Healing Doctor

Chapter 781 The Surgeon Forgot How to Perform the Surgery

Ji Xiang stood in the system's operating room, staring blankly at the system NPC.

"What's wrong with you?" The system NPC asked, puzzled, seeing Ji Xiang's bewildered expression.

Since entering the system's operating room, Ji Xiang has always greeted the system NPCs respectfully every time he enters, and he has never acted so foolishly before.

Moreover, Ji Xiang's face looked terrible; one glance was enough to tell that something had happened.

"Teacher..." Ji Xiang stammered, a little embarrassed, "I suddenly don't know how to perform surgery anymore, what should I do?"

The system NPC was not surprised by Ji Xiang's nonsensical words. He put his hands behind his back, bent over, walked up to Ji Xiang, and raised his hand to touch Ji Xiang's head.

Ji Xiang was very tall, while the system NPC was hunched over and rather short. Although Ji Xiang was confused, his instincts were still intact. Seeing the system NPC's gesture, he quickly bent down.

The system NPC patted Ji Xiang's head and said with a smile, "You are the last surgeon in the Empathy System to appear who doesn't know how to perform surgery."

"???"

Countless question marks rose above Ji Xiang's head.

What does the system NPC mean? The last surgeon who can't perform surgery?

Although the last one, this qualifier seems to be a compliment to himself, he wouldn't be performing surgery... Ji Xiang had never heard of a doctor having such a moment.

"Your performance was excellent, exceeding expectations." The system NPC smiled slightly. "Come on, let's go for a smoke."

Ji Xiang respectfully followed the system NPC into the changing room.

Under the "No Smoking" sign, Ji Xiang saw the system NPC pull out a white Ganoderma lucidum.

This time, the system NPC didn't just smell it; instead, it lit a cigarette and took a deep drag.

After a long while, he finally caught his breath.

"Dr. Ji, do you know when even the most skilled surgeon might become ineffective, feeling like you've lost the ability to perform surgery?"

Ji Xiang shook his head.

"Let me tell you a few things," the system NPC said slowly. "The first thing is about one of my students. He is very diligent and hardworking, and his skills have improved very quickly. Although his talent is not top-notch, he makes up for it with his hard work and study, and with my guidance as a master, he quickly became a top-tier mage."

Ji Xiang wasn't surprised at all when the system NPC told him that he was a famous teacher.

"Once he had surgery for high esophageal cancer, which at that time required three incisions, a neck anastomosis, and a subcutaneous tunnel."

"The surgery was considered successful, but the neck incision did not heal properly after the operation, resulting in anastomotic leakage that caused headaches."

Anastomotic leakage is relatively common, especially after high esophageal cancer surgery, which is the greatest risk. The patient's family expressed understanding, but he became emotionally unstable at this point, refusing to allow his surgeons to change the dressings, insisting on changing them himself each time and removing the purulent discharge, hoping for a rapid wound healing.

"Teacher, is this wrong?" Ji Xiang asked, somewhat puzzled, after listening to the description from the system NPC.

"Yes, yes, but he felt guilty and distrusted his own surgery," the system NPC said. "In addition, patients with esophageal cancer anastomotic leakage will have a putrid smell coming from the area, which is not only in the ward but also in the ward corridor."

"This pervasive smell further increased his psychological stress."

"Every day when I come to the hospital, I can smell the stench of decay even before I enter the ward. Xiao Ji, let me ask you, what would you think if you were the one performing the surgery on the patient?" The system NPC asked, staring into Ji Xiang's eyes.

"Uh..." Ji Xiang hesitated for a moment, then thought about it from the other person's perspective before replying, "Surgery can't be 100% successful, and the local blood supply is indeed poor after anastomosis for high-level esophageal cancer. Even if problems arise, I think it's understandable as long as there are no major mistakes during the surgery."

"Surgery can't guarantee a 100% success rate. Since it's happened, we should face it positively."

The system NPC shook its head.

"That's the difference between an intern and an attending physician," the system NPC said. "Doctors are under a lot of pressure. To put it bluntly, it might be a little better if a patient suddenly suffers cardiac arrest and resuscitation fails. Every day when they come to the hospital, they are surrounded by the smell of rotting anastomoses, which is even more unbearable for the surgeons."

