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

The next day, the small noodle shop behind the hospital had just opened for evening business.

The noodles in Ma Hao's bowl were almost gone, leaving only a mouthful of soup.

Lin Ye glanced at his phone, put down his chopsticks, and said, "Let's go, if we sit any longer we'll be at the shift handover time."

"Right away, right away."

Ma Hao picked up the bowl, finished the soup, and took a tissue to wipe his mouth.

The two returned to the emergency room through the staff entrance, changed into their white coats, and came out just as the day shift was handing over to the last few beds.

Just as the handover log was handed to Lin Ye, Nurse Zhu at the triage desk called out to Ma Hao.

Lin Ye put the bed number in his to-do list. The five beds left for the day shift were still waiting for the urine test results.

Ma Hao had just finished noting down the end time of IV fluid resuscitation for another patient, and hadn't even put the pen cap back on yet.

"A patient has arrived at examination room number two. Please assist them."

Ma Hao capped his pen, got up, and walked out.

Following behind Nurse Zhu was a woman in her thirties who kept scratching her arms as she walked. Large and small red welts were floating on her forearms, and several of them had already merged into one.

A patch of rashes appeared on both sides of her neck, and she kept pulling her collar outwards when she came in.

"Doctor, could you give me an injection to stop the itching?" The woman sat down without stopping scratching. "I've been itching since I got off work, and the more I scratch, the more it gets worse. I really can't stand it anymore."

"Don't scratch, put your hands down." Ma Hao handed over two tissues. "If it's really itchy, gently press it, but don't scratch your skin raw. What's your name?"

"Luo Jing".

Ma Hao pulled his chair forward, his gaze first falling on her lips: "Are your lips swollen? Is your tongue swollen? Is it difficult to swallow?"

Luo Jing stuck out her tongue, then swallowed in front of him: "Nothing, I just feel really itchy all over. Look at my neck, isn't it swollen too?"

"These are all rashes on your neck, but your lips and tongue aren't swollen yet." Ma Hao gestured for her not to touch the side of her neck. "Does your chest feel tight? Are you breathing easily?"

"It's not stuffy, and I can breathe easily."

Nurse Zhu had already wrapped the blood pressure cuff around her right arm: "Don't hold this hand, it'll move around and the reading won't be accurate, we'll have to re-wrap it."

Luo Jing had no choice but to put both hands on her lap.

He could only hold back for less than ten seconds before his fingertips started rubbing back and forth along the seam of his pants again.

The blood pressure monitor stopped, and Nurse Zhu glanced at the numbers: "124, 78, heart rate 92, blood oxygen 99."

Ma Hao placed the stethoscope on her back and guided her to slowly inhale and exhale.

Breathing sounds were clear on both sides, and no obvious wheezing was heard.

As he put away his stethoscope, Luo Jing had already slipped her left hand under her clothes and rubbed her waist through the fabric.

"Did it start on your waist?"

"Yes, it was only two or three yuan when I got off work." Luo Jing pulled out a photo on her phone, which she had taken in the restroom at work. "I thought I had been bitten by a bug. But after the whole bus ride, my arms and neck started itching."

In the first photo, there are only two or three pale red wisps on the side.

The second picture, taken more than twenty minutes later, shows the rash spreading to the forearm.

She rolled up her sleeves a little higher, revealing a few new patches that were even redder and had clearer edges.

"Did you eat anything you haven't eaten before today? Are there any new medications you've started taking?" Ma Hao recorded the timestamps of the two photos into the medical record.

"My company ordered afternoon tea for lunch, and I had half a cup of fruit-flavored yogurt that I'd never tried before. The rest of my lunch was the same as usual." Luo Jing thought for a moment, "I didn't take my medicine, and I didn't touch any health supplements today."

Have you changed your laundry detergent or skincare products in the last couple of days?

"Those things at home have been used for a long time and haven't been replaced."

Have you ever had this kind of rash before?

"I had a few bites of crab when I was in college, but they went away on their own after a night's sleep. I didn't have any shortness of breath that time, and I don't think I've had any problems eating crabs since."

Luo Jing paused, then raised her hand to her neck: "Was it that cup of yogurt that caused it? I'll throw the rest away when I get back."

