Title: Asclepius Revisited
Author: Still Waters
Fandom: Star Trek TOS
Disclaimer: Not mine. Just playing, with love and respect to those who brought these characters to life.
Summary: 76 McCoy episodes. 76 McCoy-centric reflections, codas, and missing scenes.
Notes: "The Menagerie, Part 1." This piece focuses around one scene early on in the episode, where McCoy comes in on Kirk, who is watching Pike on a monitor, and trying to figure out why he keeps blinking 'no.' McCoy has a short, passionate speech where he begins with "blast medicine anyway!" and proceeds to vent his frustration on modern medicine's inability to treat brain injuries. The raw emotion in those words always touched me, and made me feel like McCoy had significant experience with those injuries. The idea for Elihu McDaniels' case was the first part of this chapter to come to me. His first name comes from the grave of a young child I saw in one of the old cemeteries I explore near my current home. The subject matter got a little heavy here, but that's apparently what McCoy needed to expand. Some dialogue between Kirk and McCoy is taken directly from the episode, so if it's recognizable from the scene, it's not mine! McCoy is credited for "The Menagerie, Part 2", but does not actually appear in the episode, a fact I just discovered (IMDB failed me!)…..but I will stick to my 76 episode plan and write a little something for him anyway as the next chapter :) Thank you for your continued support, and thank you to the reviewers I am unable to personally respond to via private message. I truly appreciate you reading!
9.
Seven year old Elihu McDaniels was an artist. When Miss Jeffries told the class to go home and create a piece of art "through a bird's eyes", Elihu knew exactly what he wanted to do. With a backpack full of painting supplies, he scaled the ancient oak tree on his grandparents' farm, right up to the half-bare branch where the birds always sang. He had seen paintings where people laid on the ground and looked up, through the darkened branches and fluttering leaves, capturing that shimmering veil against the blinding sun; but he had never seen a painting from a true bird's eye view, from the bird's perch looking down the tree toward the ground…and that was what he was going to paint. Elihu figured that the birds must have loved the view from that spot if they always sat there and sang. As he reached the branch, he noticed a tiny nest with three small eggs nestled under a tuft of leaves at the far end. Excited at the chance to paint the nest as well, he moved a little closer to get a better view.
The branch cracked.
The nest tipped.
And as Elihu reached desperately for the falling eggs, he joined them in their rapid descent. The eggs shattered thirty feet down on the exposed roots and packed earth.
So did Elihu.
McCoy was the pediatric surgeon on call that day. Several tense hours in the OR later, he sat across from Mrs. McDaniels as Elihu was moved to the pediatric ICU. He told her about the broken bones, the internal bleeding, the paralysis….and about their meticulous, successful repair. Then came the massive head trauma – stopping the bleeding, removing the bone fragments, repairing the skull, decreasing the swelling, temporarily supplementing the traumatized tissue with mechanical support for basic regulation; explaining the results of the cranial scans and the meaning of the overwhelmingly darkened areas – light after light shut off forever. And then came the question, the one he always dreaded, yet the one that never failed to amaze him, that he was part of such a deep, human moment.
"Doctor, is he dying?"
McCoy swallowed back empathetic tears as his mind replaced Elihu's pale, distorted features with those of his own vibrant seven year old. He took Mrs. McDaniel's hand and broke the news, the single syllable a crushing exhalation.
"No."
And, Lord forgive him, he should have rejoiced in that word, at defying death's reach for a mother's son. The boy would live. But he would never be Elihu again. Sure, he would continue to breathe, his heart would continue to pump, his most basic reflexes would remain intact…but that was it. The brain stem was functional, but the majority of Elihu's brain, the areas that allowed him to excitedly chatter to his mother about school, to dream about starting his own art gallery, to run alongside their endlessly energetic Collie, to see and name the birds on the lawn, to hum his unique mix of old songs and spontaneous creations while painting under the sun…..they were all gone. So, yes, Elihu would live. Biologically. But would he live in any greater sense of the word? Was this truly life? McCoy had been able to treat every other physical injury, but the one that truly mattered, the brain…he could do no more for now than Elihu's great-ancestors could have done when that farm was first settled.
That night, McCoy went home, cursed modern medicine's lack of progress, hugged Johanna for a full five minutes, and banned her from ever climbing trees.
Thirteen years later, Johanna still honored that desperate, irrational order.
But modern medicine hadn't progressed.
A twenty year old Elihu McDaniels continued breathing, his heart continued pumping, his specialized bed, wheelchair, and medical staff provided him with medications to regulate what his body couldn't, with artificial nutrition for nourishment, with waste management, with therapies to prevent atrophy of muscles he couldn't consciously use, with prophylactic treatments and actions to stave off the effects of long term immobility on a body not meant for it. All while his mother looked into rolling eyes that could no longer focus or recognize, and wept for the death of the child breathing right in front of her.
And then came Christopher Pike.
