Post Khan. Technically this is a standalone one shot in which Jim is delirious, a woobie and generally in need of lots of hugs and kittens and other cute, fuzzy things after waking up with a body full of Super Blood. Spock and McCoy oblige because, well, it's Jim. This one is also rather medical and while I do my best to research everything I am not a doctor and can barely apply a band aid without getting my fingers stuck together. A pinch of salt should really be applied to everything you read.
Spock was woken from a fitful slumber by the chime of his comm. unit. He had not rested well since the destruction of Vulcan, but more recently he failed to complete even a single REM cycle before waking. He did not dream, but neither did he rest.
For the most part he was content to get most of his required repose from meditation, but after spending every night since returning to Earth watching over his Captain, Spock had finally conceded to Nyota's concerns and attempted to seek proper sleep. Jim's temperature had broken nine hours earlier, finally putting him on the winning side of the crippling fevers that had taken hold of him after the blood transfusion. An exhausted McCoy had increased his survival rate of less than ten percent to almost seventy – odds which Jim Kirk could bring the universe to its knees with.
He had relayed the news to Jim's crew, who had adopted one of the Fleet's secondary hanger spaces as an impromptu meeting area. Many were reluctant to spend time away from each other, seeking comfort and reassurance from those who had shared the same experiences. At Spock's announcement, a stunned, disbelieving silence had fallen; only to be broken like a wave against the bay as cheers rang out. Their Captain had once again done the impossible.
Nyota had valiantly denied the tears that were in her eyes as Spock told her the news, but had curled herself against Spock and shaken with the suppressed emotion. He had not held her, nor she sought his comfort, not since Jim had been taken from them. He had missed it, and that emotional vulnerability he had only just begun to acknowledge made it easier for him to agree to her terms.
He slept with her beside him and for a while, it was successful. He managed nearly four hours before being woken.
Startled into immediate wakefulness, Spock sat and answered the call. Beside him, Nyota blinked sleepily.
McCoy's voice instantly had him extracting himself from the sheets and reaching for his clothing. "It's Jim." The doctor sounded slightly hysterical. Spock knew McCoy had barely been sleeping himself. "He's gone."
For a brief moment, Spock felt the same ice-cold terror he had experienced when he'd first understood what exactly Jim had done to save them.
He heard Nyota scramble for her boots and shook free of the paralyzing fear. "Explain."
"His temperature spiked again shortly after you left." McCoy said, causing Nyota to shoot Spock a look of alarm as she pulled a sweater over her head.
"It was my understanding that-" Spock began.
"That what, I screwed up?" Spock had never imagined he would hear the self assured, cantankerous doctor sound so utterly broken, but his every word was rich with exhaustion and internalized reproach. "Just get here, please." It was the please that broke Spock's fear. He had heard the word from McCoy many times over the past few weeks and it had always been directed at Jim. He could not stand to hear the word addressed to himself. Not from McCoy.
"I am on my way." Spock announced. McCoy hung up on him.
"Could Khan…?" Nyota asked, finally dressed and close on his heels as they took the lift down from his apartment to the underground garage where he kept a vehicle.
The mere thought that Khan might have escaped custody to abduct Jim was too terrifying to comprehend and Spock wished momentarily that there had been a way to save Jim that did not require Khan's continued existence. "I do not know."
It was not Khan. While Nyota had driven them directly to SFM, Spock had commed the secure unit where Khan and his crew were being housed. Khan had once again been cryogenically frozen and was for all intents and purposes, harmless.
He was also still under guard, still in a chemically induced coma, and showing no signs of waking.
Which meant that Jim's disappearance had another cause entirely.
They pulled up outside the main entrance to the hospital. McCoy was already waiting, pacing impatiently. Neither Spock nor Nyota worried about parking and merely abandoned the vehicle before rushing to McCoy.
"I can't find him." McCoy choked, his eyes bloodshot with fatigue, fear and guilt. "I only left for a few minutes."
Nyota squeezed his hand gently. "Leonard, it isn't your fault. We'll find him."
Spock eyed the doctor critically and felt a pang of discomfort at the thought of having been at home resting when McCoy had clearly not seen the inside of his eyelids in some time.
He was pale and haggard and his usually steady hands trembled. He should never have shouldered the entire responsibility for Jim, yet he'd allowed no one else to treat him.
McCoy shook his head, leading them back into the hospital. "I've had security run the entire building."
"Did they check the cameras?" Spock queried.
McCoy shook his head. "Main system is down for maintenance. They run it every Tuesday between two and two fifteen. And there aren't any camera in Jim's room." Somehow, between transporting an unconscious Kirk from the Enterprise to SFM, someone had managed to leak a picture to the press. Fleet PR had already issued a gag order, but it had been too late to stop the image going viral and Spock had the unpleasant experience of seeing his own pale, tense face beamed across entire buildings as he and McCoy ran alongside the biobed Jim was being transported on.
