Roman Emperor
Sherlock's breathing improved rapidly, and the weaning process was not only successful, but progressed much quicker than anyone had thought possible. At night, however, he was supposed to rest with full ventilator support to prevent muscle fatigue and give his exhausted body a break from the arduous task. That worked fine in the beginning.
Until it didn't. In the small hours of a cloudy day, the patter of raindrops still in his ears, John started from his sleep: the sounds of choking and several alarms going off tore into his mind. He was stumbling to Sherlock's bedside before his mind was even fully awake. Hitting both light and alarm buttons, he lowered the side rail, fumbled for his stethoscope and checked Sherlock's lungs.
Sherlock was clearly in distress: his face was a grimace of pain, chest heaving, desperately trying to cough up the tube, a wet rattling noise in his chest.
Groaning, John put the stethoscope away. "Sherlock, can you hear me? It's John, I'm here to help you, just stay calm."
Donning a gown, gloves and mask, he continued as calmly as possible. "It's alright mate, hang in there. We need to suction the phlegm from your lungs. I'm sorry, I know it feels awful, but it will only be a moment." When the night nurse hurried in, he just looked up and indicated her to assist him. She did without protest.
He gave Sherlock several breaths with the breathing bag before he guided the catheter into the ET tube down into Sherlock's lungs. The coughing became even worse, wrecking the whole body with spasms. "It's all right, it's all right," John tried to soothe him. "It'll be only a moment. We're almost done." He glanced nervously at Sherlock's vital signs, but he bore up steadily despite his distress.
When he was done with the suctioning, he pulled up the catheter and connected the ventilator again. His own heart fluttered nervously as he listened to Sherlock's lungs, but the coughing had subsided and he seemed fine again. Setbacks were inevitable, John told himself.
"Jesus," he muttered nevertheless. "What was that all about?" Allowing himself a glimmer of optimism, he checked Sherlock's reflexes, hoping that the episode had sparked some signs of waking up.
It had not. Apart from the coughing, Sherlock hadn't progressed an inch on the coma scale, remaining as impassive as before. John sighed heavily and put his head in his hands, the adrenaline wearing off and leaving him exhausted, on the brink of tears.
The nurse gave him a pat on the shoulder and left.
"You know, Sherlock," John mumbled, "you've made it so far, I can't understand why you won't wake up. Everyone thought you'd die from either the gunshot or the pneumonia or any of the subsequent complications – but simply not waking up is not fair, Sherlock." He suddenly sat up, frowning indignantly. "Are you trying to hide from me?" he blurted. Staring at the pale face, he slumped down again. "Sorry. I shouldn't blame you. I know you're just ill and I'm losing my nerves. Or, of course, that precious brain of yours really is damaged after your prank with the pulmonary embolism and the cardiac arrest and all." He took a deep breath and wiped away the tears. "They're probably going to shove you into an MRI scanner to have a peek at your brain. Much good it will do," he huffed and returned to his cot.
He lay down and turned to the wall-sized window, watching a sunrise without a sun. Gradually, the sky turned to a leaden grey, heavy clouds hanging low over the Thames. It was still early morning and the ward was silent, lights dimmed and staff treading softly. He cried silently, allowing himself a minor and rather controlled breakdown before having to face another day with a mute and unresponsive Sherlock.
Jesus, what he'd give if this were just one of those I don't talk for days on end episodes – though he'd now say, yes, it does bother me. He'd be fine with everything right now, even bullet holes in the wall and heads in the fridge, and he wouldn't complain about being drugged by Sherlock if he just woke up. He gave a hysterical laugh, remembering Sherlock's feeble attempt at distracting him with ketchup, was it, or brown? trying to keep him from the realisation of what the sod had done to him.
God, he had put up with a lot from that genius – but Sherlock had depended on him in his own way, too. Looking at him for cues how to behave, quietly asking not good?, smiling for the hated cameras, putting on the infamous deer stalker.
Actually, John had quite liked the deer stalker – it suited Sherlock. Kind of reflected his eccentricity.
John rubbed his eyes and turned on his side, as always facing Sherlock's bed to keep an eye on him, determined to get at least another hour of sleep. As he lay there, slowly drifting into oblivion, his tired brain belatedly registered a shadow that should not have been there. A shadow at Sherlock's bed.
