Title: There Were Days (1/16)

Author: Still Waters

Fandom: Star Trek TOS

Disclaimer: Not mine. Just playing, with love and respect to those who brought these characters to life.

Summary: McCoy is critically injured and Christine Chapel does what she does best. A character study of Leonard McCoy and a look into the world of the Enterprise medical team.

Notes: This is my first Star Trek story and the first real piece I've written in several years. Dr. McCoy has always been my favorite character and after a recent marathon of the new movie and the old series, I finally got something in my head that wouldn't leave me alone. This is un-beta'd, so all mistakes are my own.

There were days Christine Chapel loved being a nurse.

Crouching on the cold Engineering grating between Dr. McCoy and a nervous Ensign with a badly dislocated knee, listening to the familiar melody of McCoy's gentle, diversionary teasing, Scotty's staccato stops as he realized his worried pacing and abruptly stamped his feet in place, and the soft, supporting whir of the medical scanner, she couldn't imagine being anywhere else. She slipped effortlessly into the conversation, dancing the give and take of humor and sarcasm, keeping one eye on the scan results, monitoring the Ensign's vital signs and running McCoy's potential orders through her head in preparation for treatment.

"I can't believe I fell that hard. It wasn't even that much of a shake," Ensign Tenzin berated himself, the nervous dart of his eyes between the swollen, displaced knee and the medical kit betraying his relatively even tone of voice.

Christine threw herself forward to brace the injured knee as the ship shuddered again. When the deck leveled out again, she gently moved one hand to Tenzin's radial pulse, while her eyes shifted to his chest and face. He was tachycardic, tachypneic and as tense as a Vulcan confronted with emotional conversation.

Keeping her fingertips lightly resting on Tenzin's wrist, she met Dr. McCoy's eyes and handed him the hypo of acetodone. "15 milligrams of acetodone?" she both asked and confirmed.

McCoy nodded and grumbled, "Damn solar flares. Why Spock insists on us flying through every one of the blasted things is beyond me. What could possibly be different from the last three that threw us around? If someone at Starfleet has nothing better to do than look at the same flare data over and over, I'd be happy to suggest a few things."

Tenzin snorted back a laugh as Christine raised her eyebrows in a 'please elaborate' gesture and McCoy slid the hypo home.

"I take it you've developed a new filing system, Doctor?" Christine inquired innocently as she prepared the next round of medication while McCoy ran his hands over the knee, mapping out the anatomical landmarks.

Scotty began chuckling at the possibilities. Tenzin, gaining courage from his commanding officer and relaxing as the pain medication took effect, piped up with mock-seriousness, "I believe telling Starfleet brass to file their data where the sun doesn't shine is considered insubordination, Dr. McCoy," he smiled.

"You've been spending too much time with Mr. Spock, son," McCoy muttered. Tossing aside that mental syntactical comparison, he met Tenzin's eyes. "How's the pain now?"

"Better. Just kind of in the background now," Tenzin said, his gaze turned inward, mapping out the pain level as he spoke.

"Good. Ready to get that knee back in place?" McCoy asked.

Tenzin grimaced. "This is still going to hurt, isn't it?"

McCoy nodded sympathetically. "What we just gave you will take the edge off, but you'll still feel the knee moving back into place." Christine loved him for this. She had worked with her share of physicians who downplayed the importance of being honest and informative. McCoy could be surprisingly nursing oriented in his patient approach.

Tenzin looked away, biting his lip and mentally preparing himself for the experience.

Scotty knelt next to the Ensign. "It'll be all right, lad," he said gently. "Nothing a bit o' scotch and the good Doctor's hypo cannae fix." He grimaced as both McCoy and Chapel shot him disapproving looks at the idea of scotch and pain medication. Scotty cleared his throat. "At least yours happened in the line o' duty," he changed tactics, glancing up at Christine and McCoy with a combination of apology and pleading.

With Tenzin occupied with Scotty's tale of dislocated shoulders and drunken brawls, Dr. McCoy and Nurse Chapel conferred over the medical kit. "What are you thinking?" Christine asked.

"Total nerve block might work," McCoy thought out loud, "but he'll still know what we're doing and I think that's what scares him the most."

Christine nodded in agreement. She rummaged through the sedatives and her eyes lit up. "What about dimzolam? I know he's got a low dose narcotic on board, but we give him just enough to put him out, I'll monitor his respiratory status and BP continuously and as soon as you're done, we reverse him. He'll be out for the procedure and get the amnesiac effects as a bonus."

McCoy thought it over. "I usually don't like to use it outside sickbay, but we're close enough that I'm willing to give it a try. I'd like to get that knee back in place sooner rather than later and I'd rather not move him until it's done. You have flumzil in there?" he nodded toward the kit.

