top student at medical school

Chapter 323 Superior's Identity (First Update, Please Subscribe)
After the shift handover, it's time for ward rounds, and the pace and process of ward rounds are pretty much the same.

Fang Ziye, who is both a PhD and the chief resident, was conscripted by Professor Deng Yong for the first time.

"Xiao Fang, could you tell me about the current research progress and challenges in the treatment of destructive injuries?" Deng Yong gestured with his index finger for Gu Yi and Yan Zhiming to spread out a bit to make room for Fang Ziye.

The bed where the ward round was held was that of a patient with a severe ankle injury whom Professor Deng Yong, Professor Qi, and Professor Duan Hong had previously worked together to secure.

Currently, the patient's treatment outcome is not optimistic.

It can only be said that blood circulation in the lower limbs has been temporarily restored, so there is a certain possibility of healing.

Fang Ziye narrowed his eyes, and after thinking calmly for a good ten seconds, he said, "Master, there are three main difficulties in treating destructive injuries. Actually, there are two main points."

"Firstly, it is difficult to clean the wound; according to the understanding of debridement, all the damaged tissue should be removed, and amputation is the safest treatment option. There is a paradox between limb preservation and the degree of damage caused by destructive injury."

"Secondly, the difficulty lies in blood supply reconstruction. Damage is not simply damage to tissues such as muscles, fat, and skin, but rather the destruction and collapse of all tissues in all layers."

"Without blood supply, it's like a person without food, or life without water."

"Thirdly, there is a high risk of postoperative infection. For example, this patient's infection is due to a combination of the two factors mentioned above."

"In principle, if the wound should have been cleaned and preserved for limb-sparing surgery, the chance of infection will increase and local soft tissue necrosis may occur, and the necrotic area may become colonized and infected by bacteria."

"Furthermore, even after intravenous injection of antibiotics, while the overall blood concentration is sufficient, poor local blood supply can prevent the medication from reaching the target area, thus failing to achieve preventative and therapeutic effects..."

"How to make further breakthroughs in these areas is the main direction to consider to get out of the current predicament... However, research progress is very little at present..." Fang Ziye mainly focused on analyzing the current predicament.

As for research progress, there has been almost no progress so far, which has led to a very, very low limb salvage rate for traumatic injuries. There are currently no systematic case studies reported.

It's not that no one has explored or researched this issue, but rather that the results of such research and exploration are so unsightly that they are difficult to publish.

Everyone knows that the amputation rate is close to 100%, so it would be shameless to spend time and effort writing articles to prove that the amputation rate is close to 100%.

"Yes, did you hear that? This patient and his family."

“We discussed this issue with you in detail before the surgery. You went to several hospitals before finally coming to me.”

"However, don't underestimate the scope of your illness; the difficulty in treating it is far greater than theirs."

"Even with the help of two other professors from Tongji and Union Hospitals, the treatment is still progressing slowly, and infections have still occurred, which is beyond human prevention."

“If problems arise, we will deal with them slowly, so please don’t be anxious…” Professor Deng Yong patiently explained to the patients and their families.

In fact, the patients and their families had a lot to say at that moment, but Professor Deng Yong had just the right moment to cut them off.

It is a fact that he was referred to multiple hospitals, and it is also a fact that he sought treatment at Zhongnan Hospital and insisted on limb preservation after several rounds of discussions. It is also a fact that Deng Yong invited Professor Duan from Tongji Hospital and Professor Qi Qiaowen from Union Hospital to perform the surgery together.

However, it is not something that can be prevented by human intervention, and they do not know if it is true or not.

The patient whispered, "The surgery is all done, how could there be an infection? No one else is infected."

The infection rate in the ward was indeed low, which made him feel down.

If you get infected, it's like your leg is on the verge of being lost...

"You're talking nonsense. Infection after surgery is a very common complication. It's not just happening in our department, our ward, or our hospital."

"This is a phenomenon that can occur anywhere in the world, in any surgical ward, and has occurred in every case."

"What's more, your situation is even more special. It's a serious injury, and in principle, amputation is the necessary procedure," Deng Yong explained.

Without wasting any more time, I said: "Please have a consultation with a pharmacist for this patient. There is currently oozing from the wound. Send a sample of the oozing for bacterial culture and drug sensitivity testing. Continue to change the dressing daily and continue with a combination of empirical intravenous antibiotics and topical antibiotics."

