An ambulance races from the Beijing Emergency Medical Centre at Hepingmen at 08:56.

Wang Honghong, a nurse, and two stretcher-bearers are in the back. Doctor Chen Zhi is in the front speaking to the patient's relative on the phone to make sure of the exact location of the patient.

On a blue screen before Chen it read "Female, 79, cerebral thrombosis, Tianningsi Overpass."

Driver Yu Lianfeng goes as fast as he can, overtaking other cars on the way.

In five minutes, the ambulance arrives at the eastern side of the overpass as a girl runs out "My grandmother is in a critical condition and you had better go and save her," she says as she climbs into the ambulance, leading us to a residential community.

We are led up to a small room of an apartment on the third floor - an old lady with fluffy hair sits on the bed groaning in pain.

Wasting no time, Chen asks the patient about her neck pain and medical history.

"Don't worry and let me measure your blood pressure first," he says while Wang picks out of the sphygmomanometer and ties a rubber band up her left arm.

After a quick examination, Chen says to the granddaughter: ''Her condition is not serious, but we had better send her to nearby Xuanwu Hospital to have a further check up."

The two stretcher-bearers put a blanket on the stretcher and try to persuade the woman to lie down.

However, the woman will not do it because of her neck pain. Chen finds a wooden chair and props up the patient after helping her with her shoes.

At 09:18, the patient is carried out of the building and into the ambulance.

In order to make her feel much more comfortable, nurse Wang bends the bed in the ambulance. On the way to the hospital, Yu avoids as many bumps as possible and in another five minutes, the ambulance cruises into the hospital. The woman is immediately transferred to the intensive care unit.

Chen, unshaven and with eyes a little red, gives a relaxed smile.

At 09:36, we enter the centre's gate, when another two ambulances speed off.

I follow Chen into the emergency medical section where doctors rest between assignments. He makes notes on the medical record.

Chen, who has worked at the centre for six years, says there are two teams working in shifts round the clock at the emergency centre, with 12 hours for each team. Each has a four-day work cycle, consisting of two day shifts, two night shifts and a day off.

There are nine doctors on day shift, but I only see two, who are sitting and reading a newspaper.

There is only a huge square table in the centre of the room, on which there is a black telephone, 17-inch TV set and computer. Three long benches surround the table.

There are three packs of cigarettes on the table.

"Most of us male doctors smoke during the night shift to keep us awake," Chen says apologetically.

When I had arrived earlier in the morning, a doctor just off night shift walked in, but I noticed his footsteps are already unsteady.

Chen hardly finishes his notes and the phone rings.

"Female, 78, cerebral infarction, Baizhifang No 61."

09:43

A minute later at 09:43, the ambulance is off again.

Another eight minutes and we're at Baizhifang, but nobody meets us.

Chen makes a call again, which lasts about three minutes.

Then a man in white overalls, who is apparently a doctor, comes to us in a rush, saying: "The patient is in the community hospital right now. She stops breathing from time to time."

In less than a minute, we enter the emergency room at Baizhifang Community Hospital. The patient is on the only bed in the room, with a pale face.

After a brief inquiry about her medical history, Chen starts taking her blood pressure and instructs nurse Wang to perform an electrocardiogram and administer an intravenous drip.

At 09:59, her condition becomes stable. Chen says she is developing a new thrombosis and suggests she is sent to a large hospital for further observation. Her family agrees and shortly later the ambulance takes her to Guang'an Hospital.

13:01

At 11:36, we return again to the centre from a patient with cardiac infarction. In the emergency medical section, five doctors have already finished their lunch. Some of them are so tired they are lying on the benches taking a nap.

At 13:01, Chen receives another call. A 68-year-old living in Xiaolazhu Lane is gasping severely after eating lunch. It takes six minutes to arrive and she is lying there with eyes and mouth widely open. There is an extremely bad smell.

It is so sick I stand near the door for some fresh air. "She was still groaning a minute ago, but became quiet now," her son says.

An electrocardiogram is performed and Chen says to the son: "The patient is on the verge of death. She may not come back to life and you should be prepared."

Wang gives the woman an intravenous drip and intubation, which is an artificial respirator.

Following the standard resuscitation procedure, Chen depresses the patient's breast rhythmically, trying to revive her. The electrocardiogram jumps in a constantly changing form.

The doctor and nurse do pressure work in turns.

However, 20 minutes pass and there is no improvement. At 13:27, Chen delivers an electrical shock, but does not revive her.

At 13:38, more than 30 minutes has already passed and in a medical sense any more resuscitation is useless.

The patient's son and daughter call out for their mother, trying to wake her. After the two children give their consent, Chen and Wang stop their work.

"It is very difficult to revive a senile patient," Chen explains on the way back, "but it offers some solace to the family members."

When asked why he could stand the bad smell, he answers with a question, "Can a doctor dislike and avoid his patient?"

"That smell is only due to incontinence of faeces and urine," he says. "If the patient suffers from malignant tumour, the stink will be much stronger."

19:00

It is already 19:00. The ambulance is preparing to return to the centre after Chen has given emergency treatment to a patient in Liuliqiao with severe chest pain. By then, he has already seen nine patients - a pretty slack day for Chen.

Then the blue screen splashes "Male, 75, fracture, Dachaye Lane."

We're off at once and Chen reveals a secret. "Today is my little niece's birthday and they are waiting for me to have a splendid feast," he says.

The ambulance siren starts again...

(China Daily December 5, 2002)