"Just how stupid can you be?" McCoy stood inside the doors of the bridge simulation room, arms crossed, eyes blazing.
The simulation rooms, or "sim" rooms, as they were called, were full-sized, realistic mockups of a starship's key areas – bridge, engineering, weapons bays – even the medical bay. During the day, the rooms were used to train cadets in the finer points of operating a starship. After hours, cadets could book them for extra practice, and this was especially common for cadets about to undergo a major practical exam.
Seated in the command chair, Jim swung around at the sound of his voice. "Bones, what are you doing here?" he asked innocently, eyes widening slightly.
McCoy immediately noticed that Jim seemed to be having trouble focusing and wasn't about to buy the innocent routine. "The better question is, what are you doing here?"
"I've got my bridge qual first thing tomorrow morning. Gotta double check that I have the firing sequences down."
McCoy shrugged off the explanation. "I heard about what happened in the probe-ball game today. You were knocked unconscious, for God's sake."
Jim looked evasive. "It was nothing. I just got smacked in the head. I got right back up and kept playing – even scored a goal," he added with a touch of pride.
"Add that to the list of dumbest things you've ever done," McCoy growled in response. "Have you been vomiting?"
"No." Jim's expression was pained.
"Any ringing in your ears? Blurred vision? Dizziness?"
"No, no, and no. I'm fine. Now get out of here; I've only got another 30 minutes of sim time and I can't afford to waste any of it."
McCoy wasn't sure whether to believe him regarding the symptoms. Jim was a reluctant patient on his good days; with an important test coming up, he wasn't likely to admit to anything that might keep him from completing it.
McCoy shook his head sternly. "Sorry, Jim. I'm not going anywhere until I've examined you and made sure you're fine."
Jim cocked his head in defiance. "Then I guess you'll be here awhile."
McCoy closed the distance to the command chair in a few steps and unceremoniously grabbed Jim's chin, staring into his eyes. "Fine, my ass. Your pupils are dilated and you're obviously having trouble focusing." With a pointed sigh, he reached into his medikit, pulled out his scanner and aimed it in the direction of Jim's head.
To his surprise, Jim immediately batted it away, the movement almost causing him to fall out of the chair.
McCoy picked the scanner off the floor and faced Jim, hands on his hips and a scowl on his face. "Jim, you're showing all of the signs of a concussion, which means you need a medical evaluation to see how much damage you've done to that thick skull of yours. Now I can examine you here, at the clinic or even in your dorm room if you insist. But I am going to examine you."
"Bones, I told you that my bridge qual is tomorrow." Jim's voice had taken on the whining, begging tone that McCoy recognized from the times in the past when he'd tried to put off medical attention. "If I don't pass, I'll be booted out of the command track. And if I don't memorize the firing sequences for phasers and photon torpedoes, the process for going to . . . going to . . . dammit, will you for God's sake get out of there and stop distracting me."
McCoy snorted in disgust. "You can't even remember what you're supposed to be doing. Concussions will do that; they affect your memory. What you need is to rest and clear that head of yours, not run through firing sequences or whatever the hell you're trying to do."
Jim looked past him. "Leave me alone."
"Jim," he said in a measured tone, "I wasn't kidding about the possibility of brain damage. You need to be evaluated for concussion; the fact that you were unconscious means your condition could be more serious than you think. If you don't come with me right now, I promise you won't like the consequences. Am I making myself clear?"
"Come on, I'm almost finished. Just thirty minutes more." Pleading.
Would and examination now versus thirty minutes from now make a difference from a medical perspective? Probably not, but McCoy couldn't say for sure. More importantly, it was time that Jim started to understand the potential consequences of not cooperating with medical personnel. McCoy might let him slide every now and then; other Starfleet doctors, including Jim's future CMOs, were unlikely to be so accommodating. "Now," he reiterated.
Jim turned away and punched several buttons on the command chair console. "Computer, resume simulation. Prepare to launch phasers."
"Jim, I'm telling you one last time that you need to get checked out. Now, are you coming with me not?"
"Phasers ready," the inanimate computer voice said in the background.
Jim focused on the viewing screen, blinking rapidly as if trying to focus. "Lock in fire control coordinates."
"Incorrect," the computer responded.
