I, Tomoya Aki, am not a bootlicker

During the operation, the first assistant, Tomoya Aki, repeatedly instructed the anesthesiologist Otani to perform anesthesia.

If it was the surgeon Yoshida Aoba who spoke up, there wouldn't be too much trouble.

But now it seems that there is something wrong with Aki Tomoya speaking as the first assistant?

For the time being, Tomoya Aki had no idea why Sasaki Ichiru came to him to ask about this matter, but fortunately, he did not feel any malice towards Sasaki Ichiru, he was just doing his job.

He didn't know whether some of his actions during the operation violated any taboos, but the most important thing in the operating room was to save a critically ill patient.

Aki Tomoya thought for a moment, then slowly said: "Whether emergency mitral valve replacement surgery for artificial mitral valve dysfunction can be successful, perioperative anesthesia management is an important link."

"As someone who has been working in the cardiac surgery department for almost three years, I have a deep understanding of this. This time, the situation happened so suddenly. At the time, there were only me and Dr. Majima on night shift in the cardiac surgery department. The only one who could assist in the emergency operation was Dr. Otani, who had little experience in cardiac surgery."

There was no complete surgical plan, only the preparations made by Tomoya Aki and Majima in the second half of the night, and the condition was critical, so they needed to improvise.

Fortunately, Yoshida Aoba lives in the hospital, otherwise the surgical team would not have a second assistant, and Aki Tomoyuki would directly serve as the chief surgeon, even if it was against his will.

Similarly, in the Department of Anesthesiology, there is only Dr. Otani.

At Kanto General Hospital, Tomoya Aki has been working for almost three years, and he has always stayed in the cardiac surgery department without rotating in other departments.

So in terms of experience, they are more experienced than the new doctors who have just completed their medical training and transferred to cardiac surgery.

In addition, as he followed Yoshida Aoba back and forth in and out of the operating room, Aki Tomoya became more aware of how important an excellent anesthesiologist is to surgery.

His statement about his lack of experience in heart surgery was enough to fully explain that Otani from the Anesthesiology Department was actually doing it against his will.

That person was not one of the anesthesiologists regularly employed by cardiac surgery.

"The patient undergoing emergency cardiac surgery is in critical condition. We are rescuing him, so we require the anesthesiologist to establish rapid monitoring of arterial and venous pressures and smooth anesthesia induction..."

"Install the extracorporeal circulation machine, pre-fill and exhaust the pipeline, and quickly establish extracorporeal circulation while avoiding major interference with the patient's circulatory system. Our cardiac surgery medical staff are well-trained and have close cooperation during the perioperative period. However, this time it was an emergency operation at night, so I also had to cooperate with Dr. Otani to establish extracorporeal circulation..."

Under normal circumstances, every step of their cardiac surgery is carefully planned, and the staff are all experienced and well-trained.

During the emergency operation the day before yesterday, due to the shortage of staff, Aki Tomoya and Majima had to take care of many things, so as to prevent the chief surgeon Yoshida Aoba from being distracted.

"Originally, like Dr. Aoki, anesthesiologists should be familiar with the pathophysiological changes of various heart diseases, as well as the pharmacological characteristics of various vasoactive drugs and anesthetics, so as to select appropriate vasoactive drugs and anesthetics according to the condition..."

"This includes administering dobutamine and/or epinephrine, nitroglycerin, norepinephrine, morphine, etc. before induction of anesthesia to maintain the stability of the circulatory system, create conditions for anesthesia and establishment of extracorporeal circulation, maintain a sufficient depth of anesthesia, and select drugs that have little interference with the circulatory system depending on the situation, with intermittent perfusion every 30 minutes..."

"It is obvious that Dr. Ohtani, who has never performed heart surgery, does not have sufficient knowledge about mitral valve replacement..."

So it’s not that he is talkative, but he really needs to be reminded from time to time.

Especially given the situation at the time, the patient was in critical condition and no mistakes could be made.

It was not Tomoya Aki's intention to interfere with the work of the anesthesiologist, but because Dr. Otani did not have enough experience and knowledge in mitral valve replacement.

And Amaki Tomoya, who has the relevant experience and knowledge, naturally has to give instructions in order to ensure the smooth progress and success of the operation.

Considering the success rate of the operation, Akitomo felt that there was nothing wrong with doing so.

Even Sasaki Ichiru, who had heard what Aki Tomoya said, didn't think there was anything wrong with it.

