Shadow Child - Part 28

Author - Kourion

Summary: 'So you're not a robot. So they were wrong, Sherlock! So everyone who thought you were heartless and unfeeling was foolish and stupid and wrong.' / Warnings for past child abuse/ non-con issues. Eventual Johnlock (romance focus only). Protective!John/ Case-fic.

Author's notes: Life? Stop being so hectic now, okay? Life? Okay? Okay?

In other news - I found that I had a terrible time expressing the emotion that I wanted to express in this chapter. So I am simply hoping that I haven't gone and made a mess of things. Or maybe, this chapter will work out fine. (I have been quite tired as of late, and I find it harder to judge anything I write when fatigued).

I am also quite sorry that this has been so delayed. No - I am not abandoning this story. And thank you, everyone, for your exceptional patience.


YURI's POV


Five days after John rushes from my home with a look of sickening anxiety on his face, I get a call.

Not from John Watson, it should be noted.

But from Sherlock.


Asking me if I still have an available spot in my weekly calendar.

'Just to review some basic topics.'

Topics that should take, he states, ''very little time to cover. This is mostly for John's benefit. So he doesn't worry so much, mostly about nothing.''

Very little time, indeed.

Don't get me wrong.

I have visited Sherlock's website.

I have read his essays on various chemicals, various experiments. I can see what he's passionate about, and I can sense how atypical he is as a person. How quickly his mind works and processes both the external world but also the internal world, too. The blunt, almost socially awkward way he writes about wanting to take on ''only interesting cases,'' and the brusque manner that seems to be infused with his genuine perplexity as to social norms and expectations.

In our (admittedly) truncated therapy session together, I even got to witness the rapidity of his speech; his jumbled, frenzied way of speaking when upset. So, too, can I sense the pressure behind his writing as he races about with words and posts on his webpage - expounding about this substance or that substance, this assay or that titration.

And it's not just his knowledge, or his passion, but the innovative way he fuses science with something that seems to me (and which I believe he'd be loath to admit) strikingly intuitive. However, he is ultimately drawn to the structured composition of science being undertaken. Science being lived out, if only just because he can test for something, test for a variable. Make an alteration to a condition, and see the changes in the situation.

That control over a dynamic - a testable hypothesis being worked out and then generating facts and data - seems to delight him. Seems to soothe him.

And while some of that interest is tied to his gifted intellect and his need to know what changes in the whole when even one small variable changes in part - I suspect that his created profession as a ''consulting detective'' also speaks largely as to his need to be in control of his whole life, and not just a scientific mindedness.

For example, he did not take a position as investigator under a well established and respected organization, even though he works with Scotland Yard. He still maintained that distance, and holds onto the comfort in being his own boss.

He even seems to have the capacity to work well with others when he sets his mind to the task. Yet, Sherlock has fashioned a life around his controls, and his ability to reject or allow the continued procession of a routine.

The closest thing he could have to someone who could order him about, or at least make him feel pressured to change his ways, would be a family member (though I am uncertain how close he is to anyone in his family) or a friend. Which he seems to be sorely lacking, John Watson aside. The legitimate concerns from people who care about him purely out of love and for no ulterior motive. Not because they are interested in what his mind can offer, nor ultimately wanting to yield something from his talents for their own benefit.

So now I wonder, in part, if perhaps Sherlock hasn't also sought out positions and work where he is the ultimate boss of his own initiatives (unconsciously, perhaps) as a way for him to test the worth of an association or a friendship. To determine the authenticity of any given relationship.

Because if he is caustic and blunt in his comments, and a person still sticks around and treats him with respect...aren't they proving their mettle? The depth of true feeling and friendship?

Does he seem to alienate others so readily to actually protect himself from growing attached to an individual, but then facing a betrayal?

The thought seized me upon my first meeting with him; I could sense his conflicted need for someone to aid him and even soothe him, yet his own seething anger at his vulnerability. And a not-too-buried shame.


So we are currently at the following position: an emaciated man in his mid 30's is denying he needs assistance, even if - by all outward appearances - he is falling apart. Prohibited from working until his physical health improves, and self-admittedly engaging in behaviours that are self-harming by their very nature. Yet angrily pushing away offers of assistance.

And truly, without legally removing the standing of competence - without sectioning him and removing his legal status as someone competent enough to make his own decisions - how does anyone (a friend or a therapist, or anyone else) proceed?

This is, to me, the issue that generally disrupts healing and overcoming past pain the very most. The inner war of the patient. The sense of sickness - the acknowledgment that they are, indeed, not healthy. And not just a little bit 'under the weather,' or a little bit 'blue.' But completely depressed in mood, self-hateful in their activities, engaging in activities which express a rage against their own ability to be healthy or whole.

It is terribly hard to get that admittance that they actually need help and to do that - need to change.

