A few hours later McCoy sat at his desk, reading Doctor M'Benga's report on Sarek, and casting a weary eye over the Vulcan Ambassador's discharge records. He had only just finished writing up his own report on Jim, but already it looked as though he was set to have another restless night.
Unfortunately the captain's condition had deteriorated again since earlier that afternoon. His temperature had been climbing steadily for the past hour, and he had now spiked a high fever. McCoy had drawn another blood sample, which Nurse Chapel was currently analysing in the lab, but the doctor didn't need to wait for the results to confirm his diagnosis – Jim had developed a bad infection. With such a serious and life threatening injury as the one he had sustained this was in itself not surprising, tests carried out prior to his surgery that afternoon had already shown that he had an elevated white cell count, but they had been pumping him full of as many high strength broad-spectrum antibiotics as McCoy had deemed safe, and he had hoped that his friend would have been spared this particular complication. He had administered some medication to try and bring Jim's fever down, and he was quite relieved that the captain was now the only patient in sickbay as he had had to lower the temperature in the room to such a degree as, he was sure, would be quite uncomfortable for most people – but their main priority now was to try and get a hold over his rising temperature, isolate the specific bacteria and get the required antibiotic into him to start to treat the infection as quickly as possible, and before anymore damage could be done. He was still on IV fluids to address the dehydration and the Chief Medical Officer had also put him on a course of strong anti-inflammatories to try and reduce the inflammation around the area of his injured lung – the last time he had checked it had seemed to be working, and with the additional aid of the respirator and two-hourly doses of tri-ox compound he seemed to be breathing a little easier.
The last remaining effects of the anaesthetic had worn off a few hours ago and his sleep was now a natural one – if not somewhat abnormally deep due to how physically weak he currently was – but from his desk McCoy could hear the captain's intermittent groans and confused mumblings. The fever was clearly unsettling him but the surgeon didn't want to risk giving him another sedative whilst his temperature was still so high.
McCoy sighed and warm ran a hand over his face – it was hard for him to accept that he had done everything he could for Jim for now. He had never wished more that there was a magical drug at his disposal, but the doctor had learnt the harsh lesson a long time ago that medical science still had its limits and there was only so much he could do – but he had also bore witness to the human body's remarkable propensity for self-healing from even the most gravest of injuries. If the eventual recovery of a patient was dependant exclusively on their will to survive he was almost certain that Jim's determination in the face of adversity would be enough to pull him through, but matters relating to the human body were rarely so simple – there were just so many things that could go wrong. Jim was fighting, but he was tired, his body was weak, and the infection which now raged within him presented him with a new battle on top of the one he was already facing. There was only so much a human body could withstand, and with the man so seriously ill McCoy wanted to keep the number of people in sickbay to a necessary minimum – rest was just as important to Jim now as the drugs they were giving hum to manage his condition, and the only way to ensure this was to keep him away from the temptation to work or ask any questions about the ship.
With Spock now also confined to his quarters that meant that command of the ship and the task of hosting the Ambassadors had now fallen to Scotty. It was a responsibility McCoy didn't envy him for – relations between the delegates felt uncomfortably tense and the atmosphere on board ship was becoming increasingly volatile. Many of the different races represented by the Babel delegation were naturally hostile and some had been at war with each other for centuries. With such extreme opposing views and conflicting priorities a fight could break out between them at any time. It took somebody with a firm but politic air of authority to keep tensions from boiling over into physical altercation.
Kirk was a natural diplomat, despite his past protestations to the contrary that he considered himself more of a solider than a negotiator. It was just one of many fine qualities that made him such a good Starfleet captain, and even Spock was able to inspire sense on occasion – logic after all so often being the cornerstone of reason – but Scotty, as skilled and knowledgeable and engineer as he was, was far more volatile in nature and hot blooded. This was a potentially explosive mix of temperaments and McCoy could only hope that the man could maintain peace aboard the ship and avoid an all-out war between the delegates – one of whom had already been murdered. With the Vulcan diplomat requiring lifesaving surgery, the Captain having been critically wounded and the First Officer also having been declared temporarily unfit for duty it had left them in a very awkward position with Starfleet and it wouldn't look good for the crew of the Enterprise for anymore blood to be shed.
