Author's note: the title of this story refers to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, which was published by the American Psychiatric Associaiton of the United States in 1994. It provides diagnostic criteria and standard lnguage for mental health disorders, and provides a specific, numerical code that can be assigned to each. (Through out this story, I've referred to specific diagnosis codes in parenthesis-a key to the codes I've used appears at the end of the story.) Although developed in the United States, the language of the DSM has been widely adapted worldwide. This document is not without controversy, and with each edition, diagnoses are added and deleted as scientific knowledge and understanding advances. The next revision (DSM-5) is due out in 2013.
Disclaimers: I don't agree with everything in the DSM-I know some of the things are specifically object to are up for removal in the next edition. That being said, depite the fact that a lot of information about the DSM is online, the specific diagnostic criteria aren't, although it's easy to find listings of the coding both in numerical order and by the specific diagnosis. I'm not a therapist, or a coder and I don't work in mental health-so my knowledge is pretty much based on PsychNet and Wikipedia. Of course, it also didn't occur to me until after I'd finished all this that I don't even know if this is the standard used in England or by the British military. (Maybe they use ICD coding, which somewhat corresponds to the DSM?) So-I apologize for any technical inaccuracies-I'm open to help. It's the thought that counts, right?
And of course I have absolutely no rights to any of this material whatsoever, the DSM or Sherlock. (Or to Martin Freeman or Benedict Cumberbatch, much to my chagrin.)
DSM-IV
He said, "You just wrote, 'Still has trust issues.'"
His therapist replied-not too quickly, so she would seem objective- "…and you can read my writing upside down." She smiled up at him briefly (a smile that didn't quite reach her eyes, or for that matter, do much to increase his faith in her objectivity) before droning on while continuing to write. John's mind was still on what she hadn't admitted to noting in his chart.
(301.82) There was some truth in that, he supposed. Given his past. Given his present for that matter…
"Start a blog," she suggested. "Writing down what happens can really help."
"Nothing happens to me," he told her.
Fuck.
At least it was a coherent thought. Perhaps it meant the migraine was beginning to pass. Wishful thinking. He hadn't caught it in time for the meds to kick in. Fuck. He'd have to wait it out.
John Watson sat gingerly on the edge of the mattress in the darkened bare-ish room with his head slumped in his hands trying not to move. If he successfully managed not to move, the pounding would subside into an easier-to-deal-with ache. Until eventually it started again and he would have to shift again to trick it into stopping. He needed to vomit. That, he knew, would make the migraine disappear within about an hour. The problem was that in the 59 minutes prior to the sixtieth minute, it would get much, much worse. Plus, the cleanliness of the bachelor-maintained toilet [Mrs Hudson was a landlady, not a housekeeper] left much to be desired. Better not to.
Because of his head, moving around was out, reading was out, eating was out, using the computer was definitely out, and sleeping was out. Significantly, his mobile was turned off.
What better time could there possibly be to contemplate one's future?
The question of which could be effectively distilled into this: what the fuck was he doing here in this shithole of a flat (albeit in a not at all unreasonable part of Westminster), contemplating his shitty life (which mostly consisted of waiting for something—anything—to happen), listening to his irritating, obnoxiously oblivious shitty flat-mate downstairs, (whom, to be fair, at the moment was making no noise whatsoever) slowly going bloody fucking mad. If only he could go mad all at once and get it over with. They'd take him away. Somewhere with clean sheets (a housekeeper perhaps?) and decent food. Maybe a pretty nurse if he was particularly lucky. Hell, there would might even be people there who would notice when it got light out and say "Good morning, John," or perhaps ask, "Hey, John how are you today?" once in a while. In person—not via text. It didn't even have to be the pretty nurse that asked. Maybe a fellow madman would talk to him. It could only be an improvement.
But he wasn't mad. He was here. And by his own volition. Another definition: codependent (301.6). Which really meant that he chose to stay here because he was a fucking idiot and couldn't manage on his own. Sherlock had said something very like in the early days of their acquaintance. (Not codependent…idiot, that is.) Even Mary…but he abandoned that line of thought, having spent too many years thinking about it already. John shook his head tentatively. It was getting worse.
