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

It was evening, and there was less than an hour left before the day shift ended.

"Teacher Lin, the blood pressure of the patient in bed three under observation has stabilized."

Fang Rui wiped his sweat and picked up his water cup as he walked to the nurses' station.

Before he could even swallow the water, the extremely piercing siren of an ambulance suddenly blared outside the emergency room.

The voice carried a chilling urgency as it rushed to the door of the emergency room.

"Bang--!"

The automatic doors suddenly opened to both sides, and two paramedics rushed in, pushing a stretcher.

"An 85-year-old male with late-stage lung cancer and multiple bone metastases! He suddenly experienced severe respiratory failure and was already unconscious when his family found him. His blood oxygen saturation is currently only 65%, his heart rate is 40 beats per minute, and his blood pressure is undetectable!"

The accompanying doctor loudly handed over the shift, his back already soaked with sweat.

"Push the stretcher over! Put it on the monitor! Establish intravenous access!" Lin Ye rushed forward almost the instant the stretcher entered the room, pulling out a pupil tracing pen to check the patient's pupils while issuing orders in a stern voice, "Fang Rui, prepare the intubation kit, get ready to put him on a ventilator!"

The old man on the stretcher was so thin he was practically skin and bones, his chest rising and falling weakly in despair, each breath accompanied by a hoarse and heavy rattling sound.

Fang Rui ripped open the intubation kit, skillfully took out the video laryngoscope, and was about to step forward to lift the old man's chin.

"Doctor! No! Please, please don't!"

Suddenly, a middle-aged woman with disheveled hair rushed up from behind the flatbed, crying and shouting.

Her eyes were red and swollen, and she looked sickly and exhausted from staying up late for a long time. She gripped Fang Rui's hand that was holding the laryngoscope tightly.

She is the old man's youngest daughter, Wang Mei.

"Family members, please release the pressure! The patient is at risk of sudden cardiac arrest and requires immediate intubation to establish an airway!"

Fang Rui was sweating profusely and tried to pull his hand away.

"No intubation! My dad said when he was lucid that he would never have a tube inserted!"

Wang Mei cried her heart out.

With her other hand trembling, she pulled a crumpled piece of paper from her pocket and desperately held it up in front of Lin Ye.

"Doctor, my dad has late-stage lung cancer. The head of the oncology department told him last week that he wouldn't make it past this month. This is what he wrote himself... He doesn't want to leave this world covered in tubes. Please, please, give him some oxygen and let him pass away peacefully!"

Lin Ye took the note that still felt warm from his body.

The handwriting was distorted and trembling due to the owner's weakness, but it was still clearly legible:

If I'm not going to make it, don't try to resuscitate me, don't put me on a machine, just let me go peacefully. Don't torture me anymore.

Lin Ye looked at the old man on the hospital bed, who was suffering his last pains, and his eyes darkened slightly.

This is called "Delayed Cardiopulmonary Resuscitation (DNR)".

For elderly patients in the terminal stage of multiple organ failure, forced intubation is not only irreversible but also an extremely cruel form of torture.

"Fang Rui, put down the laryngoscope."

Lin Ye decisively issued a new order.

"Teacher Lin?"

Fang Rui was stunned.

"Change to a non-invasive mask and give him pure oxygen. Prepare to administer one milligram of morphine to alleviate his respiratory distress and provide end-of-life care." Lin Ye calmly folded the note and handed it back to Wang Mei.

Fang Rui gritted his teeth, put down the laryngoscope, and placed the transparent oxygen mask over the old man's mouth and nose.

Wang Mei felt as if all her strength had been drained away. She collapsed to her knees beside the hospital bed, tightly holding her father's withered hand, sobbing uncontrollably, "Dad... it's alright now, you don't need to suffer anymore, Meimei will stay with you..."

With the help of pure oxygen and a small amount of morphine, the rattling sounds in the elderly man's throat subsided slightly.

Just as the atmosphere in the emergency room was turning quiet, a loud argument suddenly broke out outside the door.

"Get out of my way! I'm his son!"

A middle-aged man in a suit and tie, carrying a shopping bag from the airport duty-free shop, forcefully pushed aside the security guard and rushed into the emergency room with bloodshot eyes.

He is the old man's eldest son, Wang Qiang, who does business in other places all year round and rarely comes home.

I rushed back today after receiving a call from my sister.

Wang Qiang rushed to a bedside, glanced at the monitor showing a heart rate that had dropped to 30 beats per minute, and then at Lin Ye and Fang Rui, who were standing by the bed doing nothing. He instantly flew into a rage.

"What are you doing?! Why aren't you trying to save him?!" Wang Qiang slammed the duty-free bag in his hand to the ground, pointing at Lin Ye and roaring, "Why aren't you putting him on a ventilator? Why aren't you giving him a cardiac stimulant? Are you afraid we can't afford the medical bills?! I have money!"

"Brother..." Wang Mei stood up with difficulty, her eyes red. "Dad said last week that he was in too much pain. He wrote that note himself. He didn't want to suffer..."

"Shut up!"

Like an enraged beast, Wang Qiang suddenly turned around and slapped his younger sister across the face, knocking Wang Mei to the ground.

"Are you tired of taking care of him?! Do you want to kill him off sooner so you can take that old house for yourself?!" Wang Qiang's voice echoed in the emergency room, his face contorted with rage. "I transfer five thousand yuan to you every month for living expenses, and this is how you take care of him?! I don't need that little bit of money!"

He stared intently at Lin Ye, his eyes bloodshot: "I'm his own son! I'm the eldest son, I make the decisions! Intubate my dad right now! Use the best medicine, put him on the most expensive machines! I'll pay whatever it takes!"

"Mr. Wang, please calm down." Lin Ye stepped forward, shielding Fang Rui behind him, his gaze icy as he looked at the out-of-control Wang Qiang. "Your father has late-stage lung cancer with multiple bone metastases, and all his organs have failed. Any invasive resuscitation efforts now would only exponentially increase his suffering and have no medical benefit. Respecting his wishes is the best choice for him."

"Bullshit! As long as there's still a heartbeat, you have to save them!"

Just then, the monitor by the bedside emitted an extremely piercing long beep.

The elderly man's heart rate plummeted, and his blood pressure became undetectable. He suffered cardiac arrest.

Wang Qiang completely lost his mind. He grabbed Fang Rui by the collar of his white coat, raised his fist high, and roared with a ferocious expression.

"CPR! Defibrillate! If my dad dies today, I'll sue you to death! I'll expose your refusal to help him! I'll make your entire ER go down in flames!"

Wang Mei sat on the ground, covering her face and letting out a desperate wail.

The air seemed to freeze completely at that moment.

All eyes were on Lin Ye.

On one side is the final words left by the elderly man who died in agony, and on the other side is the hysterical, "filial" eldest son who threatens the law.

Under current medical regulations, that unnotarized crumpled note is as worthless as a piece of waste paper in the face of the immediate family's strong desire to save the patient.

This is the most somber and cruel reality in the emergency room.