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Swift, Fierce & Obscene

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There was never any more inception than there is now,
Nor any more youth or age than there is now;
And will never be any more perfection than there is now,
Nor any more heaven or hell than there is now.
— Walt Whitman

 

"That cough's getting worse," John tells me while struggling with a very contrite Rosie who doesn't want to wear a dress today. She rarely does, but it's parents' day at the daycare centre, and John appears to feel the pressure for conformity today. "You should have that checked out."

I dismiss his worries with a flick of my wrist. Being buried under a blanket on the couch for a week as the fever comes and goes and the swollen lymph glands on my neck give me a constant, throbbing headache has been trying on my patience. "I'm fine."

"When would you ever be not fine?" John asks, slightly amused but glancing at his watch once again. He doesn't want to be late. "Out of curiosity, what would qualify? You got shot and escaped the hospital to have spaghetti at a pub."

I duck under the duvet I have dragged from my bedroom and stifle another cough.


_______________

Pneumonia. How pedestrian.

It doesn't get better. There are more specialists, and finally, I am subjected to a bronchoscopy which — believe me — is worse than getting shot. At least it lasts longer. I'd let slip to John that was the diagnostic plan, and he insisted on coming with me; I vacillated between telling him not to and wishing him there. It's not as though I was going to ask Mycroft.

In the end, Rosie catches something at daycare and is vomiting profusely in the morning. We couldn't bring ourselves to turf looking after her to Mrs Hudson — who knows what gastroenteritis at her age could cause.

I just didn't want John to see the scars on my back.

I've not been entirely honest with John; it's not just the cough that persists. He doesn't know about the rash on my torso or the night sweats, about the chills or the sore throat. Mostly, it's like a very persistent head cold in its early stages. He's seen the enlarged lymph nodes, but those could be anything. "Your body's just reacting to some bug," John told me reassuringly.

I nodded like a bobblehead. Those could be anything.

Two days later, I go in to hear the results of the biopsy and bacterial samples. I hadn't told John about the appointment. I don't know why. I don't believe in premonition.

"Histoplasmosis," the pulmonologist tells me. "Quite rare in the UK."

It must be rare since I have not heard of such a thing. John's words from a week ago come to mind: "You should get that cough checked out; who knows what grows in that damned well."

I know it isn't so, but a fleeting thought of it somehow being Victor who's made me ill after all these years comes to mind. I've suffered enough for him, I think. A part of me will never let go of the idea that if I'd been cleverer, faster, older, more responsible, he'd be alive.

The pulmonologist writes me a prescription while I try to swallow around my still lidocaine-numbed throat.

"It's an antifungal which should clear this right up at this stage."

At what stage? I cannot parse the meaning of the expression.

The doctor watches my reaction, his hands on the keyboard halting. "You were told, weren't you?"

"Told what?"

I see a sudden panic on his features. He is no spring chicken, no recent graduate but an experienced physician. Yet, whatever he's just realised I am not aware of has caught him off guard.

He pushes his chair away from the keyboard and towards the left side of the table where it is closer to mine. He leans forward, his eyes serious.

"Mister Holmes–– you tested positive for HIV."

"That's not possible. I've been tested several times in the last two years, and it has always come back negative."

I know of at least two occasions on which Mycroft has literally demanded blood. Right after I returned from Serbia, and during my incarceration after Magnussen's death.

"We have reason to believe this is a very recent infection, and that some of your symptoms have been those of a primary HIV infection, not the histoplasmosis. Your CD4 cell levels are very good, which is why we're not treating the infection as fulfilling of AIDS stage criteria."

I don't understand anything after recent infection, because I'm scrambling to understand how it could be possible. "Redo the test. It can't be correct."

He leans towards the computer and presses a few keys, scrolls down something. "We always do a verification run if an HIV discovery is made. I'm afraid the results are confirmed."

Go to hell, Sherlock.

I don't remember all of those two months. I don't remember all of it. I didn't share needles. I never share needles. Admittedly, it was one of my worst binges. The worst. I had to be thorough. John had to believe me. But I never shared needles. Not that I remember.

