Title: Starfleet Medical Hustle
Summary: His hands clenched around the tricorder they were holding. Looking frantically at him was a pair of electric blue eyes. He could've cried right then and there at the sight of his best friend looking back at him.
Spoilers: Star Trek Into Darkness, general AOS
Disclaimer: The Star Trek franchise and its characters are property of Paramount.
Author's Notes: This started out as a few scenes and then turned into a beast that I'm probably going to have to write a sequel for to write everything I want. This story is finished, 4 chapters, and I'm aiming to post once a week. Although I am a doctor, I'm not that kind so I happily practice with my fictional degree, but I've tried to research everything so it's mostly correct but some liberties were taken. Feel free to leave a review!
I apologize for any mistakes, this was un-beta'd
"You get that sonuvabitch back on board right now! I think he can save Kirk."
McCoy slammed his hand down on the console, cutting off communication with the bridge. He didn't have the time to worry about catching Khan and keeping Jim alive…Jim, his best friend Jim, alive. McCoy stopped himself, he was a doctor and he knew better. Jim was clinically dead. There was no cardiac output, his respiratory system had collapsed, and any brain activity had long since stopped. Jim was dead. The ionizing radiation had blasted through his body ripping apart cells with no thought to what a brilliant man they were destroying.
"Cryogenic sequence is complete," Dr. Carol Marcus announced softly.
"Tell me this will work," McCoy looked up from the console.
He hesitantly stepped towards the cryotube. A thick layer of ice had already built up across the faceplate obscuring the man inside.
"Alert Starfleet Medical, we're not doing anything on this tin can. I want him safe on solid ground, and we're going to need a shuttle. Any news from Spock?" His mind was warping through everything he needed to do.
"Not yet, sir," a nurse replied.
"Bridge to McCoy."
The doctor reached the comm panel in a sprint that would've made his academy fitness instructor proud, "McCoy here. Do you have him? Is he alive?"
"They have him and he is alive. He's being transported as we speak."
"I'll be waiting, McCoy out."
The sound of footsteps echoed down the hall and the doors hissed open revealing a team of security personnel carrying Khan in on a stretcher. McCoy saw the phasers aimed at him and the handcuffs as he was carried by and placed onto a biobed. The security team took a few steps back but remained by the bed with their weapons ready. Spock and Uhura were only a few steps behind and stopped at the cryotube.
"Did you give him anything?" McCoy was skeptical that the prisoner was so compliant.
"No, Doctor McCoy, he was subdued through physical means."
"Meaning you beat the shit out of him?" the doctor's eyebrow rose.
"I did what was necessary."
"I wish I could've done the same, good work, Spock."
"I must return to the bridge, but I wish to be kept apprised of Jim's condition."
"Of course. We'll be evac-ing him to Fleet Medical."
Spock looked down at the tube, "Whatever it takes, Doctor McCoy."
Uhura bent down to the faceplate and planted a delicate kiss on the glass, "Save him."
For once, he didn't have a comeback or a reply so he just nodded. The comms officer gave her captain one last look before turning sharply and pulling Spock out of Sickbay with her.
"He's ready," a nurse called from Khan's side.
McCoy saw the IV tubing had already been inserted and the blood collection unit was primed and ready, "I want plasma only."
The nurse nodded and tapped in the commands onto the instrument's control panel. With a final tap the machine whirred to life and blood began to flow out of Khan's arm, and the attached bag began to fill up with the precious straw colored liquid.
The doctor held his breath as the nurse detached a full bag and placed it in the cold case already holding the first two bags of collected plasma. He wanted to guard the case with his life when it was handed to him.
"Get Khan to the brig."
McCoy had gotten word that shuttles and emergency medical personnel had arrived to assist with the evacuation of the wounded since it would be some time before the ship get a tow to the dock. He'd kept Jim's cryotube in the middle of Sickbay so that he could keep his eye on it while triaging the last trickle of wounded crewmembers and preparing the more seriously injured ones for transport back to Starfleet Medical.
His heart clenched every time he walked past the cryotube. He tried not to look, but he couldn't help himself. It was getting harder and harder to shove the fear and anxiety gnawing at his gut down as time ticked by.
The promised medical personnel arrived and immediately got to work to transport the more critically wounded crewmembers. McCoy knew that he should stay and oversee everything, but the Captain was on the list of priority one transports and being his personal physician he was going with them. M'Benga was understanding and would oversee the transfers now that assistance had arrived. He waved over two crewmen to take Jim to an awaiting shuttle.
