Voyager's Sickbay

[Shamrock Holmes]

Samantha Wildman was a science officer, yes. Doesn't necessarily mean she was a medical officer.

True, but a competent xenobiologist would be off to a better start than a half-trained chemist with learning how to be a doctor. She'd likely have training in at least some of - botany (including plant diversity & physiology), bio-chemistry, biotechnology, classification (animals and plants), cytology, ecology, environmental science, genetics, molecular biology, physics and zoology - if not all. Whereas Paris as... chemistry. Huh? (He could be the dispensing technician - ala Tarses, but nurse?).

Essentially, the EMH as designed is supposed to be a nurse, not a doctor. Pressed to work all on his own, he makes for a competent doctor, and amusingly assumes a bedside manner fitting of a self-important specialist - but said bedside manner is also natural for a laborer who's not supposed to do any bedside to begin with, merely to hand laser scalpels and sonic wipes to the actual practitioners of the healing arts.

Sorry, got to disagree, a lack of beside manner indicates that if anything he's intended to be the surgeon, as they mostly deal with unconsciousness/dying patients, beside manner is not emphased in their training. On the other hand, traditionally patient moralle and welfare was arguably the primary job of the nurse (a role that as drifted down to the minimally-trained HCA and ancillary staff in recent years.

 

[Tomalak]

That's what Timo means by "self-important specialist". That's Zimmerman's personality though. By his own admission he made no effort to make the EMH personable - what would be the need? It's designed to heal injuries as efficiently as possible, and usually alongside living medics. The EMH was designed as a short term triage tool. You don't need much bedside manner for that.

 

[Shamrock Holmes]

All true, the point I'm making is that that in no way equates to him being a 'nurse'.

 

[F. King Daniel]

Couldn't they have just duplicated the EMH program? I remember one episode (Living Witness) where his back-up program was stolen. A whole medical team of EMH's: that would've been cool .

Apparently you can't duplicate him except for in the episode they did.

It makes no sense they couldn't AT LEAST summon an army of holographic nurses.

 

[Tomalak]

All true, the point I'm making is that that in no way equates to him being a 'nurse'.

Right, yes I agree, the "soft skills" a nurse traditionally brings are arguably the toughest for a computer programme to replicate, as it requires empathy, compassion etc.

I suppose we're using the wrong terminology, the EMH is supposed to be more like an assistant triage clinician than a nurse.

The LMH which Zimmerman is working on in Dr Bashir, I Presume is specifically stated to be designed to work alone and for extended durations, hence the emphasis on a superior bedside manner. Amusing that Zimmerman picked a guy who wasn't exactly celebrated for his humble manner early on.

 

[Timo]

All true, the point I'm making is that that in no way equates to him being a 'nurse'.

Perhaps not, but the thing that does is clear: just about everybody in the show seems to think so.

The EMH is explicitly not supposed to do any doctoring all on his own. He's supposed to work in company with human medical professionals. And only in emergencies at that. Or, by his very own words, "I am programmed only as a short-term emergency supplement to the medical team".

Not that he couldn't become a doctor at the flip of a transtator junction. When first activated, he inquiries as to the status of the ship's doctor, and when finding out he's dead, becomes one. And he can be any specialist he is needed to be, although he needs to access external resources for that, what with "being programmed only as", yadda yadda.

The only exception to this concept of the EMH as a lowly assistant whose expertise/leading role is only briefly turned on if needed, the only concession to the EMH concept being one of "replacement doctor", is a series of EMHs being allowed to treat the quirky Dr Zimmerman who, out of all people, ought to know better. Then again, he's the one behind the EMH concept, and entitled to abusing it in ways not originally intended by Starfleet.

In contrast, when Zimmerman makes a sales pitch, it goes like this:

Zimmerman: "You're familiar, of course, with the Emergency Medical Holographic Programme?"
Sisko: "I've heard of it. It's a hologram designed to provide assistance during emergencies in Sickbay."
Zimmerman: "It does much more than provide assistance."
Bashir: "A holographic doctor can literally replace a starship's medical officer during an emergency."
Zimmerman: "I'm surprised you don't have one on the station."
Sisko: "The station facilities are Cardassian in origin. Most of our equipment is incompatible with Federation technology."
Zimmerman: "How unfortunate for you. In any case, the original EMH was designed for short-term use only. But now Starfleet has requested a programme designed to operate as full-time doctor."

It takes experts like Zimmerman and Bashir to see beyond the official specs of the EMH, those specs stating that he won't become the Chief Medical Officer when activated, but will only assist. The idea of the EMH as a bona fide doctor only emerges in "Dr Bashir, I Presume?" and may be what eventually makes the Marks 3 and 4 fit for treating Zimmerman's own illness in "Life Line".

