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

Chapter 72 Don't help her sit down yet.

When the call came from the CT room, there were three family members waiting to be called next to the nurses' station.

The telephone receiver was worn shiny. The day shift nurse held the receiver to her ear, while her other hand pressed a paperclip on the corner of the register.

"There looks like there's blood on the film."

As soon as those words were spoken, Qin Hai's hand reached towards the flatbed cart.

"Where is he?"

"She was still on the CT scan bed; the radiology staff didn't let her get off."

The deputy director of the day shift closed the medical record folder in his hand, and the paper inside made a dull thud as it was pressed down.

"Okay, don't let her sit up. Push the stretcher back to the red zone with a monitor."

The woman's husband had just caught up with her to the nurses' station when he heard this, and his face turned pale.

"Isn't this just a film shoot? Why can't we get off?"

No one replied to him immediately.

As the trolley was pushed out of the CT scan entrance, its wheels scraped against the cracks in the floor tiles with a thud.

The woman lay on the gurney, her eyes half-closed, her hands still clutching the sheets. Sweat streamed down her forehead and down her temples, and her mask was dampened by the steam from vomiting. The vomit bag beside her hung limply, its opening crumpled, emitting a sour smell mixed with the odor of disinfectant.

"Don't make the lights so bright."

Her voice was very soft.

The day shift nurses didn't turn off the lights; they just moved the stretcher to a spot where the light wasn't so direct.

"Til your head a little, don't choke."

Qin Hai did not rush to be at the front.

He stood to the side of the flatbed and first checked on the guardian.

Blood pressure is 203 to 112.

Heart rate 124.

Blood oxygen 97%.

Lin Ye followed on the other side, and when his fingers touched the edge of the flatbed cart, he felt a layer of cool sweat.

The woman's husband was still standing nearby, trying to explain.

"She used to have migraines. When they hurt, she would vomit. She suddenly had a headache before lunch today, and I thought it was the same old problem."

The deputy director of the day shift took the film bag from the on-duty imaging staff in the CT room.

The cameraman's name tag was face down, and there was a mark pressed into the back of his hair, clearly indicating that he had been called out by phone from the duty room.

He pointed to the computer screen.

"Let me show you first; the official report still needs to be reviewed by higher authorities. Here, there's a high-density shadow; subarachnoid hemorrhage cannot be ruled out."

The husband was stunned.

"What membrane?"

The deputy director of the day shift tucked the bag of film into his arm.

"There looks like there's blood on the surface of my brain. This can't be treated like a regular headache."

When the woman heard the word "blood," her eyelids twitched, and her fingers clenched even tighter.

Lin Ye saw her right fingertips rub against the bed sheet twice, her movements a beat slow.

He lowered his voice.

"She spoke more slowly just now than she did in the clinic area."

Qin Hai looked over.

"Look at the pupils again."

The small flashlight was handed to me by the nurse on the day shift; a piece of old tape was stuck to the battery cover.

The beam of light swept across the woman's eyes.

She frowned deeply, her left eye closing faster, while her right eye reacted a little slower.

The deputy director on the day shift tensed his jaw.

"Where is the neurosurgery department?"

Someone just happened to be calling from the nurses' station.

"Neurosurgery is in the elevator! Neurology is back too. Don't rush to do a lumbar puncture. The X-ray looks like there's blood. Let neurosurgery take a look. Prepare for vascular imaging first."

Qin Hai pulled the monitoring cable further inside the bed rails and looked down at her husband's face.

"Did you hear that? It's not about taking painkillers and sleeping it off anymore."

The husband's Adam's apple bobbed, and the registration slip in his hand was soaked with sweat, the edges sticking to his palm.

"So what do we do now? Do we need surgery?"

"Don't jump straight to surgery."

The deputy director of the day shift pressed the film bag against the flatbed cart, speaking very quickly, but each word was impactful.

"The CT scan will first check for blood. It looks like there is. The next step is to see where the blood is coming from; we can't miss any cerebral blood vessels. If it really comes to interventional procedures or surgery, the neurosurgeon will talk to you separately."

The husband grasped at a single word.

"intervention?"

Qin Hai glanced at him.

"Remember this: she cannot walk on her own, nor can she be helped to sit up. Bring a stretcher, monitor, oxygen, and intravenous line."

The day shift nurse had already torn open the packaging of the indwelling needle.

The sound of the plastic film being torn was very short.

The woman's hand was cold and white, with constricted veins. The nurse patted it twice, but there was no noticeable rebound, so she switched to the other side.

