top student at medical school
Chapter 778 The Beginning of Madness!
Friday, before the start of the weekly meeting of the institute.
Liao Jiayuan frowned as he looked at the data report in front of him for the first ten days of the month.
After everyone else had arrived and the weekly hospital meeting officially began, Liao Jiayuan gently tapped her microphone, looked around, and asked softly, "Is Director Fang from the orthopedics department still not here today?"
Upon hearing this, head nurse Huang Xiaowei immediately replied, "Dean Liao, Friday is the surgery day for Director Fang's team. Director Fang also pays close attention to the content conveyed at the hospital's weekly meeting. He always tells me to report the specific situation to him as soon as possible."
Before becoming a head nurse, Huang Xiaowei received special training on how to conduct "question and answer" within the system.
Liao Jiayuan nodded slightly: "Director Fang is very busy, but it's not good that he misses every weekly hospital meeting."
"But surgery days are also very important, and the timing of routine meetings is simply incompatible with surgical days."
"Let's get straight to the point..."
"The first ten days of this month were mostly during the holiday. The comrades on duty during the Spring Festival holiday worked very hard."
"But despite the hard work, the emergency room data still fluctuates quite a bit."
"The mortality rate in the emergency department is as high as four percent. In just ten days, the emergency department has held nearly fifty discussions on death cases!"
The person attending the meeting from the emergency department was not Chen Guofeng, but Professor Zhou Jianping from the internal medicine department. Professor Zhou Jianping said calmly, "Dean Liao, this is very normal data."
"Even at Xiehe Hospital in our city, the current success rate for resuscitation is only slightly above 97%!"
"They treat about 250,000 patients a year, and with a mortality rate of around 3%..."
"During the Spring Festival holiday, many professors returned to their hometowns, and the overall medical resources were insufficient, so such data is very normal."
"This kind of data variation is not unique to our new hospital area; it is a data variation inherent in any hospital."
"These data can all be found on the official websites of major hospitals, and they are absolutely authentic."
A mortality rate of 3% is quite high, with more than 7,500 deaths per year, averaging around 20 to 30 deaths per day.
The number of emergency patients in the new ward of Zhongnan Hospital is certainly far less than that of Xiehe Hospital, and the mortality rate is only about five percent, which is still a relatively small sample size.
Liao Jiayuan clasped his hands and asked, "Professor Zhou, the data from last month is significantly better than this month's. Could it be that everyone's enthusiasm has waned after the first month of the hospital's opening?"
After listening, Zhou Jianping remained silent for a few seconds before replying, "Dean Liao, it's not that our colleagues in the department have lost their enthusiasm for work, but rather..."
"To put it bluntly, it's the first time the new campus has opened. After all, everyone is focused on data collection, so all the department heads and professors will be there at any time."
"But these impressive figures were achieved at the cost of sacrificing the rest time of most directors and professors, who are on call 24/7."
"This situation cannot become the norm."
"For example, Dr. Tang Xiaoping, the director of vascular surgery, developed acute tenosynovitis due to the excessive number of emergency room visits last month, and even went to Professor Fang's clinic for a check-up!"
"The wrist area is severely red and swollen."
"For example, Professor Fang Ziye from the Department of Orthopedics had a participation rate of 40% in critically ill emergency surgeries last month, and all the surgeries he participated in were successful."
"But Dean Liao, Director Fang of the Orthopedics Department is the director of the Orthopedics Department. He can't really be on call 24 hours a day to come over at any time for emergency surgery."
"Take on all the responsibilities of surgery."
"For emergency departments, a rescue rate of 2.5% to 4% in top-tier hospitals is within the normal range, teaching hospitals are around 4%, and for general tertiary hospitals, a rescue rate of 5% is considered extremely excellent."
Emergency room work is not a game.
In the emergency room, you can see a 'desolate' scene where some family members are laughing while others are crying.
Zheng Jiong, director of the medical affairs department at the new hospital, had just finished reviewing all the hospital's reports and added in a low voice, "President Liao, it's normal for the mortality rate of emergency patients to rise during the Spring Festival. Even in our hospital, the rate is not low."
"Professors and department heads are human too. It's only natural for them to want to go home during holidays. Moreover, our hospital has already done this. All emergency surgeries have three-line on-call staff, including associate senior and senior senior doctors."
