It hit him suddenly, like the bullet to his shoulder. He had a chance to call out "Sarah!" before the rest of his energy was consumed by just breathing. The thud of his heart pounded in his ears, buh buh buh, at least twice per second if not more, and he was gasping like a fish, an invisible vice around his chest, squeezing. Tachycardia, tachypnea, and angina.
Sarah rang for the ambulance while asking him all the questions John had already asked himself: any radiation? Any diaphroesis? She felt along his forehead, but his skin was dry, and his left shoulder and arm were fine—not that it meant anything. She asked him other questions that she knew the answers to: any recent surgery, any existing medical problems; no, and no. No smoking, and John did not drink often. No drugs. No family history of heart attacks, at all. He was just sitting, logging his progress note in the chart when it started. Not likely a heart attack.
She echoed his thoughts. "Not likely an MI. Is it severe?"
Oh yes. He was willing to say that it hurt more than the bullets did, because at least he had the adrenaline, various tricks of his nervous system to make him notice less of the pain. Pain was, after all, a message from the body announcing that it had been hurt, and there were ways to muffle it, to silence it for a time. Now, whatever this was, his body was not shutting up.
For crying out loud, stop.
Triage pushed him to the front of the list at the hospital, bypassing the normal five-hour wait in the ER. A nurse quickly checked his vitals: Temperature was 97.6 (normal), heart rate 136 (high), respiratory rate 31 (high), blood pressure 138/86 (normal), and oxygen saturation of 82% (low).
They put him on nasal cannula oxygen and ordered an EKG, which was normal, drew blood for his complete blood count and basic metabolic panel, which showed a bicarb of 30 (high). They did an echocardiogram, which showed nothing, and the attending, working on a hunch, wanted a CT-angiography, already starting the paperwork for his admission. He ordered an IV dose of heparin for anticoagulation, and by the time John was wheeled away from the CT rooms, he was already feeling better.
"But you run after Sherlock Holmes all the time," Sarah shook her head, "You haven't gone on any road trips, or flights, and you don't have any clotting disorders." She had already guessed what the attending was thinking, just as John did.
"It's a classic presentation though," John reminded her, "other than the no recent surgery or travel, or medical problem."
"But what else causes a pulmonary embolism?"
Sherlock arrived after John was already admitted, settling in with his heparin drip and a nurse establishing an arterial line in case of emergencies. In all the commotion, John had forgotten to text him, as did Sarah. How he figured out in the first place was a mystery, but John had long since learned not to question such things.
"I honestly thought Mycroft would be in this situation rather than you," he said without preamble.
Brusque and almost inconsiderate. John was use to worse, though, and at this point he could even make his own leaps further ahead of his flatmate. Mycroft, fat, likely hypercholesterolemia; Sherlock thinks this is a heart attack. "This has nothing to do with my diet or exercise."
"Of course not," Sherlock followed his lead, "you eat the same things I do and you're only three years older than me. So what is this, some kind of inherent propensity, lousy genetics, sudden fright?"
The oxygen released a loud puff, and John glared, feeling rather silly with the nasal cannula wrapped around his face. The air made his nostrils dry, and he really wished he could take it off without feeling short of breath.
"I'd think I would have been here sooner if it were a case of being scared," he rolled his eyes for good measure. "I'm not fucking eighty. The answer is: I don't know. We need more data. They're going to do an abdominal CT in a bit."
"What for? The problem is in your chest."
"Surely you must have realized by now that the human body is not divided into exclusive compartments," John returned dryly.
Sarah answered, "They're checking for malignancy, which could cause a pulmonary embolism—what he has. John's thrown a clot in his lungs."
"Waste of time and money," Sherlock rolled his eyes. "Cancer would have caused weight loss, at the very least."
"Except when it doesn't," John replied, though he agreed.
"This is most inconvenient," Sherlock complained, "Lestrade just dropped off a case and you had to throw a clot in your lungs."