For the second time in less than two years, San Francisco had been the target of intergalactic terrorism and the death toll this time had been astronomical. Faced with such devastation, the world waited on news of its hero with bated breath.
Paranoid, Starfleet had pulled out all the stops to ensure no one snuck into Jim's room, and no more images were leaked.
McCoy had diagnosed TA-GvHD five days after arriving on Earth and three after administering Khan's blood. It was an incredibly rare disease, and as such one Spock had no insight in to. It had since been explained to him that Transfusion-associated Graft Verses Host Disease had an almost ninety percent fatality rate. There was no cure, and no treatment. Ironically, the only method of prevention was to irradiate the grafted blood cells before transfusing them. As Jim had died of acute radiation poisoning, the process in which Khan's blood had cured him was also the very same method that now threatened to kill him.
Jim had inborn immunodeficiency. While that would have once been grounds to ensure he never set foot off planet, there were by now many ways of managing the problem. It did however occasionally leave Jim cripplingly vulnerable to conditions often so rare that many doctors failed to even consider them. With the advances in medicine, there had only been two other cases of TA-GvHD in the last seventy years.
For forty-eight hours, when Khan's blood had first taken hold and Jim's rules had hesitantly crept across the monitors on his biobed, Spock and McCoy had dared to hope that this time they could win. They would keep Jim with them, to hell with the universe.
Like any good physician, McCoy had kept a constant vigil on Kirk's vitals.
First, his hemoglobin levels had begun to drop. McCoy had increased his hypobaric oxygen intake.
Then, after their number had climbed in order to counter the heavy radiation damage Jim had sustained, his white blood cell count suddenly plummeted. McCoy performed a differential count: all types were low, and steadily falling.
Finally thrombocytopenia set in as Jim's platelet count stopped regenerating entirely.
The combination was referred to as pancytopenia, and it was what led McCoy to his final diagnosis.
Only a few days after getting Jim back, of feeling his chest rise and fall beneath their hands and his heartbeat throb reassuringly below his skin, McCoy announced the inevitable conclusion of his findings. Jim was dying.
Spock had not reacted well. To his eternal shame, he had laid blame at the doctor's feet and instead of his usual barbed response, McCoy had given no form of come back at all.
Neither of them would, Spock realized in astonishment, survive losing Jim a second time.
Spock said as much when he was alone with his captain and McCoy in the lab, analyzing Jim's blood, trying to find ways to boost his immune system and fool his body into believing Khan's blood was not an enemy to be fought.
But fight Jim did. His fever climbed higher each day, an erythematous maculopapular rash developed shortly after, spreading up from his legs to his chest. During this time, Jim did not regain consciousness. He simply lay on the bed and wasted away. If any of James Kirk's tenacious will to live remained, there seemed to be no sign of it.
And then, eleven days after McCoy started him on an aggressive combination of high dose steroids and monoclonal antibodies, his fever broke. Spock allowed himself the agony of hope once more.
And now Jim was gone.
It was so unexpected, so agonizingly unfair, that as he raced through the quiet hospital corridors with McCoy and Nyota, his skin felt too tight and his ever logical mind floundered for stability.
"What about the guards?" Nyota asked. "Surely they saw him?"
"Apparently not." McCoy's jaw clenched with anger.
"Could he have woken up?" Nyota suggested. "If he did then he's bound to be disorientated."
McCoy looked lost. "Speaking as a doctor I'd say there is no way in hell my patient could have regained consciousness in the short space of time I left him…let alone climb out of bed and wander off without anyone seeing him."
"And as Jim Kirk's oldest friend?" Spock asked.
"Yeah. It's a possibility." McCoy shook his head. "Even taking in to account that this is Jim and doing the impossible and ridiculous is a daily occurrence for him… he's sick and I'm not talking the common cold. I'm treating him and he is recovering, but he's not cured."
Spock understood the meaning of the doctor's words. It was imperative they find Jim and bring him back to the safety of his room where his recuperation could continue unimpeded.
"Security are checking everyone in and out of the building." McCoy said as they finally reached the area of the hospital where Jim was being cared for.
"Should we alert the admiralty?" Nyota asked. Both Spock and McCoy hesitated and her brow furrowed. "We can't keep this a secret!"
"I agree," Spock said softly, his eyes fixed on a point at the end of the corridor: a map of the hospital beside an index of departments. "However I do not believe it is necessary to cause undue panic."
"Undue panic?" McCoy exploded. "I think panic is entirely due!" Spock ignored him and set off at a run towards the end of the corridor, the index, and the open turbolift. "Spock! Where are you going?"
He heard McCoy and Nyota behind him and did not pause.
There was no logical reason for him to be heading the way he was. No basis on fact or precedent. He was responding to gut instinct, as Jim would have done.
And so he ran.
The very lowest levels of the hospital were reserved for the storage of Starfleet personnel who had been killed in action. Where possible their bodies would be indexed, tagged for autopsy and then transferred to the next of kin once all official procedures had been followed.
