Lesson 9 – R&R
"CMO is a full-time job. Even if you're not the only MD on the ship – and some of you will be that as well – like the Captain, you never really have a day off. There's no one to fill your position, no one else able to make the decisions that only you can make. It can become overwhelming.
"Knowing that many of you, if not all, are Type A personalities, you'll be tempted to keep pushing through. I can't stress enough how important it is for you to make time for yourself. Whether it's an hour in the evening or a few days on shore leave – you need a break as much as any other crewmember, and probably more than most. Be sure you get it; you'll be much more effective in the long run if you do."
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McCoy had been in a funk since his conversation with Lisa Ngo. Medically, her condition had remained unchanged; he'd managed to keep the eye infection at bay until she'd left the ship and now her care was in the hands of others. That knowledge and her departure from the Enterprise hadn't improved his mood; he'd been more short-tempered than usual with his patients almost to the point that they found reasons to avoid coming to medical, or at least seeing him. Even his own staff did their best to steer clear of the CMO.
The complaints eventually made their way to the CMO's best friend and ship's Captain who, in turn, made his way to McCoy's cabin. McCoy ignored three hails from Jim at his door, thinking he was probably the only crewmember on the ship who could get away with ignoring the first one. He didn't want to talk with Jim, didn't want to talk with anyone.
"Bones, open the door or I'm reporting a fire in your quarters."
Damn him. He was half-tempted to call Jim's bluff until he decided that Jim probably would do just as he'd threatened, which would leave his cabin filled with fire retardant and a roomful of firefighters. Reluctantly, he released the doorlock.
By the time Jim stepped into the room, McCoy had returned to studying the readouts on his computer. Jim came up behind him and stared over his shoulder.
"Management of Penetrating Injuries with a Retained Intraocular Foreign Body," he read aloud. "Sounds exciting. Bet you can't wait for the holo-version."
McCoy didn't turn around. "Is there something you wanted?"
"It's karaoke night. Thought you might want to join me in the crew lounge. I'm told some of the folks aren't half bad."
"No thanks."
"You can't hole up in here and drown your sorrows in Scotch."
So, Jim had heard about that. "It was only the one night, Captain. I've had nothing to drink before or since."
"I don't give a shit if you drink or even get drunk when you need to."
"I didn't need to; I wanted to."
"Bones, you can't keep stewing over Ensign Ngo. You did your best for her, just like you did for Scotty."
McCoy turned, eyes blazing. "How the hell do you know? Did you suddenly get your medical degree with a specialty in vitreretineal ophthalmology? She's nearly blind in one eye and may lose sight in both. How do you know that I didn't screw up, that I'm not responsible?"
"I guess I don't."
"Then get out of here." He pointedly turned back to the computer.
Jim grabbed onto the back of his chair and swung him around. "Dammit, Bones, look at me. You're a doctor, not God. You know you're not going to be able to save every patient any more than I can keep everyone on this ship out of harm's way. I know you feel bad. I feel bad – about her and about every single crewmember we lost in that damn fight with Nero and about every one of the six billion Vulcans that didn't even know what hit them. All Starfleet asks us to do, all we can do, is our best, even when it may not be good enough. If I didn't think you were the best, friends or not I'd get someone else."
"Maybe you should."
"Bullshit. You aced your way through the Academy. Waylan gave you your pick of assignments. You know you're damn good. Yeah, sometimes your best may not be enough. And somewhere along the line, you may even screw up now and again. But you give the crew on this ship the best chance medically they're going to get anywhere in Starfleet. There's nothing more they can ask and, as the captain of this ship, nothing more than I can ask of my CMO."
Despite himself, McCoy cracked a tiny smile. "Been rehearsing that speech in front of the mirror?" When Jim got all earnest like this, it was so hard to stay angry. At some level, he knew Jim was right; he simply needed to hear someone else say the words and mean them.
"Pretty good, huh? I practiced all afternoon," Jim replied, relaxing slightly and returning the smile.
McCoy turned serious again. "Jim, during Scotty's surgery, I had to make a decision, a decision that may have cost Lisa her eyesight. It may have been the right decision – hell, it probably was – but I'm not sure. And that's going to haunt me for awhile."
"Bones, I'd be a lot more worried if it didn't haunt you." He gestured toward the computer. "Now, turn that thing off and let's go listen to some music."
***********
The second best thing about Altaria, the planet Enterprise was currently orbiting, was its extensive shore leave facilities. The Federation member world marketed itself as a vacation mecca for starships as well as general tourists. An ecologically diverse planet, it offered virtually every form of recreation imaginable – sailing, skiing, hiking, camping, fishing and more. For the more sedate visitors, there were spas, bars, shops, historical lectures, gambling and undoubtedly other, less legal, pastimes. Whatever you wanted to do, for a price, you could do it on Altaria.
