Isn't it dumb to only have 1 Doctor on Voyager and NX-01 Enterprise?

[JRTStarlight]

Star Trek has never really addressed the difficulty of doctors learning how to treat every single different species they might come across. It's hard enough to master one species. In a realistic multi-racial starship they'd probably need a dedicated specialist for every species and teach doctors they need to constantly learn the bare basics of every species they are responsible for.

That's probably the best reason to have a PMH (Permanent Medical Hologram) aboard all ships now (past the Voyager era). One doctor programed with the experience of thousands of Federation doctors required to deal with hundreds of species, the Federation would soon require something like that on every ship capable of running those holographic programs, or even just a 2D doc on the screen to direct the efforts of a smaller, less capable staff and smaller, less equipped ships.

Unless the educational system of the future has found a way to accelerate learning and memory retention, I'm not sure how else it could reasonably be done and still expect a multi-species starship to cope with most medical emergencies and routine medical problems.

And with growing and greater computer power and holographic emitters, more doctors and nursing staff beyond one would likely be the norm, too. But you'll still need RL docs and nurses in case those systems fail - more as back up, at some future point, than chiefs of medicine. Sure, I could foresee when the medical holograms are more reliable and available than regular doctors, so naturally they would be in charge of medicine aboard every top rated starship.

But before that time, you take what you can get from the people who are willing to go and live in those dangerous conditions. If you get one guy like Phlox, consider yourself lucky.

Doctor Phlox.
https://www.trekbbs.com/threads/phototrek.288654/page-2#post-12083790

 

[JirinPanthosa]

The idea that the same drugs could ever work on more than one species is also not justifiable in reality by anything except maybe the Chase explanation. On completely separate planets, every race evolves the same protein substrates to bond with the exact same molecules for the exact same biological reaction?

I suppose you could make some argument of there being limited viable evolutionary paths to produce sapient life, so just by natural selection, a similar body structure and chemical structure is needed to become the dominant species of your planet. But there should still be enough variation to not be able to safely use any drug on any unknown species.

 

[Paul Weaver]

Don't like 90% of the workers leave during winter?

Yes, but there's still a fair few. There's about 50 at Amundsen Scott for example, with 1 doctor in 2000 - http://www.southpolestation.com/trivia/00s/2000.html

I don't think that the south pole has the kinds of medical technology that Phlox has on Enterprise either (cat scanners etc).

 

[Prax]

Headache? Upset Stomach?

Swelling? Clotting? Hemorrhaging? Heart attack? Aneurysm?

Going into Shock?

Get infected with fluidic alien DNA from another dimension?

Lose a pair of lungs? Have you been attacked by a secret alien weapon that is dissolving your cerebellum?


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[Timo]

Do you mean they could be flown to a medical facility by helicopter?

More like dropped to a motorboat that takes them ashore to be picked up by a bush plane that connects to a regional airline that takes them to a jet-capable airport that allows them to fly to Bethesda in no time flat - every single leg on that journey is faster than the ship the poor saps just left, and increasingly faster to boot.

Starfleet personnel can leave starships by shuttle, but in all of TNG we never got a clear case of a shuttle actually going interstellar - there was always the possibility of the shuttle having been dropped off / picked up at system edge by the mothership. And indeed nothing else would make much sense if only the best shuttles can do warp four (a speed record from VOY "Resolutions" for an unseen "Type 9") and the demonstrably interstellar runabouts seem limited to warp five, whilst even the lame-duck Defiant can exceed warp nine.

Shuttles for medevac - fact or fiction? (Or is that "fiction or non-fiction"? "Fiction or fanfiction"?) There was a dedicated ambulance shuttle in the 2009 movie, and supposedly she went interstellar in a tight situation, but her actual intended use might have been surface-to-orbit. Picard flew a shuttle to a heart operation, but that wasn't an emergency, just a routine checkup gone all wrong. The ambulance Khan hijacked in ST:ID was explicitly incapable of warp (and originally unarmed - where did Khan get those machine gun phasers?). As for surface-to-orbit medevac, novels and the like often speak of patients too unstable to be put through the transporter, but does that ever happen in canon?

