We’re talking about the medical professionals of Trek, including:
- the changing prominence of doctors and medicine in Star Trek
- our favourite doctor (and the good characters versus the ones we’d want actually treating us)
- Liz’s nursing rant and Anika’s related ER rant (it’s on topic! We promise!)
- we have … questions about Klingon medicine
- mental health professionals
- medical technology
Episodes discussed in detail:
- “Miri” (TOS)
- “The Child” and “Ethics” (TNG)
- “The Quickening” (DS9)
- “Critical Care” (VOY)
There’s also a lot more discussion than usual about Covid and US politics after about the one hour mark, which we’re flagging in case you’re tired and need to prioritise escapism.
Anika: Welcome to Antimatter Pod, a Star Trek podcast where we discuss fashion, feminism, subtext and subspace, hosted by Anika and Liz. Today we’re talking about medicine and medical practitioners in Star Trek.
Liz: Which turned out to be a really popular topic when you posted about it on Instagram [Liz means Twitter]. We had a lot of discussion.
Anika: Yes, I’m excited that people were interested and wanted to pick their favourite doctors.
Liz: Medicine is very much on people’s mind, and it plays a very big part in Star Trek.
Anika: I have seen a lot of, you know, “which Starfleet doctor would you want to deal with the pandemic, or who’s most likely to come up with the vaccine?” and stuff like that.
Liz: I’m gonna say, all of them, because we want to throw as much brain power as we can at this problem.
Anika: I mean, I think that’s why I was interested in doing it. You can’t avoid it, so you might as well look at it from an interesting Star Trek perspective.
Liz: Yeah! And I had proposed that we do this episode as a deep dive into the character of Christine Chapel, which I still think we should do one day, but Women at Warp did the same thing very recently. So I can have my nursing in Star Trek rant in this episode instead.
Anika: That’s right.
Liz: You’ve set out a very nice list of doctors, the doctors from each series: McCoy, Boyce, M’Benga, Crusher, Pulaska, Selar, Bashir, the EMH, Phlox, Culber, Pollard, the–
Anika: The Rios EMH.
Liz: The Rios EMH and Agnes Jurati. And it’s sort of interesting how, in modern 21st century Trek, the role of the doctor seems to have declined.
Anika: Yes! In Discovery, we still don’t know who the chief medical officer is on that ship.
Liz: I thought it was Tracy Pollard.
Anika: I thought so, too, but then other people came and said that she wasn’t the CMO, she was just another doctor.
Anika: So I don’t really know. But if she is, she’s not a regular. Culber wasn’t even a regular in the first season.
Liz: And none of his arcs are really about him as a doctor.
Anika: Medicine at all, no.
Liz: Which is not a criticism! But it would be cool to have more of his profession in the third season, and more of Dr Pollard. And the CMO, if that’s a different character.
Anika: It makes sense for both Deep Space 9 and Voyager for there to be only one doctor–
Liz: Does it make sense for Deep Space 9?
Anika: Well — okay, it makes sense for there to be only one Starfleet doctor on Deep Space 9. Because it’s a Starfleet outpost on another station, a Bajoran station. It’s not a Starfleet thing. And, Voyager, they all died. So those make sense. And Enterprise, they didn’t even have a doctor. Phlox isn’t even really a part of Starfleet. He randomly joined the crew. It’s very strange.
Liz: Is he even qualified to treat humans?
Anika: Is he even a doctor?
Anika: As far as I can tell, he could have easily been, like, a PhD in biochemistry or something, and got on board and was like, “I wanna do research on you guys.”
Liz: Yeah, “This is totes ethical, by the way.”
Anika: And they were like, “Okay, sure. Here, have our sickbay.”
Liz: I have a theory about the decline of the doctor as a presence in Star Trek. Because this is almost the only franchise where we can trace this development down the decades. So you start with McCoy, and Crusher, and these are sort of the eras when Americans had a family doctor, and had better access to healthcare. So as your healthcare system evolved, and changed, and became more difficult to access, the doctors reduce in numbers on the ship, and become less accessible. Medicine is less accessible to the crew, except through emergency things like holograms.
Anika: Yeah, and you have to — so the EMHs are the only doctors we have in the most future Star Treks, right? So it’s like, they’ve actually been replaced by holographic doctors. And this is where I bring up that, in Star Wars — which is not — it’s futuristic, but also not futuristic, but I’ve always found it really interesting and odd that there are no doctors in Star Wars, they are all droids.
Anika: Every medic is a droid. It’s like they just stopped having human contact for practitioners.
Liz: Wasn’t there a doctor played by Harriet Walter in The Force Awakens, who’s sort of flirting with Chewy?
Anika: Yes, but I think that’s a cut scene. I don’t think that scene’s actually in the movie. Or, if it is, it’s only a couple of lines, and the full scene is in the–
Liz: It’s very brief.
Anika: There is a larger scene. But that’s the Resistance, and certainly, by — once you get to The Last Jedi, they have no–
Anika: Nothing, they have literally nothing. So in The Force Awakens, it’s like, they had — so she’s like an old school actual human doctor that they convinced to join their ragtag group, that’s what I get out of it. It’s just interesting. I’m not saying that — it’s this weird, “In the future, we won’t have doctors, we’ll just have holograms or droids.” And it’s sort of like, now that we’re in this pandemic, where you can’t go see your doctor unless it’s an emergency, and you just see them over the internet, I can see how teledoc is going to become droids and holograms.
Liz: I can see that!
Anika: It makes sense. Not in a good way. I think that we need to keep the human parts of doctoring. But I get it, I get why science fiction is sort of playing with that reality.
Liz: And it’s in even a thing in The Expanse, where there’s no doctor on the Rocinante, there’s a computer system which can do surgery and dispense medicine, and then, on bases and so forth–
Anika: And WebMD is taking over.
Liz: Yeah! And so human doctors are a supplement. Anyway, that’s my grand theory about the decline of the role of the doctor in Star Trek.
And you also see, kind of, the way our conception of the doctor changes, from the doctor as bartender with Boyce, and the friendly neighbourhood gruff old man of McCoy, to the much more nurturing figure of Crusher, and then sort of the male ego with Bashir and the EMH.
