July 28 - Arkada part 4 (Flight of Faith)

[pompey_01]

Title: Flight of Faith

Author: Pompey

Universe: Arkada (my own Wing!lock AU)

Rating: PG13

Warnings: Medical ickiness, including what would be malpractice in real life

Word count: 2064

Summary:  John is a Homo sapien. Sherlock and Mycroft are Homo aves. Now John has a chance to become one of them . . . if he survives the process.

Prompt: July 28 – Alternate universe
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A/N: This is from the Arkada series I wrote during the 2021 Watson’s Woes July challenge. A lot of people said they were interested in this universe at the time, and I had a lot of fun writing it, and there’s a lot of things in this universe I haven’t explored yet.  Note: I am not writing this series entirely in chronological order. This story technically fits in between parts 1 and 2.

Part 1    Part 2    Part 3
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Ninety doses of the nasty, milky-yet-astringent arkad later, John followed Sherlock into St. Milburga Hospital. Dr. Vinjay, the physician hand-picked to follow John throughout his transformation, met them at the registration desk. This surprised John for a moment. Then he recalled her telling him that his was the first recorded attempt at Arkada in over one hundred years. Together they were making Avian medical history. Professionally, John knew he’d likely be personally meeting his patient at the doors too, had their positions been reversed.

 

“Ready?” Dr. Vinjay asked, smiling, once John had finished the approximate half-mile of paperwork.

 

“Definitely,” he replied, smiling back. When Dr. Vinjay turned, John was finally able to clearly see her wings – olive green and olive brown with a dark brown channel running down each feather – tucked neatly and professionally against her back. That was the initial effect of consuming all that arkad: he could see the wings of Avians without trying and without them deliberately revealing their wings. It would wear off soon if he did not undergo the transformation. After the transformation, the wing-sight would become permanent. And if he failed the transformation, he wouldn’t be seeing much of anything because he would be dead.

 

Arkada was not a safe process.

 

Dr. Vinjay led them to a private room within the Intensive Care Unit and personally took John’s initial vital signs. She allowed John privacy to change into a hospital gown (dragging Sherlock out with her), then returned for another round of vital signs. A floor nurse whose name badge read “Emma” inserted an IV into John’s left wrist. Then she inserted then a few more into the crook of his right elbow, the curve of his right wrist, and the back of his right hand, drawing blood simultaneously with each insert and then saline locking it.

 

“Isn’t that a bit much?” John finally asked when Emma asked for him to turn his right ankle slightly for her to insert one more IV. Her light gray wings puffed up to show slightly over her shoulders, a tell for Avian displeasure.

 

“You were an army surgeon,” Dr. Vinjay replied with raised eyebrows. “How many IVs did the medics insert into your patients before you got them?”

 

John sighed and turned his ankle as requested.

 

Sherlock, his own raven wings peeking over his shoulders, had the expression he generally wore when he was confused and upset by his confusion. “How many IVs, and why so many?”

 

“Lots,” answered John shortly. The ankle IV bore was large and hurt more than a bit going in. “And it’s because in a crisis, you want immediate access to the bloodstream with as many access points as possible in case they start failing.”

 

Sherlock’s eyebrows crinkled as he frowned deeply. John sincerely hoped that, of all times, this wasn’t the moment his friend truly grasped how dangerous the transformation was going to be. “Stop it, Sherlock,” John warned quietly. Sherlock looked at him with an unchanged expression but said nothing. Emma finished the IVs and blood draws and switched to putting the telemetry electrodes on John’s chest to monitor his heart. The connected battery pouch she dropped into the little pocket in the front of the hospital gown.

 

“All right, John,” Dr. Vinjay said, looking up from her wheeled workstation, “we’ll get you started on some saline and diphenhydramine while we collect the phlebotomy equipment for Sherlock. Ah, you’ll need to remove your coat and roll up your shirt sleeve,” she added to Sherlock.

 

He nodded tightly but still said nothing while Emma hung the saline and medication on the IV pole and began hooking it up to the catheter access in John’s right wrist.

 

“Please tell me you’re not having second thoughts,” John said once they were alone in the room. “Because I refuse to accept that I drank that damned stuff three times a day for a month to have it be all for nothing.”

 

Sherlock slowly removed his coat, slung it across the back of the large, padded procedure chair, and sat down again.

 

“Sherlock?”

 

Even more slowly, the detective silently unbuttoned the cuff of his right sleeve and rolled it up past his elbow. Then he sat looking forward into the room, stone-faced, hands gripping the armrests.

 

“I want this, Sherlock. This is my choice and I want this. I want this for me, and for us.”

 

Finally, a crack in the mask. Sherlock’s eyes shifted to John’s. “Even if it kills you?”

 

“It won’t,” John said automatically though that was not necessarily true and they both knew it. He attempted a wry smile anyway. “You wouldn’t let me, anyway. You’ll keep me here.”

 

Sherlock drew in a breath to respond but let it out as Dr. Vinjay and another nurse entered with bags and tubing and needles and other phlebotomy paraphernalia. “Ready?” Dr. Vinjay asked Sherlock.

 

He glanced at John one more time and nodded.

 

Forty minutes later, the fresh unit of Sherlock’s blood was hung on the IV pole with more normal saline. Dr. Vinjay finished recording yet another set of vitals into the workstation and personally hooked up the saline-primed tubing to John’s right wrist access. She hesitated for half a second before programming the IV run time. It was the only evidence of her own nervousness.

