Don't Forget to Breathe.
It started when he was eight. He'd never been a particularly chesty child; he'd never had bronchitis or even suffered with hay fever before that day when he'd stood prodding a dead magpie in the garden of his childhood home. He'd had a cold for the past few days and while Mycroft had insisted that he should stay indoors out of the cold, wandering around outside in the crunchy frost seemed a much better idea.
Sherlock had stood on the bird by accident, his boot sliding harsh and noisy against the frozen feathers as he kicked a pile of leaves under the tree in the garden. The icy wings and solid, staring eyes intrigued him greatly and it was while he stood, bent over the magpie with a twig in his hand that Sherlock felt the first indication that something was wrong. He'd been breathing heavier than usual all morning, which was no surprise considering how stuffy his nose and how raspy his throat felt, but a strange, tight sensation in his chest had also begun to settle in. Cold sweat had prickled along the back of his neck and under his arms where an invisible band restricted his lungs within his rib cage. The boy coughed to clear the feeling, a ragged bark releasing a cloud of warm air into the frigid garden, but the sensation did not shift. He'd lowered himself down then; the damp ground beside the dead bird soaking uncomfortable wet patches into the knees of his trousers, and simply tried to breathe. It had proved far more difficult than it should have been.
Sherlock had tried to cry out, looked from one end of the garden to the other and back to the house but not even Mummy was visible at the kitchen window. Another choked wheeze and hot tears had started to blur his vision, wetting his chilled cheeks. It wasn't fair. Besides not having a clue what was going on, he had had to contend with the idea that Mycroft had been right about staying indoor. That had felt almost as unjust as the suffocating feeling. Sherlock sagged forward, harsh, wheezy sobs squeezing their way out of his throat, the frozen eyes of the dead magpie fixed on him to witness his fate.
That was how Mycroft had found him, pitched forward onto his hands and knees in the damp morning frost, gasping like a congested fish.
"Sherlock," Mycroft's newly broken voice had sounded so crisp on the chilled air. "Mummy says to come in this instant," he'd parroted, his tone well practiced.
He'd received no reply, of course, and Sherlock could remember thinking that even if he had been able to breathe in that moment, he wouldn't have graced him with a reply anyway. As it was, great, dark shadows had started to blossom before his eyes, his brain beginning to suffer from oxygen deprivation and Sherlock had rewarded Mycroft's bossy order by slumping face first into the grass.
Mycroft had probably never moved his tubby teenage backside quicker than in that moment and it had been a great regret of Sherlock's ever after that he'd spent those moments with his nose planted in the dead leaves, desperately trying to draw breath, instead of savouring the sight of Mycroft running.
"Sherlock? Sherlock, what on earth is the matter?" He'd heard as Mycroft had turned him over. "Why are you making that terrible noi-" Mycroft had cut himself short as he'd got his first look at his brother, taking in the blanched complexion, his blue tinged lips and wide, frightened eyes. "Oh my- Sherlock!" He'd stuttered, hands fluttering above the child's coat as though searching for something to make better. Resting his hands atop the heavy material, Mycroft's eyes had widened at the feeling of Sherlock's heaving chest.
"Breathe, Sherlock!" He'd urged, sitting his little brother up to try and ease his struggle. "You must slow down, you're much too fast," Mycroft told him. "Breathe. That's it. You'll be alright," He'd tried to reassure him, lifting Sherlock into his arms.
He'd taken a run back to the house, his calm demeanour disappearing with Sherlock's winded gasps terrifyingly close to his ear. "Hold on, Sherlock," he'd urged, rubbing Sherlock's back vigorously.
Mummy had been absolutely horrified when her eldest had burst into the house with her youngest slowly suffocating in his arms. They'd sat him on the sofa, stripped him to his bare chest to prevent any further restriction and held his hands while Father had called an ambulance. In retrospect, it was one of the bets Christmases that Sherlock could remember. He'd never had a ride in an ambulance before and, while the following years of his adult life held many future ambulance rides, Sherlock endeavoured to enjoy it as much as he could once the blessed steroids had absorbed into his system.
