A/N: This chapter has some serious 'ouch' moments. I haven't invented any of the facts – the hospital is based on a real asylum of the late Victorian period and the treatment described was recommended in medical texts of the time (specifically 1883 & 1911).

A Case of Insanity

Chapter Seven

"That he is mad, 'tis true; 'tis true 'tis pity;

And pity 'tis 'tis true."

I could have wished for a happier choice of reading material than the Literary Review's erudite examination of the mad scenes in Hamlet as my selection for the journey to Lullingfield Manor. I had enough on my conscience without the accusing voice of Shakespeare in my ear, telling me that "madness in great ones must not unwatched go". The journal was set aside and I turned my attention to the sweeping fields of ripening corn as we sped across the border into Kent.

It had been four days since the Diamond Jubilee celebrations – or, in terms more personal, four days since I had witnessed Holmes's removal from Baker Street to a private asylum. I had not journeyed with him, on his brother's advice. Instead, I had watched the pair of broughams depart down the empty road, the only observers to this sad ending myself, Mycroft Holmes and old Mrs Johnson of 215, a permanent invalid whose window side seat was her only outlet on a world in which she could no longer participate.

Mindful of her perpetual vigil, I had taken the precaution of covering Holmes's head with a sheet to afford him some last dignity before the attendants carried him out into the street. All Mrs Johnson would have seen was a bundle of blankets hastened into the waiting cab. The blinds were snapped down and the grim procession set off without delay. Since then, I had heard only that Holmes was being well cared for and was undergoing a series of treatments.

To a seasoned medical man, such hazy terms conveyed very little. I told his brother of my intention to visit, which met with his approval, and come the Saturday, I caught the morning train and swapped city grime for the sweeter, grass-scented air of the countryside. I arrived at Lullingfield a little after eleven and, by way of the vicar's dogcart - it was my good fortune that he happened to be passing the station when I alighted - I soon found myself striding up the main drive of the Manor Hospital.

Unhappy circumstance has occasioned me to visit a number of asylums in my time, so that I thought I knew what to expect: regular red-bricked buildings, high walls, gates and bars, with an ever present accompaniment of assorted cries and murmurs from the residents. Lullingfield Manor, however, I could only describe as positively ducal. The house itself was a grand Palladian affair, inviting one to approach up a flight of steps and enter beneath the soaring pediment, as one might a Roman temple. Had I not known better, I should have imagined I was requesting entrance to the home of the highest in the land; the idyll was only spoilt when instead of a deferential butler to greet me, I was met by a dark-suited man with an air of suspicion who politely inquired my business and struggled to contain his surprise when I informed him that I was there to visit my unfortunate cousin.

I took no offence at his assumption that I had come to the wrong door. Indeed, dressed as I was in my best suit, I still felt decidedly shabby in the midst of such magnificent surroundings. Above me, painted gods wondered at my presence in such exalted company; even the caryatids of the fireplace seemed to gaze fixedly in my direction, watchful lest I was tempted to make off with the silver. I was an interloper in their world, elevated by circumstance from mere commoner to a pretence of wealth. I lacked Holmes's flair for disguise, and my feeble efforts were poor in comparison.

I was heartily glad when my inquisitor returned and informed me that Dr Gordon would be down shortly to take me through. In the meantime, the garden was at my disposal, his tone suggesting that I was making the place look untidy. I accepted his offer and escaped the disapproving stares of the satyrs and cherubs to step out into glaring sunlight.

For a moment, I fancied myself at a garden party. A liveried servant made his way serenely across the lawn bearing a silver platter. A lady wrapped in a shawl sat beneath a silk parasol in a gothic-style summerhouse. Peacocks sat atop a green pagoda and shrieked at each other across the expanse of the garden. A groom led a pair of bay hunters down the path to the stables, tipping his cap to a maid who was gathering herbs from the kitchen garden. Everywhere I looked, gentleman smoked or discussed the best year for port, while a cluster of ladies sat in the shade, toiling over a length of embroidery.

