Rating: PG-13 for language
Disclaimer: Would love to own ST, but I just borrow the characters and return them intact
On the Enterprise bridge, Jim sank into the captain's chair thinking not for the first time that it could use a bit more padding. Now that the immediate crisis with Nero was over, and the Romulan captain and ship were part of oblivion, the various bumps, bruises and cuts that covered his body were making themselves known. He shifted in his seat to take some of the pressure off his right hip which ached terribly. On his periphery, he saw Spock's eyes narrow. The Vulcan seemed to be deciding whether to speak up.
"Mr. Sulu," Kirk announced, preempting any such attempt. "Time to nearest Starbase?"
"If we maintain our present speed, approximately nine days, four hours to Starbase 14, sir."
"Any chance of increasing our speed?"
It was Spock's turn. "Mr. Scott advises against it, sir. Jettisoning the warp core limits us to space normal speed. In order to have a safety margin—"
Jim's head was killing him. "I got it. Make your best speed under the circumstances. Head for Starbase 14."
"Captain." It was Spock again. "Starbase 14 has fairly primitive medical facilities by Starfleet standards. I recommend Starbase 17 – transit time is only an additional 43.62 hours and its offers significantly advanced medical services. It may be prudent to consult with Dr. McCoy on the subject."
Had Spock subtly picked up on his physical pain, his comment a veiled suggestion that he himself seek medical treatment? The Vulcan's expression, however, remained impassive.
This probably wasn't the moment to call Bones, who certainly had his hands full caring for Pike. "I'd rather not bother him now. Let's head for Starbase 17; we can always change course after we speak with McCoy."
At his station, Spock nodded, apparently satisfied with the decision. "Sir—" Spock seemed to hesitate.
"Yes, Mr. Spock. What is it?"
"If you'd like to go to the Medical Bay – to check on Captain Pike . . ."
Yeah, Spock was definitely trying to tell him something. "I don't think Bones would appreciate my hovering," he replied with a tight smile. And, the last thing I need is to be in the doctor's clutches.
He leaned back in his chair, forcing himself not to wince as his thoughts went to McCoy. Captain Pike's life now rested in his hands, literally. Pike had put up a good front while being rescued but Kirk suspected it was just that – a front. Even he could see that the time spent with Nero had taken its toll – Pike would never have allowed himself to collapse in front of Kirk and Spock if there had been any way to remain on his feet. Jim had made good on his promise to rescue the Captain; now the challenge passed to Bones to patch him up.
So how good was McCoy the surgeon? He really had no idea. They'd been in the same Academy class, but there might as well have been a universe between them. Command cadets and medical personnel rarely mingled professionally and thus he had only the vaguest idea what McCoy did or whether he was any good at it. In fact, he was pretty certain that Bones had a far better sense of his command abilities than he did of the doctor's surgical skill. Sure, Bones had patched him up after drunken brawls, Academy boxing matches, and other times when he'd returned to the barracks with assorted cuts and scrapes and refused to go to Medical. But patching up cuts and scrapes wasn't the same as dealing with whatever had crippled Pike.
He took solace in the fact that Starfleet didn't accept dummies and, unlike many Starfleet doctors who earned their MD degrees at Starfleet Medical, Bones had already been a surgeon when he stepped aboard that transport three years ago. He must have worked on his own many times, treated and saved many patients. And Pike, who was no one's fool, had handpicked him for the Enterprise.
Still, this wasn't some unknown patient in Atlanta. This was Captain Pike, the man most responsible for James T. Kirk being in Starfleet. Thanks to Pike, he wasn't stuck in a dead-end job or worse, in a penal facility. He'd risked his life to save Pike and would do it again in a heartbeat. Now, however, whether Pike lived or died, whether he'd ever again be Captain of the Enterprise – depended on the skill of Bones McCoy.
******************
McCoy's surgical technique was swift and efficient as he worked to expose Pike's spinal cord. Collins had turned out to be a better assistant than he'd expected, and it didn't take long for her to start anticipating his commands. McCoy prided himself on his ability to remain calm and collected during even the most taxing surgery. Just as a ship's captain in the heat of battle, it was critical for the chief surgeon to remain focused and unemotional while the battle for life raged beneath his fingers.
Right now, though, the inability to keep Pike's vital signs stable was wearing on him. Normally, machines monitoring the patient would automatically compensate for the normal changes that occurred during trauma surgery, providing pre-ordered doses of medication to deal with any irregularities. However, the huge fluctuations in Pike's bodily functions caused the monitors to alarm with regularity and forced McCoy to make constant adjustments to the medications and dosages. The process was annoying, frustrating, and stealing attention from the surgery at hand.
