Ad Astra :: Star Trek Fanfiction Archive ^{Beam me up, Scotty.}

Chapter Text

Have the courage to trust love one more time and always one more time. – Maya Angelou

ooooo

“Are you out of your mind?”

Admiral Pike raised an eyebrow at the questioner who continued, “I’m a doctor, not a poster boy for the press.”

The flag officer nailed McCoy with a stare mixing amusement, leniency, and patience, then inhaled preparing to speak. Spock interjected, “A moment sir, the good doctor’s tirades are generally delivered in triplicate.”

“I can see the headlines now … Enterprise the Expose … Taxes for Tribbles … This season the well-dressed Starfleet crewman is uniformed in gold, red, or blue.”

“Finished Bones?” Kirk asked.

The response was a clipped, “For. The. Moment.”

Pike turned his unwavering gaze to Kirk who answered the unspoken invitation, “You’ve already heard my doubts, multiple times. A civilian residing on board a deep space vessel sets up a web of complications.”

Spock said, “Admiral while I am confident you have chosen a journalist with more literary skill than our resident physician, I too, and with reluctance, must agree with him sans the exaggerated, dramatic examples. Your idea is laudable; its implementation is not practical.”

Reaching for his cane, Christopher Pike stood and paced, limping around the ready room. He stopped in front of a viewpoint and stared out of it. Silence reigned for several minutes. With a sigh he turned back to the ship’s officers. “Yes, this is a favored project of mine. Perhaps even an indulgence. Vulcan’s destruction morphed a personal inclination into a goal. Spock, your home world will be remembered due to its outsized presence in our alliance and this quadrant. But what of the species without warp capability whose planet’s environment turns hostile? We cannot intervene but they should not pass from our galaxy unknown. What of the stellar nursery, the Nye-Rogers pulsar in the Ps3i nebula, the vibrantly colored cloud ringing Omni-Centi X? What of the fledging applicants striving for membership in the Federation? What of our crews, exploring as well as aiding beings never before encountered, beings so different in mores and culture from their own? They should be witnessed as well.”

“But …”

Pike waved Spock off. “All of this should be preserved not only through statistics and scientific analysis; the stories also should be framed by poets and in prose. As well as Starfleet’s. By one as skilled in narratives as each of you are in your own disciplines of leadership, physical sciences, and the healing arts. That is the role of an embedded reporter. Not tattling your every move or mistake.”

He said after a pause, “You have fifteen minutes for arguing your case against my plan.”

McCoy spoke first. “A ship is no place for the untrained. Space is filled with danger.”

“The journalist I have in mind understands these risks.”

“How will classified information be safeguarded?” Spock asked.

“Each of you, as well as I, can embargo an article or redact passages.” Pike then warned, “I will expect thorough justification for any such actions.”

Kirk spoke as the Admiral resumed his seat at the table. “Reporters embedded with the military fell out of fashion during the various skirmishes leading to Earth’s third world war.”

“That’s right,” McCoy interrupted. “Casualty counts for those civilians were high despite all the precautions.”

“And their work was viewed as government propaganda,” Spock finished.

“Is he a hotshot looking to make his career on our backs?” McCoy asked with a snort.

“No. A freelancer with no corporate management nor editorial board mandating content.” Pike pointed at Kirk. “Who has resisted demands from those more stubborn than you.”

The doctor chuckled; the Vulcan raised an eyebrow.

“Captain, Commanders, I am not dissuaded. Enterprise remains my preference for this pilot program. Please finish preparations. You are dismissed.”

ooooo

The following morning Enterprise’s chief medical officer opened his eyes, swung his legs over the bed’s side, and stretched his back. He grumbled aloud, “I hate waking up alone.”

Leonard McCoy yearned for family.

One that didn’t, like ephemera, slip through his fingers.

Like his birth family.

Like his marriage.

Like the beloved daughter now out of reach.

This need informed his every choice, including joining Starfleet where he had cobbled together a surrogate clan and protected it with the fierceness of a lioness safeguarding her cubs. Along the way he had accepted the unexpected barreled into life when least anticipated, altering it forever; shoving one onto a different path, a path filled with pain and loss. Along the way he had purposefully stopped believing the unforeseen may be a gift.