"This is already equipped with the highest level of emergency treatment resources in the country."
"But as Professor Zhou Jianping said, if you do data for the sake of doing data, you will only exhaust yourself."
A single thread cannot make a line, and a lone tree cannot make a forest!
One person's strength is ultimately limited to one person; as long as one is a person, one's energy and physical strength are relatively limited.
Professor Zhou Jianping said with a smile, "Dean Liao, I would like to convey Professor Chen Guofeng's words, which is that he hopes the hospital can consider working with Professor Fang Ziye of the Orthopedics Department."
“If Professor Fang were willing to come to our emergency department, the data would definitely look much better.”
Before Liao Jiayuan could reply, a professor from the Department of Gastrointestinal Surgery who was attending the meeting said, "Going to the emergency department again? If you want Director Fang to stop doing what he wants, why should he stay at our Zhongnan Hospital?"
"It's not just our hospital that has an orthopedics department."
"There are better platforms waiting for him at Union Hospital and Tongji Hospital, so please don't make such bad suggestions again."
"Let's try to find other ways to deal with the current predicament..."
Zhou Jianping and Chen Guofeng from the emergency department mentioned more than once at the hospital's weekly meetings that they hoped the hospital could work on Fang Ziye and get him transferred to the emergency department.
Liao Jiayuan quickly stepped in to smooth things over: "Professor Zhou, everyone has their own area of expertise. Since our hospital has different specialties, each specialty has its own focus and tasks."
"The emergency department is certainly important, but our orthopedic department's outpatient volume is also made up of ordinary people seeking medical treatment."
"We cannot afford to focus on our own interests at the expense of others."
"However, according to Professor Zhou, our emergency department's resuscitation rate may remain stable at this month's reported rate, instead of remaining stable at last month's 3.1%?"
Zhou Jianping shook his head: "That's impossible, Dean Liao!"
"If Dean Liao insists on requiring such data, then Director Chen and I will have no choice but to resign and await the hospital's decision!"
What kind of international joke are you kidding?
The overall level of a department is set here; do you think you can surpass that level?
Liao Jiayuan took a deep breath: "I'm not asking this to hold anyone accountable, I just want to understand the specific situation."
"Professor Zhou and Director Chen's expertise is evident to all, and I hope you can further develop the emergency department."
"Medical safety is the bottom line for hospital operation. In other words, pursuing a lower mortality rate in emergency care is the fundamental goal of every hospital."
"To achieve this fundamental goal, we need to consider all aspects."
"Equipment, highly effective drugs, and highly skilled physicians."
"We not only need to bring in highly skilled doctors, but also consider continuously training even better trainees, turning them into more mature and skilled doctors. Only through this continuous virtuous cycle can we possibly bring down the 'price' of mortality..."
"The new campus is still very immature and needs the strong support of all the directors and professors to develop it before it can enter a mature stage and approach a stable stage."
"While we must ensure the quality of medical care, we should also pay attention to the quality of the diseases treated in our daily practice."
"We can't just create data for the sake of creating data. I've taken a quick look, and the number of level 3 and level 4 surgeries at our new campus is still significantly lower than that at our original campus."
"Even the range of diseases treated in the internal medicine department is not as comprehensive as that in our hospital..."
When Liao Jiayuan mentioned this, Zheng Jiong from the Medical Affairs Department raised his eyebrows rapidly: "Dean Liao, our new campus was transferred from our main campus, and none of the senior professors and former directors came."
"Otherwise, if they come and leave on short notice, the data will be even more inaccurate..."
What kind of international joke are you kidding?
In the new hospital area, many departments are led by associate professors and associate chief physicians, with only one or two chief physicians and professors serving as ward directors.
Are you trying to compare this kind of physician structure with the team in this hospital area, which is basically all professors and chief physicians?
You might as well hope that the new campus of Zhongnan Hospital will completely overturn Kyoto Kyoho Hospital; it's all just wishful thinking anyway.
Liao Jiayuan turned his head and asked, "Has anyone submitted a resume for the personnel department's talent recruitment?"
Although the new campus is separate from the original campus, the personnel department remains the same, and no new sub-departments have been built.
One of the people in the dean's office said, "There are quite a few people submitting resumes, but there are basically none of them of good quality. Most of the resumes are from directors of hospitals in prefecture-level cities in the province."