Because it means giving up all the customary and habitual (and soothing) routines that they have developed for themselves. Even if the routines are harmful.

In fact, for a good number of my patients the act of physical self-harm is psychologically soothing to them. They feel so completely conflicted as to their own worth as beings, that their worth is assigned to the acknowledgment or applause of others. Then, when that is withheld for whatever reason - the festering, damaged part of their self comes to the fore and convinces them that they can at least punish themselves (through bodily abuse) for their lack of success. For their lack of meaning, or ''worth.''

It's an entwined, horribly conflicting set of behaviours that usually starts its development quite young and tragically seems to become firmly attached to extremely intelligent and sensitive people with attachment issues.

So while I cannot be convinced that this is the case with Sherlock, I have a strong intuition that he is struggling with his own identify issues, terrified at what he might find, and running from project to project to allay those fears. And, as his medical records seem to indicate - when he's not able to outrun his anxiety - he cuts his skin, and he starves, or he takes massive doses of illegal narcotics and/or stimulants to void his mind of those concerns.

In all my time as a practicing psychiatrist, I have learned to trust my instincts about patients. And right now my instinct is telling me that not only that Sherlock needs help - both physical and psychological help - but that the greatest challenge I am going to have is not in convincing him of the facts of his sickness. But convincing him that he is a person worthy of health. That he doesn't have to earn a special status, or spot, or be seen as brilliant. But that he matters, period.


Most people - if they did not have true compassion or respect for Sherlock - would have undoubtedly left the flat by now. Looked for a place to live elsewhere. Because, obviously, Sherlock is going through hell. But equally obvious is the fact that John is sticking by him and isn't about to walk away any time soon.

It can't be easy.

In fact, I know firsthand that it isn't easy.

I know first hand that it's damned hard.

And I know that Sherlock is aware of John's efforts. (His expression of needing to see me was mostly to get John to ''stop worrying," after all).

He didn't want to see me out of concern for himself. But he was considering doing so for John.

And that tells me quite a bit about him, actually.

It tells me that a clinically emaciated man, with an undoubtedly gifted IQ, would only seek psychiatric help to allay the fears of his friend. Additionally, based on John's own discussions with me...I have been made aware that Sherlock is conflicted about his feelings for John.

Whether that is part of the reason behind his recent loss of weight and self-abuse needs to covered in therapy, but I can't help feeling that if these feelings are new for him - that if he's, indeed, feeling anything skirting the romantic - that the self-abuse may have developed yet again out of confusion of those feelings or revulsion of what those feelings indicate.

And if that's the case, there is likely something much darker and fuller and caustic ravaging Sherlock's mind.


He wanted to see me out of concern that if he didn't ''he would hurt John in greater ways and more deeply'' than he already had.

So we spent about ten minutes talking around his issues, and at one point I actually got pretty damn close to getting him to admit that he is hurting himself.

Of course, because he's likely been in therapy before - he spotted my attempts to get him to confess to his issues a mile off, and then retracted. So I ended up with a lot of loaded language, and a lot of stressing of words, and a pressured, rapid pace of speech. And the whole conversation was rather hard to experience, because it was not unlike listening to someone in pain - someone whose been terribly physically hurt and is trying to hiss back against their anguish - but who refuses to simply let go and cry.

I know that for many of my patients, part of their identity and sense of self is twined to being sick. To sometimes being deathly sick. Even if the sickness is rather well hidden - as it is for many sufferers of eating disorders - there is often an intractable need to hold onto the sickness. In the sickness, there is a bizarre sense of comfort.

And it probably doesn't make any sense to anyone who has not personally suffered from an eating disorder, or a disorder that interweaves with the aspect of self harm, but I feel that there is something rooted in the harming aspect that these patients see as self-validating.

Typically, self-harm is linked to a multitude of conditions: everything from psychosis, to extreme depression and suicidal ideation to dissociation - but in cases of otherwise functional adults who are self-harming in secret, self-harm is invariably more revealing. They get a measure of comfort from the activity, in some form. It's not generally a physical comfort, but it is sometimes addressed as being ''emotionally comforting.''

What's more, I have never had a case of severe self-harm that did not occur in a patient that had suffered - at some stage of his or her life - severe abuse. Whether the abuse was even present in the mind of the sufferer (or repressed) was variable. But it is something that I almost always became aware of as therapy progressed.

So now, when I look at Sherlock's files, and then speak to John, and then - in agonizingly roundabout fashion speak to Sherlock yet again - I get the prickling sense of horrid sadness. The sadness of a person who is dealing with a host of issues, and not just one or two.

It's never just the case that someone doesn't eat enough because they have a stomachache, or because they feel unwell. That does happen, of course. Physical reasons aside are legitimate, but readily addressed. Help is readily addressed. And a degree of fear is shown as to their weakening state when someone is otherwise psychologically healthy.

