The wind took Cameron by surprise, pushing against the door before she had it halfway open, nearly ripping the handle out from between her fingers, her gloves slipping on the cold aluminum. She grabbed tightly, pulled harder and the door inched open until she could slip inside.
The cold blew in with her. She felt it push past her legs. Two patients sitting in the waiting room glared up at her as the wind reached them. It had been getting colder all day, blasting apart what had been a mild February thaw with steady reminders that it was still winter. The skies were gray and had been spitting out a cold drizzling rain off and on since midnight.
"You didn't think it was going to last, did you?" Chase had asked that morning. He wasn't due in until the afternoon, but had gotten up sometime after she got in the shower and made coffee and poured her some juice.
They'd spent the night at her place, part of the system they'd worked out to stay at the apartment of whoever had the earliest shift. They'd agreed that it would be easier and faster for that person to get ready quickly if they were in their own space. It didn't seem to make much difference where she was these days, though. Things had migrated from Cameron's closets to Chase's, while Chase's shirts had taken over one of the drawers in her dresser.
It might make more sense to just give up on their separate lives and make it official, move in together, but Cameron hadn't asked yet if that was something Chase was ready for, maybe because she wasn't sure if she was.
"I was just hoping, it might be warm just for a few more days." Cameron had said that morning as she finished her juice, then ate some toast. She'd paused for a moment in front of the kitchen sink and listened to the rain beating against the glass before she reached for her coat. "It always seems so much harder going back to the cold."
"You can't change the weather," Chase had said. He'd sat at the kitchen table, his hair still disheveled from sleep. "Maybe if you're lucky, you'll be finished before the snow hits."
Now Cameron took a long look into the ER waiting room as she passed on her way to the locker room. There were only a few people there, spread out on the vinyl chairs that lined the concrete walls.
The locker room was empty when she walked in. She took a pair of clean scrubs from the pile and put it on the bench next to her locker.
She took off her boots and exchanged them for the clogs she kept stored there. She stripped off her coat, then her blouse and dress slacks, changing into pale pink scrubs. When she first started in the ER she'd tried wearing her own clothes, even told one of the nurses that she'd thought it was important to look like a professional -- that it set patients at ease. The nurse had just laughed. By the end of her first week, Cameron understood why. She'd already ruined one vest and two pairs of slacks on combinations of vomit, feces and blood, and her feet ached from her dress shoes. When she slipped in a puddle of urine, she finally gave up.
She had a new life now, she'd told her self, so she might as well change her look. Dying her hair blonde had been her own private joke just to mark the occasion. She'd planned to let it drift back to her natural color, but never quite did.
Once she'd finished changing, she grabbed her lab coat, clipping her beeper onto one pocket and slipping her cell phone into the other. Then she checked the pockets for pens, her prescription pad, stethoscope and the other bits and pieces she'd carry around with her all day. The coat already felt heavy as it hung from her shoulders, becoming another reminder of how everything had changed. A few months ago, she had a locker up in the renovated rooms of PPTH's upper floors, a desk with a computer in the corner of the conference room that everyone had ceded to her. She'd kept nearly everything there that she'd need. Here, she had only a small locker in a cramped break room, and what she could carry in her pockets.
She glanced up at the clock. She still had a few minutes before her shift started. Cameron eyed the coffee pot, thought about pouring herself half of a cup, but didn't. She'd gotten spoiled by the brews they used to make upstairs, the way that Foreman seemed to know just how much of the grounds to put into each pot, the way they'd sit around the table, taking bets on when House would show up. Here, the coffee was either too strong, or too weak, and there was rarely any time to sit anywhere and swap stories.
She stopped, pushed the thoughts out of her mind. It didn't do any good to think about how things had been, Cameron reminded herself. She wasn't working upstairs anymore. She'd chosen to be here. She took a breath, and told herself again that she liked it here. She turned away from the coffee, checked her pockets again, walked to the door and walked out.
There were names written in color-coded ink at the nurse's station. Another white board -- just like upstairs -- but a very different set of information. She checked the colors and the shorthand code that told her what to expect: three patients waiting for an empty bed upstairs, two in queue for radiology, four waiting for final instructions for discharge, two beds empty, seven people in the waiting room. She grabbed the charts and started reading. Basic triage -- decide which patients needed to see a doctor quickly, which could wait, which should be quietly pointed toward the clinic for treatment of minor complaints.
She took in the information on each page, her eyes flitting from age to symptoms from temperature to pain levels and locations, each detail adding to the list of possible problems for each person.
"I don't have a specialty in emergency medicine," Cameron had told Cuddy when Cuddy first offered her the job. "It's not my area."
"If you can handle House, you can handle the ER," Cuddy had said. "You've seen more with him than you'll ever see there."
Cameron had studied the papers that Cuddy had given her. It would take her years to earn a senior attending post anywhere else. Just getting on staff somewhere might take her weeks -- even months. "I don't understand," she'd said. "Why ..."
