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

"Don't stop at the third bag."

When the circulating nurse handed out the temporary blood transfusion form, the edges of the paper were still wet.

It's not water.

It was disinfectant and sweat that hadn't been wiped dry on the gloves.

Lin Ye took the order.

The paper was very thin, but it felt heavy when pressed against my fingertips.

The operating room door closed again.

The red light was still on.

Liang Shumin's wife stood beside him, her eyes following the form.

She didn't dare ask.

Nurse Zhao didn't ask on her behalf either.

Nurse Zhao simply placed the half-cup of cold water in her hand into her palm.

"Hold it."

The woman obediently took it.

She gently deformed the plastic cup by squeezing it.

Lin Ye turned and walked towards the emergency room.

The lights in the corridor stayed on all night, their white light harsh.

When he reached the nurses' station, Sun Zhiqiang was still holding the landline receiver.

The receiver cord was stretched taut and wrapped around his wrist.

"Third bag of temporary blood transfusion form."

Lin Ye placed the list in front of Qin Hai.

Qin Hai glanced at it.

"Red blood cells continue, plasma is on track, platelets are being checked against inventory. Have the coagulation results come back yet?"

Sun Zhiqiang covered the receiver and turned around.

"The blood transfusion department said the plasma has thawed, and the platelets are being sent to the central blood bank. The coagulation data from the testing platform hasn't arrived yet."

Qin Hai bit open the pen cap.

There are old teeth marks on the pen cap.

He wrote the time in the upper right corner of the form.

"The emergency blood transfusion process continues."

"Record the time of the call from the operating room, the type of blood used, who answered the phone, and who delivered the blood."

Lin Ye nodded.

"I'll fix it."

Qin Hai pushed the order to him.

"Don't just focus on replenishing blood."

Lin Ye raised his eyes.

Qin Hai kept his voice very low.

"Make it clear, why do you still need to make it up?"

"There was massive bleeding during the operation, and part of the rupture was clamped. Blood pressure is still being managed with vasopressors, and urine output is low."

"These words are more useful than 'Keep demanding blood'."

Lin Ye tightened his grip on the pen.

"clear."

He sat down on a small stool next to the nurses' station.

The seat surface was cracked, and the edges were worn white.

The emergency medical record folder was opened.

The pages were turned over and over again, and the corners curled up.

He wrote it down stroke by stroke.

Massive bleeding during surgery.

Continue emergency blood transfusions.

Blood pressure still needs to be maintained with vasopressors.

Low urine output.

The third bag of red blood cells and plasma continues to work together.

Lin Ye paused for a moment when writing "low urine output".

This is not a good word.

For someone who has been in shock for so long, these words are like blocks of cement pressing down on the record paper.

The treatment cart next to it was pushed over.

The wheel rolled over the duct tape on the ground, making a short, sticky sound.

The night shift nurse placed a stack of new IV patches on the table.

"Director Qin, a bed has become available in the thoracic surgery department."

Qin Hai looked up.

"Shen Qingyuan?"

"Yes. The thoracic surgery ward will receive them, and they require water-sealed bottles, oxygen, and monitoring equipment for transport."

Qin Hai looked at Lin Ye.

Lin Ye had already pulled out Shen Qingyuan's handover sheet.

"Left-sided pneumothorax, puncture decompression followed by closed drainage by thoracic surgery. Follow-up X-ray showed partial re-expansion of the lung, but air leakage is still present. Blood oxygen 95%, heart rate 116."

The night shift nurse listened while ticking off items on the transfer form.

"Where are the family members?"

"My girlfriend is at the door."

Lin Ye paused for a moment.

"We will only accompany patients and provide information about their medical history. The ward will also inform patients to contact their parents."

Qin Hai nodded.

Write it down.

When Shen Qingyuan was wheeled out of the emergency room, he was no longer as pale as when he first came in.

But he still used one hand to protect the side of his chest tube.

The water-sealed bottle hangs by the bedside, occasionally releasing a string of bubbles.

His girlfriend followed beside the flatbed cart, clutching her coat in her hand.

The cuffs of my coat were stained with dust from the ground.

"Doctor, is he feeling much better?"

The night shift nurse pushed the bed without stopping.

Lin Ye followed and took two steps.

"Better than before."

His girlfriend's eyes lit up.

Lin Ye continued with the next sentence.

"But it's still leaking air, he can't get out of bed on his own, and we can't remove the tubes. We need to keep a close eye on the ward."

