Periodic Tales
Calcium
Ca 20 40.078
On the periodic table in Group 2(alkaline earth metal), Calcium is a hard, silver grey metal that is the fifth most abundant element in the earth's crust (3% of the total), and an essential constituent of leaves, bones, teeth and shells. Discovered in 1808, it is named after the Latin Calix, meaning "lime".
Part One: Calcium is part of a compound called hydroxyapatite which is what makes our bones and teeth hard. Tooth enamel is almost entirely composed of calcium phosphate (Ca5 (PO4)3 OH). It is harder than bone, but unlike bone, it cannot regenerate naturally the way bones heal.
"Damn it."
John looked across the table at Sherlock in astonishment, his spoon stopped mid-air, half way on its journey from his mouth back to the cereal bowl. In the nine months they'd been sharing the flat, the doctor had never heard a single swear word from the Consulting Detective.
Sherlock held aloft a piece of toast with one perfect semicircle bitten out of the middle. He worked his mouth, as if he'd suddenly tasted something horrible.
"What's wrong?" For a split second, the doctor in John worried about his flatmate choking on his breakfast.
Sherlock lifted his plate to his mouth and spat out the half-masticated bread, which landed on the plate with a surprising clink.
"Oh- was there a stone in the flour? It is wholemeal."
With a frown. Sherlock began inspecting the soggy debris he'd ejected onto the plate. "No. Something more annoying." He poked about and then plucked something from the mess and wiped it clean with his fingers, and then placed it on the newspaper that John had been reading. It gleamed gold. Sherlock sat across the table looking at it, with an odd expression on his face.
"Oh, you've popped a crown. I didn't know you had one. Give me a smile so I can see if it's noticeable from the front."
Close lipped, Sherlock ignored his request; his frown was definitely tinged with something else that John couldn't quite identify. The Consulting Detective brought his plate up close to his face and stared at the remains of his breakfast as if he were investigating a crime scene. He picked up the magnifying glass that lived on the table and used it to inspect the half-chewed debris he'd spat out. John sensed an aura of distress emanating from him.
That made him want to reassure his flatmate, so he said, "Well, at least you didn't swallow it. You'd be digging through something far worse if that happened. If you're lucky, the dentist will be able to glue it back in."
Sherlock shook his head and kept looking through the magnifying glass. A pensive sigh was followed by a muttered, "Thought so…" He pulled out something from the toast bits and dropped it alongside the gold crown. It was an off white misshapen lump. "The tooth has broken, too." Sherlock walked over to the mirror over the fireplace and tried to see, angling his head in different positions to get a view of the broken tooth that had remained behind.
John looked at the fragment on his newspaper. As broken bits of teeth went, it was pretty big. He noted the effects of Sherlock's penchant for black coffee and the occasional cigarette- the shard of tooth was discoloured- hardly a "pearly white".
"This reminds me that I need to get registered with a dentist myself. Since I left the army, this has been the longest I've gone without a clean and a check-up. By the look of that bit of tooth, so do you. Who's your dentist? "
Sherlock turned from the mirror to stare at him; "I brush my teeth regularly. This should not happen." He glared at the gold crown on the table, as if it had somehow betrayed him.
It was true. Like clockwork, Sherlock always brushed his teeth every morning. He was as fastidious about brushing as he was about shaving. John shrugged. "Brushing can only do so much. When was the last time you saw a dentist?"
"On the Charlton Place murder- surely you remember? Lestrade was sure it was the dentist brother-in-law, but I knew the moment I laid eyes on him that it was the nanny who kidnapped the kid."
John smirked. "When I said 'saw a dentist', I meant professionally."
The brunet's brow furrowed. "I was being professional; I'm always professional on a crime scene."
That made John giggle; Sherlock's tendency to take things literally was amusing at times. "I meant, when was the last time you had an appointment with a dentist to have a clean and check-up yourself, for your teeth?"
"I don't remember."
John finally was able to recognise the peculiar expression on Sherlock's face- it was panic. Oh, he's got a phobia about dentists. Just as he started to open his mouth to tease Sherlock that at long last he'd found something "normal" about the eccentric genius, Sherlock beat him to it.
"I am not going to talk about this. And you aren't either. Ever." The tall brunet then swirled his dressing gown closed and marched off down the hall. John watched in surprise as the man shut the door firmly behind him— enough to qualify as a slam.
Trying not to chuckle, John wrapped the crown and the bit of tooth in a tissue and then put them in a specimen bottle, which he carefully placed on the mantelpiece, next to the jack-knifed bills.
It was still there a week later, after two back-to-back all-absorbing cases. In the interval, he occasionally went over to the mantelpiece and shook the specimen bottle in Sherlock's presence, and got a scowl in response. John didn't see Sherlock eat much — but he had come to realise that this was the norm with the man when he was working on a case. He managed to get him to eat some scrambled egg, but the bacon and sausage went untouched, possibly because by the time Sherlock got around to eating it, the meat had gone cold. The doctor did notice the first time Sherlock took a sip from a cup of hot coffee at the yard- a quick grimace and thereafter, every cup of tea he offered at Baker Street was met with a shake of the head or an outright curt "No" without an accompanying "thank you."