"I'm trying to hold onto an outstanding doctor with years of high quality training and experience," Cuddy had said. "What's so hard to understand about that?"
Cameron hadn't given Cuddy an answer then, instead telling her she'd have to think about it. Her first reaction had been to turn her down, but she kept finding reasons why staying at Princeton-Plainsboro made sense.
"How many cases did we handle that started in the ER?" she'd asked Chase that night at dinner.
He'd looked up from his plate of pasta and salad, the dinner he'd made while she was still at work, but he didn't say anything.
"Maybe if there was someone with diagnostics training in the ER, we'd catch more cases earlier." She'd stabbed a tomato slice from her salad. "That makes sense, right?"
He'd stared at her for a moment. "You realize you wouldn't be working for House, right?" he'd finally asked.
"Of course," she'd said. "I'm just saying that I can use my diagnostics training in the ER just as well as I could in immunology."
Chase had finally nodded, looked down at his plate again and began twirling his fork in a mound of spaghetti. "Sure," he'd said. "That makes sense. Who knows, maybe someone who knows what House is looking for might be able to get him to take more cases." Then he'd stopped, and chuckled at his comment. "Or not," he'd added.
Cameron had sat back and studied Chase. It had been more than a week since House had fired him, nearly a week since she'd resigned. While she went in to the hospital every day to finish out the last days of her two-week notice, he'd been at home. She knew he'd been considering his next move, but he hadn't told her what it would be.
"Would it ..." she'd started, then took a breath. "Would it bother you if I took Cuddy up on her offer? I know you haven't had any offers yet."
"Yes I have," Chase had interrupted her. "Cuddy called the day after House fired me, gave me the same offer for the ER."
"What?" Cameron knew her voice had climbed half an octave. "Why didn't you tell me?"
"Didn't seem important. I turned her down."
Cameron hadn't said anything, but Chase had read the question on her face. He leaned across the table toward her.
"I've worked in the ER," he'd said. "It's not my style."
"How do you know?"
"I know," he'd said, "besides, I've been thinking of going after another specialty too."
Why, Cameron had almost asked, but then remembered that she'd be adding another specialty herself if she took Cuddy up on her offer. "Which one?" she'd asked instead.
Chase had paused again for a moment. She wondered sometimes since then if he'd even decided what it would be until that moment.
"How many times have we seen something in the OR that never showed up on a scan, that wasn't on an MRI or an X-Ray?" he'd asked. "Exploratory surgery is all about diagnostics, right?"
She'd nodded. Two days later, she'd signed Cuddy's contract, and Chase found himself a spot in the surgical residency program, with Cuddy smoothing his path.
And now here she was, in the ER with its concrete walls, and uncomfortable chairs and beds with thin mattresses. Nothing here was designed for long-term use. See the patients, diagnose them, send them on. Everything was about speed.
It hadn't been easy to make the transition. She'd told House that she was getting her "caring" out of her system, and it wasn't quite a lie. There was no time to get to know each patient personally. No discussions about parents or grandparents or loved ones beyond standard medical histories. No break-ins at their homes or offices. That was someone else's job now.
Cameron kept reading and told herself that she wasn't jealous of House's new team, or of Foreman who'd ended up back in the conference room with its white board and glass walls.
Thirty-two-year-old male, she read, high fever, abdominal pain, nausea. Appendicitis, she thought briefly, then read the name again. Charles Osbourne. It seemed familiar. She looked over the pages again, saw he'd been there just a little more than a week earlier. She walked over to the computer, logged in and pulled up his information.
She'd seen him then, but it was a case of fever, coughing with congestion and a sore throat. She'd diagnosed him with a bad case of the flu and sent him home. She'd told him to follow up with his own doctor if he didn't get better.
Now the fever was higher, and with abdominal pain and nausea. She wondered what she'd missed.
Cameron nodded to one of the nurses. "Let's get him back here," she said.
Osbourne was sitting on the bed when she got there, his wife standing next to him. Cameron remembered seeing her the last time too. She'd been anxious, worried, and he'd admitted quietly that he'd only come in to make her happy. She didn't look happy now.
"He's getting worse," she said, before Cameron could say anything.
Osbourne was hunched forward, sitting on the side of the bed, his legs dangling a few inches off the floor. "It's not that bad," he said, but his voice was weak and rough, betraying his words.
"We saw our doctor on Monday," the wife said. "He prescribed these." She handed over a bottle of erythromycin. Maybe a third of them were missing.
Cameron shook her head, but didn't say anything. Antibiotics wouldn't have done any good for a virus, but they were easy to prescribe, and made patients and their families feel better.
"He seemed to get better," the wife said. Cameron wished she'd looked up the wife's name in Osbourne's records. "Then this morning, he could barely get out of bed, and he started vomiting."
Osbourne shook his head. "I got sick last night," he said, then looked at his wife. "I didn't want you to worry. I thought it would go away."
