Oh John, generally he misses everything of importance but he does occasionally have the capacity to be annoyingly observant at the worst of times. Sherlock does bother with any help and slowly pushes himself to his feet.

"Well then young lady, I can say with a fair amount of certainty you're very impressive." He means that. Both in a condescending and somehow complimentary way. He stands up at straight as he can manage at the moment and tries to appear as if he's no longer in pain.