Musgrave Blaze

Author's Warning: Chapters thirteen through seventeen are heavy duty angst. Don't like, don't read!

Chapter Fourteen

John watched as the street lights of Birdip disappeared behind them. Then suddenly Sherlock went…berserk. He started to flail, his right hand in a fist that he smashed down onto his already injured left wrist. Of all the things that John might have predicted he'd do in a melt-down, this was…not it. For a split second, the doctor watched horrified, stunned into immobility. Sherlock cried out in pain, but it did not stop him from raising his right fist again. At the suddenness of the shout, Brunton was startled and the car swerved, as he looked over the back seat. Then John was out of his own seatbelt and reaching across to his friend. He shouted at the butler, "DRIVE!"

The doctor found himself wrestling with a demonic force. Sherlock was unreachable. His eyes were closed, he was in agony, and yet he was the one who was doing it. John could not understand it, but he tried to pin the taller man's right arm back. He felt the car accelerating, as he fought to keep Sherlock from hurting himself.

"Sherlock, stop." It took every ounce of his medical training not to shout this. But he knew that loud noises would only be felt as pain. He was losing the battle to keep Sherlock's right hand trapped, so the doctor pushed his way into Sherlock's lap, to shield the broken wrist with his own back if necessary from that flailing right fist. Sherlock was fighting back, struggling to free his arm with every ounce of strength he had, as if his life depended on it. But he didn't hit John; all he was doing was trying to free his right arm.

The doctor had no idea what to do to stop Sherlock from harming himself. In an Emergency Department, he'd have fast-acting sedatives that could stop this sort of behaviour in seconds. There'd be other staff to help him restrain the patient. The doctor wrestled with the shoulder strap of the seatbelt that was behind Sherlock, trying to pull it forward so it would restrain the right arm's freedom of movement.

The car was now on the old Roman road, so straight that Brunton could push it well above the speed limit. They tore through Witcome and Brockworth, the street lights flashing by and then the car was swallowed up by the darkness again. When lights appeared again, Brunton shouted, "We're in the suburbs now. Only a few more minutes."

The man's voice set Sherlock off with renewed violence, and this time he pushed John right off of him and onto the floor. Once free of the weight, he raised his right fist and brought it down on his hand again, screaming with the pain of it. John managed to get his feet under himself again, half stood and punched Sherlock hard on the jaw. The taller man's head snapped back against the headrest and then fell forward again, limp onto his chest. John put a hand on his friend's chest to stop him from slumping forward; he was unconscious.

The silence was broken only by the sound of John's panting. That's when he realised that the hand on Sherlock's chest was not feeling any movement. Oh shit; he's stopped breathing. Fingers found the pulse point on his neck, and John was reassured. Sherlock's heart was going fast, almost too fast.

This he could deal with. He unclicked the seatbelt and pulled Sherlock down so he was lying on the seat. Too tall to fit, but at least his torso was flat. He began mouth-to-mouth resuscitation, the lingering bitterness of Sherlock's earlier vomit made him gag for a moment, but he got it under control and found a rhythm. In between breaths, he shouted at Brunton, "Hurry- I won't be able to keep this up for long."

When they came off the Great Western Road into the hospital area, Brunton took the BMW straight down the ambulance pathway to the Emergency Department. He was out of the car as soon as he had taken the car out of gear and put the hand brake on, running into the entrance. Moments later, between his cadence of his breathing for two, John heard the metallic noise of a trolley, then the sound of door handles opening and he felt the cool night air on his side.

"Let me take over, sir. We've got this." Hands in blue scrubs pulled him aside, and then out of the BMW. They moved Sherlock onto a back board, and John's breath into Sherlock was replaced by the mechanical action of a squeezed air bag and mask. As John leaned back against the side of the car to catch his own breath and chase away the black spots in front of his eyes, he watched Sherlock being wheeled into the Emergency Department.

But the time he recovered enough to follow, the trauma team were already at work. John was reassured by the heart monitor's steady beat. He stepped forward through the doors, to speak to the team leader. "I'm Doctor John Watson, his primary physician. I also have medical power of attorney. There are things you need to know about him. He's a recovering cocaine addict. He's on the Autistic Spectrum. He suffers from Sensory Processing Disorder, and has just had a meltdown. Allodynia and synaesthesia present. The wrist is broken; he says it's been broken before, but I've seen his medical records which don't mention it."

