Doctor Phlox receives a letter from his Interspecies Medical Exchange counterpart, Doctor Jeremy Lucas, who is serving a term on Denobula. He begins to compose a letter back, describing his experiences with the crew, and the ways in which humans are different. Meanwhile, on the Bridge, the crew are discussing a pre-warp vessel they have encountered. The alien they speak with, a Valakian, begs them to assist with a medical emergency their species is facing. Sub-Commander T'Pol reveals that the Vulcans are unaware of the species, but she agrees with Captain Archer to help them. Phlox continues his letter, describing the challenges of treating the disease, with over fifty million lives at stake.

Enterprise arrives at the Valakian homeworld, where they are met by Esaak, the Valakian director of a clinic, and Larr, a Menk orderly. T'Pol, Phlox, Archer, and Ensign Sato make a tour of the medical facility. Sato discovers that there is a second lesser-evolved yet unaffected race, the Menk, who live alongside the Valakians. Phlox makes the startling discovery that the Valakians are slowly dying out, not from an easily curable medical condition, but because of a genetic disease which is experiencing an accelerated rate of mutation. He also believes that the answer to a cure may lie in the Menk.

Archer, meanwhile, is debating whether to provide the Valakians with Warp drive, ultimately deciding against it. Upon further investigation, Phlox learns that the Valakians suffer from the illness because their gene pool has reached a "dead end" and that the Menk are undergoing an "awakening process." He also finds that the Valakians have been stifling and underestimating the Menk. He has found a cure, but does not believe it would be ethical to administer. Archer considers how a "primary directive" would be helpful, and provides the Valakians with medicine that will diminish the symptoms for a decade, anticipating the Menks' natural evolution and new levels of understanding between them.

Errors and Explanations

Nit Central

  1. Jason on Wednesday, January 23, 2002 - 7:00 pm: Well, they did mention the Ferengi, but it was just a passing reference. I guess that wasn't too bad. SlinkyJ on Wednesday, January 23, 2002 - 7:58 pm: The Ferengi were mentioned in passing, and will probably be easily forgotten. The thing is, from what we know of them, and I wonder if T'Pol knows of them, from the look she has when Archer asked if she knew about them, I would have thought that the Ferengi would have sold them a cure or something. Maybe, I'm reading too much into that.Chief Sharky on Wednesday, January 23, 2002 - 9:41 pm:The Vulcans may be aware of the Ferengi, but just didn't tell us. This would not be the first time they have chosen to withhold information from Earth.
  2. SMT on Wednesday, January 23, 2002 - 7:06 pm: Inconsistency on Enterprise's speed seems to be spreading. The Valochian(sp?) ship is found about a light-year from its home planet, a distance its pilot later says Enterprise crossed in a day. That would be about three times as fast as Enterprise's originally established speed of 100c. Of course, one could quibble about the length of a Valochian day, so there is fudging room.That would only work if the Valakian day was about 87.66 Earth hours long – that is a lot of fudge!
  3. PaulG on Wednesday, January 23, 2002 - 8:15 pm: Let me see if I get this straight:
    * Even T'Pol had no problem curing this race's disease. So the proto-Prime Directive is not an issue here.
    * The dominant race will most likely become extinct without a cure.
    * Phlox has a cure.
    * The ONLY reason why the cure is not given is that the Menk MIGHT become the dominant species if the current inhabitants were not in the way.
    * The only reason the Menk exist is that the dominant species was benevolent and enlightened enough not to exterminate them.
    So basically, the dominant race is condemned to extinction because they wern’t ruthless enough to dispose of a lesser race. No good deed goes unpunished. Josh G. on Wednesday, January 23, 2002 - 8:47 pm: Hardly, the episode states quite clearly that the dominant race was suffering from a genetic disease - they don't say this was caused by the Menk.
  4. Chief Sharky on Wednesday, January 23, 2002 - 9:41 pm: When T'Pol tells Archer: "90 years ago, Vulcans helped Earth, they are still there." The analysis is not quite the same. Humans had ALREADY discovered warp technology, Zefram Cochrane's ship, when the Vulcans found us. True they may have helped us along from then on, but we did it ourselves.Dragon on Friday, January 25, 2002 - 9:49 pm: Chief Sharky has a good point about humans discovering warp technology on their own, and Vulcan coming into Earth's picture only afterward. Also, humanity's very survival as a species wasn't at stake. If the Vulcans concluded later that humans weren't ready for deep space, why didn't they just pick a good stopping point in the knowledge curve and then leave Earth altogether, taking the rest of their valuable information with them? Who or what made them spend the last 90 years on Earth? Since guilt is an emotion, I wouldn't expect Vulcan to be too concerned about appearing less than graceful as they made their exit.Brian Webber on Saturday, January 26, 2002 - 3:42 pm: Well, on a prior ep's board, Luigi mentioned that maybe the Vulcans think the humans are hiding something, becuase maybe the crew of the Enterprise-E accidentally left something behind.
