Chapter Four

It was ten hours before McCoy could remove the drainage tubes and flush Jim's knee. During that time, Jim slept fitfully with fever and pain, never fully conscious or mindful of the ministrations being performed on him. Occasionally, he would wake in his darkness and call out weakly, quickly pacified by a gentle touch or soft word of comfort.

Though he continued to have difficulty breathing and maintaining acceptable oxygen saturation levels, McCoy decided to increase his pain meds enough to keep him comfortable during the invasive processes. It was a juggling act for the medical staff to maintain the balance between his comfort and his medical needs.

At the end of the final procedure, the swelling in Jim's knee had been significantly reduced and the toxicology showed enough of an improvement for McCoy to risk repairing the damaged tendons and cartilage. The tibialis anterior muscle had been significantly damaged, and he was forced to graph a new one in place. With strong doses of stem-cell regens, the regenerated muscle had been accepted by Jim's body and had begun to vascularize.

McCoy kept him heavily sedated and on full oxygen for twenty hours, allowing the knee to heal from the surgery. But true to form, Jim didn't stay down very long. After a mere twelve hours, the young captain began fighting the sedation. It took McCoy and two nurses working full time to coax Jim under again, until finally McCoy decided to reduce the dose and allow him to regain consciousness.

"His fighting is just causing more stress," McCoy told Chapel. "We don't need to battle high blood-pressure and ulcers and the effects of the toxin."

"Pick your battles," she said tongue-and-cheek.

"With Jim that's not always possible."

"I'm surprised he's conscious at all," she said, staring at the restless form on the bed. "After everything he's been through I would think he'd be out for a week."

"You'll quickly find that Jim's not your typical patient." He glanced down at the pale, fevered man. "He's a hard man to keep down."

It was hours before Jim finally opened his eyes, only to announce, with bitter resentment, that the room was still shrouded in featureless fog. This knowledge settled heavily on him, and he became unusually withdrawn and contemplative – a deadly combination in the young man.

"How many fingers am I holding up?" McCoy asked. He stood near Jim's right hip with his hand outstretched toward the bed, watching Jim's response with a keen, clinical eye. It had been more than a day since Jim's surgery, and in that time he had remained sullen and quiet, barely tolerating the medical staff's care. His response to their questions had been with one syllable words. On one occasion he had refused to answer until McCoy entered the room and demanded a proper response.

"Stop harassing my staff, Jim."

"I don't need a damn nursemaid," he said irritably. He was in pain and the fever was causing a deep ache throughout his body, adding chills and sweating to his misery. Despite his silence, he was restless due to the pain, trying in vain to find a comfortable position.

"They're not nursemaids; they're nurses. And until you can walk out of this room on your own, you need their help."

Inclined at a slight angle to ease his breathing, Jim stared in McCoy's general direction. His eyes were open and a startling blue under the diffused lights. Even his blindness had not taken away from their electric intensity.

"Don't strain so much, Jim," McCoy said gently, seeing the vein pulse near his patient's temple. He glanced at the monitor and confirmed the increase in blood pressure. "If you can't see it, that's all right."

A soft growl escaped Jim before he closed his eyes and pressed his knuckles to his temples to ease the ache. "I thought you said it would clear up. Why can't I see?"

McCoy dropped his hand. "I said it was temporary. You can see the difference between light and dark now. And you can discern figures. That's an improvement."

Jim's brows drew into a heavy line. "How much longer?"

He looked at his patient with empathy. He'd lost count of how many times a patient asked him a question he could not answer. How long do I have to live? Will I be able to walk after the surgery? What if we wait? Patients expected doctors to have answers. Jim was no different.

"Jim, I don't know. This isn't an exact science. It's taking longer than I anticipated, but there's no permanent damage. The brain doesn't heal like other organs. Even with most of the toxin out of your system, the area of your brain that controls vision has been affected. We just have to give your neurons time to reconnect."

"I don't have time," he said impatiently and dropped his hand with a thud onto the bed. "I need to get out of here."

McCoy snorted and made a note on Jim's chart. "You're running a temperature of 39.5 and I just reconstructed your knee. You're not going anywhere for a while."

"I can rest in my quarters."

McCoy looked at him, nonplussed. The central line and the various IV fluids dripping into his veins was a stark reminder of how truly sick he was. He'd lost weight in the past few days and his face appeared gaunt from the constant pain and stress. Add to that, his fever was draining his reserves and no doubt muddling his thinking. "It's not about resting, Jim. You're still on IV fluids and you're barely maintaining your O2 sats. I need to monitor you, and you need care."

