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In retrospect, given that the four-year-old version of the captain of the Enterprise simply had to put his chubby little hands all over everything he saw (no change from the adult version, McCoy thought sourly), the only surprising thing about it was that the kid hadn’t caught all kinds of bugs by this point in his four-week-long childhood. Even the sterilized environment of a starship couldn’t keep up with the amount of germs the kid accumulated just by virtue of the fact that his insatiable curiosity meant a constant hands-on approach. Also, no little boy washes his hands properly without being prompted. When he tore Spock a good one for not checking on the boy, the Vulcan’s response was only a blank look, obviously indicating that the idea of not properly sanitizing one’s self had never crossed his mind even as a (probably extremely scary) child. Fat lot of help, Vulcans.
Their first indications were overlooked simply because crew efficiency was down three percent; only to be expected, given that they had been becalmed in cartography for a month now, but the drop was still noticeable in morale and efficiency. A quarter of the crew was complaining to Sickbay about various minor ailments, most of which were brought on by too much time to think and not enough time exercising, and the physician was beginning to wonder if he should automatically hand out placebos for the first round, just to distinguish the genuinely ill from the bored and malingering. At least then he’d be able to get some decent sleep between exaggerating patients.
So when their toddler captain complained that his ‘tummy hurt’ after evening mess, he only sighed and informed the woeful upturned face that even if Mr. Spock thought German chocolate cake was perfectly acceptable as an entrée (the replicator is capable of producing the necessary nutrient content into any edible form, Doctor; it is a purely molecular process which is not altered by the eventual form of the food it synthesizes) it was a psychologically bad idea for little boys. Jim scowled at him, one hand cupped under his cheek to prop his head up as he picked at the plate of ham and greens the doctor had plopped in front of him after shoving the cake to one side.
McCoy paid no attention to the grumbling emanating from between bites of ham, only satisfied when the child swallowed a large forkful of greens with a grimace and then looked hesitantly for permission to return to his precious cake.
Honestly, Spock was worse than McCoy’s grandmother had ever been.
It didn’t occur to him until later, to notice that the child only took one listless bite of the dessert before pushing it away.
Spock was awoken on the instant by the sense that someone was approaching his personal space with admirable stealth. But the presence was non-threatening, familiar; he had not even opened his eyes before he relaxed, knowing who it was.
“Jim,” he sighed. “We have had this discussion multiple times. You are too old to be sharing a bed with an adult.” To be fair, by human standards the little one was not too old for proximital comfort, but by Vulcan standards he should be more than self-sufficient. Spock was highly uncomfortable with the idea of sharing a bed with a child based upon a cultural understanding that it was unacceptable behavior once past the infant stage. The fact that the child in question was his own captain at a future age made the whole thing that much more awkward. “Have you had a nightmare?”
“No,” came the muffled whisper.
“Then you need to sleep in your own bed, Jim,” he replied, not unkindly.
A small sniffle caused his resolve to waver, and his sigh was permission enough. A moment later the bed dipped barely perceptibly under the tiny weight, and a small body was wriggling under the comforter next to his.
“’M cold,” came the whimper into his shoulder, and he sighed, placing one arm around the squirming little one in an effort to both warm him and stop his squirreling about under the covers.
In his defense, he had just been abruptly awoken from sleep, as well as having been accustomed to illogical human behavior. He could then, possibly, be forgiven for the fact that it took him all of three-point-two seconds to realize something was very wrong.
His cabin, while cool to his tastes, was set somewhere between human and Vulcan norm due to his sharing it tonight with the child in question; it was quite chilly for him but should be extremely warm for any human. Secondly, his body temperature was considerably lower than a human’s; Jim should not be cuddling close to him for warmth because his body should feel cooler than the child’s own.
“Computer, lights fifty percent,” he said, sitting upright and tugging the covers away from the small figure next to him.
The child whimpered a sleepy protest, curling up into a tighter little ball with one hand pressed against his eyes.
“Jim.” He held a hand against the child’s face, only noticing now that the lights were on how flushed the little one's face was. He was aware by this point of the optimal temperature for a child this age, and the skin beneath his hand was dry and much warmer than it should be. “Jim, do not go to sleep yet.”
Golden eyes slitted open, their usually bright depths hazy and indistinct. “Go ‘way,” the child murmured, turning over in an attempt to hide his face in the pillow. “S’eepy.”
“Computer, activate Code Gold, First Officer’s Quarters, Medical only.” The alert would sound in Sickbay, the CMO’s quarters, and Security unless one was vocally deactivated. “Jim. Jim, wake up.” He received no answer from the unconscious little boy. 
Surely the child’s illness was not contagious, but he had no other explanation for the sudden sick feeling which knotted most disconcertingly at his insides. Scooping the little body up into his arms, he scanned the small face for signs of awareness, brushed a finger lightly over the sweat-soaked temple. He caught a vague, blurred thought-bubble coldowtummyhurtsspockmakeitbetter and was indeed about to carry Jim through the corridors to Sickbay and do just that single-handedly when the door opened and one Leonard McCoy lurched through, his uniform tunic on backward and one shoelace undone.
Spock’s head jerked up at the abrupt entrance, only peripherally making the deduction that the physician had been sleeping in his cabin one deck below, quite soundly by the look of it. “Doctor,” he said, more helplessly than he had intended.
“Did he say anything, Spock?” the physician murmured, already running a med-scanner over the small form.