A yawn escaped McCoy as he pushed his chair back from his desk and stretched, feeling the tug of several stiff muscles and rubbing his eyes wearily. He had already reached and exceeded the limits of where his stamina could continue to sustain him, and had been running on adrenaline for the past few hours. He had managed to snatch a few hours of broken sleep the evening before but the effects of exhaustion on his body were now palpable, and he knew that he was going to have to get some real rest soon if he wanted to avoid falling asleep where he sat. He would wait for the results of Jim's latest blood tests, making sure that he was hooked up to the correct course of IV antibiotics before handing over charge to Doctor M'Benga – with strict instructions that he was only to be disturbed in the event of an emergency or if Jim's condition deteriorated. The thought of being able to stretch out on the cot in his office was an appealing prospect. He hoped that nobody else would find themselves in need of his services until he could hand things over to his rank medical officer when he heard the whoosh of the sickbay doors open and close behind his heavy eyelids – which he hadn't even realised he'd closed – and he barely managed to stifle a groan of exasperation before it escaped him, feeling a knot of guilt tighten in his stomach. He opened his eyes to see that it was Mr Scott standing before him.
"Scotty." He greeted him with a smile, which was warm and friendly despite being forced, as he got stiffly to his feet and reached for the base of his back as he felt a sharp twinge – trying to massage away the ache which was starting to gnaw there. He had spent far too many hours on his feet. "What can I do for you?" He asked him.
"Doctor, I hate to bother you." The Chief Engineer sighed in his rich Scottish timbre, and looking to be at his wits end. There were a few beads of sweat glistening against his top lip and brow, which he wiped away with the palm of his hand and he looked a little red in the face. "But do you have anything for a headache?" He asked him.
"Sit down Scotty." The doctor invited him, somewhat short temperedly, although he gestured to indicate that it was a genuine offer, and the man seemed to need no second invitation as he dropped down into the chair opposite the doctor like a sack of lead. McCoy observed with a concerned frown that he looked almost as tired as he himself felt, noticing the darkened circles under his eyes as he made his way over to the cabinet where he kept a bottle of headache medicine. Turning he observed the Chief Engineer sitting with his head in his hands – the tips of his fingers gently massaging his evidently tender temples, and he hesitated – the bottle of pills clasped in his hand. The Enterprise couldn't afford to lose another commanding officer and McCoy could certainly do without another patient to worry about. The Babel delegates were certainly doing little to dispel his opinion that this latest mission and their presence on board ship was more trouble than it was worth. With a heavy sigh of his own he placed the bottle in his hand back in the cabinet and instead unlocked the door of the one next to it, reaching for a vial of medication and attaching it to a hypospray. Making his way back over to Scotty he then emptied its contents into the man's arm – the Chief Engineer didn't even flinch, but lifted his head from his hands wearily, glancing at his arm, before looking up at McCoy, who was casting a diagnostic eye over him, tricorder in hand as it hummed gently in Scotty's ear. At that moment the man really wasn't in the right frame of mind to find himself the subject of his friend's professional scrutiny, but he held his tongue and let the physician do his job.
"What was that for?" He asked him.
"It's a general painkiller." McCoy explained, placing the small devise in his hand down on his desk in from of him, evidently satisfied with his findings. Apart from being tired, hungry and mildly dehydrated there wasn't much wrong with the man that a few hours of sleep and a good meal wouldn't put right and he was sufficiently reassured that he was currently in no danger of ending up in sickbay anytime soon. "You seemed to be in need of something a little stronger, and it will last longer than any of the pills I could have given you." He told him, retaking his seat in the chair behind his desk. "I would offer you something to drink, but its inadvisable to mix alcohol with the drug I have just given you." He remarked casually. He flashed a weary smile in Scotty's direction and the man returned the gesture with a slight chuckle, which evidently made the pain in his head worse as he reached up a hand to touch his left temple with a grimace.
"That painkiller should start to take effect soon." McCoy told him sympathetically, and the engineer nodded his gratitude.
"I don't know how much more I can take from these so-called diplomats. They're more like wild beasties than Ambassadors of peace." He remarked after a moment. "All they seem interested in is fighting with each other. Its driving me mad!"
McCoy sighed. "I must admit that I will be glad when we reach Babel myself." He confessed, pinching the bridge of his nose as he felt the beginnings of a headache of his own. "At least the job of returning them back the other way isn't our responsibility." He said.
