Breathing is Not Boring
Someone was shaking me, but I was so comfortable, so beautifully asleep, that I burrowed deeper into the duvet and tried to ignore it.
Heigh-ho. They weren't giving up, whoever they were. Instincts from years of being on call, the Army, and Sherlock started to kick in, and I snapped myself out of sleep sharpish.
There was only the faint orange glow from the streets lights outside, but my flatmate's distinctive silhouette was unmistakable. I groaned.
"Whaddya want? This'd better be good."
"I don't think…. I'm very well."
Instantly fully alert, I clicked on my bedside lamp, sitting up and squinting against the light to take a good look at my patient. What I saw had me immediately swinging my legs out of bed, and pushing him down onto it.
He was grey and clammy, and panting with exertion. As he sat down, he braced his arms against the bed, and his sternocleidomastoid tendons stuck out in sharp relief from his neck – he was straining every accessory muscle to breathe. Most worrying of all, he looked frightened for a moment before he smoothed the expression off his face.
"Sherlock, you look terrible! What's wrong?"
"Cough… short of… breath…. chest hurts…. a lot… when I breathe in. Cold… but febrile…"
Inability to speak in full sentences, the automatic diagnostic response in my brain added to my initial observations.
"You idiot! Why didn't you say something before? Why let yourself get into this state?"
I immediately regretted my words, as my friend looked genuinely upset, whereas usually he'd shake off my fussing. I hadn't spoken harshly, and was already rummaging in my bag for my stethoscope, manometer and thermometer – he was being uncharacteristically sensitive. Another cause for concern.
"It… came on so… quickly", he gasped. "Sorry. Not ill very… often, just a bad cough…. bit unwell…. thought I was… making a fuss…just had… man flu,… earlier… in the day…"
"OK, I'm sorry. Stop speaking for now, it's obviously hard work." I put a hand on his shoulder. The back of his T-shirt was stuck to him with sweat. I was trying to speak calmly, but my nerves were all clanging with alarm as each new fact slotted into place. Respiratory rate significantly elevated at almost forty. Tachycardic; heart rate of one-thirty, pulse thready. Sentence construction possibly indicating mild confusion. Unequal chest movement, right more than left. Dullness to percussion both lung bases and entire right lung field. Lungs sound awful; crackling right base, but far more ominous with a near-silence on left. Blood pressure low at 90/55, temperature 40.3oC. Impression: life threatening pneumonia or adult respiratory distress syndrome.
"We're going to need to get you to hospital, Sherlock. I can't manage this here."
I spoke quietly and firmly, expecting angry resistance. Instead, he just nodded, then looked up, his face suddenly anguished.
"Took me… half an hour… to get to your… room. Don't think… can manage stairs."
I sat down next to him, hand again on his shoulder, careful to avoid restricting the desperately laboured breaths.
"Right, mate. I'm calling an ambulance. Just remember, you need to know the right buzz-words to get priority with their protocols. A little exaggeration is can be useful." I wasn't about to exaggerate as I dialled 999 on my mobile, but Sherlock didn't need to know that.
"Hello. Ambulance please. My flatmate has severe chest pain and life threatening breathing difficulties. I'm a doctor, and I believe him to be in a peri-arrest situation… Yes, that's right… Yes, he is breathing, but only just… Yes, fast and thready… Yes, 221B Baker Street… Sherlock Holmes… Yes, that's right… Good, thank you…. Yes, I have… Yes… Yes, I do know… I'm going to need to get off the phone now… thank you."
Sherlock appeared to be centring all his usually powerful concentration on breathing, a focussed frown on his face, but he looked up at me as I hung up.
"You weren't… exaggerating." I suppose it was ridiculous of me to expect to get even a half-suffocating Sherlock Holmes to swallow the smallest of deceptions. Poor sod; sometimes I'd hate to have his brain. Not often, but sometimes. I rubbed my hand gently over his shoulder blade.
"You'll be alright. The ambulance won't be long, we'll get you to hospital, and get you fixed up with some oxygen, fluids and antibiotics."
He nodded, then went back to fixing on his breathing.
He seemed a little easier when the paramedics strapped an oxygen mask to his face, but they still had to carry him down the stairs. He was trying to appear unconcerned, but his knuckles were white as he clutched the mask to his face.