“Only that he was cold, Doctor. I was not with him earlier in the evening; I had no other indication that he was feeling unwell.”
“Said he had a stomach-ache at dinner but that could easily have been from the cake or any number of things, God knows what the kid gets into on a daily basis,” McCoy replied absently, brushing a gentle hand over the small forehead, and placing the back of his fingers on the flushed cheek. Jim stirred uneasily under the contact, turning his face into Spock’s black sleep robe. “From what it looks like now, it’s probably just a ‘flu or some minor bug like that; this too-rapid aging is probably shooting his immune system to hell and depleting his body’s resources too rapidly, and he isn’t old enough for the basic inoculations like the flu vaccine yet. Fever’s not high enough yet to be alarming, but the poor kid’s gonna be uncomfortable for a little while.”
“Will he be better cared for in Sickbay?”
“I doubt it, since he hates the place unless he’s takin’ apart my machines,” the physician replied dryly. “Scanner says he’s mildly dehydrated and his body chemistry’s all out of whack, nothing fluids and rest and some loving won’t fix. Maybe we shouldn’t try so hard to get him to learn everything and accelerate the aging process, Spock, if it’s gonna cost him his health like this.”
Spock looked down at the small body dozing fitfully in his arms. “If we do not, Doctor, it is going to cost him months or years of his life. I will explain the situation to him when he next ages, and he will decide how to proceed.”
One eyebrow rose. “You’re gonna let a five-year-old who can’t think past his sweet tooth decide his own future.”
“Do you have an acceptable alternative?”
“Let me treat him this round and figure out how bad his body’s mixed up,” the physician said. “I might be able to come up with some supplements we could give him to combat the depletions, maybe even boost his immune system. It’ll take a bit of experimentation to get the dosage right.”
Spock considered briefly, and then nodded. “When Jim reaches ten years old, if a solution has not been found he will make the final decision. You have until then, Doctor. I cannot in good conscience sanction the adult losing months of the five-year mission due to our purposefully delaying his transformation.”
McCoy knew better than to argue, because they’d made it clear from the first that Spock was taking responsibility for the command decisions in this case. And anyway, he was confident he could find something that would help in that amount of time.
“Agreed, Mr. Spock,” he replied, nodding. “Now, let’s get him back into his own bed. Lots of rest, some fluids – get him to drink some juices, give him a couple popsicles when he’s awake enough. I’ll send Christine by with some soup and a vitamin booster in the morning, see if we can’t get him back to his holy terror of a self soon enough. I know he looks pretty sickly but human kids crash hard when they do, it looks scarier than it is right now.”
Privately, McCoy thought it was just a bit adorable (and creepy that he even thought that) the way Spock refused to let go of his baby captain until they were settling the drowsing child back into his little cot in the corner. Blankets were tucked snugly around the small body, stuffed panda bear secured under the little boy’s arm (Momo’s replacement, a gift from Scotty, had been eagerly accepted into the family circle).
Jim blinked awake for a minute as he was shifted. “Bonessss,” he spoke up with a surprised smile, waving a listless hand up in the air.
McCoy chuckled, snagged the hand and tucked it securely back under the blankets. “It’s me, kiddo. You’re gonna feel a little icky for a while but you’ll be fine, Spock and me are gonna take care of you.”
“Was dreamin’ about ducks,” the little boy said seriously. “Why there no ducks in space, Spock?”
“They require oxygen to live, as humans do, Jim, and an aqueous environment which is impractical for a starship.”

McCoy rolled his eyes. The only thing that saved the Vulcan a swat upside the head was the gentle hand which stroked (obviously unconsciously) over the wild mess of sandy hair covering a fevered forehead.

“Mmm,” was the non-committal answer. “I like ducks. You like ducks, Bones?”
“Sure do, kid.” Preferring the old-fashioned method, he timed the child’s pulse through the warm little wrist beneath the covers; it was a little fast but not dangerously so.
“Sam lets me play with his wubber duck,” the child rambled on, smiling up at them. Jim had a barely-noticeable speech impediment which only emerged when he was extremely drowsy or else concentrating very hard; McCoy was working on that but it still slipped through here and there. “When I’m sick an’ stay home he reads me Make Way for Ducklings an’ I make the noises.” Jim yawned, blinked slowly up at them. “'M sick now, where’s Sam, Bones?”
Spock’s eyes closed briefly, hand stilling in the child’s hair. “Aw, geez, kid,” McCoy muttered, squeezing the small hand just a little harder than he meant to. “He’s…he’s not here right now. But if you want me to read you something I can, or tell you a story about ‘em?”
One eye cracked open from where it had fluttered closed, appraising him critically. “You haveta make the noises, quack-quack, peep-peep,” the child stated warningly. 
He nodded with perfect solemnity, crossing his heart with a gesture which got a mystified twitch out of Spock’s right eyebrow.
“’kay then.” Jim’s insultingly doubtful tone was swallowed up in another yawn, and he snuggled down into the well-worn fleece blanket Spock had just magically conjured up from somewhere. 
The physician glanced up. “Go take care of getting rid of your Alpha shift tomorrow,” he said quietly, rubbing at red-rimmed eyes. “Because I’ve only got six more hours on this stim set before I’m gonna crash and nothin’ can stop it. You and Christine’ll have to take care of him tomorrow.”
Spock nodded, saying nothing. But as he crossed to the communications terminal, he made a mental note; Jim was not the only one whose immune system was being overtaxed, nor was he the only one whom Spock would likely need to keep watch on the following day.