A/N: I have decided to re-upload this story, after editing each chapter in order to tie in more closely with Lead Me To Your Door, which is meant to be a sequel of sorts. It was my first fanfic ever, and it needed a little reworking. So...enjoy! Comments appreciated.
"Give me a break, Bones. I'm busy here." The voice was scratchy and low, as if it were painful for him to talk. "Acting Captain, remember?"
McCoy grunted. The little shit is trying to pull rank already. "Well, you're probably familiar with the regulations stating that the Captain's health is the CMO's number one priority. I want to check you over and make sure you don't collapse on the job, Acting Captain. Captain Pike is out of surgery and stable, and now it's your turn, kid."
McCoy could hear the tension in his tone. "Just give me an hour, alright?" He paused. "I'll be there as soon as I can. Kirk out."
McCoy sighed. He wasn't surprised that Jim was avoiding him, but dammit, he was too tired to wait around for him much longer. Briefly, he considered lying down and grabbing a quick nap; but given the state he was in, he doubted that a fifteen-minute nap, or even an hour-long rest, would leave him better able to function. Probably make him feel worse, he thought. Better to wait until he could really sleep for at least a four-hour stretch.
Jim hated doctors. He viewed them with a deep distrust that McCoy had never understood. Even his quarterly physicals were a source of stress for him, let alone treatment of any serious injury. More than once, over the course of the past three years, he wound up treating Jim himself, patching him up after one of his stunts of bravado, using supplies filched from the teaching hospital where he worked. No amount of persuasion would convince Jim to go to the Academy Clinic, and McCoy would always cave in and treat him, against his better judgment.
"It's nothing, Bones. I just wanna get to sleep… I'll let you take care of it in the morning, I swear. It doesn't even hurt. Uh, not much, anyway."
"Don't lie. Your eye is going to be so swollen by morning that you won't be able to open it. And you're bleeding all over the rug. Just shut up and let me look at it."
"Doctors think they know everything. It's my body, remember?"
"Stop acting like such a child. I'm a doctor, and I'm telling you that if you don't clean out that cut, it'll get infected and it would serve you right if you lost your arm to gangrene."
"You'd never let that happen, Bones."
It had never really been a point of concern or contention between them. Plenty of people hated going to the doctor. McCoy himself had what he considered a healthy distrust of doctors in general; he knew his fair share of incompetent jackasses with the diagnostic skills of a teenage paramedic.
But being Jim's Acting Chief Medical Officer, even for a few days, changed the status quo. Jim was hiding injuries that needed treatment, for whatever screwed-up reason, and McCoy was going to have to insist that he behave responsibly. He had witnessed the horrific scene on the Bridge, eight hours earlier, when Jim had provoked Spock into attacking him. He was nearly strangled before Spock's father intervened; no doubt that explained the fact that he could barely speak above a whisper.
McCoy hadn't had a chance to do more than glance at him later, when he returned from the Romulan ship and handed a wounded Pike over to him. As far as he could see in that brief look, Jim had looked suspiciously battered and bruised, though clearly pumped up on adrenaline, moving fast. And then for the next four hours, as he was busy with Pike's surgery and care, Jim's condition hadn't been his top priority.
He flopped into the chair next to his desk. "His" desk – it was strange to accept that it was actually his office now, adorned with the words "Chief Medical Officer" next to the entrance. He'd barely known the former CMO, Dr. Puri, and didn't grieve for him personally, but some of the medical staff had been working with him for years and were still reeling from his sudden death during the first blast from Nero's ship.
Hell of a way to get a promotion.
He was comfortable shouldering the medical and administrative responsibilities of CMO; he might still be a cadet with a bad case of aviophobia, but he'd had a career before signing up with Starfleet, and was no stranger to positions of medical authority.
He tried to ignore the uncomfortable clench in the pit of his stomach that kept reminding him that he was liable to be demoted and grounded, if not shipped off to some remote Deep Space Station in need of a doctor, when they got back to the Academy. Come to think of it, Kirk was still officially suspended. He sighed again. Pike tended to be a rules-and-regs kind of guy, in McCoy's limited experience—which, admittedly, boiled down to a stern welcome lecture he'd given as Commandant of Cadets and an impressively icy reprimand he'd seen Pike give Jim after his second Kobayashi Maru fiasco. Jim was a quintessentially sore loser.
