James Harrison was in a meeting when his secretary knocked on the door of the board room. He looked up in surprise; few emergencies seemed to warrant the interruption of meetings these days. It appeared that to the managers at least, it was far more important to talk about cost cutting and service restrictions than to care for the patients themselves; an attitude that James found as bewildering as it was frustrating.

James was relieved for the interruption, but his relief turned to concern as he scanned the note that he had been handed. Strange how some patients never really left your radar, even after you had discharged them from your care. You found yourself thinking about them, wondering how they were getting on, months or even years later. Even after nearly twenty years in psychiatry, he still found it difficult to divorce emotion from his work sometimes; or rather to divorce the personal from the clinical. There were always going to be patients who had touched a raw nerve; who perhaps you had become more involved with than the textbooks would dictate. But then Sherlock Holmes had been very different from the average patient. So very damaged, so very vulnerable, and despite the unorthodox nature of his involvement with him, the extent to which he had gone to ensure his safety and his eventual discharge from Elmhurst, he was one of the patients whose life he felt that he had made the biggest impact on.

When Sherlock had started at Cambridge, James had felt it appropriate to hand over his care to a more local clinician, rather than managing his illness remotely, by telephone from Scotland. When the psychiatrist he had referred him onto told him, at a chance meeting at a conference, that Sherlock had failed to attend any of his recent appointments, he had been forced to suppress a small smile. Of course, Sherlock Holmes was never going to do things the easy way. He was always going to have to test the boundaries, to see how far he could push himself, to see what would happen if he did it his own way.

He had tried to contact Sherlock at college, but with no success. He had been reluctant to phone him at home, unsure of how much Mycroft Holmes knew of his non-compliance, and unwilling to breach Sherlock's confidentiality by raising the alarm. Mycroft Holmes would, he was fairly sure, work out why he was contacting him, and James felt strongly, as he always had, that Sherlock's life should be his own. That his decisions should be his own; that he had had enough choices stolen from him, enough damage inflicted. It was one of the many challenges of his job; the ability to recognise that while you might not agree with a patient's decision, while it might be unwise, provided it was not unsafe then it remained their decision, and you could only support them through it.

In the end Mycroft had contacted him. Sherlock, it seemed, had stopped taking his medication only a couple of months after starting college, as James had deduced. Complete non-compliance then. Mycroft had received a phone call from Sherlock's worried tutor. Sherlock it seemed hadn't turned up at either lectures or tutorials for several days. He had refused to open his door to college staff, indicating with increasingly colourful language that he just wanted to be left alone. Mycroft had driven up to Cambridge to find Sherlock huddled in bed, virtually non-communicative, and had metaphorically scooped him up and brought him home, where he had remained in a similar state for several days. The GP had been called, diagnosed a depressive episode, suggested an admission, which Sherlock had refused, and had reluctantly concluded that as he was drinking and was not overtly suicidal then sectioning him was not an option.

As the closest thing that Sherlock had to a responsible clinician at that time, Mycroft was contacting James directly for advice, and to ask him to resume Sherlock's care, however remotely. After a discussion with the GP, James had to agree. Sherlock was not sectionable, and his symptoms fit well with a depressive episode. Whether he would cycle out of it, or whether the depression would worsen, necessitating an admission, only time would tell. The GP reported that Sherlock had asked for a supply of lorazepam, which he had reluctantly provided, with the provision that Mycroft would administer it to him one or two tablets at a time. Sherlock had told the GP that he needed to sleep and that he thought he would be fine in a few days. James was aware that Sherlock had hit lows before, during the time that Sarah had been caring for him and occasionally afterward. They had not been this severe, but then he had still been on medication back then. They had still been bad enough to make him withdrawn for several days, occasionally forcing him to resort to lorazepam and sleep. James strongly suspected that this was just a deeper, more pronounced version of the same, and advised that as long as Sherlock continued drinking fluids then they should just leave him to sleep.

After four days at home, Sherlock had apparently appeared bleary-eyed and dazed in the kitchen, absent-mindedly eaten his way through two plates of scrambled eggs on toast, and had grudgingly agreed to talk to James. He wouldn't see a psychiatrist, he told James, and he wouldn't go back on medication, he wanted to manage this in his own way. He wanted to live his life with a mind that functioned fully to his own extraordinary level, not numbed by medication. He agreed to talk to James intermittently, in return for a supply of lorazepam, but that was the full extent of his intended compliance.

There had been intermittent telephone conversations for a while, but James hadn't talked to Sherlock Holmes for nearly six months. He had reluctantly informed Mycroft a couple of months back of his brother's non-communication, and had been told that he seemed to be managing well on his own, and that Mycroft would inform him if the situation changed. Now, it appeared that it had.