He shifted. Moved an arm down to his side, twisted his back into an odd angle and rested his head heavily in one had to better let gravity defy the pounding. Better. To an idiot, even a living in a shithole with a narcissistically self-absorbed roommate (301.81), is preferable to being alone.
Fuck.
….
But that was not quite the truth. Because John Watson wasn't an idiot, and even in his worst moments he couldn't help but be charitable. Sherlock Holmes, if not perhaps the most personable of flat-mates, was at the very least never dull. Mad genius, John sometimes thought of his housemate. And after all geniuses—perhaps mad geniuses (Was 'mad genius' its own classification? It should be…) more than just the regular kind—inhabited their own worlds complete with a set of mores that didn't neatly parallel those held by society as a whole. Ostensibly it was precisely because they were geniuses that allowed them to see through all that. Certainly that was true in Sherlock's case.
So if Sherlock was a mad genius, what did that make John Watson?
There were many words that had been applied to John Watson. Overqualified (in the non-complimentary sense) was one that had come up recently. As well as the tidily dismissive "friend." But there were also terms that had been used to describe him which bore more weight, albeit in a certain archaic sense. Terms like war veteran, and military hero; words that seemed better suited to the veterans of the last century than any modern day serviceman. In today's parlance, hero was really just a euphemism for "got blown up" or "inability to duck in time." What had Sherlock's enigmatic brother, Mycroft Holmes, said on the subject? "Bravery is the kindest word for stupidity, don't you think?' Apt.
For some two centuries, Britain had maintained an on-again, off-again presence in Afghanistan. Even today, it remained something of a British bugaboo; her troops seemingly perpetually present, and as always, prevailingly ineffective. Afghanistan was hardly signified as a great war, although it did rank in John's mind as higher than the Falklands (the Taliban being a more worthy opponent than sheep, though in its own way, no less indomitable). By the time he had been sent home, it seemed like just another bloody hot mess, destined to malinger for another two centuries hence.
So here he was, back in England. He had served as a military doctor, he had been injured, he was honourably discharged; he was unemployed. (He had locum work, though to John's mind, that was reasonably synonymous with unemployed.) Post-traumatic stress disorder (309.81). A bit, perhaps. Enough to have the dreams. Occasionally enough to make him jumpy; not at gunshots, which seemed to have an oxymoronically steadying effect, but in ordinary things like rumbles of thunder that crescendoed into thumps which shook the building. No shame in that, John told himself, although he thought the old diagnosis of shell shocked conferred a certain dignity that PTSDlacked. As if PTSD implied personal culpability for one's own dysfunction. When someone was shell shocked, people naturally blamed the shell. Simpler explanations for simpler times.
Not much use for overqualified, unemployed military doctors these days, what with Northern Ireland having become so being so peaceful. It didn't matter. For now at least, he had his pension. Iran, Iraq, the Balkans…it would all have been just more of the same anyway. He was ambivalent about going back. The military wasn't in his blood, the way it was for some people. At first he had genuinely enjoyed it—there had been something exhilarating about existing on the precipice of life and death. But after a time, it had simply become monotony. IEDs exploded at regular intervals, the wounded and maimed arrived shortly thereafter, he fixed them up to the best of his ability, and they were replaced when the next IED went off. Though the mental challenge still remained, he eventually realized that he wasn't connecting with his patients anymore. They were just packages of skin and bone who arrived in his hospital in larger or smaller pieces that were handed over to him, the puzzle master.
And gradually that horror had become rote—even banal. John was left with the nagging sense that none of it really mattered. It had been pricking at the back of his mind for a while, but he hadn't spent much time pondering philosophy while he was in Afghanistan. That fixation had started only once he came home. And now that he was here (edge of mattress, pounding head, lovely shithole, asshole roommate, etc.) he had plenty of time to think.
One thing he knew with absolute certainty was that upon his discharge he had been quickly and efficiently replaced with another, equally competent, hopefully not too jaded doctor who would preside over the healing and/or death of the British troops at the hands of one of the countless, faceless people who, for the sake of purpose, had been assigned the role enemy. And when this war was over, the troops would come home until the next war, when they were dispatched to fight a new enemy to defend God and country.
