Actions Have Consequences
Posted on Sat Feb 21st, 2026 @ 5:23am by Lieutenant Alexandra Blackstone MD/DSAPM & Lieutenant JG Jezra Siv MD
2,821 words; about a 14 minute read
Mission:
Peril at the Unification Accords
Location: CMO's office
Timeline: MD 10 - 1100
Alex swept into Jezra's office, not quite knowing what time it was as she had had to actually track her Chief down. She was back in her usual spirit and clearly had more energy as she glided through the door, positioning herself to the side of the desk and meeting Jezra's gaze directly. She remained silent for the moment, allowing Jezra to finish whatever she had been working on while sequestered away.
The CMO had let Alex in, but they were in no rush to finish typing on their computer. Jezra admittedly had been staying away from Alex after she had first woken up, mostly because they did not have the mental capacity to handle the mox of emotions. So the Trill had been doing essentially anything else that would give time to think. Jezra had given a quick glance to Alex when she had entered, and didn't look again until they had finished typing on the computer. "Before we get into it," Jezra began, gesturing to the available seats, "how are you feeling?" She certainly looked better.
"For the most part, better. Still dealing with spiking headaches here and there... but they are manageable" Alex kept her tone polite, level. She planned to keep things simple, detached from emotion as best as possible. She did notice the fragments of Tricorder scattered in corners or sitting in potted plants that had been missed during an attempt at cleaning though she said nothing.
Jezra gave a polite nod. "I'm glad to hear that you're doing better. Sorry about the headaches." While her tone remained neutral, the microexpressions in her face gave away the relief. They took in a steady breath. "I think you know why you are in my office right now." Briefly typing on the computer, Jezra shifted, either to get comfortable or perhaps to emotionally brace. "We will address that shortly. I strive to be a fair and reasonable department head, Alex. I want to hear your side of things. Since we are in the middle of an investigation, do you consent to part of this conversation being recorded?"
"I would expect nothing less." Alex' reply was short but not snippish. She was straight to the point and raised a brow expectantly. She was aware of protocols and expected them to be followed.
With another nod, the CMO set up the recording, an audible beep sounding in the office to indicate the recording had started. "This is Doctor Jezra Siv, Lieutenant Junior Grade, Chief Medical Officer of the USS Astrea, conducting a formal investigative interview in the CMO office. The purpose of this interview is to establish an accurate account of events during Ambassador T'Varel's final moments." She glanced to Alex, "Lieutenant, please state your full name and rank for the record."
"Lieutenant Alexandra Blackstone, Assistant Chief Medical Officer"
With a head tilt to silently give thanks, Jezra turned their attention back to the computer. There was a footnote that Alex had been medically cleared to answer questions, and it was timestamped in the log. "Lieutenant, will you please share the events leading to the ambassador's passing as you remember them, starting from when she collapsed in the reception hall?"
"I was on site at the conference near the Ambassador when she collapsed, seemingly from no known cause. I was one of the first to arrive at her side and begin administering basic aid and surveying her for signs of injury. She was not responsive to initial attempts to rouse or bring her round and she appeared to have fallen into unconsciousness. The decision was made to conduct an Emergency Transport from the Accords to the Astrea Sickbay."
Alex paused, taking a breath and searching her memories. "The Ambassadors condition rapidly declined once in sickbay and she went into a state of neural shock which did not match her vital signs which for several minutes seemed to be within range before they too declined. A Neural stimulator was ineffective at stabilization attempts and I made the rapid decision to attempt a partial mind meld to stabilize the Ambassador instead." The accounting was true and she left no part of what she remembered out, though she was concise and efficient in its delivery; with not a trace of emotion.
"A meld isn't Starfleet standard procedure. Can you please explain your rationale? What did you see during the medical emergency that led to your decision?" To the keen ear, Jezra's tone was tense, like she was purposefully holding back the phrasing she wanted to use.
"Are you familiar with the medical files pertaining to the U.S.S. Enterprise - D, with Captain Picard?" Alex paused for an answer.
"Familiar enough," Jezra answered. They weren't going to ask for elaboration of medical files while recording, as it was easy to violate confidentiality.
"There was an incident involving a psionic weapon of sorts that they encountered, and the signs I saw when the Ambassador began to desat despite efforts to stabilize that should have worked reminded me of that very incident. I thought that I may have been able to offer my... discipline and resolve to the Ambassador's psyche to provide a path for her mind to stabilize itself."
