The paramedics had just returned to their ambulance after leaving their latest patient at the hospital when their radios went off for their next call. They quickly turned on the lights and sirens and started making their way through the streets of London. They weaved past cars stuck in the incessant traffic, and the careless pedestrians crossing busy roads. Even with a bright yellow truck with shrieking sirens and flashing lights, it was difficult to drive in the heart of the city without a near miss or two.
The address they were going to was right in the centre of London, luckily not far from where they had just come. Baker Street was soon in sight, and they were quickly able to locate the apartment where one Sherlock Holmes needed urgent medical attention. They parked the truck as well as they could, trying to avoid a barrage of angry drivers, and made their way to the back to grab all the equipment they might need. They lugged the numerous bags up the seventeen steps to 221B, the door having been left open for them, and soon located their patient.
A man sat hunched on the sofa in the living room, clearly struggling for breath. The wheeze which accompanied each breath he took was audible even from the entrance. In front of him kneeled an older woman, who was running her small hand up and down his back. She looked over at the new arrivals, relief clear in her expression. "It's okay, Sherlock," she soothed, "the paramedics are here now, they'll take care of you."
Sherlock spared them only a quick glance before going back to looking at the woman. He was clearly in distress, one hand clutching at his unbuttoned shirt and the other at the woman's hand. But she soon moved behind Sherlock, giving the paramedics enough space to spread out their equipment and do what they needed to do.
The scene around them spoke of how the last few moments must have gone for their patient. A dressing gown and blanket lay carelessly discarded on the sofa. The coffee table was housing an untouched tray of tea and biscuits as well as several empty glasses of water. Even more tellingly, next to the tray sat a blue inhaler, probably long since effective, and a mobile flashing with unanswered calls from someone named John.
One of the paramedics started grabbing equipment and turning on beeping machines, while the other kneeled in front of their patient. "Hello, Sherlock. I'm Lauren and this is Matt," she introduced, all the while observing Sherlock's breathing and taking his pulse. "Can you tell me if this has happened before?"
She watched as Sherlock tried to speak, opening and closing his mouth several times before he finally got the words out. "Y-yes," he stuttered, "I have… asthma."
Lauren nodded her understanding. "I see you've been using your inhaler, has that helped at all?"
Sherlock weakly shook his head. "It did… at first," he puffed out painfully, finding it frustrating that he couldn't communicate. "N-not anymore… though."
While Lauren observed Sherlock's losing battle with his lungs, Matt attached him to their monitoring. They both frowned at the readings, though they were unsurprised by them given their patient's appearance.
"We're going to give you oxygen and some medication to help with your breathing. But before that I need to listen to your lungs, okay?"
Sherlock only managed a slight nod this time, and used what little strength he had left to hold his shirt out of the way. Every time he tried to speak he felt as though there wasn't enough air in his lungs to get the words out. He wanted to talk to the paramedics and tell them that he'd been sleeping when everything had started, that an annoying cough had awoken him and that Mrs Hudson's delivery of tea and biscuits may very well have saved his life, because there was no way he would have been able to call for help. But he just couldn't get the words out. His body was barely getting enough oxygen for him to stay conscious, let alone to hold an intelligent conversation.
"His sats are 78% and he's tachycardic," Matt relayed as he set up a nebuliser mask with the drugs to help Sherlock.
Lauren removed her stethoscope from her ears, settling it over her shoulders. "I can hear a wheeze on the apex of the right lung, and decreased breath sounds on both bases," she observed worriedly. She took the mask from Matt as he cranked up the oxygen and placed it over Sherlock's face. "This is going to relax your airway and help with your breathing, Sherlock."
She watched him like a hawk, noting the slight blue twinge to his lips and the fact that he could barely keep his eyes open. The hand that before had been clutching at the older woman now lay limp in her hand. His breathing was becoming increasingly ragged, and much too fast for her liking.
