When Cuddy woke up the next morning, she quickly realised that it was actually the afternoon. There was a certain amount of panic when she got up, scrambling rather ungracefully onto one of the oriental rugs on the floor, but she suddenly remembered last night's conversation with Anna and found herself rather relieved that the quiet woman kept her promise of leaving them alone to their own sleeping devices. She stood up straight and tipped her head forward, looking down at her borrowed pyjama top as she tied her hair back. After walking to the door as quietly as possible to avoid waking House, she opened it and looked outside to see that he was already in the courtyard. She peeked back and realised that what she believed was House in the half-light of the room was really the two dogs curled up partially under the sheets. She sighed.

'Come on, you two,' Cuddy said, and the dogs immediately perked up and jumped off of the bed, stretching theatrically before walking past her and into the courtyard.

As Cuddy closed the door to the room, Anna appeared from the room next to theirs, a clipboard held on her left forearm as she wrote notes with a slightly dour face. Seeing her in daylight was very different -- she looked exactly like the young woman in the pictures on Agbo's computer rather than a tired, older version. She pushed stray hair back from her face, and once she saw Cuddy in her peripheral vision, she closed the patient door quietly and looked up at Cuddy with a smile.

'Good afternoon, Dr Cuddy,' Anna said in a soothing tone. 'Did you sleep well?'

'Yes,' Cuddy replied. 'Thank you so much for letting us sleep in.'

'Dr House actually only slept until a little after sunrise,' Anna said, tapping her pen on the clipboard as she walked up to Cuddy. 'Is that odd? You look sort of confused.'

'What's he been doing?' Cuddy asked with a raised eyebrow as she walked to the stairs, setting her hand on the pillar on the left side.

'He asked for all of our patient records and has been reading the narratives,' Anna replied, holding the clipboard to her bottom lip. 'There's been a lot of laughing.'

'What's your charting style?'

'Exception.'

'Fabulous,' Cuddy groaned. 'So in other words, he's been able to read only the most horrendous things that have occurred here at the clinic.'

Anna furrowed her brow. 'I suppose you could put it that way.'

Cuddy watched House's back as he sat at the table with a foot-tall pile of folders on his right and a three-inch-tall one on his left. As he finished looking at the chart that was in front of him, he took it and placed it atop the larger pile before taking another chart. He flipped it open as a woman walked over to him and placed a steaming mug of coffee by the left chart pile.

'If you're interested, Grace is starting to make lunch for the patients,' Anna said as she began walking down the stairs. 'You could maybe see what Dr House is looking for.'

'You didn't ask him?'

'No, of course not,' Anna said audaciously as Cuddy followed her down the stairs and into the courtyard. 'He looks like he's in the zone. If he's finding out something to help Natalie, I don't want to disturb him.'

Cuddy nodded before walking past Anna, crossing the courtyard past a couple of rickety looking benches and the fire then reaching House's table. She walked around it and sat down on the far side.

'Anna says you appear to be in the zone.'

House didn't bother looking up at her. 'If we're talking about the Twilight Zone, then yes, I am.'

'Are you looking for anything in particular?'

He did a little snort laugh. 'No. This is a playground for people who hold doctorates in infectious disease. These are the kinds of cases that they told us to never expect to see because although they're insanely fun, they're nowhere near the first world.'

She pulled one of the files from the shorter stack and opened it, setting it down in front of her to read the first few pages. 'Ah, wonderful, myiasis.'

House stopped reading and looked across to her.

'And look, Polaroids,' she groaned, holding the photographs up like she was playing poker with them.

'Let me see!' House said in a theatrical, whiny tone.

When she handed them to him, he looked over them slowly, flipping from picture to picture and studying each with narrowed eyes. He kept murmuring under his breath, wagging his eyebrows each time he pulled one of the photographs closer to his eyes. Occasionally, he looked up at her expectantly as though he was going to say something about the photographs but then apparently decided whatever he was going to say was even tasteless for him, so he kept it to himself. Cuddy kept watching this pantomime until Anna and the cook came over, the cook holding two bowls that she set down after Anna cleared the files away from in front of House.