A sarcastic and at times acerbic persona masked his innate warmth and protected a gentle and kind heart, one refusing to harden despite the rigors of his profession, in spite of its losses. With this armor securely in place, he left his quarters and started the day.

ooooo

“I appreciate you taking on this assignment,” Pike said to his companion as they exited the turbolift.

“I did owe you a favor. Thanks by the way for sending your friend to help me with that minor disagreement on the rim,” she said in a casual tone as if commenting on pleasant weather.

Pike raised his voice, catching the attention of several passing crew members as he echoed, “Minor? Disagreement?”

Cara glanced sideways at him. The amusement in her eyes betrayed the carefully composed innocence in her expression.

His sigh was long and deep. “Should have put a subcutaneous subspace tracker on you years ago.”

“My uncle often says the same.” Her words paused, for a second her brow knitted voicing with silence lingering concern. “And Chris, it’s good to see you well.”

He answered with a fond smile and then gestured to the left. They walked side by side through the corridor, halting in front of the doors to Medbay.

“I appreciate the escort and know you are needed at headquarters. I’ve got it from here.” She held out her hand, her eyes were soft with affection. “I assume this is more appropriate in the halls of your previous command than my usual kiss on the cheek farewell?”

He clasped her hand in his. “Perhaps, and it’s a loss for me. Take care of yourself. Be safe. Promise.”

She drew an X over her heart then watched Pike retrace their earlier path in slow, measured steps until he was out of sight.

Medbay was like a very busy yet well-choreographed hive of technicians, nurses, physicians, and other scientists from various disciplines, the center of the ship’s Life Science’s department. A medic approached as she entered. “May I help … oh Ms. Aguirre …”

“Cara. Just Cara.”

“I don’t know …” The nurse’s response was drawn out as she weighed if familiar address was truly appropriate. Then with a firm nod she said, “Hello Cara. I’m Bonnie. Bonnie O’Malley. And I’m a devoted fan, never miss your articles. Welcome to Enterprise.”

The journalist smiled. “Thank you. I’m here for my physical.”

“Oh right, of course. Our chief medical officer performs all on boarding exams, which is rare, but he’s very particular about a lot of things. Rumor is he’s memorized the health records of our entire crew.” Bonnie’s hand flew to her mouth, covering it. “Oh, I talk too much when I’m nervous. I didn’t mean to spill secrets … no one’s told me … I’m not sure how much I’m supposed to say to you …”

“It’s okay,” Cara said in a reassuring tone. “I’m not working at the moment and we’re off the record.” In answer to the nurse’s confused expression she added, “I won’t repeat nor write anything you tell me.”

“That’s a relief. This is a plum assignment, and I don’t want to mess it up. Our CMO is a bit cranky at times, but he’s one of the best.” She glanced at the crowded waiting area thinking, no that won’t do at all, then beckoned with an outstretched arm. “Ma’am … I mean Cara. Follow me.”

ooooo

McCoy entered his domain with long determined strides, arms crossed over his chest, saying in a grumble to no one and anyone, “Used to be breakfast was a pleasant start to my day: coffee with chicory, Chef’s homemade omelet, on Sundays a biscuit or two with fresh butter and a little jam.” He emphasized the next word, “Now it’s all Vulcans, or rather a certain Vulcan, his foul plomeek broth which even racoons avoid, and his blasted argumentative logic …”

As he neared his office and its open door, Bonnie approached and offered a tablet. “Doctor, your first appointment, a routine physical.” After nodding thanks and while scanning the offered medical file he asked, “Who’s left on the onboarding list?”

“Other than the patient waiting, three.” The nurse listed the names and their ranks.

“Excellent. Wait …” He paused. “What about the journalist?” His eyes narrowed. “Damn foolish idea, allowing a muckraker on the ship.”

“Ah, Doctor …”

“… Not that anyone asked me. Or rather listened to me ...”

