top student at medical school

Chapter 201 Self-Recommendation in a Time of Crisis (Please Subscribe)

Xue Tao, with his big nose, has a deeper understanding of the characters in this room than Fang Ziye.

After Fang Ziye left Cao Zhen's operating room, he found the operating rooms of the two senior attending physicians, Zhong Xuegao and Guang Shenqing. The two had already worked together to open the operating table and had gone quite a distance inside.

The hematoma removal procedure was almost finished, and both of them were carefully searching for the bleeding point.

Fang Ziye's sudden intrusion into the operating room left them with some doubts.

Zhong Xuegao lost his usual comedic demeanor: "Ziye, can't you find the operating room? Should I call Xue Tao?"

Under normal circumstances, Zhong Xuegao would probably make all sorts of jokes, like not being able to find the door or the hole, or other such nonsensical remarks...

"No, Teacher Zhong, I just came to check on things!"

"If there are already people here, I'll go back and help. Brother Tao is worried that there won't be enough people here," Fang Ziye casually offered an excuse.

Fortunately, Zhang Mingcan is the director, and there are many people in the group. Even though Li Yuanhong went out for further studies, there is one more senior attending physician than the other two directors. Therefore, Zhong Xuegao can temporarily leave his shift to poor Guo Yunlei.

"It's good that we found it." Zhong Xuegao said this cryptically.

Fang Ziye then left silently.

Since Guang Shenqing and Zhong Xuegao are both on stage, the patient's hemostasis procedure won't require him to spend much time on it.

Turning back to Xue Tao's operating room, after washing his hands, getting dressed, and going on stage, he discovered that Xue Tao, without any help and with the scrub nurses not knowing much about the procedure, hadn't even finished a simple hematoma evacuation.

However, Xue Tao was not in a hurry. Only after Fang Ziye approached the operating table did she ask again, "Is the operating table not started yet?"

Fang Ziye only went out and came back in about ten minutes. He probably just went over for a quick look and then went back the way he came.
This was the third time Fang Ziye had put on a sterile surgical gown, and he could feel the strong smell of disinfectant on his hands.

However, he still carefully put on sterile gloves and calmly said, "Brother Tao, Dr. Cao Zhen's hemostasis has been completed. In the other operating room, Brothers Zhong Xuegao and Guang Shenqing are performing surgery, and they have also finished treating the hematoma."

"That's all."

Fang Ziye didn't know Cao Zhen's true abilities, but he vaguely remembered Huang Kai saying that Cao Zhen could perform a normal open reduction and internal fixation surgery without any problems.

Furthermore, when Fang Ziye left, he even helped Cao Zhen with the most difficult manual reduction technique in the fracture surgery. Presumably, Cao Zhen will only need to complete the temporary fixation with Kirschner wires and then insert the plate and screws.

Since this is a hematoma incision and fracture internal fixation, there is no need to pursue intramedullary nailing with a relatively smaller incision and make another incision.

As Xue Tao approached the operating table, he had just finished the initial hematoma removal procedure. He said, "Let me loosen the blood vessels first to see where the bleeding point is. I looked at it and it doesn't seem like there are any obvious broken ends of the blood vessels."

Fang Ziye scanned the surgical field and found that the muscle layer still contained a small amount of blood clots, which had not been thoroughly cleaned and needed to be rinsed.

Even so, Fang Ziye still managed to spot the course of the anterior tibial artery at a glance.

After roughly matching it with the fracture ends, Fang Ziye picked up the hemostat, bluntly separated a small section of muscle at the opening, and then pulled out a semi-continuous artery, saying, "Brother Tao, this should be it."

This blood vessel is like a half-broken water pipe; because it carries blood, there is no bleeding at the broken end.

Xue Tao said dejectedly, "I just examined the anterior tibial artery, and there was movement in both the proximal and distal ends when pulled. I thought the anterior tibial artery hadn't ruptured."

This is a small procedure for continuous exploration. It's like pulling on the proximal end and the distal end moves along with it. If this indicates that the continuity of the artery is good, then the artery is generally intact.

The same principle applies when the distal end is pulled, causing the proximal end to move as well.

However, Xue Tao never expected that Fang Ziye had only broken half of the blood vessel. This level of control over the depth was simply too unbelievable.

