House tailed Wilson closely as the two made their way downstairs to Cuddy's office. Various other department heads were rushing out of the elevators and stairwells to join the growing knot of people standing in the foyer outside the office itself. Cuddy was standing in her office doorway, letting the others gather around her. Her eyes were moving over the crowd, scanning it and checking faces. "Wilson," she greeted him, seeing him bolt from the elevator. "House." Over the heads of the others, she held his gaze for a moment longer than she'd held Wilson's a second before.
Breaking eye contact, she glanced at her watch and then back up at the rapidly assembling group. Sighing deeply, she started trying to yell over the bustle. "Some of you already know, but there were a series of explosions at the Princeton chemistry lab a few minutes ago." People rapidly silenced themselves to listen to what she had to say. "We're the first response hospital. Not only that, but all of the case are being routed through to us because various chemical leaks have been confirmed."
"There's nothing like a good, old-fashioned, chem lab explosion to shake things up," House commented to Wilson, leaning on his cane.
Wilson shushed him distractedly as Cuddy glared over in their direction. But she didn't take the time to reprimand them, instead rushing on with her delivery. "Decontamination showers are being set up outside the ER," she explained, "and everyone gets decontaminated before they come through the doors of this hospital. We don't want any secondary exposure. Order your labs sparingly, and any head scans need to be cleared through a neurologist. Remember, chemical exposure can cause neurological symptoms."
"And chemical burns. And respiratory distress. And ocular irritation," House sing-songed softly. Wilson turned to glare this time.
"We need everyone working full out on this," Cuddy declared. "Keep an eye out for the people around you, but trust them to do their jobs. You all know what you have to do. ETA for the first ambulances is about ten minutes."
With those final, not-quite-rousing words, the department heads started rushing off to co-ordinate their departments according to the emergency plan. They all wanted everything to be as ready as it could be before the first patients arrived. Once they started coming in, the doctors knew, it would be too late.
Wilson, like the others, had started off at a jog, and he had to double back as Cuddy called for him. "House, Wilson," she said, her voice dropping in volume so that it didn't carry out to everyone. "I'd like a word with the both of you." House, moving at a pace best described at an amble, turned to face Cuddy, but didn't step back towards her.
"You mean you've got time for a word?" House questioned tartly, tapping the end of his cane on the ground.
She sighed distractedly, looking down at her watch again. "It started with an explosion in one of the labs, and the fire spread to other areas of the building, setting off multiple secondary explosions," she told them briefly. "Aside from the normal bone and tissue injuries, we're going to have a lot of unknown chemical exposures."
"I'm not any good in an ER setting," House admitted sharply. He didn't like to admit his own weaknesses, and normally he'd have covered it with some kind of flippant comment, but this didn't seem to be the time. "You know that." He bounced his cane again, almost in an unconscious emphasis of the reason why.
"But you're a puzzle-solver," she countered. "The mild exposure cases we can treat supportively as unknowns, but there were chemicals everywhere and most of the students were crawling through clouds of noxious gases, trying to get beneath the smoke."
"Most of them are heavier than air," House muttered. "They're damned if they do and damned if they don't."
"What does that have to do with us?" Wilson questioned quickly. He too looked down at his watch, caught up in the sense of urgency, trying to gauge just how much time they had left.
"House, you have a balanced team," Cuddy started, stepping toward him. "You have an intensivist, an internist, and a neurologist…"
"You missed our lovely immunologist," House snorted. "Besides, that's only true if you count Verhoeven, and everyone knows that interns don't count for anything."
Cuddy ignored his comments, steaming forward with her amended plan. "I want Chase and Verhoeven down in the ER. Anyone with severe chemical exposure gets sent up to you, House, as soon as they're stable, and you figure out how to treat them. Wilson, you back him up, and your team will be running the treatments," she directed.
"What about the other two minions?" House questioned. "They're going to feel left out."
"Foreman's a neurologist," Cuddy stated, "so he has privileges with the CT and MRI. He'll run those. Cameron's good with lab work, so she'll be in charge of whatever labs you need run. They can have priority on whatever tests they run and interpret themselves."
She looked down at her watch again. "We have six minutes," she informed them seriously.
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House limped into the diagnostics conference room to find three of the departments other four doctors waiting there for him. They were standing around, their body language showing various degrees of agitation. The two fellows present, Chase and Foreman, were at the polar ends of the spectrum. Chase, his hands working double-time to shred a piece of paper, looked as though he wanted to run from the room. Foreman, his hands stuck into the pockets of his pants, looked as though there were nothing out of the ordinary going on.
