top student at medical school

Can we please not rush to Chapter 200? (Please subscribe)
"Doctor, can we postpone the surgery for the fracture and stop the bleeding first?" Fang Ziye was just a junior doctor, so the task of handing over pens to patients' family members for signatures fell to him.

Given the risks Xue Tao mentioned, as an employee of a medical device company, he must have a certain medical background.

Active hematoma can be fatal if not treated properly; this is not an exaggeration.

"How can that be? Since the fracture and hematoma have already been treated with open reduction and internal fixation, the fracture must also be treated at the same time."

“To do one and not to do another goes against principle. Only someone who deliberately wants more patients to stay in the hospital to make more money would choose that way.” Fang Ziye’s answer was quite straightforward, and naturally, it was unacceptable.

What a joke! An emergency surgery is all about treating what can be treated and treating it as early as possible. It's not like we're repairing a car.

“I can spend more money,” the patient replied.

As he spoke, he glanced at Xue Tao, who had gone over to make a phone call.

With three patients arriving at the same time, at least three teams will definitely be needed to operate simultaneously as much as possible. Fang Ziye and Xue Tao alone simply cannot handle it.

The sooner these patients' surgeries were performed, the better.

After all, the police outside were just waiting to question her, and Xue Tao didn't mind asking the neighboring hospital for help.

Because Xue Tao was feeling lost and wanted to find an opportunity to fill the void, she thought that the surgery she performed on Pang Hong that morning was a righteous act, but she didn't expect that there would be so many twists and turns involved.

After the surgery, Xue Tao was left with nothing but lingering resentment.

These patients also wanted to stall for time like Pang Hong, but Xue Tao would never give them that time.

Therefore, when making phone calls, spittle flies everywhere.

"No, this goes against the most basic principles. As doctors, we certainly can't do such a thing. It's not a matter of whether you're willing to spend the money or not."

"Look carefully, the proposed surgical procedure is open exploration, hematoma removal, hemostasis, and open reduction and internal fixation of the fracture."

“It’s not just a simple hemostasis technique.” Fang Ziye tilted his pen cap.

Outside, it seemed that family members had come to visit, but they were stopped by the police and only allowed to peek inside from the doorway.

One of the young policemen in uniform stood ramrod straight and reached out to stop them: "You can't go in, they're signing papers inside."

"The suspect currently has an active hematoma. Do not disturb the signing procedures inside. Without surgery, it's not just a matter of whether he has committed a crime or not; it could be fatal."

"You guys went too far! I'm going to file a complaint!" Seeing that they couldn't get in, the family members started trying to find a roundabout way to get in.

“He struck first. We have body cameras. If you don’t know what assaulting a police officer is, we can explain it to you gradually later.”

“We also have some brothers who were injured, but they are not in Enshi Central Hospital now, but in People’s Hospital, to avoid a large number of injured people piling up.”

"If you have any questions, wait until after the surgery to save your life," the policeman said bluntly.

As they were talking, a few more people arrived at the door.

Upon hearing this, Fang Ziye couldn't help but secretly marvel at the truly fierce and unyielding spirit of the people in his hometown.

Even though the crime had already been exposed, they still managed to injure the well-trained police officers during the arrest, which shows their fighting ability is not weak.

Even if their fighting ability is not weak, they will likely be imprisoned in the future.

Upon hearing this, none of the patients who had signed the papers objected.

……

Five minutes later, Fang Ziye received three informed consent forms for the surgery. He also had the family members sign a medical condition disclosure form. Then, Xue Tao led him and the emergency room doctor to take the three patients into the operating room at the same time.

Enshi Central Hospital is not as large as Zhongnan Hospital and does not have an emergency operating room. Most emergency surgeries are performed in the surgical operating room.

Xue Tao's prior arrangements were effective, so when he brought Fang Ziye to the operating room where one of the patients was located, the room was already fully prepared with preoperative debridement kits, orthopedic internal fixation kits, and sterile drape kits.

An instrument nurse was also on hand, who had already prepared sterilized ovum forceps and sterile iodine, just waiting for Fang Ziye and Xue Tao to disinfect and drape the equipment before immediately administering anesthesia and starting the procedure!
General anesthesia was chosen directly, solely to save time.

Fang Ziye took the initiative to stand in the leg support position.