The dreams had started while he was still in hospital. The migraines, however, had started after he came back. Coinciding also, he realized for the first time, rather neatly with the first time he had met Sherlock Holmes. Before Sherlock, there had been the trauma of his wound, which though healed nicely, manifested itself with a painful limp and an old man's cane. John could knew therapist had suspected the limp was "all in his head" rather than any the result of any lasting physical damage (307.89). (She didn't word it quite that way, but as a doctor, John had a rudimentary understanding of psychology; perhaps the reason that his therapy did not progress as well as his therapist would have hoped.)
Ironic. Sherlock, in confirming her diagnosis, had cured him.
Fuck.
…
It was an odd thing the way they had got on. Sherlock followed no discernable societal rules that John could ascertain, didn't enjoy company of others (or rather, tended to be so off-putting that company didn't enjoy him), and seemed to take a certain sadistic joy in taunting anyone whom he considered to be less intelligent (easily 99.7% of society as a whole; 99.9% of the Metropolitan Police force, and 100% of anyone employed by government—not excluding his brother Mycroft.)
Asperger's (299.80) had been John's initial analysis. Not that he'd discarded it all together. Poor social reflexes. Brilliant—but with a single-minded precision that was disconcerting. Inconsistent ability to maintain eye contact. Lack of empathy. Arrogance. Adolescent tantrums…
But there was something more to Sherlock. John had been constantly forced to amend his opinion throughout their relationship. Sherlock did understand people. He had no difficulty discerning thoughts and emotions even in the absence of words. He and John shared puerile jokes, while on other occasions they shared a certain dry sense of humour. Sherlock's difficulty lay in understanding the why-why anyone would let emotions rule their minds was to his own, unfathomable. Even when Holmes could clearly interpret motive, he didn't always understand it. He knew the appropriate social rules, even if he chose to ignore them. Sherlock could be disarmingly (and convincingly) charming – if it served a purpose. If not...
From the beginning, Sherlock had accepted John as a colleague, and treated him as something of an equal. John hadn't thought much about this at first, until he realized from the reactions of the intimate people in Holmes' life-a tiny group of people who numbered less than the fingers on one hand—(DCI Lestrade, the mousy, mooning little Bart pathologist, Molly Hooper, Sherlock's brother, Mycroft Holmes, Mrs Hudson)-that this, in fact, was something extraordinary. Which translated into the fact that John constantly had to justify his presence around Sherlock Holmes. A colleague, he would tell them, though this explanation was accepted more often than not with a knowing smirk that annoyed John intensely. Nonetheless, it was the clearest explanation he had for their relationship. Plainly it wasn't because Sherlock needed someone to share the rent—he could cover that just in advances coming in for his 'consulting services,' much to John's pauperly chagrin. Perhaps, he thought darkly, Sherlock simply didn't consider him a worthy antagonist. And worthy did matter to Holmes.
More likely, thought John irritably, it was because Sherlock needed someone around to admire him.
Sherlock Holmes was condescending, humiliated John at regular intervals, and thought nothing of invading either his public or personal privacy. (Not that John was singled out for this treatment.) Yet, when Holmes called, John jumped, like one of those little yappy lapdogs that women carried in their handbags. He knew that at least part of this relationship was sensation-seeking on his part. It seemed like most of his military comrades had been left with at least some lasting propensity towards risk-taking. Some soldiers accepted reposting immediately, going back for third or even fourth tours. Some gambled wildly, started fights in the absence of provocation, or became excessively promiscuous or managed some combination of destructive behaviors. Others self-medicated with drugs or alcohol, hoping to dull themselves enough to fit awkwardly into a semblance of normal civilian life.
John Watson had moved into a flat with Sherlock Holmes.
