John Watson, MD, slung the stethoscope around his neck, a sigh escaping his throat as he sank into the rolling chair, using his feet to propel it over to the nearby computer. Entering his login information using just his two fingers, he ignored the snort of the ER nurse sitting next to him. His typing skills were a running joke in the ER and it was something he took advantage of during tense situations. While he had gotten faster and could now type proficiently, the slow, methodological chicken peck he preferred was his default when he was exhausted and nearly done with a shift.
Their ER had been slammed the entire night. John could have sworn it was a full moon, for he had treated everything from a mother of three screaming, crying children with the flu to the five victims of a multiple vehicle collision. Fucking teenagers, not knowing their limits. Drunk and disorderly, their jeep had slammed into a minivan. The collision had killed two of the teens instantly, and the other three were in critical care up in the ICU. The two adults driving the van had been taken to another hospital. From what John knew, they were barely clinging to life.
He scrubbed a hand fiercely through his blonde hair to distract him from his thoughts. He couldn't linger on what had happened to the patients he had already treated, or the ones that were beyond his control. Finishing up charting on his most recent patient (abdominal pain, inconclusive, admitted for a further work-up), he logged out and stood up. "Dr. Watson?" One of the nurses jogged over to him, the bell of her stethoscope flapping against her shoulder. "We have an ambulance on route. Probable heroin OD."
"Why can't Mike take it?" John grumbled. "I took the last three junkies!" Disturbed by his own outburst, he shook his head. "Ignore that. Long night, sorry. How long before the ambulance gets here?"
"Any second. Trauma two." The nurse took off for the ambulance bay, John following not far behind her. It was less than a minute before a gurney was rolling its way towards the designated trauma room, the paramedics jogging to keep up as their patient was rolled inside.
"Late twenties, found in an alleyway. Used syringe next to him, empty Ziploc with traces of white powder. Probably heroin, could be cocaine. Chronic junkie, lots of track marks," the taller of the two paramedics panted out as he helped transfer John's new patient to the hospital bed. "Heart rate 30, BP 60 over palpable. Temp 99.3. Ninety five percent oxygen saturation on room air." John took a few moments to study the man on the bed, surprised at what he saw. He was tall, at least six foot, with a curly mop of brown hair that was long enough that it dipped down to his collar. Although his shirt had been ripped open, the quality of his shirt and pants was far above what John would expect for a chronic drug user.
He was pale, and breathing shallowly, the occasional breaths too far apart for John's liking. "Let's get some narcan in him," John ordered, sticking the earpieces of his stethoscope into his ears as he stepped closer to his patient. "Hello, can you hear me?" He paused, searching the man's face for any sign of acknowledgment of his voice. All that he received was a slight flicker of his eyelids. "What did you take? How much did you take?"
"I can answer that question, Dr. Watson." The smooth voice from the door sent tension down John's spine.
"I'm sorry, this is a trauma bay. Please wait outside in the waiting room," John responded automatically, turning slightly to face the man in the door. He was as tall as the man in the bed, with auburn-ginger hair and a nose slightly too large for his face. His face seemed drawn, and there was something shadowed about his eyes.
"I don't think so," the man said mildly. "His name is Sherlock Holmes. He's 29. Heroin addict for three years now. Based on his current tolerance level, he likely took at least 300mg of his drug of choice, although I cannot speak for the purity, for he was meeting with a new dealer." Who named their child Sherlock Holmes? John sighed, then turned his attention back to his patient.
"An amp of epi, we need to get his heart rate up. Saline, two large bore IVs, wide open. We need to deal with that blood pressure. Where in the hell is the narcan?" John said calmly, his orders steely underneath the calm tone. He watched the nurses search for veins, pleased when they were able to sink two large-bore IV lines into the pale skin of his arms. Addicts were notorious for difficult to find veins.
"Amp of epi given," one of the nurses reported.
"IVs started. Saline, wide open," said another.
"Keep an eye on his BP. If it goes down, let me know." John pulled a penlight out of his pocket and pried open Sherlock's eyes, examining pupil response. They were sluggish, the reaction so small that John's heart clenched. "The fucking narcan. Tell the pharmacy to pull their head out of their ass, and get it to me now."
The alarms alerted him before the nurse’s voice sounded. "The patient has gone into V-tach, BP is plummeting."
"Bag him. Start CPR." It was then that John realized that the man was still standing in the door, his face ashen with shock. "Look, I need you to go wait outside. I will do everything I can to save him." The tall man studied John for a few moments before he nodded.
"I do believe you will." Apparently satisfied, he pulled out his mobile and turned around, walking away. John groaned at the blatant violation of hospital policy but turned his attention back to his patient. One of the nurses was on the bed, straddling their patient as she performed CPR. Someone else had a mask around his patient’s mouth, breathing for him. "Stop CPR." Reaching for Sherlock's neck, John felt for a pulse, his eyes on the monitor. "Nothing. Resume CPR. Push another amp of epi, get me the intubation equipment."