These patients all have lower limb fractures!

Without any hesitation, Xue Tao went straight to disinfecting and washing her hands, then disinfecting again, laying down drapes, and finally putting on a sterile surgical gown. After wrapping the patient's feet and laying down a large single drape, she worked with the scrub nurse to prepare the sterile skin dressing.

The circulating nurse was asked to help prepare the electrocautery, suction device, adjust the current of the electrocautery, and adjust the pressure of the tourniquet on the lower limbs.

After Fang Ziye arrived at the table, Xue Tao said, "Currently, most of the people in our department are with Huang Kai. I just asked, and there's no one who can get in."

"But many people are helping, so we can't spare enough people here."

"The trauma surgery departments at People's Hospital and Minzu University Hospital are better, so they are treating some police officers who were injured on duty. Therefore, we need to complete the three emergency surgeries as soon as possible!"

"In the other two operating rooms, Guang Shenqing and Cao Zhen were temporarily called over to conduct exploratory procedures. Guang Shenqing is fine, but Cao Zhen is too young, so I doubt he can handle it."

"Ziye, can you!?" Even though the patient was under general anesthesia and couldn't possibly hear, Xue Tao still cautiously stopped halfway through his sentence.

He had only done this once before, when the old director of Hongdu led him through it.

That was the only time, when Director Hongdu, in the late 20th and early 21st centuries, during that rather unique and domineering era, came up with a small technique for controlling the duration of patient surgeries.

However, such things should not be discussed in front of the patient and their family, even under anesthesia.

"Okay!" Fang Ziye understood Xue Tao's meaning.

"Brother Tao, after I quickly performed the exploratory hemostasis here, I'll go over to Cao Zhen's side to help stop the bleeding. You and this surgical technician, try to do the rest of the debridement first," Fang Ziye replied decisively.

Actually, it's common knowledge that there are no blood vessels or nerves within a certain range around the bone.

Many orthopedic surgeons know that as long as they can see the bone and perform surgery close to it, they will not make any major mistakes; it's like finding their way home.

Vascular exploration and hemostasis without any preoperative examinations can be incredibly troublesome if you're clueless.

Xue Tao didn't know how Fang Ziye was able to do it, but she knew that Fang Ziye's ability to do it so silently and effortlessly was a testament to his mastery of repositioning techniques, far surpassing even the old director of Hongdu.

Then, Fang Ziye did not hesitate.

Fang Ziye's hemostasis technique had already been upgraded to level 4 thanks to his previous relationship with Zhang Yu.

Hemostasis is just a basic operation. Although there are more refined downstream techniques such as pressure hemostasis and electrocoagulation hemostasis, these refined specialized skills also originate from basic skills!

It's the higher ceiling of healing that makes basic skills like hemostasis completely useless.

Then, Xue Tao saw Fang Ziye break open the patient's skin without hesitation and cut a three-centimeter incision.

Immediately afterwards, Fang Ziye used his solid basic skills, namely the incision technique, to penetrate deeper layer by layer.

Of course, Xue Tao wasn't just watching; he was merely an assistant, standing opposite Fang Ziye, performing actions such as hooking, blood-sucking, or sucking up the smoke generated by electrocautery.

Before Xue Tao could see it clearly, she saw that Fang Ziye was actually inserting a hemostat deep into the gap of a muscle!

He breathed a sigh of relief: "Brother Tao, it should be fine now. In a bit, you can clean the wound and remove the hematoma. Once you've cleaned it and can see the blood vessels, you can sew it up directly."

"If you can't see the blood vessel, loosen the hemostat a little. Once you see the bleeding point, close the clamp again and start suturing."

Upon hearing this, Xue Tao's hand holding the suction device trembled slightly: "What are you doing?"

My scalp feels slightly numb.

He understood what Fang Ziye meant. Fang Ziye directly clamped the proximal end of the ruptured artery, which was equivalent to completing the hemostasis in advance. The rest was hematoma debridement, vascular suturing, and open reduction and internal fixation of the fracture.

In other words, Fang Ziye can not only create surgical indications, but also clearly know which specific artery is damaged.

What kind of inhuman skill is this?
Therefore, the operation that Fang Ziye is now performing is not as complicated as he imagined. It requires first finding the hematoma, then cutting it open, and then finding the bleeding point or even the bleeding artery inside the hematoma.