'Grace made you some red red,' Anna said as she made the files into a neater pile. 'It's a sort of black eyed pea stew with fried plantains. Very tasty.'

Anna looked at the open file that Cuddy had pushed to the side, pulling it toward her and holding out her right hand to House.

'Please, I need the pictures back, Dr House,' Anna said.

'If you let me see this patient,' he said, waiting for approval of this statement before relinquishing his Polaroid rights.

'I figure you'll want to meet every patient,' Anna replied pleasantly as House handed her the photographs. 'After all of the patients eat, we'll go work on her.'

'And when you mean work...?' House started, his hand now hovering over his spoon.

'I mean just what you're thinking,' replied Anna before closing the file. 'Let me make sure that our assistants are taking care of patient meals and I'll be right back.'

When she walked back over to Grace, House and Cuddy began eating. The food was amazingly palatable and it was for that reason that they remained silent for the two minutes that Anna was gone. Once she'd assured everything was running smoothly, she came over with her lunch and a plate of pineapple for them all, setting it down in the middle of the table before sitting next to Cuddy.

'In the name of the Father, the Son and the Holy Spirit, amen,' Anna said, crossing herself and folding her hands as House openly stared at her. 'Bless us, oh Lord, and these thy gifts which we are about to receive from thy bounty through Christ our Lord, amen.'

She crossed herself again then smiled at House before taking a bite of her red red. He looked back down at his food, stirring it.

'So,' she said, then tapped her spoon once on the side of the bowl as though the sound would diffuse the discomfort between her and House. 'Natalie called a few minutes ago to tell me she'd be back by tomorrow.'

'Good,' House replied. 'I can have fun with the myiasis girl, check out some awesome third world grossness and diagnose the HIV woman in less than five days.'

He reached out and took a piece of pineapple, taking a bite of it before speaking through half-chewed fruit.

'Life is good.'

'I didn't know she could call you,' Cuddy said.

Anna dug into her pocket and retrieved an ancient-looking Motorola that had 'GH ONEtouch' typed across the middle of its bright blue screen. Despite the feeling of being in the middle of absolute nowhere, the little satellite icon in the top left corner showed full service.

'A lot of people including Natalie use another carrier called MTN, but I don't get good international service with it,' Anna said, flipping around the phone to look at the screen. 'I like to be able to call my parents whenever I want to.'

Anna set the phone on the table.

'Natalie doesn't have anyone to call,' she continued before looking up at them. 'But yeah, she'll be here soon enough.'

'Does she know we're here?' asked Cuddy as she watched Anna put the phone back into her trouser pocket.

'No, and I don't plan on telling her,' Anna replied then laughed. 'If I did, she might not bother coming back!'

'We should try to diagnose her before she comes back,' House said between bites.

'I'd like to see that,' Anna said with a snort and House gave her a condemning look at her doubting flippancy; she backtracked. 'She doesn't keep medical records on herself for whatever reason.'

They continued eating, Anna looking up every now and then to watch her underlings bring partially-consumed meals on trays out of rooms and study them before writing down how much the patients had eaten. She would slow down as she watched them, taking a pinch of food and holding it at her lips until the assistant had walked away. Conversation completely dropped as they finished their meals, all eventually getting to the pineapple and some cold Milo that Grace brought to them. Anna was the last to finish, grabbing all of their plates and taking them over to Grace before washing her hands in a covered basin filled with rather clear water. Once she'd dried them off, she walked back over to House and Cuddy, taking the files into her arms and holding them to her chest.

'Shall we go to the office then?'

Without waiting for a response, she turned around and walked up the closest stairs and under the eaves. House and Cuddy both stood, following after her as she walked to the front entrance, turning left toward a door that neither of them had noticed the night before. Inside, Anna dropped the pile of files onto the desk and began slipping them one-by-one into alphabetised slots.

'This is our office,' Anna said as she put one of the files into a slot that was numbered rather than lettered. 'Please, sit.'

Both of them came in and sat, Cuddy looking around the room to take in the environment. The office was painted much like the hospital in Kumasi, the same warm tones that really didn't help with the perception of heat gracing each wall. The desk was massive but a rectangle rather than the L of Agbo's desk but the chairs were the same as his -- this kind of chair was obviously the highest class of Ghanaian chair available. To the left of the main bookcase was a door with a biohazard symbol on it.