In Sherlock's case I am presented with the opposite: a need to hide the worsening physical state and and a burgeoning anxiety about if and how and why he should seek help. A back and forth, tremulous exposition of his symptoms - of strictly the physical variety - and then a heated anger that he ''doesn't need help.''

And that vacillating pattern of behaviour (and of statements ushered and thoughts expressed) is actually extremely revealing.


Which takes us to today:


''I do think I could work you into my schedule, Sherlock. But I also would like for us to have a sit down meeting first. Just you and me, I mean.''

Sherlock goes quiet now. The mobile seems to buzz with static from the outside world, the busy London street below his flat. I can hear the slight rattling sound of light breath against the phone in the absence of his otherwise polished speech.

''Are you there?,'' I clarify, knowing full well that he is there and yet wanting to prompt him to act and say something.

''Sherlock?''

I hear a shadowy breath, and then I hear another swallow - as if his throat is sore - and I will away a spike of empathy. Of empathy and knowing, and memories of my own.

Because I know that going easy on Sherlock isn't likely to help him right now. Not when he will use that empathy to delay having to see me properly. Not when he will use that empathy to prolong being sick.

''Why?,'' he asks at last, sounding authentically confused. ''You said that you wouldn't mind seeing John and me together, since our dynamic is complicated.''

One thing I can definitely give Sherlock credit for is stringing together a sentence that hints at a dark truth without actually admitting to anything directly. He reminds me of a fisherman throwing out a line, angling in a fish, but sensing that the water that could grant him his sustenance is turbulent then pulls back in fear.

Possibly, I think, he's afraid of being healthy. Perhaps because he's never been completely healthy.

His greatest enemy, of which I have no doubt, is his own mind.


His voice is so maddeningly suave in tone that if I hadn't recently seen Sherlock Holmes in the flesh, I would have had no inkling as to the horrid disorder ravaging his body.

I might have even considered it a call from a well balanced but concerned friend.

A relation to a patient.

So the questions posed now seem all the more strange in their formality and their no-doubt false 'calmness.'

Still...

I know his questions are not born of a need to be disingenuous.

They are linked to a very real, very pressing need to have life be controllable and to be in that control.

To be on the track of his choosing, even if the track is careening off into dangerous territory and is hurting him deeply.

Because perhaps to him, the sense of being hurt is familiar, and thus welcomed. And despite how it looks to anyone else, it is that with which we are comfortable with that often determines what we accept. If we are familiar with compassion, we more readily accept it. If we have known nothing but abuse, we generally feel more comfortable with various forms of abuse.

To many people, even in the midst of relative suffering - they will perpetuate suffering because it is something that is known. As strange as it sounds to people who have never lived in such a world, that abuse then becomes emotionally safe. A variable they are familiar with when everything else around them is crumbling.


The disorders I studied extensively, and eventually specialized in, were related in variant forms of what are termed ''self-harm'' disorders.

The reasons behind why people abuse their own bodies or torment themselves in other ways is actually quite voluminous.

For some conditions, such as Obsessive Compulsive Disorder, self-harming was part and parcel of self-soothing because of an otherwise created 'construct' of self-assurance. A bartering, of sorts. (''If I run five miles, and tap the big, red tree three times - then my family will be safe.'') It was often an exchange between something that was considered mildly irksome but ultimately redemptive, and something much more powerful and frightening. Mildly irksome always wins out. Little evil always wins out against big evil.

So OCD is one cause behind why an otherwise highly logical child or adult engages in self-harming features.

The tyranny of a mind besieged by thoughts that were ugly, if not even cruel.

In fact, one of my first patients - a skinny adolescent named Devon - forever changed my views about apparent self-harm. Devon, more than anyone else, taught me to not be too hasty in my judgments of others.


He has started running at the age of 11, and the amount of time he devoted to this activity had grown from a modest twenty minutes in the morning before school, to over 30 kilometers a day... every day of the week.

He came to see me shortly after his 14th birthday. In retrospect, I am shocked that he lasted that long before his parents sought out clinical care.

He had collapsed on his school track. The doctors at the clinic he had been taken to determined that he had micro-fractures in both legs and yet, he had continued to jog on broken legs. Eventually, he had to stop running due to severe pain and bone shard fragments that had lead to sudden swelling and immobilization in his legs.

At the time of his admittance to Evelina, four of his toenails had previously darkened and fallen off due to compression of his shoes and swelling of his feet. This actually happens in any runner without the respite of normal and proper breaks. Additionally, Devon's nipples were bleeding from the constant rubbing of his skin against his running shirt (over many hundreds of kilometers in less than a weeks time). His gums were recessed from a combination of malnutrition and vomiting. His hair had fallen out in patches.

His electrolytes were badly disrupted, and his back was unnaturally bony. The vertebrae jutted from his skin like a knobbly snake of tethered stone, trying to rip through his body.

