Chapter Text
He hasn’t shaken like this since his first day on the Val Jean, and at least that had been familiar.
The realization, sometime in those hazy days after his court martial, that the trembling that seemed to rise from his centre and concentrate in his hands meant an age-old dependency that modern medical technology could dampen but not prevent, had been met with a sort of detached logical horror that he couldn’t feel. Exeter’s doctor had been human, not keyed to the ship’s biometrics the way the EMH is, and the sedatives he was given a mercy after the accident had suppressed enough of the withdrawal symptoms he hadn’t yet realized he was experiencing that it was a shock to wake up in his squalid little bedsit in Marseilles and discover that he couldn’t keep whiskey down anymore.
It got worse, after that. His nerves screamed with an anxiety that wasn’t emotional, that seemed at once worsened by and part of the paroxysms of sweating that seized him in between bouts of crawling breaking out along his skin, so like ants writhing and stinging at him that he could have believed they were there. He’d suffered it for most of two days by the time it began to abate enough that he wasn’t so ill he couldn’t think or move but to sip at water and broth from his limited replicator, and he’d known it was trouble when it stopped with the first absorbed swallow of Scotch, but by then he was soothed and calmed enough by it not to care.
He learned to deal with it, to keep it at bay with beer or sweet cocktails when he woke up with the dread beginning to pool inside him after a bad blackout and to eat and hydrate enough in the depths of his binges that it wasn’t usually so bad. He suffered it here and there, amazed by the feeling of vitality beginning to return to him by sometime through the third day, after he finally caught a few hours sleep that weren’t broken by the feeling of his heart trying to chisel through his breastbone or half waking nightmares that were bizarre, but that weren’t Charlie or Odile’s broken bodies reanimated and recriminating him.
He’d known, on some level, but the immediate surge of relief he got the first time Chakotay pressed a hypo to his neck with a gruff rebuke that he could suffer on his own time was a sickening revelation, one he hadn’t been permitted to drown, this time.
And this – the horror brought on not by his wildly fluctuating neurotransmitters but by the insistent voice of his own conscience – it’s always been worse. The withdrawals had been horrifying, but never personal, so ravaging that there was oblivion in the delirious feeling of his body fighting violently just to survive.
Tom really needs a fucking drink, only there’s enough of him here now to know he can’t. He’s off-duty for the next three days but he’d held it together well enough in front of Janeway to put off the idea that he needed continual cortical monitoring, or worse, some sort of counselling from Chakotay. Only he still can’t sleep, and his hands tremble so badly the text on the PADD he’s trying to lose himself in dances erratically when he tries to scroll through it.
The matter-of-fact sickness had been easier, knowing it would pass. This will, too, the memory of pain blazing bright through his own – Tolen Ren’s – chest as his vision fades out, but there’s no set biological timeline on it, and if not for the refreshing sense of purpose he’s found on Voyager, he’d consider chucking himself out an airlock.
Even still, though, he’s idly considering it when Harry finds him huddled on his couch, staring at a wall over his quivering cup of cooled chamomile tea.
“Hey,” he croaks, and shares the flinch Harry can’t hide at the raw sound of his voice.
Harry hides his alarm well enough, some measure of the Starfleet mask he’s not nearly good enough at maintaining pulling through, but the way he keeps his distance broadcasts his wariness and concern well enough over the lightness of his tone when he replies, “Hi. You know, you look like hell.”
That awkward little addition meant to calm his nerves reminds Tom of why he’s denying himself the liquid escape hatch hidden in a box in his closet. He won’t get away with this much longer, but just yet Harry’s here not on orders or protocol but a kind of genuine, uncomplicated concern Tom’s sure no one’s had for him since Charlie died.
“Gee, thanks. Help yourself to the replicator,” Tom says, but his tea splashes in jerky puddles onto his lap when he gestures, and before he knows it Harry’s talked him into going to sickbay with that staid gentleness of his, even over Tom’s protests that physically, objectively, he’s perfectly fine.
The EMH is active when they get there, and he starts in with his usual sniffy protestations over the fact, with the new addition of complaining that Kes has done it on purpose, trying to leave him to think. There’s a story there worth asking Kes about later, but now Tom just wants to be cleared so he can leave. The hologram is still complaining even after Tom’s tuned him out, but when Tom explains against his better judgment why he’s here, it fades into a mask of bland professionalism so neatly Tom can almost see his programming kicking in.
“Then I suppose I’m needed,” he says with no obvious irritation. “Mr. Kim, you may remain with Mr. Paris’ permission.”
