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

The pen was still on the first line.

He only wrote half of his husband's name, the last stroke dragging out, leaving ink smears on the paper. He held the signature board in his hand, the corners rubbing against his palm, while half of another informed consent form for interventional treatment was visible, with the small section of blood vessel that Luo Jianping had just drawn pressed against it.

The flatcar has already started moving.

The day shift nurse held onto the bed rail with one hand and repositioned the oxygen tube to the head of the bed with the other. The bed wheels made a dull thud as they rolled over the grout in the floor tiles, but she stepped on the brake with her toe.

"Wait until the anesthesia takes effect," Luo Jianping said in a short voice, "a person can't walk around empty-handed like this."

The husband suddenly looked up.

"The signature isn't finished yet."

The deputy director of the day shift pressed the signature board firmly into his hand, while his other hand had already picked up the phone.

"Continue signing the papers, prepare the personnel first. Do not perform the puncture before everything is clearly discussed, and monitoring, oxygen, and transport preparations must not be stopped."

The husband looked at the few pieces of paper and his lips moved twice.

He just asked if I had a migraine.

The paper now lists cerebral angiography, interventional treatment, rebleeding, coma, cerebral infarction, and death.

His Adam's apple bobbed.

"She was able to talk to me just now, why are you pushing her away now?"

The second-line doctor from the interventional team had already returned to the stretcher, his lead apron collar draped over his forearm. He didn't urge them to sign anything; he simply placed the film bag at the foot of the bed and pointed his finger at the bulge next to the angiography film.

"It's precisely because he could still speak just now that we can't delay any longer. If he bleeds again in this area, he might not even have a chance to speak."

The husband's hand trembled slightly, and the pen tip poked a small black dot outside the signature column.

"Will it get better once you go in?"

Luo Jianping was examining the woman's pupils when he heard this, but he didn't move the small flashlight away from his hand.

"That's not how it works."

The beam of light swept from the woman's right eye to her left eye.

"We're going in to get a clear picture and save time. If we can intervene and handle the situation, we will; if the conditions aren't right, we'll immediately change our approach. What we can guarantee right now is that we won't waste time at the door."

The monitor beeped again.

Heart rate 142.

Blood oxygen 94.

Sweat trickled down the woman's temples, and a layer of damp mist rose inside her oxygen mask. Her chest heaved less than before, as if each rise didn't reach its full depth. The day shift nurse gently turned her head to the side; the suction tube was still draped over the bed, a faint reddish stain clinging to the transparent wall.

Lin Ye stood at the foot of the bed.

He didn't look towards the signature board.

At the edge of my field of vision, a cold blue text box silently lit up.

Emergency Room Early Warning System

The risk of deteriorating awareness is rising.

[Decreased airway protection.]

The risk of vomiting and aspiration increases during transport.

The text box did not provide a treatment plan.

They didn't tell him who should make the decision either.

Lin Ye pressed his fingers against the emergency record paper, leaving a shallow indentation on the surface. He saw the woman's jaw relax slightly, and a very soft gurgling sound escape her throat as she inhaled.

An anesthesiologist pushed an airway box in from the direction of the elevator.

The wheels of the boxcar were smaller than those of the flatcar, and it bumped twice as it went over the gaps between the paving stones. The anesthesiologist didn't ask for a signature first; he pulled off his gloves and bent down to look at the woman's face.

"Did you just throw up?"

The day shift nurse immediately responded.

"I vomited twice, and just now I gagged again, sucking out a little bit."

The anesthesiologist lifted the oxygen mask up and bowed to call for help.

"Big sister, open your eyes."

The woman's eyelids twitched, but she didn't open them fully.

"Big sister, if you can hear me, shake my hand."

Her fingertips twitched slightly, but she didn't grasp it.

The anesthesiologist looked up.

"Is she less responsive now than before?"

Lin Ye pushed the recording paper forward half an inch.

"She could open her eyes and say she couldn't see clearly just now, but now we're only asking her to move her eyelids. She vomited twice after midnight, and just now she dry heaved again. Her blood pressure dropped from 216 to 186, but that's not an improvement; her heart rate keeps going up to over 140."

He paused for a moment after he finished speaking.

My finger landed on the line of time that I had just written.

"Someone needs to keep an eye on her airway before she's transferred. If she vomits again on the way, the mask and suction device must remain on the bed."

The anesthesiologist didn't look at him, but simply pulled the airway closer.

"The suction device should be with the vehicle. The oxygen cylinder should be full, and don't remove the mask. Raise the head of the bed slightly and turn your head to the side."

The day shift nurse has already gone to change the oxygen cylinder.

The pressure gauge on the old oxygen cylinder was near the green zone. She unscrewed the connector, and the metal joint clicked open. The new cylinder was pushed to the bedside table, its body bearing a worn blue label. As the valve was opened, the oxygen tubing trembled slightly.

The deputy director on the day shift held the phone, his shoulder pressing down on the receiver.

"Prepare to receive the patient at the interventional radiology room door. The anesthesia is already at the bedside. The ICU is issuing a warning first, don't tell the family it's safe, just say that they might need to be monitored in the ICU later."

The person on the other end of the phone responded.

She put down the receiver and turned to her husband.

"Make sure you understand the difference between these two documents. The first is the cerebral angiography, which is used to get a clear view of the blood vessels. The second is the interventional treatment plan. If the angiography shows that the conditions are suitable, we may proceed directly. Just because you sign it doesn't mean we'll definitely follow one approach. If the situation changes, the neurosurgery department will continue to discuss it with you."

The husband looked down at the paper.

The words were crammed onto a single page.

He couldn't understand the risks, but he could understand the signature bar.

"If I sign, will she be able to get in?"

