The Enterprise crew seems curiously disinterested in all the people that are going to die. The Prime Directive and limited resources presumably prevent them from interfering. However, they don't even seem aware of the other civilizations populating the planets. None of them recognize Gem's race, and Spock merely speculates that she couldn't have evolved on the planet.
It's not clear how Spock determines that Gem couldn't have evolved on the planet. It's a Class M planet with no noticeable difference in atmosphere or gravity or lighting. It in fact appears a bit like Vulcan or a desert environment on Earth. The Vians presumably evolved there, and they don't look that substantially different from Gem other than larger heads.
There seems to be no point or purpose to the high-pitched whining noise that painfully renders first the scientists and then the landing party unconscious. The noise doesn't accompany later teleportations, and the Vians are easily capable of rendering teleported victims unconscious or imprisoned without it, as we see when they teleport Kirk away and he's in chains.
McCoy grouses about how men weren't intended to live that far underground. However, as seen earlier it's an easy walk from the Vian testing facilities to the surface entrance, with no indication of an upward slope.
When the landing party arrives, they determine that the research team has been missing for three months. The question is, what have the Vians been doing for three months? The experiments they conduct don't seem to take more than several hours. Apparently once the two scientists died, the Vians just... waited for two months and 28 or so days until someone else came around for them to torture to determine Gem's suitability.
The Vians must view Captain Kirk as sexier than Dr. McCoy. They remove Kirk's shirt during his torture, but do not remove Dr. McCoy's during his.
During Kirk's torture scenes, the back shots have Shatner's arms stretched wide apart and yanked straight - the front shots have the chains going overhead and his arms are bent at the elbows.
Spock claims the Vian device they capture is operated by specific brain patterns and sets it to his own. At the end Kirk hands it back to the Vian and they instantly use it to heal McCoy without adjustment.
Although Kirk said back in "The Menagerie" that starships don't have elaborate zoom & pan recording logs - apparently small research bases do because when Spock plays back the log of the two scientists the automatic recording pans and zooms like a pro.
The Vians are very neat - they take Kirk's shirt off when they torture him and put it back on when they're done.
McCoy: I can't destroy life, even if it is to save my own.
McCoy: Well, personally, I find it fascinating that with all their scientific knowledge and advances, that it was good old-fashioned human emotion that they valued the most.
Scott: Perhaps the Vulcans should hear about this.
Kirk: Mr. Spock, can you be prevailed upon to bring them the news?
Spock: Possibly, Captain. I shall certainly give the thought all the consideration it is due.
Scott: Not to dispute your computer, Mr. Spock, but from little what you've told me, I'd say (Gem) was a pearl of great price.
Kirk: What, Scott?
Scott: You don't know the story of the merchant? The merchant... who, when he found one pearl of great price, went and sold all that he had and bought it.
Kirk: Yes, she was all that. And whether the Vians bought her or found her makes little difference - she was of great value.
Kirk: If death is all you understand...here are four lives for you. We will not leave our friend. You've lost the capacity to feel the emotions you brought Gem here to experience. You don't understand what it is to live. Love and compassion are dead in you. You're nothing but intellect.
Lal: Your actions were spontaneous. Everything that is truest and best in all species of beings has been revealed by you. Those are the qualities that make a civilization worthy to survive.
Kirk: How will the death of our friend serve this purpose?
Lal: His death will not serve it, but her willingness to give her life for him will. You were her teachers.
Kirk: We were? What could she learn from us?
Lal: You will to survive. Your love of life. Your passion to know. They are recorded in (Gem's) being.
Kirk: How long? (until McCoy dies)
Spock: It could happen anytime.
McCoy: The correct medical phrase, eh, Spock? You've got a...a good bedside manner, Spock.
Kirk: The best defense is a strong offense, and I intend to start offending right now.
Kirk: Why did you let him do it?
Spock: I was convinced in the same way you were - by the good doctor's hypo.
McCoy: Men weren't intended to live this far underground; it's just not natural.
Kirk: And space travel is?
Spock: Some men spend the majority of their lives in mines beneath the surface.
McCoy: I'm a doctor, not a coal miner.
Kirk: And what do you want from me?
Lal: We've already observed the intensity of your passions and gauged your capacity to love others. Now we want you to reveal to us your courage and strength of will.
Kirk: Why? What is it you hope to prove? If my death is to have any meaning, at least tell me what I'm dying for.
Thann: If you live, you will have your answer.
Kirk: I found our missing men... dead. Another one of your experiments?
Lal: You're wrong. Their own imperfections killed them. They were not fit subjects.
McCoy: I don't know about you, but I'm going to call her 'Gem'.
Spock: Gem, Doctor?
McCoy: Well, that's better than, "Hey, you."
Ozaba: (after an earthquake) "In His hand are the deep places of the earth." Psalm 95, verse 4. Looks like He was listening.
In one of his last interviews before his death, DeForest Kelly was asked what his favorite original series episode was and he responded "I suppose it would be 'The Empath'". He goes on to describe the uniqueness of the cinematography and production values, and remarks "Gee what a wild way to shoot a show".
The Vians and the Talosians (from "The Menagerie") sure seem to be related - they look about the same, they have a similarly emotionless approach to things, and they treat humans as lab animals.
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