top student at medical school

Chapter 306 Bo Er Te (Please Subscribe)
Fang Ziye did see a patient with a right foot rupture in the emergency department, but he thought it was just a common right foot rupture.

Damage is not clearly defined in textbooks!

In clinical practice, the diagnosis refers to severe limb trauma with extensive damage to major blood vessels, nerves, and soft tissues, making repair or replantation of the severed limb impossible.

Therefore, the current guidelines recommend amputation, also known as limb severance, as the preferred treatment.

Of course, not all the patients with severe injuries that Fang Ziye encountered ended in amputation, but the only exception was Master Kai, Huang Kai.

Fang Ziye did play a significant role in Huang Kai's limb-sparing surgery for severe injuries; however, even having undergone limb-sparing surgery for similar conditions, Fang Ziye still dared not attempt limb-sparing treatment on his own.

At that time, Professor Duan Hong and his teacher Professor Deng Yong said that for 'end-stage' diseases like traumatic injury, without the cooperation of several skilled surgeons, one should not even think about performing limb-sparing surgery.

After receiving Yuan Weihong's call, Fang Ziye quickly tore up his usual "Informed Consent Form for Limb Amputation Surgery" and then spent more than twenty minutes drafting a new one.

This time, the injured patient must have come prepared.

At least one of the three professors knew about his condition and situation in advance, and then contacted the other two professors. After confirming that everyone was available, they deliberately transferred him to the nearest Zhongnan Hospital.

Fang Ziye happened to become the chief resident who treated him.

If he had been closer to Tongji or Union Hospital, this whole affair might have been completely unrelated to Fang Ziye...

The right lower limb was severely injured, with the damage occurring only at the knee joint.

The risk of hemorrhagic shock is not high at the moment, which is why there has been ample time for referral. Three professors are currently in the department discussing the timing of the planned limb-sparing surgery based on his condition.

Fang Ziye skillfully found the patient's family members, and before they could speak, he said, "I'm sorry, it took a while."

"But the reason is not that I deliberately delayed or for any other reason. It is that after I reported the situation of your husband and your son to my superiors, we discussed it carefully and decided to try to make a possibility for him."

After Fang Ziye's explanation silenced the other party's rebuttals and numerous questions, he took the initiative, deftly spreading out the two informed consent forms and handing one to each person.

"As we've discussed before, the patient's current condition is limb destruction, which is defined as a condition where limb salvage is not possible. This is the most widely recognized condition worldwide."

"Whether it's the treatment guidelines in our country or the amputation I previously recommended to you, even in developed countries like the United States, the only treatment for this type of disease is amputation."

"Of course, guidelines are guidelines for physicians to conduct general diagnosis and treatment activities. In principle, all physicians must conduct standardized diagnosis and treatment in accordance with the guidelines."

"But if everything were like that, medicine wouldn't be able to develop. Exploratory research is very important, which is why we surgeons try our best to give patients a chance, right..."

"We can't guarantee a complete success rate, but we will definitely try our best."

"Think about it, given your husband's current condition, the simplest and most convenient treatment, and the one that is universally recognized worldwide, is amputation."

"I can do it, and I can finish it in twenty minutes. It's reasonable and legal, but it's not humane!"

"If it were for convenience, there would be no need for the three professors and so many medical staff like us to go through all this trouble, right?"

"If you are expecting a 100% success rate in limb preservation, then I can assure you that this is absolutely impossible. The final result is very likely, and extremely likely, that limb preservation will fail and amputation will be necessary."

"And this process will cost you more, at least around 20,000 yuan more! That's the minimum."

"If we perform amputation directly..."

As a doctor, informing patients of the risks is one part of the process when discussing and obtaining consent from them. However, in China, informing them of the financial risks is an even more important part.

The domestic medical insurance system, or rather the commercial medical insurance system, may not be as comprehensive as that abroad. Therefore, patients with medical insurance may have to pay a high percentage of their expenses out of pocket.

The amount of money they have to pay out of pocket is likely the main factor influencing their treatment choices.

"Dr. Fang, we'll sign."

"Before we were transferred here, the doctors at our county hospital talked to us. If it weren't for that 'what if' situation, we definitely wouldn't have needed to come all the way to Wuhan for an amputation."

“The People’s Hospital of Bei District can also perform amputations.”

"But the director there said that the top experts from Zhongnan Hospital and Tongji Hospital have a joint collaboration and can help my husband get a chance. The surgeons are all top experts, right?" The woman who spoke was also a middle-aged woman.

Although her attire was somewhat disheveled, it still appeared quite refined, suggesting she was at least a white-collar worker.

