The Doctor tries out a new name: “Luigi Mangione”.
When “Critical Care” first aired, I remember that fan consensus was that it was a timely critique of the American healthcare system, imagining that then-current trends were taken to an extreme.
Unfortunately, “Critical Care” is now a timely critique of the American healthcare system, just slightly exaggerated from real life. Is it better to have your healthcare denied by an insurance company or an AI? We’re going to have so much fun finding out!
Now, critiquing the US healthcare system in 2000 was not brave, or even especially progressive. It was a bit like “Nemesis” back in season 4, taking the bold stance of saying the Vietnam War was bad. “Critical Care” is mainly notable for the fact that nothing in America has changed for the better in the ensuing 25 years. It’s Star Trek as social commentary in the most depressing possible way.
It’s also an episode which is only mostly fine. Let’s get into that.
Can you call it a white saviour narrative if everyone involved is white?
If there’s one thing Americans don’t need, it’s well-intentioned outsiders coming in to tell them that their healthcare system is bad and they need to fix it. In fact, they understandably get a bit irate when this happens. They know. Healthcare worker especially know, and many put in a tremendous amount of work to stretch their limited/non-existent resources beyond their limits.
So it’s frustrating that apparently no one in this floating hospital from hell had thought of subverting the system until the Doctor turned up. The Red Level guys are just letting patients die (too bad, so sad) while the privileged Blue Level practitioners need the Doctor to explain how budgets are set.
I understand that this is a sketch, and you need broad strokes to build your world in 45 minutes, but Star Trek can do better. Voyager can do better.
Speaking of broad strokes, there’s a bit of fatphobia happening
You generally don’t get many fat people in Star Trek, because that is another “disease” which will be “cured” by the 23rd/24th century. Perhaps because this is a story dealing with capitalism and retrograde societies, this week we get two whole fat people! What luxury!
Well.
The Buyer is, at least, a sympathetic character. He’s The Fat Guy As Pitiable Figure. His wife has left him, specifically citing his weight as a reason, but she’s an asshole so he’s better off in the long run.
Chellick is more problematic. He’s the hospital administrator, which is medical drama shorthand for “antagonist”, if not “villain”. Technically the decisions around treatment and resource allocation are made by a computer, but Chellick is the face of that system.
I actually really like the idea of a species which prizes efficiency being brought in by other cultures as, essentially, corporate consultants. That’s a very turn-of-the-century concept, but it holds up. Maybe even a little too well. A 2025 Chellick would be a skinny young man who is too online and working for DOGE. I think he’s a good character.
I just hate that they’ve cast a fat actor in this role, which carries the stigma of greed, of misuse of resources, of taking up too much space. The actor does great work, but there aren’t enough fat people in Star Trek to feel like this was anything but intentional — especially when the likable guest characters are all slim and conventionally attractive.
Bad cop-bad cop
Voyager’s search for their stolen EMH covers largely the same ground as “Live Fast and Prosper”, but oddly, I’m not mad about it. Yes, it’s the same joke again (and again, and again), but it builds on what we did last season, and on a lot of other things.
For example: in “Live Fast and Prosper”, Tuvok is very bad at bluffing. Here, he’s much smoother, while also embracing his inner violent little guy and threatening the thief with a mind meld in a way that he must have found satisfying. I like to imagine that he and Janeway have been doing improv on the holodeck in their spare time.
That Neelix comes in as the ostensible good cop, only to reveal he is an Even Worse Cop, is also super funny. Is it ethical? Well, no. But look — and I will deny having said this when I’m on trial for massive human rights violations — sometimes you need to set ethics aside and lean into the bit.
What a great segue into the Doctor’s dilemma!
I mean, not to get into the Luigi of it all, BUT…
In case you live under a rock and get all your international political news from Star Trek blogs,1 on 4 December 2024, a health insurance CEO was assassinated. Luigi Mangione has been arrested and charged with the crime; he immediately became something of a celebrity, in part because he is shockingly good looking, but mostly because many people agree that while murder is bad, maybe a health insurance CEO had it coming.
That is a callous way to write about the violent death of a human being, but ultimately all health insurance CEOs are responsible for the less-violent deaths of many. I think that since December, a lot of us have been wrestling with this quandary — if the violent death of one man is required to fix a broken system, perhaps the murder becomes justified?
I can’t answer that question, not least because it’s too soon to say whether the system is being fixed. Incremental changes are happening, but also America is collapsing in on itself with such speed that, by 2050, the idea of having a blog to talk about an American cultural product like Star Trek might seem quaint.
But this is the Doctor’s choice. While Neelix makes the thief believe he has been poisoned, the Doctor actually poisons Chellick. It seems to work out — at least for Chellick and the twelve patients whose treatment has been denied — but we’ll never know if this leads to long-term change, or if Chellick’s employers are simply going to replace him with someone more hardline and less vulnerable to poison.
The Doctor can’t blame his decision on a glitch in his ethical subroutines. He has to live with his choice. Which is what ultimately separates him from the hospital computer, or ChatGPT: he is capable of taking responsibility.
Other observations
- I can’t believe I get to use this graphic again
- But also, in the interests of preserving the Doctor’s personhood, maybe his exe files need to be password protected, or something
- There’s technically nothing wrong with Janeway’s hair this season, but I hate it
- It’s 2000AD and all the doctors in this hospital are men, while the only woman is a nurse
- It’s not that I ship Janeway/Tuvok, but having them hold hands and pretend to be a couple gave me a lot of feelings
- So maybe I ship it a little
- Anyway
In conclusion
This is solid Trek with some annoyances, but they’re not necessarily episode-destroying. AND you get to picture Janeway and Tuvok doing improv. Three stolen Doctors out of five.