  5. Isn't it interesting that Hoshi is the one given Phlox advice on relationships, considering her slip-up with Malcolm last week. She could be using the aftermath of that experience to guide her.
  6. LUIGI NOVI on Wednesday, January 23, 2002 - 11:40 pm: When Archer gives Esaak a PADD with the instructions on how to synthesize the medicine at the end of the episode, is that a Starfleet PADD? Isn’t he giving them advanced technology? TomM on Thursday, January 24, 2002 - 4:38 am:It's not clear if the PADD is StarFleet, or, even if it is, that the technology involved is significantly advanced over what is available to the Valakians. Even if it is, though, it may not be a problem. If we were to encounter a culture that hadn't discovered the transistor and still used tubes in their radios, and gave them a miniature solid-state radio, it is doubtful that they could reverse-engineer it. But even assuming that they can, they would still not be able to use that knowledge to design a Super-Sonic Transport, or a Solar Cell. At best, they get minor things (e.g. static-free communications and broad-band Internet) a decade or two early.LUIGI NOVI on Thursday, January 24, 2002 - 12:54 pm: Tom, T'Pol was adamant in not allowing the Valakians to steal any of their technology, and remember that Kirk considered Bones leaving a communicator behind at the end of A Piece of the Action (TOS) to be very serious.
  7. Trike on Thursday, January 24, 2002 - 12:26 am: Denobulans have a word for washboard? Washboard is such a peculiar contraption, it’s hard to imagine it developed in multiple societies. Besides, since Denobulans are so much more advanced than humans, it’s doubtful they would have even used the equivalent of a washboard in centuries.LUIGI NOVI on Thursday, January 24, 2002 - 2:13 am: I dunno. You and I know what a chariot is, even though no one on Earth has used on in what? Centuries? A millennium? KAM on Thursday, January 24, 2002 - 2:28 am: Chariots are used in movies, Luigi. LUIGI NOVI on Thursday, January 24, 2002 - 2:32 am: My point exactly. Just because we don't use an archaic tool doesn't mean we don't know what it is, because we have other sources from which we learn about them. Movies are one. KAM on Thursday, January 24, 2002 - 2:45 am: You missed my point. We don't just have film of them. They are actually built & used during the making of films. Your statement about no one using them in centuries or millennium is innaccurate.
  8. Keith Alan Morgan (Kmorgan) on Thursday, January 24, 2002 - 2:03 am: Hoshi mentions having a pen pal from Australia. Pen pal? They don't have a version of the Internet in the 22nd century? Josh M on Wednesday, June 25, 2003 - 1:07 am:Pen pal does not necessarily mean she handwrote the letters. It's probably a term that just stuck into the 22nd century for two people living apart who keep contact through writing messages for each other. LUIGI NOVI on Wednesday, June 25, 2003 - 5:18 am: How can it get “stuck into the 22nd century” if it’s not in use now to begin with? Does anyone refer to their Internet friends as “pen pals”? I don’t. Josh M on Wednesday, June 25, 2003 - 11:26 am: Except the term "pen pals" is still in use today. And just because you don't doesn't mean that the whole world has given up on the term.
  9. How come no one in the theater told Phlox & Cutler to be quiet? Influx on Thursday, January 24, 2002 - 7:46 am: Someone did say "SHHH!" at the start of their conversation.