This sight, more than any, went some way to easing my sense of guilt. The patients, if indeed this collection of people were, seemed happy and contented. Music wafted to my ears from the open windows of the house; somewhere in the distance I caught the sound of leather against willow. It was enough to restore one's faith. If Holmes could be helped, even, dare I hoped, cured, one felt sure that this was the place where it would happen.

I took a turn about the garden, nodding to the patients and hoping all the while to catch a glimpse of my friend amongst the smiling faces. Not that I expected him to be smiling - one must not hope for miracles, after all - but the day was pleasant and the garden redolent with the scent of roses and honeysuckle. I savoured my surroundings, breathed in clean, wholesome air, listened to the idle chatter of the birds – and then dropped to the ground as the head was shot off a sunflower inches from where I stood.

As I lay prone on my back, a figure in country tweeds came to stand over me, a shotgun drooping from his arm. "You silly young puppy, didn't you hear me call out?" said he.

"I heard nothing," said I, regarding his smoking weapon warily.

"In a daydream, I suppose. Ah, well, no harm done."

He extended a hand and helped me to my feet. Upright and no longer blinded by the sun, I saw that he was elderly, grey of hair and whiskers, his face ruddy and weather-beaten, and his demeanour speaking of a military background.

"Brigadier James," said he, confirming my theory as he shook my hand briskly. "Medical chappy are you?"

"I am as a matter of fact."

"Thought so," said he, tapping the side of his nose. "Seen enough of them in my time. Sent you on ahead, did they? Wise, very wise. Keep it between you and me, young fellow. Don't want the ladies getting upset."

I felt confident in assuming that Brigadier James was a patient at the hospital. What worried me more than the direction of our conversation was the shotgun he still held in the crook of his arm. My suggestion that I carry it for him met with indignation.

"Certainly not," said he. "Never know when you might need it." Leaning closer, he lowered his voice to share a confidence. "They're everywhere, you know. Cunning little devils. There's talk of them being trained by... the other side."

"Trained?"

"To dig holes. Innocent enough you might say, but you get the cavalry galloping across a field of holes and you see how many horses are brought down. Best thing to do is to shoot them, you know."

"Horses?"

"No, man, rabbits! Scourge of the battlefield, rabbits. You've heard what happened to William III? Nasty business. His horse fell down a rabbit hole, he broke his shoulder and that was the end of him."

"I always thought it was a molehill that was to blame."

The Brigadier put a finger to his lips. "Keep your voice down. That's how we plan to fox this rabbit infestation of theirs. The moles are working for us, you see. The rabbits dig the holes, then the moles fill them in again. Hah! Dashed clever, wouldn't you say?"

"Yes, indeed."

"But I do wish they wouldn't practice on our lawn," came a voice from behind us. I turned to find a portly, round-faced gentleman in a checked yellow waistcoat strolling in our direction. "Good morning, Brigadier," said he. "How goes the campaign?"

The Brigadier stiffened and, with a final venomous stare in my direction, addressed this newcomer briskly. "Ten incursions in the past night," he reported. "And a sighting of the enemy down by the river."

"Dear me, those rabbits are prolific. I'll have a word with our gamekeeper, see if he can help you, Brigadier. Now, why don't you join the others? Cook has made fresh gingerbread and the new edition of The Strand has arrived."

"What about the enemy?"

"They won't attack while you have tea."

"Quite so, quite so," said the Brigadier. "Gingerbread, you say?"

"Hot from the oven." The shotgun was gently extracted from his grasp and he was pointed in the direction of a group seated beneath a spreading chestnut tree. "Poor fellow," said my companion, watching the old soldier amble away in search of his gingerbread. "He's been waging a war against those rabbits ever since he arrived."

"Is he quite safe with that gun?" I asked.

