While McCoy had been briefed by Spock prior to the return of the away team, the loss of the tricorder and sheer urgency of the situation meant that he was not adequately prepared for the frank disaster that greeted him in the transporter room. Rosie, laying on the floor with Spock and Sulu kneeling beside her, was gasping for breath like she had just been pulled, drowning, from a cold lake.
A quick scan confirmed what his eyes had already told him.
"Shit; we've got a tension pneumothorax here, people!" he shouted to the two nurses who had accompanied him from sickbay. Had Rosie not been the patient, he would have taken a few seconds to point out the deviated trachea to her; he hadn't realized he had gotten so used to having her around, always following two steps behind him in cases like this. He made a mental note to remember to tell her afterwards and pushed the feelings aside. "Get that stretcher in here!"
McCoy was surprised Rosie was still conscious, what with the multiple, severe fractures and sats hovering tentatively in the low 80s.
"I've gotcha', darin'." He ran hand lightly down her battered cheek before pressing his fingers into her rapidly pulsing carotid artery. It was nothing the tricorder hadn't already told him, but he often found himself reverting to old exam techniques in a crisis. Rosie moaned slightly, her glassy blue eyes trying desperately to focus on his face through the haze of hypoxia. He took the oxygen mask and hypo offered to him by a nurse and simultaneously applied both of them to his patient. The medication took effect quickly, her muscles relaxing as unconsciousness claimed her. Once she had been transferred carefully to the gurney, he made sure the oxygen mask had remained in place; her O2 level had stabilized marginally under its effects, and he wanted to keep it that way.
"Tell Chapel I'm gonna' need an OR ready to go," he barked at whoever might be listening, and rushed her out the door.
Predictably, alarms of all sorts began to sound as soon as Rosie was placed on a biobed in medbay: low blood pressure, high heartrate, and dropping oxygen saturation.
"Dammit! Can I get a 14-guage over here?" Dr. McCoy had been hoping to skip right to a chest tube once he got to the OR but, with Rosie's unstable condition, he was being forced to perform an emergent needle decompression first.
He was handed the syringe just as the nurses and technicians finished cutting away Rosie's clothes and attaching her to an auxiliary heart monitor. A rapid but thorough swipe of antiseptic, and McCoy's practiced fingers found the second intercostal space. A younger, more inexperienced doctor would have faltered, but not Dr. McCoy. Without the least bit of hesitation he pushed the needle through skin, muscle, and pleura… and was rewarded with a hiss of escaping air. A collective sigh of relief was palpable throughout the room as their patient's vitals instantly and dramatically improved, silencing many of the warning bells that had been emitting shrilly from the display besides the bed.
"All right; show's over. These fractures are going to reduce themselves, you know. Once you get that IV placed, start her on a Tradux drip. I'll meet you...where are we set up?" The last was to Christine Chapel, who had just appeared behind the hastily drawn curtain.
"OR 1."
"…in OR 1 after I scrub in. And someone tell M'Benga he's on-call now," McCoy called back, voice echoing as he hurried away.
Spock stood perfectly still and silent outside of the room, watching the flurry of activity produced by the medical ministrations of Dr. McCoy, Nurse Chapel, and another nurse whose name he didn't know. Surgery had taken longer than expected, and he was eager to know if there would be any lasting damage from Cadet McDonald's injuries.
Luckily, it did not take too long for his presence to be noticed by the doctor, who waved Spock in when the other two left.
"Have you cleared medical?" McCoy interrogated by way of greeting.
Spock raised an eyebrow. "It would be highly illogical for me to be here otherwise."
"Damn straight; last thing this kid needs is an infection. It's going to be one hell of a recovery as it is."
"Were you unable to repair her injuries?"
"Oh, I repaired 'em all right, but this isn't something you just bounce back from, Spock."
"Doctor, in no way was I implying that McDonald would be expected to simply 'bounce back,' as you put it."
"Why are you here, Spock?" McCoy sighed.
"I should have thought that would be obvious."
"I knew it: you're feeling guilty, aren't you?" The doctor, who had been standing, arms crossed, at the foot of the bed, took the vulcan's almost imperceptible hesitation as a chance to pull up a chair and drop into it as if he had never sat before in his life.
"Dr. McCoy, I fail to see how you can mistake my concern for the health of a fellow crewmember for anything other than what it is."
"Cut the crap, Spock; it's written all over your face. If it's any consolation, if it's anyone's fault it's my own. I never should have let her go; mines are dangerous places at the best of times."
"But if we do not let her go, how will she learn?"
"Exactly." The two men fell silent, listening to the steady beeps and hums of the machinery around them and watching the rhythmic rise and fall of McDonald's chest. McCoy hauled himself back to his feet. "I'm keeping her sedated until the bone regens are done. I'll let you know when she wakes up, but I don't foresee any long-term effects. Stay as long as you like, but make sure you get some rest yourself." And, with that, he left.
Stepping closer to the bed, Spock understood what McCoy meant by not bouncing back. Even asleep, McDonald looked exhausted. She looked extraordinarily pale in the bright lights of medbay, and her skin was still littered with scratches and bruises. Tubes of various sizes ran in and out from under the covers, and an oxygen mask was still strapped securely to her face. Beneath it, her parted lips were chapped and cracked.
Spock marveled that it was possible for the already petite woman to look even smaller, almost childlike, and settled into the chair beside her bed.
She wasn't exactly sure where she was, but it was awfully white. The sheer brightness of it all hurt her eyes. Her head felt like it weighed eight tons, but she managed to turn it slightly and found a blue blur sitting beside her. Too exhausted to speak, she simply starred, intrigued by the way it seemed to occasionally double. It could have been two minutes or two hours but, at some point, the blur noticed her watching it. It unfolded itself, and she realized it was a person. It said something but she couldn't tell what, and the movement made her dizzy. She was so tired; surely the blur wouldn't mind if she rested her eyes for a few minutes…