…
John knew that Sherlock was aware of the limitations imposed by his idiosyncrasies. Of his inability comprehend why people would bother cluttering clouding their minds with emotions or attachments. Of his utter lack of patience for common day-to-day discourse. Of the fact that he was unable to take the short way around to a solution. Sherlock's striking, lanky asceticism stood in contrast to John's stocky…well…ordinariness. Where Sherlock was brilliantly, fierce-mindedly impulsive, John was cautious and deliberate, preferring to explicate problems in a way that was organized, methodical and (by Sherlock's reckoning,) both tedious and plodding. Holmes had a penchant for expensive dress, which he wore with the casual ease that came of being born into wealth, more than as a conscious thumbing of his nose at convention. To John, however, it illustrated Holmes' complete lack of understanding that most people worked for such things. John, on the other hand, was still wearing the same shirts and sweaters and trousers he had owned since long before Afghanistan. Sherlock Holmes, by definition, didn't fit in. John Watson, by definition, did.
Lestrade said this: "Sherlock Holmes is a great man. With any luck, one day he'll be a good one." Ruefully, John realized, if the two clauses in that statement were flipped, the same could possibly be applied to himself. Unfortunately, this probably made him the less interesting of the two.
Sergeant Sally Donovan, Lestrade's plainspoken sidekick, referred to Sherlock as Freak, if for any reason she was required to address him at all. For his part, Sherlock clearly relished her pique. Lunatic, John had heard her grumble to Lestrade. Psychopath, she told John. (301.7). It was the whole crime thing, she said. He got off on it (302.81). Donovan may not have used the word fetish, but it was certainly implied. "The weirder the crime, the more he gets off," she added with contempt or disgust or jealousy, or maybe a combination of all three. But from what he had observed of Sherlock thus far, it was a definition that seemed closer to the core of Holmes' character than the way anyone else chose to describe him.
Sherlock merely snorted at her analysis. "I'm not a psychopath—I'm a high functioning sociopath. Do your research," he snapped, sounding nonetheless pleased.
…
Ennui. It was ennui that linked them. Unless there was something going on, something happening, Sherlock was bored. And when he was bored, he became more difficult than ever than usual, because unlike most people, he refused to do anything about it. He was a firm believer of not putting anything into his head that wasn't useful in some way. Which was why he could recite the name of every off-license clerk in the greater metropolitan area, but couldn't tell you the name of the current Prime Minister or even for that matter, whether the earth circled the sun or vice versa; information, which was to Sherlock, by its very nature not useful. All that mattered, he insisted, was his work and the careful tending of the hard drive that was his head; the tending of which left no allowances for friends, relationships, or even brotherly love.
It was also the ennui that separated them.
John Watson was different. ("Opposites attract," he was helpfully reminded by Sgt Donovan.) In his boredom, he sought out people. Even the unpleasant ones, like Sherlock's estranged brother, Mycroft (replete with all of the more unpleasant Holmesian characteristics), who had seen in John a way to keep tabs on his petulant younger brother (V61.8). And he couldn't help but feel a tinge of excitement when he answered Sherlock's phone and heard Lestrade's voice on the line, even though he knew it wasn't his own expertise being sought. John also enjoyed turning his hand to pathology, when and where the odd corpse turned up, working companionably in the lab at St. Bartholomew's alongside Molly Hooper, all the while carefully smoothing over the sharp edges of Holmes' [unintended] barbs.
However, John didn't get off on the crime, or the creativity, or the pleasure in the hunt, or the hidden treasure of the solution, or any of the aspects of the criminal mind that so intrigued his colleague. For John, it wasn't a game. He was uncomfortable with the brutality that humans were capable of, and pleased when the bad ones got caught. In fact, if it came down to it, John didn't get off on much of anything lately. (He suspected the therapist had put that in her notes as well (302.71). Lucky John. Surely the other Holmes brother had squirreled that juicy little tidbit in John's chart away for future use.)
Fuck.
Or rather, lack thereof.