Her husband probably also had a regular job, but while riding his electric scooter home from get off work, he had a "close" encounter with the tire of a bus, resulting in severe damage to his right lower limb. There was no further romantic involvement between them.

"Yes, that's right. The team that performed your husband's surgery this time is indeed quite strong."

"Professor Duan, Professor Qi, and Professor Deng from our hospital are currently among the top professors in trauma surgery in Hubei Province. Their theoretical and practical skills are at their peak."

"The older professors who may have better theoretical knowledge than them may not have as much physical strength as them, while those who have better physical strength may not be as good at theory and practice."

"This is the first time I've seen these three professors on the same stage, and even my teacher has never heard of it before." Fang Ziye did not deliberately elevate the three professors' status.

Because they are already awesome enough, they don't need any extra words to embellish them.

"I signed and paid the fees; there's also medical insurance."

"Doctor, you can give us relatively better treatments..." the woman replied confidently.

The insurance for buses is quite comprehensive.

The woman next to the middle-aged woman, who was also the patient's mother, didn't say a word or even look at the informed consent form. It was unclear whether she was illiterate or something else.

"Okay, you need to make up the difference in fees. We'll take a look before the surgery."

"But you should know that what we doctors are most interested in is the technical aspects, which involves spending more time designing and planning the proposed surgical procedure, rather than tracking your surgery costs."

"Sign here."

“Your husband must sign this power of attorney in his own handwriting. The rest of the ID number and other information can be signed by you on his behalf,” Fang Ziye said calmly.

In any case, the signature on the power of attorney must be the patient's own statement.

If you can sign, then sign; if you can put your fingerprint, then put your fingerprint.

If the patient is already in a coma or shock upon arrival at the hospital, then there is nothing that can be done.

All of the above are lessons learned the hard way...

After obtaining the necessary signatures, Fang Ziye reported the situation to Yuan Weihong.

On Yuan Weihong's side, the pre-defense team was canceled early on, and a super-luxurious assistant team was assembled in the shortest possible time. Yuan Weihong took the lead, with Qin Geluo as the general, followed by Luo Tingzhu, Wang Yuanqi and Gu Yi, several senior doctoral students. Yuan Weihong even included Dong Wenqiang, a doctoral student who was academically inclined but had strong practical skills, in the reserve team.

With the addition of Luo Tingzhu, the only "precious junior sister" in trauma surgery, this luxurious team of assistants was quickly assembled.

Fang Ziye was unaware of the specific surgical procedure and the order of the operation. In any case, after he reported it, Yuan Weihong's feedback was to send the patient to the operating room as soon as possible. Moreover, it was not the emergency operating room, but the operating room in the surgical building was opened as an emergency operating room.

This demonstrates the power of Professor Deng Yong, a senior professor, personally leading a team to perform emergency surgeries.

Even the nurses and anesthesiologists on duty in the operating room dare not be careless in the slightest, let alone curse or swear.

However, if a resident like Fang Ziye occasionally plans to perform emergency surgery in the emergency operating room, he will encounter complaints and grievances.

Even his own teacher, Yuan Weihong, only dared to ask his acquaintances to perform emergency surgeries in the operating room of the surgical building. If he were to ask the regular on-call anesthesiologists and nurses, he would definitely be criticized.

But that was before.

The gap between senior and non-senior professional titles can be bridged by having an Outstanding Young Scientist award.

Everything is ready.

After Fang Ziye entered the trauma surgery operating room, he immediately arranged for his fellow students to disinfect and drape the wounds.

Because of the patient's anesthesia, under Professor Deng Yong's intervention, the most skilled anesthesiologist in the department was invited. Even with the simultaneous use of spinal anesthesia and nerve tissue anesthesia, the entire procedure was completed in less than twenty minutes.

The disinfection and draping of damaged wounds is more complicated than that of ordinary wounds, but the general principles are similar.

Soon, Professor Deng Yong led Professor Duan Hong and Professor Qi Qiaowen, who were fully armed, into the room.

With professors from other departments present, Yuan Weihong and his assistants quickly stood close to the wall, keeping the vertical distance between the onlookers and the operating table within centimeters.

Professor Duan Hong's face was covered by a mask, and his casual hairstyle was hidden under a hat, but his chubby neck still drooped between the mask and his scrubs, as if it were a goiter.

He seems exceptionally easygoing, exuding a friendly aura.

Unlike Professor Duan Hong, Professor Qi Qiaowen is tall and thin with a broad frame, sharp eyes, and an air of seriousness.

