May 2256
Starfleet Academy
"Welcome to the Emergency Medical Course at Starfleet Academy," Dr. Puri stated as he paced back and forth in front of the small group of cadets who had chosen to pursue education over the summer instead of going on holidays. "This course will be fast paced as it runs from May to the end of August with only statutory holidays and weekends for breaks. It will be very, very tough."
From his seat in the back row, Jim snickered and looked at Arianne in the seat next to him, "I don't think it's really gonna be that hard," he whispered in her ear. "Puri's just messing around."
Arianne nodded, but her eyes remained focused on the front as Dr. Puri picked up a stylus from the teaching pulpit and handed it to a student in the front row, "This is to keep track of attendance and I want your real names," Dr. Puri stated cooly. "Unexcused tardiness will lose you marks."
There was a prolonged silence as a side door at the front of the classroom suddenly opened and Leonard came into the room dressed in black shoes, black pants, and a blue medical shirt with a stack of stylus shaped PADD's tucked under his arm. He walked over and stood next to Dr. Puri.
"Since the next few months will be divided into both classroom and practical work, I would now like to introduce my assistant for this class," Dr. Puri stated, shooting a glare at the snickering Jim in the back row. "Doctor McCoy may be a cadet, but he is currently ranked first in his class and was already a fully qualified MD when he became involved in Starfleet..."
Blocking out the rest of what Dr. Puri was saying, Arianne paled slightly, "Jim, I don't know if I can sit through this class," she whispered, swallowing hard. "I skipped my daily dose..."
"Cadet Kirk, is there something you'd like to share with the rest of the class?" Dr. Puri suddenly asked in a stern tone as he gazed up to where Jim and Arianne were sitting.
Arianne blushed and gazed at the PADD on her desk, "Uh, no, sir," Jim replied in a mischievous tone, giving Leonard an impish glance. "I was just wondering when we're going to do some hands-on work."
"Before you get hands-on training, Cadet Kirk, you must first learn the theories," Dr. Puri replied, giving Jim an icy look as he turned his attention to Leonard. "Doctor McCoy will be in charge of administering the preliminary exams to all students, as there will be strenuous hands-on training that will require good physical health and stamina. Following the exams, the theory portion of the class will last until July."
Swallowing hard, Leonard looked at the stylus in his hand and began listing off the names of students to receive their exams first; Arianne wasn't surprised when she and Jim were near the top of the list.
"All right, those of you whose names were read, go to Starfleet Medical with Doctor McCoy right now and I'll email the first theory notes to you all by tonight," Dr. Puri stated in a monotone voice. "The rest of you will be emailed the notes and will be required to go to the library for some research homework."
Arianne sighed and rose from her seat, "Jim, I'm not doing this," she whispered, relieved to see that Leonard was preoccupied with the other students to notice them. "It's none of his business…"
"Bones doesn't have access to your file," Jim stated in a quiet voice as he rose from his seat and tucked his academic PADD into his jacket pocket. "You're being treated for it anyway, so you won't be flagged."
Letting out a quiet sigh of relief as she watched Leonard lead the rest of the students selected for exams through a side door at the front of the class, Arianne smiled and pocketed her academic PADD.
"Let's just get this over with and then go study in the library," Arianne said, giving Jim a brave smile.
Starfleet Medical
It only took two hours for the day to go from completely wonderful to one filled with intense fear.
The walk to Starfleet Medical didn't take long, as Jim was eager to get it done so that he could do the required studying and then drag Arianne into town to be his sober buddy and keep him from fighting, as he had the unfortunate tendency to drink more than was good and then get into a fight with locals.
Almost immediately after they had arrived, Leonard had appeared out of nowhere with two orderlies and the three of them had escorted him off to an exam room, ignoring his protests; Arianne had quietly taken a seat in the foyer and studied, hoping that her required physical exam would be forgotten about.
Nearly an hour later, Jim had returned to the foyer in a slightly grouchy mood and several bruises on his neck that Arianne suspected were from the rough administration of hyposprays. At first, Arianne thought that Leonard had been fed up enough with Jim to go home and forget about any more exams, but her hopes were shattered when Leonard showed up in the foyer a few moments later ready to see her.