Luo Jianping put the flashlight back into his pocket.

"After you sign, complete the conversation record, and then you can go inside first. The most important thing for you right now is not to ask us if we can guarantee that everything will be alright, but to sign the document first."

The husband's eyes reddened.

The pen tip fell back down.

This time, he didn't stop.

Lin Ye lowered his head to finish taking notes.

I vomited twice after midnight.

At 1:56 PM, vascular imaging reported a suspected aneurysm in the anterior communicating artery.

At 2:04 PM, Luo Jianping arrived.

At 2:08 PM, the intervention team arrived.

At 2:12 PM, consciousness deteriorated compared to before, heart rate was 142, and blood oxygen was 94.

At 2:14 PM, the anesthesiology team came to the bedside for assessment.

As the pen tip reached the last line, the woman's slight gurgling sound in her throat intensified once more.

Lin Ye looked up.

The anesthesiologist had already taken over the suction tube and pressed the negative pressure switch with his finger.

"Don't let her lie flat; turn her head to one side. If she vomits again, we can immediately connect the suction tube."

The day shift nurse supported the woman's shoulders; the bed sheet was soaked with a dark patch of sweat. The woman's hand reached for her mask again, but Qin Hai, standing at the end of the gurney, reached out and held the bed rail steady.

His voice was hoarse.

"Keep an eye on the pipes, don't let her tear them off. I'll clear the way from behind, make sure no one blocks the elevator entrance."

Lin Ye closed the record folder, stuffed it next to the film bag, and pressed down on the monitoring line with his other hand to prevent it from dragging to the ground from the foot of the bed.

Someone was spying on us from the general clinic area.

The deputy director of the day shift glanced at it.

"Clear the passage. Move the wheelchair to the side, don't block the elevator entrance."

No one is shouting to queue anymore.

The flatcar brakes were released again.

As the bed wheels moved, the oxygen cylinder swayed slightly, its body hitting the bed frame with a dull thud. The anesthesiologist followed at the head of the bed, his hands never leaving his mask and suction tube. The neurosurgeon on duty walked to the left with a film bag, while the interventional team's second-line physician had already pressed the elevator button.

The husband took two steps with the signing board, but was stopped by the deputy director of the day shift.

"Finish signing the last page first—name, date, relationship—don't forget anything. Just because someone's inside doesn't mean everything's alright outside."

"Can I go in with you?"

"You can't go in. They need to do some operations inside, and you'll only add to the risk."

The deputy director of the day shift turned the signature board around and pointed to the empty space.

"What you can do now is to complete the signature and keep your phone on. They'll need you to add more details to your medical history and will call you immediately."

The husband lowered his head.

The signature section on the last page is empty.

His pen trembled twice before he finally finished writing the name.

Lin Ye followed the flatbed cart to the elevator entrance.

Qin Hai also took a step forward.

The deputy director of the day shift raised his hand to block him.

"Director Qin, this is enough. The day shift will monitor the family members and get the signatures. The interventional and anesthesia teams will move in later. You can come back now."

Qin Hai glanced at her, then looked at Lin Ye.

His eyes were bloodshot, and his voice was so low that only a few people at the foot of the bed could hear him.

"Don't come in either. Hand the record to the neurosurgeon and have him put it into the film bag in front of you. Come back after you've handed it in."

Lin Ye nodded.

"I know, I'll only submit the records."

The elevator doors opened.

A cool white light shone from inside.

Lin Ye handed the emergency record and time sheet to the neurosurgeon on duty, his fingertip pressing on the last three lines.

"She could answer clearly before she said she couldn't see clearly. After that, she became slower when called. The time of vomiting and the time of anesthesia arrival are all in these few lines. Her blood pressure has come down, but her heart rate has increased, and her breathing has become shallow."

The neurosurgeon on duty took the paper, glanced at it, and put it directly into the film bag.

"Okay, I'll take him in. Director Luo will be able to see the last time he was conscious and the time he vomited."

Luo Jianping stood in the elevator, his hand already pressed the open button.

"Don't let anyone outside know you're safe yet. Family members shouldn't go far, keep their phones on, we'll need to ask about your medical history later."

The flatcar was pushed in.

Before the elevator doors closed, another layer of white mist appeared inside the woman's oxygen mask. The anesthesiologist leaned over and pressed down on the edge of the mask, the suction tube against the headboard, the transparent tube swaying slightly.

The gap in the door was getting narrower and narrower.

In the end, only the small bag containing the recording paper remained.

Lin Ye stood outside the door, not taking another step forward.

The blue text box in my field of vision hasn't disappeared yet.

[Current risk: Not yet resolved.]

[Transfer phase: Continuous monitoring.]

The sounds of numbers being called, wheelchairs being pulled, and family members asking questions in hushed tones returned to my ears.

The call number screen was reopened by the day shift nurse, and the numbers in the general ward jumped. The husband was still standing in front of the signing desk, the pen in his hand uncapped, the nib leaving a small blot of black ink on the paper.

The deputy director on the day shift removed the signature board, checked the name first, and then the time.

"This page is complete. Names, dates, and relationships are all there."

The husband looked up.

"If she gets in, doesn't that mean there's hope?"

No one answered immediately.

Qin Hai leaned against the side of the passageway, raised his hand to rub his temples, and his voice was terribly hoarse.

"There's hope now."

The husband's finger was still pressed against the edge of the signing board, his fingertip stained with a little black ink.

Qin Hai lowered his voice.

"She's already inside. They can see the blood vessels clearly from there and then treat the most dangerous areas."

He glanced at the closing elevator doors.

"But don't take that as a sign of peace. Wait here for now. Luo Jianping will come out and tell you the next steps."