BBC Sherlock: Death Wish
Chapter 4: The Method
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The male guard at Fenshire District Hospital reception stopped them immediately, but the apparent 'legitimacy' of their visit—Sherlock had no need to flash a purloined warrant card—procured them a stop at the office of Cynthia Willows, Director of Patient Admissions.
"We have urgent business with one of your patients at the request of his late wife," Sherlock addressed the middle-aged redhead—dyed an unnatural color tone—as she shut the office door and returned to her chair. The detective wasted no time after exchanging introductions to get to the matter. "Earlier this morning, I rang and spoke with Assistant Coordinator Edmund Davis to inform him of our concerns. This preliminary investigation on a pending police matter required our trip from London to make inquiries."
"I see," Director Willows nodded with practiced politeness. Her professional attire, a hunter green suit jacket faded at the elbows and a black synthetic 'silk' blouse accented by a string of faux-pearls, suggested a frugal lifestyle on a modest budget. "What's the name of the patient?"
"He's currently unidentified, but we have reason to believe he is Harmen G. Cain. With our information we expect to identity him or help him remember even if he is not fully coherent to identify himself," Sherlock stated, more cordial than cocky, but the director remained wary.
"Not possible," She flung a dismissive hand and crossed her arms over her chest. "Whatever business you might have, I fear this patient is in no condition for visitors, Mr. Holmes, Dr. Watson." Her no-nonsense body language clearly meant end of discussion.
"What, may I ask, is his condition?" John asked, unperturbed by her defensiveness.
"Other than grave," Director Willows cut her eyes at John and replied curtly, "I'm not at liberty to say—" Her desk phone rang. Frowning, she pushed back in her swivel chair and sighed, "Sorry." Her focus turned inward as she lifted the handset, "yes?"
Sherlock's sharp ears picked up the gruff voice of the reception-desk guard and distinctly heard his message.
"Send him in," Willows replied and grunted as she replaced the phone. "Detective Inspector Gareth Bane from the Norfolk Constabulary is here. He says he also has business regarding this Cain person…well the patient you are claiming is Cain."
"Quite right! I was expecting him. Cain's condition may be the result of attempted murder," Sherlock's pleased tone was charged with authority. "I suggest your assistance at this time will ensure that Fenshire District Hospital will be found blameless in his death."
Director Willows eyes widened and she hesitated. "Attempted murder, you say? This is disturbing—" To the rap on the door, she responded, "Come in, Detective Inspector."
Detective Inspector Gareth Bane burst through the door, flushed and winded. His overcoat, donned in apparent haste, hung open and twisted over his large frame and carried the distinct aroma of cigarettes. "Got 'ere as soon as I cu'd," he announced in a gravelly voice that carried the cadence of a Manchester upbringing with a hint of East Anglia. Standing tall at more than 1.8 metres, his husky build had shifted from firm muscle to portly mass and his bald head sported feathery wisps of grey strands. Bland skin tones rendered his grey moustache nearly invisible. In mien he was a seasoned veteran of the law enforcement unit, yet he had the eagerness of a younger officer and his eyes gleamed like a man with purpose.
Bane's glance skittered toward Sherlock and John before he addressed the hospital authority with formal courtesy, "Director Willows, I'm 'ere to identify the patient. If it's who they think it is," he tilted his head toward the two men, "I've also got legal warrants and documentation," he waved a thick envelop in a beefy fist, "so Cain doesn't evade custody."
"Custody? I thought he was a victim?" She shook away her confusion and without waiting for an answer, briefly pressed her intercom: "Paging Dr. Sam Spencer. Please come to Patient Admissions." Clasping her hands atop the desk, she leant forward on her elbows. "Now, this patient is not going anywhere, even if he is a criminal. I will have Dr. Spencer explain. In the meantime, Detective Inspector, let me check over your confidentiality disclosures forms for release of information and your warrants..."
Bane approached the desk, carefully identifying each document he handed the director.
"Some of these arrest warrants are decades old!" Willows remarked with incredulity.
"There's no statute of limitations for murder, Director…" the DI countered.
"Isn't it alleged ..." she queried him, "until found guilty in a court of law?"
John shot furtive glances toward Sherlock, not fooled by his silent friend's calm façade. The director still had every right to deny them information; it all hinged on the DI's paperwork. The twitching in Sherlock's cheeks was nearly imperceptible—although John knew that he was seeing overt signs of Sherlock's edginess. Tight-lipped, Sherlock showed enormous restraint in the presence of all the "ordinary little brains" in the room.
"'E was evasive of the law on many counts and for many crimes…but circumstantial evidence surroundin' missin' persons made 'im the prime suspect…"
"Sorry?" The director pushed back, her lips a perfect pout.
