Domino Effect
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Chapter 4
Once they materialized on the transporter, the medical team was already on standby with a portable gurney. Chapel quickly took McCoy's side, helping Jim onto the platform whilst Spock stabilised Jim's head. The biobed's alarm came into life, before it was swiped shut by McCoy.
"OT. Now," came McCoy's crisp response, the professional mask slipping in place. Chapel nodded to Scotty, who activated the announcement system and informed all decks to be cleared for transfer to MedBay. As soon as the transporter room doors opened, Jim was rushed out at top speed to the operation theatre.
As the team reached the theatre, McCoy noticed that M'Benga and the beta shift nurses were already there, all scrubbed up and ready to go. With a practiced hand, McCoy positioned Kirk under the sterillite and pulled several machines near to the bed.
"What happened?"
"Grenade explosion. Look for head, spinal, lung injury. Third degree burns down the back. Start first. Update me later," said McCoy, as he gave a hypo to stabilise Kirk's condition. Quickly, he turned to exit the operation theatre to scrub up, but just before the automatic doors closed behind him, he looked at Kirk's unconscious form for one more time.
Keep him alive.
When McCoy next entered the Operation Theatre, he saw that Jim's head wound had been tended to by M'Benga. The neural repair device (NRD) was finishing up its last few rounds, and it wasn't long before the device beeped to signify its finish.
"How are the injuries?"
"Extensive, but can be repaired. The minor skull fracture and epidural haematoma has been treated by the NRD. Some contusions at the lumbar spinal area but probably not serious. We are now sealing the lungs first before tending to the superficious wounds. Meanwhile, Nurse Evan has informed Medical Lab 1 to look for compatible skin grafts for the burns."
McCoy nodded and took his place opposite M'Benga.
"Would you like to take over?"
"You do it, M'Benga. Not in top condition now."
The other doctor eyed McCoy suspiciously and hesitated. At McCoy's insistent gaze, he nodded and answered, "Aye sir. We will now start to seal the lungs."
Unfortunately, what started as a simple procedure turned out to be much more complex. Halfway through the procedure, the biobed alarm sounded and M'Benga suddenly noticed blood filling the lungs, effectively choking Kirk again. McCoy waved for M'Benga to continue with the lungs whilst he inspected the surrounding organs. As McCoy's hands reached for the abdomen, the unnaturally stiffness caught his attention and he called for a handheld scanner. A quick inspection revealed that there was also bleeding into the abdominal cavity due to grenade shards, which did not show up on the biobed as its material interfered with its detection. McCoy swore and reached for another scalpel.
"Abdominal bleeding?"
"Yeah some organic material pierced right through. Run another bag of blood, Chris."
"Blood in preparation, Leonard."
"You better not go into hypovolemic shock, Jim," muttered McCoy to himself as he made the first cut.
True to McCoy's word, Kirk did not go into hypovolemic shock- however, he did have a sudden episode of ventricular fibrillation which required McCoy and a defibrillator coaxing the heart twice before it could beat normally again, as well as a sudden allergic reaction to a drug he was previously not allergic to (what the hell, Jim), all of which threw the OT into a state of medical emergency a total of three times. Patching up the burnt skin also took substantial time as they had to slowly separate cloth from skin at the outside of the wound, sterilise everything, before putting the layer of prepared skin back on. Needless to say, by the time M'Benga and McCoy was done, the entire team was utterly physically and emotionally exhausted.
M'Benga secretly thought to himself that if anyone needed an emotional roller coaster, Enterprise's MedBay can provide all the experience a person would need for an entire lifetime.,
As McCoy finished the last stitch, the medical team stood in silence and monitored Kirk for ten minutes because hell, this was the captain and anything could just suddenly happen. Finally, as the OT clock chimed to indicate the end of gen minutes, McCoy waved to the standby nurses tiredly.
"Yeah okay push him to the ICU for observation."
At this, M'Benga let out a breath he didn't realize he had been holding and started the last round of examination with McCoy as the nurses prepared the transfer to ICU.
Ever since Spock came back to the Bridge instead of the captain, Uhura had kept a close eye on Spock. The crew now knew better than to ask Spock what happened- Spock would not have said anything, and if the Captain was in a bad shape, it was likely that the crew needed to be in top condition to deal with whatever would happen next. As her eyes followed Spock, she caught Sulu's eye and nodded.
Slowly, she walked over to Spock and placed a hand on his shoulder. He barely acknowledged her presence and she could see his knuckles making small indents in the captain's chair. She saw the superficial layers of strength melt down bit by bit before her and felt his growing sadness and worry seep in as his defenses fell.
"Lieutenant Sulu," he said finally, "you have the con."
"Aye sir. And sir?"
"Yes, Lieutenant?"
"Keep us informed, sir."
Spock nodded and left the Bridge, Uhura following close behind him.
Before coming onto the Enterprise, the term ICU did not have much meaning to Uhura. She knew its definition, certainly: it was where the most critically ill patients were, where their family members stayed with them day after day, praying for a miracle.
After she came aboard the Enterprise, however, it was a totally different story.
The first time she entered the ICU, she had gone to see a friend who was injured in the Nero incident. Upon stepping through the doors, she was greeted by the then newly instated CMO with a grunt and who then waved her to the bedside.
"She's gonna be fine," he had told her in a very pronounced Southern drawl as he left the room for the fourth operation, "injuries healin' up nicely."
He was right, of course.
With the CMO saving more and more patients once thought to be without hope, her attitude towards the ICU was that of cautious optimism- their CMO had pulled off as many medical miracles as Kirk had with the Enterprise, and although the ICU was still reserved for critically ill patients, the idea that their survival chances were greater than they had ever been in McCoy's hands always gave her something to clinch on to.
"Leonard will have you patched up in no time," she remembered telling an unconscious Sulu, who was battling an unfortunate case of poisoning from an unknown flower on Planet 113, now Xeron.
"Doctor McCoy will do something about the bleeding," she remembered telling an ensign as her friend lay in ICU after being taken down by a group of natives during a survey mission.
"Doctor McCoy will treat him to his best ability," she remembered telling an ambassador whose PA had been injured when the Enterprise was fired by the Tellerites en route to a secret conference.
However, just as she started associating the ICU with something that was probably not all that bad, the Khan affair screwed everything up.
Seeing Leonard breaking down in the ICU beside the unconscious Kirk, she finally tasted the fear of ICUs many had tasted before her.
Of course, McCoy somehow managed to pull off another miracle after that, but from then on, Uhura started detesting the ICU for what it could potentially mean.
And here we are, she thought to herself, waiting for one James T. Kirk to determine his fate.
Again.
"It's not as bad as it looks," she heard M'Benga's voice from the door, "burns usually looks worse than they are fatal nowadays. We've sorted out most of his injuries. Just waiting for him to wake up to see if there's any damage to the brain, but we're putting it at a 70% chance that he's alright."
"Where's Leonard?"
"He's sleeping. It's been many hours since he last slept, and he's apparently having a headache bad enough for him to admit it and get painkillers."
M'Benga paused and inclined his head to Spock, who had not spoken a word since they left the Bridge. Uhura looked at Spock's sitting form and sighed.
"He'll be alright," Uhura replied softly.
Once Jim is fine too.
-To be continued-
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