top student at medical school

Chapter 147 Theory and Practice (Please Subscribe)
People are iron rice is steel.

Although the patients who came for treatment were all very anxious, no one had the heart to refuse when faced with several doctors in white coats who all looked exhausted, asking for a few minutes to eat.

Fang Ziye felt he had learned something new and quickly jotted it down in his mental notebook.

There is a lot to learn, including not only professional knowledge, but also interpersonal skills and techniques.

Back in the office, the five of them huddled together and put together the food from each of their own boxed lunches.

Xue Tao quickly poked open the packaging bag with her chopsticks and started eating. While picking up food, she said without any politeness, "Yuan Hong, you didn't even introduce it properly. Are you making us all speak in riddles?"

Li Yuanhong is currently lifting the lids of the dishes one by one.

He said, "Tao Ge, Fang Ziye, Dr. Fang, Professor Deng, and Wei Ge's student, is a super academic genius. Among the postgraduate students in the Department of Trauma Surgery at Zhongnan Hospital, whether they are doctoral or master's students, they are all like this."

As Li Yuanhong spoke, he gave a thumbs-up.

Xue Tao nodded and shoveled a mouthful of rice into his mouth: "No wonder, I knew it."

Xue Tao paused for a moment, swallowed quickly, and then spoke fluently: "Dr. Fang is completely different from the kind of purely theoretical doctor we know."

After piling all the vegetable lids together, Li Yuanhong sat down and said, "Brother Tao, that's definitely not it."

"You wouldn't believe it, but Dr. Fang is a beloved student of a group of senior professors in their hospital's training room. It's a pure case of grandparents and grandchildren having a close bond."

“Anyway, I don’t know about others. Even if Brother Wei were to say something negative about Dr. Fang in the training room, he might get scolded. I can’t be sure what Professor Deng said.” Li Yuanhong finished speaking and quickly chewed.

After swallowing, he sent a voice message to his wife at home: "I'll be back after I finish eating. Wait for me. The department is very busy. I'll help out temporarily."

"Please explain to the two children that I miss them very much."

No one laughed; they just looked in Li Yuanhong's direction, thinking that Li Yuanhong was reliable.

He's a true brother; otherwise, he wouldn't have chosen to stay in the department so quickly. But he's middle-aged now, and after all, he has his own family and children.

Xue Tao said, "Yuan Hong, after you finish eating, please take Dr. Fang with you. We really don't have time right now."

"I was just in the small group chat when I heard Director Wu, who just arrived, say that Director Qiu twisted his wrist while it was being repositioned. Fortunately, it's okay, but he can no longer treat patients."

"There are just too many patients today. Ziye, please understand."

Xue Tao stopped calling Fang Ziye "Dr. Fang".

Once you get to know them, who the hell will keep bringing up your academic qualifications?

In the surgical system, people prefer a more straightforward relationship and won't address each other as "doctor" or "PhD" all the time.

Unless it's someone new and someone you don't know, you won't be polite and call them "teacher" or anything like that.

Of course, this also depends on one's position. If you are an intern or a regular graduate student, before you've developed a rapport with someone, you should address them as "director," "teacher," or "professor."

"Brother Tao, you're too kind. I feel like I've come at the wrong time and have only held everyone back."

"I live right across from the hospital. The key is with the property management. My aunt's bed is already made up, so you can use it right away," Fang Ziye explained as he replied.

In his mind, he was calculating what he had gained that day.

The total income of 121.2 knowledge points was enough to make him recover a lot of his losses.

It cost nearly a thousand knowledge points and recovered one-eighth of them. Although it was a bit of a loss, the skill was still my own, and my current knowledge point reserves were close to five hundred again.

Although it's not enough for a level 4 skill, a regular level 3 skill can be leveled up anytime with skill point allocation.

Fang Ziye's skill point allocation strategy is not arbitrary.

Osteotomy and reshaping surgery is a major focus for him at the prefecture-level city hospital. Among the procedures, X-ray interpretation and repositioning are crucial operations in osteotomy and reshaping surgery.