It can be described as something within the realm of theory, but outside the realm of practice.

In other words, it is theoretically possible to achieve, but practically impossible.

"Brother Tao, why don't we sew it up first, and then open it up to check the blood supply? Anyway, it'll have to be sewed up eventually." Fang Ziye didn't give a definitive answer.

"I'll be your assistant." Xue Tao already understood.

Fang Ziye's doctoral degree may be unassuming, but that doesn't mean he lacks ability.

Xue Tao, having spent nearly a month with Fang Ziye, was acutely aware of his exceptional qualities.

One thing is certain: even Shen Tao from Hubei Provincial People's Hospital, who shares the same name but a different surname as Fang Ziye, greatly admires Fang Ziye's osteotomy skills.

Fang Ziye's aptitude is exceptionally high.

So, the Fang Ziye he came into contact with was within the last month, and Fang Ziye certainly didn't become so talented in the last month either.

Three years of postgraduate study, even in the practice room of Zhongnan Hospital, was enough time for Fang Ziye to practice until he reached a very high level of proficiency. Therefore, it is understandable that Fang Ziye has exceptional abilities in some minor procedures.

After all, when Xue Tao was doing his advanced studies, he had heard that Professor Du Xinzhan, the current head of the Department of Orthopedics at Zhongnan Hospital, who was also the head of the Department of Joint Surgery, had already surpassed many attending physicians and even been comparable to associate professors in some minor procedures when he was young.

However, their surgical skills are relatively low. Once they reach a certain age, they become unstoppable and a true powerhouse.

He is one of the few professors at Zhongnan Hospital who rose to the positions of director and professor without relying on scientific research, and has now become a senior professional and technical personnel at the level of chief orthopedic surgeon.

Fang Ziye, however, was even more formidable, because Fang Ziye's scientific research was something that ordinary people could not match.

The two had a good understanding of each other.

Fang Ziye sewed the stitches, and Xue Tao cut the thread.

The anterior tibial artery is a medium-sized artery.

When the artery is relatively large, the difficulty of suturing is actually reduced, unless it is a large artery like the aorta, in which case the difficulty of suturing will increase again.

Fang Ziye can ensure no leakage and a very high vascular patency rate even in the extremely difficult rat tail artery reconnection suture procedure. He can also easily handle such ordinary medium-sized arterial partial injuries.

After Xue Tao released the clamps, he looked at the surgical field again and saw that there was still no bleeding, so he was relieved: "Then we can basically declare this operation over."

Fang Ziye's manual reduction technique is used haphazardly and indiscriminately when dealing with fractures.

Some fractures cannot be treated with closed reduction and external fixation with plaster casts, not because the surgeon is incapable of reduction, but because the fixation effect cannot be achieved.

Reduction and fixation are the principles of fracture treatment.

Therefore, during open reset, temporary fixation with Kirschner wires is added.

"Bring a Kirschner wire drill." After saying that, Xue Tao didn't even look at how Fang Ziye was resetting the device, and immediately prepared his next move.

Fang Ziye did not disappoint Xue Tao. After seeing the shape of the fracture directly, and with the patient under anesthesia, there was no need to worry about pain.

After traction and a few movements, the fracture line closed tightly and became almost undetectable.

The scrub nurse was a little slow in handing over the drill with Kirschner wires.

But it's harmless.

After the temporary fixation was completed, Xue Tao, just to be on the safe side, asked the circulating nurse to help push the C-arm machine to perform an intraoperative fluoroscopy, just to ensure everything went smoothly.

If the fixation and repositioning are done well, he can also, like Professor Deng Yong and Professor Duan Hong, say to the 'uncle' outside, "You can take this patient away. As long as the wound doesn't get wet, he can get out of bed and walk tomorrow with crutches."

Xue Tao has the confidence to fix and reset things well.

This time, it was a truly satisfying surgery.

Don't even think about staying in the hospital. Although these people are just small fry in the medical device company, they are definitely not important figures.

But once you've participated, you have to accept the consequences and face legal sanctions as soon as possible, instead of trying to delay or evade them.

The subsequent operations were even less difficult.

After temporary fixation, the steel plate screws are used for secondary direct fixation, which can be described as a tight binding.

Xue Tao even tried to loosen the patient's fractured bone fragments by fiddling with them, just like Professor Deng Yong had done, but there was no sign of them loosening!
"It's already reached the best possible point."

