When I'm on the night shift, all the department heads can't sleep.

Nurse Zhao answered the phone and casually pulled over a sticky note.

"Emergency room at the First Municipal Hospital, who is it?"

The person on the other end of the phone first gave the name of the community health service center. The doctor on duty lowered his voice, as if afraid of waking the elderly people under observation next to him.

"Hello, I'd like to check with you about Li Wencheng's medication. His family just called us, saying that your emergency department is asking about his medication."

Nurse Zhao glanced at the nurses' station.

Zhou Min was hunched over the triage and review book, filling in the missing records. She should have left by now; she hadn't finished clearing up the review issues left over from the day shift, and she was also held up by Li Wencheng's matter. She hadn't even had time to drink water yet.

Qin Hai leaned against the treatment cart, his shoulders heavy. Before taking this shift, the deputy director of the day shift had made him go back to the duty room to doze off for a few hours, but as the night rolled in, that little bit of sleepiness was long gone.

Nurse Zhao turned on the speakerphone.

The next sentence came through the speakerphone very quickly.

"He came to get his blood pressure medication last week and mentioned that he still had a bottle of old digoxin. He got it last year when he was hospitalized to visit relatives in another city. It wasn't a drug from your First Municipal Hospital's pharmacy. The bottle you have in the emergency room now should be that one. We only have records of blood pressure medication in our computer system; we can't find the prescription or batch number for this particular bottle."

Nurse Zhao paused for a moment.

"So, the bottle is with us, but you have no idea where it came from or how it's been used recently?"

"Yes. The family said they still have old medical records and discharge notes at home, and they're on their way back. We'll send you photos as soon as we find them."

Zhou Min raised her head.

Qin Hai didn't say anything, but simply unscrewed the cooled strong tea, took a sip, and quickly put it back.

There was the sound of pages turning on the other end of the phone.

"There's one more thing I need to tell you. When he came last week, I reminded him to have his kidney function checked again, but he said he didn't feel any discomfort, so he didn't have it checked. His family can't say for sure when he last took the medication, they only say that he's been feeling palpitations for the past two weeks, and he wakes up in the middle of the night and takes a pill by himself."

Nurse Zhao muttered a curse under her breath.

"This isn't taking medicine, it's like opening a blind box for yourself in the middle of the night."

The community doctor also sighed.

"A few days ago, his leg was swollen, and he even added half a diuretic pill to his own diet. His family can't remember the name, they only remember the old label. We'll have to wait for a photo of that bottle of diuretics."

After hearing those words, the nurses at the station were no longer sleepy.

Li Wencheng's heart rate was around 49 and his blood oxygen level was 96 in the red zone. The on-duty nephrologist was rushing him to the emergency room. Everyone knew he might have digoxin-related arrhythmia, but this call from the community center pulled the already unclear medication history even deeper.

It's not a bottle of medicine.

It was an old medicine I brought back from another country last year. I added the medicine myself in the middle of the night without checking my kidney function, and I also mixed it with a diuretic of unknown name.

After hanging up the phone, Nurse Zhao wrote down a few key pieces of information and pasted them next to Zhou Min's triage and verification book.

"The old man hides his old medicines more carefully than his personal stash of money. If we really had to search, we'd probably have to turn over his bedside table, drawers, and coat pockets."

Zhou Min tucked the note into the review notebook, her tone still steady.

"I'll call the family. Don't just look at the discharge record; take a picture of where they usually keep their medications too. Older people often mix old medications into their medicine boxes without even realizing it."

She dialed the family's number without exchanging any pleasantries.

"Don't rush to the hospital yet. Once you get home, take pictures of his old medical records and discharge summary. Then check all the drawers, bedside tables, and coat pockets where he usually keeps his medicine. If you see any unfamiliar medicine bottles, take pictures of the front, back, and how many pills are left."

The woman on the other end of the phone was breathing heavily, the sound of the wind and the car door notification sound mixed together.

"Sometimes he puts his medicine in his work bag, and I don't know if he has it or not."

"Then have someone at home who can contact him ask his workplace. The issue now isn't about who's responsible, but about finding out exactly what he took. If any medication is missing, our assessment becomes incomplete."

There was a brief pause on the other end of the phone, then the woman's voice sounded a little distant: "I'll have my family look for it first."

Qin Hai waited for Zhou Min to hang up before speaking.

"Sister Zhao, add this to the medication history. Report it to both the cardiology and nephrology departments. Urge the lab to update the blood drug concentration. When family members arrive, take them directly to the entrance of the red zone; don't let them sit and wait idly in the waiting area."

"Know."

Nurse Zhao sat back down at the computer and added the community phone number, out-of-town goxigenin prescription, self-administered medication, and unidentified diuretics to the electronic medical record notes. She typed quickly, all the while scolding the patient.