Then stab it...

No, it doesn't need to be that complicated.

Fang Ziye has essentially eliminated the source of the bleeding; now all that's left is to clean up the hematoma. Take your time, there's no need to rush.

Fang Ziye did not answer directly: "Brother Tao, I'll come over and help after I've finished dealing with this."

"Okay!" Although Xue Tao found it unbelievable, at this moment, it seemed to be the most scientific arrangement and plan. Fang Ziye then stepped down without hesitation.

However, after Fang Ziye left, the scrub nurse asked curiously, "Who is this guy? Doesn't he look like your subordinate?"

The scrub nurse is not a specialist nurse in orthopedics, but from another department; she just happened to be assigned to the job during her shift.

He didn't know Xue Tao, so it was even less likely that he knew Fang Ziye.

"This is a true genius. He'll definitely become a top expert and professor in the future." Xue Tao took a deep breath, not daring to say anything else to the circulating nurse.

"It looks pretty impressive." The scrub nurse couldn't understand the significance of the procedure Fang Ziye had performed.

Fang Ziye then went to another operating room. When he stepped on the sensor door, he saw Cao Zhen with her flowing hair leading Li Ruokai, a new resident trainee in their group, performing disinfection and draping procedures.

Li Ruokai was a newly transferred resident trainee, and not in orthopedics, so he knew nothing about most things in the department.

He was still complaining bitterly: "Brother Zhen, what kind of mess is this?"

"Today, it was clearly Dr. Zhong Xuegao who was on duty. Dr. Zhong Xuegao is in Director Zhang's group, and the surgical patients are in Director Wu Guonan's group. Why is it that our group is neither on duty nor has any surgical patients, yet we still have to come and move bricks?"

This is a very normal mindset.

The reason for grouping patients in clinical settings is to clarify responsibilities and tasks.

Each group should handle its own tasks.

Upon hearing this, Cao Zhen glanced at Li Ruokai but didn't say much, continuing to carefully disinfect.

However, after seeing Fang Ziye step open the foot-operated sensor-operated lead-plate door of the operating room, she turned to look at Fang Ziye with a puzzled expression: "Dr. Fang, what brings you here? Weren't you supposed to be performing surgery with Brother Tao?"

Fang Ziye had already washed and disinfected his hands outside, so he walked in with his hands raised respectfully and replied calmly, "Dr. Cao, it's like this, the hemostasis on our side has been completed."

"So Brother Tao asked me to come and help out. After I finish stopping the bleeding here, I'll go over and help out there." Fang Ziye walked straight toward the sterile drape pack, his tone neither pleased nor angry, and he didn't seem to be showing off.

Normally, Fang Ziye would be happy to feel that his skills were somewhat good, but today, Fang Ziye was indeed not very happy.

Upon hearing this, Cao Zhen, who was disinfecting the oval forceps, trembled slightly in his hand.

But the trembling arc was very, very small.

So Li Ruokai didn't notice at all.

Because of Fang Ziye's arrival, Li Ruokai stopped complaining.

Fang Ziye is not only a PhD from Zhongnan Hospital, but also a member of Director Wu Guonan's team. It would be inappropriate to complain in front of Fang Ziye.

Cao Zhen's disinfection work was nearing its end.

Fang Ziye then naturally picked up Xiao Dan, moved closer to the operating table, and helped with disinfection and draping!
"Towel clamps!" Fang Ziye called out to the scrub nurse after laying out two vertical sheets.

The scrub nurse then handed over the towel clamps upside down...

After seeing Fang Ziye take over the towel-laying operation, Cao Zhen used hand sanitizer again to disinfect her hands before getting dressed.

In orthopedics, in addition to the drape, there is also a step of wrapping the feet and hands. Unless it is a foot or hand surgery, these two areas need to be wrapped with a drape to maintain sterility.

After putting on sterile surgical gowns and gloves, Fang Ziye, with the help of the scrub nurse, completed the draping of the surgical drape.

Cao Zhen immediately took over Fang Ziye's position, folded the mid-range shirt, placed it flat under the operating table, and let Li Ruokai slowly put his feet down. Then he smiled and said, "Ziye, you did a really fast job of stopping the bleeding."