"I'm so very sorry that a clot mysteriously showed up in my lungs and kept me from helping Your Highness." Still, he was interested. "What's he got now?"
While Sarah excused herself to the bathroom, Sherlock started explaining the newest case.
The abdominal CT took about three hours because of the queue. British healthcare lagged whenever something was not an emergency, and screening for cancer was not urgent. John thought he would not receive the results until he was discharged, but the primary team came in the morning and told him of the impressions. The attending, Dr. Rose, who knew John was also a doctor, even printed out the image to display the white lesions climbing up near the stomach.
"This makes no sense," John shook his head as he stared at the findings. "Are you sure they didn't mix me up with someone else?"
He had no jaundice. He had no nausea or vomiting. Before his chest pain, he had been perfectly fine. No fevers or chills. No change in bowel movement. This was ridiculous.
"We can give them a call," said Rose, "but it fits the pulmonary embolism."
The team left John feeling stunned and dismayed.
Late in the morning, they wheeled him to the PET scan. Afterwards, Sherlock visited, but John did not tell him about the study; it would have clued him in. The detective ranted about the case again, and how absolutely unhelpful John was being—just like him to show how much he cared by being completely callous.
The PET scan was read quite quickly, faster than John expected. Later, after Sherlock left, the surgical attending popped by, hair like Sherlock's, but his face was rounder, like a doll's. He wore teal scrubs with a mask hanging around his neck and blue shoe covers over his sneakers. He also knew John was a doctor and surgeon once, and cut to the chase since he expected John to already know everything.
"It's at the head," he said to him, "but from the images it actually looks encapsulated, almost. You ever do one of those before?"
"I've done at least a hundred back when I was training," John managed not to snap. "I've done two of them back to back in one day!"
The surgeon winced. "Ooh. I would never schedule that. Anyway, you in?"
John looked at him, a fit man with firm, toned arms and towering high above where Sherlock would have been. Some Italian blood, from the looks of the skin, with fine long hands tipped with short fingernails. John was thrust back to when he had donned such scrubs, a cap over his head, looking at the MRI films, the boards with the OR schedule of the day, washing his hands and forearms, practicing knots, palpating abdomens for tenderness—so many patients, with puffy bellies tied together in stitches, lying there, helpless and miserable.
"Uh," he said to the surgeon, "let me think about it?"
And the surgeon knew where his mind went. "Sure. I'll write you in for Tuesday two weeks from now anyway, but you let me know what you decide."
Back when John was a medical student, there was one week when he had three patients die on his team's service. They were an inpatient medicine service, which meant long walking rounds and presentations consisting of everything from a patient's itch to the long list of differentials that were unlikely, and yet still must be mentioned. John had already fallen in love with surgery, the brisk, to-the-point rounds that consisted of "is the patient dying? No? Advance diet," and cutting things in the OR to the tune of the Beatles and dirty jokes between the surgeon and the nurse. He hated medicine and hated medicine rounds, because they were so long, loquacious, and boring.
But medicine was a basic field, and he learned a lot while on that clerkship, especially that week. His first patient was a 74-year-old male with stage IV chronic kidney disease on hemodialysis, intubated and demented. The problem was that the man had so much other shit going on, such as hepatitis and congestive heart failure and chronic obstructive pulmonary disease, that every time he went down to dialysis, the blood pressure drop would provoke cardiac arrest. He was full code, which meant they had to do all the resuscitation, until at one point they were at it for an hour and the doctor in charge finally called it.
Afterwards, while the family grieved, John heard the nurses and some of the attendings complain to each other about the "fucking morons, forcing him to go through this." The folks in dialysis were also furious, exclaiming "We told the primaries that he's not fit for dialysis." John's attending had to sit with the family for a long time, explaining what had happened, and everyone was in a mood because if the man's family had just let him go, he could have died with less fuss and fewer cracked ribs.