"Don't move, just insert the needle."

The moment the needle pierced her skin, the woman didn't scream; she just tensed her shoulders and let out a low groan.

Lin Ye double-checked the time she had just been given.

"What specific time before lunch?"

The husband was a beat late.

"Around 11:50. When she was picking up the bowl, she suddenly said that she felt a sharp pain in the back of her head, and before she could put the bowl down properly, she vomited."

Lin Ye looked at the deputy director of the day shift.

"It started about two hours ago. I suddenly had a headache at the back of my head, then I vomited, became sensitive to light, couldn't bend my neck down, and had high blood pressure. The CT scan now shows blood in the blood."

He didn't go on to say what the diagnosis was.

The deputy director on the day shift has already taken over.

"Follow the high-risk headache route."

The neurosurgeon on duty arrived at that moment.

As soon as the elevator door opened, a white coat with buttons undone rushed over, the mask strap tucked behind the ear, and the name tag jingled.

"Where's the movie?"

The deputy director of the day shift handed over the film bag.

The neurosurgeon didn't rush to see the family members; he first looked down at the scans before looking at the patient.

The woman lay curled up on the stretcher, her eyes tightly closed, her lips dry and chapped. The monitor beeped again, and her blood pressure reading jumped up once more.

208 to 116.

The neurosurgeon frowned.

"And consciousness?"

"I can wake you up, but you're slow to respond. Your right eye was a little slow to react just now."

Qin Hai handed over the small flashlight.

The neurosurgeon examined her again and then asked the woman to raise her arm.

"Big sister, can you hear me? Raise your right hand."

The woman lifted herself up slightly.

The arm didn't leave the bed too high before quickly falling back down.

"Left hand."

Raise your left hand a little more smoothly.

The husband finally panicked.

"She was able to walk in by herself just now."

The neurosurgeon didn't look up.

"This is what's most dangerous about subarachnoid hemorrhage. One minute the patient can still speak, and the next they might suddenly become unwell."

He handed the film back to the deputy director of the white team.

"First, do an angiography to rule out aneurysms and vascular malformations. Then, check her blood, coagulation, liver and kidney function, and electrolytes. Don't lower her blood pressure too much at once; wait for our advice and don't upset her."

Qin Hai's gaze fell on the notepad beside Lin Ye.

"Write down the dates: onset date, arrival date, CT scan date, and neurosurgeon's arrival date."

Lin Ye picked up a pen.

The pen tip had just touched the paper when another sound came from the nurses' station.

"The neurology department's phone line is still open."

The deputy director on the day shift turned on the speakerphone.

The voice on the other end of the phone sounded a little hoarse through the static.

"If the CT scan already shows this, don't rush to perform a lumbar puncture. Do the vascular imaging first, with neurosurgery as the primary care unit; we'll assist with the physical examination and differential diagnosis. Does she have a fever, rash, or injury?"

Lin Ye pulled her husband to the foot of the bed.

"Have you had a fever recently? Have you fallen? Are you taking anticoagulants, like aspirin, warfarin, or rivaroxaban?"

The husband was a bit flustered by the questions and pressed the wrong key twice when unlocking his phone.

"I didn't fall. I don't have a fever. The medication I'm taking is painkillers and blood pressure medication, though I sometimes forget the blood pressure medication."

"Did you bring the medicine box?"

"It's in my bag."

The bag was opened, and out fell a strip of ibuprofen, an opened bottle of blood pressure medication, and several crumpled receipts.

The day shift nurse placed the medication next to the treatment cart.

"I took a picture to record it."

When the husband saw the nurse tapping the medicine box, his voice tightened immediately.

"Is this related to the bleeding inside her head? She only ate it because she was in pain."

Qin Hai blocked him from entering the flatbed cart.

"The point now is not to argue about who is right and who is wrong. Only by clearly explaining the medication history can doctors avoid making mistakes."

The husband's lips moved, but he didn't push any further.

The woman suddenly vomited again.

This time, not much came out, just a mouthful of yellow fluid that dripped down the corner of his mouth to the edge of his mask.

The day shift nurse immediately brought over the suction tube.

The suction device started, and a wet, heavy sound came from the tubing.

The woman's eyelashes trembled violently, and her breathing became rapid.

The monitor's heart rate jumped to 132.

The neurosurgeon took a step forward.

"Don't let her use force. Turn her head to the side."

Lin Ye helped hold the side of the stretcher, without touching the patient's neck.