"I'm Doctor Ignubou, Attending tonight. How did he get this wrist injury?" It was calmly asked, the routine process of gathering yet another patient's history. The nature of the fall would say much about the break.

"He fell out of bed."

"Any head injury? Why's he unconscious?"

"No injury in the fall. In melt-down on the way here, he had a panic attack, became violent and…self-harming. I had no sedative. I punched him in the jaw, knocked him out to stop him from hurting himself more."

That made the trauma doctor to lift his attention away from the patient so he could look John in the eye. "An unorthodox treatment, what sort of doctor are you?"

"A retired army trauma surgeon. Battlefield conditions require quick thinking."

That brought a smile to the other doctor's face. "Well, Saturday night in an Emergency Department is something of a battleground, but we don't go punching our patients. Wish we could, at times." He then asked one of the juniors. "Portable X Ray, please."

The oxygen sat figures dipped and a soft alarm went off. "Intubate, please, Doctor Rajiv." He observed the junior complete the procedure, and the digital figures began to climb back up.

"Which is his dominant hand?"

John tore his eyes away from the oxygen saturation monitor. "Right- but he's virtually ambidextrous. Oh, and he plays the violin. So, the left wrist is more important than it is to most."

"Well, doctor, your patient is lucky. We have one of the best trauma orthopaedics departments in the country here. Now, I need you to talk to the staff outside, get his details sorted."

When he saw John's reluctance to leave, the doctor just said quietly "Leave him to us now; he's stable and in good hands, doctor."

For the first time since he'd been woken up, John realised that he could relax, just a little. He nodded and left the room.

oOo

Twenty minutes later, Doctor Ignubou came down the corridor to where John was drinking a coffee, waiting in chairs. He'd sent Brunton home. "No point in both of us waiting. I'll call Musgrave Hall when I have some news." The tall West African was carrying some x ray films. "A word, Doctor Watson?"

John went back down the hall toward the room. The ED doctor stopped at a light box, and slipped one of the films onto it. The fluorescent tube sputtered into life, and showed an image. "There's the main fracture." He pointed to the jagged line across the radius. And John could also see that Sherlock had been right- there were two more breaks on the same bone, splintering off a piece. "He said it was comminuted, a Barton's dorsal."

That made the other doctor raise his eyebrows. "He's medically trained then?"

"No, it surprised me, his familiarity with the terms."

"Well, take a closer look, doctor, because there is a reason he knows about these things." He pointed to another white line. "A healed styloid fracture here on the ulna; and two of the three new fractures on the radius are along old fracture lines." He then switched to the second film. "And because of that we took a look at the rest of his hand, too. Look- signs of five more broken bones- the carpal bones mostly, but here's a phalange, too." He pointed to the left hand's little finger, the section of the bone inside the hand itself. He switched films again. "Ortho will take a closer look in the morning, but, even though I'm not a specialist I can see all the previous damage. Must have been a couple of decades ago, when the bones were still growing, but the original injury was…significant."

He switched the light off. "His vitals are stable now, and we are keeping him sedated for the moment. We'll be moving him up shortly to the fifth floor Emergency Surgery Ward for assessment and more detailed scans as soon as the MRI opens- check for ligament damage. When the consultant arrives in the morning, he'll want to prep for an interior reduction. As much as he'd probably like to wait a while to let the swelling reduce, this unstable a set of fractures, and with that bone splinter, there's too great a risk of arterial and nerve damage, so it can't wait. Likely to involve a plate. In the meantime, see if you can track down the records for this original injury, it could help the surgeon in his reconstruction efforts."

Back in chairs, John looked at the place on his wrist where his watch usually sat- empty, left behind in his haste to get dressed. A look around the waiting area eventually found a wall clock- 4.19am, and a thirty three minute waiting time to see a doctor. The sparse crack of dawn crowd of people in the chairs were waiting patiently. He found his phone - luckily that had still been in his trouser pocket when he'd pulled them on. He walked outside into the brisk morning air. A scan down the speed dial, and he hit the one listed for Mycroft.

Three rings later, "John, what's happened?" Why doesn't he ever sound sleepy? Day or night, Mycroft's calm voice never seemed to register any degree of alarm, even though his words showed that he knew John would not be calling unless there was a problem.