The light then disappeared.

She glanced down at the water-sealed bottle beside the bed.

"I see."

The flatbed cart entered the elevator.

Before the elevator doors closed, Shen Qingyuan wanted to look up and speak.

The thoracic surgery nurse held his shoulder.

"Speak less, save your breath."

The door was sewn shut.

Lin Ye turned and went back to the emergency room.

The landline phone at the nurses' station hadn't been put down yet.

While listening to the phone call, Sun Zhiqiang wrote numbers on the back of a sticky note.

The sticky note had been glued on, but the edges were curled up and half a piece of gray cotton was stuck to it.

"The two bags of blood plasma have been thawed."

He looked up.

"The platelet center will respond within forty minutes at the earliest."

Qin Hai closed the medical record in his hand.

"Send the blood plasma first."

"Keep monitoring platelets."

Sun Zhiqiang repeated it to the person on the other end of the phone.

His voice was hoarse and raspy.

"Send the plasma first, keep chasing the platelets. Yes, they're still in the operating room."

"No, it's not stable."

"It's just a temporary hold-up."

Hold on for now.

The moment those four words were uttered, there was a moment of silence next to the nurses' station.

It's not that nobody is talking.

Everyone understood the meaning of those four words.

Holding firm does not equate to stability.

Being stable does not mean surviving.

Lin Ye lowered his head and changed "hold on for now" to another way of writing it in the record:

Continuous blood transfusions and vasopressors are still required during the operation.

As soon as I finished writing that sentence, the intervention room phone rang again.

This time, it was the on-duty trainee who received me.

He had just changed into his white coat, but one button was fastened incorrectly, and the cuffs weren't rolled up properly.

"Director Qin, this is the vascular surgery department, call Xu Jianmin."

Qin Hai took it and pressed the speakerphone button.

The voice on the other end of the phone sounded tired.

"Over here, Xu Jianmin's distal skin temperature is a little better than before, but the dorsalis pedis artery is still weak. He has urine output, but the color is dark."

"Potassium rose to 5.3, and myoglobin was also high."

"We have already told the family that it is too early to conclude whether to save the limb."

Qin Hai glanced at Lin Ye.

Lin Ye had already picked up his pen.

"Continue to administer fluids, monitor urine output, electrolytes, and myoglobin, and be alert for kidney damage and cardiac arrhythmia after reperfusion."

The person on the other end of the phone replied:

"Yes. Don't let the family members keep asking what percentage it is."

Qin Hai said:

"That's what they say too."

After the phone call ended, Xu Jianmin's daughter stood up.

She didn't rush into the middle of the passage.

She probably still remembered the words "the flatbed cart can't pass" from earlier.

She stood beside the chair, her hands gripping the bag strap.

She twisted the bag strap into a knot.

"doctor."

Her voice was very soft.

Has my dad changed again?

Qin Hai didn't directly relay the contents of the phone call.

He turned the record sheet toward her.

"My feet are a little warmer than before."

The woman nodded first.

I ordered it but didn't dare to laugh.

Qin Hai continued:

"However, blood supply is still weak, muscle injury indicators are still high, and potassium levels have also increased. We need to be wary of heart rhythm problems and kidney damage in the future."

Her throat moved.

"Could I try to talk to my mom in a better way?"

Qin Hai looked at her.

"Just say that your feet are a little warmer than before, and the doctor is still watching them."

Don't add the second half of the sentence.

The woman's eyes immediately reddened.

She looked down and took out her phone.

There was an old sticker on the back of the phone case, and the edges were peeling up.

She pressed the button twice before she finally dialed the number.

Lin Ye withdrew his gaze.

These family members are all waiting for a kind word.

But what the emergency room fears most is saying half a good thing and then making it a full statement.

At the other end of the nurses' station, the on-duty resident took the folder containing the notes that Ma Hao had finished writing.

Ma Hao is no longer in the emergency room.

His pen was pressed down on the binder, the cap was off, and the nib left a little blue ink stain on the paper.

Qin Hai saw it and reached out to put the pen cap back on.

"Did he go?"

The on-duty trainee nodded.

"He went to the duty room. He said he'd be back in twenty minutes."

Qin Hai hummed in agreement.

No one was asked to call them.

A small passageway was finally cleared at the entrance to the emergency room.

However, this gap lasted for less than half a minute.