By now, John was used to the man's lack of manners, but this was even worse than normal, leading him to mutter "a please and thank you might not hurt- just occasionally."
"Why waste time on stupid things like that?" Sherlock smirked. "High Functioning Sociopath, remember?"
That led John to snap back, "I'm getting the sociopath; still waiting for the high functioning bit."
The tooth must have been bothering Sherlock, if the man's mood was anything to go by. Even cold water became an issue, and John noticed that the water jug which normally lived in the fridge was being left out overnight on the counter.
The doctor started to worry about how long Sherlock would try to ignore the damaged tooth being exposed.
It was the day after the case, and Sherlock was sprawled as usual on the sofa, eyes closed. John almost hated to disturb the man, but there was no excuse. He'd avoided breakfast entirely, so the tooth must still be bothering him.
"You know that the longer you procrastinate getting the tooth fixed, the more likely it is that infection will set in. You might need a root canal."
Without a word, Sherlock got up and went into his bedroom, and once again the door was shut with more firmness than warranted. Being closed was bad enough- Sherlock had a habit of leaving the door ajar- even when he slept. To be shut at all was a signal; to be slammed was the equivalent of a shout.
John decided to go to the pub that evening; it was fish and chips night at The Volunteer and Sherlock had declined (yet again) a hot take-away meal. The pub was at the north end of Baker Street, its copper-topped bar and range of guest cask ales making it a popular haunt with the Campaign for Real Ale crowd.
An hour later, satiated by the plateful of batter-coated cod, chunky chips and mushy peas, John stopped at the pub doorway to draw in a breath of fresh air. That's when he noticed the black car parked illegally right in front of him. The front passenger door opened, and he recognised the long legged dark haired young woman who got out in one elegant move.
"Evening, Anthea."
She gave him a smile and then opened the back passenger door, gesturing him in.
"I've only had one pint. I can manage to walk home. It's not exactly far."
"Get in, Doctor Watson." Mycroft's voice came from the other side of the back seat.
John slid into the car. "I've mentioned before the existence of a marvellous new invention called the telephone; wonder why you don't seem to use one?"
Sherlock's brother gave him a sideways glance. "Phones leave trails, Doctor Watson. My brother routinely looks at yours."
Of course he does. By now he knew Sherlock thought anything of John's was fair game, but the lack of privacy still annoyed him. John looked at the traffic, as the car did an illegal u-turn and proceeded fifty feet the wrong way up a one way street, presumably to avoid being seen by a certain pair of grey green eyes. Buckling his seatbelt rapidly, he muttered, "So, we're taking the scenic route." The car turned onto Allsop Place and then onto York Terrace.
Clearly, his 'kidnapping' was something that Mycroft didn't want Sherlock to know about. "I told you once before that I won't spy on Sherlock for you."
"No need to repeat yourself, but I do need your assistance regarding my brother's dental problem."
Shaking his head in disbelief, John's chin went up. "You are a bugger; I mean that literally- you must be bugging the flat if you know about his crown."
Mycroft shrugged. "It saves a lot of time. In this case, I know that he is being difficult about getting his tooth fixed, so I am going to propose a course of action. I would like your assistance, however."
"I've already tried to raise it with him- and he's not willing to even talk about it, let alone do anything. Am I right in assuming he doesn't like dentists?"
John wondered if he was imagining Mycroft's fingers tightening on the handle of his umbrella. The white knuckles suggested that not only was his guess right, but that it was the cause of some concern to Mycroft.
"You have no idea, Doctor Watson. Since his very first visit to a dentist, soon after his first tooth erupted when he was six months old, he has been impossible. Anyone who went anywhere near his mouth was greeted by a screaming tantrum; even at three he had an impressive bite, as several nannies discovered. By the time he was six and his baby teeth started to fall out, the only way our mother could get him into a dentist's office was if he was sedated. And by that I mean completely unconscious. He will not go voluntarily to get this latest problem fixed- which is why I will need your help."
John had figured out the odontophobia of his flatmate- but not its cause or extent. "Why? Did something traumatic happen in a dentist chair? What happened to make him so anxious?"
Mycroft was looking straight ahead rather than at John, and seemed to be considering his words carefully. Finally he said, "My brother has hyper-acute hearing— the drill and the high speed scaling tool are instruments of torture for him. And he doesn't like the sensation of alien things in his mouth. It's part of the challenge of getting him to eat properly. You must have realised this already, haven't you?"
Actually, John had, even though he had not put his finger on exactly why Sherlock was such a fussy eater. A number of foods that his flatmate should have liked, based on his routine takeaway choices, had been flatly refused. "Texture's all wrong, John" was the only explanation given. His lip had actually curled and his nose wrinkled at the sight of his flatmate's porridge. John defended his choice—"I like porridge, and soluble fibre is good for you. A packet of oats, milk and water, plus a microwave—it's the perfect cooked breakfast for me. I even had it in Helmand."
