A Medical Consultation on a Trill

Posted on Mon 10th Aug, 2026 @ 10:13am by Commander Paul Graves PsyD & Lieutenant Victor Delling MD

2,089 words; about a 10 minute read

Mission: [MAIN] From The Ashes
Location: CMO's office, Deck 83
Timeline: A day after "Counseling a Trill: A Different Approach. Before the explosion"

Paul walked to Dr. Delling's office, PADD in hand, and rang the chime for his appointment. His most recent session with Heriah Rex replayed in his mind, and he hoped Delling could give him advice.

"Come in" Victor called from the desk. His coffee had gone cold and he was just rising to refresh it when the chime had rung.

"Hello, Victor," Paul said as the door opened. "Thanks for seeing me." He stepped inside and let the door close behind him. "Busy day?"

"My door is always open" Victor answered as he gestured with his cup. "And no not precisely busy, I just allowed a task to get away from me and leave me with cold coffee. You want anything?"

"No, but thank you," Paul said with a slight smile at Delling. He took the seat opposite Delling and tapped his PADD to awaken it. "I'll try not to take too much of your time. I came to discuss with you the possibility of increasing Commander Rex's dosage of benzocyatizine while she's in ongoing counseling with me. The sessions agitate her and her symbiont, and when Rex is agitated, Commander Rex's isoboramine level plummets."

"That, is very interesting." Victor thought about the problem for a moment and then sighed. "I have dosed her a number of times prophylactically, for low levels. Honestly, i wish there was a documented way to calm the symbiont without harming the host. Realistically speaking, i can up her dosage but at what cost to her?"

"Thank you for confirming she's had low levels; I wasn't sure how accurate information from her would be," Paul said. "How often has she needed additional injections?" He sighed. "I devoutly wish I knew of a way to calm her symbiont. He's suffering, and it's rough on Rex and Heriah. She's having to be our go-between."

"I think, that I will instead just authorize individual dosages for you to give. You're a qualified physician same as the rest of us and I trust your judgement in the matter. "

"All right. Thank you, Victor," Paul said. "By the way, have you looked over information in Commander Rex's EMR from a Dr. Rikata Mol of Trill? If you haven't, it might help. I find his letter to be informative about Rex's history and Mol's early sessions with them. At the time of her arrival here, Mol describes Rex as a 'completely healthy Trill.' Well, she isn't so now--at least, not in my opinion." Paul looked at Delling. "I don't want her to go the way of her two most recent hosts."

"I read it, it was fascinating and entirely useless to me as a practitioner." Victor mused aloud, his eyes flickering as he remembered the missive. "It seemed entirely untrusting of her own good sense, to influence the symbiont at all, and almost in despair of the situation they made for themselves. At what point should a symbiont be allowed to..." Victor misliked the idea that the host was expendable.

"Exactly," Paul said. "There was no useful information about Rex's true mental state--just that it was violent. That entire report left out the huge, most important chunk of information. I think you're right. The Symbiosis Commission is at a complete loss what to do for Rex, and they're praying but not very hopeful that Heriah will find a solution. I think they tried to give Heriah what supports they could, but even so, with a symbiont as angry and frustrated as Rex is--I feel it's abusive to the host. They've allowed the abuse of three hosts now and the deaths of two. I don't want it to become three." He sighed. "Rex is suffering from severe PTSD, but that doesn't mean abuse isn't happening."

"The problem is that the Symbiosis Commission views the host as expendable." Victor grumbled rubbing his forehead. "There's no way around that mindset. I wonder..."

Paul frowned. "I fervently hope we're misreading them, but I have to admit to feeling the same way, and it infuriates me." He glanced at Victor. "What do you wonder? I'm interested to learn what you're thinking."

"I wonder if they havent researched the problem because it never occurred to them to value both lives. Why would they, people will literally kill for a slot on the symbiosis list. Maybe there is a way to help them both...we just have to discover it. Macgyver it, if youll pardon an archaic earth term. "

"There are many more possible hosts than there are symbionts," Paul agreed. "The only way I've been able to figure out how to help them has been to get the symbiont to talk," Paul said. "I think no progress will be possible without listening to Rex and learning his complete story--if he'll tell it. The only way I can get Rex to talk to me is to allow Heriah's isoboramine levels to plummet--but doing that puts her in danger." Paul glanced at Victor. "Are you thinking of using the holodeck? I've had some success using that for other patients. I'm not yet confident Rex is up to that, though."

"No, I was thinking about constructing a way for her to draw isoboramine from external sources at a more constant level. I think the cyclical nature of the hormonal production is empowering Rex to be more...I'm not sure if i should use the term unkind or unfair in this context to his host. I think some of it is purposeful, because it believes it should have died. Some is trauma reactionary, but how do you heal trauma in..." he trailed off, thoughts blossoming before his eyes.

"Heriah can give herself benzo injections at will," Paul said. "How much more external or constant do you have in mind?" He nodded at what Victor said. "I think some of isoboramine depletion is purposeful, too. I think Rex makes her forget to take her doses on time. The more control Rex asserts, the less likely Heriah is to give herself benzocyatizine. I think Rex is trying to convince himself not to care about Heriah, because that makes it easier for him to--harm her. Loving her, wanting her to become one with him, would ruin his plans. Maybe he doesn't feel himself to be worthy of her love; I haven't been able to get far through Rex's wall of rage to find out."

