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

Lin Ye closed the cabinet, turned around, pulled over a chair, sat down, leaned back, crossed his legs, and took out his phone to do a couple of practice questions when he heard a "ding".

The emergency room's automatic doors slid open again, and two men stumbled in.

The man walking in front was about thirty-five or thirty-six years old. He was wearing a wrinkled navy blue suit with mud on his trouser legs. A large patch of skin was scraped off his right palm, and blood was dripping from his fingers onto the ground. He reeked of alcohol, and there was a bruise and hematoma on his left temple.

Behind him followed a young man in his twenties, carrying a soaking wet briefcase. He hadn't even had time to put away his umbrella and kept trying to help him, saying, "Brother Wang, slow down!"

"Doctor! Could you please bandage my brother's hand first?"

The young man shouted as he walked in, "We fell while having dinner with clients, and the contract over there is still waiting to be signed, please hurry up!"

Lin Ye took a piece of sterile gauze and went over. He first pressed it on the bleeding palm of the man, and then pressed the pulse on the side of his wrist. It was beating very fast, much faster than a normal drunk man's pulse.

"How did you fall? How long have you been lying there?"

"I slipped on the steps at the hotel entrance about ten minutes ago," the young man answered quickly. "It's just a scrape, you can disinfect and bandage it for us, we're in a hurry."

Did you hit your head when you fell?

Lin Ye glanced up at the hematoma on his forehead, surrounded by cement shards. "Are you feeling dizzy, have heart palpitations, or shortness of breath now?"

"Why are you kowtowing!"

The man, slurring his words from drinking, shook off his hand. His face flushed red from the alcohol, and he slammed his hand on the triage counter, making the QR code sign shake. "I just scraped my hand! Why are you asking so many questions? Are you trying to order more tests to rip me off? I know people in your hospital office, so stop with the nonsense!"

The young man quickly tried to smooth things over, taking out his phone to check the time: "Doctor, we're really in a rush. Our client is waiting at the hotel next door. We'll leave as soon as we get the papers signed. Can we take responsibility if anything goes wrong?"

Nurse Zhu frowned and stood up: "What are you shouting for? This is a hospital. If you don't want to watch, then leave. Don't disturb the other patients."

Ma Hao also put down what he was doing and wanted to come over and persuade him.

Lin Ye reached out to stop them, his gaze sweeping over the man's face. His face was abnormally red, his conjunctiva was congested, his breathing was rapid, and his chest was heaving greatly. When the man slammed his hand on the table earlier, the inner pocket of his suit jacket had opened slightly, revealing half a foil package of metronidazole.

"Your condition is not right. Your pulse is too fast, and your face is abnormally flushed. It is very likely a reaction caused by taking medicine and drinking alcohol. The hematoma on your forehead also needs to be checked to see if there is any intracranial problem. You cannot leave immediately."

Lin Ye's voice was steady. He turned to Ma Hao and gave him a wink. "Go and call Teacher Qin out. Tell him there's a patient with an injury after drinking alcohol. He's suspected of having a disulfiram-like reaction and there's a risk of intracranial hemorrhage."

"I'm fine!"

The man interrupted him, reaching for the door. "I know my own body. I just had a few drinks. What could possibly happen? You won't let me leave? Fine, I'll sign a waiver. Any problems that arise will be none of your business!"

Nurse Zhu stood beside him, and Lin Ye didn't stop him. He turned around, took a "Refusal of Medical Treatment Informed Consent Form," placed it on the table, and pointed it out to him one by one: "Let me make the risks clear to you one last time: If you drink alcohol after taking drugs like metronidazole, you may go into shock and have difficulty breathing; if the hematoma on your head is an intracranial hemorrhage, you might not wake up after a nap. If you insist on leaving, sign this, clearly stating that you refuse observation, refuse examination, refuse treatment, and bear all consequences yourself."

The man paused for a moment, grabbed a pen, quickly signed his name and pressed his fingerprint, then threw the pen on the table: "Is this okay now? What bad luck."

