Chapter Text
Everyone knew that John was a doctor.
Most knew he had been a soldier.
Almost no one could separate the two.
John had been introduced and addressed as “Doctor Watson” by a lot of people since entering Sherlock’s life: landladies, an extensive homeless network, Scotland Yard officials, criminal masterminds, the central pillar of the British government, and even, on that first mutual crime scene, by Sherlock himself.
All those people using John’s title, and all of them, generally, without having any idea what it truly meant; what John could do.
A misunderstanding that came down to two points: Sherlock and semantics.
Unlike Sherlock’s eccentric brilliance and reputation for being both invaluable and insufferable, John was, by nature, a quiet man; brilliantly competent in his own life’s work, yet easily overlooked and underestimated as he kept his own gifts private and praised those of others. When one of those “others” happened to be Sherlock Holmes, John didn’t even have to try and blend into the background – he was automatically overshadowed by, and viewed in relation to, Sherlock. People called him “Doctor Watson”, but they didn’t see an educated and skilled physician; what they saw was John Watson, Sherlock Holmes’ inexplicable friend, flatmate, and blogger, a constant presence at the consulting detective’s side; the man with a lingering military bearing who had once, they were told, been an army doctor.
And that, right there, was the root of the problem: “army doctor.” A seemingly small matter of semantics, but one that changed so much. Nearly everyone connected those words: his therapist, Sarah during his surgery interview, even Sherlock had done it, falling into the same compulsory drive that everyone else did, merging two distinct parts of John’s identity during their first meeting at Baker Street by quickly moving from “you’re a doctor” to clarifying and labeling, “in fact, you’re an army doctor.” By tying both together – “army doctor” rather than “soldier and doctor” – it made one identity dependent on the other. And so the civilian that London now knew, the man who had once been a military doctor, was called by his title more out of respect for what he had done, rather than for what he still did; as if being invalided out of the army made John both a former soldier and a former doctor, the only practical application for his medical skills left behind in the sands of Afghanistan. As if Doctor Watson didn’t exist without Captain Watson.
It was only when people actually saw John working as a physician, watched him put the full breadth of his knowledge and skill to use outside a military context, that they began to understand.
That it wasn’t just about bullets and IEDs and trauma care under fire. That “doctor” actually covered a pretty wide field.
And that John was bloody good at covering ground.
***
1.
Lestrade wasn’t a leaner.
While many people tended to lean against walls or doorframes when crime scenes got tedious and the hours drew on, Lestrade wasn’t one of them. He might stand near one, but never let it take his weight, no matter how worn out he was. As a man who led by example, Lestrade refused to potentially compromise forensic integrity that way. And as a man with a strong moral principle of his own, he insisted on showing respect for the lives lost and affected by the crime he was investigating, pushing through any discomfort or exhaustion and standing on his own, fully engaged, determined in his pursuit of justice.
So when Lestrade took a barely noticeable step backwards, his back lightly bumping into the flaking wall and scattering a fine mist of hideously orange paint to the ground, it was significant. The kind of significance only someone who both frequently observed Lestrade, and had an eye for catching nearly imperceptible actions, would notice.
Sherlock never even looked up.
John, however, who had been completely engaged in Sherlock’s evidence-gathering dance around the corpse at the center of the room, was at Lestrade’s side in four brisk steps, positioning himself in front of the DI with the purposeful, yet casual stance of a man sharing information, while simultaneously shielding Lestrade from as much of the room as possible. “You okay?” he asked quietly.
Lestrade started at the sudden attention. “Yeah, fine.”
John’s eyes narrowed slightly; the look of a man used to dealing with blatantly false, roundabout responses.
“Long night,” Lestrade amended. “Guess I’m feeling the missed sleep. Not as young as I used to be,” he chuckled ruefully, working for levity.
John’s lips quirked with a faint smile; both humor and tacit camaraderie. But his eyes shifted at the same time, a minute movement, his overall expression becoming a sort of John-version of Sherlock’s deductive one. Lestrade could almost feel John’s mind putting together data only he could see, hypothesizing omissions, and coming to conclusions. He wasn’t used to anyone other than Sherlock turning that sort of penetrating look on him. It was…..odd. And slightly uncomfortable, which prompted him to try and change the subject. “Sherlock come up with anything yet?” he waved toward the middle of the room.
John tossed a glance over his shoulder at Sherlock’s unceasing movements, then turned back to Lestrade with a shrug. “Probably, unless there’s some other reason he’s muttering Plato right now. At least, I think it’s Plato – never had much of a head for Greek.”
Lestrade laughed, leaning his head back into the wall and looking at the ceiling with a sigh. “You poor bastard. Subjected to this kind of thing regularly, are you?” he grinned.
John’s face shifted into one of the silent expressions of long-suffering, patient fondness that were pretty much reserved for Sherlock alone, eyes flickering through another one of those almost assessing looks in the space of half a blink, before warming as he joined Lestrade’s laughter with a low chuckle. “At least Mycroft’s not here. Get the two of them together when Sherlock’s like this and it becomes half an hour of trying to outdo one another via increasingly obscure languages. I swear, one day Sherlock’ll figure out how to text in bloody cuneiform, just to spite his brother.”
Lestrade snorted back a laugh as he dropped his chin to meet John’s eyes, shaking his head with horrified sympathy. “I can’t even imagine. Really. How….” He suddenly stopped as another thought occurred. “Wait, hold on. How does he know Plato in the original Greek, but not that the earth goes ‘round the sun?!”
John shook his head a fraction, eyebrows raised in clear ‘I don’t even try to guess what’s considered useful enough to stay in that brain of his anymore’ exasperation.
Lestrade acknowledged the silent, but unmistakable, answer with a tilt of his head and transitioned back to his original question. “How on earth have you not gone completely mad?” John’s ability to deal with not only one, but often two Holmeses, on a nearly constant basis was beyond him.
John’s face brightened with a conspiratorial grin. “Last week I recorded whatever Latin nonsense he was muttering between texting you demands for a case and managed to identify it using this website I found. Came back downstairs, grabbed the book he was quoting from his library, and dropped it right in his lap. Shut him up for almost five minutes while he figured out how I did it.”
Lestrade grinned back. This was why John and Sherlock worked as a unit – the doctor was more than able to hold his own. “You should have filmed that,” he blinked a few times, glancing over John’s shoulder toward Sherlock before focusing back on John. “And you really need to send me that website.”
John reached into his pocket for his mobile, his soft chuckle overshadowed by eyes radiating careful concern. “You sure you’re all right?” he asked, studying Lestrade’s face. “You look a bit…..” he purposefully left the sentence open.
“I was an idiot,” Lestrade filled in. “Stayed up too late worrying at another case, only to get the call for this one at 4:30 this morning. Should know better than that by now. Really, John, thanks, but I’m fine.” He shifted against the wall, leaning his head halfway back again.
John’s chin dipped with a soft nod as he pulled out his phone, a hint of, if Lestrade didn’t know better, something that looked like ‘well, that’s it then, last chance’ flashing through his eyes. John was halfway through typing the web address when the mobile suddenly dropped from his hand.
Lestrade startled at the sharp clatter of the phone striking the ground. “You okay?” he asked at John’s muffled curse.
John clenched and unclenched his left hand several times. “Yeah, fine,” he said, sighing and beginning to bend forward.
“No, I got it,” Lestrade insisted, eyeing John’s clenched hand while waving the doctor upright. He took a step away from the wall and leaned down, grabbing the phone. “So,” he began as he straightened up. “This –“
When the darkness faded and the rushing sound in his ears resolved into voices again, Lestrade found himself sitting on the floor with his back to the wall and John’s fingers wrapped around his left wrist.
Donovan’s voice came from somewhere close by. “…...sure? He’s never done that before.”
John’s voice followed, calm and matter-of-fact. “Happens to most of us once or twice. The medical term for it is postural hypotension – basically a delay in the blood pressure catching up while moving from a lower to a higher position. Hard to diagnose for certain without a few blood pressure readings to measure the drop, but it fits what just happened.”
“Are you sure he doesn’t need an ambulance?” Donovan worried.
“His heart rate’s stabilizing and he’s starting to come around. He isn’t in any immediate danger,” John said. “As long as he’s coherent when he’s fully awake, I don’t see a need for it.”
“Exactly,” Lestrade mumbled, clearing his throat and opening his eyes fully, pleased to find that his voice steadied as he continued, “Only thing I need is for someone to tell me what the bloody hell just happened.”
“You collapsed while picking up John’s mobile,” Donovan explained. “He says your blood pressure probably dropped when you were standing up. Good thing he was close by when it happened. Saved you a broken nose, at least.” Her eyes narrowed at the memory of John catching Lestrade’s suddenly boneless body.
Lestrade’s eyes widened. “Thanks,” he murmured, shifting his gaze to John.
John gave a quick nod. “You remember any of it?”
Lestrade thought for a moment. “I remember my vision sort of tunneling a little on the way up, but that’s it. Don’t remember falling.”
John looked from Lestrade to Donovan, confirming, “Yeah, sounds right for a postural case.” He turned back to Lestrade. “Just need to sit and rest for a few minutes.”
“And then he’ll be okay?” Donovan persisted. “Because he’s already been….” Her mouth snapped shut, eyes flashing, as Lestrade shot her a sharp look.
John briefly glanced between them, then refocused on Lestrade’s pulse, pretending not to pay the incident much mind.
“I’ll be fine, Donovan. Just need a minute like John said. Do me a favor and keep an eye on Sherlock, will you?” He smiled at her eye roll. “Please,” he added softly.
Donovan’s eyes cycled through several emotions before she nodded sharply and strode to the far side of the room.
Lestrade sighed, scrubbed a hand across his face, and turned back to John.
“So. Ready to tell me the truth now?” John demanded, tone deceptively light around hardened features.
“What?” Lestrade tried to catch up.
“Now that we’ve established you’re not ‘fine.’”
“You said it was just a passing blood pressure……” Lestrade paused, studying John’s face. Bloody hell, he’d been right about that ‘last chance’ look. “You dropped the mobile on purpose,” the truth dawned on him. “You knew this would happen.”
And here he’d thought Sherlock was the only one of them with highly developed manipulative skills.
“Which is why I stayed so close,” John acknowledged the accusation simply. He gave Lestrade a hard look. “You’ve looked terrible all morning and now Donovan’s worried about something you didn’t want her to talk about. What’s going on?”
“But how did you know….” Lestrade couldn’t get past the idea of John not only knowing that his blood pressure would drop, but orchestrating its occurrence as well. Had Sherlock really rubbed off on his flatmate so much?
John let a tight breath of air through compressed lips. “You were pale, sweating, and weak. Most likely suspects were hypoglycemia or hypotension. Unlike Sherlock, you’re intelligent enough to eat while working, so hypotension made more sense, and the postural episode helped support it.” He held up Lestrade’s wrist, shifting his fingers from the radial artery to pinch the skin on his hand. “You’re tachycardic, and have bloody awful skin turgor, so at least part of it is dehydration. What I need to know now, is why.”
Lestrade’s eyes widened at the surprising rush of medical jargon that came out of John’s mouth; the controlled, clipped assessment of a professional trying to do his job and being hindered by a lack of data needed to form a treatment plan. Lestrade bit back any further questions and met John’s eyes with new understanding.
John sighed. “What was Donovan going to say?” he asked, voice losing some of its previous diagnostic edge upon noting Lestrade’s newly open, cooperative focus.
Lestrade scrubbed a hand across his face. “I was in A&E Monday night. Suspect swiped me with a knife.” He saw John’s expression darken and quickly assured him, “It was just a graze, didn’t even need stitches. They cleaned it, gave me antibiotics, and sent me home. It’s been fine.”
“Is it somewhere I can see?” John asked.
Lestrade understood both the meaning and underlying urgency there and untucked his shirt, exposing the thin, red line to the left of his navel, just above his belt line.
John shifted in his crouch to provide more of a barrier between them and the rest of the room as he gently palpated the area. He nodded at Lestrade to drop his shirt. “So that’s why she’s worried and you don’t want to go to hospital,” he understood.
Lestrade nodded. “Twice in a week is too bloody much,” he sighed. “Besides, I don’t feel that bad. No need to tie up emergency services with something like this or to sit in A&E again to get it checked out. It looks fine, right?”
John gave him a look. “The laceration looks fine, yeah. You, on the other hand, still look awful.”
“Thanks,” Lestrade snorted. “Really, though, I didn’t get any sleep last night. I just need to sit for a few minutes, like you said, then I’ll be fine.”
“Greg,” John said softly, watching as Lestrade’s focus immediately sharpened with the rare use of his first name, as intended. “I understand not wanting the fuss of an ambulance and hospital, but dehydration and low blood pressure can be quite serious. And just because the knife wound looks fine, doesn’t mean that you are. We can’t ignore what just happened because we both know it’s not just the result of a long night. Now, I’ll help you avoid hospital if at all possible, but in order to do that, I need to figure out if it’s something I can treat on my own. And I can’t do that unless you’re honest with me, all right?”
Lestrade was stunned at the passion, knowledge, and steady friendship in John’s tone; the honest desire to help. He nodded. “You’re right. I’m sorry.”
John smiled, weary and tight, but genuine. “Right, then.” His face shifted into that assessing look again as he thought for a moment. “You have eaten today, right?”
“Yeah. Plain toast and coffee on the way here.”
John nodded with the confirmation. “Why didn’t you sleep last night?”
Lestrade grimaced. “Stomach went off. Didn’t eat anything unusual, so figured I picked up one of those twenty-four hour viruses or something.”
John managed to control a ‘why wouldn’t you tell me this?’ look. “Vomiting?” he clarified, judging by the plain breakfast.
Lestrade looked vaguely embarrassed as he shook his head.
“Ah,” John understood. “Diarrhoea?” he asked, lowering his voice even further to maintain the privacy of their conversation.
Lestrade nodded reluctantly.
John sighed inwardly as he processed that new information. He had never understood why people were generally fine with admitting they had vomited, yet discussing diarrhoea was embarrassing, almost to the point of taboo. Medically speaking, they were both equally dangerous with the right severity and duration.
“You’ve been taking the antibiotic since Monday night?” he asked.
Lestrade made a face. “Yeah. Bloody tablet is huge.”
John’s lips quirked sympathetically. “Augmentin?”
Lestrade’s eyebrows shot up, surprised. “Yeah, that’s the one.”
John ran a mental tally of his supplies at the flat, then nodded - a sparse, clipped movement. “All right,” he stood up and extended a hand down to Lestrade, “let’s go.”
“No hospital? You know what it is?” Lestrade asked hopefully, motioning for Donovan to come over.
“No hospital,” John confirmed. “And pretty sure, yeah. We’ll talk more in the cab.”
John got Lestrade to his feet and smoothly eased him back against the wall with a firm, guiding grip at his elbow. “Steady breaths. Close your eyes if you need to. Just stand still and let your body adjust before you move any further,” John advised softly.
Lestrade acknowledged him with a soft grunt, listening as John began filling Donovan in on the plan to take him back to Baker Street. Once Lestrade regained his equilibrium and opened his eyes, he joined the conversation and officially handed the scene over to Donovan’s control. “Keep me updated,” he said, “and try not to antagonize him,” he jerked his head toward Sherlock.
Donovan blew out a breath that was equal parts worry, frustration, and displeasure as she leveled a look at John. “Take care of him,” she demanded, eyes moving to Lestrade, then back to John. “Cab’s waiting for you outside,” she held up her mobile with a little wave. “Thought you might end up needing one.” She held each of their gazes with one final statement – I’ll do what I can, but too much time alone with him, without either of you as a buffer, and we can’t be held responsible for our actions – then turned and went back to work.
John and Lestrade nodded both their gratitude and understanding, then moved toward the door, John keeping close, ready for support if needed, but allowing the DI to walk under his own power. Once outside, Lestrade suddenly came to a halt. “Wait, did you tell Sherlock? He’ll be looking for you.”
John snorted in rueful memory of being abandoned at their first crime scene together. Granted, that didn’t happen much anymore, Sherlock having grown both accustomed to, and somewhat reliant on, John’s presence at crime scenes, but he was still Sherlock. The man who had spent over twenty-four hours in the flat, without even the excuse of a case occupying his brain, having entire conversations with his flatmate without realizing that said flatmate was actually in Dublin at the time.
“Eventually,” Lestrade amended, understanding exactly where John was coming from.
