“Critical Care”
Written by Kenneth Biller & Robert Doherty and James Kahn
Directed by Terry Windell
Season 7, Episode 5
Production episode 250
Original air date: November 1, 2000
Stardate: unknown
Captain’s log. A large hospital ship sits in the sky over a planet. The ward we look in on is overworked and understaffed. Chellick, the administrator, is talking to a trader named Gar who sells him a wonderful medical device: the mobile emitter. He activates it, and the EMH is rather stunned to find himself somewhere other than Voyager.
The EMH protests that he’s been kidnapped, but Chellick just sees a useful piece of technology, especially when the EMH is unable to help himself and starts treating a patient.
Paris and Kim report to sickbay after a holographic hockey game to discover that the EMH has been replaced with a training program. We discover that Gar had come on board to trade, and got sick from something Neelix fed him and spent the night in sickbay. He obviously stored the EMH in his mobile emitter, stole the mobile emitter, and emplaced the training program in sickbay.
The EMH works on Level Red, treating patients as best he can. However, several patients don’t have a high enough TC to receive certain medications. The Allocator, the computer that controls the facility, is very strict about who can get what medications and what treatments. TC, the EMH eventually learns from Dr. Voje, another doctor assigned to Level Red, stands for “treatment coefficient.” How high your TC is depends on how much you contribute to society.
Chellick informs the EMH that he’s being transferred to Level Blue, as his obvious skill would be put to better use there. Assuming it’s an intensive-care unit, the EMH is appalled to find that Level Blue is a quieter, less crowded, less chaotic ward, with more doctors for fewer patients, many of whom aren’t critically ill. One person is receiving cytoglobin as a preventative for a minor ailment, while down on Level Red, a young man named Tebbis, who needs cytoglobin to survive, isn’t allowed it, all due to their relative TCs.
Dr. Dysek, one of the Level Blue doctors, explains to the EMH that Chellick and the Allocator have streamlined their medical facilities. Before he arrived, they were wracked with ecological disasters and inefficient healthcare. Things are much better now, he insists.
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Voyager tries to track Gar down. They trace his ion trail, but that leads to a probe emitting false readings. Gar traded iridium ore to Voyager, which has a short half-life, so he had to have gotten it from within a three light-year radius. They find a mining colony in that radius, and upon arrival find a miner angrily asking for the stolen iridium back. Janeway agrees to return the iridium (though what Voyager has is only half of what Gar stole), and the miner informs them that Gar also stole some induction units from Velos.
Upon arriving at Velos, a trader named Kipp is pissed because he gave Gar the induction units on consignment, and he hasn’t heard hide nor hair of him. Velos trusted Gar on the word of a colleague he’s known for years. Voyager meets with that buyer, whose testimonial was based on the word of his wife—who has since left him for Gar. They track down the wife, who thinks Janeway is looking to steal Gar from her. Janeway pretends to be married to Tuvok to reassure her (which nonplusses the heck out of the security chief, to the bridge crew’s amusement), and then says they have a business opportunity for Gar.
The EMH tries to convince Voje to change Tebbis’ TC to make him eligible for treatment, but when they try to add other skills to his file, it fails. So instead, he orders more cytoglobin for a Level Blue patient who doesn’t actually need it and smuggles it to Level Red. Tebbis starts feeling better, and the EMH continues to clandestinely get meds to the Level Red patients. At first, Voje refuses to cooperate—though the recovering Tebbis, who is an aspiring physician, helps out—but eventually Voje decides to risk his job to help his patients. Meanwhile, Dysek is noticing the higher treatment allocations for the Level Blue patients, and the EMH says that it’s the only way to make sure that the Allocator continues to give them enough meds for everyone. If they use too little one month, the next month’s supply will be far lower.
Gar protests his innocence when Voyager finds him, and in response, Janeway beams him to the brig. Tuvok and Neelix both try to intimidate him, Tuvok by threatening a mind-meld, Neelix by giving him poisoned food (though it only gives him gas, not the life-endangering stomach bug that Neelix describes, that can only be treated by the EMH).