"Disgusting."
"To each their own" had been John's reply.
The doctor looked away from the traffic as they turned onto Marylebone Road and back at Mycroft. "So what do you propose?"
The elder Holmes reached into his suit pocket and withdrew a small plastic packet with some white powder in it. "Sedation. Administer it tomorrow morning; tasteless, odourless and undetectable, even to Sherlock's nose. Stir it into anything he's willing to drink at the moment. Once he's out, I will have him collected and delivered to the dentist. If we're lucky, he will wake up back at Baker Street, none the wiser."
John smirked. "I think the World's Only Consulting Detective will spot that his tooth has been fixed and the crown replaced."
"Of course. But such is his phobia that he will not mention it. How do you think the crown got there in the first place?"
"What is the sedative and how can you be sure about the dosage?" He was suspicious.
"Flunitrazepam. It's a water-soluble benzodiazepine, with considerable memory impairment, which in this case is exactly what he needs. He's had it before, with no side-effects. Once he's out, the crew that collects him will keep him under during transport. Just find an opportunity to put it into a glass of water; it can go into tea or coffee, if you think he is likely to take either. Better yet, extol the virtues of a whisky for pain relief. It works even better in combination with alcohol."
John thought about it. On the one hand, Sherlock's brother had experienced a lifetime of trying to deal with his brother's peculiarities, and if he thought this was the only way to get the man to a dentist, then how could he argue? On the other hand, he didn't like the idea of abetting this level of intrusion and manipulation. Flunitrazepam was also known as Rohypnol—a date rape drug. The idea of drugging Sherlock against his will made him feel decidedly uncomfortable. It was something that could undermine their developing friendship.
"Nope. Sorry, but I don't do this sort of thing- drugging someone without their permission is not legal, decent or honest. GMC guidelines are there for a reason, Mycroft; I'd lose my license over it. "
Mycroft rolled his eyes. "How very noble of you, Doctor Watson. I can assure you that there would be no consequences for you.* When my brother is screaming in pain from toothache, you are likely to change your mind. He can be utter hell to live with- in pain that becomes even worse. Call me, preferably before he reaches that state."
"He's not stupid, you know. If it gets that bad, I'll tell him about the drug, get him to agree to take it voluntarily, and then everyone wins." John had the feeling that Mycroft rarely credited Sherlock with much sense.
"I am not naïve enough to allow hope to triumph over experience." Mycroft leaned forward and touched a button. "My dear, ask Stimpson to drop the doctor off at the next corner, please. " He turned back to John, "Call me when you come to your senses about this."
The car stopped at the junction of Marylebone and Luxborough Street. John got out without a backward glance, gobsmacked that Mycroft had thought he could be suborned in this. Sedation without permission from the patient just unethical, and that fact alone made him so annoyed with the elder Holmes that it took him a whole day to recover. Sarah wanted to know what had put him in such a bad mood, and he just shook his head.
When he got back from the clinic, Sherlock was out. John sometimes wondered what the Consulting Detective did when he went left the flat on his own. There was no case on, no visible signs of an experiment on the kitchen table. The violin case was shut, no music on the stand. His eye landed on the specimen bottle, but quickly passed over it. Not going there. Sherlock was an adult, perfectly capable of deciding when he needed a dentist; it wasn't any of John's business.
He fixed himself an omelette and watched crap TV. He'd started to get into the Dragon's Den- one of the contestants had an ego to match both of the Holmes brothers. That made him smirk- he wondered if either of them could ever be practical enough to run a business. Then the smirk faded; if Sherlock was to be believed, Mycroft ran the British Government, so that must count for something.
By eleven he gave up waiting for Sherlock, and went to bed. He took a glass of water up with him, and wondered if he should get two filtration jugs. He always preferred his cold- probably a holdover from spending too many a night in the deserts of Afghanistan.
When he woke up, it was to see a stripe of strong sunlight across the wall- the curtain never seemed to completely block it out. Bleary-eyed and sleep fuddled, for a moment John wondered whether he'd had too much to drink last night. He had a headache that felt almost as if he'd had a hangover, but he'd only had a glass of whisky to keep him company on the sofa while watching Dragons Den. A glance at the clock on his bedside table made John groan- he was supposed to have been at work twenty minutes ago. Sitting upright, he ignored the room spinning and stumbled to his feet, looking for his phone. He'd have to call the surgery and tell them he'd be late.
There was a text message alert, and he grimaced when he recognised Sarah's number- probably chasing him up. He thumbed it open.
9.36am Hope you're feeling better. Keep your virus at home. Shifted appointments so you can take today and tomorrow off.
He stared at the screen for a few seconds, trying to make sense of the text. Had Sherlock sent a message in already, saying he was unwell, so he could sleep in? John was having real trouble remembering anything at all about last night. He had a vague recollection of coming home to an empty flat and then going to bed. Right now, though, a very full bladder was demanding his attention.