After that very first attack, they had always been few and far between throughout his childhood but they were extreme when they did happen. Sherlock had had to be hospitalised no less than twelve times between the ages of eight and eighteen due to severe asthma attacks, the last having happened during university. They were fewer after that and, as an adult, he'd had the luxury of choosing whether to submit to paramedics or manage on his own. Practice certainly helped and he became quite adept at controlling his breathing. The action of smoking – inhale, hold, exhale – came naturally and while he knew he wasn't helping himself, it was worth it for the relaxing effect (and the disapproval of his brother).
By the time he met John Watson, Sherlock hadn't had an asthma attack in almost three years. Giving up smoking had improved his lung function greatly, and while his breathing wasn't a problem, he'd never thought to mention it. In hind sight this turned out to be a rather stupid mistake on his part.
John had only witnessed one attack , not long after he'd been strangled during the Blind Banker case in Soo Lin's flat. He'd managed to make it all the way home before he'd promptly slumped over the kitchen table onto his forearms and wheezed like a broken squeaky toy. It had been the first time John had seen the detective looking anything less than dignified.
Sherlock hadn't even seemed to notice John's presence once he'd bent to get his breath back (and failed miserably); prompting the doctor to rest a hand on Sherlock's back to determine just what was wrong.
"Panic attack?" He'd asked, feeling gently for signs that his lungs were collapsing or his chest injured. Sherlock shook his head and closed his eyes, fighting to stop the rasping sound he was making. It was then that John had noticed the bruising rapidly coming up in a thick band around Sherlock's pale neck. "Sherlock, have you been strangled?" He'd asked in alarm.
That had earned him an eye roll, despite the rough panting Sherlock was forcing out. No time to explain that one, then. By that time, Sherlock had begun to try to push himself into a standing position, his hands reaching to brace himself on nearby furniture.
"No, no, stay there," John had told him, pushing him into a chair at the kitchen table. "Asthma?" He'd asked, sighing at Sherlock's curt nod. "Why the bloody hell haven't you said anything before? No, forget that, don't answer. Where should I look?" he's asked. "Bedroom?"
He'd never seen any medicine in the kitchen, living room, any of the drawers of the furniture in the rest of the flat and nothing in the bathroom, which left only the detective's room. The only room in the flat that he hadn't explored since he'd moved in.
Sherlock gave another nod, his eyes falling shut from the exertion. He'd started flagging and John wasted no time in jogging down to Sherlock's bedroom. He'd rifled through Sherlock's precisely placed possessions, paying no heed to the mess he made as he searched every draw and flat surface he could find. John had found the blue inhaler stuffed deep within Sherlock's sock index in the end, obviously unused for quite some time.
The detective was exactly where John had left him, eyes closed, lids fluttering while his eyes roved under them, his mind attempting to provide distraction while his lungs shut down. They'd flickered open as John's heavy footfalls returned, regarding him sluggishly as John had slid a hand behind the back of his neck to hold him in position, the other bringing the medicine pump to his lips. He'd given Sherlock a quick warning and depressed the pump of the reliever once, waiting five seconds and then repeated the action. John's had eyes never left Sherlock's face, watching for signs of improvement. After a minute, Sherlock had given a quiet cough, trying to hurry his lungs along.
"Steady," John had warned him, pressing the reliever into Sherlock's hand to administer the next dose for himself. "Just give it a minute."
Sherlock had given no indication that he'd heard and simply lifted the pump to his lips. He'd finally let out a full breath and relaxed against the chair. He was still wheezing, much to his chagrin, but his chest was finally beginning to feel close to normal.
"What the bloody hell was all that?" John had asked afterwards.
"Doesn't happen often," Sherlock had replied, his voice still strained.
"It was a rhetorical question," John said, rolling his eyes," Shut up and breathe."
Sherlock had huffed an audible snort but took the advice. The lectures came after that. Endless nagging about how many inhalers he had (just the one, he'd not had a repeat prescription in years) and where they should be kept (kitchen, living room, bedroom, bathroom, coat pockets). A strict new policy of using a preventer every morning and the promise that yes, he would agree to carry a reliever from now on if it would make John happy, were put into place.