So perhaps EMH Mark 1 isn't exactly a "nurse", but more like a mixture of nurse, a medical handbook, and a visiting doctor whose opinion nobody listens to even if his pair of hands may be useful. Mix and match the qualities for any given emergency; it's only in the seven-year-long one of VOY where the mixture favors the idea of the EMH as a doctor.

Timo Saloniemi

 

[MacLeod]

Another area in which the EMH (as a Doctor) could be used was on facilities to small to be assigned a Doctor and should a medical emergency arise perhaps negate the need to call for a star ship to divert there.

 

[Tomalak]

It's surprising we never saw an EMH on the Defiant, given she's a tiny ship which regularly goes into battle and takes on casualties.

On the other hand, maybe one of those background assistants or orderlies we see is actually the EMH mark III or IV?

 

[Timo]

That'd be cool.

Then again, DS9 had holodecks, but was quoted incompatible with the EMH, for hardware shortcomings / compatibility problems. The Defiant didn't even have holodecks.

Perhaps small facilities would in fact lack the resources to make use of EMHs?

Timo Saloniemi

 

[A Chimpanzee & 2 Trainees]

The whole B-story of Message in a Bottle is that it's impossible to replicate the Doctor's programme.

What bugged me about that episode was that moving file(s) on a computer anywhere is a two step process of copying them to the destination, then actively deleting the source. There's no rationale for the Doctor on Voyager to ever be in any danger, or really to even leave the ship. I feel like this is just basic computer knowledge that's almost universally known, and it was just brushed aside for the sake of drama.

As for multiple EMH's, basic snapshotting of storage is built on being able to conserve space by storing only the differences between two copies of data separately and sharing the unmodified original. While storage may have been tight, and the accumulating differences make this perhaps not a supportable model long-term, I don't see why it couldn't have been done short term on an emergency basis. That being said, I don't remember Voyager referring to computer space like a resource they had many problems managing.

The only explanation I can think of is that computer systems in the Star Trek universe are so different that the rules of present day computing don't apply for some reason or another. In other words, "Because...plot!"

Then I realize I already wasted way too many brain cells thinking about it.

 

[Tomalak]

What bugged me about that episode was that moving file(s) on a computer anywhere is a two step process of copying them to the destination, then actively deleting the source. There's no rationale for the Doctor on Voyager to ever be in any danger, or really to even leave the ship. I feel like this is just basic computer knowledge that's almost universally known, and it was just brushed aside for the sake of drama.

As for multiple EMH's, basic snapshotting of storage is built on being able to conserve space by storing only the differences between two copies of data separately and sharing the unmodified original. While storage may have been tight, and the accumulating differences make this perhaps not a supportable model long-term, I don't see why it couldn't have been done short term on an emergency basis. That being said, I don't remember Voyager referring to computer space like a resource they had many problems managing.

The only explanation I can think of is that computer systems in the Star Trek universe are so different that the rules of present day computing don't apply for some reason or another. In other words, "Because...plot!"

Then I realize I already wasted way too many brain cells thinking about it.

Thinking about it, in Message in a Bottle, his entire programme has been sent to the Prometheus, so there's nothing left for Kim to duplicate. So Paris encourages him to create an EMH from scratch, and hilarity ensues.

Maybe it's only after this incident that they create the backup module? It would be insane if they didn't consider a backup before then, given his critical importance to the ship.

Ah well, it's no worse than Roger Corby creating perfect Androids a century before Noonien Soong.

 

[Timo]

I feel like this is just basic computer knowledge that's almost universally known

Which should be our cue right there. After all, what's universally known today must be wrong tomorrow, by ample precedent.

Oh, certain basics of computing from back in Babbage's time might still theoretically be relevant. But what computers did to data in the 1950s is qualitatively different from what they do to it today. And there's no particular reason they would sustain the EMH in the form of anything we today recognize as "programs" or "files" or "processes", despite the names persisting into the 24th century.

For all we know, it's flat out impossible to "copy" a "program", any "program", in the 24th century, this in no way being related to the ability or inability to duplicate lines of programming and run the duplicates at a different location.

The only explanation I can think of is that computer systems in the Star Trek universe are so different that the rules of present day computing don't apply for some reason or another. In other words, "Because...plot!" Then I realize I already wasted way too many brain cells thinking about it.

It is a bit like trying to figure out how warp drive works. Applying the rocket equation or general relativity or browsing blueprints for past spacecraft propulsion systems won't get you far there, either.

But stuff like that wouldn't have helped much in designing the first aircraft, either: the maths until then were more often flat out wrong than not, the tools of abstraction too unrefined, the preceding efforts all dead ends beyond their meager range of applicability. Aircraft aren't fiction, though. Even though they used to be.

Timo Saloniemi