“Yeah,” John’s half-chuckle managed to be fond and resigned at the same time. “I’ll text him from the cab. It’ll probably be another hour, at least, before he even notices we’re gone,” John rolled his eyes, moving toward the taxi. When they’d left, Sherlock had still been muttering to himself, although the Greek had faded down only an occasional punctuation within his usual Sherlockian-speed English. Eventually, he’d shift from externally voiced internal muttering to a proper question to another person, or actually seek acknowledgement that someone was listening. But John was experienced enough in Sherlockian nuance to know that it wouldn’t be for awhile yet. Trying to tell Sherlock anything at this point would be a waste of time; even if he appeared to acknowledge it, he’d immediately delete it and still be looking later. A text though, he could refer to at any time.
Once they were settled in the cab on the way to Baker Street, and he had sent his text, John continued his assessment. “Did it just start last night?”
Lestrade, to his credit, jumped right back in. “That was the worst of it, yeah. But there was one time the night before.”
“So, Wednesday night and Thursday night,” John mused out loud. “How many episodes?”
Lestrade raised an eyebrow. “What?”
“How many episodes of diarrhoea?”
Lestrade turned red. “Jesus, John, it’s not like I counted. Who does that?!”
“People in my line of work,” John chuckled softly. “Seriously though, it’s important. An estimate, then. How many times last night?”
Lestrade covered his face wearily, thinking over a night he’d rather forget. “Ummm, probably about seven times?” he ventured a guess.
John nodded as if this was a perfectly normal conversation. “Any blood or mucus in the stool?”
Lestrade groaned again. “Is this what doctors talk about?”
“We’re a fun group,” John shrugged. “Either of those present?” he refocused the conversation.
“No, neither one,” Lestrade replied. “Seriously though, John…..” he gestured as if the words of their odd conversation were visible in the air between them.
“You eat lunch while looking at crime scene photographs,” John pointed out. “Every profession does something that shocks people who aren’t in it.”
“Good point,” Lestrade mused. He had never really thought about it, but he was starting to realize that he’d always thought of John as a soldier first, not a doctor – probably because it was still easy to see signs of the military in his reactions and the way he carried himself. He knew John could handle even the grisliest of crime scenes without a problem and had attributed it to what he saw in the army. But he tended to forget that even though he spent years as an army doctor, John would know how to do more than trauma care. Like assessing bowel health in a stubborn DI refusing hospital.
Twenty minutes later, Lestrade was lying comfortably on the couch at 221B with his legs elevated and sleeves rolled up while John crouched at his side and wrapped a blood pressure cuff around his arm.
“80/40,” John pronounced a moment later, removing the cuff and slinging the stethoscope around his neck in a motion born of practice. “And that’s lying flat on your back. The fact you were standing at all with that blood pressure is pretty impressive,” he grinned.
“I’m flattered,” Lestrade couldn’t help but chuckle back. “Now what?”
John leaned back on his heels. “Diarrhoea is a common side effect of antibiotics. If you had seven or more episodes in the last 24-48 hours, that could be just enough fluid loss to dehydrate you and lower your blood pressure, which would explain the weakness and other symptoms. If we can get some fluids back into you, I think we’ll see your blood pressure go back to normal and stay there. I’d like to start you on IV fluids, if that’s all right, then recheck your blood pressure a few times during and after that.”
Lestrade flopped his arm on the cushions. “Off you go, then,” he agreed.
Fifteen minutes later, Lestrade had an IV in the crook of his left arm, and the wall had a new hole courtesy of John’s need for a makeshift IV stand; a liter bag of normal saline hanging from the freshly hammered nail in the wallpaper. John cleaned up the supplies, did another quick check of Lestrade’s lungs and IV site, then sank down onto the coffee table to monitor everything.
Lestrade looked at this different version of John, so different from the man he usually saw, as if seeing Doctor Watson for the first time. Stethoscope draped around his neck, sleeves rolled up after washing his hands, eyes flitting from the IV site to Lestrade’s breathing, to the flow rate of the IV bag. “Thank you,” Lestrade said quietly. “For this,” he gestured with his non-IV hand at the set-up, “and for keeping everything quiet back at the scene, even though I was making a mess of you trying to do your job.”
John smiled warmly. “No, you weren’t. I should have asked straight away, instead of waiting until you looked worse. And….” He cleared his throat – a verbal fidget. “Uh, sorry for everything with the mobile. I guess I sort of reverted to…..nontraditional means?” he offered.
Lestrade waved off the apology with a chuckle. “Thought it was quite brilliant, actually. I figured it was Sherlock’s bad influence at first, but…..” he paused, watching John’s expression shift, almost guiltily. “Wait, it was Sherlock’s influence?!”
John focused on a point above Lestrade’s head, eyes firmly on the IV bag. “In terms of being a manipulative bastard, no. In terms of having used it on him too……ummm, yeah. A bit.”
“Hold on, Sherlock actually picked your mobile up for you?” Lestrade gaped.
“No, of course not. I dropped one of his microscope slides. Knew he’d pick that up.”
Lestrade burst out laughing at the image, then suddenly sobered, another thought taking over.
“You okay?” John leaned forward, concerned at the sudden quiet.
“Yeah. Just trying to figure out how I feel about the fact that you used the same technique you’ve used on Sherlock, on me,” Lestrade couldn’t quite hide the grin threatening his level delivery.
It was John’s turn to chuckle. “Lack of creativity?” he offered an explanation for the mirrored action.
“Yeah, right,” Lestrade snorted, knowing better. He shifted further onto his left side. “You know, I still have one question.”
John nodded for him to continue.
“You kept saying I felt weak, like you were sure of it. And you were right, I did. But I never said that; only that I was tired. How’d you know? ”
John focused on the IV again, lips slightly pursed. “You were leaning against the wall. You never do that, no matter how tired you are. I’ve seen you on 48 straight hours without sleep, and you never once let a crime scene wall take your weight. So it had to be from weakness, which would have fit, along with your other symptoms, with either the low blood sugar or low blood pressure I was considering.”
Lestrade was stunned silent. This wasn’t just John the observant diagnostician. This was John the observant friend; who knew Lestrade well enough to find alarm and pathology in a seemingly innocuous action.
“Think you could manage some tea and toast?” John broke the silence after several seconds.
“Uh, yeah. Thanks.”
“Great,” John nodded, pushing himself up with a grunt.
They shared the small meal together and kept up companionable conversation until the IV bag was empty. John stood and clamped the tubing, then crouched down to get another blood pressure reading. “Blood pressure’s come up nicely. How are you feeling?” he asked, removing the cuff.
“Fantastic,” Lestrade admitted, surprised and thrilled at the realization.
“Need to release any of it?” John’s lips quirked.
“Definitely,” Lestrade chuckled.
John clamped the extension tubing and unhooked the main line. “All right. Sit up first, nice and slow.” He watched Lestrade follow the instruction and nodded. “Good, now stay there. Any dizziness?”
“No.”
“Great.” A few more seconds and they repeated the slow change, Lestrade moving from sitting to standing. John stepped back once Lestrade reported that he was steady, watching the DI’s back as he headed to the bathroom.
Sherlock came bursting through the door in an indignant swirl of coat just as Lestrade was returning to the sofa. “I was talking to you,” Sherlock protested, leveling a glare at John.
“No, you were talking to yourself,” John corrected, pausing for a second or two before adding, “and possibly to Plato.” He held up a hand to stall any further protests. “We left over two hours ago, Sherlock.”
“No you…..”
“Look at the time on the text I sent you,” John said patiently.
Sherlock pulled out his mobile and frowned at the screen.
“Exactly,” John nodded.
“You left me with Donovan. And Anderson,” Sherlock accused darkly.
“Yes, that was cruel,” John glanced over at Lestrade who was already beginning to smirk. “Lestrade’ll have to make it up to them.”
Sherlock shot him a look. His eyes flickered over Lestrade and the area around the sofa. “Nails in Mrs. Hudson’s wall, John?” he tutted.
“Yes, because a single nail for intravenous support violates our lease more than you shooting at it out of bloody boredom,” John somehow managed to both narrow his eyes in ‘don’t even start with me’ irritation while simultaneously rolling them in exasperation.
Sherlock’s expression remained neutral but his eyes sparkled faintly at the back and forth. Lestrade felt Sherlock’s deductive gaze return to him, trying to understand the underlying pathology: a puzzle to be solved for the sake of intellectual need rather than for the sake of healing. Quite a difference, really, between Sherlock and John’s penetrating looks, when he compared them.
“Why was he dehydrated?” Sherlock focused back on John.
“None of your business,” John replied almost cheerily, shifting into a deceptively casual parade rest, a subtle, physical reminder that he could be just as stubborn as Sherlock. “I’m going to put the kettle on,” he angled himself toward the kitchen. “Are you going to catch us up on the crime scene or do I need to start looking up Plato references again?”
Sherlock’s eyes flashed with an ‘it’s obvious you’re trying to distract me from prying further into Lestrade’s medical condition’ look, but, in a testament to how far their friendship had progressed and how much John had subtly influenced Sherlock’s patterns, he allowed the distraction. Allowed his underlying respect for Lestrade, and trust in John’s medical judgment, to win out over the inherent need to know everything.
Sherlock’s put-upon huff was softened by a mischievous twist of the lips. “Why are you so sure it was Plato?”
“I’m not,” John admitted freely, with a shrug. “You know I’m rubbish at Greek. So…” he waved a hand expectantly.
Sherlock grinned and whirled around to face Lestrade. By the time John came back into the room with the tea, Sherlock was pacing a path in front of the DI, gesticulating in sharp punctuation to his rapid-fire speech. John placed Sherlock’s tea next to his chair for when he finally slowed down, and sat in his own, sipping quietly as he watched Lestrade, who was sitting up, color back in his face, follow Sherlock’s deductive process with all his usual focus, interest, and exasperation.
When Lestrade left Baker St. two hours later, it was with four things: a murder suspect’s name and life history, a written list of yogurts or probiotics to help prevent further antibiotic-associated diarrhoea while he finished the course of Augmentin, a blood pressure of 118/78, and a whole new respect for Doctor John Watson.
Chapter 2
Summary:
It was only when people actually saw John working as a physician that they began to understand: that it wasn’t just about bullets and IEDs and trauma care under fire. That “doctor” actually covered a pretty wide field. And that John was bloody good at covering ground. 5 times Dr. Watson treated others and 1 time he treated himself.
Notes:
Disclaimer: I do not own Sherlock. Just playing, with love and respect to those who brought these characters to life.
Brit-pick: Many thanks, once again, to the wonderful debriswoman, who somehow manages to find time in her busy schedule to cheerfully look over my work and teach me new things.
Notes: This ended up being both the shortest and least time-intensive chapter of the whole story. It pretty much came out fully formed and unlike other chapters (I’m looking at you, chapter 5), required almost no editing. As always, I hope I did the characters justice. Thank you for reading.
Chapter Text
2.
The sudden stop of maddeningly slow typing, the measured release of breath, the sound of wool shifting over tensing muscles…..Sherlock didn’t even have to glance up from the microscope to know who was ringing.
“Harry,” John answered his mobile carefully, attempting calm, brotherly openness over the visible stiffness of anticipation.
“I can’t take this anymore, I really can’t,” Harry launched past any pretense of pleasantries.
John sighed, signing out of his blog. “Can’t take what?” he asked, already dreading the continuation.
“This bloody flat. The sink’s backed up, the sodding Robertsons are at it again, and the stupid alarm’s broken for the fifth time this month - kept waking me up all bloody night.”
“I thought you were looking for another flat,” John recalled.
“Yeah, well, I’m still in this bloody one right now, aren’t I?” Harry shot back.
John closed his eyes and let out a slow breath. “Anything look promising?” he tried to direct the conversation back to something productive.
“Without a second income? Not bloody likely,” Harry snorted. “If she didn’t…..”
“No. Harry, no. We’re not talking about this, remember?” John had made it very clear, after the last vitriolic rant about Clara where Harry refused to even call her by her name, that he would not take part in that line of conversation again.
“I wasn’t going to…”
“Yes, you were. Now stop.” John’s voice was a weighty mix of firmness and weariness.
“No, I…..” Harry sighed heavily. “I just want to sleep.”
“So sleep.”
“I can’t sleep. Aren’t you even listening to me?” Harry demanded, voice stretched high and thin.
John blew out another measured breath, pinching the bridge of his nose. “Call your landlord about the sink, then.”
“I don’t care about the bloody sink.”
“Then put in earplugs and close your eyes while the Robertsons wear themselves out,” John tried to keep his voice level.
“I don’t have earplugs.”
John’s next breath was a little less controlled. “Did you phone me just to argue, then? Because I really don’t know what else to tell you, Harry.”
“’M not arguing. I just……need to sleep,” Harry mumbled.
John tensed at the repetition; a tension markedly different from the one usually associated with his sister. “Harry….”
“’M just going to sleep,” Harry’s mumble moved closer to a slur.
Sherlock’s eyes never left the microscope. “Oh, just hang up already,” he groaned.
John’s eyes flickered over to him even as his mind worked furiously to make sense of the sudden unsettled feeling in his gut: heavy, yet vague enough to defy definition at the same time.
“Please,” Sherlock scoffed, actually looking over at the sitting room table this time. “I don’t need to properly hear your sister to know she’s drunk and argumentative. The real question is why you insist on continuing to subject yourself to it.”
John frowned as Sherlock continued in a bored tone, “Normally, you’d have ended the conversation within the first minute.”
Sherlock was right, of course. Normally, John would have stopped the call as soon as it was obvious that Harry was drunk and incapable of listening to reason. But he hadn’t today. Why?
The realization suddenly slammed into him, that unsettled feeling screaming its true identity: clinical intuition. The inexplicable, but never incorrect, knowledge that something was not good. His mind raced back over the conversation, looking for what he had missed, what was so….
Oh.
Shit.
“Harry,” John jumped up from the chair, posture tightening into near-military attention as adrenaline shot through his body. “Harry, what alarm was going off last night?”
Intrigued by John’s sudden change in tone and position, Sherlock stood up and crossed the room to better hear the other end of the conversation.
“Doesn’t matter. Does it all the time and they always say it’s fine. No fire or anything. I’m just….” Harry trailed off.
“No, Harry, don’t sleep,” John insisted.
“But you said….”
“Forget what I said,” John’s voice was firm, demanding focus.
“John,” Sherlock said, head slightly tilted as he listened to Harry through the phone. “Surely you hear the slurring. Expecting her to listen to reason at that level of inebriation is…..”
“She’s not drunk, Sherlock,” John ground out, keeping his back to his flatmate, focus completely fixed on the phone. “Harry, you need to get out of the flat.”
“Bollocks. I’m tired, John. I’m just….”
Sherlock had barely opened his mouth when John whirled around, leveling a firm finger at him. “No she isn’t, Sherlock. I bloody well know what my sister sounds like when she’s drunk, and this isn’t it.” He got back to the phone. “Harry, listen to me. You need to get out of the flat now.”
“John….”
“Harry,” John’s voice was calm and controlled, urgency without panic; a man who knew how to give orders in a tone demanding they be obeyed. “Listen to me carefully. There’s no fire because it wasn’t the smoke alarm – it was the bloody carbon monoxide detector. You’re tired because your flat is filling up with carbon monoxide and you’re short on oxygen. I need you to get outside now.”
“But….”
“No, Harry. Now. Walk to the door.” He waited a moment, giving her a chance to move. “Are you at the door?”
“Hold on a bloody….” Harry mumbled, exhausted.
“I know you’re tired, but this is important. You need to do this, fast as you can. Tell me when you’re at the door.”
“Okay,” Harry reported sluggishly. “Opening the door.”
“Good, now start walking to the front of the building. Keep talking to me,” John encouraged, shoulders back, spine ramrod straight. He turned to Sherlock. “Get a fire crew and ambulance to Harry’s flat, now.” His eyes narrowed as Sherlock drew in a breath while reaching for his mobile. “And don’t pretend you don’t already know her address.”
Sherlock looked vaguely chastised as he made the call.
“Good, now go outside and sit on the steps,” John continued with Harry. “That’s right. Are you sitting? Great. Take deep breaths now, in through your nose and out through your mouth. Nice and slow. Just like that, good. Keep going.”
Finished with the 999 call, Sherlock took advantage of the pause in John’s conversation. “The alarm wasn’t going off in the background,” he reminded him. “Perhaps….”
“The alarm’s apparently gone off five times this month for no reason at all. If it’s been that dodgy, she could’ve taken the batteries out for all I know.” John’s tone left no room for argument as he focused back on Harry. “How are you doing?”
