My daily work as a doctor: My treatment value is increasing.

The person in question was eventually found—an unfortunate nursing intern.

If you need to return medications purchased from within the hospital, there are errand runners who will handle it. However, these out-of-pocket medications are not within the scope of their work.

Full-time employees are too busy, and no one has time for them, so in the end, it can only be left to the interns.

They go to the pharmacy several times a day, so it's hard not to complain.

So when I came across that post on a social media platform, I couldn't help but reply with what I knew.

He Ping pointed at the trembling intern and berated him furiously, spitting as he spoke.

"Delete the post right now, make her go back and reflect on it, write a self-criticism, and if that doesn't work, send her back to school," he roared angrily.

Seeing that Director He had lost his temper, the head nurse quickly advised, "You have to write it. You definitely have to write a self-criticism."

"Director, please don't be angry. They are still children and don't understand the implications. It was an unintentional mistake."

Director Zhao, who had been sitting silently to the side, also spoke up, saying, "Director He, calm down."

"Let's teach her a lesson this time, and she'll be more careful in the future. Don't let such a small thing upset her."

He Ping snorted, his face still grim, but he didn't retaliate further and turned to leave.

Director Zhao didn't leave with him, but continued talking to the head nurse. The head nurse looked serious, but eventually nodded.

The hospital announced the intern's disciplinary action: eligibility for awards and honors was revoked, and a written self-criticism was required…

The storm has been temporarily suppressed.

……

In recent surgeries, besides one patient with anal trauma, there was also a patient with anal fissure. The patient has been anesthetized and positioned correctly.

Zhang Weimin did not rush to start, but first dipped his index finger in lubricant and gently performed the finger examination.

He carefully examined the inside of the anal canal, assessing the depth and location of the tear, as well as the degree of spasm of the internal anal sphincter.

"Chronic anal fissure, with mild sentinel pile and hypertrophic anal papillae."

Anal fissure? He recalled the definition from his textbook.

There are many causes of anal fissures, including congenital abnormalities in the local anal anatomy and acquired injuries or irritations.

After the patient's skin is damaged, the wound is difficult to heal, and repeated infections and tearing occur, eventually forming a chronic ulcer, namely anal fissure.

The structure of the human anal canal is very special, making it more susceptible to injury and less prone to healing compared to other areas.

This is because the support formed by the external sphincter in front of and behind the anal canal is not as strong as that on both sides.

Especially in the later stages, the tissue is not only thin but also has poor blood supply, resulting in poor tissue repair ability and slow healing speed after damage.

It's a vicious cycle: hard, dry stools cause tears in the anal canal skin, the tears irritate nerve endings and cause severe pain, which in turn reflexively leads to persistent spasms of the internal anal sphincter.

Then the blood vessels are compressed, which further reduces blood supply. Tissue ischemia and hypoxia prevent the laceration from healing properly, forming a chronic ulcer.

Unhealed ulcers are irritated and damaged again during the next bowel movement, triggering a new round of pain and spasms, which worsens the condition.

Of course, not all anal fissures require surgery. The vast majority of acute anal fissures can be cured with non-surgical treatments such as suppositories, while chronic or complex anal fissures require surgery.

This patient developed anal fissures due to chronic constipation and hard stools, which caused him to strain excessively during bowel movements. Each strain caused the anal fissure to tear, and before it could heal properly, it would tear again, resulting in a recurring pattern of anal fissures.

Based on his condition, Lu Renxin initially determined that he should undergo a longitudinal incision and transverse suture procedure.

This is a common surgical method for treating chronic anal fissures with anal canal stenosis. Simply put, it involves making a longitudinal incision and then suturing it transversely.

The anal canal is like a water pipe. Now the pipe diameter is too small, so things can't pass through. So we cut it vertically, then pry it open and connect it horizontally to the lower part.

Of course, the anal canal is elastic. When it is cut longitudinally, not only are the ulcer and hardened scar tissue removed, but part of the spasmodic internal sphincter is also cut off.

Relaxing the entire taut ring can relieve the patient's pain and improve local blood circulation.

Transverse suturing can effectively increase the circumference of the anal canal, thereby relieving anal canal stenosis and making defecation smoother.

Holding an electric knife, Zhang Weimin made a longitudinal incision along the posterior midline of the anal fissure without the slightest hesitation.

His movements were clean and efficient, with smooth and neat incision edges and almost no excess bleeding.

The faint "sizzling" sound of the electrocautery burning tissue was very clear in the operating room.

Lu Renxin's attention was entirely focused on the teacher. His movements were minimal, but every cut and scissor was just right.

Zhang Weimin gently lifted the scar tissue at the edge of the tear with tissue forceps, while the scissors in his hand moved back and forth within the gap, skillfully avoiding the surrounding healthy blood vessels and nerves.

This is a crucial step that reduces skin tension during subsequent transverse suturing and prevents the incision from reopening. His hands were steady, without the slightest tremor.

"Look here," Zhang Weimin pointed with tweezers to the lower edge of the separated internal sphincter muscle, "this is the root cause of the spasms and pain."

Lu Renxin quickly handed over a pair of scissors, and under his watchful eye, Zhang Weimin made a single cut.

With a "click," the previously taut anal muscles instantly relaxed.

Next came treating the patient's anal papillae and sentinel hemorrhoids. Zhang Weimin remained calm and composed, his years of surgical experience allowing him to handle the task with ease.

Like an experienced gardener, he carefully pruned away the excess branches and leaves, cleaned up the diseased tissue, and left the normal structure undamaged.

The entire surgical procedure was smooth and efficient, without any unnecessary movements or panic.

Lu Renxin felt that his teacher seemed to be enjoying himself, as if he were sculpting something, which was the skill he had cultivated over many years of clinical practice.

Although his surgical skills are considered good among students, he is still just a junior surgeon compared to the experienced Zhang Weimin.

These are skills that cannot be learned quickly; they are honed through countless surgeries.

Finally, Zhang Weimin used absorbable sutures to suture the incision, inserting the needle from the upper end of the longitudinal incision, taking in a little of the basal tissue, and then exiting from the lower end of the incision.

Align the two cut surfaces and suture them intermittently with 3-7 stitches to complete the horizontal alignment. The distance between each stitch is as if it has been measured with a ruler.

Zhang Weimin's movements were skillful and graceful as he pulled the sutures tight and tied a surgical knot.

"Alright, the surgery was a success." He put down the instruments, let out a long sigh of relief, and a barely perceptible smile appeared on his face.

When will I be able to reach my mentor's level of skill? This thought couldn't help but surface in Lu Renxin's mind.

Medicine is a discipline that relies heavily on experience; he felt that one needed at least ten years of clinical immersion to master it.

Even with stitching, if I were to do it, each stitch would take twice as long as the teacher's, and the result wouldn't be as beautiful.

Wait a minute, Lu Renxin suddenly remembered, I have a system!

It seems there's a feature in the system called...precision suturing.