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(covers information from several alternate timelines)
In an alternate timeline, The Doctor examined Kathryn Janeway after she breathed in gas seeping into the critically damaged USS Voyager from a class 9 nebula. He found that the alveoli in her lungs had been chemically burned. She insisted that The Doctor treat her with trioxin so she could continue to work on repairing Voyager. (VOY: "Year of Hell, Part II")