"If there are good ones, our hospital will give them priority."
"Most of the resumes are from recent and past PhD graduates, as well as some mid-level attending physicians."
Those with associate senior professional titles, even associate chief physicians, are mostly core backbones of hospitals, or even leading talents in prefecture-level city hospitals and county hospitals.
They don't move around easily.
Well-known professors are highly sought-after by hospitals, and if a good talent is found, the hospital will not turn a blind eye!
"Sigh... They won't give us the people we need, and if we want to find a few, we have to take what's left over. Being a dean is too difficult!" Liao Jiayuan was completely discouraged when he heard this...
Before Fang Ziye was scheduled to operate on the next patient, he received a call from Huang Xiaowei and said with a smile, "If you're in clinical practice, you have to bear the pressure and responsibility of clinical work; if you're in administration, you also have to bear the pressure of administration."
"We are all cattle and horses, just in a different form."
"Apart from a few 'easy' jobs, no job is easy."
"Head Nurse, did Dean Liao say anything more? Like, did he really suggest I go to the emergency room or something..."
Fang Ziye had just settled down and didn't want Liao Jiayuan to do anything rash in the heat of the moment.
No matter what, Fang Ziye would never go to the emergency department or the pediatrics department, not even if he changed careers.
Taking on some emergency rescue tasks temporarily is different from working in these two wards.
"No, Director Fang."
"Dean Liao also disagreed with Professor Zhou Jianping's proposal. This kind of proposal has been made many times, and each time it has come to nothing."
"But Professors Chen Guofeng and Zhou Jianping always mention it, probably because they really want to poach you, Director Fang, and also to complain about their department's current staff shortage," Huang Xiaowei added in her analysis.
"Thank you, Sister Wei."
"I'm about to start my show here, you should go back to your ward first, we can talk again when you have time." Since Huang Xiaowei didn't have anything else important to say, Fang Ziye took the initiative to end the conversation.
After hanging up the phone, Fang Ziye's brows furrowed instantly!
He murmured to himself, "Dean Liao, Dean Liao, don't you dare pull any tricks just to make the data look better."
Fang Ziye had been in contact with Liao Jiayuan before, but at that time Liao Jiayuan was only the vice president of Zhongnan Hospital, so he didn't have the same direct pressure as he does now.
Now that he's the director of the new hospital campus, the higher-ups will definitely put more pressure on him, such as what level the emergency department's resuscitation rate must stabilize at...
If Liao Jiayuan feels that the current emergency department structure is insufficient to complete the task, then he should be transferred there.
The functions of the medical affairs department are higher than the personnel arrangements within the orthopedics department.
However, Fang Ziye is also a free man; he can choose to go or not.
If a forced arrangement is absolutely necessary, Fang Ziye will have no choice but to go to the hospital campus or even go elsewhere.
Generally speaking, newly appointed directors and deans tend to exhibit a certain degree of 'psychological abnormality' in the short term.
This is because the types and situations of pressure faced are different, so the perspectives on the problem are also different.
……
After the surgery, Li Nuo caught up with Fang Ziye: "Ziye, I'm thinking of trying microcirculation treatment for severe infections next month. Do you think I have a chance to perform solo?"
Fang Ziye nodded: "It should be fine, Master Nuo!"
Li Nuo has been with Fang Ziye for quite some time now. It's not difficult for him to learn how to establish a microcirculation system in two months. If Li Nuo still can't learn it, then his ability to work at this hospital and be promoted to associate chief physician is highly questionable.
Li Nuo was referring to next month!
If you think it's possible, then it definitely will be possible!
"It feels great to learn new techniques. Now I can handle severe infections on my own," Li Nuo said with a happy smile.
Severe infections of the limbs can be treated relatively well on their own. If Li Nuo were to open an infectious disease surgery department at a private hospital at this time, he would definitely earn more than he would at Zhongnan Hospital.
The medical profession is all about skills. As long as your skills are not easily replaceable, you're considered top-notch.
What others cannot do, is what makes a product scarce, and it takes the high-end route.
"Master Nuo, how much do you know about spinal surgery?" Fang Ziye suddenly asked.
Although Li Nuo did not come from a spinal surgery background, he did work in spinal surgery for several years, so he must have learned something, right?
If some surgical procedures can really be performed, Fang Ziye will no longer need to have Professor Wang Ou from the Department of Spinal Surgery come over.