The two crewmen guided the torpedo cart loaded with the cryotube out of Sickbay and into the corridor. A passing ensign saw the commotion and pressed himself against the bulkhead to let the group pass. He stole a quick glance at the face beneath the frost and immediately snapped to attention. McCoy looked up from the preliminary plasma screenings he was reviewing as one by one, passing crew members stopped what they were doing and stood at attention. They knew what their Captain had done for them.
Crewmembers lined the entire path to the service turbolift, and were waiting for them when they arrived at the deck leading to the shuttle bay. Jim would be embarrassed by this display…if only he could see it. The kid had done good.
"SFM to Medical Shuttle 12, you are cleared to land on pad three."
McCoy gripped the case hard enough to turn his knuckles white as the shuttle gently touched down on the landing pad at Star Fleet Medical. He'd been too busy with wounded to really think about the ship tumbling through the Earth's atmosphere so he figured a brief moment of panic now was okay.
A team was waiting for them when the shuttle doors opened and the cryotube was deftly transferred to an awaiting gurney. The doctor in him took over and gave a rundown of what happened to Kirk and his proposed treatment plan as they made their way to an operating room. There was no sense in denying that Kirk was clinically dead to the medical team. Once inside, he didn't waste any time heading for the scrub room and changing his duty uniform for a set of scrubs.
"Doctor McCoy, this is madness," an aging attending joined him at the sterilizer unit.
"Believe me, I know."
"I don't think this is a good idea, how long was he down? Have you tested this plasma? What good does it do to pump him full if his heart's not beating to circulate it?"
"Doctor Boyce, I can't explain it, but I have to try. I know it looks bad, but I'm not giving up on him."
"Leonard, I know you two are close, but you shouldn't be doing this."
"I'm his CMO, I know him better than anyone else-"
"You're not on your starship, you're here at Starfleet Medical, and I'm in charge of his case here. Not to mention what you just went through with your ship; I've seen the preliminary action reports already. Do you really think you can keep going for much longer?"
"Sir-" McCoy's patience was growing thin and time was precious.
"Need I remind you that despite being surgeons, we're also Starfleet officers and I outrank you Lieutenant Commander? Now, listen to what I have to say," the men were nose to nose.
"Yes sir," damn Starfleet and their ranks.
"I'm willing to allow you on Captain Kirk's case, but not as his attending. You'll have complete access to treating him, but at any moment I feel that you're compromised in any way, I'll revoke your privileges. I was a CMO once, I know that you're in charge on your ship and you have to treat your friends, but you need help for something this big. Now, tell me what's your treatment plan. I'll go along with this for now, Doctor McCoy."
McCoy let out the breath he'd been holding, "The condensed version is that a prisoner we took on board has amazingly fast cell replication and his plasma should help promote new cell growth in Jim. This should reverse the damage done by the radiation."
"I just got your notes from your Sickbay, there's a lot of damage to fix. How long was he in arrest before you put him in stasis?"
The doctor's mouth went dry; he knew it'd been too long, "Approximately twelve minutes. We had to wait for the decontamination to finish to get him out."
Boyce merely nodded, "Okay, what's the deal with the plasma and how do you plan to circulate them?"
"I injected it into a dead tribble, and it came back to life."
"It just came back to life?"
"I know it sounds crazy, but it did. It's like it kick-started its cell replication processes. It began forming healthy tissues. The tribble was small so I guess diffusion took care of the circulation, so for Kirk we can use ECMO."
"Leonard, if this doesn't work it'll only bring more pain. Are you sure it's not best just to let him go in peace?"
"He doesn't believe in no-win situations," McCoy said with such fierce determination.
Boyce studied McCoy's face, "Alright, but I'm ending things if I feel that it goes too far. This'll be a helluva comeback if you pull this off."
The two surgeons quickly ran their hands under the sterilizer unit and walked into the OR. They stepped up to Jim's cryotube having been gowned and gloved. McCoy punched in the sequence to initiate the thawing process. The minutes it actually took seemed like hours until two techs pulled the faceplate off the tube and laid Jim out on the table. A nurse sliced off his shorts before covering him with a gel blanket.
The sound of the bioalarms reacting to the lack of vital signs was unnerving, only rubbing in the fact that this was an incredible long shot. McCoy smirked at himself thinking of Spock rattling off some obscurely small percentage of this actually working.
"Alright people, let's work quickly. Let's keep him at nice thirty three degrees."
