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

Zhou Mingyuan paused for a moment when he reached the door.

"Linye."

Lin Ye looked up.

"You follow."

Qin Hai immediately frowned.

"What's he doing there? Didn't he just say that resident trainees don't sit at the table?"

Zhou Mingyuan turned around.

"Not serving at the table doesn't mean we can't bring those few pieces of paper with us."

After he finished speaking, his gaze fell on the old medical records in Lin Ye's hand.

"The family wants to ask the emergency room why things were so urgent that day. Don't explain anything else, just clearly describe what you could see at the time."

Qin Hai did not stop him again.

He stuffed the stack of copies of Chen Jianguo's medical records into Lin Ye's hands.

"Make fewer promises."

Lin Ye caught it.

"Know."

"you do not know."

Qin Hai lowered his voice.

"At this time, what the family wants most is to hear 'It's okay.' If you say 'It's okay,' no one can cover it up later."

Lin Ye's hand paused for a moment at the edge of the medical record folder, then quickly clenched it.

"It's fine if you don't talk about it. Just tell me what risks we need to address now, and who will take over later."

Qin Hai glanced at him.

"This sentence can be said."

The outpatient clinic for cardiac and vascular surgery is in another building.

The elevator descends from the administrative area, the numbers jumping one by one.

Zhou Mingyuan stood by the door, his phone never leaving his ear.

"Let's do the ECG first. Don't wait in line. Bring out your discharge summary, follow-up appointment slip, and medication box."

When the elevator doors opened, the call for numbers in the outpatient corridor was just halfway through.

Before Lin Ye could see anyone, he first saw the transparent plastic bag in Li Guilan's hand.

The bag was crumpled from being squeezed, and inside were medicine boxes, follow-up examination forms, payment receipts, and a discharge summary folded into three sections.

She looked a little thinner than she had that night.

Her hair was casually tied back, and the cuffs of her coat were frayed.

Upon seeing Zhou Mingyuan, she first stood up, then immediately turned back to help Chen Jianguo, who was sitting in a chair.

"Director Zhou."

Chen Jianguo sat on a waiting chair in the outpatient clinic, wearing a loose gray coat. A bit of the edge of his post-operative elastic vest was visible below the collar.

His face was healthier than that night, but he still looked weak from his illness.

He wanted to stand.

Zhou Mingyuan raised his hand.

"Sit down."

An outpatient nurse pushed an electrocardiogram machine over, but the wheel got stuck in a crack in the floor tiles and bumped it slightly.

Li Guilan hurriedly moved aside, and the plastic bag in her hand bumped against the back of the chair.

The medicine box rattled.

Her eyes immediately welled up with tears.

"We're not here to cause trouble."

Zhou Mingyuan looked at Chen Jianguo first.

"Why were you feeling so down just now?"

Chen Jianguo took a breath.

"After leaving the community hospital and walking to the bus stop, I felt a bit stuffy. It wasn't the same pain as that night, but it felt like there was something pressing on my chest. I sat down and rested for a few minutes."

Zhou Mingyuan bent down and put the stethoscope into his ear.

"Do you have back pain?"

"no."

Sweating?

Chen Jianguo glanced at Li Guilan.

"A little."

Li Guilan immediately took over.

"He wouldn't say. He just said he was tired from walking. I saw that his face was pale, so I pulled him back. The community doctor said that he had this surgery before, and if he felt uncomfortable in his chest, he should go back to the First Municipal Hospital."

The outpatient nurse clipped the electrocardiogram clip onto the device.

Chen Jianguo's arm was exposed, and there were still faint marks left by old needle marks on his skin.

Lin Ye stood aside, opened the medical record folder, and did not rush forward.

The first sheet of paper still shows the triage time from that night.

2:17 a.m.

Upper abdominal pain.

A tearing pain in my back.

Weak left radial artery.

Blood pressure difference between the two upper limbs.

Li Guilan's gaze fell on those few lines of text.

"All I remember is him saying he had a stomachache."

She looked up at the woods.

