[7.4/10] It’s hard to Tyler Durden me at this point. I don’t want to go rattling off spoilers for unrelated projects, but suffice it to say, since Fight Club’s famous twist, umpteen shows and movies have pulled the “they were never really there!” trick on the audience to the point that it’s become more of a cliché than a shocking reveal at this point. You really have to work for it to pull that particular brand of wool over the audience’s eyes at this point.

“Doctors Orders” pulled it off, though! I will cop to the fact that until the last minute reveal, I had no idea that T’Pol was a figment of Phlox’s “reconfigured space”-addled imagination. That in and of itself is something of an achievement, particularly for a show whose tricks and tropes tend to be remixed versions of other bits from the franchise’s forty year history, and other classic television beats.

But what’s especially impressive is that the whole thing makes sense in hindsight. I’ll admit, I haven’t gone through the episode frame-by-frame or anything, but there’s little details that point to T’Pol being a product of Phlox’s mental agitation. The fact that she appears awake at all without prior mention seems a little odd, but you can write it off due to a little narrative ball-hiding and the fact that her Vulcan physiology has often been an excuse for her being immune to this or that. Still, in hindsight it makes sense that Trip would probably have entrusted the engineering routines to her rather than Phlox if he’d had the choice.

At the same time, it’s not hard to read T’Pol’s statements about the ship as extrapolations from things Phlox already knows or realizes in process. When T’Pol remarked that Phlox once told Hoshi that Denobulans often hallucinate and view it as healthy, my first thought was “She wasn’t there for that conversation,” but I wrote it off as a simple T.V. shortcut. Instead, it’s a subtle clue as to what the real scenario is, and dovetails with details like “T’Pol” reminding Phlox about the difference in capabilities between the main sensors and a hand scanner.

I’m probably overemphasizing the twist here. It’s a small part of a much larger episode. What I appreciate about is not just the twist for twist’s sake, but the way it retroactively helps tie into the theme of Phlox laboring under the pressure of having the Enterprise and the health and safety of the crew resting solely on his shoulders, and cracking a little bit under that pressure, but ultimately coming through in the clutch.

You see that manifested in his other hallucinations. An imaginary Trip pops up to tell Phlox that he never should have entrusted the ship’s warp engines to the good doctor. Archer himself pops up in hallucination form to be magnanimous with Phlox but still say that it was too much to put that sort of responsibility on his shoulders. And the imagined presence of some insectoid Xindi represents both a good paranoid fantasy set piece, as well as a sublimated representation of Phlox's concerns about his ability to keep everyone on the ship safe.

The episode tips its hand a bit when Phlox goes to put Archer in his coma, and Archer tells a visibly touched Phlox that the doctor is one of the few people the captain would trust to protect the well-being of his crew and his ship. Still, that thematic undercurrent makes the rest of the episode’s panic, scares, and plot obstacles more meaningful, given that the stakes are personal and not just the usual weekly “the ship’s at risk and everyone could die!” possibilities that will basically never happen on a continuing network drama.

More than anything, I just enjoy the mood of “Doctor’s Orders”. There’s a real The Shining vibe to the episode, where Phlox is isolated and something seems off about his location, but for much of the runtime, you cannot tell whether there is genuinely something wrong or if this is the product of an isolation-induced bit of hallucination.

The episode plays that multiple ways. At first, it’s kind of fun just seeing what Phlox does when no one else is around. Him feeding his pets in the nude, or watching old Danny Kaye movies, or writing to his exchange program pen pal is all fun, vaguely MASH-esque eccentric doctor stuff. But the episode also spends a lot of time keeping sinister-seeming things at the edges of the frame. You get the sense of his solicitude being punctuated by something nebulously unsettling, in a way that translates nicely to the audience. Like “Impulse”, this is a good bit of Star Trek adopting some tried and true horror tropes, in this case more psychological horror, and making good use of them.

The episode also does well at connecting that with Phlox’s Denobulan origins. While part of this show is always going to be nigh-literally pie-in-the-sky, part of what’s made people connect with Star Trek for decades is the human element within it. Phlox talking about how Denobulans are a well-socialized and packed-in people by choice, and his struggles to be alone, feel human and heighten the inherent distress of the situation. Plus, hallucination or not, the episode does a good job of contrasting it with T’Pol and the Vulcans’ more traditional desire for peace and solitude.

None of this is wholly original. Even the story of isolation on a Starfleet vessel where most of the crew is in stasis in a trip through difficult space, while the doctor and emotionally-reserved senior officer keep watch is a tale Voyager told previously. But “Doctor’s Orders” tackles the story of isolation and responsibility well, matching it with a nice series of problems both paranoid and real, and pulling off one last twist at the end that took yours truly by complete surprise. Whatever the episode lacks in originality, it makes up for in giving Phlox the spotlight, and making the most of his solo tour of duty.

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