"We were unable to apprehend 'im… or arraign 'im for his crimes." Looking down, Bane noticed his skewed coat and straightened it to make himself more presentable.
"And why is that?" Willows implied with disapproval in her tone.
"'Ave you neva' read the papers, Miss?" A shadow of frustration, perhaps something more, crossed the DI's face. "Wild Man Stalks the Fens"—it's no ghost story. It's common knowledge in these whereabouts, goin' back about forty years!"
Comparing the flat boggy sound of the DI's undertones with the lingering hint of West Midlands in Willow's pronunciation, Sherlock suspected she had been far removed from the stories that circulated the Fens nearly half a century ago.
"This Cain bloke," Bane did his best to temper the sizzle in his voice, though his accent and his disregard for mild profanity grew stronger as he recalled the events, "was, was…a shrewd devil…yes… a throwback… a Neanderthal, rumor 'as it. Whatever 'e was, when we considered 'im a primary suspect, 'e 'id in the wetlands where 'e grew up. Bloody 'ell, 'e knew the waterways better than anyone alive. The bastard could disappear for years and evade any of our efforts to pursue 'im. Some units that went in after neva' came back—" Bane coughed to cover the quaver in his voice. He cleared his throat and swallowed. "The loss of our men…our brothers…might be explained by the treacherous marshland, but in our gut we knew…the goddamn monster attacked 'em. Picked 'em off one by one! Somewhere in the murky depths of that 'ell 'ole, of that bloody stinkin' swamp, are graves of brave men—."
"And you think our patient is this…this fugitive?" Willows displayed a mix of dismay about what she had heard and sympathy for Bane. She shook her head and returned to reading through the DI's documentation. "You have the proper warrants, I grant you that, but the man you claim is a criminal and the patient who is near death in this hospital may not be the same person. As it is, the patient lacks the mental capacity to either give or withhold his consent and there is no next of kin…."
"No next of kin because he's unidentified," Sherlock hissed through clenched teeth; only John could hear him, and barely at that.
"Regardless of kin or the patient's consent," Bane countered with conviction,"this investigation comes under the Public Interest Disclosures Code, allowing for the release of patient information essentially to prevent or detect—in this case—a serious crime." The DI stifled a cough and continued, "Consent is not required; in fact, the 'ealth professional is mandated by law to disclose medical information."
Sherlock leant over to whisper in John's ear. "Good, this DI is prepared." The words were so faint, John was not sure he heard them correctly, but more surprising was the possibility that Sherlock approved.
"I can confirm 'is identity," Bane pushed. "Let me tell you whether 'e's 'Armen G. Cain."
"How?" The Director exhaled a dubious scoff. "You've just said that he spent his life in hiding, yes?"
"Before that, before 'is crimes came to light, before I joined up as a constable, I had…some dealings with 'im. 'E was no stranger in our small parish."
"So, even after all this time, you think you can recognize this man?" Willows chewed her lower lip, her mouth zigzagged with misgivings.
"Recognize 'im? The man's looks are… unusual," Bane snapped, a scowl knitting his brow as he muttered, "'E's unforgettable!"
When she said nothing more the director appeared to be slowly coming round.
...A bit too slowly for Sherlock. "The FDH has asked for the public's help in identifying this patient, Director Willows," Sherlock urged with his overly enthusiastic voice of reason. "Here is someone who can help. This good detective claims he can give you an official ID." While his act to conceal his growing irritation with the director's infuriating resistance may have fooled Willows and the DI, the fire in his bright eyes and the rumbling baritone meant Sherlock was near erupting, "Is there anyone more trustworthy and reliable than a member of the Norfolk Constabulary?"
John covered his amused grin with a subtle gesture—scratching his upper lip. Sherlock's words "trustworthy and reliable" were typically reserved for his favorite bloodhound, Toby; he must have been at his wits end to grant such a generous endorsement without concrete proof.
"Still, I'm averse to disturbing a man in his last hours when there is a possibility it could be mistaken identity." Her reply was more maddening because it was half-hearted.
Sherlock barely stifled a groan of despair when the office door opened once again, revealing a slight-built, young woman in a white labcoat. Her FDH badge—Dr. Samantha Spencer in block letter—included the photo of a smiling face. Yet it bore little resemblance to the woman who walked into the room. Her face appeared drawn with worry.
"Oh, Dr. Spencer," Willows' greeting betrayed her relief. "Thank you. Your assistance is needed in a certain matter."
It did not take long for the physician to be updated and her look of disquiet to vanish. "Finding anyone who can identify and perhaps explain this patient's history—the incongruities we've encountered are troubling—would be most welcomed." The promise of answers raised a congenial smile to match her ID. "Gentlemen, you could not have come at a more opportune time."