'So like I said,' Anna began as she slipped the final chart onto the bookcase. 'Natalie doesn't keep a medical file here, but I'd be glad to answer questions. I bet I could answer them better than Kwame.'

'How long have you known her?' asked Cuddy.

'I've been in Ghana for nearly two years,' Anna replied, sitting down behind the desk and looking at them. 'I worked at KATH then came up here soon after Natalie got back from her long trip to Australia.'

'And when was that?'

'Um... hm. I guess about a year ago,' she said, leaning back in her chair looking pensive. 'Yeah, it was. I spent Independence Day down in Kumasi then came up here during the Commonwealth Games.'

She spoke confidently as though House and Cuddy should have known exactly when these things occurred. Neither of them asked for more details in an attempt to save face.

Cuddy remembered what Agbo had mentioned about Natalie's time in Ghana. 'Did you work at KATH at the same time as Dr Chase?'

'No,' Anna replied. 'She had already gone back to Australia by the time I got here. Here to Ghana, that is, not to Sumpini.'

'In my department, there's an Australian named Robert Chase,' House said, leaning forward to put his hands on the desk. 'Do you know if she's related to him?'

Anna considered this. 'No. All I know is that her parents died within a few months of each other about a year and a half ago. She's never mentioned any other family.'

'No siblings? Has she been married?' House pried.

'None that she's mentioned,' Anna repeated.

'What did her parents do for their livings?' Cuddy asked.

'Her mom was a doctor, but she hasn't mentioned much about her dad.'

'What is her hometown?'

'I just know she's from Australia.'

House and Cuddy looked at each other with exasperation before House continued.

'Do you know where she got her degree?'

'Ah, now that I do know,' Anna said delightedly. 'She has degrees in pharmacoepidemiology and communicable disease epidemiology from the University of Newcastle.'

'I mean... is there absolutely anything else you can tell us, medically or personally?' Cuddy asked.

'She had really bad epilepsy when she was a kid but it's pretty much been under control until a couple of weeks ago. When she was about five years old, she had a seizure that was bad enough that she fell down the stairs and cracked her skull, had to receive a lot of blood and spent a few months in the hospital,' Anna said. 'And after that HIV test came back positive, Natalie told me that that was when she received the tainted blood that led to her HIV positive status.'

There was the clicking of the dog nails and Baring came in, stopping by Cuddy for a head scratching before walking over and laying in a dog bed next to the bookcase.

'The dogs belonged to her father,' Anna offered. 'She brought them back with her from Australia and neither of them were happy about it at all.'

Baring moaned and sighed.

'I think they've done a good job of adjusting though, and they seem to have helped Natalie's coping with her parents' deaths.'

They fell into silence once more, a common occurrence in this odd, ambient soundless place.

'I want to see that patient,' House said, pointing to the one file that Anna had left out.

Anna nodded. 'Let's go see her then.'

All stood, Anna keeping the file with her despite the fact that House looked as though he physically ached for the touch of the file's manila skin on his own. They walked out, Anna nearly running into Martin as he made his way into the office to curl up with his sister. They made their way through the courtyard then took a sharp left and finally stopped at the room next to the one that Anna had left that morning after Cuddy woke up. Anna stood in front of the door and turned to them.

'Her name is Mercy Nsiah and she's ten years old. She came to the Damongo hospital three days ago because of intense pain in her nose and boils on her back, chest and shoulders,' Anna said in a hushed tone. 'The doctors at the hospital identified the boils as botfly larvae but after seeing up her nose, they sent her to us because she requires more specialised and extensive care. They've all seen the boils and do the extractions for that, but...'

Anna took a deep breath.

'There are maggots everywhere,' she continued. 'We've cleaned out the ones in her nose, but they managed to migrate before she got here. I've pulled them out of her ears, they've gathered in a hole in her palate, we're still trying to get those botflies out because not all of them had come to a head. Just try to be calm about it because she's very uncomfortable. Today we're trying a new technique that I read about in a Malaysian journal article about myiasis -- one of our assistants brought some turpentine from Damongo and we're going to use it to flush out the maggots.'