The doctor fumbled his dressing gown on and went downstairs. Sherlock's coat and scarf were hanging on the hook as usual, but the living room and kitchen were empty. He wandered down the hall and stopped in the bathroom for a pee. The relief was amazing- and it made him wonder if he'd had a lot to drink. That summoned the memory of the pub… and then like a glimmer of light through his mental fog, a recollection of a conversation in the back of a car.
Oh shit. He stumbled back out into the living room and opened his laptop. He had to type in his password twice, because his fingers still felt half asleep.
There in the bottom right hand corner of the screen was the time and date. And it was Thursday, not Wednesday**.
He'd lost a whole day, and he had a sneaking suspicion that he wasn't the only one.
Fuelled by anger, John marched down the corridor to Sherlock's room, knocked and opened it without waiting for an answer.
The man was sound asleep, on his side in what John immediately recognised as a recovery position. And dressed in pyjamas.
Anyone who actually knew Sherlock knew that when he finally deigned to sleep in an actual bed, he would spread out like a starfish, taking up the whole mattress. And he slept naked in his ridiculously expensive Egyptian cotton sheets. The pyjamas were only worn when he got up- as a concession to sharing the flat with another human being. And even that sometimes turned into a sheet off the bed, when he couldn't be bothered with actual clothing.
John walked over and decided that if this was what he thought it was, then the man would probably sleep through for some time yet. He lifted Sherlock's hand, found the pulse and counted.
He resisted the temptation to look in Sherlock's mouth. It was slightly ajar, and a sound somewhere between a deep breath and a snore was emerging. He decided to let sleeping consultant detectives lie and went back into the kitchen to fix some strong coffee while noting the conspicuous absence of the specimen bottle on the mantelpiece.
Two cups later, his head was clear enough to deal with the other Holmes. John turned on his phone and hit the third speed-dial number listed.
On the third ring, an urbane voice answered, "Good morning, Doctor Watson. I trust you are recovering from that bout of winter vomiting sickness?"
John stared at the phone. "You bastard. You drugged us both. How the hell did you do that?"
"Cherchez la femme, Doctor Watson. I asked Mrs Hudson to put it into the jug of water in your kitchen the night before last. Given that you both drank from it, Sherlock cannot now blame you. Your …honour remains intact."
"Why would she do that?"
"Never underestimate the power of maternal instincts in a woman; they will always overcome scruples. Mrs Hudson thinks of you two as 'her boys'; I merely allowed her to do what had to be done to ease Sherlock's suffering."
"What drugs were involved?" This was asked through clenched teeth.
"I had a feeling you might ask that. Bear with me for a moment, while I get my notebook." A brief moment and then Mycroft started reeling off the drugs: "flunitrazepam in the water to put him to sleep, then he was dosed with ketamine during transport. When he got to the hospital, he was briefly ventilated by a bag mask, while an infusion of propofol and something called remifentanil was started. They used nasal intubation so they could get to work in his mouth. When they were done, and the anaesthetic was stopped, he started breathing on his own again. And then he was given a dose of ketamine with midazolam, with one top up of ketamine on route to Baker Street. When they got him into the bed they gave him one more dose of midazolam***. He won't remember a thing, but he will know that it's been taken care of. If you don't mention it, he won't either."
"And me? I didn't wake up, so you must have continued to drug me."
"Just the flunitrazepam to start and then midazolam- applied buccally."
"Just for the record, Mycroft, I object most strenuously to being drugged without my permission. I might have had a bad reaction to it."
There was a sniff from the other end of the phone. "Doctor Watson, I can assure you that your medical history was consulted before anything was administered. As too many medicines provoke a paradoxical reaction from Sherlock, we were very careful. Ability to impair memory was particularly important in his case. You didn't need that; hence you have more memory about the incident."
"Don't ever do this again, or I will tell him." He put his Captain's voice of authority into the words, even though he knew that it would have little effect on the elder brother's behaviour. Come to think of it, both brothers seemed to have the same attitude towards boundaries.
"In this case, you should look a gift horse in the mouth, Doctor. When you brush your teeth this morning, you will find that you've had a full cleaning and a check-up, too. I am happy to pass on the news that you are in fine dental health."
John hung up on him. There was an incoming call from Lestrade.
oOo
"It's definitely human." Molly lifted the sheet on the body, as Sherlock strode into the mortuary, with John and Detective Inspector Lestrade following close behind.
The victim had turned up rather bizarrely at a funeral home yesterday morning, delivered there at some point the night before last and left in one of the coffins on display. There were no signs of a break in, and Lestrade's team had come up with nothing in the statements from the various employees as to how a body could have been dumped quite so easily. There was nothing with her in the coffin to identify the body. The naked woman was blonde, blue eyed, of average height and weight. She had no distinguishing features— apart from one.
On the phone to Lestrade earlier that morning, Sherlock had not been enthusiastic. "What's worth getting out of bed for?"
Lestrade's answer was succinct. "You're good at this sort of thing—the weirder, the better. "
"You think that's a reason to be interested?" Sherlock's question was a rhetorical one, he didn't sound like he agreed.