That evening, his team admitted a 98-year-old woman with Alzheimer's with severe dehydration and a urinary tract infection. She was a "hummer", as they called it, wordlessly singing random melodies as she looked around the room without recognition. The cause of her dehydration was poor food intake, or more accurately, no food intake, because the lady refused to eat because she was demented, and her children asked the doctors to place a peg tube—then a relatively new operation—once the infection cleared.
They had less data about these things back then, so the primary team consulted the surgeons, who followed through and placed a peg tube in her. Not too long after, the elderly woman started screaming incessantly, to the point where they had to sedate her with haloperidol. She began clawing at herself, and managed, with a surprising feat of strength, to rip the peg tube out of her stomach before they could place her in restraints.
That did not end well for her.
But as traumatic as that was for John, the worst case was the last one, 41-year-old male, 5'10" and 76 kilograms, pancreatic cancer, status post Whipple Procedure one year ago, with a giant jagged scar on his belly to prove it. Not that it did him any good, because it was detected again, this time in his liver, his spine, and three rock-hard palpable nodes right above his clavicles. He had six bowel obstructive episodes over the past year because of the surgery. They thought he was having another, but when John saw him, his belly protruded like he was 8 months pregnant, full of fluid, his skin was a bright, glowing gold, and his ankles were like clay, keeping the imprint of John's finger for a whole ten seconds. He was in so much pain, he could barely talk, and his wife and child could barely talk either.
They gave him a whopping load of dilaudid, but he went into respiratory failure the next morning, and coded before they could transfer him to the intensive care unit. They could not resuscitate him.
Pancreatic cancer was like that. Struts around as if perfectly fine, and then whoosh, gone.
"Mike," John said afterwards, when he shared these stories with his classmate, "I want to cut people. I want to sew, to do all of that stuff instead of standing around and talking. But I am not going to undergo surgery, for anything. If I need to be on dialysis, just let me die. Especially if I'm already demented. If I get cancer, just give me lots of dilaudid. Give me like, a hundred packs of them, and twenty pills of Xanax."
"You want to write that in your will?"
John, of course, did undergo surgery later. There was no way to talk a bullet out of one's body, or to lecture a wound closed. Yet he always knew that when the time came to it, he would not try to postpone death. It boggled him, why people would go through such lengths, such suffering, just to stick around to be burdens to other people. As a childless bachelor with few friends and a sister already on her way to being a drunkard, John Watson saw no reason for such lunacy. Quick, sudden, in an unknown land far away from home, when without the bullet he would have been fit and fine—yes, he wanted to live, please, God, let him live. But if his body and mind were already failing, if all survival meant was more machines, more pills, more pain…
What would he go through that for?
He could breathe. He could run.
He tried pushups when he got home. Twenty-five with one arm, though he was out of shape from civilian life. Not a problem.
Denial.
"Don't touch those!" Sherlock yelled as he entered the room, and John looked reflexively at the kitchen, which he had actually avoided. "Those need to sit for at least two more hours. I'm going to look at them when we come back."
He visited John as the latter was being released from the hospital. John had done his best to appear casual, and even Sherlock, the brilliant observer that he was, could not see everything while he was distracted. The new case was frustrating yet puzzling, and Sherlock spent most of the time talking through it to John, his observations, his deductions, Anderson's incompetency, Lestrade's long-suffering.
"…drunkard, of course, his phone looked exactly like yours even though it was only bought two months ago. Likes to visit the Starbucks on eleventh street based on the smell of his clothes…"
John had breathed, for the first time hardly listening. He was thinking, not about himself or his figure, but about Sherlock. His eagerness for intellectual stimulation, enthusiasm over puzzles, rejection of sentiment or anything else that could hinder one's logic.
Ordinary man…John thought to himself, no accomplishments to speak of, except making this one amazing friend. That's an accomplishment, no?