Boyce grabbed the offered laser scalpel from the nurse and made a small incision in Jim's neck. McCoy felt bile that was climbing it's way up his esophagus, but gulped it down and pulled apart the incision. The pair worked swiftly to insert and secure tubing into arteries to completely reroute Jim's circulatory system. A sleek looking instrument whirred to life and dark red blood began to flow out of one of the tubes only to be returned a bright cherry red into Jim's body by another tube.
McCoy watched Jim's face go from a ghastly grey color to a sickly white as his tissues infused with the much-needed oxygen. It was far from the vibrant color he normally had, but it was a step in the right direction. Dr. Boyce sealed the incision in Jim's neck and stepped back.
McCoy took this as his cue and popped open the case containing the plasma. A simple snap into the IV control box and the straw colored fluid began dripping into an IV line that a nurse had already established.
"This could take some time to work," McCoy increased the flow rate.
"Lets get stabilizers on his other internal injuries and we'll come back an fix them if this works. We can't close any internal bleeding until his tissues are healthier. Get a set of neural scans too."
McCoy numbly nodded as he watched the plasma drip into his best friend's veins.
There was a gentle shake of his shoulder. His eyes blinked open, funny, he didn't remember closing them. He looked around the unfamiliar ICU room before settling on Jim's prone figure on the biobed.
"Jim?" his back cracked in protest at the sudden movement from falling asleep upright.
"Still the same, Doctor McCoy," a brunette nurse stepped between him and the biobed.
"Why did you wake me?" he groaned.
"You fell asleep in the chair. I had a cot brought in for you. You need to rest."
"I'm fine Nurse…"
"Bauer, and no you're not. You've been aboard a starship through a battle and now this. I have orders from Phil Boyce to sedate you if I deem it necessary."
He knew this tactic well; he'd used it on Jim several times during their last voyage.
"Give me a sit-rep, and then I'll sleep."
"As I said, there's been no change. It's only been a few hours yet. He's still a frosty thirty-three degrees, and the second unit of plasmas is finishing. Anti-rejection meds and antimicrobials have been started as a precaution," she pointed to the multitude of containers hanging on the IV stand.
"Any spontaneous cardiac activity? Any new cellular scans?" his tired joints protested as he leaned forward on his knees.
"What about the neural scans?"
"No detectable activity, Doctor McCoy. I promise to wake you if anything changes."
He knew he wasn't going to make progress with this no nonsense nurse. After taking a moment to summon up the strength he pulled himself up. The weight of the entire world seemed to fall on him, dragging his bones to the ground. It had been one hell of a couple of days, and he hadn't gotten much rest on the way to Qo'noS.
"Easy there," he felt a pair of hands steadying his wavering form.
Those hands guided him to a cot that had been placed in the corner and gently set him down. His hands fumbled with his boots and he closed his eyes before falling sideways until his head connected with a pillow. He felt his legs placed on the cot and a scratchy blanket pulled up to his chin. It was nanoseconds and he was encompassed in the blessed relief of sleep.
"Engineering to Sickbay," a thick Scottish brogue resonated from the comm panel.
"McCoy here, I'm a little busy at the moment," he was surrounded by wounded.
"Sir, you're needed down here."
"Scotty what is it? I'm up to my eyeballs here. I can't spare the manpower, can you get them up here?"
There was a pause from the engineer, "I understand, we'll take care of it."
The comm went out and he didn't give it another thought; there were too many patients in his Sickbay for him to leave. He was in the middle of packing a profusely bleeding leg wound when he saw the doors open out of the corner of his eye. Scotty and a couple of engineers were carrying a body bag.
"We're diverting casualties to Cargo Bay Three," he yelled over his shoulder.
"Doctor," Scotty and the crewmen set the body bag on the table in the middle of the bay.
The body inside hit with a thump and immediately his heart dropped into his stomach. He took a good look at the Chief Engineer and saw tears glistening in his eyes. The instruments were pulled from his hands and he felt himself drifting to the table. A shaky hand grasped the zipper and slowly pulled it open. A wave of nausea rose up as the flap fell open. Jim. His best friend, Captain James Tiberius Kirk was dead. Two fingers to his carotid confirmed this. He was gone. Sickbay fell silent and everyone froze where they were.
"He went inside the warp core, he saved us all."
He couldn't do this.
He felt himself jerk awake. His eyes opened to a plain white ceiling, not his best friend's dead face.
"Your breathing pattern suggests that you are awake, Doctor McCoy," a distinctly Vulcan voice floated over him.