House didn't doubt that had Chase not been paged to the conference room, he would have been running straight down to the ER, ready to pitch in and start seeing patients. But the Australian was obedient, if nothing else, and had waited for instructions first.
Like Chase, Verhoeven looked ready to run from the room as well. Her crutch would have made it more difficult, but House didn't doubt that she could do it anyway. If she didn't have a job to do, he didn't doubt that she would have run, and not to the ER like Chase. Interns were notoriously nervous about everything, and especially about things like this. There was a nice supply closet on the third floor that the interns liked to frequent, House knew. He knew about it too; the reception was good and he could always get General Hospital without static if he hid out in there.
"Where's Cameron?" House questioned, his eyes searching for the immunologist. Thoughts of General Hospital had drawn him right back to what was going on now. Cameron and Foreman, although they probably wouldn't react like characters on a soap opera, were going to be plenty displeased with their assignments.
"She'd gone out to lunch," Chase explained. "She called a couple minutes ago, and she's on her way back in."
"Good," House noted. "I'm going to need her down in the lab."
"You weren't planning to have her helping victims, like the rest of us?" Foreman questioned, his brow furrowing a little.
"Oh, don't worry," House said. "You're not going to be helping victims either. You're going to be running the scanners for me."
Foreman's thus far imperturbable manner cracked for a moment, his confusion displaying itself clearly on his face. "And you don't think…"
"They're Cuddy's thoughts," House interrupted with a shrug. "She saved me the effort." As he spoke, he thrust a couple of pairs of scrubs forward with his free hand. "Chase, Verhoeven, you're going to want to put these on. It's going to get messy downstairs and you wouldn't want to ruin those perfect outfits." He paused to wrinkle his nose at Chase. Honestly, a green shirt and a purple tie?
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Foreman managed to contain his arguments until the two blondes had left the room. Then he rounded on House with an expression that was clearly more angry than confused. "I didn't go to med school to be a lab tech, and I certainly didn't spend all those years specializing in radiology," he declared.
"No, but you're in a diagnostics fellowship right now," House informed Foreman tartly, "and today you're going to be a diagnostician."
"You're sending an intern down to see patients, but you're making me sit and run tests. And you're going to make Cameron sit in a lab," Foreman pointed out. "How is that the best use of resources in this situation?"
House shrugged. "Think of it as a compliment to the department, rather than as a personal insult."
"It's a compliment that I'm being packed off to run tests in the middle of a minor disaster response?" Foreman contested. "How is that possibly a compliment?"
House shrugged again and wandered across the room to erase the whiteboard. The symptoms for their last patient, discharged only the day before, were still scrawled all over it. "If you'd get over your own ego for a minute," House drawled, letting the neurologist stew, "then maybe I'd explain how this is going to work. But if you want to go on about your own qualifications for a while longer, we can do that too. Best use of resources and all."
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"Do you know the signs of acute chemical exposure?" Chase inquired, tying on a surgical cap as he waited with Verhoeven for an elevator to take them down to the ER. Dressed in the scrubs that House had thrown at them, the two looked almost like brother and sister with their fair skin and blue eyes.
"It depends on the type of chemical," she responded cautiously. "And on both the method of exposure and the duration."
"Right," Chase nodded. "But has anyone explained how Cuddy wants things to work?"
She nodded back, her movements tense and nervous. "Doctor Cuddy spoke with in the changing room," she answered.
"Wilson talked to me," Chase revealed. "But you know what we're watching for, right?"
She swallowed hard and nodded again. "Severe respiratory distress, worsening symptoms as systemic toxicity progresses, renal failure, discolorations of the skin aside from cyanosis, large areas of dermatitis or chemical burning, discoloration of the cornea aside from irritation, or anyone with symptoms unusual enough to attract our attention," she recited softly.
"Good," Chase told her as the elevator doors opened. "And remember, we don't need to figure out what it is. We just have to pick them out, stabilize them, and send them upstairs." He laughed, trying to reassure her a little. "We've got the easy job. House and the others have to figure out how to actually treat them."
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By the time that Chase and Verhoeven made it downstairs, the patterns of semi-organized chaos were already starting to develop. A few of the ER residents had stuck around inside to help, but most of the ER staff had relocated outside the hospital to do triage and provide some measure of preliminary treatment for the victims moving through the hastily set up decontamination showers. The emergency room itself had been all but abandoned to the hospital's other doctors.
