A Case of Identity
“Life is infinitely stranger than anything which the mind of man could invent.” – Arthur Conan Doyle, A Case of Identity
Molly felt ridiculously out of place in her long, elegant gown while the doctors and nurses in lab coats and scrubs were passing her by. She wished for her own lab coat at the moment. Maybe wearing it would have given her some desperately needed confidence. The only comforting thought was that John looked just as out of place in his black suit. Mycroft, on the other hand, did not look out of place in a suit, not even here in the fluorescent lights of the hospital. Maybe it was because Mycroft Holmes would look ridiculous without a suit. Molly could not help but imagine the elder Holmes at home in sweatpants and a hideous jumper. That thought made her smile and almost laugh.
John realized and turned towards her, “Penny for your thoughts.”
Molly waved it off. “Nothing, just...” She sighed deeply.
John drew a hand through his hair. “This waiting drives me crazy. There must be something we can do.”
John had tried to stay at Sherlock’s side, being his doctor, but they would not let him. After protests from his side and some calming words from Molly, he had finally given up. When they had realized that Sherlock seemed confused, they had called Doctor Moreau. He had decided to run some further tests to know more about the extent of Sherlock’s injuries. The patient had not really complained and had endured most of it without protest. That alone was proof enough for his friends that something was very wrong with him. The Sherlock Holmes they knew would not only have protested, but also insulted and deduced all of the people in the room in a single long sentence without taking a breath.
Not long after Sherlock had been brought to radiology, his older brother had arrived. He had not asked any questions about the state of his brother and they had not told him anything. They had assumed he already knew. And if not, he would have asked them or the doctors if he had wanted to know. But he had not. He had only sat in one of the chairs outside of Sherlock’s room and had waited silently. A few times he had gone away to make a phone call and while seated in his chair he had tapped away on his phone most of the time.
The hours had gone by slowly. John had phoned Mary a few times, asking about their daughter and always having to tell her that there was nothing new regarding their best man.
At noon, Molly had just left to get them something to eat (Mycroft had answered her question about lunch with a dismissive wave of his hand), Doctor Moreau approached them again and addressed Mycroft, ”Mister Holmes, I’d like to talk to you for a minute.”
John assumed they already knew each other and Mycroft had sent for him, because they had not been introduced to each other by him or Molly. Mycroft got up and so did John. The elder Holmes nodded and got ready to follow the doctor, but when John was about to do the same, Doctor Moreau turned towards him, “I need to speak to Mister Holmes, alone.” He put the emphasis on the last word.
”But I am his doctor and... family... kind of...,” John tried to protest.
”John, I appreciate your concern, but I will talk to Doctor Moreau alone at first,” Mycroft stated firmly.
John thought about putting up a fight, but knew that he was too tired and exhausted to win an argument with the British government. So he could only watch Doctor Moreau and Mycroft leave him behind.
One and a half hours passed until John saw Doctor Moreau again. Molly was at John’s side again and looked up at the man in the lab coat with tired eyes.
”Miss Hooper, Mister Watson, sorry for keeping you
waiting for so long,” he said.
John looked around the corridor. “Where is Mycroft?”
”He is gone. He said he had some important business to attend and then needed to talk to his parents about his brother’s condition.”
John snorted and mumbled something that sounded suspiciously like, “typical.”
Doctor Moreau pulled a chair towards them and the three of them sat down.
”We did some tests on Mr Holmes and had a talk with his brother and of course with Mr Holmes himself. It seems like his injuries are more severe than we have initially thought.”
John grew impatient. “We already know that. But what’s the matter with him?”
Molly laid a hand on John’s arm in order to calm him down. He did not say more, but waited for an answer.
Doctor Moreau started to explain, “Mister Holmes
suffers from a severe head trauma. The sharp blow to the head resulted in a
concussion, and the tests showed a swelling in the brain. It seems that Mr
Holmes is suffering from memory loss, to be exact, from retrograde
post-traumatic and dissociative amnesia. As you may know, brain injuries are
complex and every case is different.”
Both Molly and John stared at the doctor. They had suspected something like that, but hearing it now made it very real all of a sudden.
”But he knew us,” Molly interjected, “he knew my name, he only seemed to mix up some facts.”
Doctor Moreau nodded, “Yes. He has not lost all of his memory. Despite popular believe, a complete loss of memory is relatively rare. The episodic memory is more effected than the semantic one, therefore general knowledge is remembered by the patient and Ribot’s law applies as well.”
