Bruce was engrossed in his morning paper enjoying a cup of jasmine tea. He was surprised to be joined by Pepper. She rarely had breakfast in the communal kitchen, preferring instead a quick cup of coffee on the go. He gave her a close look and noticed that her eyes were red and puffy. She had obviously been crying for quite some time.

"Good morning. Can I get you some coffee?" He got up from his place and pulled out a chair for Pepper. "Is everything alright?"

"I don't know Bruce, I really don't know anymore… I really want to be there for him, but he is doing everything he can to push me away… I know it is not his fault but …" Pepper was trying her best not to burst into tears. She decided that it was neither time nor place for this discussion. She was not even sure, if Bruce was the person she wanted to have that conversation with.

"I am going to fly to Tokyo today; there is a conference that I must attend. I will be gone for a couple of days. That will give us both some space…"

Bruce took a deep breath. He knew that there was going to be trouble. He had noticed that Tony had become increasingly irritable in the past couple of days. Jarvis and Dummy were getting the brunt of it, as Tony was spending best part of the day alone in the lab again. If he did come out, any interaction he had with others seemed to end up in an argument. Nicola did warn him that it was not uncommon with Sertraline to initially worsen anxiety symptoms and give patients a 'bit of an edge', as she had nicely put it. She was a bit worried about how Tony was reacting to the medication and was seeing or calling him every day to keep an eye on him, whilst the dose was slowly titrated up. Unfortunately Tony had fallen out with her two days ago and refused to go to his appointment. Bruce considered his options and decided to leave Tony to his own devices for the time being. Jarvis was constantly keeping an eye on him and would let him know, if anything untoward was going on.

Nicola sat in her office, trying to clear her desk of outstanding paper work. She was looking forward to the weekend ahead. She had nothing in particular planned, but she felt that she needed some rest to recharge her batteries. She sighed deeply when she heard the phone ring. It was never good news on Friday afternoon. She was not exactly surprised to hear Jarvis on the other side.

"I'm very sorry to disturb you but Doctor Banner requests, if you could assist him in the Tower as a matter of urgency." Nicola could swear that she could hear anxiety in Jarvis voice. Surely that was not possible.

"What's going on Jarvis?"

"Sir seems to have developed a sudden suicidal ideation and proceed to act on those plans with a surprising haste…"

"I see… Can I speak to Bruce?" The line went silent. Nicola battled herself in her mind as she waited for Bruce to come to the phone. She knew that things were not going smoothly, but she clearly failed to anticipate the impending crisis.

"Hello, Nicola, I know that you don't do home visits as principle, but I really don't think that this can wait… I don't know… should we go to psychiatric ER…" From the tone of Bruce's voice Nicola knew straight away that they were in some serious trouble. "This whole situation makes me feel a bit angry… if you know what I mean… I don't know what to do…"

"Slow down Bruce. Take a deep breath … Just tell me what exactly is going on." Nicola tried to sound calm and reassuring, but she had alarm bells going off in her own head. If Bruce is going to 'turn' this is going to turn into a right mess.

"I am not sure. Tony was growing restless all day long. Tearful, irritable. He has not slept for at least 48 hours. This morning he had an argument with Pepper. Nothing out of the ordinary. Next thing I know I have found him in the lab counting out a stash of pills and talking about ending it all. I can't reason with him. I have never seen him so agitated before. I just don't know what to say to him…"

"Have you got anything that you can give him to help him to calm down? Some benzodiazepines?"

"I have some lorazepam in my bag." Bruce kicked himself for not thinking about this earlier.

"Great, that should take the edge off it. I will be there in next half an hour"

On arrival Nicola headed straight for the lab. She was quite alarmed by the sounds of commotion that she could hear as she was walking along the corridor.

"What is going on Jarvis?"

