CHAPTER EIGHT
McCoy had just left the bedroom, where he'd hung Jim's fourth, and last, bag of IV solution, and was on his way to the little kitchen to make himself some lunch when his door chimed, the sound shockingly loud in the quiet of the room. Cursing under his breath, McCoy hurried to answer before it could chime again. He'd left Jim sleeping peacefully; he'd like the kid to stay that way.
He opened the door to find a smartly dressed ensign waiting in the hallway, the creases in his uniform pants sharp enough to slice bread.
"Dr. McCoy?" he inquired, sounding doubtful.
"Yes, that's right," he acknowledged.
It was probably the jeans, McCoy figured, along with the Johns Hopkins Medical Center sweatshirt and the leather slippers, that had the ensign staring dubiously at him. Christ, did the man really expect him to be decked out in Med whites at home? Since his arrival at the Academy, he'd noticed that Starfleet personnel had a tendency to focus on the uniform, not the person inside it, as if the sum total of who you were could be defined by the rank – or lack of it – you wore.
"Compliments of the commandant," the young man said briskly, apparently deciding he wasn't trying to pull a fast one, after all. He removed a PADD and a communicator from his satchel, and handed them to McCoy. "For Cadet Kirk. To replace the ones that were discovered in the wreckage."
"I'll make sure he gets them when he wakes up."
"Thank you, sir. Also, Commandant Pike would like Cadet Kirk to comm him as soon as he feels up to it." The ensign hesitated. "Do you have any idea when that might be, sir? How is he doing?"
"I don't know when Jim— when Cadet Kirk will awaken but I'll pass the message along when he does. Kirk's in fair condition, so I suspect he'll be in touch yet today, if his condition remains stable."
"Thank you, sir," the ensign said again, looking relieved. "I'll let Commandant Pike know." He snapped off a salute before wheeling around and striding off.
McCoy quietly closed the door and leaned back against it, lips pursed in thought.
Well, now, wasn't that interesting? This was the first time, outside the hospital, he hadn't been treated like gum on the bottom of someone's boot. McCoy wondered if that was a result of Captain Pike's instructions, Jim's heroic actions yesterday, or just the ensign's personal take on the situation. Maybe all three, for all he knew, but it was the first indication he'd had that Starfleet's regular ranks weren't totally comprised of rule-following yes-men and assholes.
Straightening, McCoy walked back into the cramped living area and placed the two items on the battered coffee table for Jim to deal with when he awoke. After his own early start to the day and busy morning, he was more than ready for some lunch, and he planned to continue reviewing Jim's Iowa medical records while he ate.
It didn't take long to throw together a chicken sandwich, and he carried the plate into the living room, setting it on the scratched end table alongside the ancient armchair, next to his mug of coffee. Sitting, he crossed his legs and picked up his PADD, balancing it on his thigh, before reaching for his sandwich and settling back into the chair's lumpy embrace. Taking a bite, McCoy contemplated the screen in front of him, glad to finally have the opportunity to do some more sleuthing into Jim's medical history.
Tucking Kirk into bed after the late breakfast, he'd realized that the weekend was in danger of getting away from him, so he'd forced himself to finish the detailed outline of his xeno-pharmacology paper that was due on Friday instead of reading more of Jim's chart as he was itching to do. Creating the structure for a solid, ten-page paper had been pretty straightforward since he'd had plenty of experience in his former life with writing articles based on his medical research. He'd also reluctantly completed the reading for Monday's History of the Federation class, aka Federation History from a military viewpoint, which had been equal parts boring and useless. Depending on the class, his courses ranged from interesting to a waste of time, but they all required a shit-ton of reading and other homework.
In-between homework assignments, he'd made sure to perform regular checks on Kirk's IV. The kid had been out cold each time, his breathing deep and even. Eating, and using the head, coupled with the let-down effect of adrenal fatigue, had apparently exhausted him – and told McCoy quite a bit about the toll the injuries from the explosion had taken on Kirk's body.
Finally finished with his homework for the time being, McCoy settled into the more interesting task of forging a more thorough acquaintance with Kirk's medical history. He clicked to the beginning of the records from IUH that he had downloaded to his PADD – the oldest, chronologically – and starting reading.
