This was going to be part of a story, but one I finished the first paragraph, I figured it would be better as a short one-shot.
Warnings for some blood and death.
I don't own Star Trek.
So many things went wrong so fast, Leonard McCoy thought if he so much as blinked, he would see the end of the away team. Caught between swearing to a higher power and ordering the ensign to stay with him, McCoy put pressure on the boy's wounds, trying to keep him alive by stemming the bleeding while evaluating the damage. The more rational part of his mind, buried deep under his frenzied, furious part, tried to tell him it was futile; without working communicators, they couldn't signal the Enterprise to beam them up, and without the equipment stored away in the starship's sickbay, it would take a miracle for the kid to survive being almost totally eviscerated. And the away team was short on miracles.
Some shore leave, he thought sardonically.
The ensign's body shook and he choked on the blood bubbling in his mouth, running past his lips and creating vivid streaks of red over his pallid, youthful cheeks. Kneeling by the boy was his friend, who cradled his head and tried to assure him with distressed mumblings. Don't look at it, Jake. You'll be okay, just don't look at it. Jake let out a series strangled cries for his mother, which faded into weak murmurs, then stopped moving. There was no more blood seeping through soaked bandages; no more life slipping through McCoy's fingers.
The friend patted Jake's cheek, trying to rouse the ensign. "Jake? Jake, stay awake. You're gonna be okay." His eyes were wet with tears, and his pleas died down to sobs.
McCoy removed his hands from the boy, and said the words he's said so many times before, "He's dead, Jim." He never knew why he said that. It was obvious the boy was gone, long before McCoy reached him. Maybe it was out of routine? Like how he went through the motions of saving someone whose already over the threshold, to have them die on him and leave another stain on his hands that he couldn't wash away. It happened so often, and to the young ones, he thought he'd be used to it by now.
But no one gets used to it. No one gets used to the blood on their hands. Or the countless lives they have failed and will fail to save, whether its their fault or just a bout of horrible luck or a fatal shortage of miracles. No one gets used to saying "He's dead, Jim" even when Jim already knows he's dead.