Day 6, morning
"John?"
A knock on his door.
"Yeah?" John blinked, woken by a familiar voice calling his name.
The door opened a bit and Mrs Hudson peeked into his bedroom.
"I can't rouse our patient," she said in a low voice.
Greg had stayed with Sherlock through the night and the landlady had taken over as planned in the morning, giving Greg the chance to go home and sleep before work.
"What?" John asked still half asleep.
"I tried to rouse him. To make him take his meds and drink a bit. But I couldn't wake him. I thought he needed the rest, or maybe he just ignored me, so I let him sleep. Now... I still can't wake him."
"When was that?"
"Two hours ago."
It was almost nine o'clock.
Without conscious thought, John climbed out of his bed and put on his sweat pants and a jumper before he followed her to Sherlock's room. He had done too many night shifts to need to be really awake for that.
"Oh dear, look at him. He's such a mess," Mrs Hudson lamented when they reached the downstairs bedroom. "What does it mean?"
"What does what mean?" John asked stupidly.
Gee, he was tired.
"That he won't wake, John!" she stated.
"I don't know," the doctor stated and swiftly took Sherlock's temperature and checked his pulse. Both seemed perfectly normal considering what he was going through.
"Oh, dear," she sat on the bed next to Sherlock's tightly curled up body while John tried his best to rouse his friend.
But Sherlock remained unresponsive, even when John shook his shoulder harder.
"Is this bad?" the landlady asked, poking Sherlock's leg repeatedly as if to produce an unnerved reaction.
"Could be harmless, could be dangerous, and anything in between. For the moment, I'll examine him in every way I can. If he seems well, we'll wait another hour before taking action. In the meantime I'll call the withdrawal specialist Mycroft has on call to consult with him - as a precaution."
As John struggled to roll his friend onto his back, the landlady stepped in and helped. They carefully moved him into a supine position and stretched out his limbs, so the doctor could wrap a blood pressure cuff around Sherlock's arm.
The battery operated sphygmomanometer inflated and a few moments later, it light up and showed the results in green bright letters. They seemed even brighter due to the semi dark room.
Sherlock's BP was a bit higher than the doctor liked, but not alarmingly so.
After that, John went to the kitchen to get the bulky medical bag.
"So, what now?" she asked when he returned.
"Well, right now I plan to insert an IV and see if that wakes him up," John told the landlady.
She looked a bit scandalised, which made John frown.
"You think pain will bring him out of it? Might make him go deeper, especially if it is inflicted by you."
John froze momentarily and stared at her. The directness and the slight accusation hitting him hard. She was a bit crisp with him these days, and he was very aware that he deserved it.
"I am not... This is not about hurting him. Patients do sometimes wake up or respond when you poke them. He needs liquids… We can't risk him falling into a coma due to dehydration," he explained, heaving the heavy bag onto the armchair they used when they sat with Sherlock during the nights.
"Right. I am worried, too. He is so thin!" she said in a much more understanding voice.
"I don't like hurting him as much as you do, but he has barely eaten anything in the past days. Although I expected his appetite to increase during this stage of withdrawal. It is the normal thing to happen."
"Of course dear, you are right. If he needs it, this is probably the only way at the moment."
As John opened the curtains and switched on all the lamps in the room to see better,
Mrs Hudson left and started busying herself in the kitchen.
The bright light revealed fine lines of pain on his friend's face. Sherlock looked a bit cachectic as well as older, the wrinkles in his face were more visible due to the lack of fluids.
"Sherlock? Can you hear me?" John leaned over him and tried to rouse him once more.
The doctor waited and paid close attention to spot any movement that might indicate Sherlock was just asleep or faking it.
Usually, it was not easy to distinguish between the mind palace and sleep, except when Sherlock was using the memory technique actively, moving his body to navigate the mental environment. But John had learned it over time that it wasn't necessary.
Most of the time, while in the mind palace Sherlock's body remained in position and kept up a certain degree of muscle tension.
Like someone deep in meditation.
The breathing slowed down to a regular but constant rhythm. Eye movement under the closed lids happened, but usually looked different from the one during REM sleep, which John would describe as jerkier and faster.
For some reason this distinction not that clear when drugs were involved.
Now the eye movement was there, but it was kind of lethargic and hesitating. Sherlock's features were not as relaxed as they would be in sleep, but his breathing sounded as if he was.
The only thing that was obvious was that he was in pain.
Overall John wouldn't describe Sherlock as a happy drunk. From all that John had witnessed in the past, what Sherlock experienced during a high seemed not to give him a good time. And he knew that wasn't why Sherlock turned to drugs.
The detective did it to mute his restless thoughts, or to enhance his already ridiculously fast thinking, to channel his focus, improve creativity. But it also made him unconfident and vulnerable, which he tried to overplay with over-confidence that made it even worse.
When high, Sherlock also tried to make jokes that didn't really work, which was probably related to his social insecurities that surfaced.
Another interesting thing was that he uttered his abstract, unfiltered feelings and bared more of his inner core. But he always seemed jittery and unsettled under the influence.
