Chapter Seven: Reviewing the Troops


Mycroft climbed the seventeen steps to the flat, knowing that he would be heard. He'd used a key he had made when Sherlock had first moved in. Just in case was his excuse for such a liberty with his brother's independence. He didn't abuse it often, but tonight there was ample reason.

He pushed open the door to the living room, and heard a "Good evening, Mycroft." John was at the table, using a laptop. A substantial pile of medical files was to his left. "I wondered when you were going to show up."

Mycroft walked in and pulled a familiar grey box from his pocket, set it on the coffee table and switched it on. A small green light came on.

John frowned. "Is that really necessary? Didn't you sort this place out while we were gone?"

Mycroft hung his coat up next to Sherlock's and leaned his umbrella against the wall. "Of course, John- all the latest technology. By definition, however, it can be subverted and infiltrated. I'm not the only one with a vested interest in Sherlock's health. How is he, by the way?" It was mildly said, but the implication was there. You didn't ring back, so if you haven't got this under control, I will be very annoyed.

"That's a good question. Wish I had a straight forward answer."

Esther Cohen came down the hall from Sherlock's bedroom. Even before she got into the room, Mycroft said, "Good evening, Doctor Cohen." He watched the grey haired petite woman come in, and the question hung unasked in the air between the two of them.

It was John who broke the ice first. "She's here because I invited her, Mycroft. No, we didn't discuss a formal consultation or retainer fees. I know you fired her the day before yesterday, but she came because I asked her to- and I want her opinion on something now. But, before I ask it, I need to know, given you've been in meetings all day, whether you're aware that Sherlock had a Grand Mal seizure today."

There was no reaction, no expression on his face as Mycroft walked over to Sherlock's chair and sat down in it, rather heavily. He ran a hand over his eyes, and John realised that he was seeing Mycroft tired. No, even more extraordinary, Mycroft willing to be seen as being tired. That was a first.

"No, I didn't know. My PA told me that you had things under control."

"And we do, Mycroft." Esther sat down in John's chair. "John called me to say that Sherlock was having a subclinical, an absence seizure, and I came over. We were both here when the full-blooded variety occurred, and we kept him safe. He's sleeping off the effects now."

"Why? Why now?" Sadness and frustration leaked into Mycroft's question. There was an implied comment, too, that John heard, even though Mycroft didn't say it. This is the worst possible time for this to happen.

"There's never a good time for this, Mycroft. But, I think Sherlock knew that something was going to occur. Afterwards, he wasn't making much sense but he pointed me towards his laptop. He spent most of last night up researching. I've unpicked his work, and it makes pretty amazing reading."

Esther Cohen was watching Mycroft. Two days ago, she'd been sent packing by the man, who thought nothing of dismissing her when she had refused to sign sectioning papers that would keep Sherlock locked up for at least 28 days. That had been the hard, steel-edged older brother, one used to giving orders and having them obeyed. The man sitting in the chrome and leather chair across from her now was not that person. Not tonight. Something had happened, and it wasn't just to Sherlock. There was empathy in her eyes as she saw him digest John's words.

John saw it, too. "What's happened, Mycroft? What's changed?"

It was said quietly: "Moriarty."

John visibly flinched. "Back again, then?"

"In spades, John. Three little 'reminders' delivered to me today, with his fingerprints all over them. The damage is superficial at first glance. But ideas have been planted, which will grow in fertile soil. I am being targeted, and I fear that Sherlock will be caught in the crossfire."

Esther looked confused. "Who's Moriarty?"

Mycroft just shook his head. "Don't ask. It's not relevant to you and what you need to do, doctor." He leaned forward, his elbows on his immaculately clad knees, and said to her, "fix my brother, Doctor Cohen, and hurry. We're going to need every ounce of that brain of his to get through what's coming. And there isn't much time."

The psychiatrist tilted her head in surprise. "And you think such a thing is possible- a 'cure'? What out of that nine inch stack of his medical files over there gives you any grounds for such a hope?"