"And then, teacher?" Ji Xiang asked.

"Later, he couldn't perform surgery anymore. Three surgeries failed in a row, and I was the one who saved the day."

"Once I went to assist him and confirmed that he was no longer capable of performing surgery, I simply let him go on vacation and have some fun. Being away from the hospital would help him recover faster."

"Well……"

Ji Xiang could vaguely sense the feeling that the system NPC had described.

Suddenly he couldn't perform surgery anymore, so much so that the senior doctor became his assistant.

But none of this benefited the practitioner; instead, it became a burden.

"Teacher, what happened next?"

"Later, I found a junior doctor to change the dressing twice a day and give the patient enough protein. After more than 20 days, the anastomotic leakage in the patient healed."

"Does he not know that esophageal anastomotic fistulas take time to heal? He definitely does. What do you do in this situation? Just let it heal, it's common sense that even an intern knows."

The system NPC asked and answered its own questions, and Ji Xiang listened attentively.

"But the pressure was too great, which caused my technique to go awry. It's similar to sports competitions. In key events, some people's bodies can withstand the stimulation of large amounts of dopamine and adrenaline, and they can perform exceptionally well. Others can't handle it and will definitely falter before the big competition."

Upon hearing from the system NPC that something had gone wrong, Ji Xiang scratched his head.

Although he knew he was better than himself, Ji Xiang was still a little embarrassed.

"Later, when he came back, I told him a lot. To be honest, I know these kids say behind my back that I'm willing to instill my worldview and they're annoyed by my long-winded lectures, so I rarely talk to them about it."

"But this time is different."

"He got better later, right?" Ji Xiang asked, a little nervously.

"Of course, could someone really forget how to perform surgery?" The system NPC laughed. "There are similar cases, though I'm not a doctor, but it's an extremely rare disease, so I won't go into details."

Seeing that Ji Xiang was still a little uneasy, the system NPC laughed and said, "A doctor suffered from amnesia due to a car accident. He could no longer be diagnosed with amnesia, but he still had the muscle memory from the surgery. He insisted on having surgery a month later after being diagnosed with amnesia."

"!!!"

Ji Xiang remained silent.

"That's just one thing. Let me tell you a second story, which I also experienced firsthand."

Ji Xiang felt that he was not in the first situation. He listened carefully and did not forget what the system NPC had taught him at any time, as he usually did.

"Something happened when I was young." The system NPC's expression turned serious. "Back then, I was in a field hospital, and the old sergeant in the mess hall was a good friend of mine. We couldn't find any tobacco leaves, so we would roll up dry tree leaves and smoke them. Every night after dinner, if we weren't busy, we would smoke tree leaves and chat together."

"Later, when the old squad leader was injured, my mind went blank. All I saw was blue blood, just like the sky."

"!!!"

"At that time, I forgot everything, not even the most basic first aid, let alone surgery. Looking at the old sergeant, I was completely stunned and just rolled him a cigarette." The system NPC said, sighing deeply, "If I hadn't panicked, perhaps the old sergeant could have been saved."

Ji Xiang never expected that the system NPC would tell him such a past event that he would never want to remember for the rest of his life.

"Would you like to give it a try?" the system NPC suddenly asked.

"Huh?" Ji Xiang was taken aback.

He saw the system NPC's cloudy eyes suddenly become clear, and he nodded subconsciously.

Go to the battlefield filled with the smoke of gunpowder?

Ji Xiang's palms were sweating.

Although it was just empathy, Ji Xiang couldn't help but feel nervous.

The system NPC stubbed out the cigarette, and Ji Xiang took the cigarette butt, threw it into the toilet and flushed it away. He then followed the system NPC to the outside of the operating room.

The light flickered, but Ji Xiang didn't open his eyes immediately. Instead, he took a deep sniff.

There was no smell of gunpowder, nor any deafening cannon fire; instead, there was a faint smell of a hospital.

Disinfectant, sweat, and noisy voices mingled together.

