Mark was sitting at the admit desk, Ella sitting on the counter in front of him as she played with his stethoscope.
"Mark?" Susan asked, clearly confused as she approached the pair. "What are you doing here?"
"Good to see you too." Mark joked before making eye contact and seeing the concern in her eyes. "Ella had a bit of a scare this afternoon." He said softly as he ran his hand along Ella's cheek. "She had an anaphylactic reaction."
"Oh God." Susan replied, looking more closely at the toddler in front of her.
"She's fine." Mark assured her quickly. "We're waiting for someone from immunology to come down and do a skin test before we take her home, but Chen took some kids into the exam room we were in who look contagious, so they had us come out here."
"You shouldn't even be here." Susan replied suddenly. "Your immune system is practically non-existent, what are you doing hanging out in the ER?"
"Trust me, this wasn't my idea of a fun evening." Mark deadpanned. "I thought I was going to get to spend a day at home for once."
"Oh foolish doctor, don't you know that as an employee of County General you have to be here for at least seventy percent of the year or else it will begin to suck you back in." Susan replied with a grin.
Mark was about to reply when Abby ran up to the desk. "Hey Doctor Lewis can you take a look at something in exam four?"
"Chen is in there." Susan replied, clearly confused.
"Yeah, so is Carter. They want your opinion on something." Abby replied.
"Where's Weaver?" Susan asked impatiently.
"Not here." Abby replied. "I think you should come look at this."
Susan rolled her eyes. "I guess I'll be joining the party in exam four." She said before following Abby. She was confused when Abby handed her a mask and a gown as she approached the door. "What's going on?"
"They think its smallpox." Abby replied, pulling a gown and mask on herself.
"What?" Susan asked, following her quickly into the room.
"Doctor Lewis, this is Ben and Amy." Carter quickly introduced her to the kids. "Their parents brought them in they think its chicken pox, but I'd like you to take a look."
Susan nodded calmly realizing that the parents didn't know the potential severity of the situation. "Alright Ben, I know you're cold but I need to look at your rash." She said gently as she took the blanket off from him. Her eyes widened as she saw the large white marks along his arms. "I need to go check something." She said calmly to their parents. "Doctor Carter will you come with me please?" She said before moving out to the hallway.
"It's smallpox." Carter said seriously as he pulled his own gown and mask off as they got outside the room.
Susan reached for one of the large books on the reference shelf in the hallway before flipping through the pages before she found the one labeled smallpox. "Damn." She cursed softly as she found the picture she was looking for. "Call CDC and hospital security. We're going into lockdown. ER circulation needs to be exclusively exterior, and no one leaves until we know what's going on." She said seriously as she threw the book across the hall.
"Do I tell the people in chairs to go?" He asked.
Susan shook her head. "No one leaves." She repeated.
Susan went to return to the exam room as Carter ran to the admit desk. "Jerry shut us down." He said quietly.
"Is this a drill?" He asked as he put down the deck of cards he had been using to entertain Ella.
Carter shook his head. "I'm calling the CDC, we're going down."
Mark looked at him in concern. "What's going on?"
"What are you doing here?" Carter asked suddenly, noticing the head resident.
"Ella had an allergic reaction… That's beside the point. What's shutting us down?" Mark asked harshly.
"We think its smallpox." Carter replied quietly, causing Mark's eyes to widen.
"Jerry shut us down." Mark said firmly as he picked up Ella. "Haleh!" He called to the nurse that was passing by. "Take Ella into the lounge and lock the doors. We're locking down." He said softly as soon as she was close enough.
"Only staff?" Haleh asked softly as she took Ella from him.
"Staff that is cleared. They'll have a green wristband as soon as they're cleared." Mark said firmly as he pulled open a drawer. "You need to watch Ella for any symptoms of anaphylaxis. I'll bring you a few doses of epinephrine as well as some antihistamines." He said as he handed her a clipboard. "Only cleared staff. Keep track of who is who here." He said as he attached a staff roster to the board.
"You got it." She replied before calmly making her way to the empty lounge, locking the doors behind her.
He looked up and saw that the security had arrived, which was beginning to cause a panic among the patients. "John?" He asked as he watched him hang up the phone.
