Was Sherlock put on some sort of ‘heart assist system’? (EMP meta)

So, this is for @monikakrasnorada because we just love to scream our favourite Sherlock-is-in-hospital-in-a-coma headcanons at each other.:) What can I say, I like angst.:)

Also, this is a reply to @mrskolesouniverse‘s good question, which was basically: But shouldn’t the show make everyone want to go back and re-watch the whole of s4? To see s4 in a different light once the rug is pulled…So, yes, I am currently re-watching s4 with my EMP goggles on. And boy, is it suddenly good and painful.

One of the things that I realised today is that Sherlock was probably put on some sort of heart support system in TST.

I don’t know if it’s a “heart-lung machine” (cardiopulmonary bypass (CPB)) or an ECMO? I’m not sure. (Can you insert a VAD into a comatose patient?) Medicine is not my area, as you can see. But whatever it was, let’s just say Sherlock was put on some type of heart support system.

Here’s what I think happened:

The CARDIAC ARREST has already been mentioned several times. (We have also talked about the whole ‘injurious to your heart comment’ in TAB.) In TST, Sherlock also mentions heart medication pretty much as the words ‘Cardiac arrest’ flash across the screen.

So, that’s what happens…to Sherlock, yeah? His heart is fried. He’s going into v-fib.

The scene immediately following this one is the car scene.

But what if this is NOT Mary being driven to hospital? What if, outside of Sherlock’s EMP, this is actually Sherlock being rushed to the OR (or some other part of the hospital):

I know we all thought Sherlock furiously typing away on his ‘phone’ in all these scenes just means that Sherlock is connected to his heart because of Mary giving birth to John’s child and the fact that Sherlock can’t deal with what’s going on and is trying to look out for his heart (aka his emotions). But what if that’s not what’s happening?

What if it’s LITERALLY about his heart…about the organ, that is?!!!

Sherlock is so, SO focused on that phone heart of his in that car scene (and in the ones before and after that, too). It’s like he’s really, desperately trying to keep his heart (the organ!) alive. I mean, do we really think Sherlock clutching his heart phone in this car scene is just a metaphor for Sherlock having ‘the feels’? Maybe this is Sherlock LITERALLY trying to keep that organ alive with all his might, as he’s going into v-fib.

What if, “I’m a nurse, darling. I think I know what to do,” is not actually Mary’s line. It’s some snippy nurse who snidely tells John to shut his pie hole and stop interfering while she tries to save Sherlock’s life.

And we know that, whatever is happening to Sherlock’s heart (the organ!), there are probably two people present trying to save him: a nurse and John. 

After the car ride scene we get three very bright flashes of light, ostensibly photographs taken by Mrs Hudson. What if the flashes are actually Sherlock’s heart being shocked with a defibrillator?

Then Sherlock is again holding onto his heart phone for dear life. So, this doesn’t look good for his heart either way. 

What’s more we’re even told that it’s an ‘automated’ heart now (the automated (!) voice on his phone during the christening). 

So, this is probably not really his own heart anymore. He’s on some sort of heart support system (whichever, I have no idea). I mean, his heart phone speaks with the voice of an assist system! This is a ventricular assist system or a cardiopulmonary bypass or god knows what they use on coma patients. It’s some type of heart assist system because that’s literally what we’re shown in this scene: Sherlock’s heart phone being operated through an ‘assistant’.

You know what a common complication with these types of heart support thingies is (with all of them)… 

Clotting! Blood clots. 

And right in the next episode (in TLD) Sherlock calls Culverton a ‘coagulation of human evil’. So, Sherlock has trouble with his coagulation, right? His body is throwing blood clots. Looks like into his brain, which is next on the list of organs to get fried. Yeah, we’ve talked about that before extensively.

You know what other common (and deadly) side effects heart support systems have? All sorts of bacterial infections! Wikipedia tells me that Pseudomonas aeruginosa, for example, is typical for medical equipment of this kind and that it fries your kidneys. Ding, ding, double kidney failure, anyone? (See: TLD). 