I never shared needles. I never shared––


_________________

 

I don't believe in stages of grief, as explained by the leaflet that's shoved into my hand as I depart from my first appointment at the Wharfside Clinic of St Mary's Hospital.

The only stages I plan to go through include anger which shall be followed by resignation. A part of me always knew it was childish to believe that those two years I lost to hunting down Moriarty would be repaid, somehow. With what? Happiness? Ha. That has eluded me all my life, save for the too few years I got to spend with John living at Baker Street. I was never destined for an easy, long life.

Some stars, when they reach the end of their celestial lives, diminish into white dwarves. I remember that this notion disturbed me as a child as I devoured countless books on science. I was much more pleased with the notion that some of them expanded into red giants and exploded into supernovas. Eventually, what remained was a black hole or a beautiful nebula. What is the point of it all, unless you can leave behind something beautiful and everlasting — or take everyone down with you in revenge if your life has been an endless line of adversity and suffering.

I don't want to take anyone down with me. John should have stayed away, but I wanted him back for my own, selfish reasons. Sometimes it's hard to believe the universe is not punishing me, but I have vowed never to succumb to such magical, self-centred thinking. This virus, this uninvited guest, this parasite in my cells is not part of a nefarious master plan. It just does what any living creature seeks to do: leave a legacy, to replicate, to not die and go extinct.

I skim a poster taped to the wall opposite. It promotes HIV testing. Wouldn't all those attending this clinic have passed that stage in the proceedings? Isn't that why they're here, because they have been tested?

Back in the day, they used to stage HIV appointments in back rooms, side buildings with separate, concealed entrances. Now, those patients are treated like anyone else, except that sometimes, they have their own units such as this one. Instead of walking out, I sit in the corridor and watch the people moving past. Which ones of them have it, and which ones are here as family members? Can I deduce it from the hunch of their shoulders, from the way they glance at others, from the way they carefully select a seat far away from the right appointment room door even if it hasn't been marked with any kind of a sign?

They're hiding in plain sight. Could someone clever deduce it on me?

_______________

 

The doctor is a forty-something male of Caribbean descent. His smile is kind of distant. He's been doing this for a long time, judging by that and his routine-soaked tone. "These days, Mister Holmes, it's a chronic illness, a latent infection, not a death sentence. The medications are excellent and require a less strict daily regime than before. These days, people who have it can give birth, have sex and enjoy a pretty normal life. People who get it now usually die of something else decades later."

"You should record that and just press play when you get a new patient," I tell the doctor.

Why would I want to die of something else? Why not this, in thirty years or however long it takes for my immune system to cave in? Is it still less dignified, less decent, less embarrassing?

He explains to me that my antiretrovirals are free of charge. He tells me that for the first six months, the transmission risk to a partner persists because viral suppression takes time. He's careful to use gender-neutral words. I suppose in his line of work he has to be more sensitive to these things than the average NHS employee.

"No partner," I say.

"You need to be particularly responsible during casual encounters, then."

"No casual encounters."

The look he gives me is sad. "So, you contracted this through––"

"Contaminated needle."

"Are you still using?"

"No. I've been clean for three months."

"That's very good, Mister Holmes. This may be a difficult time to stay sober; we have excellent support groups, and I can refer you to––"

"I have a support group." It's a group of one person, and his name is John. I can't cause him more worry and grief. I've done enough of that.

"I recommend we start with a triple combination of medications; it's standard, and with the infection you recently contracted, we'd best err on the side of caution."

I nod, rubbing the plaster on the crook of my elbow through my shirt; I'd removed my jacket for the physical examination. Bloods have been drawn to get a baseline of kidney and liver function and god-knows-what-else.

"Tenofovir and emtricitabine combined with dolutegravir, brand names Isentress, Viread and Emtriva," the doctor announces, then goes to explain doses and intervals. "The goal is to make your viral load drop down to where it cannot even be measured. At that stage, you will not be significantly infectious. We'll estimate at six months whether we should continue with this regime or swap one of the drugs."

I have questions. I don't have questions. I just want to get out of here, with these medications stuffed into my pockets so that people might assume, at most, that they're just packets of cigarettes.

"Thank you," I say at the end of the appointment, greatly confused as to why.