Chellick finds out what the EMH has been doing, and starts discharging patients whose treatments aren’t finished, because they’ve gotten more than their allocation of meds. Tebbis also dies when he’s denied his meds. The EMH is devastated. Chellick then interfaces the EMH with the Allocator so that he can only go where the Allocator sends him.
While the EMH’s movements are now restricted, his interface with the Allocator allows him to have the computer summon Voje to Level Blue. Voje is stunned—he’s never even seen Level Blue—and is conscripted by the EMH to smuggle his mobile emitter to Level Red. Once there, Chellick, of course, follows, and the EMH injects him with the same virus Tebbis had. What’s more, the Allocator identifies patients by blood factors, and the EMH’s injection also makes Chellick seem like Tebbis to the Allocator. Chellick is now violently ill, but because the Allocator thinks he’s Tebbis, it won’t authorize the medication.
Voyager arrives at the hospital ship. Torres can’t beam the EMH out because his program is interfaced with the Allocator. Attempts to communicate fail because only Chellick is authorized to speak to anyone outside the hospital, and he’s indisposed. So Chakotay and Torres beam to the ship. The EMH puts off his rescue long enough for Dysek and Chellick to come to an arrangement where some of Level Red’s most critical patients are transferred to Level Blue—including Chellick.
After being restored to Voyager, the EMH asks Seven to examine him to make sure he’s functioning right. He thinks his ethical subroutines may have been compromised by the interface with the Allocator, given that he deliberately poisoned a healthy person. But Seven assures him that he’s functioning normally.
There’s coffee in that nebula! Janeway gets ever-more-frustrated with Voyager’s jumping from victim of Gar’s mendacity to victim of Gar’s mendacity, culminating in an epic “are you fucking kidding me?” expression on Kate Mulgrew’s face by the time they get to the woman who left her husband for Gar.
Mr. Vulcan. Tuvok does excellent work in tracking down Gar, being his usual methodical self working his way to finding him.
Everybody comes to Neelix’s. Neelix is worried that he himself was responsible for Gar stealing the EMH, as he added spices to the dish he fed him that Gar was susceptible to. Janeway assures him that food poisoning doesn’t turn someone into a thief, and he would’ve found another way to get what he wanted.
Half and half. Torres tries and fails to beam the EMH out of the hospital ship. Presumably, she is able to untether him from the Allocator on site…
Please state the nature of the medical emergency. The EMH is unable to help himself from treating the sick on Level Red even though he’s been kidnapped. Nor is he able to help himself from trying to heal everyone no matter what…
Resistance is futile. When the EMH explains what he did in the hospital, Seven says, “You were prepared to sacrifice an individual to benefit a collective,” to which the EMH angrily replies that he doesn’t exactly aspire to Borg ideals…
No sex, please, we’re Starfleet. Tuvok is obviously put off when Janeway grabs his hand and announces that she and he are a happy couple, but he still is able to help get the information they need.
Do it.
“Because you performed so efficiently last month, the Allocator will determine you’re able to do with less next month. If we don’t order more medication now, we may not get it when we need it. Think about it, Doctor. If you don’t have the proper resources, your cure rate could go down. If that happens, the Allocator may assign you to a lower level.”
“Are we having a problem with our newest piece of technology?”
“Actually, he seems to be learning the system quite well.”
–The EMH telling Dysek how to game the system, Chellick interrupting, and Dysek admiring the EMH’s mendacity
Welcome aboard. Trek veterans Gregory Itzin and John Durbin are in this one as Dysek and the miner, respectively. Itzin previously appeared in DS9’s “Dax” and “Who Mourns for Morn?” and will appear twice on Enterprise in “Shadows of P’Jem” and “In a Mirror Darkly, Part II.” Durbin was on TNG’s “Lonely Among Us” and both parts of “Chain of Command,” and also was in DS9’s “A Simple Investigation.” Debi A. Monahan, last seen as Melissa in DS9’s “His Way,” plays Gar’s new girlfriend.