Whenever he attempted to eat, he vomited out of fear that he would be 'punished' or that his family would 'suffer' and possibly die. From that conviction, he developed an extreme fear of eating - most notably a phobia of consuming solid foods. The fear of food was tied to a seemingly irrational fear of dying if he partook in certain activities.

He eventually comprised a list of fourteen 'safe' foods that he would allow himself following his daily running regime. These items included: lemon water; sugar-free mints; broth; jello; fat-free chocolate popsicles; herbal tea; black coffee; miso soup; gum; allergy medication; daily supplements; sorbital sweetened gummy bears; sugar-free jams and jellies and finally tapioca pudding made without milk or sugar.

Understandably, his weight plummeted as his disorder worsened. And it worsened quickly and without much of an attempt to hide the ravishing effects of over-exercising and under-eating.

But what I always found astounding was that as his OCD worsened in severity, so too did his appreciation of how far he was physically suffering.

He would run until his sneakers were coated in blood, but he didn't seem to care about these bruises or blood.

He only craved the momentary feeling of safety and peace that the compulsion offered.

Because, as he insisted, it was better than the ''alternative.''


When I took on his case, he had been admitted to the adolescent eating disorders treatment wing at Evelina and had been in treatment two other times, relapsing both times.

I quickly learned that simple re-feeding wasn't going to be effective in the long term for Devon.

I was able to sense that the development of his symptoms were not linked to a dysmorphic appreciation of his body - as is often the case with individuals that are truly suffering from eating disorders - but a regimented obsession with numbers for the distraction that his compulsion offered him. In other words, I had the task of convincing three other primary psychiatrists devoted to his care that he was not, indeed, a sufferer of anorexia or exercise bulimia - but perhaps of something equally insidious but not yet addressed in his case file.


In medicine, and indeed in psychiatry - the issue is not simply in writing down symptoms and then proclaiming a diagnosis that reasonably can fit the symptoms. You always have to dig a little bit deeper than that, as caloric restriction related to anorexia usually is rooted to a different need and motivation than starvation that is worsened by Obsessive Compulsive Disorder. What's more: there is often overlap between the two, with aspects of eating disorders presenting similarly to OCD. In fact, a good number of sufferers of eating disorders also suffer from eating disorders, and therein lies our task. To differentiate between the different diagnoses and to not give up on a future of health for our patients, no matter how bleak the present seems to be.

So for now - with Sherlock - the primary issue I need to identify has to do with one primary issue alone.

Does he want to suffer? Does he want to hurt himself?

And if so, is it because he feels that he deserves punishment or because he deems himself unworthy of being healthy or whole?


''What can I get out of an appointment with you alone that I can't get alongside John's company?,'' he asks me suddenly.

I pinch the bridge of my nose.

It's one of those questions I hate getting as the rationale for my suggestion isn't off the cuff. It's based on the assessment of hundreds of individuals with disorders similar to the ones he possesses. And yet I have a strong suspicion that if I give name to any of those disorders, that I will be met with either mockery or heated denial.

I take a moment to comprise me thoughts, and then think to myself: ''fuck it.''

Tact hasn't worked well thus far, so I should be open to a different tactic.


''Do you feel that your eating is disordered?,'' I ask plainly.

No accusation, but also no timidity.

''Are you asking me if I consider my eating bad?,'' Sherlock clarifies with a tone of something odd, something hard to peg.

I hesitate, because it's never a word that I want to link to eating.

'Bad.'

While behaviours related to self-care can obviously be considered healthy or unhealthy, the word 'bad' is generally tied to something skirting the moral sphere. Bad gets linked to guilt or innocence. It gets linked to the very notion that they, the patient, is somehow inferior in a particular area. Either incompetent, or even unworthy of continued efforts.

''Can eating be bad?,'' I qualify.

Sherlock sighs.

''It's not a trick, Sherlock,'' I say evenly. ''It's a valid question.''

''Well obviously John thinks my eating is bad, or he wouldn't be pressing me on this at all,'' he replies quickly a moment later, his voice an octave higher. ''He wouldn't be wanting me to see anyone. To see you, I mean.''

I digest his words, and test: ''Has John told you that he considers your eating 'bad'?''

The tone is clipped when he answers.

''It was implied. It was very obviously implied, Yuri.''

''How was it implied?''

''He gets upset when I eat.''

I jot down a few questions in my journal.

That sounds a little distorted, if I can go off anything John has told me about himself or the situation at hand.

''Does he gets upset when you eat, or does he get upset when you don't eat what he considers to be an adequate amount?''

Sherlock sounds irritated with me now.

''The latter.''

''Ok. Do you think his concerns for you are valid?''

His breath comes out in a huff. But at least I'm getting him to talk.

''I think he's overreacting.''

I blink back shock at his assessment.

''You think he's overreacting.''

It's not a question. It's a statement of bewildered fact.