“A little….clearer?” Harry offered, still taking careful breaths as instructed.
John let out a breath of his own. “Good, keep going. You’re doing great.”
Several minutes later, Harry’s measured respirations were drowned out by fast-approaching sirens and the slamming of vehicle doors. One paramedic took the phone from Harry while another began looking her over. He listened to John’s assessment, confirmed which hospital she was going to, and informed Harry that her brother would check in on her later, before ending the call in order to start transporting her to A&E.
John set the mobile on the table and stared, purse-lipped, out the window.
“John….” Sherlock said quietly.
John didn’t turn around. “Irritability and restlessness are early signs of hypoxia. Add the drowsiness and it’s classic carbon monoxide poisoning.”
“I…..shouldn’t have presumed that her behavior was due to alcohol.” Sherlock managed to sound both apologetic and angry at himself for making such an assumption without full data at the same time.
“I almost missed it, too,” John sighed, running a hand across his face as he leaned further into the table, right forearm cording under the thick jumper as it took the brunt of his weight.
“You didn’t,” Sherlock pointed out.
John smiled softly. “Are you saying that you did?”
Sherlock’s lips quirked at the reassuring display of John’s reflexive humor. “I’ll leave you to your deductions.”
John snorted softly, dropping his chin to his chest as some of the tension left his neck.
“Tea?” Sherlock offered.
John turned around in surprise at the offer, only to find Sherlock putting on his coat and scarf rather than filling the kettle. “Yeah,” he smiled, seeing through the seemingly contrary action to its true intent.
He kept a brisk pace through the chilly night air, working off the energy of long-distance diagnosis and lingering adrenaline, grateful that Sherlock had chosen the long route. By the time they got to the café, John’s mobile rang with an update that it was carbon monoxide poisoning, but a mild case, and that Harry was on oxygen and would be released later that night.
“Forgot how bloody good you are, Doctor,” Harry teased as she took the phone back from the nurse. “Thank you, John,” she sobered.
“Just make sure the bloody landlord actually fixes the alarms this time, okay?”
“Oh, he’ll be hearing from me as soon as I’m out of here,” she promised.
“Poor sod,” John grinned.
“Shut up,” Harry tossed back with a laugh. “I’ll talk to you later, yeah?”
“Yeah. Good night, Harry.”
“Good night, John.”
John sighed and looked up at the stars, searching out familiar constellations as his mind wandered. Sherlock came back out of the café and moved to John’s left side, joining him in his study of the night sky, silently holding a cup of tea close enough for John to reach out and take it, yet not so close as to crowd him or make demands.
His self-professed sociopathic flatmate, who was always quick to invade his privacy and personal space, while also being the only person who knew him well enough now to know when not to touch him.
“I would have hung up on Mycroft,” Sherlock said, eyes still on the stars.
“You always hang up on Mycroft,” John pointed out.
“Hmmm,” Sherlock acknowledged. He glanced over as John took his tea and began warming his hands through the cardboard insulator. Better?
John dipped his head in a short nod. Yeah, thanks.
The silence on the walk back to the flat was comfortable and the tea exactly how John liked it.
Chapter 3
Summary:
It was only when people actually saw John working as a physician that they began to understand: that it wasn’t just about bullets and IEDs and trauma care under fire. That “doctor” actually covered a pretty wide field. And that John was bloody good at covering ground. 5 times Dr. Watson treated others and 1 time he treated himself.
Notes:
Disclaimer: I do not own Sherlock. Just playing, with love and respect to those who brought these characters to life.
Brit-pick: Many thanks, once again, to the wonderful debriswoman, who somehow manages to find time in her busy schedule to cheerfully look over my work and teach me new things.
Notes: This chapter is dedicated to all those who have walked the hospice path. I’d like to give extra thanks to debriswoman, who truly went above and beyond with this chapter, helping me adjust my knowledge of American hospice protocols to properly fit those in the UK. Thank you to all who have reviewed while following this story – I am trying to get the chapters out as quickly as I can, and so proper review replies have taken a back seat at the moment, but I will certainly be responding and truly appreciate your feedback and support. As always, I hope I did the characters justice. Thank you for reading.
Chapter Text
3.
Phones ringing at 2 AM generally didn’t bode well for John. When it was Sherlock’s mobile at that hour, it was usually Lestrade with a case, which meant that John was about to go haring off after Sherlock on however little sleep he had managed to get, silently thanking both his military and medical experience for enabling him to be able to function in life-threatening and life-saving situations on an amount of sleep that the medical side of him would never allow in a patient.
If it was John’s mobile at that hour…..well, at this point in his life, he automatically figured it related to Sherlock somehow: that the idiot had gone and gotten himself into a mess somewhere which required John’s medical, diplomatic, or bail-posting skills. Or that it was Lestrade or Mycroft, phoning John because Sherlock was “thinking” and not answering his bloody phone. It was only after filtering through those that John’s brain went back to considering more normal, pre-Sherlock possibilities: Harry was drunk or in hospital, or one of his mates still in the service was dead or injured. For a man others gravitated towards due to his warm smile and unassuming nature, John wasn’t much of an optimist.
Instantly awake, he rolled over and grabbed his mobile, bolting upright, brows tight as Mrs. Hudson’s name flashed on the screen. “Mrs. Hudson?” he answered, voice low, instinctively categorizing breathing patterns and searching for threats.
“Oh, John. I’m sorry to wake you at this hour.”
He could picture the motherly guilt on her face. Tone sounded stable enough, background was quiet except…..was that a stifled sob?
“What’s happening?” John continued to keep his voice low, so it wouldn’t project far beyond the phone. “Are you all right?” he asked, firm and concerned, already getting out of bed and dressing one-handed.
“What’s that? I’m fine, dear. Why…..” she suddenly stopped, feeling ashamed. Of course John had been worried. The boys gave her that mobile for emergencies and there she was calling at such an awful hour. “Oh, there I go, not thinking properly, like some silly old fool. I’m sorry, John. I should’ve realized….”
“It’s all right, Mrs. Hudson,” John assured her, the soldier standing down a fraction with the knowledge that she was safe; no immediate threat present. He could hear her smile over the phone, followed by another soft sob in the background. “Where are you?”
“Mrs. Turner’s.” The name held a solemn sadness.
John closed his eyes briefly. “Danny’s passed, then?” he asked softly.
“No, not yet. But he’s…..well, he was breathing something awful and he’s not waking up anymore. She rang me because she didn’t know what to do, so I went over and now….” Her voice caught as the words got away from her.
“It’s good you’re there. She shouldn’t be alone right now,” John assured her. “Did she call the district nurse?” he asked, shifting the phone from hand to hand to keep it near his ear as he pulled a jumper over his head.
“I called for her when I got here. Held the phone up to Danny’s mouth and everything so the nurse could hear his breathing. She said to give him the morphine first.”
“Good,” John agreed, holding the phone between his shoulder and ear as he leaned over to tie his shoes. “How much did you give?”
“A full dropper. That’s what the nurse said. Seemed an awful lot.”
John calculated the dose in his head: 20 mg. Good. “No, that’s good,” he assured her. “How’s his breathing now?”
“A bit better, but he still just looks…..uncomfortable? I can’t explain it, and I know it sounds silly. I mean, he’s dying of course, but….”
“But it doesn’t have to be uncomfortable,” John both reinforced and agreed with her. That was the beauty of hospice care as opposed to traumatic battlefield medicine: the chance for a good death. “Is the nurse coming over?”
“Yes, she’ll be here in half an hour,” Mrs. Hudson fretted, hair crackling against the phone as she turned her head toward Danny’s bedroom.
“Good. Would Mrs. Turner like me to come by and check on Danny while she waits for the nurse?” John offered, knowing Mrs. Hudson was warring between her ‘I don’t want to bother you’ nature and knowing what support her friend needed. The question was irrelevant, as he already knew the answer and was going to go over there either way, but he asked all the same.
Mrs. Hudson let out a relieved breath. “Oh, could you, dear? I know she’d feel better with you here to take a look. She knows you said she could call anytime, but she didn’t want to wake you, what with Sherlock keeping you out at all hours.”
John chuckled softly; such mothers, the two of them. “I’ll be right over,” he promised.
“Thank you, love. I’ll tell her.”
John pocketed his mobile, grabbed his kit, and headed downstairs. He had just opened the sitting room door, eyes on the stairs, when Sherlock’s voice shot out of the dark room from the direction of the sofa.
“Is Mrs. Hudson all right?” Sherlock’s tone appeared to be his usual, even, bored one, but John knew him well enough by now to hear the fine layer of concern underneath.
John frowned. “Were you listening?” he demanded. He hadn’t heard anyone outside his door, and he’d thought Sherlock had learned his lesson after John’s last ultimatum on eavesdropping, but Sherlock flouted basic privacy conventions even more than usual when he was bored and the man could be quite a stealthy bastard when he wanted to be.
“Don’t be dull,” Sherlock dismissed. “It’s two in the morning, and you’re leaving the flat with your medical bag. Someone phoned you for assistance, but you don’t have far to travel because you walked past your coat without taking it. Conclusion: Mrs. Hudson requires medical attention,” Sherlock sighed as if it was the most obvious thing on earth. “Is she all right?” he repeated.
John felt the full weight of Sherlock’s gaze even before his eyes adjusted enough to make out the shadow of Sherlock’s head and steepled fingers turning along the arm of the sofa to face him.
“She’s fine.” Another reassurance, yet so different than the ones he had given Mrs. Hudson moments ago. Both compassionate at the core, but honest, gentle emotion at the forefront for Mrs. Hudson, while Sherlock was favored with simply delivered facts; his doctor’s training, always unconsciously assessing and adjusting his responses for different needs. “I’m off to Mrs. Turner’s.”
Sherlock was silent, mind working to hypothesize the emergency.
“Danny’s getting close. I’m going to see if I can help,” John offered a hint.
“Danny?” Sherlock echoed, looking at him blankly.
“Yes, Danny. Mrs. Turner’s nephew?” John sighed, exasperated. “Surely you’ve heard Mrs. Hudson talking about him?”
The blank look remained unchanged.
John shook his head. “Right,” he threw his right hand up, the left clenching into the handle of his medical bag. “Irrelevant. Deleted. Whatever.” He sighed again and turned back toward the stairs. “I have to go.”
“Danny is dying,” Sherlock pronounced.
John instantly recognized that tone. That ‘I’ve just discovered something interesting and I’m going to dig in and study it’ tone. “Oh, no,” he insisted, spinning on his heel to find Sherlock standing up.
“No, what?” Sherlock asked, petulant and oblivious in equal measures.
“No, you are not coming,” John planted himself in the open doorway, holding his ground.
“Really, John. Within twenty-four hours of our first meeting, you were giving me your professional opinion on a corpse.” He gave John an ‘honestly, did you think a dying person would shock me?’ look. True, he found the dead far more elegant and interesting than the messy humanity that complicated the simple science of dying, but he was bored. Surely there was something he could study. “Dead, dying,” he waved a hand loosely, rationalizing the decision to himself more than anything, “it’s all the same in the end.”
“It really isn’t,” John stretched the second word, voice low and dangerous; a tone Sherlock didn’t hear often enough to immediately recognize, yet one his brother had heard within minutes of meeting John. “And it’s hardly your reaction I’m worried about,” he huffed disbelievingly, giving Sherlock a ‘how can you possibly be such an idiot?’ look; one of the only people who had ever thought of, and gotten away with, doing so. “Sherlock, Danny is not a case, nor is he about to become one of your bloody experiments. He’s a twenty-eight year old kid dying of cancer being cared for by his devastated aunt. The last thing either of them need is…..”
“Me,” Sherlock supplied, both a question and a statement.
“Exactly,” John deflated slightly at the admission, a flash of guilt quick through his eyes even as the protective anger remained. He ran a hand over his face. “Look, I….” he sighed. “I really have to go.”
Sherlock flopped back onto the sofa as John’s footsteps faded beyond the front door, resumed his thinking posture, and went back to contemplating the ceiling.
***
Mrs. Hudson met John at Mrs. Turner’s door, ushering him in with a hand on his back and tears in her eyes.
“How are they?” John asked, both compassionate concern and clinical assessment.
“Holding on, dear,” Mrs. Hudson replied mournfully.
John nodded and followed her up the stairs, turning right at the top, and knocking lightly on the open bedroom door. Mrs. Turner lifted her head off the edge of the bed and turned around, tears overflowing even as she smiled gratefully. “Oh, John. Thank you for coming. I didn’t want to wake you, but…”
John, despite his overtly human and good-natured persona, was quick to avoid touch in most situations; John the soldier, when stressed or threatened, doubly so. But John the doctor instinctively understood and employed the therapeutic human need for touch without thought. He stepped forward and laid a gentle hand on her shoulder. “Mrs. Turner, you know who I live with. I hardly keep regular hours,” he smiled lightly.
She chuckled wetly. “No, I suppose you don’t,” she agreed.
“And I don’t tell people to call me anytime if I don’t mean it,” he reminded her with gentle firmness.
“Thank you,” she reached up and squeezed the hand on her shoulder.
John nodded and stepped back, walking to the dresser near the foot of the bed and setting his kit down. Danny wasn’t technically his patient, and John certainly wasn’t a palliative care specialist, but he had kept up on the young man’s condition through Mrs. Hudson and Mrs. Turner, and offered to help in any way he could. He pulled on a pair of gloves, put his stethoscope around his neck, and moved to Danny’s left side. “Danny? It’s John Watson. I’m going to look you over and see if we can make you more comfortable.” He ducked down to look behind Danny’s ears, then down to his chest. “How long has he been unresponsive?”
“About twenty-four hours now,” Mrs. Turner sniffled.
“And how often is he medicated?” John looked up from his watch after counting Danny’s respirations.
“He gets the morphine every two hours.”
John moved his stethoscope from Danny’s trachea to his chest, listening to his anterior lung sounds and heart. He glanced down at his watch to count Danny’s heart rate, then auscultated his abdomen, before moving back up to pull Danny slightly toward him, on the young man’s left side, to listen to his posterior lung sounds. John put the stethoscope back around his neck. “Does he have any lorazepam?” he asked, palpating Danny’s abdomen.
“The anxiety liquid? Yes, we have some, but I haven’t used any since he stopped waking up,” Mrs. Turner froze with sudden worry, eyes wide, hand going to her chest. “Oh no, should I have been using it?”
“No, no, it’s fine,” John soothed, examining Danny’s fingernails and checking the strength of his radial pulses, before gently laying his hands back down and taking up a crouch at the end of the bed, pulling the blanket up to check the temperature and color of Danny’s feet and lower legs. “Have the Macmillan or district nurses given him any injections today?”
“No,” Mrs. Turner replied.
“Right,” John murmured to himself, rocking back on his heels.
“What do you think, then?” Mrs. Turner asked, dabbing her eyes with a tissue.
“I’ll talk to the nurse when she gets here, as she knows his case better than I do, but I’d like to try a dose of the lorazepam in the meantime, if you have it.”
Mrs. Hudson stepped away from the doorframe and headed to the kitchen, the refrigerator clicking open and shut as she retrieved the bottle and returned to the room, handing it to John.
“How do I tell when he needs it when he’s like this?” Mrs. Turner gestured at Danny’s unresponsive form. “Did I miss….”
“No, no,’ John insisted, making sure she met his eyes, staying in his crouch to keep at her eye level across the bed. “You are doing a fantastic job with all of this. Really.” He took the medication from Mrs. Hudson with a quick nod and muted smile and measured out a 1 mg dose, motioning at the skin around Danny’s eyes and mouth. “There’s a little bit of tension here,” he pointed out as he eased the dropper between Danny’s cheek and lower gum, slowly emptying the medication to be absorbed by the vascular tissue there. “Do you see it?”
Both women nodded.
“I think that’s what I was seeing,” Mrs. Hudson added thoughtfully, recalling her earlier attempt to describe how Danny still appeared uncomfortable to her.
“It probably was,” John agreed. “Usually, if it’s tension from pain, the morphine will ease it out, unless he needs a different dose or medication. Sometimes though, that little bit of tension can be the only sign of restlessness or anxiety, which is very common this close to death.”
Mrs. Turner hiccupped. “So he’s close then?” she choked. “I mean, I know he’s not well, that he’s….” she struggled to form the word, “dying….” She looked at Danny’s pale face, then forced her eyes back to John. “But…..” she worked to compose herself, to actually voice the question. “Will it be soon?”
