top student at medical school

Chapter 103 The Great Feeding Spell and the Great Summoning Spell (Please Subscribe)
There are just too many junior doctors in the department. Even though Fang Ziye is quite outstanding, he is not in the same group as Jin Hongzhou. During the last annual meeting, Jin Hongzhou was the chief resident and therefore was not in the private room.

Later, when the superiors returned, even though Fang Ziye and Luo Tingzhu treated Jin Hongzhou to a KFC meal, it didn't leave a particularly deep impression on the chief resident.

Now that he had finally matched up with the junior colleague in that department, Jin Hongzhou was able to send a few more minor dislocations to Fang Ziye from the emergency department.

After reviewing each diagnosis, Fang Ziye found that none of them were particularly complicated.

One is a mild anterior shoulder dislocation, and the other is a mild ulnar wrist dislocation.

None of them are particularly complex diseases.

Because the "junior" who had a ulnar dislocation of the wrist said he was a student at the Medical School of Han City University, Fang Ziye simply asked him to wait a moment while he went to see another middle-aged man.

"Your dislocation requires manual reduction, and currently, many people in our department can do it."

"But the doctor who does it the most is Dr. Jin, whom you just saw in the emergency department..." Even after the other party had signed the consent form, Fang Ziye still had to ask if the other party agreed to let him perform the procedure.

This needs to be made clear. What if the other party decides at the last minute that they don't want me, a young doctor, to reposition the patient? Even if I manage to reposition him, if he makes a scene, I'll feel uncomfortable.

The middle-aged man quickly replied, "Dr. Fang, I understand what you mean, but don't worry."

"When I entered the department with this young man just now, Dr. Jin said that Dr. Fang's skills are very good, no less than his, and that we can rest assured."

Fang Ziye's undergraduate junior nodded, while looking Fang Ziye up and down, seemingly curious and scrutinizing something.

Fang Ziye put away the informed consent form and began writing some treatment instructions in the middle-aged man's medical record. He looked up and said, "No, Dr. Jin is just being polite. Dr. Jin is my superior and teacher, so he is definitely more skilled and experienced than me."

"You can believe the teacher's praise, but I can't take it seriously. I still have to learn skills step by step."

"It should be manageable, but if not, I can call a senior physician to handle it for you." Fang Ziye finished writing the middle-aged man's medical orders, then took his 'junior brother's' medical record and wrote a few sentences there as well.

The first sentence is about manual repositioning, and the second sentence is that if you feel unwell, please seek medical attention immediately.

“No problem, Dr. Fang.” The middle-aged man nodded first.

Immediately afterwards, Fang Ziye, unsurprisingly, pulled both of them into the control room one after the other, and they simultaneously completed the reset and fixation operations in an assembly-line manner.

Naturally, when he was treating the middle-aged man, Fang Ziye grabbed a strong man, a classmate who had accompanied his junior to see the doctor. This classmate was also a student in the five-year clinical medicine program at Han City University, and Fang Ziye made him his assistant.

He was overjoyed.

So while he was demonstrating the procedure to his classmate, the guy's eyes were filled with ill intent.

Even when that classmate looked at Fang Ziye's name tag with a long face and called out "Senior Brother Fang," Fang Ziye ignored him.

It's good enough that he wasn't made to write his own emergency room medical records.

Fang Ziye remembered that he had a classmate who was a master's student in the same year, majoring in urology. He performed meniscectomy in the sports medicine department. During his residency rotation, he came to the sports medicine department of the orthopedics department, which was even more ruthless.

He wrote his own hospital admission records and major medical records, conducted his own interviews and signed his own documents, wrote his own surgical records, and wrote his own medical orders, clearly demonstrating the meaning of "cheap labor".

Even the orthopedic student who was in charge of the patient that time didn't write a postoperative medical record. Instead, he created a template and completed it himself, up to the last postoperative ward round, discharge summary, and discharge diagnosis, before the urology graduate student was discharged. I heard that he left the sports medicine ward with tears in his eyes...

After two manual reduction techniques were completed, and the condition was relatively minor, only eight points of knowledge were obtained.

But it's enough.