That last sentence didn't sit well with Jezra. While well aware of her own lack of knowledge around the inner workings of telepathy, fundamentally they all had similar treatment procedures. Using prior knowledge wasn’t forbidden, per se --Jezra did that a lot herself-- but the way Alex phrased it made it sound like an educated guess rather than an informed decision. "Prior to initiating the meld, did you rule out other interventions?"
"I was monitoring the activities of my colleagues that were working on the Ambassador's vitals to try and stabilize them and I myself was working on trying to do the same via a specialized Neural Stimulator. Neither seemed to be working and I did not honestly think that I had time to try and change tacks to a different method to rule out other possibilities." Alex' words were matter of fact, straight to the point. Nothing was wasted on emotion or anything beyond the facts as she remembered them.
Jezra laced her fingers together on top of the desk as she watched Alex. "And at what point did you intend to brief another physician before initiating the meld?"
"Unfortunately... this is an area where my specific expertise was too valuable to waste trying to follow procedure; not to mention we didn't have the time to spend. I was more concerned about trying to save the Ambassador than trying to get permission to do a meld. Even had melds been entered into standard therapeutic policies I would not have wasted the precious seconds it took. I am sorry that it didn't work as well as that it has complicated the entire situation." Alex was unapologetic though her eyes did betray that she understood the repercussions of her actions even as she kept her gaze solid on Jezra.
With this being Jezra's third lifetime in medicine, one would expect her of all people to understand prioritisation under pressure. Deep down, Jezra knew that Alex's actions were probably the most logical given the circumstances. If they were in her position, with telepathic abilities at their disposal, they'd... probably do the same thing. Hell, even Sialle Siv had to make some ethically ambiguous decisions during the Dominion War.
Jezra just never expected to have to deal with this. As Jezra Tirrahn or as Jezra Siv.
"I understand." The words were mostly neutral, but surprisingly they were also honest. "Thank you for your response. Further discussion on the procedural details is outside the scope of the investigation, so I'd like to transition briefly to the ambassador's last impressions. As you were technically the last person to make contact with Ambassador T'Varel, did she say anything or did you otherwise become aware of any information that may be relevant to determining the cause of her death or aid the investigation?"
Alex took in the words for a moment, not expecting them to have been what they were. After some consideration she took a breath. "I retrieved.... a jumbled mess from her psyche. At the moment I don't know what to make of it... but I am certain there is important information in those memories. I just need some time to meditate and figure out what is what."
Given all that Alex had gone through, that response wasn't unexpected. It did mean that nothing else of significant value was likely to come out of this part of the conversation, so Jezra nodded. "Of course. We can revisit once you have been able to sort through the information. There are no further questions at this time. Thank you for your cooperation, Dr. Blackstone. Unless you have any additional information for the record that you wish to share, I will conclude the interview."
"Nothing further for the Record." Alex took a small breath and leaned back slightly in her seat. She glanced around the office with a slightly amused look but didn't say anything further. She had herself been in Jezra's very shoes in the past and she related on a very instinctual level.
Jezra completed the formalities of concluding a recorded interview, but the ritualistic nature did little to calm their emotions. The computer's confirmation sounded dull. A quick verbal command filed the recording with the other medical data collected so far on T'Varel's death, which was protected by a medical security seal. Jezra checked the computer to make sure the file made it, then closed the tab and removed their hands from the controls.
Then, silence.
Even the air in the office seemed to be waiting. Jezra slowly took in a breath of air through her nose, one of her hands running through her short hair. This was the part she hated to do. The dreaded anticipation showed itself in her slumped shoulders, in the way her eyes closed to collect her thoughts, in the lack of words spoken.
"The situation was messy," Jezra admitted, finally breaking the silence. It almost sounded like self-reminders than the beginning of a lecture to Alex. "It was deteriorating and under pressure. We're trained to navigate that ambiguity, to survive it." Jezra pulled up the notes they had made on the computer, the thoughts they had over why this bothered them so much. Two days was a long time to think. "I'd be a hypocrite if I were mad at a decision made under pressure." Her voice was quiet, but it also wasn't soft. "What bothers me is what that decision did to the rest of the room."