He started muttering to me in the ambulance, but his words were muffled beneath the oxygen mask. I leaned closer.
"Lestrade… tell him… was Lewis… killed Trafford… animal smuggling…"
I winced inwardly. "Sherlock", I said, gently, "It's OK. He already knows. The pneumonia's making you a bit forgetful."
There was a pause as he absorbed these words, then his eyes widened, the whites a thin rim around his irises, tears springing to the corners. He was petrified.
"It's temporary, Sherlock, it's OK. Your brain's fine, it's just your bloody transport jamming its signals." I grabbed his hand, and he squeezed hard.
We pulled in at A&E, and we were immediately wheeled round to Majors. It was surreal, suddenly being on the other side of the bed, so to speak. I found myself appraising their response; severe chest pain and respiratory distress, triage code red, to see a doctor within ten minutes.
They were there within the first minute; thankfully there weren't too many punters at 4am. One of the few times I've been thankful for Sherlock's semi-nocturnal habits. They were cannulating him within another two minutes, and the mobile Xray was being swung around as they were finishing. I watched approvingly as the IV bag was set up, as the antibiotics were prescribed, drawn up and given. Very slick. Couldn't have done better myself.
An absurdly youthful and rather posh SHO named Josh took the history, mostly from me. I answered concisely, mechanically, in our own language. Sherlock understood most medical jargon. He wouldn't want to be patronised.
It was as I was explaining that no, Sherlock had no immune deficiencies that I was aware of, and I simultaneously noticed them pulling up his Xray on the computer and saw the white-out of his left lung, the patchy shadows across the right, that it clicked.
"Oh, Jesus. Legionnaire's. I bet it's Legionnaire's. You smart-arse, you couldn't get something so mundane as a normal pneumonia, could you?" Sherlock actually seemed to perk up in interest, then give a huff of amusement. "He spent most of Tuesday hiding in an air conditioning shaft." I looked back at Josh. He was regarding me as if I was slightly mad. I compounded it by giving a nervous giggle, then felt I really ought to explain myself. "He's a detective. He was on a case."
The young doctor's face suddenly lit up, and he clicked his fingers in excitement. "Oh, wow! I knew I'd heard the name! You're the one with the hat, who came back from the dead!" There was an awkward silence.
"Pleased… to meet you", muttered Sherlock from behind his mask, and even in his current state, the irony was plain. Abashed, Josh finished his history with punctilious professionalism, then left.
Sherlock was talking again. "Severe… pneumonia…Legionella Pneum…ophila… outbreak in Barrow… In-Furness… in 2002... criminal case… dull, though… gave Streisand idea… often acquired… from dirty water… or air conditioning…"
"No, not often, Sherlock. It's very rare. That's why it'll be so typical of you if that's what it turns out to be." I wasn't sure how my friend contrived to look smug with an oxygen mask obscuring much of his face. I rolled my eyes out of habit, then glanced at the small crowd of doctors and nurses conferring around the computer, plainly trying not to glance over at us.
"Look at them, Sherlock. They're in a flap, 'cause I mentioned Legionnaire's. What did I tell you about buzz words? They'll be getting all worked up, calling Public Health, Infection Control, the Night Nurse Practitioner, the Bed Manager, all before they've determined that you haven't just got a common Strep. Hospitals, huh? Mind you, it'll probably guarantee you a private cubical. Good job too, I wouldn't inflict you on the rest of the ward, exotic bacteria or not."
Scornful. He was projecting scornful from behind the mask now. How did he do it?
"They've already… decided… I need… a private room… Now they're… worked up… about my being… a celebrity… The fat one's… wondering… whether it's… appropriate… to ask for an… autograph." They caught us looking, and two of the nurses blushed.
It wasn't long before the medical registrar arrived, and much to my relief, he was one of my old house officers. Sherlock was on his way to the respiratory ward and Simon was quite happy to convince the nurses (his offensively good looks no doubt playing a part) to turn a blind eye to my staying a while despite it not being visiting hours.
I stayed whilst Sherlock was connected to a heart and oxygen monitor. He looked better. I was relieved to see his heart rate had come down after the fluids, and his sats were holding. When he fell asleep, I left to get some things from home, and grab forty winks myself.
I was woken by my mobile. It was still dark as I fumbled for it; quarter past seven. A serious voice greeted me as I answered it.