"If the infection does not improve after a period of observation, then another debridement procedure may be necessary. If the infection still cannot be controlled after the debridement procedure, then the leg cannot be saved any longer."

Deng Yong's words were very decisive and ruthless.

Upon hearing Deng Yong say this, the patient and his family immediately panicked.

"Professor Deng, you must think of a lot of ways to help us..." The two looked anxious.

"Aren't we trying to find a solution?" Deng Yong smiled casually and led the group away again.

Fang Ziye and the others secretly kept this scene in mind. When communicating with patients, simply being patient and yielding is not very effective; occasionally taking a firmer stance can facilitate better medical communication.

……

The other hospitalized patients are in relatively stable condition. Although there are occasional infections, the consequences of these infections are not as severe as those of the patient with the devastating injury.

"Yuan Weihong, Qin Geluo, Fang Ziye, come with me to the office. We need to carefully review the treatment plan for this patient after the trauma surgery." Deng Yong said, touching the mole on his lower right chin as he walked.

Clearly, although Professor Deng Yong said in the ward that the worst that could happen was amputation, the worst that could happen was amputation.

However, as the first clinical patient to undergo limb salvage surgery for severe injuries at Zhongnan Hospital, no matter how hard we try, we cannot easily move towards the final stage of the clinical trial (amputation)!

Fang Ziye was stunned for a moment, then immediately nodded.

As a resident and doctoral student, I have finally managed to get a foothold in the hospital's intelligent center.

Now that I'm part of this hospital and in this department, I can at least make up the numbers when we encounter difficult or complicated cases.

In the past, these small meetings were always held privately by Deng Yong, Xie Jinyuan, Qin Geluo, Li Nuo, Yuan Weihong, and others. It was impossible for him to bring a student like Fang Ziye along.

Being invited in means you've crossed a threshold.

Fang Ziye was suddenly called out, and other PhDs such as Luo Tingzhu were also caught off guard.

Even though Luo Tingzhu was Fang Ziye's girlfriend, she was still quite unaccustomed to hearing that Professor Deng Yong had taken Fang Ziye away from the group of doctoral students when he encountered a difficult case.

Wang Yuanqi and others found it even more difficult to get used to.

When Luo Tingzhu first started her doctoral studies, she had a fairly good relationship with Fang Ziye. However, when Fang Ziye enrolled in the doctoral program, everyone felt a little less involved, and then half a year passed.

Before anyone had a chance to participate in Fang Ziye's graduation, and in their mental preparations, Fang Ziye was still considered a junior. But unexpectedly, in the blink of an eye, he became a 'mutant superior'!
Professor Deng Yong left as soon as he finished speaking, without considering the feelings of the students.

If we have to find ways to balance things out of reluctance, then Deng Yong is more suited to be the director of the Empathy Department than the administrative director of the Trauma Surgery Department. "Then you two go ahead and get busy. Shu Lang, Jie Han, you two remember to take good care of the interns. Give them a couple more opportunities to change their dressings." Fang Ziye casually gave these instructions before turning around and following Qin Geluo.

Behind Fang Ziye, the group of people once again had different thoughts.

……

Fang Ziye was in the office and was not forced to express any sentiments or show off his prowess; he was just there to make up the numbers.

Of course, Fang Ziye was soon released because his chief inpatient consultation phone rang.

The reason Fang Ziye was called over by Deng Yong was because Fang Ziye's current role should be in the case discussion meeting, not because Fang Ziye was indispensable or because his personal ability was the highest in the group.

After leaving the director's office, Fang Ziye answered the phone: "Hello, okay! I'll be there in a bit, thanks bro."

Fang Ziye knew that these were people from the emergency surgery clinic who had reserved a few simple fracture patients for him.

There is a lot to learn about manual reduction techniques for fracture patients.

Adhering to the principle that even a small mosquito is still meat, Fang Ziye tries not to let any mosquito go unnoticed. If he really doesn't have time while on the operating table, Fang Ziye will send a message to the taxi drivers on duty in advance.

They were told to send the patient to another smaller hospital for surgery.

Of course, Fang Ziye also planned to consider whether there was anyone in the department who was suitable to learn manual reduction techniques. Following his previous relationship with "Jin Hongzhou," Fang Ziye would try to find similar patients for the department.

Other junior students can try the reset operation themselves, and check the reset indications. If they can also obtain knowledge points, then that will be a new way to obtain knowledge points.