It mainly depends on how much Li Nuo can do!
“I only know some basic surgeries, Ziye. I understand what you mean, but I don’t think I can win it!” Li Nuo’s voice became barely audible.
Spinal surgery is a complete specialty, and he only went there for a little over two years. His knowledge was quite limited.
If Li Nuo can become a highly skilled spinal surgeon in just two years, then he is a born spinal surgeon and shouldn't be returning to trauma surgery.
Fang Ziye frankly stated, "Actually, it's not necessarily better to be good at more complex surgeries. It's more scientific to develop in a more specialized direction."
Li Nuo nodded: "I think so too. Changing the direction halfway through?"
Li Nuo looked at Fang Ziye: "Aside from a freak like you, most people can't do it, and it's not worth it."
"I'm starting to regret going to the spinal surgery department!"
“But if I hadn’t gone there, I wouldn’t have been able to stay, and I wouldn’t have been able to get promoted.” Li Nuo went to the spinal surgery department to avoid danger after being implicated with Jin Hongzhou.
Spinal surgery doesn't have many emergencies to handle.
"Master Nuo, what's past is past, there's no need to dwell on it or get involved."
"Actually, knowing some spinal surgery techniques is also very helpful in dealing with neurological issues," Fang Ziye comforted her with a smile.
Li Nuo shook his head: "Ziye, you mean participating in more advanced spinal surgery. During my time in the spinal surgery department, I only did some single-handed removal."
"Other procedures, such as nerve root decompression, are simply not feasible."
"I couldn't hold on any longer. I felt that my previous experience wasn't focused on spinal surgery, but I couldn't bear to give up the trauma surgery I had studied for so many years, so I came back."
"Ziye, what I mean is, it's better to specialize."
"Especially for people like us who aren't very talented, never be greedy. If you try to do too much, you'll end up with undigested food and nothing to chew on. It will just lead to indigestion..." Li Nuo said, speaking from the bottom of his heart.
Fang Ziye found it difficult to fully empathize with Li Nuo, but he knew that Li Nuo was speaking from the bottom of his heart.
Before he could reply, Fang Ziye noticed that Tang Yi, who was smoking, had returned: "Teacher Tang."
"Ziye, what are you and Li Nuo planning to do?"
"Want to grab something to eat sometime? It's Friday, treat yourself..." Tang Yi, a newcomer, was very clever in trying to integrate herself into the team.
The best thing would actually be to take Fang Ziye and Li Nuo out for a swim, thus establishing one of the ironclad rules of men's relationships. However, Tang Yi knew that Fang Ziye wouldn't go, so he didn't bring it up.
“Sure, I’m fine with it!” Li Nuo immediately raised his hand.
Fang Ziye didn't refuse: "Let's make it clear first, no drinking today... I have a lot of things to do later."
Tang Yi said with a half-smile, "Director Fang, you're a director now, with so many students around, you should make use of them to write and run documents!"
"Don't always take on everything yourself. You didn't make them just run errands, so it's not like you're exploiting them."
The group went downstairs, discussing how to exploit the students' "labor"!
Fang Ziye nodded frankly: "We still need to use them when necessary, but none of them have experience, so we can't carry out the current tasks."
"I still need to accumulate more experience; writing tender documents is not something to be taken lightly."
"I didn't win the bid last year. What if I don't win again and the hospital liquidates my assets?"
Although Zhongnan Hospital does not explicitly state that it has research tasks, if a doctor cannot obtain research grants for a long time, he may be subject to a talk!
"You didn't win the bid last year, but weren't you given a big one instead?"
"Which general research project can compare to the value of yours?"
"Others get their grants by writing proposals, but your grant was offered to you by the National Natural Science Foundation of China."
Tang Yi inquired, "Ziye, if you were to apply for another research grant this year, you'd at least be eligible for the Excellent Young Scientists Fund or even the Outstanding Young Scientists Fund, right?"
"According to regulations, an associate professor can only participate in and lead two research projects at the same time."
"Almost there. I'll try my best to keep up with Master." Fang Ziye nodded and pulled his teacher out.
"Haha, you little rascal... Liu Huanglong is really unlucky to have met you..." Tang Yi was envious at this moment.