"Dr Watson? This is Beth, the sister on Ward 6B. I'm calling about Sherlock – I think you need to come in."
"Wha-what is it? What's wrong?" I mumbled, trying to blink the cloying remnants of sleep away, my stomach clenching with unease.
"He's suddenly become more short of breath. We're going to trial him on BiPAP – that's a machine with a tight mask that blows air into his lungs and makes breathing easier..."
I was already hopping around the room getting dressed with my phone clamped to my ear. I got both feet into one leg of my jeans, and fell over onto the bed. "I'm a doctor, I know about BiPAP – how bad is he? You said trialling." The slight silence down the line was telling. I'd spent too long around Sherlock.
"The ITU outreach team are coming to see him. He may well need ventilating."
"I'm on my way. Thank you."
It probably took me longer to leave the house than it should have done, because my sleep deprived panicking left me forgetting things and flapping backwards and forwards in indecision as I tried to get ready, but I was legging it down the stairs and banging on Mrs Hudson's door within five minutes. She emerged in her nightie, and I gave her a garbled explanation, before rushing out of the door to get my minicab. Then running back in to get my wallet.
I was panting almost as badly as Sherlock had been by the time I got to the ward. This is ridiculous, I chastised myself. You've seen sick people before, and you don't usually flap around the place like a headless chicken.
A nurse lead me to a different cubical; this one a respiratory high dependency space, then left me at the door, saying she was going to ring the doctor. I opened the door, then almost reeled back out again.
Sherlock was sitting propped up on his pillows, his bare chest heaving. His posture was stiff and unnatural; he looked as if every fibre of his being was being pushed into breathing for him.
He looked up as I came into the room, and his eyes were terrified.
"Oh, Sherlock. You'll be OK."
He gave a little shake of his head, and groped for my hand.
"You will be. If need be, if the worst comes to the worst, they can breathe for you." He still looked wild. I took his hand in mine, and he tightened his grip.
I sat, my own blood pressure rising, as I watched his struggles becoming worse. It was probably only fifteen minutes or so, but it felt ages.
Sherlock was deteriorating really rapidly. His chest fluttered like a trapped bird's - there was a desperate, jerky quality to it. His head lolled sideways, the inflatable BiPAP mask strapped tightly to his face with uncompromising black Velcro. His eyes were closed. He was dead white, and he shone with sweat, his black hair hanging limply soaked over his forehead.
A strange ringing filled my ears as I squeezed his hand again. He opened his eyes at the pressure, and tried to roll them at me; their edges crinkled at my shaky laugh. He intertwined his fingers with mine, then his eyes drifted shut once more. He was the picture of abject exhaustion. Even the fear seemed to be leaving him.
I looked around frantically for the return of the nurse. There was no way Sherlock was going to cope much longer; the hospital cleaner could have told that. I was about to ring the emergency bell when I saw their shadows through the door and a doctor in scrubs and the nurse entered the room.
I knew that he took one look at Sherlock and his decision was made.
"Hello, Mr Holmes." Sherlock's eyes half drifted open, then closed again. The doctor nodded at me too. "Are you a relative?"
"His partner", I answered immediately, prioritising ensuring I was kept informed over ruining my future heterosexual sex life. "John Watson".
"I'm Raj Pierson; I'm the ITU registrar. I understand you're a medic too, Dr Watson?"
"Yes. And it's John, please", I replied tightly, feeling too wound up to offer much else.
"Raj. Then I assume you can see Mr Holmes is becoming exhausted?" I nodded, and he nodded back, then gently shook Sherlock by the shoulder.
"He prefers Sherlock", I croaked.
The tired grey eyes opened again. It took them a moment to focus on the doctor in front of him, the most certain sign he was failing yet.
"Sherlock, can you give me a nod if you can understand me?"
The smallest incline of the head. The eyes were closing again.
"Sherlock." Another little shake, and they reopened. "Sherlock, my name's Raj, Dr Pierson. You're pretty unwell at the moment. You need some help with your breathing. We need to take you to intensive care, and look after that for you. We'll need to give you a gentle anaesthetic, then we can take over your breathing for you. When you wake up, you'll be on the way to recovery."
Sherlock turned to me, frantic again.
"It's alright", I said gently, my thumb rubbing over his hand. "It's the right thing to do, it won't hurt." A small nod, then the eyes closed, and stayed shut.