“But Doctor …”

McCoy was now fully warmed up on his topic. “As if we don’t have enough hostile aliens, poisonous rocks, and supernovas to contend with without also babysitting a civilian who considers himself above regs as evidenced by blowing off a mandated routine visit to his friendly doc, one that may well save his life down the line. We’ll just see about that. Not to mention, I, for one, will not have the bits and bobs of my life splattered across all the gossip rags in the quadrant … Bonnie why in tarnation are you thumpin’ my arm?”

The nurse inclined her head towards the woman waiting a few feet away, sitting on the office sofa with legs crossed. “Sir, meet Cara Aguirre.”

With a nod in the newcomer’s direction he said, “Be right with you Ensign.” Then without pause resumed his rant. “Mark my words, this so-called journalist, he’s going to be a galaxy of trouble.”

McCoy raised an eyebrow and turned in her direction when Cara said, eyes bright with amusement lending her an impish air, “You can count on it.”

Chapter Text

“You know our journalist?” McCoy asked the woman sitting in his office.

“She is the journalist,” the nurse standing beside the CMO said, her cheeks pinking. “I’m sorry sir.”

He faced his staff member. “Not your fault my manners are wantin’. You did all you could short of whacking me upside the head.” He paused then flashed a grin. “Next time, as something of this nature will inevitably happen again, you have my permission to do so.”

Bonnie’s chuckle preceded her shoulders relaxing. “Aye sir. Official treatment for foot in mouth noted.”

“I’ll take it from here,” he said.

“Exam one is free.”

McCoy motioned for Cara to follow, introducing himself as they walked. When the doors to the small room closed, he blurted, “You’re a girl.” Then double checked the tablet in his hand. “Yep, says right here, you identify as a Human female.”

“How astute of you Doctor,” Cara replied with a smile, her mouth lifting accentuating her cheekbones and crinkling the corners of her brown eyes.

“I can see the headline now, Starfleet Physician Mistakes Gender Preference,” he said in a grumbling tone.

Her response was immediate and delivered matter-of-factly, “No. Enterprise Chief Medical Officer Bewildered After Seeing Sex.” She paused and then ticked off the bullet points with her fingers, “Prominent ship, recognized personality, alliteration, and … well … sex, though it’s a misdirection. All the necessary elements for effective click bait.”

Lifting his chin and fixing her with a stony glare, McCoy considered whether this was her intention.

Cara held his gaze for several seconds and then shook her head. “Teasing.” She settled on the edge of the biobed sitting with her legs dangling over its side.

“Not funny,” he muttered, “thought you were writing your next article.”

Her tone was emphatic. “If you read any of my work, I hope it would be clear I’d never write such a headline nor publish the accompanying juicy details.” She tilted her head slightly to the side as if considering. “Though don’t underestimate the public’s interest in the flagship’s dashing healer.”

“I’m just a simple country doctor,” McCoy said as he scrutinized his scanner’s data. “And I did read the briefing materials about our embedded reporter Charlie March, this making a hasty and erroneous assumption from there. Hence my surprise.”

“Ah, so Chris … sorry Admiral Pike … only listed my nom de plume?”

He repositioned the scanner. “Again, simple country doctor who does not speak whatever language you just uttered.”

“Name of feather, you know, like the old-style quills?”

His glare returned.

“Pseudonym. Pen name.”

“Humor me. How did Cara Aguirre become Charlie March?”

“Oh …” She started and then her cheeks reddened. “It’s not an interesting story and would probably sound silly to you …”

“Try me,” McCoy responded in his soothing professional voice as the scanner whirled. He had noticed her anxiety rose on hearing the equipment and assumed the reaction was typical white coat syndrome.

“It was a childhood thing …”

Raising an eyebrow he composed his face in a credible imitation of Spock. “Curiosity flummoxed the Vulcan.”

“I was … on my own a lot growing up,” Cara said.

“Why?”

She shrugged. “Different reasons. We moved to Pavlopetri when I was eight.”

“The ocean world whose inhabitants live in underwater cities?”

“Yes. My father is a marine biologist, my mother an engineer. There were no other children near my age.”

“Because the Pavlopetrians propagate their species via cloning?” He was pleased her vitals calmed as she continued talking.

“That was one factor. I’m an only child but longed for sisters. And I read a lot. So I wrote myself into the March clan as Charlotte.”

