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

Xie Guangyi had just pushed the stretcher past the nurses' station when a call came from the catheterization lab.

Zhou Min turned on speakerphone.

"The entrance to the catheterization lab has been cleared; we'll be there in five minutes."

Tang Zhendong held onto the bed railing with one hand and pressed down on the second electrocardiogram chart with the other.

"Know."

He looked up at the nurse.

"Is the monitor battery charged enough? Don't use the nearly empty oxygen cylinder. Make sure the defibrillator is securely attached, and don't switch hands on it during transport."

The day shift nurse lifted the portable monitor from the side of the bed; the battery light was on. She glanced down at the oxygen cylinder gauge; the pointer was still in the green range.

"Reaching the catheterization lab."

"It's not enough to reach the door."

Tang Zhendong's voice was very low.

"Reach out and connect to the catheterization lab for oxygen and monitoring."

The nurse didn't object and immediately replaced it with a full bottle.

The metal bottle hit the flatbed cart's legs with a dull thud.

Xie Guangyi lay on the bed, layers of white mist rising from his oxygen mask. His son followed behind outside the yellow line, clutching the still-unfurled informed consent form, the paper softened by sweat.

"Director Tang, my dad was talking just now, why is he so quiet now?"

Tang Zhendong glanced at the old man's half-closed eyes.

"Don't let him talk. Talking consumes oxygen when you have chest tightness."

The man's Adam's apple bobbed.

"Where should I sign?"

"Let's get to the entrance of the catheterization lab first."

Tang Zhendong shoved the pen into his hand.

"Listen to me on the way, ask if you don't understand, and don't cry as you walk."

The man gripped the pen so tightly his knuckles turned white.

On the other side, Shen Qingyuan remained in the emergency monitoring position.

The chief resident of thoracic surgery squatted by the bed, gloves already on. The water-seal bottle was lowered and hung steadily on the side of the bed, and the transparent tubing had been rearranged, with faint creases still visible on the section that had been flattened by the bed rails.

Shen Qingyuan's blood oxygen level fluctuated between 92 and 93.

His complexion was a little better than before, but he still clearly didn't dare to exert force in his left chest every time he inhaled.

The on-call thoracic surgeon is holding up his phone, listening to the radiology staff report the bedside X-ray.

"The left lung is not fully open; you need to clearly see the position of the duct tip."

The chief resident physician raised his head.

Send me the video.

A cell phone rang softly on the other end of the line.

He looked down at the screen, his brow furrowing slightly.

"The tube is positioned so that he can't return to the ward like this."

The caregiver stood beside him, her face even paler than Shen Qingyuan's.

"Then, should we push it back into the chest?"

Qin Hai turned his head.

"Shut up first."

The caregiver immediately fell silent.

Lin Ye stood in front of the nurses' station, with two pieces of paper in front of him.

An emergency intervention preparation record by Xie Guangyi.

An abnormal chest tube transfer record for Shen Qingyuan.

Zhou Li used a tablet to make up for lost time.

"At 3:36 PM, Xie Guangyi was taken away from the emergency room by stretcher to the catheterization lab."

"At 3:37 PM, Shen Qingyuan reported from the bedside X-ray that the left lung had not fully re-expanded, and the position of the chest tube awaits review by the thoracic surgery department."

Lin Ye looked at the second line, but didn't immediately put down his pen.

"Not pending review."

Zhou Li looked up.

"How do I write it?"

Lin Ye looked toward Shen Qingyuan's bedside.

The chief resident had the nurses reopen the chest tube fixation tape a little, and ran their fingers along the tube, not rushing to go deeper, but only straightening out the traction and folds on the outside little by little.

"The thoracic surgery department has completed the bedside review; I will not return to the ward for the time being."

Zhou Li is typing.

"reason?"

"The pneumothorax is still present, the left lung has not fully re-expanded, the external fixation and patency of the chest tube after transfer have not been clearly verified, and the risk has not been eliminated on the way back to the ward."

"Was that too harsh a statement?"

Qin Hai happened to overhear this.

"Not heavy."

He walked over and tapped the table with his knuckles.

"The worst part is that we almost had to send him back just now."

The chief resident in thoracic surgery did not raise his head.

"I'll take over. Shen Qingyuan, reserve the emergency monitoring position first. I'll finish the bedside treatment and then assess whether he can return to the thoracic surgery ward. Don't go through the transfer channel again."

Liu Zhenhua stood by the nurses' station, opening and closing the folder in his hand.

He did not immediately look for responsibility.

I only glanced at the transfer registration board.

The label reads: "Return of chest X-ray".

The handwriting is very clean.