"Could you add a column to the triage form in the future to ask if they have any family-inherited traditional medicines? The elderly are very frugal; they won't throw away even half a bottle of pills."

Zhou Min added, "Even if they added it, they might not say so. We'd have to ask where the medicine is."

Qin Hai lifted the curtain over the red zone.

Li Wencheng lay in bed, still awake, but reacting slowly. His heart rate on the monitor fluctuated between 49 and 50, like a light that refused to go out completely.

"First, stabilize the patient. Wait for the blood drug concentration to reach the target level; don't let the medication history come later than the patient's."

Nurse Zhao dialed the number for the laboratory.

They said the specimen had been loaded onto the machine and I should go back to the emergency room as soon as it came out.

She hung up the phone and called back the cardiologist on duty, speaking in a clear and concise voice.

"We've obtained Li Wencheng's medication history. Last year, he took Goxin from another city and increased his dosage on his own. A few days ago, he also took half a tablet of an unknown diuretic. His blood potassium is 5.6 and creatinine is 176. We're still waiting to determine his blood drug concentration. His family is going back to find his old medical records and other unfamiliar medications."

There was a brief silence on the other end of the phone.

"I understand. Keep the monitoring going. Send me pictures of the old medical records and any other medications you don't recognize. When you arrive at the nephrology department, have them check your kidney function and potassium levels first."

In the duty room, Lin Ye had just settled into the narrow bed.

The thin blanket still smelled of disinfectant from the previous all-nighter. The bed was narrow, and it creaked whenever he sat down, the sound particularly clear in the small room.

The hands-free audio from outside the door came through the door panel.

He heard it when the community doctor reported the old location, Gaoxin.

He also heard Zhou Min asking her family to take pictures of the drawers and bedside table.

When Nurse Zhao reported the blood potassium, creatinine, and unknown diuretic to the cardiology department, his back was not yet fully secured.

The blue text box at the edge of my field of vision popped up at that moment.

[Incomplete Loop Tracking: Gaps in the Drug Supply Chain.]

There is only this one line of text.

There was no treatment plan, nor were there any answers presented to him.

Lin Ye had already sat up.

His first reaction was to open the door.

He added the community phone number to the medical record, re-reported the risk of mixed medications, urged the lab to send the blood drug concentration report, and kept an eye on the old medical records and other unfamiliar medications. In the past few nights, he always felt that if he was even a second too slow, some unseen leak would occur.

But he stopped as soon as his hand touched the doorknob.

Outside, Zhou Min had already called her family.

Nurse Zhao's computer keyboard was clicking loudly.

Qin Hai entered the red zone again and asked the nurse through the curtain if the monitoring alarm limits had been adjusted.

The cardiology department has taken over the medication history, the nephrology department is on its way, and the laboratory specimens have already been loaded onto the machine.

There was someone outside the door.

Outside the door was a whole night of emergency room work. When I was so sleepy I was numb, I managed to connect the dots regarding the medication.

Lin Ye stood inside the door, the tension in his chest still lingering.

Qin Hai just took his pen away, saying that someone would fill in the missing records and someone would take over the process.

Nurse Zhao pushed him in and said, "Twenty minutes. If it's even a minute less, I'll come and pull off the blanket."

Zhou Min didn't even look up, and said, "Go ahead and don't worry, I'll call you if anything happens."

These words weren't meant to comfort him.

It means making him retract his outstretched hand first.

Lin Ye slowly loosened the doorknob.

He pressed his white coat against his pillow and lay down again.

The lights in the duty room were off, with only a sliver of emergency room light seeping through the crack in the door, casting shadows on the floor. Outside, the sounds of telephones, monitors, and keyboards mingled together, creating a chaotic cacophony, occasionally punctuated by Nurse Zhao's hushed urging and Zhou Min's rustling of the checklist.

He closed his eyes.

Soon after, the voice of another nurse on duty came from outside the door.

"Sister Zhao, the one in the observation bed, the 27-year-old with chest tightness, it's time for her follow-up ECG. Should I go get her, or will you go?"

His eyelids twitched.

But Nurse Zhao had already spoken outside.

"Okay. Go distribute the thermometers to the patients under observation first. After you're done, come back and keep an eye on the entrance to the red zone. If Li Wencheng's family arrives, make sure they don't wander around."

After she finished speaking, she walked towards the waiting area, her voice quickly drowned out by the calls of numbers in the corridor.

Zhou Min is still supplementing the triage verification form.

Qin Hai asked at the entrance of the red zone whether the blood drug concentration had returned.

Soon, a voice came from the nurses' station saying, "The specimen is ready for the machine." Nurse Zhao responded from outside and then lowered her voice to urge the young man with chest tightness to lie down properly.

Lin Ye did not open his eyes again.

My breathing gradually subsided.