Therefore, it cannot be considered an unnecessary complication.

Without affecting the overall direction, you can also gain knowledge points through skills, which is a very pleasant thing.

"Ziye is quite good; he's a true young talent."

"Ziye is still very young, isn't he? How old is he this year? Does he have a girlfriend?" Xue Tao subconsciously asked three questions in a row.

"Twenty-seven, and in more than half a year it will be twenty-eight, which is close to thirty."

"As for a girlfriend, I guess I do!" Fang Ziye explained with a smile, trying to avoid any further complications.

However, Li Yuanhong was inhuman: "Even abroad, far away, the girls in our Enshi still have the chance to cause trouble."

Xue Tao immediately understood. She pursed her lips in refusal while chuckling. After eating, she sniffed, tore off a piece of tissue to wipe her mouth, and said, "This isn't a long-distance relationship, it's an international one. It won't last."

"At least give the girls in Enshi a quality option, right?" Xue Tao said with a smile.

It doesn't need to be taken seriously, but it can't be completely ignored either.

Fang Ziye just smiled; there was no need to engage in verbal sparring.

Even during mealtimes, a few patients' family members came over to take a look at the situation in the office. After seeing several people in white coats eating boxed lunches together, they didn't say much.

This may be due to one of the most basic rules in China: eating is of utmost importance.

After finishing their meal, Xue Tao and Li Yuanhong remained still, but Wang Zhongxing and Zhang Jinchuan, who was on duty that day, quickly wiped their mouths and rushed outside to further sort and process the patients.

For dislocations, plaster casts are applied; for luxations, manual reduction is performed.

Operations are operations, and diagnosis is diagnosis. First, diagnose to determine what kind of operation needs to be performed, and then proceed with sorting.

It sounds a bit like an assembly line operation, and it actually is.

If there weren't many patients, we could see them one by one, and the diagnosis and treatment would be done in one go. But now that so many are crowding in at once, if you don't save time, then the waiting time for patients may be very long.

If it's not sorted out, it might be a small dislocation, and you might not be able to get a doctor to treat it even after a whole day.

After the two went out...

Li Yuanhong quickly took his leave, but Xue Tao wasn't in a hurry. As an associate chief physician, he was the leader of the team that performed manual reduction and plaster cast application in the wards, so he didn't need to do everything himself.

"Ziye, let me ask you something. How did you determine that the patient with the anterior hip dislocation was irreducible?"

"Also, why is it that the patient who had their elbow joint reduced posteriorly and laterally necessarily had ligament damage, making manual reduction seem meaningless?" Xue Tao was genuinely curious.

Can so much information really be seen on a single flat sheet of paper?

Fang Ziye was currently scanning the message Luo Tingzhu had sent him, indicating that she had already gone to bed. After reading it, he turned off his phone screen. It was late at night for Luo Tingzhu, so he didn't want to disturb her.

What if Luo Tingzhu wakes up after hearing the notification?

"Brother Tao, this is a review of the images. I remember Professor Deng Yong from Zhongnan Hospital mentioning during his ward rounds that some joint dislocations, ligament remnants, and muscle remnants can be occasionally seen."

Fang Ziye thought for a moment and then replied, "Of course, our department doesn't see many joint surgery patients, so we don't have much experience in reading images. But when Professor Deng Yong first started working, joint surgery wasn't a separate department yet, so Professor Deng Yong had experience in that area."

"Professor Deng said that if there is no dislocation, these afterimages may be ignored by us. If a dislocation occurs, the joint will inevitably be misaligned. After the joint is misaligned, we can see X-ray afterimages that are different from the plain films we usually see."

"It is more conducive to observation and diagnosis."

“I didn’t really understand it before, but I just kept that sentence in mind. I just noticed it today.”

As Fang Ziye spoke, he tried to learn and imitate the methods Yuan Weihong used when he was teaching him. He moved to the computer, but as soon as he turned on the black screen, Fang Ziye felt numb.