"Shit," Jim mumbled. "What comes next? Prepare, lock-in, set . . . computer, what comes next in the sequence?"
The disembodied voice replied immediately. "You must check with fire control to ensure all phasers are on-line."
Jim pounded his fist on the arm of the chair. "Shit!"
"That is not a proper command."
McCoy tried one last time. "Jim, I'm warning you. You're leaving me no choice—"
"Dammit, Bones, go away!"
McCoy hesitated. If Jim had been honest about his lack of symptoms, he didn't think Jim was suffering from more than a mild concussion. Of course, his opinion based on a brief visual check was no substitute for a proper examination. At the moment, however, his hands were tied. He couldn't forcibly remove Jim from the sim room and, given what he suspected was a relatively minor condition, didn't want to call security.
His best option at this point would be best for Jim the patient and Jim the future Starfleet officer. It was also one he didn't like and one that Jim definitely wouldn't like.
He was beyond arguing. "Okay, Jim. Finish up here and then come see me in the clinic. And, if I don't see you within the next two hours," he warned, "I'll send security to find you."
Jim nodded absently, his attention already focused on the next step of the simulation.
McCoy wasn't surprised when, two hours later, a clearly angry and somewhat disheveled Jim burst into the clinic exam room where he was concluding his examination of a post-surgical patient.
"Bones," Jim demanded, hands on his hips, "What the fuck do you think you're doing?"
McCoy's patient, the elderly and somewhat frail wife of a retired admiral, looked up with alarm. "What in the world. . . .?"
McCoy turned around and gave Jim his sternest look. "Outside. Now." After assuring his patient that he didn't have psychotics as friends and that he'd send in a nurse to finish up the visit, he stepped into a hall where a seething Jim was waiting for him.
Jim was almost twitching with impatience. "I asked you a fucking question."
"Not here." He grabbed Jim by the arm and propelled him into the nearest empty exam room. Inside, he voice locked the door. "If you ever again walk in on me when I'm examining a patient, I'll make sure your next physical includes procedures that have yet to be invented." McCoy's voice was icy.
Jim swallowed hard and was silent for a moment, which, McCoy realized, was as close to an apology as he was likely to get at this juncture.
"You got my bridge qual canceled," Jim said accusingly. "They said it was for medical reasons." He almost spat out the words.
McCoy sucked in a breath. Here we go. "Yes, Jim, I did."
"What the fuck did you do that for?"
McCoy refused to match Jim's irate demeanor or foul language. One of them had to remain professional. "Because, in my professional opinion, you aren't in any condition to participate."
Jim shook his head in defiance. "I'm ready for the exam."
McCoy shook his head. "I don't think so; not from the looks of things when I left you and not from the looks of things now."
Jim leaned back against the wall, eyes briefly closing. "There's nothing wrong with me that a good night's sleep won't cure."
"You were hit in the head and knocked unconscious. You're unsteady on your feet and your pupils still aren't focusing. That means you almost certainly have a concussion," he said slowly, enunciating each word for emphasis. "Until you're evaluated, I can't determine how serious it is and, until I do, I can't let you go ahead with tomorrow's practical. Not to mention that, if you try to do the qual with a concussion, you'll screw it up and probably your Starfleet career as well. I'm trying to help you avoid that."
"You're not my goddamn mother!" Jim interrupted, eyes blinking rapidly. "You had no right."
"I'm a Starfleet doctor and you're a Starfleet cadet. That gives me every right."
"Pulling rank on me, huh? Damn you, McCoy." Jim's quiet voice didn't conceal the undercurrent of anger and indignation.
McCoy kept his face impassive. "Pulling common sense on you, kid." He might have "won" the battle but took no pleasure in doing so. "Now, that you're here, are you going to let me examine you or do you want me to find you another doctor?"
Jim's eyes met his. "I want you to get the hell out of this room."
McCoy sighed. He knew Jim had been putting in incredible hours in recent weeks. The end of third year was do or die time for the command cadets, and McCoy suspected that some of Jim's irascibility was a combination of fatigue and stress as much as the concussion. Maybe it was better to get someone else involved, at least until Jim had calmed down a bit. "Fine. I'll send in Dr. Brumbaugh, the on-call neurologist." He turned at the door. "And don't even think of leaving until she checks you."