"Interns are going to the clinic to deal with the ambulatory," someone informed the two brusquely as they started toward the ER. In other words, the interns were being sent to stitch up wound caused by flying glass, packed off somewhere where they only needed minimal supervision and could free up the better-trained residents and attendings for treating the more serious injuries.
Verhoeven hesitated for a moment, frozen between the hall to the clinic and the one that led to the ER entrance. "Lose your lab coat," Chase told her. "No one will know the difference."
"Okay," she said cautiously, switching her ID to her scrub top and shedding her lab coat. She tossed it carefully behind a potted plant, trailing a few steps behind Chase as they made their way into the emergency department. Already, not quite twenty minutes since they'd first been paged, it was teeming with people.
The two stood for a moment in the doorway, letting the ebb and flow of the department wash over them while they tried to figure out where best to jump in. Chase reacted first, grabbing a pair of latex gloves from a nearby box and pulling them on. "Stick close," he told her, stepping toward the nearest gurney. He didn't bother to look over his shoulder to see if she was following.
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"I had to come in through the parking garage," Cameron panted, throwing her bag onto one of the empty chairs and starting to peel off her jacket. Her eyes were already searching the conference room for her lab coat. "There are people overflowing out of the ambulance bay."
House grunted at her distractedly, spinning his cane idly with one hand and using the other to flip through an opened toxicology book.
"The ER is probably working at close to capacity," Wilson noted. "Unfortunately for the people outside, they won't be able to get inside until the people down there have room to treat them." He looked up from his own thick volume to smile thinly at Cameron.
Cameron looked around the conference room in sudden bewilderment. The thought had just struck her that, compared to what she'd seen outside and what she imagined the ER must be like, this was an oasis of complete calm. House and Wilson were just sitting there, reading, as though it were just a normal day. She might have expected it from House, and may even have partially excused him because of his cane, but Wilson was a different matter.
"There's no need to get all morally outraged on us," House told her after a moment, glancing up at her as he flipped another page. "As always, there's a method to my seeming madness. And you know what they say about madness and genius."
She sputtered. "But what about…"
House cut off her protest. "Chemical exposure," he stated cryptically, flipping another page.
"But they're overflowing…"
"Chemical exposure," he repeated, not quite as patiently.
"But…"
"Don't make me say it again," he snapped, completely abandoning his text to glare at her. "Twice was bad enough."
She stared down at him for a moment. Her lab coat had been hastily thrown on and hung slightly askew. Her hair was mussed from her dash up from the parking garage. House lifted his eyebrows at her and waited. Opening and closing her mouth once or twice, she finally settled on crossing her arms over her chest and glaring back at him.
"There's a good girl," House said patronizingly, looking back at his book. "Now, hurry along. The lab needs you."
"The lab?" Cameron repeated in shock. "But what about…"
"Yeah, yeah," House sighed. "What about all the poor, little, hurt people? They need you in the lab."
Finding that her protests weren't getting anywhere, and having learned long ago that normal logic was usually useless, she switched tactics. "Why the lab?" she asked, trying to ooze confusion out of her voice. She might have followed up with a matching look, probably puppy-dog eyes, but House wasn't paying her any attention.
"Chemical exposure," House replied, sighing heavily. "And now you've made me go and say it again. I warned you…"
"Do you know what happened?" Wilson cut in, trying to defuse the situation a little. Cameron nodded. "There are people coming in with acute chemical exposure, and it's up to us to figure out how to treat them. The lab is completely overwhelmed, but we need test results in order to figure out what we're dealing with. If you're down there to run the tests we need, we can skip the line."
"Where are…"
"Foreman managed to get over his own ego for long enough to get us the scans we need," House told her shortly. "And if you'll hurry with the moral outrage part of today, we can actually get some lab work done too."
"But what…"
"The blondes are downstairs," House interrupted. "Hopefully they're treating patients, but you never know. They could be discussing the best brand of bleach to use to keep those dark roots away."
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Cuddy stood in the foyer outside her office, trying valiantly to get some sense of what was going on in her hospital. She'd lost personal control over the situation almost the moment that the first ambulances pulled in. She wasn't sure what good having control would have done, but it made her feel uneasy. This was hundreds of patients streaming in, all with different injuries, all needing care.
It had taken almost exactly half an hour for the MRI and CT to completely back-up, but the radiologists had been behind even before that. The lab was swamped within the first ten minutes. Every operating room the hospital had was full, and each surgeon had at least two patients waiting to go in as soon as the rooms opened up.
It was chaos. And there was nothing that she could do.