Timo Saloniemi

 

[Prax]

Naval vessels have their own Medics. On larger craft, like an aircraft carrier, they'll have a doctor and a dentist. Sailors go out for 6 month tours I believe. They stop in different ports around the world, go west through the canal, come back through the canal, etc. They spend most of their time on board.

The scenario you describe would have to be some extreme emergency for such an expensive trip. Does that ever happen?

TNG has warp shuttles. I thought the only non warp shuttles were the little ones like in "Time Squared." The Enterprise had two larger shuttles that could warp and runabouts.

 

[JRTStarlight]

I should point out the impression I got after watching many doctors on Trek. They aren't pill pushers, or try it and see, or take this and call me in the morning, doctors. At some point their medical knowledge has reached a particularly deep understanding on the cellular level - why this works, scientifically speaking, what is wrong with it, and their medical scanners are so advanced they can see what's going on in short order instead of eating 4 hours for a cat scan and then being told that's not good enough so now wait longer for an MRI, etc. So it isn't as bad as, hey, that's a different species and I have no idea what works or not. They have a reasonably good idea based on a deep, scientific understanding of life and the biochemistry that makes it work far beyond today's modern doctors, so regardless of what species they are looking at, they got a pretty good idea and what's going on.

Of course nothing beats actual experience when you delve too deeply into the guts of another person, so surgery on an unfamiliar alien is always harder - but that's more mechanical practice than knowledge of internal medicine.

And don't forget, for whatever reason of parallel development they wish to use to explain why most aliens look like dressed up humans, most of them are eating the same foods, breathing the same air, drinking the same liquids, and probably (though they really shouldn't) have more in common, medically speaking, than they have differences. While there are doubtless Federation members who are different enough, they wouldn't be serving on a starship, or at least most starships, but perhaps one dedicated to their own species then. Most ships we see are one designed around earth-human-like norms and those aliens that are fine with it (mostly).

 

[thewanderingjack]

As for surface-to-orbit medevac, novels and the like often speak of patients too unstable to be put through the transporter, but does that ever happen in canon?

Quick answer, yes. I've been re-watching all the shows (enough that they've run together a bit) but never read any of the novels or other materials... I can recall (though not clearly) situations (mainly in TNG) where the doctor said the person wouldn't survive transport due to the severity of their condition.

 

[thewanderingjack]

Sorry to post in a row, accidentally posted before I was done.
In answer to the OP, yeah that's freaking dumb... in fact not having at least 3 shift changes of staff , and 1 set of back-ups for that, is dumb. Same for systems... they need not only back-up systems, but also spare parts on board.
Then most reasonable (in-world) reason: supposing that Starfleet is mainly dedicated to exploration/research, and that health and safety systems (and services) have vastly improved, how often would you need a doctor? People should hardly ever get injured or sick, and treatment should be pretty quick... as people have pointed out both the abilities of humans seems to be greater (ability to learn faster and learn more) as well as sciences themselves, so one doctor even to treat multiple species is somewhat credible... to a point.
You'd still need expert medical/science staff, even if they are mainly doing other duties, both for support and for emergencies. It would make sense to have a resident, or doctor in training, as well... for the same reason as we have residency programs now, and as support/back-up. And as a ship of science/exploration you imagine all kinds of scientist (including many medical doctors) would be on there doing research, and either scheduled for sickbay duty or at least ready to lend a hand.
In VOY, the fact that Tom Paris was the only one left aboard with any apparent medical knowledge, and that was shown to be very limited, is definitely idiotic. In ENT the set-up is even more incredible, as most of their missions involved a lot of potential for battle.
Then again, this goes along the lines of why is it always the senior personnel going on away missions? Stupid.

 

[Prax]

Voyager had a medical team

 

[JRTStarlight]

Yeah. They just got snuffed out in the opener.