And then Phlox — I love Phlox, he’s actually one of my favourite characters on Enterprise, but I have so much trouble fitting him into the role of doctor. And I think it’s like you said, I don’t know that he is a doctor. [laughs]
Anika: I don’t think he’s a doctor! I think he has a PhD. And he’s a research scientist. I really see Phlox as more of a research scientist than an actual medical practitioner. Which is interesting, and I agree that he’s a great character, but I wouldn’t want him treating me.
Liz: I think this was part of the discussion on Twitter, that a lot of these characters are wonderful, wonderful characters, but would you want them to be treating you at all? And, uh, yeah, I have a list of Star Trek doctors who I would as my doctor. And in order, it goes, Crusher, Pulaski, Culber, McCoy, Bashir, the holographic doctor, Phlox. And I didn’t — I completely forgot about the EMH on La Sirena and Agnes, because Agnes doesn’t practise medicine. She has a medical degree, but she doesn’t practise.
Anika: It’s sort of like, she is the doctor on that show? She doesn’t actually do doctoring, but–
Liz: She has a 100% fatality rate with her patients!
Anika: [laughs] So my notes for — I wrote out the list for us, and then I put in a little bit for each person, and my note for Jurati is just, “Jurati — LOL”.
Anika: That’s it!
Liz: It sort of annoys me that she has a medical degree, because I think Alison Pill is too young to play a character with two doctorates. But–
Anika: It could be an MD-PhD, where you get them at the same time.
Liz: No! Because she already has her medical degree when she hooks up with what’s his face as his grad student.
Anika: Well, then, I agree with you, it’s stupid. [laughs] It’s also, like, in the future, apparently, everyone gets their college degrees when they’re twelve, or whatever, and then they join — whatever, it’s fine.
Liz: I’m going to assume — I’m going to headcanon that she finished high school at 16, went straight to the Academy, and only — and did the whole medical thing, and then belatedly realised she did not want to be in space. And I still wonder why they let her in, but uhhhhh, I guess it’s like the Sorting Hat, and people’s psychology changes as they grow up?
Anika: Who knows?
Liz: Who even knows?
Anika: Imagine Jurati taking her no-win scenario test to get into the Academy. It would be a mess.
Liz: I thought that one was to graduate?
Anika: Well, no, because in — Wesley takes that one to get into Starfleet Academy–
Liz: Oh yeah! The psychological test.
Anika: –and he has to prove that he can make a decision and choose someone who has to die. Which is like — apparently, that is the number one way to test someone? Because that happens to Troi, it happens to Wesley, it happens to everybody in the actual no-win scenario Kobayashi Maru test. It’s like, whatever!
Liz: I feel like that particular test was tailored for Wesley, like, it’s different for everyone, and with the way Wesley’s father died, that’s what he needed.
Anika: Yes, that’s what it said, but it’s just interesting to me that the Star Trek writers think that that’s the biggest test.
Liz: I kind of think the Federation, as a culture, values life so highly that it really must be very difficult for the average citizen, if they are faced with a scenario where they effectively have to triage — so yeah, I can see that being a real point of division between people who are suitable for Starfleet and everyone else. I don’t think I could do it.
Anika: I don’t know. I would have to take the test. I can’t imagine it. My existence is such that I would never be in that position.
Liz: Yeah, I don’t even like killing my squad in video games. I feel bad about it. And they’re pixels! And not very well animated pixels at the best of times!
Liz: So do you have a favourite doctor?
Anika: [sighs] It’s hard. It’s hard because — I think I’ve told this story, where I told Alexander Siddig that I loved all the doctors, and so that’s why he was going to be my favourite character.
Liz: Yes, you have.
Anika: So in my head, I have this idea that I love the doctors most? But then, when I actually write down my favourite characters, they don’t make it onto the list? So it’s this weird — like, medical, Starfleet Medical track is my favourite of all. I like them more than Command, I like them more than Engineering, and Ops, or whatever that one is. But the individual characters, I love them all, but I don’t know. It’s weird. So I guess Dr Crusher is my nostalgic heart’s favourite.
Anika: Because I loved her so much when I was a kid watching The Next Generation. I just was so drawn to her as a character. She was the first character in The Next Generation that I really connected with.
Liz: Same, yes.
Anika: So I would say that that’s — like, Dr Crusher is going to be my favourite. I have a lot of affection for Dr Bashir, because I — [laughs] I love trash boys.
Anika: I just do! I have this problem!
Liz: No, no!
Anika: And I really — he reminds me a lot of Tom Paris, in that he starts out as a really terrible person who you can’t root for because he’s horrible and creepy towards all women, and treats people in a very elitist “you’re my property” weird way. Like, he’s entitled, or something? But he grows into someone who decides not to be that. Both Tom Paris and Dr Bashir do this in this interesting arc where — I don’t know, I wrote here, “He’s creepy about women and becomes a much better character when they stop doing that, it’s almost like you shouldn’t prioritise having a ‘ladies man’ in your cast”.
Liz: I couldn’t agree more.
Anika: All of them, they tried to do this with these characters, and it’s awful and doesn’t work. No one likes it. Not just me, not just women, but no one likes it, because they stop doing it and then the characters become better, you know?
Liz: Yeah, yeah!
Anika: Riker, Paris, Bashir, all go through this. It’s like, maybe don’t have that be important to your cast? Just a suggestion?
Liz: I’ve been listening to the podcast Delta Flyers, with Garrett Wang and Robert Duncan McNeill — it’s rather good, everyone should give it a go (if they like Voyager) — but he is saying, in the first couple of episodes, he wishes that he hadn’t played Paris as such an aggressive sleaze, because it’s unpleasant to watch, and it’s so far removed from what the character eventually becomes, which is, like, suburban space dad.
Anika: Exactly. And I see Bashir in the same way. He doesn’t become the same type of character, but he does start out as a person that I don’t really want to win, but in the end, I really love him.
Anika: He never quite grows out of “trash boy”, but he’s not like an Archer, he’s not a complete trash boy.
Liz: I think the thing is that he learns better. He stops being a creep about women, he stops being incredibly colonialist about Bajor and “the frontier”. And he loses his ego.
Like, “The Quickening” is a really great episode because initially he fails, and a lot of people die, and he keeps going, and he leaves Deep Space 9 for months — or a couple of months, at least, to leave with these people in relative poverty and cure their disease. And, in the end, all he can do is ensure that it’s not passed on to the next generation. The work of curing it for this living, dying generation has to go to other people. That’s an outstanding episode, and I think a lot of Bashir-as-doctor — if I think of him in that role, I think ego. And that’s sort of a story about breaking his ego.