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Dr. Spencer, nodding in greeting to the sisters and aides she passed, led John, Sherlock, and Gareth Bane through the corridor. She was more forthcoming than Willows, more impacted by the perplexity of her medical case. "The patient's prognosis is definitely bleak. He remains unconscious and although quite old, his age is indeterminate. One estimate is that he may exceed one hundred. Since he was brought in unconscious to the resus room for assessment a few days ago, we ran the standard tests—including x-rays for obvious broken bones—to determine what we were dealing with, but after all those tests it was apparent that administering palliative care is our only option."
While the doctors engaged in conversation and walked a step ahead, Sherlock paired off with the Norfolk detective inspector explicitly to derive intel about Gareth Bane. Observations from the man's physical bearing were instant:
—Keeping up our brisk pace despite arthritic knees causing his limp,
—Chain smoker, obvious by the scent of stale cigarettes, the phlegmy coughs and stained fingers,
—Baggy, loose skin under his eyes tattles of too much drink,
—Right tilt of head obviously compensating for some hearing loss in his left.
"Without knowing who the patient is," Spencer spoke in hushed tones, accustomed to being discreet, "we cannot access NHS records for a healthcare history or procedures that may have been performed, but from the looks of him, I doubt he has ever sought professional medical help."
"It's the diagnosis that interests us," John replied. "We want to determine whether the disturbing information my friend received," he twisted around toward the men behind them and gave a head nod: all eyes briefly alighted on Sherlock, "has any bearing on his condition."
Sherlock waited the few seconds until their gazes flitted away to continue his assessments of the Detective Inspector. Deductions about the man's motives required a bit more concentration.
—Bitterness in the lines around his mouth; set of his brow perpetually furrowed; like old seafarers who stare into the horizon, the DI has weathered the worst of humankind,
—Smoking and drinking to excess suggests a man who cares little about his own longevity,
—Well past his prime, should have retired years ago if not for some unfinished business urging him to stay, keeping him involved in investigative work,
—With no wife at home—no indentations in his ring finger—and likely no one for a long time, he's a man married to his job.
Bane had been straining to catch every word about the ailing patient. Distracted so, he had dropped his gruff and gritty professional mask, exposing a haggard and haunted expression.
— Oh! There are demons beneath…. Sherlock recognized that look. He had seen it in numerous clients. Often, he had caught a glimpse of it in his own reflection. This is deeply personal! An old wound. He's confronting his nemesis in Harmen G. Cain!
"You wonder if it might be attempted murder…premeditated?" Spencer frowned at John. Making an abrupt turn, the physician gestured them to follow. "Let's speak in this office." Spencer waved her guests to the seats across from her desk while she logged on to the computer terminal for file access. Only Sherlock insisted on standing.
"The surname Cain is not uncommon in our file databanks, I see. Nope, he was never admitted here previously under that name. However, he is our only current John Doe. Let me see the latest—" her voice trailed. "Okay. Here we are! You've asked what his condition is? Perhaps it is better to ask what his condition ISN'T? Blood work and diagnostics indicate a lengthy history of chronic afflictions from foodborne illnesses, parasites, arteriosclerosis, gout, toxicity—from among other things—excessive licorice intake, believe it or not?... Apparently, tainted foods have been his regular diet."
"D'ya think he ingested these things deliberately?" John's brows shot up, but his eyes darted toward Sherlock for confirmation, except, Sherlock's gaze was introspective, processing the physician's information and sorting possibilities from probabilities.
"That's a good question. Certainly, he had a strange diet…," Spencer nodded, then shook her head. "No. Let me correct that—a terrible one! There's more. While there are critically high levels of lead in his blood, he also has hypertension, wet-form macular degeneration, neuropathy in the extremities…" the doctor trailed off, bewildered. "Yet if I understand you, Detective Inspector, he has managed to live an isolated existence and to fend for himself in the Fen marshes...and not without some hardships... well, at least until now."
"'Ardships?" Bane's somber voice brightened. "What do you mean?"
"Oddly there are numerous old scars on his chest, arms, legs, ankles, and back—lacerations of various kinds. There is also evidence that he had suffered several broken bones left to heal on their own without professional medical intervention, which accounts for the deformities in his fingers, toes, his right foot, his left ankle, and a partially severed outer ear."
"Aah! Apparently 'idin' in that 'ell 'ole was no 'aven for 'im," Bane muttered to no one in particular, but he sounded buoyed by the revelation. "That un'oly monster got as good as 'e gave, then?"
John knew that if he noticed Bane's elevated tone, Sherlock should not have missed it. Expecting his friend to pounce on the DI with ferocity to extract the truth quickly—Sherlock's verbal version of pulling a tooth—John instead witnessed something completely different.
