Spock could not look away from the man cocooned in the cryotube. By all accepted criteria, he was dead. Jim Kirk's eyes were closed, no longer open, dull and unseeing. His face was relaxed into a gentle sculpture, free of the pain and despair that had rippled through the youthful features only minutes before he had drawn his final breath.
Rigid and unmoving, the Vulcan stood by the cryotube, a cross between a sentinel and a shomer. He did not allow himself to think …to hope. Looking down at the motionless figure, he could convince himself only too easily that Kirk was sleeping.
"I want a full platelet draw," McCoy ordered tersely. "As much as you can pull."
Enterprise's Sickbay filled with the hum of medical personnel rushing from station to station. Most of the wounded had been moved into another section to accommodate the additional staff that crowded into the main bay. There was an intense urgency in the air that seemed to electrify the room. At the center of all activities was Khan, unconscious and securely strapped to a gurney.
All of this went on without Spock's notice.
"Is this going to work?"
The sound of Uhura's soft and uncertain voice did not distract him. He felt himself retreating into the core of his Vulcan heritage, centuries of mental endurance and unyielding discipline that was Vulcan.
"Spock?" Her hand rested lightly on his arm.
He deepened his resolve, refusing her comfort. Kirk, who now consumed his attention, had also inspired his rage toward Khan. Not since Nero had he felt such unbridled fury, and even that time it had seemed as if his anger was a misdirected attempt to divert the pain of his mother's death, rather than the single-minded pursuit to end a man's life…the very man for whom he had recently argued leniency.
He shifted his gaze to Khan and felt the cold stirring deep within.
"You…you can't even break a rule. How can you be expected to break bone?"
But he had broken bone. It had felt alarmingly satisfying to smash his fist into Khan's face, to punish the man who had caused him so much pain. How he had wanted only to crush the life out of the man, to see his eyes light with fear then dull to nothingness. He wanted Khan to know who had extinguished his life…and why.
Savagery?
Vulcans had almost annihilated themselves because of their savagery. Warriors bred for conquering. That ancient drive was still part of them, buried deep beneath the discipline of Kohlinar.
"Start a central line," McCoy ordered.
Medical staff worked feverishly, syphoning blood from the still form like hungry parasites. It was satisfying seeing the man who had announced that he was better at everything now reduced to this: A means to an end.
The imposing figure now lay supine and artificially benign. McCoy had gone to great lengths to assure that Khan would not awaken. Still, four security guards remained in the room on Spock's orders.
McCoy stepped away from Khan and walked toward Spock. He looked like a condemned man – resigned, hostile. What they were doing was immoral and illegal. It defied the Hippocratic Oath and every law that governed civilized societies.
"We have to take him now," he said.
It was time.
StarfleetMedicalCenter was equipped with the most advanced medical technology available. It boasted the Federation's finest research departments and attracted physicians and scientists from the farthest reaches of the galaxy. It was a mecca of innovation and diagnostics with an impressive patient recovery rate. On any given day it tended and treated over three thousand patients. The most critical were assigned to the prestigious Intensive Care Unit.
The ICU was unnervingly void of human sounds. Beneath the steady thrum of medical technology was the faint murmur of voices conversing. Kirk had been removed from the cryotube in Enterprise Sickbay and given a vial of Khan's platelets. It had done as McCoy hoped. Fresh new platelets were reproducing at an astonishing rate, replacing the damaged ones within Kirk. As impossible as it seemed, against all medical reason, it had brought Kirk back from the dead, reviving his primary systems. Outside the protective covering of the cryotube, Kirk drew his first true breath.
A beginning hint of color tinted his pale face just before his organs began to fail. The lethal amount of radiation he had sustained had absorbed into every cell, poisoning his blood, quickly destroying his liver, kidneys. Even Khan's genetically enhanced platelets couldn't reverse the damage quickly enough to keep the radiation from affecting Kirk's respiratory system. Within an hour of the first small injection, Kirk's primary systems had begun to fail. McCoy was forced to put him on by-pass and full respiratory support to keep him alive.
"Doctor." The ICU nurse handed him a PADD.
"Damn it," he said under his breath, studying the readouts. Whatever was in Khan's blood, however it had been genetically modified, it had revived Kirk.
He was alive. It was the radiation that was killing him.
Out of the periphera of his vision, McCoy saw a figure move forward. Spock stood straight-backed with his arms to his sides, at attention and yet removed from the commotion of the ICU. His gaze was transfixed on Kirk who lay frighteningly still. The respiratory support system was cumbersome and invasive, pumping oxygen into his still lungs through a tube inserted into his trachea.
"Why isn't it working?" Spock asked. His voice was low, almost guttural.
There was a primitive aura about Spock that made McCoy uncomfortable.
"He's alive. That's more than a miracle in and of itself," McCoy said carefully and stepped up to the bed on the opposite side of Spock to study his friend and patient. Jim looked small and vulnerable in a way McCoy had never seen. The intubation tube parted the pale lips, forcing a slight, even rise of his chest. Beneath the light-weight patient gown, tubes had been inserted into his chest, directing blood back into a complex and sophisticated by-pass system that was anchored just at the head of the bed.
Spock looked up at the diagnostic panel that displayed Kirk's vitals. "Doctor, he is dying."
"I know," he said so softly that only Vulcan ears could hear.
"Can you not use more of Khan's blood?"
He sighed heavily. "It's not that simple. The radiation has done substantial damage. It's still in Jim's blood and tissue, attacking every organ. We're trying to filter it out, but…."
