Chapter 4

Spock was on the bridge. Kirk had been in surgery for two hours now, and still there'd been no word from either Nurse Chapel or McCoy. He'd kept the ship running normally in his usual efficient way, but those of the crew who worked closely with the Captain were struggling to keep their mind on their work, and the atmosphere on the bridge was particularly tense. Spock kept on feeling Uhura's eyes on him, making the hair stand up on the back of his neck, and Scotty had been comming him every twenty minutes for the past hour, wanting to know if he'd heard anything from sickbay yet. As he hadn't the constant interruptions from the Chief Engineer were becoming wearing. Regardless of his own personal feelings about his friend he had a job to do. They couldn't just leave the Enterprise suspended in space indefinitely – it made the ship too vulnerable to attack. He did his best to keep their focus on the job, by reminding them of the sacrifices the Captain had made for his ship and its crew. He tried to remind them that he would want them to continue on with their mission and therefore the best thing they could do was to keep things as normal as possible. He couldn't honestly deny the existence of the worry within his own heart, but he had a choice, he could either embrace it, as humans so often did, and let it overwhelm him, or choose to supress it – and worrying wasn't an efficient use of his energy.

Meanwhile in sickbay McCoy was in the process of closing Jim's chest incision. The first part of the surgery had taken longer than he's anticipated. There was a lot of internal inflammation and swelling and he'd needed to flush the cavity around his injured lung, and had double checked the repair he'd made the previous evening. To his relief there hadn't been any further bleeding, but it was the severity of the inflammation which was causing him additional pain and making it difficult for him to breathe. McCoy had asked Nurse Chapel to put in a request for IV anti-inflammatories to be brought up from the medical store.

Jim had to be re-draped before he could examine his abdomen. It was necessary for them to dispose of the first sterile field and replace the old drapes with new ones to prevent the spread of infection from one surgical site to another. Whilst Nurse Chapel was doing this McCoy took the opportunity to take another look at the results of Jim's abdominal scan. It showed a significant amount of inflammation around his spleen and the surrounding tissue, suggesting he'd sustained an injury to his stomach during his confrontation with the Andorian impostor. It showed a small tear to the splenic capsule, and a resulting slow leakage of blood into the space surrounding the organ. General stats taken showed that he had a slight fever, his white cell count was also raised – a sign of infection – and his blood pressure was low – a result of the internal bleeding.

McCoy sighed, stripping his bloody gloves off, and disposing of them in the nearest bio-hazard bin. He rubbed a hand over his tired eyes and pinched the bridge of his nose. He couldn't understand how the abdominal trauma had previously been missed. It hadn't been flagged up during his initial examination – early tri-corder readings hadn't shown up anything to suggest that Jim had sustained anything further to the chest wound. Jim had sustained extensive bruising during the attack, along with a few superficial abrasions – in particular defence wounds to his arms and cuts to his torso – but the greatest cause of concern and therefore the biggest priority had been the penetrating injury to his back. It was possible that they'd missed something important in their haste to get him to the sickbay – where McCoy had been forced to perform emergency surgery – but he suspected it much more likely that Kirk had sustained further internal damage during the attack on the bridge. The rupture to his spleen was a relatively recent injury, and the blood loss he'd incurred as a result not serious enough to have been going on any longer than the past couple of hours – besides that Jim had only just started to complain of abdominal pain.

McCoy let his mind wander – his thoughts drifting back to the events of the day before. He was still secretly berating himself for letting Jim return to the bridge. Whilst it was true that Sarek hadn't stood a chance at life without the blood transfusion from Spock it was never acceptable, in his eyes, to allow the trade of one life for another. Any risk one person was willing to take to save the life of another had to be carefully considered, to make sure their life wouldn't be put at risk as a result. Jim's injuries had already been life threatening, he'd been vulnerable to massive spontaneous bleeding. In sickbay he could be closely monitored, and any treatment quickly administered. McCoy had been torn, but Spock was stubborn and he'd made it quite clear that he couldn't hand command over to Scotty under the circumstances. On the other hand it hadn't been part of the plan for Jim to remain on the bridge once Spock was clear, but the ship had been at risk and its crew in danger. McCoy had known that Jim's track record where matters concerning his health were concerned wasn't good. He would attend sickbay for painkillers to treat a simple headache, but neglect a case of the flu until it turned into raging double pneumonia, and it sometimes seemed as though the more serious the illness or injury the more he seemed to think he could simply push through the pain – McCoy was beginning to wish he'd paid closer attention to his instincts.

