CHAPTER 33: CASE 5 OPENING - PATIENT ZERO
The page comes at 6:47 AM, three hours after I finally fell asleep.
Emergency transfer. Isolation ward. Now.
I'm still wearing yesterday's clothes when I arrive—the date clothes, because I'd been too tired to change after driving home. Cameron catches my eye across the diagnostic room, and something passes between us that I don't have time to examine. Everyone else is already there: Foreman reviewing a tablet, House standing at the whiteboard with his weight shifted off his bad leg, Cuddy in the doorway looking like she hasn't slept either.
"David Chen," House says without preamble. "Thirty-five, aid worker, just medevaced from West Africa. Bleeding from his nose, gums, and eyes. Fever of 104. Organ failure beginning." He writes HEMORRHAGIC FEVER on the board in block letters. "CDC's on their way, but they're three hours out. We've got full isolation protocols in place, which means nobody's actually examined him yet."
"Ebola?" Foreman asks.
"Could be. Could be Marburg. Could be Lassa. Could be something we've never seen before." House turns to face us. "Mortality rates range from 'you'll probably be fine' to 'start writing your will.' We won't know which until someone gets in that room."
The silence that follows is the particular kind that happens when everyone is calculating their odds of survival. I've been in rooms like this before—in my previous life, during flu seasons that turned ugly, during the early days of outbreaks that hadn't been named yet. The math is always the same: someone has to take the risk.
"I'll do it," I say.
Cameron's head snaps toward me. "Chase—"
"Someone needs to examine him. Full physical, samples, proper history if he's lucid enough." I keep my voice steady. "BSL-4 protocols aren't possible here. Standard isolation is what we've got."
House's eyes fix on me with an intensity that makes my skin prickle. "Interesting volunteer."
"I'm the logical choice."
"Why?" The question is a scalpel. "Why are you more logical than Foreman, who's done infectious disease rotations? Or Cameron, who's an immunologist?"
I've prepared for this moment since House confronted me about Marcus. The cover story is ready, technical enough to sound real, vague enough to be uncheckable.
"Documented HLA variant," I say. "Hyperactive immune response. My body fights off pathogens faster than normal. It's in my medical records—Cuddy can confirm."
Cuddy nods, though her expression suggests she's only partially following. "He filed paperwork about unusual immunity when he was hired. Something about genetic markers."
"So you're telling me you've got a superpower." House's voice drips with sarcasm, but underneath it is something sharper. Curiosity. Suspicion.
"I'm telling you my odds are better than anyone else's. That's all."
Cameron steps forward, grabbing my arm before I can move toward the door. "You don't have to prove anything. Not to him."
"This isn't about proving anything." I meet her eyes, seeing the fear there—fear for me, specifically, which is still new enough to feel strange. "Someone has to examine the patient. If my immune system gives me even a small advantage, I should be the one taking the risk."
"And if you're wrong?"
"Then I get sick, and you help me get better."
She doesn't let go of my arm. For a moment, we're not colleagues in a crisis—we're two people who kissed in a parking lot last night, and one of them is about to walk into a room with a potentially lethal pathogen.
"I'll be careful," I say quietly. "I promise."
House clears his throat with theatrical impatience. "If you two are done with the Hallmark moment, we've got a patient dying of something that might also kill the rest of us."
Cameron releases my arm. Her fingers trail across my wrist as she steps back—a touch that says come back.
The isolation ward smells like bleach and fear.
I suit up in the anteroom: two layers of gloves, N95 respirator, face shield, full gown, boot covers. Not BSL-4 level protection—we don't have those capabilities—but as close as we can get. My hands are steady as I seal each layer, muscle memory from a career that technically belongs to someone else.
Through the observation window, I can see David Chen. He's conscious but barely, thrashing weakly against restraints someone added to keep him from pulling out his IV. Blood crusts around his nostrils and the corners of his eyes. His skin has taken on a grayish pallor that I recognize from the worst cases—the color of someone whose body is shutting down.
House is at the observation window when I approach the door. His reflection overlaps with the dying man beyond the glass.
"Thirty minutes," he says. "Full exam, samples, whatever history you can get. If you start feeling symptomatic—"
"I'll signal immediately."
"If you start feeling symptomatic, you're already dead, so don't bother signaling. Just try not to contaminate anything on your way out."
Classic House. I'd smile if my face weren't covered.
The airlock hisses as I step through. Negative pressure, keeping whatever's in this room from escaping into the hallway. The patient's monitors beep their steady rhythm—steady for now, but the numbers are all wrong. Blood pressure dropping, heart rate elevated, oxygen saturation dipping every few minutes before climbing back up.
"Mr. Chen." I keep my voice calm. "I'm Dr. Chase. I'm going to examine you."
His eyes focus on me briefly, then slide away. "Rats," he mumbles. "Told them about the rats."
I start the exam.
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