"We keep it locked away, but he always manages to find it. He's harmless really... as long as you're not a rabbit." He smiled genially, and I had the irresistible impression of being in the company of a latter-day Mr Pickwick. His eyes twinkled benevolently behind his silver pince-nez as he extended a hand in greeting. "Welcome to Lullingfield Manor, by the way. I'm Dr Erasmus Gordon. You're Mr Watson, I take it."

"Dr Watson, actually."

"Forgive me, but Mr Sunley at the reception was somewhat vague as to details. Pleased to meet you, Doctor. You have a particular interest in mental disorders? It is your specialism, perhaps."

"No, I was an army surgeon before I went into civil practice."

"Then you have the advantage over me. I am only a poor specialist, treated with the utmost suspicion on account of my dealing with people's 'nerves', as we in the profession call it." He chuckled. "If one could be a general specialist, then how much the better for all concerned. I'm sure it's the reason why I can never get seats at the theatre. Now, Dr Watson, how may I be of assistance?"

"I'm here to visit my cousin, Mr James Watson."

Gordon's eyes narrowed and gleamed faintly with surprise, no doubt wondering how a lowly general practitioner could afford the fees at such an institution as Lullingfield Manor. "Yes, yes, I see," he commented. "I did wonder about the similarity of names."

It had been Mycroft Holmes's stipulation that his brother's condition never be known, lest it cause a shadow to fall over the question of his judgement and tarnish his reputation. In a practical sense, this had taken the form of a ruthless purging of his identity. I understood the reasoning, but I lacked his severity of nature and had been moved to lend Holmes my name after he had been stripped of his own. I trusted he would forgive the liberty I had taken in bestowing him with a less than illustrious epithet and that he would not be too offended at the notion of being adopted by the Watson clan.

"Well, now," said Gordon. "There isn't much to tell at the moment. He was only admitted on Tuesday, so, as I'm sure you appreciate, it is too early to speculate."

"Yes, I understand. How is he?"

"Quiet now. He was very agitated when first he arrived and suffering from the most grievous delusions, poor fellow. Did you know he is quite convinced his name is really Sherlock Holmes?"

My stomach churned. "Is he?"

"Yes, indeed. I must say, we found that most amusing." Whilst Gordon extracted his handkerchief to dab away at the tears of merriment that had beaded at the corners of his eyes, I gave silent thanks that Holmes's insistence had been attributed to nothing more than delusional ravings. "Well, with a name like Watson I should have expected it," the doctor went on. "Identification with a famous person is not uncommon. We've had them all – Napoleon, Julius Caesar, even one lady who responded only the name of Cleopatra."

"A most exalted company."

"And troublesome," Gordon confided. "As it happened, we had the lady and 'Julius' here at the same time. My word, did the sparks fly! We had to keep them apart, given their past history."

I smiled weakly, unable to share his amusement.

"Well, well, delusions such as these take the strangest forms. Often we find in conversation with the family that the afflicted individual has always been given to certain 'fancies', if you see what I mean. Tell me, Dr Watson, would you say that was true of your cousin? Has he always been erratic in behaviour and eccentric of habit?"

I thought back to Persian slippers stuffed with tobacco, a wanton disregard for the tidiness of our rooms, of indoor pistol practice, and correspondence speared to the mantelpiece with a knife. I caught myself smiling at the thought of cigars that left a black smear across the lips on account of their being kept in the coal scuttle, and realised with great sorrow that unless by some miracle Holmes recovered, never again would I have to complain about the strange relics that appeared from time to time in the butter dish.

"Yes, he has," I replied in answer to the doctor's question. "It was never as pronounced as it has been in this last month or so."

Gordon nodded thoughtfully. "Dr Rochdale mentioned something about a poisonous vapour precipitating the crisis?"

"Yes." I saw from his expression that he expected a little more information. "My cousin was – is – something of an amateur scientist."