Well, Pike won't be giving any more reprimands for a while.
He stretched his arms behind him until he was rewarded with a series of satisfying clicks from his spine. Then he reached toward the wall behind him, took the bottle of brandy off the shelf (Puri's private stock, but he didn't think he'd mind) and poured himself a small glass. There was only Jim's checkup to get through before he could rest; he could allow himself to relax, just a little.
Turning toward the computer console, he said quietly, "Medical monitor, Christopher Pike." Immediately, the screen displayed the assortment of readouts of Pike's bodily functions that were currently showing on the monitor over the head of his bed in the Medical Bay. Pike was still unconscious, although the effects of the surgical anesthesia were beginning to wear off. McCoy was more than a little concerned about the lack of nerve response around the lower spinal cord, where the alien creature had lodged. Pike needed complex, immediate treatment for neural regeneration; the facilities on the Enterprise were not as comprehensive as he'd like.
He wondered how long it would take them to return to Earth—he'd heard a wild rumor about Jim ordering the crazy Scottish engineer to jettison the warp core, but that was so patently ridiculous that he assumed the truth had to be much more banal. Maybe Jim had ordered the engineer to deploy some torpedoes, or jettison some equipment. Did that even make sense? This was a starship, not a sinking ship, and God, he was really tired.
Recalling the next issue to be dealt with, he muttered, "Medical file review, James Kirk." Prior to beginning treatment of whatever was wrong with Jim, he thought he'd familiarize himself with his medical history again. Given the severe allergic reaction that he'd witnessed that morning, he didn't want to take the chance of letting any detail, no matter how minor, slip his mind. Wonder what caused that reaction, he thought. Better note it in his file, at any rate.
He was so tired, really exhausted; he hadn't gotten any real rest for almost two days.
He scanned the file quickly, not really paying attention. He'd seen the information before. After a truly remarkable number of early childhood hospitalizations for allergic reactions, Jim had been hospitalized a number of times in his early teens, treated for assorted lacerations, minor injuries, and broken bones—including a broken jaw, ruptured spleen, fractured skull, and concussion when he was 13. He could just imagine what kind of daredevil stunt led to those injuries.
I played a little rough when I was a kid, Jim had told him once, after McCoy saw his file for the first time. I guess I was a little accident-prone.
You still are, idiot. For Christmas I'm getting you your own portable dermal regenerator.
Thanks tons, Jim retorted. I'm getting you your own flight simulator.
In his teen years, the medical history became surprisingly sketchy, as if Kirk had enjoyed near-perfect health since then. Knowing Jim, though, McCoy guessed that it was more likely that he'd just stayed away from doctors. From what he'd observed at the Academy, Jim still attracted trouble like a magnet.
McCoy frowned, staring at the small blue icon blinking at the bottom of the screen. "Confidential psychological profile, as yet unread by Chief Medical Officer," prompted the computer helpfully in a melodic female voice. "Would you like to review it at this time?"
I'll be damned. Maybe there were advantages to being CMO after all, McCoy thought.
He'd seen Jim's medical file several times over the years, before administering the superficial treatment Jim would agree to accept, after this or that reckless maneuver. But he'd had no access to a confidential psych profile; in fact, he had no idea one even existed. Maybe this was standard practice for command cadets. Why wasn't he told these things?
"Affirmative," he responded to the computer. "Begin profile review now." Jim wouldn't show up for the next hour at least, unless McCoy meant to go and get him. There was time.
As he began to read, he leaned closer and put the brandy glass down untouched.
The psych profile had initially been requested during Jim's long hospitalization when he was 13, after he'd received the broken jaw and head injury; there were more recent notations as well, from Starfleet Medical. The language of the report was dry and factual, although McCoy could read between the lines. He scanned through it briefly, eyes narrowing, then stopped and began reading again slowly from the beginning.