“Gloves, size 7.5.” Qi Qiaowen, who is 1.85 meters tall, is not broad-shouldered, but his frame and serious tone make everyone’s heart tremble slightly.

Even in an unfamiliar operating room, a top professor's serious snort can exude an aura of authority that commands respect.

Yuan Weihong subconsciously clenched his gluteus maximus and gluteus medius muscles, making his standing posture even more standard, so as not to embarrass his hospital by being seen as undisciplined.

Fang Ziye has finalized the assistant positions, and Yuan Weihong and others are all proposed assistant positions.

Three professors, one leg, one hand-appointed chief resident assistant, and that's it.

Before Professor Deng Yong introduced him, Fang Ziye didn't dare to disregard the rules and call out to him.

The focus now is on emergency limb-sparing surgery, rather than on interpersonal relationships.

After confirming that the tourniquet and other equipment were in place, the group took their positions.

Duan Hong and Deng Yong stood facing each other like teammates, their positions marked by their knees.

That leaves only Professor Qi Qiaowen's team and Fang Ziye's team.

After that, it seemed there was still an empty seat on the other side of the operating table, so Professor Deng Yong said, "Yuan Weihong, you come up and make up the numbers, and learn how to clean the ankle and foot from Professor Qi."

Upon hearing Professor Deng Yong's words, Qi Qiaowen slightly turned his head, glanced in the direction of Yuan Weihong, and with a very serious look in his eyes, managed to squeeze out a joke: "The Brother Ye that Dong Dongsheng mentioned?"

This is a bit hard to understand at first glance.

Yuan Weihong's name doesn't contain the surname Ye, nor does it contain the character "Ye". So what's the background of this "Brother Ye"?
However, if you connect it to Yuan Weihong's official nickname, "One Leaf in the North Sea," you can understand the meaning.

Yuan Weihong dared not be presumptuous in front of Professor Deng Yong. When he stepped out of the operating room through the sensor door to wash his hands, he still turned back and said politely, "Professor Qi, my name is Xiao Yuan. You can also call me Xiao Wei or Xiao Ye."

Despite his politeness, he still maintained an air of arrogance.

If Professor Qi Qiaowen were familiar with the jokes, he would know that Yuan Weihong was expressing his love, and that he hadn't used such language for many years...

If the bigwig involved this time hadn't been truly powerful, he wouldn't have brought the Serena Williams meme back into the spotlight...

“Little Wei…?” Professor Duan Hong repeated from the side, also bringing along the sheet music that was once very famous.

Yuan Weihong had already slipped away, while Deng Yong blushed with embarrassment: "Professor Duan, Professor Qi, Yuan has always been unruly, please don't take it to heart."

"As usual, Professor Qi will be in charge of debridement, I will be in charge of probing blood vessels and nerves, and Professor Duan will be in charge of blood supply..."

Upon hearing this, Duan Hong raised his voice and asked, "Professor Deng doesn't have much contact with professors in hand surgery either?"

The sound of that voice seemed to be a form of revenge.

Upon hearing this, Professor Deng Yong first sighed, then looked in the direction of Fang Ziye: "Well, things were alright before, but we had a fight last year."

"To insist that our trauma surgery students have an exceptional talent for hand surgery is utter nonsense."

Upon hearing this, Fang Ziye looked up sharply and realized that his trip to the hand surgery training room to show off might not have ended as easily as he had imagined.

Professor Deng Yong did not mention a word about these matters.

Compared to his teacher Yuan Weihong, his expressions of emotion were much less frequent and less noticeable, but in reality, he was present at all, wasn't he...?

"Do you know debridement? It's a basic skill in trauma surgery." Qi Qiaowen started working directly and asked Fang Ziye in a calm tone.

"I know a little, Teacher Qi." Fang Ziye glanced at his wound cleaning skill, [Wound Cleaning Skill Level 3 234/500], which wasn't low in level or proficiency.

Qi Qiaowen immediately became interested upon hearing this and said, "Oh, you know a little bit? If you know a little bit, let's do it together."

It's next door!
Professor Deng Yong quickly explained, "Professor Qi, Xiao Fang is younger than Xiao Yuan and hasn't officially started working yet. He might not have understood what you meant."

Qi Qiaowen tilted his head slightly and made a rather unfunny joke: "Bo Erte can't understand what I mean?"

Yuan Weihong and Fang Ziye were known as the "Two Special Agents," and Fang Ziye was also known as "Little Fang Special Agent."

But later, because Fang Ziye's identity was so outrageous, to describe how fast Fang Ziye ran, the name was changed to a homophone for "Bo Er Te" (meaning "bo er te").

(End of this chapter)