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

The ambulance's back door closed, and Dr. Han sat on the right side of the stretcher, first checking the address and alarm details on the dispatch form.

Nurse Xu Qing sat near the door, her first-aid backpack at her feet.

Lin Ye and Ma Hao sat side by side in the back row, their reflective vests tucked into their work clothes.

Dr. Han fastened his seatbelt: "Report anything you find to me first. When you enter the building, check the environment first, then the patients. Electrical wires, pets, gas, stairs—any one of these can take you down first."

Ma Hao nodded and placed the record board on his lap.

The alarm sounded from the roof, and the carriage tilted to one side as it turned.

Lin Ye raised his hand to hold onto the edge of the seat, but his knee still bumped against the stretcher brace.

Eight minutes later, the ambulance stopped in front of an old residential building.

The neighbor who called the police was waiting at the entrance of the building. He was around sixty years old, wearing an apron with a cardigan over it. When he saw the person come down, he led him into the building.

"Old Wu lives on the third floor. The door wasn't locked, and when I went in, I saw him lying next to the sofa. I called him several times before he opened his eyes."

"Did you hit your head?" Dr. Han asked.

"I didn't see him. He went downstairs to take out the trash last night, and he was walking perfectly fine."

The stairwell was narrow, and two old bicycles were piled up at the corner.

Dr. Han instructed the stretcher bearers to remain on the second-floor platform while four people took emergency backpacks and monitoring equipment upstairs.

The door was half open.

The living room lights were off, the windows were tightly closed, and the air smelled of leftover food and medicine.

An elderly man with gray hair sat leaning against the sofa at the foot of the sofa, with a cushion given to him by a neighbor behind him.

He wasn't wearing a slipper on his right foot; his socks were on the floor, and he was holding a plastic cup beside him.

Dr. Han squatted down in front of the old man: "Mr. Wu, can you hear me?"

The old man looked up, his eyes sweeping over the faces of the group. "I can hear her. She insisted on calling an ambulance, but I'm fine."

"What's your name?"

"Wu Yongfu".

How old are you this year?

"Seventy..." the old man paused, "...seventy-three."

Xu Qing had already tied the armband around his left arm.

Blood pressure 106/64, heart rate 92, respiratory rate 18 breaths per minute, steady rhythm, blood oxygen 96.

Lin Ye supported the old man's wrist from the other side, checked his arm, and then looked at his forehead and face.

There was no cut on the right side of the forehead, and there were no lumps on the scalp.

The old man could raise both hands, his mouth was not crooked, and his tongue was centered. He answered the action instructions a beat slower, but he did everything.

After Xu Qing tested her blood sugar level on her fingertip, the screen displayed 3.1.

"Too low."

She reported the results to Dr. Han.

The old man heard this and pointed towards the kitchen.

"I didn't eat breakfast. Some sugar water will do. I'm not going to the hospital."

On the table was a half-bowl of hardened rice, and next to it were several medicine boxes.

The package contained antihypertensive drugs, metformin, glimepiride, and two strips of white pills cut from the packaging, with only half of the drug name remaining on the back.

"Did you take your medicine today?"

Lin Ye asked.

"have eaten."

"What time did you eat, and what kinds of food did you eat?"

The old man looked at the table.

"It's the same thing every day."

Did you eat after taking your medicine?

"Getting ready to eat."

Ma Hao stood by the table, but didn't touch the medicine. He first let his neighbor take a look.

"Who usually distributes these medicines to him?"

"He divides it up himself. His son lives in another city and comes back once every one or two months."

The neighbor pointed to the small cabinet against the wall.

"There used to be a medicine box with seven compartments divided by the week, but I haven't seen it in the last few days."

The elderly person was able to respond continuously and swallow in portions as instructed, without choking or changes in voice.

Dr. Han then instructed Xu Qing to administer glucose gel sublingually, establish intravenous access, prepare for intravenous glucose supplementation, and continue monitoring.

The elderly man ate the food, but kept saying that he didn't need to be taken to the hospital.

"This isn't the first time I've had low blood sugar. Eating something will do the trick, but there's always a queue when I go there."

"How low was it before?" Dr. Han asked.

"I don't remember."

"Have you ever been unable to wake up before?"

The old man didn't answer, but reached for his phone on the sofa.

Lin Ye handed him his phone: "What day is it today?"

"Thursday."

The calendar on the wall was set to Monday, but it was Wednesday.

"What time is it now?"

The old man glanced at his phone screen: "Two o'clock in the afternoon."

The time displayed in the upper right corner of the screen is 5:06 PM.

Dr. Han did not correct her further, and instructed Xu Qing to continue to fix and observe the intravenous access.

The old man pulled his hand back.

"You've already eaten the candy, why bother with acupuncture?"

"You just collapsed on the ground, and now you can't even say when or what the date was. Leave the needle in for now; if your blood sugar drops further, you can take medication immediately."

Dr. Han held his wrist.

"Once the person is awake and their blood sugar has stabilized, then we can discuss whether or not to go to the hospital."

The neighbor stood by the door, clutching the corner of his apron: "He spoke to me at noon, and seemed quite normal."