REASON FOR REFERRAL: Psychological evaluation prior to removal of minor child, 13, from potentially abusive home environment. Iowa Social and Family Services became involved during hospitalization of minor child JK for injuries the boy originally claimed to be the result of a traffic accident, but upon examination proved to be inflicted by his stepfather, then custodial parent. Medical staff also expressed concern over partially healed contusions and abrasions on JK's upper torso, and evidence of healed fractures, although both the boy and his stepfather claimed that the injuries resulted from roughhousing with neighborhood children…JK's manner was evasive and he showed reluctance to tolerate any form of physical contact … ISFS determined that the child was at risk for recurrent abuse in the current familial situation and intervened to remove JK temporarily from the home, pending psychological assessment and recommendations.
The basic facts of Jim's birth were unfortunately so well-known that Jim was often put in the awkward position of being recognized and singled out for his father's heroism; more than once, McCoy had watched Jim's expression freeze and his eyes grow icy as he was recognized as the famous baby who was born on the Kelvin shuttle. McCoy knew that the salient fact of Jim's childhood wasn't the absence of a father he never met; it was his relationship with his mother, in the aftermath of that disaster.
He knew that Jim and his mother weren't close, and that he had a stepfather that he didn't get along with, to put it mildly. Jim had alluded to the fact that he'd spent time in a foster home while his mother was on extended service, for a year or two, but he had never explained what brought that about or talked much about the experience. "My stepdad needed a break from me," he'd said once, and on another occasion, "Mom wanted me to stay with her cousin Jeanine, but it didn't really work out, so I went back to live with that loser again."
He knew that his mother had rarely been around since his early teen years, leaving Jim alone for months at a time with the stepfather he'd described as a "drunken ass who should never have been given a license to breathe, but Mom never saw that."
McCoy had assumed, from the casual way that Jim referred to it, that his mother's Starfleet duty had left no one to care for him at home, so he went into foster care. It made sense, so McCoy didn't question it. Now, however, a different explanation presented itself.
CHILDHOOD HISTORY. JK's mother, widowed on the day of her son's birth, suffered from recurrent bouts of depression and anxiety during his early years…She reported difficulty maintaining a stable, nurturing bond with her son, whom she seemed to resent for tying her down to "a life she'd never wanted"…JK was described as a physically active toddler, fearless and headstrong…Problems adapting to pre-school group care…aggressive behavior…extremely bright with a forceful personality…Social interactions suggested dependency issues which were repeatedly re-enacted in symbolic play…
Mother's remarriage, when JK was 5, was seen by the boy as a betrayal and a threat to his position in the home…In interviews, the stepfather, owner of a contracting firm dealing in security, who described himself as "a strict by-the-book guy", said that he was drawn into frequent conflicts with JK, whom he saw as antagonistic and rude, unresponsive to his attempts to discipline him…
According to school and police reports, JK's behavior became increasingly provocative after the mother began leaving on a succession of long-range Starfleet science missions…A series of minor delinquencies, including vandalism and underage alcoholic consumption, culminated in the theft and destruction of an antique automobile owned by the stepfather. Subsequent hospitalization for serious injuries inflicted by the stepfather, according to local authorities… Stepfather eventually admitted to beating the boy on a regular basis, claiming that the violence had been "deserved" and that excessive alcoholic consumption had caused him to lose control on occasion…No physical evidence of sexual assault was discovered, despite suspicions on the part of educators…
McCoy's eyes widened. Shit. Even if the physical examination was inconclusive, it would have been uncomfortable and invasive. Traumatic, for a young boy.
And good God, was he raped?
McCoy had seen Jim's disinclination to commit to a long-term relationship with any woman he'd dated, and there had been an endless stream of them, it seemed. That had suited McCoy fine, since he wasn't looking for much female companionship either, after the divorce. Jim was a hell-raiser and a daredevil, and a good drinking companion any night of the week. He could be charming and sweet to the women he dated, as long as they didn't put any emotional demands on him.
McCoy had noticed that Jim never seemed to show fear or admit to pain, even when he clearly should have been hurting. McCoy had never seen it as much of a cause for concern—although maybe he'd felt a twinge of jealousy on occasion, knowing that he didn't have that kind of magnetism or physical courage. His own pain tolerance was embarrassingly low. Now, with perfect hindsight, he was disgusted with himself for being so oblivious.