Sound and smell can be mixed together, which is a particularly strange feeling, but Ji Xiang insists that it is real.

Lying in bed, "oneself" is from the perspective of an observer.

Ji Xiang had nothing to do this time, so he immediately read "his" memories.

It turned out that her own grandfather had terminal lung cancer and there was no possibility of treatment; he was waiting to die.

"I" am a doctor, and I take turns with other family members to take care of my grandfather.

But ever since Grandpa was hospitalized, "I" know very well that he doesn't have much time left, so I've been suffering from insomnia and anxiety lately, and haven't slept for several days.

After taking a break from my shift, I lay in bed but couldn't fall asleep at all; all I could do was let my mind wander.

Ugh.

Ji Xiang sighed helplessly.

Joy and sorrow, separation and reunion—these are the normal occurrences in human life; there's nothing we can do about it.

However, my grandfather is in the terminal stage of lung cancer, so surgery is probably not required.

eccentric.

When Ji Xiang is searching his memories, he is often disturbed by his own recollections.

When I was little, I lived with my grandfather, and my memories are full of the warmth of my childhood.

There are elm tree coins, and... silly roe deer.

Grandpa took his hunting rifle and went hunting with "himself"; the prey was a silly roe deer.

That thing is really stupid; Ji Xiang is particularly helpless about the roe deer's stupidity.

It seems that my own silly roe deer is much smarter.

The warmer the memories, the more painful it is at this moment.

People can't be kept here, so "I" can only stay in the department day and night, accompanying the elderly person through their final days.

Although exhausted, "I" felt nothing at all, lying silently in bed, not sleeping, just gazing at the sky.

"Brother Ji! Grandpa says he can't breathe properly, can you take a look?"

The nurse pushed open the door and hurriedly said.

"Myself" immediately jumped up.

"Bang!" Her head hit the bunk bed. Ignoring the pain, she shuffled off in her slippers to the ward.

The elderly man had a withered face and sat upright, breathing. With each inhalation, the supraclavicular fossa, suprasternal fossa, and intercostal spaces would simultaneously retract, a very typical three-recession sign.

"Grandpa," Ji Xiang called out softly.

The old man sat on the bed and gently waved his hand.

The simple movements made it increasingly difficult for him to breathe, especially since the depression above his collarbone was so deep it could hold a bowl of water.

Ji Xiang hurriedly took out his stethoscope.

The elderly patient had lung cancer in the right lung, with metastases throughout the body. There were originally a few breath sounds on the right side.

But there were no breath sounds on the right side during auscultation!

Ji Xiang immediately performed percussion and confirmed that it was pneumothorax with a large amount of pleural effusion.

Moreover, it must have appeared suddenly, because this didn't happen earlier in the morning.

What should we do next?

"Prepare for closed thoracic drainage!" "Myself" shouted.

The nurse immediately went to prepare the items.

Ji Xiang recalled a time when he was undergoing closed thoracic drainage and the doctor almost pushed him against the wall.

That fucking hurts!

However, that's in young people, caused by local tension after an injury, resulting in tight muscles and pleura.

If it were an elderly person, they probably wouldn't have such a strong reaction.

and……

Ji Xiang hoped the nurse would bring in a chest tube, a high-value consumable.

As luck would have it, the nurse brought in a bunch of things, including a chest tube, a high-value consumable.

This type of chest tube is thinner than the ordinary one and has a steel core in the middle, making it easier to insert into the chest cavity.

Even if there is pleural or muscle tension, the patient will not end up slamming their head against the wall.

"I" am a thoracic surgeon, so I imagine that a minor procedure like closed chest drainage should not be difficult for me.

Is it...

Ji Xiang suddenly recalled the content of this empathy.

Surely they can't even handle something this small?

"She" opened the incision kit herself, and the nurse quickly filled the breast bottle with topical saline and opened a bottle of ropivacaine.

Draw anesthetic into a 5ml syringe, dilute with saline, and prepare for local anesthesia.

Although Ji Xiang is not a thoracic surgeon, he understands the most basic principles.

In cases like this elderly person, ultrasound positioning is unnecessary; the chest tube can simply be inserted between the 6th and 7th ribs along the mid-axillary line.