His eyes snapped open. His neck cracked viciously as he sat up too fast, gawping at the bed.
Sherlock was lying on his back, as before.
With one arm raised.
John stared and gaped and could not take it in. Sherlock's arm was suspended in mid-air, hand outstretched, fingers splayed in a commanding gesture, like a Roman emperor addressing the masses.
John giggled.
And that was when it dawned on him that he was indeed heading for a nervous breakdown on a grand scale, because his brain refused to categorize the movement on the Glasgow coma scale, and all he could see was Sherlock swathed in a sheet, a dignified Julius Caesar determined to cause trouble. In Buckingham palace.
He laughed hysterically, his body shaken by a violent hiccup, and when he tried to get up, he just plopped back onto the bed helplessly. After another minute of erupting into silly giggles, he slowly realised that Sherlock had just undertaken a step towards waking up.
He should check his reflexes. Assess him properly according to the coma scale.
Instead, he just blinked.
The arm did not waver, still greeting an imaginary crowd.
John dissolved into giggles again, and that was why he did not foresee what was next.
In a flash, Sherlock's arm plunged down, fingers instantly wrapping around the breathing tube.
John jumped up and yelled, "No!" all silliness gone. He dove for the bed, pushing the alarm button and grabbing Sherlock's hand. What ensued was a surprisingly embittered struggle.
The nurse stormed in, calling "What's wrong?" and "Oi! My!"
"Sherlock!" John wheezed, desperately trying to prevent Sherlock from ripping out the tube. "Stop it! For God's sake, stop it! I'm going to take the tube out, put STOP PULLING AT IT YOU IDIOT!"
Somehow, that worked, or maybe Sherlock simply ran out of strength, but his hand suddenly went limp, and John was able to pry his fingers away. "So much for impaired fine motor skills," he grumbled. "We'll extubate him," he instructed the nurse. She looked worried, but before she could protest, he promised, "On my responsibility. I think he's ready."
John hurriedly slipped on gloves and checked whether everything was available for reintubation, should it become necessary.
"Sherlock, can you hear me?" John asked, breathless.
No reaction. The nurse raised her brows, but John decided to talk Sherlock through the procedure as if he were awake. With him, you never knew.
"Alright, Sherlock, I first need to suction out your mouth, then the tube in your trachea. You know the drill, it's unpleasant but necessary. Then I'll remove the tape and disconnect the tube. I'll give you some breaths with the manual breathing bag before I deflate the cuff and pull out the tube. When I tell you to, try to cough, okay? I'll guide you through, don't worry."
Sherlock gave no sign of understanding and his eyelids never fluttered, but he did not resist either.
John went through the steps as quickly as possible, and at some point Sherlock started coughing, again struggling against the tube. John placed the oxygen mask within reach, took a syringe, deflated the cuff and calmly explained, "I'm going to pull out the tube now. Keep coughing, you're doing fine, Sherlock."
The tube came out easily enough but the procedure left Sherlock coughing and retching; John placed the oxygen mask over his face and squeezed his shoulder reassuringly. "Easy, go easy mate. It'll be all right in a moment."
Eventually the coughing and retching stopped, and Sherlock's breathing became steadier. John listened to his lungs for a long time, making absolutely sure that Sherlock was up to the task, but he was breathing entirely on his own now, and doing so steadily, despite the phlegm threatening to clog the lungs.
John smiled and felt a happiness spreading through him as if it were Christmas morning with a live pony under the tree. "That was brilliant, Sherlock. Absolutely brilliant. Your throat's gonna be sore for a while, and I know you don't like the noise and the pressure of the mask, but please tolerate it, it'll help you breathe despite all that stuff in your lungs." John settled in his chair again, watching over Sherlock like a hawk. He couldn't help but grin proudly when the doctors came for their morning round, exclaiming in surprise at Sherlock's progress.
However, his exhilaration faded when Sherlock seemed to lapse back into the coma again: he kept breathing on his own with a wet rattling sound in his chest, only supported by a nasal cannula supplying him with oxygen, but he made no further movements; he neither stirred nor opened his eyes.
John took up his vigil again, and it was as if the whole process was repeating itself. He kept talking until his voice failed, then took Sherlock's hand in his and stroked it, biting back the tears.
With every passing hour his chances of waking up dropped.
In the end, John gave in and cried shamelessly.