Sherlock is flush with cash - John is a doctor - and I am clueless

[impulsereader]

He never claims to be skint..."Told Mike this morning I must be a difficult man to find a flatmate for."

All the dialogue about money is either from John - or Sherlock feeding John's assumption of lack of such.

Hence - my belief that Sherlock is flush with cash gains canon ground.

In a practical sense, what is John’s skill set as a doctor? At the surgery he writes scripts and performs some triage in deciding if someone should be sent to hospital, but he’s over qualified for this. He doctored soldiers who were wounded by bullets and bombs rather than strep throat. So what sorts of injuries do we think John could successfully treat on his own, given the proper supplies?

As an example sort of a scenario – someone is stabbed in the torso. In my head, John binds the wound and then we go off to hospital because the victim needs additional scans and care. But if someone is stabbed relatively superficially in the leg, and once the wound is bound he can walk just fine, indicating no muscle damage – in my head perhaps John could stich this wound on his own if he’s not worried about internal bleeding and such. Would he set a broken bone? Probably not without an x-ray unless it was a real emergency situation, I would imagine.

Sorry, just trying to set my doctor so he shows off best in the available light...without being a show off...

Comments

[221b-hound.livejournal.com]

I've assumed that although John might have some skills in general practice (depending on his internship) his main skillset would be in trauma injuries. If he was in the field I guess that would mean basic triage and stabilising serious injuries until the patient can be sent to surgery. Assuming he actually worked, MASH-style, in front-line surgery, he'd have been there stitching up the poor bastards as well.

I don't really know how medics are deployed in the field though.

I sometimes wonder how well he does as a GP. I have a friend who is a GP, and he's pointed out before that in some ways it's a bit more challenging that being a specialist, because your knowledge has to be broad rather than deep. There's so much more to know about *everything*, from nutritional advice to identifying possible diseases from a wide range of often not-very-specific symptoms.

Anyway, I think your summary seems right. And although his hand tremor disappears while under stress, I imagine it's why he's no longer a surgeon. Convincing the medical board that your intermittent tremor is going to disappear while you stitch people up in an emergency ward is going to be very difficult if it shows up at other times when you're *not* under stress.

I think in a pinch, as long as he had supplies of some kind, he could perform emergency surgery. I think in the absence of that kind of situation, he's still an experienced and uber competent field surgeon, prepping folks and keeping them alive until they can be taken to a hospital for full and correct diagnosis and treatment.

This might actually involve some quite complex emergency treatment to keep people from bleeding out or just to keep them breathing until help arrives. Since he's not in a full war zone any more, maybe trying to triage a dozen or more patients, he could probably spend a lot longer trying to save someone who, in a battle situation, he might have to abandon in favour of someone with a better chance of survival.

Stitching up an uncomplicated wound would be part of that, as well as aftercare of the wound.

Have I been babbling? Possibly. If you have specific questions, I could ask my Dr friend when he returns from his holiday, if you like.

[221b-hound.livejournal.com]

Oh, having said all that, even soldiers on deployment must just get strep throat sometimes so he doubtless has GP skills as well. Probably knows a lot about sexual health as well, what with looking after the general health as well as specific battle traumas of troops of mainly men on the front line - probably has had to deal with more VD than he ever thought likely in a battlfield.

[ladyuranus.livejournal.com]

I've always had the headcanon that the Holmes are rich. I'm kind of surprised that Sherlock would go looking for a flatmate, but I imagine there were extenuating circumstances.

And I'm pretty sure John could stitch people up, etc., but he wouldn't cause he still worries about his shaky hand. In an emergency he'd probably go at it-- he did the bulk of his doctoring during the war, as far as we know.

[221b-hound.livejournal.com]

And look what was just posted that may answer all your medical questions about John's skill set!

http://arbitrary-fic.livejournal.com/27881.html

[natsuko1978.livejournal.com]

Regarding money.

It is certainly possible to argue that Sherlock has a trust fund or some other income becyond his earnings as a detective (especially as it is canon that he is unpaid for police cases) but even then, a flatmate would be a boon.

Sherlock wears expensive, dry-clean only clothes. He takes black cabs *everywhere* and I know people on 6-figure incomes who only take black cabs when they can claim it on expenses. He may simply figure that he has better things to spend his money on than central London rent.

My 2-bed flat in a not-very-good area, half an hour from Liverpool St, cost £850 pcm in 2008. 221B Baker St may well rent for twice that, and even with Mrs Hudson's "deal" could be over £1000 pcm. And that's without council tax (probably over £120 pcm) and utilities (a winter quarter gas bill can easily be £400, then there's water and electric and mobile phone contract and internet...)

Even before cabs and other luxuries, Sherlock and John probably need about £2,000pcm between them to live. London is very much Not Cheap. (If you do a job with a set income, such as government/teaching/NHS, there's a London weighting to the salaries, offical acknowledgement of how expensive it is to live in, or within commuting distance of, London.)

And dividends from shares, income from savings etc etc has all been hard hit by the recession/financial crisis.

Even if relatively flush, Sherlock could need a flatmate to ensure that he doesn't need to start budgeting or cutting back on luxuries, you know?

ETA: As discussed in comments over in my John-meta, soldiers get strep throat too. RAMC staff have to deal with men in their late teens and earliy twenties being men in their late teens and early twenties as well as everything the enemy can throw at them. Stress has an inhibitory effect on the immune system, too, and in Afghanistan British troops are in a very different environment from Blighty. Our boys are going to pick bugs up, get Delhi-belly (even if they aren't actually in Delhi) sprain and twist things having a kick-about in camp etc etc.

Not everything a base camp/field hospital sees will be injuries caused by bullets and bombs.

[quarryquest.livejournal.com]

As a First Aider at Work for many years, I am not a doctor, but I have triaged any injuries that needed deciding whether it was 'wait and see', 'make an appointment with your doctor', 'take them to casualty' or 'get an ambulance'.

The reason one goes to hospital rather than to a doctor these days is because they have more complex methods to test you /view inside you. They also have drugs, ways to monitor you, nursing care ... oh and ways to ressusitate you if it really is that bad.

Having had a 'walk-in centre' near me in a town in the middle of nowhere (long journey of 20 miles to big town and big hospital) so at one point nearly everything got taken there. Drs were treating stuff that nurses would treat and vice versa depending on how busy they were. I learnt a lot, and developed diagnostic skills so I could spot things (not limited to, but including) pneumonia, broken fingers and appendicitis!

I also had a friend who was a field Medic (but not a Dr) in the Falklands War in the 1980s and he was apparently trained to such a high standard that when he came out he could have been fast tracked to become a GP.

I would say that unless the person needed prescription drugs, blood, IV fluids or some sort of medical investigation, John could manage quite well on his own, thank you very much.

[northernwalker]

Point A- Well, in the classic Sherlock, he describes himself as a poor man in The Priory School. However, I always worked on the assumption that he had some sort of income from his family- what someone describes as "Enough that I can do anything. Not so much that I can do nothing."

Point B- I think of him as a field surgeon working in a combat support hospital, like the old MASH units.

On his own with no nursing staff and specialized equipment? Probably the same thing combat medics do.