Christine pulled the hypo out, double-checked the label and set the dosage. "Ready. We've also got laxnone in case you want to reverse the narcotic." She placed the hypo closer to her end of the kit, while setting the dosage for the dimzolam and handing that hypo to Dr. McCoy.

McCoy double-checked the hypo and nodded, while Christine began explaining the plan to Ensign Tenzin and Scotty.

"So I'll be out the whole time and when I wake up, I won't remember any of it?" Tenzin asked incredulously.

"Most people are out completely," Christine clarified. "Some people stay in a twilight state where they are semi-aware, but even those people don't remember anything once they're fully awake again."

Tenzin nodded. "Sounds good to me," he consented. Scotty met Christine's eyes and nodded his thanks.

McCoy ran a baseline scan of the Ensign's vitals and nodded, pleased with the results. With the anxiety and pain addressed, everything was well within normal. "What do you say, Sean?" McCoy smiled at Tenzin, "Ready to nap on duty?"

Tenzin grinned. "You bet, Doc."

Christine grabbed the scanner, noted the baseline readings, and set the machine for continuous scan as McCoy administered the hypo. She looked up at Tenzin. "You may feel a disconnected feeling, or like everything is going gray and sounds are fading," she informed him.

"Oh yeah," Tenzin breathed. A moment later, he was out.

"Nice call," McCoy said, nodding toward the empty hypo. Christine smiled as McCoy checked Tenzin's level of sedation, asked for a reading, and moved his hands into place.

The ship rolled left, hard.

Scotty, McCoy and Christine scrambled to keep the Ensign in place and prevent the medical kit from disappearing down the corridor. McCoy met Christine's eyes, looking for confirmation that Tenzin's vitals were still strong and once she nodded her assent, he sprang to his feet with a growl and stalked over to the comm.

"Bridge. Kirk here," came the reply.

"Would you leave that damned flare alone and stop dislodging crewmembers all over the ship?" McCoy demanded, flicking his eyes back at Christine and Tenzin.

"I take it you're in the middle of something?" Kirk replied dryly.

"I've got a sedated patient in Engineering about to get his knee put back in place," McCoy noted Kirk's sympathetic groan, "and unless you stop throwing him and his medical officers around….." McCoy grabbed at the wall as the ship lurched again. Christine swore softly as the scanner dropped. She laid a hand on Tenzin's chest to monitor his respirations while Scotty retrieved the scanner and reset it for her. "Dammit Jim, you want to come down here and do this procedure?" he shouted.

"Not particularly, Bones. I'll have Spock pause the readings and we'll hold position until you're done."

The ship shuddered slightly as Sulu made the changes. "Jim…." McCoy threatened.

"Noted, Bones," Kirk said. "We're not going anywhere. Get back to your patient."

McCoy grumbled his acknowledgment and jabbed the comm button. He returned to Tenzin's side and glanced at Christine for report.

"Vitals steady," she reported, "Heart rate 82, resps 12, deep, even and regular, BP 110/72, sedation still adequate."

McCoy nodded, replaced his hands and swiftly manipulated the knee back into place. Scotty winced as McCoy ran his hands over the joint, double-checking the placement.

"Vitals still holding nicely," Christine reported.

"Good," McCoy said. "Now, see how easy that is when the damn ship stays still?" he grumbled as he dug through the kit for the cortisone and a longer-acting pain medication. "Ready to reverse him?" he asked Christine.

She placed the scanner down for a moment and reached for the flumzil. She resumed her readings as McCoy administered the anti-inflammatory and pain medications. At his nod, she gave the reversal agent. A few moments later, Tenzin's eyes fluttered open. He blinked a few times, managed to focus on Christine and realized, "it's over already?"

Christine smiled. "Yep. Good stuff, isn't it?"

Tenzin yawned. "Oh yeah."

McCoy grinned. "We'll go over your discharge instructions a little later Ensign," he said. "Just relax for now and we'll get you a stretcher to sickbay."

"M'kay right here," Tenzin mumbled sleepily.

McCoy chuckled. "That you may be," he acknowledged, "but as your doctor, I have to insist on rest in a proper bed."

"Also, your back is not going to be happy with your lying on this floor once the drugs wear off," Christine pointed out.

"That too," McCoy laughed.

"Okay Doc," Tenzin closed his eyes.

"Nice work," McCoy nodded to Christine as she separated the used hypos from the fresh ones in the kit while taking a few last readings.

"Thanks. You weren't so bad yourself," she grinned back.