A porter materialised, and we wheeled down the corridor together to ITU. I hung back when we arrived. I found myself standing like a spare part. I heard Raj telling the team on ITU that I was a doctor. I wished he hadn't, as they all seemed to assume that, as one of the initiated, I was happy to glean what was going on myself, and my brain just seemed to be buzzing with white noise. They didn't even ask me to leave the room as they gave him the sedating and paralysing drugs, then tipped his head back and cranked back his jaw with the laryngoscope before poking the tube down into his airway. I'd seen it done a thousand times, I'd even done it myself more than a few times out of necessity, but that didn't mean I wanted to see it now. I found myself fighting back tears as they taped the tube to his face.
They really had forgotten I was there. The ITU consultant who was inflating his chest with a hand held bag was commenting on their stiffness.
"Almost a two-handed job here. Lungs are awful."
I focussed on a loose ceiling tile, and breathed in through my nose, out through my mouth, in through nose, out through mouth again.
"We'll need to get physio in, see if we can't get some of this crap off his chest. Needs a good pummelling."
I could see pipes behind where the ceiling tile was hanging down. It was becoming blurry.
Then, one of the junior doctors was asking me if I was alright, and I was shaking my head, unable to find the words.
"This is Sherlock's partner", she explained, pointedly.
The outspoken consultant turned around, looking a bit apologetic.
"Very sorry, sir. John, is it? Why don't you grab a cuppa, John, and we'll be through to talk when he's a bit more ship-shape?"
A middle aged nurse was leading me off. I couldn't deduce anything about her, except that she was kind, and treating me like a normal relative, thank God, bustling me off and sitting me on the sofa in the relative's room and promising to get me a drink. I wasn't even aware she'd gone before she reappeared with a cup of tea. It wasn't bad either. I think she was apologising for letting me see my "partner" being mauled about, medically speaking, but I couldn't really take it in. I just smiled weakly, and made polite neutral noises.
I was left alone again, and I drank my tea, then dozed off. When I came to, it was with a jolt. I'd been dreaming I was falling from the roof of the hospital.
Not long afterwards, the consultant came back, with the nurse who'd be looking after Sherlock. He explained that he was very ill, that he had adult respiratory distress syndrome, that he was now connected to the ventilator, and that they'd need to monitor his response. Too early to say about prognosis, etc etc, heard it all before, said it a thousand times myself.
I followed them back into ITU. My friend was now propped half upright. His chest was rising and falling with the steady rhythmic hiss of the ventilator. Otherwise, he was still. I had to remind myself that this time, he wasn't dead – he'd been given paralysing drugs. Of course, that was the same as the last time... but this time, it wasn't all an act.
His eyes were held shut with little squares of gel. Someone has coated his lips with Vaseline, and moved his hair off his forehead. I noticed these details slightly before the medical ones.
I looked at the monitors. Oxygen saturations in the high 80's/low 90's – acceptable, but not normal. Arterial blood pressure trace – blood pressure still on the low side. Heart rate elevated – only to be expected. End expiratory carbon dioxide a little high – less good. Saturations drifting down a bit – starting to alarm, in fact. Drifting back up again.
I turned to the ventilator. My eyebrows raised at the pressure settings. High. Chest not moving enough for those sorts of pressures. Needing high pressures to push against his poor stiff lungs. I wished I didn't know that.
I took Sherlock's hand, feeling a little silly, but defiant. I moved his ID bracelet back; it was digging into the base of his hand, and had left a red mark. I rubbed the red mark until it faded.
The nurse came over to take a blood sample from Sherlock's line. She crossed the room to run it through the blood gas analyser. I watched her face carefully. She frowned at the print-out. Definitely not good. I tried to make myself not ask, told myself that I couldn't have it both ways; wanting to be the sheltered relative on the one hand and an involved medical professional on the other. But it was like an itch, nagging at me, and I found myself inching around trying to read the chart on the end of his bed. In the end, I gave up, stood up, and looked. Then I sat down again and ran my hand over my face, feeling a chill crawling up my spine. His blood gases were awful.