The best thing about Altaria, from the view of one Leonard McCoy, MD, and CMO of the Enterprise, was its outstanding medical facilities. The planet had state of the art equipment and personnel, including several who had previously served in Starfleet. Which meant that that McCoy could, for the first time this mission, actually take off for a couple days, confident that any emergencies that arose would be well handled by indigenous medical staff.
The only crewmember that he really needed to keep tabs on was standing right next to him in the transporter room and staring with disdain at the medikit attached to his belt.
"Bones, this is supposed to be fun. Time off. That means not working. Besides, we have our communicators in case anything really bad happens."
McCoy gave him an irritated look. "It's a first aid kit, not a portable trauma center. I'm not going on a two-day rafting trip without some basic medical supplies." He didn't bother to add that he'd stocked his kit with stuff to treat everything from heat rash to a major injury. After all, he was a doctor; he liked to be prepared.
"They're Class 3 rapids, not exactly dangerous. Do you really think we're going to hurt ourselves?"
"It's not me getting hurt that I'm worried about." McCoy pointed at the gear piled neatly beside them. "Come on, if we're going to do this, let's get going."
The trip had been Jim's idea – a well-intentioned but misguided effort to boost his morale after the situation with Lisa. McCoy at first resisted but, like most of his efforts to resist Jim's infectious enthusiasm, it was doomed to failure. Jim had encouraged, nagged, pleaded, and ordered until McCoy had finally given in. Spock proved resistant, noting that for Vulcans, relaxation meant literally that, not engaging in physical exertion. And besides, with Scotty still on the mend, someone had to mind the store while Jim was away.
Once they'd reached the beam down site, he and Jim made quick work of stocking the raft, settling into the water, and starting down the long river. They both had rafting experience from before they joined Starfleet and then in a couple of obnoxious "team building" experiences they'd been forced to endure while there.
This trip was billed as technology free. Other than the medikit and communications devices that could be used only in an emergency, they carried no modern conveniences. That suited McCoy just fine. Much as he relied on 23rd century equipment in his medical bay, his idea of relaxation was to leave the newfangled machines behind.
They set a comfortable pace, the first hour primarily still water and the second running through a series of Class 1 and 2 whitewater. McCoy had to admit that the physical exertion, which taxed an entirely different set of muscles than his daily runs, felt good. He knew that he'd be exhausted by the time they pitched camp for the night. That in turn might allow him to get his first full night of uninterrupted sleep since he'd joined the Enterprise.
Jim warned that a set of Class 3 rapids was directly in front of them. In the aft position, Jim was responsible for navigating them smoothly through the obstacles. "Paddle hard on the left," he called out. "Okay, backwards. Ease up a little. Now, right!"
McCoy switched the oar from one side to the other, trying to keep up with Jim's demands. The raft suddenly dropped over a small rock formation, tipping slightly as it hit and spraying them both liberally with water. In the heat of the planet's three suns, the cold was infinitely refreshing and, for a brief moment, McCoy forgot about Lisa Ngo, the pressures of being CMO, his patients, and everything else except not letting the raft overturn.
By the time they reached the recommended overnight spot a few hours later, McCoy was ready to quit for the day and, he strongly suspected, so was Jim. Veterans of Starfleet training, they had no difficulty setting up camp and, within minutes, were eating a nutritious, if not particularly tasty, prepackaged dinner.
"I haven't done that much physical exertion since that Starfleet survival course," McCoy said, nibbling on a biscuit. "At least here we get real food, such that it is – I wasn't much for munching on bugs."
"You're complaining? You medical folks got the short course. We had to do three weeks with only berries or food we could kill. I lost over five kilos."
"Well, I hope the rest of the crew is out doing something equally productive and not swilling in bars. I swear this time I'm not passing out hangover remedies like candy – better for 'em to suffer a bit. Speaking of which," McCoy pulled a small flask from his pack, "I've been waiting all day to enjoy this." He opened the top and took a long sip. And immediately shook his head at the shock of the bitter taste going down his throat. He offered the flask to Jim.
Jim raised both eyebrows. "Bones, that's what – only your second drink since we left Starbase 17."
"Jim, I'm the only doctor aboard. I never know when I'm going to have to perform surgery or make some other life and death decision. And, before you say it, I don't trust those 'miracle cures' that are supposed to sober you up in an hour. First, I may not have an hour and second they leave your head feeling like cotton."
"Any word on when they're going to assign us another doc?"
"Medical Command says they've identified someone and she should be joining us at the end of this mission."