Scotty looked relieved and another small smile seemed to ripple across his lips – lingering for a few seconds – but at that moment Jim let out another whimper from the next room – this time a little louder than the others and carrying a note of considerable more distress – and his expression set serious again as McCoy got to his feet and made his way over to the door to check in his patient. Scotty remained respectfully seated.
"How is the captain doing?" He asked the doctor gravely, his tone carrying the weight of the heaviness in his own heart, and he suspected that he already knew what the answer would be – the distressed mumbling now carrying from the adjoining room testament to Kirk's condition.
McCoy shook his head, inclining it sideways with a frown as he observed his friend in the bed. He knew that there was nothing more medically he could do for him until they could identify the cause of the infection and the right antibiotic to give him, but he wished that he could at least give him something to help settle his sleep. His jaw set tight as he spoke, the strain of seeing Jim's suffering becoming apparent.
"His temperature has been climbing for the past hour and he's spiked a high fever." The surgeon explained. "He has a bad infection, but we're treating him with antibiotics."
"I'd like to see him if I can." Scotty told him, and McCoy considered this for a moment before beckoning the Chief Engineer over to stand beside him in the doorway, permitting him to see Kirk for a moment, but only from a distance.
"He's sleeping, if you can call it that." He explained unnecessarily as Scotty got to his feet and made his way over. It was hard for him to see the captain in his current condition and even though he tried to conceal it he knew that he'd been unable to disguise the look of shock on his face, as he took in the site of his superior officer from the distance of the doorway. The hum of the IV pump was audible now from this distance, as was the beeping of the monitors connected to the biobed on which he lay. Kirk's complexion was alarmingly pale, apart from the flush of pink to his cheeks, and there were beads of sweat glistening against his top lip and brow and plastering his hair to the back of his neck with trickles of sticky perspiration.
Scotty sighed.
"Oh Jim." He muttered sadly under his breath.
He rarely used the captain's name in the presence of others, as a sign of respect to his authority, and the address had also somehow become a term of endearment used even when the two of them were off duty and during informal situations. He had seen Kirk in varying states of illness and injury in the time they had served together – but not even McCoy's candid account of seriousness of Jim's condition could have prepared him for the full extent of the damage the Orian's blade had inflicted. The words had been spoken to himself, as a private expression of his personal sorrow and grief, but McCoy heard him and echoed his sentiments.
"I know Scotty." He sighed sadly. "It hurts me to see Jim like this too, but it was a bad wound and it would have been extraordinary if he'd got away without something like this happening." He explained, observing as Scotty physically started to relax – the painkiller evidently taking effect. His mind however remained troubled by what he had seen.
"How's Mr Spock?" He asked McCoy quietly – his voice hushed so as not to disturb Jim. He hadn't forgotten about the First Officer.
The doctor turned to him and nodded with a small smile – at least the Vulcan's prognosis seemed more positive.
"By M'Benga's account he appears to be improving." He told him. "I would prefer to have had him admitted so that I could monitor his condition myself, but with Jim so seriously ill I want to keep sickbay as quiet as possible, and all Spock needs is rest." He explained. "M'Benga's specialist knowledge of Vulcan physiology has been invaluable where Spock and Sarek are concerned though. Jim needs twenty-four hour monitoring, but I have been kept up to date of Spock's condition and I plan on scheduling him for a complete physical tomorrow to determine his fitness to return to duty. If he is doing as well as my most recent medical report on him indicates then he should be well enough to resume full duties in the next couple of days."
"That will be good news, for Mr Spock as much as it is for me I suspect – not that he would admit it." Scotty chuckled softly, although it came out more as a vacillating breath than a defined laugh – the humour in his tone was spurious and he lacked heart enough to keep forcing the pretence. "I can't wait to get back to my engines." He confessed – thinking how nice it was that they didn't answer him back. "I tell you, it will be grand to have Mr Spock back on the Bridge again."
McCoy watched however as the smile seemed to dissolve from the man's face. Jim shifted position uncomfortably and the engineer's gaze was immediately diverted back to the bed on which he lay as he watched him squirm and then grimace in his sleep - McCoy knew that he was still in pain, even in sleep, but there wasn't anything else he could do about it until it was time for his next dose of painkillers. When Scotty next spoke his tone was more sombre.