"CDC is on their way. We're supposed to go into lockdown. Everyone in the ER is to stay here and we're to call anyone who has left since the arrival of the infected patients. The rest of the hospital is fine as long as we redirect ventilation." Carter replied quickly.
"Okay." Mark replied. "Jerry page everyone who's on except Abby and Susan."
Nearly ten minutes later the entire staff had arrived. "What's up?" Lydia asked as she watched the security patrol the entrances.
"We're locking down. Carter will brief all of you I just wanted you to have a heads up before I make the intercom announcement." Mark said quietly, watching as the patients sitting in the lobby continued to question Jerry about the sudden increase in security.
"Here comes hell." He muttered quietly before moving to the intercom. "Hello everyone my name is Doctor Mark Greene, I am a resident here at the County General Hospital Emergency Room. Due to a potential exposure to a contagious illness the ER has gone into lockdown." He began to hear an increase in the background noise around him. "Everyone in the emergency department is to stay where they are. We realize that this is an inconvenience, but for your own safety you need to remain here. If you have an immunodeficiency please find a physician immediately, we will do our best to ensure your removal from the potential infection as soon as possible. Otherwise please remain calm until we know more. I promise none of you are in immediate danger. Remain calm." He said firmly before turning off the intercom.
It was less than fifteen seconds before several individuals tried to rush the door, finding themselves running into a heavy barricade along the door.
"Oh this should be fun." Mark said tiredly as he followed Lydia to help the men who were now writhing on the floor.
"Let me out!" One of them screamed as Mark approached.
"Sorry buddy, we're both stuck here. I'd behave if I were you. We control exactly who gets out of here first, and right now you're on the bottom of the list.
Hours later Lydia came into the staff room with the CDC representative. "Doctor Greene?" He asked as he came into the room.
"Yeah?" Mark asked, not looking up from his sleeping daughter in his lap.
"We've determined the infection isn't smallpox." He said firmly. "We've isolated the contagion and are running tests, but we may not know what is causing the infection for several days."
"Days?" Mark replied, his eyes widening.
"Days." He replied firmly. "We're going to evacuate the hospital. All ER patients will be re-directed to the ER at Mercy for monitoring. All other patients will be transferred around the city. All personnel outside of those working with the contaminated patients are to go home."
"How long?" Mark asked, handing his daughter to Haleh.
"An hour, then we're shutting down. Transportation is on its' way." He replied.
"Surgery is going to need more time." Mark replied immediately.
"Get me the head of surgery, they're going to have to close." He said sternly.
"Lydia get me Romano." Mark said tiredly.
"He's not going to answer his phone." Lydia replied. "He wants in here to help with management."
"No one else can come in." The CDC director interrupted firmly.
"Honestly if he got smallpox it would be a relief." Mark said back, his eyes showing the anger behind them. "Let him in from the outside of the ER, there's no additional contamination risk, except to him."
"I'm not allowed to…" He protested.
"If you don't you risk infecting the whole hospital. Just let him come down and assess the situation." Mark cut him off.
"What is your position here?" He replied indignantly. "You're not the ER chief. Who are you?"
"He's the best emergency doctor in the whole hospital. Listen to him." Haleh replied for him. "None of us would ever ask for you to let Romano down here unless we needed him. Let him in."
The CDC director looked taken aback but he nodded before pulling out his phone and following Lydia back out of the lounge.
Twenty minutes later, the lounge was full of people yelling. Ella had woken up as soon as Robert came into the room, his voice startling her, bringing her to tears almost instantly. Haleh was still trying to calm her down while Mark and Robert argued with the infection specialist.
"I have three ORs mid operation right now and there's two floors of patients on long-term stay. How the hell am I supposed to re-locate this type of trauma center in under two hours?" Robert seethed.
"We can heli-evac all surgical cases to the nearest trauma centers, everyone else will have to be transported on the ground. It's going to take organization but a center of your size should be more than able to do it." The CDC advisor who had revealed his last name to be Langford, replied. "This isn't an option. Everyone who isn't showing symptoms yet is to be evacuated immediately."