"She?" Jim's eyebrows arched and his eyes twinkled mischievously. "Is she good looking?"
McCoy rolled his eyes. "Mind out of the gutter, Jim or I'll have her doing your prostate exam."
"Promises, promises." Jim took a bite of his prepackaged sandwich. "Speaking of minds, I've been meaning to ask you. Now that you're CMO, do you really get to read everyone's psych eval?"
This was always a touchy subject with any crewmember, and even more so with Jim. McCoy had been Jim's closest friend for three years; he didn't need to be a psychiatrist or to read the eval to know that the joking, the bravado, and the rowdiness Jim so often put on display were largely a front for some serious insecurities. Jim had probably opened up with him as much as anyone and that wasn't much at all.
"The short answer is 'yes,' in that I can read them, meaning that I have access to them and the authority to read them. That doesn't mean that I spend my leisure time poring through the crew's psych files; trust me, most of them are incredibly boring and the rest are things that I don't need to know unless circumstances dictate otherwise."
"Such as?"
He shrugged. "Mental breakdown, serious disciplinary issue, that sort of thing."
"Did you read mine?"
Of course Jim would ask. How much did Leonard McCoy, all around good-guy and now also CMO, really know about him and what went on in that crazy mind of his? McCoy could tell Jim he hadn't had time, hadn't needed to read it, didn't consider it appropriate. That wouldn't be true and Jim wouldn't believe him even if it were. Better to tell the truth, which wasn't all that bad and spared him the effort of having to remember the lie. Besides, what he had read didn't reveal much he didn't already know or suspect.
He tried to make his reply as non-threatening as possible. "Have I read it word for word? No. Have I looked through it? I'm the CMO; it's part of my job description to care for the physical and emotional health of the Captain who, right now, happens to be you."
Jim seemed to consider that for a minute.
"Besides," McCoy continued, "the examiner gives you a summary of his or her findings. So you've got a good idea what it says."
"Did you have one?"
"A psych eval? Of course. It's required for all starship crew, didn't you know that?"
Jim shook his head. "I was so focused on my own, I guess I really never thought about it."
"It's not a secret; your examiner would have told you if you'd asked. There are different levels of evals –from those that make sure you can handle extended time in space and can work and play well with others to more complex exams for command types."
"Can you do them?"
"I could do a basic one -- I'd no more attempt a command-level eval than I'd let a psychiatrist perform surgery; not my area of expertise."
"Do they really do any good?"
McCoy sighed. "It's a question Starfleet Medical and Starfleet Command have debated for years. My personal view is that they have two benefits. First, they tend to weed out folks with personality disorders or who just aren't suited for life in space. Second, we all have quirks; they're what make us who and what we are. Having a little insight into them isn't altogether a bad thing."
"They're still damn invasive."
"They're meant to be."
"Was yours bad?"
Great. Somehow, Jim had managed to turn the conversation into one about his own psych eval, something he didn't want to discuss with Jim – or anyone else for that matter. "It was . . . interesting," he finally managed.
McCoy was in one of the eval rooms, in a chair designed to promote comfort and relaxation and which in fact did neither. Across from him sat John Dougherty, MD and psychiatrist, who would lead him through this mental evaluation of his life. Or something like that. One advantage of being a Starfleet physician was that you knew who the good and bad docs were. And, given a small measure of choice in who would perform his eval, McCoy had immediately chosen Dougherty. He had a healthy skepticism about most of the Starfleet psychiatric community – Dougherty was one of the few good ones.
The image that came to mind when first meeting the 250-pound psychiatrist with sandy hair that covered more of his face than his head, was "papa bear." The comparison ended there. The man possessed an acerbic wit to rival McCoy's own. More importantly, he had an uncanny ability to slice through the bull. While Dougherty wasn't close enough to be a friend; he was the doctor to whom McCoy willingly entrusted patients with psychiatric issues.
Dougherty himself seemed surprised that McCoy had chosen him to conduct the eval. "Must say, Leonard, I would have thought you'd pick another doctor."
"Who else would give me such a run for my money?" he joked nervously.
"You get what you pay for," Dougherty replied without a trace of a smile.
McCoy knew that the purpose of his eval was to ensure there were no obvious anti-social or other personality deficiencies, that he was not some sort of megalomaniac, and that he could work and play well with others. And anything else Dougherty might deem important.
And, thirty minutes into the evaluation, Dougherty had obviously decided that it was important to understand what had happened to his marriage. "It's not a secret that marital problems led you to join Starfleet. Tell me about that."
McCoy had practiced this answer to perfection. He explained the long hours he worked, the demands his job put on his marriage, the fact that the pressure had been too much and Jocelyn had eventually asked for a divorce. She'd taken everything he had and, with nothing left in Atlanta or anywhere else, Starfleet seemed his best, or maybe only, option.