Pulling up the visual feed from sickbay during the medical emergency, Jezra turned the computer around for Alex to see, the sound muted. It started with T'Varel's scream, then continued through the team's recovery until the first defibrillation was ordered, which was when the playback paused. "Six seconds," Jezra said, watching Alex with a gaze that didn't bother to hide the emotions that had been simmering. "For six seconds, attention was divided. Resuscitation response was slowed because it had to be adapted. I won't sugarcoat it: it was the worst possible time to remove yourself as a clinician. The last thing we needed was a chaotic change in de facto command in the same moment the situation depended on the team's cohesiveness."
Jezra turned the screen back around, glancing only briefly at the recording before focusing her attention on Alex. "I'm no stranger to moral and ethical ambiguity in times of crisis. The Dominion War demanded it from Sialle Siv, and the Gamma Quadrant demanded it from me. I am intimately familiar with how easily these types of situations can turn complicated. But between those two experiences, I never compelled another to commit an ethical violation. Your neural shock was preventable, or could have been mitigated if... if anything had been done differently. My only options were to focus on one of you and put the other at risk, try breaking the meld and put you both at risk, or do nothing and watch you both die. On top of it, I had to violate the autonomy of someone I'm supposed to trust. That's what I can't forgive easily."
"We have not been colleagues for long, Dr. Siv. But I think I have gained enough knowledge of you to be able to make a judgement call that had you been in my position with my knowledge and ability to attempt an intervention you would have likely chosen the same actions. That being said, I did not wish to cause difficulty for you and I am the first to admit that I disliked the idea of losing the Ambassador while I had some ability to maybe stop it." Her focus likewise was firmly on Jezra and she had a look that made her look more Vulcan than normal, her human traits seeming to vanish for a moment.
If there was any decent way of visualising Jezra's inner monologue, it was: Jedex wanting to tell Alex off for being stupid, Sialle holding him back, and Jezra covering his mouth and telling him to shut up. Jedex was not one to talk about making stupid decisions.
"I'm not a fan of dwelling on speculatives," Jezra began. Having been around speculation for the last couple days, receiving yet another hypothetical made Jezra's shoulders tense up. There was no argument that both of them would have done everything in their power to save the ambassador, but to her there was no point in entertaining a scenario that could never actually happen. "It's impossible for me to ever be in your situation, with your knowledge and abilities. That said, I still wouldn't have taken myself out of command like that."
She crossed her fingers together on the desk as she met Alex's unwavering gaze. "I'm not the only one your actions affected, Alex. How exactly am I supposed to explain in an official report that the team was left without instruction because you initiated a meld with a high-ranking official?" Jezra's tone began to shift in subtle ways as they moved on from the rhetorical question. "At best, I could probably find an argument for implied consent, but I doubt it would hold under pressure. At worst, you gave yourself consent, which is an abuse of de facto power."
"You don't offer an explanation in your report. Logically, your report should contain the facts as you were witness to. Any inquiry will fall squarely on my shoulders then. As for instruction, we are all a team and we are trained to think on our feet and accept input from all sides simultaneously, especially in life or death situations which the Ambassador's condition most certainly was." Alex nodded as she spoke. "There is some argument to be made for implied consent within the facts of the situation as it was officially our job as well as our moral duties to provide any intervention that we had available to prevent the Ambassador's death."
Intuitively, that made sense. It was what Jezra expected of the medical staff who were involved. They spent hours making sure the official report was devoid of emotional speculation. "The report is factual," they affirmed. "But no matter how I phrase it, there are documented actions that invoke responses under Starfleet regulation."
Alex nodded, not wasting the effort of unnecessary words. "I am sure that there will be responses invoked under Regulation. Of course; there will likely be an official inquiry but that is an eventuality I am prepared for."
Jezra took in another steadying breath. She hated this part of her job. "Dr. Blackstone, effective immediately you are hereby on a 48-hour medical suspension pending review. During this time, your medical clearance will be revoked per Starfleet Medical Regulation 39-Alpha. A formal reprimand will go into your file, and since you endangered yourself you will complete a mandatory psych evaluation before you are cleared to return to your duties." They didn't need to tell Alex what they were feeling, as it was probably very evident in their expression.
Alex nodded, none of the repercussions surprising her as they were much the same as she would have done. "Understood. I will see about scheduling with the Counselor soon."
With a curt nod, Jezra had nothing else to say. "Dismissed."
Alex stood, walking crisply out of the office and taking a glance around sickbay before departing for her own quarters.
Lieutenant J.G. Jezra Siv
Chief Medical Officer
USS Astrea
Lieutenant Alexandra Blackstone
Assistant Chief Medical Officer
USS Astrea
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