John sighed softly to himself; always the hardest question. “Everyone passes in their own time,” he said. “I can’t tell you for certain when it will be, but I can show you what I saw.”
Mrs. Hudson moved to Mrs. Turner’s side and put an arm around her shoulders, holding her close as John explained the mottling of Danny’s extremities, the coolness and purple coloration indicating loss of circulation as the body began to shut down, keeping blood flow to the core; the weak pulses and slow respirations from the dying process and medication; the slowing bowel, and finally, how the unresponsiveness could last hours or days, but that is was well-believed he could still hear them talking.
“His breathing…..” Mrs. Turner bit her lip, fixing her eyes on Danny’s chest and the soft gurgling, wet sound on each inhale. “It’s the death rattle, isn’t it? Like the shows on the telly?”
John nodded, even as he simultaneously cursed the lack of thought that often went into medical programs; how often accuracy was sacrificed for drama. He refused to watch most of those shows now, especially since Afghanistan. While Sherlock yelling at crap telly such as reality programs and talk shows was entertaining for John, and a study in humanity’s most ridiculous horizons for Sherlock, John could only be amused by medical programs for so long before the shaking head and snorted, disbelieving laughter became real, burning anger as he recalled actual cases and patients of his: those who had come to him with frighteningly harmful misconceptions of human health from those shows, and those who had suffered horrific diseases or injuries only to have their specific suffering minimized, improperly dramatized, or mocked in some stupid television show. “Yes, but it’s not as bad as the telly makes it out to be. He’s not in any distress.”
Mrs. Turner’s eyes widened in disbelief.
John smiled gently. “I know it sounds bloody awful, but it’s just the sound of saliva in the back of his throat. The muscles have loosened and he isn’t swallowing and clearing it away as he normally would. When I listened to his lungs, there wasn’t any fluid in them. It may sound like he’s drowning, but he really isn’t.”
Mrs. Turner’s face crumpled. “Is there any way to….clear the fluid?”
John understood the fearful discomfort that the rattle brought. It was a terrible sound to those sitting vigil, even if it didn’t hurt the dying person. “Suctioning it out usually doesn’t help and can be quite traumatic for the person….”
“Oh no, I don’t want that,” Mrs. Turner was quick to interject.
“I know,” John soothed. “But there are medications, like hyoscine, that can help dry up the secretions. I’ll talk to his nurse about trying a dose from the emergency drug pack when she gets here.”
“Thank you…….oh, dear,” Mrs. Turner interrupted herself, pausing in her readjustment of the blankets when her hand found a small circle of dampness. She moved to stand up. “I’ll just get some towels…..”
Mrs. Hudson, already halfway to the door to get some from the bathroom, startled at the sound of the doorbell and hustled downstairs to answer it instead.
“The nurse and I can clean him up,” John said gently. “When was the last time you slept in your bed?” he asked, noting the well-worn chair she was slumped into.
“I had a brief lie-down when the Macmillan nurse was here this morning. It’s just…..ever since he got like this, I’m afraid to leave him. I don’t want him to die alone,” she choked.
“Doctor Watson and I can be with him for a bit, Mrs. Turner. Why don’t you and Mrs. Hudson have some tea, maybe get some air? We won’t leave him alone,” Diane, the district nurse, said from the doorway.
Mrs. Turner smiled, warm and watery, at the familiar presence. “Diane, dear. I’m sorry to drag you out too.” She pushed on as Diane went to speak. “I know it’s your job, but I’m still going to thank you.”
Diane chuckled. “My pleasure. Mrs. Hudson filled me in on the way up, and if Doctor Watson here doesn’t mind giving me another set of hands, we’ll get Danny comfortable and see what else he needs.”
John nodded his agreement.
Mrs. Hudson stepped forward and guided Mrs. Turner up by the elbow. “Come on, dear. I’ll make you that cuppa.”
Once the two women left the room, Diane stepped in and strode to John’s side, holding out a hand. “Diane Weston. Lovely to finally meet you, Doctor Watson.”
John shook her hand, firm and warm. “Same. And John, please.”
“Right, then,” Diane nodded, setting down her own bag next to John’s and pulling out a spray bottle, thick disposable cloths, and gloves. “Shall we?” she motioned to the wet blanket.
Half an hour later, Diane went out to the kitchen and updated Mrs. Turner, who was then guided back into the bedroom to find Danny in clean bedding and pajamas, a urinary catheter in place for dryness and comfort, pillows placed under his heels and along his left side to ease the pressure on his body, and a fan gently blowing air across his face to manage any potential feelings of air hunger.
“Oh, he looks so peaceful,” Mrs. Turner breathed, eyes shining at Danny’s unlined face. “Even that awful rattling sound isn’t as bad.”
“I gave him an injection of hyoscine, to help decrease the saliva in his throat,” Diane explained. “It doesn’t always stop it completely, but it should at least help.”
“No, I understand. He looks……comfortable. Thank you both,” Mrs. Turner looked from John to Diane with a warm, shaky smile.
They spent another ten minutes sitting together in the room, Mrs. Turner reminiscing about Danny’s childhood, when Diane’s mobile rang. As she excused herself to take the call, Mrs. Turner’s cat trotted past her and slipped into the room for the first time that night. Diane turned around and shared a significant look with John before continuing to the stairs. When she returned a few minutes later, the cat was perched on the bed near Danny’s feet, watching him intently.
“If you have another patient, I can stay,” John offered, eyes moving to the cat, then back to Diane as she moved to the foot of the bed.
“They were just checking on a dosage. Should be all right,” Diane said quietly. She moved to Mrs. Turner’s side and began speaking softly, the older woman’s eyes widening as she moved her chair up near Danny’s head, touching his face lightly and speaking to him.
“What is it, dear?” Mrs. Hudson asked quietly, reappearing in the doorway after washing up the dishes and straightening the kitchen.
John crossed the room and explained the significance of the animal’s sudden presence. He’d spent some time in a field hospital in Afghanistan that had a scraggly mutt that hung around. The dog seemed to have some sort of innate sense of infection control, never nosing around any bandages or tubing, and so the staff encouraged him to stay; his presence alone being soothing in a way that medicine couldn’t always manage. And it didn’t take long for everyone to learn that when he settled in at a patient’s bedside, that death would occur within the next twenty-four hours. Always.
Mrs. Hudson stifled a sob and squeezed John’s arm, walking over to gently stroke the cat’s head before resuming her place at Mrs. Turner’s side.
Fifteen minutes later, the cat let out a mournful meow just as Danny took his last breath, to the sound of his aunt’s soft voice telling him she loved him.
After pronouncing the death, assisting with the phone calls and post-mortem care, waiting for the undertaker, and making more tea for Mrs. Turner and Mrs. Hudson, John didn’t get back to the flat until 7 AM. Finding Sherlock gone, he gave the fridge a quick survey, decided he was too bloody exhausted to eat, and trudged up to his bedroom to sleep.
He woke up seven hours later to his mobile chirping: a text from Sherlock seeking support for digitalis toxicity as a cause of death, followed by a lengthy list of medications. John reviewed the list with weary eyes, sent a detailed, but pared down response that gave Sherlock everything he’d need, and snorted at Sherlock’s resulting comment about Anderson’s latest shortcoming.
So long as Sherlock was amusing himself with a case, John figured it was time to get up and enjoy the silence for a bit. Dragging himself downstairs, he found an envelope on the table, addressed to him. An envelope that, in a clear sign Sherlock had stopped back at the flat at some point, had already been opened, carefully slit along the top by a pocketknife. Anger swelled in John’s chest, overpowering the weary resignation of this new normalcy. They shared living arrangements, food, acquaintances, Sherlock’s work…….the least Sherlock could do was leave his post alone.
John sighed and pulled out the card, a slow, soft smile smoothing the lines of tension on his face as he read Mrs. Turner’s flowery handwriting, breath catching at her final sentence: I’ve always believed that God puts people exactly where they ought to be. He’s brought you to Sherlock, and last night, He saw fit to send you to me. I hope Sherlock knows what a blessing you are. I certainly do, and I’ll be forever grateful.
John reverently tucked the card back into the envelope; he hadn’t been thanked so sincerely for his medical attention since the service. He’d almost forgotten how it felt, what he could do when he wasn’t constantly being pulled away from that part of himself by Sherlock and his work. He suddenly groaned, remembering that Sherlock had actually read the card; imagined him muttering something about sentiment and caring too much, then wandering back off to the crime scene.
But when John went to put the kettle on, he found the worktop completely cleared and the kettle both clean and free from experimentation. Opening the fridge revealed a fresh carton of milk that hadn’t been there when he first got home.
Sherlock would never be the card-writing type, nor was he prone to verbal statements of gratitude or praise. But that didn’t mean he didn’t have his own Sherlockian brand of approval and sentimentality. He would have opened the card out of a boundary-ignorant sense of curiosity, a need to know what happened at Mrs. Turner’s, but if the contents of the writing had been nothing more than simple data that allowed him to put together a picture of the events, or worse, boring sentimentality, he would have simply dropped the card and moved on; the state of the kitchen would have remained unchanged.
So, with a pleased, private smile, John went about his unobstructed preparation of tea, knowing exactly what it meant.
Chapter 4
Summary:
It was only when people actually saw John working as a physician that they began to understand: that it wasn’t just about bullets and IEDs and trauma care under fire. That “doctor” actually covered a pretty wide field. And that John was bloody good at covering ground. 5 times Dr. Watson treated others and 1 time he treated himself.
Notes:
Disclaimer: I do not own Sherlock. Just playing, with love and respect to those who brought these characters to life.
Brit-pick: Many thanks, once again, to the wonderful debriswoman, who somehow manages to find time in her busy schedule to cheerfully look over my work and teach me new things.
Notes: Thank you to all who have reviewed while following this story – I am trying to get the chapters out as quickly as I can, and so proper review replies have taken a back seat at the moment, but I will certainly be responding and truly appreciate your feedback and support. As always, I hope I did the characters justice. Thank you for reading.
Chapter Text
4.
Sherlock was walking through Regent’s Park, animatedly running through their current case data out loud, searching out connections by bouncing ideas and information off John, when he felt his flatmate’s attention drifting; the nods, grunts, and occasional insights or opinions dropping off significantly. He allowed himself a breath and glanced over to find John’s head cocked toward Sherlock, still listening with one ear, but his eyes focused on a young woman a few meters down the path, who was frowning worriedly at an elderly woman sitting on a bench. John pursed his lips slightly, then resumed his previous walking speed, Sherlock picking up right where he had left off, until John finally came to a halt, eyes fixed on the two women.
“Sherlock, give me a minute, will you?” John asked, angling his body toward the bench.
Sherlock’s response was a put-upon huff. “Going to lend a gallant arm, Doctor Watson?” he sneered, a mixture of irritation at being interrupted and exasperation with John’s incessant need to be helpful, particularly to pretty young women.
John’s eyes narrowed. “No,” he replied carefully, tone tightly contained. “I’m going to see what’s wrong.”
“The only thing that’s wrong is that the young lady is out of training.” Sherlock sighed at John’s silent reply, his flatmate’s face somehow managing to be blank while also shouting ‘oh just get on with it’ at the same time. “Her shoulders, John,” Sherlock gestured toward the bench. “Clearly a competitive swimmer, but one obviously out of regular training seeing how she currently lacks the upper body strength to assist an elderly woman to her feet.”
John tilted his head slightly, face tight with his ‘I’m holding back exactly what I want to say to you’ expression. “Right. And I suppose her shoulders are more important than her face.”
“She’s frowning because she’s unable to perform a simple task,” Sherlock dismissed.
“No, she’s frowning because something’s wrong,” John corrected. “That’s the third time the elderly woman’s legs have given out while trying to stand.”
Sherlock squinted across the way. “She’s seventy-five years old, John,” he said, not the slightest hint of uncertainty in that number. “Surely you’ve seen enough elderly patients with muscle weakness that this isn’t news to you?”
John’s eyes narrowed. “Yes, and when they’re that weak they’re in a wheelchair, not this far out in Regent’s Park with only a walker,” he shot back, feeling a small stab of satisfaction when Sherlock’s eyes flickered over to verify that claim. He sighed heavily. “Look, I’m just going to make sure they’re all right. I won’t be long. Stay here, if you want, and keep at it.”
Sherlock opened his mouth to reply, but John was already striding off. He blew out a breath that was half-sigh, half-growl. He knew he was close with the case; just another few minutes of working through it out loud and he’d have it. But while Sherlock certainly had no problem talking to himself in public, not caring if other people thought he was a complete nutter, he’d grown accustomed to doing it with John, whether John was actively listening and contributing, or silently acting as a sounding board to Sherlock’s own conversant thought process. John’s very presence somehow helped clarify the storm of data in Sherlock’s head; illuminated hypotheses and conclusions that should have been obvious from the start, yet had somehow eluded him. So as much as he hated to be interrupted during a case, Sherlock decided to put active consideration of the data on hold until John’s attention was back where it belonged, and strode down the path to observe John’s distraction instead.
John slowed his pace, easing back on the purposeful, military-sharp stride as he got closer to the women. “Hello,” he greeted them, eyes flickering to the elderly woman’s lack of response, before settling on the young woman at her side. “Is everything all right?”
“I’m sorry?” the young woman asked, confused. Her gaze shifted over John’s shoulder to take in the long strides of Sherlock’s dark, approaching form.
John turned his head and shot a clear ‘back off and shut up’ look at Sherlock, before returning his focus to the young woman. “I couldn’t help noticing that your….” He paused for a second, looking between the two women, “mum?” he asked, more with his eyebrows than his voice. At the young woman’s nod, he continued, “seemed a bit unsteady on her feet.”
The young woman deflated a bit as John’s intentions became clear. She kept her eyes on him even as Sherlock arrived, assuming a looming position a step behind John’s right shoulder. “Yeah, she’s not usually like this,” she worried at her lower lip. “Hardly even needs the walker most days.”
John nodded, eyes moving carefully over the older woman, already assessing, humming to himself as if he’d already noted something of particular significance. “Maybe I could help? I’m a doctor,” he added in quick explanation. “John Watson,” he offered a hand. “Would it be all right if I examined her?”
The young woman shook his hand warmly. “Oh, yes, please. That would be wonderful. Lucy,” she introduced herself. “And my mum, Marjorie.”
John could feel Sherlock’s eye roll without looking and promptly ignored it. He crouched down in front of Marjorie, getting a closer look at the bruises on her left hand and inner left elbow that had caught his eye earlier, nodding to himself. “Marjorie, can you hear me?” he asked.
She nodded, a bare fraction of movement.
“Can you tell me your full name?” John asked, noting the saliva at the corner of her mouth.
She made a weak attempt to speak, but was unsuccessful, eyes squinting tighter despite Lucy’s new position shadowing her face from the sun.
“Does your head hurt?” John read the deepened furrows around Marjorie’s eyes.
Another weak nod.
“Does she usually have any difficulty speaking or swallowing?” John asked, glancing up at Lucy.
“No, never,” she said nervously. “She was fine, just ten minutes ago.”
John measured her pulse and respirations, then took a small torch from his pocket and shaded Marjorie’s eyes. “Marjorie, I’m going to shine a light in your eyes for a moment,” he explained, moving the improvised penlight across each one. He hummed to himself, moved to do something else, then suddenly stopped, emptying his pockets and removing his coat to lay it across Marjorie’s lap.
Lucy’s eyes widened. “Oh, you didn’t have to….” She gestured at John’s coat.
He shook his head. “It’s no bother, really,” he said, assuring Marjorie as much as Lucy.
“I suppose it’s a urinary infection then, yeah?” Lucy asked. “She’s lost bladder control and gotten confused and weak with them in the past, although never this bad. Maybe it’s just a really bad one?”
John shook his head. “No, it’s more than that this time.”
Sherlock’s ears perked up at the unwavering confidence in that statement; a trait practically synonymous with his own voice, yet this manifestation uniquely John. The sound of a man who truly knew what he was doing. Intrigued, Sherlock moved from his place behind John to a position along his flatmate’s left side, to better observe his face as he worked.
John took Marjorie’s hands in a light grip. “Marjorie, can you squeeze my hands?” he asked, firm and clear, yet with an undercurrent of gentle compassion. He watched as her hands began to move. “Hard as you can,” he encouraged, squeezing them once himself. “Good,” he nodded, observing the response. He moved down to her feet, lifting one off the ground and placing one of his hands underneath the sole of her shoe and the other on top of the foot. “Now, push down on my hand, hard as you can,” he instructed. “Good, again,” he switched to her other foot. “Very good, thank you.”
