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

The following evening, when he returned to the emergency room, the nurses at the station had been replaced.

Sun Zhiqiang is not here.

Nurse Zhao is not here either.

Sitting behind the triage desk was Nurse Li, who was on the night shift that night. When she saw Lin Ye, she first pushed a takeout order to him.

"your?"

Lin Ye looked down.

Mala Tang (Spicy Hot Pot).

The note says: No cilantro, add more vinegar.

He shook his head.

"It's not mine."

Nurse Li took the form back.

"I told you you didn't look like someone who would have time to order takeout."

Qin Hai was on the night shift tonight. He had just come out of the red zone entrance when he heard this.

"Even if he has time, he might not remember to eat."

Lin Ye put the bag in the cabinet.

"Teacher Qin, I ate it yesterday."

"Just because I ate yesterday doesn't mean I ate today." Qin Hai glanced at him. "Have you slept enough?"

That's enough.

Qin Hai didn't ask any further questions.

For the first half of the night, I was unusually not pushed forward in one go.

In the observation area, someone complained of stomach pain; at the triage desk, a child with a fever cried and refused to have their temperature taken; in the red zone, a man who had fallen and injured himself while drunk repeatedly asked where his phone was.

They're all annoying, but they're all still within my control.

Ma Hao also made a bowl of instant noodles during a break. Just as he inserted the fork into the noodles, the father of the child with a fever ran over and asked if he could get some fever-reducing medicine first.

Ma Hao hid the instant noodles under the registration desk.

"My noodles aren't fully cooked yet, and your child hasn't been seen in time. Let's take your temperature first, don't just ask about medicine right away."

Nurse Li added the finishing touches from the side.

"He knows to wait three minutes for his instant noodles, so you should wait for the doctor too."

The child's father felt embarrassed by what was said, so he picked up his child and sat back down on the chair.

Lin Ye came out of the red zone and saw Ma Hao bringing out the instant noodles again.

"Is this considered a midnight snack, or is it for salvaging supplies?"

Ma Hao took a sip of noodles.

"Let's see if you can finish this tonight. If you finish it, it's a midnight snack; if you can't, it's just instant noodle soup."

Qin Hai walked by.

"Stop being silly. You'll have to copy it yourself from the soup spill log later."

Ma Hao immediately moved the flour bucket away.

Lin Ye had just handed the scalp laceration of the man who had fallen and injured himself while drunk to the surgical team for cleaning when a middle-aged woman in a wheelchair was pushed over from the triage desk.

The man who accompanied her pushed the cart while hurriedly explaining.

"Doctor, she just pulled a muscle in her back. She was moving flowerpots this afternoon, and suddenly she couldn't move. Give her a painkiller injection and let her take a nap; she has to open the shop tomorrow."

The woman was in her forties, her face was covered in sweat, her back was tense, and she dared not lean back.

Nurse Li clipped the triage form onto the board.

"She has lower back pain, numbness in her right leg, blood pressure of 156.92, and heart rate of 108. She said the pain was severe and she almost couldn't stand up at the door just now."

The man immediately responded.

"Her back has always been bad, it's an old problem. In the past, just using a plaster would be enough, but she probably twisted it too hard today."

The woman didn't speak, but simply pressed her hand against the bag on her knee.

Lin Ye squatted down next to the wheelchair, without touching her waist first.

"Auntie, where does the pain start?"

The woman gritted her teeth.

"From the middle of the waist, it shoots up to the buttocks and legs."

"Is it one leg that's numb, or both legs?"

She hesitated for a moment.

The man answered for her.

"The right side, the right side is numb. She can't speak clearly when she's nervous."

Lin Ye didn't look at the men, only at the women.

"You tell me yourself."

The woman gripped the bag strap tightly, her voice low.

"Both sides are a bit affected. The right side is heavier."

The man then paused for a moment.

"Didn't you just say it was on the right?"

The woman was even more annoyed by what he said.

"I was in so much pain I almost threw up, I didn't care about being so particular."

Lin Ye continued to ask.

"Can your toes move?"

The woman bent down and tried, but her right foot moved slowly.

"Yes, it's numb."

"Is there any numbness around your buttocks and crotch?"

Upon hearing this, the man's face immediately showed embarrassment.

"Doctor, do you even need to ask that?"

The woman also turned her face away.

Lin Ye did not go around it.

"You should ask. Lower back pain isn't just about whether it hurts or not; if there's numbness in some areas, it can't be considered a regular sprain."

