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

On Tuesday afternoon, the First Municipal Hospital held a multidisciplinary quality control and major accident review meeting.

The projector's cold light shone on the screen, displaying a staggering amount of consumables and medication details.

"Twenty bottles of 20% human serum albumin, plus an imported plasma separator, were forcibly scrapped."

The director of the medical insurance office took a pen and tapped it heavily twice on the printed bill on the table.

"This bill totaled 14,600 yuan. The family members were not present at the time and did not sign it beforehand. The most critical issue is that the case file does not contain a 'paper certificate of plasma supply interruption' issued by the blood bank."

There was no written evidence to prove that routine plasma exchange could not be performed at that time, yet your emergency department dared to overstep its authority and use excessive amounts of controlled albumin, and even destroyed a set of high-value consumables. This constitutes a serious procedural violation, and according to regulations, this deficit should be fully deducted from the performance bonus of the doctor on duty.

The finance department staff member was flipping through the reports and supplementing them.

"Now that DRG-based disease-based payment is in place, this patient has just been admitted to the ICU and the medical insurance coverage has already exceeded the limit by 150%. The hospital cannot cover such unfounded emergency treatment."

Qin Hai, the director of the emergency department, sat across the round table, his face ashen.

Qin Hai braced himself on the edge of the table, about to stand up and start cursing, when Liu Zhenhua, the deputy director of the medical department sitting next to the head of the table, suddenly moved.

Snapped.

Liu Zhenhua slammed a thick copy of the document onto the center of the round table. The paper slid across the table and stopped in front of the director of the medical insurance office.

Turn to the third page and look at the black line at the top.

The director of the medical insurance office frowned as he opened the photocopy.

That was a graph of operational data exported from the backend of a special blood purification machine.

"Transmembrane pressure (TMP) vertical spike curve. From normal value to extreme over-limit forced pump shutdown in just 45 seconds."

Liu Zhenhua stood up and scanned the conference room with an extremely imposing air.

"The patient suffered acute hemolysis in his microvessels due to the inhalation of high-pressure refrigerant, causing a massive flood of blood clots that blocked the micropores. His hemoglobin level had dropped below 50 g/L. In this extreme pathological condition, you expect frontline doctors to wait in the emergency room for the blood bank to issue a paper certificate of blood supply shortage?"

The meeting room was completely silent.

Liu Zhenhua continued his attack, pointing at the data chart.

"If we don't immediately discard the filter and proceed with whole blood perfusion using albumin instead of waiting for paper documentation, the patient will suffocate from hemolytic pulmonary edema and die on the resuscitation bed within three minutes. Then, how will you explain to the media and the family that we couldn't save them because the blood bank certificate wasn't delivered?"

Liu Zhenhua straightened up and looked at the people from the finance department and the medical insurance office.

"I, Liu Zhenhua, personally signed the special approval form for those twenty bottles of albumin on-site. We used over ten thousand yuan worth of consumables and so-called irregular procedures to save a life in a major accident. That's the rule of the medical affairs department. Any deficit in the accounts goes directly from the medical affairs department's account; the emergency department doesn't deduct a single penny!"

The director of the medical insurance office moved his lips, but ultimately put the pen back on the table.

At the end of the corridor is the office of the head of the emergency department.

Liu Zhenhua followed Qin Hai inside and closed the door behind him.

"Old Liu, thank you for your help today." Qin Hai poured Liu Zhenhua a glass of warm water. "Those administrative guys have no idea how precious a second is when lives are at stake in the Red Zone."

"I'm not doing this to shield you, Qin Dapao, from a bullet." Liu Zhenhua didn't take the water glass. "I'm doing this to protect your department's sharp knife."

Qin Hai's eyes flickered slightly: "You mean Lin Ye?"

"Whether it was the decisive action of cutting the femoral artery or performing whole blood perfusion despite the risk of platelet depletion when the blood bank ran out of supplies, Lin Ye's decisiveness far exceeded that of an ordinary resident physician." Liu Zhenhua pulled out a chair and sat down. "Not only is his physical examination accurate, but most importantly, he knows how to choose the lesser of two evils in a desperate situation and knows how to stop the damage in time. This is the commander's intuition."

Liu Zhenhua looked at Qin Hai.

"The night shifts in the emergency room's red zone are too stressful. We can't always rely on you and the other veterans working non-stop. Delegate some authority. Stop treating him like a regular second-line support. Starting next month's schedule, let Lin Ye lead a separate resuscitation team. Let him make decisions on the front lines and take responsibility."

Qin Hai was silent for a moment, then a satisfied smile appeared on his lips: "This kid's shoulders are indeed strong enough."

Friday afternoon, emergency room nurses' station.

Sister Zhao took a few magnetic snaps and slapped the new work schedule for next month onto the whiteboard.

It was the shift changeover time, and a group of doctors and nurses habitually gathered around.

Ma Hao and Fang Rui were at the very front.

Ma Hao's eyes darted quickly across the form. Suddenly, his gaze stopped on the column for the red zone (emergency room), and he gasped.

Fang Rui followed his gaze and froze.

In that meticulous and complex scheduling matrix, Lin Ye's name was removed from the list of "second-line assistants/patients" for the first time.

It was printed in the most central position, alongside senior attending physicians such as Qin Hai.

This was followed by several bold black characters:

[Team Leader of Emergency Room A (Leading Physician)]

A suppressed gasp erupted from the crowd.

The rules in the emergency department are extremely strict. Being able to lead a team means having absolute final discretion in the red zone.

They don't need to ask their superiors for permission for everything, and they even have the authority to force the on-call staff of various specialties to come to the emergency room to admit patients.

Lin Ye walked out of the treatment room with a stethoscope in his hand, and stopped at the nurses' station.

He looked at the bolded name on the whiteboard, but his face didn't show much excitement.

He was well aware of the weight behind the words "leading a team".

Starting next Monday's night shift, once the red zone gates are closed, no matter if a patient is brought in with a heart attack, massive bleeding, or multiple traumas, even if the sky falls, he will have no superior to call for help at any time. He will no longer be the hand that executes orders, but the brain that issues instructions and bears all the consequences of medical malpractice.

He will face the rejections of major specialist hospitals, the limitations of medical insurance reimbursement, and stand alone on the front line between life and death.

"President Lin, we'll be counting on you to look after us during the night shifts from now on." Ma Hao turned around and patted him on the shoulder, half-jokingly.

Lin Ye withdrew his gaze, hung the stethoscope around his neck, and calmly walked towards the hall.

"Shift handover complete."