Sherlock catalogued what data he could gather. Elderly woman, right-sided weakness, saliva spilling over the sides of her mouth where Lucy was now wiping it, inability to speak, sluggish response to commands. What more did John need? Clearly the woman had had a stroke.
Lucy gasped as Sherlock muttered the conclusion under his breath. “Is that what it is, Doctor Watson? A stroke?” she wrung her hands, twisting the napkin she’d used to wipe her mother’s mouth.
“Clearly,” Sherlock rolled his eyes.
Lucy’s own eyes widened as she pulled out her mobile; a swift, trained action.
“No, not clearly,” John corrected Sherlock firmly, eyes remaining on Marjorie as his body language radiated a sharply unmistakable demand of ‘you need to shut up now.’ His voice softened for the two women, a jarring juxtaposition to the tight lines of Sherlock-induced muscle tension. “But Sherlock is going to call for an ambulance while we keep talking,” he acknowledged the sight of Lucy’s mobile in his peripheral vision; good to know that someone was paying attention to all those adverts about dialing 999 at the first sign of stroke symptoms.
Sherlock stiffened in reflexive annoyance – a trait he firmly blamed on Mycroft’s presence in his life – at being ordered to do anything. But John’s tone held no trace of his previous irritation at his flatmate’s conclusion; just a simple statement as to what Sherlock would be doing, voice calm and sure for an increasingly worried Lucy. As much as Sherlock generally bristled at being told he was wrong, naturally assuming that the other person was an idiot and therefore inconsequential, John’s words actually mattered to him; rather than filling Sherlock with dismissive affrontedness, John’s confident opposition to the stroke diagnosis made him curious. So Sherlock conceded to pulling out his mobile and dialing 999 while keeping most of his focus on John’s continued assessment.
John’s hands had moved to Marjorie’s head. “Lucy, does your mum take any anticoagulant medications?” He paused, adding the more common lay term for clarification, “Blood thinners?” His fingers moved through Marjorie’s hair, palpating her skull. “Warfarin, maybe?”
“Yes, that’s exactly the one she takes!” Lucy breathed. “How did you…..”
John gave a fractional shake of the head, a clear ‘in a moment’ gesture, as he continued palpating. “Why was it prescribed?”
“She has a heart problem. Atrial fibrillation,” Lucy replied.
John’s fingers finally hit a small, swollen lump.
There.
John felt the familiar rush of a confirmed diagnosis run through him. Even though he took locum shifts as a GP at the surgery, people, at least those who remembered that he was a bloody doctor to begin with, tended to see him solely as an army doctor; pictured him treating life-threatening combat injuries under heavy fire. It appealed to people’s fascination with excitement and heroics, where anything worth something had to be some big, grand gesture on a massive stage. No one imagined that a simple observation in the park, followed by a calm, invisible-to-passersby assessment and diagnosis, could be just as important and lifesaving. That diagnosing a potentially life-threatening condition in a perfectly conscious elderly woman on a park bench could be just as satisfying, and impressive, as the adrenaline of battlefield trauma.
“Lucy, has Marjorie fallen recently?”
Lucy’s eyes widened. “Yes, about a…..” she thought for a moment, “…day and a half ago? She lost her balance and hit her head…..” she suddenly realized where John’s hands were, what he had found. “But she was fine,” she quickly assured him. “A little bump, but she never lost consciousness. Hardly even had a headache. She was fine,” she repeated, with the desperate edge of someone thinking back to see if she had missed anything.
“I believe you,” John soothed, tilting his head slightly to focus on where Sherlock was in the 999 call.
“Oh,” Sherlock breathed in sudden understanding. Stupid! How had he missed it? It was obvious now that John had known immediately, from the first time he set eyes on Marjorie, that he was looking at a brain bleed. The final questions about the warfarin and the discovery of the lump on her head confirmed it. But how? He dismissed the confused dispatcher’s question as to his sudden vocalization, interrupting him with a curt, “suspected brain bleed.”
“She’s bleeding in her brain?” Lucy gasped, whirling to face John and crouching at his side, hands on her mother’s face. “How is that possible? She was fine! She didn’t even bleed from the bump, for God’s sake!”
John shot Sherlock a ‘thanks for that’ look, reigning in his sigh and focusing back on Lucy. “Lucy,” he said gently. “You asked before how I knew your mum was on warfarin.”
“Yes, how did you know?” She couldn’t help the resurgence in her curiosity, even while continuing to look worriedly at her mother.
John motioned at the bruises on Marjorie’s hand and inner elbow. “She needs regular lab work to adjust her dosage and these are at sites where blood would be drawn. Warfarin affects the clotting process, which puts people who take it at greater risk of bruising and bleeding, especially the elderly, who are more prone to falls. When your mum fell, she began bleeding in her head, but because it was a small area and at a slow rate, she didn’t show any symptoms of something being wrong until now, when it became enough to affect her regular functioning.”
Sherlock listened silently. Of course! Obvious. So why didn’t he see it when John did?
Lucy swallowed back tears. “Don’t you need a brain scan or something to be able to see that?”
“They’ll do one at hospital to confirm it,” John said. “Has she ever had differences in pupil size or weakness on one side?”
“No,” Lucy shook her head.
“Well, she does now. Putting that together with the warfarin and fall, makes an intracranial bleed the best explanation for the sudden changes you saw.” His face softened as Lucy began to sob. “I know it sounds awful, but it’s not a death sentence,” he assured her, nodding at the sound of approaching sirens. “The sooner she gets to hospital, the sooner they can operate to stop the bleeding and relieve the pressure.”
He helped Lucy up as Marjorie began to list to one side, the young woman joining her mother on the bench, putting an arm around her to hold her steady. John took another pulse and respiratory rate, keeping a careful eye on Marjorie’s ability to maintain her airway around the accumulating saliva.
“John,” Sherlock said quietly.
John followed Sherlock’s eyes to find the paramedics coming down the path. He stood from his crouch with a faint pop of cartilage and jogged to meet them. “Doctor John Watson,” he introduced himself.
The paramedics nodded in greeting. “What’ve you got, doc?”
John joined in their brisk pace, giving his report as they walked. “Seventy-five year old woman,” he realized he was taking Sherlock’s word for Marjorie’s age, yet couldn’t find it in himself to argue the number, “with suspected intracranial hemorrhage. Her daughter states she’s on warfarin for AF and fell approximately thirty-six hours ago at home, striking her head. There was a small area of posterior swelling, which is still present, but no LOC or noted deficits from baseline until approximately half an hour ago when she presented with generalized weakness. Initial assessment showed new-onset aphasia, dysphagia, anisocoria, and right-sided weakness. She is alert to person, unable to respond to questions verbally, and follows commands with some difficulty. Left pupil is approximately 6mm, round and sluggish to react. Right pupil is 3mm and responding appropriately. Peripheral sensation appears intact, hand grip and foot strength on the right side are severely diminished compared to the left. Last heart rate was 106, respiratory rate was 24. Patient’s name is Marjorie, and her daughter is Lucy,” John finished as they reached the bench. He stepped back and took up a place at Sherlock’s side, hands clasped tightly behind his back while the paramedics worked.
“You’re welcome,” John smiled gently. “Go on,” he nodded her back toward her mother.
John stretched his shoulders, rolling the earlier tension loose as he watched the paramedics leave, hoping that the bleed had been caught in time to prevent permanent damage. As much as the final diagnosis was never one he’d want to give to a patient, the thrill of the diagnostic process was still thrumming faintly through John’s veins. From the moment he’d laid eyes on those warfarin-induced bruises, he’d known – it had only been a matter of finding the supporting data. Most people had no idea that John liked the puzzle, the intellectual side of medicine, just as much as the adrenaline rush of battlefield trauma care. He figured it was probably one of the reasons he got on so well with Sherlock, actually. Sherlock’s brilliantly analytical mind and rapid-fire deductions appealed to John’s intellectual side, just as the breathless alley chases and lingering threat of danger surrounding the detective’s work satisfied his adrenaline addiction.
“So, you work it out yet?” John asked, acknowledging the fact that Sherlock had been staring at him, eyes moving rapidly as he processed data, and deciding that his flatmate had had enough time to look through him while solving the case.
Sherlock looked surprised for a moment before recovering his usual neutral mask. “Neglecting the significance of the bruising being over the median cubital and dorsal hand veins was an oversight,” he swallowed with classic ‘I’m annoyed I got something wrong’ reluctance. “But I have yet to determine how warfarin-induced bruises can be distinguished from those regularly produced by phlebotomy.”
John took a few seconds to process that. “Wait a minute, you…..” he shook his head as it became clear. Of course, Sherlock had made Marjorie his case, and of course he was annoyed that he had been wrong about the stroke, that he had missed some detail that John had seen. But as much as he was annoyed at someone knowing something he didn’t, Sherlock was also curious. He knew when he needed more information, from someone with more in-depth knowledge on a subject than he had, and his outward musing just now was his way of asking John to explain, so that he could learn and incorporate that knowledge into his own for future use. “Warfarin doesn’t change how a bruise presents, Sherlock,” John explained, keeping his tone matter-of-fact, just as Sherlock would want it. “I recognized it because it’s my job. I see an elderly woman with a sudden decline and multiple bruises and I immediately think ‘warfarin’ and look for sources of internal bleeding. It’s no different than you looking at dirt and determining that it’s actually some sort of exotic tobacco ash because your job somehow involves knowledge of two hundred…….”
“Oh, that’s it!” Sherlock clapped his hands into a prayer position under his chin, eyes moving rapidly as everything fell together. “John, you are brilliant!”
“Cheers,” John shrugged. “What’s what then?” he sought clarification for whatever it was that he’d just helped Sherlock figure out.
“The nicotine stains around the murder victims’ fingers – all from the same exceedingly rare tobacco. Clearly, the murderer supplied all three victims and the supply was tainted…..”
John couldn’t help but smile as Sherlock went off at full speed, walking briskly at his flatmate’s side and listening to the brilliant resolution, side-stepping wild gesticulations as the case was solved to the sound of increasingly distant sirens.
Back at the flat later that night, exhausted after a long evening of trailing Sherlock through dozens of tobacconist shops, John settled down to find a new comment on his last blog entry: Surgery for subdural haematoma was successful. Doctors believe she’ll make a full recovery. Thought you’d like to know. ~Lucy
John smiled at the news, closed his laptop, and went to bed before Sherlock could harass Lestrade for a new case.
***
The next morning, John returned to the sitting room after signing for a package to find Sherlock reading his blog. On his laptop. “You do know that typing the address for my blog into your laptop brings up the same page, right?” he sighed.
Sherlock made a ‘don’t be ridiculous’ noise and kept reading.
John shook his head and sank into his chair to open the package. Inside was his freshly laundered coat, a packet of chocolate HobNobs, and a note.
Dear Doctor Watson,
I swear I’m not a stalker or anything, really. I forgot to ask for your mobile number, so I looked you up online, which is where I found your blog and this address. I just wanted to thank you for everything you did for me and my mum. I know it’s not much, but I had your coat dry-cleaned, and the biscuits are mum’s favourite – she’s quite a believer in gratitude via sweets, so it seemed right. I’ll keep you informed during her recovery. Thank you again, from the bottom of my heart. You truly saved her life.
Regards,
Lucy Warren
John smiled warmly as he got up and hung his coat by the door, pocketing the note along the way to be added to the small scrapbook he kept from patients, both civilian and military, that he’d treated in the past. He went into the kitchen and put the kettle on, then strode over to Sherlock, holding out the packet of biscuits.
Sherlock glanced up with a ‘well, what do you want me to do with that?’ look.
John’s eyes flickered to the screen to see that Sherlock had reached the comments section of the entry that contained Lucy’s update. “Shut up and take one,” he ordered, waving the biscuits.
“I didn’t say anything,” Sherlock pointed out with a petulant huff.
“Not out loud you didn’t,” John retorted, with an ‘I know your looks’ tilt of the head. “They’re one of your favorites and you still haven’t eaten since solving that case last night. It’s this or a proper breakfast,” he threatened.
Sherlock rolled his eyes, but snatched three biscuits.
“Don’t get crumbs on my keyboard,” John warned, returning to the kitchen and munching on his own biscuit while laying out the mugs.
John knew that Sherlock had read Lucy’s comment by the time he handed him his mug, because Sherlock not only took another two biscuits without prompting, but his eyes flashed through a split-second expression that stunned John in its significance and familiarity. He sank into his chair with his tea as Sherlock switched to answering comments on his own website, rolling his eyes at the general stupidity of the world as a whole.
But for that split-second, Sherlock had looked at John, not just with one of his pleased flashes of pride, but the same way John often looked at him: with open admiration.
Chapter 5
Summary:
It was only when people actually saw John working as a physician that they began to understand: that it wasn’t just about bullets and IEDs and trauma care under fire. That “doctor” actually covered a pretty wide field. And that John was bloody good at covering ground. 5 times Dr. Watson treated others and 1 time he treated himself.
Notes:
Disclaimer: I do not own Sherlock. Just playing, with love and respect to those who brought these characters to life.
Brit-pick: Many thanks, once again, to the wonderful debriswoman, who somehow manages to find time in her busy schedule to cheerfully look over my work and teach me new things.
Notes: This chapter, the longest and most time-intensive in terms of editing, came about because I noticed that John’s coats tend to have a lot of pockets. The back story and medical scenario that were born of that observation somehow grew to approximately 5,400 words of action and character study. Thank you to all who have reviewed while following this story – I am trying to get the chapters out as quickly as I can, and so proper review replies have taken a back seat at the moment, but I will certainly be responding and truly appreciate your feedback and support. The final chapter still needs some personal editing before I can send it to my amazing brit-picker, so it will be a few days before it’s ready to be posted. I have truly enjoyed writing this series and I’m honored and humbled to hear from so many readers who have been touched personally by some of these medical scenarios. As always, I hope I did the characters justice. Thank you for reading.
Chapter Text
5.
This was the John Watson most people imagined.
Running through narrow, murky, moonlit alleys, haring off after an art thief smuggling suspect whose latest operation Sherlock had just interrupted, the sounds of sirens in the background indicating that Lestrade had received John’s text about Sherlock’s stupid plan, and was bringing assistance while they got themselves caught deeper within the labyrinth of London’s alleyways.
John regulated his breathing with unconscious training and squinted through the gloomy night air at Sherlock’s flaring coat and, a few paces ahead, the fleeing suspect’s back. Something about the way Roger Merrim ran when they interrupted his theft-in-progress set John’s instincts on edge. He was particularly attentive to the wealth of information found in how a person ran; observations that had made him aware of underlying pathologies as a doctor, and saved him from physical harm as a soldier. Sherlock, for example, true to who he was, never did anything in halves – when he ran it was at a full sprint, no sign of moderation, with all the singular focus and energy he put into his deductions; whereas John’s military training kept him at a solidly quick, but steady pace, sprinting short distances if necessary, but ensuring that he maintained his energy to cover the possibility of long distances or upcoming danger.
But Roger Merrim……he ran differently, unique yet familiar at the same time: a man escaping arrest, fast and hard, yet not quite desperate enough. As if he had some private knowledge that lessened his fear of capture.
As if…..
John flattened himself against the wall as Merrim’s sharp turn into an even darker alley on their right was immediately followed by gunfire from one of its bordering rooftops.
…..As if Merrim knew that he wasn’t alone; that he just had to get to a pre-arranged point where he’d have cover fire for his escape.
Perfect.
“Sherlock,” John hissed. His flatmate had taken cover behind a skip about three meters ahead of him, at the other corner of the alley opening; cover he was about to abandon as he inched away from the solid protection, coiling to run again. “Stay down!”
“He’s still close, John. We almost have him,” Sherlock pressed.
He was right: Merrim’s footsteps hadn’t continued far down the new alley. But that in itself was all sorts of wrong. There was no way the shots were friendly fire – Lestrade’s squad was just arriving and there had been nothing in John’s text to indicate a need for an armed unit. And it couldn’t have been an enemy of Merrim’s looking to pick him off because of how Merrim had been running. He’d purposefully led them to this area, John was certain of that. But if the accomplice was firing merely to help him get away, why wouldn’t Merrim have taken advantage of the distraction and taken off down the alley toward freedom? He had already proven that he could run hard enough. No, there was something else going on here; something putting every one of John’s senses on full alert. He was just starting to inch along the wall toward the alley opening to try and get a look around the corner, when Sherlock bolted to his feet.