After nodding to herself, she opened the door and walked in, turning on the lights and immediately saying something including their names to the girl. She moaned in response and Anna gestured to them as she checked the girl's IV site and injected a bolus of what they assumed was some sort of analgesic into the port on the girl's hand. House stood at the door and allowed Cuddy past him before going in and closing the door quietly. Cuddy walked to the end of the bed and laid her hands on the footboard, looking up at the girl. House waited by the door and watched Anna gather the supplies. Once the metal plate was full of what she needed, she rolled it over to the bedside, the thing squealing horribly as the wheels jammed around in their covers.

'We've already tried saline for the oral and nasal myiasis,' Anna said as she lined up the supplies then said something to the girl which caused her to open her mouth. 'Come around on the other side and you can see what a miserable failure that attempt was.'

Cuddy stayed where she was but House walked over and stood on the other side of the bed, looking down into the girl's mouth where he could see grey squiggling things fighting in her palate. Many of her teeth were missing and the ones that remained were various shades of yellow and black.

'We're attempting to encourage oral hygiene in the family,' Anna said as she opened a bottle of turpentine -- the aroma washed over them like a thousand paint-killing olfactory memories. 'We'd like her younger siblings to avoid this problem.'

'Obviously,' House said.

'Can you put the head of the bed up?' Anna asked as she dropped a large cotton ball into an emesis basin of turpentine. 'If this works like they talked about it Malaysia, we're gonna want her up so she doesn't choke on the maggots.'

House looked at the side of the bed, suddenly unsure of the procedure around an insanely old-school bed.

'The foot of the bed,' Anna said, laughing at the mystified look on House's face. 'There's a crank. Can you get it, Dr Cuddy?'

'Of course,' Cuddy said, crouching down and cranking the handle -- it was incredibly noisy, but Anna and Mercy didn't seem at all phased by it.

'Now, if you'll come and sit next to Mercy on the bed,' Anna said, looking at Cuddy. 'Just sit near Dr House.'

Cuddy seemed unsure about this, but came around and sat down without protest, finally looking into Mercy's mouth as one of the maggots lost its grip and dropped onto her tongue. House and Cuddy both flinched as Mercy leaned forward and it fell onto the sheets.

Anna said something to Mercy in a slightly berating tone and she leaned back again as Anna reached out and handed another emesis basin of turpentine to Cuddy.

'Hold this right under her chin,' Anna said, then turned back and grabbed the cotton ball of turpentine in a pair of forceps. 'Would you like to do the honours, Dr House?'

He shrugged, trying his best to appear bored despite the fact that this was one of the most exciting and disgusting opportunities he'd had in awhile. 'Why not?'

She handed the forceps over Mercy and House took them, leaning down to put it in Mercy's mouth. As Anna gave Mercy instructions, House held the turpentine-impregnated cotton ball up near the area where the maggots were congregating. Almost immediately, they began rushing out of the area. Anna helped Mercy lean forward and dozens of writhing maggots spilled out of her mouth and into the emesis basin. After each splashed into the liquid, it was dead within seconds. Once the flow ebbed, House removed the cotton ball and Anna quickly leaned in to examine the area with her penlight. Pleased with the results, she took a syringe of normal saline and sprayed it into the area.

'Looks good,' Anna said, looking over at the emesis basin in Cuddy's hands; rather than taking it from her, she simply leaned over and picked up the maggot that fell from Mercy's mouth, rather unceremoniously dropping it into the basin with her bare hands. 'Next task then...'

Cuddy stood, looking down at the basin of dead maggots and walking slowly around the bed to set them on the instrument tray as Anna pulled back Mercy's covers and exposed the girl's chest.

'Wow,' House murmured and Cuddy was tempted to leave the room right then, but for some reason made the mistake of turning around to see what was worth wowing about.

Dotted all over the girl's chest were healing bright red spots, a few brownish yellow bumps and, the most horrifying of all, two places where grey-yellow larvae were sticking out a quarter-inch from her skin.

'Ooh, good, look at that,' Anna said as she looked between the larvae and House. 'Want to have another go?'

