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

Lin Ye took the film bag from Nurse Zhao; the film still carried the warmth of the radiology machine.

Nurse Zhao tilted her head towards the examination room: "Director Qin is waiting inside."

Lin Ye carried the X-ray film bag to the examination room.

The door was half open, and Qin Hai and Dr. Zhang from the pediatrics department were already standing by the film viewing light. Dr. Liu from the general surgery department had just rushed down from the inpatient department, with a little sweat on his forehead.

"You're here?" Qin Hai turned around and glanced at him, then reached out and took the film bag, pulling out the film and clipping it onto the viewing light.

As soon as the light came on, several people looked over at the same time.

Dr. Zhang pointed to the repeat X-ray on the light: "Look, two hours ago the four beads were still a bit far apart, but now they've basically clumped together. The location is in the small intestine segment around the navel, and it hasn't gone any further than before."

He flipped through the physical examination record: "The child complained of stomach pain twice more 20 minutes ago. The tenderness around the navel is more obvious than before, the abdomen is soft, and there is no rebound tenderness, but this progression is not right."

Dr. Liu leaned over and stared at the film for half a minute, then pointed his finger at the cluster of bright shadows and said decisively, "We can't keep them under observation any longer."

Dr. Liu's fingertip was still hovering beside the clump of shadows. He glanced back at Qin Hai and Dr. Zhang: "Several beads are clustered together and haven't moved. It's possible they're sucking each other together through the intestinal wall. The child's pain is getting worse. If we wait any longer, the intestinal wall will be compressed to the point of ischemia, necrosis, and perforation. The child will suffer even more."

He pulled his hand away from the film viewing light: "Now we're not gambling on whether we can arrange it ourselves, we're going straight to general surgery and following the emergency surgery pathway."

"Continue withholding food and water. Immediately establish an intravenous line for fluid replacement. Draw all the necessary blood tests, including complete blood count, electrolytes, coagulation, and infection indicators, for the preoperative period. I'm calling the second-line team now to inform the anesthesiology and operating room to prepare a table in advance. Prioritize laparoscopic removal of the foreign body; if it can be done minimally invasively, we won't perform a major operation on the child."

Lin Ye stood to the side, scribbling notes. After Dr. Liu finished speaking, he added, "The child vomited once around 4:30 pm, and hasn't eaten dinner since. He's been on observation without food or water ever since. We just checked his history of drug allergies, and the family said he doesn't have any. What he vomited before was just stomach contents, not blood."

Dr. Liu nodded, signaling to call the family members in.

The child's parents came in, holding onto the door frame. The mother was holding the child, who was curled up in her arms with a frown, clutching the hem of her clothes, and occasionally whimpering in pain.

"Dr. Liu," the child's father stared at his face, "does it... require surgery?"

"The scans and physical examination haven't indicated any perforation yet, so please don't worry." Dr. Liu pulled out chairs for them to sit down.

"This is what we're worried about. If the bead doesn't move down and stays in one place for too long, the intestinal wall won't be able to take it. We're now preparing for surgery. The general surgeon will assess the situation first, and if it can be removed laparoscopically, we'll do so as much as possible, minimizing the incisions. We don't want to wait until the child is in so much pain that they can't bear it anymore before we start working on them."

Upon hearing the word "surgery," the mother tightened her grip on her child, her voice trembling, "He's only four years old. Will he be able to withstand the anesthesia?"

"The anesthesiology department will come to assess her, checking her weight, fasting time, allergy history, and everything else one by one." Dr. Liu looked at her. "Preparing in advance now is so that we won't be flustered when we actually go into the operating room."

Qin Hai took the film off the viewing light and put it back in the film bag: "Dr. Liu has contacted the general surgery second line, and the anesthesiology department and operating room are also on standby. The child is still in the emergency room. We will continue to check the abdominal signs, monitor the vomiting and stool, and press the call button immediately if there are any changes. The nurses will be there as well."

Upon hearing this, the child's mother burst into tears, which fell onto her child's thin coat. She didn't dare to cry out loud, but gently patted her child's back to comfort him.

The child's father took the informed consent form from the nurse, his fingers trembled slightly as he held the pen, and the pen lingered on the paper for two seconds before he wrote his name. After signing, he said in a low voice, "We didn't take good care of the child."

"Don't think about that now, just cooperate with us." Dr. Liu patted his arm and handed the signed form to the nurse next to him to put into the medical record folder.

Nurse Zhao brought over the printed wristband, carefully checked the child's name, gender, and age, and confirmed with the family that the child had not been fed water or anything else since being placed under observation.

She placed the wristband on the child's wrist and pressed the edge with her fingertips: "Loosen your hand a little, and Auntie will leave you a needle; it'll be done in a second."

The child was in pain and kept shrinking into his mother's arms. The mother instinctively tried to pull his hands back to protect him, but Nurse Zhao didn't stop: "Mom, help me hold his shoulders, don't block his hands, the more you block, the more scared the child will be."

Several blood collection tubes were lined up in the treatment tray, along with cotton swabs, adhesive tape, and indwelling needles. Nurse Zhao wrapped the tourniquet around the child, while Lin Ye held the child's arm beside her. The child whimpered, tears clinging to her eyelashes, and the corner of the Zero sticker in her other hand folded again.

Nurse Zhao secured the indwelling needle and moved the "No Food or Water" sign to a more prominent place by the bedside: "Bring the stretcher over, get ready to transfer to general surgery."

Upon hearing this, Ma Hao turned and ran towards where the flatbed carts were parked.

The flatbed cart bumped against the entrance of the observation area. He bent down to straighten it, and casually tucked the transfer handover form into the medical record folder before handing it to Nurse Zhao.

Lin Ye reached out and gently lifted the child onto the stretcher. In the child's other hand, he was still holding the Ultraman Zero sticker that Ma Hao had given him earlier, the edges of which were already crumpled and curled up.

Ma Hao glanced at the sticker, then reached up and snapped the flatbed railing up again. Not satisfied with that, he looked down and checked the clips one more time.

Dr. Liu pushed the gurney to the elevator entrance and told the staff there to take the operating room elevator instead of waiting for the passenger elevator, which would waste time.

The child's father stood beside the flatbed, his hand gripping the cold edge of the cart, while the mother stood beside him, bending down to protect the child's head.

As the elevator doors slowly closed, Lin Ye saw the child raise the sticker in his hand, but perhaps because his stomach hurt from pulling it, he put it down halfway and shrank back towards his mother's arm.

Lin Ye turned back to the triage desk. The nurses at the station called him to answer the phone. It was the ophthalmology department calling: "Just letting you know, we've seen Zhou Qiming from earlier. He has a retinal tear with superficial detachment. We're arranging for emergency laser treatment. He's been admitted to the ophthalmology department. Just keep a record here in the emergency department. Don't worry about it."

Lin Ye agreed and wrote the information in the emergency room registration book.

He opened his small notebook and wrote down the time points one by one. He then drew a circle next to the line that read, "Four magnetic beads, no significant downward movement in two hours, increased tenderness, transfer to general surgery emergency surgery evaluation."

The call light above the nurses' station lit up, followed by a ringing sound. It was pressed by the family of a feverish child who had just been brought in from the observation area.

Lin Ye closed his pen cap, picked up his stethoscope, and walked towards the observation area.