"Ah, I see. An experiment that went wrong. Unfortunate. Usually these things clear up in the fullness of time; however in some rare cases, the effects are not so much lingering as permanent in nature. A weakness is created, you see, what might be described as a pathological and morbid deterioration of the brain matter."

"You believe this to be the case with my cousin?"

"Had his condition worsened in the days immediately following his exposure, one might speculate that the effects were transitory. That it has taken time to develop, well, I fear does not bode well for a complete recovery. However," said he, brightening, "there is always hope. We have found that patients generally respond well to improvements in their general nutrition and the remedying of insomnia. The latter, we consider especially important in any course of treatment. The most disruptive of patients may awake after an induced period of sleep in a state of tranquillity and lucidity. In the case of your cousin, we have been alternating prolonged sleep periods with shorter intervals of wakefulness for mealtimes and other necessary activities. The result has been encouraging."

"He is eating then?"

Gordon hesitated. "Not willingly, I fear. He refused all meals at first. His lack of appetite and state of emaciation was such a cause for concern that we had to resort to artificial feeding. He protested most vigorously at first, then, after the first few times, he began to take food voluntarily, as is often the case. We often find that the sight of the feeding tube is enough to induce even the most reluctant to eat."

The mind can play strange tricks. One of my first memories of life on the wards as a lowly medical student was a practical demonstration on the methods of force feeding. The patient, an elderly lady paralysed by a stroke, had been rendered unable to feed herself and had been steadfastly refusing all food offered by others. What seemed to us a humane act that day was to her the cause of great distress. The fear I saw in her eyes transplanted itself in my imagination to an image of my poor friend. All my previous misgivings resurfaced with a vengeance, and I was ceased by the unreasonable impulse to have him discharged into my care with all possible speed.

I did not, of course. Instead I listened to Dr Gordon describing the diet he had prescribed during the process – the usual mixture of milk sops, egg yolks, dry wines and beef juice – and was thankful that Holmes had had sense enough remaining to bow to these well-meant attempts to make him eat. It was not how I would have approached the problem; but then, as I was well aware, I was too close to the case to be able to give a dispassionate opinion or to question standard medical procedure.

I did feel moved to mention, however, that Holmes at the best of time had a spare diet. If they were forcing him to consume a full meal three times a day, I could foresee future conflict, whether he was doing his best to eat or not.

"I'm glad you said that," remarked Dr Gordon. "I had to take him to task for not clearing his plate only yesterday. I'll tell the nurse not to give him such large portions in future."

We had made our way back into the house and into a wing that had less of the cheery aspect of the rest of the hospital. Save for the sound of our footsteps upon the wooden floor, it was silent, disturbingly so. Here resided those patients deemed not fit enough to join the others in the garden. Through the windows of closed doors, I had glimpses of green metal bed frames and crisp white sheets covering slumbering figures in the beds. Then, at the last of the doors, Dr Gordon stopped and began to fiddle with a large bunch of keys, trying to find the correct fit for the lock, finally succeeding.

"Your cousin is here," said he, leading the way into the room. "He had his three-hour spell in the bath this morning – I am a great believer in the value of hydro-therapeutics – and then we put him back to sleep. As you can see, he's quite peaceful."

There were no curtains at the barred window, allowing the full glare of the sun to penetrate the chamber and bathe the bed in brilliant light. Holmes lay on his side facing us as we entered, his thin face as pale as the sheets, his dark hair a sharp splash of colour against a sea of white. He was, as Dr Gordon had said, in a deep sleep, and I would have thought him dead had it not been for the almost imperceptible rise and fall of the bedclothes. While Dr Gordon took a moment to converse with a nurse in the corridor outside, I approached the bed and stared down at the sleeper.

In all our years of acquaintance, I had never seen him so still. Even asleep in a state of exhaustion in his chair, his hands would twitch and jerk and he would utter the occasional, unintelligible word before awaking with a start to flatly deny such a thing had ever taken place when I happened to mention his disturbed dreams.

