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

The vascular images were just printed, and the edges of the paper were still warm from the machine.

The neurosurgeon on duty held the film under the viewing light, his finger hovering next to that small, bulging shadow.

He muttered something under his breath.

"Anterior communicating artery".

The woman lay on the flatbed and did not respond.

Her eyes were open, but her gaze didn't fall on anyone's face. Her right hand groped on the sheets twice, her fingertips grasping at nothing, then slid back to the edge of the bed.

The monitor beeped sharply.

Blood pressure is 216 to 120.

The day shift nurse immediately fastened the side rails of the stretcher, and the metal clips clicked shut.

"Don't grab it, put your hands here first."

The woman's hand slid off the sheets and groped aimlessly towards the edge of the bed. Her husband stood beside her, his phone still to his ear, someone on the other end repeatedly asking what was wrong, but he couldn't answer a single word.

The neurosurgeon on duty pulled the film out from under the light.

"Did Director Luo answer the phone?"

The deputy director on the day shift had his phone tucked under his shoulder, and with his other hand, he pulled up the inspection time from earlier.

"I received the call, the video is being transferred. He asked if the person could still be woken up."

Qin Hai leaned against the side of the corridor, his voice hoarse, but his eyes never left the monitor.

"It can call out, but slowly."

Lin Ye pushed the record sheet forward a little.

"Around 11:50, she suddenly had a severe pain in the back of her head, and vomited twice after midnight. Her blood pressure was 192/106 when she arrived at the hospital, 203 after the CT scan, and it was 216 just now. Her right eye was slow to react once. After she said she couldn't see clearly, her reaction was slower than before, and her hands started to grab randomly."

After he finished speaking, he pushed the record sheet to the deputy director of the day shift.

Lin Ye stopped writing and did not continue.

The neurosurgeon on duty took the record sheet and glanced at it.

"Medical history?"

"The blood pressure medication was irregular, and ibuprofen was used for pain relief. The family said they did not take aspirin, warfarin, or rivaroxaban, and there were no external injuries or fever. The medicine boxes have been photographed and recorded."

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

Luo Jianping's voice was deep on the other end of the phone, with an elevator notification sound in the background.

"I saw the angiography. The anterior communicating artery is suspicious; don't waste time in the emergency room. Has the interventional team been notified?"

The neurosurgeon on duty pressed the film back onto the flatbed.

"It's calling."

"Did you draw blood for coagulation, complete blood count, and liver and kidney function tests?"

The day shift nurse looked up.

"The blood has been sent, the kidney function is in urgent need of treatment, and the coagulation function has also been activated."

"Prepare blood."

Luo Jianping paused for a moment.

"Also, don't make any definitive statements with the family. Right now, we can only say it's a suspected aneurysm or a suspected rupture. We might need to do cerebral angiography, interventional procedures, or even open craniotomy to clip it. We need to see the images and the patient as well."

The husband finally heard a few words.

"What embolism? What clamping? Doctor, she was just talking to me a moment ago, how did she get to this point?"

The deputy director of the day shift pulled him half a step toward the conversation corner, avoiding the wheels of the flatbed truck.

"Don't block the bedside yet. What she's most afraid of right now isn't the pain, but the bleeding. That vascular scan just now looked like a bulge in a blood vessel in front of her brain. If that bulge ruptures, the patient could be talking one minute and then faint the next."

The color drained from the husband's face even more.

"Shall we have the surgery now?"

The neurosurgeon on duty took over the conversation.

"Don't scare yourself. We need to consult with both the higher-ups and the interventional department. If necessary, we should perform cerebral angiography. Whether interventional treatment is appropriate, and whether craniotomy is needed, cannot be decided with a single sentence at the emergency room entrance."

The husband gripped his phone tightly, the screen flashing on and off against his palm.

"Then I'll sign it, I'll sign it now."

"You'll be asked to sign what you need to sign."

The deputy director on the day shift took the registration slip from his hand and replaced it with a medical information form.

"Monitoring, blood tests, and emergency treatment cannot begin until you sign the consent form. When it comes to cerebral angiography, interventional procedures, or surgery, the neurosurgeon will explain the risks clearly before you sign."

The woman on the flatbed suddenly frowned.

She curled up to one side, letting out a suppressed dry heave.

The day shift nurse immediately turned her head to the side and extended the suction tube.

A heavy, damp sound came from the pipes.

Lin Ye reached out and held the monitoring line to prevent it from being pulled down by the woman's arm.

Qin Hai glanced at him.

"Take a half step back. Don't let her pull the thread off, the rest is from the auditory neurosurgery department."

Lin Ye pressed the monitoring line further inside the bed rails.

"If she vomits again, or if she can't be woken up, I'll call her immediately."

The woman gasped for breath again, her eyes half-open.

"pain."

Her fingers gripped the edge of the bed so tightly that her knuckles turned white.

"It hurts even more than before."

The neurosurgeon on duty looked grim.

"Disperse the crowd and don't agitate her. Slowly lower her blood pressure, don't let it drop too drastically at once. Provide pain relief, stop vomiting, and sedation if necessary. I'll confirm with Director Luo first."

The day shift nurse has already brought the IV pump over.

A piece of old duct tape was wrapped around the wheel, making a slight scraping sound when it was pushed over the paving stones.

The deputy director on the day shift lowered his voice on the other end of the phone.

"Director Luo, the patient's headache has worsened, he vomited again, and his blood pressure is still high."

"I've arrived at the elevator."

I heard footsteps coming through the phone.

"Who is in the hospital who will be involved?"

"The interventional team's second-line doctor has returned and said he will come to the emergency room to review the images within five minutes."