And McCoy found himself ruminating anew on the continued relevance of his question from thirteen years ago.
Was this truly life?
Jim was subdued, deep in thought at the monitor, eyes only briefly shifting to McCoy's entrance before speaking. "He keeps blinking 'no.' 'No' to what?" The next question was quick, curious, confident in an answer that his first question may always lack…..yet with an almost hidden, heartbroken undercurrent in the stiff posture, the focused eyes. "How long will he live?" It wasn't a question of whether Pike was dying…..directly. Indirectly…..
McCoy's own heartbreak was palpable in the sighed response. "As long as any of us." He thought back to Elihu, to countless others whose families suffered at modern medicine's inability to advance in the one area that truly mattered; how this case was even worse, because while Elihu's higher brain function was gone, Pike's was still intact…..and the fact that they knew that, could get a wheelchair to move at his command, could create a 'yes/no' response system, but still couldn't access anything deeper…the frustration exploded. "Blast medicine anyway. We've learned to tie into every human organ in the body except one. The brain. And the brain is what life is all about. Now, that man can think any thought that we can. Love, hope, dream as much as we can, but he can't reach out, and no one can reach in!"
Jim's voice was soft, sad, uncomprehending. Ever the leader searching for a solution, he repeated, desperate to understand, "He keeps blinking 'no.'"
McCoy echoed the second half of Jim's earlier question, "No to what?" But even as he said those words, even as the same nagging gut feeling Kirk was about to propose, the one McCoy was about to vehemently deny on both emotional and genetic grounds, churned his insides, McCoy's mind choked on the sudden, obvious answer.
"'No' to what?"
He thought of Elihu. Of Mrs. McDaniels. Of hundreds of similar cases throughout his career. Of hundreds of cases he had yet to see.
"'No' to what?"
Honestly, what was there for the poor devil to not say 'no' to?
'No' to the moment that baffle plate ruptured. 'No' to the deaths of the cadets he couldn't save. 'No' to the very existence of delta rays. 'No' to what that radiation took from him. 'No' to the embarrassing, uncomfortable treatments he experienced daily. 'No' to how everyone suddenly spoke to him, not as a Fleet Captain, but as someone to be pitied, or worse, as someone who didn't understand - a child. 'No' to the complete lack of control over anything that now happened in his life. 'No' to a fully active mind having to express itself solely within the confines of 'yes' or 'no' responses, the ability to ask questions, to share insights, cruelly torn away by an invisible enemy.
And McCoy had the sinking, knowing feeling that, while in this moment, the 'no' was likely related to the Enterprise's presence…that the continued 'no's' seen in the earlier record tapes since Pike's accident went much deeper.
"They could question him for days, weeks, before stumbling upon the right thing."
"He keeps blinking 'no.'"
Because they haven't stumbled upon the right question.
Because that one question was the one nobody in medicine, completely trained against the very thought, had the guts to ask.
The one McCoy silently asked thirteen years ago at the bedside of a living child surrounded by mourners.
Was this truly life?
Biologically, the answer was 'yes.' Ethically, which Pike's brain was still fully capable of debating and processing, the answer could very well be 'no.'
His physician would then be obligated to discuss termination of treatment based on lack of quality of life, to provide comprehensive education on exactly what would happen if Pike elected that option. McCoy wondered if anyone had ever asked Pike, since the implementation of his answering system, if he wanted any of his daily treatments. Not just the choice of whether he wanted something done now or later, but if he wanted them done at all. If he wanted to continue like this in the hope of a cure coming along modern medicine's advancing horizon, or to let nature take its course as it would have before this moment in history.
The physician would have to clarify, beyond any doubt, a shift from 'no' to 'yes.' Would have to ask, "Do you understand that you will die without these treatments?" All while inwardly panicking, as the importance of honoring patient choice grated against the deep- seated training to prevent death at all costs.
And there would be no nonverbal cues in the expressionless face, no restlessness to denote uncertainty, no specific follow-up questions….just the simple, clearly objective response of a single flash of light, a solid mechanical sound. There could be no doubt if the answer was 'yes.'
That their patient was choosing death.
And the panic would surge, their own uncertainty drowning years of training and practice, ethics churning with oaths in the storms of their mind; feeling that they lost the battle even as the general declared victory in his final order. There would be no going back.
And that's why Pike's medical team didn't ask, why they wouldn't ask that 'right' question, even if they knew what it was.
Let him keep blinking 'no.'
Because if they asked…..if they offered death as an option…
Their own medical training would compel them to blink 'no.'
But McCoy's gut suddenly realized that, given the opportunity, Pike, like Elihu had he been blessed with continued cognizance as he aged, would be just as compelled to choose differently.
Because Fleet Captain Pike was a man of action. A man with a fully capable, reasoning mind. A man who, when asked if this was truly life, may say 'no.' And a man who, given the choice to let life take its natural course, to explore that new, unknown frontier as the explorer he had always been, might take it.
And blink 'yes.'