"Don't rush to conclusions. Remember everything you ate or touched today, so that you can confirm it during your follow-up visit if it recurs."

"So, should I get an injection or an IV drip?" Luo Jing couldn't help but ask. "Can you stop the itching quickly?"

"Let's find out the situation first, then we'll see how to administer the medication." Ma Hao pushed the cushion under her arm. "Are you dizzy? Do you feel unsteady when you stand up? Does your stomach hurt? Do you feel nauseous?"

"No, not at all. I was walking quickly after getting off the bus, so I didn't feel dizzy."

A notification of the inspection results pops up on the other side of the partition.

Lin Ye called the patient in bed five, who had been handed over during the day shift, back to the examination room and closed the door for a second evaluation.

After recording Luo Jing's rash area, breathing condition, and vital signs, Ma Hao got up to call Qin Hai.

Qin Hai came over, listened to Luo Jing say a few words, then looked at her lips and tongue, and listened to several places behind her with a stethoscope.

"Treat it as acute urticaria." He put his stethoscope back in his pocket. "First, give her oral antihistamines and keep her in the observation area. Check her every half hour, and observe her for at least a full hour."

Luo Jing paused her scratching, then looked up at Qin Hai: "Will taking medicine help?"

"The medicine will take effect gradually; the rash won't disappear immediately after you swallow it." Qin Hai pointed to her hand that she kept reaching towards her neck. "If you feel tightness in your throat, shortness of breath, or suddenly feel dizzy, have a stomachache, or vomit, call for help immediately. Don't wait for your follow-up appointment."

Ma Hao returned to the workstation and prescribed cetirizine and a medical order for observation.

Qin Hai checked the doctor's orders and then turned to look at the other bed.

Nurse Zhu brought over the pills and warm water, and watched as Luo Jing took them in front of her.

After swallowing the pill, Luo Jing held onto the paper cup tightly. "This disease isn't contagious, is it? My daughter always crawls into my bed at night, so I don't dare go straight home for fear of catching it from her."

"Hives are not contagious." Ma Hao tucked the observation form at the foot of her bed. "There's no need to worry about passing it on to the child, and you don't need to wash everything in the house. The specific cause is still uncertain."

Luo Jing then deleted the long string of messages she had already typed, and only sent her husband a message saying that she needed to stay in the hospital for observation.

She took a sip of water, then remembered something and grabbed her phone: "Does this medicine make me sleepy? My car is still parked at work; I was planning to drive it back myself after I finished."

"Don't drive tonight." Ma Hao put the water glass back on the bedside table. "Someone might feel sleepy after eating. Tell your family to send someone to pick you up, or you can take a taxi home."

As soon as the call connected, Luo Jing first asked her husband to pick up the child, and then sent him the location of the parking space at her workplace.

"Please pick up the car tomorrow morning. Wait for my message. Don't bring the child; the emergency room is crowded."

After hanging up the phone, she leaned back in the observation chair, took a tissue and pressed it against the itchiest spots, no longer scratching with her nails.

Nurse Zhu left the blood pressure cuff on the observation cart and placed the call bell to her right: "I'll come back to take my blood pressure in half an hour. The bell is here, you can reach it, right?"

"I can reach it, this is troublesome." Luo Jing glanced at her arm. "It's still itchy, but not as intense as when I first came in."

About ten minutes later, Luo Jing lifted her clothes slightly. The edges of the first few swirling blobs on her waist had faded, but the ones on her forearms were still swirling, and a small swirling blobs had appeared near her wrists.

She gently pressed the area with her fingertip, not daring to scratch it, and called out to Ma Hao, who was passing by, "Doctor, it seems like the old ones are receding, but why are new ones appearing? Won't it get worse?"

"You took the medicine about ten minutes ago, wait a little longer." Ma Hao glanced at her lips, "Is your throat tight? Has your breathing changed?"

"No, it's still itchy."

"Then sit and observe for now. Ring the bell if there are any changes. I'll check together when the time comes."

She nodded.

Ma Hao stood next to the observation station, recording the time of medication administration and the location of the erythema on his wrist, and also marking the time for the next follow-up examination.