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

At eight o'clock in the morning, which should be the most tiring time of the day, the shift change room was so quiet you could hear a pin drop.

"...Patient number three, Li Xu, 24 years old. He was brought to the emergency room by a friend due to 'severe vomiting after drinking alcohol, accompanied by sudden, tearing pain in the upper abdomen for two hours'."

Lin Ye stood in front of the projection screen, holding the handover log in his hand.

His eyes were bloodshot from staying up all night, and his white coat was wrinkled from running around all night.

"Initial physical examination: blood pressure 105/65, heart rate 118. Abdominal muscles tense and tender to palpation. Key positive signs: obvious subcutaneous emphysema palpable in the neck and supraclavicular fossa. Extremely weak breath sounds in the left lung."

Lin Ye paused slightly at this point, glancing at the crowd below the stage.

"Based on the patient's history and physical examination, simple intoxication and acute gastric perforation were ruled out. Spontaneous esophageal rupture (Boerhaave syndrome) was highly suspected. The general practice green channel was activated, and an emergency combined chest and abdominal CT scan was performed. The results confirmed a rupture in the lower esophagus accompanied by mediastinal emphysema and left-sided pneumothorax."

"We then requested an emergency second-line consultation with the cardiothoracic surgery department. At 3:15 a.m., the patient was directly transferred to the second-floor operating room via the emergency green channel for open-chest esophageal repair and mediastinal drainage. The patient's vital signs are currently stable."

After he finished speaking, the shift change room remained deathly silent.

The other resident trainees from the other medical groups sitting in the back row even stopped taking notes with their pens, looking at each other in shock.

Add to that the aconitine poisoning and nail gun pericardial puncture that happened during the previous shift... Is this the kind of lineup you'd expect to encounter on a typical weekend night shift?

Aconitine gastric lavage, blind pericardiotomy for decompression, blindly grabbing a ruptured esophagus from a drunkard... Any one of these three bombshells could trigger a somber "medical adverse event analysis meeting" for the entire department this Friday afternoon.

As a result, these three critically ill patients with extremely high mortality rates were completely dismantled, closed, and safely handed over to the specialists by Lin Ye and Ma Hao, two young doctors who had only recently been promoted to resident physicians, during a night shift when even senior doctors were not present.

This can no longer be explained by "good luck." It is an extremely terrifying clinical intuition and execution ability.

Qin Hai, the head of the emergency department, sat at the head of the conference table, holding a thermos. He didn't show much surprise, only nodding slightly after Lin Ye finished speaking.

"Well handled, very clear thinking." Qin Hai's voice was as serious as ever. "After taking over the day shift, follow up on the progress of these three patients in the specialist department and complete the final archiving of the emergency room medical records. Meeting adjourned."

As Qin Hai got up and left, the stagnant air in the handover room began to flow again.

Ten minutes later, in the director's office.

Deputy Director Zhou Min pushed the door open and walked in, then closed it behind her.

She walked to the water dispenser, filled herself a glass of warm water, turned around and looked at Qin Hai who was watering the potted plants, and couldn't help but shake her head.

"Director Qin, you were incredibly composed outside just now." Zhou Min took a sip of water, her tone filled with undisguised admiration. "When I checked the shift handover system this morning, I broke out in a cold sweat. Cardiac tamponade and esophageal rupture! I was prepared to be called back in the middle of the night by Lin Ye or Ma Hao to clean up my mess. But those two guys didn't utter a sound and managed to keep their composure."

Qin Hai put down the spray bottle, walked to his desk, and sat down. A subtle smile finally appeared on his lips: "If I can't even handle this kind of situation, then all my hard work over the past few months will have been wasted."

Zhou Min pulled out a chair and sat down: "To be honest, I can understand Lin Ye's handling of cardiac tamponade; he's steady and bold. But to not be fooled by appearances from a drunkard who was reeking of alcohol and complaining of stomach pain, and to find subcutaneous emphysema upon palpation... that's incredibly shrewd. I heard from the nurses that Fang Rui initially reported it as a perforated stomach."

Upon hearing the name "Fang Rui," Qin Hai's smile faded, and his eyes became more profound.