The nurse returned with the SHO, who turned up the settings on his ventilator, and I sat there and worried about the long term damage such high pressures must be doing to his lungs. When I bit my nails enough that I realised I was bleeding, I thought I'd really have to get out for a moment. It was then I realised something peculiar; I felt suddenly conscious that I hadn't called Mycroft, and then wondered why on earth he wasn't already here, getting underfoot and trying to issue instructions. I then remembered the last time Sherlock had been seriously unwell and in hospital - his usually urbane brother had been strangely intimidated. I therefore wasn't surprised to hear my name called as I walked past the waiting room.
Mycroft was rising to his feet, a small frown of worry creasing his forehead.
"Mycroft, sorry. I was going to ring you. What are you doing out here?"
He studied his well-polished brogues, and muttered something about "didn't want to get in the way".
I suppose it must be a reaction to being accustomed to controlling everything; as soon as something is out of control it becomes frightening. He wasn't even assertive enough to go into ITU on his own, and I suddenly had the oddest feeling that he was waiting for instruction from me.
"Come on," I said. "I need a coffee; there's a decent machine in the ground floor canteen; let's go and get something, and I'll update you. We can go and see him afterwards."
"Allright, John", he replied meekly.
As we sat at the formica tables on our plastic chairs, Mycroft stirring three sugars into his coffee and absently crumbling a blueberry muffin, I told him what was going on. He was watching me as I talked, not the way an ordinary person would, but the way only a Holmes could.
"You're worried." He said, as I finished. "You don't think it's just a pneumonia."
I sighed. It was pointless even trying to hide anything. Apparently my face just wouldn't allow it – it was why I'd had to witness Sherlock's "death", and now why I had to voice my inner concerns.
"I think it's serious, Mycroft. The ventilator works by delivering a positive pressure to inflate his lungs. It's on really high settings, meaning that it's difficult to do, and it can cause pressure trauma – barotrauma – to his lungs – they're usually a low pressure system, and they shift air in and out by negative pressure. There're giving him loads of supplementary oxygen too, and yet it's still not getting into his blood properly."
Mycroft nodded, the crease on his brow unchanged. "Is there anything else they can do?"
I sighed again. "I'm not sure. I know some places use a different ventilation technique, but I'm not sure if they do it here…" Mycroft seemed to straighten up, a martial light in his eyes at the thought of doing something, "…and if they're not used to using it, it wouldn't be safe, and he's not well enough to move." Mycroft sagged again.
"Why do you think he's so ill?"
"It could just be bad luck. I wondered if he's got Legionairre's, though – he was hiding in an air conditioning…" I stopped. My companion had turned very pale.
"I've had to deal with aspects of the outbreaks. It's very nasty, isn't it?"
"All pneumonia as bad as this is nasty, Mycroft", I said, gently. "It isn't special. He's young and fit though. The odds are well in his favour."
We sat in uncomfortable silence for a while, then I suggested we return to the ITU. I felt instantly nervous when I saw three doctors and two nurses standing around his bed, and another nurse bringing over a machine that I vaguely recognised as an oscillation ventilator, that I was only really used to seeing used as last ditch rescue therapy in burn victims. I heard an intake of breath from Mycroft, who must have recognised my change in posture.
One of the doctors was the consultant I had already met. He looked up at our entrance.
"John", he greeted. His face was serious. He looked questioningly at Mycroft.
"Um, this is Mycroft. Sherlock's brother." The consultant's hairy eyebrow twitched at the name (he wasn't good at dissembling either). He recollected himself, and held out a hand.
"I'm afraid Sherlock is deteriorating, and not coping with the ventilator. We need to try a different strategy – this machine inflates his lungs more fully and wobbles them, like a panting dog, to allow a better surface area for oxygen exchange. It's gentler than the old-fashioned type, but it doesn't allow him to do anything for himself…."
The explanation wore on, but I found my attention wandering. Tendrils of fear were starting to poke their way in everywhere, and I was suddenly very conscious of my bladder. I excused myself, and went out to use the gents.
It was a bit of a long walk, and when I returned, I felt my legs turning to water. A sheet-white Mycroft was shaking in the corner, a motherly nurse virtually holding him up and talking earnestly to him. Sherlock's bed was alive with activity – all the monitors were alarming, and the young SHO was holding up a bag of fluid, squeezing it in. Nurses were hurridly drawing up drugs and readying infusion pumps. I heard random words; "hypotensive", "Dopamine", "adrenaline" and "noradrenaline" – enough to realise my friend was in severe shock. This was the point at which, if I was helping with the resuscitation myself, I'd be meeting my colleagues' eyes and sadly shaking my head.
