The Case of the Missing Detective

by Spockette

Sherlock wakes to find he is the object of a sex fantasy mistress. What could she want? Warning: sexual themes, nudity, torture and later medical healing and John! I don't own any of the rights to Sherlock (BBC) but I sure like to fru his good looks, and John aint bad either.

13. Chapter 13

Ch. 13

Physician Progress Notes

Day 4 of patient hospitalization.

William Scott Sherlock Holmes Caucasian male, age 38.

Condition Serious

Mr. Holmes entered my care following a traumatic experience of kidnapping and torture. This is day 4 of his hospital stay and he remains in the Intensive Care Unit.

Diagnosis:

Pneumonia following respiratory failure. Currently intubated and remains on an assisted ventilator cycle. Weaning has been slow due to his chest congestion, weakness and pneumonia. Plans for extubation today if patient is ready. BiPAP will be used to assist patient's breathing rate and volume. Lung percussion with albuteral treatments twice a day as tolerated to loosen up secretions.

Sepsis from multiple trauma

Rib fractures x 4 left side

Open wound to lung left side, stabbed with scalpel during torture. Subsequent hemothorax, resolving nicely. Little to no bloody drainage in chest tube. Removal at the time of extubation planned.

Multiple back skin lacerations being treated, dressed. Healing.

Contusions to penis and scrotum. Scrotal swelling down, using support. Foley intact and draining dark urine.

Overdose multiple opiates, benzodiazepines and heroin. Past user of heroin. Pain and anxiety control is more important than addiction issues. Will watch for withdrawal symptoms and seizures. Treat with methadone liquid if necessary.

Heart arrythmia, resolved

Electrolyte imbalances resolving. Continue to monitor

Acute kidney failure from drug toxicity. BUN-creatnine values getting better. Continue to monitor, hold dialysis for now. Leave in femoral permacath.

Continue with antithrombic pump to prevent DVT in lower extremities and support blood flow. ROM exercises twice a day.

Fluid overload from torture infusions and instillations.

Malnutrition. Patient has history of anorexia when working, poor nutrition. Started on NG tube feeds. Continue if patient tolerates. Consider PEG tube since he will have a long recovery period. Will mention to patient and family.

Patient has family and friend support. Flatmate is a physician. Continue with support system and encourage patient compliance.

Dr. J. Hillcrest, MD