Now, because Senior Brother Wu Xuanqi has left Enshi and is no longer close to TCM Doctor Chen, Fang Ziye's previous "topic" on new fracture classification and new applications of fracture reduction techniques is not as widely applicable in clinical practice.

The amount of knowledge one can gain each day is not very large.

After returning to China, Luo Tingzhu did not go to the laboratory every day. The large research group she had previously led had now disbanded, and Fang Ziye did not gain any additional knowledge points from observing the experimental results.

Therefore, the sources of knowledge are now very limited.

Every bit of knowledge is worth cherishing.

Fang Ziye then walked towards the emergency department.

Lan Tianluo happened to be leaving his office when he saw Fang Ziye coming out of the director's office. He greeted him, "Senior brother, perfect timing! I was just about to talk to you about something!"

"In the laboratory..."

Before Lan Tianluo could finish speaking, Fang Ziye interrupted, "I need to go to the emergency room to treat a fracture reduction. Do you have time to come with me?"

"If it's inconvenient, then let's discuss it in detail when we get back?"

"An urgent consultation? Then you go ahead, senior brother. What I need to say isn't particularly urgent." Lan Tianluo understood that Fang Ziye's current status required him to prioritize the urgent consultation. He was no longer the student who could relax as long as he did his job of managing the patients and conducting experiments.

"Not enough, still not enough. Far from enough..." Fang Ziye muttered to himself on the way to the emergency room.

[Current knowledge points balance: 6904.3 points.]

Looking at my skill list, it seems impressive, and some skills are at a high level. However, in the field of trauma surgery as a whole, due to the short time I've been involved, I haven't had time to activate many of the surgical techniques.

Of course, both Professor Deng Yong and his mentor Yuan Weihong have said that each stage should do what it is supposed to do at each stage.

During the entire hospital stay, the time and condition are not fixed, so it is not easy to provide teaching and surgical opportunities.

Before becoming a chief resident, most physicians in the hospital will spend some time training under professors before they can become chief residents.

But Fang Ziye's abilities were strong enough that he skipped this stage.

To save time in the early stages of the procedure, Professor Deng Yong also made full use of the concept of "time squeezing".

The purpose of doing this is to get Fang Ziye into the queue for intermediate professional titles as soon as possible, and then promote him to associate senior and senior professional titles sooner.

With the teacher's arrangements and plans in place, Fang Ziye's main task is to build up his own abilities and prepare an impressive resume.

Planning for a promotion is not the same as having an impressive resume. The former requires the latter, but the former does not necessarily mean that you will have the latter.

The person on duty changed from Chen Jiamengge during the day yesterday to Fang Songlin during the night, and today it is naturally Huige from the neurosurgery department on duty.

"Brother Hui, thanks for reminding me. The patient is in the control room, right?" Fang Ziye greeted him politely upon arrival.

Li Hui and others helping to retain patients is a favor, not an obligation.

It's just that a few people are still decent; otherwise, if they were afraid of trouble and unwilling to accept favors, they would have preferred to deal with the patients in a one-size-fits-all manner after knowing that Fang Ziye could either dismiss them or not.

Instead of what it is now, where time is spent calming the patient while also notifying Fang Ziye, the chief resident.

"Xiao Fang, this patient is a bit difficult to deal with. Be careful, especially if he's being too assertive."

"Stop it." Li Hui was of medium build, about 1.8 meters tall, with slightly fair skin and abundant body hair. The hair on his forearms was particularly prominent, and when he touched his head, the hair on his arms became slightly tangled with his head hair.

"Okay, thank you for your hard work, Brother Hui."

"I'll trouble you to take the delivery later, Brother Hui," Fang Ziye replied before walking out.

"Ziye, you're tempting us to make a mistake. Isn't bribing us with coffee against the rules?" The guy called Hui Ge shouted this in the office in a very funny way. His smile was a bit lewd, and he didn't seem really scared.

Fang Ziye did not reply immediately, but went to the operating room to see the patient.

Not all patients are oddballs, but neither are all their families. It's just that there's a chance of encountering one, and when those chances accumulate, they become 100%.

However, Fang Ziye was just thinking about this when he wondered what kind of family members would be so difficult to deal with.
It turned out that the person in the consultation room was an old acquaintance.

He has a bald head, a large face, and a short neck.

Fang Ziye only remembered one person dressed like this: "Director Zhang? What happened to you?"

(End of this chapter)