Sherlock Holmes groaned as he woke, coughing a little bit which made pain shoot through his side. He gasped from the shock of it, feeling tears prick in the corners of his eyes. He opened them and stared blearily at the ceiling of Baker Street, reaching out the fingers of his left hand to feel his right side was heavily bandaged. When had that happened? He breathed heavily through his mouth, trying to push the pain out of mind so he could rise. He was usually able to compartmentalize his pain and focus on the task at hand, but this time he found it exceedingly difficult and it seemed as if everything was muddled and hazy in his mind.
He wasn't quite sure what had happened, and that was the worst bit. He did know he hadn't been feeling well: he'd felt a sharp pain in his side and his abdomen, hadn't eaten supper, and had felt nauseous. He had tried to lie down and read, but the pain had become intense, and so he'd simply tried to rest and wait for Watson to get home, progressively getting more frustrated as Watson didn't come for hours on end. What is the point of having a personal doctor, after all, if he is always out treating other people? Holmes had been too irritated and had been suffering too badly to admit to himself it was his own fault for not telling Watson sooner that he'd been feeling the sensation for some time and it had been growing increasingly worse. Holmes had eventually given into the pain and used morphine for its intended medical purpose, hoping everything would be fine by morning and that Watson would look after him when he came home.
Holmes' head snapped up, then. Watson. Where was he? He should be here, shouldn't he? Holmes struggled to sit up, looking around and finding Watson laying on the floor of Baker Street, blood coating his shirt.
"Watson!" Holmes gasped, attempting to get up and half-falling off the couch, landing on his hands and knees and groaning in pain.
"Holmes! What are you doing?" Watson exclaimed from beyond his field of vision.
Holmes felt Watson grab him by the shoulders, hauling him back onto the couch. His friend was laying him back down, then, and even though the pain was intense he reached out, grabbing his shirtfront before the doctor could pull away.
"Watson, are you hurt?" He gasped, trying to determine if Watson had been injured in the same way he had. "I don't understand..."
Watson took Holmes' hand in his own, extricating his friend's fingers from the stained fabric. "It's your blood, Sherlock Holmes, not mine. I'd call you daft, but I highly suspect it is the pain that is muddling your excellent faculties of observation and deduction, and the painkillers in your system won't be helping, either."
"This is the pain after medicine?" Holmes grumbled. "What have you done to me?"
"I cut open your abdomen and removed your appendix," Watson answered him bluntly, and Holmes gazed up at him in wide-eyed surprise, not having anticipated receiving an answer.
Then, he glanced down at his bandaged torso. "In the middle of our living room? Tonight?" he asked, a bit bewildered to learn he'd undergone a surprise surgery without his knowledge.
"Yes, of course. It was an emergency, and needed to be done immediately. I thought you'd be pleased not to be in hospital, and fear not: I set up carefully and have already cleaned what mess was made."
"I am, I assure you, glad to be at home and would not begrudge you making a mess. I suppose I don't fully understand what has transpired, however. Do tell me, won't you?"
"Of course. I came home well after midnight, and to my dismay I found you resting fitfully on the lounge with a bottle of morphine on the ground next to you. You are quite lucky you decided to wait for me and not go to bed, by the by, else I may not have seen that you were in distress. If that were the case, you would have been dead by morning."
"Watson? Surely you don't mean that literally."
"My dear fellow, I assure you I do not make light of medical emergencies. The rupture of an appendix is quite serious; you likely would have had more time than my vague 'morning' estimate, but I cannot guarantee that. It is a quite a real possibility that I may well have come downstairs to breakfast only to find you dead." And he spoke very calmly and would have given no indication at all that he was distressed about that fact if Holmes hadn't noticed a very small twitch of his eye.
"What convinced you it was a medical emergency?" Holmes asked, and he looked away from Watson's face to avoid watching it fall at the reminder Holmes sometimes chose the oblivion of morphine of his own accord.
Watson sighed, rising and moving across the room to strip off his bloody outer shirt, dropping it carelessly into the fire. Holmes watched him in confusion; why burn it? Surely if he burned all the clothes he stained during the course of his professional career he would have nothing to wear. But then Holmes remembered that the blood was his, and he wasn't sure he would want to scrub Watson's blood out of one of his shirts and wear it again, either.