Feeling sick with dread, I went to stand by Mycroft. We didn't speak, just stood and suffered together.
After a while, the monitors calmed down. I watched the blood pressure start to rise on the machines, and breathed a silent thanks that he was responding. At least for now.
They came and explained. I was a little relieved when they reminded me that inflating the lungs with the new ventilator could compress the veins returning to the heart, and cause the blood pressure to crash. At least there was an obvious cause.
Mycroft and I stood by the form in the bed, still except for where his chest jerked with the ventilator, going at a rate of six cycles per second. I half-hysterically wondered if he'd start wobbling towards the edge of the bed, like a mobile phone on the vibrate setting. It didn't look comfortable – I was glad he was unconscious. His eyelashes looked very black beneath the gel.
I don't think Mycroft could stand it for long – watching, without having the option of controlling or manipulating. He reached out and touched his brother's shoulder briefly. He then set his jaw, said "Please do keep me informed, John", in an approximation of his normal voice, and left the unit without looking back.
I settled in for a long wait.
The next few days were some of the most hellish I can remember, except for the obvious. Sherlock seemed to get worse by degrees. He was in septic shock. He required enormous amounts of fluid. His kidneys started to fail. I stayed by his bed for several hours each day, but came home during the nights - I remembered how exasperating and oppressive "bedside vigil" relatives could be to the staff, and I didn't want to distract them, although I hated leaving Sherlock and coming back to the echoingly empty flat. It felt empty even with the steady procession of well meaning visitors – Lestrade, Molly, Stan, Sally, Sarah. I could cope with Mrs Hudson, because she was as worried as I was. She had come to see Sherlock with me, and she'd fussed around him, talking the way she would if he had a bad cold. It was sort of reassuring.
On the third day, it was confirmed that Legionella Pneumophila was growing in his sputum. I had to laugh, bitterly. Of course. He'd be pleased that it was the outlandish bug after all. If he woke up.
By the fifth day of his illness, I was starting to feel numb. Sherlock wasn't recognisable. Lestrade had come in to visit him, and had seemed unable to speak at the sight. He was incredibly puffy, litres and litres of fluid just sitting where they had leaked into his soft tissues. His skin stretched tight and was oozing, and they'd coated him with soft paraffin to prevent him loosing too much fluid. A slimy crust caked his mouth, from where the mucus reaccumulated every time they suctioned it. He was covered in bruises from old cannulae and failed attempts (on one occasion, I had watched the poor SHO try seven times to site a line, and had eventually asked if I could try myself. I'd succeeded on the fourth attempt). There were tubes and wires everywhere – a chest drain, an abdominal drain, electrodes, a catheter, the breathing tube, a feeding tube, his central line, his arterial line. And he remained so still, apart from the disturbing oscillation of his chest. It just wasn't Sherlock.
Then things started to stabilise. I tried to refuse to hope. There was no improvement yet, but at least things were static.
Slowly, slowly, he began to improve. He was peeing properly, at least, sign that his kidneys were improving, and that he could start to get rid of some of the fluid that was trying to drown him from within. I took some photos with my phone, as I'm sure he'd want to see, and I'd want to tease him. Michelin Man. Mr Stay Puffed – God, how I ached for things to be normal again.
Off the blood pressure maintaining medication. Off the oscillator and back on to the normal ventilator. Off the paralysis; just on sedation now. Off the diuretics, as he was peeing well enough on his own. Off the antibiotics, as he was just having to mop up the damage his own immune system had caused now.
"I can see your cheekbones again", I told him, on day ten. His eyes opened just a crack at the sound of my voice, and I smiled at him.
By day twelve, I was no longer worried. The ventilator was back on minimal settings, and his sedation was very light. He was responding slightly to his surroundings. I stayed for his tube being taken out. I'd seen him have one removed before, and remembered the look of panic. This time, it was less dramatic, and suddenly he was coughing fitfully, then looking over to me. He was nervous – took a few breaths on his own, then smiled.
"Breathing… no longer boring", he croaked, barely audible. He then immediately fell asleep.
The next day, he was managing to alternate between grumbling at the residual swelling in his hands ("I'm fat, John!"), complaining he was "utterly, intolerably bored", and sleeping.
