CHAPTER SIX
As McCoy had predicted, it was a rough night for both of them. He took a long swallow of coffee as he sat thinking back over the hours while waiting for the medical supplies he'd ordered to arrive.
The neuro check at 0100 had gone fairly smoothly. Kirk had, not surprisingly, reacted irritably to being awakened again so soon after falling back to sleep. And, while irritation was a normal response under such circumstances, it was also a well-known symptom of brain edema or intracranial bleeding. Kirk had been less than thrilled about the more in-depth scan McCoy had subjected him to, in order to rule out both possibilities. He'd downed the required glass of water in three large gulps and had been pretty terse answering the standard questions, proving— testily— that he was oriented x 3. But McCoy had let the less than gracious tone of the cadet's responses slide right off his back. He wasn't sure he'd personally have reacted half as well as Kirk had, all things considered. So he'd gotten Jim re-settled with a minimum of fuss, administered the hypo of analgesic, and gone back to back after updating his comm alarm.
Only to be awakened at 0240 by a sharp cry from Kirk.
Instantly awake, he had ordered the lights on and jumped out of bed.
The kid was writhing silently on the bed, white-faced and sweating, as he clutched his right calf.
McCoy grabbed the scanner but he was already sure that it would confirm his initial impression of a cramp in thegastrocnemius muscle of the leg. Or, in layman's terms, a calf cramp. From the way Kirk was reacting, this was a vicious one.
"Let me," he ordered. Brushing Kirk's hands aside, he began to firmly massage the rock-hard, knotted muscle. Kirk shoved his fist against his mouth in an attempt to stifle the guttural cries of pain escaping from his throat.
After a long minute, McCoy cursed under his breath, giving it up for a lost cause. "Sorry, kid. This is gonna require a hypo."
He quickly located the carpule of muscle relaxant in the med kit. Loading it, McCoy deftly trigged the hypospray against the taut skin of Kirk's neck, then laid it aside and resumed massaging the corded muscle. Soon, the twin assault of the medication and the pressure of his fingers began to have results. McCoy could feel the muscle gradually soften, then finally relax. He gave a last, stroking sweep of the muscle from knee to ankle, and removed his hands.
"Better?"
Kirk took a shuddering breath and nodded. "Sorry, Bones," he murmured from behind the arm he was holding over his eyes.
"Nothing to apologize for, kid," McCoy said. His gaze narrowed on Kirk, and he reached up and nudged the young man's arm away from his face. The unobstructed view had him grimacing. Kirk had bitten his lower lip— or jammed his hand so hard against his mouth that his teeth had cut through the tender flesh— leaving it bloody. The redness clashed garishly with the cadet's sweaty pallor.
"Damn it, your lip is bleeding. Hang on, kid." McCoy strode to the bathroom, where he wet a washcloth with cool water. Back in the bedroom, he detoured to his med kit, extracting the portable dermal regenerator and a pair of gloves, before returning to Kirk.
He laid the items on the bedside table and, sitting down on the edge of the bed, said, "Let me take a look."
Kirk peered up at him, his gaze miserable. "I didn't realize… I hope I didn't get any blood on the pillow."
McCoy drew on the gloves. "Not the end of the world if you did." He gently swiped a finger across Kirk's lower lip, wiping away the worst of the accumulated blood, looking for the source of the bleeding. "Doesn't look too bad, fortunately," he said, examining the small laceration. "Let's clean you up and I'll use the regen unit to repair it."
Kirk gave a little sigh of relief at the cool touch of the washcloth. When the worst of the sweat and blood had been removed, McCoy set the cloth aside and picked up the unit. "Don't move or try to talk until this finishes," he cautioned. The kid watched him work from beneath heavy lids, lying quietly as the regenerator hummed. When it cycled off, Kirk cautiously touched his tongue to the now unbroken skin.
"Thanks, Bones."
McCoy studied him for a long moment. "You're welcome, kid."
"Jim."
He laid the regen unit aside. "Fine. Jim it is."
The new accord hadn't lasted long. Thinking he was cutting the kid— Jim— a break, McCoy had considered their previous exchanges an adequate substitution for the orientation questions. But when he had tried to check Jim's pupils, the kid had knocked the penlight away, grumbling that he was tired, that the light hurt his eyes, that he was fine, that McCoy was fussing like an old woman….
"Too damn bad. Shut up and suck it up, cadet. This exam is not optional."
And Jim had obeyed, jaw clenched, stoically enduring McCoy's examination of his eyes.
