A Study in Misdiagnosis: a BBC Sherlock Critical Fanfiction

Watson sat stiffly in the armchair in his psychiatrist’s office. He loathed these appointments. She always wanted to talk about him. There was nothing interesting about him.

“I see you’re no longer walking with a cane,” she greeted him. There was a slight trace of a smile on her face.

“Oh, yeah… I guess I just found better things to focus on.”

“That’s good to hear. I saw on your blog that you’ve befriended Sherlock Holmes and are helping him consult on murders the police are investigating?”

“Well, he sort of pulled me into it. He’s very convincing.” Watson folded and unfolded his hands nervously.

“And you’re living with him now?” She raised an eyebrow, as if to imply she was asking more than just to confirm his change of address.

“We’re just friends!”

“Of course.” She pursed her lips and scribbled something on her notebook.

Watson feared today’s session would be spent arguing whether or not he was a closeted homosexual and if this had anything to do with his rocky relationship with his sister (it didn’t) or some Freudian analysis of an irrelevant life event from the past.

Instead, she said, “On your blog, you spoke about everyone’s warnings regarding pursuing a friendship with Sherlock, and your disregard for their cautions.”

“That’s true.”

She flipped through the pages of her notebook. “You even said Sherlock diagnosed himself as a high-functioning sociopath.”

“Yes, he did.”

“Why are you not concerned by this, John?” She adjusted her posture and set her gaze squarely on him.

“Because he’s not.”

“What makes you think that?”

“I googled it.”

She almost managed to conceal her snort. “Is this where you’ve relocated your leg pain to?”

“No, the leg pain’s gone.” He maintained eye contact with her to reinforce his statement. “Completely.” He paused, re-crossing his legs. “Actually, I thought maybe you could help correct his self-diagnosis.”

“From your blog it sounds like he’s very confident in whatever claims he makes.” She pushed her glasses up the bridge of her nose. “Do you really think he’d accept that you’ve proved him wrong?”

There was silence for a moment. Watson knew Sherlock would not accept his claims without good supporting evidence. “Sometimes it’s hard to believe you’re a good person when everyone says you’re not.”

“Sherlock seems very sure of himself and his beliefs.”

“I’m not trying to clear him of his oddities. He’s very aware that he’s different. I’m just not sure that he’s the kind of different everyone believes him to be.”

“What evidence do you have that he’s not a high-functioning sociopath?”

“He has a life plan.”

“What is that?”

“He solves crimes. He’s a police consultant. Of course, he’s not making any money from it, but he does seem to do a lot of crime solving for other people. Maybe it’s not a mapped out plan of where he’s headed, but he knows his skills and how he can use them to support himself.”

She moved her head from side to side, as if she were considering it. He could tell that he hadn’t convinced her.

“He’s not violent either.”

She stood up and pulled a large book from a shelf. In glossy letters on the cover, it read Diagnostic and Statistical Manual IV. She leafed through the pages. “There’s fine line between psychopathy and autism, you know. Many of the behaviors overlap and I’m not sure ruling out a couple psychopath behaviors is enough evidence.”

Watson knew he wasn’t grasping for straws. He looked at her and continued, “He’s obsessive. The police describe it as an addiction, but it’s definitely an obsession with knowledge, knowing the answers, but not just about anything. He has very particular interests that drive him to do things most people wouldn’t for the sheer purpose of learning.”

She ran a finger down a page. “What else?”

“He has terrible manners. He’s incredibly honest, very snippy and rude. He loves to figure everyone out, even if it means announcing their more private dealings. He figured out that Lestrade is cheating on his wife with one of his co-workers and he just announced it at the crime scene, he didn’t think otherwise about it. He’s obviously gotten better about it, as he’ll say something insensitive to me, but try to clarify it in a way that makes it less hurtful.”

“So his social skills are lacking?”


“Sounds like he doesn’t have the charm and suaveness typically associated with sociopaths or psychopaths.”

Watson nodded. “He also not very expressive or interested in other people’s lives unless it’s him playing the game, you know, solving the puzzle of who they are and what the details of their lives are.”

She nodded. “That does seem to contradict the usual facade people with asocial personality disorders typically reside in.”

“He’s very particular too. Always wearing the same scarf and coat. The tiniest things bother him, affect his ability to concentrate, he claims. He had to have Anderson turn around because looking at him was affecting his ability to focus. And sometimes he uses Nicotine patches to help him better think through things.”

“Does he have outbursts when he’s overstimulated or too many things that bother him are in the vicinity?”