 

“We’ll stick to standard procedure,” she told John. “Starting at two mL a minute and then adjust the run time as tolerated. But we’ll take vitals every five minutes for the first fifteen minutes.” She paused. “We are looking to induce a transfusion reaction of sorts, so things aren’t going to be exactly by the book.”  

 

John nodded. “I know. And I know what symptoms to expect.”

 

“Right.” Dr. Vinjay smiled, slightly strained, but turned and pressed the start button on the IV. “Well, here we go.” The three of them watched the saline in the tubing disappear into John’s vein. It was all too quickly followed by Sherlock’s dark red blood.

 

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Five minutes in, John stated he felt fine but his pulse had increased by ten and his respiration had increased by four.

 

Seven minutes in, he started to feel warm and slightly itchy.

 

Ten minutes in, his temperature had gone up a full degree. Heart rate and breathing were noticeably increased.

 

Twelve minutes in, a headache was starting and John was definitely feeling hot.

 

Fifteen minutes in, Dr. Vinjay was ready to stop the IV. Sherlock and John protested almost simultaneously.

 

“If we don’t finish this completely, there was no point to starting it in the first place,” Sherlock insisted, rather to John’s pleasant surprise.

 

“Experimental treatment for science,” he chimed in, hitting Dr. Vinjay in what he knew to be her weakest point. “I signed all the clearance and waivers anyway.”

 

Dr. Vinjay sighed and allowed the IV to continue running, setting the rate to run at three hours – halfway between the standard two to four hours. But she personally stayed in the room the entire three hours and collected John’s vitals and symptoms checks herself, and even collecting blood specimens from his left arm every fifteen minutes.

 

By the end of it, John was feeling far worse than he wished to let on. Everything hurt, or itched, or was too bloody hot. And things were getting a bit hazy and strange, like a 1970s music video.

 

“You got wings,” he murmured to Dr. Vinjay. “You too,” he added to the blonde nurse with small, brown speckled wings and a name badge that stated Hannah. “You angels? . . . . Wait.”

 

John sat straight up and stared intently at an increasingly horrified Sherlock. “You got wings too. But you’re not an angle. I mean angel. Angel. You’re not . . .” He stopped and turned to look directly at Dr. Vinjay. “Am I dead?” Suddenly his eyes rolled back and he collapsed backward. Dr. Vinjay immediately hit an alarm button near the bed.

 

“John!” Sherlock cried and jumped up to rush to his friend but hesitated. As much as he wanted to be at John’s side, he didn’t want to get in the way of much-needed medical care. Medical personnel were already crowding into the room.

 

“Seizure precautions,” Dr. Vinjay ordered. In short order, John’s hospital bed was lowered into a flat position, the bedrails near John’s head were lifted and lined with padded bolsters, and new IV bags were being hung with stuff Sherlock couldn’t even guess at. Suddenly he understood on a visceral level why John had been given so many IV access sites and it turned him cold and sick.

 

“Is this the transfusion reaction?” Sherlock asked softly once more than half the sudden crowd of people had left John’s room. John himself lay on the bed, quiet but rather restless.

 

“Yes,” Dr. Vinjay said, pausing in her frantic typing. “He’s in metabolic acidosis as well. That is, his body’s pH level is too acidic to maintain completely normal functions. Notice his breathing?” Sherlock had. It was very fast but surprisingly deep. “Kussmaul respirations. It’s a way for the body to try to blow off carbon dioxide to lower the pH level.” She resumed her typing.

 

Proteins could denature in acids, Sherlock knew. “Are his proteins denaturing?”

 

The blonde nurse, Hannah, looked faintly amused. “No. It would take a lot more acid in his system to do that. But it is enough to affect his perception and consciousness. You can talk to him, though. It might help ground him.”

 

Sherlock looked at John, then up at the various bags on the IV pole.

 

Hannah answered his unspoken question while Dr. Vinjay continued typing. “We’re trying to help John’s accept the Arkada transformation naturally but without letting the process hurt him any more than absolutely necessary. It’s a bit of a balancing act and there’s not exactly a lot of precedent to follow.”

 

“You’re guessing at treatment, then.” Sherlock didn’t bother trying to hide his disdain nor his hackling feathers.

 

“Educated guessing,” Hannah corrected, her own feather tips twitching slightly. “Look, you’re a detective, yeah? When you make your deductions, you don’t always know for a fact that you’re right. But you observe and you gather data and from that information you make your conclusion based on what is most likely to be right. We’re doing the same thing. We are observing John’s condition and gathering data about his systemic functions. We do have previous knowledge about the best treatments for patients in similar – not identical, but similar – conditions. So we combine what we know about John’s condition with what we already know about similar treatments to come up with what will likely be the best course of action for John. We may not get it totally right the first try but we can adjust treatment until we do.” Hannah stopped for a breath. “One thing that we do know can help is a friend or relative talking to the patient or holding the patient’s hand. An unconscious person seems to be more aware of their surroundings than we used to think possible.”

 

Sherlock blinked at the nurse once, then twice. Then he nodded sharply and turned back to John and carefully held the twitching hand in his.

 

Dr. Vinjay paused in her documentation long enough to smile at Hannah approvingly.
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** for anyone curious, Dr. Vinjay has kea wings. Kea are a type of parrot from New Zealand. 

Comments

[debriswoman]

A fascinating and well-penned scenario.