Matt counted Sherlock's respiratory rate, unhappy with the results he had. "He's in respiratory distress; he's tachypnoeic and cyanotic. Do you want the cannulation kit?"
"Yeah," Lauren replied, "he needs steroid as well, this isn't going to be enough."
After Matt handed her the bag, she busied herself with setting up her equipment and, as always, the sight of a needle seemed to alarm everyone in the room.
"Is he going to be okay?" the woman chirped worriedly from behind Sherlock.
Matt was preparing to tape down the IV once it was ready, but he looked up at her. "What's your name, sweetheart?"
"Mrs Hudson," she replied. She looked down at Sherlock, a warm expression in her eyes. "My boy is a fighter, please tell me he'll be alright."
Matt chuckled, "That he is, Mrs Hudson. We're doing everything we can to help him, his lungs just need a little bit of a nudge. But we'll still need to take him to the hospital afterwards. Will you be coming with him?"
"Oh, I don't know," she seemed distressed at the thought. "John usually goes. That's his fiancée, you know!"
"You can call John, if you'd like, to let him know what's going on. We'll look after Sherlock," Matt reassured her. It was always good to keep distressed relatives busy and out of the way. Besides, John might be in a better state to tell them about Sherlock's health than Mrs Hudson was right now.
She seemed to think about it for a moment, glancing back and forth between the paramedics and Sherlock before deciding that he would be in good hands. "I'll be right over there, my boy," she said to Sherlock as she dropped a kiss on his forehead, to which he barely reacted. She tried not to let it alarm her. "I'm going to get John for you. He'll be here in no time, you'll see."
Sherlock could hear the conversations going on around him, but didn't have the energy to react to them. He felt detached from the whole thing, unable to communicate and barely able to comprehend what was going on. He could hear the worry in poor Mrs Hudson's voice as she spoke to one of the paramedics, asking questions they didn't have the answers to. On the few occasions when he could keep his eyes open, he could see the concentration masking worry on Lauren's face.
He watched as she looked between him and the monitors, frowning when the drugs didn't do what they should be doing. He could feel his breathing getting slower, but he wasn't sure that was a good thing. If his lungs couldn't get enough air, surely he should be making a bit more of an effort, but he was exhausted. He saw but didn't feel the needle going into his hand, and watched as Lauren's lips moved. He had no idea what she was saying.
He tried to stay conscious, knowing that as soon as he gave up so would his lungs, but it was becoming impossible. Every breath was wrenched out of his chest painfully as his airway constricted further and further, his lungs trying to scrape along without oxygen. He coughed around the mask, watching as it fogged less and less. He drifted off and thought of John.
The paramedics watched worriedly as Sherlock started flagging. He was slouched on the sofa, head lolled to the side as he lost the strength to hold it up himself. While Matt relayed the steadily worsening observations and tried to rouse Sherlock, Lauren administered the steroids, hoping that they would take effect quickly. She spoke to Sherlock as she worked, trying to keep him awake, but it was clear that he wasn't taking anything in. Having heard the earlier conversation, she even asked about John, but all she got in reply was a muffled groan behind the mask.
Lauren continuously took Sherlock's respiratory rate, noting the lengthening gap between each breath and watching for the moment when the next one wouldn't come at all.
"Sherlock," she called out loudly, "can you hear me?"
She received no response, though he was still breathing. If only just. "Matt, I need the adrenaline. And we need to get him on the floor," she stated grimly.
Mrs Hudson, who was still on the phone with a frantic John, couldn't keep a whimper from leaving her mouth as she watched Sherlock being pulled onto the floor, dragging a litany of wires with him. The machine beeped incessantly now, Sherlock's saturation levels having long since dipped below normal, even with the oxygen he was being provided.
Lauren grabbed the bag valve mask and then kneeled behind Sherlock, tilting his head back while Matt administered the adrenaline. She removed the oxygen mask, and after adding more medication covered Sherlock's mouth with the new one. She deflated the bag, watching carefully as Sherlock's chest rose and fell with the delivery.
