top student at medical school

Chapter 203 So you weren't just bragging? (Please subscribe)
Fang Ziye ran into the bathroom, grabbed a lot of tissues, and used them to wash the bloodstains on his face, without wiping them off.

It's not that we dislike the patient's blood because it's dirty, but because it affects vision and facial expressions. Similarly, this mask is also unusable.

After rinsing several times, Fang Ziye began to wash it, then wiped it clean with a paper towel. He then looked at himself in the mirror.

The young man inside looked somewhat tired, and his eyes also revealed a sense of growth.

Fang Ziye didn't have time to think about anything else. Before coming to Enshi, he had gained a deeper understanding of the instructions his master, Professor Deng Yong, had given him.

In summary, the world is vast, with both prosperity and complexity. The real world is not just the ivory tower we are currently exposed to. The student stage only provides a pure side under the relative protection of teachers and schools.

The lure of money; once you're in the game, you're often caught in a web of temptations...

Sometimes, it's difficult to judge the right or wrong of certain things and people based on appearances alone.

Some things that happen in real life are even more fantastical than those depicted in TV dramas and movies.

Upon further reflection, Fang Ziye looked up at the ceiling.

The sentiments expressed by Professors Deng Yong and Duan Hong are not entirely without merit.

In China, doctors do not have a high social status, and it is very difficult to become a true doctor, unless...

But that step was still a bit too far, and Fang Ziye didn't intend to take it to heart.

These past few days have been filled with many events and people, with significant reversals and disappointments. In many aspects, Fang Ziye has been unable to see or understand clearly.

But perhaps it's a blessing that I'm so oblivious and don't understand.

Do your best, help out if you can, do whatever you can, do your best to make a difference—that's all you can do right now.

Fang Ziye went down to the operating room entrance again, asked the operating room administrator for a new set of scrubs, a cap, and a mask, and put them on again before returning to the handwashing station at the operating room entrance to wash and disinfect his hands again.

This was Fang Ziye's fifth handwashing in a short period of time. The hand sanitizer stung his skin slightly, but the principle of aseptic technique had to be strictly followed. He had to wash and disinfect his hands before going on stage, otherwise it would be devastating for the patient.

After putting on a sterile surgical gown and two layers of sterile surgical gloves again, Fang Ziye once again seized every opportunity to go to Professor Deng Yong's side.

The person who made way for Fang Ziye was Director Fu Qianjin of Minzu University Hospital.

He took a few steps back before saying, "Professor Deng, Professor Duan, we have enough staff here, and there's not much I can do to help. I have some things to do at the hospital, so I'll head back now!"

"Thank you both for your hard work."

Fu Qianjin is the director of the Department of Trauma Surgery at Minzu University Hospital. If there's something going on at the hospital, he'll definitely have to rush back.

However, Fu Qianjin's explanation was met with a simple thank you from Director Zhang Mingcan of Enshi Central Hospital. Both Deng Yong and Duan Hong were carefully searching for bone fragments within the mass of flesh and blood in the pelvis and had no time to pay attention to the matter.

At the same time, even Dr. Wu Xuanqi from Minzu University Hospital was carefully performing some actions to pry open the bony compression, which is actually a flexible application of manual reduction in comminuted fracture compression.

Common fractures are usually typical and relatively regular, and can be described and classified. Even if they are complex, they are just localized comminuted fractures.

However, Huang Kai's fracture was caused by a fall from a height, resulting in a destructive fracture of half of his lower limb and soft tissue damage. Fragments of the femur could even be seen in his pelvis.

It's no exaggeration to say that they are as close as blood and flesh.

Director Zhang Mingcan simply thanked Director Fu Qianjin and then returned to the area around his lower legs and knees to meticulously perform debridement.

However, Huang Kai's lower legs and knees are now only conceptually connected, with skin and flesh still attached, the bones long gone, and the blood vessels and nerves in a complete mess.

Therefore, how to handle the aftermath of this surgery remains a complete mess.

Even the most basic debridement stage hasn't been completed yet.

