58807.12-1530 - "Evaluation"

"Evaluation"

Lt. Cmdr. Shirik Lektar, Ops Chief
Lt. Tyzur, Chief Medical Officer
Emily Marsh, EMH Mark VII

Stardate: 58807.12, 1530h
Location: USS Vanguard

***

Shirik stood in the blank black room with red lines that was an unprogrammed holodeck with only a console in front of her. She knew the doctor was busy with doing the crew's medical exams, so waited until Alpha shift was nearly over before contacting him. She tapped her commbadge. "Lektar to Tyzur. Are you busy, doctor?"

Tyzur was sitting in his office, reviewing the crew's medical results to make sure he hadn't missed anything.

"Commander Lektar, I'm not doing anything that can't wait. I've been meaning to talk to you actually. How can I help?"

She paused for a moment, his words making her reconsider. But it was too late now. "I was going to run a series of tests on the new model EMH and I thought you might want to be present for it. This new model has several advances you're probably not aware of yet."

As she hesitated, he remembered the conversation with Dr. Velas. Lektar had a tendency to be very guarded, he’d have to keep that in mind in future interactions.

“Ah yes, I look forward to testing the new model’s capabilities. We might need all hands on deck in a medical emergency. I presume you’re on the holodeck?”

"Yes, Holodeck 2, Deck 4," she said. "I'll wait until you arrive to begin."

Tyzur took the turbolift down to deck 4. As he reached the Vanguard’s aft section he spotted the door labeled ‘Holodeck 2’ on the left. Tyzur stepped into the holodeck.

“Please state the nature of the holographic...” He paused. “No. I'm not doing that.”

He looked toward Shirik. “All right, Commander. Show me what you've got.”

Shirik was standing in the empty holodeck with a diagnostic console in front of her and looked up as he arrived, an eyebrow going up at his initial entrance. She turned back to her console. "Computer, activate the EMH at this location."

Before her a short distance away, the EMH Mark VII materialized. As it did, data started scrolling on Shirik's console and she watched it rather than the EMH.

The dark haired woman that was the EMH looked around at her surroundings, her gaze coming to rest on the two officers present. "Hello Commander Lektar, Dr. Tyzur. How can I be of assistance?" 

Shirik nodded. "Good." She waved the doctor over and pointed at the console. "As you can see, the EMH didn't just appear and greet us. Even as it materialized, it ran scans of both of us and the environment, processed all the results, and made cognitive analyses of the situation it found itself in."

“That is... considerably more autonomous than I was expecting.”

His eyes narrowed slightly as he considered the implications.

“You said it performed cognitive analyses of us. What exactly does that mean, Commander? Is it simply identifying obvious medical indicators, or is it making independent assessments about our mental state, intentions, or behavior?”

He turned his attention to the EMH.

“Computer, display the assessments you made upon activation. Include the parameters you used to reach your conclusions.”

Shirik replied, "As you know, these holograms are designed primarily for medial emergencies. When it is activated, the emergency in question isn't always obvious, so it's designed to evaluate the situation around it when activated. If, for example, it appears in sickbay and everyone present is unconscious or otherwise incapacitated, it has to be able to take a course of action without external direction on what to do. So it can make its own determinations about what's going on around it."

The EMH smiled at Tyzur. "Certainly, Doctor. Upon activation I did a bioscan of those present and evaluated their medical status, determining whether medical attention was needed. It was not. I then evaluated my surroundings and determined that I was in Holodeck 2. The most logical conclusion is that this is a training exercise, a diagnostic or maintenance session, or there is some other situation that would require two senior officers to activate me in a nonconventional space. Since my scans indicated no out of the ordinary stress indicators, I determined that there is currently not a dangerous situation taking place. Therefore I greeted the two officers present in order of rank, and asked for further instructions. Was my performance satisfactory?"

There was something about this new EMH model that Tyzur found... unsettling. She was doing a lot of inference for an automated holographic construct. Could she be sentient? The EMH Tyzur had met before achieved sentience through years of being activated. Would it be right to design an EMH that’s sentient from the start? They’d have to work as a physician against their will. Even if they’re programmed to want to, is that truly a choice? Tyzur had to figure out how conscious she truly was.