"Anesthesia also has early warning systems; inquire about intensive care unit beds first."

Luo Jianping's voice was even shorter.

"Don't let her leave guardianship yet."

Qin Hai didn't interfere with the decision on the specialty; he simply turned to look at the nurses' station.

"Make way. Family members, don't crowd around. Keep the flatbed truck lane clear."

The day shift nurse raised her hand to turn off the call screen. Someone in the general ward was about to complain, but when they saw the woman on the stretcher and the oxygen cylinder at the foot of the bed, they swallowed their words.

Lin Ye lowered his head to finish taking notes.

Onset time.

Arrival time at the hospital.

Head CT scan time.

Time for head and neck vascular imaging.

Neurosurgeon's arrival time.

Luo Jianping's phone call time.

The pen moved quickly across the paper, and just as the last line was finished, the woman's husband suddenly grabbed her sleeve.

"Dr. Lin, this really isn't a migraine, right?"

Qin Hai's gaze swept over.

Lin Ye neither rolled up his sleeves nor complied with the family's demands for an answer.

"All I can say is that she can't be treated like a typical migraine now. The scans and the patient are here; the neurosurgery department has taken over."

The husband loosened his grip a little.

"What if he doesn't wake up?"

He was still clutching Lin Ye's sleeve when the phone rang.

The deputy director on the day shift answered the phone, and after only two seconds, his voice tightened.

"Your kidney function has returned to normal, so we can prepare for the angiography. The coagulation results are not yet available."

The neurosurgeon on duty nodded.

"Keep pushing."

The woman's hands started grabbing randomly again.

This time, she didn't grab the sheets; her fingernails scraped directly against the IV catheter attachment on her wrist. A corner of the transparent dressing was lifted.

The day shift nurse grabbed him and held him down.

"Loosen your grip, the needle is still in use, don't pull off the tube."

Qin Hai stepped forward and helped put her other hand back on the bed.

"She's getting irritable."

The on-call neurosurgeon immediately re-examined the pupils.

The light from the small flashlight flashed.

The woman's eyelids twitched; her reaction was even slower than before.

The elevator at the entrance of the clinic area is now open.

Luo Jianping has arrived.

He still held his phone in one hand, the screen still on the vascular image that had just been sent, while his other hand hurriedly reached for the image reading light.

Let's watch the video first.

Then look at the people.

Finally, check the monitor.

"Call her again."

The neurosurgeon on duty bent down.

"Big sister, can you hear me? Open your eyes."

The woman's eyelids twitched.

Not fully open.

The husband took a step forward, but was stopped by the day shift nurse.

"Let the doctor see you."

Luo Jianping handed his phone to a second-line doctor in the interventional team.

The second-line doctors from the intervention team also arrived, still clutching the lead apron collars they hadn't had time to fasten, and breathing a little rapidly.

"I've looked at the scans. It looks like an aneurysm in the anterior communicating artery area; the shape isn't good. We need to do an angiography to get a clearer picture. If the conditions are suitable in the angiography, we'll proceed with the treatment directly."

When the husband heard the word "aneurysm," his legs went weak and his back bumped into the plastic chair in the corner of the room.

The chair leg scraped against the ground with a screeching sound.

"Doctor, do you need an imaging scan or surgery?"

Luo Jianping looked at him.

"First, we'll do an angiography. If we can block the blood vessel, we'll proceed with interventional procedures; if we can't, or if the patient's condition worsens, we'll have to prepare for craniotomy. We'll discuss the risks with you on both sides."

The husband's throat moved a few times.

"What about the risks?"

The second-line doctor in the intervention team flipped the film in his hand to another one.

"Rebleeding, coma, cerebral infarction, or even discovering halfway through angiography that the conditions are unsuitable and we cannot continue according to the original plan—all of these are possible. There is no easy path now; we are racing against time before the next hemorrhage."

The husband looked at the flatbed cart.

The woman's face was soaked with sweat, which had completely dampened her temples.

Her lips moved slightly, but no complete sound came out.

The deputy director of the day shift handed over the signature board.

The signing board had old cracks along its edge, and two informed consent forms were tucked underneath.

A cerebral angiography informed consent form.

An informed consent form for interventional treatment.

"Read it first, then sign."

The husband took the pen, his hand trembling violently.

The pen nib lingered on the paper for a long time.

Lin Ye stood at the back of the flatbed cart, not looking at the signature column, but staring at the woman's breathing rate.

once.

twice.

The third time, the rise and fall of her chest suddenly became less pronounced.

The monitor beeped again.

The day shift nurse's expression changed first.

"Blood pressure dropped a little, 186 to 102, heart rate 138."

Luo Jianping had already bent down.

"Say it again."

The neurosurgeon on duty raised his voice.

"Big sister, can you hear me?"

The woman did not respond.

The pen in the husband's hand fell to the ground with a thud.

Lin Ye saw her right hand slide off the edge of the bed, her fingertips hovering in mid-air, and sway gently.

Luo Jianping looked up.

"Open the interventional room and prepare for emergency treatment."

He glanced at the signature board, his voice not slowing down.

"Continue signing the document, and supplement the conversation record simultaneously. Push the person to the door first, and do not perform puncture until the discussion is clear."

The second-line doctors in the intervention team had already turned and walked out.

The deputy director on the day shift grabbed the phone.

"Anesthesia, we need to take over the emergency intervention. Her consciousness is deteriorating, and we're worried we won't be able to protect her airway soon. You guys come and keep an eye on her."

Qin Hai placed his hand on the end of the flatbed cart, his voice very low.

"The road is clear."

The signature board is still in her husband's hands.

The name on the first line is only half written.