"I don't know how he does it." He remarked, gesturing in Kirk's direction. "The strain of it all is killing me."
"I hope that is just a turn of phrase Scotty." McCoy said with a note of good humour in his voice, although the other man could tell that he was serious. "I really can't afford anyone else getting sick right now." He told him wearily.
The engineer flashed him a final forced smile to indicate that he was indeed speaking figuratively.
"Bones…" Jim moaned weakly and McCoy quickly made his way over, taking him by the hand and giving it a gentle squeeze in a gesture of reassurance, as the captain reached out with an uncoordinated arm – the one that wasn't still restrained by the surgical support frame. The monitor above his bed recorded a sudden spike in his heartrate – he was tachycardic – and the temperature gauge indicated that his fever was climbing again.
"It's alright Jim, you're safe in sickbay. I'm here." McCoy tried to comfort his friend, whose agitation was growing. He quickly administered another hypo of corophozine and acetaminophen to try and reduce his temperature and metrazine to stabilise his heartrate.
"I'm losing the Enterprise Bones." Jim whispered – his voice catching in his throat as he spoke and a strangled noise which sounded uncharacteristically like a sob escaped him. As one of the captain's closest friends McCoy had seen him at his most vulnerable before – he had seen him sick and injured many times, and had also witnessed his heart consumed by sorrow and turned to grief. It was a privileged position he found himself in, and one which he knew was shared with only one other – Spock. He considered it an honour to call the man a friend as well as him being his commanding officer, but Jim did not usually surrender himself to his emotions so easily, even in the presence of his two best friends, and he suspected that he probably wasn't even currently aware of where he was or remember what had happened to him. "They want to take my ship away." He told McCoy weakly – only confirming the doctor's suspicions. He gasped, the air catching in his wounded chest, causing a painful sounding cough, and his head moved deliriously from one side to the other on the pillow.
There was a heart wrenching sadness in his voice as he spoke and warm tears spilled out from his eyes and trickled down his pink cheeks – mingling with the glistening patina of sweat. He was evidently in the grip of a fever induced hallucination – and whatever illusion the flames which flickered within him would have him believe it was one which turned his mind to fear and his heart to depression.
"The ship is yours Jim." McCoy did what he could to try and reassure him - hoping desperately that his words would reach him and that from somewhere beyond the veil of fever he currently resided behind a small part of him was still functional enough to understand. "There's no need to be afraid. You've been badly injured and you're fighting a pretty nasty infection. It's caused you to develop a high fever and you're probably feeling a little confused right now, but believe me Jim, the ship is safe – nobody's going to take her away from you."
McCoy only hoped that this was true – they still hadn't received confirmation from Starfleet that Kirk would be allowed to remain on board for the duration of his recovery.
"Bones… don't go… stay… please…" Jim called out, and Bones leaned in closer to him as he looked up at the screen above his bed and took another hypo, gently injecting the contents into the captain's arm. He knew it was a risk, but Kirk's vital signs indicated that he could no longer avoid administering him a sedative – his blood pressure was also spiking and this carried with it the very real danger that it could cause him to start to bleed again.
"I'm not going anywhere Jim, I promise you." He soothed as the medication started to take effect, and placing a warm and reassuring hand on the man's shoulder. "I'm going to stay right here until you fall asleep, just try to relax."
Scotty turned back into the adjoining room. He felt uncomfortable intruding on the captain when he was clearly so unwell. He had seen Kirk sick and even feverish before but never quite so seriously, and he knew that he wouldn't want anyone to see him in his current condition. Scotty knew that he would probably have been deeply embarrassed if he'd been aware of his presence, but he'd intended no disrespect when he'd requested to see him – only wishing to allay his concern. Instead he felt the knot of worry tighten in his chest. He hadn't quite allowed himself to believe it before, even having listened to Doctor McCoy's grave account of the captain's condition – but for the first time the realisation crossed his mind that Jim really might die, and it was hard to accept such a possibility.
He leaned heavily against the wall nearest the door – feeling bereft. His headache had now subsided slightly and become a dull ache on the periphery of conscious awareness. It still throbbed faintly but the pain was now bearable, and he knew that he needed to return to the Bridge. His duty was to Starfleet and the reputation of the Enterprise and her crew was now dependant on them delivering the rest of the delegates safely to the Babel conference – they couldn't afford for anything else to go wrong. More importantly however was that the captain's reputation depended on the successful completion of their mission, and he needed to see it successfully concluded for him.
