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

Zhou Kai was a support doctor from the Department of Gastroenterology, and his white coat was buttoned up perfectly.

He glanced at Xu Desheng's triage form, then at the old man's hand clutching his upper abdomen: "Old stomach problems, burning sensation after meals, acid reflux. Don't jump to conclusions about myocardial infarction in the emergency room; first, get a clear medical history."

Xu Desheng's son quickly nodded: "Yes, yes, my dad has had stomach problems for over ten years. He ate chili peppers yesterday, it must be his stomach."

The old man sat in the chair, his face ashen, still stubbornly insisting, "I don't want to be hospitalized, just some medicine will do. The gas at home is still on."

Lin Ye attached the electrode pads: "The ECG will take two minutes, it won't delay you from turning off the gas."

Zhou Kai's expression was not good: "Lin Ye, you just came back from the medical department, can you be a little more composed?"

Several nurses nearby heard this as soon as it was said.

Nurse Zhao didn't stop what she was doing, she just glanced at Zhou Kai.

Lin Ye did not argue.

He stared at the sweat on the old man's forehead and asked again, "Where does the pain go?"

"Right here." Xu Desheng pressed his upper abdomen. "Sometimes my left arm aches, it's an old problem."

"Were you out of breath just now while walking?"

"I get out of breath climbing stairs; it's common to get out of breath when you're older."

When did you start sweating?

"It comes out when it hurts."

Zhou Kai clicked his tongue softly from the side: "You're trying to lead a consultation."

Lin Ye attached the last electrode: "I'm asking about dangerous symptoms."

The electrocardiograph machine started spitting out paper.

The white strip of paper slid out one square at a time, making a soft rustling sound as the needle tip passed through it.

Zhou Kai had been standing with his arms crossed, showing little reaction when he saw the first few leads. But when the note was spat onto the lower lead, his brows slowly furrowed.

Lin Ye first reached out and pressed down on the edge of the paper.

"II, III, aVF ST segment elevation."

Nurse Zhao leaned over and took a look: "Oh no."

Xu Desheng's son's face turned pale: "What's wrong?"

Zhou Kai picked up the electrocardiogram and looked at it twice more. He lowered his voice and said, "It might be an inferior myocardial infarction."

"It's not possible." Lin Ye looked at the countdown in his field of vision.

[Effective treatment window: 24 minutes and 50 seconds.]

"He is currently exhibiting symptoms of an acute myocardial infarction."

Upon hearing the words "heart attack," the elderly man froze: "My stomach hurts, how could it be a heart attack?"

The son became anxious: "Doctor, could the machine be inaccurate? My dad had an electrocardiogram before, and it said everything was fine."

Zhou Kai was momentarily speechless.

This is the most troublesome part of a heart attack.

Patients don't believe it, family members don't believe it, and even doctors themselves, once misled by the phrase "chronic gastritis," are prone to first think of the digestive tract.

Xu Desheng was still waving his hand, his voice very weak: "I'm not going to the hospital. My wife is home alone. Please prescribe some stomach medicine for me, I'll go back and lie down."

His son helped him up while explaining to Lin Ye, "Doctor, my dad is stubborn. He used to sweat when he had stomach pains. It's not that we're uncooperative, it's just that we're afraid of going through all that trouble only to have him say he's fine."

Lin Ye spread the electrocardiogram in front of him and pointed to the raised leads: "This is not a hassle. You can wait for the stomach medicine, but you can't wait for myocardial ischemia."

Lin Ye clipped the electrocardiogram onto the board: "Initiate the chest pain procedure immediately, draw troponin, but don't wait for the results. Contact the cardiology department."

Zhou Kai's face darkened: "Don't give me orders based on just an electrocardiogram."

"So what is your judgment now?"

Zhou Kai choked.

Lin Ye didn't raise his voice: "If you determine it's not a heart attack, I'll write your diagnosis into the medical record. If you also suspect a heart attack, then don't argue about who spoke first."

Nurse Zhao has already pushed the elderly man to the emergency room.

Zhou Kai stood there, his face turning red and then white.

Xu Desheng suddenly clutched his chest and leaned back.

"Suffocating... I can't breathe..."

As soon as the monitor was connected, my heart rate dropped and my blood pressure became unstable.

Nurse Zhao rushed to the door and shouted, "Prepare the defibrillator! Connect the cardiac monitor!"

While recording the time, Lin Ye dialed the general ward of the cardiology department.

Xu Desheng's son was pulled aside by the nurse to sign the papers, his pen tearing through the paper several times.

"Doctor, my dad just said he could walk," he said weakly. "How could he be walking so fast?"

Nurse Zhao pressed the signature board firmly into his hand: "A heart attack can happen this quickly. Write your name clearly, don't delay the ward."

The old man lay in bed, muttering "gas at home." His son heard these words, his eyes welled up with tears, but he dared not cry out loud.

After hearing the patient's condition over the phone, the person on the other end said, "Send the scans. Dr. Tang is on second-line duty today. Let me check."

Lin Ye said directly, "Inferior ST segment elevation, progressively worsening symptoms, and unstable blood pressure. Please contact the catheterization lab immediately."

The person on the other end paused for a moment: "Who are you?"

"Emergency room, Lin Ye."

There was a two-second silence on the other end of the phone.

"Are you the resident trainee from last night?"

Lin Ye glanced at the old man's increasingly pale face: "Now is not the time to recognize people."

The other person swore softly: "Send the picture."

Lin Ye sent over the electrocardiogram.

The call came back in less than a minute.

This time it wasn't a long-term hospital stay, but the voice of a middle-aged man.

"Emergency room?"

"Yes."

"I am Tang Zhendong, a cardiologist. Where is the patient?"

"In the emergency room, a 67-year-old patient presented with predominantly upper abdominal pain, accompanied by chest tightness and sweating. ST segment elevation was observed in the second, third, and aVF vertebrae, and blood pressure began to become unstable."

The person on the other end of the phone only asked one question: "Are your family members there?"

"exist."

"Sign up, open the catheterization lab."

Before Lin Ye could answer, Zhou Kai, standing beside him, whispered, "Director Tang, so fast?"

Lin Ye pressed the phone even closer to his face.

Tang Zhendong added on the other end of the phone, "Also, tell your emergency department to stop bothering the head doctor day and night."

As Lin Ye watched Xu Desheng being wheeled deeper into the emergency room, he replied, "Director, you'd better not hang up the phone."

There was silence on the other end of the phone.

The next second, Tang Zhendong's voice turned serious: "What do you mean?"

Lin Ye looked at the waveform on the monitor that had started to jump around erratically.

"He might not be able to wait for you to slowly walk over."