"Go for a follow-up check-up first. After that, you come to me to look at the films. Then the two of you can look at your own films, you can refer to the book or look up some information. If you still don't understand, come to your senior brother." Fang Ziye instructed the three people outside the operating room.

The middle-aged man chuckled to himself: "It's time to examine myself. You're all doctors; you'll understand at a glance."

The medical student surnamed Huang almost burst into tears.

His expression and eyes seemed to say, "Uncle, this is really different, you don't understand..."

Interlaced like mountains.

But at this moment, Fang Ziye gave his two junior brothers the warmest smile: "It's okay, your senior brother is not ignoring you, right? Actually, we can already deduce part of it now."

What are the surface signs and clinical manifestations of successful manual reduction of joint dislocation?

The junior student surnamed Huang didn't reply. Another junior student, wearing a jacket, pushed up his glasses first: "The deformity has disappeared, the joint has been repositioned, the swelling is still there, and the pain has been relieved or even disappeared. And, there's more, I don't know."

The young man has already left.

Fang Ziye saw his two junior brothers off for a while, and as he walked toward the door of the ward, he nodded: "Almost there, especially since the swelling is still there, which proves that you have studied the book very carefully. But there is another point: active and passive movement has recovered."

Another junior colleague quickly slapped his head, forgetting the most typical clinical manifestations; he deserved a beating.

Fang Ziye waved to them, telling them to hurry up and take the elevator downstairs for a follow-up X-ray examination.

The re-examination results were all fine, but Fang Ziye had nothing else to do. Since they were all his junior brothers, he patiently reviewed their films and taught them a lot.

From reviewing X-rays to classifying joint dislocations, to surgical indications and manual reduction indications, to how to assess the success of postoperative reduction, to postoperative rehabilitation, how to apply cold and hot compresses, and the corresponding principles.

Even at the very end, Fang Ziye explained to the two that if they were interested, they could go a step further and compare the indications for different reduction techniques, perhaps even writing a meta-analysis…

The two junior brothers were immediately terrified and fled. But after running a distance, they looked back at Fang Ziye a few times, while Fang Ziye went into the doctor's office and began to do his own thing.

The dressing for the patient I'm in charge of hasn't been changed yet...

It's noon.

Fang Ziye looked at his knowledge points, which had surged to 76 points once again, meaning he had gained 23 knowledge points in just one morning.

With five patients, the average knowledge point gain per patient was as high as 4.6.

The benefits of clinical skills are equivalent to the efficiency of laboratory experiments. Even outpatient services have to take a backseat.

However, while Fang Ziye was diligently eating his meal in the office, he noticed that his teacher, Yuan Weihong, had somehow sneaked in, as if hiding from a ghost.

After entering the office, he closed the door behind him.

Hearing the door creak, Fang Ziye instinctively jumped back: "You did it!"

"Master!" Fang Ziye felt a chill run down his spine.

Generally speaking, around noon, the office is mostly occupied by doctors on duty or attending physicians who have just finished surgery, who come in to write medical orders.

With these two identities, who would close the door unless there's a reason?

Fang Ziye thought he was about to be betrayed by an unidentified family member.

There is precedent for this.

"Shh!~"

"You only ordered one takeout?" Yuan Weihong looked around.

Fang Ziye nodded. "Yes, Master, you haven't eaten yet."

Who orders two takeout meals for no reason?!

Yuan Weihong wiped his forehead, which was already four fingers high.

Yuan Weihong first found a chair and sat down, taking out his phone as he said, "This Jie Han is someone I can't afford to offend. You eat first, I'll eat later."

"Master? Junior Brother talks a lot?" Fang Ziye asked.

"More than just a lot? He's practically a chatterbox. Is he like this when he's with you?" Yuan Weihong retorted.

Fang Ziye thought about it carefully again and shook his head: "My junior brother was a little talkative during the experiment yesterday, but he was fine the rest of the time."

“Actually, having a sharp mind and keen observation skills is a good thing sometimes.” Fang Ziye thought Jie Han was a good person, just a bit too much of a problem, and these problems were the result of asking questions.

"A certain amount of sharp thinking is a good thing, but too much will annoy people. Where does he come up with so many strange questions? It's really unbelievable."

"No, no, he can't go this afternoon. If he goes, there are already fewer patients in the outpatient clinic in the afternoon, and I'll be bombarded with his questions."