He closed the scanner. “The Marches were friends of your parents? Doesn’t sound like a Pavlopetri surname.”

Her eyes widened. “The Marches? Meg, Jo, Beth, and Amy? Arguably literature’s most famous sisters?”

Shaking his head, McCoy raised his hands in question, palms up.

“Little Women by Louisa May Alcott?”

“Never heard of it.”

“Where did you go to high school? The Klingon home world?”

“Georgia.”

“If you ever have a daughter, read it with her. It’s that good.” Cara missed a brief pained expression crossing his features. “Charlotte, me that is, is younger than Jo and older than Beth. I have notebooks filled with their adventures.” Feeling shy and vulnerable, she looked away.

“Not silly at all.” Placing an instrument resembling a space age version of a twenty-first century stethoscope on her chest he instructed, “Deep breath. Good.” Repositioning he said, “Again. And Again.”

“Doesn’t the biobed register all my vitals?”

“Medical scanners are fine and important, but nothing replaces a physician’s five senses.” The instrument’s diaphragm was moved to her back. “Deep breath. Again. Again.”

Discarding the stethoscope he held up his hands. “May I?” Receiving permission McCoy said as he palpitated her neck, “Another can join us if you prefer.”

“Not needed.”

After conducting the hands-on physical examination, he cast a set of metabolic results on the mounted viewscreen. His finger jabbed at the data. “How in the name of all that is holy does a journalist end up with these readings? Dehydrated and with electrolytes a mixture of bad, worse, and still worse?”

“Had a bit of trouble on the rim. I feel fine by the way, no need to overblow it,” Cara said.

“Oh, it’s a big deal to me.” Retrieving two hyprosprays from the replicator McCoy administered both, one on the side of her neck, one on her inner wrist. In response to the unspoken question he said, “Vitamins and time-released hydration fluid packets inserted just under the skin. And for heaven’s sake, eat three balanced meals a day.” He warned in a stern tone, “I’ll be checking.”

“You’re very thorough,” Cara said with a faint smile.

Hands on his hips, he retorted in a raised voice, “Damn right. This isn’t a luxury cruise taking in the scenery between Earth, Vulcan, and Andoria. In deep space minor problems escalate fast, too fast. Losing someone over something I can prevent is not an option.”

“I apologize. It was not my intention to belittle the dangers nor your commitment to the crew.”

“Well then … okay …” he stuttered. “You didn’t … We’re done by the way. And my earlier comments …”

“You’re uncomfortable with my presence. And I get that.”

“Not you personally. I disagree with the prudence of the Admiral’s determination to add a reporter to the crew.” His eyes clouded, memories pounded of those he couldn’t save during and after the battle for Vulcan and Earth. A quick head shake cleared these thoughts. “Regardless, my apologies ma’am.”

Standing, Cara held out her hand. “A pleasure to meet you, Doctor.”

Accepting her invitation, they shook hands, “I’m certain the sentiment will pass in time, once you get to know me better.” He added in a mumble under his breath, “Just our ask our first officer.”

ooooo

Obtaining a tray from the replicator, McCoy joined Kirk and Spock at their table in the senior officer’s mess hall. Spock’s eyebrow shot up after observing his colleague’s dinner choice.

“Don’t start with me, I’m in no mood for indulging a food critic,” the physician warned. “Besides, it’s not even a proper steak.”

“But it is, imprecisely, amino acid residues joined by peptide bonds and therefore the very definition of a genuine protein,” Spock replied. Kirk caught a hint of amusement in the Vulcan’s eyes.

“Geesh! As if you knew anything about a prime New York Strip. And I suppose making love is merely genitalia contact between one or more beings.”

“Perhaps for yourself Doctor and your partners,” Spock replied, his expression deadpan. “However,” with perfected comedic timing he paused, “I possess multifaceted techniques.”

“You … you,” McCoy sputtered.

“Give it up Bones; he got you. Concede and depart the field gracefully,” Kirk said between chuckles.

Enterprise’s chief medic jabbed a bite on his fork with more force than necessary. “I met the embed today. And she’s female.” He winced at his inadvertent reference to the day’s earlier embarrassment.