"You were talking so fast that day, I didn't understand anything. Later, when he was wheeled into the operating room, I still didn't understand anything. Now he's back alive, but I can't sleep well every night."

People waiting for their turn looked this way.

The outpatient nurse pulled the curtain a little closer.

After listening to the heart sounds, Zhou Mingyuan removed the stethoscope.

"Don't stand up yet. Let's talk after the ECG results are available."

The electrocardiogram (ECG) paper was ejected from the machine.

The paper is still warm.

The outpatient nurse tore it off and handed it to Zhou Mingyuan.

Zhou Mingyuan glanced at it and then handed it to the chief resident physician of the Department of Cardiac and Vascular Surgery behind him.

"No acute ST-segment elevation was observed. What about the blood pressure?"

Another nurse was untying the blood pressure cuff from Chen Jianguo's right arm.

"Right upper limb 148 or 190".

She then switched to her left arm.

When the sleeve bulged, Li Guilan switched the plastic bag to her other hand.

She squeezed the corner of the bag until it left a white mark.

"Left upper limb 14288".

Zhou Mingyuan nodded.

"Not much difference."

Li Guilan seemed to breathe a sigh of relief, but she didn't dare to relax completely.

"Is everything alright?"

Qin Hai happened to walk from the back to the curtain.

"Don't worry, everything's alright."

He didn't yell at her, he just lowered his voice.

"The ECG and blood pressure don't look like they've reached the worst point yet, but that doesn't mean we can turn around and go home. People who have had aortic surgery and are experiencing chest tightness need to have a follow-up check-up arranged by the cardiac and vascular surgeon."

Zhou Mingyuan pulled out the discharge summary.

"How do you take the medicine?"

Li Guilan quickly opened the bag.

The medicine boxes were piled up one by one on the small table next to the chair.

There are antihypertensive drugs, stomach protectants, and several boxes of medicine that I brought back from the hospital.

"When I was discharged, they said to take me once a day, and I set the alarm for that. It's this one."

She picked up one of the boxes.

"He said he felt dizzy after eating, and that he had skipped a meal a few days ago."

Zhou Mingyuan's face darkened.

Which meal?

Chen Jianguo lowered his head.

"That dinner tonight. Just this once."

Li Guilan immediately looked at him.

"Didn't you say nothing was missing?"

Chen Jianguo's lips moved, but he didn't say anything.

Zhou Mingyuan turned the medicine box over to look at the label.

"You can't stop taking your blood pressure medication on your own. If you feel dizzy, you should call to ask about it; you can't reduce the dosage yourself."

Li Guilan's eyes reddened with anxiety.

"I don't know who to ask. The discharge summary has a list of outpatient follow-up appointments and the ward's phone number, but when I call, they tell me to register for an outpatient appointment. I can't get an appointment. I went to the community health center, and they told me to go back to the First Municipal Hospital. When I got to the First Municipal Hospital, the triage staff told me to go to the Cardiac and Vascular Surgery outpatient clinic first."

As she spoke, the plastic bag in her hand slipped.

The two boxes of medicine rolled onto the ground.

She bent down to pick it up, and Chen Jianguo suddenly pressed his hand to his chest.

"I felt a bit stifled again."

Li Guilan's hand froze in mid-air.

The calls for numbers were still ringing in the corridor, but suddenly stopped inside the curtain.

Zhou Mingyuan did not let Chen Jianguo stand.

"wheelchair."

The outpatient nurse had already turned around.

The wheelchair was pushed from next to the nurses' station, the foot pedals hitting the floor tiles with a very short sound.

Zhou Mingyuan pressed the electrocardiogram paper onto the discharge summary.

"Outpatient observation area. Take your blood pressure again, and expedite the echocardiogram. Should we repeat the aortic CT angiography? I'll decide after I review it."

The chief resident picked up the phone.

"The ultrasound room is packed."

Zhou Mingyuan looked over.

"Tell them they have chest tightness during a follow-up examination after type A aortic dissection. Set up a bedside table, or I'll go over and tell them."

The chief resident didn't ask any more questions and dialed the number directly.