John Kassir plays Gar, Paul Scherrer plays Voje, and Dublin James plays Tebbis. Other hospital staff are played by Christinna Chauncey and Stephen O’Mahoney, while other folks Voyager interviewed on their way to finding Gar are played by Jim O’Heir and John Franklin.
And we’ve got two Robert Knepper moments in this one. First there’s Larry Drake, best known prior to this for his Emmy Award-winning role as Benny on L.A. Law, as Chellick, and also the voice of KITT from Knight Rider, William Daniels, as the voice of the Allocator.
Trivial matters: This is the first Voyager script by James Kahn, who joined the staff as a supervising producer for the final season. He previously co-wrote TNG’s “The Masterpiece Society.” In addition, he wrote the novelization of Star Wars: Return of the Jedi.
The EMH expresses concern that his ethical subroutines have been compromised, which has already happened twice before, in “Darkling” and “Equinox, Part II.”
Set a course for home. “That feeling you get from helping someone—infectious, isn’t it?” Star Trek is well known for its tendency toward social commentary, and this is a particularly unsubtle—but also successful—example of that. The issue of healthcare resource allocation is one that was very timely when this episode aired in the United States at the turn of the millennium—a decade after the Clinton Administration’s failed attempt to get some manner of universal healthcare in the U.S. and a decade before the Obama Administration would pass the Affordable Care Act—and it’s one that still resonates in 2021 as we find ourselves still mired in the grip of a global pandemic.
The primary appeal of the episode—as usual—is Robert Picardo. He shines as always, showing the EMH’s snarky compassion and dedication to the healing arts regardless of the circumstances. I particularly like how he objects to being stolen but the nanosecond there’s an obvious medical issue, he jumps right in.
The ending is a much more clever telling of an AI moving past his programming than the ending of TNG’s “The Most Toys,” which was a bit mealy-mouthed about the whole thing. The EMH has grown and developed over six-plus years of constant activation, and while Seven’s Borg-like comment that he sacrificed an individual for the good of the collective (because saying the needs of the many outweigh the needs of the few would be too obvious, I guess) appalls him, it’s also true. He was serving the greater good, and there’s also the fact that even so hidebound a bureaucrat as Chellick would have enough of a self-preservation instinct to get himself treated.
All the guest actors do quite well, also, though Paul Scherrer and Dublin James are both baby-faced white guys with similar voices, and it’s sometimes hard to tell them apart. Still, they all comport themselves well. I especially like Gregory Itzin’s subtle portrayal of Dysek. Both Voje and Dysek need the reminder from the EMH—who literally has the Hippocratic Oath programmed into his brain—that the patients should come first. Voje’s cynicism and desperation is more obvious, but Dysek is just as tired of the bullshit, and he also uses the EMH’s idealism for his own purposes. And Larry Drake is, typically, superb. It would be easy to play Chellick as an over-the-top bad guy, but Drake sensibly plays him with a bland, bureaucratic affect—banal, reasonable evil is way way more scary than cackling diabolical evil.
On top of that, the cuts back to Voyager as they try to find Gar are delightful, especially the expression on Kate Mulgrew’s face when Janeway has to deal with yet another person who isn’t Gar…
Having said all that, the episode doesn’t quite commit to dealing with the issues as strongly as it can. Chellick’s solution is extreme, yes, but it was also necessary. In the abstract, the streamlining and prioritizing is important for a society that has limited resources, something the EMH—who comes from a replicator-based society—would struggle to even understand. (Especially given how half-assed Voyager’s own supply issues have been during their sojourn.) Still, it’s a strong enough allegory, and full of enough great performances, that it stands out as one of Voyager’s finest hours.
Warp factor rating: 9
Keith R.A. DeCandido is also reviewing the new season of Star Trek: Lower Decks on this site. Check out his review of the second-season premiere, which should be appearing today on the main page…