”Ribot’s law?” Molly asked.
”It means that the memory is temporally graded. Events nearest to the trauma are hardest to remember again,” John explained.
When Molly looked at him quizzically, he shrugged, “Being an army doctor you have to deal with traumatized patients on a regular basis.”
Doctor Moreau went on, “Dr Watson is right and that’s why the memory of the circumstances surrounding the case Mister Holmes had been working on are most influenced. Through my talks with his older brother and you two and Mr Holmes himself, it seems as if his brain has constructed new memories out of the back-story he has made up for the case.”
John shook his head. “I don’t understand. Which back-story?”
”It seems as if Mr Holmes is convinced that his name is William and you are his fiancée, Ms Hooper.
Mycroft set it right and told me you are his pathologist.”
“I am not his pathologist. Well, I am, but…” Molly was at a loss of words.
So Doctor Moreau continued his explanation, “He created kind of a new identity, but based on his real autobiography. It differs only slightly from reality.”
Molly gaped, “Slightly?! He thinks I am engaged to him!”
Now it was John’s turn to lay a hand on Molly’s in an attempt to calm her down. Granted, he was having a hard time himself staying calm and collected, but he knew they needed to let the doctor finish. There would be time to freak out later. “So, you’re saying that he is confused about certain aspects of his personal life?” John asked.
Doctor Moreau nodded. “He is unable to recall autobiographical based knowledge, but the general knowledge about the world is usually unaffected in such cases.”
John scoffed, “That doesn’t matter, he doesn’t have such a thing as general knowledge about the world.”
Doctor Moreau gave him a funny look, but went on, “He shows strong signs of confabulation. He has created himself a false history that is fabricated by distorted and misinterpreted memories, but honestly believes it to be true. He has access to some parts of his memory, to others he doesn’t.”
Sherlock’s blogger sighed deeply. “And what do we do now? I mean, there is no actual cure for memory loss. How should we deal with it? Do we confront him with the truth?”
The doctor held up a hand. “No, that would be the worst thing to do. He is very fragile in this state. Patients suffering from confabulation tend to paranoia and aggressive behaviour when confronted with the truth. They are confused and have a hard time understanding their environment. That’s why they have felt the need to invent new details about their past in the first place. His environment should act as normal as possible. A familiar environment, and a normal daily routine are of the essence. Exposing patients to memories from the loss can help, but it takes time. It is a complex process, and as I’ve said before, every case is different. As you have said so yourself, Doctor Watson, there is no actual cure, but exposing the patient to the past will speed up the rate of recall. Memory is usually recovered due to spontaneous recovery, but if and when is unpredictable.”
Sherlock’s friends stared at the doctor for some time and let the information sink in.
“So basically you’re saying, “ concluded John, “that we should play along. We should not tell him the truth. We should lie to him?” The former army doctor was getting angry.
“No. What I am saying is that you should play along, but you can correct him on minor details.”
“And I don’t suppose me being his fiancée does count as minor detail?” Molly piped in sarcastically.
Doctor Moreau nodded, “You suppose right. Try to play along with the back-story he has constructed. And if you are correcting him, make sure that you’ll have a logical explanation.”
The pathologist had another question, “And how are we supposed to know what he believes to be true? We don’t know which back-story he has created for the case.”
Now the doctor looked a bit helpless himself and shrugged. “I’m afraid that is something you’ll have to figure out bit by bit.”
John drew a hand over his face. “This is… I don’t know… I mean, when Sherlock still had his memory I was not sure what was going on this complicated mind of his most of the time. How are we supposed to figure it out now?”
“I am sorry, Doctor Watson. I understand that this a difficult situation for all involved but I strongly recommend following my advice. Neurological disturbances change emotional responses and therefore Mr Holmes is likely to behave differently than from before the accident. He should not be confronted with his new created identity just yet.”
Molly and John stood there unmoving and speechless. There were so many questions to ask, so many ifs and buts, yet they could not manage to verbalize them. And even if they could, what would it had been good for? It would not have changed the situation.
Doctor Moreau felt that he was not needed here anymore and got up. “Doctor Hooper, Doctor Watson, I have other patients to see as well. If you’ll excuse me?”
The other two got up too and shook hands with the doctor. Molly was not able to say something, so John did the talking, “Of course. Thank you, Doctor Moreau.”
“You’re welcome. If you have any questions don’t hesitate to contact me or my staff.”“We will. Thank you.” Doctor Moreau nodded once again and then left them alone to come to terms with the new developments.