However, it didn't mention that the oxygen was running out quickly, that the chest tube was compressed, or that the accompanying nurse was holding the water seal bottle alone.

Liu Zhenhua removed the pen cap.

"I'll add this shipping record later."

Qin Hai looked at him.

"Don't give the supplies to people now."

"Know."

Liu Zhenhua bit the pen cap back in his mouth, his voice lowered.

"Fill the gaps first."

The sound of elevator doors opening and closing could be heard from afar, coming from the direction of the catheterization lab.

Xie Guangyi had already pushed the flatbed to the entrance of the transfer channel. Tang Zhendong didn't let anyone into the elevator, but instead parked the bed by the door.

"Recite it again."

The day shift nurses look down at the monitoring devices.

"Heart rate 112, blood pressure 138.82, blood oxygen 98, chest tightness persists."

Tang Zhendong looked at Lin Ye.

"Did he get bored while waiting in line?"

Lin Ye had just reached the entrance of the passage, still holding the notebook in his hand.

"The patient reported feeling chest tightness while waiting in line for examination, but did not mention it. It worsened at 3:28 PM, and the triage nurse called the emergency room. The first electrocardiogram showed incorrect inferior leads, and the second one showed more obvious dynamic changes."

Tang Zhendong nodded.

"besides?"

"No recent black stools or vomiting blood. No history of hospitalization for cerebral hemorrhage. Has been taking aspirin for a long time. The family says they do not have anticoagulants such as warfarin or rivaroxaban, nor do they have long-term painkillers."

"Crotonin?"

"Not yet."

Tang Zhendong took the folder and glanced at it.

"That's enough, let's go."

When Xie Guangyi's son heard "enough," his face turned even paler.

"Enough of what?"

Tang Zhendong did not beat around the bush.

"It's enough for us to race against time, if not enough to say we're safe."

The pen in the man's hand trembled slightly.

"I'll sign."

The elevator doors opened again.

As the stretcher was pushed in, the wheels passed over the threshold, causing a slight jolt. The old man's eyelids twitched, and the white mist inside his oxygen mask momentarily dissipated.

Lin Ye stood outside the elevator and did not go in.

Tang Zhendong glanced at him.

"Go back and look at the other side."

Lin Ye nodded.

Just before the elevator doors closed, he heard Xie Guangyi's son ask in a low voice.

"Doctor, if he had said he had chest tightness earlier, would this have happened?"

Tang Zhendong's voice was muffled by the crack in the door.

"Don't ask that now. Let's open up the blood vessels first."

The elevator doors closed.

Lin Ye turned and ran towards the nurses' station.

On Shen Qingyuan's side, the chief resident of thoracic surgery had already removed the old fixation tape. As the tape was being torn off, Shen Qingyuan gritted his teeth, and a fine layer of sweat appeared on his forehead.

"pain?"

The chief resident asked.

Shen Qingyuan nodded.

"Bloating".

"Could you bear with it for a moment? I need to check the section outside the pipe."

Shen Qingyuan closed his eyes.

"able."

The nurse held the water seal bottle down with one hand and protected the tubing with the other. The on-call thoracic surgeon unpacked the sterile dressing pack, spread the wrapping paper on the treatment cart, and rolled up the corners.

Qin Hai stood at the foot of the bed.

"Should we send him back to the thoracic surgery department for treatment?"

The chief resident shook his head.

"Sending it back now would be riskier, as it would involve another detour en route. We'll address the external fixation at the bedside first, and recheck the connections and water seal. If deeper adjustments are truly needed, I'll call the operating room or treatment room. We don't want to waste time in the corridor."

He glanced down at the side of the bed again.

"Place the water seal bottle low, make sure the tubing isn't bent, and make sure the gas can escape first."

Qin Hai's jawline tightened slightly.

"Write this sentence in."

Lin Ye had already pressed the pen onto the paper.

At 3:42 PM, the chief resident of thoracic surgery conducted a bedside assessment: The patient should not return to the ward immediately; instead, the external fixation, connection, and water seal of the chest tube should be reviewed in the emergency monitoring position. If further treatment is required, the thoracic surgery department will decide on the treatment location to avoid the risk of retransfer.

Zhou Li stood to the side, looking at the line of text.

"Is this what you meant by 'don't send it to the wrong place'?"

Lin Ye didn't look up.

"Xie Guangyi cannot be sent back to the general examination area. Shen Qingyuan cannot be sent back to the thoracic surgery ward; we'll have to wait on the way."

He only realized after he finished speaking that his voice was a little hoarse.

Zhou Li didn't reply, but simply handed the tablet to Liu Zhenhua.

After reading it, Liu Zhenhua's gaze lingered on the words "avoid the risk of retransfer".