"I hate the sound of that word," he said, closing his eyes with a scowl. "It's hot in here."

"It's your fever." McCoy finished making his notes and moved toward the other side of the bed to examine the injured knee. "I'll get you a cool cloth in a minute."

"I want to talk to Spock." It wasn't a request.

"After I finish my exam." McCoy set the chart down and focused on the knee.

"Now!"

McCoy scowled and glared at Jim, feeling his temper rise. A biting remark teetered on the tip of his tongue. Jim was a difficult patient under the best of circumstances, but McCoy had come to understand Jim's self-determining nature that saw needing help as a sign of weakness. They had done this dance before, these small power plays where each man tried to assert his position and gain control. But it wasn't about power for McCoy. Jim Kirk didn't understand his own limits, and it was McCoy's responsibility as CMO to draw the boundaries…and, when necessary, enforce them.

"I'm not your yeoman to do your bidding, and you don't outrank me in this room," he said sternly. "I'm your doctor and you're my patient. My primary concern is your health."

"And my primary concern is this ship," Jim fired back. "Damn it, Bones. I need to talk to Spock."

"You're also injured and not on active duty." He paused and took a breath. He quickly scanned the monitor, noting the elevated vitals and slight dip in the O2 sat. "I'll get Spock after I finish examining you." He drew the blanket back from the elevated knee. "Spock's not going anywhere…and neither are you."

Jim dropped his head back against the pillow and rolled his head away from McCoy, pushing down on the blanket that covered him. Slightly breathless and flushed, his irritation was tangible.

McCoy took a moment to evaluate his patient. Still startlingly pale despite his fever, the exhaustion that consumed him was evident in the labored breathing and the heavy, boneless way he lay on the bed. Still, he looked like he wanted to hit something or someone. At that moment, McCoy wanted nothing more than to comfort his friend, to remind the young man that there were capable people to look after the ship, and he had to take care of himself now. He wanted to lay a comforting hand on the fevered skin and tell him everything was going to be all right, they'd figure out who had shot him, and it would end up a story they tell over drinks one night. But that was something one friend would say to another, and he was not Jim's friend at the moment. He was Jim's doctor.

With a sigh, he turned his attention to Jim's knee. Despite the trauma and recent surgery, the knee looked surprisingly good. The swelling had been reduced considerably and the incisions had begun to heal in thin, pink lines. He pressed his fingers gently at the base of the knee, checking the newly implanted tendons, feeling for tension or swelling. His probing elicited a grunt from Jim.

"I'm going to flex your knee and check your range of motion. Just relax your leg as much as you can. Let me do the work." He carefully bent the injured knee a few degrees, keeping his fingers pressed close to the quadriceps muscle as he manipulated the joint. The leg convulsed beneath his hands and he stilled his probing.

"Does that hurt?" he asked, studying Jim's tightly pressed lips.

"Yes, it hurts!" Jim ground out.

"Okay, settle down." He kept a hand in place to stabilize the leg as he continued his exam, his sensitive fingers feeling the reaction of the flesh beneath him. When he finished, he lowered Jim's leg and settled it onto the cushion that kept it elevated. He reached for a small scanner and took a quick reading. "The new tendons and muscle have accepted well. You'll need to build up strength, but it looks good. Now, if we can just get your fever down."

"Why didn't you just scan it to begin with?" Jim asked in an irritated tone.

"The scanner can't tell me everything that my hands can." He pulled the blanket to cover Jim's knee and checked the monitor again before retrieving the cool cloth he had prepared. "I'm going to use a cloth to try to lower your body temperature. It should help to alleviate some of the fever symptoms. I'll start at your shoulders."

Despite his alert, he felt Jim jump at the first touch of the cloth. The material was synthetic and designed to hold temperature. It had been saturated with alcohol that would help to cool the fevered skin. Jim was naked beneath the Sickbay blanket. The sheet covering the biobed's pad absorbed perspiration and body fluids, drawing them away from the patient to maximize comfort. The temperature of the bed had been lowered, offering an additional cooling element that Jim appeared not to notice.

McCoy wiped the cloth over Jim's arm, allowing the alcohol to evaporate on his skin. The idea was not to cleanse, but to offer some comfort. He soothed the cloth across Jim's bare chest, careful of the catheter site that had become red with irritation, a common complaint. Jim winced as he wiped the cloth over his torso.