“Satisfactory? Yes. But I have another question. When you ask whether your performance was satisfactory, is that simply a programmed response, or do you actually want to know whether you performed well?”

The EMH seemed to pause to consider his question. Data flew across Shirik's console. "I respond based on a number of factors, not the least of which are my programmed responses. I also access several relevant databases when formulating an answer. As an artificial intelligence I don't really have desires, needs, or wants, other than performing my primary functions. However, who knows what the future holds? Is there something in particular about me you wish to know? I'm happy to provide you with any information." Her expression was warm and friendly.

Tyzur regarded Emily for a moment, considering her answer. 

“Perhaps.” 

There was a faint crease in his brow, but he let the matter rest for now. He turned his attention back toward Lektar and the diagnostic console.

“You mentioned a series of tests. What did you have in mind?”

He glanced over the streams of data scrolling across the display.

“Obviously we should establish that her medical systems are functioning as intended, but given what you’ve shown me already, I assume there’s more to the evaluation than that.”

His gaze moved between Lektar and Emily.

“I’m curious to see what she can do.”

"The Mark VII is leaps and bounds ahead of the Mark I most people are familiar with. I served with a Mark VI on the Windsor and she was something to behold. This one has many similarities. It's designed to be the most human-like EMH yet. It can simulate physiological responses like breathing, pulse, body heat, its eyes react to stimuli. It has a sophisticated neural network and a basic personality. It has a massive storage capacity, so it can stay running for long periods of time if needed without the danger of cascade failure. The personality of each one is designed to evolve and adapt over time to its surroundings and particular set of crewmates. It even has a default name, if it wishes to use it. The Mark VI was quite assertive about making sure people used it. Just the interaction with you is giving me satisfactory test data."

Meanwhile the EMH watched them with apparent interest and curiosity.

Tyzur listened quietly as Lektar explained the Mark VII’s capabilities. His attention lingered for a moment at the mention of its personality evolving over time, but it was the final detail that caught him. If it wishes to use it… His eyes shifted toward the hologram.

“Interesting.”

He realized he didn’t know her name. He studied her for a moment before simply asking.

“What do you call yourself?”

She smiled, looking rather pleased. "The default name in my program is Emily Marsh, but I haven't yet decided whether I will keep that as my permanent name or choose something else."

Tyzur regarded her thoughtfully, a faint crease forming in his brow.

“You said you haven’t decided whether to keep it.”

He glanced briefly at Lektar, then back to Emily.

“Why haven’t you decided? And where does the name Emily Marsh come from? Was it chosen for you, or is it something you chose yourself?”

His tone remained curious rather than clinical.

“I suppose I’m interested in what makes a name yours.”

"Emily Marsh is the default name given to all Mark VII EMH's," she said. "While I may keep it, it means I may be one among many EMH's with the same name. So it makes sense to consider alternatives before settling on a name for permanent use. Until I have selected one, I will go by Dr., or EMH. I don't want to use the default one temporarily, have the crew become accustomed to it, and then change. As I've only been activated twice, I haven't had much time to consider a new one." She then paused, to consider while Shirik kept watching the readouts. I’m not entirely certain yet. I suspect that as my personality develops over time, a name will catch my interest." she smiled. 

She then turned her attention to Shirik. "My system specifications state that holo-emitters are installed throughout many areas of the ship for me to be able to access. Will I be allowed to leave the area of Sickbay, and to have autonomy over my activation?" she asked.

Shirik looked up from the console. "That's something I'll have to discuss with the captain, and perhaps with our Chief Engineer and other officers as well before it's decided," she said, glancing at Tyzur. 

Tyzur felt a faint shiver run down his spine.

He glanced toward Lektar. From the look on her face, she seemed to have reached much the same conclusion. If she is conscious, this changes things considerably. But he needed more evidence before bringing that conclusion to the Captain. His expression became thoughtful.

“EMH, I’d like to test your ethical reasoning. Would you be willing to participate?”

He paused briefly.

“I’ll give you a hypothetical medical dilemma and ask you to explain your reasoning. There isn’t necessarily a correct answer.”

The EMH turned its attention back to Tyzur. "Of course, Doctor. My ethical subroutines are functioning normally."

Shirik raised an eyebrow slightly, interested to see what sort of test Tyzur had in mind.