"Sew it up!~"

“Circuit nurse, could you go to the entrance and talk to Officer Zhao there? Should we send this patient directly to the ward, or should he take him to the detention center or something…” As the surgery was about to end, Xue Tao turned around and said confidently to the circulating nurse.

"Okay." The circulating nurse nodded immediately and jogged out the door. At the same time, the anesthesiologist stood up and asked, "Can I wake up from anesthesia now? I'll wake up when the surgery is almost over."

“Okay, teacher, it should only take about ten minutes. Please assess the depth of anesthesia and the extubation time,” Xue Tao said.

The patient needs to be transferred out, and the anesthesia will definitely wear off.

Upon hearing this, the anesthesiologist said, "It's alright. You all said this surgery would be quick, so I didn't even intubate him. He'll wake up in a little while."

……

Fang Ziye and Xue Tao worked very quickly on the suturing. They finished the suturing and bandaging procedures in no time.

After the patient regained consciousness, he had virtually no chance to resist and was personally escorted by Xue Tao to the door of the operating room, where he met with Officer Zhao outside.

Looking at the cast and gauze on the patient's foot, it was clear that he had undergone surgery. So I asked, "Dr. Xue, are you sure that the surgery was just finished and the patient can be transferred out?"

"Is no additional treatment needed after the surgery?"

He's not a doctor, he doesn't understand at all, he thinks that after surgery, you always have to stay in the hospital for observation for a period of time.

"There's a medical room in the detention center, right? As long as we can get regular IV drips and dressing changes done, there shouldn't be any problems," Xue Tao replied confidently.

Upon hearing this, the patient's family member said, "Hey, how can you talk like that, doctor? What if we get infected?"

"Didn't you say it was just in case? In his case, he won't need antibiotics for long after the surgery, maybe only once or twice at most."

“It doesn’t matter where you use it. Our hospital’s surgeons are actually not as good at prescribing medication as the doctors in the detention center. They mainly provide surgical techniques,” Xue Tao told the patient’s family.

"You can't do this, you... this?"

"To have surgery and then go straight to detention—that's inhumane!"

“There are beds in the medical room inside the detention center, and you can visit them without any problems…” Officer Zhao saw that even the usually cautious Xue Tao was saying this now, so he understood what Xue Tao meant.

Without hesitation, they took the patient and transferred them away.

Detention centers are different from prisons. Prisons have hospitals, while detention centers only have medical rooms. Although there are beds, the medical equipment inside is actually very rudimentary.

Therefore, if Pang Hong had to be transferred immediately, he would have had to go to the hospital, because Pang Hong's injury was more serious and was an open fracture, which would have taken longer to heal.

Otherwise, what's the point of bringing back a corpse or an infected person and putting them in a detention center?

However, if the patient does not have an open fracture, then they can be sent to the detention center.

Unless absolutely necessary, suspects will not be allowed to roam outside!
Xue Tao personally went over to complete the handover.

Although the patient's family members were making a scene outside, the police were already waiting outside and wouldn't allow them to get close.

Even if the patient's family members hurl insults, or even bring in the patient's child to engage in moral blackmail, such moral blackmail is meaningless when it violates the law.

……

Fang Ziye did not go with Xue Tao, mainly because Fang Ziye's current status is that of a student, while Xue Tao is a doctor in the hospital and an associate chief physician. Their positions and representation are completely different.

So, after Fang Ziye finished suturing, he finally had some free time and came to Huang Kai's operating room.

Inside the operating room, a large crowd gathered, with many onlookers, but most of them sat close to the wall.

These people are not young; they are all in their forties or approaching fifty. They are likely the directors or at least deputy directors of their respective departments, including both internal medicine and surgery.

For example, the director of the ICU, Huang Qiaoshan, the director of the Department of Anesthesiology, and Professor Feng from the Department of Anesthesiology at Peking Union Medical College Hospital were discussing Huang Kai's current vital signs.

"At present, his life is safe and there should be no immediate risk, but it still depends on the progress of the surgery. It seems that the vascular surgery and general surgery departments are not progressing smoothly," Professor Feng said.

The operating table was surrounded by people, at least a dozen, leaving no room for anyone to observe.