"Just take it easy Jim." McCoy advised as they made their way slowly from sickbay to the bridge. He'd given him some IV fluids and pumped him full of as many high strength painkillers as he'd deemed safe, but the man was evidently still uncomfortable. The drugs had numbed the pain in his chest until it was little more than a dull ache but little could be done for the thickness of the air in his lungs. His condition was unstable and McCoy knew that it wouldn't take much to cause him to start to bleed again. Jim was having trouble breathing, and it was becoming increasingly evident that he was a lot weaker than he'd initially made out – far too weak to be out of bed. He needed rest, and under normal circumstances he'd have kept him under enforced sedation to ensure that he received it. He was going against every instinct he had as both an experienced surgeon and Jim's friend, but these were unprecedented circumstances, a man's life was at stake – and not just any man, this was Spock's father. McCoy inwardly cursed the stubbornness of the Vulcan – if he would only hand over command to Scotty there would be no need for Jim to risk his life like this. As soon as the operation was over and Sarek as out of danger he resolved to go straight to his quarters with a full medical team and have the Captain brought straight back to sickbay.

Judging by the sound of his breathing he already suspected that he would probably require further surgery, but he would need more detailed chest imaging to be sure of how to proceed with his treatment.

"Jim, I'm concerned about your breathing." He frowned – compelled to raise his concerns. "It doesn't sound right. Do you have any tightness in your chest at all?" He asked him.

Kirk shook his head – but McCoy suspected that this was probably a lie. The Captain could feel his friend's eyes on him, and he knew that he was intentionally remaining close by. He found it reassuring. His legs felt like water and he realised that McCoy would have recognised how weak and exhausted he was. He was watching him intently, taking in his awkward gate, the way and speed at which he walked, and his rigid posture. He observed the pain on his face with every step he took and readied himself to steady him in the event that he stumbled or fell.

Beneath the fresh uniform shirt Nurse Chapel had fetched him from his quarters Kirk's chest was swathed in bandages. A few crew members – predominantly red shirts who worked in the lower recesses of the ship – smiled at him as he passed them and he forced himself to smile back at them. He was doing a pretty good job of keeping up the pretence of normality but he was evidently finding it a strain. They'd made it halfway up the corridor when his vision suddenly blurred and sharp pain surged through his chest. He swayed and immediately felt Bones' hand on the small of his back, steadying him, as he gasped and clutched at his painful side.

"You alright Jim?" McCoy asked him. Unable to form words in that moment Kirk simply nodded. Pale as he was, and the sweat dripping from him his struggle was evident. "You know I'm really not sure this is a good idea." He told him. Kirk's body wasn't responding well to the physical exertion, and he doubted he'd be able to keep going for much longer. "You're too weak Jim." He told him, but Kirk shook his head.

"I'm alright." The Captain assured him, rather unconvincingly. He finally managed to remove his hand from his injured chest as the pain receded. It took a few more seconds for him to regain control over his breathing though.

"Sarek needs that operation Bones." He huffed the words out of himself – his chest rattling slightly. "You said so yourself, this is the only way."

McCoy didn't know how but somehow they made it to the elevator shaft – he hadn't thought Kirk would, half expecting him to collapse in the hallway, but his will was strong – stronger than his body. As they stepped inside he ran his hand-held scanner over his friend before flipping the switch for the bridge. Jim's face glistened with tiny beads of sweat and if his vitals had been less than ideal before they were now so low as to cause McCoy significant concern – although not yet life threatening. His blood pressure was on the low side, despite the physical exertion – so the doctor reasoned that at the very least he was likely to be experiencing some dizziness, and it was fair to assume that he'd stumbled before because he'd been light headed. His heartrate was already irregular, and his pulse was weak and thready. He realised that nothing he said would convince Jim to abandon his plan and return with him to the sickbay, and although he was putting his health on the line his life wasn't currently in enough immediate danger to override his authority as Captain – but if they were to succeed something had to be done to stabilise his condition otherwise the chances were he could lose consciousness on the bridge before they'd even had the chance to convince Spock to leave. Before the elevator could reach its final destination the doctor prepared another hypo-spray and injected it into Jim's arm.

