Rating: PG-13 for language

Disclaimer: Would love to own ST, but I just borrow the characters and try to return them intact

Thanks to Ceri for the great beta; mistakes are mine alone.


Medical emergencies were the same, Leonard McCoy decided, whether in the trauma center of Atlanta's largest hospital or millions of miles into space.

He rushed through the Enterprise corridors toward the transporter room prepared for the worst. Pike had spent over a day on the Romulan vessel in the clutches of Nero and his henchmen – more than enough time for them to inflict serious damage on the Enterprise captain. Not to mention that Jim himself could well be injured – he hadn't been in the best shape when he'd transported to the Romulan ship and a visit with the enemy probably hadn't improved his condition.

Kirk's cryptic message had only requested an immediate beam-out and for a medical team to meet them in the transporter room. No mention of the type of injuries or the severity. Or even who was hurt.

McCoy skidded into the room in time to see Pike collapse in Jim's arms. His medical team quickly took over, easing Pike onto the stretcher. No obvious injuries, but internal damage was often the worst.

Playing a scanner over the Captain's barely conscious form, McCoy barked orders as he made his assessment. He didn't need any instruments to see the man was in pain. "50 milligrams Tencefladine."

A hypo was immediately pressed against Pike's neck, reducing his heart rate and sinking him into unconsciousness. "We're gonna need neurogenic stimulators and—" McCoy frowned as his scanner locked onto a small dark shape pressed against the Captain's spine. What in the hell was that? If he didn't know better, he'd swear it was . . . the hand scanner lacked the precision of his medical bay instruments, but it sure looked like . . . some sort of a tarantula. What was that thing doing in Captain Pike's back and how in the world did it get there?

He gestured for the medtech to help roll their patient onto his side. Pushing up Pike's shirt, McCoy examined his back for evidence of an entrance wound. Nothing. Weird. But this wasn't the time or place to figure out the mystery.

"Ok, folks, let's go." He turned to the transporter tech. "Call medical and tell them to prep for surgery." McCoy looked around for his other patient, but Jim, aka Acting Captain Kirk, was long gone. If Jim was fit enough to flee the transporter room, McCoy thought, he was in a lot better shape than Pike. For now, that would have to be good enough.


The trip to the medical bay was short and once there, Pike was transferred to a biobed, stripped of his clothes, and covered with a sheet. Techs and nurses hooked up monitors and dutifully recorded the information they produced. It seemed everyone wanted to help; Pike was popular among the crew and McCoy found himself ordering several of the medical staff away from the bed to allow him room to work.

He was anxious to start what he expected would be a long and complex surgery. First, however, he needed to get a better sense of Pike's condition, starting with that thing in his back, something none of his staff had yet seen.

"Give me a shot of L1 through L3 with the hi-res," he ordered. A medtech adjusted the equipment to zoom in on Pike's lower spine. Above the bed, a detailed projection revealed that the black mass was definitely a creature, an arthropod that the sophisticated diagnostic equipment wasn't able to match to a known species. Studying the image, McCoy decided that his initial impression of an oversized tarantula wasn't far off. Suddenly the creature shifted and a tentacle stretched itself more tightly around Pike's spinal cord.

Across the bed, a gasp emerged from his nurse. "Oh, my God."

McCoy glanced sharply at her. "Collins, pull yourself together or get someone else in here." Without waiting for a response, his eyes returned to the screen. "Torrance," he summoned the medtech with a nod, "take an image and search the science library. We've got to figure what that thing is."

"Looks like he was beaten up a bit, some abdominal trauma," another technician reported after completing a full body scan, "but no serious contusions or abrasions and no entry or exit wounds."

Well, that was good news, to an extent. Still, that thing wrapped around the spinal cord was a major problem. The Romulans had put that creature in Pike's body for a reason and that meant getting it out was priority number one.

"Doctor McCoy." Nurse Collins pointed to another section of the scan. "Look at the scarring in the esophageal region."

"Damn." On the screen, McCoy traced the scarring through the digestive track. So that's how the creature had entered Pike's body. The thought made him sick to his stomach. Emergencies might be emergencies, but they sure didn't make them like this in Atlanta.