The day after that, he wheedled and begged and charmed the nurse until she let him have his catheter out, and wear some "proper pyjamas". Later that day, it was sitting in a wheelchair. He tried to talk a re-crisped Mycroft into obtaining a portable oxygen cylinder, so he could leave the room, rather than be chained to the wall by his nasal cannulae. Mycroft refused adamantly, doubtless wanting to find an excuse to keep his incorrigible sibling safely in hospital. An experiment at managing without the oxygen had been aborted rather quickly and sheepishly. "Turns out turning blue is rather unpleasant, John."
The day after that, he had succeeded in talking Mycroft into obtaining his portable oxygen, and he had to be rescued when he ran out of energy trying propel his wheelchair down the corridor in search of stimulation.
"Is there any way we can set up home oxygen for him?" I asked desperately, drinking in the canteen with Mycroft again after Sherlock had fallen back to sleep. I was exhausted – a convalescent Sherlock was more tiring then a whole nursery-full of sick toddlers. "It usually takes weeks to organise, but if there is any way…"
The next day, I was being talked through the home oxygen system at Baker Street whilst Sherlock delightedly sawed on his violin. When the team left, I brought two cups of tea through, and flopped on the sofa next to him.
The next week was predictably hideous, but at least I felt he could leave the house for short periods now, and Sherlock was making a far faster recovery than I would have expected.
My friend was out of danger, and everything was getting back to normal, so I wasn't sure why I was feeling so miserable. It was as if the prolonged adrenaline exposure had drained me of all positivity. I had caught up on my sleep, but the slightest exertion left me exhausted. I feel like a battery, trying to pour energy into a non-conductor I thought, and then decided I must be going slightly mad. Perhaps it was the bad dreams: a swollen, bloated Sherlock, falling past me, whilst I kept trying to grab at him, Sherlock's chest getting bigger and bigger with the ventilator, until he started to split open, and I kept trying to fill the gaps with plasticine, blood pouring out of Sherlock's mouth as he coughed, his silver eyes wide with fright. If it wasn't tedious nightmares along these lines, it was just vague, unsettling dreams, of the running-but-not-going-anywhere, or crying-out-but-making-no-sound variety. I even dreamt I'd turned up to an maths exam that I hadn't prepared for, and then realised I was naked – but I didn't really think that was relevant to my current low mood.
I told myself it wasn't an uncommon reaction; having a depressive episode at the anti-climax following the severe illness of someone close. It was still frustrating though, especially as Sherlock was in one of his uncommunicative moods.
One morning, I had to get out. I hadn't booked himself any locum shifts, and I wasn't really sure what to do. I decided, on a very random impulse, to take myself off to London Zoo – I had a lifetime pass there after Sherlock and I had solved a rather interesting problem involving a Sumatran tiger and a giant anteater.
I felt immeasurably cheered up watching two gibbons scream at each other. One of them threw something, probably shit, at the other, then retired to a tree trunk to sulk. The other stalked off with offended dignity then started stuffing himself with food. However, my good humour was short-lived, as I began to feel assailed by the inescapable sameness of the universe, then became annoyed with myself for indulging in such existentialist nonsense.
It was getting dark as I headed back to Baker Street. I hadn't left Sherlock alone for so long since his illness started. I hoped he was OK, although, I thought moodily, in all probability, he hasn't even noticed I've gone out.
I heard the shrill shouting before I even opened the front door. It went up a decibel level as I warily pushed it open, and was approaching fire-alarm status as I entered the flat.
It was Mrs Hudson, in full tirade. How impressive the usually diminutive lady could be was testified to by the fact that I was so distracted by it, I didn't even notice the strong smell of smoke at first. It was only as my mind began to filter phrases like "MY BLOODY TABLE" and "MY BLOODY WINDOW" and "BLOODY GLASS AND SMOKE EVERYWHERE" that I began to take in the finer details of my surroundings.
There was indeed glass and smoke everywhere. It appeared there had been a medium-sized explosion in the kitchen. Standing in the epicentre of the blast zone, with a soot-blackened face and singed eyebrows, was Sherlock. His head was hanging, as he was rocked by the wrath of his landlady, which was clearly directed at him. He wasn't wearing his oxygen cannulae – the tubing was instead attached to what had once been an intricate looking system of flasks and retorts, but was now mainly glass splinters that were liberally strewn over the kitchen. There was a small trickle of blood on his cheek, probably from the same source.