Tom’s prepared to grant it and to explain that this is all overblown but that Harry’d made it clear he’d have no peace until he consented, but Harry withdraws to the hall so quickly he doesn’t get the chance, and Tom finds himself thinking with equal parts annoyance and reluctant warmth that the kid gets him, at least enough to know not to give him an out. He sits on a biobed without being asked, figuring the sooner he gets a scan the sooner he can leave, but the EMH just stares at him, all blank expectation.
“Look, Doc, I appreciate Ensign Kim’s concern,” he concedes to fill the silence. “But you and I both know I’m fine, so scan me and I can get out of your hair.”
The hologram frowns, but snaps into action and seizes a tricorder before coming to stand before him. “Ensign Kim did note physical symptoms, Lieutenant. It would be remiss of me not to determine their source.” The tricorder hums, and the doctor’s frown deepens. “Adrenaline elevated, adenosine elevated with no apparent somnolence, acetylcholine levels consistent with high stress and sleep deprivation...”
“Right,” Tom accedes. “And nothing at all indicating neurological damage, which we knew. All right, so I haven’t slept. I tried, it didn’t work, and then I got distracted. I’ve gotta lay down and give it another go, that’s all. So if you can just pass that on to Harry...”
“Mr. Paris,” the doctor begins with grave patience. “It’s true that your state no longer indicates any outside physical cause for concern, however–”
“Okay, so it wasn’t an easy ride down there, but–”
“However,” the EMH repeats peevishly, “your vital signs give every indication that you are experiencing a great deal of distress that is indeed affecting you physically.”
“Yeah, and eventually exhaustion will win out. That’s how it works for we mere mortals,” Tom drawls. “There’s nothing going on here I haven’t dealt with before. Things’ll look better in the morning, it’s just a matter of getting there first. You did your job, now let me go.”
“No, Lieutenant, I’m afraid I didn’t.” The doctor looks as though this is as much a surprise to him as his persistence is to Tom, and seems frankly disturbed about it in a way that isn’t emulated superiority. “Your symptoms may well be psychosomatic in origin, but I can assure you your body doesn’t care about that. Unprocessed trauma takes a very real physical toll. Certainly someone...” he stops. “Someone should have noticed, but as we’re operating without the usual psychological resources, it was a failure on my part to assume. Certainly someone,” he repeats with less pique, “ought to have offered you assistance.”
Tom shrugs, and the EMH just stares at him again, looking through him the way only a mechanical construct truly could. Zimmerman or whoever was responsible for it deserves credit for that look, because it has its intended effect. Harry would be spilling his guts by now. Torres would be haranguing him for his obtuseness. Either would get him what he needs, and Tom may be more savvy than to give that much away, but he still feels like he has to explain, “Chakotay was probably as glad I wasn’t made to talk to him as I was not to have to.”
“And yet the protocol exists for a reason.” It’s a very binary assertion, just a variable marked true or false somewhere in his matrix, but how slowly the doctor voices it has the feel of a realization. “Mr. Paris, clearly I cannot empathize with your situation, but on a factual basis it’s hard to dispute it’s very difficult to dispute that you’ve had an experience that would be difficult for most humanoids to process without some outside influence. You may not have the medical training I would hope for in an assistant,” he says, and the veiled complaint holds every note of an actual preference, “but even Starfleet Academy’s general curriculum would have taught you as much.”
Tom rolls his eyes. “Those same rules also include a right to privacy, Doc, so long as personnel aren’t believed to be a danger to themselves or others. They put me on leave; I’ll figure it out. I’ve gotten good at that.”
“Your state would indicate otherwise,” the EMH retorts. “If you were capable of fending for yourself as you’re positing, you’d have asked me for a sedative twelve hours ago.”
“Now hold on, I’ve seen my own file,” Tom argues. Even though he had the right to most of it and hadn’t tried to crack the encryption on the parts he didn’t, he knows he wouldn’t have bothered, except for one too many boring hours spent manning his post here in sickbay. One thing that had been emphasized had stuck with him. “You know, history of substance abuse? Not to be given psychotropic medication with a potential for abuse barring meaningful extenuating circumstances? I had worse in New Zealand, and they didn’t bend on that one there.”
Tom feels his cheeks colour with the admission, one he thinks he wouldn’t make with a flesh and blood doctor. His ‘history of sexual abuse’ had been noted just as bloodlessly as his perceived failings, and the doctor had referenced it as briefly and mechanically as his previous chemical dependency and lack of an appendix, in his first physical. It had been far less humiliating than having an actual humanoid physician bring it up, though he’d thought at the time that at least that physician would have known better than to bring it up at all.