Anika: Yes. And he comes out better for it.
Liz: Yeah, like, he was already a good character, but after that, I would trust him as a good doctor. As opposed to, like, a Dr House type, who is absolutely brilliant at medicine, but would you actually want to be treated by him?
Anika: Right. Exactly. You don’t. I’m in the middle of a House rewatch right now–
Liz: Oh my God.
Anika: –and you absolutely do not. You also don’t want to spend any time with him.
Liz: My confession is that I wrote a fair — like, not a lot, but a little bit of House fic, back in the day. It was a whole thing.
Anika: I have House fic. We can compare notes. Mine’s all about Cameron, I’ll be honest.
Liz: I really detested Cameron as a character–
Anika: I love her! She’s one of my favourite fictional characters!
Liz: I think if I went back now, ten, fifteen years — oh my God, how long has it been? I think if I went back now, I would really appreciate her more, but back then I found her annoying, and I wanted more Cuddy. And now I’m much older and wiser, and we can have both! But House is the origin of my great love for Lisa Edelstein.
Anika: That’s fair.
Liz: Anyway! Back on topic…
Anika: So Crusher, Bashir, and I will say that I really like Culber, but I have yet to see him as a doctor at all. I don’t even count him as a favourite doctor. I like his character, such as it is. I like the character that I think he is, I’ll say that.
Liz: I feel like I would enjoy being treated by him because, like the women, he has a very gentle manner, and he doesn’t seem to let his ego get in the way of much. And I think those are good traits to have in a personal physician. I would be open to being treated by Hugh, I think — he’s gentle. I think I like my male doctors [as characters, not as real doctors treating me] to be gentle and my female doctors to be spiky.
Because I watched “The Child”, the episode of TNG that introduces Pulaski, the other day, and I’m like, (a) this is truly terrible television; (b) I kind of feel like, aside from all the reasons that Pulaski doesn’t work, like, her relationship with Data is off-putting, and all of that — I think she was just too outspoken and too ahead of her time as a character. I look at Pulaski, and I see a woman who can tell a bunch of men to cut the manlier-than-thou bullshit. And Star Trek wasn’t ready for that.
Anika: Star Trek was not ready for that. And it’s also — even with the stuff with Data, I think they were trying — she has a lot in common with McCoy. And McCoy is beloved–
Anika: –and Pulaski is not. She’s sort of having maybe a renaissance now. I see more Pulaski fans than I had. But she’s never going to be on McCoy level of belovedness. But they have a lot in common.
Liz: She was an explicit attempt to bring in an older, female McCoy type to the show. And to bring a bit more conflict without breaking Roddenberry’s rules. And I just — the problem is that she goes after Data. And to me, watching “The Child”–
Anika: And Data’s not Spock.
Liz: Yeah, Data can’t fight back the way Spock does. So to me, she meets Data, and it’s like me if Siri started expressing preferences, I’d be like, “That’s hilarious! Who programmed that?” Like when Siri makes Skynet jokes! But the audience has known Data for a season, and knows that Data is a person. So they just cannot see it from her perspective. And so she comes in like this complete bully.
Liz: And she does get over it, to her credit, but I think it was a bad note to start off on–
Anika: Yeah, it was a terrible note to start off.
Liz: –and a lot of people — yeah. It’s like watching an adult bully a child.
Anika: And also that Picard really disrespects her a lot in that episode. He’s just, like, “I’m so annoyed that you’re a part of my crew, now, that I’m just going to treat you terribly.” It’s like, wow.
Liz: He’s kind of the audience stand-in for the Beverly fans going, “Wait, what?”
Anika: Right! So, yeah. Pulaski’s just never going to be my favourite because I loved Crusher so much. And it’s all wrapped up in my mother, and my mother’s death, which all happened at the same time. So it’s like, no.
Liz: No, I understand!
Anika: I cannot. But I understand why people like her, and I think she is or could have been a good character.
Liz: I really wish Diana Muldaur had been able to stick around as a recurring character at some point, or come in on her own ship once a season, or something. Because I do think Pulaski could have been a character as popular and interesting as Ensign Ro, and I think the series would have really benefited from having that sort of strong, no-bullshit female force. But my heart belongs to Beverly.
Anika: Right. Exactly.
Liz: And Selar — season 2 of Next Gen is like the season of missed opportunities with female doctors, because Selar only appears in one episode, and she’s still being namechecked as late as First Contact. Go Suzie Plakson!
Anika: Yeah, and she’s very memorable. And she also brought Suzie Plakson in. Because she’s such a presence throughout Star Trek now, it’s like she elevates Selar, because she played her. But I do think that just the idea of a Vulcan doctor is fun and interesting, and I want more of that.
Liz: It’s also that she only appeared in one truly terrible episode, but she had so much presence.
Liz: And I think, to be successful as an actor playing a Vulcan, you need to have a lot going on behind your eyes. And she did that. She was brilliant. And I love Robin Curtis, but I think Selar was, like, Kirstie Alley level good. So it’s a real shame that we never see her again.
Do you think, like, in terms of really obscure characters we can bring back for Picard, we could bring back Selar?
Anika: Oh my gosh, that would be amazing. They do need a doctor! Like we said!
Liz: They do!
Anika: They need a doctor!
Liz: I think that, with all of these Romulans running around, we need a Vulcan for comedy alone.
Anika: [laughing] So good! I love this idea.
Liz: But I also want Suzie Plakson to play L’Rell’s mother in Strange New Worlds. Because we know she can do a Klingon, we know she can handle make-up, and she is actually taller than Mary Chieffo.
Anika: Amazing. It’s so good. So good! Okay, let’s make that happen. Make it happen!
Liz: Because we’ve established that CBS is paying so much attention to our ideas.
Anika: Obviously, they listen to us all the time.
Liz: [laughs] So do you think it would be weird to be treated by an emergency medical hologram that looks exactly like you?
Anika: Uh, yes! Yes, it would. However, this is — okay, so it’s been established that you don’t have to have them all look like you. That you can buy this program, and you can choose whatever you want them all to look like. And he chose to keep it himself.
Anika: Which is a whole layer of interesting on Mr Rios. But I would hate to be treated or joined in — like, okay, that’s not true, I think that, for the navigation — if I wanted to have a bridge crew, I can imagine a bridge crew of just me. And that would be kind of cool, I’ll be honest.