"What about the ER? Where do they go?" Mark asked as he flipped through a folder in front of him. "They all need to be monitored."
"We have a bus en-route to take everyone to quarantine outside of the city. We'll make sure that no one else gets far enough into this illness without us knowing about it." Langford replied.
"I'm not evacuating, the monetary losses…" Robert began.
"You can either evacuate or I can shut you down. Take your pick." Langford replied evenly.
Robert slammed his fist on the table. "Give me an hour to work with all of the departments. I want to do this with minimal disturbance to our patients."
Langford nodded. "You have two hours to get everyone out. The ER will be evacuated in fifteen minutes."
Three hours later Susan came out of exam four, throwing her infection control equipment into the sealed bin as she made her way to the lounge. "What are you still doing here?" She asked as she saw Mark sitting on the couch.
"I got quarantined." He replied with a smirk. "I'm not exhibiting any symptoms, and all things considered I should be fine, but I'm stuck here with everyone else 'just in case' according to that bastard."
"Oh you aren't happy about being stuck here with us?" Susan replied with a laugh.
"Elizabeth is going to kill me." Mark deadpanned.
"Oh." Susan realized, looking down to see Ella on the floor, her fingers grasping an apple slice. "Is she at home alone?"
"I haven't called since the evac." Mark admitted. "She was upstairs earlier, so I wanted to wait until she had a chance to get home. But her parents are here for Christmas, and Rachel's at home."
"You should call before she wants to kill you." Susan advised, opening the fridge to find several sandwiches that had been brought in.
Mark smirked before getting up to get to the phone, which had been set to only allow outgoing calls for hours at this point. He dialed his home number and waited a few moments before he heard Rachel's voice. "Dad?" She asked anxiously.
"Hey bug." Mark replied, smiling at the sound of his daughter's voice.
"Are you okay? Is Ella okay?" Rachel asked anxiously.
"We're both fine." Mark assured her quickly. "Can I talk to Elizabeth?"
"She's with you." Rachel replied, clearly confused by his question. "At the ER, she was with you and Ella…"
Mark shook his head. "She was upstairs when the ER went into lockdown, she would have left during the evacuation over an hour ago when they took surgery out."
"She's not here." Rachel replied.
"Okay." Mark said, trying to keep his voice even. "Tell her if she gets home to page me." He said before slamming the phone back onto the wall.
"Elizabeth's not home?" Abby asked from her spot at the table.
Mark shook his head before digging around in his pocket for his pager. "My pager's dead, do we have batteries around somewhere?"
"Here." Lydia said as she handed him some batteries from a drawer.
Mark quickly changed out the batteries and groaned when several messages popped up instantly. He was reading through several from hours earlier when a new one came in.
My office NOW.-EC
"Dammit." Mark said angrily before running out of the lounge.
"Mark where are you going?" Susan asked as she began to run after him, Abby just behind her.
Robert was watching as Mr. Langford set up the isolation tents around various parts of the ER as the three of them ran past towards the stairwell.
"You can't go anywhere else in the hospital!" Robert yelled after them. "We'll have to disinfect more areas!"
"Elizabeth's still here!" Mark yelled back before starting up the stairs, as quickly as he could manage considering his mental and physical exhaustion.
"They can't go upstairs." Langford told Romano as he watched his expression changed from one of anger to concern.
"That's our associate chief of surgery, she's eight and a half months pregnant. If she didn't evacuate…" Robert began.
"You can't go up there." Langford insisted. "They can't go up there."
Mark was out of breath when he got to the third floor, but he maintained a fast pace as he made his way through the floor over to the surgical offices, he swiftly knocked on the door before opening the door.
Elizabeth was on the floor next to her desk, her pager firmly grasped in one hand, the other pressing firmly against her clearly tightened abdomen. Her eyes we closed so tightly Mark wasn't sure if he'd ever seen them that small.
"How long?" Mark asked anxiously as he knelt next to her, prying the pager from her vice-grip and putting his hand there instead.
"Hours." Elizabeth replied quietly, burying her face into his shoulder as she groaned, willing the pain to stop.
"You know the hospital is shut down?" Mark asked her quietly.
Elizabeth nodded. "I can't stand." She whispered. "I tried, but something feels wrong. It hurts so badly Mark."
