Lessons in Friendship 3 - Setback

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Chapter 3 - Talking

Two hours later, when they had just passed Slough, John stirred.

Soon, he sat up to wake properly and rubbed his face. Sherlock watched him in the rear view mirror.

"Feel better?" he asked carefully.

"Hmm…" The sound carried a hint of a 'yes', Sherlock observed.

"You want me to stop so you can sit at the front?"

"No, I want to be ridiculous and try to climb there while you drive."

Was it a joke?

The tone wasn't sarcastic and in fact for a small person like John it might be possible to do this in this car, the land rover was spacious.

He was still trying to figure it out when John started to do exactly that: started to climb to the front. He was a bit uncoordinated but made it finally.

Sherlock grinned. Was this a gentle move towards forgiveness?

John knew this was Sherlock's kind of humour, to do things just because one wanted to know if one could… or because it would irritate onlookers and it was fun watching those watching their thoughts pass their faces in reaction, like photographing a group of people that were all photographing the same object.

Sherlock grinned, John chuckled, dragging his leg into the small space under the compartment.

"Daily exercise, doctor?"

"Something like that," John slurred slightly - very slightly. Everyone else than Sherlock would have missed it.

They drove in silence for another few minutes.

"You want to know what happened…" It was a statement, not a question.

"Please…" Sherlock answered honestly, the question must have been written all over his face. He was proud most people weren't able to read him, it was suiting his job. However, John was getting better with it every day.

"I had a flashback. It was caused by the memory of Henry putting the gun in his mouth… Which mingled with a memory of a young soldier doing exactly the same, but... he pulled the trigger… Couldn't live with what he had seen. He wasn't dead immediately. Took some minutes… died in my arms." John's voice broke.

Heavy silence settled in the car and Sherlock wondered how often John had been tempted to do the same thing to himself and how many suicides he had witnessed in his time as an army doctor. He wanted to know both answers, but suppressed the question.

Don't trigger him! Let him talk if he wants to.

John fetched another bottle of water and sipped carefully.

"It's okay… ask. I realise if we had talked about my PTSD more you might have understood how bad an idea it was to use me as a test subject. You thought it was just a diagnosis and not really something that was affecting me? …'cause you were never really confronted with it? Maybe partly because I hide it and partly because you weren't interested and ignored it? I didn't want to talk about it because I knew you'd use the information to look down on me."

"I do not look down on you…"

"No? So why do you constantly bug me about being dumb and take me for granted? Treat me like an assistant for the dirty work? You know this shows perfectly how you look down on me. You use me when you need me and ignore me when I have served the purpose. My needs are completely irrelevant to you. So if it's going to change anything to talk things through with I'm all for it, let's do it.…" There was no aggression in John's voice, only resignation.

"Have you witnessed many suicides?" Sherlock tried to get back to the original topic.

"I have witnessed three so far. I have treated the aftermath of more than I dare to count."

"Did you…" Sherlock started but then decided this question might be over the line… and changed the course. "Did you have many flashbacks in the past years?"

"About twelve since I moved in with you. They became less frequent in the past year…" John pressed out, clearly not eager to share this kind of information.

"What's it like?" Sherlock hoped his interview-like style of conversation was not too firm but helping.

John burrowed his face in his hands, blowing breath out slowly.

"It's like somebody threw you right back into a traumatising event. Reliving it as if you were there again, with all the input: smells, pains, threats to your life, tastes, sounds, adrenaline rush, all the physical feelings, and… just bloody everything. It feels almost as real as being there, not at all like normal memories feel." John stopped briefly and was silent for a moment, but continued when Sherlock took a sideways glance at him to make sure he was okay.

"When it's happening - most of the times - I'm not really able to realise it is a memory… it's like dreaming, you usually are not aware that you are dreaming. Sometimes - like in a dream - there is a distant awareness, like 'that can't happen' or 'physics are not like this'… A small idea of the fact that this has happened before and therefore can't happen again is sometimes present, but since your senses tell you otherwise it is very hard to fight your way back to reality. Sometimes, in another variation, it's like a black-out. I'm aware where I am but without realising it I have stared at a wall for an hour and don't know what really happened. It's a bit like a time-warp, my thoughts go in circles but are lost fast… making me feel numb. This 'zoning-out' happens more often then the flashbacks… It feels a bit like the state between waking and sleep, when the body's input is significantly reduced, time passes in a rush and I feel overloaded by simple, bad thoughts."