"I knew," Watson said, coming back into view after retrieving one of Holmes' old dressing gowns from the hall closet, "because I am a good doctor. I know what your regular habits are as both your doctor and as your friend, and I know your use and amount of morphine tonight was not regular. A closer examination of your person revealed a low fever, and I only had to touch your side with the slightest pressure to make you cry out so loudly it woke Mrs. Hudson. To make the story short for the sake of your rest, I will tell you simply that I set up a camp bed and prepared a space, started the surgery, and then found that the worst scenario had occurred and your appendix had ruptured."
"I am afraid I do not follow you, Watson."
"Perityphilitis, Holmes. You're forgiven for not knowing: there are few books on it. You are quite fortunate I have read them, and also that I personally know Doctor Henry Hancock, who was perhaps the first man in the world to successfully address a intestinal tract perforated by an enlarged appendix. I know you study anatomy and so I will not condescend very far, only tell you that your appendix was swollen and covered with an ulcer. It had to be removed."
"And you say it had ruptured? What does that entail?"
"Much more effort on my part than a simple extraction, I assure you, and much more pain for you after the fact as well as a larger scar on your side. As for details, you wouldn't like to hear those at the moment. It was not the most grisly medical sight I have witnessed, but you have a morbid enough imagination as it is, and no man ever wants to hear about the contents of his own bowels being anywhere than where they ought to be."
"You mean to say you are more acquainted with my small intestine than I am?"
"The appendix is attached to your large intestine, but that hardly means you are wrong."
"I apologize, Watson. I should have sent for you."
"Yes, you should have, though no apologies are needed: you didn't know how serious your condition was, and only knew I'd be home late, not that I'd be out well into the morning."
"When was that?"
"Around two, I believe."
"Ah, so that is why I found you lying asleep on the floor as if it was you who were in peril."
"Yes. I never intended to frighten you, of course, only to watch over you for a while before I went upstairs to change, but I fell asleep on the job. It's been a long day, or, to be literal, yesterday was, and the surgery exhausted me."
"And I suppose operating on a friend is no small feat."
"Actually you'll be pleased to hear it's quite the opposite. I already told you, Sherlock Holmes: I am a good doctor. I am quite calm under pressure, and at my best when working on a friend. I could have called for a second opinion or for another to perform the operation, but I am quite afraid that I am guilty of that pride which members of my profession are often— and often justly— accused of. You are right that operating on a friend requires more mental and physical energy than any other surgery, but I imagine that I would not be content with the job unless I was the one to do it. I can take the time and care another might not; you've gotten the best set of stitches I've done in years."
"I suppose I should be flattered," Holmes grumbled.
"Perhaps, but then again maybe not: I did it in part because you're much more reckless than most of my patients. I had to ensure they would not pull out if you decided to push yourself too far and too fast during your recovery in spites of my best advice."
"I think in this case I will be happy to bend myself to your wishes," Holmes replied with a grimace. "I believe some significant amount of pain is to be expected after having another man root around in my abdominal cavity, and I will confess I do not feel like moving at all."
"I will remind you of that in the morning," Watson said, and it almost sounded like a threat.
"At least that means I will be here in the morning, and that is thanks to you, my friend. So I thank you sincerely, Watson, and I will bid you goodnight for I see you need rest as much as I."
"Goodnight, Holmes," Watson said, and the slight shaking of his hands as he covered Holmes with a blanket was the only indication he was more disturbed by the whole ordeal than he was letting on.
Holmes sighed, closing his eyes as Watson moved around the room turning down the lamps. He was almost asleep again when he felt Watson check his pulse, murmur something to himself, and then move away. Holmes heard him sit in a chair and didn't hear him leave, and that was where he found him in the morning, sleeping seemingly peacefully. Holmes didn't say anything to disturb him, and if, when Mrs Hudson arrived later with the breakfast tray, she thought it was odd that the one of them who had just gotten cut open was the one up and laying a blanket gingerly over the other, she didn't say anything at all.
Author's Note:
According to the article "The early days in the history of appendectomy" by Damiano Rondelli for the Hektoen International Journal, "The first successful operation addressing an intestinal perforation due to an abscess of the appendix, was reported by the English surgeon Henry Hancock (1809–1880) at the Charing Cross Hospital in London." I like to think of Watson as a professional and competent doctor who would have stayed up to date with the medical advancements of his time and would, of course, have used that knowledge to aid Holmes. This story was born from that notion, although I admit I have very little knowledge of what an appendectomy is like today, let alone what it would have been like for Hancock or Watson, and this story is not intended to be taken as completely historically and scientifically accurate.
Thank you for reading, and I sincerely hope you enjoyed.