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

Just as Lin Ye was about to make a call, there was a loud crash from the red zone—the sound of a bed railing being slammed shut, mixed with a nurse's shout: "Director Qin! The patient is having convulsive seizures!"

Lin Ye dialed the phone number of Director Zhang of the Intensive Care Unit. It rang twice before being answered, and the alarm from the monitor could still be heard on the other end.

Director Zhang's voice was hoarse, carrying the exhaustion of just finishing a busy day. He asked in a low voice, "What's wrong? Just tell me the situation."

"A 26-year-old male worked on an exterior wall in high temperatures for nearly eight hours during the day. His axillary temperature was 40.2℃, blood pressure was 90/58, and heart rate was 132. He experienced transient syncope before arriving at the hospital and just had a seizure; he is currently in a state of light coma. His creatine kinase level was 12876 U/L, blood gas pH was 7.31, lactate was 4.2, and catheterization revealed 20 ml of dark brown urine. Dr. Qin, we are considering the risk of severe heatstroke and heat exhaustion. Please provide an urgent consultation."

"Okay, I'll be right there. You guys quickly start fluid resuscitation, monitor urine output and color, and I'll be there in five minutes."

Director Zhang hung up the phone abruptly without saying a word.

After hanging up the phone, Lin Ye picked up the medical record book and quickly recorded the time points. Just as he wrote down the creatine kinase value, the door to the red zone opened.

Qin Hai came out, his face grim: "We've been pumping for over a minute, we've given midazolam and put on an ice blanket, but the urine output is still low."

"Director Zhang will be here in five minutes. Bring the transport cart over." Lin Ye handed over the medical record he had written down.

Qin Hai glanced at it, then pointed to the line about creatine kinase: "Highlight this in red, and emphasize it during the consultation."

He paused, then added, "The medical history was very comprehensive just now. From now on, if someone comes in hot weather, reacts slowly, or has a flushed face, we'll check their armpit temperature first; forehead thermometers aren't accurate."

"Understood, Teacher Qin."

Lin Ye nodded and carefully clipped the medical record to his folder.

Several patients in the waiting area craned their necks to look into the red zone. An older woman muttered to the person next to her, "That young man looked quite young, what illness does he have that's so serious?"

"I heard it's heatstroke, and they're going to send him to the ICU. In this sweltering summer heat, you can't just stand there in the sun."

Lin Ye walked over and just saw Liu Kai returning from the payment counter. Liu Kai was clutching a stack of receipts and ran over to him, his voice trembling.

"Doctor, how's my brother? The foreman just called and said he'll transfer the money and that we should treat him well without deducting his wages."

"They're still trying to save him. The head of the ICU will be here soon." Lin Ye patted him on the shoulder. "Go sit down for a bit. You're all sweaty. The doctor will explain your condition to you later."

Liu Kai nodded, holding his phone as he sat in the waiting area, his palms sweating nervously.

Within five minutes, Director Zhang arrived with two nurses pushing a stretcher.

Several people went directly into the red zone. Lin Ye followed them in and reported in order his experience of working in the high temperature during the day, fainting, convulsions, oliguria, and the results of the recent examinations.

As Director Zhang listened, he flipped through the test results, pointing to the report from the recent follow-up examination: "Cretin 210, lactate 4.5, slightly higher than before. There's a high probability of heatstroke complicated by rhabdomyolysis, and a high risk of acute kidney injury. Transfer him to the ICU first, closely monitor his kidney function, muscle enzymes, and urine output. If creatinine continues to rise and the high potassium doesn't come down, then prepare for bedside hemofiltration."

Ding Yong was quickly lifted onto a stretcher in the ICU.

He was still in a light coma, with ice packs on his body, and the monitor readings fluctuating around the warning line. Liu Kai stood at the entrance to the red zone, tears welling up in his eyes, repeatedly muttering, "It's all my fault. I should have insisted on pulling him away. I actually believed him when he said he was fine..."

"The delivery is on time, so don't worry too much."

Lin Ye handed him a form and patted him on the shoulder: "Go and pay the deposit first. His family has been contacted and is on their way here. We will continue to contact them as needed."

Liu Kai nodded, took the form, and left.

With the door to the red zone closed, the people at the triage desk could finally catch their breath. Lin Ye and Ma Hao were flipping through their residency training materials when, at the same time, a flash of lightning streaked across the window, and the rain outside gradually intensified.

Nurse Zhu took a sip of hot water from her thermos and casually remarked, "This sweltering heat is really awful. The two patients with mild heatstroke just left after observation and IV fluids, and now we have a severe one. We've already had three heatstroke patients this shift. That young man's condition was definitely precarious."

Before I could even rest for a moment, the phone at the triage desk suddenly rang. The 120 dispatcher's voice was urgent: "Someone has fallen from a height at the construction site in the south of the city. They are unconscious. We'll be there in ten minutes."

Just as Lin Ye was about to get up to prepare the rescue equipment, the phone rang again less than thirty seconds later. The 120 dispatcher sounded apologetic: "I'm sorry, the people from the construction site have already been taken to the nearest district hospital. You don't need to wait any longer."

Ma Hao breathed a sigh of relief, plopped back into his chair, and his stomach growled.

He had clearly eaten quite a bit of stir-fried pork and sweet and sour pork ribs for dinner, but after all that commotion, it seemed like he had already digested it all. He took out some soda crackers hidden in his white coat pocket, and just as he tore open the packaging, the automatic door at the emergency room entrance slid open, and a young girl in a white dress walked in.

The hem of her skirt was damp with rain, and her hair was a little wet.