"No respect," McCoy grumbled good-naturedly. He pulled himself to his feet with a groan, stretched out his back and took the proffered kit from Christine.

Christine watched him walk over to the console, lay the kit down and grab the PADD to log the medications in the Ensign's record. Normally, she would do that when logging the vital signs, but one of the great things about Dr. McCoy was that he never separated work into "doctor" and "nurse." Everyone in sickbay knew not only their own duties, but those of the other medical staff they worked with. Not only was it essential for delegation, but it also tended to keep the workload spread evenly among the staff, with everyone stepping in wherever they were needed. While McCoy began charting, Christine called sickbay for a stretcher and continued monitoring their patient. "Vitals all back to baseline," she reported, tucking the fire blanket Scotty had brought from the Engineering kit around the sleeping form.

McCoy nodded and charted the information as Scotty thanked them both and moved to meet the orderly coming in with the stretcher.

Christine met McCoy's eyes and they shared a soft smile. This was what it was all about. Christine loved working with a doctor just as committed as she was, if not more so, to providing excellent, individual patient care. It wasn't just about diagnosing problems and giving medications – it was treating the patient as a person, finding out what worked best for them and supporting and educating them through the process. What could have been an anxiety-ridden dislocation repair became something completely different. By recognizing and validating the Ensign's anxiety, they were able to come up with an alternate treatment plan that was more acceptable to both the Ensign and his medical team. Hell, they had even gotten the Ensign to share a sarcastic comment or two with his senior officers – a testament not only to adequate pain medication and a good bedside manner, but to the relationship the medical staff was allowed to have with the crew; the relationship Dr. McCoy encouraged.

Christine Chapel smiled. A good end to the shift. Yes, some days, she really loved being a nurse. She helped Scotty and the orderly, Mike, move Tenzin onto the stretcher. As Scotty insisted on helping Mike move the Ensign back to sickbay, Christine took the opportunity to stretch out herself. She turned to McCoy, who was packing up the kit. "Do you want to log the vitals now, or back in sickbay?" she asked.

"Nah, you can do them in sickbay," McCoy's eyes twinkled. "I wouldn't want to deprive you of the pleasure."

Christine rolled her eyes. "You want me to walk with them?"

"Sure. I'll be right behind you," McCoy replied, heading for the comm.

"You going to apologize for threatening the Captain?" Christine teased.

McCoy raised his eyebrows in an 'are you kidding me?' gesture and snorted back a laugh. He hit the comm button lightly. "McCoy to Bridge."

"Ah, Bones. I take it I can have the ship again?" Kirk teased.

"As if I could ever take her away," McCoy grumbled with a chuckle. "We're done down here, so if….." he was cut off as the ship lurched to the right.

Scotty motioned to Mike to place the stretcher on the floor. Christine took over stabilizing Tenzin on the deck as Scotty ran to the comm, panic flitting across his face. "Captain, that felt like a hit," he exclaimed.

"What the hell could have hit us here?" McCoy demanded, pulling himself off the floor.

"It appears the flare has moved to our current location," Spock's voice joined the conversation.

"They can do that?!" McCoy asked incredulously.

"Indeed, Doctor," Spock explained patiently. "The very nature of the phenomena would suggest…."

"Dammit Spock, I'm a doctor, not an astrophysicist. A simple 'yes' would do," McCoy grouched.

"Scotty, I may need some creative engineering," Kirk's voice returned over the comm.

"Aye, Captain," Scotty acknowledged. He looked over at McCoy. "Will ye be all right getting the Ensign back?"

McCoy waved him to his station. "He can sit tight for now. I'll get another orderly down here to give us a hand. I'll want a few more stabilizing hands anyway with all this rattling around."

Scotty nodded hurriedly and rushed to his console. McCoy called sickbay for another orderly, then checked in with the Bridge again. "Jim, is everyone all right up there?" he asked.

"A few bruises, but nothing serious," Kirk replied. "And before you comment on my medical judgment, I'll be sure to send them to you later to be checked out."

McCoy smiled ruefully. "Acknowledged Captain," he replied. As he moved to end the communication, the ship groaned and violently pitched to the right. McCoy slammed into the console, grabbing it for support. Sparks flew around Scotty's station down the corridor. "Scotty, watch ou - " his warning abruptly cut off as the console acting as his support exploded in a shower of sparks and wild, displaced energy.

"Doctor!" Christine shouted as he was thrown back from the console. She grabbed the kit, double-checked Tenzin and told Mike to stay with the Ensign before bolting to her feet and running down the corridor.

"Doctor McCoy!" Scotty called out. He waved away the sparks dancing around his head, grabbed the nearest fire extinguisher and rushed to the smoking console while shouting for one of his crew to take his station.

