The following contains spoilers for Doctor Strange in the Multiverse of Madness, now playing in theaters.
The world of Doctor Strange is filled with perils both of the human and the magical variety. While his previous Marvel Cinematic Universe appearances have seen him fight zealots, aliens and witches, his next deadly enemy could come from somewhere he least expected. However, if this foe did appear in a future sequel, it would likely be the most devastating foe that Strange would ever encounter, not because of his power but his cunning.
Nicodemus West first appeared in Doctor Strange: The Oath by Brian K. Vaughn and Marcos Martin. The series brought the hero back to basics as he had to use both his magical and medical expertise to save himself and his friend, Wong. All the while, themes of morality and the power of life and death came into question.
West was the book's main antagonist and acted as a fellow surgeon and rival to Strange. He was the one who healed Strange's hands to the best of his ability and later followed him to Kamar-Taj, where he tried to learn the ways of the Mystic Arts under The Ancient One. Ultimately, he left before his training was completed and tried to use his skills to aid others but failed. Looking for the elixir of life, West's actions put him on a collision course with Strange that ended in his death.
In the films, West's role was lessened to more of a medical rival to Strange, who, while skilled with a knife, was prone to making quick decisions that could have killed many patients. This was shown in the first film when he nearly sentenced a man to death before Strange noticed the bullet in his brain hadn't yet killed him. However, while it seemed like their rivalry had ended when Strange trusted West to operate on The Ancient One, it was once again reignited following The Blip.
In Doctor Strange in the Multiverse of Madness, West and Strange reunited at Christine Palmer's wedding, where his animosity toward the sorcerer reached new heights. Not only had he lost his cats in the five years he was dust, but he also lost his brother. He didn't believe that Strange had no other way of stopping Thanos and used every chance to slight him. While it was likely a narrative tool to set up Strange's internal conflict, it's hard not to see the writing on the wall for what could be West's villainous origin.
Always coming in second during his career with Stephen, West could use his losses during The Blip to justify believing he could do better. This could force him to go his own way and teach himself the mystic arts. In doing so, he could gain power of his own and learn spells and tricks to stop Strange, like the Sands of Nisanti.
Not only could he use magic to further his medical career, but he could also plan a detailed revenge plan against his rival. Like The Oath, his actions could lead to Strange being injured and even Wong's brush with death. This would then cause Strange to confront his colleague as a surgeon trying to bring his colleague back from the brink rather than a sorcerer.
Nicodemus West's life in the MCU has been the butt of the joke within Strange's world, and while he's seemed like a side fixture to his past as a surgeon, he could be much more. While villains like Nightmare and Mordo would likely take precedence, there's a uniqueness to the concept of West as a villain. Where Strange has spent years fighting otherworldly creatures of untold power, West is an antithesis to Strange. As a result, he's both unsuspecting and dangerous and could be the perfect villain to ground Strange and remind him enemies could come from anywhere.
To see Nicodemus West's anger grow, Doctor Strange in the Multiverse of Madness is currently playing in theaters.