After making Jim promise to wait for her, Arianne had reluctantly followed Leonard into a private exam room and had laid down on the biobed to be scanned; she was silent during both that and the scan that he had done with a medical tricorder, although he had not explained why the second scan took place.
In silence, Leonard had compared the scans and then jotting something on a stylus, he had left the room in a hurry without so much as a backwards glance at her. Arianne had lay there, knowing that she had lied to Jim about her progesterone use; she hadn't taken any for a week because it made her feel sick.
Everything was suddenly cold and Arianne felt a gentle hand on her arm, "Ensign Pike, I'm gonna need you to wake up now," the soft Southern drawl that was Leonard's voice filtered into her ear.
Arianne opened her eyes and was embarrassed to realize that she had fallen asleep on the biobed in the exam room while waiting for Leonard to return, "What time is it?" she asked in a groggy voice as she sat up. "I was going to meet Jim in the library and take him off campus later tonight…"
"Ensign Pike, I'm afraid you're not going anywhere tonight," Leonard said in a solemn voice as he sat down on the edge of the bed. "The scans detected abnormal densities in your breasts…lumps."
Arianne swallowed hard, "Are they cancerous?" she asked, her voice full of fear.
"I don't know yet, but Doctor Puri and I are gonna operate and take some of the lumps out so we can see if they are cancerous," Leonard replied in a gentle tone. "A nurse is coming to take you to pre-op in a minute and it'll be a short surgery; you'll probably be back in a patient room by dinner time."
Fear filled Arianne's heart, "My father-," she began, worried that nobody would tell him about this.
"I know that your father was in Iowa, overseeing construction of the new flagship," Leonard replied in a tone that he hoped was calming. "He's in Doctor Puri's office right now, though, doing whatever work he can through videoconferencing. There's not enough time for him to see you before the biopsy."
Arianne nodded, "Someone needs to tell Jim what's going on," she said, her voice trembling.
"I took care of that just before I came in here," Leonard replied as the door slid open and a nurse came into the room carrying a patient gown. "I'll leave you in Nurse Chapel's hands and see you on the table."
Without another word, Leonard turned and left the room, leaving Arianne feeling uneasy.
"I hate when McCoy refers to me as Nurse Chapel in that tone of voice," Nurse Chapel said, smiling as she walked over to the bed and handed Arianne the gown. "I'm a second year student, but Doctor Puri insisted that nursing students work alongside the nurses during the summer term...Nurse Mora should be along shortly."
"I'm Arianne Pike," Arianne replied as she got off the bed and quickly removed her cadet uniform.
Nurse Chapel smiled, "Well, outside of the madhouse that is Starfleet Medical, I'm either known as Cadet Chapel or Christine," she stated as she took the clothes from Arianne and watched her put the gown on over her. "I'll just put these in the closet and help you do up the back of that gown."
Christine quickly hung the reds up in the closet and returned to Arianne's bedside, "If the lumps are cancerous, I don't want to have to leave the Academy," Arianne said in a small voice as Christine did up the back of the hospital gown. "I just feel very much alone right now and very scared."
Before Christine could reply, the door slid open and a nurse whom Arianne assumed was Nurse Mora entered the room carrying a med-kit, "All right, Ensign Pike, I've got strict orders to quickly prep you for surgery and get you into pre-op," Nurse Mora stated, relieved to see that Arianne was already in the hospital gown. "Nurse Chapel, help her lay down and I'll do the rest..."
As Christine helped her to lie back down, Arianne sighed; she was finally starting to feel comfortable with being in a double track at the Academy and was even beginning to consider going to cadet parties.
Now, the dreaded possibility of cancer seemed to bring all her inadequacies back to the surface and make her wonder if she was ever meant to be comfortable in life; maybe her life was meant to be horrible.
I'm so scared. Arianne thought as she stared at the ceiling in the pre-op area and ignored how cold and flimsy the gurney covering felt on the parts of her back barely covered by the loose gown. The pillow supporting her head was cold and barely fluffed; the whole situation was very overwhelming for her.
"...Honestly, Doctor Puri, you didn't do a good job of reviewing these scans," Arianne suddenly heard a gruff, yet very familiar voice snap from somewhere nearby. "...get Phlox in here...he's a better choice..."