''You think I am being ridiculous too, don't you? You and he are on the same team, so what difference does it make what I even-''

I can sense that he's gearing for a fight. That he wants to vent but also doesn't want to talk about This Issue (and yes, it's capitalized), and he's upset with himself for not knowing how he wants to proceed.

''I don't think you're being ridiculous. I only am trying to clarify. I don't live with John. I don't know him like you do. But from the little I have spoken with him, he seems to be fairly logical. Reasonable.''

''He's not at all reasonable. He chooses to live with me!''

There is no denying the self-recrimination now. His voice is laden with it.

''Why do you think that means he's unreasonable?''

Another huff.

Louder than before.

''Not unreasonable so much as illogical.''

I will let him be precise to a degree normally reserved for pedants if it keeps him talking.

''Alright. Why would his interest in being or remaining your flatmate make him an illogical person?''

''I am not easy,'' Sherlock replies softly. Uncertainty pains his voice.

''You are not easy to live with?''

''Yes, but that's not even it. That's not even what I meant! I am not easy to like. He should have left a long time ago. But he hasn't. I don't understand why he's still here.''

It comes out as a spat, a rush of hot, angry sounds.

''Sherlock,'' I try gingerly, ''John obviously likes you as a person. He seems to respect you very much. He also told me, and gave me permission to tell you this - but he mentioned that he was confused about his own feelings for you. He told me that he spoke to you about that subject and that this is why he also is considering therapy for himself right now. Because he has feelings for you, and cares about you very strongly.''

My words are not calming him down, unfortunately.

''I don't need a reiteration of his own words! And again... illogical. And it's not true, anyway. What you're even saying.''

I frown.

''What's not true? That he likes you, or that he respects you? Or that he could have feelings for you?''

''Oh what does it even matter?,'' he hisses, ''What does my assessment of John Watson's extreme idealism have to do with anything?''

I take a few seconds, determining if I should continue the conversation or let Sherlock decompress.

I decide to compromise on both.

''Why do you consider John an idealist, Sherlock?''

''He thinks if he's just kind enough and loving enough and patient enough, I will be the type of person he suspects he wants. Maybe romantically, maybe because he's confused, and maybe because he just wants to fix everything and everyone. Maybe because he has some kind of doctor-complex where he doesn't feel good enough unless he fixes everyone that he thinks is damaged. If someone is hurting, he wants to fix them. Under everything about me that drives everyone else on the planet away, he thinks there is something in me - something worth...,'' his breath is ragged now, and I realize how quickly he's breathing. ''He thinks there is something in me that he might love, but it's just...it's...he could love anything! That doesn't say anything about me, Yuri. Just him. He wants to make people healthy again, and I know he thinks I'm sick and-''

Sherlock stops talking as if suddenly jolted into awareness as to what he's admitting.

I close my eyes and will myself to say the right thing.

''Do you think you're sick?,'' I query. I try to keep the tone even, unwavering, lacking in force but also lacking in hesitancy.

I hear the convulsions of his throat reverberate against the phone.

''No. I'm not sick. I'm not sick,'' he grits out in upset. ''I'm not mentally ill, if that's what you are implying. I know what mental illness looks like, and I'm not that! I'm nothing like that.''

There is something here. Right under the surface of an admission.

Something that likely could help Sherlock just as assuredly as it could rip a hole the size of a shotgun blast through his heart.

My body feels like a live wire of nerves. If the sickness in Sherlock's mind was likened to a bomb that needed to be deactivated, and there was a dozen wires to cut - many the same colour with only slight variation - and I had to determine the slightest shade that set the necessary wire apart from the rest, the damage I could do would be immense if my actions brought about a failure.

''Ok. Let's just address that last point, then. Have you known someone who was mentally ill?''

''Mmm,'' he hums, his voice less raging and intense now. Calmer.

''You have?,'' I prompt.

''Yes, I have,'' he admits.

Words have huge power in the world of therapy and treatment. More often than not it is the specific arrangement of words - the specific relation of words from one person (the therapist) to the next (the patient) in an order that is most receptive and impacting for the individual that is the impetus for some of the biggest changes in behaviour.

Or in wanting to change. In actually wanting to get better.

It's not drugs that heal someone. Medications, at best, are stabilizers.

Usually it takes a shift in some mental preconception that is skewed and full of self-revulsion for healing to actually begin.

''Okay. You have known someone who was mentally ill. Can I ask if John said or implied that you were mentally ill?''

Sherlock's breath makes a hiss against the receiver.

''He said I was sick! And that I was playing him! Playing everyone. I'm not trying to play him, but he thinks I am. And I don't understand why he'd-''

Damn it.

''What?''

''If he thinks I'm really one of those, how could he really love me? In any way? I-I don't understand, and I can't ask him in case he thinks-,'' his whisper dies off into nothing.


