#just need some new music to stimulate my brain while im resting.........

[udurghsigil]

i have a headache and have no energy to do anything.... does anyone have any good metal recs

[nova-fanart-dump]

SCIENCE LECTURE

In my fic here, Sherlock has a little brainstorming session while drugged out of his mind, and this sheet of notes below is the result of it. I decided to write out a little explanation as to what all the individual parts of it mean. The explanation will be in the format of ITEM - TRANSLATION - BREAKDOWN. The item will be the selection of the notes that the section will be explaining, copied roughly verbatim for the reader's convenience. The translation, if needed, will be translating Sherlock's (my) shorthand into standard notation. The breakdown, then, will be the explanation.

Disclaimer: I was a medical student, before I had to withdraw due to hand injury, and my area of study in undergraduate was neuroscience and neuropsychology (and music performance, but that's not relevant here). I do try and explain everything in layman's terms, but 1) it will get a little technical in parts, fair warning, and 2) I'm still learning on how best to explain concepts to other. I try my best, people!

ITEM 1: THE LIST

1) Narcotics- hallucin? (Translation: Hallucinogen)

2) Sleep dep. Halluc (Translation: Sleep deprivation Hallucination)

3) Mycroft- test?

4) Lights show

5. GMO (Translation: Genetically Modified Organism)

6) Moriarty???

7) Acute psychosis xxx

Breakdown:

In the episode, Sherlock says that he had come up with seven possible reasons for how he, Henry, and John could have all seen the dog-that-could-not-exist, and that he'd settled upon narcotics as the most likely. I came up with a list of seven of my own reasons:

1) Narcotics- hallucinogen: self-explanatory, as explained by the actual episode.

2) Sleep deprivation hallucination: this episode takes place what appears to be several days into pretty severe nicotine withdrawal, for Sherlock. His sleep schedule seems to be disastrous as is, and the nicotine withdrawal would've made him even more wired, so there's a solid chance he hadn't slept for several days, which is long enough to for sleep deprivation-induced hallucinations. While the hypothesis itself is perfectly sound, Sherlock puts it at number 2 instead of 1 because A) Henry ALSO saw the dog, B) sleep deprivation induced hallucinations generally don't start out with a full-fledged monster dog screaming in your face. If this hypothesis had been correct, he should've been experiencing more subtle hallucinations all night long.

3) Mycroft- test?: As discussed in series four, Mycroft occasionally has been employing tests into Sherlock's mental stability for decades, focusing on what Sherlock believes to be a dog. Sherlock, being Sherlock, has likely noticed this. Mycroft knows Sherlock is hanging around Baskerville. Sherlock also knows Mycroft knows this. Under the influence of a paranoia-inducing narcotic, Sherlock very easily could suspect his nosy brother at being somehow responsible.

4) Lights show: Again, inspired by series 4, and how the illusion of a ghost is created in TAB with nothing more than a projector. The logistics of how this would actually work are hazy, which is why this is further down the list, and quickly discounted by Sherlock.

5) GMO: While GMOs are usually discussed in the context of resilient strains of plants, all it really means is genetically modified organism. I'm speaking as one educated in 2014+, not 2012 (the ep air date), but breeding an especially large dog, and genetically modifying it to have red eyes, would probably not be too difficult a feat, scientifically. It could even be glowing, if you spliced in that GFP gene that the scientist mentions! However, this possibility is unlikely, because it raises the very big question as to why the scientists would allow their experiment to roam wild and attack people, why the scientists would bother making it in the first place, why haven't others taken pictures, etc. This is why it's so low on the list.

6) Moriarty???: Similar premise as the Mycroft's inclusion.

7) Acute psychosis xxx: AKA, "I lost my mind". Very unlikely, because it doesn't explain why Henry shared his hallucination, has no explanation as to why or how, and he has no other symptoms suggestive of a psychotic break. Which is why Sherlock scratched it out, and marked it with three Xs.

ITEM 2: THE FEEDBACK LOOP

This refers to the diagram, sitting just to the right of the list.

Breakdown:

X -> SNS Act -> Occ. -> (SNS Act) | (Amyg up) (Temporal) (up up Amyg)

Translation:

Unknown Substance X -> Sympathetic Nervous System Activation -> Occipital Cortex

(Amygdala stimulation) (Temporal) (Further Amygdala stimulation)

Let's define some terms!