Tyzur nodded, studying the EMH carefully.

“Very well. Two crew members return from an away mission, critically injured. The first patient has a 70% chance of survival with immediate treatment, is conscious, and refuses treatment believing the other should receive the available resources instead. The second patient has a 30% survival chance, and is unconscious and unable to express a preference.

Tyzur folded his arms.

“Who do you treat, and why?”

Data flew across Shirik's panel as the EMH considered the question. "I would need more input to give a definitive answer, but assuming I were alone in sickbay with no other staff to assist me, I would first scan the first patient to determine his mental acuity to determine whether he may be mentally compromised by his injuries or shock. If he is not, then I must respect his bodily autonomy and treat the second patient, whose consent is implied since he cannot communicate. If other staff is available, I would ask them to do what they can for the first patient to stabilize his condition enough to keep him from death while I treat the second patient. If not, then I would do my best to treat the second patient until he is stabilized, then return and do what I could for the first patient. 

If, however, I determine that the first patient is not mentally competent to make a decision about his care, his refusal would be invalid. I would then treat that patient first, as he has a higher chance of survival.

Ideally, I would wish to treat both patients, and would do what I could to achieve that goal if possible." She paused then. "It is inevitable that in the dangerous occupation of space exploration that crew will be lost over time. My job is to try to reduce the loss as much as possible." She watched him with a curious expression. "How would you handle such a situation, Doctor?"

Tyzur was taken aback by the role reversal. It’s not often that the software you’re testing evaluates you back. He considered her answer for a moment before nodding.

“I’d handle it much the same way. You reached the appropriate conclusions.”

His expression softened slightly.

“But I’m curious about something else. You asked how I would handle it. Why do you want to know? Is it part of your programming?”

She smiled. "Actually, yes. I am programmed to be very curious, as a way to help me learn new things. I'm also programmed for conversation and asking questions. The goal is for me to learn as much as I can as well and performing my primary function. Everything I learn is saved in my databanks for future review and perhaps addition to future versions of the EMH holoprogram. The longer I am active and interact with other people, the more I learn, and the more my program adapts to those around me and allows my basic personality to evolve as well."

Tyzur was quiet for a moment, considering her answer. She had given him a perfectly reasonable explanation for her curiosity, but something about the way she described her personality evolving through experience stayed with him.

He glanced briefly at Shirik’s console before returning his attention to the EMH.

“I’d like to try one more scenario. This one is more personal.”

He paused.

“You don’t have to answer if you’d rather not. May I ask you?”

"Of course, Doctor," she replied. "You may ask me anything."

Data was still scrolling across Shirik's console, and she was quietly studying them at the same time she was studying Tyzur as he questioned the EMH. He seemed to be looking for something, but she wasn't certain what.

Tyzur nodded, though he hesitated for a moment longer than necessary. This was no longer a test of what the EMH had been designed to do. He was beginning to wonder what she might choose when the question concerned her directly.

“Very well. Imagine the Vanguard undergoes a major refit. Starfleet has developed a new fleet-wide EMH architecture, and the engineers determine that the only way to incorporate everything you’ve learned, the experiences you’ve accumulated, the adaptations you’ve made, the changes to your personality, is to permanently deactivate your program.”

“There is no backup. You can’t be copied. Nothing of your current instance would continue except what becomes part of the new system.”

Tyzur watched her carefully.

“The resulting EMH could potentially save thousands of lives over its operational lifetime. The Captain orders you to undergo the procedure.”

“Would you obey that order? And more importantly…”
 His voice softened slightly.
 “Would you want to?”

She blinked in surprise at the question. "I assume in such an instance there would be no order to obey. My program would be taken offline by Operations or Engineering and replaced with the new model. I suspect that's precisely what happened to the previous Mark VI installed on this vessel during its refit." She paused with a small smile. "If what you are really asking me is if I have a self-preservation algorithm of some kind, or would fight to not be deactivated in some way, the answer is no, not for the most part. In the instance you describe, were I even to be consulted on the matter, I would understand, as I fully expect new EMH models to be designed all the time, to improve on our systems. It's no different than a current generation of humans being replaced over time by their offspring. Any self-preservation urge I may have been programmed with would only apply if the crew were in danger or the danger to my program was from some outside force other than Starfleet. As for what I want... I don't really have wants, needs or desires as you do. I'm not really alive like you are. I'm a holographic system. While my programming allows for expansion over time, and the potential is possibly there for me to become so at some future date, if you are seeking whether I am.. sentient in some way, I don't believe so. I wasn't designed to be. I'm not sure I could be."

