT = new RegExp(`\\b(?:${[
+  'rectal bleeding',
+  'bleeding from (?:the )?(?:rectum|bottom|back passage|anus)',
+  '(?:blood|bleeding)\\b[^.!?]{0,30}\\b(?:when i wipe|when wiping|on (?:the )?toilet paper)',
+  '(?:blood|bleeding)\\b[^.!?]{0,20}\\b(?:from|in|out of) (?:my|the) (?:bottom|rectum|back passage|anus)',
+  '(?:blood|bleeding)\\b[^.!?]{0,20}\\b(?:in|mixed (?:in|into)) (?:my |the )?(?:poo|poop|stool|bowel movement)',
+  '(?:diarrh(?:ea|oea)|loose stools?)\\b[^.!?]{0,15}\\bwith blood',
+  'blood(?:y)? (?:in|on|with) (?:my |the )?(?:poo|poop|stool|bowel movement)',
+  '(?:stool|poop|poo) (?:has|contains|with) blood',
+].join('|')})\\b`, 'i');
 const URGENT_TEXT_PATTERNS = Object.freeze([
-  ['blood', /\b(?:rectal bleeding|bleeding from (?:the )?(?:rectum|bottom)|blood(?:y)? (?:in|on|with) (?:my |the )?(?:stool|poop|bowel movement)|(?:stool|poop) (?:has|contains|with) blood)\b/i],
-  ['blackOrDarkRed', /\b(?:(?:black|dark[- ]?red) (?:stool|poop|bowel movement)|(?:stool|poop|bowel movement) (?:is|looks?) (?:black|dark[- ]?red))s?\b/i],
-  ['severePain', /\b(?:severe|constant|unrelenting) (?:abdominal|stomach|belly) pain\b/i],
+  ['blood', BLEEDING_TEXT],
+  ['blackOrDarkRed', new RegExp(`\\b(?:${[
+    '(?:black|dark[- ]?red|tarry) (?:stool|stools|poop|poo|bowel movement|bathroom visit)s?',
+    '(?:stool|stools|poop|poo|bowel movement) (?:is|are|was|were|looks?|looked|seems?|came out) (?:very |pitch )?(?:black|dark[- ]?red|tarry)',
+    '(?:stool|stools|poop|poo) (?:that )?looks? like tar',
+    'black[^.!?]{0,15}\\btarry',
+  ].join('|')})\\b`, 'i')],
+  ['severePain', new RegExp(`\\b(?:${[
+    '(?:severe|constant|unrelenting|unbearable|worst) (?:abdominal|stomach|belly|tummy|abdomen|gut) pain',
+    '(?:abdominal|stomach|belly|tummy|abdomen|gut)[^.!?]{0,20}\\bpain\\b[^.!?]{0,20}\\b(?:severe|constant|unrelenting|unbearable|worse)\\b',
+    '(?:severe|constant|unrelenting|unbearable|worst)\\b[^.!?]{0,40}\\bpain\\b[^.!?]{0,40}\\b(?:abdominal|stomach|belly|tummy|abdomen|gut)\\b',
+    '\\bpain\\b[^.!?]{0,25}\\b(?:abdominal|stomach|belly|tummy|abdomen|gut)\\b[^.!?]{0,25}\\b(?:severe|constant|unrelenting|unbearable|worse)\\b',
+  ].join('|')})\\b`, 'i')],
   ['vomiting', /\b(?:vomit(?:ing|ed|s)?|throw(?:ing|s)? up|threw up|thrown up|puk(?:e|ed|ing|es)|barf(?:ed|ing|s)?|upchuck(?:ed|ing|s)?|toss(?:ed|ing|es)? (?:my|your|his|her|our|their|the) cookies|los(?:e|t|ing|es) (?:my|your|his|her|our|their|the) lunch|(?:i|we|you|he|she|they|someone) (?:(?:have|had|just|already|recently|am|are|was|were|kept) )?(?:hurl(?:s|ed|ing)?|spew(?:s|ed|ing)?)(?=\s*(?:[.!?]|$|again\b|twice\b|all night\b))|emesis)\b/i],
-  ['fever', /\bfever(?:ish)?\b/i],
-  ['cannotPassGas', /\b(?:cannot|can['’]?t|cant|unable to|not able to) pass gas\b/i],
+  ['fever', new RegExp(`\\b(?:${[
+    'fever(?:ish)?',
+    'running a (?:high )?temperature',
+    'high temperature',
+    '(?:temp|temperature)\\b[^.!?]{0,15}\\b(?:of |is |was |at |hit |reached )?(?:1\\d\\d(?:\\.\\d+)?|3[89](?:\\.\\d+)?|4[01](?:\\.\\d+)?)\\b',
+  ].join('|')})\\b`, 'i')],
+  ['cannotPassGas', new RegExp(`\\b(?:${[
+    "(?:cannot|can['’]?t|cant|unable to|not able to|not|never|stopped|have not|haven['’]?t|did not|didn['’]?t)\\b[^.!?]{0,30}\\bpass(?:ing|ed)? (?:any )?(?:gas|wind|fart)\\b",
+    '\\bno (?:gas|wind)\\b[^.!?]{0,20}\\b(?:passing|passed|coming)\\b',
+    '\\b(?:cannot|can[\'’]?t|not)\\b[^.!?]{0,15}\\bfart(?:ing)?\\b',
+  ].join('|')})\\b`, 'i')],
 ]);
 
