There was palpable silence between Sumpini and the closest large town, Busunu, but somehow it managed to avoid being awkward. At Busunu, House stopped for a moment to allow a group of goats to cross the road and Anna took that opportunity to begin giving directions -- it was a right up ahead and from that point, she'd pull at his shirt to guide him rather than yelling over the rather loud motor. They powered through the dirt, driving past small thatch encampments surrounded by millet fields and cacao orchards. About forty minutes after they'd left the clinic, they finally arrived at a completely unmarked village. Anna tugged at the left of his shirt and he turned, stopping the motorcycle in front of a circle of five houses. Once he kicked the stand down, Anna slipped off of the back, handing him his cane before stretching. He took the cane and stood, staring at the mud-and-thatch houses in front of him as Anna unloaded their supplies. Once she gathered everything, she stood beside him and looked up.

'We have just one patient in this village,' Anna said, holding up a file and letting the biggest bag fall into the crook of her arm as she handed it to him. 'Yaa Addo.'

He took the file but did not open it. 'We drove almost an hour to visit one patient?'

Anna gave him a dark look before brushing past him to run to the middle of the circle of houses -- a woman had walked out and yelled Anna's name. As she reached the woman, the woman threw her arms around Anna as they both began to chatter at the same time. House watched from the outskirts for a moment before Anna began looking at him almost imploringly. He had almost made it to her when a small face peeked around the doorway of the hut from which the woman had appeared. Anna took one step toward him and took his arm.

'That's Esi. She speaks fluent English. She'll take you to Yaa and knows everything that needs to be done,' she said simply before passing off the largest bag, which was embroidered with 'Cader' in frilly letters.

Once she'd returned to conversation, House listened for a few moments before walking past them with the bag thrown over his shoulder. As he came closer, the child disappeared from the door and one by one the dirty cloths covering the window holes in the mud walls of the house slid open. He had only a moment to glance at the chart before the girl, clad in a faded brown and orange school uniform, reappeared at the door and held out her hand professionally.

'Mma aha.'

House considered this seemingly unfamiliar string of letters before something clicked. 'Yemu.'

'I am named Esi. We have not met, sir,' she said in relatively stilted speech. 'How are you faring in Ghana, sir?'

'Fine,' he said a bit shortly. 'Nurse Cader said that you'd take me to Yaa.'

The girl gave a half smile then stepped aside, casting her open hand at the area behind her. 'I welcome you to our home.'

He began walking past her and she immediately took the bag from his shoulder, awkwardly pulling it over the chart before turning to walk to one side of the room where she set the bag down and looked back to wave him over. As he walked toward her, she slipped back a sheet that was hanging from the ceiling to reveal a small woman curled up on a reed mat. Esi smiled at him once again before crouching down and shaking the woman's shoulder.

'Mama,' she said softly. 'Mama, wake up. The doctor is here.'

House once again opened the charting, aiming to do more than look at the patient's name this time around. He glanced over the cover sheet that carried the woman's history and diagnosis including a relatively recent CD4 count and viral load test, both presenting abysmal numbers. He flipped to the next page, stopping to look at a Post-It note with a single word on it: 'palliative'. It wasn't Cader's flowing writing that he'd seen written on the charts he'd read at the clinic, but rather a strict print that just screamed Natalie Chase. He brushed his finger slowly around the worn edges of the note before looking at the long list of ailments that the woman had endured from oral thrush to diarrhoea. She began to cough with the effort of failing to sit up, and without even looking at her, House spoke.

'Tuberculosis,' he said succinctly as he heard Anna walk through the door; her footsteps came closer and she knelt down beside him to pull something out of the bag. 'I don't know which antibiotics you brought with you, but we'll need--'

Esi interrupted him. 'We know about the tuberculosis, sir, we--'

Anna, in turn, interrupted her, sounding a bit flustered as she did so. 'Esi, your grandmother wants you outside. We'll take care of everything.'

Esi looked down, gnawing at her lip a big before leaning down to take her mother in her arms and kiss her forehead. Her mother reached up as much as she could to rub her daughter's shaved head before Esi got up, her wrist held under her nose as she sniffled, tears gracing the rims of her eyes. When she'd left the one-room hut, House looked sideways at Anna as she finally found what she was looking for in the bag and began pulling supplies out: a tourniquet, two pairs of rubber gloves, a disposable needle, gauze, a freezer bag and a catheter. She took the chart from him and put it in the bag before pulling out a glass vial; she collected everything in her hands then walked over to Yaa, dropping to her knees and spilling the supplies onto the edge of the mat, flipping off the plastic cap of the vial before beginning to speak in low tones as she snapped one of the pairs of gloves on. As she began prepping for the IV, she asked Yaa a question and the woman said a few things then she and Anna began to recite something.

House suddenly became very aware of what was happening. He walked to them, leaving his cane leaning on the wall beside the bag.

'No tubing, no IV fluids?' he asked as he looked down at the tiny ring of aluminium covering the neck of the vial she'd set in the dust.

Anna stopped her recitation, hesitating for a moment with her hand paused over the woman's skin before she started palpating for a patent vein again. 'Nope.'

He watched as she punctured the vein -- blood flashed into the catheter hub and she made quick work of advancing the plastic catheter and removing the stylet. She snapped off the tourniquet and looked down at the hub then capped the used stylet with a scoop before reaching behind her and grabbing the needle and vial, handing them up to House.

'It's your job to prep the needle and inject her.'

'Like hell it is,' he muttered, staring at her hand and the vial before reaching out and grabbing the vial only, scanning the label and raising his eyebrows. 'Secobarbital?'

'Please,' she said, pressing the needle toward him between her index and third fingers. 'I start the IV, but that's all I ever do.'