With his prickly flat mate at the ready to offend any female John came into contact with—usually even before the stage where he could have invited her back to 221B—there wasn't much hope of fucking even if he'd wanted to. It rankled. He didn't know if Sherlock's insults were intended to sabotage any of John's potential relationships before they had a chance to germinate, or if the man was truly oblivious. John feared (obliquely) the former, but suspected the latter. He sighed. At least there was one thing he could remedy himself. Endorphins sometimes offered useful treatment for headaches, and maybe it would make him sleep so he could ride the worst out in blissful unconsciousness. He fixed a picture of Mycroft's bland, pretty, text-addicted…whatever she was…in his mind and snaked a hand downward to perform the task. His head exploded into a new round of throbbing, but when release finally came, at least he could feel himself on the edge of sleep. "Take that, Mycroft," he thought with black amusement. (302.71) Chart be damned.
John rolled onto his side, and fell into oblivion.
Was it daylight? Yes. Morning or afternoon? The light coming in around the edges of the blinds was grey. He couldn't tell. By habit, he checked his mobile on the nightstand, noticed it was off and switched it on, shoving it under his pillow as it powered up so as not to alert Holmes.
Automatically he began to count down in his head. …29…28…27…26…It buzzed.
Foiled.
John sat up, cautiously shaking his head from back and forth, testing to see if his brain would rattle from one side to the other. Remarkably, it did not. He found that while he could remember the pain, it wasn't actually there anymore. This made John ridiculously happy, almost giddy. If the world seemed particularly black during an attack, afterwards was like coming into the light after a long, dark winter.
The phone beeped. A message. John peeked down to see who was calling, though he knew he needn't.
Sherlock.
Typical. But somehow much less irritating than it would have been 12 hours ago.
You're feeling better.
Rhetorical, John decided. He hadn't run into Sherlock when he came in. However, he hadn't missed any calls while he was upstairs, which of course meant that not only had his flat mate known he was here, he had inferred why he wasn't downstairs and had actually had the graciousness (or common sense) to leave him alone. Sometimes 'the art of deduction' stood the man in good stead.
John got up, showered, brushed his teeth and generally pondered his improvement. Another message has been left in the interim.
Now you're feeling better and you're clean. Come downstairs.
Still, he didn't respond. Instead, he automatically tidied up his space. Made the bed. He was a stickler for beds. Army holdover.
The phone vibrated again, atonally rattling as at slid gently along the wood of his nightstand and stopped to vibrate against his ceramic mug.
Coffee downstairs. Extra scoop.
John's brow furrowed. It was obviously just a ploy to get him down. Making coffee was beneath Sherlock.
Which caused John to circle back to the original line of questioning. So, he asked himself for the umpteenth time, why was he here? Except that this time, in the exquisite clarity that only comes with the absence of pain (and John knew pain intimately) he knew the answer.
Because, he realized, unlike society, with its spoken and implied rules for what and who he was and where he fit in; unlike the military which defined him within its precisely proscribed system of rank and duties; unlike his patients, who valued only his medical skill as a doctor and his ability to piece together the most complicated of puzzles; unlike his therapist who viewed him merely as person with symptoms that needed to be treated; unlike Mary who had wanted in him something he was not; unlike Mycroft Holmes who considered an individual's worth only as it was relative to their personal secrets which would at some point be used as ammunition in his own vast, impenetrable war of the worlds; unlike DI Lestrade who saw in him an accessible, affable face of Sherlock Holmes; indeed, quite unlike the rest of the world, Sherlock Holmes did not define John Watson.
His mobile buzzed again, this time with anthropomorphically more insistence.
Fine. It's from next door. You need caffeine. I need an outside eye.
John smiled down at the tiny glowing window into the mind of the man downstairs.
Perhaps he could define Sherlock Holmes after all: Friend.
…
He carefully shut the door to his bedroom behind him, and headed down.
DSM-IV Codes and Diagnoses
301.82 Avoidant Personality Disorder
301.6 Dependent Personality Disorder
301.81 Narcissistic Personality Disorder
309.81 Posttraumatic Stress Disorder
307.89 Pain Disorder Associated with Both Psychological Factors and Medical Conditions
299.80 Asperger's Disorder
301.7 Anti-social Personality Disorder
302.81 Fetishism
V61.8 Sibling Relational Problem
302.71 Hypoactive Sexual Desire Disorder