"That's a great story, Leonard," Dougherty replied when he'd finished. "One that I'm sure you've trotted out many times and is very socially appropriate. But this is a psych eval not the hospital Christmas party. What really happened?"
He obviously wasn't getting out of this without giving Dougherty more. What had happened? The story he'd told was mostly true, as far as it went. He and Jocelyn had met at a New Year's Eve party. The initial attraction was as much physical as anything. From that first night, he couldn't keep his eyes or his hands off her and, judging by her reaction, she felt the same way. They moved in together two weeks later, married three weeks after that.
Sex, McCoy quickly came to realize, was not the basis on which to forge any meaningful relationship. And, in his marriage, it turned out to be about the only thing they had in common. She was an incredibly successful real estate broker; he, a workaholic surgeon. She preferred to party with her friends, he'd rather sit at home and read a good book. Her idea of vacation was baking on a secluded beach whereas he preferred outdoor adventure. She liked yoga; he was into marathons. She wanted to buy a huge house to host huge parties for her huge group of friends. He was just as happy staying in their condo and eating quiet dinners alone.
Soon, he was spending more and more time at the hospital. It wasn't that demands of his work were taking time away from his marriage. No, he spent more time at work because, other than the sex, there was simply no reason to come home.
He wasn't sure when he first suspected that Jocelyn had been unfaithful or what led him to that conclusion. The sex was still good, the conversation before and after still non-existent, the emotional commitment totally absent. It was, he supposed, the accumulation of events that defied explanation – nights she came home late or not at all, bills from places he'd never been, and that fact that she no longer seemed to care that he was never home.
Not long after he'd met Danielle, a hospital attorney, at one of the stupid banquet fundraiser things that he was expected to attend. Jocelyn should have been there and wasn't – probably with her new boyfriend. He'd had too much to drink. Danielle was . . . intoxicating. It hadn't taking much convincing. An hour and three double-scotches later, they were in a hotel room. And two nights later. And again two nights after that.
And then the summons had come from the hospital administrator, followed by the letter from Jocelyn's lawyer. And the realization the whole thing with Danielle had been a setup. Why Jocelyn, he asked himself more times than he cared to count. If you were so damn unhappy, why not just tell me?
And when it had all come crashing down, he blamed himself. He'd recited the wedding vows, had agreed to be faithful, and had failed miserably. Sure she'd probably cheated as well, but that didn't make his transgressions any less wrong. When Jocelyn asked for the world in the divorce, he'd given in and given up. Take what you want, he'd said. And she had. In the end, the only thing he was left with was his medical degree . . . and his bones, as he'd told Jim.
"I couldn't stay in Atlanta," he said. "For a big city, it's a damned small town. Everyone knew."
One evening out of the blue, a Starfleet recruiter had contacted him. "I hear you might be in the market for a change of venue," she'd said. "I've got just the place for a surgeon with your talents."
"Do you see Starfleet as an escape?" Dougherty asked.
He hesitated. "I don't know," he finally replied honestly. "I wanted to practice medicine. I suppose Starfleet was as far away as I could get from everything and still be a doctor."
"Do you consider Starfleet to be your new home?"
"I don't have a home right now. I have a dorm room."
"Have you made any friends these last three years?"
"Of course."
"Close friends?"
"One or two."
"If they were here, would they say the same thing? Or do you keep them away so they can't hurt you the way Jocelyn did?"
"That's psychiatric bullshit."
"Is it? Tell me, Leonard, who is your closest friend?"
"Bones. Bones!"
McCoy shook himself into the present, seeing Jim's blue eyes boring into his and feeling Jim's fingers gripping his bicep painfully. "Sorry, just thinking back."
"Must have been one hell of an eval."Jim released his grip and started fiddling with his hands, picking at something.
No way was he going to bare his soul to Jim. "Not really," he replied absently. "Just brought back some memories." His eyes narrowed at Jim's movements. "What the hell are you picking at? Let me see your hands."
Jim upturned his palms. "It's nothing – just a few blisters."
He took Jim's hands in his own, turned them over and gently ran his fingers along the open palms; for once, Jim's diagnosis was spot on. The hours of intense rafting had taken their toll. "Want me to fix them up for you?"
"We're supposed to be low-tech here. Will it hurt me if you don't?"
McCoy shook his head. "It'll hurt like hell with those oars tomorrow, but it won't cause any serious damage from a medical standpoint."
"Then let it be."
McCoy didn't press the point. There were enough times when he'd insist that Jim accept medical care and this wouldn't be one of them. If Jim wanted to endure the pain, that was his choice.
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