"I'm at Gloucestershire Royal Hospital. Sherlock's being treated for a broken wrist."

There was the briefest of pauses. "I assume he wasn't riding at this time of the morning? Thank you for sending me that video clip, by the way. How did it happen?" The tone was a little cautious, as if he knew that a simple fracture would probably not be sufficient cause for John to be waking the British Government at this hour.

"He fell out of bed."

That raised a little laugh. "Oh lord, how pedestrian! He will be most annoyed."

"Mycroft, it's not the first time. What happened the first time he broke his wrist?"

The seriousness of the doctor's tone provoked a cautious pause. "August 17, 1994; I wasn't in the country at the time. Father later told me that Sherlock had broken his wrist. Why do you ask?"

"Because Sherlock said he'd broken it before, but when I saw the x rays- well- it wasn't just a wrist the first time. There were seven broken bones. There would have been extensive cartilage damage, soft tissues, tendons, muscles. It was a significant injury, not a simple fall- and there are no records of it in that nine inch pile you gave me six months ago. That's odd- distinctly odd. The orthopaedic surgeon here will want the details before he operates."

"The new injury needs surgery?"

"Yes- interior reduction, a plate, he's not going to be playing the violin anytime soon. But, I'm more worried about the original injury, because it just might explain why he went into total meltdown in the car on the way to the hospital- just lost it completely. Allodynia and synaesthesia. He became violent, but was trying to hit his own hand, his broken wrist. I can't imagine why he would do that, not to mention the agony he was inflicting on himself. Maybe it's related to the first time. The trainer at Musgrave remembers Sherlock from 1994, said that he'd heard that Sherlock's horse died. Could that and the injury be linked?"

"I don't know. I told you that when we last spoke. I don't know why Sherlock stopped riding."

Then the doctor realised what was bothering him. "Mycroft, why don't you know more about this?"

There was the briefest of pauses. "As I said, I was out of the country at the time. When I telephoned Father in mid-September, he mentioned an incident. That was his exact word- an incident. Said Pirate had died, and that Sherlock had broken his wrist, but he was back at school. It was a dreadful line- kept cutting out. The next time I saw Sherlock was seven weeks later, at our father's funeral. I seem to remember he was still wearing some sort of thing on his wrist, but not a proper cast. We didn't discuss it. I had other things on my mind at the time. We both did."

Oh. That was something he had not known until now- when Sherlock's father had died. Losing a mother at ten, and a father at fifteen. John knew how his friend had never got on with his father. Still, becoming an orphan, and totally reliant on Mycroft in a parental role. Even a hate figure was a point of stability to someone on the Spectrum, and losing that would be upsetting in a way that neurotypicals wouldn't understand. So soon after losing a beloved horse? Emotionally traumatic wouldn't begin to describe it. "How did your father die?"

"It was a car accident in Jakarta; he was killed instantly. I got home the day before the funeral, Sherlock insisted on going back to school the day after, claiming that he needed to focus on his A level preparation. During the times we were together on those three days, he wasn't communicative, but not apparently distressed. You know they didn't get on. I spent the next week sorting out legal and financial issues, and then had to return to my posting overseas. I was in the middle of something…rather delicate."

Then there was another pause. "I am as surprised as you are, John, about the missing records. Leave it with me. I will do some digging. As it turns out, I have a meeting later today after lunch at GCHQ in Cheltenham, so I will be in the area. I will stop by the hospital before that. And, thank you, John; you were right to call."

When they had said their goodbyes, John settled back into his chair. He found it frustrating that he'd have to wait until after 8am at the earliest. NHS hospitals didn't like to operate between midnight and 8 am unless the injury was life or limb threatening. Their argument was that everyone was tired and there was good evidence that mortality and complications go up dramatically in the middle of the night. John couldn't help but think that everyone was going soft. Some of his best surgeries in Afghanistan had been in the wee hours of the morning. Neither the enemy nor casualties respected clocks or surgeons' convenience, so they'd been used to operating all night, if necessary.

A glance at the wall confirmed what he already knew- 4:43am. He had a long wait ahead of him. Hospitals were very much like being in the army- moments of frantic, terrifying activity, followed by long periods of boredom, hanging around waiting for something to happen. Except when it came to Sherlock's health, he was never sure, really sure, which one he preferred.