I suddenly know that THIS is why he's called me.


It's not to simply put John's mind at ease about Sherlock tackling his problems or facing his issues.

It's about Sherlock needing help in determining something about himself in relation to John.

More specifically: about how John perceives him as a person.

As a person not simply worthy of support, but one who is even possible to help in the first place.

But I'm missing something huge here. Huge and vital to understanding Sherlock's fear.


''One of what, Sherlock?,'' I inquire firmly. ''One of what?''

''I've looked it up, and some things fit, and I think I used to believe that maybe if people really thought that I was...''

I stand up from my chair, and press my hands firmly against the wall, needing the pressure. The conversation seems to becoming more anxiety-filled and ungrounded as it proceeds.

I need to focus.

''What is your concern right now, Sherlock? I can't do anything to help if you don't tell me.''

''I am telling you,'' he whispers. ''I'm trying.''

This man has been in the clinic for a perforated stomach ulcer, and he seemed almost flippant about his physical problems at certain points in our conversation. (Obviously nervous that he had been assigned to talk to a professional, but otherwise disinterested in communicating with me.)

So I am having difficulty understanding what could be causing him so much fear now. What could have prompted the change in such a relatively small period.

''I don't really think I am,'' he whispers again, and something about the insistent repetition is unnerving me.

''Would it help if I came over there?,'' I test, glancing at my watch. ''My last patient booked off at the last moment. Caught that flu that's been going around.'' I have no further appointments this afternoon, and I feel as if Sherlock's words are ominous. Generally, that's never a good sign with patients that show the sort of symptoms and mood issues that he has already displayed.

''You don't have to do that,'' Sherlock murmurs. ''Forget I said anything.''

''No. I don't want to forget you said anything. Not when it's upsetting you, and not when I suspect I could help you.''

He doesn't say anything for several beats, and then: ''I am wor- I am wondering if I have a personality disorder.''

I sit up straight in my chair, shocked.

''Why would you think that?''

''I can be manipulative,'' and his voice cracks. ''Many people have said I am manipulative.''

''Manipulative? Sherlock - anyone can be manipulative at various times in life. That in itself doesn't tell me enough. That's one trait.''

''There are others, too. I am not typical. Sometimes I think that I don't really understand the social niceties. I can lie, and not feel guilty about it, and John says I am often impulsive, and prone to irritability and-''

I push my notebook away, concerned.

''Hold on. What personality disorder do you think you may have?''

He sighs, harshly. Swallows again.

''I used to tell people I was a sociopath.''

My heart buzzes with adrenaline.

''Why would you do that?''

No answer.

''Sherlock, why did you tell people that?''

''Because it fits.''

He says it emphatically, as if he can not possibly understand my confusion.

''And what about the criterion that is most important to diagnosis, are you overlooking?''

His words are crisp when he responds. Careful. As if he doesn't trust himself to speak.

''I don't know what you mean.''


''John told me about your last case. With the little boy.''

''What does that have to do with anything?''

''John mentioned that you initially didn't want to take the case, because you generally never take cases that have to do with children.''

''Mmm. Yes. That's true.''

His voice sounds odd. Something seems off. My radar is on high alert, and as I speak to him, I pull out my mobile and pull up John Watson's work number.

''Why?,'' I ask as lightly as I can. My 'nothing-is-the-matter' voice.

''Because I find them distasteful.''

''Children?,'' I say carefully, not thinking that this is what he means at all - but wanting to prove a point.

''Don't be daft, Yuri,'' Sherlock hisses.

''So you find such cases more emotionally distressing, is what you really mean.''

Sherlock says nothing.

''Is that right, Sherlock?''

There is a pause.

''Sherlock?''

''I don't want to talk about this any more.''

But it comes out slurred. Not unlike ''I doan wanna talk 'bout this any more.''


A few seconds later, Sherlock asks me crisply: ''Do you know of a non-defective nutritionist?''

''Do I know of a non-defective nutritionist?,'' I repeat, slowly, if only to qualify that he wasn't trying to insult an entire profession. Which I suspect he actually was, if only to drive my attention away from the proceeding topic.

Or maybe it has nothing to do with the profession. Maybe I'm not thinking about this logically enough.

Most likely, Sherlock considers the majority of people on this planet - regardless of their profession or accomplishments - to be idiots.

''Yes,'' he responds quickly - without reservation - and I feel another surge of amusement at his tone. The interplay between his word choices and his question arguably insulting (to some) yet still (legitimately) asking for help.

''Your view of non-defective is not necessarily my view,'' I start with a cautionary tone to my voice. ''I would like something more specific. What are you looking for, precisely? What do you want in a nutritionist?''

A long suffering sigh, then. As if I am trying to test his patience, and not save him further aggravation.

''Are you trying to be difficult on purpose?,'' and now - another sigh. ''Okay, here it is - in simple language. I am looking for a competent individual who can create a dietary plan that will be well rounded enough to put John at ease, while not aggravating my constitution.''