The phone rang again in Qin Hai's cell phone from the operating room.

Qin Hai answered the call.

"explain."

A low whistling sound came from the other end of the phone.

It's like a ventilator pushing air.

The vascular surgeon spoke very close.

"The blood plasma has arrived."

"The main segment of the rupture has been treated, and the bleeding is less than before."

Qin Hai did not loosen his grip on the phone.

"blood pressure?"

They paused there for a moment.

"Eighty-six fifty-two."

Someone took a soft breath next to the nurses' station.

Eighty-six fifty-two.

It's better than seventy-something.

But it's still not a reassuring number.

The vascular surgeon continued:

"Still using vasopressors."

"Low body temperature, poor blood clotting, and significant bleeding in the abdominal cavity."

"The anesthesiologist said there was only a little urine output, not much."

Qin Hai closed his eyes briefly.

"Next step?"

"Continue to correct blood clotting and body temperature."

There was the sound of equipment being put down on the other end of the phone.

"If he can step down, he should be transferred directly to the intensive care unit with medical supervision."

"You should notify the intensive care unit to request a bed first."

Qin Hai did not deliver any good news.

He only said:

"I'll inform them."

The phone hangs up.

No one cheered in the emergency room.

Sun Zhiqiang was still sitting next to the landline.

He rested his elbows on the table, his eyes red as if they had been sanded.

"Intensive Care Unit?"

Qin Hai nodded.

"beat."

Sun Zhiqiang picked up the landline phone.

He dialed two numbers, then stopped.

"Doctor, keep your phone for receiving calls from the operating room."

"I contacted the intensive care unit using a landline."

Qin Hai glanced at him.

"His brain is still intact."

Sun Zhiqiang tugged at his mask.

It looked like he wanted to laugh.

I didn't laugh.

After the call was connected, he only explained the procedure.

"Emergency room, Liang Shumin, intraoperative resuscitation for ruptured abdominal aortic aneurysm, may be transferred after intubation, vasopressors, and continuous blood transfusion. The surgery is not yet over, so we are alerting the bed availability."

Lin Ye stood to the side and wrote this sentence into the shift handover.

Early warning beds.

It's not about stopping it.

Possibly transferred.

They are not out of danger.

Every single character has to be pronounced precisely.

A voice came through the walkie-talkie from the operating room doorway.

"The family asked if he could be released."

Nurse Zhao's voice followed, hoarse but steady.

"I'll hold this in for now. Just give me one thing to say."

She did not return to the emergency room.

She was still outside the operating room.

Lin Ye looked at Qin Hai.

Qin Hai handed him the phone.

"Just three sentences."

Lin Ye took the phone.

There was an echo from the hallway on the other end of the phone.

Nurse Zhao should be standing by the operating room door.

Lin Ye said:

"The bleeding is less than before."

There was silence on the other end of the phone.

He went on to say:

"Your blood pressure is a little higher than before."

Nurse Zhao did not interrupt.

Lin Ye finished speaking the third sentence.

"But we're still on medication, our blood clotting and body temperature haven't been corrected, and the surgery isn't over yet."

Nurse Zhao only replied with one word.

"OK."

The phone hangs up.

Lin Ye returned the phone to Qin Hai.

Qin Hai didn't answer.

His gaze fell on the door of the emergency room.

There, paramedics were pushing a wheelchair in.

The elderly man in the wheelchair was wearing a thick coat.

In the early hours of May, the coat was buttoned up to the top.

The old man's face was ashen, and his lips were dry and chapped.

The middle-aged man accompanying her pushed the cart while explaining to the triage nurse:

"I had diarrhea for two days, and I couldn't stand up steadily when I woke up in the morning."

He said he was fine.

The elderly man rested his hand on the armrest of his wheelchair.

There was a layer of dark red stains under my fingernails.

It's not mud.

Lin Ye's gaze lingered on that dark red layer.

Qin Hai saw it too.

He put his phone back in his pocket.

"Linye."

"Don't send him to the regular clinic yet."

The triage nurse had already wrapped the blood pressure monitor around the elderly man's arm.

The cuffs bulged out.

The numbers jumped twice.

82/46.

The old man lowered his head and suddenly vomited a mouthful of dark red stuff.

The sour and fishy smell spread immediately.

The middle-aged man's expression changed.

"dad?"

Qin Hai's voice had already faded.

"Push the red zone."

"This is not ordinary diarrhea."