Nutshell: Not the most audacious of premises, but the execution and realizations are absolutely stellar.
When Bashir, Dax, and Kira answer an old automated distress call in the Gamma Quadrant, they arrive at a destroyed planet to find a culture infected by an incurable disease designed by the Dominion two centuries ago as a terrible punishment. The disease is known only as "the blight," and every individual on the planet is born with the condition and is fated to ultimately die by it. The disease is a sort of time bomb; "the quickening," the very advanced and painful final stage of the blight, kills everyone sooner or later. Many die in their childhood, and since most do not live to have children of their own, the culture is looking upon the prospect of their ultimate extinction.
There's nothing particularly special about the way the story of "The Quickening" unfolds, other than its absorbing execution. The idea, after all, of Bashir getting so personally involved in the plight of his suffering patients is nothing we haven't seen before. But execution here is everything. Like with "Hippocratic Oath," Rene Auberjonois proves quite capable at directing DS9 and making a show have lasting impact on an emotional level. "The Quickening" is small, slow, quiet, and involving drama. It's a very simple medical-oriented show for Bashir that really works, unlike "Life Support" from last season, where he was constantly at the mercy of a manipulative plot.
The most important reason for "Quickening's" success is that it allows us to care about the characters and the victims of the blight. I can't put my finger on why exactly it all works so well—whether it's Auberjonois' direction or Naren Shankar's precise dialogue or a combination of both—but the show makes us very sympathetic for these people. Like the Federation, they were once very much in control of their own fate, but their resistance to the Dominion's autocratic hand led to a vicious attack and endless suffering ever since. Yet while keeping everyone someone we can sympathize with, the drama keeps its bounds and never goes the least bit overboard. There's no preaching or excessive melodrama here—just a very even-handed, fair approach to the material.
And such is the case with pretty much the entire story. The creators and actors all seem to know where they're going with the story, and never push harder than they should. Take, for example, the character of Doctor Trevean (Michael Sarrazin). He's a Kevorkian-type who wants to spare people the agony of their final days of life by assisting them in a dignified suicide once the quickening sets in. In the first act, the character initially seems blatantly obvious, right down to an understandable but exaggerated conflict between him and Bashir, who finds it incomprehensible that anyone would help end the life of someone who needs real medical treatment. But the creators play down the conflict angle and make Trevean a sincere and well-intentioned character whose points and actions are very bit as relevant as Bashir's considering that a cure for the condition has indeed been assumed impossible. I appreciate that the episode shows Bashir's disapproval for Trevean's assisted suicides yet still remains completely fair to Trevean and doesn't slight his position.
The show also raises the very true notion that such a culture wouldn't exactly welcome an outside hope for a cure with open arms. Indeed, Trevean even makes a not-so-subtle threat aimed at Bashir and all healers "who bring false hope." The fact that everyone has lost hope in saving themselves is certainly understandable, and the episode manages to work it into the equation realistically. In order to run experiments, Bashir needs volunteers. But it takes a while for the hopeless to work up enough hope to defy the pain and allow Bashir to work with them in their weak, quickened stage.
One of the first Bashir works with is Ekoria (Ellen Wheeler), a pregnant widow who has not yet quickened—who hopes she can survive long enough to give birth. Wheeler does a terrific job with the material. She's another example of the show's strong point: precision characterization performed without needlessly maudlin moments. Eventually, Bashir has a roomful of volunteers, and before too long he even thinks he may have a potential cure.
But things turn dreadfully wrong when all of Bashir's patients begin gyrating and trembling in pain as an unforeseeable element causes them to reject the treatment. (This leads to perhaps the show's one slightly excessive scene where Bashir gets overly involved in trying to save one dying patient while yelling "Breathe! Breathe!" until Dax has to shake him back into reality.) By morning, Bashir has a roomful of bodies, most of whom asked for Trevean's poison to speed their death. Only Ekoria survives the night.
The deaths lead to an interesting character scene where Bashir reveals to Dax that his arrogance got the best of him. I especially liked some of Bashir's dialogue: "I was so arrogant to think I could cure these people in a week; but there is no cure—the Dominion made sure of that." And Dax's response was even better—very relevant and a very scorching wake-up call: "Maybe it was arrogant to think that. But it's even more arrogant to think there isn't a cure just because you couldn't find it." This is a very good scene that's easy to overlook.
Kira and Dax head back to the station, but Bashir decides to stay behind and observe Ekoria's pregnancy while continuing the search for a cure. Things look bleak. Ekoria quickens while still several weeks away from being ready for delivery. She doesn't think she will make it, but Bashir helps her through it until the scene where we're presented with the obligatory childbirth scene. Childbirth scenes make for one of TV's biggest cliches, but this birth is a powerful one—Ekoria gives birth to a child with no signs of the blight, and seconds after she realizes what this means, she collapses and dies. A bit theatrical, perhaps—but very effective nonetheless. Bashir realizes that his treatment will not cure people who already have the blight, but it will prevent mothers from passing it onto their children. It isn't a complete cure, but it's a very large and important step forward. It's nice to see Bashir be a hero under believable circumstances.
The writers also further prove Trevean is not a simple caricature by providing a scene where he enthusiastically takes on the responsibility of seeing others get the vaccine in hopes of curing the future generation. The ending also features a particularly poignant moving crane shot that shows Bashir watching from afar as the people crowd around the newborn baby that they see as their savior. I really liked this shot. Kudos to Auberjonois. David Bell's score also deserves recognition.
While "Quickening" isn't a groundbreaking episode that goes out of its way to choose a topic that's particularly audacious or new, it does cover its chosen topic almost perfectly and with emotional depth. Dramatically, it ventures just up to the point that it should and no farther. The result is a story that feels very real, with characters that act rational and true to themselves, such that we care about what happens to them and we care about the story.