His eyes critically scanned the monitors which stubbornly refused to stabilize. Something was playing havoc with Pike's entire metabolism. Heart rate, blood pressure, temperature – Pike's values were jumping all over the place despite the medications he'd been given. The sooner that creature was out of his system, the better. It was time to get started.

"Okay, folks. I want him ready in five minutes. Collins, you and Beckworth will assist. I'll start with a posterior midline incision." He turned toward the changing room. "And make sure we have a container to hold that thing when we get it out."

As he held his hands under the Sterilite, McCoy thanked Mr. or Ms. or Dr. or whatever Cartajena-Pena – the wonderful soul who'd invented a sterilizer that did in less than fifteen seconds what used to take surgeons at least that many minutes. The tedious scrubbing with harsh brushes and abrasive soap was now relegated to the history books.

A surgeon by training, McCoy had learned and then honed his skills as a surgical resident in Jackson, Mississippi and then cleaning up gang violence in Atlanta. Not many surgeons arrived at Starfleet Academy with well over a decade of experience under their belts. Of course, not many men his age were looking to start a career in Starfleet – no, they were home with their families enjoying a suburban existence, not having their molecules scattered throughout the universe and pulling large spiders out of their patient's spines.

At Starfleet, the medicine had come easily, even on species new to him. It was all of those damned rules and regulations that drove him nuts. He could wield them to his advantage – as he'd done in sneaking Jim onto the Enterprise – but he generally found them an impediment to what he really wanted to do, which was to practice surgery and save lives. Now was his chance to do just that and on no more important patient than his commanding officer.

Across the surgical table, his two nursing assistant stood ready. The death of the Enterprise's original CMO, Dr. Puri, left him as the only physician, let alone surgeon, aboard the Enterprise. In its infinite wisdom, Starfleet saw no reason to provide more than two doctors for a crew of 500 incredibly healthy young men and women. That made perfect sense, McCoy thought, until one of those doctors was killed and the crewmen were no longer quite so healthy.

McCoy gave the monitors another glance – Pike was as stable as he was going to get. "Let's get started." Collins handed him a laser scalpel – a number six.

McCoy bit his lower lip, looked heavenward, and did his best not to groan. "I always use a five-blade to open." Of course, the laser scalpels didn't have blades, per se, but the terminology persisted. And, of course, Collins had never worked with him before, so it wasn't surprising that she didn't know his preferences. Still, the surgery would be complicated enough without having essentially to train an assistant as he went.

"I'm sorry, sir." Collins quickly placed the correct instrument in his hand.

McCoy was about to tell her not to worry about it, not to call him "sir," and about to make the lengthy incision, when suddenly the deck seemed to fall out from under him. "What the hell—" He grabbed for a handhold, scalpel flying out of his hand. He held on tightly, just like he'd been taught at the Academy – the first one's only the beginning, his instructors had said. There was a brief shudder, another jolt. More instruments went flying. Pike, firmly secured to the table, seemed to be the only one – or thing – not tossed aside.

Shit! Was the ship under attack? Having already experienced one battle with the Romulans, he didn't think so – the ship's movements felt different and, besides, there'd been no word from the bridge on expecting casualties. Speaking of the bridge, what in the world was Jim doing up there? How was McCoy supposed to stand up, let alone perform delicate neurosurgery under these conditions? For now, they still had the artificial gravity – if that went . . . . The ship rattled again and his grip on the handhold tightened. There was a Starfleet Medical protocol for this – he was sure he'd memorized it and probably practiced it more than a hundred times, but for the life of him he couldn't remember step one.

"Stability control!" Collins called out. The OR shuddered slightly then seemed to stabilize. He'd momentarily forgotten that the OR could be isolated with gravitational sensors that automatically steadied the room despite the shocks to the ship. The result wasn't perfect but it was a heck of a lot better than a few minutes ago.

"Beckworth, need a new surgical tray and find someone to clean up this mess," Collins called out. A moment ago, she'd seemed terrified and unsure of herself; now she was more in control of the situation than the ship's acting CMO.

For a moment, McCoy considered calling the bridge to tell Jim to stop shaking this ship around, then thought better of it. Jim more than anyone knew about Pike's condition – if the ship was being tossed like salad, there was obviously a good reason for it. McCoy's responsibility was his patient. Time for him to stop quaking like a scared cadet and start acting like a surgeon. Jim and the Vulcan would have to take care of the rest.