I'm not sure it would be advisable to have 3 full medical staffs for 3 different shifts on board most ships, though. Sickbay should mostly be closed the majority of the time as it is. Unless it's also the heart of most scientific lab work and analysis. Otherwise, it's easy enough to wake up most doctors for emergencies during his off hours, and he/she can take care of most routine stuff during normal hours.

 

[thewanderingjack]

Yeah. They just got snuffed out in the opener.

I'm not sure it would be advisable to have 3 full medical staffs for 3 different shifts on board most ships, though. Sickbay should mostly be closed the majority of the time as it is. Unless it's also the heart of most scientific lab work and analysis. Otherwise, it's easy enough to wake up most doctors for emergencies during his off hours, and he/she can take care of most routine stuff during normal hours.

If sickbay is supposed to be manned all the time, you do need (at least) 3 shifts (assuming 8 work hours... hopefully less, in this wonderful future, thus more shifts and more people to cover each). Even if the med staff is on call, then they probably have other duties, meaning other work shifts. It would be unrealistic to have someone work x hours, then get woken up for an emergency to go work in sickbay and then get back to their other work shift. If the staff is only medical and on call... that's a bunch of people with a lot of free time, in fact nothing but free time except when there's an emergency. It seems that as an exploration ship there should be a lot of experiments going on, such that there'd be many medical experiments, and thus a lot of "doctors" and researchers around, to then also work on-call shits in sickbay. I also imagine that part of the future of medicine is not having to wait around for a) regular dr's hours or b) the dr to be woken out of bed for your mysterious headache (which might be a simple migraine or could be an alien brain eating virus)... so, someone has to be in sickbay all the time.

 

[Shamrock Holmes]

I agree that on larger vessels, someone should be on duty in sickbay - or nearby research labs - at all times, but that wouldn't necessarily need to be a full MD, indeed I'm uncertain on US practice but in the UK, there is a trend towards taking routine medical procedures/consults away from MD and giving them to nurses and even specialist technicians, with doctors moving into more of a diagnostican/researcher and surgeon role. However, canon does seem to suggest a slightly higher proportion of MDs than the above would.

NCC-1701 had up to three doctors (McCoy (doctor/surgeon), M'Benga (doctor/surgeon) and Sanchez (pathologist, possible surgeon) and also Chapel - identified as a nurse, but also qualified as a Life Sciences researcher - so IMO probably at least 'general practioner' level as a medical officer. No specifically referenced corpsman, but there were several background characters that could have been such.

NCC-1701-D specifically per dialogue usually has a staff of at least nine (three doctors (Crusher, Selar & Hill as of s4's Remember Me), two duty nurses and at least four other "members of (my) medical staff") but later dialogue indicates that a minimum of four medical personnel should be on-duty at again given time, which suggests a minimum of 12-15 personnel (for a nurse and two technicians per doctor) and I seem to recall seeing a reference to a medical staff of 5 doctors, eight nurses and twelve medical technicians (tho I can't remember where) which gives a total of 25 personnel and would allow for the above ratio of 1:1:2 but with limited time off for the doctors).

TNG: Disaster also seems to imply that basic field medic training is at least optional for Security Officers (and I would expect some MA/SG's). However, this is contradicted later by VOY which suggests that Voyager has only 1 doctor, 1 nurse and no technicans/field medics or even any cross-trained back-ups until Kes (sensible) and Paris (ridiculous) are co-opted.

Deep Space Nine generally seems to be somewhat short on Starfleet medical personnel other than Bashir, but Bajoran doctors and nurses are occassionally seen and IIRC at least a couple of corpsman are implied on occassion to be attached to the Defiant.

 

[JRTStarlight]

I was speaking of smaller ships, but larger ones, sure, have somebody there all the time - or the PMH (permanent medical hologram) . On smaller ships, the doctor may not need to work full days, so he's relatively relaxed and capable of being on call most of the time - his other duties light, little more than talking to the crew and being a shrink, running experiments, or administrative stuff.
But for Constitution class starships with countless science departments, there's likely always somebody up and just a few minutes away.

