Top-tier doctoral supervisor, reborn as a first-year graduate student in standardized residency trai

Gu Lin tilted his head and thought for a moment.

"This is the first time I've stitched up the outside of the stomach and intestines."

Song Zhe: "..."

The answer is perfectly correct, but something just feels off.

Just then, a system notification sounded quietly.

[Initial skin suturing completed]

[Rating: Excellent]

[Award Awarded to Specialists in Surgical Suturing]

[Surgical Care Growth Path: 15% → 20%]

A plethora of techniques for intradermal suturing, interrupted suturing, continuous suturing, and tension-reducing suturing instantly flooded my mind.

Gu Lin blinked gently. It seemed the patient would be very happy when the stitches were removed.

After the surgery, the patient was sent to the recovery room, where the scrub nurse began to count the instruments, and the operating lights slowly went out.

The tense atmosphere in the operating room finally relaxed.

Lin Hanchuan took off his sterile gown and gloves.

"This is the only machine our group has today. The rest have been distributed to groups two, three, and four. You two come back to the ward with me. I have other things to do this afternoon."

"Okay, Director Lin."

Gu Lin and Song Zhe took off their surgical gowns and followed Lin Hanchuan outside.

As soon as he stepped out of the operating area, Song Zhe couldn't help but come over and whisper.

"Honestly, you've never worked in surgery?"

Gu Lin thought for a moment.

"Wait until you get to the emergency room."

Song Zhe: "..."

Of course he knew that Gu Lin had been to the emergency room.

The problem is that emergency medicine and gastrointestinal surgery are completely different fields. The coordination just now was nothing like the first time they were on the operating table.

But seeing Gu Lin's expression, Song Zhe couldn't get any answers from him, so he could only give himself an explanation in his heart.

talent.

Some people are like that; they learn everything so quickly that it's impossible to be envious of them.

When I got back to the office, it was already past 1 p.m., and many doctors were eating their boxed lunches while writing medical records.

Gastrointestinal surgery doesn't have the same thrilling pace as the emergency room, but it has its own kind of constant busyness.

Discharge records, medical progress notes, preoperative discussions, examination requests, and doctor's orders must all be completed without error.

Just as Gu Lingang was about to turn on his computer, the office door was suddenly pushed open, and the chief resident poked his head in.

"Director, the case discussion is at 2 PM this afternoon. The meeting room is ready."

Lin Hanchuan was looking at the medical records and responded softly.

"understood."

Gu Lin paused slightly.

Case discussion?

Lin Hanchuan glanced up at him briefly.

"You'll be with me in a bit."

"Yes, Director."

At 2:00 PM sharp, in the gastrointestinal surgery conference room.

This was Gu Lin's first time participating in a formal case discussion since his rebirth.

The meeting room wasn't large, but the projector was already on, and a dozen or so doctors took their seats one after another.

Almost everyone, except those currently undergoing surgery, came – including resident trainees, attending physicians, several attending physicians and deputy chief physicians.

Lin Hanchuan sat at the front, with various patient information displayed on the computer in front of him.

The person in charge of the presentation was a senior resident physician. The projector lit up, and patient information appeared page by page.

A 52-year-old male presented with recurrent abdominal pain for three months, a weight loss of seven kilograms in the past month, intermittent abdominal distension that worsened after eating.

The inspection results were flipped through page after page.

The gastroscopy and colonoscopy were normal, and the abdominal CT scan did not reveal any obvious lesions.

However, the patient's symptoms continued to worsen, and he even showed signs of incomplete intestinal obstruction.

After the presentation, the meeting room fell silent for a moment.

Song Zhe spoke first.

"I still lean towards a small bowel tumor, given its unusual location, which makes it difficult to detect with routine examinations."

The other attending physician next to him shook his head.

"It doesn't seem like it. The tumor markers are too clean, and there's no supporting evidence on the enhanced CT scan."

The discussion lasted for more than ten minutes, with various possibilities being raised one after another.

Crohn's disease, intestinal tuberculosis, stromal tumors, and even some rare diseases have been mentioned, but none of them can be explained, and there is always something that doesn't add up.