  10. Yasu on Thursday, January 24, 2002 - 6:59 am: At the end Phlox leaves sick bay and turns off the lights. A nice way to end an episode, but I am assuming that the ship has people on duty at all hours and might need the services of sick bay during Phlox's off hours. Wouldn't there be some sort of medic on duty in sick bay at all times? What happens in the middle of the night? "Thank you for calling Enterprise sick bay, our regular office hours are from 9:00 am to 5:00 pm, if you require emergency assistance please contact your nearest hospital." gary on Thursday, January 24, 2002 - 9:04 am: Maybe there's another part of sick bay with somebody on desk duty catching up on his reading.Sparrow47 on Thursday, January 24, 2002 - 1:00 pm: Luigi- if the ship is swept with a nasty virus (how many times did we see this in TNG, DS9, etc.) then you're darn straight they'd want more doctors around, or at least a bigger medical staff of nurses, techs, and so on.Richie Vest on Thursday, January 24, 2002 - 2:26 pm: Remember folks Phlox said he need very little rest so perhaps he is on call. But It does seem to be a bit wrong that Phlox does not have at least have a nurse. LUIGI NOVI on Friday, January 25, 2002 - 3:10 am: I agree. In addition, we don’t know exactly what he meant by "very little" (four hours instead of our six or eight? Two?). Also, he isn’t just off duty when he’s resting. He’s off duty when he’s eating, watching movies with the rest of the crew in the screening room, studying, or any other recreational activity.TJFleming on Friday, January 25, 2002 - 8:12 am: Who says he doesn't (have a nurse)? It's just that it wouldn't make sense in a population that small to have additional DEDICATED support/service-support staff (with nothing to do most of the time) when you can cross-train mission staff to assist the department head as-needed. Where would it end? Does Chef really need a full-time cake decorator? Kosher butcher? Olive stuffer? (BTW, that was NOT Popeye's full-time job.) Richie Vest on Friday, January 25, 2002 - 10:01 am: Tj the point is that that Phlox is the only medical person on board period. It seems unilkely there would not be at least ONE other person to be what the Navy would call a coremen or someone else who is medical trained even in a crew with 83 people besides Phlox.LUIGI NOVI on Thursday, January 24, 2002 - 12:54 pm: It might be a good idea for personnel to be there at all times (Remember Me (TNG) established that there are four personnel required in sickbay at all times--even if Violations (TNG) contradicted it), but how many doctors is it a good idea to have on board for 81 people?
  11. Hans Thielman on Thursday, January 24, 2002 - 7:12 am: Did Phlox attend dental school as well as medical school? Sparrow47 on Thursday, January 24, 2002 - 8:49 am: Yes, Phlox went to dental school.
  12. Rene on Thursday, January 24, 2002 - 11:54 am: the Vulcans who hide things from humans. Am I missing something here? Wasn't one of the points of this episode for Archer to realize the Vulcans WERE RIGHT in not giving Humans advanced tech before they were ready? Sparrow47 on Thursday, January 24, 2002 - 3:47 pm: The Vulcans witheld information from humans in the belief that humanity wasn't ready for it. Now maybe when the two sides first met, that's fine, but flash forward to "Broken Bow," and note how the Vulcans seem reluctant to give Starfleet any information about the incident with the Klingon. Note also how quick the Vulcans are to use the incident as an excuse to delay Enterprise's launch. Obviously, their attitudes haven't changed in the past 90 years. Thus, the entire series is about proving the Vulcans wrong. The parallel in this episode is that Phlox witheld from Archer that he had found a cure, but when he had that information, Archer proved that he could use it wisely (or that's what the episode would have you believe) and won Phlox over.
  13. The Undesirable Element on Thursday, January 24, 2002 - 5:05 pm: I can't see a correct solution to this problem. The key to the problem is that this is not a disease at all. The problem is GENETIC. It is the NATURAL COURSE OF THEIR EVOLUTION for this to occur. Giving them a cure would change the natural course of their evolution. This is the type of thing that the prime directive would explicitly forbid. Suppose one of the cured people grew up to be a galactic Hitler or something. That's why that directive was instituted in the first place. But the problem of the episode is that doing the right thing pretty much involves sentencing the Valakians to death. I doubt Phlox would have been willing to give them the cure even if the Menk didn't exist. I think it was just an added point. LUIGI NOVI on Friday, January 25, 2002 - 3:10 am: Which is what we do every time we search for a cure for any fatal disease. Just out of curiosity, TUE, (and I’m just asking) do you feel this is only wrong if our guys cure somone else’s disease? And if so, is it ALWAYS wrong to do so? Our SF guys created, searched for or delivered cures for diseases in Requiem for Methuselah (TOS), Code of Honor (TNG), Allegiance (TNG) (mentioned as having happened prior to the ep), The Quickening (DS9), Macrocosm (VOY), etc. I’m just curious how you feel about these instances.The Undesirable Element on Friday, January 25, 2002 - 2:03 pm: But this isn't a fatal disease as Phlox points out. This is some kind of genetic degradation. Human beings can't live forever. They die. That's natural degradation. If suddenly aliens came by and decided to give us an anti-aging device, that would be interfering with OUR natural progression. The way I saw it, Phlox had no problem with finding a cure for this problem when he thought it was some sort of epidemic. He only had a problem with it when he found out that it was something inherent in their genetic makeup. But then, I'm not a biologist or a philosopher so I don't claim to be an expert in such things. :)LUIGI NOVI on Friday, January 25, 2002 - 4:48 pm: On the individual level, and usually not all of them from any type of disease or condition. That isn't the same with the Valakians, who are going to die en masse as a species in a relatively short amount of time. And did Phlox say it wasn't a disease? I remember him saying it wasn't caused by a virus, but that doens't mean it isn't a disease. Cancer is a genetic disease, some forms of which, degrade the cells, but it is not caused by a virus. Anthrax isn't a virus, it's a bacteria. Also, why do you make a distinction between that which is "natural", and diseases and epidemics? Aren't those things natural too? Aren't most agents of disease natural? I admit, TUE, I'm not sure about this either, and I'm neither a philsopher or biologist, but hey, we both call 'em as we see them.