Sherlock spoke courtesiously, devoid of impertinence or impatience, "This is not altogether a surprise, then. Do you wish to elaborate, DI?"
Surprise arched John's brows. Sherlock surely gleaned more from the DI's remark, but chose tact over attack.
"I might," Bane met Sherlock's scrutiny before looking away, "but for now I'll keep my peace. I need to work some of this out myself. Go on, Doc. What about broken bones?"
"Well," Spencer continued, "some of the fractures to his ribcage appeared to have been injuries from his prepubescent youth."
"From a violent upbringing, perhaps?" John suggested, partially distracted by Sherlock's more restless pacing.
The subtle twitch on Bane's face, triggered by John's remark, did not escape Sherlock who kept adjusting his vantage point to study the DI's reactions.
"Hard to say. Likely...although at this point, none of these old injuries are causing his demise," Spencer scrolled further down the screen before continuing. "With no way to identify this man, we were preparing a public appeal with partner agencies ...At intake two days ago, we shared what we knew about this John Doe with our parish constabulary. They took the information and gave us a case number. Here, Detective Inspector," Spencer paused and recited the reference for Bane to jot down "We expected they'd be in touch once they learned something ..."
"Not much of a bleeding priority they gave it. Your constabulary should 'ave got a photo and circulated a bulletin to the Norfolk Constabulary," Bane criticized and pushed back in his chair, annoyed. "Instead, it took Sherlock bloody 'Olmes to inform me!"
Sherlock kept his face impassive, although John could tell by the flicker in his eyes he was pleased by this confirmation of his efficacy.
"I can't explain the oversight of our local police," Spencer threw Bane a stern look, "but as for the photo… On balance, the patient is …a bit…unsightly.. Well, to be honest, I'd say he's awfully grotesque for the public to see like this…"
"How long does the patient have…?" John redirected the discussion, asking the question that he knew was foremost on Sherlock's mind. Sherlock was showing self-control thus far, but John was hoping to circumvent the inevitable tantrums about wasting precious time.
"Not long…except…" Spencer shrugged and turned off her computer, "yeah, it's hard to explain…We thought he had mere hours several days ago! I've read medical accounts, but this, this man is my first experience. It seems this patient is unwilling to die…fighting tooth and nail…" the edges of her lips turned downward; gathering herself, she drew in a deep breath. "Well as I've said, he's unconscious. He has cirrhosis of the liver, kidney stones, severe bladder infection, and prostate enlargement most likely from cancer, congestive heart failure, along with uncontrolled diabetes all causing Multiple —."
"—Organ Failure, MOF," John clarified with a head nod, "after a remarkably long-life despite unhealthy nutrition and terrible accidents."
"Yes. Only now is he succumbing to what would have killed an 'ordinary' man much sooner...," Spencer looked at the men in turn and shook her head. "In both my professional experience and in my personal opinion, this is unprecedented. There might be some genetic abnormalities present to explain it, but I am not a geneticist… I'll take you to see him now. Perhaps you'll understand it better." She rose to her feet and as an afterthought remarked. "I can think of no way to describe his constitution rather than with a quote I remember from a mystery series I read when I was a girl … 'This fellow is a perfect savage, as strong as a cart-horse and as fierce as the devil.'"
An impatient Sherlock bypassed the irrelevant literary reference to focus on the facts. "Aside from the fractures, the lacerations, and home remedies to patch up his wounds, you are saying that this man has additionally gorged on an inordinate diet of rich or under-cooked foods and consumed toxins that are linked to a host of diseases?" Sherlock met John's eyes, his own bright with excitement. "We know method now. This has been what's killing him… next, we must prove it was premeditated."
"You say his wife is owning to it?" Spencer headed to the door. "You think it's true?"
"The deceased wife," Sherlock corrected. "I wouldn't be here if I didn't believe the wife's claim holds some truth."
"The truth! That's what we're 'ere for, at long last," Bane grimaced and clutched his knee when he rose from his chair; swearing softly, he eased himself into a standing position, favoring one leg.
"Deceased, you say? Now I really don't understand," Spencer grew thoughtful, resigned, "Much of this is decidedly difficult to believe. I've heard of being starved to death," she laughed dryly and paused with her hand on the doorknob, "but not this. His wife deliberately overfed him…to kill him?"
"That's one possible explanation of some of the facts," Sherlock shared a smirk with Spencer and Bane; John saw in it a knowing smile. "I now suspect the wily woman also used an arsenal of tricks and traps to inflict pain."
Aghast, Spencer's jaw dropped slightly, while Bane's lips curled into a devilish grin and cheered, "That's my lass!"
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A. N. *The mystery story quote is from "The Adventure of Wisteria Lodge", part II: The Tiger of San Pedro.
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