A few days ago, Mrs Hudson had told him details about Sherlock's habit that made it very clear that although it overlayed his mental and physical agony with euphoria, he suffered. Her depictions had made him wonder if it was more about self-injuring than anything else.
"Hey mate, I know you are in pain. It is time for another dose of painkiller. I'd like you to take it…. Sherlock… Come on, wake up."
The detective's unresponsiveness started to unnerve him.
Maybe Sherlock was just so annoyed with everything he ignored them all?
It made John nervous though, because some time ago, Sherlock had told him John had kind of a personal direct speaking tube into the mind palace.* It was supposed to enable Sherlock to hear John clearly, only John. If Sherlock wanted it or not.
Apparently, it didn't work any longer or Sherlock couldn't answer for some reason.
"Sherlock, it is time to wake for a bit. I really need you to talk to me... just for a minute."
John waited for a few more moments, in which he continued to observe Sherlock's body closely, but nothing changed.
"I need to examine you and get an IV in. I am sorry, but there is no other way if you don't react to me. I hope this is caused by the lack of fluids, though I know it would be an unusual intense reaction. If you can hear me, please respond."
He just spoke to talk, not to say anything meaningful, though he found it necessary to talk his friend through what he was planning to do.
On one hand, he was hoping Sherlock would wake in time to protest. On the other he doubted that the amount of fluids Sherlock needed right now could be compensated by drinking, especially since Sherlock had refused to swallow large amounts of anything in the past weeks. His repulsion of having things in his mouth - not only certain textures like normally, but anything - had made it even harder.
"Alright. I'm gonna insert in the cannula... Clean your skin first," John announced and wiped the back of his hand with alcohol.
Inserting the needle into the vein proved to be quite difficult. The level of dehydration made it hard to pierce the blood vessel and John needed several tries until he finally was in.
But even that neither made his patient twitch nor grunt, the other man remained indifferent.
Mycroft had prepared the flat for Sherlock's care and several robust hooks for various equipment had been installed. Other larger medical equipment was waiting in one of the storage rooms. There was an IV stand, John knew, but he'd prefer not confronting Sherlock with more medical equipment than necessary. Sherlock associated hospitals with his needs being stamped on and walking a fine line between necessity and constantly risking a sensory overload. Besides the bad memories of being wronged and in horrible pain of course.
With a sigh, John connected a bag that contained fluids and electrolytes to the IV port and hung it onto one of the hooks, then adjusted it to a relatively fast flow rate.
For a moment, he sat in the comfortable armchair they had used for their vigils the nights before, and continued to watch his friend. But the longer he watched him the more unsettling he found the entire situation.
There were more drastic actions to try to rouse an unresponsive person, like pain stimuli in the tenderest places. However, he hesitated to use them after what Mrs Hudson had said, at least as a friend. The doctor in him argued it was necessary.
He had barely sat there a minute when he stood up again and clipped a wireless pulse-ox to Sherlock's finger.
Sherlock remained unmoving and dead to the world.
If Sherlock's body needed the break, fine. But...
The doctor finally realised he needed to make sure it really was that and not an underlying condition. Sherlock had done lasting damage to his body and going cold turkey at home was not the optimal course of action – from a stricly medical point of view. They needed to be extra careful to spot underlying issues as fast as possible, delayed reactions might show at any moment.
In addition, it was possible that Sherlock had secretly managed to take drugs, no matter how carefully they watched him, this needed to be checked, too.
John returned to the living room and dialled the specialist supervising the entire 'get Sherlock off the sweeties' operation.
Before he had even dialled, he heard someone on the stairs and a moment later Mycroft came in.
"What happened?" the older Holmes asked without greeting.
"I don't know, yet, Mycroft. Give me some time to figure it out."
Mycroft made a testy movement with his umbrella, before he headed for Sherlock's room. While walking, he slipped out of his winter coat and threw it and the brolly onto the kitchen table.
"Update?" he urged the doctor, who hurried after him.
"We can't rouse him. I was about to call the consultant to confer about the next step. But maybe I should try to assess his level of consciousness first..." John thought aloud.
"That is no use if he is ignoring us willingly," Mycroft tiled his head in that typical smartarse way that irked Sherlock so often.
"Sherlock! I demand you open your eyes right now," Mycroft barked at his brother, "Otherwise I will do as Mummy asked and give you a hug and a kiss from her."
All John could do was stand there, gaping at the odd one-sided conversation.
Mycroft then sat on the bed and unceremoniously shoved his hands under Sherlock's shoulders. When nothing happened, he and lifted him a bit.
The movements were tender and careful, a stark contrast to Mycroft's tone. He gave his sibling a moment to react to the shift in position and then kissed his brother on his forehead.
Sherlock did not even move a single muscle.
At first, John had to hold back a giggle, then he realised what it meant.
"Shit," Mycroft cursed, out of character.
"Yeah," John agreed. "This puts things into perspective."
Mycroft looked up at him with a frown, "The threat usually works on its own... most of the time."
Mycroft was pragmatic, even when not liking the option, that much was clear.
"Prep him for transport, take some blood to shorten the proceedings," Mycroft ordered, stood up and returned to the kitchen.