The woman remained silent for a few seconds.

"A little."

The man became anxious.

Why didn't you tell me?

"What do you mean?" The woman's eyes reddened instantly, and her voice became anxious. "I've been in pain since this afternoon, and all you know is to tell me to bear it. The shop is waiting for me to go back and collect the money."

The man was speechless, and his hand on the wheelchair loosened its grip slightly.

Lin Ye lowered the bar by saying a sentence.

"How was your pee today?"

The woman didn't answer immediately this time.

She looked down at her hands, her fingertips constantly rubbing the edge of the bag strap.

Qin Hai, who was flipping through triage forms on the side, looked up when he heard this.

The man was worried for her.

"Why are you asking about urination when your back hurts? She hasn't drunk much water today."

Lin Ye continued to look at the woman.

"Have you urinated since this afternoon?"

The woman's lips were pressed together until they turned white, and she didn't speak for a long while.

"no."

"Is it that you don't feel the urge to urinate, or that you want to urinate but can't?"

The woman's face flushed red.

This time, the man didn't rush to answer for her.

Lin Ye lowered his voice.

"This sentence is very important, so tell the truth."

The woman finally raised her eyes.

I need to pee, but I can't.

Qin Hai placed the triage form on the table.

"What time does it start?"

The woman was startled by Qin Hai's voice.

"It stopped after noon. Around 5 pm, I wanted to go to the toilet, but when I sat down, I couldn't urinate. Later, my lower back hurt more and more, and my legs went numb."

The man was truly panicked this time.

"Didn't you say you were embarrassed to use public restrooms?"

Tears streamed down the woman's face.

"I don't want to say this in front of people!"

Lin Ye stood up.

In the corner of my field of vision, pale blue lettering flashed briefly.

Emergency Room Early Warning System

[Possible diagnosis: Risk of cauda equina syndrome.]

[Key abnormalities: perineal numbness, difficulty urinating, and worsening numbness in both lower extremities.]

[Risk Warning: Delays may cause damage to urinary function and lower limb function.]

Lin Ye only glanced at her before his gaze quickly returned to the woman's face.

"Teacher Qin, this can't be treated like a regular back sprain with just painkillers."

Qin Hai looked at him.

"Give me your evidence."

"The pain in my lower back radiates to both legs, more severe on the right, but there's numbness on both sides. She also said the perineum is numb. She hasn't been able to urinate since noon, and it's not just because she hasn't drunk water."

Qin Hai's face darkened.

"Move her to the treatment room. Don't let her stand on her own yet, Nurse Li, go with her. Check her lower limb muscle strength and sensation, and do a bedside bladder ultrasound to check for any retention. Contact the orthopedic spine specialist now, and send her for an emergency lumbar spine MRI as a suspected case of cauda equina syndrome. If you can't get an appointment, contact the on-call supervisor."

The man's voice changed when he heard "MRI".

"Is it that serious? It's just a back strain, isn't it?"

Qin Hai glanced at him.

"If it's just a back strain, that's for the best. Don't try to save her time by getting her checked out yet."

The woman sat in a wheelchair, her hand still on her bag.

She had been holding back, but now she finally asked in a low voice:

"Doctor, will I be unable to urinate in the future?"

Lin Ye paused for a moment as he gripped the wheelchair handle.

He didn't say no.

"That's what I'm worried about right now, so we can't delay. Tell me about all the discomfort you felt earlier, don't try to make things easier for anyone else, and don't be shy."

The woman closed her eyes, and tears slid down her cheeks.

My right leg feels even more numb.

Qin Hai had already picked up the phone.

"Is the orthopedics department on duty? There's a patient in the emergency room with lower back pain, urinary retention, perineal numbness, numbness in both lower limbs, and poor dorsiflexion in the right leg. We're preparing for an emergency lumbar spine MRI. Could you come down and take a look?"

I don't know what was said on the other end of the phone.

Qin Hai didn't raise his voice.

"Yes, don't treat it as a regular lower back sprain."

Lin Ye glanced down at the wheelchair footrest.

The woman's right toes slowly drooped downwards without her even realizing it.

He reached out and held onto the edge of the pedal.

"Auntie, hook your right foot up a little."

The woman tried it.

It didn't hook up.

The man loosened his grip on the wheelchair handle and didn't urge him to "get an injection" again.

"I could walk a few steps at home just now."

Qin Hai hung up the phone and looked back at him.

"So let's not delay any longer."