Great, that green-blooded hobgoblin was here. There was a tug at the inside of his arm when he brought his hand up to rub the sleep from his eyes. His eyes opened further to reveal an IV unit strapped to his arm and a metal monitoring bracelet encircling his wrist. When did that happen? He was confused.
"The nurse tells me that you've been unconscious for approximately 13.3 hours and you required hydration therapy."
He rose up and swung his feet over the side of the cot. Spock was sitting rigid in the chair at Jim's bedside.
"Thirteen hours?" he tapped a button on the IV box to disconnect itself and slid it, and the monitor, off his arm.
"Affirmative. A set of cellular imaging scans completed six hours ago show that there has been a 4.9% increase in Jim's cellular regeneration. Minimal brain activity has been detected."
He pulled down his sleeve and pulled his boots on before gingerly standing up. Gravity did nothing to help his decidedly full bladder. After a quick trip to the head, a couple of taps to the biobed's control panel confirmed Spock's news. Jim's brain was functioning, but barely.
"A Doctor Boyce was here and did not wish to disturb you with the news. I was told to give this to you," he set a stainless steel thermos on the hovering table.
McCoy couldn't grab it fast enough and chug the piping hot coffee. The caffeine made its way into his bloodstream, filling him with energy.
"You are a good man, Spock," he chugged more coffee.
"It was not my idea, but I will take it as a compliment."
McCoy eyed the Vulcan, assessing his condition. As usual not a single hair was out of place and his dress grey uniform was immaculately pressed. The injuries he had sustained during the fight with Khan were already healed. However there was something he'd never seen in Spock's eyes, fatigue.
"Have you gotten any rest, Spock?"
"Briefly. It was some time before the Enterprise could be towed to the orbital dry dock and the admiralty has been most curious about recent events. My debriefing is scheduled to resume in an hour."
"What about the rest of the crew?"
"Rest rotations are underway, but general debriefings are scheduled to start later this afternoon. We've all been ordered to participate in relief efforts throughout the city once we have been questioned. You have been relieved of these necessities for the time being."
Good, he thought to himself, he didn't have it in him to face the events. It was better if he could just keep going and putting it out of his mind.
"He's been transferred to a maximum security facility to await trial."
Some part of him is disappointed that the bastard had survived to make it trial. He could see the destruction he'd caused on the Bay area from the hospital window. God knows how many people were dead.
Spock stood up in one fluid motion, "I must return to headquarters, but I will attempt to return after I am finished."
McCoy did something he never thought he'd do, he grabbed the Vulcan's shoulder, "Make sure you take care of yourself too."
"Your concern is appreciated, Doctor McCoy," Spock said expressionless as he grabbed his cover from a nearby table.
The doctor watched Spock leave. Something must've happened between him and Jim. He turned to face the man in the bed. Jim was normally so full of life he moved constantly, even in his sleep. Now there was nothing, not even a steady rise and fall of his chest as the ECMO machine pulled his blood out, oxygenated it, and pumped it back through his body at a constant pressure. He jerked in surprise as he grasped Jim's ice-cold hand. All of this work to keep him alive only made him seem deader.
"How's our patient this morning, Doctor McCoy?" the nurse from yesterday walked in.
"Nurse…" he knew he got her name yesterday, but it just wasn't coming to him.
"Bauer, Anna Bauer," she set her tray down.
"No worries, yesterday was pretty awful and you were exhausted."
He watched as she went about her duties checking the biomonitors, adjusting IV feeds, and the ECMO machine. Jim would've loved all of this attention from a good-looking nurse. She delicately turned his arm over and pressed a blood collection device against his skin. With a click and a hiss the sample chamber was full.
"Doctor McCoy, could you step back for a moment? I need to take a new set of scans."
McCoy looked down, he hadn't realized he'd been holding Jim's hand the entire time, "Oh, sure."
He let go and the scanner began humming with a tap on the control panel. A green light made its way from the bottom of Jim's feet all the way to the top of his head.
"Alright, he's all yours again. Doctor Boyce is supposed to come back by this evening, but until then I'd suggest you take some time to yourself and get a change of clothes and something to eat."
"Can you send me the scans?"
"After you've taken care of yourself. You won't do him any good if you run yourself down."
He really didn't want to leave but there was really nothing he could do. It was a waiting game for now. Jim's body had to build up enough healthy tissue so they could repair all the damage. He really wanted those scans so it was probably best to play along and stay on everyone's good side.
"I'll have them ready for you when you return," she said pointedly while waiting for McCoy to walk out of the door before her.