Before she could react, Arianne felt the gurney being moved into the operating theatre, "Okay, Miss Pike, just move over to the operating bed please," the stringent voice of Nurse Mora stated. "Doctor Puri and Doctor McCoy have been temporarily delayed, but they'll be along shortly...just do as I ask, please."
Unnerved by this unexpected delay, Arianne swallowed hard and, rising, she silently moved from the gurney to the operating bed, "What happens if it's cancer?" she asked, gazing worriedly at Nurse Mora.
Nurse Mora clicked her tongue, "Now dear, don't worry about it," she replied smoothly. "Just lie down."
Arianne lay down and immediately, a surgical support frame rose up out of a side panel and covered her entire upper body, pinning her to the bed; she felt the top of her gown slide off her chest to her waist.
"All right, Puri decided to take a backseat on this one and Phlox is going to be assisting," Arianne heard Leonard say as a door slid open. "Put the patient under and get the area prepped…"
Panic flooded Arianne's mind and she suddenly whimpered, "I can't do this!" she shouted, her voice trembling as she struggled to move. "Tell everyone I'm sorry, but I really can't do this…"
"Nurse Mora, go see if Phlox is ready yet," Arianne suddenly heard Leonard say in a quieter tone.
Nurse Mora grumbled quietly, but left the room, "Okay, I'll be honest with you," Leonard said as he approached the bed and put himself in Arianne's direct line of vision. "I lied to you earlier."
Arianne must have looked confused, as Leonard sighed, "The lumps ARE cancerous and there are a lot of them in both breasts," he said in a grave tone. "My hope is that the cancer can be removed before it spreads to the rest of your body. Unfortunately, you probably will lose both breasts in surgery."
"Does anyone know?" Arianne asked in a fearful voice as she thought of the reactions her father and Jim would have upon knowing about it. "I'm not sure I want anyone else knowing right now."
Leonard sighed, "The only one other than me that knows is Phlox," he explained in an unusually gentle tone. "Now, I know you're scared, but you need to get put under so the surgery can start, okay?"
"If something goes wrong, a list of my stuff is under my bedroom pillow," Arianne replied in a soft voice that Leonard could hear was full of fear. "Make sure it gets to the people who are on the list..."
There were footsteps, "Nurse Mora's gonna give you a little medicine to relax you and then you'll be put under," Leonard stated, not wanting to discuss the fact that Arianne had mentioned a will. "Nurse Mora, if you could put her under, I'm gonna go dress and talk to Phlox...then we'll both come in."
Before Arianne could protest, she felt something being pressed against her neck that promptly let out a quiet hiss; a feeling of intense exhaustion promptly began to wear her body and mind down.
Arianne's vision began to blur and before she knew it, she had slipped into total darkness.
Chief Medical Office – Starfleet Medical – Three Hours Later
"Cancer?" Chris replied, his voice full of utter shock as he gazed at Dr. Puri, who sat behind his desk with his elbows resting on the counter and his fingers intertwined. "How is that even possible?"
Dr. Puri sighed and turned the computer screen so that Chris could see it, "As Doctor McCoy found in the scan, Arianne has been exposed to massive doses of radiation at some point in her life," Dr. Puri explained; being sure to repeat exactly what McCoy had told him after the surgery had been completed. "Any exposure to radiation can put a person at risk for cancer, even according to today's medicine."
Chris nodded, "If the surgery's over, why isn't Doctor McCoy in here explaining all of this to me?" he asked, slightly irritated about the young medical professional's absence. "This is very unusual."
"Look, Chris, I'm breaking confidentiality by even telling you about this," Dr. Puri confessed. "I know it's pretty much illegal, but I think it's important that you know…Arianne is your only child, after all."
Fighting the urge to roll his eyes, Chris glared at Dr. Puri, "I asked you a question," Chris hissed.
"McCoy's taking care of post-op stuff," Puri replied in a tired voice. "He's really good to have around."
Chris narrowed his eyes, "I heard you and McCoy had a disagreement over the diagnosis," he replied, having overheard McCoy shouting at Puri because the intercom had been on in Puri's office.