"What would be the best course of action if you were 'zoned-out'?" Sherlock asked, well aware he had witnessed that, but had just thought John was thinking about something harmless.

The question made John looked up at him, raising an eyebrow.

"Being dragged into something good."

"And how to drag you?"

John hesitated, "I don't know… Are you asking me what you can do? Really, Sherlock?"

The doctor stared at him, maybe trying to find out if this might be a joke and if he'd regret it.

"I'm asking a doctor for first aid instructions in this particular kind of… event, yes," Sherlock hissed uneasy.

Once more, his friend raised his eyebrows, a hint of surprise on his face.

It took some moments before he continued.

"To be honest, it's difficult. Create a safe environment… I don't know… I try positive sensory input, like a nice cup of tea, something that smells or tastes good, any form of stimuli I associate with nice things… They tried to teach us to do this in rehab, but to be honest, it's helping only a tiny bit. And I try to remove the triggering factor… which is not that easy, because often I don't even know what it was… I mean it's not always as obvious as the memory of Henry with the gun… If the trigger is a memory, it is not that simple at all."

"What happens if you stay 'zoned' longer?"

"Stress accumulates. It might cause drifting, loss of awareness, pathetic situations in public, anxiety attacks… There are also physical side effects, pain in the leg, rebelling stomach, headaches, dizziness, and blurred eyesight… But those things might also happen spontaneously without the semi-black-out if I get stressed in the right way… It's the same in the aftermath of a flashback."

"Why do you think it's pathetic?"

"Because it bloody is pathetic! You of all people, who is not even able to admit he is hurt somewhere or needs help, should know… God, can you imagine what it feels like to be stared at by strangers and see in their eyes that they think you belong into a closed ward?… Or as if you were a junkie and that they fear you might try to kidnap their kids to sell them for drugs?"

"I have experience living in the streets, I know that look," Sherlock offered a detail from his own past.

"Jesus, what?"

"Sorry, didn't mean to interrupt, go on."

"The worst is pity, though… You know, not like in 'I feel with you', but like that disgusting 'Poor bastard'-stuff."

"As a doctor, you should know that mental illness is a sickness like any other, you get hurt, you need to heal, you can do things to get better yourself and you can disturb healing…" Sherlock tried to elaborate, maybe even say something positive, or signal he understood, he was not sure he did though.

"Tough luck… Yeah, I do. But you know how many people are out there, who still think mental illness is kind of a personal failure? I saw comrades in rehab who were told by their own parents, that they are just too weak to pull themselves together or face life… or worse, a fiancé who left her husband and told him he was just too lazy to go to work."

"What did Harry say?" Sherlock suddenly wondered.

"Please don't ask me that... I can't..."

"Right, sorry."

"During rehab I had a panic attack in the public once, in a bus, riding back to the clinic after an afternoon off. Made it quite clear to me how society thinks… I got five lines like 'Get a grip, stop drinking.' - 'Get a job.' - 'Piss off, tramp' - 'Serves you right, junkie' until one person tries to help. The other twenty just ignore your distress or you at all. I often heard comrades speak about people they considered friends before who broke off contact after the diagnosis, although they had kept all PTSD-topics away from them. Social isolation and loneliness make this thing even harder, makes one feel more defective with this kind of reaction than one already does."

"Yes. I can relate. Freak, remember."

John gave him a tired gaze and Sherlock continued, "People are dumb… you know that."

"Yeah, hurts nevertheless, and it's almost as bad as a flashback or a panic attack. Another thing is that traumatic experiences make you lose your trust in everything. It's as if the world had turned wrong. Things that you consider valuable lose their meaning, there is only darkness… and the total awareness of every waking minute that bad things will happen and are heading your way… Like you know your parents will die one day and you spend thirty years in fearing exactly that… Never able to get rid of the fear… and you know you might get into a car crash if you get into traffic in whatever way and every time you enter a car, bus or cab you remember that. PTSD makes the world turn dark and it will never be the same again… unrecoverable. One of my mates in group therapy said he felt like a little child who isn't the same after truly understanding for the first time in life what it means to die. Innocence lost. After having seen the dark you can never shed the memory of it. I found it fit very well. During the first months in hospital, every minute of my life I was constantly aware that in the next moment everything could be broken and that death is lingering everywhere… No rest, no comfort, no light, no escape."

Sherlock was quite surprised how all this finally poured out of John. He hadn't hoped he would ever hear him talk about it. Maybe the medication had also relaxed him a bit about sharing his issues.