"Has your water broke?" Mark asked her as he began to apply firm pressure to the small of her back, trying to alleviate some of the pressure she was feeling.
She shook her head. "It's stuck in my back." She whimpered. "I can't do this… I can't do this anymore."
"It's going to be fine." He said, looking nervously back at his colleagues who had stopped outside of the door. "Susan and Abby are here, can they come in to help?"
Elizabeth nodded, breathing deeply as she tried to pretend she was anywhere else, just as she had been doing for hours.
Mark turned behind him and motioned for the two of them to come in.
"Elizabeth how frequent are your contractions?" Susan asked as she began to take Elizabeth's pulse.
"Constant." She breathed out. "It's just waves of pain."
Abby nodded. "I need to check how dilated you are." She said softly. "We need an idea of when this baby's coming."
Elizabeth nodded in agreement and cringed as her husband and his colleagues helped her out of the black maternity slacks she was wearing.
"Mark." Abby said quietly as she looked down at her own fingers, finding them covered in blood. "She's been bleeding."
"How badly?" He asked, moving so he could comfort Elizabeth who had heard them despite their low voices.
"It's heavy, but it's not a hemorrhage, I can't tell what's going on." Abby admitted.
"Okay we need a bed and a room. We're not doing this on an office floor." Mark said anxiously before going out into the hallway to look for a wheelchair.
"Mark!" Robert called out as he watched him look around the floor. "Where's Elizabeth?"
"She's in her office, in labor. I need a wheelchair or something, she can't have it in there." Mark replied anxiously, opening several other doors.
"I'll get a gurney out of pre-op." Robert volunteered.
Mark nodded in gratitude before going back to Elizabeth's office. He cringed as he watched Susan try to support Elizabeth through what was a clearly painful contraction so that Abby could check her cervix. He moved quickly to help Susan support his wife.
"I can't see anything." Abby said gently. "It's too dark. Did you get a wheelchair?"
Mark shook his head. "Robert's getting a gurney."
"No." Elizabeth groaned as she tried to sit back up. "He's not helping with this."
"Elizabeth…" Mark tried to comfort her. "We've got five doctor's in this hospital including the two of us, the only one not helping right now is Carter who was potentially exposed to smallpox, would you prefer him?"
Elizabeth moaned in disapproval as another pain took over.
"This is going to be fine." Mark assured her, watching as Abby tried to calm his wife down. "You're going to be fine." He said, trying to comfort himself as much as he was trying to comfort her. This all felt too familiar. Years ago, when he was still a med student, he had felt this helplessness as he tried to help another woman give birth in a situation that ultimately was just too difficult to handle. He wasn't about to let what happened to her happen to Elizabeth, not his Elizabeth.
"Mark." Elizabeth whimpered slightly as she watched him get lost in his own thoughts. "Mark I know that look don't do this to me now."
Mark nodded as he moved so he was behind his wife, trying to support her through the endless pain. "I'm here. I promise you I'm here."
Moments later Robert knocked on the door. "I've got power going to a delivery suite on the fourth floor." He reported as he opened the door, revealing a gurney. "We still can't use the elevator but if we can get her upstairs…"
Elizabeth shook her head as she looked at the distance from her spot on the floor to the gurney just outside of the room. "I can't move."
Mark sighed as he realized that he couldn't be the physical support his wife required in that moment. "Robert can you help me?" He asked anxiously as he looked from the man he had blamed for so many of their family troubles, to his wife who was once again curling into herself, trying to avoid the continuing pain.
Robert nodding, not asking any questions before quickly helping Mark carry her to the gurney in the hallway, and then the four of them quickly lifting the gurney up the stairs to the fourth floor. As soon as they rolled the gurney into the delivery room Abby took control. "Mark and Susan help me lift her onto the bed." She said firmly. "One, two, three." She counted down before the three of them quickly moved her, revealing a large red puddle on the white sheet beneath her.
"That's too much blood." Mark said softly as he looked over to see his wife's visibly pale figure. "How much blood has she lost?"
"We don't know Mark." Susan replied, clearly feeling the stress herself.
"Well find out."