The DI then added, "She's been bitten. And not by an animal. It's a message- and I need you to help me figure out what it is, who she is, and how she ended up that way."
John had encouraged Sherlock to take the case. "You're the one who's been moping for the past few days; I could do with a stretch of legs myself."
When the pathologist pulled the sheet off the corpse, John took a closer look at a set of bite marks, rather more oval than circular, with deep bruising, on the woman's left breast. He tried to imagine how it could be done- and what possible motive a person could have for such a desecration.
A rather raspy baritone elaborated on what John was seeing. "Inflicted either while she was still alive or post mortem, within a minute or two of death." Sherlock was on the other side of the mortuary trolley, examining the same wounds with his pocket magnifier. He'd been grumpy and curt ever since waking up, when he could be bothered to say anything.
"Why would someone bite a victim? What kind of motive are we looking at?" Lestrade was trying to make sense of the crime, but not making much headway.
Sherlock cleared his throat and shrugged. "Two kinds of biting- one is done in anger, using teeth as a weapon in a fight. That causes a distinctive wound pattern—lots of tearing and bruising. This bite is precise, slow and designed to leave an imprint. Biting like this is a very intimate thing; it suggests a sexual motive and that could even be the main sexual act the killer wants to perform - surprisingly few sexually motivated serial killers have intercourse with their victims or even masturbate at the scene."
Lestrade shook his head. "No sign of that in the coffin, according to the Forensic team, but we don't know where the primary crime scene was. In fact, we can't actually be sure she was murdered."
As Sherlock zeroed in on the wound, putting his face just inches from the dead woman's breast, he started a running commentary. "All thirty two teeth fully erupted- so an adult: 8 incisors, 4 canines, 8 premolars, and 12 molars, including 4 wisdom teeth."
"So, the murderer is a clever adult," John teased, looking across the body at the brunet. He was trying to use humour to get Sherlock to lighten up.
Sherlock wasn't amused. "How droll, John. They're called wisdom teeth because they are the last to emerge- usually between the ages of 17 and 25, but sometimes they don't show until much later. Mycroft's top left is impacted, gives him grief from time to time." He sounded rather pleased by the fact.
Greg sniggered, "how many wisdom teeth have you got, Sherlock?"
That provoked a sniff rather than an answer.
Helpfully, Molly offered, "Some or all of the last set of molars can remain unexposed because there isn't enough space."
"I would have thought Sherlock has a big enough mouth," Lestrade said.
"The number of wisdom teeth is not a sign of intelligence," was the baritone retort. As if to push the conversation onto safer territory, Sherlock waved in the vague direction of the pathologist. "Did you manage to swab the wound for traces of any saliva? It could provide DNA."
Molly nodded. "Of course, Sherlock, a forensic odontology course is compulsory for pathologists. There wasn't any in the bite marks. In fact, the whole area shows signs of being wiped clean with disinfectant. No traces of micro-organisms either. Not in the bite anyway. There were some under her fingernails. I've sent it for analysis."
Sherlock stood bolt upright and glared at her. "Why didn't you save them for me? I could have done that analysis better, and in half the time." His tone was decidedly peevish.
Molly looked embarrassed.
Lestrade came to Molly's defence; "Neither of you two could be bothered to answer your phone yesterday. I couldn't wait."
Sherlock sniffed, and returned to his scrutiny of the wound. "I'm assuming that the fingerprints did not match anything on the system and that no one has reported a missing person fitting this description?"
Lestrade shook his head, as Molly chipped in, "All we know is that she's been dead for anywhere between four and ten days; the rate of decomposition would depend on the temperature and humidity of where the body was kept."
"You've taken photographs of the wound?"
"Of course. They're already on the computer."
"Anything else?"
"Apart from the fact that she stopped breathing, she was in good health. No broken bones ever. No signs of any medical conditions. In fact, she was fit- good, well-defined musculature, healthy heart and lungs. She took care of herself- natural colour of her hair, nails, skin and teeth are in great shape."
Lestrade nodded, "…and pretty, too; attractive enough to catch the eye of her killer."
Molly glanced at the DI, before continuing her description. "No sign of sexual assault- or recent activity either, but she's not a virgin. She's aged between thirty and forty, I would say. No signs of pregnancy- no stretch marks, no change in nipple colour."
Sherlock looked down at the corpse. "She's been married though- for at least a decade, maybe more."
Lestrade frowned, and Molly threw a questioning look at Sherlock. "She wasn't wearing a ring when she was brought in- and there's no tan line, so how can you tell?"
Sherlock rolled his eyes, and poked at the woman's left index finger. "Look below the knuckle. The narrowness around the proximal phalanx bone is caused by a set of rings constricting the soft tissue; the superficial flexor tendon in particular gets squeezed. That only happens when a ring is worn for years. In her case, the missing tan line just means she's been divorced for at least a year."
A little tentatively, Molly asked, "Or maybe widowed?"
Sherlock snapped back, "No. Widows generally continue to wear their rings in a gesture of marital commitment, unless the marriage was a total disaster. Balance of probability is divorce." He lifted the woman's side, and peered underneath at her back and buttocks . "Recently arrived in this country."