It was then that a man frantically ran into the room, breathing heavily and looking panicked when he saw the scene in front of him. "Jesus, Sherlock," he breathed, dismayed.
His fiancée was laid out slack on their living room floor, drugs being pumped into his body while someone did most of his breathing for him. It was unnerving to watch, made even worse by the fact that John knew exactly what was going on in his body for things to have gotten this bad. He knew that Sherlock's airway was becoming narrower by the second, the spasms and inflammation leaving no space for oxygen to enter. He knew that Sherlock's brain was receiving what little oxygen he was getting into him. He knew that Sherlock's body was too exhausted to breathe as often, or as deeply, as it should.
He knew that if things didn't improve soon, Sherlock would stop breathing altogether.
His brain wouldn't get any oxygen.
His heart would eventually stop.
The realisation hit him, and it took only a couple of seconds for a steady look of resolution to settle over his face, and he marched decisively towards Sherlock. "I'm a doctor, what can I do to help?"
Lauren looked over at him for a few seconds, trying to work out if he was in the right state of mind to be doing anything. "Are you John?"
"Yes, I was an army doctor," he explained, as he squeezed Sherlock's free hand tightly. "You have to breathe, Sherlock. I know it's boring, but you have to."
The paramedics shared a look between them, silently deciding that it would be best to keep John busy. Besides, it was always helpful to have an extra set of hands, especially from someone who knew what they were doing. "Monitor his GCS, keep talking to him," Matt said. He looked at Lauren, "I'll take over ventilating."
Lauren nodded towards Matt, and after they had swapped places she printed off a strip of paper from the machine. "His heart is holding up for the moment. What's his GCS, John?"
Sherlock's eyes were glazed over and unfocussed, but John's voice seemed to trigger some recognition in his gaze. "He's GCS 5, his eyes are open," he quickly rattled off. He was still holding Sherlock's hand, trying to ignore the fact that it was lax in his own. "I'm right here, Sherlock," he whispered, "I'm right here."
Lauren hoped she was being overcautious as she inserted another IV into Sherlock's other arm, but it was always better to be prepared for the worst. While doing so she watched John, noting that a steely resolve had settled on his face. This man appeared unshaken as he watched the proceedings in front of him. But Lauren knew that beneath that mask John must be completely overwhelmed with worry. Army doctor or not, it was never the same when it was someone you loved.
Tense minutes passed while the three gazed between Sherlock and the monitors, Mrs Hudson forgotten for the moment as she sobbed quietly in the corner. Minutes when Matt squeezed the bag less often, when the machine beeped a bit more steadily, when Sherlock's chest rose and fell a little more often.
Everyone waited with baited breath as Sherlock seemed to slowly come back to life. He blinked up at John, his eyes still slightly glazed, and gave him a weak semblance of a smile before shutting them. A strangled laugh left John's mouth, the anxiety and fear of the last few minutes still making him tense. "You're okay, Sherlock," he said as he stroked the detective's face. "God, you scared me."
Sherlock couldn't respond, but he tried lifting his hand up to squeeze John's. He didn't quite manage it, but John saw, and knew what he was trying to say. John always understood him.
I'm sorry.
I didn't mean to scare you.
I love you.
He grabbed Sherlock's hand and laid a gentle kiss on his knuckles before letting go.
Matt removed the mask from Sherlock's face, and relief flooded through everyone in the room when they heard Sherlock take a deep breath. It ended with a coughing fit which left him raspy and weak, but Lauren quickly placed the oxygen mask back over his face.
"Sherlock," she watched as his eyes met hers, "we had to help you with your breathing for a little while there, but you seem to be doing that all by yourself now which is good news. But we still need to get you to the hospital, okay?"
Sherlock nodded, and that was all the confirmation she needed. "Matt, can you get the truck ready?"
