Chapter 35: Risking Lives? I Have a Better Method
The team rushed to the maternity ward's NICU.
The infant from earlier had now been transferred here.
One of the nurses attending the baby looked up and happened to see David returning.
Seeing David following behind House, her mouth fell open slightly in surprise:
"You're actually from Diagnostic Medicine?"
David smiled without responding.
Cameron, however, noticing the interaction between David and the nurse, looked at him curiously, then quietly asked:
"Do you two know each other?"
David also leaned closer to Cameron's ear and whispered:
"We just met. Small misunderstanding earlier about my credentials."
Hearing they'd just met, Cameron unconsciously exhaled in relief—a subtle reaction she didn't even register.
House, ahead of them, completely ignored the nurses' greetings.
He grabbed the chart from the bedside and reviewed it independently. After a moment, he frowned:
"David's right. There's an unknown infectious disease spreading through the hospital.
Because besides her, the infant next to her also developed unexplained high fever.
The difference between onset times is no more than four hours. They were born in the same delivery room.
The postpartum rooms are adjacent. This completely fits transmission patterns."
Foreman frowned:
"But this female infant's fever was caused by bowel obstruction. This male infant has isolated pyrexia. There's no connection, right?"
House shot Foreman a sidelong glance and handed over the X-ray film:
"See for yourself. There's gas in the intestines. Can't be obstruction.
This is just an erroneous diagnosis by some physicians whose clinical skills aren't up to standard.
David, examine every infant in maternity.
Note whether they exhibit similar symptoms. If so, isolate them immediately.
Also, Chase—inform Cuddy. Tell her I said so. The hospital needs to stop accepting maternity admissions. Clear?"
Chase nodded and headed upstairs.
Then House addressed the two behind him:
"Start them both on standard supportive care. I need their lab results and drug responses ASAP."
Shortly after, David—having completed his examination of the entire maternity ward—discovered six additional infants with high fevers.
Bringing this result back to Diagnostics, everyone felt the mounting pressure.
Because in recent assessments, all infants showed fever, hypotension, and were barely maintaining cardiac contractility.
If this trend continued, all infants would be dead within twenty-four hours.
This meant eight families would experience the devastation of child loss!
And now, the pressure to rapidly identify the infectious agent had fallen on every physician in Diagnostics!
Looking at the symptoms listed on the glass whiteboard, House turned toward David, who'd first identified the outbreak.
"Where are these babies from? Any commonalities?"
David, already prepared, began guiding House's reasoning:
"Two delivery rooms, four postpartum wards. No shared staff, no shared equipment.
Theoretically, they shouldn't cross-contaminate, but I noticed one person in the hospital had contact with all of them."
"Who?"
"The elderly volunteer who distributes stuffed animals. And I observed she wasn't wearing a mask or sterile disposable gloves as required.
Which means these infants likely contracted an adult pathogen."
Hearing David's 'insightful observation,' Foreman couldn't help but counter:
"If it's an adult virus, then why are only infants symptomatic while their parents show no signs?
And explain why lymphocytes didn't elevate during bloodwork?
Also, we've already administered ribavirin to them with zero response.
I think we should prioritize bacterial infection."
David shook his head and identified the critical flaw:
"If you assume bacterial infection, these babies are already dead.
Bacterial cultures require minimum forty-eight hours. They don't have that long.
Unless you administer different broad-spectrum antibiotics separately, essentially using these children as guinea pigs.
But that's incredibly risky, and several infants will definitely die.
I maintain my assessment. Neonatal antibodies derive from maternal transfer.
I suggest drawing blood from healthy infants first as a control group.
Then test the mothers of symptomatic infants to identify which viral antibody they're lacking. That way, we can pinpoint the correct pathogen from numerous possibilities.
In that scenario, we only need to run panels on the eight mothers and the elderly volunteer."
David, having finished his rapid explanation, reflexively reached for coffee but found nothing.
At that moment, Cameron handed her cup to David.
David was momentarily surprised, then smiled at Cameron and drained the bitter coffee in one swallow.
Meanwhile, House was contemplating the feasibility of David's proposed method.
Foreman, however, stood nearby looking like he wanted to object but couldn't.
He realized he couldn't find grounds to refute David's approach.
David's method could most rapidly determine if the infants were collectively infected with a virus.
His method, conversely, required gambling with infant lives first.
The superiority of the two approaches was immediately apparent.
At this point, House had made his decision:
"Proceed. Draw blood from their mothers. I recall a healthy infant was transferred to the fifth floor and hasn't been discharged yet. Draw a tube from her.
After ruling out non-viral etiology, then we'll consider the high-risk approach."
Hearing House's decision, Cameron was first to exhale in relief.
After all, if they followed Foreman's suggestion—empirically treating possible MRSA with vancomycin and other pathogens with aztreonam—they'd have to inform families to prepare for child loss.
This was the absolute last thing Cameron wanted to do. She hated delivering despair.
David's method, however, effectively circumvented this possibility.
Even if David's approach ultimately failed and they still had to take the risky path, at least she'd have time to mentally prepare.
For now, she just had to perform the straightforward task of phlebotomy.
Observing the relieved Cameron, House's eyes flickered. He recognized the vulnerability in Cameron's psyche.
Among his three fellows, Foreman had now lost composure and was aggressively targeting the newcomer.
Cameron was too emotionally invested. Chase, due to his privileged background, wasn't sufficiently invested in the work.
He looked around. These three fellows' performance was now actually inferior to David, who was merely a newcomer.
This genuinely disappointed him.
Seems necessary to speak with David after shift and figure him out.
Having decided, House headed toward clinic. He still had clinic hours to complete.
As for the lab work, he could delegate it to David and the other three.
It wouldn't be too late to reassume command once results were available.
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