I wait for a few seconds, trying to digest what he's saying.

''Your...constitution?''

''Yes, my constitution!,'' he exclaims, ''I have a bleeding ulcer, Yuri. I can't just eat anything.''

What he really is saying, I suspect, is that he's actually having difficultly putting anything into his mouth. Period. The 'just' could easily be removed from his wording, and the statement would suddenly be a lot more revealing about what is truly creating many of his problems.

''Okay. Well...can you give me a rundown of what you can eat, currently?''

Sherlock snorts.

''How does that help anything? You're not going to be my nutritionist,'' he says sullenly.

I'm quickly starting to realize that the combativeness I had observed from Sherlock when he was in the clinic is nothing unusual.

Also, I realize now that John Watson must have the patience of a saint.

''Perhaps not, but you can test out what you will say to a nutritionist on me first.''

Another sigh then, and then a pause.

I hear his light breath over the phone. I sense his anxiety.

''Sherlock?,'' I qualify.

''Okay,'' he says so softly that I can't be sure the word is even intended for me at all. A little louder, then: ''I eat...soup. Most days, umm, I have soup.''

I lightly tap my Bic pen against a yellow pad of paper. 'Soup' is rather meaningless.

That could mean almost anything, really.

''What types?,'' I say evenly, feeling a welling up of foreknowledge. Awareness of what is to come next, in variant form.

''Miso. With green curry,'' he says rapidly. ''Sometimes yellow curry.''

I write it down.

I am plenty familiar with miso soup, and it's use by the Evelina adolescent ED ward, unfortunately.

''What about pea? Clam Chowder? Chicken noodle? Other varieties?''

There is a delay - a tide going out with his words - and coming back with darker water than I would have expected.

''Not usually,'' he responds in a restrained voice. ''Sometimes I add marmite to it. To the miso, I mean.''

I swallow away a swollen burn in my throat.

Miso is essentially broth. While healthy enough as part of a balanced meal structure, on its own it's not enough to sustain a mouse.

''For the vitamins,'' he adds with a false brightness, as if trying to gloss over his earlier words. ''The marmite is high in B vitamins. It's healthy.''

''Right,'' I say primly. ''And what else?''

''I used to eat a lot of fruit - most fruits - a lot of vegetables. Rice cakes, hot sauce on them.''

''You used to?,'' my question comes out colder than I had intended and I strive to soften my tone. ''What do you mean you 'used to'?''

''Before my stomach got bad,'' Sherlock explains in a rush. ''Now I can't...I can't eat like that,'' he tries, and I can feel his nervousness.

'I can't eat like that.'

I press my fingertips into my temples.

''What else do you eat besides miso soup with marmite, Sherlock?''

A shudder like a sound of air rustling papers, and: ''Dandelion tea, most herbal teas, sometimes black tea. Coffee. Seltzer water, tap water, sometimes sugar free jello. So I can take vitamins. Otherwise I'd get sick if I took them on an empty stomach.''

He sounds apologetic, and all I can hear is 14 year old Devon talking to me in his wheezy rasp. Itemizing his list of 14 foods. All low caloric, and all sugar free, and all essentially nutrition-less.

I hear Devon, and then I hear Sherlock - in his apologetic tone. And it feels like the same damn patient, only aged 22 years.

But still apologetic.

For the fact that he sometimes eats sugar-free jello.

I close my eyes and let the sense of desperate yearning to fix this! wash over me.


I have worked as a therapist for almost 20 years, and yet I still find that certain subjects make my throat ache with sadness. Certain admissions are harder to hear than others, and always will be, but one of the more jolting admissions is when I hear people approach the subject of food with actual fear, and sometimes with disgust.

The long-term reluctance that they've built up towards taking a bite of something that most of us take for granted is hard to witness. The slow erosion of their physical health is the tip of the iceberg.

These disorders are particularly pernicious, and once they have developed over many years - and well into adulthood - they are notoriously difficult to treat.

Generally, even a slight alteration towards health and slight improvement in BMI is considered a rousing success for the treatment team, but is often actively detested by the individual receiving care.

Still, I can't help but feel a sorrow at the loss. The horrible loss of energy and focus and passion and determination. Some of the brightest minds so turned towards their own self-destruction...

In some ways, it seems even more painstakingly drawn out than other forms of suicide.

''Yuri?,'' Sherlock asks carefully now.

''So no solids?,'' I test gently, knowing the answer already - and hating that I have to ask. ''Is it only liquids right now?''

''Usually,'' Sherlock admits, octave dropping at the admission. ''Sometimes I deviate, but I take vitamins, Yuri. Liquid vitamins. Iron, B12, calcium, vitamin D. Things like that. I am a scientist. I know what essentials I need. It's not bad like John thinks it is.''