"Did I hurt you?" McCoy asked.

"No." But he was frowning. "When can I get that out?"

Central lines were uncomfortable and patients typically didn't tolerate them for long. "Today. We'll move the site to your arm. You still need IV medications and fluids."

He lowered the blanket to just above Jim's pubic bone, exposing the narrow waist and flat belly. Jim shivered as the cloth drew across his lower abdomen, then he shifted restlessly.

"Are you in pain?" McCoy asked, studying the tense features.

Jim shook his head curtly, but the tension remained.

McCoy scanned the monitor. Nothing alarming there, but Jim seemed uncomfortable and hesitant. He looked at the pale face. Jim was a master at hiding his pain, even from the sophisticated monitors. "If you're uncomfortable, let me know. You shouldn't be having any pain in your abdomen."

"I'm not in pain," he said shortly.

"Well, something's wrong. You're strung tighter than wire." He waited, but when there was no reply, he asked, "Do you want give me a hint?"

Jim scowled. His blue eyes stared unseeing at the ceiling. "Something doesn't feel right."

"Okay," McCoy said slowly. His stomach tightened. "Where doesn't it feel right?"

"In my penis. It feels likes there's pressure."

He released the breath he'd been unconsciously holding, letting the tension drain suddenly from his body. No emergency. "You have a urinary catheter in. Let me take a look."

He drew the rest of the blanket back and examined where the narrow tube entered Jim's urethra. "There's no sign of infection or swelling." His fingers moved to examine the testis for distension. "Everything looks good. Is it uncomfortable?"

"Of course it's uncomfortable; there's a tube up my dick."

"All right," McCoy said easily and pulled the blanket up again. Moving to the side of the room, he disinfected his hands. "It's been in for a few days. I'll remove it later and reset a new one. It could be just irritation."

"How about we remove it altogether."

He looked at Jim and the uncompromising expression on the flushed face. "Sorry. You can't get out of bed yet and we need to keep monitoring your urine output. It'll only be a few more days. Once you get your mobility back, you won't need it."

Jim released a short breath and threw his left arm over his eyes. "Are we done?"

He wasn't done, but Jim's stress indicators were rising and that would trigger a decrease in respiratory function. As it was, his oxygen saturation levels were still slightly below normal. He wanted Jim to rest and stay calm, something that wouldn't happen if he continued pressing. "Yeah, Jim, we're done for now."

"Then get me Spock."

He waited until he heard the sound of Bones' steps fade and the doors hiss shut before allowing himself to relax. He dropped his arm and stared at nothing. Although his vision had improved, he was still unable to distinguish forms. Person or piece of equipment—he couldn't tell one from the other. The only thing that told him Bones was there was the doctor's familiar scent. Bones smelled of sandalwood and strong soap. Jim hadn't noticed it before, but the scent put him at ease, which was strange, because Bones wasn't exactly the type of man who put anybody at ease.

He pushed the blanket down, feeling the heat rising in his skin. Bones' impromptu bathing had helped, but he hated all the care and attention as much as he hated his own helplessness. His knee had felt pleasantly numb until Bones had manhandled it. The manipulation activated the pain, setting in a deep ache that stretched from mid-thigh to his ankle. The new muscle Bones had graphed in place was hyper-responsive with new nerves firing off what felt like electric shocks. Bones had promised him the new muscle would settle down as soon as the stem-cell regens had a chance to take effect.

It's what he hated the most about medicine, the wait-and-see methodology. As advanced as modern medicine had become, there still was no cure for the common fever. He wiped at the perspiration on his forehead. He would give anything for a real shower.

The ache behind his eyes had steadily grown stronger since waking and he closed his eyes to rest them. It was less stressful to see nothing than to strain to decipher shapes. He made a conscious effort to relax his body, letting the softness of the mattress take his weight. The small reprieve helped him to focus and settle his thoughts. He needed to have his mind clear to speak to Spock.

The door finally hissed and he immediately opened his eyes, seeing a tall shadow approach the bed.

"Captain," Spock said and came to stand on Jim's right side. "It is good to see you alert and more rested. Doctor McCoy informs me that your reconstructive surgery was successful. You are feeling less discomfort?"

"I'm fine. Take a seat." He had come to know that Vulcans were terrible at small talk, and anyway, he did not want to talk about himself. He had other things he needed to discuss.