"Honestly, I don't even know how you've managed so long without adequate supplies. You'll end up killing yourself if you're not careful," John had complained. The doctor had even resorted to carrying one of Sherlock's relievers himself after that.
Unfair as ever, Sherlock's lungs had always chosen awkward and inappropriate moments to make their protests known and it was at the end of a particularly dull case several months later that Sherlock had begun to feel that familiar heavy feeling.
There had been no exciting chase, no explosive conclusion, not even a resonating shock waiting for them at the end. A simple discovery of the murder weapon in a woman's underwear drawer and an emotional confession as to where she'd hidden her boss' body was all the fanfare they got.
"Thanks for that, gents," Lestrade said, coming back up the stairs to the bedroom where John and Sherlock were still examining the phials of poison that the suspect had hidden. "Just how did you know it would be in her knicker drawer?" He chuckled.
"Obvious," Sherlock grunted, loosening the scarf around his neck. "It was the first…First place she…Thought to protect when," he coughed, trying to loosen the muscles at the base of his throat and chest, "When we arrived… Same… Principal as… Mother in… Burning building," he managed to get out, one hand sliding up to his collar to loosen the neck to his shirt as well.
"Sherlock?" John's voice cut through his thoughts, his tone enquiring. He didn't want to embarrass the detective but the doctor within him was unwilling to let the change in his friend go. John had learned to always be prepared where Sherlock was concerned. Which was why, when he plunged his hand into his jacket pocket, he did not expect to find it empty. "Shit," he muttered, trying the other pocket just in case. "I took it out last week when this went to the dry cleaners," he said apologetically. "You'll have to use yours."
Sherlock shook his head, his features unmoving as he felt behind him for the solidity of the wall. "Outside," he demanded his voice deep and strained.
"Ay?" Greg said in confusion, uncrossing his arms as Sherlock pushed past him and tramped down the stairs on heavy feet. "What's going on?" he asked John, face pinching in concern when he realised that something wasn't right.
"Bloody idiot's having an asthma attack," John informed him as he hurried after Sherlock.
By the time the doctor and the inspector got outside, Sherlock was leaning back against the garden wall, his laboured breaths creating clouds of steam in the chilly night air.
"Asthma? Since when?" Lestrade's voice could be heard as they came through the front door.
"Since childhood, apparently," he said at Greg's incredulous look. "He didn't mention it to me either until I caught him gasping like a fish one day."
Coming around in front of the labouring detective, John shoved a hand into Sherlock's coat pocket, feeling around for a second before roughly diving into the other one with a new sense of urgency.
"Where is it?" He hissed. "Sherlock, where's your reliever?"
Sherlock shook his head, a humourless smile pulling at the corner of his mouth. He huffed an almost amused sound and gripped the rough brick of the wall behind him.
"Bin," he answered at last. "Ran out… Yesterday. .. Thought you had… A spare," he coughed.
"Oh God," John breathed, realisation hitting cold and shocking like a bucket of ice water being dumped over his head. "Christ, Sherlock, why didn't you- Never mind. Greg, call an ambulance," he ordered, shucking his coat from his shoulders and laying it on the floor.
He pushed gently at Sherlock until the detective obliged and slid awkwardly down onto the coat, sitting with his back to the wall. Sherlock's shaking fingers scrabbled for purchase in the waxed material under him, fisting it into a bunch between his clenched digits and squeezing reflexively until the texture was all he could think about. For every convulsive breath he managed to draw, he squeezed the jacket. John's jacket. John was there and so all would be fine, he concluded.
"Go and see if anyone else on the squad has an inhaler," John's voice requested as Sherlock blinked his eyes open, unable to remember when he'd closed them. "Breathe, Sherlock," he heard John tell him as the doctor knelt down beside him on the pavement.
Sherlock wanted to roll his eyes, he wanted to laugh and ask John just exactly what he thought he was trying to do but the words wouldn't come. He was emitting a truly terrible sound with every forced chest movement now and Sherlock just about managed to lift his chin as Lestrade came jogging back to them.