Anika: As I was saying it, I was like, wait, no, actually, I would like that. But for doctoring, it’s like I want to trust that they are going to be able to figure it out and take care of me and stuff. And I don’t. Because I have some medical training, I am certified in CPR and first aid, I have enough healthcare training to work with developmentally disabled populations in their home. So I’m a — I forget what I’m called. Oh, I’m a nurse delegate, I’m a nurse delegate.
Liz: Oh, nice! What a good title!
Anika: That doesn’t mean I have any nursing. And it certainly doesn’t mean I have any medical training, actual, you know, take-care-of-a-person training. That’s twelve years. So I wouldn’t want the person to look like me, I wouldn’t want my doctor to look like me, even if it was a computer. I would want it to look like Dr House. You know, someone I can trust to take care of me.
Liz: Yeah, I was thinking — because I sprained my wrist on Sunday, and on Thursday, I finally went, “Hey, this really hurts, maybe I should see someone about it?” So I had to go to an actual doctor’s surgery, and it occurred to me as I was walking in that I kind of have an idea of what’s wrong, and I really just want someone with training and authority to say, “Yes, this is wrong, and you are doing the right thing.” And that’s what I want from a doctor, and I don’t want the doctor to look like me, because then I won’t trust them.
Anika: Exactly. That’s just crazy, Mr Rios.
Liz: But I think, also, as a character note, it kind of suggests that he trusts himself more than–
Anika: Only himself. Only himself.
Anika: And I absolutely believe that, I absolutely believe it. I absolutely believe that he only trusts himself. He’s a Gryffindor. It’s very much his trait, I get it.
Anika: I am not a Gryffindor, so–
Liz: I am a very sensible Hufflepuff, and I believe in trusting people with proper training.
So after the list of doctors, we have a list of nurses. And it’s a lot shorter. It’s Chapel, Ogawa, Kes, Paris.
Anika: Okay, so can we start with Paris? Because I had to include him, because I find it hilarious that he is the closest thing that Voyager has to a nurse once Kes leaves.
Liz: And we never see him going through any training to improve his skills.
Anika: Yeah, there’s like three episodes where he even does anything in sickbay. But the conceit, if I recall correctly, is that he got a B+ in biochemistry at the Academy, and therefore he can be the nurse.
Anika: That is terrible on every level.
Liz: So this is my whole nursing rant, that nursing is not treated as a profession that requires training and qualifications. Like, Kes is being trained to be a doctor, Chapel was studying to be a doctor and then left to become a nurse and run off after her fiancé, and Ogawa’s professional arc is actually where Beverly goes, “Oh yeah, you’re doing great, let’s talk about boys.”
And I think one thing that the whole Covid thing has really brought home is how much we need nurses. It’s all very well that all your doctors are holograms or droids or whatever, but who is changing the bedpans and giving the sponge baths, and — you know, even if your biobed puts out the vital signs on a little screen, who is there to read and understand them?
Liz: And I guess Star Trek takes this [attitude] of, “Oh, the doctors will do it!” But we know that that’s not how real life works, and it really troubles me that we see so few nurses, and they’re so relatively disregarded. And it’s a joke that Paris is a man, and a ladies man, and a nurse. And Kes and Chapel are “failed doctors” or “doctors-to-be”.
Nursing gets a lot of disrespect.
Anika: It’s terrible.
Liz: I would like to see better depictions of nurses in Star Trek.
Anika: So I love medical dramas. I love to watch them. And my favourite is ER. So this comes up in ER, because — so my favourite in ER is Carol Hawaway (Juliana Margulies), and she is a nurse. And she is the heart, you know, at the beginning of that series. And it’s very clear that, as much as the doctors work hard and care about their patients, and take care of them, it’s the nurses who really take care of their patients. They’re the face of the ER. They’re the people who you’re going to see over and over again, the three hours that you’re there. They’re doing all the — like, the doctor says, “Do this thing,” and then the nurse does it.
Anika: So Carol has this arc where she decides that she wants to be a doctor, because she never thought she could. Like, she wasn’t good enough to be a doctor, so she became a nurse, but now she realises that she is good enough to be a doctor, so she takes the MCATs and she’s going to become a doctor.
And then, after passing, and Kerry starts treating her like a med student, and starts respecting her in a way that she had never respected her as the chief nurse, even though she was the most senior nurse, and she was there before Kerry even began — she realises that she wants to have that patient interaction, she wants to be the face of the ER, she wants to be the heart of everything, she wants to actually take care of people, and not be a doctor. So she decides to stay a nurse.
And then she gives up her career to go join Doug in Seattle. And, obviously, she doesn’t give up her career, she just moves it to Seattle, but that’s what she’s remembered for? She went after her boyfriend.
Anika: And then Abby Lockhart, who is introduced in Carol’s last season, has the same progression.
Liz: Oh my God.
Anika: She is a nurse who wanted to be a doctor, but gave it up and decided to become a nurse, but she really wants to be a doctor. And she has this whole thing where she’s like, no, nursing is great, and she has a whole speech about it, how it’s really wonderful and important, and it’s valid, and just as important as being a doctor. But then she becomes a doctor. And is a doctor for the rest of the series, and that’s what she’s best remembered for, as the nurse who became a doctor.
And it’s like, that progression, those two storylines, the way they echo each other, and the way that Carol is remembered for her relationship with Doug, but Abby is remembered for being a nurse who became a doctor — it just upsets me, because nothing against those characters, and nothing against a nurse who wants to become a doctor, like, sure, great. But there are plenty of people who actually wanted to be nurses. Who chose to be a nurse. And they do have that patient interaction, and they do matter as much as a doctor. And it’s just sort of threatening to have this idea that (a) nurse can just become a doctor if they take a couple more years, or whatever.
Liz: If they want it enough.
Anika: Yeah, if they want it enough. And that just being a nurse isn’t a good enough end goal. Like, of course it is.
Liz: Right, there’s this idea that professional success for a nurse is becoming a doctor.
Liz: We even see it a bit in Doctor Who, with Rory — and I love Rory, and it is so rare to see a male nurse in media, but even in “Amy’s Choice”, that sort of wish-fulfilment universe, he’s … a doctor! And, granted, he’s a gerontologist, which is, like, one of the hardest forms of medicine around, and one that requires the most care, but … you know. A nurse is a not a failed doctor.
