At the heart of the story is Baek Kang-Hyuk, a brilliant and notoriously abrasive trauma surgeon with the moniker "violent angel," who is appointed to lead the comatose trauma center at Hanguk University Hospital. His mission is to combat the daily reality of potentially savable patients dying due to delayed transfers, inadequate initial treatment, and a lack of specialized personnel. The narrative follows his relentless, often confrontational campaign to revitalize the underfunded and overlooked department against a backdrop of hospital politics and administrative inertia.

The manga centers on the intense, high-stakes environment of the trauma bay, where every second counts during the "golden hour" following a critical injury. The main cast coalesces around Baek Kang-Hyuk, including Yang Jae-Won, a general surgery fellow who becomes his unwilling but devoted first disciple, often subjected to harsh training and nicknamed "slave captain". Other key members are the skilled and composed anesthesiologist Park Kyung-Won and the sharp, capable trauma nurse known as White Rose, who can match Kang-Hyuk's demanding pace. The team also contends with the hospital's administration, notably Chief Director Choi, who initially prioritizes budgets and hospital reputation over patient care.

The overarching conflict is twofold: first, the daily battle to save patients from severe traumatic injuries like complex nerve damage and on-site decompressive surgery, and second, the systemic war to secure resources, personnel, and recognition for the trauma center. Notable narrative arcs include the formation of the core trauma team as Kang-Hyuk handpicks his staff, the political struggle to acquire a dedicated medical helicopter for faster patient transport, and a later arc that follows a disillusioned Kang-Hyuk as he leaves the institution to work with Doctors Without Borders in a conflict zone, ultimately passing the torch for the center's leadership back to Yang Jae-Won.