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

"The on-call ophthalmologist took the patient to the examination room on the second floor of the outpatient building to complete visual acuity, pupil, slit-lamp, and fundus examinations. After review by the second-line physician, the patient was treated for retinal tear with superficial detachment, and emergency laser treatment was arranged before being admitted to the ophthalmology department."

The teacher from the Science and Education Department lowered his head and carefully wrote down a line of words in his notebook.

Zhou Min turned a page of documents, her gaze falling on the new content, her tone carrying an assessment tone: "This case was handled according to regulations and was promptly escalated. Now let me ask you, why didn't you escalate the case of the delivery driver's dog bite vaccination to your superiors? Don't give me a perfunctory answer like 'it looked fine.'"

Lin Ye gently tapped his knee with his fingertip.

"It's not that he didn't want to get vaccinated, he was just scared by the short video, thinking that if he delayed by a day, all the previous shots would be wasted," Lin Ye said. "I checked his vaccination card first. The first two shots were given at the dog bite clinic, and the third shot was a day later than scheduled. The wound was on the web of his hand, and it had already healed, with no redness, swelling, or pus. The cat that scratched him is a stray cat that the shelter feeds regularly, and its condition is stable; we were able to observe it afterward. He washed the wound with soapy water for more than ten minutes after it was injured."

Zhou Min did not interrupt and listened quietly.

"I then asked him about severe allergies, long-term use of hormones, history of chemotherapy, and low immunity, but he didn't have any of those. Afterwards, I took his vaccination card to the dog bite treatment window and had the nurse on duty review it according to the procedure. In the end, it was treated as a delayed booster shot, and he received his third shot that day, with the subsequent shots postponed accordingly."

Liu Zhenhua looked up at him and asked, "What do you think is the value of this case?"

"We can't let him go through all that trouble for nothing," Lin Ye said. "He's a delivery driver, and missing a day of injections is already scary enough. Making him get five more injections from the beginning would cost more money, require more time off work, and make it easier for him to get the dates mixed up later. This case isn't critical, but we can't just brush it off with 'no special circumstances.' We need to clearly write down who approved the card, how many days the delay was, how to make up for it, and what the circumstances were when he returned."

Zhou Min lightly touched the paper with her pen and continued asking, "The little girl with the fever, her family rang the call button saying they couldn't wake her, why didn't you do any additional tests at the time?"

"Her mother was already panicked when she saw the child with the magnetic beads being pushed away on a stretcher, and when she touched her own child and found her fast asleep, she became even more frightened," Lin Ye said. "I first confirmed whether she was truly unresponsive or just sleeping soundly after her fever subsided. She could hum when called, could turn over, her breathing was steady, her hands and feet were warm, she had urinated twice in two hours, and she had no rash. At this point, there's no need to wake the child up for a checkup, but you need to make it clear to the family: if the child's temperature exceeds 39 degrees Celsius, has convulsions, wheezing, is truly unresponsive, urinates significantly less, has a rash, or is getting increasingly lethargic, press the call button immediately."

"Did you write all these details into the medical record?" Zhou Min pressed.

"It's all written down." Lin Ye nodded.

Zhou Min put down the documents in her hand and said calmly, "You still understand why you didn't conduct further examinations, instead of blindly acting on your gut feeling."

Liu Zhenhua didn't give him a chance to catch his breath, directly pulling out the page of the medical record containing the magnetic beads: "This child who swallowed the magnetic beads was initially kept under conservative observation, and later transferred to general surgery. Explain clearly why we didn't push for surgery directly from the beginning, and why we had to intervene immediately later and couldn't wait any longer?"

Lin Ye did not answer immediately.

The image of that child being carried onto the stretcher flashed through my mind.

The child was still clutching the crumpled Zero sticker in his hand, and his mother, with red eyes, carefully protected his little hand from the IV drip.

"The family was anxious at that time, and so were we," Lin Ye said, slowing his pace slightly. "We couldn't just rush the child into the operating room because we were anxious. After confirming that the four magnetic beads were in the intestines, Director Qin, Dr. Zhang from the pediatrics department, and Dr. Liu from the general surgery department all reviewed the scans and examined the child. At that time, the child's abdomen was still soft, there was no rebound tenderness, no rectal bleeding, and the abdominal pain was not getting worse. The treatment plan was to withhold food and water, keep the child under observation, and take a follow-up scan in two hours to monitor abdominal pain, vomiting, bowel movements, and abdominal signs."

