How Sherlock Survived a Cardiac Arrest

[wellingtongoose]

The Most Miraculous Thing

The medical explanation I am about to give for Sherlock’s survival is nowhere near as uplifting or exhilaration as watching Sherlock struggling out the steps of his mind palace with the sheer determination to live for John. If you want to keep thinking about Sherlock’s “revival” as a miracle of love and a testimony to our

Comments

[wellingtongoose]

Thank you for the very thoughtful comment.

I actually wrote a substantial section about the anatomy of the liver and then cut it out because I thought no one would care.

The first important thing I cut out was measurements and screenshots. From the picture I estimate the bullet wound is actually between 2-3 cm below the nipple line so it would be in the sixth intercostal space or it went through the seventh rib. I would say that it is definitely in the superior aspect of the liver. You are right in saying that it is most likely in the lateral aspect of segment 2 or medial aspect of segement 4a. The exact location of the bullet in the medial-lateral axis is more difficult to discern. I think from the images that it is around 1-2cm right of the midline, so there is a good chance that it could have land between the two great vessels.

The second thing I cut out was a discussion of surface anatomy. It was very difficult for me to estimate where the bullet was just from the shots of Sherlock whilst clothed. Even when Sherlock was a naked corpse I still had to use the nipples as surface marking in order to estimate the site of the bullet wound. If they had say covered the top half of his chest in the picture it would be very hard to say where the bullet was besides that fact it was right of the midline.

Mary is having to estimate anatomy without any guidelines apart from the buttons on Sherlock's shirt which give a rough guide to where the midline is. It is incredibly difficult to get an accurate grip of where you think the lungs end and the liver begins if your person is clad in a loose dark coat. Even the midline can be hard to get right if the person is at a slight angle and/or their shirt is slightly off center.

Mary shot Sherlock just inside the v of his suit jacket. I believe she was using his suit jacket and his shirt as rough land marks. The border of his jacket marks around 2cm right of his midline. The buttons on his shirt provide the midline. The inferior border of the suit lapel is a good landmark for avoiding the lungs.

Mary is an amazing marks man but she might not be quite as good at anatomy. As an assassin she would have learnt exactly where the human weak spots were but that usually entails learning the paths of arteries rather than veins and there is much more emphasis on targeting the heart or the head. The rest of her anatomy might be fairly basic.

She knew where the abdominal aorta was, which is why she didn't shot him in the midline but did she ever think about the vena cava? I would question whether Mary even knew where the vena cava actually is because it would have no relation to her job.

The reason why she didn't shoot Sherlock more laterally was because the further one moves away from the land marks the less accurate the estimate. The lateral part of Sherlock's body is clad in one homogeneous colour: black. This makes estimating position difficult. The colour itself makes his outline harder to accurately see in a dark room, particularly if he has his right hand by his side. Thus aiming for the midclavicular line would be much harder than aiming for a spot marked out by his shirt lapel and buttons.

[illereyn]

Yay! Glad to know my anatomy is not so bad.

Fair enough point about the limits of Mary's anatomical knowledge.