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She Got It From Jim: A Clinical Review Of The Works Of Dr. Leonard McCoy and Transmission Network Analysis of "Patient J.", by Galatrini of Regulus V, University of Andromeda, 2403.7

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She Got It From Jim1: A Clinical Review Of The Works Of Dr. Leonard McCoy and Transmission Network Analysis of "Patient J."

Author: Galatrini of Regulus V, University of Andromeda, 2403.7.

Abstract:
Objectives: The author intended to review the recently-published case studies of the late Dr. Leonard McCoy and place them in their proper context in galactic social history.
Methods: The case studies were carefully read. Literature searches were conducted to connect the most interesting case study to medico-sociohistorical events. Transmission network analysis was performed.
Results: One specific patient appears to have been responsible for or connected to a disproportionate number of these events, specifically, the patient noted as J in McCoy's documents.
Conclusions: Further research on the sexual habits of Starfleet will be indispensable to the medical community at large.

Introduction: The long-awaited publication of the late Dr. Leonard McCoy's case studies2 was the initial spark of this paper. Obviously, a physician of his caliber and with his wide experience of the universe would have fascinating insights on the medical profession. The author had, however, not expected to become interested in the exploits of one particular patient, noted as J in the good doctor's documents. Not only did this patient have a great number of injuries recorded, he had an unusual number of sexually-transmitted diseases. The good doctor treated and cured all of these diseases, but often suspected that he had not done so in time to prevent their further transmission. This intriguing side-note led the author to examine the timing of J's illnesses in the context of medico-sociohistorical events through transmission network analysis (see Figure 1, a map of J's known sexual partners and their sexual partners2), and to discover that this single patient was very likely responsible for many of them.

Discussion:
In general, determining a connection between a single patient and larger events is extremely difficult. Fortunately for the author, J happened to have been allergic to both Melvaran mud fleas and Retinax V, an uncommon combination. This allowed a comparison of J's information across various physicians' notes. Following are a selection of the most interesting cases with J's involvement.

Q Fever 3:
The first medico-sociohistorical incident in which J plays a part is the discovery that Q fever was transmissible between Caitians and Humans. McCoy notes that J claimed to have had intercourse with a pair of Caitian twins approximately two days before developing mild flu-like symptoms that lasted 10 days, then jokes that perhaps it was, in fact, an act of intercourse with a common house cat instead2. (The doctor will soon be renowned nearly as much for his humor as for his expertise, the author supposes.) The timing of this entry was just three weeks ahead of the publication of a monograph by Dr. M'Rarr of Cait (15 Lyncis), a Caitian himself, describing the transmission of Q fever between a healthy Caitian carrier of the disease and a Human with allergies to Melvaran mud fleas and Retinax V: none other than J!

Chancroid 4:
The next sociomedical incident took no particular detective work on the part of the author. Dr. McCoy notes that the discovery of a chancroid on J's sexual organ led him to start a campaign to vaccinate the entire population of, and all visitors to, Argelius II against H. ducreyi 2. This has, naturally, played a large part in the increase of travel to Argelius II since then.

Gonorrhea 5:
It has long been assumed that gonorrhea was naturally found in the population of Neural; however, there is a strong possibility that it was, in fact, brought to Neural by Dr. McCoy's patient J, who came down with a case of urethritis with purulent discharge and a throat infection shortly before their initial arrival on Neural in 2255, but failed to mention this to the doctor until shortly afterwards2. The doctor determined both of these ailments to be due to gonorrhea. Upon their second visit to Neural several years later, J appears to have picked up gonorrhea again. The Enterprise visited Triskelion not long afterwards. Although there is no documentation directly connecting this visit to the Triskelion gonorrhea epidemic of that year, it seems highly likely that patient J was at least one of the disease vectors, and, as everyone knows, the epidemic is what led Starfleet to send physicians to Triskelion, both to treat patients and to keep an eye on the Providers' promise to educate the former thralls.

Chlamydia 6:
Ever since the Horizon visited Sigma Iotia II in 2168, that planet has been afflicted with chlamydia. From the doctor's notes, it appears that after the Enterprise's visit in 2268, J developed infectious urethritis2; shortly thereafter, their ship was temporarily taken over by scouts from the Kelvan Empire. Nearly a century later, upon next contact with the Kelvan Empire, we learned that they believed themselves to have been cursed by the Enterprise -- with a disease that turned out to be chlamydia. J, as the saying goes, strikes again.

Pubic Lice 7:
Pubic lice, or Pthirus pubis, is an obligate ectoparasite of humanoids, which has affected Humans for over 3 million years. McCoy mentions that he helped to smuggle a Platonian off-world at one point, and later treated him for what is colloquially known as "a case of the crabs." Not long after that, the Enterprise was visited by a Scalosian ship, demanding some of their male crew members to expand their breeding population. According to McCoy's notes, J had an inventive solution to the problem, and also his own "case of the crabs."2 More recent contact with the Scalosians has led to the discovery that pubic lice, while unknown before their contact with Starfleet, are now endemic among their population. The simplest explanation would be that J shared his genetic material in the traditional way, and in so doing, shared his pubic lice.

Andorian Shingles:
While the form of Andorian shingles that causes eyeball bleeding has long been known to be transmissible between Andorians and humans through casual contact, the sexually-transmitted form was long believed to appear only in Andorians8. The work of physicians T'Preen and Origula described the first human patient with this form of the disease as having an allergy to Melvaran mud fleas and Retinax V, and showing a dermatomal pattern of rash in S2 (see Figure 2 and Figure 3, the areas in purple, for reference)8. Dr. McCoy described the same rash in his patient J, though his language, as was his wont, was a great deal more colorful2.

Conclusion:
It is evident from the presented information that more research on the sexual conduct of Starfleet is essential. How many of their personnel are potentially super-sharers like patient J? How much suffering could be prevented by arming them not only with contraceptive injections, but with vaccines that could protect against sexually-transmitted diseases? We just don't know.

References:
1 Lehrer, Tom. "I Got It From Agnes." Songs & More Songs by Tom Lehrer, 1997.
2 McCoy, Leonard, MD. They're really making me do this. Starfleet. Retrieved 2403.5.
3 Derrick, E.H. "Q" fever a new fever entity: clinical features. diagnosis, and laboratory investigation. Medical Journal of Australia. 1937; 11:281-299.
4 see Sexually Transmitted Diseases, 49th ed. McGraw Hill Professional. 2401. pp. 689–698. for description
5 see the Galactic Health Institute's page on Gonorrhea
6 see the Galactic Health Institute's page on Chlamydia
7 Rapini, Ronald P.; Bolognia, Jean L.; Jorizzo, Joseph L. (2007). Dermatology: 2-Volume Set. St. Louis: Mosby.
8 T'Preen, Origula. (2368). "Antigenic and biologic differences in herpesvirus andorianus.". Progress in Medical Virology 1000: 110–59.