"No asthmatics on the squad. Donovan's checking inside the house for something that might help," he said, regarding Sherlock with a stricken look. "Jesus, Sherlock," he muttered, alarmed at the harsh scraping sound squeezing from his throat. "What can we do?" he asked.
John shook his head, dropping his chin between his shoulders for a moment and pinched the bridge of his nose with one hand, the other firmly pressed to Sherlock's shoulder to keep him vertical against the wall.
"We wait for the ambulance," he said quietly. "All we can do is try to keep him conscious and keep him breathing."
At the sound of John's voice, Sherlock's hand lifted, clumsy and uncoordinated, tangling in the soft wool of John's jumper. He could feel his eyes trying to slide shut again, the exhaustion setting in. How long had it been now? Four minutes? Seven? It felt like a lifetime but it couldn't have been more than eight minutes because there was no ambulance and he knew he'd heard Lestrade dial 999 and bark at an EMD to get some paramedics to them pronto.
"Sherlock," someone was calling his name, he realised. "Sherlock! Open your eyes!"
Cool fingers patted his cheek none too gently and when his eyes refused to open, a sharp set of knuckles were dragged forcibly up his sternum prompting a groan from deep within his chest. His eyes opened a crack.
"Look at me, Sherlock, that's it. Keep looking at me," John insisted, his face much closer now. John had the fingers of one hand pressed firmly against his carotid artery, the other hand gripping his shoulder tight. "We need to lower your heart rate."
It seemed a sensible idea to Sherlock, who could feel the organ banging against his rib cage violently. He gazed at John who knelt beside him, the perfect image of impeccable calm and practiced army doctor.
"Sherlock? Are you listening to me? You're going to lose consciousness if you don't oxygenate your body. Your transport needs you to focus. If you stop breathing, your brain will suffer the consequences. So breathe."
Trust John to use blackmail to keep him awake when all he wanted to do was close his eyes again. The fatigue was impossible to ignore and he was dimly aware that he wasn't making much noise now. That would explain the second painful dig at his sternum.
"Wake up, you bastard," the doctor growled, giving Sherlock's face a much harder slap.
"Steady on," Greg muttered from beside him, watching as Sherlock took a shocked, reflexive breath in.
"Same principal as a new born," John told him, shaking his head. "The shock of the blow stimulates the lungs for a moment," he explained, locking eyes with the detective as they opened tiredly.
"Come on, Sherlock. The ambulance is almost here, stay with us," he said, his tone softening a bit when the detective's eyes focused on him. "That's good. Deep breaths if you can. In, hold and out."
"J-ohn," Sherlock managed to hiss, fingers tightening in the material of John's jumper.
"Don't talk, Sherlock, save your breath," John hushed him. "Just breathe for me, nice and slow."
The ambulance arrived three minutes later, though Sherlock was barely conscious enough to notice. As the vehicle skidded to a halt just a few meters away, the detective let out a gurgling sound and promptly stopped breathing.
"Shit! John!" Lestrade called, shaking Sherlock's shoulder to try to rouse him.
John swore and took Sherlock's head in his hands, guiding him onto his back. He bent to hold his ear to Sherlock's lips and when no breath sounds could be heard or felt, John fumbled for his pulse again, relieved when it beat erratically against his fingers.
The doctor wasted no time and titled Sherlock's head back, pinched his nose closed and delivered two breaths to Sherlock's lungs himself. He turned his head to watch his best friend's chest rise and fall, felt the exhale against his ear and did it again.
"Come on, Sherlock, breathe," he urged. "Please don't do this. Come on… Come on!" He repeated the artificial respirations three more times before two paramedics dropped to his side. One ripped Sherlock's shirt open to begin attaching sticky electrodes to his chest for an EKG to assess his rhythm, while a female paramedic took over from John. She fitted a bag valve mask over Sherlock's nose and blue lips, beginning a steady deliverance of air to Sherlock's lungs while John explained what had happened.
