Sherlock - Dangerous Mould and Shot in the Dark Trilogy

Chapter 18

John felt for Sherlock's pulse, which had dangerously sped up while being extremely weak. He literally saw the life streaming from his friend. John knew that if help in units of stored blood wouldn't arrive soon, there was nothing they could do. No CPR would help Sherlock anymore.

John felt empty. He hadn't realized that he had started gently rocking his flatmate backwards and forwards when finally the medical team arrived in the flat.

The first thing John noticed consciously was Mycroft violently cursing. A fact so strange that the ex-army doctor came to life again.

"Finally," he managed to say, ignoring the tears that had already started finding their way from his eyes.

Together with two men in white they lifted Sherlock from the floor and carried him from the bathroom to the living-room where there was more space to move. Finally, his medical training kicking in again, John gave a report on his flatmate's status.

"Arterial epistaxis, hypovolemic shock stage 4, tachycard, unsuccessful pressure application, applied vasoconstrictant, however no change in blood flow. We need blood transfusion immediately, have the defibrillator ready – and who's the ENT-specialist?"

One of the medical team briefly raised a hand, continuing in his preparations.

"Dr Jones," the man said, nodding once. John just looked at him intently. Jones, yeah, or whatever name it really was.

"I'm going to try cauterization first. If that doesn't help, we'll have to make an angiography and embolize the artery."

John raised his eyebrows in amazement.

"Here?"

"We have portable x-ray and we'll go into the carotid artery from the neck, not from the groin."

"You must be very good, then!" John remarked.

"He's better than any ENT-specialist you have ever met, that's why he's here," John heard Mycroft's more or less steady voice behind him. So, he had regained his composure as well. John threw a glance over his shoulder and saw that that wasn't quite true as Mycroft's complexion could almost compete with his brother's, but at the moment John couldn't be bothered about him.

The rush of adrenaline helped John to be able to work alongside the medical team. He didn't want to be left outside this time, he wanted to help.

Sherlock was intubated, so that the blood couldn't get into his lungs and suffocate him. At the same time an IV cannula was attached to the pit of his elbow and the first unit of stored blood started to fill Sherlock's veins. It seemed as if the blood ran from his nose again as fast as it ran into his vessels. Soon the second unit had to be attached and still the bleeding was continuing.

The ENT-specialist had a hard time trying to see the spot where the artery was ruptured. He finally shook his head.

"No, this won't work, I'll have to embolize."

"Ok, what can I do?" John asked while pressing an Ambu bag in a very regular pattern to support Sherlock's breathing.

"Make sure he doesn't die in the meantime."

"Funny one," John grumbled, although he knew that this was the toughest part. Sherlock was only barely alive. They had to stop the bleeding fast as the attached heart monitor clearly signalled imminent danger.

"No miraculous cure on hand for this?" John remarked snidely in Mycroft's direction. Mostly the reasons for artery nosebleed were high blood pressure, which Sherlock didn't have, as far as John knew, or inherited aneurisms. You could never know about the latter, however, John had a feeling that this wasn't just an unlucky coincidence. He was convinced that it had to do with the drug Sherlock had had administered after the Tabun poisoning. He would have to get back to that later. For the time being he needed to keep his full concentration on taking care of Sherlock.

"I'm afraid not," Mycroft answered honestly, ignoring the ex-army doctor's jibe. "You know, if I had one I would not hesitate to use it."

"Yup, no matter what – I know." John felt that he was getting angry. He told himself to calm down. This wouldn't help at all, he really had to concentrate. John watched the doctor disinfect the skin on Sherlock's neck, then push a cannula into his artery. Pushing a catheter into the carotid artery in a hospital was difficult and held a danger of hitting the wrong vessel, which could easily result in blindness; doing the same on a living-room floor was insane, and yet the only means to stop this damn bleeding!

John felt somebody hang a lead vest over his shoulders and saw the portable x-ray device being set into place.

"We're running out of blood." Somebody said and John felt something cold crawling up his back. They hadn't managed to slow down the bleeding and Sherlock was in fact instantly losing most of the blood that was running from the bag into his body.

"You don't have any more blood?" he asked without addressing anybody particular.

A still very pale Mycroft stepped up to him. "We didn't have enough time. Sherlock's blood group is not the most common."

"What is it?"

"A negative."

Looking at his blood-covered friend John shook his head, "You have to be extraordinary in every possible way, haven't you? Mycroft, what's yours?"

"A positive."

No, that wouldn't work.

"Anybody here in this room with A negative?" he shouted.

Nobody answered in affirmation. John sighed. What he was about to offer held a very high risk, however, they had to try.

"Take mine! Have a quick cross-match. I'm O negative. If not any of the other subgroups are too different, it'll work."