After Fang Ziye approached the operating table, Professor Deng Yong instructed him to count the bone fragments that had been pulled out of the flesh and place them in a square tray, mixed together.

"Try to sort these bones."

"Currently, we can only classify them according to long bones and irregular bones, and then determine how much bone tissue will be retained," Deng Yong said.

“Okay, Master!” Fang Ziye turned around and went to the sterile instrument table where the scrub nurse was.

Just like in emergency care, all actions should be taken under command. Finding your place and doing your assigned task well is the greatest help you can give, rather than just showing off your prowess on the operating table.

Fang Ziye only glanced at it briefly, but he could roughly tell that the bone fragments on the tray came from many different sources.

It includes the ilium, ischium, sacrum, and coccyx.

There are definitely also irregular bones in the femur, tibia and fibula, and ankle, scattered and arranged without any pattern.

What Fang Ziye needs to do now is to sort these fracture fragments according to the most basic systemic anatomical classification, such as long bones and flat bones.

This is not a routine procedure for fracture treatment, but it is absolutely necessary to do so given Huang Kai's current condition.

There is no special skill involved in picking bones; it depends on one's basic skills and understanding of bone shape and type.

The easiest thing to distinguish is the sacrum and the coccyx.

Because of its unique shape, which resembles the structure of oracle bone script with holes, it retains its basic shape even after being broken.

Fang Ziye carefully picked out each of the bone fragments and placed them on another square tray.

In the operating room, there were five or six scrub nurses and numerous trays containing various tissues. There were also empty and extra trays, so Fang Ziye had enough space to sort them.

Then come the long bones.

Long bones are relatively easy to find. If you don't distinguish whether it is a femur or a tibia and fibula, then as long as you see a medullary cavity, you can treat it as a long bone.

Fang Ziye also finished distinguishing them in a short time.

Then there are flat bones like the ilium and ischium, as well as irregular bones like the tarsal and metatarsal bones of the foot.

This is a bit embarrassing.

The foot has many bones, all of which are comminuted fractures, losing their original shape and making them very difficult to distinguish from flat bones that have been comminuted.

If it were a month ago, Fang Ziye would probably have thrown away what he was holding immediately if asked to do this.

However, Fang Ziye had a junior brother named Lan Tianluo. When Lan Tianluo was doing pure data modeling for manual reduction and new fracture classification, he collected a lot of detailed data about bones.

This includes its shape classification, size, length, width, height, axis, and other basic measurement data, which are some of the most fundamental data in the field of basic anatomy.

It has virtually no clinical application, because during surgery, once you expose it, its size and shape are fixed.

In the process of modeling closed reduction of fractures, if you do not have enough real patients as a data source, and you also need to differentiate the magnitude of force on the fracture, you can only perform modeling and analysis based on these basic data.

Normally, teachers of basic anatomy wouldn't do something like this, but Lan Tianluo did, and Fang Ziye, as the initiator, also looked at it very carefully and even memorized a lot about these basic data.

Although he didn't develop any new skills, such as basic anatomy (new) or bone anatomy (new), Fang Ziye still had some impression of these things.

This is a very pure and basic skill.

For example, the metatarsals are long bones, consisting of five bones, numbered 1 to 5 from the inside out. Their shape and arrangement are roughly the same as the metacarpals, but they are thicker and larger.

The base of the talus forms the base, which connects to the tarsal bones; the middle section is the body; and the distal end, called the head, connects to the base of the proximal phalanx. Each metatarsal bone can be divided into three parts: base, body, and head…

This is something many orthopedic surgeons memorize and master, because only in this way can you identify them.

The foot also includes tarsal bones, phalanges, etc.

However, most orthopedic surgeons focus on the angle between the bones, rather than their size or diameter, since the size varies from person to person.

However, his junior brother had paid attention to this matter and even compiled some statistics. If Fang Ziye remembered correctly, Lan Tianluo used a certain fixed ratio for the diameters of the femur, tibia, fibula, and phalanges in adult males when calculating the diameter ratios. Therefore, distinguishing between the phalanges and smaller long bones like the fibula would be easier under such circumstances.