"Blood pressure's spiking," Collins reported. "240 over 120."
"Goddammit—" Bones swore softly. Twenty minutes ago, the pressure had plummeted. Now it was skyrocketing. "Hyroxidine."
"How much, Doctor?"
"Let's start with 40 mg." He kept his eyes on the surgical field and reached out a free hand. "Give me some retraction and a number three probe."
The retractors carefully pulled apart another layer of skin, exposing Pike's spinal cord as well as the creature that entwined it. McCoy's eyes narrowed; he'd seen a lot of strange objects inside the human body, but this was definitely a first. As he watched the thing seemed to shrink away, pulling itself to the underside of the cord. Double dammit.
"Pressure's coming down," Collins reported, "but still 180 over 110."
Another alarm went off. Pike's respirations were now dangerously low. He stole a glance at the monitors, mentally calculating the combination of meds that would lower BP and raise respirations without causing some other problem.
"Give him a 200 cc bolus of Lebutol and start a flow at 100 cc per hour. Increase the Hyroxidine to 60 mg." His attention returned figuring out the best way to remove the creature from Pike's body. Should he kill it or try to extract the thing while it was still alive? Keeping it alive would help him analyze it and its affect on Pike. But the effort could cause the creature to do any number of things which, given its proximity to Pike's spinal cord, were all likely to be bad.
Taking a deep breath, McCoy wished not for the first time that the "real" CMO were here. In civilian practice, there was always another surgeon across the table or in the next OR who could be called on for advice. Here, he was on his own. The decisions he made in the next few minutes could well mean the difference between Pike having or not having a neurological deficit or even between living and dying. There were reasons they paid CMOs the big bucks, figuratively speaking of course, and this was one of them.
"Pressure's falling. Fast," Collins added.
"Ease up on the Lebutol and have some Colazine standing by."
The medtech's voice sounded over the intercom. "Torrance to Medical. Dr. McCoy, I think I've found it. I think that spider is a Romulan arthropod, called a lichant--, licant—"
"Dammit, I don't care what it's called. I want to know what happens if I touch it – and how to kill it."
"Yes, sir. Our database is incomplete but it seems the thing is sensitive to light and cold. It doesn't say anything about being harmful outside of the human body."
McCoy mentally blasted the scientist who wrote this garbage without telling him what he really needed to know. "Does it bite?" he asked.
"Bite, sir?"
"Yes, you—" Calling his subordinate a moron probably wasn't a great start to his CMO career. He took a calming breath, just like they'd taught during residency. "When I touch it to remove it," McCoy spoke very slowly enunciating each word, "will the blasted thing try to bite me?"
"Uh, I don't think so, sir."
He didn't think so. Great. Just fucking great.
McCoy looked into the surgical field. Sensitivity to light – that explained why the thing had shrunk away when exposed to the harsh OR lights. It was the sensitivity to cold, however, that gave him an idea. Maybe he could try something between killing it and pulling it out alive and kicking. Even better, something that might keep him from being bitten.
McCoy allowed himself another deep breath. "Give me a number two cryoprobe."
***********************
As a surgeon, McCoy was about good as they came and he knew it. Maybe that's why he and Jim got on so well. Surgeons and starship commanders shared a certain level of self-confidence, a trait some might describe as cockiness. But it was also necessary – who wanted a surgeon or CO for that matter who considered himself just "okay" in terms of skill level? A smile creased his face, then instantly faded. The surgery on Captain Pike required total concentration. Another monitor alarmed and he gave another order of medication to compensate. He wasn't sure how much more of this Pike – or he – could take.
The intercom crackled. "Kirk to Medical."
McCoy ignored the call as he carefully dropped the creature into a waiting container. Touching it with the icy probe had done the trick – freezing the creature literally and figuratively and allowing him to remove it without additional damage to Pike's spine. The thing appeared still to be alive; outside of Pike's body that state might not continue for long. No real loss.
"Doctor." It was the medtech. "Captain, uh, Acting Captain Kirk wants to speak to you."
I'm a little busy here, McCoy thought to himself. However, it was understandable that the Acting Captain wanted an update on the condition of the permanent Captain. "Transfer it in here," he called out.
"Bones, how's Pike?"
"He'd be better if I could focus on his surgery and not you," he replied, irrigating the wound to ensure all traces of the arthropod were removed. "He's having a rough time of it. I'll call you when I'm done. McCoy out."
Jim probably wasn't too happy with the short report or that he'd unceremoniously cut him off. Too damn bad; he had work to do. It was time to close the spinal incision and start repairing the intestinal damage. He held out his hand. "Protoplaser."