The young woman looked to be in her early twenties. She was carrying a backpack, her face was very pale, and she had been leaning against the door frame, panting for a while. Her hands were still trembling. When she got to the triage desk, she could barely speak: "Doctor, I'm feeling anxious... my hands are numb, and I can't breathe."

Lin Ye had just finished organizing Ding Yong's medical record folder when he looked up at her. Her forehead was covered in cold sweat, and her lips were pale.

He quickly handed over a chair: "Please sit down. What's your name? How old are you?"

"Su Xiao, 20, junior in college."

The young girl sat down, holding onto a chair, her hands trembling so badly she could barely grip her backpack strap. "I just finished my pharmacology final exam this afternoon. I studied for three days and three nights, and I didn't eat anything all day, just drank two cups of coffee. My heart was racing when I left the exam hall. I thought it was just nervousness, but I sat in my dorm for ages and still couldn't breathe. My hands were numb. Do I have a heart condition?"

As she spoke, tears welled up in her eyes: "I have to retake my departmental exam next month, please don't let anything happen..."

"Don't panic, let's check your blood pressure first."

Lin Ye picked up the blood pressure cuff and tied it on her. Nurse Zhu handed over a thermometer, scanned her forehead, and read 36.4℃. No fever.

Blood pressure 102/66, normal; heart rate 112, slightly fast.

Do you have a history of heart disease or asthma?

As Lin Ye asked, he counted her pulse. The rhythm was regular, but it was beating fast.

"No, I got full marks on all the physical tests. It's just that I've been working really hard these past few days. I even threw up last night. I thought it was from memorizing so many questions."

Su Xiao started panting again as she spoke: "Look, my hands are still numb. Am I going to die from overwork?"

Ma Hao quickly handed her a tissue and comforted her in a gentle voice, "Don't scare yourself. Have you not eaten anything properly all day?"

"Hmm... I only drank half a cup of soy milk this morning, and ate two bites of bread at noon before throwing it away. I didn't have an appetite because I was memorizing the questions."

Su Xiao nodded, her eyes red-rimmed.

"Treat her for low blood sugar first, Sister Zhu. Could you please give her a cup of warm sugar water and check her blood sugar level on her fingertip?" Lin Ye said, turning his head.

Nurse Zhu quickly brought over the blood glucose meter and placed the warm sugar water on the table.

The lancet is inserted into the fingertip, a drop of blood is placed on the test strip, and a few seconds later, the blood glucose meter screen displays a number: 3.2 mmol/L.

"Your blood sugar is low." Lin Ye handed her the sugar water. "Drink this first, and you can go after you feel better. If you still feel palpitations, chest tightness, or shortness of breath, say so immediately."

"No matter how important the exam is, you still have to eat. If your health collapses, memorizing the questions won't help."

Ma Hao was sitting there bored when he saw Lin Ye looking at his phone. He leaned over and asked, "Brother Ye, do you think I'll pass my exam next month? Can you tell my fortune?"

Lin Ye rolled her eyes at him and simply ignored him, paying him no attention whatsoever.

Su Xiao held the cup and slowly took two sips. The steam gradually brought color back to her face, and her breathing became less labored. When she heard them mention the exam, her eyes flickered.

"Is the residency training exam difficult? I'm so tired of memorizing pharmacology, I can't remember it at all."

"It's difficult."

Ma Hao pointed at Lin Ye: "Look at him, he doesn't say it, but his manual is practically worn out. When I was memorizing pharmacology, I copied the mnemonic for antihypertensive drugs onto my meal card and recited it while getting food. Now, just seeing the card makes me want to throw up. When you get your residency training, the exam might be even harder."

"Oh? Then I'll have to study hard."

Su Xiao stuck out her tongue and continued to drink slowly, holding the cup. After sitting for about ten minutes, her hands stopped shaking and her breathing calmed down.

The blood sugar level was 4.8 after a follow-up test, the heart rate dropped to 82 beats per minute, and the blood pressure was stable.

"Your blood sugar and heart rate have come down now." Lin Ye handed her the results. "Go back and have a good hot meal and get some sleep. If you feel palpitations or discomfort again, come anytime."

"Okay, thank you, doctor! I'll take a taxi home now; this rain isn't going to stop anytime soon."

Su Xiao stood up, took out two chocolates from her backpack and handed them over: "These are for my exam, you guys can have them. You guys work really hard on duty."

Lin Ye was about to decline when Ma Hao reached out and took it: "Hey, thanks! We're both hungry. This is a lucky chocolate for top students; we're sure to pass our exams next month."

Su Xiao was amused by him, waved, and walked out of the emergency room.

Ma Hao tossed one of the chocolates to Lin Ye, then tore open another one and took a bite.

"Do you remember when we took the general surgery exam? I stayed up for two nights straight, and my legs were so weak when I entered the exam room that my classmates had to help me in. I almost fainted on the spot."

"Yes, I drank a glass of cold milk that morning and threw up at the entrance of the exam hall."

Lin Ye unwrapped the chocolate. The dark chocolate was a little bitter, but a sweet taste slowly rose in his throat after swallowing it. Back when he was preparing for his medical licensing exam, he spent every day in the library, memorizing questions until his nose bled. He never imagined then that he would be eating chocolate given to him by a patient at the emergency room triage desk.

The rain outside was getting heavier and heavier, pattering against the glass.

Ma Hao had already sat back down to memorize his questions, humming off-key rhymes. Nurse Zhu was typing on her keyboard. The last person picking up their medication at the window had left, and the waiting area gradually quieted down, leaving only a few patients receiving IV drips looking down at their phones.