Warnings: Bloody surgery described in minor detail.

Disclaimer: Characters are not mine. Procedure from tracheotomy is actually just how my parents explained that part of the Nancy Drew movie to me. They could be wrong. Other medical terms, well, I'm an anatomy and physiology student. As for the time without oxygen, google "how many minutes without oxygen before brain damage" and you'll get answers anywhere from 3-10, so I decided not to state it explicitly. They'd probably have a better answer by the time it's set.

A/N: This procedure fascinates me for some reason. I realize there's not a whole lot of background—why they're there, for example, or how exactly they get out—but I really just wanted it to be McCoy's point of view, and his world is about saving people, not diplomacy. I thought this would be close to how he remembered the event.

Jim gasped a little and turned to McCoy, gesturing at his throat. McCoy swore loudly and began to bang on the iron door holding them captive.

"Help!" he shouted. A guard appeared at the door. "The Captain is having an allergic reaction," said McCoy without preamble, checking his watch. Only a certain amount of time without oxygen, and Jim would suffer brain damage. "He will die without immediate treatment."

The guard appeared to consider whether they would be likely to be telling the truth. Kirk's lips turning blue as he passed out may have convinced him.

"What do you require?"

"Epinephrine. Norepinephrine. Antihistamines…" McCoy realized belatedly that the guard had no idea what he was talking about. "Something to raise his heartbeat and relax his muscles." The guard exchanged a look with the other guard.

"We do not know of any such substance."

"The Enterprise has it," said McCoy, willing to try anything. The guard stiffened.

"We shall regard any attempt to contact your vessel as an escape attempt."

"You could contact them for us." No reply. "The other option," McCoy swallowed, "is a small, very sharp knife, and a thin, hollow tube. And we need one or the other within the next few minutes, so hurry up." The guard talked to its companion for a moment, then moved away.

McCoy swore when he saw what the guard was returning with.

"How they rationalize epinephrine as more dangerous than a knife…"

"Move away from the door," barked the guard, and McCoy complied. The guard set the planetary equivalent of a scalpel and drinking straw by the door, then retreated. McCoy surged forward and seized the materials. He tilted Jim's head backward and felt for breath. Absolutely nothing. It was this or brain damage. He palpated Jim's neck, finding the thyroid and cricoid cartilages. He took a deep breath, then cut into the soft spot. It was a procedure he'd never actually done before; thanks to modern medicine, he rarely did anything without the benefits of hyposprays and dermal and various other regenerators. This was a throwback several centuries worth of treatments. A tracheotomy. Using the knife as leverage, he placed the straw through the slit and into Jim's trachea. He held one bloody hand over the opening, and was relieved to feel a gasping breath as Jim's lungs compensated for the pressure difference invoked by the diaphragm. For the first time in his life, he thought about what a miracle breathing was.

Until a scream and a click startled him from the automatic monitoring of Jim's vitals, and he turned to see Sulu clutching the knife, a guard howling in pain, and the door swinging open.

"What the…?" He didn't have time to wonder, as within a matter of minutes Sulu had got a communicator from the other guard and had tossed it to him. McCoy caught it reflexively in one bloody hand as Sulu began to engage in hand-to-hand with the other guard. McCoy flipped open the communicator. "McCoy to transporter room. Three to beam up. Have a med team at the ready."

"Aye-aye, Doctor," came the nearly resigned voice of Scotty, and McCoy grinned suddenly. Somehow, they always made it out. And if it took Jim having an allergic reaction in the middle or prison, well, maybe that was just life on the Enterprise. Didn't mean he wasn't going to yell at Jim for it when he woke up, though.

Fin