He reflected on their adventures as Sherlock took a seat in his armchair. "Go make some tea, will you?" his request butted in. John rose to his feet before his mind even wrapped around the question—more of a command, really. Suddenly, he was remembering a Chinese family he had once taken care of as a surgeon before he went to the army; a mother was dying from heart failure, and the daughter had given up work to take care of her. Bedpans, blankets, washclothes, combs. The mother was thin, but the daughter actually seemed thinner. Tired. Stretched, like Bilbo from Lord of the Rings, functional but exhausted, depleted, hopeless and desperate. She had lost her job to take care of the mother, and when the patient finally passed away, the young woman wept in that stuffy room with blue curtains and fake flowers, wishing she had done more. Wishing that she had not been so tired that she was half-praying for her mother to die and find release so she could finally rest herself, and then regretting that wish, deep remorse and guilt, because she was such a bad daughter that she had wished her own mother to die. 5'2" and maybe 39 kilos at most, she was a pretty woman,or at least would have been if taking care of her mother had not aged her so. Thirty years old, looking like fifty. That was dramatic, for an Asian. What was the mother, 55? History of GERD, osteoarthritis—
"What are you doing?" Sherlock suddenly asked.
John looked up. He had been standing in front of the stove for a long time, pot in hand. He placed it on the stove and turned the stove on.
"Sorry. Brain's not working quite right yet."
He saw Sherlock give him a considering look, but did not acknowledge it.
He was sitting at the café across the surgery when Mycroft slid into the seat across from home. John continued staring down at his coffee. He did not want to go back to the surgery yet.
"I was expecting you to stop working," the elder Holmes said softly.
John shrugged. It figured that Mycroft already knew. Probably had his people hack into the hospital files or something. Him being the British Government was very annoying, but it was not like John could do anything about it. Especially not now.
"Sarah knows. I need to sign off on my patients though."
There was a long pause. John took a sip of his coffee. He had gotten it black, no sugar. God, that was bitter.
"Sherlock doesn't know," Mycroft remarked.
"He's been a little busy with his case."
"Are you planning to tell him?"
John finally looked him in the eye. "Let me guess. If I don't, you will."
Mycroft splayed his hands out, palm upwards. "This is entirely your decision, Doctor. However, I should warn you that my brother will not take it well either way. He is likely to be even more displeased if you do choose to withhold this from him."
John grinned. "Look at you. 'Displeased'. You're so funny."
Mycroft was still wearing his long grey coat. He stared back at John, silent, his face absent of any mirth.
John looked out the window. London bustled, busy as ever. Bright blonde hair went briskly past, atop high heeled boots. A dog, a black labrador. A few sparrows. A brunette in a parka.
"I haven't even made my decision yet," he said.
"What's keeping you?"
"It's a big procedure," John replied, "for a small guarantee."
John would know.
"You ever did it yourself?"
"Oh, yes. At least a hundred. Once back to back, and they both lasted over ten hours. My sneakers were good but…my feet were still aching two days later."
"What are the odds of surviving?"
"Depends."
Mycroft waited, feeling it unnecessary to prod.
"Stage I was 25-30%. It gets worse as you go on. Plus there's chemo."
"What stage are you?"
"Stage IIB. Not sure what kind it is, not that any of them are good."
Mycroft frowned. "Why are you so unwilling to find out?"
John shrugged. He sipped his coffee again.
"I often thought I should have died in Afghanistan," he confessed. "Didn't really understand why I survived. Can't even do surgery, after that. You see a lot of death when you're a doctor. My first year on the wards, I saw five deaths myself. It's the dying process that is scarier, not the end of it. When you're dead, you're dead," he leaned back, "and the ones you leave behind are the ones that grieve. But if you try to survive, you deny it, you're in denial, you reach for that 25% possibility that you'll live, combined with the 40% possibility that the remainder of your life will be shit and you'd spend most of it in a hospital hooked onto a ventilator with a crash cart on standby, you can't talk, you can't move, you can't be bothered to learn what's going on beyond you, and you're almost unconscious with dilaudid, and then they give you miralax to make you shit, your abdomen's a huge bruise because they give you heparin shots, your creatinine bumps and then they pump you full of fluids to protect your kidneys—" he cut himself off for a moment. "I wouldn't come out of it ready to run behind Sherlock on cases, Mycroft. Chances are, I'd be even more crippled than I am now." He looked up at Mycroft. "I once asked God to let me live. He's shown me what it could mean. Ultimately, Sherlock saved me," at this, he smiled, "but he won't be able to save me from this."