The doctor looks thunderstruck, for all of a nanosecond. “They didn’t,” he says, more to himself than as a question to Tom, and then there’s another of those abrupt shifts in his demeanour that means he’s run some internal process to compare information with his programming. “They didn’t,” he says again, more definitively, and then businesslike gives way to something not unlike shock, the way he’d looked before. “That’s appalling. I’d noted it, but I assumed faulty record keeping.”
It’s not accompanied by a remark on organics’ inefficiency, and Tom can’t help but squirm, deeply uncomfortable. “No,” he says to forestall another of those piercing, seeking stares. “Turns out that sort of thing is left to the clinician’s discretion, and I don’t think Dr. Michaels liked me any better than most of them there. I kept it together, so it wasn’t considered a pressing need.”
“That’s ethically indefensible,” the EMH protests, seemingly at a loss beyond that.
“It’s not a decision that can be made with facts and figures,” Tom points out. “I didn’t tick the boxes for mandatory treatment, so I didn’t get it.” He figures this line of thinking ought to help the doctor wrap his processors around it.
“No, it’s not a decision to be made with facts and figures!” The EMH snaps. “Everything we know about human psychology makes it a matter of simple compassion. A negative interpersonal relationship is hardly an excuse to withhold comfort giving measures after a sexual assault!”
Tom flinches, and he’s about to quip that there’s something to be said for leaving treatment decisions to a program after all when the doctor does something that stuns him.
“I’m sorry, Mr. Paris,” he says, looking so miserably contrite and conflicted that Tom feels the absurd need to comfort him. It reminds him of the empathy he’d tried to program into Sandrine, only she was a barmaid and he was a medical tool, and it’s far more unsettling in this context. “While I’d feel obligated to report such a lapse in duty of care in the Alpha Quadrant, and I certainly shall, when we get there... It was equally inappropriate to make you the target of my frustrations. In that I was as as wrong as Dr. Michaels was, though I can only offer in my defense that I lack the personal motivation he must have had. You were entitled to psychologically ameliorating care, both then and recently, and I would not have refused it had I known.”
“It’s fine, Doc,” Tom says, too fast. Anything to get off of this topic. “You couldn’t have – well, you didn’t know. And once we’d settled things on Banea, I didn’t want you to. I made the choice to wallow.” He feels a flicker of self-discovery over that admission, but elects not to analyze it. “Give me the sedative to go, and I’ll let Harry hang around ‘til it knocks me out.”
Tom doesn’t know what the EMH is struggling to find words for, only that he is, and he’s relieved when the doctor’s head inclines and he turns his attention to a PADD, instead.
“I’ve put the authorization through to your replicator,” he says without affect. “And amended the notes on your medical file. The previous annotation was obviously false, in regard to concerns of drug-seeking behaviour. As for the rest of it: I could mandate you see a counsellor if we had a proper one. Since we don’t, I can only urge you to speak with Kes, as your behaviour doesn’t indicate any more stringent measures. You may rest assured in the future that any decisions made in your treatment will not be predicated on your past,” he says, very softly, with a far away sort of look Tom realizes he has to have adopted from Kes. He’s grateful for the curiosity it stirs in him, because it mutes the sharp pang he feels at the hologram’s palpable remorse. “You may go, Mr. Paris, and you may assure Mr. Kim you have my blessing in doing so.”
“Uh... Thanks,” Tom offers, glad he doesn’t have to say more for the emotion he knows is bleeding into his voice. It doesn’t seem quite enough, and he reiterates lamely, “Really.” He’s at the door when he remembers the EMH’s stated preference that he be deactivated, but finds himself feeling he has to ask, “Um, should I... turn you off?”
“No, thank you, Lieutenant,” the hologram responds with alacrity. “I believe I need to re-index some of my files, and I don’t see the need to disturb anyone from engineering over it.”
What he needs, Tom realizes, is to deal with his own emotions, simulated or otherwise, and that’s fascinating, in a construct never intended for it. Harry would find it equally intriguing, but Tom can’t bring himself to do something that feels so much like intruding on someone’s privacy. Instead he makes a sarcastic remark at Harry about having listened to mother when he finds him in the hall, and then he regrets that, so he apologizes by replicating them a pizza in his quarters that’s the first thing he’s really tasted in days. He doesn’t wake Harry when he dozes off on his couch after the meal. He doesn’t think about the fact that the past two hours have given him a sense of comfort that’s not from the buzzing warmth of the sedative, either, but soon enough that melds with his exhaustion and he’s in the dead sleep he’d needed, one he wouldn’t have gotten without what he could no longer entirely convince himself he felt was unneeded interference.