“Sherlock, don’t!” John’s throat burned as the shout was restrained to a harsh hiss.
But Sherlock was off like a shot, around the skip and down the alley as John rushed forward, past the edge of the wall and into the opening of the narrow passageway, his screaming instincts exploding into sudden realization milliseconds before it played out right in front of him.
Merrim hadn’t gone far because he wanted revenge on the man who had mucked up his plans.
Sherlock made it about five meters down the gritty cobblestones before Merrim stepped out from a shadowed doorway, swinging a massive piece of lead pipe that took Sherlock directly across the chest, throwing him backwards to hit the ground with an impact almost as horrible as the dull ring of metal against fragile tissue.
“Sherlock!” The shout escaped John’s control as Sherlock fell, the potential damage running through his clinician’s mind with the pace of his galloping heart. Shots rang out in an almost gleeful warning that forced him to sprint forward and take cover behind the skip Sherlock had abandoned.
John took a measured breath and got down to it. Right. Sherlock was down. Blunt force thoracic trauma, unknown status. Two combatants: one known – Merrim - on the ground with a lead pipe, the other – unknown - on the far rooftop, approximately 11 o’clock from Sherlock’s current position, with a handgun. Sniper with a firearm would usually be a priority as his presence severely compromised John’s movement, but the sniper had had at least three opportunities to shoot one of them and hadn’t, which either meant he had orders to threaten rather than to kill or wound, or that he was inexperienced. Merrim, on the other hand, had not only injured Sherlock once already, but going by the fact that John still hadn’t heard the pipe drop, was prepared to do so again.
John sank into the clarity danger brought him; adrenaline sharpening his focus, sympathetic response ensuring his body was ready to support him, mind clear, hands steady.
First threat identified, options prioritized.
He pulled out his gun, let out a centering breath as he flicked off the safety, and surged around the skip toward the bit of wall between it and the opening of the alley where Sherlock lay. “Drop your weapon, Merrim!” he shouted, edging closer to the corner.
Nothing.
No…..there. Footsteps. Moving closer to John - and by extension Sherlock - rather than further away. Purposeful. Malicious. And distinctly lacking an accompanying sound of lead dropping to the ground.
“Drop it or I will shoot you,” John demanded, his left shoulder just passing the edge of the wall now, into the open entrance to the alley, ready to turn.
Two shots hit the wall near John’s shoulder. Right, then. He let out a breath and pivoted sharply around the corner, coming into full view of the alley, yet remaining close enough to the wall that he could take cover again if needed. Merrim was two steps away from Sherlock, tapping the pipe provocatively against his leg, as if thinking about how and where to inflict the worst damage.
And that was just not going to happen.
Merrim had been nothing more than a thief and a smuggler. Now he had threatened one of John’s own. And it was true - John didn’t trust easily, didn’t count many in his inner circle, but when he did, he was intensely and irrevocably loyal. Going after Sherlock, no matter how stupid Sherlock may have been in running off like that, was a mistake.
A mistake that ran a fine line between being very painful or very fatal.
Merrim dropped with a howl, John’s bullet tearing through his right shoulder, forcing the pipe to drop from suddenly nerveless fingers.
Two shots slammed into the wall near John’s head, sending brick shards flying. He pivoted back around the corner for cover, swiping at a trickle of blood near his left eye, and refocused his hearing as the gunshot echoes faded. Merrim was moaning between ground out screams, panting heavily as he rolled on the ground. But then the movement changed from dragging himself along the ground, to the struggling, pained huff of an injured man pulling himself to his feet. John’s eyes narrowed. Any rational person would be dragging himself as far away as he could get after a warning like that. Merrim however, was currently demonstrating his appalling lack of rationality by once again moving toward Sherlock, rather than away.
John took another steadying breath. “Move away from him, Merrim, or the next shot will kill you.” It was both a warning and a promise; low, dark, and deadly. The voice of a man who knew what he was capable of and kept his promises. A protector called up into the very height of his oath.
A new sound filled the alley; a syncopated rhythm to Merrim’s painful movements. A strangled groan in a voice John knew better than his own, followed by the sudden, marked sound of ragged, dyspneic breathing. Sherlock was still alive then, and had regained enough consciousness to feel his injuries. But that breathing pattern was far more than pain and anxiety. It was nine kinds of not good; the sound of a man in immediate need of emergency medical attention.
John was done playing games.
He had been prevented from reaching patients too many times in Afghanistan and refused to allow it here, in supposedly safer London. He pivoted, hard and fast, around the corner, his torch still untouched in his pocket. He didn’t need it. The murky moonlight, an intuitive sense of aim born of practice and training, and a driving need to neutralize the threats so he could get down to his real work, were far more useful than any additional light.
Merrim was pulling himself along the wall near Sherlock’s left side, his determined, pinched face focused on Sherlock’s unguarded throat.
John’s shot took him right through the head, throwing him back and away.
Sherlock’s ragged breathing picked up speed, left hand weakly scrabbling at the gritty cobblestones.
The resulting shot from the sniper landed menacingly between John’s current position and Sherlock’s supine one.
That was a mistake.
John didn’t duck back around the corner. He flattened himself against the wall closest to him instead, gaze moving from Sherlock up to the man who dared separate him from his patient and friend; chest tightening with a growl that remained silent but for a hardening of his eyes. “Stand down or I will shoot,” he shouted to the roof.
No response.
When John repeated the order, it might have been English; could have been Dari or Pashto or a combination of all three. It didn’t matter. Sherlock was weakly trying to tilt his head back, a reflexive attempt to open his airway, the very picture of a man toeing the line between severe respiratory distress and full arrest. The smell of blood and gunpowder was thick among the sounds of impending death, and in that space, where panic was born and resignation and self-preservation often took hold, John Watson was calm. Steady. And had only one response.
No.
John stepped away from the wall, the sniper not only repeating the mistake of putting a bullet between John and Sherlock, but also proving his inexperience by standing up to take the shot, halfway to a run as he realized Merrim was dead.
The moonlight was all John needed to take aim.
If the bullet didn’t take the sniper immediately through the heart, it was close enough. He went down without a sound, gun clattering over the ledge to the alley below.
And all that existed was Sherlock.
Keeping his weapon in his right hand, John pulled out his torch with his left and rushed to Sherlock’s side, performing a quick check to ensure Merrim was dead while silently cursing how the man fell. He really didn’t want to move Sherlock, but Merrim’s body, and Sherlock’s nearness to the wall, were restricting his access and he needed more space to properly assess him. He briefly shone the torch across Sherlock’s face and chest, decision made.
Christ.
Sherlock’s eyes were wide with panic, accessory muscles straining to pull in air, chest heaving inefficiently, color leached out of his face toward a disturbingly cyanotic edge. His eyes locked onto John’s, the relief and fear in them staggeringly open and unchecked as he struggled to wet his lips.
“No,” John cut him off firmly. “Don’t talk.” His tone was clipped, no extraneous conversation as he tucked his gun away and shifted the torch to his right hand, pulled out his mobile with his left, and hit the speaker button followed by Lestrade’s speed dial. “I need to move you so I can get a proper look,” he both informed and apologized, tucking the torch under his right armpit and holding the phone against his left ear with his shoulder, barking their location and orders for an ambulance to Lestrade while simultaneously fisting his hands in Sherlock’s coat collar and dragging him back from Merrim’s body and out from the wall so he had room to work. He dropped to his knees on Sherlock’s left side and reached into the detective’s coat for his torch, turning it on and laying it on the ground facing the alley opening to assist Lestrade’s rapidly approaching squad in finding them while Sherlock struggled to regain the horrible, but slightly less horrible, breathing pattern he’d had before he’d been moved.
John was all efficient movement, quickly, but carefully, removing Sherlock’s scarf, easing the feeling of pressure on his throat while opening the area to assessment, and pushing the heavy coat back to expose the damaged chest.
Lestrade and Donovan came rushing around the corner, followed by several PCs.
“Bloody hell,” Lestrade breathed, taking in the smell of blood and gunpowder, the sound of Sherlock’s ragged breathing, and the very dead man lying nearby. “John?” To Lestrade’s credit, the question wasn’t one of bewildered surprise or subtle chastisement; it was a simple, straight-forward request for a report, recognizing the severity of the situation and knowing that the full details could wait.
“Merrim’s dead. Sniper on the roof,” John waved toward the position, “took a bullet to the chest.” He was reaching into one of his coat pockets. “I need you and Donovan with me now.”
Lestrade nodded quickly, accepting John’s command and assessment of the situation. He directed officers to cordon off the areas around the bodies as Donovan radioed their location to the rest of the backup and called for a coroner’s van, both of them working while jogging the rest of the way to John’s position.
“Oh my God,” Donovan breathed, looking down at Sherlock’s rough, desperate respirations. Her stomach twisted at the absence of Sherlock in his eyes, everything that was frustratingly him replaced by primal human distress, his focus flickering as it struggled to center on John.
“Donovan,” John barked, thrusting gloves and a pair of trauma shears at her. Last name, command-clipped, authoritative without ever raising his voice. She immediately felt herself straighten, focusing on the task at hand. John waved to Sherlock’s right side. “I need full view of his chest. Cut the front of the shirt first so I can get in there, then the shirt and coat sleeves after. Understand?”
“Got it.” Donovan hurriedly donned the gloves, dropped to her knees on Sherlock’s right side, and began cutting.
“Lestrade, get that scarf under his head, keep him quiet, and get me a heart rate.” John was pushing Sherlock’s shirt aside as Donovan finished the center and moved to the sleeves. He thrust the torch at Lestrade. “And hold this so I can see,” he added, eyes rooted to Sherlock’s exposed chest, cataloguing observations as his hands sought familiar landmarks.
“Got it,” Lestrade parroted Donovan’s acknowledgement, dropping down at Sherlock’s head and placing the scarf as a thin pillow, looking down into the panicked eyes that drifted in his direction. He knew exactly what John was doing, putting him at Sherlock’s head and Donovan to the other tasks. Lestrade had no doubt that John needed him to monitor Sherlock’s heart rate and maintain decent lighting for him to work, but he also knew, as John did, that Sherlock would never admit to needing comfort at a time like this. So rather than Donovan, whose relationship with Sherlock was generally rocky and fraught with animosity, John was putting Lestrade, one of the few people Sherlock actually trusted and got on with, in the position of reassuring focal point.
“Just keep breathing. John’ll get you sorted,” Lestrade said, laying two fingers on Sherlock’s carotid and beginning to count.
Even on the edge of respiratory arrest, Sherlock rolled his eyes. Obviously.
“Shut up,” Lestrade muttered, even as the normalcy of that response sent a tiny wave of relief through him.
Donovan finished Sherlock’s right sleeve and hurried beside John to do the left one.
“Hundred and thirty,” Lestrade announced Sherlock’s heart rate.
John acknowledged the information with an almost absent-minded nod. His hands were on Sherlock’s already bruising chest, both palms flat, measuring the breaths and chest movement on each side, eyes moving with rapid, clinical precision from Sherlock’s face to his throat and chest. He removed his hands and rocked back on his heels, lips pursed, expression grave, eyes set in experienced readiness.
Severe dyspnea. Tachycardia and tachypnea. Raised JVP. Hyper-expanded left chest barely moving with respirations. Tracheal deviation to the right. Rapidly progressing hypoxia and impending cardiopulmonary arrest.
Sherlock didn’t do anything by halves; it truly was all or nothing. Not talking for days on end, or talking nonstop for hours without breath. Running full speed through alleyways, or sprawling on the sofa and not moving a muscle.
Taking a lead pipe to the chest and coming out with a bloody classic tension pneumothorax.
Lestrade angled the torch over Sherlock’s chest. “God,” he breathed. “What the hell happened?”
It was a testament to how bad Sherlock was getting that he didn’t even try to answer this time. His eyes were fluttering, fighting unconsciousness, desperately trying to focus on John.
“Lead pipe,” John replied shortly as Donovan reported she was done with the sleeves and returned to Sherlock’s right side. John reached into another coat pocket and tossed a packet at her. “I need a betadine scrub, right along here,” he instructed, motioning along the left side of Sherlock’s chest between the nipple and clavicle.
“Right,” she confirmed, tearing open the packet and leaning over Sherlock to start swabbing. Her eyes flickered between the cut coat and exposed skin. Seeing him like this, stripped of his coat and scarf armor, face open and distressed and dying…..it was a harsh reminder that, no matter what he did to suggest otherwise, underneath it all, he was human. The kind of human that desperately focused on his best friend as he slipped away; an intensity of focus mirrored in how John worked to save him. For all she called him “freak” and knew he was dangerous, she’d never wanted to see him suffer like this, and she certainly didn’t want him dead. And while John may have been safer and saner without Sherlock, Donovan couldn’t really imagine either of them without the other at this point.
John reached back into his coat as Donovan worked. There was a reason he favored coats with multiple pockets. One of the hardest things about adjusting to civilian life had been the loss of his field kit. He had got so used to carrying it everywhere; the comforting weight and knowledge of having at least some supplies with him for emergency situations. Then he came back to London and walked streets that could just as easily hide rooftop snipers or car bombs or heavily clothed humanized explosive devices and he had nothing on him, nothing to treat the types of wounds those things could cause; the ones that could kill before a call for further support was even made.
Then he met Sherlock, and Mycroft had been right – walking with Sherlock was a battlefield. It was kidnappings, shootings, bombings, and unpredictable people; constant danger and running into unknown situations. And while he and Sherlock survived most of them amazingly intact, there were some potential injuries and complications that would quickly be fatal without proper, immediate field treatment. John knew he couldn’t realistically run around London after Sherlock with a full field kit, but he was a doctor: he knew how to prioritize supplies and triage potential possibilities. So he started carrying a few things with him beyond the exam gloves that were always tucked in one pocket. Even with body armor, he’d seen a lot of thoracic trauma in Afghanistan; could practically diagnose a tension pneumothorax with his eyes closed. Death was quick to follow if one little thing wasn’t put to immediate use after making such a diagnosis.
So John pulled a long, 14 gauge catheter from one of his pockets, changed his gloves, and prepared for needle decompression.
Sherlock startled at the loss of the betadine swab’s cold bite as Donovan finished; rapidly losing consciousness, yet still fighting to catch John’s eyes, ignoring Lestrade’s close voice and soothing, “take it easy.”
John’s eyes snapped briefly to his left, drawn to Sherlock’s unspoken need; a split-second meeting of gazes as his fingers found the center of Sherlock’s left clavicle before he focused his attention back on Sherlock’s chest. But while Sherlock lost John’s eyes as the physician continued his efficient work, he gained his voice. John started to talk. And this time it wasn’t the command-clipped tone of Captain Watson, experienced trauma physician, giving orders. It was the calm, matter-of-fact voice of a friend – Sherlock’s friend – explaining everything he’d seen and was about to do, paring it down to the basics while still using full scientific terminology. What, at first glance, seemed like an incredibly out of place teaching moment, was actually John giving Sherlock exactly what he needed; exactly what would soothe him.
Data.
“Tension pneumothorax. Your left lung’s collapsed and mediastinal shift is compromising venous return to your heart. Each inhalation brings more air into the pleural space that can’t escape.” John glanced into struggling eyes that somehow still held a spark of intense focus as they latched onto his words. “That doesn’t mean you should stop breathing,” he warned Sherlock, before softening slightly and adding, “but close your eyes if you need to.” He handed the catheter to Donovan and explained how to peel open the packaging so he could grab it, then resumed his simple recitation tone with Sherlock, who had actually allowed his eyes to close, letting John’s words wash over him.
“Immediate treatment is needle aspiration, performed at the 2nd intercostal space, mid-clavicular line.” Two fingers of John’s right hand slid over the betadine to the landmark between Sherlock’s 2nd and 3rd ribs, his index finger marking the 3rd rib as he reached across Sherlock’s chest with his left hand for the catheter, gripping the top of it as Donovan peeled the rest of the packaging away. “A 14 gauge IV catheter is inserted into the pleural space…..” He pushed the needle straight down into Sherlock’s chest just over the top of the 3rd rib and smiled tightly at the sudden hiss of air coming from the site. “…..To allow the excess air to escape.”
Donovan and Lestrade’s eyes widened at the sound - like air being let out of a tire - as Sherlock’s eyes snapped back open, some of the tension leaving his face; his breathing, while still rough, easing significantly.