Yuan Weihong received the Outstanding Young Scientist award thanks to Fang Ziye's efforts. Now, Fang Ziye himself may also receive another Outstanding Young Scientist award, or even directly become a Distinguished Young Scientist.
Good heavens, Liu Huanglong will be unable to suppress Fang Ziye on any level from now on.
In comparison, for Liu Huanglong, the only department of orthopedics at Zhongnan Hospital that doesn't hinder him is hand surgery.
Looking at the entire field of orthopedics, he's still a 'little brother'!
Fang Ziye glanced at Tang Yi and smiled, saying, "Teacher Tang, how can you not guess that it's our good fortune that Teacher Liu and I can work together?"
"Professor Liu's output in recent years has been quite substantial!"
As expected, Fang Ziye's words provoked Tang Yi.
When interacting with people, it's either aimless boasting or deliberate empty promises.
If you only see Liu Huanglong as a 'younger brother' and don't see the depth and experience he has accumulated, then you've lost, Teacher Tang!
Tang Yi quickly realized what was going on, his smile deepening as he leaned closer to Fang Ziye: "Hey, Professor Fang, what do you think of me?"
"He looks better than him, at least. I think Li Nuo is really dragging down the overall attractiveness of our team..."
Li Nuo immediately lost his composure, but quickly crossed his arms and said in a condescending tone, "Brother Tang, I suggest you rephrase your words and apologize to me!"
"Otherwise? Heh..." Li Nuo's threat intensified.
Fang Ziye chuckled, "Teacher Tang, you must have forgotten to check the almanac before you went out today. You're just going to bump into walls no matter which way you go..."
It must be admitted that Tang Yi is quite handsome and has the potential to be a 'scumbag,' but if he says Li Nuo is stinky, he's really picked the wrong person.
Who is Li Nuo?
He's known as the second "gold digger" in orthopedics!
He was originally in first place, but after Liu Huanglong arrived, he became second.
In terms of overall influence, Li Nuo's father-in-law's family is in no way inferior to Liu Huanglong's father-in-law; it's just that their 'professional title' isn't as high, and their reputation isn't as impressive.
Why was Li Nuo able to get promoted after going to the spinal surgery department? Besides his own abilities and hard work, there must have been some other connections!
Tang Yu cursed and went to face the wall to reflect on his actions...
Friday was close to the weekend, so people in the animal lab arrived a little later; at least not everyone came right after get off work.
However, the key figures are actually Fang Ziye and Liao Jia.
After the two arrived, they didn't wait for the other veterans and immediately began today's 'experiment'.
After instructing people to make preparations, Liao Jia said, "Ziye, that's not very kind of you. You went to eat barbecue without inviting me."
"I ate KFC all afternoon!"
Fang Ziye said, "How was I supposed to know you'd be in the animal lab? I thought you went to keep Sister Wang Si company."
"How can I bother you? You've already sent me a message!"
Fang Ziye took out his phone and presented the chat history as evidence.
Liao Jia said, "Don't even mention it. She's writing bids like crazy right now. If she wants to get the job, she'll have to put a huge dragon-suppressing stone in her boss's pocket."
"We had already made plans, but I was kicked out again."
"It's a pity I can't directly apply for general research projects, otherwise I would at least throw you a few Dragon-Suppressing Stones."
Liao Jia's expression was somewhat indignant.
He was kicked out because he was loafing around at home.
Although Liao Jia has good research capabilities, his area of expertise is far removed from Wang Si's, so it's better not to give advice to avoid disrupting Wang Si's train of thought.
Fang Ziye said, "Throw it? I'll catch it. I will definitely use your great ideas, Brother Liao, to rise step by step and carry them forward."
"I want you to be a great, untainted man behind the scenes!"
Liao Jia broke down and exclaimed, "Damn!"
"That's not even behind the scenes. I'm practically in the grave behind the scenes, and you still call that behind the scenes?"
"Sigh, but let's take it one step at a time." Liao Jia sighed again.
"just in case."
Liao Jia's eyes lit up: "No, it's not just a possibility!"
"Once this project is completed, the bombs we've planted won't just be limited to the domestic market!"
"I really look forward to that day."
"Even if you're just doing odd jobs behind the scenes, it's worth it."
Liao Jia was very clear about the value of this research topic.
Before Fang Ziye could reply, he saw Wang Xinghuan walk over with a slightly gloomy expression.