House held himself back from obvious schoolgirl bliss and handed the forceps over to Anna, receiving a pair of tweezers in response.

'Grab them right at the head,' she said, pointing at the end of one of the botfly larva with her pinky finger. 'Don't play around with it; when you grab it, pull it out and don't let it break.'

Without the slightest hesitation, House grabbed onto the one closest to him and yanked it out as Mercy moaned groggily; Cuddy found herself wondering exactly how much analgesic Anna had given the girl when they walked in. House held the larva aloft, looking at it carefully as it wiggled around on the end of the tweezers.

'Basin?'

Cuddy reached for the emesis basin again, stepping forward to hold it over the girl as House dropped the larva in to join its maggot brethren. The second extraction went just as quickly, House watching the larva that time as it writhed and died. With that sensation that follows a job well done, House stepped back and watched Anna examine the botflies that hadn't yet erupted.

'That's really the only interesting part,' Anna said from close to Mercy's chest, rubbing a gloved finger over one of the welts. 'If you two want to go do something else, feel free. I just need to bandage her and clean up in here, then I'll come and get the two of you to meet the other patients.'

She stood straight and looked at them.

'Go out into the courtyard and ask for Muwinyo. She's making a trip into town and will pick up clothes for you, but she needs to know your measurements,' Anna said as she took the emesis basin from Cuddy. 'If you don't mind, I'd rather you stay here at the clinic instead of me taking you into Damongo -- we got a few more patients this morning, so I don't think I can get away long enough to acclimate you to the town.'

'I don't think we have a problem with that,' Cuddy replied for both of them before looking down at the oozing wounds on Mercy's chest. 'You're sure you don't need anymore help?'

'Just lower the bed on your way out. I have this handled.'

'Do you get a lot of cases that are as bad as this?' House asked, slowly making his way toward the door.

'We get the worst of the worst,' Anna said in an unreadable tone. 'I've seen diseases here that I never thought I'd ever see, things that I'd heard about at Harvard but sort of assumed they were urban myths. Africa certainly isn't the real world, Dr House.'

Cuddy went to the foot of the bed and lowered it once more and as she did so, Mercy coughed and another maggot fell out. Anna laughed, grabbing it and dropping it into the basin, and Cuddy darkly looked over the footboard at her. They met eyes.

Frowning, Anna spoke. 'Dr Cuddy, when you've been here as long as I have, you have to laugh or you'll just cry all the time.'

---

A/N: First off, thank you for reading and reviewing! I adore getting story reviews in my eMail especially considering this time of year -- I just took my fundamentals of nursing final and Thursday is my pharmacology final, so having happy little breaks where I read wonderful reviews really makes my day. I love that all of you seem to really be enjoying Occlusion and the comments about my characterisation of House and Cuddy are definitely my favourites!! I really hope to finish writing this over the holidays and then attempt to do a weekly update to the end -- currently, I believe it will be about twenty to twenty-five chapters, but we'll see where that goes, heh.

For those who haven't been reading since the beginning, yes, I've been to Africa. I work at a school for mentally challenged students in Kledjo, Ghana, West Africa, which is outside of Hohoe in the Volta region. I spend at least a month there during the summer. Occlusion takes place in the region of West Gonja which is a sixteen-hour-long drive from Hohoe -- I know this because I had to make that drive last summer. All of the details in the ride from Kumasi to Sumpini are from my own experiences during that drive from hell including the horrible tour guide, Posse and the hitchhiker. ALL of those events occurred -- pushing the van, not being able to turn, the speedometer breaking, pieces falling off of the van, speeding through towns and of course that atrocious road from Fufuitso to Larabanga. I've heard it's worse coming from Tamale to Larabanga, but I highly doubt anything could be worse than the Kumasi-Larabanga route, ugh.

If you want to see pictures from Ghana, my Flickr is my homepage on my author profile. If you ever have any questions, please PM me and I'll be happy to answer when I get the chance.

So yes, thanks for reviewing and I hope I'll get this all finished very soon (with the possibility of a sequel, ha!). Enjoy watching House tonight -- I hear there's some Huddy, wahahahaha!!