According to observations by medical staff, throughout his hospital stay JK was extremely resistant to medical treatment even when it was clearly necessary. The child occasionally needed to be sedated and restrained during medical procedures… Physically aggressive, belligerent, and uncooperative during social services eval…
McCoy sucked in his breath. No wonder Jim hated doctors and clinics. It wasn't hard to imagine him as a rude, abrasive and angry teenager, furiously swinging at whoever got too near him. It was harder, even heartbreaking, to accept the idea of him as an abused and neglected child, pretending bravado, masking pain, hiding insecurities stemming from issues of abandonment and rejection. Who the hell beats up a child, breaking his jaw and giving him a concussion and internal injuries, for Chrissake?
Jim had told him about that joyride and the wreck of the antique, but had glided over his stepfather's reaction, saying only, "He tried to beat the crap out of me. But I didn't really care, and it was worth the ride!" And laughed.
UPDATE, STARFLEET MEDICAL: JK has undeniable strengths: surprising resilience and ego integrity despite the chronic stresses in his family of origin, high intelligence, self-confidence, determination, and self-reliance. Yet his self-destructive tendencies, resistance to authority figures, and reluctance to admit weakness should be considered major impediments to his eventual command aspirations. Unless he can achieve a measure of introspection and self-awareness which will allow him to temper these qualities, his ability to lead responsibly is questionable. JK has resisted or evaded all attempts by Starfleet Medical psychologists to begin treatment. Prognosis at this time is poor.
The report ended with a blunt suggestion that Kirk be given the choice of either complying with psychological treatment combined with hypnotic drug therapy, or changing his command cadet status to engineering.
McCoy supposed he should be able to read the psych profile with a certain amount of clinical detachment, but he felt restless, stunned, unable to sit still. He got up to pace the room, his mind racing.
It all was starting to make sense now: the daredevil, almost suicidal recklessness, as if Jim felt that he had to obsessively prove that he wasn't afraid of anything. The disdain for authority. His resentment of doctors' arrogance and what he saw as their invasion of his privacy. The brash "leap before you look" attitude that must have been what held him together during those times of helplessness.
He could see now why Jim had been so obsessed with the Kobayashi Maru test. He didn't want to accept that there were times when you had to submit with grace, to deal with failure without railing against it. He couldn't give in, even when the odds were against him. He was determined to find a way out with his wits, his daring, and his belief in himself. And often enough, it worked, too.
McCoy recalled the tense scene on the Bridge, after Spock had ordered the Security guards to escort Jim out. He'd been watching Jim's face intently, concerned and anxious, and he saw the way Jim had seemed to lose control when the guards grabbed him and began pulling him away. At the time, he'd thought it was sheer foolishness—Jim being pigheaded as usual. Now he wondered whether the guards' rough grasp had triggered unconscious memories. Jim had reacted at a primal fight-or-flight level. Spock, of course, had seen it as mutiny. And Jim probably had no idea why he reacted the way he did.
Jim had now been catapulted into a command position by Pike. Reviewing the events of the day through the new filter of the psych profile, McCoy could accept that Kirk's tenacity and refusal to accept no for an answer, even at the risk of his personal safety, might be construed as an advantage in certain command situations; Jim had proven that today. But it could also be interpreted as a desperate irresponsibility and proof of impaired judgment.
They'd all been lucky; for the moment, the crew was inclined to regard him with awe bordering on hero-worship, despite his youth and inexperience. But that wouldn't last long if they thought they couldn't trust him.
As a healer, it was clear to McCoy that Jim needed to accept and integrate his past, to see his reactions for the childhood defense mechanisms that they were. But he was fully aware that most psychological work involved a long, delicate process, even when the patient was asking for help and committed to change. That wasn't the case here, and Jim didn't have that kind of time.
Jim had arrived at his goal much earlier than planned: he was captain of a starship at the remarkably young age of 26. He was in command, with tremendous forces at his disposal. He'd distinguished himself heroically in his first space mission. But he obviously needed help, or he might lose it all.
McCoy was not at all sure that he knew what to do. But the next step was clear. Jim needed to come down to Medical.