Lots of people get sick or wounded in Star Trek—it’s why a medical officer is always a vital character in a series, why their sickbay is as crucial and oft-visited a locale as a starship bridge. And part of that is that occasionally Trek dabbles with the idea of depicting chronic illness, for better or worse, and the potential reality of characters having to face long-term care. But 30 years ago today, Voyager explored that while also introducing us to one of the best recurring alien species it ever got in its seven-season run.
Voyager has quite a number of recurring antagonist species, even as the back half the show gets a little too Borg-obsessive for its own good. Early on there’s the repeated looming threat of the various Kazon clans, later we get the faux-Predators in the Hirogen (providers of the series’ best holodeck episodes in “The Killing Game” two-parter)—with everything from the asshole polluters in the Malon or the sinister Species 8472 in between. But three decades ago today, still early into the show’s run, we got one of the best of the whole show when “Phage”—my own personal very first episode of Star Trek, sparking a lifelong love—introduced us to the Vidiians.
A species pushed into organ-harvesting piracy by the deadly, pan-generational affliction that gives their debut episode its title, the Vidiians combine a plethora of elements to make them such a compelling foe, and eventually tragic frenemies. First, their appearance is a remarkable bit of prosthetic work, gruesomely tragic humanoids ravaged by a disease that has visibly scarred and ravaged their bodies—sincerely creepy and uncomfortable to look at. The second is that they are, even pushed to the extremes we first encounter them through, at least somewhat understandable in why they are the way they are, something the series explores further and further in their future appearances, but is also present from the get-go in “Phage.” But “Phage” is also really the one Vidiian episode that absolutely nails what makes them so scary: the potential reality of what their actions inflict on others.
“Phage” opens as a routine away mission (that Neelix has, in his usual manner early on in Voyager‘s run, managed to annoy himself onto) going catastrophically wrong when a mysterious assailant attacks Neelix with a peculiar energy device. But Neelix hasn’t been phasered, as the Doctor quickly realizes: he’s had his lungs removed.

What follows is genuinely one of those early Voyager scenarios that speaks to the series’ incredible potential. There’s the “a character tries to deal with Neelix being annoying” stuff that is common in early Voyager, sure, even as those annoyed acquiesce that they’re dealing with a suddenly chronically disabled colleague. But as the doctor works through stopgap treatment after stopgap treatment, a mess of complications makes handling the prospect of Neelix needing immediate, lifelong treatment really fascinating to consider even beyond the body horror of his situation. This early on, Voyager is still grappling with just how resource-strapped a ship stranded tens of thousands of lightyears from support handles itself: the ship doesn’t have the energy or personnel to spare; the medical department, all-but-eradicated by the damage Voyager took being flung into the Delta Quadrant, is pretty much just the doctor flinging things at the wall to see what sticks in an area of treatment he has no history or understanding of. Trying to sustain a Federation member species without lungs for an extended period of time would already be a meaty idea to tackle, but Neelix is the only Talaxian the crew or we the audience know at this point, compounding treatment even further.
And the fact that we sit with this struggle for most of the episode not knowing how or why it’s occurred—heightening the mystery of this new threat while also actually getting to feel out and explore the show laying out this idea as a potentially ongoing plot—just makes the horror of the idea linger in your mind all the more, while giving Neelix some great early characterization beyond being the Quirky New Alien. But for as good as “Phage” is—especially by the time of the fourth-act reveal of who the Vidiians are and what their deal is—it does ultimately still suffer from the issue that plagues a lot of Voyager‘s best ideas, not unlike a disease that will never go away.

At the end of the day, Neelix has to get better, no matter how much time this one episode sets up him and his friends coming to terms with a life-altering affliction, not because the story really demands it, but because Voyager‘s heavily episodic nature means that, outside of broad swings, very few things in the show ultimately persist beyond an episode or two. As quickly as the Vidiians are introduced and go from being shadowy, threatening foes to still-dangerous, but tragic figures, it’s just as quickly established that they can help Neelix get replacement lungs and everyone can be on their way. The show can’t sustain the existential challenge of having a chronically ill character, because everything has to soft-reset after 45 minutes. The fact that both Neelix and Kes (his eventual donor, thanks to the Vidiian’s organ-manipulation tech) just have a singular lung for the rest of their respective runs on the show is brought up perhaps once or twice, and not in a significant manner. For as packed with fantastic ideas as it is, “Phage” has to make its impact and then get out with very little really changed about the show, other than it acting as the turning point where the Doctor decides to take on Kes as medical support staff.
And yet, that impact is still keenly felt 30 years later: the strength of the idea, even knowing that it has to be resolved much sooner than it should, is still there, as is the great, conflicted first impression the Vidiians make on Voyager‘s crew and the audience at large. “Phage”, even this early into Voyager‘s journey home, still stands as one of the show’s best versions of itself—even if that also means it has to stand as a testament to one of the series’ perpetual weaknesses in the process.
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