…3-year-old transferred via emergency medical shuttle from Riverside Urgent Care on 2236.43 in acute respiratory distress... admitted to Pediatric ICU… suffered respiratory failure secondary to acute anaphylactic reaction caused by antibiotic, Vintallicillin… patient intubated and placed on respirator… alternate antibiotic, Eryosyn, initiated… patient responding slowly… Tranestin added to pharmacologic regimen… extubated 2236.49… discharged home 2236.56… referrals to Pulmonology, Allergy and Home Care…
The pneumonia that Jim had mentioned in the Emergency Room had been more serious than he'd let on. Whether Kirk had intentionally concealed the gravity of his illness or not, reading between the lines made it clear to McCoy that Jim had been gravely ill and nearly died. A three-year-old with bilateral pneumonia? One who'd suffered a severe allergic response? It was a miracle the kid had survived.
It was a pattern that recurred throughout the remainder of Jim's chart.
The notes on the Danthers-Duseault therapy filled page after page, charting Jim's rollercoaster ride of recovery. But it was the initial consultation that McCoy found most interesting. …extensive discussion with child's mother, Winona Kirk… advised her to delay the start of therapy due to child's significant pneumonia 20 months ago and subsequent stress to his fragile immune system… mother states she is returning to active duty with Starfleet in two months… further states she "will be out of reach for extensive periods of time" and that her son's immune system "needs to be stabilized so she is not required to deal with his allergic reactions in the future from deep space"…
McCoy tugged at his bottom lip, wondering whether Winona Kirk's insistence on the therapy was due to necessity or indifference.
Read one way, the specialist's notes could be interpreted as a means of justifying his decision to proceed with the therapy despite Jim's age and medical history, due to the needs of a working, one-parent household. Sixty months was the minimum age for the treatment to be initiated, so Jim had met the age criteria. However, he had been a preemie at birth, which normally would have any competent physician proceeding very, very cautiously.
But, from another perspective, the information noted on the PADD screen could just as easily be read as a troubling take on a less than ideal family situation.
McCoy tapped a key, calling up the nursing notes this time, rather than the doctors' progress notes, and began to skim the entries, searching… There. Seven weeks and four days into Jim's recovery, an entry leapt out at him. …Mother visited today and informed Jimmy that she is leaving Earth in six days. She stated that if he is still hospitalized at that time, 'Uncle Frank' will take him home when he is discharged. Jimmy is very upset and crying inconsolably. O2 sats degraded rapidly, and oxygen was restarted via nasal cannula. Request made to Social Work and Discharge Planning departments to ascertain appropriateness of this individual for post-hospitalization care…
Jesus. Who the hell dumped that kind of news on a sick kid and expected him to be okay with it? Jim had been five, for Christ's sake. He'd still been fragile, health-wise, too, and McCoy knew from going through the reams of physician progress notes, and matching then up by dates with the ancillary entries, that his mother's departure had precipitated a real set-back in his progress. Jim hadn't been discharged until three weeks after his mother left Earth.
McCoy tapped more keys, searching for the social worker's intake evaluation on the man Winona Kirk had chosen to care for her children while she was in the black. A shiver washed over him – his great-grandmother would have said a goose had just walked over his grave – as he was caught in the grip of a grim foreboding and a desperate desire to be proved wrong. Finally, he found what he was looking for in the notes from a group discharge planning session that included Jim's Allergy Attending, a nurse from the inpatient unit, a discharge planner, and the social worker. The social worker's assessment had included the following facts:
Mr. Frank Hawthorne, a single, 38-year-old male, was granted restricted guardianship of Jimmy, as well as his brother Sam, who is four years older than Jimmy, by Commander Winona Kirk. Guardianship is valid for day-to-day custodial care and routine and emergency medical decision-making on behalf of both children. A legal document outlining these rights has been drafted by the Commander's personal attorney, with all signatures duly witnessed and notarized. A copy has been filed with the hospital and is available for review.
Mr. Hawthorne states he is not a blood relative of the Kirk family, despite Commander Kirk referring to him as an uncle of the children. Rather, he is the adopted son of Jimmy's paternal grandmother's sister and brother-in-law (both now deceased). Frank Hawthorne is not currently employed. He states he quit his job as an e-car mechanic in order to "help Winnie out of a tight spot." Mr. Hawthorne further states it is his intention to remain a full-time stay-at-home custodial adult. He appears quite confident of his ability to manage both the household and the boys, despite having had little contact with either child since Commander Kirk's return to the family farm after the Kelvin tragedy.