Anika: No, it’s a completely separate job. They work together as a team to take care of people. If there were only doctors, a lot of stuff wouldn’t get done. Because the doctors don’t even know how to do that.
Liz: Exactly. Right.
Anika: Because it’s not their job. The things that the nurses do are real skills, they have real significance, and it’s mindboggling. And, you know, we were saying that you could replace the doctors with the holograms, or with a droid, and it would be harder to replace the nurse.
Liz: Yeah. I know Deep Space 9 had a rotating cast of Bajoran nurses — and that’s the other thing, you know, the Bajorans aren’t doctors, they’re nurses. But we rarely see nurses as characters, save for Ogawa and Chapel.
Anika: And, as you said, both of their characterisations are much more about their personal lives than their nursing.
Liz: Yeah. And it’s just frustrating! I would like to see more!
What I would actually like — I was thinking, in the wake of the Strange New Worlds announcement, which we will discuss in detail at a future time — but what I would be doing, if I was in charge of Star Trek (still waiting for that phone call), I would be looking at about two short series a year. Three to six episodes, just doing a deep dive into an aspect of the Star Trek universe. And one of them would be, like, Star Trek: Pasteur, starring Gates McFadden as the captain of a medical ship, and basically doing a medical drama in space.
Anika: That would be great.
Liz: I knew you would love the idea.
Anika: They would go to planets that were having an outbreak, and they would have to take care of them, and it would just be amazing.
Liz: Yeah! ‘Cos I watched — as research for this episode, I watched “The Child” and I watched “Ethics”, so two Next Generation episodes, and both involved the Enterprise dealing with a medical emergency outside of itself. You know, there’s a spaceship crash and a plague. And it would be cool to see those stories stretched out over several episodes.
Anika: I would love that.
Liz: And I don’t think this concept would sustain a full 13-episode series, but I think three to six episodes, and the sort of thing where you can reuse a lot of sets for the next one, and … yeah. Again, CBS, why do you not have me on speed dial? My lack of experience is no impediment whatsoever!
Anika: We would definitely give the nurses their due!
Liz: We would! And I think it would be really cool to see, you know, are there doctors who specialise in a particular race, or a particular type of race? And what if it’s the 2390s and you’re a Romulan and you’re serving on a Starfleet medical ship? How does Beverly adjust from being a chief medical officer to a captain?
Anika: And in “Ethics”, it’s almost a throwaway line, but it’s really kind of incredible to me that they have this conversation about how, “Oh well, I called the Klingons to get their opinions, since Worf is a Klingon,” and they were like, “Well, we would let him die.” And it’s just — wow, okay! Cool medicine there, Klingons!
Liz: Yeah. My favourite fact about “Ethics” was that one wheelchair-using writer was so incensed by this depiction of Klingon ableism that he wrote the Deep Space 9 episode “Melora” because he wanted to depict a character whose use of a wheelchair wasn’t something to be pitied.
Anika: Right, because it also happens with Captain Pike.
Liz: Right! Right. And I think what this guy was saying was really interesting, that it is a reasonable point of worldbuilding and detail for the Klingon culture, but at the same time, this attitude that the severely disabled deserve to die is present among humans, so it’s not nice to see it in fiction.
Anika: And we talked last week about how the Romulan was like, “Oh well, you know…”
Anika: “…you’re blind, so we’d kill you, too.” And it’s just, like, okay, I understand that they’re trying to make a line between the humans, who are good, and believe in medicine, or something, I guess, and then these other races. But if these races are supposed to be our equals, and we have a treaty with them, and they’re on par with us, and that’s their attitude? It’s a little — okay, maybe we need to — it’s another one of those things where we’re like, “Star Trek, you need to explore that a little bit more.”
Liz: Right, it’s an interesting and complicated issue, but you need to do more. And I think it’s touched on in Star Trek VI, in the wonderful dinner party scene where — I think it’s Chekov who asks about the human rights violations in the Klingon Empire. And Azetbur deflects it by pointing out that the very term is racist — which it is, in this context, and I love her for that, but the question is never answered.
“Ethics” was a really interesting episode for me to watch as an adult because, um, this is embarrassing to admit, but before she retired, my mother was a professional pro-life lobbyist?
Liz: But this whole end-of-life, assisted suicide thing, you know, really got her fired up. So it was quite interesting to come back and watch it as an adult and go, “Okay, yes, this is not really an episode — air quotes– ‘about assisted suicide’, it’s more like the clash between culturally appropriate medicine versus … not. Because — I think this is one of the criticisms someone had on Twitter, of Beverly, that she is very paternalistic in her approach to patients from other cultures.
Anika: Which is true.
Liz: And Worf often bears the brunt of it, like that terrible episode where she’s pressuring him into donating blood to a Romulan, and he straight up doesn’t consent. Which is his right. So “Ethics” was a really — I really enjoyed watching it, actually! Partially because, like Dr Toby Russell is a woman, and you so rarely see women as unrepentantly amoral scientists in Star Trek. Also, the actress bears an uncanny resemblance to Hillary Clinton in that era, and I just found that slightly funny.
Anika: She totally does!
Liz: No one talks about that time Hillary Clinton was in Star Trek!
Anika: I spent the entire episode going, “Why do I know you? Where do I know you from?” But you’re right, that’s absolutely true, she was very Hillary Clinton-esque.
Liz: I went so far as to look up the actress’s IMDB to see what else she’d been in, and I couldn’t place her after that, and then she just hit the right angle. And the way her hair sat, and everything, I was like, ohhhh, that’s the first lady.
Anika: I like it. And I kind of — she was totally a Hillary Clinton type character, too!
Anika: So I’m into this! It works!
Liz: Particularly that very ’90s idea of her as this terrible woman who puts her profession above humanity. And we can talk about whether or not that’s fair to Clinton, but I think it makes for a really interesting character, and a really interesting foil for Beverly. And, yeah, we rarely see that type as a woman in Star Trek.
Anika: Yeah. The story that’s told in “Ethics” is similar to the one that’s told in “Nothing Human” in Voyager. And what’s interesting about it is that the character that she is an analogue for in “Nothing Human” is a genocidal maniac Nazi doctor. That’s what he is. So it’s really kind of terrible to say those are the same. Because they’re not. She is not a Nazi, she is not prioritising medicine over people as a whole. There are layers to her.