"Honestly, Chris, I had no idea that the problem was that severe until McCoy explained it," Dr. Puri replied in a voice full of awe. "For someone with aviaphobia, he sure knows a lot about effects of space radiation...I'd sure like to know how Arianne got exposed to that much radiation, though."
Before Chris, who had no answer to give, could reply, the intercom beeped, "...Doctor Puri, Captain Pike, I was wondering if you knew that Cadet Kirk is still hanging around Starfleet Medical," a timid voice spoke over the intercom. "...He's been sitting there most of the day...should I tell him to leave?"
Suddenly, the doorbell chimed, "Come in," Dr. Puri replied, letting out an annoyed sigh as he stood up.
The door slid open and Jim entered, "Look, I know it's not my business, but is Arianne okay?" he asked, the fact that he was both very tired and worried obvious in his eyes and voice.
Dr. Puri and Chris exchanged a look, "Arianne will be okay, Jim," Chris replied gently as he stood and walked over to where Jim stood. "If it's okay with Doctor Puri, maybe we can walk by the post-op area on our way out? If you saw that Arianne was okay, would you be willing to go back to your dorm?"
Jim gazed at Dr. Puri a moment before looking back at Chris and nodding, "All right then, we'll go," Chris replied gently. "After we see that Arianne is okay, I'm going to walk you back to your dorm."
Fighting the urge to bawl Chris out for allowing this disruption to take place, Dr. Puri walked over to them and gestured out the door. Giving Jim a reassuring look, Chris shepherded Jim out into the hallway.
"...It's going fine, Doctor Phlox...Just using the time to mark some papers for Doctor Puri..."
"...Be sure to get some rest before class tomorrow...Doctor Puri needs you alert..."
Nausea was the first thing that Arianne felt as the familiar voices of Phlox and Leonard filled her ears.
Sudden pain shot through Arianne's body as she opened her eyes and found that she was lying on her back, staring at the plain white ceiling that she recognized to be of the surgical recovery ward.
"I'm gonna puke," Arianne moaned, surprised by how weak she sounded. "Someone help."
Fighting the urge to swear, Leonard turned from the computer console he was working on just in time to see Arianne slowly sit up, turn her head, and puke clear liquid all over the floor. Nearby, Phlox winced.
"My chest," Arianne whispered as she placed a shaking hand on her chest. "Hurts so bad..."
Phlox quickly moved over to the bed, "Just lie back down, Arianne," he said gently as he eased Arianne back down on to the bed. "Doctor McCoy, I believe a wet facecloth would provide some relief."
Nodding, Leonard quickly replicated a small bowl of water and a cloth. He then brought it over to Arianne's bedside and set it on one of the metal portable tables within Phlox's reach.
"There now, just relax," Phlox said in a calm tone as he gently cleaned Arianne's face. "Better?"
Arianne sighed, "I'm so sleepy," she replied in a faint voice. "How did the surgery go?"
Leonard flinched, "Um, Ensign Pike, maybe you'd better rest awhile first," he said, hoping that he wouldn't have to tell her about the total mastectomy just then. "You've still got anaesthetic in your system."
"Cut the crap and tell me how the surgery went," Arianne replied in a weak, but very sharp tone.
Phlox gave Leonard a reassuring smile as he suddenly noticed Jim, Chris, and Dr. Puri walk into the viewing area of the recovery ward, "I think Doctor McCoy can take it from here," he replied gently.
"Thanks Doctor Phlox," Arianne replied groggily. "Don't work too hard, okay?"
As Phlox left the room, Leonard sighed and sat down on the stool next to the bed so that Arianne could see him without having to move, "The cancer was spread throughout both of your breasts," Leonard gently explained. "I had no choice but to remove your breasts and supporting chest muscles."
Arianne was silent for a moment, "Did the cancer spread further?" she asked, deeply concerned.
"Fortunately, no," Leonard replied softly. "You're cancer free, but you'll be tired and sore for a while."
Letting out a tired sigh, Arianne let her hand drop to her side, "I'm so tired," she stated, fighting a yawn.