Gu Lin sat in the last row, not saying a word from beginning to end, just quietly watching the video and then flipping through the medical records page by page.

In his past life, when he was supervising doctoral students, his favorite thing to do was to see what others had overlooked.

Often, the diagnosis isn't hidden in complex tests, but in the most easily overlooked details.

Just then, Lin Hanchuan, who hadn't spoken until now, suddenly raised his head, his gaze passing over the conference table and landing directly on the last row.

"Gu Lin, tell me your thoughts."

The discussion in the meeting room gradually subsided, and everyone turned to look at them.

Gu Lin has only been here for one day, and it's already surprising enough that he's participating in a case discussion. But the director specifically called him out. This treatment is a bit outrageous.

Gu Lin glanced at the CT scan on the projector, paused for two seconds, and then spoke.

"I think we can try a different approach."

Lin Hanchuan raised an eyebrow slightly.

"continue."

Gu Lin pointed to the image on the screen.

"The patient's problem is not necessarily in the intestines themselves."

As soon as he finished speaking, several attending physicians and deputy directors looked up at him.

Gu Lin continued.

"Gastroscopy, colonoscopy, and CT scans did not find any clear lesions, but the patient's abdominal pain worsened after eating, his weight continued to drop, and he also developed incomplete intestinal obstruction."

He paused, then continued.

"Is it possible that the problem lies in the blood supply?"

The meeting room was quiet. Song Zhe paused for a moment, then asked.

"Blood supply?"

Gu Lin nodded.

"For example, the blood vessels in the mesenteric region."

Lin Hanchuan put down his pen, looked down at the medical record, and remained silent for a moment.

In the conference room, many people had already begun to review the video materials again.

Because this direction hadn't been mentioned before, but upon closer examination, it seems to make sense.

The meeting room was silent for a good three or four seconds.

The group of people who were just discussing intestinal tumors, Crohn's disease, and intestinal tuberculosis lowered their heads and started flipping through their medical records again.

Because the direction Gu Lin mentioned was one that no one had seriously considered.

Or rather, someone considered it, but quickly ruled it out.

After all, mesenteric ischemia is often associated with emergency situations.

Severe abdominal pain, advanced age, atrial fibrillation, vascular embolism...

The patient in front of me had been experiencing symptoms for a full three months, which seemed very unusual.

Song Zhe twirled the pen in his hand.

"Chronic mesenteric ischemia?"

Gu Lin nodded.

"Possibly."

After he finished speaking, he got up and walked to the projector.

"The patient's symptoms are quite distinct: pain after meals, rapid weight loss, negative results from both gastroscopy and colonoscopy, and the symptoms continue to worsen."

Gu Lin lightly touched the image with his pen.

"Because the intestines consume more oxygen after eating, pain will occur if the blood supply is insufficient."

The meeting room fell silent, and many people's expressions subtly changed, because the more they listened, the more plausible it seemed.

One of the attending physicians suddenly spoke up.

"Wait, I have a question. If it's mesenteric ischemia, why didn't the enhanced CT scan report it?"

Gu Lin looked up, and said somewhat uncertainly.

"Is it possible that nobody is looking in that direction?"

One sentence silenced the entire conference room.

This is true of many things in clinical practice; images don't lie, but the person reading them can miss things.

People who suspect intestinal obstruction and those who suspect vascular disease, when looking at the same X-ray, focus on completely different areas.

Lin Hanchuan looked at the chief resident next to him.

"Pull up the video."

The raw radiology data was quickly projected back onto the screen, the conference room lights dimmed, and everyone looked up at the large screen.

Lin Hanchuan stood up, walked to the screen, and flipped through the images one by one.

The entire conference room was so quiet that the only sound was the clicking of the mouse wheel.

Gu Lin sat back down without saying a word.

He knew that he wouldn't need to explain anymore; Lin Hanchuan would personally verify whether what he said was right or wrong.

Time passed second by second, and suddenly, Lin Hanchuan stopped, and the mouse stopped moving.

Everyone in the conference room felt their hearts leap into their throats simultaneously.

The next second, Lin Hanchuan zoomed in on the image.

At the root of the superior mesenteric artery, a narrow area slowly comes into view.