Sarah's note had to been brief and to the point. 'I've got Sherlock on the phone in my office,' it said. 'Sounds as if he's in trouble and is asking for help. Can you come and talk to him?'

James stood up, made his apologies, and less than five minutes later was at the door to Sarah's office. A ward sister now, she had excelled at her new role at the Edinburgh clinic, but still insisted on maintaining clinical contact with patients. She could get through to some of the more troubled teenagers in a way that few others could, and the more junior members of staff appreciated her leading by example. She somehow managed to simultaneously be kind, gentle, understanding, and yet at the same time to remain firmly in control. Just as she had with Sherlock, James Harrison recalled.

Sarah had been waiting for his arrival, and beckoned him into the office enthusiastically with her free hand. She was still on the phone, talking quietly, her voice calm and level while her right hand was jotting down frantic notes on a pad of paper, as if the two halves of her brain were entirely disconnected.

As he walked in she slid the pad of paper across to him, as she continued to talk. She was trying to persuade Sherlock to stay where he was, and to let her contact someone to come and get him, he realised.

'Who?,' she had written on the piece of paper at the bottom, with a large circle around it. James Harrison read her notes quickly before getting to that sticky question.

Sherlock, pub, somewhere near river, The Plough, probably few miles from Cambridge ? where, upset.

Drugs - heroin, cocaine, speed, benzodiazepines. Out of control, asking for help, scared if goes back to college will use and take too much. Alcohol too, slightly drunk but using it to 'take the edge off'. Cocaine and benzos with him, but not taken yet. Heroin this morning. Not suicidal, not enough drugs with him to cause significant harm.

Doesnt want brother to know

Scared.

Need to get someone to go and find him - who?

This last word underlined and circled three times.

James Harrison listened to Sarah's conversation with Sherlock, and indicated for her to hand him the phone. 'Sherlock, James Harrison's just walked into my office,' she said to him, 'will you talk to him?'

'No!' he sounded panicked, 'I can't. He'll - he'll be, I don't know..'

'Angry? Disappointed?' Sarah prompted gently, 'is that really what you think? He won't be Sherlock. It happens, especially in people with bipolar. You try to take things to make yourself feel better, you self-medicate, and sometimes it gets out of control. Its not your fault, nobody is blaming you, but James might be able to help.'

'Okay,' he whispered, and James took the phone from her, sliding her his own note on a piece of paper as he did so.

'Phone Mycroft Holmes,' the note said. 'Tell him to get someone over there to keep Sherlock safe, but that they shouldn't approach him for now or he'll bolt. Someone to watch and wait until he can get there himself to pick him up. Tell him what you have to and no more - that he's in a pub, he'll be able to work out where, he's an intelligent man and he knows the area; that Sherlock is in a mess and he needs picking up and taking somewhere safe.'

Sarah nodded and left the room with the piece of paper in her hand.

'Sherlock, its James Harrison,' he said as he took over the phone. 'Tell me whats been happening.'

There was silence and a little rustling. 'Shaking your head isn't useful on the phone you know,' James Harrison told him. 'Start at the beginning. When did you start using the drugs?'

And as James Harrison talked Sherlock through it, gently, calmly, Sarah was phoning Mycroft Holmes.

He was in a meeting, in her experience he was always in a meeting when you were trying to get hold of him, but the words 'brother,' 'emergency' and her name were enough to obtain his presence on the phone within five minutes.

'I'll send someone to pick him up,' Mycroft said with a sigh, when she had briefly outlined the issue.

'No, Mycroft,' she said firmly, 'not this time. He's out of his depth and he's asking for help. I don't think that he's ever done that before. I'm sorry but I think that you need to go yourself, or there's a good chance that he'll bolt.'

'With respect, Miss Thompson, this isn't the first time that my brother has required bailing out of trouble.'

'True, but its the first time that he's admitted to taking heroin.'

There was a long pause, 'I see,' Mycroft said, obviously rattled. 'Anything else that I should know?'

'Cocaine too and it sounds as if thats only part of it. He's out of control, Mycroft, he needs help, proper help; he wants to stop using and tha'ts an important step. I would advise finding him a rehab place that can take him as soon as possible; today if they can, but you need to go and get him and take him there. He won't take this from anyone else, you know that.''

'My brother and I do not have what you might call an easy relationship, as you are very well aware,' Mycroft said slowly.

'True, but he knows that you care, and he respects you in his own way. If you tell him its his only option then I'm sure that he'll listen to you.'

'And James Harrison can arrange an admission in the interim I imagine.'

'I'm sure that he can. He's on the phone to Sherlock now. Just - get there, Mycroft please, if he leaves that pub then I can't guarantee his safety.'

'I'll arrange for someone to get down there to watch him,' Mycroft was saying.

'If they approach him directly, he might well bolt,' Sarah warned.

'I'll make sure that they're unobtrusive,' Mycroft said as he hung up.