Qin Hai, who had been silent all along, looked up at him at this moment.

"During the follow-up scan, the four beads were clustered together, and the position hadn't moved much downwards. The tenderness around the child's navel was also more pronounced than before. After evaluation, Dr. Liu felt that they couldn't gamble on the child expelling the beads on their own, so they initiated the emergency surgery procedure. At that time, I asked about the duration of fasting, how many times the child had vomited, and whether there were any drug allergies, and then left this information to the general surgery and anesthesiology departments."

Liu Zhenhua leaned back in his chair, his gaze sharp: "If the final intraoperative examination reveals that the condition wasn't as serious as initially thought, and the family comes back demanding accountability, accusing us of over-treatment and deliberately scaring them, who will bear that responsibility?"

The demonstration room fell silent for a moment.

The air conditioner vents gave a soft hum, and the curtains were blown slightly against the wall by the airflow.

Lin Ye looked at the documents on the table: "I don't have the authority to decide on the surgical plan for Dr. Liu, nor can I set the treatment procedure for Director Qin. What I can do is to write down clearly what I saw, touched, asked, and the changes during follow-up examinations. Whether the child was in pain, whether the abdomen was soft, whether the bead position had changed, who reviewed the X-rays, when the repeat X-rays were taken, when the signatures were obtained, and the person who takes over next must be able to understand it clearly."

He paused briefly: "If a judgment is wrong, people need to know where they went wrong. It can't end with just 'it's not a big problem' or 'continue to observe,' without even knowing why they did it in the first place."

Qin Hai unscrewed the lid of the thermos, paused, didn't drink any water, and then tightened it again.

Zhou Min put down her pen and continued asking, "What do you do when a patient refuses treatment and insists on leaving the hospital? Emergency rooms can't keep patients; you can't just forcibly detain them."

Lin Ye knew she was asking about the patient who had suffered an injury from drinking alcohol.

"First, explain the risks until he understands," Lin Ye said. "The patient who had an injury from drinking insisted on leaving. I told him about the risks of head injuries, the contraindications of taking medication after drinking, and the possibility of accidents if he left the hospital alone. I had him sign an informed consent form for refusal of medical treatment and repeatedly reminded him not to drive himself. In the emergency room, we can't just detain people, but we can't just assume everything is fine just because he says he wants to leave. I wasn't sure what to do at the time, so I kept an eye on him and didn't move the resuscitation equipment far. Later, he fainted at the entrance, and Director Qin took over the treatment."

Liu Zhenhua turned to Qin Hai: "Did you handle this case?"

Qin Hai replied calmly, "I handled the follow-up treatment, and I've reviewed the medical records. There are no problems."

Liu Zhenhua didn't press further, and quickly wrote a few lines on the assessment form.

The sound of the red pen gliding across the paper was extremely soft, yet exceptionally clear in the quiet classroom.

Half a minute later, Liu Zhenhua closed the assessment form: "The defense will be considered a pass."

Lin Ye looked at the directors.

"It's just that you passed the defense." Liu Zhenhua said seriously, "Whether you can stay in the hospital and how you are ultimately assigned to a position depends on your subsequent performance. The emergency department never decides people based on just one defense."

Zhou Min pushed his medical records back in front of her and instructed, "For the next night shift, focus on refining and polishing the handover content and medical records. You can ask questions now and grasp the key points, but the records are still incomplete. Just because you are on-site and understand the whole situation doesn't mean the day shift doctor taking over will understand all the details."

Qin Hai pulled out a schedule from the side, folded it in half, and handed it to Lin Ye: "Take this. Go out and call the next person in."

Lin Ye reached out and took it, replying softly, "Okay."

He gently closed the door to the demonstration room, and everyone waiting in the corridor immediately looked up.

Ma Hao was the first to rush over, eagerly asking, "How did it go? Did you pass?"

Lin Ye looked down at the schedule in his hand and said softly, "I passed the defense. I still have to work one more night shift."

Ma Hao was both amused and exasperated: "I knew it, there's no such thing as a free pass in this world."

Jiang Peng stepped forward: "Let me check the shift schedule."

Lin Ye didn't hand it over, but simply unfolded a corner.

At the very bottom of the table, Qin Hai personally added a line of text using a black pen, the handwriting clear and neat:

Emergency room observation: next round of night shift.