Creasing his forehead, Spock looked as if he couldn’t decide what to say first, a sort of Vulcan silent stuttering.

Kirk asked, “Is she pretty?”

Spock found his voice. “Did you manage this Sherlockian-worthy deduction on your own or was a medical scanner required. Or a personnel file?”

Rolling his eyes McCoy responded, “Yes.”

“To which?” Jim queried.

The doctor flashed an enigmatic smile and resumed eating.

“I presume your faulty assumption stemmed from reviewing only the provided briefing materials rather than further exploration of her biography and work?” Spock asked.

“I spend the bulk of my days and nights keeping the two of you alive and somewhat whole. That leaves little time for recreational pursuits,” McCoy grumped.

“Charlie March, aka Cara Aguirre, won a Pulitzer for her articles documenting the ice hurricanes and the colony they decimated on Uranus,” Kirk said.

“You too?” McCoy huffed.

“This ship runs like a well-oiled machine thanks to its first officer, and the crew is healthy thanks to their chief medical officer. So I have time to indulge now and then.” Kirk then repeated, “Is she pretty?”

“And your extensive research did not include a hologram, vid, or photograph?”

“Personal assessments take precedence,” the Captain answered with a grin.

“Not your type,” McCoy said with confidence.

“That is … unlikely,” Spock interjected.

Kirk turned and stared at his second in command.

McCoy echoed the earlier advice in a sarcastic tone, “Jim, concede and depart the field gracefully.”

Shaking his head, Kirk picked up his finished tray and said before leaving, “Gentlemen, dinner tomorrow evening, 7:00pm. Skip the uniforms. It’s only polite for this ship’s senior officers to welcome our journalist on board.”

ooooo

Later in his quarters McCoy retrieved the latest packet of news about his daughter. These infrequent offerings from his ex-wife were like an oasis in the desert. The first was a recent picture of nine-year-old Joanna on her first day of fourth grade. His fingertips traced her profile.

He replayed the video of Joanna’s ballet recital identifying each of her graceful movements via their correct terms as he watched. The vid of her championship soccer game from last season was also cherished and he called it up. She played center midfielder, an alternate; fast and agile, good at reading the other team’s intentions, and on her way to first string.

McCoy thought back to the hours he spent in the pool teaching Joanna how to swim before her first trip to the ocean. There she squealed with delight when a pod of bottlenose dolphins joined them in the water within petting distance.

The hours of bedtime stories were the most treasured and painful memories of their time together. After she learned to read, they took turns each night. Curious after this morning’s conversation, he called up Little Women from the ship’s library and quickly scrolled through its contents.

‘I don’t like to doze by the fire. I like adventures, and I’m going to find some.’ He chuckled and thought, Yep, that’s Joanna.

As he scrolled other passages caught his attention: ‘Now and then, in this workaday world, things do happen in the delightful storybook fashion, and what a comfort that is.’

‘So she enjoyed herself heartily, and found, what isn’t always the case, that her granted wish was all she had hoped.’

‘She preferred imaginary heroes to real ones, because when tired of them, the former could be shut up in the in the kitchen till called for, and the latter were less manageable.’ This, with its reflection of Kirk and Spock, prompted a snort.

‘I’ve got the key to my castle in the air, but whether I can unlock the door remains to be seen.’ For reasons unknown to McCoy the sentence felt like a foreshadowing and a promise.

And one pierced his heart: ‘I do think that families are the most beautiful things in all the world.’

He rubbed his chin. Damn. Tears threatened. He willed them back, a skill honed through years of treating the ill and injured. Joanna’s voice, like a ghost from the past, beckoned to him, as she had on the night he lost a young patient, “Daddy Leo, I’ll read a story to you, and you’ll feel better.”

An idea coalesced. Should I … maybe … it would be a way to feel close to her … but … no … her mother won’t allow it … and I promised to stay away, not to interfere in their lives … not to confuse my daughter … but when she’s grown Joanna might contact me … and this would show, despite the distance and my absence, she always remained in my heart …

“Computer start a new journal and record.”

