Chapter 16: Case 2 Opening - Maternity
The page comes at six-thirty AM, jolting me awake.
MATERNITY WARD EMERGENCY. MULTIPLE INFANTS CRITICAL. DIAGNOSTICS NEEDED.
I'm dressed and out the door in ten minutes.
The hospital at dawn is different—quieter, the calm before the day shift chaos. But the maternity ward is anything but calm. Nurses rushing between rooms. Monitors beeping. Parents crying.
House is already there, looking deeply uncomfortable around the bassinets. Foreman arrives thirty seconds after me. Cameron two minutes later, still tying back her hair.
"Five babies." House doesn't waste time on pleasantries. "All presenting within twelve hours. Respiratory distress, fever, lethargy. No obvious common factor."
A nurse—Murphy, according to her badge—hands us charts. "Baby #1, full-term, healthy delivery three days ago. Started showing symptoms at midnight. Baby #2, preemie, here two weeks, symptoms started at one AM. Three, four, and five all within the same window."
Foreman scans the charts. "Different gestational ages, different mothers, different delivery times. What's the connection?"
"That's what you're here to find out." House hands me a chart. "Chase, you've got Baby #3. Foreman takes One, Cameron takes Two. I'll supervise and mock you all equally."
Baby #3's chart makes my stomach tighten. Twenty-eight weeks gestational age. Born premature, been in NICU for two months. Already fighting for every breath before this new problem hit.
Babies. Of course it's babies.
I head to the NICU. The room is a maze of isolettes and monitors, each one holding a tiny human fighting to survive. Baby #3—the chart says her name is Emma Chen—is in the far corner.
She's so small. Red and wrinkled, with tubes and wires everywhere. Respiratory rate elevated. Temperature 101.3. Oxygen saturation dropping despite the ventilator.
I scrub in and approach the isolette. The parents aren't here—probably sent away while the crisis unfolds. It's just me and this impossibly fragile life.
"Okay, Emma." I keep my voice soft even though she probably can't hear me. "Let's figure out what's hurting you."
Physical exam through the isolette ports: Lungs have crackles bilaterally. Heart rate elevated but regular. Abdomen slightly distended. No rash. No obvious signs of sepsis beyond the fever.
I check her recent history. Normal labs two days ago. No new medications. No procedures. Nothing that should have caused this sudden deterioration.
What changed?
I look around the NICU. Four other babies with identical symptoms. All in different isolettes, different locations in the room. No obvious commonality.
Except they're all in this room.
Environmental?
I find Foreman near Baby #1. "Symptoms identical?"
"Yeah. Respiratory distress, fever, elevated white count but cultures negative so far." He looks frustrated. "It's like they all caught the same thing simultaneously, but there's no infectious agent we can find."
Cameron joins us, holding Baby #2's chart. "Could it be viral? Something that doesn't show up on standard cultures?"
"Possible." I scan the ward again. "But five babies presenting within hours suggests simultaneous exposure to a single source. Not person-to-person transmission."
"Environmental toxin?" Foreman suggests. "Something in the air, water, cleaning supplies?"
"Has anything changed recently?" I direct the question to Nurse Murphy. "New products, new procedures, maintenance work?"
She thinks. "We switched to a new industrial-strength disinfectant two days ago. Hospital administration wanted stronger infection control after that staph outbreak in peds."
There.
"What's the disinfectant?" I ask.
"Some quaternary ammonium compound. Supposed to be safe for use around infants." She pulls up the product information on the computer. "Says right here—non-toxic, hospital grade."
I read the label. Quaternary ammonium compounds are generally safe. But in combination with certain other chemicals, they can create toxic byproducts.
"What else are you using? Wipes, formula preparation, anything new?"
"We switched formula brands for two of the babies. Supply chain issue." Murphy checks her records. "Let me get you the list."
Formula plus disinfectant. That could be it.
House appears behind me. "Found something?"
"Maybe. New disinfectant deployed two days ago. Some babies on new formula brand. Quaternary ammonium compounds can create toxic byproducts when combined with certain organic materials—"
"Like formula residue." House's eyes light up. "In the air system. Aerosol particles."
