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

The siren of the ambulance came to an abrupt halt outside the triage area.

Lin Ye and Fang Rui, who had just emerged from the harrowing whole blood perfusion in the intensive care unit, were still on edge, their nerves taut in a state of high alert.

The two rushed out of the reception area almost reflexively and pulled open the back door of the ambulance.

There was no coma covered in blood, nor the piercing alarm of the monitor's heart rate.

Sitting on the stretcher was a young man in his early twenties, wearing a windproof jacket with one sleeve torn, who was hugging his right arm and grimacing as he sucked in the cold air.

"It's nothing serious, he's conscious." The pre-hospital emergency doctor who accompanied the patient jumped out of the ambulance, took off his gloves, and said, "He was riding his electric bike across the intersection when a car making a right turn cut him off. He didn't break any bones; he just slid along the asphalt for three or four meters. I checked him; there was no tenderness in his chest or abdomen, and his pupils were normal."

The air in the emergency room lobby seemed to relax instantly.

There were no fatal injuries, and the vital signs were stable.

For emergency room doctors who have just snatched people from the jaws of death, this is the most friendly "halftime break".

"Come on, young man, get down and walk a few steps, then come with me into the wound cleaning room." Fang Rui let out a long breath, his tone becoming more relaxed, and stepped forward to support the patient's left arm.

In the surgical emergency debridement room, the operating lights are on.

The young man took off his tattered coat, revealing the injuries on his right forearm and right cheek under the light.

Although there was no serious injury, the abrasion looked shocking.

The epidermis has been completely eroded away by the rough road surface, revealing the bright red dermal tissue underneath.

What's more troublesome is that the wound is densely filled with black tar gravel, dust, and unknown black debris, like black sesame seeds sprinkled on red raw meat.

"Ouch... Doctor, please be gentle, it hurts so much..."

As soon as the young man sat on the debridement bed, Fang Rui rinsed him with sterile saline solution. He immediately trembled in pain and tried to back away.

The dermis is rich in nerve endings. Without the protection of the epidermis, even a gentle saline solution will cause an unbearable burning pain.

"Bear with it, it's full of sand inside. If you don't wash it clean, it will get infected." Fang Rui reassured him while picking up a sterile cotton swab and trying to pick out the black particles embedded in the meat little by little.

But his movements were far too light.

The cotton swab gently rubbed against the bloody wound, only removing the surface layer of loose sand.

Those black tar particles that are deeply embedded in the dermis remain completely still.

"Doctor, please stop applying it! It fucking hurts!" The young man's forehead was covered in cold sweat, and he gripped the edge of the bed tightly. "Just spray some medicine on it and bandage it with gauze. I'll buy some anti-inflammatory medicine when I get home, and it'll be fine once it scabs over!"

Fang Rui glanced at the patient's pained and contorted expression, then looked at the large area of ​​abrasion.

For resident trainees who have just started clinical practice, patients' pleas can easily evoke empathy.

Fang Rui looked at the surface and saw that it had been almost completely washed away by the saline solution, and the tiny black particles seemed "insignificant".

"Alright then." Fang Rui softened, casually tossing the blood-stained cotton swab into the yellow medical waste bin, and turned to get an iodine-soaked cotton ball. "Then I'll bandage it for you..."

"lay down."

The door to the wound cleaning room was pushed open, and Lin Ye strode in. He glanced at the young man's arm and immediately stopped Fang Rui's actions.

"Teacher Lin?"

Fang Rui paused for a moment, still holding the tweezers in his hand.

Lin Ye walked to the sink, stepped on the foot switch, and while quickly washing his hands with hand sanitizer, he gave instructions without turning his head: "Go to the cabinet and get two sterile stiff-bristled brushes, and three packs of dry coarse gauze. Also, prescribe a 2% lidocaine injection."

Fang Rui was completely confused, but he still reflexively turned around to get the consumables.

Upon hearing the word "brush," the young man turned pale with fright: "No, doctor, what are you going to do? Brush what? I already said just a simple bandage is fine, I don't want treatment anymore!"

Lin Ye dried his hands, put on sterile gloves, and walked to the wound cleaning bed.

"If you just bandage it up now, the wound will indeed scab over and heal in half a month, but the asphalt and carbon particles from the road will remain under your skin forever."

The young man was stunned: "What will happen if I keep it?"

"Macrophages in the dermis will engulf and encapsulate these black particles, forming permanent pigmentation." Lin Ye pointed to his cheek. "Medically, this is called a 'traumatic tattoo.' In the end, half of your face and your entire right arm will have large patches that look like bluish-black birthmarks. They can never be washed off unless you go to a plastic surgery clinic later and spend tens of thousands of dollars on laser blasting, or have the skin cut off and re-grafted."