Yuan Weihong waved his hand, then after ordering takeout, he asked Fang Ziye to pick it up for him while he went to hide in the general inpatient duty room where Jin Hongzhou was on duty.

Fang Ziye agreed.

Then he sent a message to Jie Han: "Junior brother, what did you ask Master this morning?" "I didn't ask anything, I asked the patient," Jie Han replied.

Fang Ziye: "..."

Sure enough, the longer you spend together, the deeper you get to know someone. Fang Ziye only just discovered that Jie Han also had this side to him.

"Think carefully and do your work honestly. If you don't give the teacher time to speak, how can the teacher teach you?" Fang Ziye pointed out.

"Okay, I understand, thank you, senior brother." Jie Han was still very well-behaved and obedient.

Just after Fang Ziye delivered the KFC that Yuan Weihong had ordered to the inpatient ward, another patient with a dislocation came from the direction of the nurses' station. As Fang Ziye passed by the doctor's office, his eyes lit up at first glance.

I quickly adjusted my mask and went to greet them.

They had only just begun talking.

Yuan Weihong came out of the resident's on-call room. He walked to the office door, looked around, and after identifying Fang Ziye's direction, said, "Oh, right, Ziye is in the department. But, Brother Zheng, isn't it inappropriate to have Xiao Fang do a suture in your hand surgery department?"

"He has not received any professional training in vascular suturing."

"There's nothing we can do about it. I don't know what happened today, but there were a lot of emergency surgeries in our department. All the professors and associate professors were assigned to different surgeries. I'm just here with a junior resident, and I've been assigned to a separate surgery."

"Professor Ni Yaoping said that he would ask Ziye to come and help with my vascular suturing. As you know, his vascular patency rate is better than mine."

"Brother Wei, can I do you a favor and borrow Ziye for a bit?"

"Is he on duty?"

"Well, it won't be long here. Call your department's chief resident and ask him to come back and temporarily fill in."

"In a crisis, one must act expediently. Who would have thought that nine people would have severed fingers and limbs in one morning?"

"We even borrowed an operating room from the emergency department," Yang Wenzheng explained in detail over the phone.

“Alright then.” Yuan Weihong also felt that if all the hand surgeons hadn’t been sent out, they wouldn’t have needed to borrow people from the trauma surgery department.

After hanging up the phone, Yuan Weihong walked over, patted Fang Ziye on the shoulder, and took over the joint dislocation reduction that Fang Ziye was going to perform, saying, "Emergency operating room, room 4, go there."

"Yang Wenzheng called you. I'll call your junior brother over to take your shift later."

Fang Ziye's mind went blank for a moment; this was something he hadn't encountered in the past few years.

However, Fang Ziye immediately nodded: "Master, what about the dislocation on this side?"

“Leave it to me. I’ll call Jin Hongzhou later,” Yuan Weihong replied.

"Thank you for your hard work, Master." Fang Ziye slyly ran into the doctor's lounge.

The reason for calling Jin Hongzhou is that all on-duty doctors must be at their posts in the ward. If they need to go out for any reason, Jin Hongzhou, the chief resident, needs to be informed.

In this way, if any unexpected situation arises, Fang Ziye, the doctor on duty, won't be held entirely responsible.

Of course, someone will still need to be on duty in the ward 24 hours a day.

Fang Ziye took off his white coat, left the orthopedic building, went to the emergency department, and then wandered around to the operating room in the emergency department.

Feeling a bit emotional, I realized that I was so idle during my shifts a while ago. But now, just when Jin Hongzhou finally found the right person to perform the "Great Feeding Technique," the hand surgery department unleashed a powerful summoning spell.

The quick way to acquire knowledge points is gone.

I wonder if I'll be able to earn back the knowledge points this time I go into the operating room.

But since it was Yang Wenzheng from the hand surgery department who spoke up, Fang Ziye certainly didn't dare to delay.

A few minutes later, he washed his hands, got dressed, and went on stage.

On the stage, there was only Yang Wenzheng, plus a junior hand surgeon whom Fang Ziye didn't recognize. He was a first-year master's student and was just as adorable as Jie Han.