"Babies with extended NICU stays would have the most exposure," Foreman adds. "That fits the severity distribution."
Cameron checks her patient. "Baby #2 has been here longest. Shows worst symptoms. Baby #4 just arrived yesterday, symptoms are milder."
"Test it." House pulls out his phone, already calling maintenance. "Shut down the NICU air system, open windows, move babies to clean environment. And someone test the ventilation ducts for that disinfectant compound."
The ward erupts into organized chaos. Nurses moving isolettes. Maintenance crew arriving. Parents being notified and relocated.
I stay with Emma Chen while they move her, monitoring her vitals. The moment we get her into a different ward—clean air, untainted environment—her oxygen saturation starts improving.
We got it. Environmental toxin from chemical interaction.
Six hours later, all five babies are stabilizing.
The air system tests came back positive—trace amounts of the disinfectant combined with aerosolized formula proteins created a mild respiratory toxin. Not enough to harm adults, but devastating to premature infants with underdeveloped lungs.
The hospital immediately discontinued the new disinfectant. The babies are on supportive care—oxygen, fluids, careful monitoring.
Emma Chen is breathing easier. Still on a ventilator, but her O2 sat is 95% and climbing.
I'm documenting everything when Cameron appears.
"You saved them." She looks exhausted but relieved. "Figured out the environmental connection before anyone else."
"Foreman helped. You helped. Team effort."
"You noticed the disinfectant first. Asked about changes to the ward." She sits next to me. "How do you do that? See the patterns everyone else misses?"
Because I'm running deduction powers my brain shouldn't have, trying to spot details that might matter while everyone else is focused on the obvious.
"Experience. Questions. Refusing to accept coincidence." I close the chart. "Five babies don't get sick simultaneously from five different causes. Had to be something they all shared."
"Still impressive." She stands. "Emma's parents want to thank you. They're in the family waiting room."
Mr. and Mrs. Chen are in their thirties, exhausted and terrified.
"Dr. Chase." Mrs. Chen grabs my hand. "The nurse said you figured out what was wrong. That you saved Emma."
"The team figured it out together—"
"She said you noticed the connection. That you asked the right questions." Tears are streaming down her face. "Thank you. Thank you so much."
I don't know what to say. Emma's not out of danger yet. She's still fighting. But she's fighting with clean air now, and that makes all the difference.
"She's strong," I tell them. "She's been fighting since she was born. This is just one more battle. And she's winning."
They hold each other and cry. I leave them to their relief and head back to the ward.
House is there, leaning on his cane, watching the monitors.
"Good work," he says without looking at me. "Environmental deduction, systematic questioning, pattern recognition. You're getting good at this."
"Thanks."
"Don't thank me yet. I'm still figuring out what makes you different." He turns to face me. "But today? You did what needed doing. That's worth something."
It's the closest to genuine praise I've gotten from him. I'll take it.
That night, I'm back in my apartment, exhausted.
The notebook comes out. New entry:
Case 2: Maternity Ward Environmental Toxin - RESOLVED
Five premature infants, respiratory distress from chemical interaction
Quaternary ammonium disinfectant + formula proteins = aerosolized toxin
My contribution:
Deduction: Asked about environmental changes, connected disinfectant timingPattern recognition: Realized simultaneous onset meant single exposureSystematic questioning: Found the chemical interaction
Powers used:
Deduction (primary)Disease resistance (not relevant)Lie detection (not relevant—babies can't lie)
Team reactions:
Cameron: Impressed, grateful. Seeing me as competent and caring.Foreman: Professional collaboration, building respect.House: "Good work" = high praise from him. Still suspicious but approving.
Risk assessment: STABLE
Successfully contributed without exposing unusual abilities.
Deduction is becoming my trademark—need to ensure it stays plausible.
I close the notebook and stare at the ceiling.
Two major cases. Two victories. Two steps closer to House figuring me out.
But babies are alive. Rebecca Adler is recovering. I'm doing what I'm here to do.
Save lives. Use the abilities ethically. Walk the line.
Can I keep it up?
Have to.
Tomorrow brings more cases. More tests. More chances.
But tonight, five babies are breathing easier.
And that's enough.
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