"How the hell can you tell that?"
"She's got an all over natural tan- so not a sunbed, but spent time somewhere overseas where naturist bathing is legal. It's started to fade, so maybe here for a couple of weeks before she was killed."
"Well I suppose we can start by looking at any passport entries that match her description, but there are going to be tens of thousands. We need to narrow it down, Sherlock."
Sherlock shifted his focus to her left forearm. "She's recently had a cannula here."
The pathologist nodded. "Yes. I thought at first she was a drug addict and that it was an injection site. There are signs of nasal bleeding- mucus membranes get damaged by insufflation of drugs. But a dipstick on her bladder contents showed no positives for opiates or cocaine, so I ordered a blood test, which showed traces of midazolam, propofol and fentanyl. The murderer could have used drugs to put her out completely before he bit her. Whatever the dose, it caused her breathing to stop, which was technically the cause of death."
The doctor's eyebrows raised in surprise. "IV propofol and fentanyl are hospital anaesthetics; surely that limits who could have used them to kill her. A medical professional would know all he had to do was let the drugs suppress her breathing- that's murder. You don't need an anaesthetist to inject drugs into IVs; you need them to keep the patients alive after what those drugs do to them. Maybe the killer just took a DIY approach."
Lestrade was listening. "Maybe she's a medical tourist- you know, someone who comes here just to be able to get an operation on the NHS. And it went wrong."
"The bite, Lestrade. This isn't accidental."
"But, if it is murder, this fentanyl's hardly the sort of thing found on a street corner dealer, so we should start checking hospitals."
Still bent over the body, looking for other injection sites between her toes, Sherlock grunted.
"Don't be so sure, Lestrade. An analogue, alpha methylfentanyl's been around since the late 70's- and recently the Mexican cartels have started cutting heroin with fentanyl for a bigger kick. The street names give you a clue- China White, Drop Dead and Serial Killer- which tells you what you need to know about its strength. Fifty times more potent than a natural opiod, fentanyl is undetectable in a conventional urine drug test, which makes it highly attractive to the wealthy user. And even in a full immunoassay test, it's almost impossible to detect the difference between medicinal fentanyl and illegally manufactured versions- so you can make up a conceivable excuse if you are caught in a random drug test. Propofol is illegally used, too—but over ninety percent of propofol abusers are healthcare professionals, because they have access to hospital supplies, which can be sold on the street. Ketamine was also first used in hospitals, but is now readily available on the street, too."
John drew a shaky breath. Sometimes, Sherlock's encyclopaedic memory for illegal drugs worried him intensely. And the fact that he kept that knowledge meticulously up to date.
"So, why's the bite so important?"
Sherlock shrugged. "A murderer's way of marking one's territory; claiming the kill- but it can be counter-productive as Ted Bundy**** discovered."
"Okay…I'll bite. Who's Ted Bundy?"
Oblivious to John's word play, Sherlock stood upright again to throw a perplexed look at the doctor. "Really? You haven't heard of the most notorious serial killer in US history?"
John snorted. "No, can't say that information's high on my list of priorities."
Sherlock looked askance. "Ted Bundy confessed to the murder of thirty women in seven different states, all killed between 1974 and 1978, but the authorities believe that he'd murdered at least twice that number. He had a habit of returning to where he buried the bodies, performing sexual acts with the decomposing corpses."
John heard Molly's "eww" behind him.
Undaunted by her expression of disgust, Sherlock continued, "Bundy decapitated at least twelve of his victims, keeping some of the heads in his apartment. He was very clever, a law school graduate well versed in police procedure and able to avoid detection for years. When he was facing murder charges in Colorado, he managed to escape from remand prison not once but twice and went on to kill more women. Eventually, he was caught, tried and convicted for attacking four women in a fifteen minute homicidal spree at a sorority house in Florida. It was forensic dental work that was key circumstantial evidence- a bite mark on the left buttock of one of his victims matched his teeth. He was executed in January, 1989. How could you not know this?"
How Sherlock had the breath to ask that question after rattling off his long winded explanation, John would never know. "I don't make a habit of learning about serial killers, Sherlock."
Greg stifled a laugh. "We don't all have special interests that match yours, Sherlock."
This provoked a huff; "There've been four movies made about him; I'm surprised you haven't run across at least one of the films while watching your crap TV late at night, whilst bemoaning the fact that you aren't out with some woman on a date."
Before John could defend himself, the DI shifted uncomfortably. "Sherlock, get to the point. Miss Hooper says there is no sign of sexual assault; no one's mucking around with a corpse on this occasion. But if you can give us an idea where to begin, just a line of enquiry would help."
Sherlock returned to the body. He cupped his gloved hand behind her neck and tipped her head back. Opening the dead woman's mouth, he peered in, using his pocket magnifier.
"Oh!"
"What?" Both John and Greg asked the question at exactly the same time.
Sherlock set the head down gently and then stepped away from the body, his hands up under his chin. Then he spun on his heel and returned to the trolley, peering at the wound again from just inches above the dead woman's breast. When he stood up again, it was with a self-satisfied smile.