"Okay."

"Dr. Cao, I'm going to get dressed too." At this moment, Fang Ziye was only thinking about saving as much time as possible.

Since we're already in the operating room, we should still go see Huang Kai after the surgery.

Fang Ziye and Huang Kai have a good personal relationship, so he should have gone to visit. However, the reason he didn't go before was that Fang Ziye himself had surgical duties to perform and needed to work on the operating table.

Then Master Deng Yong came to Enshi. As a student, it was equally important to entertain my teacher.

Otherwise, even if I went to see Huang Kai, it would just be a glance. Could I possibly go on stage, push someone else out of the spot, and show off my great power?
In reality, emergency rescues and surgeries are not performed in this way.

Whoever is in that position does the work of that position.

Later, after Professor Deng Yong and others were called away, Director Wu Guonan made other arrangements for Xue Tao and himself.

At any time, finding one's proper place in medical practice is the most crucial thing.

Especially in urgent situations, every position is crucial and cannot be left vacant or absent. If there are any special circumstances, they must be reported.

When someone entrusts you with a position, it's a sign of their trust in you!
……

Fang Ziye arrived and spent about five minutes disinfecting and laying out towels.

After putting on sterile surgical gowns and applying sterile skin dressings, Fang Ziye and Cao Zhen immediately began to try to stop the bleeding.

Cao Zhen placed the steering wheel in front of him, intending to operate it himself.

At this moment, Fang Ziye offered, "Dr. Cao, how about I try to stop the bleeding?"

Upon hearing this, Cao Zhen raised his head slightly and thought for a moment. Fang Ziye was able to stop the bleeding so quickly next door, so he probably really had something on his body.

Cao Zhen was unaware that Fang Ziye had displayed remarkable skill during Zhang Yu's surgery, as he hadn't witnessed it firsthand.

However, this time Fang Ziye was even faster than when he performed the hemostasis procedure with Xue Tao before.

Because the popliteal artery's course is more superficial!
Basically, once the skin is broken and you penetrate two or three centimeters in, the popliteal artery is exposed.

However, Fang Ziye did not directly clamp the popliteal artery, but instead snapped the posterior tibial artery with hemostatic forceps.

After thinking for a moment, he said, "Dr. Cao, I won't get involved in the hematoma cleaning and fracture open reduction and internal fixation. Brother Tao still needs people."

After Fang Ziye finished his procedure, he took a careful look at Li Ruokai, who was not yet dressed. He figured that if he stepped back from the operating table, he wouldn't contaminate Li Ruokai, so he quietly stepped back.

Then he began to take off his gloves and untie the belt of his clothes, all in one smooth motion without any hesitation.

At this point, Li Ruokai didn't even go on stage.

The act of getting dressed froze in place.

Fang Ziye wasn't trying to show off. After throwing the clothes into the cloth recycling bin, he walked to the storage table in the operating room and calmly left the operating room.

There were no graceful strides, only the steady footsteps of someone hurrying along and the squeaking of rubber slippers against the ground.

Cao Zhen only realized that Fang Ziye was leaving when he arrived at the operating room door; Fang Ziye had already stepped off the operating table.

And this speed was so fast that from the start of Fang Ziye's operation to the end, it only took a little over a minute, which was ridiculously fast.

However, Cao Zhen still didn't say much, nor did he suspect that Fang Ziye was simply leaving to show off.

Because Fang Ziye didn't have to come. If he didn't, given his temperament and personality, he certainly wouldn't have come at such a crucial time just to show off and then leave.

He arrived so quickly and with such confidence, clearly indicating that he knew what he was doing.

And this is what Director Hongdu meant by the confidence that some people have in terms of strength.

"Li Ruokai, come up on stage." Fang Ziye's figure disappeared, and the lead-plate door closed again. Cao Zhen still saw Li Ruokai standing there in a daze, and shouted.

Li Ruokai's eyes flickered rapidly, his face full of confusion.

When Cao Zhen realized what was happening and refocused his attention on the operating table, he discovered that Fang Ziye had silently and without him noticing that he had already completed the reduction of the fracture, and now he was just a tool for internal fixation.

Damn it.

Cao Zhen's defenses crumbled.

Can we not go so fast?

(End of this chapter)