This little diagram is a positive feedback loop, drawn very messily and with multiple steps added in after the fact. In biology, a feedback loop is a circuit in which the output of a system feeds back around to affect the system's input, which indirectly affects the system's output again, and so on. A simple example of a positive feedback loop is as follows: Addition of Substance X to System yields output of Substance Y. Substance Y triggers the production of more of Substance X, which again yields the output of more of Substance Y, which again triggers more production of Substance X- and so on. (feedback loops in the body are far more complicated, and most will eventually trigger their own end, etc, but such discussion is beyond the purpose of this post).

Unknown Substance X = input of whatever Sherlock was drugged with

Sympathetic Nervous System = simplistically speaking, our autonomic nervous system has two parts that work together, the sympathetic nervous system, and the parasympathetic nervous system. PNS can be summed up as rest and digestion, while SNS can be summed up as fight or flight.

Occipital Cortex = simplistically speaking, the visual center in the brain. There are other areas involved, but this area is the key and center to visual perception.

Temporal = simplistically speaking, the auditory cortex in the brain.

Amygdala = simplistically speaking, the fear center of the brain.

(I am defining all these terms as their relation to this situation at hand, nothing more. The brain is not so simple as to allocate X Function to Y cortex.)

So, Sherlock theorizes that input of Drug X stimulates the SNS and/or the amygdala, which caused inappropriate occipital lobe stimulation leading to hallucinations, which increased Sherlock's fear response, which caused further SNS activation, and so on. He suggested temporal lobe as a possible step; however, at no point during the episode did the drug cause auditory hallucinations, which is why it's not including in the loop proper.

There are actually a few problems with his loop, because he drew it out on the fly, while high off his mind, and he's not a neuroscientist, but he's got the right idea. The inappropriate, uncontrollable stimulation of the amygdala is almost certainly what Drug X causes, and would result in fear, paranoia, and increased suggestibility, all stated symptoms of Drug X. Inappropriate amygdala stimulation leads to inappropriate SNS activation, which encourages hallucinations, but would not cause them directly. It's likely that the drug also caused overproduction of dopamine, which can cause hallucinations. (However, there is no guarantee the occipital cortex was involved).

Whatever the chemical cause of the hallucination, he "sees" the dog, freaks out more, amygdala continues to be stimulated, freaks out because he’s Sherlock and isn’t used to freaking out, and the cycle continues, which is what leads to Sherlock's panic attack/meltdown in the pub- short-term, we're able to handle those stress reactions, especially if they're rational reactions to a stimulus, but keep them going for hours at a time and the body will start to freak out.

ITEM THREE: SYMPTOMS LIST

3a. Tachycardia, (up)hidrosis, shaking, panic attack?, nausea, emesis

(up)hidrosis = hyperhidrosis

Breakdown: Very rapid heartrate, increased sweating, shaking, nausea, emesis = vomiting, panic attack? (Question mark because Sherlock is not convinced of the diagnosis. Even high off his mind, he's still got his pride- he's Sherlock Holmes! He does not Get panic attacks! >;0)

3b. NOT NICOTINE, WITHDRAWAL UPUPUP

Breakdown: as John says in the pub, Sherlock was pretttty wired before all of this. Sherlock notes down that these symptoms are not the result of the nicotine withdrawal, because he can still feel the now increased effects of the nicotine withdrawal going on alongside these new symptoms. Chemically speaking, Drug X probably wouldn’t have any /direct/ effect on nicotine withdrawal, but it very well might exacerbate it indirectly.

3c. OH NO EFFECT - NOT STIMULANT

Translation: Alcohol no effect - not stimulant

Alcohol, to our bodies, is a depressant. If you drink it with a straight stimulant, like caffeine, their effects will counteract each other; for example, if I want to drink but keep clear-headed, I'll have a soda with my glass of wine. (DISCLAIMER: this will not make it safe to drive, this will not prevent alcohol poisoning, this can be dangerous, and do not do it in anything but careful moderation). Sherlock, as seen in the show, gets a shot of alcohol, probably in a desperate bid to calm down. It also does not work at all, because he was not dosed with a stimulant, but a hallucinogenic. The hallucinations led to stimulant-esque effects, but with no stimulant to counteract, Sherlock would simply end up sloshed and panicking. Sherlock realizes that the alcohol is not having the desired affect, and, when he realizes he was drugged, concludes that it therefore can not have been with a simple stimulant.