Paul paused for a moment and then continued. "My next step is to get Rex to tell me why he feels he has to harm his hosts. If I can find some people who've been disconnected from the collective to speak to him, that might help--at least he'd be able to talk about his experience with people who have been through a similar experience," Paul said. "That way, he could get exposed to a variety of experiences and a variety of ways people handled recovering. None of them are likely to be a perfect fit, though. I couldn't even promise that another joined symbiont would have the same experience or feel the same things. And there'd be the mental health of those survivors to consider, too."

"How do you isolate a mind, when it's just a mind....The Trill have to have a precedent for that. This cannot be an isolated incident, with the length of time a symbiont lives and the numerical possibilities involved in just living life."

"How many encounters have joined Trills had with the Borg?" Paul countered. "I think that part of it will be crucial to understand. You're right--Rex isn't the only emotionally disturbed symbiont that has ever existed. There was Joran Dax in the literature--except that was the host, not the symbiont. I also found a vague reference to a symbiont named Marh from the 2270s, but it was extremely vague, and most LCARS results that I searched claimed there's no such symbiont."

"Of course they would. I think we may need to access a database that the Trill don't have control over." Licking his lips, he offered Paul a conspiratorial smirk. "You ever had the backdoor key to the Vulcan Science Academy Research Database?"

Paul's eyes widened. "Lanis might; he did a month-long fellowship there once. I've never been. You have one?"

"I have one" Victor answered with a conspiratorial smile. "Old research project granted me access and never rescinded their permissions. Vulcans are lovely in their assumptions that every researcher continues to want to do research."

"Which most do," Paul agreed. "And continuing to use the database is likely to maintain your access permission. We might actually get somewhere."

"One can only hope so." Victor murmured and entered the search criterion.

"It will be interesting to see what Vulcan researchers have observed of the Trill, without bias or obfuscation from the Symbiosis Commission," Paul said.

"They do have a way of seeing through obfuscation that I truly appreciate. Though, their opinion of my own species is...less than appealing if one reads the literature available."

Paul glanced at him. "That's right, you're Ventaxian, aren't you? You look so Terran, I always have to remind myself. Why would Vulcans have a low opinion of your people?"

TAG

"What...what is the Soong method?" He asked absently- pulling that bit of information onto another screen so that it could run a directive search concurrently.

Paul grimaced. "It's a method of preserving a person's consciousness that I have mixed feelings about," he said. "It involves scanning and mapping a person's neural structure and then recreating it in an organic android body to provide a home for the consciousness." He pursed his lips. "If I had a wife and children I might feel differently, but in my current situation, I think I'd rather be allowed to die peacefully than survive in an android body."

"They used it to remove a single host consciousness from a symbiont. A modification of the Zhian'tara allowed him to in fact fully disappear into the android body. " Victor looked thoughtful, "what would Rex be like without the memories of the broken hosts? "

Paul mulled that over. "You mean restore Rex to who he was before he was implanted into Refkin? That would mean he'd lose everything from the lives of Refkin, Davmorda, and Luftrine." He sighed. "That's a lot of memories. I would be fascinated to meet that version of Rex, but only if the later memories could be restored to him. What was the outcome for the symbiont you're reading about?"

"Were all three of those incarnations of Rex traumatic?" he asked quietly, the man looking thoughtful. "It says that they used a modified Zhian'tara to transfer Gray, the host of Tal, from Tal that was causing problems for the human host into a golem, successfully restoring Gray to physical form and resurrecting him. It doesn't speak to the why...but the how is there."

"My impression is that the joinings with Luftine and Davmorda were not traumatic existences, but the records I have indicate that their deaths were violent, just as Refkin's was. What happened to Gray?"

"He became a guardian...the resurrected Gray." his voice was bitter "So why wouldn't they offer this to broken symbionts...or maybe they've never had a symbiont as affected as Rex is..."

"That's the impression I get," Paul said. "The Commission doesn't know what to do, and Joining Rex to Heriah was simply their best guess as to what might begin Rex's healing process. Heriah's personality is completely unlike those of Davmorda and Luftine. And...so far, it has worked--but I don't think it will work permanently."

"Cementing my belief that she was always expendable." he muttered his brow furrowing slightly. "Why didn't they just....put him back in the pools?"

"I don't know," Paul said. "Returning Rex to the pools would at least save host lives. But it occurs to me that, since their primary mode of communication while in the Pools of Ma'kala is by transmitting electrical currents to each other, perhaps what one symbiont knows, all know, and they don't want to subject all of the other symbionts and the Guardians to Rex's suffering? Your guess is as good as mine."

"I think, were that the case...they wouldn't be so anal retentive about the continuity of the hosting.."

"Yeah, that's a good point," Paul admitted. He sighed. "Thank you for talking about this with me, Victor, and thank you for helping to research this. There's got to be a way to help them."

 

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