"'Chances are'. 'Possibility'. You're talking all about the worst case scenarios," Mycroft pointed out.
"I've seen enough that I don't want to take that chance," John replied. "Pancreatic cancer is a bad cancer. One of the worst, if not the worst. But it lets you live your life before it kills you," he nodded. "Painkillers don't always work when the end comes, in fact, they rarely do. Your body screams at you that something's wrong," he smiled again, "but compared to the slow deaths many other cancers cause, pancreatic cancer is merciful. I'd be able to run behind Sherlock all the way up until the end. Be like that awful cabbie," at this, he had to suppress a chuckle, "and continue driving around, working. No one would really know. And I want that, you know? I don't want to waste time, waste life, going through all these drugs, losing my hair, feeling like shit. I want to enjoy life while I still have it, and I want to enjoy it with Sherlock. I don't want him mourning me before I'm already dead."
"You might not die," Mycroft insisted, and John realized that for all his passive demeanor, the elder Holmes was scared. "You can go through with the Whipple. They could take all the cancer out."
"Not likely," John stated. "They only saw one lymph node, but I had a PE, Mycroft. That usually comes late in cancer."
"You usually have symptoms before you have a PE."
"True." So Mycroft had been reading up on this. John had to smile. The British Government was looking up on his well-being. That had a certain humor to it. "But PE's are bad, Mycroft." He looked aside. "In retrospect, I probably should have let that kill me now, instead of waiting for death later. It's going to be really bad. I better be unconscious for most of it."
He was not going through the Whipple, John knew. Even though the surgeon still had him on the schedule, John was going to say no. He was already looking ahead to how it will be as he lay on his deathbed. Probably a belly as ballooned as his former patients, reclining like an asshole and totally high on opiates. Dilaudid and Benadryl. That was what the malingerers liked to have. He could try it and see what the fuss was all about. He wasn't able to last time.
Today was Friday. He had one week and four days to call. He will call tonight.
Mycroft looked aside. "Sherlock calls himself a 'highly functioning sociopath'." He looked back at John. "The truth is, Sherlock feels too much. If you do this, John, it will kill him."
The words provoked a sliver of doubt in John's heart.
"He's done fine before he met me," he pointed out.
"Just think about it," Mycroft said, instead of answering.
John smiled and made tea and made phone calls to doctors he had referred his patients to. He checked his email and wrote in his blog, agreed to go with Sherlock to examine the park and local stores like he usually did. Somehow, Sherlock still figured out something was wrong.
True to form, the way he announced this was to turn to John as they were heading home and asking, "What's wrong with you?"
"What's wrong with you?" John stared at him, putting on his best incredulous mask. He was a doctor. He knew how to act. It was half of the job these days.
"Don't try," and Sherlock scowled, "you've been acting off ever since the hospital. Pulmonary embolism. They did a cat scan. What did it show?"
'Nothing,' John wanted to say. 'Everything's normal'. Except when it came down to it, he could not lie to Sherlock, even if the man could not smell a lie from halfway across the world.
"This is not the place for this conversation," he said at last.
"Tell me," Sherlock demanded, as impatient as ever, but John had a stubborn will of his own.
"We should get back first. I need to sit down for this." Because in the end, John was not sure how Sherlock would react. Apathetic? Perhaps not. John had taught him better than that by now. Falsely sympathetic?