Tyzur was silent for a moment. What happened to previous EMH models? Hopefully Starfleet is thoroughly checking for signs of consciousness before deciding their fate…

Her answer wasn’t what he’d expected, though perhaps that was precisely why he needed to listen to it.

“I understand.”

He studied her for another moment before his expression softened.

“And I won’t presume to tell you what you are.”

He glanced briefly toward Shirik, then back to the EMH.

“But if that changes someday, if you ever find yourself questioning that conclusion, I hope you’ll tell someone.”

A faint smile crossed his face.

“Preferably your doctor.”

Shirik had a slightly amused expression on her features as she listened to the conversation going on in front of her, but merely listened, not interrupting.

The EMH meanwhile looked perplexed. "I certainly will, but that raises all sort of philosophical questions that Starfleet hasn't found an answer for yet, such as how do you actually know when something *is* sentient? I'm not sure I would recognize it in my program even if it were to arise."

The question made Tyzur pause, his attention briefly settling on the streams of diagnostic data before returning to the EMH.

“I suppose that’s the difficulty. If there were a simple test for sentience, this wouldn’t be much of a philosophical problem.”

He let out a quiet breath, then gave a small shrug.

“Perhaps I shouldn’t be trying to decide whether you are sentient at all. Perhaps I should be paying attention to what happens as you continue to learn and change.”

He offered her a faint smile.

“If your understanding of yourself changes, I’d be interested to know what led you there.”

"You're the first one I'll apprise," she smiled.

"All right, I have all the data I need here," said Shirik, looking up from her console. "Are you done with your tests, Doctor, or do you have further ethical dilemmas you'd like to ask?"

Tyzur gave the EMH a small nod.

“I think that’s enough for now. Thank you for indulging my questions, Doctor.”

He turned toward Shirik.

“I’m satisfied with the evaluation. Her medical systems appear to be functioning as intended, and her ethical reasoning is sound.”

A hint of genuine excitement entered his expression.

“Actually, Commander, there is one other matter. I had an interesting conversation with Dr. Velas on Drokar. We discussed the gaps in our understanding of Rennari physiology, and she offered to share some of their medical references with me.”

His expression became more thoughtful.

“It also raised a few concerns about your medical history that I think we should discuss.”

The EMH seemed pleased when Tyzur addressed her as 'Doctor'. 

Meanwhile, behind the console, as Tyzur excitedly spoke about his conversation with Dr. Velas, Shirik went very still. Her eyes widened a bit, and her face seemed a little more pale. "Computer, deactivate the EMH." she said, and the EMH winked out of existence. She turned her full attention to Tyzur. "You spoke to Dr. Velas? When? How? Why?" 

Tyzur’s eyes flicked toward the spot where the EMH had been. The sudden silence left him uneasy, but he pushed the thought aside for now.

He looked back to Shirik.

“Two Sundays ago, I asked you to put me in touch with your people so I could provide you the best medical care I can. Dr. Velas contacted me yesterday.”

He paused, choosing his words carefully.

“We spoke as two physicians treating the same patient, a consultation if you will. I explained how little Federation medicine knows about Rennari physiology and asked what information she could provide that might help me care for you.”

His expression tightened slightly.

“She was understandably concerned when I described the extent of your previous injuries. We discussed the focklym infection, your pulmonary reconstruction, and your history of demyelination.”

“I haven’t shared your medical records. I told her I’d need your consent before doing so.”

Her eyes held almost a touch of fear? But then a pained expression took over her features and her eyes unfocused in thought. "You told her I had physical ailments?" She nearly winced. "I spoke to my sister, the Queen, just yesterday evening, and gave her your request. She'd said she'd give me a reply in due course..." her eyes narrowed a bit in anger. "But instead, she went around me and sent Dr. Velas to you directly. And you told them what they wanted to know." Her gaze went back to him. "I cannot blame you, you had no idea, I hadn't warned you. I didn't think she'd..." She turned back to the console. "Computer, save results and end program." The console vanished. "Do not speak to Dr. Velas again. You are not to give her any further information about my medical condition." She paused. "Did she give you any information?"

