Chapter Text
When he was growing up, Leonard would hover over his mother when she had the flu, splint the wings of birds he found in the yard, and apply dutiful ice packs to the bruises of anyone who would sit still long enough to let him.
Every time, it was the same. He would be relaxing, off guard, and then something would be wrong . Fever. Cough. Blood. And he would become hyper-focused, the world narrowing down to this one point of wrongness , this one point of need, where something was broken and needed to be fixed.
And he would throw himself at the problem with singleminded determination, mouth set in a tight line and eyes narrowed as he nursed his patient back to health. And every time the problem would fade away, the fruits of his labors quickly becoming visible as the world was set right again.
There weren’t many medical problems that couldn’t be solved in 23rd century Georgia, where the science of the Federation was more than the equal of the everyday rural maladies of country life. Still, Leonard would watch the holonews, and listen to stories, and know that somewhere, out there, people were not being saved.
They were dying, from injuries and disease and malnutrition and a thousand other things - some preventable, some not. And when he lay awake in bed at night, he would insert himself into these scenarios - Dr McCoy, who always had a hypospray and a home remedy for any problem.
In these fantasies, Dr McCoy saved every patient, each vision ended with a happy family embracing each other, laughing and crying in their joy. Sometimes Dr McCoy cured an incurable disease, and it was distributed to every planet in the Federation. Sometimes one of his friends (nameless, faceless beings who must be in his future) would become terribly ill, and only the great Dr McCoy could save them.
It wasn’t that he didn’t know that no one was perfect. That no doctor could save everyone. It was just that, deep down, it would never happen to him . Every day found Leonard curled up with a textbook, a medical paper, a journal detailing the latest treatments, and the future seemed endlessly bright.
The first terrible blow to encroach upon his glistening fantasy was disease. A young, college-age Leonard McCoy, heart clutched with ice as he watched his father give the terrible diagnosis (untreatable, 99% mortality rate, say your goodbyes), but it didn’t crush his spirits. He would find a way to treat this, cure this, there was time, there was…
He did not cure it. Standing over his father’s coffin, a man who wasn’t truly his patient, but who he had still failed to save, Leonard’s will still did not break. If anything his passion grew stronger. This was failure. This was unacceptable. Death had entered the realm of possibility, with all its heart-rending acidic pain, and it only made Leonard’s resolve stronger. He would not let this future come to pass for anyone else. Not without throwing the weight of all his knowledge and abilities at each individual problem until there was nothing left to be done.
Time passes, certifications are earned, and the reality of Dr McCoy sees more death than he ever wants to see for the rest of his life. Still, he is good at what he does, he learns quickly, and in many ways he remains the same little boy squinting with steely-eyed determination at a stubborn injury that doesn’t want to heal.
He becomes used to the rush of adrenaline when he sees a new patient, schools his expression into a professional veneer, makes sure the compassion that drives him every moment of the day comes out in his voice, and his hands are steady as they heal his patients.
He finds love. A daughter even. He’s never been so happy. But then scandal. Coming home early to find another man in his home and the ground drops out from under his feet. He wants to work past it. She doesn’t. Screaming and tension and papers that sever his last name from hers.
Joanna is too young to understand.
He runs away.
Space is a horrifying vacuum of hidden terrors, violent aliens, unknown diseases; gravitational anomalies. It terrifies him as much as it fascinates him, and it is as far away as he can ever get from the wreckage of his life.
Starfleet brings him cadet James T Kirk. And Bones thinks he’s found that faceless friend from his daydreams as a child. Jim is bright and energetic and everything Bones can’t find it in himself to be at the moment. Bones is still driven by that all-consuming compassion; that drive that won’t let him look away from someone in need, but he buries himself in his work in a way he never did before.
Jim won’t let him wallow. Jim drags him to the parties he’s never been invited to, and stays up late with him and listens sympathetically whenever Bones needs a friendly ear.
And Starfleet brings new things to learn. Of course he’s already familiar with alien biology, but in Georgia, humans make up 96% of the population, and he has to train himself out of following the more obvious non-humans with his eyes. But he learns about new organs, differences in blood clotting, and which medicines are compatible with different species.
He learns how to treat someone in phaser-shock, or who’s gone space-happy, radiation burns, telepathic brain damage and more. Bones sees an Andorian writhing with a broken antenna, and that same childhood drive forces his hands into action like a man possessed. In the heat of the moment blue blood and twitching antenna on sky-blue skin fade away until all that is left is a being in need of help.
When he comes out of his emergency-haze, he’s still a little uncomfortable. A little uneasy. No matter how much he studies, he will never understand alien anatomy as inherently as a human’s and that makes him nervous. But he practices. And he excels.
Postings and assignments come and go until he’s standing by Jim’s side on a five year mission. Five years. In space. Uncharted space, no less.
Bones has never been so uncomfortable in his life.