Dear Doctor - Plot

Plot

Doctor Phlox is taking care of the various creatures he keeps in the med lab. Ensign Hoshi Sato enters bearing a letter from Phlox's exchange doctor, Jeremy Lucas, who is serving a term on his home planet. Phlox begins to compose a letter describing his experiences with the crew, commenting on the many differences between his own society and point of view, and the ways in which Humans are different. On the bridge, the crew are discussing a pre-warp vessel they have encountered - it is not responding to hails, and has two weak biosigns on board. The alien they speak with, a Valakian, begs them to assist with a medical emergency their species is facing. They have met two warp-capable species, one of which is the Ferengi.

T'Pol reveals that the Vulcans are unaware of either species. She states that as the Valakian culture has already been exposed to a couple of warp-capable races, the risk of cultural contamination is acceptable, and she agrees with Archer to help them. Phlox continues his letter, describing the challenges of treating the disease – with over fifty million lives at stake, and his discussions with T'Pol about the possibilities of inter-species relationships. Meanwhile, the Enterprise arrives at the Valakian homeworld. When they arrive at the planet, they are met by Esaak, the Valakian director of a clinic, and Larr, a Menk orderly. T'Pol, Phlox, Captain Archer, and Sato make a tour of the medical facility. Sato discovers that there is a second race, the Menk, which live alongside the Valakians. The Menk are apparently not affected by the disease.

Whilst Phlox is explaining a method to slow down the symptoms, Hoshi discovers that the Menk are a lesser-evolved species than the Valakians and haven't caught the disease. Phlox makes the startling discovery that the Valakians are dying not from an easily curable medical condition, but because of a genetic disease which is experiencing an accelerated rate of mutation. He reveals this to Captain Archer, and states that he does not have confidence in curing it. He predicts that the Valakians will be extinct within two centuries. He also believes that the answer to a cure may lie in the Menk. Upon further investigation, he finds that the Valakians have been stifling the Menk and underestimating their abilities. Archer, meanwhile, is debating whether to provide the Valakians with Warp technology, ultimately deciding against it.

Phlox figures out that the illness is because the Valakian's gene pool has reached a "dead end" and that the Menk are undergoing an "awakening process." He has found a cure, but does not believe it would be ethical to administer. Archer ruminates on how a directive would be helpful, and provides the Valakians with medicine that will diminish the symptoms for a decade.