He quickly nodded and hurried down the stairs. While he was gone, Lauren listened to Sherlock's lungs once again and watched as the colour slowly returned to his face. Next to her John was trying not to collapse in relief as he watched Sherlock breathing on his own. He still looked pale and exhausted, and his breath hitched every so often, but the drugs had finally kicked in and the oxygen was helping.
As soon as Matt came back, carrying a backboard and plenty of blankets in his arms, 221B went into a frenzy. Mrs Hudson had been sent to put together a bag of Sherlock's clothes and medications, John gathered up the paramedics' equipment and Lauren untangled all the wires so that they could slide the backboard behind Sherlock.
"I know it's uncomfortable, Sherlock, but it's only for a moment. We'll get you downstairs and onto our bed in no time."
Sherlock only nodded and shut his eyes once again. He was beyond exhausted, and his chest was killing him. He could feel the oxygen flowing into his burning lungs, and it was the best feeling he could imagine. Beside him, John watched as the mask fogged with each breath he took. He tried to stop himself from constantly watching Sherlock's breathing, but after seeing him so still and lifeless, it was almost impossible.
He reluctantly left Sherlock's side while the paramedics moved around the room decisively, splitting the backboard in two and rolling Sherlock onto it before putting it together again. They covered him in blankets, tucking all the wires into them before wrapping the straps safely around him.
"Sherlock, we're taking you downstairs now," Lauren explained, "You're strapped up nice and tight but I need you to stay still while we move you so no one gets hurt. Don't try to reach out with your hands, we've got you."
Matt was packing up the last of their equipment, getting ready to help Lauren. He picked up the monitor and handed it to John. "Can you take this while we carry him down the stairs?"
"Yeah, of course," John grabbed hold of the monitor, sneaking a peak at the readings more often than was strictly necessary. The paramedics carefully manoeuvred Sherlock down the stairs, trying not to bump into any of the tight corners of the building.
They deposited Sherlock on the trolley which was waiting for them right in front of 221B. They all ignored the stares of curious passer-by's, focussing instead on getting Sherlock out of the cold and into the ambulance.
John was left outside while they put everything away and set up what they needed to for the short trip to the hospital. It was then, as he waited in the cold outside 221B, that it finally hit him.
Sherlock had nearly died.
His best friend, his lover, his fiancée, had almost died on their living room floor. His lungs almost giving up on being lungs. His heart would have followed closely behind. He had been this close to dead.
From the moment Sherlock had texted him saying that he wasn't feeling well he had been worried. Sherlock rarely admitted to being anything but fine, so the fact that he was texting John out of the blue to tell him was reason enough to be concerned. When, not ten minutes later, he had stopped replying that concern had quickly grown into fear, quickly evolving into panic as he shouted at the cabbie to drive faster.
He had tried to keep his calm as he spoke to a frantic Mrs Hudson on the phone. He had managed, mostly, to remain steady as he helped the paramedics, trying to imagine anyone but Sherlock in that position. If he thought of him as any other stranger, any other patient, maybe he could hold himself together long enough to actually do something helpful.
But now that they didn't need him anymore, now that Sherlock was stable enough to be moved, he could feel himself coming apart at the seams.
The first sob took him by surprise. He could feel his eyes spilling over with tears, his chest so full it felt like it was going to explode. When he felt Mrs Hudson's warm embrace, he finally broke down.
He latched onto her as the cries were ripped from his chest, releasing all the pent-up emotions of the last hour. He could feel the saltiness of the tears on his lips as they spilled down his face, and could see the stains they were leaving on his landlady's cardigan. She held him as he fell apart, sobbing and hiccupping and laughing all at once. He'd seen countless injuries on the battlefield, treated endless illnesses at the surgery, but nothing could have prepared him for this.
John and Mrs Hudson broke apart when the ambulance door opened and Lauren stepped out. "We're ready to go, John."
"Keep me updated, would you, John?" Mrs Hudson pleaded as he stepped onto the ambulance.