''Then why do you need to see a nutritionist? It sounds like you know what vitamins to take. Everything is in order, right?''

A pause then, and a clipped sound.

''Right,'' Sherlock says with mock conviction, a waver in his words. ''Everything is in order. Everything is fine. It is. I mostly don't want John to be so concerned.''

His voice is faint, lost, and I metaphorically bite my tongue.

''You're right, Sherlock,'' I admit softly.

''I know I am,'' he says tiredly, in agreement - all fight suddenly lost.

It's time to stop this charade.

''There is nothing wrong with you, Sherlock. I mean that.''

''Mmm?,'' he murmurs, ''Okay.''

I can sense the note of confusion, as if he's unsure if I am done or not.


I'm not done.


''You are not wrong, Sherlock. And your feelings are not wrong. Any fears you have - those are not wrong, either.''

He makes a weird sound - a chuckle tied to a choking sound - and then says, ''I know feelings are not wrong.''

''Ulcers, by themselves, are not psychological issues that need or warrant my assistance. So I agree with you. John's wrong. Obviously, he must be. You've outlined why he's wrong, and why your approach to your health is logical. I will tell him that when I see him at his next appointment. Does that allay your fears?''

''Okay,'' Sherlock says softly, a voice like silt lightly settling. The lack of weight in his tone - the lack of joyous vindication - tells me more than I needed to hear.

''Okay. Good. Then we are in agreement. We just need to get this ulcer treated, then you'll be back to your old self, and everything will be fine.''

He doesn't respond, and I close my eyes.

''Sherlock? There is nothing else wrong, am I right?''

''N-no,'' Sherlock says hesitantly in response to my bluntness. ''There is nothing. Nothing else, really.''

And in that momentary hesitation, my mind pulls up old words and old images. Sherlock in the clinic, pale to the extreme. His bare arms shifting about as he tried to hide faint, but still present, puncture scars from his younger days. The hard words of his file: parasuicidal ideation; mood disturbance; self-harm.

''Okay. Well, I will get around to talking to John. But I want to thank you for calling me.''

There is nothing but the rapid breath against the phone for a few seconds. No acknowledgement.

Of course, I have no intentions of hanging up.

I hold on a few more moments, waiting for the eager agreement that he doesn't need my help. That he's fine. That he needs to heal his stomach ulcers and other physical disorders. That he is happy I am aware that John is overreacting - and so on.

Then a wheeze. A high, streaky wheeze. A shuttery breath.

''Sherlock?,'' I test more gingerly.

''I don't know what to do,'' he whispers.

''What?,'' I ask more out of shock than anything else.

''I. don't. know. what. to. do,'' he grits, the words deepening in emotion. ''I don't know what's wrong with me,'' he hiccoughs, obviously trying to keep his fear at bay; in that moment, I feel a well of pity for him.

''Do you think you might be sick?,'' I question delicately, aware of the power of certain words. Of certain suggestions. ''Psychologically unwell?,'' I clarify in the moment, to preserve this conversation, this admission.

So he cannot go back on this later.

''Ma-maybe. I doan know,'' he mumbles, miserable. ''I doan know what to do anymore.''

I look at my mobile screen, and at John Watson's number, and I then type in a message. Within 15 seconds, I have received confirmation of my message and an acceptance of my suggestion.

''Alright, Sherlock. I understand,'' I test carefully. ''And I know you are probably feeling pretty overwhelmed right now. So I want you to text John and ask him to come back to the flat as soon as possible, alright? Is that okay with you?''

''I doan wantto disturb him,'' he mumbles, his stress much more apparent now. He's likely been skirting his ability to cope with his issues for a long time now.

''Would you like me to text him?,'' I offer carefully, willing to accept responsibility for the action that seems to be causing him his present anxiety - and also wanting to maintain the illusion that he has some choice in what comes next. When ultimately, from an emergency standpoint, he really doesn't.

Because I have already texted John.

''I doan know,'' he mutters. ''I doan know what to do!''

''Alright. Well, I think that I might know what to do right now, okay Sherlock? I think it's a good idea if John comes back to the flat. I know he'd want to help you right now, and if you can just admit to John - even just to John, and no one else - that you need his help - then you will start to feel better.''

Nothing. Static. Hiss.

Nothing.

Please.

A pause, and then a tiny, barely audible. ''Okay.''

''Okay,'' I repeat, mirroring his sentiment. ''Good. You did really well, Sherlock. It's going to be okay.''

''Okay,'' he whispers again, sounding torn. Sounding as if he has betrayed himself.

If only I could convince him of his strength. That he's done nothing wrong in calling me, or wanting me to call John.

That he's not a sociopath. Nor is he damaged in any way.

Wounded, perhaps.

But not damaged.

Damaged, to me, means destroyed.

And Sherlock is obviously not destroyed.

But he's in pain.