Between the Stethoscope: Inside Starfleet Sickbay

Posted on 240301.16 by Elor Letek in Editorial, Special Reports

Starfleet teaches its doctors hard truths early: patients die, and some outcomes cannot be changed. But life in sickbay quickly reveals the exceptions found not in regulations or textbooks, but in moments of quiet humanity. Lieutenant Elor Letek, MD assigned to the USS Eagle provides insight.

The first rule a doctor learns in Starfleet is this: patients die.

The second rule a doctor learns in Starfleet is this: doctors can’t change the first rule.

But not everything is as absolute as they teach you at Starfleet Academy. There are countless nuances between absolutes—countless shades of grey between black and white.

As a doctor, you’re not just busy writing reports and treating critically ill patients. It’s not an either/or. The profession involves more than boring night shifts and the constant struggle between life and death.

It can be funny. Sad. Thought-provoking. Surprising. Frightening. Disgusting.

When a medical officer is thrown in at the deep end after graduating from the Academy and gets their first posting aboard ship, no one knows what to expect. Many associate that first assignment with fear, curiosity, worry, and uncertainty. Even if the first case is straight out of a textbook, those feelings still resonate. You have to take a few steps in your new shoes before you feel comfortable in them—and can walk confidently.

That’s especially true when an insectoid colleague stands in front of you with an unusual problem. Insectoid humanoid physiology takes up only a small part of the Academy curriculum, and some issues simply aren’t the kind you can foresee.

That was exactly what I experienced.

One of my esteemed insectoid colleagues came to sickbay for a routine check-up and raised a concern:

His shell felt a little tight in some places.

So there I stood, under the bright lights, as if I were being questioned in an exam—nodding thoughtfully while mentally calling for help. What should I do now? That wasn’t a diagnosis we’d covered at the Academy. The expectant silence between us, while he waited for a solution and I tried to invent one, only increased the pressure.

Here’s my general advice: don’t overthink it.

In the end, we agreed on light stretching exercises and physical therapy to get the problem under control.

The moral of the story is simple: you can spend years completing an incredibly complex degree, but to tackle the right problems, sometimes you have to stretch a little first.

Sometimes it takes more than stretching exercises. Sometimes a doctor needs to be able to perform magic.

There comes a time in a doctor’s life when they have to treat children. The fact is, children often require a different approach from adults.

After a rescue mission, we took aboard a large number of refugees, including one very special young man. One of my colleagues found him wandering the corridors alone—nothing remarkable about that—except he was injured. They brought him to sickbay, and treating him proved to be a major challenge.

Not because his injuries were especially severe, or because he carried an exotic disease. It was because his fate touched me.

As it turned out, the injuries had been inflicted by his guardians.

Although I felt sick at the thought that anyone could do such a thing to a child, it was now my job to keep my expression gentle—offering him a sense of safety and security. The first priority was trust.

Then came the physical treatment. And here it became clear that a doctor does have a little “magic” at their disposal.

The lights were dimmed. The engines’ hum became a soft, rhythmic backdrop. The boy held his breath, waiting.

And then I spoke them—the ancient Bajoran words of healing.

At this point, I should probably note that I didn’t use real magic, of course. I used a dermal regenerator. But it worked all the same. Sometimes you have to make medicine a little more palatable.

Even now, months later, I think back to that bright, injured boy and still feel moved by the encounter.