"Written by a resident trainee?"

Qin Hai threw the gloves into the trash can.

He wrote the truth.

Liu Zhenhua returned the tablet.

"Let the facts remain."

In the group chat for the directors, Tang Zhendong sent a picture.

It's not an electrocardiogram (ECG).

It's the time sign at the entrance of the catheterization lab.

3:44 PM.

Tang Zhendong: The patient is entering the catheterization lab. Family members are already at the door; information dissemination will continue. Considering acute inferior wall myocardial infarction, with a high suspicion of right coronary artery disease, angiography will be performed first.

The group chat remained quiet.

A few seconds later, the chief resident of thoracic surgery also made a comment.

Thoracic Surgery: Shen Qingyuan is currently in the emergency monitoring position. The external fixation of the chest tube has been re-treated, the water seal is unobstructed, and the blood oxygen level is 94. He will continue to be observed and will not be transferred back to the ward for the time being.

Zhou Min looked at the two messages and then put her phone face down on the nurses' station counter.

"Both sides are in the process."

Qin Hai did not agree.

"Entering the process doesn't mean everything is fine."

After he finished speaking, he looked at Lin Ye.

"Go and update the passage time. Write down clearly who went first and who stayed behind, and what the basis is."

Lin Ye nodded.

He had just turned around when the landline at the nurses' station rang again.

This time, everyone instinctively looked over.

The day shift nurse answered.

"Emergency room."

She listened for a couple of sentences, her expression didn't change, and she simply handed the receiver to Qin Hai.

"Catheterization lab".

Qin Hai took it.

Tang Zhendong's voice came through the receiver, accompanied by the muffled sounds of machinery in the background of the catheterization lab.

"The proximal segment of the right coronary artery was closed. The guide wire had already been passed, the balloon was opened slightly, and blood flowed out."

The people in front of the nurses' station paused for a moment at the same time.

Qin Hai held the receiver in his hand.

Where are they?

"We still need to monitor blood pressure and heart rate. Don't tell the family that things are stable. Give them a preliminary report: the blood vessels have opened up a bit, but we still need to keep an eye on their lives."

Qin Hai responded in a low voice.

"Know."

The phone hangs up.

He put the receiver back on the landline, and the base of the landline wobbled slightly.

The tablet in Zhou Li's hand was still lit up.

"Is this considered stable?"

Qin Hai looked at her.

"It can only be considered a temporary solution."

He emphasized the word "temporary".

Lin Ye wrote the catheterization lab reports into the log.

At 3:52 PM, the catheterization lab reported: right coronary artery proximal occlusion, guidewire passed through, blood flow partially restored after balloon dilation; continued monitoring of blood pressure, heart rhythm, and subsequent interventional procedures is still required.

He paused for a moment after writing that line.

The blue text box in front of me lit up very light.

[Multiple risks: eased in stages.]

[Risk of erroneous transfer: Blocked.]

[Current Status: Under Observation.]

Lin Ye turned his gaze back to the notepad.

He simply pressed the paper down to flatten it.

The ink on the paper was still wet.

Liu Zhenhua stood beside him, watching him finish the last bit of time.

"Linye."

Lin Ye looked up.

Liu Zhenhua did not use procedures to pressure him.

There was no praise.

He took the transfer registration board off the wall and placed it on the nurses' station counter.

"You can sit in the back row for tomorrow's debriefing."

Qin Hai raised an eyebrow.

"The back row?"

Liu Zhenhua looked at him.

"I won't sit at the table."

He then looked at Lin Ye.

"But you have to be there. Today, you have to explain to yourself who left first, who stayed behind, and why they weren't sent to the wrong place."

Lin Ye looked at the transfer registration board.

The original clean line of text on the board has been filled with densely packed time points by Zhou Li.

Shen Qingyuan's chest tube transport was abnormal.

Xie Guangyi experienced acute chest pain.

The catheterization lab received the patient at 3:44 PM.

Bedside treatment in thoracic surgery.

There wasn't a single word about peace on the board.

Each line is followed by a time space.

Qin Hai pushed the transfer registration board a little towards Lin Ye.

"Did you hear me?"

Lin Ye nodded.

"I heard you."

Outside the nurses' station, the family members from the catheterization lab area had not yet returned.

The chief resident physician of thoracic surgery was still squatting beside Shen Qingyuan's bed, and the liquid in the water-sealed bottle swayed slightly.

Lin Ye picked up a pen and added a line at the bottom of the transfer registration board.

At 3:54 PM, Xie Guangyi had entered the catheterization lab, while Shen Qingyuan remained in the emergency monitoring position.

The pen tip stopped.

He added another half sentence.

None of them are out of danger.