However, the head of the hospital, where the anesthesiology department is located, is an absolute no-man's land. Only the anesthesiology department staff can guard this place, acting as guardians of the patients' lives during surgery.

No matter how limited the space is, without anesthesia care, who would dare to perform surgery?

If vital signs are poor, even the best surgery is meaningless.

So, Fang Ziye still didn't see Huang Kai. He only saw two cold, brightly lit operating lights above his head, which the surgeon on stage instructed the people below to move around!
After hearing from the professor in the anesthesiology department that Huang Kai's vital signs were currently fine, Fang Ziye slowly moved towards the direction of the lower limbs, because that was the area of ​​orthopedics.

You can't perform general surgery standing at someone's feet.

Only when you get closer can you hear that some people on the stage are holding their breath, as if they are performing some crucial operation!
About half a minute later.

Fang Ziye heard a familiar voice calling for a halt: "Stop!!!"

"No way!"

“Master, Professor Duan, it’s still not working. My current control over power is only at the level of using techniques to leverage force, and I haven’t reached the level of Dr. Chen’s meticulous control.”

"This pelvic rotation problem will probably require the help of Dr. Chen." Wu Xuanqi said, panting heavily, his legs trembling slightly. He was clearly exhausted from exerting himself so much just now.

Director Hongdu didn't go to the operating table, but dressed in his clothes, he went to the sterile area at the foot of the operating table and replied in a deep voice, "Dr. Chen said he was going to clean house, after all, this matter involves his son."

"Under such circumstances, asking him to save people instead of dealing with his own son's problems is indeed asking too much."

"If it's not easy to handle, then we can take Professor Duan's advice and just cut off the internal pudendal artery and the vesicocele."

"Even if you lose the function of your genitals and bladder after the surgery, it's still better than losing your life." After saying this, Hong Du looked in the direction of Duan Hong and Professor Deng Yong.

Immediately afterwards, Fang Ziye heard his teacher's voice again.

"At this point, the fractured pelvis has severed two arteries, causing local compression. It's not enough to just forcefully reduce it."

"Excessive force can easily lead to secondary fractures in other parts of the body or damage to other arteries."

"This is the most difficult barrier to overcome in ultra-complex pelvic osteotomy and reconstruction surgery."

"But if there's really no other way, we can only follow our old methods and cut what needs to be cut."

"To save my life..."

At this moment, Professor Duan Hong of Tongji Hospital, who is also Wu Xuanqi's teacher, looked at Deng Yong and asked with some confusion, "Professor Deng, didn't you say that you have made some new breakthroughs in manual reduction techniques? Isn't this the direction?"

"What I did was redefine the classification of fractures, not raise the level of the manual reduction procedure itself. One is cognitive theory, and the other is practical operation, the subtle control of force."

"How can these be the same?" Upon hearing this, Deng Yong's forehead darkened slightly.

There's nothing he can do. His own student is the one who's been framed. No matter how heavy or dark the blame is, as long as it doesn't affect his reputation but rather proves his excellence, he has no choice but to bear it.

No matter how heavy it is, I have to carry it.

"I thought you could do it," Duan Hong said, not in a sarcastic tone, but with a hint of regret.

"Can we find anyone else?" Duan Hong asked his student Wu Xuanqi.

"Actually, there is another person who could come, but it would definitely be even more difficult for him than for Professor Chen. He is Dr. Chen's son. In fact, Dr. Chen's son, when he was in his thirties, had already achieved a level of expertise in traditional Chinese medicine that was equivalent to Dr. Chen's when he was in his fifties."

"But Teacher Chen prefers the entrepreneurial path. Apart from the two teachers, maybe I..."

"Forget it, I'm not going to say anymore." Wu Xuanqi stopped bragging to himself and giving the people on stage any more hope.

"Then we'll have to cut it off." Duan Hong quickly prepared a way out for his student.

Just then, Fang Ziye overheard the gist of the conversation in the crowd, placed his hands tightly in front of his abdomen, and carefully looked at the progress bar of his manual repositioning, as well as the remaining 1200 knowledge points he had just earned.

Remembering what Wu Xuanqi had said, he said, "Professor Duan, Master, shall I give it a try?"

"It will only waste a minute at most and won't affect the overall progress of the surgery," Fang Ziye said, volunteering his services.

(End of this chapter)