As the head of cardiac surgery, Sasaki Kazuyuki is no stranger to the doctors in the anesthesiology department, especially the few doctors who would cooperate with them in performing operations, who have almost become their exclusive anesthesiologists in cardiac surgery.

"Doctor Sasaki, I..."

"It was just a normal conversation. I just came to understand your situation. Doctor Yoshida thought you could participate in the operation as the lead surgeon, and he told me to come and talk about it."

Sasaki Ichiru signaled to Aki Tomoya not to be nervous.

Today's conversation is just to test Aki Tomoya.

I specifically mentioned what Tomoya Aki did during the operation the day before yesterday, just to see his abilities.

Judging from the tip of the iceberg, at least in one aspect, Aki Tomoya is good enough, and his overall view is sufficient.

Although his experience was a little short, since he had Yoshida Aoba's recommendation, Sasaki Ichiru considered that Yoshida Aoba could help out, so he might as well do him a favor.

If any doctor in the department, especially a new one, wants to be the chief surgeon, he must get his nod. Only with his approval can he take that position.

After all, Director Monobe is no longer in charge of things now, and Sasaki Ichiru is apparently the head of the cardiac surgery department.

But at the same time, he is responsible to the department, to the hospital, to the patients, and to Aki Tomoya. He must first confirm whether Aki Tomoya has the ability to do so.

"I heard that Dr. Yoshida also gave you the plan for postoperative care?"

"Yes, Dr. Sasaki, I sent the plan to Dr. Yoshida's email yesterday morning."

Chapter 480 The location of the surgeon

There is still a lot of work to do after the operation, one of which is to specify a postoperative care plan based on the patient's specific situation.

Yoshida Aoba handed the plan over to Aki Tomoya.

After returning that day, Aki Tomoya did not rest immediately, but instead developed a postoperative care plan and sent it to Yoshida Aoba's email yesterday morning.

"Well, I've seen it, and I'll just follow your plan."

I have already seen it and I still ask...

Aki Tomoya frowned, and at this time he didn't think that Sasaki Ichiru's action was unnecessary.

The other party's confirmation only made Akitomo Aki feel that it was almost time.

Yoshida Aoba has already told Sasaki Ichiru that he wants to be the chief surgeon. As long as Sasaki Ichiru nods, his position as the chief surgeon should be secure.

Becoming the chief surgeon is the dream of every surgeon.

Especially in cardiac surgery, where operations are extremely difficult and complex, if you want to become the chief surgeon, you have to work harder than your peers.

But perhaps it is precisely because he has someone to take care of him in college and in the hospital that he has many more opportunities than his peers.

Originally, as he was just starting his two years as a resident trainee, he was not supposed to participate in surgeries. If he had followed normal procedures, he would still be rotating in cardiac surgery, and then start as an assistant, slowly accumulating experience before he would have the opportunity to serve as the lead surgeon.

But now it’s different. With Yoshida Aoba’s recommendation and recognition, he is willing to give Aki Tomoya a chance to prove his worth.

And most importantly, Yoshida Aoba is an excellent surgeon. Although not as good as Sasaki Ichiri, he is only ranked behind Sasaki Ichiri in the Department of Cardiac Surgery of Kanto General Hospital.

Such a cardiac surgeon, who is also his teacher, will humble himself and serve as his first assistant in the operations that he will perform in the future. It can be said that he will escort him throughout the whole process.

Compared with the other two people who entered the Department of Cardiac Surgery at the same time, Yoshida Aoba's training efforts were very strong. It was a blessing for Sasaki Ichiru to let him be under Yoshida Aoba's tutelage and to be his instructor.

"You have the opportunity to be the lead surgeon. It depends on how Dr. Yoshida arranges it. Dr. Aki, don't let everyone down."

Sasaki Ichiru patted Aki Tomoya's shoulder with a hint of congratulations in his eyes.

In his eyes, Akitomo is also an outstanding junior. Since they both graduated from the University of Tokyo, there is a sense of familiarity between them.

After all, most of the people here graduated from the University of Tokyo School of Medicine and the Department of Cardiac Surgery affiliated to the University of Tokyo, so the friendship between classmates is very strong.

And it’s not as strict as in university hospitals. The atmosphere in private hospitals is very relaxed compared to university hospitals.

The relationship between seniors and juniors is also purer here.

"Please advise!"

Aki Tomoya replied solemnly.

He had joy in his eyes but maintained a calm expression on his face.

Tomoya Aki felt relieved to get a response from Sasaki Ichiru.

He got the position of chief surgeon.

But whether it can be maintained depends on the subsequent performance.

