As a progressive Canadian, I don’t need to be convinced that a system where a person’s social class determines their level of access to health care is wrong. But I’m more than happy to watch a Star Trek episode about it, especially if it features the Doctor.
For a quick summary in case you need a plot refresher, “Critical Care” starts out with the Doctor being kidnapped by a thief named Gar, who sells him to a hospital on Dinaal. The hospital’s administrator, Chellick, has been hired by the Dinaali to implement their central computer, the Allocator’s orders.
The Allocator determines who gets what level of treatment based on their “Treatment Coefficient” or TC, a number that’s supposed to represent someone’s overall worth in Dinaali society.
Needless to say, the Doctor is appalled when he finds “important” patients on Level Blue are receiving unlimited amounts of a drug they don’t really need, but which is unavailable to dying patients, including an earnest young miner named Tebbis, on Level Red.
The Doctor enlists Level Red Dr. Voje’s help to administer medicine he steals from Level Blue. After Tebbis dies, and the Doctor is found out, he confines Chellick as a Level Red patient and poisons him with the virus that killed Tebbis until he agrees to make the medication for that condition available to Level Red patients.
Overall I really like this episode. The message is clear but not too heavy-handed. The pacing is snappy. The way the difference between Level Red and Level Blue is shown in colour, space, lighting and conditions is effective. And in between the Doctor’s scenes there are a bunch of entertaining vignettes where Voyager, on their search for him, meets a whole bunch of other aliens who’ve been conned by Gar.
But I also have some quibbles and things I think could’ve been done better, or at least differently.
There are an awful lot of white men in the hospital. The doctors are white men and the patients who talk are white men (there are a few women in the background). There’s really no reason Dr. Voje or Dr. Dysek (the Chief of Medicine), just for example, couldn’t have been a woman and/or a person of colour.
One white woman in the hospital has a speaking role and that’s an unnamed nurse on Level Blue. The Doctor is outright rude to her, not even waiting to get a sense of her politics or convince her to see his side, like he does with Drs. Dysek and Voje. He just uses his power as a doctor over a nurse to get her to help him (unknowingly).
Doctor (accusingly): Why hasn’t this patient received her additional cytoglobin injection?
Doctor: If you’d examined her chart, you’d see that I’ve increased her dosage.
Nurse: Doctor Dysek didn’t say anything.
Doctor: Doctor Dysek is at home with his family. Would you like me to contact him so you can explain why you’re not doing your job?
Nurse: No, Doctor. Requesting one cytoglobin injection for Patient B three, priority blue seven gamma.
Allocator: One cytoglobin injection authorized.
Doctor: I’ll do it myself.
Nurse: Can I assist you?
Doctor (waves her off): You may go.
In addition to the nurse whose only purpose in the episode is to get bullied by the Doctor, we have the other unnamed woman guest star, listed in the credits as “Adultress.”
The Adultress is shallow and catty. She defends leaving her husband because he was “overweight and depressed”. As I’ve said previously, the trope of a wife “letting herself go” after marriage and becoming unappealing to her husband (an idea that usually includes fat-shaming) is stereotyped and offensive. Flipping that to make it about a husband whose wife leaves him for similar reasons does not make it better.
When she accuses Janeway of going after Gar for herself and Janeway grabs Tuvok’s hand and says “I already have a man,” it’s pretty great, though. Janeway’s just so clearly exasperated and wants to get out of the conversation as quickly as possible.
And we all know its more awkward for Tuvok.
My other quibbles are about bigger plot holes.
First, it’s seriously that easy to kidnap the Doctor? I wouldn’t be able to smuggle a book out of a library without an alarm going off, but Gar can steal the Doctor’s mobile emitter without anyone noticing for several hours? You are tens of thousands of light years from home, Tuvok. Use the time more effectively!
Second, when Dysek flips at the end of the episodes and sides with the Doctor, his motivations seem pretty weak. Yes, the Doc showed him how good performance now was resulting in lower allocation of resources for future, but he seemed like he was more interested in gaming of the system for his own benefit, not overthrowing it.
Third, at the end the Doctor is worried about his ethical subroutines. He asks Seven to examine him to determine if his choice to infect Chellick was a malfunction. She says it’s not. While I like that discussion, there could potentially also be a question of whether it was ethical for him to focus so much on Tebbis above the other Level Red patients.
Which leads me into my fourth point, the fact that he infects Chellick and his goal is only to get one group of Level Red patients treated for one condition, and not even by reallocating the medicine from Level Blue but by reclassifying those patients to get the same entitlements.
We know there are other conditions that could be treated on Level Red – at one point earlier Voje had suggested the Doctor might be able to reallocate other medications and the Doc says, “Now you’re thinking like a doctor”. But after Tebbis dies it seems like it’s enough to just deal with this one disease, and put no safeguards in place to ensure Chellick and the Allocator won’t just change things back once he’s gone.
We also know there’s at least one more level in the hospital (not including Level White – the morgue): Level Green, which we can assume is worse than Level Red because a patient with a particularly low TC gets transferred there from Red. The ending leaves all the Green patients, and all the Red patients who have something other than a chromo-viral infection, SOL.
We also know the patient’s TC isn’t only determining their health care. Earlier, Tebbis had asked to remain in the hospital so he could train under the Doctor, rather than having to go back to work in the refinery with his father. He says he would never be authorized for higher schooling and medical training otherwise and Voje confirms this. So even the Red patients who do get treatment are going to be back in their rigid caste system.
Maybe in the last scene with Seven the Doctor could’ve expressed regret that he couldn’t have done more, or talked about why he pushed for that one change to try to prevent future cases like Tebbis’. Because as it is, the concession he wrings from Chellick feels like a hollow victory in the guise of a happy ending.
Bechdel-Wallace Test: Fail. Janeway and B’Elanna have a short exchange on the bridge but it’s about retrieving the Doctor.