  14. Scott McClenny on Friday, January 25, 2002 - 6:16 pm: I noticed that at the end Archer did give the Valakians the needed schematics to make their own warp drive, without giving them any further assistance. LUIGI NOVI on Friday, January 25, 2002 - 9:20 pm: They didn't give them warp schematics, that was just data on how to sythesize the medicine to alleviate the symptoms.
  15. Dragon on Thursday, February 28, 2002 - 10:11 pm: When Phlox arrives in Main Engineering, he wanders around looking for his patient until Tucker sees him and yells, “Up here, Doc!” Wouldn’t it have made more sense to have someone greet Phlox at the door and direct him to right where he was needed? They were probably needed at their posts.
  16. How does the Denobulan mating season work? Apparently the urge didn’t hit Phlox this go-round. Will Enterprise have to plan on being near Denobula Traxia when Phlox’s next turn does come up? LUIGI NOVI on Friday, March 01, 2002 - 7:25 pm: Well, just because Denobulans have the same urges humans do doesn't mean they HAVE to have sex in order to survive like Vulcans do. TomM on Friday, March 01, 2002 - 11:02 pm: Another possibility is that only the females (assuming there are only two sexes -- the large communal marriages may indicate intermediate genders) go into "heat." The males don't go into a seasonal "must" (like elephants and Vulcans) but are especially aroused by the female pheremones (like dogs). This would be why Phlox is apparently unaffected despite it being mating season, and also why he is so interested in human pheremones.
  17. LUIGI NOVI on Friday, September 06, 2002 - 9:44 pm: One of the nits that’s been in the back of my mind, and which could be made for a number of Trek episodes, but came out when rewatching this one is how multi-talented Trek doctors seem to be. They are experts in general medicine. They are surgeons who can perform major surgery, and some cases, groundbreaking surgery using new technology or procedures, as in The Host (TNG) and Ethics (TNG). They are veterinarians, as seen in Genesis (TNG). They are plastic surgeons who can radically alter a person’s appearance, as in Unification Part 1 (TNG), Apocalypse Rising (DS9), and Faces (VOY). They are dentists, as seen in this episode. And most oddly, they are experts in fields extremely far removed from general medical practitioners, such as water contamination (as in The Most Toys (TNG)), and epidemiological research (as in episodes like The Quickening(DS9), Tacking Into the Wind (DS9), Macrocosm (VOY) and in this one). When Phlox tells Archer at the end of Act 2 that genetic diseases like the one afflicting the Valakians are extremely difficult to cure, Archer tells him to take all the time he needs to find one. Archer then goes to see the bedridden Valakian astronaut in Act 3, and tells him he they have a lot of faith in Phlox. But prior to Phlox telling Archer in Act 4 that he found a cure, neither Archer nor anyone else ever mentions the idea of sending all data on the disease to Earth, and maybe even sample materials by way of a Vulcan courier, so that Earth epidemiologists can study the situation, as if they’re pinning all hopes on the Chief Medical Officer of a primitive starship. Can you see the Vulcans agreeing to that?
  18. LUIGI NOVI on Wednesday, April 16, 2003 - 11:27 pm: When Phlox mentions the Denobulan annual hibernation cycle to Archer in the Mess Hall, Archer asks if he’s going to be without his Chief Medical Officer “this winter.” If this is the first time Archer is hearing about this Denobulan trait, how does he know it’s going to be in the winter? Josh M on Monday, February 19, 2007 - 5:50 pm: I would guess that Archer is thinking of hibernation cycles of many Earth-based creatures and makes his comment based on that.JM on Wednesday, February 21, 2007 - 10:05 pm: It's just another way of asking Phlox to clarify something about him that Archer doesn't know.

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