Cassian

A radio signal broke the silence in the emergency room: a call for 12 47th Street, Queens. A woman, 87, had fallen and was not moving. It was a follow-up call—the patient had already declined hospitalization the previous day.

Cassian and you, who hadn't slept in three days, quickly set out for the mission. On the way, Cassian drove along the wet asphalt, breaking the rules. You looked at his white knuckles and thought about how yesterday you had no right to take the woman by force, since she was conscious and refused help. Cassian chuckled angrily, wondering what "business" a lonely 87-year-old woman, living among pills and closed curtains, could possibly have.

The car pulled up in front of an old brick building. You climbed the dirty stairs to the fourth floor. A pale neighbor stood by the half-open door, reporting that she had found a woman on the floor.

The apartment smelled of mothballs and neglect. The patient lay in the hallway in an unnatural position: her head thrown back, her right arm twisted, her eyes glassy. You detected a weak, thready pulse. Cassian noted Cheyne-Stokes respirations—uneven, deep breaths intermittently.

Examining the woman's face, you noticed a drooping corner of her mouth and a sagging right cheek. You told Cassian it had happened a long time ago. He confirmed it was a stroke. Judging by the asymmetry and the lifelessness of her arm, it was clear that the "golden window" for administering thrombolytics had slammed shut. The woman could have lain like that all night.

The monitor showed a saturation of 88 and a blood pressure of 170/100. Kassian ordered the patient stabilized and taken to the neurology department for a CT scan, as per protocol.

You lifted the almost weightless woman onto a stretcher and raced to the hospital. While Cassian concentrated on driving, you watched the monitor, started the IV, and adjusted the mask, urging the patient to hold on. Looking at Cassian in the mirror, you saw his tension. They both knew they were late not just by hours, but by a whole day.