The laryngoscope and the tubes were within John's grasp before he could finish speaking. He waited for the second round to finish. "Stop CPR." Slipping the metal instrument down his patient's throat, John swiped the vocal cords aside so he could slip the tube down into Sherlock's lungs. Securing the tube to the bag, he handed it off to the nurse. "Bag 'em. Begin CPR." He waited another cycle before checking for a pulse again. "Stop CPR."
Grabbing the paddles, John waited for the nurse to squirt the gel on them. "Charging. Clear." Waiting for everyone to move clear, John quickly placed the paddles onto his chest and discharged the jolt of electricity straight onto the man's body. He winced inwardly in sympathy as Sherlock's back arched off of the bed, spasming. It was seconds later when John heard the beeping of the monitor as it registered a heart rate. "Status?" he asked brusquely of the nurse closest to the readout.
"Heart rate 60, BP 100/73, saturation 99%," the nurse reported. "Narcan given."
"Finally," John exhaled, relieved. "We've got him back. Let's get him prepped to go up to the ICU. I'm going to go talk to the man - I think he's family."
"He's waiting not far from the room," one of the nurses muttered. John nodded his thanks and stripped off his gloves, shooting them into the biohazard bag near the door. Using the hand sanitizer dispenser near the door, he stepped out, cleaning his hands as he looked around.
"Dr. Watson." The man appeared to his left and John jolted, his mind flashing back to the war for one brief moment. "How is my brother?"
"He's your brother?" John asked stupidly. Shaking his head, he gestured for the man to follow him to a smaller room that served the doctors as a place where they could talk to a patient's family.
"Yes. He's seven years younger," the man answered. "Mycroft Holmes." John snorted inwardly at the name. It was unusual, but not the worst he’d ever heard in his ER.
"Well, he's stabilized," John started. "Definitely an overdose, he responded to the narcan. His vital signs are normal - well, within normal limits, anyway, for what we’re expecting right now. He's intubated, sedated, and being transferred up to the ICU."
"But he's alive?"
"Yes," John confirmed. "He's a fighter."
There was a strange near smile on Mycroft's face when he looked at John. "Yes. Yes he is."
"Do you want me to see if there's a referral to a rehab center we can get for him?" John looked at Mycroft, his face serious. "Since it sounds like this has been an ongoing problem."
The elder Holmes sighed. "I am afraid that rehabilitation has been tried many times and has failed on each account." The sadness on Mycroft's face was oddly familiar, and John thought back to the many years spent watching his sister struggle with her alcoholism.
"Well, if there's anything I can do, please let me know." Extending his hand, he shook Mycroft's firmly. There was a clattering noise in the trauma room and John glanced at the door, apologetic. "I think he's about ready to transfer. If you would like to go upstairs and wait for him there?" The auburn-haired man nodded and John turned around, walking in to see the last of the IV bags being transferred to the portable IV pole.
"Amy just called report up to the ICU. They've got a bed for him," the smallest of the nurses reported. "He's ready to go, neat and packaged just the way they like them." She grinned at him. "All he needs is a bow."
"Allright, let's go," John chuckled. The nurse bagged Sherlock as they walked him up to the ICU, meeting the critical care doctor as soon as they were out of the elevator. Report was given quickly, for an overdose was a fairly regular cause for transfer, and John signed off the last bit of paperwork and prepared to go back downstairs. His shift was just about done and all he had left was to finish his sign-out to the doctor taking over for him. Glancing up as he waited for the elevator, he saw the auburn-haired man standing outside of the glass cubicle holding his brother, watching the pale form being settled inside.
Without realizing it, John's feet were moving him in Mycroft's direction. "Why don't you go in?" he asked quietly, the white coat rustling as he moved.
"He would not appreciate my presence," Mycroft said, his voice just as soft, as if either man feared to disturb what was happening beyond the glass walls.
"But you're his brother." John frowned slightly.
"Blood does not always mean that one's presence is appreciated," Mycroft said bluntly. "Your own sister's issues, for example. A history of alcoholism."
"How did you know?" John blinked, startled and defensive at the same time.
Mycroft shrugged. "Your shift is over, Dr. Watson. I fear for the patients down in your emergency room not dutifully looked after."
"Fine, fine," John muttered, walking back over to the elevator. He had just stepped in when a voice drifted after him.
"Do feel free to come look in on Sherlock whenever you might have the time or inclination. Your presence will be beneficial to his recovery." Mycroft sounded resigned, regretful. John stared at him as the elevator doors closed, cutting him from view.
He finished his shift, signing off the patients to the doctor who took over for him. He went home, his mind flashing over the sequence of events. Something about Sherlock haunted John, lingered in the back of his thoughts. It was extremely inappropriate for him to even contemplate initiating or maintaining any kind of relationship with his patient or their family members. Unethical only began to cover how wrong it was.
Yet that did not stop him the next day. He spent a few hours up in the ICU, sitting at Sherlock's bedside, studying his face, his steady breathing.
A few days later, when Sherlock finally woke up, John was there.
A few months later, when Sherlock was finally clean, John was there.
A few years later, when Sherlock threw him against a wall and finally kissed him senseless...John was there.