"Dean Wang!~"
"Teacher Wang." Liao Jia and Fang Ziye immediately changed the subject and greeted him.
Upon hearing their voices, Wang Xinghuan's expression softened slightly: "Professor Liao, Professor Fang, you've arrived so early!"
"I thought I'd be the first one to arrive." Wang Xinghuan wasn't afraid of the long journey and had come all the way from the main campus so early.
Wang Xinghuan has a heavy workload. He is not only the director of the ward but also the hospital director. He also has to attend and organize various meetings. His presence at this time proves that he has squeezed all his time into a tight schedule.
“Teacher Wang, we live close by,” Fang Ziye said politely.
Wang Xinghuan glanced at Liao Jia and took the initiative to say, "Professor Liao, would it be convenient for Ziye and me to have a few words alone?"
Liao Jia understood and said, "I was just about to make coffee. Dean Wang, would you like a cup?"
"Thank you," Wang Xinghuan replied, merely to get Liao Jia to leave.
Fang Ziye's smile gradually stiffened and then faded, before his expression turned serious: "Teacher Wang, is there something important?"
Yes!
“I just received a notification that a team in Jinshi is submitting an application to transfer you to a relatively important research project.”
"Currently, this process is already underway."
“The team from the China-Japan Friendship Hospital said they sent you an email, but you didn’t reply,” Wang Xinghuan said.
Fang Ziye was startled upon hearing this: "No way, I haven't received this email. Could they have sent it to the wrong email address?"
However, Fang Ziye immediately asked, "Shouldn't this kind of research project secondment involve contacting me directly? How can it be done without me?"
The specific reason is still unclear at the moment.
"I heard about this shameless thing happening!"
After hesitating for a moment, Wang Xinghuan sighed and said, "Actually, it's not just the China-Japan Friendship Hospital that's putting pressure on us; many teams within our province are also putting pressure on us."
"It seems that word of our research project leaked out by accident, and now someone wants to slow down our progress, or they're just trying to steal our thunder!"
"That's absolutely shameless!"
Fang Ziye understood immediately upon hearing this.
The previous project on bone tumor combined with a micro-circulation device was initiated by Fang Ziye, who contacted people in the industry, and then Academician Gu Yuandong and others directly invited people from the National Natural Science Foundation of China to come and make an assessment.
They decided to focus their research directly on Zhongnan Hospital.
This time, Fang Ziye did not do that; he did not give an initiative academic presentation.
Such an important research topic certainly cannot be taken away from Fang Ziye, but a team wants to take over the communications unit of Zhongnan Hospital.
Moreover, they even knew that if the team from Zhongnan Hospital left Fang Ziye, the research project would not be able to proceed normally. So now they were temporarily transferring Fang Ziye away, and then trying to find a way to get him to continue the treatment and the research project...
The benefits that a world-class, groundbreaking treatment for a new disease will bring to hospitals are self-evident!
Throughout the entire country of China, there are only a handful of people who have received such an exceptionally high level of honor!
"Professor Fang, what do you plan to do?" Wang Xinghuan asked.
After hearing Wang Xinghuan's explanation, Fang Ziye breathed a sigh of relief: "Dean Wang, I think we don't need to worry about them. We should just do what we need to do."
"This kind of temporary transfer procedure is useless!"
Fang Ziye's file cannot be accessed by ordinary teaching hospitals, and Fang Ziye has most of the autonomy to access it.
Wang Xinghuan explained, "Professor Fang, we can't be careless either. I know you mean you can rely on the military region's sanatorium."
"But what if Kyoto also makes a move?" Wang Xinghuan presented an even worse scenario.
Upon hearing this, Fang Ziye's brows furrowed instantly.
There is not only one sanatorium in Enshi, nor is there only one military sanatorium in Hubei Province.
If what Wang Xinghuan said is true, then Fang Ziye really doesn't know what to do for the time being.
Seeing that Fang Ziye remained silent, Wang Xinghuan continued, "Ziye, after the last functional reconstruction surgery, those people in Kyoto didn't receive the best benefits, and things became extremely difficult afterwards!"
“This time is completely different from the last time.”
"Personality reconstruction and functional reconstruction after spinal cord injury can drive people crazy and even cause them to lose their minds!"
"Therefore, they will definitely make prior arrangements to secure priority!" (End of Chapter)
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