He made tea first, much to Sherlock's frustration. It was not until they were both sitting with the cups in hand; Sherlock's knee bouncing up and down like it were being tased—that John began.
"They found a mass," he told Sherlock, "at the head of the pancreas. It's a tumor, and it's spread to one node. Stage IIB, we call it."
Sherlock did not really have a face for complete shock. It was more the lack of movement, how his face really looked like marble, and his eyes became more vivid, focused, but without calculation.
"Is surgery an option?" he asked.
"It's a bad option," John replied.
"Why is it bad?"
"Because the surgery is a complicated procedure. Pancreaticoduodectomy, or 'Whipple procedure'. It involves slicing off part of the stomach, duodenum, bile duct and gall bladder, along with the head of the pancreas. It's risky, it's got a high rate of complications, and you might live for five years if you're lucky."
"When are you going to do it?"
John hesitated. Despite having his doubts before, he could not deny that his next words would provoke a shitstorm. "I'm not."
Sherlock paused for a full five seconds. It was the longest five seconds of John's life—this must be how Sherlock felt when everyone else was trying to think.
"What?" he demanded.
Sherlock had been mean, callous, inconsiderate, and annoyed before. He had never been angry at John, as far as John could remember.
There was a lot of yelling.
"You're just looking at all the negative things that can happen!" Sherlock spat while he pointed vehemently at the computer screen. "Look, the Americans—Johns Hopkins posted that survivors rate a 79 out of 100 in terms of how well they can function!"
"Sherlock—"
"They slice and they sew and that's that! You've been operated on before! What's the difference?"
"Sherlock, I've done these procedures. I've taken care of patients afterwards—"
"Well of course you're only going to see how they suffer—people don't come to the hospital if they're doing well!"
"I do happen to follow-up on my patients as well, thank you—"
"No, you're just scared," Sherlock turned to him with his eyes blazing, "I never thought you were a coward, John Watson! You never seemed this pathetic—"
John was done listening to him. He turned and retreated to his bedroom, slamming the door closed.
He stared up at his ceiling from his bed, looking at the various cracks in the paint. An hour and a half passed before Sherlock opened his door without knocking. John was about to tell him to piss off, but Sherlock was subdued this time. Maybe they could have a proper conversation, like adults.
He did not realize how much he was fuming until Sherlock's words took it out.
"I don't want you to die."
The remark, considering the person speaking and the circumstances, was actually rather inane. Stupid enough that John knew just how much it took for Sherlock to vocalize that simple thought. He looked over at his flatmate.
"The Whipple's not necessarily going to save me."
"I know," Sherlock wavered. He was still fully dressed, John noted; he had not changed out of his clothes, only putting his coat and scarf on the hanger.
"I cheated death many times already," John pointed out, "at least for this one, I get to say goodbye."
Sherlock clenched his teeth. "I am prepared…" he inhaled coarsely, "I am prepared to fight for you. Every step of the way. I will do that. I will pour everything I've got. As long as you do it too."
John sat up at this. He knew a vow when he heard it. Sherlock's eyes glittered at him, glossy with desperation.
"Five years," he said softly, "One year's not even a good chance. And all the while, I would be living a pale imitation of a life. I wouldn't be able to help you on cases. I would probably be sick all the time. I use to tell patients with relatives who have this cancer to book them trips around the world. Let them get totally wasted. Live life to the fullest. Don't bother with chemo."
"I don't care about the cases."
John looked away. "I'll drag you along with me. You're underestimating what this is."
"I know exactly what this is. You're afraid of losing, so you're giving up now. That's cowardly of you."
"It's not a question of giving up, Sherlock. The battle's already over."
"No it isn't! You said this was operable!"
"And the operation does jack!"
"No it doesn't! It certainly gives you more of a chance than you do without it!"
"It's not meaningful, Sherlock!"
"It is to me!"
John stared at him, stunned beyond words.