ITEM FOUR: DIAGRAM B

Oral --> long-lasting VS inhale --> feedback loop

no IV/IM

BLOOD TEST NEC ASAP (check)

Breakdown:

While the identity/structure of the drug he was dosed with are important, the route/method of administration are also a huge factor of variability that affects the intensity and timeline of the symptoms. Sherlock mentions four different routes of administration, here: oral (PO), inhalation, IV, and IM (intramuscular). A drug taken orally will have slower and longer lasting effects than one that is inhaled: one that is inhaled will act almost immediately, as seen in the episode, and its effect will also wear off very quickly.

Sherlock theorizes he must have taken the drug either orally or inhaled it, because the only other options are being stuck with a needle at some point, which he is sure never occurred. (Really, there are a few other options, most notably transdermal, that is unlikely for other reasons). Because the drug affects him for so long, he assumes he must have taken it orally, but also allows inhalation a spot on the list, by noting it could have instigated a feedback loop, and continued affecting him even after it'd left his system. He also notes the need for an urgent blood test, in the case that there are still some traces left to analyze. Especially if the drug was inhaled, the blood needs to be drawn ASAP. (Without any information on the chemical structure of Drug X, though, I can’t make any sort of estimation on what results Sherlock’s own blood test would show, with the sample drawn ~8 hours after being dosed).

ITEM FIVE: TIMELINE

To the left of diagram B, eleven hash marks next to a supremely messy "hours". AKA, eleven hours of 'experimentation', after Sherlock realizes he was drugged.

(upside down-items):

ITEM SIX: FORMULA

C12H22O11

The chemical formula for a sugar, which, as Sherlock states in the episode, was his initial theory. This would suggest PO as method of administration, not inhalation, but Sherlock's also not thinking too straight, right now. Give him a break. (He's also probably got a ton more information on PO medications in his head than airborne compounds).

ITEM SEVEN: SHERLOCK'S THEORY

THC? -amyg overstim in subject

-no SNS activ

(scratched out, termed STUPID by Sherlock)

Translation:

THC? - amygdala overstimulation in subject

-no SNS activation

Breakdown (this is the most technical passage of the post, fair warning:)

The 'subject' in this case refers to Sherlock. THC, as you probably know, is is the primary hallucinogenic/psychoactive component of cannabis (marijuana). Also as you probably know, cannabis tends to reduce anxiety effects in most individuals, but in some, it results in a paradoxical panic reaction. We're not entirely sure why, but this panic reaction appears to be due to GABA paradoxical disinhibition. Essentially, in a standard patient, cannabis leads to mass increases in GABA, which is the calm-down chemical in the brain. However, in these select patients, cannabis' initial activation of GABA may lead to the brain telling the production of GABA itself to calm down, which lead to an overall decrease in GABA levels in the amygdala, which leads to a panic reaction. (Disclaimer: This is still a working theory in the scientific community, and all depends on an individual's makeup of receptors and neural circuits. This is by no means settled discussion, either the end result or its mechanism.)

Overall, irrelevant to THC and cannabis, patients with severe childhood trauma do tend to have amygdalas that are primed for overstimulation (possibly by the very process described in the paragraph above). Whether Sherlock deleted Eurus and Victor or not, those neurological affects aren't something he could just will away. This is not saying that if you have childhood trauma, you will have a negative reaction to cannabis- but it IS saying that Sherlock might be a candidate expected to have a negative reaction.

Now, given Sherlock's extensive drug history, I'm sure he tried cannabis, at some point. It is also, however, never once brought up in the series proper, which suggests he has absolutely no interest in trying it again- perhaps because he had a negative reaction the first time. The panic reaction and amygdala overstimulation would probably feel similar to how Drug X affected him, which is why, initially, Sherlock writes it down as a suggestion, and also notes that it would not directly cause SNS activation. (At this point, he is not sure if SNS activation is a direct symptom or not).

He then swiftly marks it out as a stupid theory, because he realizes that he has a very atypical reaction to THC, so the likelihood of Henry sharing his hallucination and panic is very low. More to the point, because his reaction is so atypical and unpredictable, it makes no sense that unknown criminals would drug them with it.

TO SUM UP:

Sherlock is a graduate chemist, not a medical doctor, neuroscientist, or neuropsychologist. He does seem to have a great degree of interest and expertise in pharmacology, and probably also has a lot of knowledge in different routes of administration, due to his own personal history and his interest in forensics. However, he has no need to know, for example, the exact neuro-chemical causes of hallucinations. Therefore, his sheet of data is intentionally a bit spotty and with questionable accuracy, at points. (He also gets a bit of a break, considering he was "off his tits", or whatever the fuck that means, at the time. Poor guy needs a rest and a blanket and a hug.)

And that sums up Ranowa's entirely unnecessary lecture on pharmacodynamics!