"That's the real reason I assigned Fang Rui and Tang Wen to them." Qin Hai placed his hands on the table, looking at Zhou Min. "Director Zhou, do you really think I sent them two free laborers to write medical records because I thought they were working too hard?"

Zhou Min was stunned for a moment, then realized what was happening, and her expression changed slightly.

"If a person can diagnose a patient without making a mistake, that's considered excellent. But that's not enough in the emergency room." Qin Hai's voice became deep and powerful. "The emergency room is a place where a high margin of error and a zero margin of error coexist. What we need are frontline commanders, not lone wolves fighting alone."

Qin Hai paused, then continued, "Fang Rui is a very bright prospect. He can see abdominal muscle tension and can deduce a stomach perforation, which proves his foundation is very solid. But what mistake are bright young people most prone to making? Tunnel vision. They get stuck on the patient's chief complaint."

"Lin Ye's biggest improvement last night wasn't that he performed the puncture himself, but that he didn't snatch the patient away to examine him like he used to. He let Fang Rui examine the patient and draw conclusions. Then, at the last moment when Fang Rui was about to make a mistake and give incorrect medical advice, he calmly stepped in, not only pointing out the error but also personally teaching him how to avoid it."

Qin Hai leaned back in his chair, his eyes gleaming: "What's this called? This is called a safety net. Lin Ye now has the ability to see through the blind spots in the thinking of junior doctors and preemptively stop the erroneous chain of events. He has finally learned how to be a 'safety net'."

Zhou Min suddenly realized, recalling Ma Hao's record of teaching Tang Wen how to deal with family members in the observation area, and couldn't help but sigh: "So, this is also a test paper that you gave to Lin Ye and Ma Hao. Fang Rui and Tang Wen are the test questions."

"Yes." Qin Hai nodded, his expression turning serious. "Next month, the hospital will be undergoing a major overhaul of the emergency department's treatment process, officially establishing the 'Integrated Pre-hospital and In-hospital Rapid Response Team for Critical Care.' I need commanders who can be deployed and lead their teams to hold the first line of defense firmly. Lin Ye and Ma Hao delivered a perfect performance last night."

Meanwhile, there's a food street outside the hospital.

Fang Rui and Tang Wen, dressed casually, sat under the plastic awning of a steamed bun shop. Both had dark circles under their eyes, disheveled hair, and two steaming baskets of steamed buns and two bowls of soy milk in front of them.

"I almost got yelled at to death last night." Tang Wen took a bite of her steamed bun, still feeling lingering fear as she recalled the terror of being attacked by a family member. "If it weren't for Teacher Ma coming over and calming that family member down with just a few words, I probably would have been crying at the triage desk last night. Teacher Ma is amazing; the 'emergency room communication skills' he taught me are a million times more effective than any textbook."

Fang Rui took a big gulp of soy milk, swallowed it, and let out a long breath.

"What's that?" Fang Rui looked at his wrist, which was still throbbing slightly. "Can you believe it? Last night, I held the ultrasound probe myself and watched as Teacher Lin inserted such a thick needle directly into his pericardium and drew out fifty milliliters of blood."

Tang Wen's eyes widened: "Blindly transmigrating by the bedside? That's so wild?"

"Not only wild, but divine." Fang Rui's eyes no longer held the confusion of a resident trainee, but only a pure fervor and admiration. "You don't know, that drunk patient with a ruptured esophagus, I was so sure that it was a perforated stomach. Teacher Lin was standing right behind me, casually asking me, 'Did you vomit first or feel pain first?' Then he pulled up my clothes and touched me, and there was subcutaneous emphysema."

Fang Rui gripped his chopsticks tightly, his voice trembling slightly: "That was a ruptured esophagus... If it had been discovered half an hour later, the person would have been gone. Teacher Lin didn't even do a preliminary examination; she relied solely on her hands and her mouth to snatch the person back from the jaws of death."

He looked up at the somewhat old building of the emergency department of the First People's Hospital of Chenguang City and muttered to himself.

"Tang Wen, we're so lucky." Fang Rui took a big bite of his steamed bun and said, his words muffled but extremely firm, "We've got two real ER specialists working with us. As long as we stay with them, one day we'll become the kind of people who can save lives in the middle of the night."