He allowed himself to embrace just how tired he felt, feeling the heaviness which infiltrated his limbs, and the weariness which had burrowed deep into his very bones, just for a moment. He felt his body sag and allowed the wall behind him to take some more of his weight, as he closed his eyes slowly and longed for his bed and the comforting purr of his engines. He didn't get long to savour the moment however, as the voice of Nurse Chapel cut through the silence of the room like a knife to his brain.
"Nurse Chapel to Doctor McCoy."
The source of the sound was the communication panel on the other side of the room, and Scotty forced his eyes open as the noise distortion caused his head to start throbbing again with a renewed vengeance. The doctor quickly appeared in the doorway.
"How is he doing?" Scotty asked McCoy as he stalked past him, making an urgent beeline for the comm. He realised that he was still leaning against the wall and redistributed his weight, feeling the heaviness in his legs as he stood up. In just another couple of hours the night shift would take over and he would be able to get some sleep and rest his aching head. Most of the delegates had already retired to their quarters for the evening, and he hoped that this meant he wouldn't have to play referee to anymore boiling tensions.
"He's sleeping again." The surgeon said without even sparing him a glance – he was too focused on finding out what news Nurse Chapel had for him.
"McCoy here." He said, tapping the button on the intercom, worry masquerading as short temperedness and his tone was unnecessarily sharp, but this didn't appear to phase the young woman. She had worked with the Chief Medical Officer for long enough to know that the gruff exterior he often projected held no real meaning – the man's real substance was in his compassion and how much he really cared for the patients in his care. He was particularly close to the captain and Mr Spock, and his concern for Jim right now was as much as his friend as it was as a doctor – it was making him short tempered and easier to prickle. She understood this.
"Doctor, I've isolated the bacteria. It's Pleuratic Viripirum Perifercurlosis." She revealed.
McCoy's shoulders seemed to sag slightly and Scotty observed the look on his face – reading from the deep frown lines that this obviously wasn't good news.
"It's bad – but treatable." McCoy muttered thoughtfully – so quietly that the engineer wondered if his words were meant for Nurse Chapel or if he was talking to himself. "He'll be on antibiotics for a while." He then looked up suddenly however as though realising that the channel of communication was still open. "Thank you Nurse Chapel." He told her. "Get back up here as quickly as you can. I'll begin treatment straight away but the captain's going to need constant monitoring, at least until the fever breaks. I'll brief you and Doctor M'Benga on the next course of treatment in my office in fifteen minutes." He then punched the button to cut the connection.
"Will the captain be alright?" Scotty asked him anxiously.
"I don't know Scotty, it's quite a virulent bacteria," McCoy explained as he shook his head honestly, "but with any luck we will have caught it in time. The key in these cases is to catch things quickly, that is what makes all the difference. We acted as soon as Jim started displaying the first signs of infection, so he stands a good chance."
The engineer nodded – there really wasn't much more either man could say.
"I'll get back to the Bridge." He said, turning to leave and the sliding doors opened as they detected his approach. Before they closed behind him however McCoy stopped him.
"Hang on Scotty, before you go how's that headache feeling now?" He asked him, and the Chief Engineer turned back to face him, forcing a grin which looked far too much like a grimace to appear genuine, and he had to try to conceal a slight wince as he nodded his head.
"Oh, much better doctor, thank you. That injection you gave me was just the ticket." He lied.
McCoy couldn't be so easily fooled however and the Chief Medical Officer looked at him sceptically.
"I'd like to say I believe you," He sighed wearily, as he rubbed the back of his neck and stretched out his stiff muscles tentatively, "but I don't have time to stand around and argue. You just make sure that you come back to me if it hasn't gone away by tomorrow or if it gets any worse. This ship can't afford to lose another senior officer." He said.
"Ay, I'll do that." Scotty promised emptily. He knew that he wouldn't disturb the doctor again unless it was absolutely necessary. There was a sadness reflected on both men's faces, which not even the strained smile on the engineer's face could conceal as the door slid slowly closed behind him and he headed back towards the Bridge, whilst McCoy set to work gathering the medication Jim would need to help him fight the infection.