After the anesthesia was administered, "Zizi" appeared perfectly normal, and Ji Xiang calmly observed him.

Disinfect the area, lay down a drape, pick up a 5ml syringe, and then push the air out.

The movements were skillful and steady; to say they were fluid and effortless would be an exaggeration, but they were absolutely flawless.

Ji Xiang stared intently at "his own" movements. Holding the syringe with sterile gloves, the needle tip just touched the skin when "himself" suddenly stopped.

Uh……

Ji Xiang could feel that his mind was blank and his hands were shaking. He couldn't even use a knife, let alone the simplest anesthesia.

At this moment, Ji Xiang really wanted to take control of the body and start anesthesia and closed thoracic drainage.

Such a simple minor surgery!

But "I" am so useless. My hands are shaking so badly that I have lost all muscle memory. My body is sore and weak, and I start to see stars.

"I" steadied myself and took a deep breath.

As fresh air was inhaled, "oneself" seemed to become a little more energetic.

Try again.

The moment the needle touched Grandpa's skin, "I" chickened out again.

The muscle memory mentioned by the system NPC had completely disappeared, and "I" was like a novice who didn't know how to perform surgery, staring blankly with a syringe in my hand.

"Brother Ji?"

The nurse looked surprised and asked in a low voice.

Ji Xiang could already feel cold sweat all over his back, which instantly soaked his white clothes.

How can you be so useless!

Ji Xiang was criticizing "himself," but more importantly, he was criticizing himself.

They can't even handle a simple matter; are they really that useless?

Recalling his strange behavior in the operating room, Ji Xiang understood somewhat, but was still dissatisfied.

The situation I'm facing is far less severe than what I'm experiencing now; it's just some accumulated feelings from sharing those experiences. I can't even have surgery; I'm truly useless.

But right in front of him was the grandfather who had raised him since he was a child; he couldn't bring himself to do it...

That doesn't seem right either.

The old man sat upright, breathing heavily, and every second was painful for him.

The sooner we take action to resolve the issue, the sooner the elderly person can catch their breath; that's what we should do.

But I just can't bring myself to do it.

Seeing "himself" trembling, Ji Xiang felt anxious and eager to take over.

A few seconds later, "he" put the syringe into the incision kit, took off his sterile gloves, and without saying anything to his family, muttered a curse under his breath and turned to leave the ward.

"Brother Lang, it's me, Xiao Ji."

After leaving the house, "I" started making phone calls.

"Is it convenient for you? My grandfather needs closed drainage, but I can't bring myself to do it..."

"Thank you, Brother Lang."

After making the call to Shen Lang, "myself" felt weak in the legs and slowly slid down to the ground, leaning against the wall.

Patients and their families in the corridor looked at "themselves" with strange eyes.

They didn't understand, but Ji Xiang did.

This time, the empathy is different from usual.

In the past, we had feelings in the virtual world and then applied them to reality.

But this time, Ji Xiang "forgot" how the surgery was performed in reality, so he came to the virtual world to seek answers.

"He" sat on the ground, his hands covering his head.

Although my eyes were closed, I saw stars flying everywhere and heard a buzzing sound in my ears.

The earlier the surgery is performed, the less suffering the elderly will endure. "I" am well aware of this, but I cannot do it.

Ji Xiang sighed. That was indeed the case.

He compared the differences between reality and the system's empathetic experience and seemed to have found a clue.

"Xiao Ji, I'm here."

Shen Lang appeared before him. He didn't smile, but turned around to change his clothes, and then jogged over.

"Did they take an X-ray?"

"No, the physical examination confirmed it."

"Okay, I'll go take a look. Let's install a pipe first."

Shen Lang didn't hesitate and went straight in to begin the physical examination.

Everything was ready. Shen Lang administered anesthesia, made an incision in the skin, bluntly separated the subcutaneous tissue, and gradually moved to the pleura.

When the pleura was punctured, bloody pleural effusion flowed out directly.

Shen Lang pressed gauze against the incision and inserted the steel-core chest tube.

