MEDICAL LOGS

SACRED GROUND
Season 3 : Episode 49

 

MEDICAL REPORT:

While on the Nechani home world touring a sanctuary which honors the Nechani ancestral spirits, Kes enters the shrine and is struck down by an energy field around it (an intense biogenic field), later determined as 800 megajoules and the thoron radiation levels are off the scale. As a result of the contact with the biogenic field, Kes's synaptic pathways undergo a severe neuroleptic shock that disrupts all cortical functions, and she is left in a coma.

the sacred shrine

Kes enters the shrine and is struck down

Kes in Sickbay, in a coma

The Brothers (and Sisters) of the Nechisti Order prepare themselves specially for the sacred ritual before entering the shrine, their most holy of places. In the ritual the members of the Nechisti Order speak directly with the Ancestral Spirits and are able to enter the shrine safely. Following a Nechani historical precedent, Janeway goes through the ritual in an attempt to save Kes' life. The Doctor monitors Janeway's biological condition throughout the ritual, via a subdermal bioprobe which is a small medical device implanted just under her skin which transmits biochemistry readings to a remote location (i.e. to Voyager). The Doctor and Janeway expect the ritual, in keeping with many ritual tests, to consist of a series of physical challenges designed to prove the supplicant's worthiness. In the ritual's early stages, Janeway's respiration and pulse remain steady, but there is a gradual build-up of lactic acid in her extensor muscles due to light strain (at one point the guide instructs her to hold up a rock for hours). After the ritual becomes more intense there are significant increases in her respiration, neural peptides, and adenosine triphosphate levels, which suggests she is going through a gruelling physical experience.

the Doctor monitors Janeway's vital signs during the sacred ritual

She goes for over three days without sleep, but her vital signs remain normal, and she is fully conscious with complete motor control. Her entire biochemistry undergoes a series of unique interactions, forming an amino acid as a result of the breakdown of the nesset's toxin in her bloodstream which the Nechisti use as a psychoactive drug to induce hallucinations as the gateway to audience with the Ancestral Spirits.

Sickbay. Chakotay: "It's been three days since she had any sleep. How long are we going to let her go through this?" Doctor: "I understand your concern, Commander. But I must point out that her vital signs are stable. She seems to be in no immediate danger." Chakotay: "She's been poisoned by some unknown toxin. It may be having an effect we can't gauge. It could lie dormant for a few days and then suddenly fluctuate and kill her in minutes." Doctor: "You seem to be implying that I'm not paying attention. I assure you I am monitoring her constantly. If I thought she were in jeopardy I would act." Tuvok: "Doctor, is there anything that might be preventing her from using the homing signal in her implant?" Doctor: "Not that I'm aware of. She's fully conscious and has complete motor control. If she wanted to transport she could signal us." Chakotay: "Are you getting enough meaningful information to justify her continuing this ordeal?" Doctor: "I am getting some remarkable data. Her entire biochemistry is undergoing a series of unique interactions. Look," he calls up data on the monitor: "this amino acid has been formed as a result of the breakdown of the toxin in her bloodstream. It's affecting the normal flow of neurotransmitters and very likely having an hallucinogenic effect." Tuvok: "Is she delusional?" Doctor: "I think she's experiencing the Nechani version of a psychoactive drug." Chakotay: "Then is it possible she's in no condition to activate the homing signal?" Doctor: "I don't believe that's the case, and I strongly suspect this biochemical change is going to give us the answers we need. The toxin in her bloodstream may very well be the key to getting a treatment for Kes."

The Doctor takes the information learned from Janeway's bioprobe and creates a program to analyse the immune mechanism and develop a treatment regimen for Kes but that regimen ultimately fails.

Doctor: "Hmm, her electrolyte balance is deviating, but that's not entirely unexpectedHer cardiac functions are being disrupted. I don't understand it." He administers lectrazine. "This is baffling. Her biochemical levels are exactly what they need to be to correct the damage. She should be awake and alert. I can't explain it. Her vital signs are unstable, I have to discontinue treatment. I don't understand it. No. I'm sorry, Captain, but it appears that everything you went through was meaningless."

Janeway realises that she has to take the ritual's spiritual nature on trust, and returns to complete the ritual properly. She succeeds, and when she carries Kes back through the shrine she (Janeway) is not harmed and Kes awakens fully restored. Afterwards the Doctor explains the cure upon examining the tricorder readings which Chakotay took at the shrine reveal traces of iridium ions. The Doctor believes they caused a temporary dielectric effect in the outer epidermal layers, which neutralised some of the biogenic energy enough to make Janeway's altered biochemistry an effective defence. The metabolic treatment he administered protected Kes against the full impact of exposure to the field when Janeway took her back through it. That exposure functioned like a natural cortical stimulator, and reactivated her synaptic pathways.

Janeway carries Kes through the shrine and Kes recovers, and the Doctor gives the scientific explanation

LECTRAZINE:

This drug, administered to stabilise cavdiovascular and renal systems in humanoid patients, is used in  [#35 Lifesigns], this episode,  [#52 Warlord] and  [#75 Scientific Method], and a mixture of lectrazine and hyronalin is administered in  [#64 Real Life].

DOCTOR'S QUOTE:

About Kes: "Mr Neelix, you're wallowing, wallowing in useless remorse. I'll have to ask you to stop, it's bad for the patient."