Star Trek TNG Ethics

This episode is an interesting conversation starter for things like assisted suicide and experimental medical innovation.

So it starts with Geordi and Worf dealing with the menial task of trying to figure out the strange tricorder readings they're getting in a cargo bay. They're discussing the last poker game and Worf's loss to Troi.  Nobody can see that one of the containers up on a high shelf is leaking, but once it loses enough mass, it begins to shudder underneath another full container and they both fall off the shelf.  The full, heavy container crashes down upon Worf's back and Crusher is immediately called to the cargo bay.  The analysis is a crushed spine and permanent paralysis.

Worf is devastated but Crusher has called in a neurological specialist to consult with.  I know I'm probably in the minority here, but I've always thought this part should've gone to Dr. Pulaski. It would've been a great way to bring the two doctors of this show together and it would have been fitting that Dr. Pulaski would be able to come up with a solution since she'd been built up to be a genius level doctor in the second season. But, of course it wouldn't have worked since they wanted to create friction between Crusher and Dr. Russell regarding her seemingly reckless wielding of experimental medical procedures. She is also frank and emotionless to the point of coming off as a total bitch, which would certainly not have suited Pulaski. They start off on a good footing.  After all, this is an unknown factor of Klingon medicine since Klingons who suffer these kinds of injuries often commit ritual suicide as a matter of pride. We learn that Klingons have a back up of every major system in their bodies with more ribs, an extra liver, and an eight chambered heart. Russell sees all of the extra things as a nuisance and more chances for something to go wrong. You also learn that they have ridges down their back and on their feet too just in passing.  This is the kind of creative writing I like.

So, Riker goes to see Worf and he asks him to help him preform the Hegh'bat, that ritual suicide which entails Riker handing him the knife to stab himself in the heart.  Riker is offended and outraged.  If we were talking about regular people, I'd feel the same way, but Klingons are a fictional race and I can't help but feel for Worf.  Living as a paraplegic would be a dishonor to his race and honor is put above everything else.  It's surprising that I find myself on this side of the argument for assisted suicide, but what is even stranger to me is the way Dr. Russell is painted as the bad guy for most of this episode. Knowing Worf's inability to cope with paralysis, she suggests a procedure to Dr. Crusher involving genetic replication to create a new spine for Worf. (The forerunner of 3D printing? Lol.) But it's never been tested on a living person yet, so there's no guarantee that it would work or that he'd live through it. Crusher doesn't approve of the only 37% success rate of holographic simulations and refuses to allow her to present Worf with this option.  She relents and goes with Crusher to show Worf some leg bands that will create impulses to the right nerves and help him to move again, however he'd never be able to regain full mobility. Worf is not pleased and against Beverly's wishes, Russel tells Worf about the genetic replication and the risks and asks him to consider it.  Crusher is livid, but I don't understand why. Worf would've undoubtedly found a way to die anyway and with this option he has the chance to die fighting for a full recovery.  This also illustrates a difference in episodic stories versus long, epic tales.  This episode is advocating playing it safe whereas in long fantasy tales, the best option is to go all in to achieve the goal, risking death because the alternative would be worse for not just one person, but usually entire civilizations. I think my love for these types of stories may be interfering with my ability to side with what is a more realistic reasoning. After all, Worf is a fantasy - Klingons aren't real - and his morals are in line with the honor and duty that are usually prevalent in the great fantasy classics.  Still, I see no reason to demonize this Dr. Russell for coming up with another approach. If it was real, I think several real people may choose it over life in a wheelchair even if it could result in their deaths.

 Worf hadn't been letting Alexander in to see him up till now because he didn't want Alexander to see him in this condition, but Troi finally convinces him to see him. He uses the leg bands to prop himself up so that he will seem relatively normal.  But he soon falls down and in humiliation orders Troi to take Alexander away. Meanwhile the Enterprise had been diverted to a ship transporting a large number of colonists that had hit a Cardassian mine and needed emergency medical help.  In all of the times the script calls for the Enterprise to give medical aid, this is the only time I remember seeing them set up a scene in which they're actually fulfilling that purpose. Triage units are set up in various cargo bays to take on the large number of patients.  Crusher asks for Russell's help but then she sees that a patient has died under her care because she used an untested experimental treatment. The the circumstances were dire - the if nothing was done the patient would die or if common procedures were followed, the patient was still very likely to die, but Crusher's disapproval is a little more understandable in this case since it's inferred that neither the patient nor a family member had a choice. That is undeniably wrong and irresponsible. It's also not a mistake Pulaski would've made although she was always trying radical new techniques in her tenure. Maybe if they'd done this scene a little earlier on, then maybe Beverly's attitude towards Russell would've made more sense... to me anyway. Still, this is the one and only scene where she is  justified in her anger and resentment.

So Crusher is really mad and relieves Russell of duty but Picard talks her into allowing Russell preform her procedure since he has an intimate knowledge of Klingon culture and knows that Worf would never psychologically recover if left as a paraplegic and that his life is basically over now.  Riker comes back and tells Worf that even though he's disgusted by the notion of his ritual suicide he would probably step up and help except that he's researched it and the honor that he's giving Riker should be given to his oldest son.  So, with a smug grin on his face he leaves him to face the fact that he probably doesn't have the nerve to ask this duty of Alexander.  I think the smug face was a little unnecessary.  So Worf calls Alexander in and tells him about the Hegh'bat but says that he will not do that.  Instead he tells him he will go through with the experimental procedure even though he might die from that too.

So they proceed with the surgery and these scenes are pretty wonderful.  Picard and Riker waiting anxiously in his ready room with a tension that is much more real and deserved than that ridiculous melodramatic scene from the first season where everyone on the bridge was worried about Riker fighting Worf in his holodeck calisthenics program. Troi and Alexander play a game while waiting.  The spinal transfer is cool looking. But Worf's vitals crash even after everything seems to go right and Beverly has to go out to deliver the bad news. This entire segment is really the best part of the show because even though it's set in the future, it's so very much like real life here and now. Almost everyone can identify with this sort of tension whether it turned out good or bad.

But all those Klingon redundancies and back ups that Russell had complained about at the beginning save Worf in the end as it appears that his brain is backed up as well.  His synaptic functions return and they are able to revive him. It's a happy ending and Crusher is still cold and self righteous towards Russell as she leaves, not giving her any credit and sulking behind her desk.  Sorry, but I'm on Russell's side in this episode and I can't understand why a liberal show like this is leaning so anti-science.  I still would've liked to have seen Pulaski come back and been set working with Crusher on this brilliant technology... showing off why she was super-doctor..., but I guess, then, there wouldn't be any crisis of ethics to pick apart.

It ends with Worf doing his physical therapy and accepting Alexander's help even though it means showing weakness to his son. But it's a compromise that he can live with.

So, emotional, intellectual, and philosophical areas are all compacted into this episode. Excellent for debate and conversation. Wonderful for drama. There's not much to not like about this epidsode.  I'm still not understanding why Russell was the antagonist, but this is still a top notch show.  Four stars.