"Dr Banner did attempt to act on your suggestion however Sir would not accept the medication. He seems to believe that Dr Banner is attempting to poison him. I find that idea highly irregular. Also, I can't quite understand how the strong resistance to perceived attempts at being poisoned can coexist with the desire to consume a lethal amount of Atenolol tablets…"

Nicola wondered, if it was possible for Jarvis to experience emotions. He did sound genuinely worried. "Jarvis, the technical term for this would be… madness… It is hard for anyone to relate to. There is no logic behind it…" Nicola arrived at the entrance to the lab. "Can you let me in?"

"Certainly. Please, proceed with caution."

On entering the lab Nicola was faced with a scene of utter destruction. Tony was sat on the couch next to Steve, who was trying his best to keep him in place, whilst Bruce was attempting, to no avail, to persuade Tony that he meant him no harm. When he saw Nicola, he stood up and took her to the side to speak out of Tony's earshot.

"Thank you for coming. I really appreciate it. I am out of my depth here. I mean, there is anxiety, there is depression, I have been there myself… but this is … I don't know what this is…"

"This is most likely a medication induced mixed episode, form of an agitated depression. I think we have moved beyond a point when I could talk him down… Do you have any injectable sedatives?"

"Hmm, I don't know. Tony keeps a crash trolley in here. There should be something with the intubation kit. Touch wood, we never had to use it before." Bruce proceeded to rummage through the draws and returned with a prefilled syringe.

"Midazolam. That should do the trick. I am not sure, how ethical or legal for that matter it is to inject him against his will…"

"I think the only alternative would be to take him to the hospital and have him formally committed. That would address the legal predicament. I am not sure about the best interest principle…"

"Oh for God's sake, is it really the time for philosophical discussions? I definitely don't have any objections to giving him something." Natasha took the syringe from Bruce's hand and before he had a chance to protest, injected the contents into Tony's thigh.

Nicola looked at Bruce with slight alarm in her eyes. "How much was in that syringe?"

"20mg." Bruce swallowed hard as he watched Tony stop struggling and become completely limp like a rag doll.

"Get him on the floor Steve". He barked angrily.

"Congratulations, Natasha on your first ever general anaesthetic." He kneeled by Tony's head and leaned over to check for breathing.

"Vitals, Jarvis!"

"Blood pressure reading comes at 80/60. Other parameters are within normal limits however oxygen saturations are dropping."

"Shit, he is obstructing his airway." Bruce could hear the unmistakable snoring like sound coming out with every breath that Tony made.

"To be expected really. Here, that should sort it." Nicola threw Bruce a plastic guedel airway from the crash trolley.

"Fantastic. Have you got any IV fluids in there? We need to get his BP up."

"Is he going to be OK?" Natasha asked quietly as she watched Nicola pull out a bag of normal saline and a giving set.

"Yeah, don't worry about it. He is just going to sleep for … quite some time." Nicola decided that it was not particularly helpful at this stage to point out to Natasha all the potential perils of administering anaesthetic in such an uncontrolled manner, particularly taking into account Tony's heart condition.

Nicola handed Bruce a cannula and busied herself running the fluids through. She watched from the corner of her eye, as he struggled to obtain IV access.

"Shit, how many of those cannulas have we got?" Bruce's hands were shaking. He was trying his best to remain calm and deal with the situation in a logical and collected manner, but he felt the anger rising up in him. The last thing they needed at the moment was for the other guy to show up.

"Don't worry, we have plenty… Let me try." Nicola took another venflon out of the packet and inserted it into the vein at the wrist.

"Here, this one always does the trick for me… Do you think it is wise to stay and play here or should we call for cavalry and get him into hospital?" Bruce was relieved to see how confident Nicola seemed to be in dealing with the acute situation. He figured that having spent a lot of time working with NGOs, she maintained her skills in responding to emergencies. In a rural third world country a doctor is a doctor and even a psychiatrist needed to be prepared to occasionally save the day. Between the two of them they could manage the situation, at least for the time being.

"It is an IM injection, it should reach its peak effect in the next hour or so. If he carries on breathing on his own, then I think we are fine here. Otherwise we will have to rethink the situation. We have a lot of kit here, but not a ventilator… Honestly Nat, what were you thinking." Bruce shook his head in resignation.