In brief: A skeleton plot, but it supplies some pretty decent psychological-thriller atmosphere.

The secret at the end of The Sixth Sense has to go down as one of the best-executed narrative twists in recent years. I didn't see the movie until it came out on DVD, and still I didn't see the ending coming, even though I had heard for months that there was a revelation at the end. The key, I think, is misdirection. The solution is sitting there in plain view, but you are not thinking about it, because you are not aware there is even a puzzle to be solved. You are too busy concentrating on the character drama.

Or, in the case of Scrubs, perhaps you are too busy laughing. A similar narrative twist -- with a reasonable level of underlying poignancy -- appeared at the end of this week's episode. I wasn't expecting it at all, perhaps because Scrubs is not the sort of series where you expect a twist like that. But the clues were there.

"Doctor's Orders" guards a similar secret (funny how the same twist aired six days apart on two different TV shows), although in this case I'm not so sure it guards it so well, since I had clearly figured it out ahead of time. (The only tiny remaining doubt: Maybe I was being tricked into thinking there was a twist, and there actually wasn't one and they were just using weird events to make me think there was. Talk about over-analysis. As Data once said, "Knowing that he knows that we know that he knows...") All the hints are clearly there in "Doctor's Orders." The second Phlox offers to walk T'Pol to her quarters, the jig is up.

I admire the intentions here, and I admire most of the execution, which deals in psychological terror. But I wonder: Was anybody actually taken in by the trick ending? Had anyone actually not figured it out? (I ask in all seriousness, and would be interested in hearing from those who were.)

The issues, then, are (1) whether the experience of the journey is worth our time in getting to this predictable destination, and (2) whether the twist holds up as dramatically sound given the underlying material. For me, the respective answers are yes, and just enough.

As a rule, I like psychological thrillers, and I liked many aspects of this one. There's nothing in this episode that we haven't seen somewhere before (and, indeed, the basic premise is very similar to Voyager's fourth-season outing, "One"), but between John Billingsley's performance of an increasingly frantic Phlox and Roxann Dawson's skillful direction of a situation slowly but surely running off its rails, "Doctor's Orders" turns into a nice little pressure cooker. It starts calm and cold, turns mysterious and ominous, and then heats up with crisis and desperation. There's not a whole lot of actual substance here; it's more about mood, atmosphere, paranoia, and momentum, and on those counts it delivers.

The premise is that the entire crew (less Phlox and -- sort of -- T'Pol) must be put into a comatose state so the ship can travel through a massive spatial anomaly (the same type as the one encountered in last week's "Harbinger") that would cause the humans fatal brain damage if they were awake. Phlox's Denobulan physiology makes him immune to the effects. Also immune to the effects are T'Pol (sort of) and the captain's beagle, Porthos. Passing through the anomaly will take four days at full impulse; Trip warns that to attempt going through at warp would be too risky.

So the Enterprise becomes a vessel where everyone has gone to sleep, and where Phlox now finds that every routine bang and shimmy is magnified into dreadful sounds of forthcoming doom.

It's not until near the end of act one where we even see that T'Pol is still walking around the ship. It's a nice little craftily hidden surprise that keeps us just a little off-balance -- and, of course, provides a major hint that telegraphs the twist at the end.

The twist at the end, to get this out of the way, is that T'Pol isn't and never was awake during the time Phlox is tending to the sleeping ship. She's a figment of his imagination, apparently designed by his mind to keep him from becoming completely unhinged, which happens gradually as a result of unforeseen effects from the anomaly field.

Obviously, the fact that T'Pol isn't real is hidden from the audience more for our benefit than for Phlox's, and the fact that it's T'Pol whom he imagines is for obvious script reasons: she's a Vulcan and could logically be immune to the anomaly's effects.

This holds water to a point, since Phlox is no more aware that T'Pol is a hallucination than we (at first) are. On the other hand, the question "Why T'Pol?" is an interesting one, and it raises some issues that the story doesn't really address. If this hallucination is designed to help Phlox deal with his isolation (Denobulans do not like isolation, and there's dialog explaining how they choose to live in crowded cities on their homeworld), why would his mind pick T'Pol, who tends to keep to herself both in real life and in this hallucinated version? Why not pick someone he knows better, like one of his wives or a close friend? If he must imagine someone from the ship in order to fool himself into believing that he is not alone, would his mind really pick T'Pol? (I ask in sincere curiosity, not purely as a nitpick. Perhaps he identifies with T'Pol as the other non-human outsider.)

It probably doesn't really matter, because the story is more concerned with structure and technique than deep psychology or character significance. On those chosen levels, the episode works pretty well, giving Phlox a series of hallucinations that he eventually recognizes as unreal and must cope with. One hallucination is his deranged hunt for the Xindi insectoid, which ends when he nearly phasers Porthos. (T'Pol: "You nearly shot the captain's dog!")

T'Pol is in no better shape than Phlox, and is losing control of her emotions as a result of the anomaly's effects. In retrospect, I like the idea that T'Pol falls apart just as Phlox does; since they are both really just Phlox, it makes sense that they would both go insane at the same time.

The crises stack up when it turns out the anomaly is growing at a faster rate than expected, and Phlox realizes it will take 10 weeks for the Enterprise to emerge on the other side. ("TEN WEEKS!" Phlox announces desperately, in a great line delivery that makes us fully identify with his desperation.)

Ten weeks is obviously not an option, especially given Phlox's (and T'Pol's) mental state, so Phlox (and T'Pol) must figure out how to start the warp engines and pilot the ship out of here. The resulting scene shows exactly why starships need engineers, and why going to warp speed necessitates an engine room staff.

Noteworthy is how useless T'Pol proves in these scenes -- how she never takes action or pushes buttons -- and it's a rather obvious hint that tips us off to the ending: She isn't doing anything because she isn't really there. I have mixed feelings on Jolene Blalock's performance, which eventually degenerates into a series of weird facial expressions amid T'Pol's increasing paralysis -- which may be the point, but comes across as a little off.

Much better is Billingsley, who displays a range that begins at affable and ends up at frazzled, but all the while comes off as "Phlox." The thing about Phlox is that he has an overly expressive, cheerful style of speech. Most people typically only speak like that if they're on stage or in some other stylized medium (like, say, Star Trek). But with Phlox, it's his everyday style, and we accept it because he's a Denobulan -- but more importantly because Billingsley brings a credibility to it. This is a solid and versatile performance, delivered within the boundaries of Phlox-isms.

Meanwhile, Dawson and director of photography Marvin V. Rush maintain a visual style that stays active and interesting, including one odd shot that looks straight down on Phlox and T'Pol, who stare up into a fisheye lens. This shot, and the performances, are perhaps a little too over-the-top in the way they draw attention to themselves, but I respect the attempt here to go for an effect to convey the desperation. Dennis McCarthy shares musical credit with Kevin Kiner; together they turn out an effective score.

I'm sure some will argue that there isn't much story here. They would be correct. It's essentially a two-character show, the impetus of which is a silly spatial anomaly with arbitrary properties. And, no, the ending is hardly the surprise that it wants to be. But that's okay. This is an acting showpiece, and a technique showpiece, and a fairly entertaining one.

Not to mention it has Phlox's letter narration, ending with him deciding to leave the hallucinated parts in.

Gotta love that guy.

Next week: Mutiny aboard Voyager! I mean, Enterprise!

Previous episode: Harbinger
Next episode: Hatchery