The woman's shoulders and back were stiff, and with each retching, her fingers creased the sheets.

The phone screen lit up briefly in his pocket.

Only he could see that line of text.

[High risk persists: Suspected subarachnoid hemorrhage, with an increased risk of rebleeding/deterioration of consciousness.]

Lin Ye turned off his phone.

"He vomited again, his heart rate is rising, and his right eye was a little slow to react just now. The transfer needs to be quick, but we can't let up on monitoring during the journey."

The neurosurgeon's gaze swept over the monitor and then returned to the woman's face.

"Yes. Bring oxygen and keep a clear IV line. I'll call the CT room."

The deputy director on the day shift has already dialed the CT room.

"That patient with the headache earlier, don't let her wait in line for the regular tests. Suspected subarachnoid hemorrhage, need to do head and neck vascular imaging. Yes, neurosurgery is at the bedside. We'll get the kidney function results later, let's get her through the testing route first."

There was the sound of keyboard clicking on the other end of the phone.

After hearing this, the keyboard clicks stopped for a moment.

"Push her over here. Don't let her use a wheelchair."

The deputy director on the day shift hung up the phone.

"Walk."

The husband was so startled by that one word that he took a half step back.

"What do I need to sign? I'll sign, I'll sign."

The neurosurgeon took the informed consent form and didn't make him lower his head to write it down.

"Listen to me first. This is a vascular imaging test, which uses contrast agents to see where the blood vessels are having problems. She has high blood pressure and there's a suspected hemorrhage in her head. There are risks involved in moving her there and conducting the examination. But without testing, we won't know where the blood is coming from. If intervention or surgery is needed, we'll discuss it separately; it's not something we can just do right now."

The husband's hand trembled as he held the pen.

The pen tip touched the outside of the signature column, leaving a black dot.

"Will I die?"

The call for numbers next to the nurses' station rang briefly at that moment, only to be silenced by the day shift nurse.

The neurosurgeon looked at him.

That's why we need to be fast.

The call number screen next to the signing desk was still displaying numbers. The day shift nurse raised her hand to turn off the notification sound, preventing the electronic voice from drowning it out.

The paper was pressed against the flatbed cart. The husband bent over to sign it, and when he signed the last word, the pen tip slightly scratched the paper.

The flatbed cart started moving again.

The oxygen cylinder hung at the foot of the bed, its metal buckle wobbling twice. The monitor was secured to the side of the stretcher, its power cord wrapped around the wheel by the day shift nurse to prevent it from dragging under the wheels.

Qin Hai followed to the entrance of the passage, where he was stopped by the deputy director of the day shift.

"You two go back and sit down. I'll take some men over."

Qin Hai's voice was still a little hoarse.

I won't steal your life.

He glanced at Lin Ye.

"He doesn't steal it either."

Lin Ye's hand was still pressing on the record paper.

Four time points were written on the paper, the ink still wet.

The deputy director of the day shift took the paper away.

"Then don't just stand there. Emergency room staff aren't only available for night shifts."

Qin Hai was momentarily speechless, but instead of retorting, he leaned his shoulder against the wall.

The stretcher entered the CT scan lane.

The woman's husband followed behind, making a phone call home as he walked. The call connected, but he only managed to say half a sentence, "It's not a migraine," before his voice cut off.

Lin Ye stood next to the nurses' station, feeling a sour emptiness in his stomach.

The day shift nurse put the blood pressure medication and painkillers from the bottle into a transparent bag and labeled it with the patient's name.

The sound of the tape being torn was very clear.

"Dr. Lin, Lu Yifan just received another message from the cardiology department."

Lin Ye looked up.

"What's wrong?"

"No bad news."

The day shift nurse turned her phone screen to him.

"The Holter monitor has been set up. The child won't let us get out of bed, so Director Tang said we'll do another detailed ultrasound this afternoon."

Qin Hai rubbed his temples.

"Okay, keep an eye on it for now."

As soon as he finished speaking, the door leading to the CT scan area was pushed open again.

The neurosurgeon's voice came from inside, lower than before.

"The vascular imaging results are in."

Qin Hai stopped pressing his brow, and the day shift nurse sealed the transparent bag by pressing it against half a piece of tape.

He held the freshly printed sheet in his hand, its edges still warm from the machine.

"There's a suspected aneurysm here on the anterior communicating artery."

The woman still had her husband's phone pressed against her ear.

The person on the other end of the phone kept asking what was wrong.

He did not answer.

The neurosurgeon pressed the film against the side of the trolley.