Dr. Nicodemus West may not factor largely in to the Doctor Strange films, but he does serve a crucial role in the comic books. Seen in 2016's Doctor Strange, Dr. West (Michael Stuhlbarg) is Stephen's rival in neurosurgery and is often portrayed as incompetent. He assists in saving Strange's life after his car accident and even attempts to save the Ancient One, though he ultimately fails with the latter. While his appearances throughout the 2016 film and Doctor Strange in the Multiverse of Madness are minor at best, Dr. West's character in the comic books has a far more interesting and compelling arc.
Dr. West returns for a bit part in the second Dr. Strange, confronting Stephen during Christine's wedding. West is a changed man since the first movie, having lost his brother and cats during the five years Thanos snapped him and countless others out of existence. Embittered by the experience, West's chat with Stephen provides emotional resonance in the wake of such a catastrophic event, and shows just how many ordinary people were affected. Despite this touching moment, Dr. West does not appear again in the film.
In the comics, Dr. West teaches a very important lesson on facing consequences. Written by Marcos Martin and Brian K. Vaughan, the comic series Doctor Strange: The Oath features West also learning sorcery. Though his exact powers aren't fully revealed, he can cast a variety of healing spells and astrally project. After Strange's car accident, West, unable to forgive himself for not being able to fix his hands and indirectly contributing to the end of Strange's medical career, follows Stephen to Kamar-Taj and is trained by the Ancient One. He doesn't complete training, believing he is well-equipped in magical healing basics. Once he returns to New York, Dr. West tries out his abilities on Reginald Pavlish, a local activist and cancer patient. However, his spell goes awry and Pavlish ends up dying. In order to cover up his malpractice, West joins Timely Pharmaceuticals, with the caveat that he will cease using magic to treat anyone else.
Later on, West discovers the Elixir of Otkid, a potion meant to cure any disease and essentially end modern medicine. He enlists the help of Brigand, a professional thief, to break into the Sanctum Sanctorum and steal the elixir. The attack on the mansion kills Wong, and West is advised by Timely Pharmaceuticals that he must destroy the elixir before it can be distributed. Dr. Strange confronts Dr. West, Dr. West conjures the Sands of Nisanti to temporarily prevent them from using magic against each other, and the two fist-fight on Timely Pharmaceuticals' rooftop. In this confrontation, West confesses his less than ethical choices due to his reliance on magic and, in an attempt to escape, dies after falling off the roof and smashes the Elixir of Otkid. Dr. Strange is able to save the last drop and resurrect Wong.
Like several other comic-book characters making their live-action debut in the MCU, Dr. West likely won't receive this fully fleshed out backstory or arc in the future. Doctor Strange: The Oath is the only comic book series Nicodemus West appears in, and it's surprising the MCU included him in the movies without expounding upon his story. Perhaps in another Doctor Strange movie, the Blip could act as the catalyst that pushes Dr. West to pursue the mystic arts for himself and pit him against Stephen.
