There was no sense of either night or day in space. The ship manufactured its own false time frame to prove conducive to both sleep and wakefulness. That evening both Captain Kirk and Sarek remained confined to the sickbay. Spock had been discharged a few hours previously, having been certified fit by McCoy, and had resumed command of the ship from Scotty. The lights had been dimmed in the sickbay, and McCoy was examining his only two patients for the final time before bed.
"You're still in pain aren't you?" He asked as he examined the Captain's wound. It was bad. He'd remained stable for the past few hours, but the jolting of the ship during the earlier attack had put his body under a tremendous amount of strain. Any further exertion could cause him to start bleeding again and so the doctor had ordered complete bedrest for the foreseeable future. He couldn't move from his current position, not even to go to the toilet. The Captain had been critically wounded, and the hours which had passed since had done nothing to reduce the threat to his life.
Kirk was sweating. He'd had enough painkillers to have completely incapacitated him under normal circumstances, but it still hadn't been enough. He was cold – so cold that it made him shiver – but his face and forehead were boiling hot, his cheeks deeply flushed. There was still no sign of infection setting in, but his entire chest ached. He nodded slowly.
"I'm going to give you something more for the pain Jim." McCoy told him as he completed his examination. "Something slightly stronger. For some reason none of the usual painkillers seem to be working, but it's a bad wound."
The Captain reached out a hand to grab McCoy by the arm as to turned to go. The doctor sighed. He'd known Kirk a long time – long enough for him to realise what was coming.
"No, I don't want anymore drugs Bones." He told him weakly.
McCoy turned back to look at him. He noticed the Captain's flushed cheeks, but the rest of his complexion was alarmingly pale.
"I've stitched you up as best I can Jim," he told him, "but the cut is deep, it penetrates right through to the chest cavity. By rights you should have died, it was only by sheer luck that you weren't killed, and there is only so much I can do. The rest is going to take time – and your cooperation." He placed significant emphasis on this final statement – Captain Kirk wasn't known for his cooperation with the doctor when it came to matters concerning his own health.
"If I might be so bold as to intervene Captain," Sarek interrupted them, "it is completely illogical to refuse medicine if you are in pain."
Kirk craned his neck a little to look at the man as best he could. McCoy had given Spock's father a sedative to help him sleep, but the drugs were taking slightly longer to work on his Vulcan physicality, and his exceptional hearing had meant that he hadn't been able to help but overhear their conversation, despite his drowsy state.
"Spock has always told me that pain is all in the mind." Kirk forced a smile.
"As Vulcan's we are able to supress the body's response to pain temporarily, but not the pain itself." Sarek explained. "It makes no sense to suffer unnecessarily. As the ship's Captain you are important, you are needed. Your priority should be to get better and return to duty as soon as possible, any other course of action seems completely illogical."
"Well I can hardly argue with that." Kirk said, looking from Sarek to McCoy with raised eyebrows. He couldn't help but feel as though he'd been well and truly put in his place. He noticed the doctor look gratefully around at Sarek as he released his grip on his arm. The Vulcan wouldn't comprehend the significance of the gesture. Kirk had always doubted Spock's claim that his race were completely devoid of emotion, but over time they had certainly lost their ability to understand it.
McCoy might have charge of the sickbay but, as the ship's Captain, he didn't officially have the authority to override Kirk's decision – even if he was risking his own health by refusing medical intervention. Not that he hadn't been forced to disobey his Captain's orders in the past – but Sarek's words seemed to have spared him having to commit yet another act of mutiny.
"I'll prepare a hypospray." He told Kirk as he left the room.
The Captain lay back in the bed, looking up at the ceiling, until his friend returned. He was incredibly tired, but his chest was so sore and felt heavy – it made breathing very uncomfortable. His vision blurred for just a second and he had to blink hard until everything came back into focus. His head was swimming, and the air in the sickbay felt unusually thick – but he realised that his damaged lung would have had a lot to do with his compromised breathing.
It didn't take McCoy long to return with the hypospray.
"I'm going to give you Thyoroxine Jim." He explained as he prepared the Captain's arm for the injection. "It's a very powerful painkiller with strong sedative properties. It's a controlled drug we very rarely use here."
"I don't want to be knocked out Bones." Kirk said. "I need to remain functional, in case anything happens with the ship."
"You're not going anywhere Jim. If you move anymore you could die," McCoy told him, as he quickly injected the Captain with the spray before he had chance to protest further, "and a fat lot of use you'd be to the ship then, a corpse laid out in the morgue!" He exclaimed.