Cameron held back a sigh, and tried to quiet the voice in her head that sounded like House and its comments about how patients were idiots. Instead, she smiled at the wife, and thought that she seemed to relax just a little. "Now that you're here, let's go ahead and take a closer look, see if we can clear things up."
The wife moved out of the way, and Cameron put her hands on either side of Osbourne's neck, feeling the heat from his fever, and swollen glands under his jaw. He looked pale -- just another nonspecific symptom, she thought, but opened his chart and marked it down.
"Let's get a new set of vitals, and let's get some blood for a Chem-20," Cameron told the nurse, who nodded, and walked around the bed to get the BP cuff. Cameron glanced at the "next of kin" name on the chart before she closed it. "Jennifer Osbourne," it read, "wife."
"I need you to lie down," Cameron said, and stepped back a little to give him room to move.
"Do I have to?" he asked.
"I need to check your abdomen so we can try to rule out appendicitis," Cameron said, then looked at him again, the way he was leaning forward. "Why don't you want to lie down?"
He still didn't move. "It ..." He looked at his wife, then down at the floor.
Osbourne looked at Cameron. "It hurts more when I sit back," he said.
"Your stomach?" Cameron stepped closer to him.
"My chest," he said, then quietly added, "I've got the worst case of heartburn, and it's worse whenever I lay down." He shrugged slightly. "Crazy, huh? I've got heartburn when I can't keep anything down."
It wasn't crazy, Cameron thought. It was another symptom. But it didn't sound like heartburn. Or the flu. She took her stethoscope out of her pocket.
"Sit still," she said, and put the earpieces in her ears. She raised the stethoscope to his chest. "I just want to check something here."
"Pericardial effusion in a thirty-two-year-old male." Cameron didn't bother holding the chart out to House yet. She knew that wouldn't be enough, but knew she had to have an opening card to play.
She knew he'd been in the clinic, knew he'd head straight from there to his office, knew he'd be looking for an excuse to sit and read something. A new patient's file was as good as anything else. It was the best time to get his attention, if she could catch him before he made it to a TV.
House didn't even bother looking at her as he walked out of the elevator and turned toward his office. "So call cardiology."
House passed the hallway to Wilson's office.
"I would if it were just a heart condition," Cameron said. "We removed eighty milliliters of fluid from the pericardial sac, but his condition hasn't improved. There's also fever, nausea and tenderness in his lower right quadrant."
"Infection," House said. He slowed slightly as he passed the conference room. Two more steps and he pushed open the door to his office. Cameron followed him.
He walked through the room, past his lounge chair. He passed the TV without turning it on. He came to a stop on the far side of his desk, staring out the door at the gray sky. Cameron heard the whistle of the wind as it tried to force itself past the door and windows. It had gotten colder, the rain changing to snow -- tiny flakes battering themselves against the glass.
Cameron could see House reflected in the glass, but it wasn't dark enough outside to see details, to make out the expression on his face. "The white count is normal," she said, "and he's already on antibiotics."
House turned to look back at her, his head slightly cocked to one side. Cameron tried to hold back her smile. She'd missed this moment -- that split second when she'd see that she'd gotten his attention, when she could sense his mind coming alive to every possibility, see the light in his eyes change from some faint reflection dimmed by drugs and pain to become something brighter, something that flickered and became stronger with each new clue, something that she'd only sense for a half of a breath before he'd turn away and hide it again.
She held out the file.
He took it, then sat. He slouched back in his chair and swung his left leg onto the corner of the desk, then lifted the right on top of it, crossed at the ankles. He opened the file.
Cameron looked at his feet. "You're wearing boots," she said.
House nodded. "Yes."
"You never wear boots."
He looked at her over the top of the file, then at his own feet. "Apparently, I do." He flipped over a page in the file, kept reading.
Cameron shook her head. "You always wear sneakers," she said.
"Apparently I don't," House said, "and he's only had garden variety antibiotics." He closed the file, held it in the air between them, not extending it toward her, but not ready to keep it for himself yet. "And your blood tests are useless. The really cool stuff always hides from blood work." He shook the file at her. "He just needs something targeted to the infection."
Cameron ignored the file, and crossed her arms over her chest. "Sure," she said, "but then first someone would have to find what kind of really cool infection it is in the first place."
"And I suppose you want me to do your dirty work." House lowered the file slightly.
Cameron didn't say anything, waited for House to make his move. House looked away, staring at something off in the corner of the room, at something only he could see.
Finally he looked at her again and nodded. "Fine," he said.
He swung his legs off the desk and stood. She stepped back to give him room and watched as he walked into the conference room. "New case," she heard him say, then the door closed behind him. She saw him toss the file onto the table and Taub reached for it, opened it. Kutner got up and stood behind him to read over his shoulder.
House kept walking over to the white board and picked up a marker.
Cameron wanted to follow him, to tell them what she knew, what she suspected, but that wasn't her job anymore, she reminded herself. That wasn't her place. It wasn't where she belonged. Not anymore.
Her pager went off and she looked at it, recognizing the extension for the emergency room. She took one last look through the glass, then walked away.