"Just sleep for a while," Leonard suggested. "When you wake up again, you'll most likely be in a private room. Doctor Puri wants you to stay in the hospital for a few days so you can regain your strength."
Too exhausted to argue, Arianne mumbled something incoherent and promptly fell back asleep.
Leonard sighed and allowing Arianne to sleep, he sat back on the stool and continued marking the assignments for Dr. Puri's class the next day, fully unaware that he was being watched very closely.
While Phlox walked Jim back to the safety of the cadet dorms, Chris and Dr. Puri lingered at the window providing a view into the recovery area; with McCoy occupied, now was a good time to discuss the future.
"...Academy Command wants to meet with Cadet McCoy in July concerning his unsupervised surgery in December and continued confrontational attitude," Dr. Puri stated as he checked his PADD and gazed at Chris. "I'm really worried that he fell off the wagon since he won't follow my recommendations..."
Chris sighed, "McCoy is a good doctor and has the potential to be a wonderful Starfleet officer," he replied in a cool tone. "If he's asked to leave the Academy over minor infractions, it would be a waste of potential and I've thoroughly researched McCoy's background; he doesn't have anything else but Starfleet."
"Leonard McCoy is NOTHING like David was!" Doctor Puri argued in a slightly raised voice. "He's the exact opposite and he may be the top of his class, but his attitude and the way he carries himself-"
Relieved that the walls were soundproof and the intercom was off, Chris fought to keep his cool, "Might I also remind you, Doctor Puri, that Doctor Leonard McCoy was responsible for saving my daughter's life?" he said in a 'don't mess with me' tone. "He also saved Cadet Kirk's life back in December as you recall."
Dr. Puri flushed a deep red, but said nothing, "Yes, I agree that Leonard needs more counselling and possibly some sensitivity training as well," Chris hissed. "However, tossing a skilled doctor and potentially exemplary cadet out of the Academy over simple attitude issues is not the answer...it really isn't right."
"It's late, we can discuss this later," Dr. Puri stated in a resigned voice. "Before the meeting next month, recommendations have to be made by everyone apprised of Cadet McCoy's progress in an official capacity...I know Arianne's just had surgery, so I'll try and find a way to keep her out of this.."
Chris nodded and Dr. Puri let out a yawn, "Anyway, Chris, we'll talk later," he said. "Get some rest."
As Dr. Puri walked off, Chris turned back to the window and watched the silent scene before him continue to play out; Leonard worked quietly on several PADD's while Arianne continued to sleep peacefully.
In this case, the helped truly had become the helper and the counselor was now in need of care.
Two Days Later
Starfleet Medical – Patient Room – Late Afternoon
"Jim, let's take a break for a minute," Arianne stated in a tired voice as she sat down on the unmade hospital bed and lifted her slipper-clad feet and sweatpant clad legs on to the bed. "I'm tired."
Jim nodded and sat on the edge of the bed as Arianne placed a hand on the button-up shirt that covered the heavy bandages on her upper chest, "I'm so glad Doctor McCoy's not here to shout at me for not staying in bed," Arianne said with a sigh. "He doesn't get that moving around helps me feel better."
"Bones is just being Bones," Jim replied as he grabbed the blanket and recovered Arianne's legs. "He doesn't know that I skipped Puri's class today to hang out with you. Admiral Archer's off buried in meetings right now, so I have his place to myself...Porthos is with him, so I'm kinda scot free."
Arianne sighed and grabbed Jim's hand, "My dad's probably off at the same meetings," she replied as she pulled the blanket up her waist with her other hand. "Jim, I need you to be honest with me for a sec."
Jim looked at Arianne and nodded, "My father told me that Doctor McCoy is facing an inquiry board about whether or not he's going to be allowed to remain at the Academy," she stated. "I know that Leonard can be impulsive, brash, and very stubborn, but I don't think he should be expelled...how can I help him?"
"Bones is very stubborn, he won't even let ME help him," Jim replied. "He won't even talk to me about becoming roommates again and he barely wants to hang out anymore. Most of the time, he's either doing work for Doctor Puri, studying in the library, or just wanting to be alone...I'm kind of worried about him."
