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

When Liang Guoan's son heard the word "no," his face immediately darkened.

"Doctor, my dad has had this problem many times. Every time he comes to the hospital, a shot of glucose solution helps, but why doesn't it work here?"

Nurse Zhao had already established an intravenous line and, as Lin Ye had reminded her, had taken an emergency blood sample for the hypoglycemic attack before administering glucose. The old man's complexion gradually improved, and he was able to speak incoherently again.

"I'm so hungry..."

The son quickly pulled out some biscuits from his bag: "Dad, have some."

Lin Ye reached out to stop him: "Don't rush to feed it."

"You won't even let him eat?" the son snapped. "He has low blood sugar, what are we waiting for if he doesn't eat?"

Sun Zhiqiang walked over and placed the medical record folder on the bedside: "First, monitor blood sugar, check insulin, C-peptide, liver and kidney function, and ask about the medical history."

The son frowned: "Why do you need to do so many tests? My dad doesn't have diabetes, he's just old and eats less."

He squeezed the biscuit bag so hard it rattled: "It's not that we don't want to treat him, but he always gets sick from hunger. One injection and a couple of bites are enough to make him better. Hospitalization and tests cost thousands or even tens of thousands of yuan, and the old man himself doesn't want to go."

Lin Ye asked, "How often does he experience low blood sugar?"

"About three or four times in the last month."

"When were all those times?"

"Mostly in the morning, sometimes before meals."

"Did you feel better after eating?"

"right."

"Are you using any blood sugar-lowering medication? Does anyone in your family use insulin?"

"No," the son said impatiently. "No one in our family has diabetes."

Lin Ye stared at the old man.

The system did not start the death countdown.

The IV catheter in the elderly man's hand hadn't been removed yet, and the blood glucose meter reading next to him was just starting to rise.

But the few lines on the medical record that said "hypoglycemia improved after eating" were glaringly obvious.

This time, the sugar injection might wake you up, but next time you might collapse in the toilet, at the bottom of the stairs, or by your bedside where no one can see you.

"An endocrinology consultation is needed."

The son sneered on the spot: "Calling another department again? Do you ERs even have quotas for consultations now?"

As soon as he finished speaking, several doctors at the office door looked over.

Qin Hai also came out.

"Who said there are quotas for soliciting consultations?"

The son paused for a moment under the pressure of his gaze, but still stubbornly insisted, "I've read it online, low blood sugar can be cured with a shot, right? Why do you have to go through all this trouble and do all these tests?"

Qin Hai didn't argue with him, but only looked at Lin Ye: "Based on this."

Lin Ye pushed the freshly sealed blood sample tube in front of Qin Hai: "This is a non-diabetic patient with recurrent hypoglycemia, which occurs more frequently on an empty stomach and is relieved after eating. There is no history of exposure to exogenous insulin or hypoglycemic drugs. We need to rule out endogenous hyperinsulinemia such as insulinoma."

Sun Zhiqiang added, "This blood sugar correction is just a temporary measure; without investigating the root cause, it will definitely relapse."

Qin Hai nodded: "Call it endocrinology."

The son wanted to argue, but the old man suddenly grabbed his hand: "Investigate."

The son was taken aback: "Dad?"

Liang Guoan opened his eyes, his voice weak and unsteady: "I don't want to fall again. Last time I fell in the toilet, I couldn't get up for ages."

The son's lips moved, and his anger subsided by more than half.

When Han Qing, the director of endocrinology, arrived, it was almost midnight.

She seemed much more composed than the heads of surgery, yet her eyes were bright. After listening to the patient's history, she asked only three questions before instructing the nurse to collect a crucial blood sample.

"During a hypoglycemic episode, insulin and C-peptide levels should be measured simultaneously. The blood sample you just collected is crucial. Further tests should be conducted, and the patient should not be allowed to eat anything that might obscure the testing window."

The son then realized why Lin Ye had stopped him from feeding him cookies.

"So it's not that I'm not letting my dad eat it, but that I want to find out the root cause of his illness when it flares up?"

Han Qing nodded: "Yes. This window of opportunity is very short. If we miss it, we'll have to wait for him to have another episode of low blood sugar. Are you willing to wait for him to faint again?"

The son finally realized something was wrong: "Director Han, is this really not just ordinary low blood sugar?"

Han Qing looked at him and said, "Ordinary hypoglycemia wouldn't send an elderly person to the emergency room three or four times a month. You guys just give them a shot of glucose and leave each time, which is like silencing the alarm, not putting out the fire."

The son's face turned red immediately.

Liang Guoan was admitted to the endocrinology department for further examination.

Before leaving, Han Qing glanced at Lin Ye: "This isn't one of those cases where you have to be rushed to the emergency room the moment you walk in. Are you still able to keep an eye on the risks?"

Lin Ye nodded: "Recurrent hypoglycemia is itself a high-risk signal."

Han Qing smiled and said, "That's right. Everyone in the director's group says you only make emergency calls in the middle of the night, but I don't think that's entirely true."

Qin Hai's face darkened immediately: "Director Han, could you please stop talking about my department's resident trainees in that group chat?"

Han Qing took out his phone: "I'm afraid that won't work."

She turned the screen towards Qin Hai.

In the group chat for the directors, Zhou Mingyuan sent a message.

[It is recommended to establish an emergency room night shift reminder mechanism.]

Tang Zhendong: [Agreed. Swear before answering the phone, then check the evidence.]

Liang Xiulan: [Pediatric Supplement: Children's medical records must not be delayed.]

Jiang Shumin: [ENT supplement: For airway cases, administer directly.]

Shen Ruomei: [Obstetrics and Gynecology Supplement: When asking about a woman's medical history for abdominal pain, protect her privacy first.]

Han Qing just posted: [Endocrine supplementation: It's not just diseases that lead to rapid death that are dangerous.]

Qin Hai's temples throbbed as he looked at it.

"Did you guys hold a meeting in private?"

Han Qing put her phone away: "Consider this a new rule we set."

After she left, Qin Hai called Lin Ye into his office.

"Starting tomorrow, the medical affairs department will be conducting night checks in the emergency room."

Lin Ye was not surprised.

"Because of me?"

"It's partly your fault, but not entirely." Qin Hai tapped the table. "The directors have reached a tacit understanding, and the medical affairs department feels that the process is out of control."

He pushed a night shift schedule over to me.

"In the next phase, you will still be with the emergency room, but every time you report a high-risk assessment, you must synchronize it with both me and your mentor. Don't let them find any evidence that you have overstepped your authority on your own."

Lin Ye picked up the work schedule.

Qin Hai stared at him: "Lin Ye, the directors are willing to answer your calls now because you always have solid evidence and haven't made a mistake."

"I know."

"But if you make a mistake even once, you'll be the first one held accountable."

Lin Ye nodded.

Outside the office, the lights in the emergency room lobby were blindingly bright.

Lin Ye folded up the night shift schedule and stuffed it into his pocket.

The paper was folded to create a sharp ridge.

Every phone call I make from now on must be backed by solid evidence in the medical records.