John stretched out one arm, carefully going on pressing the Ambu bag with the other one.

Nobody argued, they simply slid a needle into the vein at the crook of John's arm, attached a catheter to it and took a sample. Having done the same with Sherlock, the man in white mixed the two and checked for agglutination under the microscope that had miraculously materialized from seemingly nowhere.

"Match!" he exclaimed. "Alright, there's just half a bag left; we'll prepare you."

While John was laid down on a blanket the ENT-specialist carried on trying to find the ligated vessel. John watched the monitor of the portable x-ray anxiously. Chances weren't too good that this would have a happy ending and Sherlock's vital signs were getting worse from minute to minute. If the tachycardia stayed like this it was only a matter of time until cardiac arrest. John wouldn't want to think about it.

Suddenly Dr Jones clicked his tongue. "Found it! I will now embolize it. Let's hope it'll work."

He slid a second catheter into the artery and at the same time when John's blood started to flow into Sherlock's body, he finally managed to stop the bleeding. The x-ray picture displayed an interrupted blood flow in one of the arteries.

"He's lucky after all. If it doesn't start bleeding again, this will be it." Dr Jones informed them.

John sat up slightly, supporting himself with his lower arms, relieved that at least Sherlock wasn't losing the blood he was being donated any more. John hoped that there wouldn't be any transfusion reaction, since they had only done the roughest possible testing as to the matching of the blood groups.

Dr Jones pulled out the catheters slowly and very carefully and another medical man applied pressure on the arterial wound on Sherlock's throat before removing the dressing again and stitching the wound up.

John felt slightly dizzy and lay back onto the blanket, closing his eyes for a moment. After some time he felt that the catheter in his arm was disconnected. He forced his eyes open, looking straight into another pair of worried eyes. John pushed himself into an upright position, glaring at the aristocratic person in front of him.

"I am grateful. And I am sorry," an unusually touched Mycroft stated quietly.

John felt anger rising in his guts. Bloody hell, he was supposed to be!

"Are you sorry for Sherlock having nearly died the second time? Then you should probably ask yourself what the reason is for that!"

"What do you mean?"

"Isn't it too much of a coincidence that this has happened right now? Don't you consider it possible that it has to do with the secret drug you had your doctor administer him?! I thought that you, at least, would keep an eye on him!" John ranted.

"I asked you to keep an eye on him, remember?" Mycroft asked coldly. "Where were you? You were still wearing your jacket when we arrived, and there's a travel bag in the hallway, so apparently you weren't here when the nosebleed started, were you?! So, don't you talk to me about keeping an eyeon my brother!"

"Stalemate," John had to admit quietly, avoiding telling Mycroft anything about his trip to Germany.

"John, as much as you want to see the villain in me, you may realize one day that you are wrong."

The ex-army doctor was stunned. Whatever he had expected Mycroft to say, it hadn't been anything like that.

"I doubt that," he snapped back, when all of a sudden the heart monitor set off the alarm.

"Ventricular fibrillation!" Dr Jones barked.

"Sherlock!" John and Mycroft yelled with one voice.

"Defibrillation! Back!"

This felt like a déjà vu, seeing Sherlock's torso jump from the electroshocks twice before the pulse was back.

John crawled over to his flatmate, suggesting the other doctor that he could do the cardiac pressure massage. Together with Dr Jones he worked on Sherlock, John pressing thirty times, the other one pressing the Ambu bag twice. They kept going like this until they felt it was safe to let go of the Consulting Detective. The heart monitor beeped regularly, and yet the pulse was very flat and still too fast.

Nobody spoke a word, apparently everyone was too shocked.

John felt miserable. They had managed to finally stop the bleeding and Sherlock hadn't gone into cardiac arrest before, so was this a sign of haemolysis? Had there been any incompatibility that they hadn't seen in the quick check of the blood samples? If Sherlock showed any other signs of it and died, then he, John himself, would have killed his flatmate!

John crouched in front of the unconscious man, giving free rein to his desperation. His shoulders started shaking violently, the tears blurring his vision.

"You need to rest." A distant voice reached his consciousness and John felt a firm grip on his shoulder. He knew the grip and the voice – they were Mycroft's. He tried to shake the hand off his shoulder, but didn't manage.

"Get your hands off me!" John hissed. He stumbled to his feet and dragged himself to the bathroom. Having taken a fresh wash cloth and wetted it, he slowly walked back to Sherlock, ignoring the glances in his direction.

He gently wiped his friend's face, trying to get the blood off, but the cloth was quickly soaked with it, smearing, not cleaning. Somebody handed a bowl of warm water to him, which he took without noticing who had done it. He washed the cloth and went on cleaning, having shut himself from the rest of the world. Don't die, was all that he could think.


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