 

[The Wormhole]

the fact that Tom Paris was the only one left aboard with any apparent medical knowledge,

Not the only one, just the most qualified. We do see other personnel helping out in sickbay during medical emergencies.

 

[Shamrock Holmes]

Not the only one, just the most qualified. We do see other personnel helping out in sickbay during medical emergencies.

True. Which suggests that additional personnel were trained later. Xenobiologist Wildman would seem to be a more obvious candidate than Flight Controller Paris who a) only took biochemistry (which might have helped with doing CFC Tarses' job on the E-D but isn't going to do much for a nurse); and b) is likely to busy with his main job during a battle situation, which is exacrly the time when you most need extra medical personnel.

IMO, most security personnel should have at least basic field medic training (FBI HRT get most of an EMT as part of their training, and we know in-universe that Security Officers (can) get a pretty advanced emergency medical course as part of their training), likewise any Yeoman, Quartermasters (Supply) or similar, and as noted above, most bio sciences personnel would be trained to 'help out as needed' even if it's with research and testing rather than hands on 'nursing'.

 

[JRoss]

Yes, medical staff didn't arrive u till Tuesday

Oh that was the B.

How many doctors do mid-sized Antarctic bases (c.100) have?

I would think they only have one. Remember that Jerri Nielsen had to treat her own cancer down at the South Pole.

 

[thewanderingjack]

Not the only one, just the most qualified. We do see other personnel helping out in sickbay during medical emergencies.

Ok, but also shown to be barely qualified, at first... so if that was the best... and as Shamrock said, with him on helm (which is another duty that often goes beyond shift)...

 

[Prax]

There's a medic team on Voyager. They show up during various emergencies. They're blueshirts and there's usually a half dozen or so.

I'll try to find a screenshots later.

Sickbay doesn't need to be manned 24 hours. The doctor spends most of his time mixing test tubes and golfing on the holdeck. They aren't running a nursing home, it's more like a ctmc. People go there when feeling ill, or trying to skip out of duty. In a shipwide emergency, that's different. If people are being killed and wounded then there would be more people working in Sickbay because they have patients there.

On a typical, normal, average day in the delta quadrant, no one goes to Sickbay. The EMH sits in there all day doing research, schooling Kes, or thinking about things to tell B'elanna to add to his program.

 

[thewanderingjack]

There's a medic team on Voyager. They show up during various emergencies. They're blueshirts and there's usually a half dozen or so.

I'll try to find a screenshots later.

Sickbay doesn't need to be manned 24 hours. The doctor spends most of his time mixing test tubes and golfing on the holdeck. They aren't running a nursing home, it's more like a ctmc. People go there when feeling ill, or trying to skip out of duty. In a shipwide emergency, that's different. If people are being killed and wounded then there would be more people working in Sickbay because they have patients there.

On a typical, normal, average day in the delta quadrant, no one goes to Sickbay. The EMH sits in there all day doing research, schooling Kes, or thinking about things to tell B'elanna to add to his program.

It has been established that there was a medic team, but it must've been formed after some training period occurred, since right after losing the actual medical team Paris is "the most qualified" and he seems anything but (unless he was faking incompetence to avoid the duty from the start).

On a busy ship with lots going on, it seems likely that "minor" emergencies are a common occurrence (and we see evidence of this here and there). Since, except in cases of real emergency, it doesn't seem that anyone's informed of such stuff until the victim gets to sick bay, that would mean calling a nurse and waiting or her to come to sick bay once you get there, her deciding if it requires the Dr, another call and wait... inefficient on a starship where we need certain people at their stations, generally doing their jobs.

It makes a lot of sense in VOY, since the EMH is activated as soon as someone enters sick back and never requires rest. He is literally always on call and available, as you pointed out (aside from his own pursuits and research).

On a large ship without an EMH... how many head aches, plasma burns, etc etc happen in a day? Can you really be running people back and forth on-call, especially i they have other duties?

What the heck are all those scientists doing on Voyager anyway? doesn't seem like they were needed for their original mission, and apparently none of them were medical doctors/scientist/researchers (which would have made them way more experienced tan Paris).