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

Lin Ye arrived at the emergency room half an hour early on Monday evening at 7 p.m.

An elderly woman with a thermos was sitting by the window in the waiting area. The curtain in the observation area was half-drawn, and someone inside coughed twice.

Nurse Zhao was checking the last set of medications with the day shift nurse when she heard footsteps and looked up at him.

"They really did arrive ahead of schedule."

Lin Ye put his bag on the back of the chair: "Hahaha, Sister Zhao, are you saying I'm so busy I don't even recognize my own family?"

"I meant I don't want to be on the same shift as you," Nurse Zhao signed her name at the end of the medication handover form. "You never listen to my scheduling."

Lin Ye took the handover folder and turned to the last two pages.

The two patients who were electrocuted last Thursday are listed at the bottom. The electrician who collapsed on the spot was kept under observation overnight. The monitoring did not report any abnormalities, and he was transferred to the cardiology department for a follow-up examination the next day.

The person who suffered an electric shock to their hand was discharged after six hours of observation. They received a follow-up appointment slip and left their phone number.

Lin Yehe handed over his shift and walked to the entrance of the observation area.

The elderly person in bed three is already asleep, with the nasal cannula still in place, while the person in bed four is waiting for a follow-up blood gas test.

After asking for information from the two patients, he returned to his workstation, just as Ma Hao came in from the doorway.

Ma Hao entered the room carrying a small bag of drinks, with his notebook tucked under his arm.

He placed a bottle of ice water next to Lin Ye and a bottle of oolong tea on the triage table.

"Sister Zhao's, less sugar."

Nurse Zhao unscrewed the bottle cap and took a sip: "I remembered correctly this time. I'll keep the night shift's medical history in the same way."

"I've got it." Ma Hao pulled out the chair next to him and opened his notebook. "We're in the same class tonight, so don't let me miss anyone right away."

Lin Ye pushed the water bottle next to the keyboard and opened the night shift triage log.

There were no beds in the emergency room, and the first emergency bed was empty. The call bell in the observation area rang every now and then.

Ma Hao rewrote the information about the third bed he had just handed in into his notebook, and casually asked Nurse Zhao how much IV fluid was left.

The observation area had two rounds of IV fluid changes, the triage desk received several inquiries, but the emergency bed remained empty.

Just after 11 a.m., the automatic doors at the emergency room entrance slid open.

A woman in her forties helped a boy in.

The boy was wearing a school uniform jacket, his face was pale, he was holding his lower abdomen with his left hand, and he would stop every two steps.

The woman was still urging, "Hurry up, tell the doctor what you ate tonight. Your stomach hurts so much, it must be that fried food stall near the school."

Nurse Zhao first led the person to the triage desk: "How old are you? When did the pain start?"

"Fourteen," the woman answered for the boy. "He ate fried skewers at the school gate before evening self-study, and after self-study he said his stomach was upset. He just threw up once and went to the toilet, but couldn't poop."

The boy had his head down, his forehead covered in sweat.

Ma Hao had already clipped the triage form onto the board: "Where does it hurt?"

"abdomen."

Which side of your stomach?

The boy's lips moved, but his hand pulled the hem of his school uniform down even further.

The woman pointed to below his navel: "Here. He usually gets like this when he eats cold food, and we have stomach medicine at home."

Ma Hao squatted down to be at eye level with the boy: "Tell me yourself, does it hurt in your stomach, or below your stomach?"

The boy said in a low voice, "Below the right side."

Ma Hao looked up and called to Lin Ye, "Lin Ye, don't put him in the waiting room yet. His pain isn't located around his navel."

Lin Ye put down the handover folder he was holding and walked up to the boy: "When did it start? Did the pain suddenly begin, or did it start gradually?"

"It hurts when I stand up after finishing evening self-study. It's past 9:40."

"Did your stomach hurt first, or your right side?"

The boy's face turned red, and he pinched his school uniform twice with his fingers.

The mother became anxious: "Just tell the doctor what they're asking! What's there to be embarrassed about?"

"Lower right side, around the scrotum," the boy finally spoke. "Later, my stomach also hurt."