“Yes, he can be very curt with people. It’s the closest I’ve ever seen to him being violent. But he can also be extremely excited over crime scenes and serial killers and all the things that interest him.”

“Does he like to stick to a strict schedule?”

“Not necessarily. When he gets caught up in an investigation, he’s everywhere at anytime. Always running off to do something. But he has his favorite restaurants and his habits when there’s no crime at hand to solve.”

“From what you’ve said about him on your blog and here today, it’s obvious that he’s an intelligent man, and this is not a sudden change in his behavior but the way he’s always been and the way he’s always understood and deciphered the world.”

“It seems that way.”

“I’d have to agree with you, John, that he’s incorrect to diagnosis himself as a high-functioning sociopath then. He’s clearly autistic.” She closed the large book and set it aside.

John sighed in relief. “Thank you.”

“Of course.” She looked at her watch. “Maybe next week we can talk about you?”

John pretended to consider it before getting up and walking out of her office.


Sherlock was talking to his skull when Watson returned from his appointment. “Good, you’re back. Now I can talk to you.” He set the skull back on the mantle.

“Good afternoon, Sherlock.”

“I’ve finally figured out what happens to eyeballs when you put them in the microwave…”

Watson sat down in the armchair as Sherlock began to pace about the room describing his discoveries. He paused mid-sentence. “You were talking about me to the psychiatrist.”

“Were your ears burning?” Watson teased.

“No. I’d be at A&E if they were.”

“Sherlock…” Watson considered trying to explain it to him, but Sherlock would probably just misappropriate it like he’d done with a blanket signifying being in shock.

“You were discussing me. You’re looking at me differently. You would have told me I’m brilliant by now, at least intelligent with what I determined about the eyeballs.”

“Sherlock, I…” He didn’t know how to begin the sentence. They spent so much of their conversations talking about the intimate details of other people’s lives and problems that theirs were often pushed to back burner, touched on just for a moment before they returned to the bigger mystery at hand. He finally managed to continue, “Sherlock, I have something to tell you.”

“If it’s about your feelings for me, I’m sorry, but I’m don’t have time for that kind of relationship in my life.” He raised his eyebrows slightly.

“No, it’s not that.” Watson sighed.

“I was making a joke. Like everyone else does about us.” Sherlock offered a slight smile, closest Watson had seen him come to laughing.

Watson didn’t know how to say it so he just said it. “Sherlock, you’re not a high-functioning sociopath or a psychopath.”

“Well, I’m not like you, John. And I don’t want to be like you anyways.”

“I know. And you’re right, you’re not like me. I believe the proper diagnosis is autism.” John tried to enjoy his pleasure for a moment before Sherlock began to give him the third degree.

“Your evidence?”

Watson recounted his conversation with his psychiatrist.

Sherlock seemed to consider it for a moment, withdrawing into his head instead of regurgitating all his thoughts and computations in hyperspeed.

“Everything alright?” Watson finally asked.

Sherlock glanced at him. “John?”


“Does being autistic instead of a high-functioning sociopath change anything?”

Watson thought about it for a moment.

In an ideal world, it would hold some significance, give Sherlock’s intelligence and intuition a benignness that might cause the police to consider how they treated him. This knowledge and these passions for things most people would turn away from didn’t mean he had some kind of perverse addiction that ultimately meant he’d become a murderer himself–even if that twist would probably garner more readers to John’s blog. All it meant was that Sherlock just held a different perspective and relationship to the world that allowed him to understand and interact with it differently, and fortunately, in a way that could help him do some good in the world. Then again, switching out the label wouldn’t make him any more included and would give him a whole new set of stigmas to fight against.

Watson finally replied, “No.”

“Good. They’re more agreeable when they see me as a possible threat. I wouldn’t want to change that.”

Watson nodded, before asking, “So you were saying about the eyeballs in the microwave?”

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  1. I like your overall conclusion that the label doesn’t matter – it’s more important that Sherlock solves crimes.

  2. Here’s what Sherlock showrunner Steven Moffat has to say about this issue, (https://goo.gl/hT3AmT)

    “It’s funny how people are always wanting to prove me wrong on this one. They say: ‘But he’s not a high-functioning sociopath.’ I never said he was! Sherlock Holmes tells people he is. Why would you listen to him? Nobody can define themselves. That’s what he’d like people to think he is. And that’s it–and I think he probably longs to be one. I think he loiters around prisons for the criminally insane, envying them their emotional detachment. He knows emotion is a problem to him. A man who has decided to suppress all his emotions in order to be better at what he does clearly has an awful lot of emotion. That’s a very simple deduction. It clearly is a problem for him. So, in itself, that is an emotional decision.”

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