Spock sat in the chair without making a sound. He was the only person Jim knew who could move as silently as a cat. He'd seen the Vulcan remain in one place for three hours, never so much as shifting his weight or uttering a sound. He even breathed silently.

"Status report."

"We are no further in our investigation than we were five days ago," Spock said.

He had expected as much. Spock would have questioned the landing party extensively. If they'd had any information that would be helpful to the investigation, Spock would have skillfully extricated it from them. One thing about the First Officer, he was meticulous and thorough in his processes. Jim knew that the crew would not be of help.

"Tell me everything you know about Aegis."

"Class M. First explored by the USS Constitution over four years ago as part of the Federation expansion initiative. It was categorized as uninhabited with a well-established system of multi-organisms. Early stage evolution of organisms with evidence of genetic drift. A typical terrestrial ecosystem of—"

"What about anthropological studies?"

Silence. His knee throbbed, but he ignored the pain, keeping himself still with the appearance of being relaxed and at ease. He remained focused on Spock, putting on his best command expression.

"The planet has not developed to the stage of sentient beings," Spock finally said. "There is no evidence to suggest the planet was ever inhabited by intelligent life."

"No archeological finds?"

"The Constitution reported none."

Standard exploration procedures-before even stepping foot on the planet, the First Contact team would have run a series of scans to detect any indications of life forms. If none were found, they would have done a planetwide scan to search for any unnatural structures that might indicate past or current habitation by intelligent beings. But something told Jim that the crew had been looking in the wrong spot.

"Did you run a scan?" he asked Spock.

"Yes, Captain. A standard Class Two scan per protocol after you were injured."

"A Class Two scan isn't going to detect anything more than six meters beneath the surface. I want a detailed Class One scan in a thirty-two hundred meter radius from where you found me."

For a moment, there was only the sound of the monitor softly thrumming in cadence with his vitals. The dark shadow that was Spock did not move. Jim waited, feeling a heavy weight settle on his chest. His eyes hurt and the ache that always seemed to reside behind them had grown into a stabbing pain.

"May I ask what we are looking for, Captain?"

A flash of white light blinded him, igniting an intense pain in his eyes. A grunt escaped him as he pressed his hands to his temples in a vain attempt to ease the pain.

"Captain, are you all right?"

He shut his eyes tightly, forcing the darkness. What the hell? His head felt like it was going to explode. His heart hammered frantically against his ribs as a sudden wave of heat overtook him.

The light blinded him. It had appeared so unexpectedly that he had not had time to shield his eyes. In an instant, he was moving…and yet he was not. Something pulled at the center of him, deep in his solar plexus. For a moment, it was as if he didn't exist, as if everything within him had just… stopped.

"What the hell happened?" It was Bones' voice, distant and frantic. "Tri-ox, now!"

He felt the bed being lowered so that he was lying flat. His body was limp, as if all his muscles had separated from the bones. There was a sense of motion around him, but it had very little to do with him. The sting of a hypo against his neck was barely felt, his flesh like clay. Hands touched him….

At first cruel and demanding, they held without apology, then softened to comfort and soothe. He could only see the white light stretched across the canvas of his mind.

"What have we done?"

Oxygen flooded into him. He felt the mask on his face, pressing close. It hurt to breathe, as if someone were forcing down his chest, crushing his lungs. Slowly, he became aware of his body and the pain radiating from his knee.

"I told you to keep him calm, Spock." Bones' voice was cutting. "His breathing is stressed enough."

The cold press of a hypo against his neck drew his attention. A cool hand rested on his shoulder. He opened his eyes. The world before him was cast in grey shadows and faint blotches of light that looked like a poorly painted water color. The medication infused into his veins and he felt the pain recede as a heaviness overtook him.

"Spock." His voice was weak and muffled by the mask.

"Here, Captain."

"Someone…." So much effort to draw air into his lungs.

Another hand on his forehead, soothing.

"Don't try to talk, Jim," McCoy said. "You should go, Spock."

No! He reached out into the darkness toward the sound of Spock's voice. His hand made contact with the soft fabric of a uniform. He twisted his fingers into the fabric as a hotter than human hand covered his. The medication was pulling him down. His fingers weakened.

"Rest, Captain."

With his fingers still twisted into the fabric, he drew it toward him with the last remaining strength. "Someone was…waiting for me."

His fingers slipped. The weight of his hand was too much to support. It would have fallen to the bed if not for the hand that still held it. As he fell into the blackness of blissful sleep, he felt the hand squeeze his own.