Christine dropped to her knees at McCoy's side, touching the nonconductive material of the medical kit to his body to ensure she wouldn't end up on the floor as well. Satisfied it was safe, she shook him gently, calling his name. No response. Her stomach clenched. A nurse's intuition, her instructors had told her back in school: sometimes you'll just know something's wrong. As she bent over McCoy's face, tilting her head to look at his chest while listening and feeling for breath against her cheek, her intuition was screaming at her.

Scotty ran over. "Is he….?" His question was cut off by Kirk's demand for warp.

Christine waved him off. "Go!" she insisted. She concentrated on her assessment. Nothing. Respiratory arrest. She felt for his carotid, counting the seconds, ignoring the scanner nestled in the kit at her side. Working for Dr. McCoy, you couldn't help but learn to do some things the old-school way and to trust your own senses over the machines at times. Ten seconds and no pulse. Cardiac arrest. Shit.

She didn't even bother checking a rhythm. She knew what it was going to be. She began chest compressions, silently thanking Dr. McCoy again for teaching the staff and crew CPR. "It may not be a cardio stimulator and fully stocked cardiac med kit," he had said at the in-service, "but it gives the patient a chance when you're on a primitive planet with no medical supplies and a halfway repaired transporter. You won't be as effective as the heart, but you can at least keep some oxygen circulating."

"Mike," she shouted down to him. "Stay with Tenzin, but as soon as your relief comes, I need you." She sucked in a breath and turned toward Scotty. "Scotty, do you have a cardio stimulator down here?"

"Aye, Dr. McCoy had one stocked here last month," Scotty responded, fingers still flying over the console as energy demands continued to pour in from the Bridge. After one too many cardiac emergencies due to errant mechanical energy, McCoy had insisted on stocking certain areas of the Enterprise with cardiac kits and teaching the crew the basics of applying and setting the cardio stimulators. "It's too big a ship," McCoy had pointed out to Kirk, "and the longer a crewmember is in cardiac arrest without a cardio stimulator, the less the chance they're going to come out of it. There's no excuse for the number of cardiac fatalities on Federation starships, especially in Engineering, Jim."

"Get anyone you don't need working on the engines to bring it to me," Christine shouted, trying to remember where she was in her cycle count.

Scotty's eyes widened as he paged Ensign Settler to follow out the order.

Zandin Klebsl ran into Engineering. Mike grabbed the orderly, filled him in and sprinted to McCoy's other side. He watched Chapel do a quick pulse check. "Anything?" he asked breathlessly. She shook her head and he picked up the compressions while she grabbed the scanner and checked the rhythm. V-fib. "Probably R on T," she muttered to herself. Her head snapped up as Ensign Settler skidded to a halt next to her with the cardio stimulator already out of the kit. Mike briefly stopped compressions while Christine applied the device and applied the first setting, then resumed compressions while Christine administered a hypo of epinephrine and cordarone.

"Continue compressions for another two cycles," Christine ordered Mike, "then we'll do another pulse check." Mike nodded, breathing hard.

Christine forced herself to take a deep breath. The event had been witnessed, compressions started quickly, and thanks to McCoy's pilot program with the cardio stimulators, the device was placed and drugs delivered in a timely manner. Did it give him a better chance? Sure. But it really didn't mean much. Even with immediate, proper treatment, lethal dysrhythmias were still very often lethal. Christine looked up. "Hold compressions," she said.

The clock was ticking. Time was muscle. The ship bucked left, the warp engines screamed, the comms were thick with tension, Scotty was throwing out last-ditch escape efforts.

"Nurse Chapel, the Captain is calling for Dr. McCoy," Ensign Settler relayed the comm message nervously.

Christine sighed.

There were days she loved being a nurse.

She reached for McCoy's carotid artery.

Suddenly, today wasn't one of them.

*Medical notes: Most of this is based off my own medical knowledge. Most of the drugs in this story are simply variations of the names of drugs used today. I took the liberty of having characters use hands-only CPR as the current research is pointing that way anyway and the discussion of cardio stimulators and cardiac drugs largely follows the Advanced Cardiac Life Support algorithms from the American Heart Association today. "R on T" phenomenon occurs when something, like an electrical stimulus, hits the heart during a certain part of the cardiac cycle (the "T" wave" on the EKG) where it is vulnerable to being taken over by that new stimulus. This tends to lead to lethal rhythms like v-tach (ventricular tachycardia) or v-fib (ventricular fibrillation). Most of the Engineering discussion about energy requirements and ship maneuvers through a solar flare are pretty sketchy – I'm a nurse, not an engineer (*grin*)