Don't slack off!

He reminded himself that the position of chief surgeon was not easy to come by.

Especially since the next operation he will be performing will be his first, which is particularly important!

Akitomo didn't know what Yoshida Aoba would consider when arranging the first surgery for him.

But he knew that becoming the chief surgeon not only meant a higher status in the department, but also brought with him responsibilities.

As the surgeon's responsibility, it is to bring the patient out of the operating room safely.

……

After returning to his seat, Akito Tomoya loosened his clenched fists. He took a deep breath, but his eyes still couldn't hide his excitement.

Yoshida Aoba, who was far away, noticed his appearance and understood instantly.

Being able to perform surgery as the lead surgeon is something worth celebrating. Yoshida Aoba had the same feeling when he first took on the position of lead surgeon.

"Doctor An Yi, is there any good news?"

Nishikino Maki asked from the side. She seemed to have heard some rumors and had some plans in mind.

"Looking at his expression, the surgery should be a sure thing."

Majima said this enviously. He was extremely envious of his good friend and classmate.

At the same age, Aki Tomoya has already become a chief surgeon, but he still needs to hone his skills.

There is no need to blame myself, or envy that Tomoya Aki's supervising physician is Yoshida Aoba. I just feel a lot of emotion that Tomoya Aki has gone ahead of them.

"Dr. Sasaki has agreed."

Aki Tomoya looked at the two of them helplessly and replied.

He was excited about this.

I am also very grateful to Yoshida Aoba.

If it weren't for Yoshida Aoba's cultivation, he wouldn't have been able to become the chief surgeon so easily.

But having said that, the first surgery has not been decided yet, and there is still a lot to prepare.

He also had other things to do, and he also had to find time to deal with the projects that Professor Yano sent him at the university.

Speaking of Professor Yano, things in the graduate school are not too complicated. Professor Yano said that as long as one participates in his research projects, one can get his master's degree smoothly and faster than others.

As long as he can keep up and provide some results, it will be easy for him to get a doctorate degree by following his research topic after obtaining his master's degree.

This is what the person said. For the sake of promotion, his future, and also because of his own importance, Akitomo had to listen.

"Doctor An Yi, since you can now perform surgery as the main surgeon, you should be able to decide on the assistant surgeon, right?"

Nishikino Maki's question made Aki Tomoya stunned for a moment.

He only thought about it briefly before he understood what the other party meant.

She needs more surgery.

Obviously, her supervising physician had no way to realize his wish in a short period of time. After all, in terms of status, Yoshida Aoba's say in the department was only less than that of Sasaki Ichiru.

"Dr. Nishikino, I think you should talk to Dr. Yoshida about this. Although I can perform the surgery, I should thank Dr. Yoshida for many things."

Aki Tomoya was not only explaining this to Nishikino Maki, but also to his good friend.

I won’t explain why he was able to come to this hospital, but the fact that he could have so many conveniences in the cardiac surgery department here was all thanks to Yoshida Aoba’s position in the department.

Realizing that everyone, including Majima, seemed eager to try, Akitomo could only tell them that they had found the wrong person.

"But can you give me some advice? Dr. Majima is fine, but it's not convenient for me to go to Dr. Yoshida rashly..."

Chapter 481 Let Me Test the Waters First

It is normal to have the thought that you need more surgical opportunities, or to reach the position of first assistant as soon as possible and strive for the opportunity to perform the main surgery.

Because it is not in a university hospital, the more relaxed atmosphere towards newcomers also means more opportunities to relax.

This is similar to the fact that patients from university hospitals are later sent to affiliated hospitals for training.

But Kanto Private Hospital is a big hospital in Tokyo after all, and the cardiac surgery department does not have as many staff as the Tokyo University Affiliated Hospital. So the surgeries that can be done at the Tokyo University Affiliated Hospital can also be done here.

Therefore, there are many surgeries every week, and it is not an exaggeration to say that sometimes the waiting time is several months.

The shortage of medical resources is also a problem in Neon. The demand for medical personnel will only increase, rather than being sufficient.

However, it takes time to train excellent doctors due to the strict system and different surgical levels according to different departments.

Majima and Nishikino were not content to be just assistants, and wanted to be the main surgeon just like Aki Tomoya.

And their supervising physician is not like Yoshida Aoba, who has a say in the department that is only weaker than Sasaki Ichiru.

Although I have enjoyed a lot of conveniences here, I still need to gain experience as an assistant in the surgical team first.

However, they do not allow the doctors to participate in every surgery they instruct them to do.