But when McCoy left and returned with the metabolic milkshake, Jim had balked.
McCoy took another sip of coffee, smiling crookedly as he remembered how much Kirk had resembled a mutinous five-year-old refusing to take his medicine.
"Listen, kid. If you don't want a repeat of that leg cramp, you'll drink this. Your electrolyte levels are depleted and your muscles aren't very happy about it. You think your calf is the only muscle in your body? Your heart's a muscle, too, kid. Just imagine how'll you'll feel if it, or any number of the other muscles in your body, decides to put up a protest in order to get your attention. Plus you're on the borderline of being dehydrated."
He'd been quite proud of that little speech, especially since it had resulted in Jim reluctantly reaching for the glass.
The rest of the time until the 0500 alarm had been mercifully uneventful. McCoy had managed to make the exam a veritable model of efficiency; by 0508, Jim was horizontal again, checked, watered and hypoed with another dose of analgesic. By 0510, still riding the muscle relaxant, his breathing had taken on the rhythm of sleep.
One ear alert for any signs of distress, McCoy had dozed until 0600, when he had slipped out of bed for good. He'd showered and shaved. Padding out to the kitchen on bare feet, he'd quietly made coffee and, once it was done, poured a mugful. He'd taken it to his chair in the living room, settled in and, between sips, made his plans for the day.
The mug was almost empty when he heard the soft rap on the door. Pleased that the individual making the delivery had followed his instructions to knock instead of ringing, he set his coffee aside and hurried to the door.
"Morning, Dr. McCoy," the young woman chirped when he opened the door and invited her inside. "Supplies from Starfleet General for you. You'll need to sign the requisition," she said, handing him a PADD.
"Do I know you? Your face looks familiar."
"Agnes Santiago, sir. PhD Pharmacology student. My wife is in her first year of residency. Orthopedics. We live on the sixth floor, and we've shared the elevator a couple of times."
McCoy nodded as he affixed his signature to the PADD, exchanging it for the holdall. "Thanks for bringing these over. I'm sorry they had to press you into courier duty."
"Honestly, it wasn't a problem," she assured him. "I spent the night in my research lab and was on my home to have breakfast with Gabby, so it just made sense for me to drop these off and save someone else the trip." She gave him a bright smile, looking entirely too energetic for someone who had been up all night. "Have a nice day, Dr. McCoy."
"You, too, Ms. Santiago."
He held the door for her as she left, as his mama had taught him to do for a lady, and saw a cart slowly weaving its way in his direction down the hallway. McCoy remained in the open doorway, watching as Agnes stepped briskly past the cart, giving it a wide berth, on her way back to the elevators. As the heavily loaded cart drew near, he saw that his hunch had been correct: it was the grocery delivery.
"Thanks for coming so early. Just set everything on the counter in the kitchen," he ordered. "And try to keep the noise down. I've got a patient sleeping in the bedroom."
"Wondered why you were ordering so much food," the young man said, and began ferrying bags to the kitchen with brisk efficiency.
"Your regular order is usually a lot smaller. This is the biggest delivery today, so I wanted to get it out of the way before the elevators got busy." After several back-and-forth trips, the young man plunked the last bag down on the now-crowded counter and, turning, shot him a cheeky grin. "Hope it all fits in your cool-freeze, sir," he said, and loped energetically through the open door past McCoy.
Was everyone trying to make him feel tired? Shaking his head, McCoy quietly shut the door and headed to the kitchen to start the task of putting away the groceries.
McCoy thumbed the scanner off and laid the device aside.
The results were largely reassuring. Kirk's cranial inflammation and edema were resolving nicely, thanks to the Gafronil. The cadet's pain levels were down, too, although, according to the readout, his headache was still present. McCoy had a feeling he was going to have to keep a sharp eye on the kid. Kirk could easily stir things up with injudicious levels of physical activity.
The most concerning finding was Kirk's depleted mineral and electrolyte levels and the cadet's growing dehydration. The metabolic drinks had staved off the worst of the possible complications from the regen therapy but the kid's body was crying out for fluids and food, hence the vicious, middle-of-the-night leg cramp.
Kirk was about to become very unhappy with him….
McCoy laid out the prepped items, placed the brick-shaped, portable antigrav hook on the wall above the bed, and hung the bag of intravenous fluids on it, the solution enhanced with replacement electrolytes and minerals. He ran the air out of the IV line and capped it, allowing the tubing to dangle down next to Jim's pillow, where he could easily grab it once he'd inserted the catheter needle.