John nodded, "Of course, but he's going to be fine. You don't have to worry." He tried to ignore the little whimper as she walked away, a handkerchief clutched in her small hand as she wiped the tears from her face.
Once John had sat down and put his seatbelt on, Lauren silently handed him a tissue, ignoring his red rimmed eyes and the tears still spilling down his face, and gave him a minute to get himself together. She signalled to Matt that they were ready to leave, and the sirens wailed even inside the ambulance.
John tried not to think about the fact that, even less than ten minutes from the hospital, they still needed the sirens on.
He looked at Sherlock, still pale under the oxygen mask, but looking much better than he had back at Baker Street. "How are you feeling, Sherlock?"
Sherlock slowly opened his eyes, and sighed deeply before answering, relishing in the fact that he could do so now. "Tired," he admitted quietly, his voice nearly a whisper. "Better now that you're here."
John chuckled, "I think the paramedics might have had a little something to do with it as well."
"Maybe," Sherlock shrugged, amusement clear on his face.
John looked over at Lauren, worried that he would have to start making apologies for Sherlock now that he was conscious, but she too was smirking at the conversation. She was alternating between her paperwork and the monitor, and would occasionally look at her watch- probably taking Sherlock's respiratory rate to make sure things didn't go sideways again.
"John, can I ask you some of these questions? It'll probably be easier for you than for Sherlock to answer right now," Lauren asked.
The rest of the ride was spent with John clutching Sherlock's hand and answering Lauren's questions. When they arrived at the hospital Lauren and Matt quickly wheeled Sherlock into a room where a doctor and a nurse were already waiting for his arrival.
John stayed by Sherlock's side the whole time, never more than two steps from his fiancée. He answered their questions as best as he could, if only so Sherlock wouldn't insult or deduce anyone- which John could tell he was now doing- it was an insurmountable relief to see that focus back in his gaze.
The paramedics left for a few moments, leaving the doctor and nurse to deal with Sherlock. They were asking questions and planning on running tests to find out what could have triggered such a severe attack to prevent it from happening again.
John hoped there would never be a next time. He could deal with the coughs and colds, and the occasional shortness of breath that Sherlock experienced. He could deal with having to carry around an extra inhaler and constantly having to remind Sherlock to take his medication. But he couldn't deal with watching Sherlock barely breathing, laid out unconscious on their living room floor. He had a feeling that image was going to stay with him for some time.
The doctor had just finished listening to Sherlock's lungs once again when the paramedics walked back in. John felt like he was seeing them properly for the first time, no longer scared that Sherlock would expire in front of him. They were both young- younger than Sherlock- but had handled themselves like professionals throughout everything. Although they looked clean and tidy in their uniform, their face told the story of how this was their fifth 12-hour shift in a row. The skin around their eyes a little darker, a little sunken in, and their face a couple of shades paler than it should be.
What John didn't notice was the tan line around Lauren's finger. How she and Matt stood a little closer to each other than was strictly necessary, and how they had casually bumped into one another on their way in just as an excuse to be closer to each other, if only for a moment.
Sherlock, while ignoring his doctor, noticed all of this and made a mental note to tell John, who had now approached them both and was holding his hand out.
"Thank you so much for everything you did," he said sincerely. He couldn't be more grateful to them and everything they had done for Sherlock. He saw how hard they had worked, and how quickly they had acted. He had no shadow of a doubt that they had saved Sherlock's life.
"We were just doing our jobs," Matt replied a little awkwardly, "but you're welcome." They both shook hands with John, not used to such praise and gratitude.
"He wouldn't be here if it wasn't for the two of you, I can't thank you enough for saving his life."
Lauren nodded, accepting John's words. She was feeling quite emotional herself, and felt like she needed a minute away from the emotionally charged situation. "Just take good care of each other," she nodded towards Sherlock. "He looks like a handful," she joked.
John chuckled, smiling fondly at Sherlock who was now arguing with the nurse. "He is, but I wouldn't have him any other way."