"Take a look inside her mouth- all of you."
Molly grasped the corpse's jaw again, and the three of them peered in. After a few moments, they exchanged dubious glances. "What are we supposed to be seeing?"
Sherlock rolled his eyes. "Are all of you equally blind? It's obvious; the murderer is someone who is in the dental business."
"What?!" This time, John beat Lestrade to the question, but it was Molly who followed up with one of her own, "How do you know?" She let the head down and the woman's mouth closed.
Sherlock whirled back to the body and pointed to the bite marks on her breast. "Oh, for God's sake, just look. The bite wound matches her teeth."
Greg's spluttered in disbelief. "Sherlock, it's a physical impossibility for her to have bitten herself like that."
Sherlock smirked. "Who said she did? What I said is that the bite marks match her teeth."
The DI raised an incredulous eyebrow. "How can you tell something like that by just looking at her teeth?"
Sherlock blanked, and then pointedly looked at both John and Molly, as if seeking confirmation that the DI was being dense. When he didn't get that reaction, he was shocked. "You really can't see it?"
"No," was the DI's answer. John shook his head. Molly just looked pained.
Lestrade blustered, "How on earth can you just look into her mouth for a couple of seconds, and then say that it's an exact match to the wound? One's a three dimensional set of teeth, the other is just a bunch of two dimensional marks."
Molly added, "Sherlock, there are thirty two teeth, and no one person's teeth exactly match another- not even identical twins; by the time they're adults, different wear patterns, dental work, even decay makes it possible to separate them. The only way an exact match can be confirmed in a court is to take a mould of her teeth, then make a cast version, injecting fast setting plaster into the mould and then put the result on the wound marks to see if it matched. That's what the forensic odontologist said."
Sherlock waved his pocket magnifier at them, dismissively. "I don't need that. I can see that they match— exactly. My spatial reasoning and object visualisations skills function well. Don't yours?"
John, Molly and Greg all gave Sherlock an uncomprehending look, which led the tall brunet to roll his eyes and mutter, "I am surrounded by idiots."
Lestrade crossed his arms and challenged him, "So, clever clogs, prove it. You'd have to if you were on a witness stand and had to convince a jury."
"Molly, have you got a piece of foil about fifteen centimetres by ten- or even better, a piece of wax that size?"
"Um…maybe some foil. Let me see." She went over to the lab bench and started rummaging in some drawers.
"What's that for?" John's curiosity was piqued.
"How dentists check a bite, once they've made a filling. It will render the three dimensions of her teeth into a two-dimensional version that I can overlay on the wound- so those of you with limited perceptual skills can understand something that is blatantly obvious to me."
"Oh, why didn't you say so? I have articulating marking paper." Molly had been listening while trying to find the foil. "I use it to help identify unknown bodies from dental records- they're easier to send to practices that don't keep photographic dental records."
"Good, I'll need a hard surface that can fit into her mouth, too."
She came back with a pair of scissors and a pad of what looked like rectangles of old fashioned carbon paper.
Sherlock tore off the back of the pad and overlaid it with a carbon sheet, before returning to the corpse. "Lift her head and open her mouth, John. I'll do the top teeth first, and then the lower."
A few minutes later, the Consulting Detective laid the sheets with the blue marks made by the woman's teeth onto her breast. The original bite wounds could be seen through the thin pink paper- and the marks aligned, exactly.
"You could really see that just by looking? How do you do that?" John's admiration shone through the questions.
Sherlock shrugged, "How is it possible that you cannot see that they match?"
Greg sighed. "So, let me get this straight. The murderer is a dentist, who takes a mould of her teeth and somehow creates a set of false teeth that he uses to bite her? Why would anyone do such a crazy thing? And how are we going to find this guy?"
"Not easily. Normally, one would send the dental information to dental practices and ask them to check their records. But the murderer is unlikely to admit that this woman was his patient, so will deny that there is a match."
"So, without a finger-print match or dental records, and with no missing person reported who matches her description…"
Molly finished the DI's statement, "…she remains a Jane Doe. There's nothing in the rest of the body that marks her out- no broken bones, no implants with a serial number that could be traced. So, there is no hope of identifying her."
"I didn't say that, did I?"
Three sets of eyes returned to the Consulting Detective, who continued, "Sometimes, it's what you can't see that is the important thing."
Greg snorted. "Okay, Sherlock- now you are just taking the mickey."
"No, I mean it- there are three obvious clues. First, look at the teeth." He waved the carbon sheets, but, when he got an uncomprehending shrug from the DI, Sherlock sighed and went back over to the corpse and tilted her jaw, theatrically pointing into the gaping mouth. "What's missing?"
Molly shrugged, "she's not missing any teeth."
He rolled his eyes. "She's missing any dental work at all. She's got perfect teeth. Not a cavity in sight, no fillings, no crowns, no implants, no sign of gingivitis or gum retreat. This is a woman who brushes, flosses and keeps her teeth in perfect condition. So why would she consent to a procedure involving conscious sedation?