Lin Ye pointed to the examination room next to the emergency area: "Sister Zhao, please accompany me for a moment and have a physical examination first. Ma Hao, order a blood routine test, a urine routine test, and an emergency scrotal ultrasound. Also, inform the second-line urologist that he is fourteen years old and has experienced sudden pain in his right scrotum, which started around 9:40."

The mother followed him inside, her steps faltering: "Didn't you say you had a stomachache? Why did the tests lead to that place?"

Lin Ye stopped at the door of the examination room: "His pain initially came from his right scrotum, and later spread to his lower abdomen. For someone his age to suddenly experience such severe pain, we need to rule out testicular torsion first. If the blood flow is blocked, it can affect the testicles if left untreated for too long."

He turned to the boy: "I need to check the area that hurts on your right side. The nurse will be there the whole time, and your mother can stay behind the curtain with you, okay?"

The boy nodded.

The mother, carrying her schoolbag, followed Nurse Zhao into the examination room.

Ma Hao stayed outside to conduct examinations and contact the ultrasound team.

Another nurse pushed the treatment cart over, checked the name, drew blood, and inserted an indwelling needle.

Lin Ye completed the physical examination behind the curtain and asked a few questions about his past medical history.

The boy had no external injuries, had not been bumped after strenuous exercise, and did not have a fever or diarrhea.

He pulled back the curtain and turned to Ma Hao: "The swelling on the right side is quite noticeable, and it's positioned high up; it reacts strongly to touch. When can we do an ultrasound? Send the test results first, without waiting for the outcome."

Ma Hao had already dialed the number and listened to a couple of sentences through the microphone: "The ultrasound doctor is doing bedside work for the patient in observation bed number seven. He'll be down in ten minutes."

"Don't wait for the report to call the urology department." Lin Ye took the phone. "Connect me to the backup line."

The mother stepped outside the examination room, still holding her schoolbag.

She looked at the blood collection tubes on the treatment cart: "Do I need surgery?"

"It's not certain yet." Lin Ye held the phone to his ear. "We'll do an ultrasound and a urology consultation together. If it really is torsion, the sooner it's repositioned, the better."

The call was answered.

Lin Ye recited his age, the onset time, the location of the pain, and the findings of the physical examination in one breath, and then added a sentence at the end.

"The ultrasound is in progress. The baby started having contractions at 9:40, and it's 11:16 now."

The urology second-line doctor paused for two seconds on the other end: "I'm going to the emergency room. Call me as soon as the ultrasound results are out, and tell the child not to eat or drink."

Lin Ye hung up the phone and said to his mother, "From now on, don't give him any water or food. The ultrasound doctor will be here soon."

The boy lay on the examination bed, his face deathly pale.

Ma Hao moved the IV stand a little closer to the side of the bed: "If you feel nauseous, press the call button. Don't try to hold it in."

"Am I going to be cut off?" The boy stared at the ceiling, his voice trembling.

The mother stood at the foot of the bed, her fingers gripping the bed railing, biting her lip.

Ma Hao moved the call button next to the bed closer to him: "Nobody said anything about needing to cut it, let's finish the examination first."

Lin Ye walked to the bedside: "We're racing against time to find out the bleeding. If you can tell me when the pain started and which side hurt first, that will be helpful."

As the ultrasound machine was pushed to the door, the second-line urologist also hurried over from the other end of the corridor.

He took the registration form from Lin Ye, first checked the onset time, and then bent down to check the condition on his right side.

"Let's do the ultrasound first, and also prepare the operating room phone."

The probe was placed on the screen, and the screen lit up.

The ultrasound doctor changed two sections, tapped a few times on the keyboard, and frowned more and more.

Lin Ye stood at the foot of the bed, staring at the time ticking in the lower right corner of the screen: 11:24.

The ultrasound technician looked up: "The blood flow in the right testicle is much less than in the left, almost invisible. Based on the physical examination, torsion is highly suspected."

The urology second-line doctor took out his phone and said as he walked out, "Green channel, get him to the operating room immediately."