top student at medical school

Chapter 328 Passive Showing Off (Second Update, Please Subscribe)
After leaving the banquet hall, Fang Ziye carefully considered the national standing of the Department of Orthopedics at Zhongnan Hospital!
In recent years, the official comprehensive rankings have been released, and hospitals ranked from top to bottom have been ranked from 30th to top. Even Tongji Hospital and Union Hospital have not made it into the top ten.

Shanghai Sixth People's Hospital happens to be one of the top three orthopedic hospitals in China. Rumor has it that the world's first successful limb replantation surgery was performed there…

The world's first case, with such fame?
Fang Ziye gradually calmed down.

Long ago, Master Yuan Weihong and Professor Deng Yong had helped Fang Ziye prepare mentally, explaining that the world is vast, the world is wide, and it is also very exciting.

Jealousy won't make you progress; ignoring the gap and forcing yourself to think you're better won't bridge the difference in achievement levels.

We should cherish every moment. Fang Ziye is far from being ready to consider enhancing the national standing of the Department of Orthopedics at Zhongnan Hospital. He is currently only a chief resident, and as a chief resident, he has his own responsibilities.

……

After examining the patient in the emergency department, Fang Ziye discovered that the patient transferred from Chishi was in a very difficult condition.

I'd rather die than risk my life!
The patient presented with a classic case of long-segment thrombosis following lower limb trauma and was transferred from Chifeng to Zhongnan Hospital for further diagnosis and treatment.

The reason why Zhongnan Hospital was the first choice was because the patient knew someone there and had heard that Zhongnan's orthopedics department was quite good. Also, the patient had called other hospitals but had not yet received a definite answer.

I planned to come to Zhongnan Hospital for a check-up first.

After examining the patient, Fang Ziye's first thought was not how to save the lower limbs, but rather he immediately shouted in the group: "I just encountered a very typical case of post-arterial thrombotic 5P syndrome. Anyone interested, come to the emergency department's surgical clinic."

"I'm only giving you ten minutes. @Everyone." Fang Ziye called out directly in the group chat for the attending physicians.

This time, a total of four doctoral students graduated. Professor Han Yuanxiao's group did not have any doctoral students graduating this year, so his juniors did not go to the banquet hall to join them.

Fang Ziye's fellow disciples were still in the banquet hall drinking with their senior brother, and Fang Ziye didn't know who was available.

But this 5P syndrome is so typical that it would be a shame not to call a junior colleague to come and take a look, so I just posted a message.

When there is arterial embolism or thrombosis in the limb, the characteristic manifestation is persistent pain, accompanied by symptoms and signs such as pallor, pulselessness, paresthesia, and paralysis in the affected limb. These five symptoms and signs all begin with the letter P, hence the name 5P signs.

In addition, he privately messaged Guo Ruodun, "Xiao Guo, you're on emergency shift today, so this physical examination opportunity is given to you first. Come to the emergency department immediately to complete the preoperative consultation and signing procedures."

"The patient currently has a certain willingness to undergo surgery."

After completing these steps, Fang Ziye sent the patient's lower limb CTA results to Wu Xuanqi and his senior colleague Nie Mingxian.

He then asked, "Senior Brother Wu, Senior Brother Nie, based on the current CTA results and the patient's appearance, is there any possibility of resuscitation?"

"The current examination results are..."

Wu Xuanqi is only good at vascular surgery. Fang Ziye is in a similar situation to Wu Xuanqi. He can perform the surgery once he decides whether to do it. However, whether he is suitable and whether he meets the usual surgical indications is something that Nie Mingxian has a more thorough understanding of.

As for the idea that asking others for help would tarnish his genius label, Fang Ziye never took it to heart. The more mature he became, the less important the so-called genius and face-saving issues became.

As long as it benefits the patients, brings them a better experience, and improves the quality of my work, I don't care if my face is displayed at the door.

Fang Ziye could also add points, spending several thousand points on vascular surgery and arterial thrombosis-related theories, and he could reach Nie Mingxian's level.

However, Fang Ziye is currently short on knowledge points and doesn't apply them much, so he's reluctant to add more for now. If he had more knowledge points, he would definitely prioritize skills in trauma surgery, such as bone transport techniques...

Although Nie Mingxian had gone back to pursue his doctorate, he had not lost contact with Fang Ziye and Wu Xuanqi. In particular, after Fang Ziye was reinstated as chief resident, he, like Wu Xuanqi at Tongji Hospital, frequently asked Nie Mingxian for remote consultations.

The reason is simple: if our hospital's resident physicians encounter a similar case of arterial thrombosis, their first recommendation is to shut down the affected area!
"Senior Brother Fang, what is the surgical procedure?" Guo Ruodun arrived at the emergency department quickly, first inquired about the surgical procedure, and then planned to write the risk items on the informed consent form for the surgery.

This is a test of the attending physician's ability. It tests the corresponding theoretical basic skills based on the surgical procedure. Fang Ziye went through the same process. However, nowadays, Fang Ziye is making this kind of test more and more public.

Guo Ruodun is a first-year master's student under the supervision of Zhang Zixi. He is a classmate of Lin Yihuang, whom Zhang Ziye had met before.

"Amputation is being prepared for lower extremity arterial thrombectomy."