He turned and walked towards the door, and the young man quickly followed behind to help him.

Lin Ye didn't say much, but gave Ma Hao a wink. Ma Hao understood and quietly pushed the stretcher behind the door. He also brought the oxygen device and first aid kit to the triage desk in advance. Both of them stared at the man's back.

Just as he reached the automatic door, the man's legs suddenly gave way, his body swayed, he reached up and grabbed his collar, opened his mouth, his face turned ashen, and he fell to the side.

Lin Ye was prepared. She rushed over, reached out and gently placed him on the ground, supporting his shoulder. She grabbed a sterile pillow and placed it under his head to prevent injury. She turned his head to one side, quickly wiped away the vomit from his mouth, opened his airway to prevent suffocation, and called out, "Sister Zhu, get the monitor and oxygen! Ma Hao, lend a hand!"

Qin Hai immediately came over, squatted down, felt his carotid artery, shone a flashlight on his pupils, and waited for the nurse to connect the monitor before glancing at the values: blood pressure 85/50, heart rate 132, blood oxygen 88.

"What's going on?"

"I sustained an external injury after drinking alcohol. Half a strip of metronidazole was exposed in the inner pocket of my suit. I am now considering a dithiol-like reaction and the risk of traumatic brain injury cannot be ruled out. I just signed a form to refuse medical treatment."

Lin Ye's hands didn't stop moving as he worked with the nurse to establish an intravenous line. "Rapid pulse, flushed face, conjunctival congestion, and a 4cm hematoma on the forehead."

Qin Hai nodded, asked no further questions, and immediately gave the medical orders: "High-flow oxygen therapy, rapid infusion of crystalloid fluid to expand blood volume, continuous monitoring of vital signs, and once the blood pressure stabilizes, immediately take the patient for a head CT scan to rule out intracranial hemorrhage. Continue observation until the CT results are available and the vital signs are stable."

"it is good."

The nurse responded quickly and efficiently, inserting the IV, adjusting the oxygen flow, and connecting the monitor.

After the oxygen was administered, the IV fluids were dripped in, and the man was laid on his side to stabilize himself, his breathing gradually became smoother after more than ten minutes. The cyanosis on his lips subsided, and his oxygen saturation slowly rose to 95. When he opened his eyes, he was still dazed, unaware of what had just happened.

The young man was terrified, his face turning deathly pale. He stood to the side, bowing repeatedly, his voice trembling: "Doctor, I'm so sorry! We were being unreasonable and shouldn't have caused trouble. Please don't take it to heart. We'll cooperate with whatever treatment you give us, and we'll pay right away!"

"Let's go and complete the paperwork first, then I'll accompany you to the CT scan later."

Lin Ye handed him the test results. "Tell him when he wakes up that he shouldn't drink alcohol for several days before and after taking this medicine. This is no joke."

The young man nodded repeatedly, took the slip, and ran off to pay the fee.

After pushing the person to the observation area, Qin Hai folded up the signed informed consent form and put it into the medical record folder. He glanced at Lin Ye and said, "Write those risk disclosures into the case file later."

After saying that, he turned and went back to the consultation room.

"Understood, Teacher Qin."

Lin Ye responded, threw the gauze soaked with vomit into the medical waste bin, and went to the sink to wash his hands.

Ma Hao leaned closer, letting out a sigh of relief: "Damn, that scared me to death. It would have been a real problem if I had actually fallen at the door."

"A person who's drunk won't listen to anything you say."

Lin Ye shook the water off his hands.

Nurse Zhu handed over a cup of hot water, pursing her lips: "Only you have a good temper. If it were me, I wouldn't bother arguing with him. If he really wants to leave, I'll just let him go."

"Those working in the emergency room can't just watch people walk into danger."

Lin Ye took the hot water and drank a sip.

The rain gradually subsided in the latter half of the night.

Lin Ye and Ma Hao took turns leaning back in their chairs and dozing off for a couple of minutes. By the time they finished their shift at 7:30, it was already dawn.