He flinched, and McCoy suspected that he was probably beginning to bruise after the unprecedented amount of injections he'd received.

"What was that one for?" Kirk asked him, still somewhat breathlessly, and in that moment McCoy wished they were both back in sickbay so he could get a respirator mask on him – he hated to see him struggling and suffering like this, and he hated himself for agreeing to go along with such a ridiculous plan. If Spock was so cold hearted as to allow his own father to die then he didn't see why Jim should have to be the one to risk everything to try and rectify the situation he'd created – it wasn't fair. On the other hand he wasn't going to let Sarek die because of sheer Vulcan pig-headedness. He felt so torn.

"Something to help with your breathing Jim." He told him. "Obviously your current difficulty is being caused by the damage to your lung, so there is only so much I can do for now, but this should keep you going for just long enough to get Spock off the bridge. After that you must retire to your quarters – Jim I can't emphasize this enough. If you start to bleed again away from sickbay there is no guarantee I could get to you in time."

He was doing everything he could to impress upon him the importance that he take his condition seriously – because he didn't entirely trust that he would. A serious internal bleed would constitute a medical emergency. In sickbay they had machines and scanners to monitor him and drugs to keep his condition stable – but without all that he was vulnerable.

"I haven't really certified you fit." He reminded him. "I'm only going along with this because without that operation Sarek will die, and as much as I don't agree with that pointy eared hobgoblin, or understand what motivates him half the time, I don't want him to have that on his conscience for the rest of his life. I'm very worried about you though Jim. What you are doing is placing a tremendous amount of strain on your heart and cardiovascular system, and your breathing has already been compromised."

Kirk nodded. "I know Bones. I'll be sensible." He promised him. The truth was that he didn't have to be told how ill he was – he could feel it. He'd been relatively lucky in combat so far, and even luckier with his health. He was certainly no stranger to pain – but nothing he'd ever experienced in his life before had ever compared to this. It was strange – he'd thought the Andorian had simply landed a particularly heavy punch at first, winding him. It had taken him a few seconds to realise that he'd been stabbed, and even then he'd been surprised by how little it had hurt him initially.

Now that the adrenaline had worn off, even with the strong painkillers in his system, it was a very different story however. His body didn't feel like his own anymore.

He could feel Bones' eyes on him as the elevator reached the bridge. The door opened and he could see the figure of his Vulcan friend sitting in the Captain's chair. The doctor continued to watch him closely as he approached his First Officer, waking stiffly and evidently in pain. Spock wasn't stupid – very far from it. He could see that his Captain wasn't well. He could see that he clearly wasn't fit to be outside of sickbay. It was going to take everything Jim had left to give of himself – every last ounce of his strength – to convince his friend that he really was fit to resume his command. McCoy watched him struggle to maintain his façade, under the scrutiny of the Vulcan's suspicious gaze, until he himself felt compelled to intercede.

"I've certified him physically fit Mr Spock." He growled. "Now since I have an operation to perform and both of us are required…"

"Get out of here Spock." Kirk told him, taking advantage of the doctor's support – although McCoy noticed that his smile was a little too broad to appear genuine. Spock still seemed unconvinced and it nearly gave the game away.

That he finally succeeded in convincing Spock to leave the bridge with the doctor was a true testament to the strength of his character. That he would eventually succumb to his injuries would prove a harsh reminder to him that he was still human – bringing him face to face with his own mortality.

"Doctor, I've finished with the Captain if you want to examine him." Nurse Chapel said, pulling McCoy from his reverie. He looked at her, and then across at the operating table. The raw, pink flesh of the incision in Jim's chest was now hidden by the fresh sterile drapes, his abdomen was now exposed. Unconscious he looked so vulnerable – no longer in control, but his life now in the hands of medical science. It was not how McCoy was used to seeing him, but as a doctor he knew that all humans were fragile no matter how strong they appeared to be.

They were all made up of the same blood, bone and soft tissue, and all too easily affected by illness or injury.

"Thank you nurse." He nodded his acknowledgement, putting down the tricorder. "I'd better scrub up again." He said, indicating his bare hands. "Then we'd better take a look at what's going on inside his abdomen. I just hope the damage isn't too extensive." He sighed, as he disappeared into the adjoining room.