Ma Hao turned around: "Do you remember what time we talked at noon?"

"It was around 12 o'clock. I went out to buy groceries, and he opened the door and asked me if there was a tofu shop downstairs."

Has anyone seen him since midnight?

"No. I came back at five o'clock, saw that his door was open, and then I went in."

Ma Hao asked the neighbors again, then turned to the old man to ask him to see the most recent phone call on his phone.

The old man held onto the phone tightly, refusing to hand it over.

Why are you checking my phone?

"We want to know when the last time you were lucid enough to speak to anyone was," Ma Hao said, squatting down. "You can check your call log yourself; we won't look at anything else. Who was the last call?"

The old man stared at him for a few seconds, then pressed his thumb twice on the screen, but failed to unlock it.

"Incorrect password."

Do you remember your son's number?

The old man opened his mouth and named seven people, then stopped.

The neighbor pulled out the number from his phone.

"I have his son's. We added each other on WeChat during the Chinese New Year."

Ma Hao first looked at Dr. Han.

Dr. Han nodded, and then he used the emergency center's work phone to contact the family on speakerphone.

After the call was connected, the person on the other end quickly reported the elderly man's history of high blood pressure and diabetes.

The son spoke to his father on the phone at 9:30 in the morning. He spoke normally and even reminded his father to take his blood sugar medication after eating.

"Has he changed his dressing in the last couple of days?"

"No. But sometimes he can't remember if he's taken it or not, and he'll take it twice. I bought him a pillbox, but he thinks it's too much trouble and doesn't use it."

Lin Ye looked at the dining table.

The glimepiride blister pack was placed on the edge of the bowl; the two adjacent aluminum foil holes were freshly opened, and the edges were still shiny.

Do you know where this medicine was taken yesterday?

The person on the other end of the phone couldn't answer.

The old man tried to stand up, holding onto the sofa.

"Have you finished asking your questions? I'm going to eat."

Lin Ye supported his right arm, preventing him from getting up directly.

The elderly man was able to use his legs, and when he stood up, his body swayed noticeably before he sat back down on the cushion.

Xu Qing's blood sugar was retested and it was 4.2.

The values ​​had improved, and Lin Ye checked both pupils, limb strength, and sensation again, but found no obvious unilateral abnormalities.

"Orientation has not yet been restored after blood sugar correction."

Ma Hao added, "For someone living alone, it would take at least two hours for family members to arrive. There would be no one on-site to continuously monitor the situation."

Upon hearing the last sentence, the old man raised his voice slightly: "I've lived here by myself for over ten years; I don't need anyone to look after me."

"There are still two things that don't make sense. How you collapsed is unclear, and while your blood sugar has recovered, the timing is still uncertain. You may have taken the same medication twice, and your blood sugar may drop again later. We recommend that you go to the hospital for further examination and observation."

"I'm not going."

Dr. Han looked at him: "Could you repeat the risks I just mentioned? What's the most likely thing that might happen if we stay at home?"

The old man frowned, saying only that he would eat something and couldn't answer what the consequences would be if his blood sugar dropped again.

"You can't even say for sure what time it will take, and you don't understand what dangers staying at home might pose. Your condition could relapse, so we can't treat it as a regular refusal of transport." Dr. Han held his wrist. "We'll take you to the hospital for further monitoring first."

He turned to Ma Hao and instructed him.

"Tell his son about the elderly man's reluctance to go to the hospital, his current level of consciousness, and the risk that his blood sugar might drop further. Inform the family to go directly to the First Municipal Hospital without waiting for their consent before setting off."

Dr. Han then asked Xu Qing to record the elderly man's refusal to be transported, his state of mind, the risks he was informed of, the contact information with his family, the lack of on-site care, and the basis for the transfer.

The old man continued arguing, but his speech became slower and slower.

Xu Qing secured the intravenous access, and the stretcher bearers carried a soft stretcher up from downstairs.

Before the transfer, Dr. Han checked the condition of the head, neck, and limbs again.

Four people worked together to move the elderly man onto a soft stretcher and down the narrow stairs.

The old man kept saying he didn't have his keys, so the neighbor put the keys and medicine box that he had left on the coffee table into a transparent bag and handed it to Xu Qing.

"Take all of these with you, lest you have trouble explaining yourself later."

The ambulance's back door closed.

The monitoring was reconnected, and the elderly man, leaning against the stretcher, was still asking which hospital to go to.

As soon as the car left the residential area, Xu Qing prepared to have her blood sugar tested for the third time.

The old man's raised hand didn't touch the cotton swab she offered; the back of his hand brushed against the bed rail and then fell down.

Lin Ye called his name.

The old man kept his eyes open but did not answer.

The heart rate on the monitor jumped from 94 to 103.

Xu Qing held the old man's hand, pressed the lancing device against his fingertip, and pressed the button. A bead of blood appeared, and she brought the test strip closer.

The blood glucose meter started counting down.

Dr. Han had already bent down beside the stretcher: "Wu Yongfu, look at me. Can you hear me now?"

The numbers were displayed on the screen.

2.6.