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I don't know if you've got the whole picture, but he's not exactly working on all thrusters.
— McCoy ‧ Star Trek IV: The Voyage Home

Behind the line May contain spoilers.
Our reading
An editorial interpretation.
The speaker questions whether the listener understands the situation, then describes someone through the language of machinery. Not working on all thrusters suggests reduced capacity. The technical metaphor makes the criticism sound dry and indirect, while leaving the particular difficulty unexplained.
Context reviewed