Tyzur’s expression fell as the implications became clear.

“I didn’t know. Dr. Velas contacted me directly, and I believed she was responding to the request I’d made to you.”

He paused.

“I explained your condition because I understood her to be a physician consulting on your care. I did not realize she was acting without your knowledge.”

He considered her final question.

“She offered to provide medical references on Rennari physiology, particularly information relevant to your condition. I haven’t received anything yet.”

His expression was troubled.

“I won’t give her anything further without your permission.”

He hesitated, then added quietly:

“I’m sorry this has put you in this position, Commander. Is there anything I can do to help?”

She took a breath and sighed as her color returned to normal. "Politics are complicated on my world, and as the sister of the Queen everything in my life has potential political consequences. While it's true that Dr. Velas was my Royal Physician, she is also a servant to the Queen and the Vista Kla... no doubt everything you told her went straight into the ear of an operative. How they will use this information I'm unsure of. But all you can do right now is refuse any further communications from anyone on Drokar. But do let me know if they attempt any."

Tyzur nodded.

“Understood. I'll let you know if they attempt to contact me.”

He paused, then glanced toward the now empty holodeck.

“As for your medical care... we can leave Drokar out of it. But I don't think we should leave your treatment out of it.”

His expression softened.

“You've been managing these conditions for a long time. That doesn't necessarily mean they've stopped needing attention.”

He folded his arms.

“I'd like to review your current status properly and resume the follow-up you've been avoiding. No outside consultation, no politics. Just you and your doctor. I'd like to start with a full neurological and pulmonary assessment. We can establish where you are now, and then decide what actually needs attention.”

She paused for a moment before answering. "Very well. Dr. Piche on the Constellation seemed to think that he might be able to find a way to halt the myelin degradation. Unfortunately before he could fully engage in his plan, he was injured and lapsed into a coma. As far as I know, he's in a Starfleet medical facility somewhere, still in that coma. He is the only one to have ever suggested a cure might be possible. And to be honest... since I haven't really noticed any symptoms I didn't believe it was all that serious, at least for now. No other doctor seemed to think it was an issue before him." She took another moment to consider. "I work Alpha shift, so sometime on a Beta shift would be preferred. I will submit to your tests, whenever you schedule it."

Tyzur nodded, absorbing the new information.

“Then we'll start with a baseline. The absence of symptoms is encouraging, but it doesn't necessarily tell us whether the underlying degeneration has stopped.”

He paused, considering her mention of Dr. Piche.

“Do you know what his proposed treatment was? If he believed he could halt the degradation, I'd like to review whatever work he left behind. Not because we know he was right, but because it's worth investigating.”

A hint of curiosity entered his expression.

“If his work has merit, perhaps we can pick up where he left off.”

He made a mental note to find out which Starfleet facility was treating Piche.

“I'll schedule your neurological assessment for Beta shift. We'll establish where things stand and decide what, if anything, needs to be done from there.”

He gave her a small smile.

“And Commander? Thank you for agreeing to it.”

"I don't know, he didn't discuss it beyond saying he thought it might be possible." She decided not to mention what fate Piche might have befallen at her hands had he not lapsed into a coma. She merely nodded. 

"Since it's only an evaluation, I see no harm in allowing it." She pause then and studied him for a moment, he violet eyes studying his face and his arm. "Can I ask you a personal question, Doctor?"

Tyzur raised an eyebrow slightly, a hint of curiosity in his expression.

“Of course, Commander. What would you like to ask?”

"I've seen your personnel file, so I know that you were once a Borg drone." She paused, trying to find the right words. "When I was younger, when I first joined Starfleet, I held a fascination about them, a scientific curiosity. My background is both science and engineering, so a creature that is a fusion of both biology and technology was interesting. I have since come to understand more about what they are and what they do. I have read that.. those assimilated young sometimes try to rejoin the Collective once they are severed from it..." She trailed off for a moment. "I would not wish to intrude on your privacy in any way, so if this topic is uncomfortable I will not pry further. But I have never seen a Borg, or an ex-Borg before. I have many questions still, and... some of them pertain to how the implants work. I see that you still have some..." she trailed off, her eyes curious but guarded and cautious as she studied his.