“Today I learned of this book. The main character, Josephine, reminds me of you. Nine years old is probably too grown-up for bedtime stories … Computer pause.”

McCoy stared at the wall. After a sigh he said, “Resume … but indulge me.”

“Little Women by Louisa May Alcott. Chapter One. Playing Pilgrims. Christmas won’t be Christmas without any presents,” grumbled Jo lying on the rug …”

Chapter Text

Seven Years Ago

Emory University Hospital

Atlanta, Georgia

“So Leo, what bet did you lose to pull the overnight shift on a Saturday night?” the charge nurse asked the physician leaning casually against the wall.

“Why ever would you assume that?” Leonard McCoy answered, his tone of voice feigning innocence.

“Senior research fellows who double as surgeons don’t pull emergency room duty. Especially on holiday weekends,” one of the interns clustered around the nursing station said.

“I’m a simple country doctor …” McCoy began.

The chief resident standing nearby rolled her eyes.

“… who relishes any opportunity for treating patients,” McCoy finished.

“Uh-huh,” the charge nurse responded with a skeptical expression and sounding less than convinced. “Rumor is you caught our illustrious medical director in a mistake.”

“That you pointed it out during grand rounds. In front of the new crop of surgical interns,” the chief resident added.

“And will be on the weekend emergency room rotation for the next three months,” another intern finished.

McCoy swiveled facing the intern and grumbled, “We point out your errors. In front of your peers. Why should that be any different for the brass?”

“But we aren’t Dr. Mark’s peers!” the intern exclaimed.

“Of course you are,” McCoy responded emphatically. “Everyone in this room is a health care professional and therefore a peer of mister ‘too big for his britches.’” Now wound up, McCoy settled into a frequently voiced tirade. “In fact, you children need to see that no one, no matter how experienced and talented, no matter what position to which they are rightly or wrongly promoted, is immune from making an erroneous diagnosis. Our patients deserve rigorous attention to detail and others’ input.

“So you admit to it?” the veteran nurse said with a grin.

McCoy’s expression turned sheepish before morphing into triumph. “Damn right. And if he whose name must be whispered in reverent tones can’t take the heat, he needs, as my Grandmaw says, to get out of the kitchen.”

A first-year resident exited a nearby exam room looking for the charge nurse. “Anna, I’ve got a child presenting with a simple ear infection. I prescribed the standard treatment. But the mother is nearly hysterical. Says her daughter has been sick for months. I’d appreciate your help.”

McCoy waved Anna back into her seat. “Take a break, I’ll do it.”

The resident looked nervously at Anna; she returned the unspoken question with a smile and a faint nod. He then handed a digital tablet to McCoy who refused it with a headshake, instructing. “Give me the highlights.”

“Yes, sir. The child is female, 30 months old. Presents with an ear infection including pain, tinnitus, dizziness, and infrequent vertigo. I administered an injected antibiotic and prescribed an oral follow-up for the next seven days. Her mother documents multiple ordinary childhood illnesses over the past nine months.”

“Hmmm, anything else of interest?”

“Those are all the symptoms … the child does not take any maintenance medications and is not currently undergoing any other forms of treatment,” Evan replied.

McCoy raised an eyebrow. “Anything else?”

“Ah … nothing of note … they recently returned to Earth after spending a couple of years with the construction crews building the colony structures on Uranus.”

“Did you run any additional tests?” McCoy continued his inquiries.

“No, sir. Not with the obvious symptomology.”

“Knock it off with the sirs, I’m a …” McCoy held up his hands encouraging a response from the others.

“Doctor, not an insecure bigshot requiring sycophants,” the interns repeated in unison.

“There may be hope for you children after all,” McCoy replied with a chuckle. He grabbed a modern version of the ancient stethoscope. In answer to the sideways glances among the junior physicians he said, “Scanners can’t replace a healer’s five senses. If I teach you nothing else, remember that. Okay, somebody find out what atmosphere processors are in use on Uranus.”

“Why?” asked one of the nursing students.

“YNK,” McCoy replied.

“You never know,” Anna whispered to her pupil. “It’s a Leo McCoy motto.”