Because this wasn't the hospital's internal computer system, he couldn't even find the medical record system. Upon hearing this, Xue Tao immediately moved and carried a stool to Fang Ziye's side: "Our hospital's image reading system is separate, especially the outpatient system, which is not connected to the image reading system. Only the inpatient medical record system is connected to the image reading system."

"This system is not working well..."

Xue Tao's heart tightened as she watched Fang Ziye quickly write down the orthopedics department's account and password for the image reading system on his phone's memo app.

Such an outstanding person, yet still working so hard, how can anyone live?
But this was Fang Ziye's habit, so Xue Tao didn't say much.

After reviewing the X-ray of the patient with anterior hip dislocation, Xue Tao stepped aside.

Fang Ziye zoomed in on the page with his mouse: "Brother Tao, I don't know if I'm right. I certainly don't have the systematic knowledge that professors have, so I can only share my own understanding."

"This dislocation is certain, and it is a typical anterior dislocation. It can be diagnosed by reviewing the X-ray or by observing the patient's specific deformity signs."

"However, if we look closely, we will find a faint, cord-like shadow on the lateral side of this anterior dislocation, at this point in the acetabulum."

As Fang Ziye spoke, he continued to zoom in: "In my guess, this should be the location of the round ligament."

"So, I guessed that this round ligament might be causing elastic resistance, like a rubber band, which hindered our repositioning. Part of its tension and stress was directed inward."

"Furthermore, since the femoral head has an anteversion angle, the layer we see will definitely show some compression between the femoral head and the acetabulum. Simply applying traction to the lower limb will definitely not be enough."

"Moreover, it's not a posterior dislocation. Under normal circumstances, we wouldn't think of moving the thigh towards the side we're operating on, but it's precisely because of this that irreducible dislocations occur."

"Of course, the reason I'm so sure is that I feel there must be something fishy about the fact that you guys have tried to reposition the body so many times but haven't been able to."

“In this situation, before it is reset, we need to find the clamping point.”

When Fang Ziye made this deduction, it was to some extent a consideration of Xue Tao and the others' feelings.

Then, Fang Ziye said, "In that case, we must first resolve the longitudinal compression point, and then separate the joint through traction."

Fang Ziye demonstrated at the same time, hooking his right hand's fingers around the back of his left hand and pulling it down. Unless the fingers were deformed, there would definitely be some pressure.

However, Fang Ziye immediately moved his right hand a short distance in his direction, and then slowly retracted, thus relatively easily restoring the original trajectory.

Fang Ziye's theory was neither profound nor simple.

At least it's not cloying; it's not the kind that's deliberately mysterious.

Xue Tao was astonished: "You can really see it on an X-ray? This is unbelievable!"

To some extent, Xue Tao once felt a sense of aversion to the superiority of her academic background.

He is more inclined to believe that ability is more important than academic qualifications, and practical skills are more important than theoretical knowledge. After all, especially in medicine, all theories must ultimately be applied to clinical practice.

However, after pursuing further studies, Xue Tao gradually changed her mind.

After all, he had studied at Zhongnan Hospital. He knew from many people that medicine, at least in the field of orthopedics which he was familiar with, involves many procedures that cannot be explained by theory. If you think that's the case, then it's definitely because your skills are not good enough, your understanding is insufficient, and your knowledge is inadequate.

Professor Deng Yong, Associate Professor Xie Jinyuan, and others—at that time, Xie Jinyuan was not yet an associate professor—could all orally explain the relevant theories in a relatively easy-to-understand way.

It's not profound or mysterious; in fact, once you understand it, it's just some simple things. But if you try to figure it out on your own before it's explained, then it's difficult.

Only by opening the door can you see the scenery outside; otherwise, it's all just wishful thinking.

However, after Xue Tao returned from his advanced studies, a brilliant scholar with a doctorate came to the department. He was initially quite happy and humbly sought his advice, but later he realized he was being ridiculous.

"Brother Tao, at first glance, you definitely wouldn't be able to tell. I don't think I have that level of skill, but if I try and fail, I'll consider it in that direction." Fang Ziye didn't try to show off.