Li Guilan finally picked up the medicine box, her hand rubbing against the chair leg, leaving a red mark.

She didn't have time to look.

"Director Zhou, is he going to get into trouble again?"

"It's too early to say that."

Zhou Mingyuan interrupted her.

"But we can't let him go home by himself."

When Chen Jianguo sat in the wheelchair, his face was a little paler than before.

The outpatient nurse placed the foot pedal in place.

"Don't slip."

The wheelchair was pushed to the observation area.

Li Guilan followed behind, carrying a plastic bag. The medicine boxes inside the bag rattled together.

Lin Ye followed half a step behind, pressing the old medical records in his hand tightly.

At the edge of his vision, a blue text box silently lit up.

[Follow-up tracking risk: The loop is not closed.]

[Target audience: Patients who have undergone high-risk resuscitation.]

[Publicly disclosed evidence: Chest tightness upon re-examination/Self-adjustment of medication/Unclear entry point for follow-up.]

Lin Ye shifted his gaze from the blue frame back to the patient's medical record.

No one saw that line of text.

One bed in the observation area has become temporarily available.

The nurse re-attached the blood pressure cuff.

One hundred and fifty-six, ninety-two.

It's a little higher than before.

Chen Jianguo leaned against the headboard, his breathing not rapid, but he kept pressing his chest.

Li Guilan stood by the bed, her eyes fixed on the monitor.

"And then what?"

She suddenly asked.

"If he gets depressed again, should I go to the cardiovascular surgery department or the emergency room? What if it's at night? What if the community health center tells me to come back? If I can't explain it clearly, will they make me wait in line again?"

Only the monitor's soft beeping could be heard from behind the curtain.

Even if she says "come to the hospital," she will still end up going back and forth between the outpatient clinic, community clinic, and emergency room next time.

If she does meet someone again, she'll have to find the right door.

Expert Du also followed him down from the conference room.

He stood outside the curtain and did not come in.

Liu Zhenhua was still holding a notebook in his hand, and he wrote three lines in it.

Entry point for review.

Change of medication.

If you experience chest tightness, please seek medical attention again.

Expert Du spoke through the curtain.

"Linye."

Lin Ye looked up.

"What this family member asked was, after the emergency room saved the person, how to prevent her from relying on luck to find the door."

Lin Ye did not rush to answer.

Zhou Mingyuan didn't urge him.

Li Guilan was still clutching the plastic bag, with the medicine box inside pressed against her palm.

Lin Ye turned to the last page of the old medical record.

There were the call records that Zhou Mingyuan had taken over at that time.

He pulled the paper out and placed it on the small table.

"What the emergency room could do that day was to identify the most dangerous situation and call in the cardiac and vascular surgery department."

He spoke very slowly.

"The same applies today. If you feel tightness in your chest, don't try to diagnose it yourself. If you're at the hospital during the day, find a nurse in the cardiovascular surgery outpatient department or the emergency chest pain channel and have them review your discharge summary and surgical record."

He paused for a moment.

"If you experience chest tightness, back pain, sweating, or a sudden spike or drop in blood pressure at night, or while you are outside, call 120 immediately and go to the emergency room. Do not take public transportation."

Li Guilan stared at him.

"Then what should I say? I can't explain myself clearly when I'm in a hurry."

Lin Ye picked up a pen and wrote on a blank sticky note.

Chen Jianguo.

Postoperative aortic dissection of type A.

A follow-up examination revealed chest tightness.

I have recently missed taking my blood pressure medication.

Please have your cardiovascular surgeon or emergency chest pain channel evaluated.

He pushed the note over.

"Just say this. Don't just say your stomach hurts, and don't just say your chest is tight."

Li Guilan looked down at the note.

The paper is very small.

She held down the edge of the paper, like a guiding thread.

She slipped the sticky note into the first page of the discharge summary and carefully flattened it.

"And today?"

Zhou Mingyuan took over the conversation.

I'll take it today.

He turned Chen Jianguo's re-examination form back and handed it to the chief resident physician.