Liz: She’s not doing it on an industrial scale. But at the same time, she has looked at this severely disabled and deeply depressed man and gone, “Yes, that is the guy, the perfect target for my unethical experiment.”
Anika: For my experimental … yeah.
Liz: Spine replicator.
Anika: It’s interesting.
Anika: And then I also mentioned “Miri”, which — I don’t know if you’ve seen “Miri” lately…
Liz: I have not seen “Miri” for quite a few years.
Anika: It’s a bad episode! I don’t suggest you–
Liz: I remember it being a bit creepy.
Anika: Don’t watch it on purpose.
Liz: Is that the episode where a teenage girl falls in love with Kirk?
Liz: And he handles it about as well as you could in the 1960s?
Anika: It’s bad on every level. But it’s an episode where there’s a disease that only attacks adults. So Miri, towards the end of the episode, starts showing episodes of this disease because she’s gone through puberty. So it’s kind of terrifying that a girl who has not yet gone through puberty is flirting with Captain Kirk. But.
Liz: It was the ’60s! [cry-laughing]
Anika: And everything about — yeah, it’s a bad episode. It’s a very bad episode. But the idea is that there’s this disease, and McCoy is trying to come up with a cure and vaccine. I mean, this happens a lot in Star Trek, this whole, “We’re gonna come up with this cure and this vaccine for this disease, and it’s gonna happen in this 45-minute episode. It’s gonna be great, and it’s gonna work by the end.” That is not how that works. Even with time jumps, like in “The Quickening”, where it’s a month, it’s still — no. It takes over a year for this to actually happen. But that’s fine.
Liz: And we have all become experts in the timeline of vaccine development.
Anika: Right. McCoy successfully comes up with his hypospray of magic that is going to fix it, and he injects it into himself. Because that’s what you do when you’re McCoy.
Liz: [literally does a spittake??? Apparently I found this really funny!]
Anika: It’s like, he refuses to inject it in anyone else, because it’s untested, because he has some semblance of, you know, understanding of reality, and knows that it couldn’t possibly actually be the cure. But he injects it into himself. So I like to look at these three episodes, and they bring up these questions of medical ethics and how you address — and the idea of experimentation on willing or unwilling participants. It’s interesting! As a little — like, these are the different ways that we look at it. And it’s interesting that, in all three cases, they end up doing it, because they decide that the risk is worth it.
Liz: I feel like going, “Oh, we found a potential cure, but we’re not going to test it because that would be really dangerous–” it just makes for a very unsatisfying story. And I don’t think anyone except possibly you or me would be entertained by “The Federation Ethics Board” and “This is the paper I wrote to substantiate my research” and “Here are my test subjects”.
Anika: You’re right, I would be interested in that. I would be more interested in that than an argument between Beverly and — I forget her name.
Liz: Toby Russell.
Anika: Toby Russell. Like, in the hallway of the Enterprise, you know, for, like, back and forth for three lines, and then Beverly’s like, “You’re fired.” It’s interesting for the characters, but there’s a better story somewhere.
Anika: There’s more to that, I want to see more of it. And, of course, I hate — sorry to Worf, but I hate the ending, where Worf dies but doesn’t die. That is– [laughs]
Liz: I like it better now that we know just how stupidly redundant Klingon systems are, thanks to Discovery, and showing us more of them. But I do have to wonder when Klingon medicine regressed from, “Hey, we can turn this guy into a human” in the 23rd century to “Just let him die.”
Liz: “We don’t want him.”
Anika: That’s the other thing, like, Klingon physiology and Klingon medicine do not make sense together. It does not make sense. How can you have–
Liz: They’re bodies are so sophisticated–
Liz: –that they should have much more sophisticated medicine to deal with them.
Anika: And they have less, they have more primitive medicine. It’s very strange. And this is another thing, I really wish that, in all of the many, many Klingon episodes — there are so many Klingon episodes!
Liz: There are a lot.
Anika: I wish that any of them dealt with these questions of Klingons who are not warriors, Klingons who are scientists and want to be scientists, Klingons who are engineers and want to be engineers, and how they are looked down upon in their society. Klingon society is so strange, the way that it has been presented, and this idea that only a warrior — only a soldier has value, when–
Liz: I think we sort of see that now, where — you know, people like grocery workers and delivery drivers, and nurses and teachers, are just completely devalued until suddenly they’re “essential”. And people who have spent their lives stocking up on guns, or whatever, to “protect their families” can’t cope with protecting their families by staying in and wearing a mask.
So I can sort of see that, but there’s also an episode of Enterprise which, I think, touches on it. I’m blanking on the title, but it’s the second season episode where Archer and … someone or other … are put on trial, and it’s all a big knock-off of the trial scene in Star Trek VI.
Anika: Right, yes.
Liz: But J G Hertzler plays the Klingon lawyer, and he has this speech about how the Klingon Empire is in decline because they have over-valued their warriors, and one day this is going to come back and bite them. And I think, 200 years later, that is still the problem that they’re facing.
Anika: It’s definitely the problem. And there are great tie-in novels about Klingons who are not warriors, that I love, and I wish that was represented. Because the Klingons that I’m interested in are the ones who poke at Klingon culture, and say, why is this like this?
Liz: Yeah! Which I think is the case with any story. And maybe Strange New Worlds will give us a bit of that?
Liz: I’m trying to be optimistic, because my initial reaction to its announcement was so negative. But we can talk about that next time. You have a list of counsellors here.
Anika: Yes! I like to remind everyone that counsellors are part of the medical system.
Liz: They are, and we have two psychiatrists in Dr Elizabeth Dehner and Admiral Katrina Cornwell, and two psychologists in Troi and Ezri. What do you think happened to psychiatry after the 23rd century?
Anika: [laughs] That’s a good question. I guess — I mean, it might be as simple as saying — as you said with the doctors — as society changed, so did Star Trek. Because I would say that, certainly in this day and age, the people that you go to see in therapy tend to not be the people who give you the medication.
Liz: Yeah, the psychiatrists dispense and the psychologists counsel.
Anika: Exactly. So I think that it’s — it used to be, it was the psychiatrist. And it was very clinical. And it’s become much more about therapy, and talk therapy, and cognitive — like, all of this stuff, cognitive behavioural therapy. It’s become more than just fixing your biochemistry.
Anika: And I think that shift is the same.