"That's the second thing that's missing. No signs of struggle at all. So she was a willing participant when that venous cannula was inserted."
Greg looked at the woman's forearm. "How can you tell?"
Sherlock unbuttoned his cuff and rolled up his sleeve, revealing a similar mark on his forearm. "Because I've got one, too."
The DI looked worried. "Um, Sherlock…are you…"
Before he could finish the question, Sherlock glowered. "Of course not, I'm clean. But yesterday, when I couldn't be reached on my phone I was having dental work done- hence the needle mark. And the fact that I've had a nosebleed at some point and my throat is sore is because I was intubated nasally during the procedure. Her nosebleed suggests she had something similar."
John groaned, "Mycroft thought you wouldn't remember a thing."
"Yes, well, he's stupid like that. He still thinks I'm ten years old. Drugs can affect memory recall, but once I'm awake I can deduce what happened. And you're an idiot too if you thought I wasn't going to figure it out. Next time, I'd really rather have been given a choice than be drugged without my permission. " He glowered at John.
"Yeah, well I told him that, too. He got miffed and drugged us both."
"I hope you gave him grief for that. He's no right."
"I agree. Of course, none of it would have happened if you weren't such a wuss about getting your tooth fixed."
Sherlock looked offended. "I am not a…a wuss, whatever that is."
Lestrade stepped in; "Alright children, that's enough. You said there were three things we were missing. What else?"
Sherlock tapped his left index finger. "One- she has perfect teeth, so why go to a dentist? Two- if she has perfect teeth, why consent to have that dentist sedate her?"
"So now you're saying it wasn't a dentist?" Greg was getting seriously confused.
That got him a snort of derision. "Yes and no. It's the third thing you're missing. Most dentists in this country usually bring in a qualified anaesthetist for conscious sedation during dental treatment; he or she couldn't do the constant monitoring and a procedure like an extraction, crown or implant at the same time. So, unless our murderer has a willing accomplice, that makes a dentist unlikely. However, an oral and maxillofacial surgeon needs both a dental and medical qualification, would have access to anaesthetic, and would be able to convince someone with obviously healthy teeth to submit to a procedure."
He went to the top of the trolley and lifted the woman's head again, feeling her face with his fingertips, probing down the cheeks from her ear towards the jaw line. The he shifted the position, sweeping his fingers firmly under the jaw line toward her mouth. Then Sherlock smiled, leaving his left finger in position. He gestured to Molly, "Feel that?"
The pathologist placed her fingers on the spot as he withdrew his. "Oh, yes, yes I do feel something."
"Calculi are salivary stones, formed in the salivary glands and they block the ducts. Can be painful especially after eating when the stone blocks the normal flow of saliva. The stones are mostly calcium- but oddly a patient having them won't often show a calcium imbalance or build-up anywhere else in the body."
Molly looked mortified. "How could I have missed this? I took X-rays."
Sherlock shook his head. "Not your fault. They are usually so small that they only show up in a CT or MRI scan. And those little stones are the true cause of death."
"How?"
"Logic says that this woman went to her ex-husband for the procedure- probably because she couldn't afford to pay for it; maybe she even asked him for the money, but he refused, saying he'd do it privately. That suggests they fought over the divorce settlement, and that she left him, rather than the other way around. Once he had her unconscious in the dentist chair, he just couldn't miss the opportunity to stop her for good. Biting her with her own teeth was a way of expressing his frustration, without leaving any incriminating evidence. He'd know that because she was living overseas, if no one here filed a missing person report, he'd get away with it. Our surgeon couldn't pay for a funeral without arousing suspicions, so dumped the body in the funeral home, knowing it could not be identified."
John smirked, as Lestrade rubbed his hands over his face. "Jeez, Sherlock…all that sounds possible, but how the hell am I going to find this guy?"
"Oh, that's the easy part. Narrow it down…there are nearly five thousand dentists in London, but less than a hundred OMY surgeons, of whom a small subset specialise in salivary gland diseases." He pulled his phone out of his pocket, swiped a few times and then typed furiously. A moment later, he turned the screen to the three of them. A google style map of central London had a number of red pushpins on it. "According to the British Association of Oral and Maxillary Surgeons, there are thirteen suspects. Eliminate the unmarried ones, and find the one whose wife left him a year ago and went overseas."
Sherlock gave a triumphant smile, and John noticed that his teeth were remarkably clean.
Author's notes:
* This is set early on in their relationship, pre- Collateral Damage in terms of timeline. At this point, John Watson is unaware that Mycroft has medical power of attorney over Sherlock's affairs. And Mycroft is being discrete about how much he is revealing about his brother- eg only his sensory issues, not that he is on the Spectrum.
** This is a "missing Wednesday" story- in honour of SailOnSilverGirl, ThessalyMc, GhyllWyne and J_Baillier- AKA the beta coven
*** Mycroft always has a list!
****Ted Bundy is REAL- the most extraordinary serial killer in US history, and makes Hannibal Lecter look tame.