Arianne sighed, "Leonard's a grown man and capable of living the way he wants to," she replied, a slight yawn in her voice. "Jim, I think those laps around the hospital room wore me out...I need a nap."
"I can stay here until someone else comes if you want," Jim replied as he turned and looked at the mess of PADD's on the portable table in the corner. "I see that you haven't been short on visitors."
As she lay back and let her body relax, Arianne sighed, "Those are notes from Doctor Puri's class that Doctor Puri dropped off yesterday," she said in a sleepy voice. "I don't want many people knowing I'm recovering from a cancer-related surgery, Jim; it's too embarrassing to talk about in the open."
Jim sighed, "You're brave for even having to deal with this," he replied. "I'll help you with the notes later."
There was silence, so Jim turned and saw that Arianne had fallen asleep; she looked so peaceful.
For a moment, Jim silently watched Arianne sleep and was so scared to move or make any noise that he didn't hear the door slide open behind him; he jumped at suddenly feeling a hand on his shoulder.
"Bones, I thought you had class," Jim whispered as he gently released Arianne's hand and stood up.
Leonard folded his arms across his chest, "I thought you did too," he replied cooly. "You blew it off, I see."
"Arianne's like my sister, Bones," Jim stated. "I'm not going to leave her to deal with this by herself."
Scowling, Leonard gave Jim a shove towards the door, "Okay, well, Ensign Pike is a patient and obviously needs her rest," Leonard hissed. "Go catch up on the class you missed."
Jim, however, remained standing there, "Are you preparing for that meeting with the execution board you have in July?" he asked, a tone of concern in his voice. "You can't just pretend that it's not happening."
"Both Doctor Phlox and Captain Pike told me not to worry about it right now," Leonard replied in a standoffish tone. "They said just to concentrate on my TA work for Doctor Puri and my work here...Archer and Puri are out to get me, I think."
Unable to think of a reply, Jim nodded, which prompted Leonard to frown and silently leave the room; it was a time of high stress and Leonard knew that if he didn't find an outlet soon, he'd fall off the wagon.
Jim sighed and moving back over to the bed, he sat down and took Arianne's hand in his...pure peace and quiet.
Golden Gate Park – Early Evening
After ditching his cadet uniform at the dorm, Leonard found himself walking through Golden Gate Park in civilian jeans, boots, a dark t-shirt, and a jean jacket while thinking about his uncertain future.
Admiral Archer had promised that his future was secure, but Leonard knew that Doctor Puri had most likely brought the whole unsupervised surgery up again and got Archer's support to hold the meeting; Leonard knew that he shouldn't have done such a surgery without authorization, but Jim's life had been on the line and there were honestly no regrets.
"Leonard McCoy?" a voice suddenly said as Leonard found himself straying from the footpath.
Leonard looked up and saw an aged man lingering near a tree in scrub pants, a sweater, and boots; the man's face was kind and a small badge that read "Mark Piper, M.D." was clipped to his breast pocket.
For a moment, Leonard was silent and then he swallowed hard, "Hello, my name is Leonard McCoy and I need some help," he said in a toneless voice as he gazed at Dr. Piper. "I can't do this alone anymore."
Dr. Piper nodded and extended his hand, "Doctor Puri told me who you were and I looked you up in the Academy files," he explained as he and Leonard shook hands. "It's nice to finally meet you."
Leonard was silent, "Okay, why don't we go for a walk and then I can tell you what kind of a helper I am?" Dr. Piper suggested, gesturing across the park. "Then you can decide if you actually WANT my help."
Swallowing what little pride he had left, Leonard nodded and silently walked in-step with Dr. Piper as they moved across the grass; whatever happened with Starfleet, Leonard knew he needed help with himself.
As much as he wanted to ask Arianne for help, Leonard reflected as he struggled to concentrate on what Dr. Piper was saying, he knew that she was recovering and that it was best not to stress her out.
Besides, Leonard knew that nobody could help him until he learned to love himself enough to accept the love that others were offering him; he was a messed up individual with a broken past and a shaky future.
Maybe...maybe once he got to the root of himself, maybe other help would be welcome.
Little did Leonard know, however, that stubbornness and love would be the key to reaching inside and outside of himself; the future would be something he would have never thought possible...ever again.