Moreover, even for irregular fractures of the femur and tibia, as long as there is a rounded surface, its size can be determined.

"Take down the measuring rod!" Fang Ziye thought of this and asked the scrub nurse.

There are usually no rulers on the operating table.

However, in orthopedics, especially during fracture surgery, it is necessary to measure the length of the screws.

In addition to the screw's own model number, there is usually a vernier caliper and a depth gauge for the screw channel.

"Vernier caliper? Here you go!" Although the scrub nurse was puzzled, she was an orthopedic specialist nurse and knew what Fang Ziye wanted. It was precisely because she was a professional specialist nurse that she knew what Fang Ziye wanted.

Knowing that we are far from reaching that point, we don't know what Fang Ziye is planning to do.

Even though she had doubts, she didn't dare to show off her extensive experience at this moment!

During routine surgeries, they can chat and laugh, crack jokes, and boast about their skills. They can handle the work of a regular scrub nurse and circulating nurse, and even tease new doctors. But when it comes to a real emergency...

Even if it's a resident training program, if you ask them for something in a special situation, you should give it to them. The division of tasks must be clear; this is the most basic quality.

Fang Ziye wasn't on the operating table, so no one paid any attention to what he was doing.

The fact that no one is paying attention doesn't mean Fang Ziye will stop. On the contrary, Fang Ziye will do his job even better.

First, the fracture fragments are classified into general categories, and then their proximal and distal ends are distinguished.

Ideally, the fractures should be able to be properly pieced together to distinguish between the proximal and distal ends. Otherwise, it will be necessary to measure the ratio of the medullary cavity to the bone diameter.

This proportion varies across the entire lower limb and is one of the indicators for assessing the quality of fracture reduction.

Fang Ziye is not particularly talented, but he is not incompetent, so he doesn't limit his thinking when applying his skills flexibly.

Fang Ziye worked silently.

Just as he was about to sort and clean all the removed bone fragments, he quietly sat down by the sterile instrument table, waiting for the newly removed bone to be divided into different trays.

After the scrub nurse finished reading, she swallowed a few times, looked at Fang Ziye, and asked in a low voice, "If you have this ability, go play with building blocks with little kids, and you'll probably make an entire kindergarten cry."

She joked, not daring to speak loudly, only in the lowest possible voice, as she spoke to Fang Ziye.

Fang Ziye raised his head slightly without being polite: "Thank you for the compliment."

"Can you break it open? Do you need Ziye to do it?" Just then, Professor Duan Hong suddenly asked Wu Xuanqi, who was operating the machine.

"Go ahead and call out, I feel a bit unstable. The bone fragments below are uneven, and it's difficult to assess the amount of force." On the operating table, Wu Xuanqi was doing the same bone-breaking work that Fang Ziye had previously performed during debridement.

Upon hearing this, before the chubby Duan Hong could even call out, Deng Yong, after a man in green voluntarily moved aside, turned to Fang Ziye and said, "Ziye, go!"

Before Deng Yong could finish speaking, he turned around abruptly and saw the items on the tray in front of Fang Ziye.

The sound stopped immediately.

Then, he blurted out a truly heartfelt exclamation of traditional Chinese culture: "Holy crap!!"

He spoke from the heart, and although his voice was very low, it was still caught by the person in green next to him.

Fang Ziye was assigned to classify the bone fragments, as everyone knew, but most of the attention was on the operating table, and even blinking felt like a waste of time.

The sterile instrument tables were all behind them and behind their buttocks, and the eye in their buttocks couldn't possibly have a field of vision. Apart from the scrub nurse, no one noticed what Fang Ziye was doing.

Even the scrub nurses didn't dare to joke or speak loudly in such a setting; they could only appreciate it to themselves and then secretly joke with Fang Ziye.

Therefore, upon hearing Professor Deng Yong's exclamation of "Holy crap!", the group turned around and immediately realized that the situation was hopeless, with no solution in sight.

"Master!" Fang Ziye stood up calmly, clasped his hands in front of his chest, and walked towards the operating table.