The wound cleaning room fell silent instantly.

The young man subconsciously touched his unaffected left cheek, his Adam's apple bobbing with difficulty. His initial resistance instantly crumbled: "Doctor... what should we do now?"

"Brush it hard while the skin hasn't healed yet." Lin Ye took the lidocaine injection solution from Fang Rui and poured it evenly onto the sterile gauze. "It will definitely hurt. I'll apply a topical anesthetic for five minutes first, which will relieve it a little, but it will still hurt a lot. You'll just have to bear with it."

Gauze soaked in local anesthetic covered the horrific wound.

Five minutes later, Lin Ye removed the gauze.

Instead of using cotton swabs, he picked up a dry, rough-textured piece of sterile gauze and rubbed it hard against the bright red dermis covered with black tar particles.

"Ugh!"

The young man screamed and jerked violently on the cleaning bed, but Fang Rui held his shoulders down firmly.

Lin Ye's methods were extremely ruthless, without any hesitation.

The rough gauze was forcibly rubbed against the flesh that had lost its skin, causing the newly congealed capillaries to rupture again, and bright red blood mixed with black tar and mud flowed down the arm into the curved plate below.

"Fang Rui, look carefully." Lin Ye instructed coldly while scrubbing vigorously, "Emergency wound cleaning is not embroidery. Cotton swabs are useless for dealing with deep abrasions like these on asphalt roads. You must use coarse gauze or a stiff-bristled brush to forcibly destroy those tiny tissues wrapped with carbon particles."

A piece of gauze was quickly soaked with blood and black mud.

Lin Ye casually tossed the waste into the bin, replaced it with a second piece, and continued to scrub vigorously.

Those tiny black dots, deeply embedded in the crevices of the flesh, were finally brought out little by little by the inhumane physical friction.

"As a doctor, if your leniency is based on depriving patients of their long-term quality of life, then you are derelict in your duty."

Lin Ye changed to a sterile hard-bristled brush, dipped it in saline solution, and used it to clean the wound on the side of her face.

"It's better to make him suffer for ten minutes now than to make him live with half his face disfigured for the rest of his life."

Fang Rui stood beside him, looking at Lin Ye's steady hands, a fine layer of sweat appearing on his forehead, and nodded vigorously.

A full twenty minutes of extreme debridement.

When Lin Ye put down the stiff-bristled brush and rinsed the wound with a large amount of saline solution for the last time, the young man's right forearm and cheek finally revealed clean, even, bright red dermal tissue, without a single black impurity.

The young man looked as if he had been pulled out of the water; he was soaked in cold sweat and lay on the bed, panting heavily, too weak to even cry out in pain.

"It's clean now." Lin Ye took off his blood-stained gloves, turned to Fang Rui, and said, "Cover it with Vaseline gauze, then apply a pressure bandage with dry gauze. Get three days' worth of cephalosporin, and then go to the injection room for a tetanus antitoxin shot."

"clear!"

Fang Rui immediately took over the bandaging work. Although his movements were gentle, there was a new determination in his eyes.

By the time the young man left the wound cleaning room with the prescription, full of gratitude, the clock on the wall had already quietly pointed to 5:30 p.m.

Through the glass doors outside the emergency room, the setting sun cast its golden rays across the hospital plaza.

The peak period for day shifts is finally coming to an end.

I don't know which window wasn't closed properly, but the aroma of food from the hospital staff canteen cart wafted in—stir-fried green peppers and shredded pork mixed with the steam of rice.

Lin Ye stood in front of the sink, slowly rubbing his fingers with hand sanitizer.

The aroma of food, filled with the warmth of everyday life, mixed with the distinctive smell of Lysol from the emergency room, instantly pulled them back from the high-pressure quagmire of life and death, blood and pain, back to the reality of daily life.

"Teacher Lin..." Fang Rui leaned against the doorframe, his stomach making a loud rumbling sound. He scratched his head awkwardly. "Um... Dr. Ma said he ordered a big plate of chicken for delivery and asked if we wanted to go back to the break room to eat together after our shift ends?"

Lin Ye turned off the tap, shook the water droplets off his hands, and a faint sense of relaxation finally appeared on his face, which had been cold and stern all day.

"Tell him to add an extra serving of belt noodles." Lin Ye dried his hands, unbuttoned one button of his white coat, and said, "Let's go to the nurses' station and get ready for the shift handover."