"Whenever someone says 'see you' one wonders if one would ever see him again, and this issue remains. The realisation that there is no safeness in life, that the only sure thing is death, and that the next bad thing is just around the corner is ever-present. The only thing to keep it at distance is action and adrenaline."

"Oh, so we better keep up the case-work, then!"

John huffed, his expression bitter, "The ironic thing is: this state eventually kills lots of PTSD patients. The ability to ignore the approach of death or just bad things in general, that a normal mind has to function normally, is lost. It's not possible any longer to just enjoy something. Panic attacks are just the inordinateness of this constant condition, like a spike."

"What can I do to help if…" Sherlock started.

Why was John talking about this in third-person?

"I don't know, Sherlock… honestly… I'm at a loss there myself. Usually a doctor tells family members to go with what they feel is right and comfort the patient, but I doubt you'd know how to try or would bother to even try to comfort me, so… I don't even know myself, no one comforted me so far. The therapist tried, but that feels... not honest… Being able to receive care depends on the person trying to give. Usually the family is most people's choice. Not mine, though… I can't talk about these things with Harry. And I am not the kind of guy who feels the need to talk about this. I don't even really know why I'm telling you this. I can't tell you what might help… and even if there was a thing a person did once that was good… it wouldn't mean it would be good if you did it... Do you understand any of that?"

"Guess most of it," Sherlock said a bit hesitant.

"You're sure?" John looked as if doubting it.

"You mean like I don't want to be touched, but when you do it at least I don't feel the urge to run away… because it's you?"

Had he told John this before?

Opening up a bit himself might be good for this conversation.

"Yeah… You got it right." John took a deep breath, looking more distressed now. "Family members are told not to do anything that the patient doesn't want in the situation… and listen when he voices something - especially dislikes."

"Okay…"

"Can we continue this conversation later, it's-"

"Of course," Sherlock agreed, sensing it was getting too much. His own tone reminding him of Molly.

His thoughts were now chasing each other.

"If something would come to your mind that might help, would you be able to ask me for it?… I ask because I myself would have severe problems with that," Sherlock offered a little more insight into his own psyche in exchange for John's openness. The doctor had criticised weeks ago that entrusting somebody with his feelings who didn't trust him with theirs was really a bad thing in a friendship. Sherlock had understood that, mostly.

"I don't know, Sherlock… the past days were kind of a setback. Ask me later, if you're still interested, my mind is too empty right now."

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They entered the outskirts of London.

Sherlock felt repulsed by himself now. John didn't deserve a friend like him.

How had he become so reckless?

He knew it was probably a coping mechanism… and he had started it in full conscience a long time ago. Let nothing in so nothing can hurt you… and everyone will hurt you sooner or later.

In his youth, he had been the target often, had been called a freak, had been made fun of and ridiculed, had been used because of his honesty and not-understanding of the nasty aspects of human nature. He had been constantly misunderstood and always been blamed for that, as well as for others not understanding him, because he was so weird. Therefore, he had learned to shield himself and killed his desideratum to care and to receive care long years ago.

Now he had caused agony in another person with this behaviour. One he had no intention to hurt. But ignorance could do much more damage that bad words, some intelligent person had said once… and he was guilty of that ignorance now.

"Sherlock, why didn't we go by train? Wasn't that the plan?"

"I though you might… be more comfortable with… privacy," Sherlock explained.

"You were right." There was a hint of a smile, though John still looked depressed and exhausted.

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They had a decent meal for dinner after unpacking the car.

John was slowly regaining his composure and seemed to relax while cooking.

Sherlock felt the need to play the violin after John had sat down on his computer, checking for new emails.
When John went to bed Sherlock was still playing… maybe trying to soothe them both while he sorted through all the new information, placing them in the right databases, storing copies in his mental file cabinets and created cross reference and alert-tags.

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A/N:

I was diagnosed with PTSD seven years ago after quite an odyssey and nine years of trying to cope with it alone, without knowing what I was dealing with. The last two years of that being treated by unskilled (in the field of PTSD) threapists for depression, which was more than counterproductive.

I am grateful that a lot has changed about treatment and awareness of PTSD and depression in society over the past years, though it's still far from enough. I'm glad and grateful this thing is part of the BBC-series because this might help change society's way to look at depression and this kind of disorder, which would help the people suffering from it.

Everybody experiences the symptoms different and there are quite a lot.

I don't have any medical knowledge, just the stuff you learn by having to cope with it.

The approach how to treat PTSD seems to be different in countries all over the world and even in clinics within one country.

Please review… :)