The doctor hadn't even really recovered from the surprising action when he heard Mycroft talk to someone on the phone.
He checked Sherlock over again and this time tried pain stimuli. He wasn't careful, but the total lack of reaction remained - and most of these tests were mean.
Trying to quell his suddenly arising panic, John closed his eyes for a moment, realising he should do a proper coma scale evaluation, mind palace or not. He was torn between keeping Sherlock comfortable and making sure he was medically okay.
Mycroft re-entered the room.
"Maybe we should wait another hour," John addressed him. "Maybe he really just needs rest. All his vitals are okay and he is getting fluids now. It might just be the dehydration and the fact that he is really exhausted. Last night was bad."
"What happened?" Mycroft typed on his phone, appeared to follow the conversation only partially.
"He hallucinated. Thought there was a fire in his room."
"A fire," Mycroft's gaze shot up and he stepped closer to John, gazing at him with narrowed eyes. "What else?" he demanded in a tense voice.
"Nothing else," John stammered, the scrutiny was unnerving.
"Details!" Mycroft ordered in a tone that underlined how unsettled he was.
"We had to physically keep him in the house. He tried to make us all leave the building. At first I thought he was just trying to get out to acquire drugs."
"He probably wasn't," Mycroft said in a sinister tone.
"What makes you say that?" John wanted to know, but the older Holmes ignored the question.
"What else?"
"He was quite shaken by it all. We checked every room to make sure there was nothing going on. It was hard to reassure him that nothing was burning. I decided to help him bathe after that, to take his mind of things."
"Transport will arrive in about six minutes, we should get ready."
"What? Why?" John babbled.
"You probably failed to notice, but my brother is acutely suicidal and withdrawal is known to cause suicidal tendencies, so how is this not an emergency?"
"What?"
"You do realise he went into St. Caedwalla's Hospital and allowed Culverton to choke him to death – fully conscious and on purpose!" Mycroft explained with a hard expression on his face. "I sometimes fail to understand what my brother sees in you. You can't really be that blind sighted not to have noticed."
Apparently, Mycroft's patience had run out.
Dumbfounded John stood there and listened.
"This is not the first time his depression has caught up with him. And it is certainly not the first time he almost died because he failed to avoid deadly circumstances," Mycroft continued. "Yes. Usually it's that subtle. He just doesn't fight death when it approaches. This time however, he actively sought out a danger he was sure would kill him. He hasn't actively tried in years... until a few months ago."
"What the hell?" John asked.
"He overdosed. On purpose. Before you two met..."
"Shit," John huffed, horrified.
"... and on the plane, leaving for a suicide mission. Because he clearly wasn't eager to being tortured to death. Instead preferred it fast and..."
"I got it," John chocked. No one had said it this directly, although Mary had hinted at it. It was still a shock.
"I doubt that," Mycroft was on a roll expressing his worries, it seemed. "Shooting Magnussen re-awoke trauma he had just barely managed to overcome. You know how much hunting down Moriarty's web affected him. You went through EMDR therapy with him. Nevertheless, he felt he had to kill Magnussen, to protect you. And the price he paid for that was enormous. It re-awoke his issues. He was not only in solitary confinement because they deemed him a danger to others, but first of all: a danger to himself. Unfortunately, it worsened his state because it left him alone with all his demons. And no one was there to help him cope. Not even I could help at that point."
"Mycroft... I am sorry."
"Not enough," Mycroft hissed. "I asked you to watch out for him because I knew you were the only person he would allow to do so. He was devastated about Mary's death. On top of that, he was also cut off from the only thing that might have helped him to cope. He suffered double, because he also lost you... and you blamed him."
John was a bit shocked about the outburst and the obvious distress Mycroft was not bothering to hold back.
Someone wearing heels came up the stairs and crossed the kitchen, a moment later Anthea entered the room.
After she gave Sherlock a worried glance, she handed Mycroft a tablet computer.
"I checked the surveillance," she started without a greeting. "After having the bath he stayed in bed. No odd movements or actions."
She then addressed John, "Did you leave him alone while he was in the bathroom?"
"Of course," John replied, "We agreed that we want to trust him so far. Though we made sure to check on him every few minutes and not give him unlimited time alone in there. There is a glass door, you know."
"I never should have left this to you," Mycroft said ruefully. "He is a master in deceiving you. And you are not fit to take care of him. We are lucky Lestrade is always ready to jump in."
"I don't think he has taken anything, Mycroft!" John said, suppressing his anger.
"Gentlemen, transport is here," Anthea interrupted them.
"Get your shoes," Mycroft hissed and headed back to his coat.
Only three minutes later, the three of them were in Mycroft's black car following the private ambulance.
John was a bit abashed about having been told he was not capable of taking care of his friend, but realised his crash two days ago had made things worse and Mycroft had every right to be mad at him.
He was mad at himself.
.
.
* The thing about the direct speaking tube into Sherlock's mind palace developed in Ch. 30 of my story 'Define Vulnerability'. When Sherlock is struggling with PTSD and they both work hard on restoring Sherlock's mind palace, which has taken serious damage.