"Brother Zheng," Fang Ziye called out.

Yang Wenzheng looked up at the sound: "Perfect timing, Ziye, hurry up and sew up these arteries. Restore blood flow to the distal end; this is a partial amputation of an upper limb."

"I have already explored the course of the arteries and veins. I still need to do some debridement and lay out the vascular bed above."

"The earlier the blood vessels are sutured, the better."

Upon hearing this, Fang Ziye dared not be careless: "Was the injury already quite long when you were admitted to the hospital?"

"Yes, they came all the way from Xian City. Our hospital has really done something terrible. Such damage could have been treated directly at Xian City People's Hospital. A second spinal rotation would have been fine too."

“But this patient has a relative who works at our hospital and trusts us too much. He sent an ambulance directly over. You can imagine how much trouble this caused,” Yang Wenzheng told the truth.

Fang Ziye then asked why Yang Wenzheng had sent him over.

Following that, Yang Wenzheng briefly explained the suturing requirements to Fang Ziye.

Well, suturing large arteries is not as delicate as suturing small arteries in finger replantation because the blood vessels are thick enough that even with a patency rate of 80% or 90%, it can temporarily prevent necrosis of the distal limb.

The patient's injury was quite coincidental; the chainsaw severed the brachial artery, but the nerve and blood vessel damage was minimal.

The other wound was a longitudinal incision on the forearm, which only involved tendon and soft tissue damage, without any nerve or blood vessel damage.

A relative of ours traveled hundreds of miles to come directly to us, and the hospital certainly had to do its best. However, the problem was that his condition wasn't serious. All the other professors were on stage, and the associate professors were all busy, so we could only have Fang Ziye come over to perform a temporary suture on the artery.

After ensuring blood flow is restored and preventing necrosis of the distal limbs, a repeat repair suture may be needed later to ensure a higher rate of vascular patency.

The suturing technique, specifically suturing blood vessels, is flawless in terms of the suturing operation itself.

However, vascular suturing is a specialized procedure that is relatively difficult to perform in vascular surgery and hand surgery. Fang Ziye's experience and proficiency are not high, so the upper limit is estimated to be only 90%, unless he can be upgraded to a higher level of simple suturing.

Only then can we hope to improve the quality of suturing without relying on specialized basic procedures in vascular suturing.

Since it was a temporary teaching session, Fang Ziye couldn't worry about too much.

I put all the remaining knowledge points into Vascular Suturing, and my Vascular Suturing skill level went from Level 2 to Level 3 with a proficiency of 44/500.

Regardless of whether it was enough or not, Fang Ziye did his best.

After adding points, quite a few techniques were introduced into my mind. Although it didn't have the same sense of security as adding points gradually, it was a matter of expediency in an emergency.

The subtlety of suturing doesn't lie particularly in the technique of suturing itself. There's really only a handful of things involved in suturing.

Level 3 vascular sutures may seem similar to Level 2 sutures, but the differences lie in the control of the technique and the objective data on postoperative efficacy.

The brachial artery is not very large in diameter.

After suturing the artery, Yang Wenzheng quickly loosened the arterial passage, allowing blood flow to be unobstructed in the distal part of the patient's affected limb for a short period of time.

At this point, about half an hour had passed since Fang Ziye entered the operating room.

"Phew, that's done."

"Thank you, Ziye."

"Once you finish suturing the veins, you can go back," Yang Wenzheng said.

"We mainly wanted to put the patients first, so we tried our best to do every step well. That's why we called you over. Your mentor said you still have to work a shift, so you should go back first."

"Professors and associate professors will come over later to handle it further." Yang Wenzheng was only temporarily requisitioned and would be returned after use.

Fang Ziye didn't reply, but silently continued working. Another forty minutes passed...

Fang Ziye asked Yang Wenzheng for his opinion before nodding and saying, "Thank you for your hard work, Professor Yang. I'll be going now."

Yang Wenzheng's words, and what they had done, made Fang Ziye stop jokingly calling him "Brother Zheng" and start referring to him as "Teacher."

If it weren't an emergency, Yang Wenzheng would have inserted the needles in just a few times, out of a sense of responsibility to the patient.

Who wouldn't prefer not to ask for help?
(End of this chapter)