McCoy inclined his head. “Any teddy bears left in the bin?”

Anna retrieved the requested stuffed animal and tossed it to doctor. “Nice catch,” she observed, “for a man of your years.”

“I try to keep in practice despite being over thirty,” McCoy responded in a dry tone. He then pinned Evan with a sharp gaze. “And the most important information?”

Baffled, the young doctor shook his head slightly and raised his shoulders.

“Their names,” McCoy prompted with impatience.

“Oh. Joanna is the patient. Mrs. Alderson is her mother.”

McCoy gestured to the exam room’s door. “Let’s get to it then.”

Jocelyn looked up as the duo entered, her eyes immediately drawn to the handsome face and deep blue eyes of the older physician. He probably has a nice smile … though a smile would be inappropriate, she thought, this is a serious place. But his calm confident expression is soothing in all the right ways… “What? I’m sorry, would you repeat …”

“I’m Dr. McCoy ma’am,”

His southern drawl eased her tension further.

“But most folks call me Leo.” He did smile when looking down at the child sitting on the biobed. “You must be Joanna.”

The little girl nodded and sniffled. “Ear hurts.”

“I know sweetheart. It’s gonna feel better real soon,” McCoy assured her. He retrieved the teddy bear from his pocket. “This is my friend Earl. If it’s okay with your Mama, maybe you will hold him for me while I listen to your chest?”

Joanna glanced at her mother who mouthed, “Sure.” She eagerly held out her hands and then hugged the bear tightly.

“Okay darling this is going to feel a little cold. Deep breath for me?” McCoy demonstrated. The child inhaled. “Okay, breathe out.” He demonstrated. Joanna mimicked. “Again. And again. Now your back.” While he repeated the process, McCoy said quietly to Evan, “Add a 2.5mg nebulizer to her prescriptions.” With Joanna happily chatting to the bear, McCoy stepped closer to her mother and spoke in a conversational tone. “Mrs. Alderson, you mentioned your daughter has suffered from an unusual number of mild illnesses over the past several months?”

“Oh, I’m not Mrs. Alderson anymore … I mean we’re divorced …” she stammered. Why did I bring that up? “That’s why she and I moved back … just call me Jocelyn. Yes. Joanna no sooner gets over a cold then a week later she’s picked up a respiratory infection or a virus. The physician on Uranus said frequent minor bugs are not unusual for small children in the insular environment of a domed construction zone and that Joanna would grow out of it.” Her eyes watered. “I’m new here … on my own … don’t know anyone … with her never-ending illnesses … it’s exhausting.”

“I understand,” McCoy said, his voice soft. Leaning closer he gave the distraught mother his full attention. “Have you noticed anything else?”

“This is going to sound silly.”

“I doubt that. You’re her mother, no one knows Joanna better than you. Go on.”

Jocelyn took a deep breath and summoned her resolve. “The doctor on Uranus … she said it wasn’t anything to worry about … that I should be grateful … I’ve never had any trouble getting Joanna to nap. Or to go to bed at night.”

“Because she is tired?” McCoy prompted.

“Yes, I think so. And she doesn’t play much with others. Not because she is shy, it just seems like … it’s too much for her.”

“That’s good information,” McCoy encouraged.

The door swished open. An intern entered. “Here’s the data you requested.”

“Excuse me ma’am,” McCoy said. Meeting the intern at the door he scanned the offered digital tablet and frowned. Looking up he asked Joyelyn, “Does Joanna bruise easily?”

“Ah … I never thought about that … but yes, especially in the past four months. One time she scraped her knee and it bled for thirty minutes before stopping. There wasn’t a lot of blood, but it seemed like an eternity. And then her knee swelled up like a balloon afterwards. Is it related?”

“Hmmm. Possibly. Nothing to be alarmed about. I’d like to run a few more tests if you permit me. As a precaution,” McCoy assured. After Joycelyn’s weak nod, he beckoned Evan over and ordered, “Run a complete blood scan. Stat. I want counts for white blood cells, red blood cells, and platelets. And ask Anna to come in and sit with Joanna.”

Returning to Jocelyn McCoy said, “May we talk privately? My colleague will stay with your daughter.”