“The catheter is advanced and maintained until further treatment,” John continued smoothly in his ‘for Sherlock’ tone, easing the catheter down until the hub was flush with Sherlock’s chest wall, removing the needle, and taking the empty packaging from Donovan to use as a makeshift sharps disposal. He held the catheter in place with the thumb and forefinger of his right hand while reaching back into his coat for some tape. “Better?” he asked Sherlock quietly, clinical eyes noting the decreased dyspnea and other small improvements along with the improved level of consciousness.
“Obviously,” Sherlock croaked.
John rolled his eyes and huffed a small half-chuckle, a smile quirking his lips, easing some of the focused tension around his mouth.
“I’ve never experienced that procedure before,” Sherlock gasped.
“Well, congratulations. Now you have. Let’s try and avoid experiencing it a second time, shall we?” John said mildly. “Sally,” he glanced back to Donovan. Her head snapped up, the switch to more familiar first names a jarring change after everything that had just happened; his next words still steady and confident, but more of a request than an order, the emergency doctor stepping back a bit for the local GP. “Can you hold the catheter while I anchor it?” he asked, nodding toward the tape in his other hand.
Her eyes widened nervously for a moment before settling into the determined readiness that had moved her through the police force. “Of course,” she agreed, moving to mimic John’s grip.
“Just like that, great. Thanks,” John nodded, stripping off his betadine stained right glove and using the ungloved hand to tear strips of tape.
“Blimey, John. How much do you keep in that bloody coat?” Lestrade finally asked, gaping at the deceptively filled pockets.
“Just what I need,” John shrugged dismissively, reaching around Donovan’s grip to tape the catheter in place. “How’s his heart rate?” he asked Lestrade as sirens began echoing off the alley walls.
Donovan tipped her head at the sound and, with John’s nod, jogged off to direct the paramedics.
“Hundred and ten,” Lestrade reported with a frown. “Still a bit high, isn’t it?”
Sherlock opened his mouth to speak, his eyes promising a characteristically acerbic retort, but John shut him up with a solid glare. “Don’t,” he said firmly. “You’re still down a lung and believe it or not, smart-arse remarks are not a priority with compromised oxygenation. Just breathe.”
Sherlock rolled his eyes, but kept quiet, yielding to his body’s needs only with John’s insistence.
“Releasing some of the trapped air doesn’t reinflate the lung. He’ll need a proper chest tube in hospital for that,” John explained to Lestrade. Honestly, the fact that Sherlock hadn’t arrested right off with that blow was damn near miraculous. “110 after massive thoracic trauma and emergency needle aspiration is pretty bloody impressive,” he said, finding himself smiling back as Sherlock’s eyes sparkled with pleasure, taking the statement as praise.
Donovan came hurrying around the corner with the paramedics. John fired off a quick report, assured Sherlock he’d ride with him, then warned him to behave as he got up to give the paramedics more room to work, joining Lestrade a few paces away.
“Remind me never to get between you and a patient,” Lestrade said quietly, glancing over at where Donovan had slipped away to check on a PC’s progress. He was a bloody good DI; good enough to know exactly what had happened in that alley. “Sure glad you’re on our side, mate,” he let out an impressed breath.
John stiffened, swallowing uncomfortably at Lestrade’s insight, even as he wasn’t surprised that the DI had figured it out.
“Ready, Doctor Watson?” one of the paramedics called, standing up as he fastened the last strap around Sherlock.
John tilted his head toward the stretcher, eyebrows raised as he sought Lestrade’s permission to leave the scene; the same silent ‘may I?’ gesture he respectfully used before inspecting corpses.
“Off you go,” Lestrade waved John toward the paramedics with a small smile. “Someone needs to help those poor bastards deal with him,” he cast a pitying look at the ambulance crew.
John blew out a breath that was half-gratitude, half-chuckle. “Yeah,” he sighed. “Thanks.”
Lestrade nodded, both in acknowledgement of the thanks, and confirmation of the layers of meaning John infused into that single syllable.
With a quick dip of his chin, John spun on his heel and jogged off after the departing paramedics.
Donovan stepped up to Lestrade’s side, watching them go. “You know, for someone who probably doesn’t even believe in luck, the freak’s sure got a bloody lot of it,” she mused aloud.
“What?” Lestrade forced his attention back to the present.
“Not many people out there who would do all this,” she waved at the scene, “just for a chance to try and save the bastard’s life.”
Lestrade’s head whipped around to find Donovan giving him a wry smirk; her eyes resigned, yet understanding. I know exactly what happened here. I may not like it, but don’t worry, I’ll keep my mouth shut.
Lestrade smiled tightly. Of course she knew. Donovan was a smart woman; had a good eye, like him. And he realized her response probably would have been different had it been Sherlock doing the shooting rather than John, but he appreciated it all the same.
Donovan nodded once and strode off, back to work.
Lestrade turned around to face the scene and ran a weary hand through his hair, trying to figure out how the bloody hell he was going to report how two criminals were shot dead while being pursued by two supposedly unarmed civilians.
Because the military-trained doctor most certainly did not have a handgun.
Illegal, that was.
***
“I can’t believe you had Donovan cut off my coat,” Sherlock groused the next afternoon, propped up in bed and glaring at the incentive spirometer on his over-bed table as if it had personally offended him.
“Yes, well, I figured dramatic coats are replaceable. Dramatic consulting detectives on the other hand….” John shrugged.
“Hmmm, true,” Sherlock’s lips quirked, acknowledging what was left unsaid. He picked at the chest tube dressing, watching John lean forward to lift the tubing, allowing the accumulated blood to drain down into the collection device on the floor.
“It’s a closed system, Sherlock,” John sighed, recognizing the light of potential experimentation in his flatmate’s eyes. “You can’t just crack it open and help yourself to a sample of thoracic drainage.”
“Surely they have no need for the container once it’s full,” Sherlock pointed out.
John sighed again, digging the heels of his hands into his eyes. “You do realize that hospitals are actually obligated to follow proper biohazard disposal procedures, right?”
Sherlock rolled his eyes and shrugged; a ‘rules are dull and don’t apply to me’ dismissal. He focused back on John’s drawn face. “You still haven’t slept,” he noted.
John shrugged self-consciously and shifted his attention to the window, avoiding eye contact.
Sherlock paused for a moment, studying him. “You can hardly expect to keep saving my life with such efficiency without proper sleep,” he finally stated, smirking as John straightened in his chair, accepting the challenge as intended.
“I haven’t had a proper night’s sleep since we met,” John scoffed.
Sherlock wisely refrained from pointing out that John hadn’t slept well before their meeting either, between Afghanistan and its resulting nightmares. Sherlock may not have had much use for being tactful, nor was he always the most emotionally observant of people outside of what he needed to manipulate others, but he knew John well enough to see the shadow in his eyes; the one that said he was already sharing Sherlock’s thoughts - recalling the memory of the place that had helped shape and train him to kill in order to protect Sherlock Holmes.
“And I wouldn’t have had to save your life if you hadn’t run off after I specifically warned you not to!” John added, exasperation, adrenaline crash, and resignation warring for dominance in his tone.
“Perhaps I should listen next time,” Sherlock said wryly, running a hand over his bandages. No one else would have done what you did for me. More importantly, no one else could have done it the way you did.
“You won’t,” John pointed out wearily. I’d do it again in a heartbeat and you know it. Just please try not to make me have to anytime soon.
“I’ll try?” Sherlock offered. I’m sorry. You were absolutely brilliant.
“All right,” John conceded, releasing a weary chuckle and taking Sherlock’s words for what they were. Thanks. Glad you’re going to be okay.
“Go home and sleep, John,” Sherlock ordered quietly.
“Yeah, all right,” John scrubbed his hands across his face again and dragged himself upright with a groan. “You sure you’re okay?” He’d seen Sherlock’s chart of course, but that’s not what he was asking. He remembered the fear in those eyes.
“Fine,” Sherlock dismissed with a vague wave of his hand.
“I’ll be back in a few hours. Text if you need anything,” John shrugged into his coat.
Sherlock made an acknowledging grunt and picked up the incentive spirometer, turning it over with a scientist’s deconstructive eye.
John rolled his eyes, pitying the nurses who had to encourage him to do his coughing and deep breathing exercises, and went to call a cab.
He was back at Baker Street and settling into bed when his phone chirped.
Thank you, John. SH
A warm smile softened John’s exhausted features at the significance of those three simple words. Saving the text with the same gratitude and reverence with which he saved cards, letters, and dog tags from previous patients, he closed his eyes and fell into a restful, dreamless sleep.
Chapter 6
Summary:
It was only when people actually saw John working as a physician that they began to understand: that it wasn’t just about bullets and IEDs and trauma care under fire. That “doctor” actually covered a pretty wide field. And that John was bloody good at covering ground. 5 times Dr. Watson treated others and 1 time he treated himself.
Notes:
Disclaimer: I do not own Sherlock. Just playing, with love and respect to those who brought these characters to life.
Brit-pick: Many thanks to the wonderful debriswoman, whose help and support were invaluable during the writing of this piece.
Notes: My apologies for the wait – my eye condition was acting up, making the final editing process take longer than intended. Thank you to all who have reviewed, bookmarked, favorited, and put this story on alert – I truly appreciate your support. I will be slowly catching up on proper review replies over the next week or so, and have treasured every response. I truly enjoyed writing this series and I’m honored and humbled to have heard from so many readers who have been touched personally by some of these medical scenarios. As always, I hope I did the characters justice. Thank you for reading.
Chapter Text
6.
Sometimes John wondered if Sherlock wanted to be strangled.
There certainly was no shortage of people ready and willing to oblige him on that point; being the infuriatingly superior and smugly tactless prat he was, Sherlock tended to add to the list of those who’d gladly choke him as consistently and naturally as breathing. Hell, John generally wanted to strangle him at least once a day and he was his friend.
Sherlock was, in most respects, an observant genius. He not only recognized, but also freely verbalized, the fact that he had enemies and pissed people off on a regular basis; knew it and simply didn’t care because all that mattered was The Work. Therefore, either he wanted to encourage potential asphyxiation or he was displaying further support for the ‘spectacularly ignorant’ label that he’d taken such offense to on John’s blog. Another deletion like the heliocentric truth of solar system perhaps. It was the only way John could rationalize why a supposed genius going into a known, violent murderer’s flat would still wear that bloody scarf.
The one that practically screamed, ‘I’ve probably given you seven different reasons to want me dead just by looking at you, so here’s a convenient garrote – come strangle me!’
The one their murderer, Victor Coller, was presently taking full advantage of, twisting the fabric behind Sherlock’s head to compress his trachea.
Because of course the flat hadn’t been empty, despite his accomplice having been arrested the previous day.
And not only was Coller home, but the third accomplice went from theory to fact.
A very solid fact, currently trying to bury a knife into John while Sherlock asphyxiated.
John ducked another swing as the man went for his carotid again, silently cursing Sherlock for showing up at the end of a short surgery shift and dragging him off without either bringing his gun, or allowing John to stop off and get it first. Because John could really use that gun right about now. Sherlock was almost silent, indicating severely restricted, and soon to be completely absent, air flow. This needed to end – now – and his weapon would have certainly helped speed that along.
On to Plan B then.
John planted his weight, jaw set with experienced determination as the man rushed him again. He grabbed the suspect’s wrist and twisted sharply, forcing him to drop the knife with a snarled yelp. Keeping a hold of the wrist, John shifted forward and landed a clinically placed kick to the man’s right knee, dislocating the patella with a sharp pop and dropping him to his good knee with a scream. Taking advantage of the man’s unbalanced position, John got behind him, locked an arm around his throat – a choice that felt quite appropriate considering what his partner-in-crime was doing to Sherlock at the moment – and applied a quick, sure choke hold.
Pushing himself up once the man was unconscious, John rushed at Coller, who was so intent on killing Sherlock that he hadn’t bothered to change position and investigate his accomplice’s howl of pain; his back still to John. The murderer let out an angry, surprised grunt at the sudden restriction of his own oxygen as John grabbed him from behind, not expecting the physician to have been a threat. He dropped the scarf and shoved Sherlock forward, freeing his arms to throw a sharp elbow back into John’s side. John grunted but held on, readjusting his grip. The elbow came back again, catching John’s lower chest, causing him to loosen his grip a fraction as the air rushed from his lungs.
Coller took advantage of the opening and extricated himself from the hold, side stepping John to grab an arm and throw him forward into the kitchen worktop. John’s upper abdomen hit the blunt edge of the worktop hard, fingers scrabbling for a hold as his knees buckled with the violent loss of breath. He tried to twist aside as Coller came up behind him, stalking across the room with feral, predatory intent, but couldn’t get enough air to complete the movement and was pulled back and slammed against the worktop a second time. His legs finally gave out, vision sparking, abused diaphragm desperately trying to pull in oxygen as he crumpled to the ground.
And then Coller was on the ground too, leaving John with the blurred image of Sherlock’s pale form towering over him, swaying slightly, the long, steady fingers of his right hand gripping a heavy statuette from the mantelpiece.
“Are you all right?” Sherlock demanded, tossing aside the statuette and rushing into a crouch in front of John. He rapidly catalogued the immediate data - alarmingly unbalanced sitting position, legs folded under him, back curled away from the cabinets as he hunched protectively around his torso – and ducked his head to seek out his friend’s face. “John?” he pressed, voice tight with worry at the lack of immediate response and continued wide-eyed struggles for air.
“Just…..need…..a….minute,” John choked out, closing his eyes as his vision wavered again, forcing himself to override the panic of air hunger and regulate his breathing.
“Ribs?” Sherlock asked, reaching to push aside John’s coat as if it were impeding his deductive x-ray vision.
John swatted his hands away, annoyance winning out over weakness. “Sod…..off,” he gasped, a little stronger this time. “I’ll check…..in a …….minute.”
Sherlock looked him over, recognizing the ‘back off and let me get myself together’ need in John’s tight features. He nodded once, rising with a grace that shouldn’t have been possible for a man who’d just been choked, and stepped away, busying himself with restraining the unconscious suspects and texting Lestrade, surreptitiously glancing over at John to check on him at regular intervals. When he got back to his flatmate’s side, the doctor was still pale, face tense, but his breathing was largely under control again as he ran a practiced hand under his jumper, palpating his ribs.
John looked up as Sherlock loomed over him, deductive eyes taking him in. “Ribs are fine. Just got the wind knocked out of me,” John responded to Sherlock’s silent demand for a diagnosis. He turned a clinical eye on Sherlock in turn. “You okay?” he asked, focusing on Sherlock’s throat and breathing pattern; that bloody scarf, while loose and open, still in place.
“Fine,” Sherlock dismissed.
The response was hardly unexpected even as John noted the rough undertone to that single syllable; the low voice scraped through a lingering external redness that would likely progress to impressive bruising later. But Sherlock was moving well, color normal for him, no accessory muscle use, airway obviously patent and body oxygenating adequately. He was stable – fine – for now, and so John accepted the response without his usual sarcastic argument; not having the energy for anything more than the immediate present.
“Good,” John said. “Lestrade’s on his way?”
Sherlock nodded.
“Right,” John decided, dragging himself to his feet with a grunt. “Bloody scarf,” he muttered, steadying himself against the worktop as he got his legs under him.
Sherlock rolled his eyes and huffed an ‘oh, not this again’ sigh before resuming careful study of his still unsteady friend, who was showing no signs of stepping away from the worktop’s support anytime soon.
John tried not to bristle at the subsequent return of Sherlock’s intense ‘I’m reading your DNA’ focus. He recognized that Sherlock was staying close for more than deductive clarity or potential physical support and chose to focus on the importance of that - and breathing - instead.
***
An hour later, they were back at Baker Street, Sherlock rambling about the history of the unique rope he’d found at Coller’s flat and how it obviously explained the murderer’s history and methods, when John stumbled, grabbing the banister with a sharp, bitten-back hiss.
Sherlock stopped, whirling around from his place three steps ahead. “You’re still in pain,” he noted, cataloguing John’s vocalization, tight features, and the left arm that had gone to cradle his upper abdomen.
“And you’re still croaky,” John shot back at Sherlock’s rough voice. He clenched his jaw and took a careful breath.
Sherlock tilted his head slightly, eyes raking over John. “You’re sure your ribs aren’t broken?” he asked, equal parts question and statement.
“Yes, I’m sure. Believe it or not, Sherlock, this,” John briefly took his left arm away from his abdomen to wave a hand between his own body and Sherlock’s throat, “is a normal human body’s response to injury. It’s going to bloody well hurt for awhile.”