I have many reservations about this arrangement, not the least being that Mr. Hawthorne is a virtual stranger to the children. Therefore, I am referring this case to the child's local Washington County health department's social worker, and requesting that regular visits occur for a minimum of one year, in order to monitor the children's home environment and well-being.
With numb fingers, McCoy maneuvered through the records until he relocated the entry from the emergency room pertaining to the trauma Jim had sustained when he was twelve. The first time he'd read through it, he'd been more focused on the injuries. Now, McCoy dug deeper.
…requesting that legal contact the Riverside Police Department and ensure that assailant, Frank Hawthorne, is in custody. In addition, legal is requested to liaise with the Washington County district attorney in order to file charges against the assailant on behalf of the victim, James T. Kirk, who is currently being maintained in a medically-induced coma…
McCoy reached out blindly and grabbed his mug, took a bracing swallow of the cold coffee, wishing it were a shot of bourbon. He nearly jumped out of his skin when Jim spoke from behind him.
"Bones? Can you take this thing out of my arm? The bag is practically empty."
McCoy carefully closed Jim's medical record and brought up the chapter in his History of the Federation text that he had already read in its place, before laying the PADD aside. "Sure," he said, adopting a bland expression before rising from the chair.
When McCoy turned around, Jim was leaning against the doorway to the bedroom, holding the nearly empty IV bag in his upraised hand. His cheeks were flushed and his eyes were heavy-lidded but the pain lines around his mouth and eyes had softened. "Did you get lost in your reading?" he asked.
"What can I say?" McCoy replied, shrugging. "History of the Federation is a real page-turner."
"Apparently," Jim said, yawning. "I thought you'd be monitoring my every exhale, so I was a little surprised to wake up and find this..." He yawned, again, and the arm holding the bag began to droop.
"Let me take that," McCoy said, hastily reaching for the drained intravenous bag. Once he had it in his grasp, he gestured for Jim to move back into the bedroom. "It will be easier for me to remove the cannula if you lie down on the bed. All the supplies I need are on the bedside table."
"Okay." Once back in bed, and horizontal, Jim eyed the insertion site. "When I woke up and you weren't here, I almost took it out myself. But then I remembered what a control freak you are, and decided I'd better not. Figured you'd report me for practicing medicine without a license." He offered McCoy a crooked smile. "So, have at it, Bones."
Ten minutes later, IV cannula out and the site nearly invisible after a cycle with the dermal regenerator, McCoy settled Jim on the lumpy sofa in the living room. "Commander Pike had those delivered," he said, pointing at the waiting PADD and communicator. "According to the ensign who delivered them, they're replacements for the ones you lost when the stairwell collapsed."
Kirk nodded. "I remember having my communicator in one hand and my PADD in the other." A thin smile twisted his lips. "I was going to call you as soon as I reached the lobby, to talk about where we wanted to meet for drinks later, but…"
"But?" McCoy prompted.
"One minute, I was headed down the stairs. The next, my ears were ringing and I was falling. I don't remember dropping my stuff."
"Not surprising." He leaned over and pushed the devices within easier reach. "Pike wants you to call him."
Kirk's gaze sharpened. "Pike called you?"
"Naw. His by-the-book ensign delivered the message for him when he dropped off the devices. I can step out, if you'd like some privacy to make your call." He nodded towards the desk in the corner. "Feel free to use my comm unit."
Kirk flicked a glance at the desk unit. "Pretty rude, to chase you out of your own apartment."
McCoy shrugged. "A few turns down the hall and back won't kill me."
"That's not necessary, Bones." Jim's lips quirked. "You've already seen me naked. I don't have any secrets left for you to discover." His amused blue eyes gleamed with innocence.
McCoy snorted. "Right. Well, then, I'll just go and put some snacks together for the two of us while you make your call." He hesitated. "Call out if you feel dizzy. I won't be far."
Jim rolled his eyes. "Your desk is six feet away, not six miles. I'll be fine. Go."
"That smart mouth is going to get you in trouble one of these days," McCoy grumbled.
"Seriously? Do you listen to yourself? You sound like a cranky old fart."
"Whatever," McCoy groused, suppressing a smile, and headed to the kitchen, one ear nonetheless tuned to Jim. He heard his desk chair squeak as he opened the chill-freeze, followed by the faint sound of tapping keys. The comm unit hummed.