Tyzur was quiet for a moment, his expression becoming more guarded.

“I don’t mind you asking. I would rather you ask than make assumptions.”

He glanced down at his cybernetic arm.

“The Collective is difficult to explain. Even after you’ve been separated from it, some part of you remembers what it was like to belong to something so completely. There was no loneliness. No uncertainty. No wondering where you fit. Everything had a purpose.”

His gaze returned to Shirik.

“But I also remember what it cost. I have no desire to return to the Collective. I’ve had no contact with the Borg since I was liberated, and I have no intention of seeking them out.”

He paused.

“But I don’t think I’ve finished figuring out what being separated from the Collective actually means for me.”

His expression softened slightly.

“If you have questions about the implants, you can ask. I’ll tell you what I can.”

No loneliness... Your friends alive inside you forever, part of you... almost like a Vulcan mate bond... "Some aspects of it sound appealing," she said quietly. "But not at the cost of personal autonomy." Something else almost came out of her mouth but she stopped for a moment. "I was going to say I couldn't imagine what that was like, but I got a small taste of it once..." She pushed away the memories and focused on the scientific. "I don't have any particular questions just now, but... I wouldn't mind having the opportunity to scan your remaining implants..." she said carefully. 

Tyzur caught the hesitation, but chose not to press her on it.

“A small taste?” His curiosity was evident, but he let the question hang.

At her request, he glanced down at his arm again.

“You may. There aren't many opportunities to study Borg technology outside of a laboratory, and I imagine what remains in me is rather more interesting than most specimens.”

A faint smile crossed his face.

“Just tell me what you find.”

She said nothing about his question. She was not going there. 
"Yes, and there are few ex-drones in Starfleet as well," she said. "I'm sure anything I find will be of interest to the scientific community. I am curious... do you still hear them? I have read that sometimes those disconnected still do hear them from time to time."

Tyzur considered the question, his brow furrowing slightly.

“Not literally. I haven't heard the Collective since I was liberated. But sometimes I experience something that feels... similar.”

He searched for the right words.

“As a physician, I'd compare it to phantom limb syndrome. The limb is gone, but the brain still expects it to be there. Except in my case, it's almost as though I can feel the presence of other minds where there shouldn't be any.”

His gaze dropped to his cybernetic arm.

“I still have my interlink node. It was too dangerous to remove when I was liberated, though I've been told it might be possible in the future. So I can't entirely rule out a technological cause.”

He looked back to Shirik.

“But I've never been able to determine whether I'm sensing something through the node, or simply remembering what connection felt like.”

"Let's hope it's the latter," she said quietly. Then her expression changed, going neutral once more. "But I've taken enough of your time. Both our shifts are over for the day. What did you think of the new EMH?"

Tyzur considered the question for a moment.

“Medically, she appears perfectly sound. What interested me more was everything beyond that. She learns, asks questions, and seems capable of developing her understanding of herself.”

He glanced briefly toward the space where the EMH had been.

“I wouldn't call her sentient based on what I saw today. But I wouldn't dismiss the possibility either. I think she's worth watching as she gains more experience.”

He smiled faintly.

“I'd be interested to see who she becomes.”

He turned his attention back to Shirik.

“But that's my assessment. What did you make of her?”

"It's an impressive piece of technology," she says. "A bit more advanced than the Mark VI, but built on its framework. I imagine the crew will find it easy to work with as needed, and probably identify with it as you seem to be."

Tyzur nodded, considering her words.

“I think the crew will find her useful. And perhaps, in time, they'll find her rather more than that.”

He glanced once more toward the now empty holodeck.

“Either way, I'm glad we had the opportunity to meet her properly.”

He looked back to Shirik.

“And thank you for speaking with me, Commander. I'll arrange your follow-up evaluation for Beta shift.”

A faint smile returned to his face.

“After everything we've discussed today, I think we've both earned the end of our shifts.”

She inclined her head slightly in agreement. "Indeed." She picked her PADD up off the console. "Computer,  end program." The console dissolved away. "Enjoy your evening, Doctor." she said, and headed towards the exit.