“My throat doesn’t hurt,” Sherlock half-dismissed, half-argued.
“Of course it doesn’t,” John muttered in his ‘you may not eat or sleep like a normal human being but I don’t believe a word you’re saying right now’ tone, maintaining his right hand on the banister as he resumed climbing the stairs.
Within seconds of entering the flat, John sat Sherlock down, insisting that he apply ice - just fifteen bloody minutes before you bury your head in that damn microscope – and submit to a proper examination of his throat. Once he was satisfied that Sherlock was all right, John swallowed two paracetamol with a full glass of water, grabbed a tea towel and another cold pack from the kitchen first aid kit, and informed Sherlock that he was going to have a lie-down and to let him know immediately if he started to have any trouble breathing. Sherlock acknowledged the statement with a non-committal grunt, immersed in his study.
“Seriously, Sherlock, I mean it. Immediately,” John said firmly, standing stiffly in the kitchen doorway.
“Yes, fine,” Sherlock’s agreement was too quick to be anything other than a dismissive placation; attention still rooted to the microscope.
John turned and walked away, knowing he wasn’t going to get any more than that and too tired to do more than hope it had actually got through that selective skull.
It was only when John’s back was to him that Sherlock briefly looked up, following John’s careful movement toward the stairs with an unwavering focus diverted from his tissue sample, and an uncertain frown.
***
While most people would consider living with Sherlock to be a nightmare of its own, John’s nightmares had decreased significantly since moving in with him. So when he bolted awake a little over an hour after falling into an unplanned sleep, heart pounding and breathing rapid as familiar images exploded him into panicked consciousness, it was a bit of a surprise.
A surprise that may just have saved his life.
Because when John snapped into a sitting position, expecting an unpleasant roll of nausea under burning eyes, what he got was a sharp flash of pain on his right side that threw him back into a supine position and left him gasping even harder. His left arm instinctively moved to guard the painful area, splinting it as he struggled through deep breathing exercises to control the nightmare-induced panic. Shivering, he pulled the duvet up and over his cold left hand, then tucked his right in as well, anxiety clawing at his chest as the images faded under feelings that cruelly persisted. He forced himself to count, measuring the length of each inhalation and exhalation in a now ingrained coping mechanism and treatment plan, but found that the silent numbers, so often a comfort, kept getting away from him.
Time was an odd thing during these episodes: while it always felt like it took hours to regain control, part of John was also hyper-aware of the true passage of time; enough so that he recognized that this particular episode was off. John had a set, proven method of dealing with panic and nightmares; implemented it unconsciously and knew how long he needed to get back under control. He pulled his left arm out from under the duvet to check the time, having already instinctively glanced at it when he first woke up. Fifteen minutes. It never took him more than ten anymore to get his vitals back to normal, to at least look like he wasn’t being crushed by fear and memory. But here he was now, fifteen minutes later, no better than he had been when he’d first launched back into consciousness: heart racing, breathing shallow and rapid, anxiety like an electrified predator, snapping and snarling at the edges of his shaky perimeter, making his skin crawl.
John carefully moved to a sitting position, fingers digging into the sheets with a white-knuckled grip as he swayed under a nearly capsizing wave of weakness. He gave himself a moment, waiting for his vision to clear, then attempted to stand, hoping a few splashes of water on his face would set him right.
No such luck.
His legs immediately buckled, dumping him back onto the bed, upper body twisting with the force of the drop, pain and nausea flaring dangerously. He weakly lowered himself onto his left side for the nausea, before quickly shifting onto his back again as his abdomen violently protested the pressure of lying on any side with a fresh, agonizing wave of pain. His left arm moved back to its protective cradling position, abdominal muscles tightening at the contact, whole body shivering at the chill of his bare forearms through the thin cloth of his vest.
What the bloody hell was going…..
On.
Oh.
And there it was, everything coming together in a nearly Sherlockian-speed, diagnostic rush.
Oh, Christ.
This wasn’t lingering post-nightmare anxiety and pain from deep bruising.
It was so much worse.
Persistent tachycardia and tachypnea. Cold, clammy skin. He lifted his right hand to his face and pressed on one fingernail: delayed capillary refill. Weakness and anxiety.
Shock.
A quick survey of his abdomen immediately gave him the etiology. Pain and tenderness after two blunt force blows into a worktop. Careful palpation around his left arm – guarding behavior – yielded unmistakable rigidity. Right upper quadrant pain diffused throughout the rest of the abdomen.
Internal bleeding, most likely originating from the vascular liver.
Diagnosis: hemorrhagic shock secondary to intraperitoneal bleed. Initial injury over two hours ago.
Christ.
John fumbled for his mobile on the bedside table, shaky fingers dialing 999. He mentally ran through his symptoms, struggling to control his skittering mind. The human body could lose about 15% of its total blood volume without an overt change in status, so he’d lost at least that much so far. Startling at the dispatcher’s voice, he dragged his attention to the phone, relayed his emergency and address and hung up, drifting back to his previous line of thought. Probably between 20-30% loss at this point. More than 30% and he’d get more confused, closer to unconsciousness and full circulatory collapse.
And while John may have been able to diagnose himself and call his own ambulance, he couldn’t perform CPR on himself when it, inevitably, came down to it.
It took him several tries, struggling with blurry buttons and uncoordinated fingers, but he finally got a text off to Sherlock: open doors for amblnce come upstaisr
Sherlock had barely received the text before he was pelting up the stairs, the order to open the doors ignored. But in a typically Sherlockian defiance of convention, he wasn’t alarmed at the mention of an ambulance, like most people would have been; he was reacting to the spelling errors.
John still displayed an undeniable military precision in everything from the organization of his room to the buttoning of his shirts; a meticulousness that transferred to his texting as well. He always used proper spelling and punctuation. So two dropped letters in ‘ambulance’, a lack of punctuation separating that word from ‘come’ in the absence of a connector like ‘then’ , and an inversion of the last two letters of ‘upstairs?’
That was all the data Sherlock needed to know that John was seriously compromised.
He burst into the room to find John lying on his back, skin frighteningly pale, chest heaving with rapid, shallow breaths, left arm curled protectively against his upper abdomen, still clothed but for his jumper and button-down which he had removed before lying down to ice his injury.
“Doors, Sherlock?” John asked immediately, voice weak through the knowledge that Sherlock couldn’t possibly have done it with how fast he got upstairs.
Sherlock pulled his mobile from his pocket and stabbed at one of the speed dials. “The doors need to be opened for the ambulance. Send them to John’s room when they arrive.”
“Ambulance?!” Mrs. Hudson gasped on the other end of the line. “Sherlock, what’s happened?”
“The doors, please, Mrs. Hudson,” Sherlock was striding across the room to John’s side, eyes narrowing as the picture worsened.
It was a testament to Sherlock’s regard for Mrs. Hudson that he hadn’t immediately hung up after telling her to send the ambulance crew upstairs. His voice was cold and low, but the reply itself, especially with the significant addition of the ‘please’, said it all.
And Mrs. Hudson knew him well enough to take that regard for what it was. “Of course, dear,” she replied hurriedly, worried and gentle all at once before hanging up.
“Diagnosis?” Sherlock demanded, stuffing the phone into his pocket as he came to a stop next to the bed, shifting his looming position in order to maximize the late afternoon sunlight for better analysis.
“Shock. Intraperitoneal bleed. Probably hepatic,” John closed his eyes, voice trailing to a whisper as if that had taken all his energy.
Sherlock’s eyes flickered as he recalled John’s pain and stumble on the stairs earlier. “You’ve been bleeding since Coller’s flat,” he realized. “Why didn’t you call an ambulance then?” It was equal parts demand, frustrated incomprehension, and desperate searching for what he had missed.
“Didn’t know it then,” John nearly whispered, squinting up at Sherlock, trying to bring him back into focus. “Peritoneal cavity can hold a lot of blood before any symptoms start.”
“How much have you lost?” Sherlock asked; a seemingly ridiculous question in the absence of a direct measuring apparatus, yet one he was somehow confident that John could answer.
“Probably about 30%,” John’s eyes were closed again.
“What do you need me to do?” Sherlock asked urgently.
John was silent.
“John!” Sherlock barked.
“Hmmm?” John moved his head weakly on the pillow.
“John, open your eyes,” Sherlock demanded, grabbing John’s face to force his focus, alarmed at the coldness of his skin.
John’s eyes slowly made it half-open. “Sherlock?” he murmured. “What….” He looked around, confused, eyes tracking sluggishly.
“Intraperitoneal bleed and shock,” Sherlock reinforced. “What do you need me to do?” he repeated forcefully.
“I….” John swallowed thickly, a flash of panic surging through confused eyes as he realized that he was confused. He visibly struggled to focus, clearing his throat weakly. “Help me to the floor.”
“The floor?” Sherlock echoed, trying to figure out if John meant it or had progressed to delirium. “John….”
“Now, Sherlock,” John insisted, meeting Sherlock’s deliberation with a frighteningly clear, serious gaze. “CPR on a bed is bloody useless.”
Sherlock’s eyes widened as he got John to his feet, moved him a few steps from the bed, and eased him onto his back on the floor. He had just finished elevating John’s legs and covering him with the duvet per the physician’s fading instructions, and was standing to get a pillow for his head, when John clumsily grabbed at his wrist.
Sherlock stilled. “John….”
John’s fingers slackened, losing the energy to maintain his grip. He dragged his left hand up to his chest, holding two fingers at the lower margin of his sternum. “Xiphoid process,” he identified the landmark. “Hand’s length above that. Midline. Lock your elbows. Hundred a minute. Just compressions,” he gasped, slurred and weak around shallow, panting breaths.
“I do know CPR, John,” Sherlock’s characteristically offended, smug tone was buried under raw concern, even as the words unconsciously left his mouth with the inherent, driving need to make the correction.
“Just a reminder, then,” John offered with a weak tug of the lips that, on some other day, could have been a weary, indulgent smile.
“I won’t need it,” Sherlock dismissed. “The ambulance is almost here,” he cocked his head toward the sound of approaching sirens.
The rapidly declining clinical part of John’s brain wanted to tell Sherlock that over 40% blood loss, which he was surely approaching, would bring him to complete circulatory collapse, where CPR would give him just the barest chance of surviving the trip to hospital. The gallows humor that defined him as a physician-soldier wanted to sarcastically point out that his body wasn’t likely to wait for emergency services before giving out; that internal bleeding tended to be beyond even Sherlockian-level powers of conscious control. And John, Sherlock’s friend, wanted to offer some humor and comfort, to comment on feeling honored by Sherlock’s faith in John’s perceived ability to bleed slower; to see some of that rare, raw worry ease back behind a flash of amusement, a half-huffed laugh, or a low chuckle.
But John never got a chance to choose. The world faded out, achingly slow and terrifyingly fast all at once, leaving him with only the distant echo of Sherlock’s sharp shout.
Amazing what emotion a self-professed sociopath could infuse into his name.
***
The first time John woke up, he wasn’t quite sure that he was awake. He had a vague memory of the feel of an endotracheal tube, the mechanical push of a ventilator, a glimpse of red directed toward his subclavian – blood transfusion and central line? There might have been a voice, a presence greater than the all-consuming environment of intensive care, but sedation and exhaustion pulled him back down before he could be sure of anything.
The second time he woke up, the endotracheal tube was gone, and the logical, clinical part of his mind figured that he must have been awake at some point earlier for the extubation to happen. But he couldn’t hold onto that thought, or any thought really; each one jarred loose and skittering away as his body shook, burning and freezing at the same time. He felt the icy, full body bite of a cooling blanket, swallowed against a nasogastric tube he didn’t recall feeling before, and knew this feeling: infection. He instinctively reached for his shoulder, memory taking over, but his hand was caught and laid back at his side, fingers lingering at his radial pulse in a manner that was less clinically diagnostic and more grounding need disguised as scientific curiosity. He opened his mouth to give that presence a name, but all that he heard was his own spoken in a low, familiar voice. Quickly determining that listening took much less of his nonexistent energy than speaking, John gave up on attempting to speak, letting that familiar voice drown out the equally familiar calls for antipyretics and antibiotics as the darkness took hold again.
The third time that John was aware enough to recall, he woke up on the general ward, looking into the calculating intensity of Sherlock’s full attention. He blinked sluggishly, slowly taking stock of himself and the room.
“John?” Sherlock asked as the silence stretched.
John recognized that tone from standing with patients’ families on the other side of the bed. It was the weary, hopeful pitch of someone wondering if their loved one was really awake this time; the trepidation of having asked the same question numerous times before. All in Sherlock’s deceptively even tone.
“Sherlock?” John had to clear his throat halfway through, but he got it out.
Sherlock unfolded from the bedside chair, some of the tension hidden in that seemingly haphazard tangle of limbs disappearing with the movement. He leaned forward. “Do you know where you are?” he asked carefully. There was an overtone of disgusted guilt, as if he hated having to ask such an obvious, insulting question, but underneath was the pause of a man who had seen multiple justifications of its necessity.
“John Watson. Hospital. No bloody idea what the date is. Hopefully it’s still 2012?” John grinned lightly at that last bit as he ran through the orientation responses before Sherlock had a chance to ask the rest of the questions.
Sherlock let out a breath and smiled – one of those joyfully honest, full smiles that not only reached his eyes, but shone in them. The relieved smile of a man who had long been waiting for good news.
“Finally,” he huffed; an illusion of long-suffering, expected impatience. “Honestly, John. Three more weeks in this section of hospital and I’d have gone absolutely mad. At least the morgue occasionally has something to keep my brain from rotting.”
John pushed back the half-curious, half-panicked part of his mind that started shouting a surprised, ‘3 weeks?! Bloody hell!’ and snorted back a laugh instead; one that quickly devolved into a groan as he reached for his abdomen.
Sherlock thrust a pillow between John’s arm and abdomen so that he could splint the incision; an action that made John realize some poor nursing staff had actually been giving Sherlock pre-discharge teaching. Poor sods.
“Thanks,” John ground out, splinting his abdomen through the resulting pain and coughing.
“Are you all right?”
John immediately recognized the concern of someone who had seen too many things go wrong recently. Sherlock’s eyes moved through a quick personal scan before meeting John’s, waiting expectantly for the physician’s personal assessment.
“Right now? Yeah,” John assured him, easing the pillow to his side for later use. “You want to take me through it?”
Sherlock steepled his fingers, leaned his elbows on his knees, and began to talk. John let the words wash over him, painting a picture of classic decompensation: hepatic hemorrhage, multiple transfusions, full respiratory and hemodynamic support, central line infection and sepsis, re-intubation and full support for a second time, a running tally of vital signs. When Sherlock finally finished the detailed litany, it was with a minute jut of his chin and three confident words completely unrelated to what came before them: “I was right.”
John was generally accustomed to sudden, non sequitur statements from Sherlock, whether out of the blue or in the midst of one of his deductive rushes. But he was already fighting a heavy resurgence of exhaustion while simultaneously coming to terms with just how bloody surprising it was that he had - for the third time in his life – actually survived, so he just didn’t see the connection as he otherwise might have. “Right about what?” he asked, confused.
“I didn’t need to perform CPR,” Sherlock said, the smugness of being right weighted with something much deeper. “You didn’t go into cardiac arrest until the paramedics arrived.”
John swallowed at the raw truth in Sherlock’s eyes: an open glimpse of the man who had been desperately afraid for his best friend’s life and embarrassingly relieved that he hadn’t had to manually act as his heart. A quick, honest drop of that all-consuming mask; an action that Sherlock rarely permitted others to see.
“Well,” John cleared his throat roughly. “I’m chuffed that my timing managed to support your bloody ego.”
Sherlock let out a burst of a chuckle, quickly suppressing the laughter, but leaving the smile. “Nice work,” he said softly.
The hospital room faded away to the memory of a night sky, an orange shock blanket stark against flashing emergency lights, a dead cabbie, and the start of a friendship that defied definition. It was “good shot” all over again, in tone, eye contact, and significance. Layered and honest, with excited intrigue, surprised pleasure, and earned respect.
‘Nice work holding back cardiac arrest.’
‘Nice work treating your own medical emergency.’
‘Nice diagnosis, Doctor.’
‘Thank you for surviving, John.’
John smiled warmly, acknowledging all that was said and unsaid with a single look.
Sherlock nodded fractionally – message received and appreciated – and settled back in his chair, reaching for his mobile.
And so John finally allowed the exhaustion to take him, closing his eyes to the equally comforting sounds of a stable patient’s medical equipment and Sherlock texting.
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