"Urgent echocardiogram needed. Please sit in the outpatient observation area first, and have your blood pressure checked again in half an hour. Take a photo of the medication box and add it to your medical record, clearly stating which dose you missed. A repeat aortic CT angiography is required; I'll arrange that."

The chief resident nodded.

"I'll take it with me."

Chen Jianguo leaned on the handrail and remembered.

Just as Li Guilan was about to help, the outpatient nurse pushed the wheelchair closer first.

"Sit here."

Chen Jianguo looked at the wheelchair, feeling a little embarrassed.

"I can walk."

Zhou Mingyuan slapped the follow-up form on the armrest of his wheelchair.

"If you can walk, sit."

Chen Jianguo shut his mouth.

Li Guilan hung the plastic bag on the handle of her wheelchair, pushed the wheelchair a couple of steps toward the ultrasound machine, and then turned back.

"Dr. Lin."

Lin Ye stopped.

She looked at him for a few seconds.

"I don't remember what you said that day."

She pressed the discharge summary to her chest.

"I remember this piece of paper from today."

Lin Ye didn't say anything polite.

He simply nodded.

"If you feel unwell, take it to a doctor."

The wheelchair went deeper into the observation area.

The curtain was lowered again.

The call for numbers sounded again, and the outpatient corridor returned to its original state.

But the three lines of text on Liu Zhenhua's notebook were still wet.

Chen Shouyi walked over from behind, his gaze fixed on the three lines of text.

"Could we create a high-risk alert for the week following hospital discharge?"

Zhou Mingyuan sneered.

"Ask who said that first. Our ward is so busy we don't even have time to drink water, and the emergency room isn't a follow-up center."

Qin Hai looked at the old medical records in Lin Ye's hand.

"The emergency room is not a follow-up center. But people who are saved in the emergency room will eventually return to the emergency room, no matter how stuffy they are in the middle of the night."

Liu Zhenhua paused for a moment while writing in his notebook.

Expert Du turned to a new page in his notebook.

"Then let's not call a follow-up visit yet."

He put down his pen.

"Order follow-up reports after high-risk treatment. Start with the most risky categories: aortic dissection, acute coronary artery disease, and cerebral hemorrhage. Don't make frontline doctors write lengthy reports; three things are enough."

Liu Zhenhua looked up.

Which three items?

Expert Du looked in the direction Li Guilan had left.

"Who should I talk to if I'm not feeling well?"

"Take anyone who needs to go directly to the emergency room."

"You can't stop taking the medication on your own; if you do, you need to consult which department."

Zhou Mingyuan neither said it was good nor bad.

He simply picked up Chen Jianguo's follow-up form again and smoothed out the creases.

"For the first one, I wrote down the parts that cardiac and vascular surgery can handle."

Qin Hai looked at him.

"You write it?"

"Or will you write a follow-up examination report after aortic surgery?"

Zhou Mingyuan handed the paper to Liu Zhenhua.

"The emergency room should write down how to handle nighttime cases. The medical affairs department should write down where to put this sheet, so that no one can find it again."

When they returned to the conference room, the projector had already been cut to a blank template by the young staff member.

The first line reads:

Follow-up report after high-risk treatment.

The bottom three columns are empty.

Who to look for?

When are you going back to the ER?

How do I ask about the medicine?

The young staff member pushed the keyboard towards Liu Zhenhua.

"Director Liu, shall we record Chen Jianguo's case first?"

Liu Zhenhua did not type immediately.

He glanced at the stack of debriefing materials that hadn't been put away yet on the table.

Aortic dissection.

Acute myocardial infarction.

Chest tube transport.

Brain hemorrhage.

Each piece of information has saved a life.

There is also blank space behind each document.

Expert Du put the pen cap back on.

"Don't just record Chen Jianguo."

He looked away from the paper.

"Get the list of all the high-risk patients who have been saved in the emergency room in the past few days."

The cursor is still on the first line next to the keyboard.

Lin Ye stared at the blank space.

The blue text box flashed briefly at the edge of my field of vision.

Risk tracking: Not yet closed-loop.