It's not that she does not feel anything. Not like B'Elanna. She still can recall her shock at what the young woman had inflicted on her own body, and the pure disregard for her wellbeing. Which is why what she is doing is not what B'Elanna had wreaked onto herself.
She's not endangering her life. She's not receding from the living. The crew is still her sole focus. The get-them-home, her sole mantra. Day and night.

Another failed mission. Another shuttle destroyed. Another stint in sickbay.
Officially they had been allowed on the damn planet, and nobody had had the slightest inkling that the political conditions had changed so fast from under their feet. That their genial hosts would alter the rules and shoot first. That the fleeing shuttle would start to lose integrity three days before their rendezvous with Voyager because of a worn-out micro-manifold they could have replaced so easily if the trade mission had gone off without a hitch. That they would have to share one air tank from the sole spacesuit in the shuttle because they can't replicate complex lifesaving equipment without the metals and alloys they were so close to getting.

That a young man with barely twenty-two years to his life would not make it, and they would have to watch him die, terrified of the coming darkness.

It's so easy to get hurt and then miraculously be healed, ready for the next time, thanks to a very efficient and self-aware EMH. He can't do much for the dead, but he's just too good at patching up the living. He cleans up the wounds, resets broken bones, clears up the skin and lung damage from corroding gases. He makes it all go away and there she is, renewed, reborn, a blank canvas.
There are no consequences for getting shot at, pummelled by a ion storm, or succumbing to strange diseases picked up from worlds that do not care less about the safety of who is coming to their shores. Even the ship seems to know that whatever it throws at the captain, her body will bounce back, intact, immune.

Even the memory of the pain fades away. She thought she knew all about lingering pain, the kind the young man bore so bravely, if she ignores the stench of his emptied bowels and the dark tentacles of coagulated blood on the shuttle floor. Death had taken its own sweet time to come and she had stayed with him through to the unpleasant end, nursing his broken body while he coughed mucus and blood, his skin erupting in aching sores. Her presence had been worthless, though, her words of comfort hollow and pitiful in the face of overwhelming odds.

Twenty-two years. He hardly had a life, barely put his personal mark on anybody but his closest Maquis friends. They alone will remember his laugh, his kindness, his hopes.

The noises from sickbay keep her awake, mercifully.

Memories are like limpets, attaching themselves tightly to the unexpected and insignificant. She sits restless in her quarters but a smell, a sound, and she is back there, holding his bloodied hand. He stands at the edge of her consciousness, wanting in. Others crowd behind him, the deaths she's witnessed, the ones she knows only through dry, cold reports.
All of them hers. So many.

It is not fair on the dead that she would abandon them, but duties to the living rule her days. She can't afford to jump out of her skin every time the dead push against her thoughts. She'll need something to distract her from cold sweats and shaky hands when resuming her command seat on the bridge, the shift after next.

With the help of a couple of dermal regenerators modified for the task, she unravels what the EMH has spent hours erasing. A little bit at a time, the wounds come back. Ugly welts on the arms, the slash of a broken bone prodding underneath the skin, the deep gash over the stomach she suffered when the shuttle navigation console exploded.
She goes in too far and ends up in the bathtub. The water carries the blood away, while she hastily repairs the damage.
Tomorrow, she's got to lead the ship. She needs to control the when and the where the dead will manifest themselves. Nothing like B'Elanna's recklessness.

Sleep eludes her.

She's distracted all right. Whenever she presses on the wrong spot — or is it the right spot — the pain infuses her with almost sensual undertones as over-sensitive areas of her body react to the tantalizing pressure. The endless debriefings, the sombre looks from the bridge officers, and Chakotay's over-solicitous attention fall away nicely indeed.

But at the end of the shift, she can hardly function, unable to distinguish between agony and pleasure.
She feels a fraud.

She repairs her body, deleting the pain with a few sweeps of the regenerator. She can't help thinking that she's failing the dead once again. Her mind works too well at triage. With all the insensitivity of an emergency doctor, she has to deal with the living foremost. The dead take second place. Soon, there'll be nothing left of them, just a fading jumble of wretched, unreliable images, sensations, whispers.
That will not do. Not after that young man. She's discarded them, surrendered their lives to the darkness, and their deaths to the black holes of her memory.
Not anymore. She wants to remember them, a personal memento of each of the deaths she's caused. Something she can touch and see, and feel. Something which will remain with her for all times.

Armed with her medical file, she catalogues every wound, sore, contusion and concussion her body has sustained since arriving in the Delta Quadrant, and compares the dates with Voyager's official reports of enemy attacks, failed missions and other misfortunes. She can't believe the number of times she's ended up on the operating table. The Doctor has touched her more intimately than any other flesh and blood being on Voyager has done.

Shaking that unwelcome thought away, she goes back to her research.

The sound of the whistle is still ringing in her ears, as the torpedo casket leaves the cargo bay. She needs all her strength to mingle with the crowd, speaking a few words of support to those assembled to farewell the young man.
Chakotay is ever present at her side. She resents his warmth, his eyes following her. She says she's fine, once, twice, and he retreats.

One by one, she brings the injuries of the past four years back, but just the scars this time. She's had enough of unmanageable pain.

The dermal regenerator slips and the skin of her left hand puckers. Curious, she scans the other hand, uncovering the same pattern. She walks to the bathroom, and faces the mirror. Forcing the regenerator in full reverse, she watches, mesmerised, as her face reddens and melts, the damage spreading towards the scalp and shoulders. Unsettled, she stops the device before the ravaged skin stretches over her whole body.
Her medical file has no record of such extensive burns and she can't recall ever being in a fire. She ponders who might have died so she could stay alive. Finding no satisfactory answers, she quickly erases all traces of an event that never existed.

She keeps to the scars she can attach the names of dead crew members to, like invisible tattoos, while avoiding parts of the body that would show during waking hours. The EMH will be easy to silence, but no one else needs to know. B'Elanna was right on that subject, although the similarity with what she's doing stops here. She's not after the meaning of life.

The carved mementos stand proud on her pale skin. She smiles, and continues her handiwork through the night.

She is itchy, an unforeseen, faintly ridiculous side effect of the phantom wounds. The bridge crew throws puzzled looks at her, and Chakotay's frown deepens as she rubs against the lip of the ready room table and the arm of her command chair.

She wonders if B'Elanna had the same problem.

Exposing more scarred tissue on her breasts, upper arms, legs, everywhere, she forgets why she started it all. A web of thick pale lines travel slowly across her body, a map with no rhymeorreason, a Moebius strip of bad decisions.

She has not slept in five days.

The itching is getting worse. Chakotay hardly leaves her alone, and when he does, Tuvok, Paris, Neelix, they come in with a pretext, making noises that she has some rest, that the accident has badly affected the crew, that they understand how she must feel.
What do they know? She finds the dead so much easier to live with. Maybe that's what B'Elanna thought too.

There is no more room, except for the sole of her feet. The dead have deserted her, left her behind.

Her body screams.

Deck nine. She presses the door chime.

"Captain?" Worried dark eyes peer into her soul. "You look like hell."

"I need your help, B'Elanna."

Thanks to Mia Cooper for the thumbs up.