Inside the Emergency and Critical Care Center, alarms rang through the entire building.
“Dr. Yamasaki!”
The head nurse of the emergency center, Nagai Masako, was leading six night-shift nurses as they pushed gurneys and hurried over at a brisk run.
She was forty-five this year and had worked in the emergency center for twenty years.
So she did not need Yamasaki Hiroki’s instructions. The moment she heard the alarm sound, she knew what to do.
“Bring out the backup defibrillators!”
“Open treatment rooms three, four, and five!”
“Prepare ten venous cutdown sets!”
“Get the intubation kits ready!”
“Notify the operating room head nurse. Tell them to warm up every operating room!”
Nagai Masako spoke extremely fast, but every order was clear.
At a time like this, one dependable head nurse was more useful than ten trainee doctors.
Though the young nurses’ faces showed tension and fear, under her command, their hands did not slow in the slightest.
Yamasaki Hiroki stood at the entrance to the emergency hall.
Cold wind poured in through the cracks of the doors.
He hung his stethoscope around his neck and slapped his own cheeks hard.
From the distance came the sound of sirens, rising and falling, growing closer and closer. From the sound, there was more than one vehicle.
It was a large-scale convoy.
“They’re here!”
The first ambulance screeched to a stop at the entrance, its tires making a piercing scrape against the wet, slippery ground.
The red rotating warning lights flashed wildly, staining the walls crimson.
“Male, twenty-four years old. Severe impact trauma. Cardiac arrest en route. CPR in progress!”
The emergency crew member, drenched in sweat, rushed down while pushing the gurney.
Before he had even finished speaking, the second and third ambulances had already arrived one after another.
The automatic doors slid open to both sides.
Cold wind mixed with snowflakes surged in together with the emergency crew members, who reeked of blood.
The hall descended into chaos.
Groans, cries, the alarms of instruments, and the shouts of medical staff all tangled together, battering everyone’s eardrums.
“Is this hell?”
Ichikawa Akio stood in front of the triage desk, the thick black oil-based marker in his hand falling to the floor.
In an era when the START—Simple Triage and Rapid Treatment—system had not yet become widespread, the chaos on-site increased exponentially.
“What are you standing there for? Go over there and apply pressure to stop the bleeding!”
Yamasaki Hiroki picked up the marker from the floor and strode toward the area for newly arrived casualties.
With this many people, they had to be sorted first.
It was a cruel mathematical problem. When resources were limited and there were too many casualties, doctors had to play God and decide who would be saved first, who would wait, and who… would be abandoned.
But current triage relied more on a doctor’s clinical intuition—this one could still hold on, that one was about to die.
“Yoshimura, what are you doing? Don’t move!”
“You, and Ichikawa! Neither of you is allowed to think. Just listen to my orders!”
So he roared, stopping Yoshimura Hideki, who had taken a marker and was about to go mark patients.
He did not trust these two trainee doctors.
Because newcomers were usually drawn by the most miserable screams, rushing to treat minor injuries that could actually hold out a little longer, while ignoring the dying patients who could no longer even cry out because of shock.
Yamasaki Hiroki rushed to the first stretcher.
A twenty-four-year-old male. His head was already deformed.
He reached out and felt for the carotid artery. No pulse. Then he checked the eyes: pupils dilated, light reflex gone.
“Send him to the morgue. Don’t let him take up space.”
As he spoke, he took the black oil-based marker and drew a circle on the casualty’s forehead.
“Doctor, he might still be saved…”
But the emergency crew member pushing the gurney had a slight tremor in his voice. Perhaps the patient was someone he knew.
“He can’t be saved! There are others waiting behind him!”
Yamasaki Hiroki roared back, his eyes red.
The resources here were limited.
Doctors were limited. Nurses were limited. Ventilators were limited. Even each bottle of lactated Ringer’s solution was limited.
Wasting resources on someone certain to die was murder against those who still had hope of surviving.
This was the cruelty of emergency medicine.
The next casualty had a penetrating abdominal wound.
His face was ashen, his skin clammy and cold, his breathing shallow and rapid. His abdomen was bulging high, and a broken section of metal handrail was still lodged in his belly.
Hemorrhagic shock.
“Push him to Resuscitation Room One.”
He wrote an “I” on the casualty’s forehead, indicating unstable vital signs and possible death at any moment.
“Hey, you’re an anesthesiologist, aren’t you? Stop standing around! Go intubate him!”
Yamasaki Hiroki pointed at a bewildered young doctor in the corner.
Then came the third ambulance.
“It hurts so much…”
A young woman, her face covered in blood, moaned in agony on the stretcher. Her right leg was twisted at a bizarre reverse angle.
She could cry out, which meant her airway was clear and cerebral perfusion was still acceptable for the time being.
Yamasaki Hiroki used the black marker to draw a “II” on her forehead.
“Fracture, plus scalp laceration. Serious injury, but not life-threatening.”
“Push her to the observation room. Start an IV. Don’t give painkillers yet. Wait for the surgical team to come down!”
“Next.”
“…”
Several casualties passed in succession.
Ichikawa Akio finally came back to his senses. He looked at Senior Yamasaki, who was covered in blood, while his own legs were still trembling.
“Dr. Yamasaki, what… what should I do?”
“Stop getting in the way here!”
Yamasaki Hiroki cursed without even turning his head as he examined a casualty.
“Go establish IV access for the second-priority casualties!”
“You know how to place an indwelling needle, right? If you can’t even do that, then roll back to medical school and start over from your first year!”
“Yes! Yes!”
Ichikawa Akio scrambled and stumbled toward the observation room.
There were more and more casualties in the hall.
In just ten short minutes, eighteen casualties had been brought in.
Three of them were dead on arrival and were sent directly to the morgue. Of the remaining fifteen, six were severely injured patients who needed to enter the operating room immediately.
Just then, the automatic doors slid open again.
But what came in was not a stretcher, but a man wearing a dark down jacket, the collar of his pajamas showing underneath.
His hair was somewhat messy, and he carried a briefcase in his hand.
The doctor on duty from the Third Department of Surgery—neurosurgery—Kijima Shunsaku.
“Yamasaki! What’s the situation?”
He did not even have time to change into a white coat, directly pulling a stethoscope out of his briefcase.
He had actually slipped home long ago.
For someone like him, who did not want to drink with the professor and did not want to listen to his colleagues brag in the medical office, pretending to be sick and going home to watch videotapes was the proper thing to do.
He had not expected that the moment he got home, his pager would start going off nonstop.
“There are three head traumas. One has brain herniation, two have cerebral contusions and lacerations. They’re all in Treatment Room Two.”
Seeing him, Yamasaki Hiroki relaxed slightly.
“Leave them to me.”
Without another word, Kijima Shunsaku turned and ran toward Treatment Room Two.
Immediately after, the people from the Second Department of Surgery arrived as well.
It was also a young specialist trainee, leading two trainee doctors who looked as if they had not yet fully woken up, his face full of reluctance.
“What the hell? I was just about to fall asleep.”
He muttered in dissatisfaction, but after seeing the scene in the hall, he immediately shut his mouth.
Blood was everywhere on the floor, along with scraps of clothing that had been cut open.
Complaints could only wait until tomorrow.
Today, this book is going up on Sanjiang. When I received the news, the author sat in front of the computer in a daze for an hour, mouth dry, unable to believe it. My deepest thanks for everyone’s support. I said before that I wanted to see the scenery near the top of the new book rankings, and in these final few days, this book has finally squeezed into the top ten. This result has already exceeded the author’s original expectations. My gratitude is beyond words, so let me kowtow three times to everyone—bang, bang, bang.