I was suddenly aware of a rushing in my ears, and a constricting of my vision, and I heard a tight, quiet voice, that I subsequently realised was my own, ask: "What the hell happened here?"
Mrs Hudson fell quiet, then suddenly fluttered to the door, babbling that she was leaving us to it. Sherlock shuffled on the spot and looked awkward.
"I asked what happened, Sherlock. Why has our kitchen exploded?"
Sherlock was muttering something about "not used to such an unpredictable oxygen supply".
Suddenly, I exploded, my bellow the sort that had sent hardened squaddies rushing for cover.
"WHAT THE HELL DID YOU THING YOU WERE DOING? Did you not realise that I've spent the last two weeks almost watching you die, and then you go and start messing around with a bloody smoky experiment when you've only just come off an effing ventilator? You idiot! You total, shitty, stupid, selfish, arseholing lunatic!"
I realised there were tears on my face. Sherlock was staring at me in shock. He cringed as I suddenly stomped towards him, then stiffened as, instead of throwing a punch, I threw his arms around him instead, and started making noisy, embarrassing sobbing noises.
"Shut up, you shitting moron."
I was just starting to calm down, and feel a little self-conscious, when I realised Sherlock's shoulders had begun to judder unevenly, and he was making sniffing sounds.
"Please don't leave, John."
It was my turn to freeze in shock now.
"What? I'm not going to leave. I'm just furious about this particular explosion, and a bit overwrought that you're not dead… no, that's not what I meant. About that you nearly died, but that now you're better… oh, God, you know what I mean."
"I was awake for a lot of it, you know. Quite tolerant to opiates, so the sedation was pretty light, although the paralysis was still there. It was like after – you know, after I jumped, but it went on for so much longer. And there were these constant beeps and bells, and people talking in the background, but I wasn't awake enough for it to make complete sense. It drove me mad. It was better when you were there, talking to me, 'cause I could anchor onto you, but the nights seemed to go on forever."
I was horrified. "Oh God, Sherlock, I'm sorry." I guided my trembling friend to the sofa, and sat him down, allowing the curly head to bury itself against my shoulder.
"It hurt, quite a bit, too. And it was so humiliating when I had to be, you know, washed and changed. I could smell everything, feel everything. I…I keep dreaming I'm back there, and this sitting around's driving me stir-crazy, but I'm not going out with this oxygen set-up, to have all the proles staring at me. I just wanted to do something normal – I'm sorry I blew up the kitchen." There was a pause, as we both digested this ludicrous statement, then the giggles started. They alternated with tears for a while, before we both began to calm down.
I eventually sat up straight and dried my eyes.
"I'm having nightmares again too. Bunk in with me again? We can poke each other if we think we're having a bad one. Um, that sounds really dodgy, but you know what I mean."
My flatmate brightened perceptibly.
"Yes please. It was rather useful after the hound case."
"You've managed a good twenty minutes without the oxygen now. How do you feel?"
Sherlock looked surprised. "Fine. I feel fine!"
I got up and fetched the oxygen sats probe. I attached it to Sherlock's finger, and we waited until it started beeping regularly.
"Ninety-three percent. Not too bad. Looks like you can do without for now. How about we wait another half hour, and if you're still feeling OK, we pop out and visit Lestrade? He had a couple of cases he wanted you to look over when you're well. After we organise a glazier and a cleaner. You're paying."
Sherlock looked ecstatic.
"Just one condition" I added. Sherlock glanced at me enquiringly. "Please hold off on climbing down musty ventilation shafts, or scrambling through fetid sewers, until your sats are back in the high nineties again and your cough's cleared up."
"John", said Sherlock, solemnly. "For you, I agree to never enter another dangerous looking disused or dirty passageway in my life, unless you give me the OK first."
"Well, that's good then".
As we both shrugged on our coats and walked downstairs thirty minutes later, Sherlock humming with his usual energy, I realised that I was grinning to myself. Yep, the knot of anxiety had vanished. Sherlock hailed a cab with typical imperious success, and we were heading to Scotland Yard.
The Game was back on.
Thanks for all your reviews! Glad you liked a bit of well-past-Reichenbach fare. Please do continue – you all made little bits of my day…
Hope this fulfilled the illness-through-stupidity request. Any more wishes? There is more on the way, but I remain open to ideas.