While "he" was still in a daze, the nurse acted swiftly, clamping the chest tube before Shen Lang could speak and starting to connect it to the tube in the chest bottle.

The nurse then squatted down and opened the clamped chest tube, and bloody pleural effusion and gas were drawn out with a whooshing sound.

"Brother Lang, how much should we use?" the nurse asked.

"500 first, then another 400 in half an hour. The old man is weak, so take it one step at a time," Shen Lang said. "Your brother Ji is already failing, so please keep an eye on him."

"Okay," the nurse replied promptly.

The atmosphere in the department is really great, Ji Xiang thought to himself.

Shen Lang's operation took about a minute from start to finish. Even with such a simple operation, "he" simply couldn't bring himself to do it.

"Keep an eye on things and check back every few minutes," Shen Lang added before pulling "himself" away.

"Xiao Ji, have a smoke and calm down. Your back is covered in sweat." Shen Lang didn't mock "himself," but comforted him, "It's okay, I just couldn't bring myself to do it."

"Brother Lang, I... I'm really useless."

"What are you saying?" Shen Lang lit a cigarette and put it in "his" mouth, then lit another one and smoked it.

"You think everyone's like the director! He's a real beast."

"what?"

Ji Xiang was taken aback when he heard Shen Lang describe Professor Zhou like that.

"A beast!" Shen Lang actually described Professor Zhou like that.

"The boss had aortic dissection years ago and had already signed the 'give up' papers. His eldest brother rushed back from abroad to see him, and no one dared to say a word against it. But just after they had given him some milk, the boss fell asleep, so Congwen turned off the insulin pump and rushed the boss to surgery."

As Ji Xiang listened to Shen Lang describe the past, he felt a sense of longing.

He could roughly sense the relationship between Professor Zhou and the boss; they were like teacher and father, not distant as they were in the present situation.

But Professor Zhou acted swiftly and decisively.

"The eldest and second eldest brothers were completely dumbfounded. No one dared to step in; they were too hesitant. In the end, I followed Wen's lead and used an interventional method to remove the large scaffolding. It was the first time in China that a 3D-printed scaffolding had been attempted."

"I thought to myself later, people like the eldest and second senior brothers are normal. But look at Wen... the boss is still in good health now, he's lived so many more years."

Shen Lang was still rambling on, and Ji Xiang was completely captivated by it.

"So, Congwen is nothing but a beast!"

"Brother Lang, don't talk about the director like that."

"I'm praising him." Shen Lang smirked and laughed. "Only a man would dare to take action in that situation."

"Well……"

"I'm asking you, what makes a person with a strong inner self?" Shen Lang asked.

Ji Xiang pondered, and "himself" did not answer, but looked at Shen Lang, waiting for him to give an answer.

"A psychiatrist on Twitter made a very insightful comment—people who can't empathize with others are actually very strong inside."

Ji Xiang was suddenly stunned.

Shen Lang seems to have given the ultimate answer, but his answer contradicts the Empathy System.

What exactly is going on?

Ji Xiang originally thought that he was only going through a "trial", but he never expected that Shen Lang would give him an answer that exceeded his expectations.

This answer even completely overturned the empathy experienced in the operating room.

"Is that so, Brother Lang?"

"Of course! Look at Old Zhao from the gynecology department, he's always so empathetic, which is why he couldn't even be a doctor. But he's incredibly capable; he's now the head of the medical records department."

"From a literary perspective, it would be better if Lao Zhao had low empathy."

"He is highly skilled, meticulous, and his surgeries are superb."

"pity."

Shen Lang, with a cigarette dangling from his lips, mumbled something like a hoodlum.

Ji Xiang fell into deep thought.

Although this was an observation from an outsider's perspective, and he didn't have a chance to chat with Shen Lang, it didn't stop Ji Xiang from thinking.

Shen Lang makes a good point.

But should we empathize, or not? Ji Xiang pondered this question for a long time.

Empathy allows you to put yourself in the patient's shoes and think from their perspective.

However, at times, empathy can make one vulnerable, to the point that one "forgets" surgical skills.

Since he couldn't ask questions, Ji Xiang wrote this down and planned to ask the system NPC when he got back.

(End of this chapter)