Also, they pretty much spell it out in the episode that the problem is an infection: they talk about going ‘beyond viral’ (‘beyond viral’ is literally bacterial, right?).

It’s also possible that Sherlock’s heart condition is compounded by something that’s always been wrong with his heart, right from his birth. Why else mention the word ‘congenital’ in TLD? It would even make sense on a meta level: Sherlock has had a congenital ‘heart condition’ since his ‘birth’ in ACD’s books.

And then, there’s this other hint that what’s going on, in reality outside Sherlock’s EMP, is that they’ve put Sherlock on a heart support system in TST and that that move backfired and produced complications:

In the recently aired ‘Doctor Who’ episode ‘World enough and Time’, which was written by Moffat, Bill (a blatant Sherlock!mirror if there ever was one) is first shot in the heart, then sent somewhere where time progresses at a different pace (like in a coma!). 

The whole point of the episode being that Bill’s heart is replaced by a type of heart support system, initially to help her…But said heart support system produces the dire, dire consequences that follow for her.

In Sherlock’s case the dire consequences would not be that he’s turned into a cyberman. Obviously.:) The dire consequences in Sherlock’s case would be that the heart support system causes a clotting issue which hits his brain.

Also, don’t forget that between Sherlock’s heart being put on some sort of heart assist system and the coagulation trouble Sherlock is in TLD, he is:

a)…shown debating with himself whether he will ever ‘get out of here’ or should lose faith in ‘them’ out there. I mean that is the whole point of the Tbilissi dialogue between the ambassador and that other guy, right? All of that happens in front of a Georgian flag that is almost certainly a reference to the medical Red Cross, as I pointed out here. (So, Sherlock is on some level, aware of his surroundings in the hospital.)

And b) Sherlock is pumped full of drugs (at the beginning of TLD). Yeah, that’s what would happen if you were put on some sort of heart assist system.

Also, the needle marks on his forearm in TLD…well, you can probably guess how many needles they’re sticking into him.

We’ve discussed the rest before, of course: There’s a clotting issue (coagulation!). A blood clot hits his brain. They suspect the brain is toast. (The dark skull painting!) They test his reflexes via pain stimulus (@shylockgnomes proposed this in their comment: here.) They debate whether Sherlock’s brain stem is still active (cf. @ebaeschnbliah‘s phenomenal discovery of the ‘reptile’ brain thing which happens right as the skull painting goes black). Then they take Sherlock off ventilation (Culverton ‘suffocating’ him), which is when Sherlock reflexively gulps in air, which is, in turn, how they know he’s not brain-dead, after all. Phew. He’s passed that test. And then the skull painting starts glowing softly again. So, thank God. Not brain-dead. Good.

Because our Sherlock has to survive with his mental faculties intact to get his happy end in s5.

P.S.

Also, it’s right before the christening scene in TST that Sherlock tells John that, “God is a ludicrous fiction dreamt up by inadequates who abnegate all responsibility to an invisible magic friend.” 

Just imagine for a moment that this isn’t actually Sherlock talking! 

Sherlock was put on some kind of heart support system. Some doctor comes out to tell John about the results, “Your friend made it. He’s pulled through. He’s stable. At least for now.” And John replies in relief, “Oh, thank God,” then adds with a sad smile, “Although Sherlock himself would probably say, ‘Don’t thank God. God is a ludicrous fiction dreamt up […]’”

Yeah, I know…why does my brain keep providing me with this darkness?

Tags: @monikakrasnorada @mrskolesouniverse @ebaeschnbliah @gosherlocked @fellshish @88thparallel @raggedyblue @possiblyimbiassed @tjlcisthenewsexy @sarahthecoat

All screencaps taken from here.

Bringing this one back, too. :D Because I had completely forgotten my own reading here (heehee): 

The automated assistant voice on Sherlock’s phone in TST means his ‘phone’ (heart) is now only working because he was literally put on a heart assist system.

In other words, Sherlock’s in a coma.