+// A reported symptom is a claim. Anything truthy-ish is read as reported; only an explicit clear
+// (false, 0, "no", blank, or absent) is read as not reported. Dropping a value because it was not
+// the literal boolean `true` would silently clear a symptom the person reported, which is the one
+// direction this boundary may never fail in.
+export function isReportedSymptom(value) {
+  if (value === true) return true;
+  if (typeof value === 'number') return value === 1;
+  if (typeof value === 'string') return /^(?:true|yes|y|1)$/i.test(value.trim());
+  return false;
+}
+
 export function bucketForBristolType(type) {
   const value = Number(type);
   if (value === 1 || value === 2) return 'constipation';
@@ -18,7 +62,7 @@ export function bucketForBristolType(type) {
 }
 
 export function detectUrgentFlags(symptoms = {}) {
-  const flags = URGENT_KEYS.filter((key) => symptoms[key] === true);
+  const flags = URGENT_KEYS.filter((key) => isReportedSymptom(symptoms[key]));
   return {
     urgent: flags.length > 0,
     flags,

src/hermes-agent-service.js

@@ -1,7 +1,7 @@
 import { execFile } from 'node:child_process';
 import { randomBytes, timingSafeEqual } from 'node:crypto';
 import { isAbsolute } from 'node:path';
-import { detectUrgentText, hasUrgentLedgerContext, urgentChatMessage } from './domain.js';
+import { detectUrgentText, hasUrgentLedgerContext, isReportedSymptom, urgentChatMessage } from './domain.js';
 
 const MAX_MESSAGE_CHARS = 4000;
 const MAX_LEDGER_ENTRIES = 20;
@@ -125,7 +125,7 @@ function sanitizeLedger(entries) {
     urgency: Math.min(4, Math.max(0, Number(entry?.urgency) || 0)),
     discomfort: Math.min(4, Math.max(0, Number(entry?.discomfort) || 0)),
     note: String(entry?.note || '').trim().slice(0, 300),
-    symptoms: Object.fromEntries(Object.entries(entry?.symptoms || {}).filter(([, value]) => value === true).map(([key]) => [String(key).slice(0, 40), true])),
+    symptoms: Object.fromEntries(Object.entries(entry?.symptoms || {}).filter(([, value]) => isReportedSymptom(value)).map(([key]) => [String(key).slice(0, 40), true])),
   }));
 }