Liz: I suspect there’s also a reluctance to get into too much detail with the nitty gritty of futuristic psychopharmaceuticals. Because, for one thing, if someone’s problem can be fixed by manually adjusting their brain chemistry, that’s a very short story. But then there’s things like Lorca’s trauma, or Lorca’s so-called PTSD, which should have been detectable — like, it would be detectable in an MRI now.
Anika: Absolutely. Well, this is super interesting to me, as you might suggest.
Liz: I believe you literally did a thesis on it.
Anika: Yes. I did. So it’s interesting to me as a student, as an academic, and it’s also interesting to me as a person, like, on a personal level, as someone who was sort of raised to be — my family wasn’t really into therapy. I should — my father wasn’t into therapy. He thought that was not a thing. And I really, really needed therapy! And so did he. [laughs]
And I didn’t get any until I became an adult and could get it for myself. And then I had a whole decade-long awakening, or whatever, I worked really hard to become comfortable with my mental stability, to figure out how to live in my brain for the rest of my life. Because I can’t change my brain.
Yes, medication stabilises, medication can address issues that are actually chemical, which are very, very prevalent, and which anybody who has any kind of trauma, it’s a part of it. Because trauma changes your brain, that’s what happens. And so the medication adjusts that. But the medication doesn’t help you address the trauma itself. What happens to you. You need both.
Liz: It’s not a band-aid, but you need to learn new ways of thinking as well.
Anika: So I like that Troi and Ezri are talk therapists. I think that that is hugely important and vital, and we need as many representations of that as we can get in any media. Not just Star Trek, not just sci-fi. Anything. All of it. Before all conventions were cancelled this year, I was shopping around a panel that I entitled Saving The World Isn’t Therapy.
Anika: And the idea was that, if you look at — I was focusing on young adults. Because, you know, Harry Potter, Hunger Games, look at them and they’re like, these are 17-year-old people who are expected to save everything. Even Star Wars, they’re all 19. It’s just crazy.
Liz: Right! I’m watching The Clone Wars, and I’m going, Ahsoka is 14 years old, she should not be doing this!
Anika: It’s like, what is going on?! And anime — oh my gosh. They’re all 13 through 17 years old in all of these things, and they are expected to be acting as superheroes. And even adults who are superheroes desperately need therapy. That’s what Iron Man 3 is all about, which is great. I love that they’re starting to realise that these things are important.
But I think that it’s definitely true in Starfleet, like, you need a counsellor. And that’s why I love the fact that Elizabeth Dehner exists, because at least saying, like, in the pilot of this series, we are saying we need someone who cares about mental health. Because going out to explore strange new worlds, where no man has gone before? You need someone to help you deal with what you find.
Liz: Right! And it makes sense that it would be a psychiatrist at this stage, because they can sort of do the empirical stuff and set up a baseline, and build the map on which the psychologists can travel.
Anika: I love that. I love that she exists. And I love — I’ve said many times that Ezri is the character where I sat up and said, “I want to be her!” And I love that she is a counsellor. I get annoyed with people who say she only became interesting when she started caring about command, because–
Liz: No! No!
Anika: –much like the nurses, it’s like, counselling is vital and important and needed.
Anika: It’s great that Counsellor Troi becomes a commander, and takes the test, and does all of that, and deals with it, and proves that she can do it, but she didn’t need to. She was still super important and necessary to the show and to the ship before she did that.
Liz: Right. And I was also going to say, with the echo of the nurses thing, I love that Beverly becomes a captain in “All Good Things…”, but that is not what she has to do to be successful in her career, and you don’t have to go to Command. And with Ezri and Kat, it’s not that they went to command instead of mental health, it’s that they brought their mental health skills into Command.
Anika: Exactly. And they would be so good at it. It’s like, of course you went into Command, because you had the skills, you had so much better skills than someone like — oh, let’s talk about Archer! My favourite trash captain has none of those interpersonal skills. He’s super charming, but he is not good with people.
Anika: So the idea that he would be valued over a Cornwell is ridiculous to me.
Liz: One of the things that made me sit up and take notice of Cornwell in “Choose Your Pain” is the way she is speaking about Starfleet morale, and the needs of the fleet — the people within the fleet, and also about Michael, and how she draws the distinction between Michael being scapegoated for the war and Michael being actually responsible for it. And that clearly comes from her background in psychiatry and mental healthcare, and it really sets her apart from all the other admirals we’ve ever seen.
Anika: Right. Right. It’s amazing, and I love it.
Anika: Kat, I just–
Liz: I mean, spoilers, we love Kat a lot.
Anika: I love every counsellor. I love Troi, I love Ezri, I love Kat. I even love Elizabeth Dehner, and I get upset that her only episode is, again, all about a man that she happened to fall in love with, and it destroyed her life.
Liz: Maybe she can be a regular in Strange New Worlds. Seems like a good role for Anna Torv.
Anika: Oh my gosh. I would love — I would love — I was really mad when Carol Marcus ended up in Into Darkness instead of Elizabeth Dehner. Because she had the haircut, and so everyone was saying that she was going to be Elizabeth Dehner, and I was like, oh my God. All I want is for Elizabeth Dehner to be a big thing.
Liz: There was a rumour going around before Into Darkness came out that the whole Khan thing was a fake-out, and that Benedict Cumberbatch was actually playing Gary Mitchell–
Anika: Gary Mitchell, right.
Liz: And I really liked the idea that Kirk’s all-American best friend was now this weedy Englishman. And I really — I don’t like Into Darkness, and I really wish we’d gotten that movie instead. Once again, I like the Star Trek in my head better than canon.
Anika: Alice Eve would have been a great Elizabeth Dehner. And, honestly, I like her Carol Marcus. But it would have been so much more interesting if it was Gary Mitchell and Elizabeth Dehner than–
Liz: Right. Because, if nothing else, Khan is just done to death.
Anika: I’m tired and I don’t care.
Liz: Do we want to talk about medtech? That’s the final point on our list that we haven’t covered.
Anika: I just think it’s amazing that Star Trek has really — there are biobeds, there are people who are working on tricorders, there are people who are working on hyposprays. All of these things, they’re trying to create.
Liz: It’s amazing, yeah.
Anika: That’s true across all of Star Trek, but the medical technology that they are — I have a friend who is literally working on a project that is basically a biobed. He is trying to make biobeds.
Liz: That’s amazing.