The drug didn't take long to take effect. Kirk was already tired, and the rapid pain relief coupled with the sedative properties of the drug meant that he fell asleep quite quickly. McCoy stayed with him until he finally lost consciousness, monitoring his breathing and making sure that he really was asleep before he left to get some rest himself. Spock's father was still awake long after Kirk had fallen asleep.
It was a few hours later when Kirk next awoke. He was finding it much harder breathe now than he had when he'd fallen asleep. There was a sharp, stabbing pain in his chest which was worse when he tried to breathe in, and he didn't feel able to fully inflate his lungs. His chest was tight – rattling on intake, and as he exhaled he was wheezing badly. He opened his mouth to try and say something, but couldn't get any words out – instead the act only made him cough, which caused more pain to surge through his chest. Kirk groaned.
He looked around as best he could to see if he could see any sign of McCoy, but the doctor didn't appear to be anywhere nearby. He then remembered that he wasn't on his own – Sarek was in the bed opposite.
"Sarek…" He tried harder to force the words which had previously evaded him, and was relieved when he was able to produce something vaguely resembling speech. "Sarek… are you… awake?" He gasped.
"Yes Captain." The Vulcan responded, to Kirk's surprise – he hadn't expected him to be awake at this time of night, especially after the sedative McCoy had given him.
"Where's… McCoy?" He asked him.
"The doctor went to get some rest, but said he wouldn't be far away if he was needed." Sarek explained. "Are you alright Captain?"
"No… Sarek… I can't… breathe…" Kirk told him. This caused the Vulcan to sit a little further up in bed – this way he could hear Kirk's laboured breathing and how much he was clearly struggling. He heard his noisy gasps, and the wheeze when he exhaled.
"You're breathing doesn't sound good Captain." He observed, but became immediately alarmed when he received no response from Kirk.
"Doctor! Doctor!" Sarek shouted. "We need you in here, quickly!"
"What is it?" McCoy asked as he came hurrying in, evidently thinking that there was something wrong with the Vulcan. He approached Sarek's bed first, failing to notice Kirk, but Spock's father immediately shook his head and pointed towards the Captain, indicating that it was he who needed help, not himself.
"He says he can't breathe." He told the doctor, and as he turned to look at his friend McCoy could tell that there was evidently something seriously wrong. Now that he had stopped to listen he could hear Kirk's laboured breathing – the choking gasps and severe wheezing.
"I'm… suffocating… Bones." Kirk told him as McCoy approached him gently, he was sweating profusely and the medic could see the panic in his friend's eyes. Not being able to breathe was quite possibly one of the most frightening experiences anyone could go through. He already suspected he knew what was wrong with the ship's Captain without even examining him, and a pneumothorax – if that was indeed what this was – was incredibly painful. He'd heard some patients compare the experience to drowning.
"It's alright Jim." He tried to reassure him, holding out a hand to silence his words. "Don't talk now."
Kirk looked at him – deep into his eyes, as they met each other's gaze. McCoy knew that the ship's Captain trusted him, they'd known each other a long time, and were close friends as well as colleagues. But being a doctor never made it easier to see your friends in pain.
Kirk tried to relax back on the bed as best he could, but it wasn't easy. He was trying not to panic, he was trying to remain calm, but he knew that he was dying. If McCoy couldn't do something to ease his breathing soon he was going to pass out, and the thought that he might not wake up again terrified him. He remained silent as the doctor ran his scanner over his body – which in itself wasn't a good sign. All of his energy and focus was being put into trying to breathe.
It didn't take long for the scanner to confirm McCoy's suspicions.
"What's… the… matter?" Kirk, struggling with the words, asked – seeing the concerned look on the doctor's face. His breathing was already getting worse, and his vision was becoming hazy around the edges.
"I thought I told you not to talk!" McCoy said, fixing him with a stern look. This silenced the Captain again immediately – his last question seemed to have drained him – but he was still communicating with his friend with his eyes. McCoy bent down over him and gently managed to turn him over onto his side slightly. This caused Kirk to visibly flinch, and he gasped with the pain the motion caused to surge through his chest – but in that moment the doctor was grateful that he couldn't see the expression on his face. He couldn't conceal his shock, and mild horror, as he observed the Captain's blood soaked sheets.
The wound had obviously started to bleed again at some point during the night. They had no way of knowing for how long he had been losing blood but it was the pressure of the fluid which had caused his lung to collapse.
Easing his friend gently back down onto the bed, he sighed.
"It's as I suspected Jim," McCoy explained, "and I did fear this might happen. It's one of the reasons I didn't want you moving around too much. I'm afraid your lung has collapsed again. I need to try and re-inflate it."
He turned urgently to address Nurse Chapel who'd suddenly appeared by his side.