"Commandant Pike's office, Ensign O'Malley speaking. How may I help you."
"Cadet Kirk calling for Commandant Pike. He asked to speak with me."
"Oh, yes! One moment, please, Cadet Kirk."
McCoy smiled as he continued to slice rectangles of cheese off the block of cheddar, laying them in a neat row next to the salami rounds on the plate. He was trying to give Jim some privacy by staying out of sight in the kitchen, but it was mostly an illusion. The apartment just wasn't that big, and sound carried – the ensign's pleased relief was clearly audible.
"Jim! Thanks for getting back to me, son. How are you feeling?"
"Fine, sir. Looking forward to resuming my normal activities."
A pause. "Well, I'll concede your face looks better than it did after the Shipyard Bar fight. However, Dr. McCoy's report indicates you should be on medical leave until Monday, and then light duty for a week after that."
"That's really not necessary, sir. I'm feeling much better."
Even from the kitchen, Leonard could hear Pike's sigh. "I agreed with the recommendations Dr. McCoy submitted, and I've already forwarded notice of your restrictions to your instructors. So, there's no need to leap back in at the deep end of the pool right away. Try taking it a little easy for once."
A longer pause. "Thanks for replacing my stuff, sir."
Leonard snorted silently as he emptied a sleeve of crackers into a bowl. The kid had abruptly abandoned the topic of his health when Pike's conversation made it clear there wasn't going to be any leeway granted. The mystery was why he'd even tried. Kirk still had a significant headache; why pretend otherwise?
"Least I could do, Jim." Pike's voice sounded warm and gentle. "We've got some grateful parents who'd like to thank you in person for everything you did. Both of those cadets you extracted are going to make it. It's looking like Damarski will keep her leg, too, although she's got a few rounds of reconstructive surgery ahead of her."
"I… I did what anyone would have done. I just wish I'd gotten them freed from the rubble sooner. And that's great news about Nikki's leg."
He cleared his throat, and Leonard wondered if it was dry from a lack of fluids or from embarrassment.
"There's no need for anyone to thank me, sir. I'd prefer it if no one made a big deal about it, in case the press gets involved. I'd rather not have to deal with nosy reporters."
A longer pause, this time. "I understand," Pike said quietly. "No hugs and happy tears from strangers. I'll tell them you're shy."
McCoy rolled his eyes.
"Thank you, sir. I appreciate your willingness to run interference with Starfleet's PR department. I'm sure Commander Garfield had a nice little press gig planned with plenty of refreshments – and photographers. You know, the usual dog and pony show when the Kirk name is involved."
Pike laughed wryly. "I see you're still pissed about their last publicity stunt. Alright, Jim. I'll nix Garfield's public event but I'm afraid I can't do anything about the commendation for 'actions above and beyond' that the Academy Board will be bestowing."
Leonard pursed his lips in a silent whistle. A commendation? What-all had Kirk done on scene?
"Honestly, that's not necessary, sir. I was there. I just did what I could."
"That's a pattern with you, Jim," Pike said softly. "One I personally admire, son. Please let me know if there's anything else you need or if you receive any pushback from your instructors on the light duty restrictions. Like I said on the day you enlisted, I intend to keep a much closer eye on you this time, son. This time, there won't be anyone running interference. I'm damn sorry about losing touch, son. That won't happen again." McCoy heard him clear his throat. When Pike spoke again, his voice was firmer, more authoritative. "The commendation is non-negotiable. And well-earned, in my opinion. Now, you get some rest. We'll talk again soon."
"Yes, sir."
"And take it easy on the studying this weekend."
"I will, sir."
"See that you do. That's an order, son. Pike, out."
McCoy heard the faint hum of the connection fade to silence. Questions whirled in his head but he forced a mask of benign calm into place. If there was one thing he'd already learned about his patient, it was that Jim carefully guarded his privacy. He was adept at deflecting with a smile or a joke or a well-placed question, while his blue, blue eyes warned you to keep your distance.
Picking up the plate, McCoy headed back to the living room.
"How about something to eat?" he asked, setting the plate on the battered coffee table with a smile. "And I have lemonade or water to drink. Which would you prefer?"
There would be plenty of time later to poke more deeply into the mystery called Jim Kirk.