"This is Sherlock Holmes, thirty six year old male, suffering from a severe asthma attack. It started," he paused to check his watch, "About twelve minutes ago; he's been in respiratory arrest for about one minute. No medication administered, he wasn't carrying any."
The paramedics were grateful for John's quick and detailed description of events, prepping Sherlock quickly for transport and loading him into the ambulance. The woman delivering artificial breaths via the bag valve mask did not look up from her task as John climbed in behind them and her partner slammed the doors shut, getting their journey under way. The EKG above the gurney showed sinus tachycardia, which wasn't unexpected, but it gave John a decent idea of just how hard Sherlock had been working to keep breathing.
"I've never seen this in a man his age before," the medic said to him, looking up from her task. "He's extremely lucky that we're so close to the hospital.
She was right. This was rare and had they been further away from treatment, there was only so long that he could have kept Sherlock going. The doors were thrown open as soon as the ambulance pulled to a stop outside the accident and emergency department. Sherlock was whisked away in a flurry of scrubs and stethoscopes to be intubated and pumped full of bronchodilators and steroids while John was left to spend the evening in an uncomfortable plastic chair. The doctor texted Greg his thanks and then pulled up Mycroft's number, staring at it for a good five minutes before actually sending a message. He kept it brief. Asthma attack. He's at the Royal London. JW, and shoved the phone back in his pocket.
The reply came fifteen minutes later, a simple, Thank you, John. MH, and the rest of the night passed in a drawn out silence. In the early hours, a young doctor in scrubs came out of the resus room to inform him that Sherlock had been intubated upon arrival and would remain that way until the next day.
"He's responding well to treatment," the doctor told him, "And I don't foresee any complications. An asthma plan might be a good idea to keep in his wallet," he advised.
John snorted but agreed to provide a nurse with Sherlock's details so that they could draw one up. The detective couldn't even remember his medication or his own wallet half the time, settling for the assumption that John would just take care of things. What were the chances of Sherlock remembering to carry a medical card?
They let him in to see his friend at just after three in the morning. He'd refused to go home until they let him see Sherlock and though he knew there was nothing he could do for the time being, John felt better for being there.
Sherlock was extubated the next afternoon and sent home with a bag full of prescription inhalers to keep him going. Mycroft had stopped by that morning and, to John's surprise, Sherlock had simply nodded at whatever his brother had whispered into his ear. John had expected an eye roll at the very least, perhaps a grimace around the ventilation tube, but he'd simply closed his eyes as Mycroft's hand gently brushed a curl from his forehead.
The elder Holmes did not stay for long, though he offered John what was the doctor assumed was the closest look he could manage to gratitude and shook his hand before he left.
"I don't suppose I need to tell you just how incredibly stupid you've been?" John asked once Sherlock had been discharged and they sat in a cab on the way home.
"No, you needn't suppose that," Sherlock croaked, his voice gravelly from the abuse his trachea had received via the tube.
They remained silent for the rest of the journey and neither of them felt the need to say anything more on the subject until they sat in their chairs, a cup of tea on each tea table, and Sherlock finally raised his eyes to John's face.
"Thank you," he said at last, his expression just a little softer, "For what you did. It was…good. Mycroft insisted I should thank you verbally. I had intended to thank you by agreeing never to take carrying medication for granted again, but he insisted.
"Just promise never to do it again. I mean it. I thought you under stood last time it happened. It isn't always controllable and you can't will it away," John told him, rubbing a tired hand over his eyes. "Next time I might not be there."
"My word on it," Sherlock promised.
The next time it happened, John wasn't there. The first few wheezes were met with a horrified look from Lestrade, who promptly pressed a familiar blue inhaler into his hand.
"John gave it to me," he told the detective once he'd stopped wheezing.
"And them?" he asked, glaring at the crowd of Metropolitan police officers from Lestrade's squad who stood nearby with back up inhalers.
"Well… Pays to be prepared where you're concerned," the inspector chuckled.
In his pocket, Sherlock's phone buzzed with a message from John.
Enjoy your case. Don't forget to breathe! JW
Sherlock snorted, closed his eyes, and breathed.