"Then what the hell do you want me to say, Jim? This isn't something I can fix with a goddamned hypospray! The only thing I can fucking do is what we've been doing, and that's obviously not good enough!" McCoy was a doctor. He was supposed to fix things, and help people, and make them better, and right now all he could do was sit there and hope things would get better. And that really fucking sucked.

So sorry, Jim, you're being yelled at a little. Mostly from a place of desperation and concern.

"You don't think it drives me crazy to know what this is doing to you - to all of us - and not be able to do anything to change it? I get it, you're more than allowed to be a selfish ass about this, but good god, Jim, I'm just trying to help, and I don't know how the hell I'm supposed to do that right now."