Anika: It’s incredible to me! Can you imagine how helpful it would be to have a biobed right now? To have someone — you lie down, and it takes your temperature, and it tells you your vitals, without hooking anything up, and it says, you know, “These are the four diseases that are probable.” It would be so incredible to have even a tenth of that technology.
So the fact that people are inspired by Star Trek to try to create it — Gates McFadden has talked about how she is kept in the loop about medical tricorders. People just send her emails, like, “Here’s the quarterly report on our research into a medical tricorder.” And she’s like, “I don’t understand any of this, but it’s amazing that you are doing it, and that they — it’s inspiring that they have been inspired by the work that I’ve done.” It’s incredible.
So I love that, and I just — as much as I have been saying that I worry that technology is encroaching on human interaction in medicine, I think that if used — instead of as a replacement, but as something to make doctors better at their job, to make it easier to be a doctor, easier to have the human interactions — we should support that in every way.
Liz: Absolutely. I went to my local hospital a month or so ago, to drop off some masks we had accidentally stockpiled after the bushfires. And they just waved a thing and took my temperature from centimetres away. And it was amazing! And I was like, oh, this is so futuristic! And then, you know, you apply the hand sanitiser, and you mask up, and — yeah.
[This is where I seamlessly cut about nine minutes of talking about Covid]
Anyway, we’ve gone very far off-topic, and probably I’m about to cut all of this Covid stuff [See? Seamless!] because it’ll probably bring people down a bit. But! [laughs] “I signed up for a Star Trek podcast! About medicine in Star Trek! Why are they talking about a terrible disease?
Anika: This is what our life is right now, and I think it’s valid. That’s just my opinion.
Liz: I think it is, too.
Anika: I will say that I watched “Critical Care” for this episode.
Liz: Oh yes!
Anika: And that’s an episode — and this is true of all my — I said that I love watching medical dramas, right? So ER is old, now, okay? And yet, in the first season, they had storylines that dealt with how terrible healthcare insurance is, and how awful the idea of some people getting better healthcare because they can afford it is.
Anika: And that’s true in every medical drama. And it’s usually in the first season. These are things that, if you’re writing a medical drama, if you’re writing about anything that has to do with it–
Liz: It’s the cliche you need to get out of the way.
Anika: Yeah, you have to acknowledge the fact that our healthcare system is horrible. And “Critical Care” is literally about deciding, this person is more useful to society, and so, therefore, they will get better care.
Liz: And the thing is, it seems like a very uncontroversial thing to say, but then you have the current state of American politics with regards to public healthcare?
Anika: And it’s literally happening right now. There are plenty of people who are publishing their personal stories about, “I’m a doctor in Minnesota, and I’m dealing with Covid patients, and we are deciding which ones get the ICU beds and which ones don’t.” Based on who they are, and what they can afford, where they are in their life — and it’s horrible to think that — but it’s also, like, I feel for these people who are in the hospital, who have to make those decisions because they don’t have enough space. Because no one cared to fix it before the fact.
Liz: Yeah, or, “That hospital wasn’t making a profit, so that’s closed down, so all the patients in this town have to go to this other hospital, further away, that’s overwhelmed because suddenly it’s dealing with two populations instead of one.”
Anika: And also there’s the 36 million people, or whatever, who filed for unemployment. Which means that they don’t have a job, which means they don’t have healthcare.
Anika: It is the worst possible scenario for so many people.
Liz: No, it’s terrible.
Anika: And I want to be like the — you know, I’m not the EMH, but I can be the little guy who’s in the ward, who’s doing his best with no equipment and no medication, and barely minimum training to try to do the best he can do. And it’s just, like, ooh. That episode was really hard to watch in the current environment. It was hard to watch back in 1998, or whatever, and it was super hard to watch today.
Liz: It’s not as if anything’s gotten better.
Anika: No, it’s gotten much worse. And it’s upsetting. And the fact that it’s still controversial to say that healthcare is a right?
Liz: Yeah. And that’s controversial here, too! We have a really good public healthcare system, but our government thinks we would be much better off with an American style one.
Anika: Remember earlier in this conversation, I said that I didn’t get mental healthcare until I was an adult and could ask for it. I also was no longer on my father’s insurance, and I was on public insurance at that point. Because I didn’t have a job. And I got it. And it covered everything. That one moment in time — and I don’t think it’s true of — I think that the Connecticut Husky plan has changed since I was on it. And the fact that I was in this golden age of healthcare for two years, the one time that I desperately needed it, this is why I want to be Ezri, and I want to be a counsellor, and I want to help people, it’s because I know that it’s so hard to get the help you need.
Liz: And it is here, too, it is actually harder to access mental healthcare in Australia than America. Which is not usually the way we expect it to go. Anyway…
Anika: Yeah, so, sorry to get super political, but healthcare is a right, it should be free, people are terrible, especially right now, in the middle of a pandemic. You should just get to be taken care of, the end.
Liz: Star Trek is optimistic! Which is the sort of attitude that I usually rant about, but I’ll let it stand for now. It’s 45 minutes and we’ve cured a disease.
Anika: In “Critical Care”, it ends with the terrible jerk doctor and the overworked, undertrained doctor working together to take down the administrator. And it’s like, well, that wouldn’t happen! But it’s a nice story. But, of course, at the end of the episode, Voyager leaves, the Doctor leaves, what happens on that planet? Probably those three people lose their job, and then everything is status quo and it’s horrible.
Liz: [heavy sigh]
Anika: I wish I was optimistic!
Liz: [laughs] Yeah.
Anika: But I’m an idealist, I’m not optimistic. There’s a very big difference. There’s a big difference between idealism and optimism.
Liz: That is the rant that I’ve been trying to articulate!
Anika: I say I’m a Slytherin, which is an idealist, I am not an optimist.
Liz: [laughs] Okay. Thank you for listening to Antimatter Pod.
You can find our show notes at antimatterpod.tumblr.com, including links to our social media and credits for our theme music.
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And join us in two weeks when we’ll be discussing the newly announced Strange New Worlds.
Liz: Is it? Is it really?
Anika: [laughs] Look, Number One and Spock are gonna make out. It’s gonna happen.
Liz: If they’re going for an episodic, old series sort of vibe, then sooner or later there’ll be sex pollen. That’s the rules.
Anika: Exactly. There will be a reason.
Liz: And an episode where someone gets turned into a lizard. REAL STAR TREK.
Anika: REAL STAR TREK!