'You're a nurse. You administer the medications as ordered by me,' he said forcefully.

'Not this medication,' she murmured and looked at him for a long moment before he took the needle from her and uncapped it, flicking the cap down toward her before jabbing the needle through the metal film and flipping over the vial.

'How much?'

'Ten,' she said simply, turning back to Yaa and holding her hand.

House pulled back the plunger of the syringe, not bothering to be incredibly succinct in his measurement. Regardless, he looked at the syringe before blindly reaching down to Anna and tapping her shoulder with the hand containing the vial. 'Cap this.'

She took it from him and grabbed the purple cap by her knees, tapping the cap to the neck then holding it firmly in her hand as she looked up at him. 'You need to be where I am.'

'No, I don't,' he said, making the move to hand the needle to her. 'You need to learn how to do your job, nurse.'

She gave him a stern look. 'I'm advanced practise, so don't treat me like some throwaway, useless fresh grad. We're all health professionals from the NA to the double board certified doctor, Dr House. This application isn't my job. Get down here and do it yourself.'

With that, she moved aside and stood, turning sharply away from him to go back to her bag and drop the vial in before grabbing out another freezer bag. She walked around him and settled herself at Yaa's head, taking her head into her lap and watching House as he looked blankly at her. He waited, considering whether he was going to let this injustice stand or simply do it himself. Anna's look remained stern, but tears were gathering at the rims of her eyes, so he decided that it was much easier to just do it instead of risking the creation of an upset woman who could just leave him in this horrid non-fluency-in-English place. Slowly, he sat down and set the uncapped needle on the reed mat before snapping on the other pair of gloves.

'Wait just a minute,' Anna said after a relaxed sigh, and House looked over as she crossed herself. 'In the name of the Father, the Son and the Holy Spirit, amen.'

House quickly looked away, barely containing a groan as Anna began her recitation.

'Enti mommɔ mpae sɛ: Yɛn Agya a wowɔ soro, wo din ho ntew, w'ahenni mmra, nea wopɛ nyɛ asase so, sɛnea ɛyɛ ɔsoro,' she said, pausing for a moment during which House looked over, focusing on her mouth as she continued in one of the most soothing tones he'd heard in his lifetime. 'Ma yɛn yɛn daa aduan nnɛ, na fa yɛn aka firi yɛn, sɛnea yɛde firi wɔn a wɔde yɛn aka. Na mfa yɛn nkɔ sɔhwɛ mu, na yi yɛn fi bɔne mu.'

Yaa closed her eyes. 'Amen.'

Anna grabbed the bag next to her and pinched off a piece of bread. 'This is the Lamb of God who takes away the sins of the world. Happy are those who are called to his supper.'

Yaa cleared her throat then spoke in heavily accented and well-rehearsed English. 'Lord, I am not worthy to receive you, but only say the word and I shall be healed.'

Yaa kept her mouth open and Anna dropped in the piece of bread. 'The Body of Christ.'

After she swallowed, Yaa closed her eyes and took a deep breath. 'Amen.'

'May the Lord Jesus protect you and lead you to eternal life,' Anna finished then placed both hands on the sides of Yaa's sunken face. 'She's ready now, Dr House.'

She never looked up at him, so after a moment, he looked down at the port and took it in his left hand, balancing it on his ring finger as he lifted the syringe and pierced the needle into the hub. He injected the entire bolus without any consideration of application time then quickly pulled out the entire IV contraption instead of just removing the syringe from the port. Yaa started bleeding from the IV site so he grabbed a piece of gauze from the mat and pressed it to her skin as she began to convulse. Anna simply held her head as well as she could, looking down with complete calmness and a comforting smile.

It seemed like only an instant later that she laid completely still, and Anna held her for another minute before slipping her head down onto the mat, crossing herself once more before standing. She looked moderately numb as she stepped to House, gathering the spent supplies with her still gloved hands -- she pulled off her gloves around the catheter and dropped all of it into the freezer bag. House picked up the cap he'd flicked at her and dropped it into the bag after her gloves. She sealed the baggie and walked over to drop it into the larger bag by the wall. She picked it up along with his cane and walked back to him.

'Do you need help getting up?' she asked a bit nonchalantly before extending a hand to him.

He took her hand and stood, looking down into her eyes once he was up and steady. She looked away after a moment.

'Here's your cane,' she muttered, pressing it into his hand.

She shifted the bag onto her shoulder before pulling the curtains around the place where the body laid. She went before House, stepping through the door slowly and taking the extended hand of Esi before saying something to her in low tones. The girl started sobbing as she clung to Anna, setting off a growing cacophony within the housing complex. By the time House and Anna were able to break away from the group and make it to the motorcycle, all of the people in the small village had gathered in front of the House, all theatrically wailing for the lost Yaa. House watched as Anna strapped her bag to the motorcycle, noting the lack of the other bag that she'd brought.

'Your smaller bag is missing,' he said over the wails.

Anna turned to look at him, wiping at tears that were sliding silently down her face. 'Esi's antiretrovirals.'

His lips parted slightly, but he did not speak. Anna nodded a bit then turned back to the motorcycle, tightening the strap around her bag. When she stood straight again, he walked past her and got onto the motorcycle, handing his cane to Anna before she got on behind him. He balanced the motorcycle before turning it on -- Anna made a move to grab the back of the bike, but House reached back and took both of her hands in his, pulling them to his waist. At first, she seemed even more unsure than she had back at the clinic, but as soon as they began moving, she leaned into him and grabbed tightly. He couldn't hear her, but a minute later, he knew that the wetness of his t-shirt was not caused by sweat alone.