He grasped Kirk's shoulder and shook it gently. "Jim? Time to wake up."
The long, scrub-clad body stirred, and McCoy was rewarded with the sight of heavy-lidded blue eyes. "Bones?" Jim said huskily, in a tone halfway between recognition and uncertainty.
"That's right."
"Time for more questions?"
"Yes, and a few other things." McCoy picked up the penlight. "You know the drill, so start talking."
"James T. Kirk," the kid intoned wearily, his voice rough.
McCoy flicked the beam of the penlight into each eye.
"October twelfth— no, wait." Kirk darted a quick look at the nearby window. "It's light outside, so it's morning. Which makes it October thirteenth, right?"
McCoy grunted and set the penlight aside. "Your pupils are reacting normally, which is good news because you're now officially over the twelve-hour post-injury hump. Neuro checks can be done every four hours now, instead of two. How's the headache?"
"Fine. What time is it?"
"0735. Keep going, you're on a roll."
Kirk yawned and cautiously stretched. "I'm in Room 4142 in Bondar Hall. I'm in your dorm room, your bedroom to be precise." He smiled sleepily. "Told you I had a good memory, Bones."
"So you did," McCoy said. He picked up the tourniquet. "I need your left arm."
"What? Why?" Kirk asked, eyeing him warily.
"I'm going to start an IV. You need fluids and electrolytes."
Kirk began to push himself up in bed, wincing as he did. "I can drink. Bring me some water, Bones. Even one of those awful shakes. I don't need an IV."
"Kid, you need more than that flat belly of yours is going to comfortably hold." McCoy sighed. "Listen to me, Jim. You haven't urinated since the accident, which was over fourteen hours ago. I know that your muscles are tender and sore, because your pain levels spike when you move. Your body is literally running on empty." He shrugged. "If you prefer, I can have you transferred back to the ER for treatment. Or you can let me start the IV and give you a couple of liters of fluids. Once they're onboard, you can get up, take a shower, and have some breakfast. Then you can go back to bed and I'll hang two more while you sleep. It's your choice." McCoy allowed the silence to play out, counting on Jim's dislike of hospitals to tip the balance in his favor.
"Fine. You win."
"Smart decision. Now, give me your arm."
The process was so ingrained, McCoy barely had to think about it, even without the assistance of an autostart device. He was aware of the kid's gaze following his hands as he applied the tourniquet and disinfected the site. Kirk's lack of body fat made it easy to find a suitable vein. "This will pinch a little," he warned, his fingers poised to make the insertion into the distended vein.
Kirk didn't react when he deftly inserted the needle and threaded the cannula into the vein. He attached the prepared syringe of normal saline to the hub and drew back on the plunger, testing for patency. Blood immediately flowed into the syringe, staining the salt solution red. McCoy adjusted his grip on the syringe and reversed the pressure on the plunger, flushing the cannula. With a deft twist, he detached the syringe, hooked the intravenous tubing to the port hub, and taped everything in place.
"All done," he said, standing. The entire process had taken less than a minute. "How about something to drink before you go back to sleep?"
"I smell coffee. How about some of that? Black."
McCoy snorted. "Not a chance. Not today anyway. Maybe tomorrow."
"Well, if coffee is off the menu, water is fine." Kirk glanced at the tubing attached to his arm. "How long is all this going to take? I'd really like to have that shower you offered. My scalp itches."
The kid was likely feeling sore and grubby and, no doubt, a hot shower sounded enticing. McCoy sympathized, but the treatment of Kirk's metabolic deficits was the primary concern. "These first two bags should finish up around 0900. Like I said, once they're in, I'll do a scan and, if things have improved, I'll help you shower."
Kirk grimaced. "No need to play nurse, Bones. I'll be fine on my own."
"We'll see."
"What about this?" Kirk asked, lifting his arm with the IV. "Will you have to take it out and restart it again afterwards?"
"It won't be a problem. Don't worry about it."
Kirk sighed and closed his eyes. "Okay, Bones. Whatever you say."
"Don't fall asleep before I get back with your water," McCoy ordered gruffly.
Jim hummed low in his throat in acknowledgement, his eyes dark-shadowed in his pale, fatigue-drawn face.
Even as McCoy strode briskly to the kitchen, filled a clean glass with water, and hurried back to the bedroom, he knew he was fighting a losing cause.
Sure enough, Jim was sound asleep when he returned.