In light of the chaos caused by Khan's attack on the city, many autopsies had yet to be carried out, and as such the basement storage levels were at maximum capacity.
Aside from those killed on the ground when the Vengeance had crashed, were the bodies of ninety-three men and women who had been killed aboard the Enterprise. Another fifty-one had been lost to space, resulting in nearly one third of the ship's crew killed in action.
Spock wasn't sure how Jim even knew they were there, but as he raced into the large chamber, he suddenly came to an abrupt stop. McCoy collided with his back and stumbled. Nyota, slightly more graceful, skidded to stop beside him, her hands flying to stifle as gasp of horror.
"Jim?" Spock cautiously raised his hands and spoke as soothingly as he knew how. Jim was the bravest man he knew, yet Spock was afraid to startle him.
Standing barefooted amongst the rows of stasis chambers that had eventually replaced the cryotubes Khan and his crew had been stored in, Kirk looked shockingly pale and vulnerable. His gaze was unfocused and glassy and his body shook with minute tremors that could have been either the pain of his condition or the weakness in his limbs. What was most frightening however was the shard of broken glass clutched in one bloody hand and the rapidly spreading stain of red that crept across his white robes.
"Jim, what are you doing?" Spock took a hesitant step forward, aware that both Nyota and McCoy were too horrified to move.
Jim's head tilted up and for a moment Spock was overwhelmed with emotion. He had never expected to ever see Jim's eyes open again.
But the joy passed quickly as fear once again crept in. "Jim?"
The quirk of Jim's head suggested he was listening but he moved unsteadily along the rows of his deceased crew, pausing to press bloody hand prints against each one.
Spock crept closer, taking advantage of Jim's distraction to close the distance between them.
When Jim brought the glass to his arm to open another incision, Spock propelled himself forwards. He knocked the glass from Jim's hand and wrapped both arms around his chest, pinning Jim's arms and bringing them both crashing to the floor.
Jim fought him. He would not have been Jim if he didn't, but he was pitifully weak and clearly delusional. He wore himself out quickly and was slumped in Spock's arms by the time McCoy crashed to land beside them.
"What the hell are you doing?" McCoy screamed, making Spock frown when he realized the words were being flung at Jim. Jim blinked up at McCoy, his eyes wide in the hollows of his face, and pressed a bloody hand to the doctor's cheek. McCoy flinched but caught Jim's hand in his own, his hands clamping over the open wound dissecting Jim's wrist. "God kid, what have you done to yourself?"
"Blood." Jim said by way of explanation, his vowels long and awkward, as though he wasn't quite sure how to say them any more. "Heard you. Blood heals. Healed me. Heal my crew."
Spock barely heard Nyota's sob over the white noise in his head.
"They're dead, Jim." McCoy said, his voice soft and gentle in a way Spock had never before heard it. "You can't bring them back."
Jim's head lolled against Spock's arm and his eyes rolled. "Brought me. Shouldn't have."
McCoy leaned forward and grasped Jim gently around the back of his neck so he could press their foreheads together. "I'll always bring you back, you impossible brat."
"My crew," Jim whispered.
"We're here, Captain." Nyota moved into his line of view. She was not as close to him as McCoy, nor had she been present at Jim's death. Clearly she hoped her presence would be enough to assure Jim that not everyone he commanded was resting in one of the many units.
But if anything, Jim only got more worked up. McCoy sighed as Jim began to squirm weakly, his bloody fingers digging into the open wound.
"Damnit, Jim, stop that!" McCoy snapped, grabbing Jim's hands and holding him still.
Jim coughed and sobbed as he tried to fight, then suddenly slumped over senseless as McCoy managed to sedate him.
Spock stood with Jim in his arms. "Doctor?"
McCoy needed a minute to compose himself, but quickly shook away the tears on his face and nodded. "Let's get him back."
Spock saw the way Nyota's hand curled into McCoy's and squeezed and whished he was as eloquent with his support as she.
Jim remained unconscious for another week, this time in an induced coma. McCoy wasn't taking any chances with him. Between he and Spock, Jim was not alone for a single minute and though the two of them barely spoke a word that was not related to Jim's health, Spock surprised himself by coming to appreciate the doctor's company, and he shared in the tentative hope that bloomed when McCoy finally announced that Jim was out of danger and firmly on the path to health once more.
A day later, when he was finally brought back to consciousness, Jim blinked up at them with blue eyes, no trace of fever or insanity. McCoy had healed his self inflicted wounds and you'd never know from the doctor's demeanor that Jim's recovery had been anything less than textbook.
Jim smiled at them both, only awake for a few minutes before his exhausted body forced him to sleep unaided.
"What will you tell him?" Spock asked McCoy curiously as they watched Jim sleep.
McCoy looked up. Jim's return to health had done wonders for his own. "Nothing, you?"
"Only the truth." Spock said, looking down at Jim's peaceful face. "That he saved the crew."