In stillness, he appeared to be at peace, and I wished I could have shared Dr Gordon's confidence on that point. Not too long ago, Holmes had told me that he feared to sleep, believing that one night he might close his eyes and be unable to re-awake. At the time I had dismissed his talk as being wild and illogical, but how prophetic his words seemed now. Sleep had been forced upon him, plunging him into the realm of those very nightmares of which he had spoken, escape from which came only with consciousness. But what if there were no escape? What then would become of him, what damage would be done to his already fragile mind? And if they did wake him, would it be in time? Would anything remain of the friend I had known and admired?

It was as I had predicted. One whose conduct was distinguished by his refusal to adhere to 'normal' patterns of behaviour was at the mercy of those who thought they knew how he should act, what he should eat and when he should sleep. His very essence was being subjugated by those who thought they were helping, when in matter of fact the problem was only being compounded. Worse of all, I was powerless to prevent it happening. Holmes's fate lay in his brother's hands, not mine, and whatever my recommendation based on my visit, Mycroft Holmes would deal with his ailing sibling as he saw fit. How much easier it is to be dispassionate when not faced with the results of one's actions.

I sensed rather than saw Dr Gordon's return to my side, and for a while we stood in quiet contemplation. As time passed, I gathered he was growing impatient to resume his duties. With Holmes asleep and not due to be awoken until the evening, there was little to be gained in my remaining any longer than necessary.

"Are you quite satisfied, Dr Watson?" he asked, keen to bring the interview to an end.

I nodded. "I'm glad to see that his cuts are healing." Faint red lines and marks showed on the upturned palm of his left hand above deeper crimson and purple blotches, where the leather restraints that now dangled from the metal uprights of the bed had chafed and bruised his wrists. "At least infection hasn't set in."

"They were clean enough," said Dr Gordon. "Dr Rochdale said something about an encounter with a mirror?"

"He attacked it, believing his own reflection to be the face of an intruder."

"That is not uncommon. It could have been much worse, of course. He was lucky."

"Indeed," I concurred, although whether luck was involved in his subsequent fate was debateable.

"Well, then, if you have seen enough…"

I gathered that this was my invitation to leave. I had no good reason to linger with my duty in this respect done, and my task was now to convey my report to his brother. Dr Gordon relocked the door and led the way in thoughtful silence back to the reception hall.

"About your cousin," said he, as we paused to shake hands. "You mentioned a lethal vapour of some variety. Do you know what it was?"

I could hardly tell him the truth. "It was an exotic alkaloid poison. No other specimen is in existence in this country, if you are worried about others repeating the experiment."

"That is indeed a comfort, but I was wondering: how is it that your cousin survived?"

"I pulled him out of the room."

Dr Gordon hummed a little and regarded me with concern. "So you were also exposed to its effects. I only mention it because of your cousin's deterioration after so long a time."

"I had considered that."

"And?"

"I appear to have escaped any lasting ill-effects."

"Capital," said Dr Gordon, smiling benevolently. "But do be on your guard, Dr Watson. If you should find any symptoms developing, even the smallest thing, do seek a medical opinion without delay. Well, good day to you, sir."

With such advice ringing in my ears, I made my way back to the station. I had much to think about, possibly too much, for when the railway official asked to see my return ticket, I could not find it anywhere about my person. Under the disapproving stares of my fellow passengers, I had to admit that I had lost it, aware that this was the standard excuse of those boarding trains without paying. There is something to said for having an honest face, for on this occasion I was given the benefit of the doubt, although I did have to buy another ticket.

As I took my seat, the matronly lady opposite tutted and muttered something to her companion about not knowing what the world was coming to, while the man beside me gave me a sharp glance and retreated behind his newspaper. Suitably abashed, I fished inside my pocket to consult my watch – and promptly found the missing ticket.

Any relief I might have felt at having cleared my good name was tempered by another, more worrying consideration, that I had no memory of stowing my ticket in that particular pocket.

Continued in Chapter Eight