"Remember, talk to the patient about the amputation options and risks. Limb salvage is just an alternative. If the patient doesn't agree, suggest they seek another hospital." Fang Ziye instructed Guo Ruodun after receiving confirmation from Nie Mingxian.

During the master's program, opportunities were limited, and everyone had to compete and strive for them.

As the chief resident, Fang Ziye has overcome many obstacles in the past and is now relatively generous, delegating authority a little more leniently. However, when Fang Ziye checks the relevant risk clauses later, he will be more stringent.

"Okay, Senior Brother Fang, I'll let you review it later. I type very fast," Guo Ruodun boasted.

Fang Ziye put away his phone and went outside the consultation room to explain to the patient's family in detail: "Regarding your situation, I also consulted with the vascular surgery teachers, and their opinions differ slightly from those of Dr. Liu, the chief resident of vascular surgery."

"There is a small chance we can try to remove the thrombus. If we can't remove it, then we'll amputate the limb. It won't increase the cost much." "But if you don't want to go through all that trouble, our hospital's only option is amputation. If you want to save your limb and get more assurances about saving it before the surgery, then you might need to inquire at other hospitals."

The patient and their family had already seen some new messages on their phones, and their expressions became even more grim.

The family members put away their phones and asked repeatedly, "Dr. Fang, are you sure there's a chance we can save the limb?"

"There is one thing we can only hope for and try our best to achieve."

"If we can save the limb, we'll do so; if we can't, we'll save the life. Otherwise, if the limb dies, it will be very troublesome if there is an infection or reperfusion injury..." Fang Ziye explained.

I had a hunch that the information this patient and their family had gotten through the inquiry might not be good.

Of course it won't be good. Who would want to create unnecessary trouble?
If Fang Ziye hadn't known Nie Mingxian and hadn't also had some connection with Wu Xuanqi, the general advice from the head of trauma surgery and the head of vascular surgery would have been amputation.

Once amputation is indicated, it's not easy for anyone to conjure up several professors to save your limb. Even professors in vascular surgery may not have available time.

“Okay, Dr. Fang, we’re willing to give it a try.” The family member was the patient’s husband.

After replying, he looked at his wife and repeated, "Let's give it a try. Dr. Fang dares to say that, so he must at least have some confidence..."

The despair in the patient's wife's expression eased slightly, and she nodded gently...

……

After obtaining permission from the patient and their family, the remaining tasks are to prepare for the operation and arrange the operating room.

If a patient is newly admitted to the hospital and does not have an absolute emergency condition such as hemorrhagic shock, it is impossible to immediately arrange for an operating room regardless of everything. Emergency preoperative preparation still needs to be done, which takes some time.

While this may waste some time and increase the chance of limb necrosis, from a doctor's perspective, a safer surgical procedure throughout the entire process is of higher quality and more important than a single surgical procedure.

Fang Ziye sent another message to his two junior brothers to inquire about the atmosphere in the banquet hall, and the reply was positive.

Fang Ziye was relieved.

In fact, Fang Ziye was overthinking things. With so many big shots arriving, how could he, a recent PhD graduate, possibly handle all the social interactions and interpersonal relationships?

Even when Fang Ziye presented his thesis, the topic he presented was quite impressive. The animal experimental model had great clinical significance, and the unprecedented HK2 knockout animal model even aroused the interest of several professors.

But after all, they are juniors. In their eyes, Fang Ziye is probably just a middle school student with good grades who has now been admitted to the best high school with excellent results.

But in reality, for adults, not getting into university means not graduating.

For top professors, those who haven't crossed the threshold from associate professor to professor are still below the mark...

When Fang Ziye took Guo Ruodun to perform an arterial thrombectomy, they were caught by Yuan Weihong.

The phone rang quickly: "Ziye, I heard from Jiehan that you're planning to lead a team to perform thrombus removal surgery to save the limb?"

"You can't do this recklessly, can you?" Yuan Weihong's voice was clearly tinged with alcohol, and his tone carried a warning.

Upon hearing this, Fang Ziye frowned slightly and asked, "Master, we've carefully discussed the amputation risks with the patient, and even if the surgery is thrombectomy, is that not an option?"

"Does our hospital only allow vascular surgeons to perform thrombectomy? Is it that no one else can perform it?"

After all, it's only one leg.

Fang Ziye has undergone amputations before, but those were mostly due to destructive damage. Without the help of a powerful figure, Fang Ziye could only resort to amputation and dared not hope for limb reconstruction or limb-sparing surgery.

However, this was only a necrotic limb after the thrombosis had formed, and it was a real pity to amputate it so easily, from Fang Ziye's perspective.

"There isn't such a rule, but... Ziye, if you're highly skilled and daring, that's acceptable."

"But if you don't do it well, it will give people something to talk about. Although vascular incision is an interdisciplinary procedure between orthopedics and vascular surgery, it is actually a procedure between hand surgery and vascular surgery."

“If you fail at interdisciplinary operations, it will be mistaken for a failed attempt to show off…” Yuan Weihong explained the crux of the matter to Fang Ziye.

“Master, I never intended to show off,” Fang Ziye corrected.

“But what you did was somewhat in line with that, wasn’t it?” Yuan Weihong corrected again.

(End of this chapter)