John intervened. "Actually, Sherlock may have some new answers himself."

That made both Mycroft and Esther look at him in puzzlement.

"I've just spent the last two hours reading what Sherlock researched last night. Dr Cohen, would you consider yourself an expert in adult autistic patients?"

"No, of course not. No one is. There are specialists who focus on autistic child patients, but nowhere near enough research has been done on adults with the condition."

"Why is that?" The blond doctor seemed genuinely surprised.

"Well, in part because the concept of the Autism Disorder Spectrum is relatively new in terms of mental health. There are literally thousands of mental institution inpatients and outpatients for that matter who are undiagnosed adults on the spectrum. But, nine times out of ten, they are being treated for other conditions, such as depression, anxiety, schizophrenia- you name it. While the ADS idea's been around for most of the twentieth century, it wasn't a recognised differential diagnostic until the 1980s, and PDD-NOS was even later in the nineties. And most research since has focused on kids."

"What about neurochemical research?"

She just snorted. "That's so new that it's not made much impact yet on treatments for children, let alone adults. The pharmacology mostly involves testing drugs created for other purposes to see what affect they have on autistic symptoms- again, almost all the clinical research is with children."

"Well, last night Sherlock read just about everything he could get his hands on- and there are some interesting conclusions. First, did you know that naltrexone has been used successfully to control anxiety and aggression in autistic children?"

"Oh! I didn't know that." Dr Cohen looked impressed.

Mycroft's eyebrows also rose. "Then surely it is a good thing that he's had the pellet inserted?"

"Not necessarily- he told me yesterday; in fact, he's been saying it all along, that the naltrexone makes him feel 'weird'. I just thought it was him, you know, being difficult about taking medicine."

Esther shook her head. "Actually his reaction makes sense. Sherlock's frustration symptoms have only very rarely ever pushed him into aggression, even as a child. He's used more of an avoidance strategy. He's probably adapted to dealing with the neurochemical pressures, and when they get repressed, it makes him feel 'off'. Well, to be honest, I doubt it's doing much good in terms of stopping cravings- it wasn't a full-blooded addiction this time, anyway. We could remove the pellet, if he really wanted it out."

"Could it be the reason for the seizure?" Mycroft wasn't a doctor, but over the years, he'd had to understand just what was going on with his brother. "He hasn't had one of those since he was fourteen."

John replied. "Maybe, but maybe not. One article he bookmarked suggests a regression into more overtly autistic symptoms, including seizure, could be due to bacterial issues in his gut. And we've been pumping him full of antibiotics for the pneumonia, which can have side effects in one's digestive bacteria."

"So, what you're saying, John, is that the treatment we've been subjecting him to for the past month has made the autism more of a problem for him?" Esther could not keep the concern out of her voice.

"That's what his research last night is suggesting. I wouldn't have a clue, myself. This is so far out of my medical comfort zone that I couldn't argue one way or the other."

Cohen smiled ruefully. "Out of everyone's comfort zone. John. Mycroft, maybe that's your answer. All these years, doctors have been treating him without realising that he is finally capable of holding his own when it comes to diagnosis and medication. Sherlock is a biochemist, after all, and, knowing him, I'd guess that he's become something of an expert on the condition. Maybe we should just ask him when he wakes up what he thinks will get him back to what passes as normal for him."

Mycroft searched the eyes of the grey haired woman – checking for any sign of duplicity. When he didn't see any, he looked away for a moment, before seeking John's reaction. What he saw there clinched it for him. "If both of you think it is the right thing to do, then I am willing to try it. I don't think we have any choice. We've run out of time for anything else."

He got up slowly and straightened his shoulders, as if settling the burden of responsibility once again. Mycroft collected his coat and umbrella, and said quietly to John, "Tell him I was here- and why. After today's events, I'll have to increase the protection and surveillance. Regrettable, but tell him not to take it personally. And keep that jamming device on when you need to say anything important; no need to let the enemy in on our deliberations." With that, the British Government went back down the seventeen steps to his waiting car.