Fear gripped her like a vice. Nodding weakly, she followed the physician into an office and sat in the offered chair. Her hands fidgeted. She wiped her eyes.

He handed her a glass of water before sitting in a chair behind the desk and opposite the distraught mother.

Funny how having something for your hands to do calms, Jocelyn thought. “Doctor?”

“Leo,” he reminded.

“Leo, is it serious?”

“Let’s not jump the fence before we see what’s in the pasture.”

“Wwhat?”

“Let’s see the results before rushing to worse case scenarios. How long did you and Joanna live on Uranus?”

“We moved there when Joanna was six months old. It was awful. Always dark and cold, the ice storms and their winds a constant background whine like white noise. I couldn’t take it anymore. I begged Luke to leave his job and move back. He said we needed the money, and it would only be for two more years … Sorry.” She placed the glass of water on the desk. “You’re the first person in a long time who has listened to me and believed what I said.”

McCoy rested his elbows on the desk and steepled his fingers. “Then please continue.”

Jocelyn looked down and to the side. “It’s nice, having someone listen. Everybody needs that in their lives. Luke and I, well, we quit hearing one another sometime last year. We started talking at one another instead. Please don’t think badly of him, I was as much at fault. His work is brutal. We were saving every penny to buy a little place in the sun … again sorry.”

“Not at all. The pressures of work and family are hard enough without living in a hostile environment.” The test results flashed on the terminal in front of McCoy. He reviewed them with a neutral expression. Moving to the front of the desk, he stood in front of Jocelyn and said in a gentle voice, “Your daughter is ill.”

Jocelyn burst into tears and jumped to her feet throwing her arms around McCoy.

He held open his arms and whispered, “May I?”

She nodded.

Embracing her, McCoy traced circles on Jocelyn’s back. She lost herself in the feeling of strength and comfort found in his arms. When the flow of her tears slowed, he withdrew and offered his handkerchief.

She wiped her eyes with the offering.

“Ready?” he asked.

She nodded weakly.

“Joanna is ill and there is a treatment. I’m going to refer you to a friend; she’s a specialist in this area. After I get your daughter admitted and you get her settled, we’ll discuss the diagnosis and next steps. Then I’ll arrange a comm link with Joanna’s father. There will be a bed for you in her room. You need sleep and care too.”

ooooo

Present

Emory University Hospital

Atlanta, Georgia

Nine-year old Joanna skipped into the waiting area, her parents following closely behind. Seeing a familiar face she ran to Evan who leaned down and administered a bear hug.

“Here for your check-up?” he asked.

“Yep.”

“I have a new intern today; can he join us too?”

“Sure.”

“We will see you in a few minutes.”

Turning to his student Evan asked, “Did you study the chart for this case?”

“Yes sir.”

“I prefer a more informal stance, as my mentor did. You can drop the honorifics.”

The intern recited, “Aplastic anemia due to bone marrow and DNA damage from trace amounts of radiation emitted when the noble gas triargon is part of the artificial atmospheric mixture in subzero environments. Inert gases break down in those conditions rather than remaining stable. The resulting illness is very rare as a recessive gene must also be present in homo sapiens for the radiation to be detrimental. DNA resequencing and stem cell treatments eradicated the condition with no lasting or permanent effects. I memorized the file. It was a brilliant diagnosis.”

“Which I missed,” Evan replied. “I saw the immediate problem, an ear infection. Leo McCoy teased out the disparate threads from random bits of information and connected them. That was the day I truly started learning how to be a good physician. If I teach you nothing else, let it be the importance of seeing the big picture rather than the most immediate image in front of you. Get started on vitals, I’ll join you in a moment.”

Evan dreaded these annual visits. After Jocelyn’s choice, a choice breaking McCoy’s heart into a million pieces, he wanted to refer this case to another physician. Instead, as a favor to his friend and mentor, Evan pushed through his bitterness and managed a cordial relationship with Jocelyn for Leo and Joanna’s sake. He was less sanguine of maintaining such a rapport with her once his own daughter was born in three months. Once he experienced firsthand what McCoy lost.

Sighing, Evan joined the family in the exam room.