In two strides, Sherlock was upon him, hands cupping the sides of his head and his own face close, eyes right in front of his. Ludicrously, the words I'm not gay echoed in his brain, but they washed away with the intensity of Sherlock's words.
"Every minute counts to me," he whispered, the voiceless words like a scream. "Every minute counts. Please. You haven't lost yet. We haven't lost yet. You're not dead yet, and you can live. Every second counts. You can't give up."
Cancer liked to metastasize to the spine, so when a 36-year-old Russian woman with squamous cell lung cancer with established metastases to the liver showed up, weeping due to severe upper back pain that radiated to her arms, they did a STAT MRI of her thoracic spine. Which showed nothing, so the medicine team was forced to admit her. Everyone grumbled, because they had no idea what to do; there was no physical source of her pain, and they figured it was just a paraneoplastic syndrome; the body just complaining about how it was eating itself. There was not much more to be done than throw narcotics at her, so John went about his business looking at charts, copying labs and writing his SOAP note, copying the assessment of "paraneoplastic syndrome" and signing and dating, making sure to label himself as "med student".
Their attending was not an oncologist, and certainly not her personal doctor. She did see an oncologist at St. Barts, though, and one day the man went over to pay her a visit. Her family was there, including her 55-year-old mother. John went to observe how he spoke to the family.
"There are other options I can give you," he said, "I know that these recent developments seem like a step back, but we have other medicines we can try, if you're open."
"No," the woman wailed, "I want to stop. I want it to end. I'm tired. I want to stop."
Her mother was frantic. "Listen to me," she exclaimed, "You listen to me. You can't give up. You can't just stop fighting. We are here for you, we don't think you are a burden, we want you with us. Don't you quit now. Don't give up."
The oncologist listened calmly, but when the mother thought she was done, he added, "It's your choice. If you want us to stop all medicines, all invasive procedures, and just keep you comfortable, that's fine with me. That is completely appropriate. I am just letting you know that there are other options, we have not exhausted all of our resources yet. You can think about it for a bit. In the meantime, I'll let the primary team know to keep you as comfortable as possible."
He came out and told John, "We haven't exhausted everything…but she's Stage IV. She's never going to be 100%. You'll see a lot of this when you talk to families; family members will try to manipulate the patient and tell them, 'don't give up! You can't give up!' There's a difference between giving up, and saying 'you know what? All of this painful effort to postpone the inevitable isn't working for me. I just want to live life to the fullest for as long as I have left'. Because these treatments do decrease the quality of life, and you have to make a decision, is it worth suffering more to live just a little longer, or is it better to just be comfortable for how long you've got?"
It was interesting then, because until the oncologist pointed it out, it never occurred to John that when family members say such things, they were 'manipulating'. He always thought of them as being encouraging, giving a proper pep talk. But afterwards, as he mused on the case, he came to agree with what the oncologist said. Calling it 'giving up' is inaccurate. That was not what patients were doing when they wanted to stop treatment, and to define it that way was manipulative. Even if that was not the loved one's intention.
Afterwards, John would sporadically think back to this case, because it had caused such a paradigm shift.
But John could also see why some patients chose to fight for those extra days. He was no longer a young medical student, independent and free and without responsibilities.
"I'm sorry for this inconvenience," he said to the phone, while the surgeon reassured him, "No, no, this is totally fine. I'll put you in for Wednesday? A patient just dropped from the schedule, so I can put you in."
After confirming, John took a deep breath and glanced at Sherlock sitting on the sofa, feeling suddenly lost. This was it. He was going through with the procedure. The days ahead would be rough.
Sherlock stood and stepped over, placing a hand on the back of John's neck and squeezed.
"I'm here," he said.
A/N: This is not a recommendation for anyone out there who needs surgery. Nor do I think patients are assholes. Doctors have a different expectation of themselves, though. We are use to the other side of the hospital, and a lot of us hate being patients. I can see John Watson being the same way.