Hearing Professor Duan Hong's inquiry and invitation, he naturally didn't put on airs.

"Come here for a second!" Professor Deng Yong is no longer a child.

When faced with an unexpected situation, he just muttered "Damn it!" and that was it; he quickly suppressed it, showing remarkable mental fortitude.

Then, Zhang Mingcan, who was next to Professor Deng Yong, moved aside.

Zhang Mingcan learned that the debridement and bone removal in the pelvic area, which was being performed jointly by Wu Xuanqi, Professor Deng Yong, and himself, had encountered another problem.

The brief opening allowed him to turn around and look at the sterile instrument table, where he was genuinely startled, his scalp tingling with a jolt.

Is this the level of expertise of PhDs at Zhongnan Hospital? Are Professor Deng Yong and his colleagues really on the verge of becoming gods?

Fang Ziye was able to distinguish these messy bone fragments, even differentiating between the proximal and distal ends, and even reassemble them to resemble the original bone structure.

This is simply too shocking.

Even a broken mirror is difficult to mend.

A mirror is only a relatively planar structure; a shattered fracture, on the other hand, is a cubic structure!
Professor Duan Hong and Wu Xuanqi weren't curious about who Professor Deng Yong had tricked earlier; they were simply waiting for Fang Ziye to use his extraordinary repositioning technique to perfectly remove yet another wedge-shaped 'bone knife' fragment.

He breathed a sigh of relief, surveyed the surgical field, and found that the removal of the bone fragments could finally be completed. He then asked, "Deng Yong, who do you want to fuck?"

Fang Ziye was slowly releasing the pressure, letting go of Huang Kai's only remaining two bones connected to his own muscles, the ischium and ilium, which did not need to be removed. Then, he silently took the hook from Professor Deng Yong's hand and freed Deng Yong.

At that moment, Deng Yong took a deep breath and had no time to pay attention to Duan Hong's words.

Instead, he quickly pressed Fang Ziye for an answer: "So, what you told Professor Li Guohua before, that giving you more clinical practice opportunities would lead to greater improvement than just practicing in the training room, wasn't just you bragging, but the truth?"

Boasting and showcasing one's abilities and qualifications is a form of negotiation.

Everyone, including Professor Li Guohua, thought that Fang Ziye was just trying to promote himself, and they didn't want him to actually improve rapidly after going to the countryside, just as he claimed.

As long as you can make normal progress and complete your grassroots work experience ahead of schedule, you can quickly be promoted to a higher professional title later.

After all, Fang Ziye's progress was already fast enough. It shouldn't be any faster, or it would be completely unacceptable.

Fang Ziye's previous rate of progress was, at least, hard to accept.

Fang Ziye remained silent, but he understood what his master meant and nodded slightly: "Master, there must be some exaggeration involved."

"However, the improved understanding of bone structure was inspired by Senior Brother Wu Xuanqi, and then by my junior brother who collected the data and conducted the modeling!"

"After all, in the basic principles and biomechanical analysis of reclassifying fractures and matching them with different manual reduction techniques, the shape and properties of the bone itself are very important data. I just selected some important data and used it for splicing."

After listening to Fang Ziye's words, Duan Hong handed the hook and suction device in his hand to Wu Xuanqi, and then placed the bone forceps on the curved plate.

With his hands clasped tightly in front of his chest, he took a few steps back, dragging his plump body, and made a special trip to the sterile operating table. After seeing the contents of the tray and the assembled bone pieces, he fell silent on the spot.

Five seconds later, he tilted his head with a complicated expression and asked, "Deng Yong, how about letting Ziye come here and brag? I can allow him to brag."

"Go to hell with your dam!" Deng Yong burst out with profanity almost instantly.

Can this prescription still be delivered to you?

Even if Fang Ziye is bragging, he still loves it. If he's not bragging, how could you take it away? I'm not dead yet!

"It's better not to brag. Let's be honest people ourselves." Deng Yong whispered to Fang Ziye, then had Fang Ziye stand beside him and began cleaning and tending to the muscles inside the wound.

(End of this chapter)