After acquiring Level 4 X-ray reading skills, Fang Ziye's abilities have improved by at least several levels compared to when he was at Level 3.

Fang Ziye roughly understands that at level 3 of X-ray reading, the performance of different levels of proficiency is reflected in the different layers that can be seen.

This level of understanding goes beyond just front-back and left-right relationships. It involves using image reading techniques and basic anatomy to reconstruct these things and imprint them in one's mind.

Level 3 X-ray reading skills only allow you to see many detailed anatomical details on X-rays, but cannot reconstruct the layers.

The current X-ray interpretation technique can at least divide the structure into five layers on an X-ray, five layers each on the front, back, left, and right sides, which should amount to about ten layers in total. This is the capability and level of a Level 4 X-ray interpretation technique.

Fang Ziye couldn't judge for sure who he could be compared to at this level, but he estimated that his teacher, Yuan Weihong, was only slightly better than him at the moment, which was a fairly accurate estimate.

Yuan Weihong is my mentor. He is over thirty-four years old this year, almost thirty-five. He is very talented, so it is not an exaggeration for him to have such abilities.

Of course, Level 4 image reading skills are not something everyone can acquire. Perhaps Associate Professor Xie Jinyuan possesses them, but attending physician Qin Geluo and chief resident Jin Hongzhou probably do not, making them extremely capable.

"Precision, sound reasoning, and the combination of theory and practice—that's true skill. I admire you," Xue Tao said sincerely, not out of timidity, but out of envy.

He is now increasingly able to understand a sentence his mentor once said when he was pursuing his master's degree.

When you reach a point where you feel you need to explain your actions, but you can't quite articulate why, you'll realize how useful reading is.

Xue Tao is still reading literature, but he is gradually becoming less familiar with and less concerned about some basic theories. The literature he reads mainly focuses on operational principles.

It's like his foundation is unstable. Even if he wanted to go back and make up for it now, his ingrained way of thinking and logical habits would probably be impossible for him to change.

"I envy him, but I can't have what he has." Xue Tao looked at Fang Ziye with an indescribable mix of envy and respect.

Fang Ziye relaxed his posture slightly and smiled in return: "Brother Tao, I also admire your experience."

"Experience accumulates naturally as you move forward, but the theories, insights, and knowledge reserves you possess now are something that others cannot turn back to."

"Forget it, I won't say anything more. I'll learn and catch up on my own slowly."

"Ziye, go and rest first." Xue Tao stood up and walked out.

When you reach middle age, you have to do things, and you can't be like Fang Ziye at that age, just giving pointers on the world with a wealth of theories.

The pressure on him in the department was to perform surgeries and prepare him for leading teams in the future, unlike Fang Ziye, who could systematically and comprehensively make up for his shortcomings.

Playing to his strengths was the only option he could take.

The age for filling in the gaps in his knowledge and skills is no longer his; he missed that age, and once missed, it's gone forever...

Fang Ziye watched Xue Tao's retreating figure, lost in thought.

He stood up abruptly, quickly returned to the break room, put his white coat back, and then pushed his suitcase out of the department.

No more agonizing, no more drawing attention.

If needed, people here will definitely send him a WeChat message or call him. He has already found a certain sense of presence, so there is no need to keep looking for it.

There are many people in the department, but it's not necessary to know them all the time.

On the contrary, being able to have a relatively in-depth heart-to-heart talk with Associate Chief Physician Xue Tao made Fang Ziye even more certain of his initial choice.

If I came here right after graduating with my master's degree, I might be able to get some financial compensation, a certain social status, and realize some of my life's value in a short period of time.

But when I really feel lost, will I feel just as lost as Xue Tao?

Fang Ziye didn't know, but at least he hadn't missed it.

Theory and practice are equally important. This is a principle that Fang Ziye heard from his teacher and also needs to gradually understand on his own.

But he still had a chance, Fang Ziye said with a smile as he left, no longer feeling lost about his future.

Opportunity is, to a certain extent, greater than effort and choice.

(End of this chapter)