"Nurse, could you prepare me the implements needed for a chest tube, and a respirator?" He asked her.
"I'm on it doctor!" She nodded. As head nurse she understood the urgency of the situation, and immediately hurried from the room. Meanwhile McCoy turned back to look at Kirk, who in his fear reached out and grabbed him by the hand, squeezing it hard.
"Jim, there is no easy or painless way of doing this." He told him gently, still keeping hold of his friend's hand, whilst with his other free one already pulling at the Captain's loose white t-shirt and blue hospital robe to expose his chest and abdomen. "I need to make a small incision along the length of your ribs and insert a tiny tube into your chest cavity in order to reinflate your lung." He explained.
"This… is going… to… hurt… isn't it… Bones?" He asked him, his voice now barely a whisper.
"Yes Jim, I'm afraid it is." McCoy responded, squeezing his hand hard in response to Kirk's own vice-like grip. At that moment Nurse Chapel reappeared at the doctor's side, handing him the respirator mask. McCoy gently released his friend's hand and placed it back down on the bed beside him before placing the mask over the Captain's face, and setting it to maximum airflow.
"This will help you breathe Jim." He told him. Kirk was then vaguely aware as the doctor stepped away from his side. It unnerved him slightly, that his friend was no longer in eyeshot, but he could still sense his presence in the room, and his eyes slowly started to close as he felt the highly-oxygenated air being forced into his lungs.
He could get a sense of the urgency of the situation. He wasn't sure of what was going on but he was vaguely aware of the frantic buzz of activity going on around him – everything seemed to be happening in slow motion though.
Suddenly McCoy reappeared at his side. He was wearing a surgical mask and even in his current condition Kirk wondered at how strange he looked. The doctor hadn't had to perform an old-fashioned operation in a very long time.
"There's a very sharp pinch coming now Jim." He explained to him, holding the scalpel just out of eye shot of his friend, not wanting to alarm him. "Just work with me though. Stay as relaxed as possible. It'll be over soon." He smiled.
Kirk felt the sharp blade penetrate his side and gasped, trying hard not to flinch away or arch his back off the bed with the pain. He moaned as he felt McCoy slicing through his flesh, but was vaguely aware of the doctor talking him through the procedure as best he could. It was a massive relief when he finally felt his friend slide the tube into place.
His side throbbed badly, but his breathing became easier almost immediately. McCoy smiled as he heard the air which had been trapped in the Captain's chest cavity slowly escape through the tiny tube, and his lung began to reinflate. He watched the rise and fall of his friend's chest until his breathing became deeper and less laboured. He then fixed the tube in place with a couple of sutures and a sterile dressing.
"That's the worst of it over now Jim." He reassured him gently as he stood back, wiping the blood from his hands on a towel Nurse Chapel handed him. "You can relax for the moment."
Kirk looked up at him, a slight smile curling the corners of his blue lips as he visibly tried to do as the doctor instructed. He grimaced as his side started to sting viciously. He was still sweating profusely but some normal colour seemed to be returning to his face.
"So much for... I'll be out in two days." He teased - his voice still muffled behind the respirator mask.
"It's worse than I thought Jim." McCoy explained. "You're bleeding again. I need to try and redress the wound, stop the bleeding, and then you're going to need a blood transfusion to replace the blood you've lost. You're going to be here a while I'm afraid."
"It's good to see you looking a bit better though Captain." Sarek told him. "You seem to have given everyone here quite a scare."
"Thank you Sarek." Kirk responded, as McCoy injected him with another hypospray, and he wondered what this one was for. He couldn't crane his neck to look at Spock's father, and his voice was hoarse and still somewhat weak. His speech was restricted by the tightness in his chest but he knew that the Vulcan, with his exceptional senses, would still be able to hear him. He then turned to look up at McCoy, his smile widening slightly as their eyes met.
"Thank you too, my friend." He said as he reached out a hand towards the doctor. McCoy took it and squeezed it hard. He smiled back at him.
"I've still got work to do Jim." He reminded him. "We need to stop the bleeding."
"Do what you... need to do... Bones." Kirk nodded. His eyes were growing heavy again now and we're already beginning to close. The look McCoy gave him suggested that his sudden bout of fatigue wasn't entirely unexpected, and Kirk suspected that the injection the doctor had just given him had probably been some sort of sedative.
"Just rest now Jim." McCoy told him, laying his free hand on his shoulder to steady him. "I'm here. I won't let anything happen to you."
Kirk did his best to try and convey him a look of total trust - the highest compliment he was able to pay his friend in that moment - before finally drifting back off to sleep. With McCoy taking care of him Kirk knew that he would feel much better when he next woke up.