But radiation caused blood to stop clotting. Patients died from internal hemorrhage, loss of neurological functions. He didn't have to tell Spock. Every Starfleet personnel knew radiation protocol.
"Then you must give him a total transfusion of Khan's whole blood."
McCoy stared at Spock. "Are you out of your Vulcan mind? Platelets are one thing; blood is another. Humans have to match blood type. Khan doesn't even have a blood type as we know it. I have no idea how his blood has been genetically modified and to what extent. If I give it to Jim it could kill him."
"Doctor, he is already dying."
Sometimes the simple, logical statements the Vulcan made were enough to make McCoy want to scream. He spun away from Spock and Kirk, wanting for the first time to be free of the decision only he could make. He was a physician first and foremost. He had taken a Hippocratic Oath to do no harm. Doctors are taught in med school to assess, to diagnose, to plan. It was better, they were told, to do nothing than to do harm.
But hadn't he already done harm? Jim had been dead, resting peacefully and out of pain. He had played God on a hunch and took the biggest gamble of his life. He had brought the young captain back to this.
He closed his eyes. Behind him were the taunting sounds of the respirator and by-pass machine, refusing him respite. The truth was, he didn't want Jim to die and he would do anything – moral or immoral – to give his friend a chance at life. That was all Jim ever needed – a slim margin to beat the odds.
"I don't believe in no-win scenarios."
Maybe McCoy didn't either.
He opened his eyes. "If I can synthesize a serum from Khan's blood, it might act as antigen." He turned back to his patient, knowing that the longshot was not going to be enough.
On the opposite side Spock stood, offering him no quarter.
He was going to have to give the transfusion.
It defied every protocol.
The medical staff had properly processed Khan's blood for transfusion. There was nothing unusual about its physical appearance and when they prepared to transfuse, it entered Kirk's veins in the usual manner.
McCoy stood near the bed and monitored the procedure that the nurses performed a dozen times each day. Their movements were practiced and fluid. In a matter of moments, Khan's blood was being pushed into Kirk.
The only sound in the room was the steady hum of the by-pass machine.
McCoy looked at Spock who was observing from the far corner of the room, out of the way of the medical staff. He was glad to have the Vulcan's company, even if it was silent. Medical science was all about waiting. There was nothing more for them to do for Jim but wait and see how his dying body handled the transfusion.
Still, it was difficult to watch the procedure. McCoy wondered how the cool, disciplined Vulcan mind interpreted the process. Was it a simple matter for him to separate his emotions from what he witnessed and focus on the procedure at hand? Or did he see what McCoy saw – the failing remains of a young man who had finally been broken?
He reluctantly shifted his gaze back to Kirk who lay supine on the bio-bed, bared to the waist to allow the medical staff full access to his body. His chest was covered with purple and red bruises, some from the beating Khan had delivered, some from whatever he'd gone through bringing the core back on line, and the rest from radiation exposure.
McCoy didn't need any high-tech medical device to tell him the radiation was killing his patient. With a sigh, he moved to the narrow console on the wall and began running a diagnostic on Khan's blood. He hadn't had the time he needed to study the man's blood on the Enterprise, but he had discovered enough about it to know of its rapid regenerative powers.
The scientists who had created Khan had come from a period on Earth known as the Eugenics War, when genetically engineered humans, originally altered to lead the planet out of war, took control of most of Earth, throwing it into a second Dark Age. Little if any records had been kept, and those that survived were quickly sealed.
Genetically modifying humans was strictly prohibited.
McCoy put the blood through the synthesizer. Now this 300 hundred year-old transformed blood was going to save Kirk…or kill him.
Spock watched McCoy out of the periphera of his vision. For all the doctor's emotional outbursts and colorful vernacular, he was an excellent physician and medical scientist. And…he cared deeply for Jim. He would find a way to bring Kirk back. They had already come this far. Spock would not contemplate failure.
He had already lost the Captain once.
"I'm scared, Spock…help me not be." His face tightened with pain. "How do you choose not to feel?"
What was he feeling now, Spock wondered? Was he lost in the darkness of unconsciousness? Was he suspended in that terrible empty place when death took him, feeling what Pike felt in his final moments? Was he in pain?
He studied the vitals readouts on the display. McCoy had promised him Kirk was too deeply unconscious to feel pain. The machines were keeping his body alive and the new blood promised a chance of restoration, a chance to heal the damage the radiation had done.
His gaze shifted to the motionless form, barely recognizable to him. Where the flesh was not discolored by bruising it was inhumanly pale. Kirk's red blood cells had all but been destroyed by the radiation, leaving him severely anemic.
The nurses tended his body; their attentions professional, their movements almost mechanical.
He did not like seeing his friend this way.
Jim would hate being this vulnerable – completely reliant on their care, on McCoy making the right decision that would determine his fate.
"Come on, Spock. That's deep space!" Kirk was a live wire, energized with enthusiasm and confidence as they walked to Admiral Pike's office.
Spock recalled his captain's boyish eagerness that day, a man so completely certain of who he was and where he was going that he could not even contemplate being denied command of the Enterprise. And why should he? He was the youngest captain in Starfleet with the newest ship. He had received Starfleet's highest honor for saving Earth. He had been declared a hero by the Federation. Starfleet's best and brightest….
Spock took a few careful steps forward, moving toward the bed. The intravenous lines pushing blood into Kirk were of a higher gauge to speed the process. Still, the procedure would take hours. The question was: Could Kirk's body survive that long?