Chapter 782: The Operator Forgot How to Perform Surgery

Ji Xiang stood in the System Operating Room, staring blankly at the System NPC.

"What's wrong with you?" the System NPC asked, puzzled, seeing the blank look on Ji Xiang's face.

Ever since entering the System Operating Room, Ji Xiang had always greeted the System NPC respectfully upon arrival, and had never before been in such a dazed state.

Moreover, Ji Xiang's complexion was terrible; one glance was enough to know something had gone wrong.

"Tea... cher..." Ji Xiang felt a bit embarrassed, stammering, "I suddenly don't know how to perform surgery anymore. What should I do?"

The System NPC, however, was not surprised by Ji Xiang's nonsensical words; he walked up to Ji Xiang with his hands behind his back and his waist hunched, raising a hand to pat Ji Xiang's head.

Ji Xiang was tall, and the System NPC was hunched over, appearing somewhat short. Although Ji Xiang was bewildered, his instincts remained. Seeing the System NPC's gesture, he hurriedly bent down.

The System NPC patted Ji Xiang's head and said with a smile, "You are the latest 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 did the System NPC mean? The last Surgeon who didn't know how to perform surgery?

Although "the last" sounded like a compliment, the part about not knowing how to perform surgery... Ji Xiang had never heard of a Doctor having such a moment.

"Your performance has already been very good, exceeding expectations." The System NPC smiled slightly. "Come, accompany me to smoke a cigarette."

Ji Xiang followed the System NPC respectfully to the changing room.

Under the 【No Smoking】 sign, Ji Xiang saw the System NPC take out a White Lingzhi.

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

After a long while, he finally let out a breath.

"Doctor Xiao Ji, do you know when a skilled Surgeon might find themselves unable to perform, feeling as if they don't know how to operate?"

Ji Xiang shook his head.

"I will tell you a few things," the System NPC said slowly. "The first thing is about one of my students. He was very diligent and hardworking, and his level improved quickly. Although his talent wasn't top-tier, he excelled through hard work and study, and with the guidance of a master like me, he quickly became a First-line Operator."

Hearing the System NPC call himself a master, Ji Xiang didn't feel surprised at all.

"Once, he performed a surgery for High-position Esophageal Cancer. At that time, High-position Esophageal Cancer required a Three-incision Surgery, Cervical Anastomosis, and some Doctors would even perform a Subcutaneous Tunnel."

"The surgery was considered a success, but the cervical incision did not heal post-operatively, and an Anastomotic Leakage occurred."

Anastomotic Leakage is relatively common, especially in High-position Esophageal Cancer surgeries; it is the greatest risk. The Family Member expressed understanding, but at this time, his own mindset developed issues. He wouldn't let the subordinate Doctors change the dressing, insisting on changing it himself every time, debriding the pus, hoping the incision would heal quickly.

"Teacher, isn't that the right thing to do?" Ji Xiang asked, feeling a bit confused by the System NPC's description.

"It is correct, but he developed a sense of guilt, and also a lack of trust in his own surgery," the System NPC said. "On top of that, patients with Esophageal Cancer Anastomotic Leakage have a foul, rotting smell emanating from the local area; it wasn't just the ward, even the hospital corridor was filled with the stench."

"This pervasive smell only increased his psychological pressure."

"Every day when he came to the hospital, he would smell the rotting odor before even entering the ward. Xiao Ji, I ask you, if the patient were someone you operated on, what would you think?" The System NPC stared into Ji Xiang's eyes to ask.

"Uh..." Ji Xiang hesitated for a moment, and after putting himself in that position to think, he replied, "Surgery can't be one hundred percent successful, and the local blood supply after a high-position esophageal anastomosis is indeed poor. Even if a problem arises, I feel that as long as there were no major mistakes during the surgery, it is understandable."

"Surgery, after all, cannot guarantee one hundred percent success. Since it happened, one should just face it actively."

The System NPC shook his head.

"This is the difference between an Intern Doctor and the attending physician," the System NPC said. "A Doctor's pressure is immense. To put it bluntly, if the patient suddenly suffered cardiac arrest and the rescue failed, it might even be better. Every day when you come to the hospital and smell the rotting odor of the anastomosis, it makes it even harder for the Operator to accept."

"What happened later, Teacher?" Ji Xiang asked.

"Later, he didn't know how to perform surgery anymore. Three consecutive surgeries failed, and in the end, I had to be the one to save the operation."

"Until I went to act as his assistant and confirmed he really didn't know how to perform surgery anymore, I just sent him on vacation to go have fun. The further away from the hospital, the faster the recovery."

"Uh..."

Ji Xiang could vaguely sense the feeling the System NPC was describing.

To suddenly not know how to perform surgery, to the point where the Lao Zhuren had to act as his assistant.

But all of this did not help the Operator; instead, it became even more of a burden.

"Teacher, what happened after?"

"Later, I found a junior Doctor to change the dressing twice a day and provided enough protein. After more than 20 days, the patient's Anastomotic Leakage healed up."

"Could he not have known that an esophageal anastomosis leak takes time to heal? He certainly knew. What to do when encountering this situation? Just grind it out with time; it's common knowledge that even an Intern knows."

The System NPC asked and answered himself, and Ji Xiang listened intently.

"But the pressure was just too great, which led to his technical movements becoming distorted. It's similar to sports competitions; in key matches, some people can withstand the stimulation of large amounts of dopamine and Epinephrine and perform extraordinarily well. Others cannot withstand it, and they are bound to mess up when it matters most."

Hearing the System NPC talk about "messing up," Ji Xiang scratched his head.

Although he knew it wasn't about him, Ji Xiang still felt a bit embarrassed.

"Later on, he came back, and I told him a lot. To be honest, I know these little brats say behind my back that I like to instill my worldview and are annoyed by my long-windedness, so I rarely talk to them usually."

"But this time was different."

"He got better later, right?" Ji Xiang asked with some trepidation.

"Of course, could he really forget how to perform surgery?" The System NPC laughed. "There are similar cases, though not Doctors, but those are extremely rare diseases, so I won't tell you more about that."

Seeing that Ji Xiang was still somewhat uneasy, the System NPC smiled. "There was a Doctor who got amnesia due to a car accident. Diagnoses and such were out of the question, but the Muscle Memory for surgery remained, and he actually performed surgeries for another month after being diagnosed with amnesia."

"!!!"

Ji Xiang was speechless.

"That is only one thing; I will tell you a second thing, which is also something I personally experienced."

Ji Xiang felt he was not in the first situation; he listened carefully, not forgetting what the System NPC was instilling in him at any time like he usually did.

"When I was young, I encountered something." The System NPC's expression turned serious. "At that time, I was at a Field Hospital, and the Squad Leader of the Cook Squad and I were very close; we had a great relationship. At that time, we couldn't find tobacco leaves, so the two of us would find dried leaves to roll and smoke. Every night after eating, if we weren't busy, we would smoke leaves together and chat."

"Later, the Squad Leader was injured, and my mind went completely blank. The blood I saw was all blue, as blue as the sky."

"!!!"

"At that time, let alone surgery, I even forgot the most basic rescue procedures. Looking at the Squad Leader, I was completely stunned, only thinking about rolling him a cigarette." The System NPC said, sighing deeply. "If I hadn't panicked, perhaps the Squad Leader might have been saved."

Ji Xiang didn't expect the System NPC to actually tell him about such a past event that he would never want to recall for the rest of his life.

"Do you want to try it?" the System NPC suddenly asked.

"Huh?" Ji Xiang was stunned for a moment.

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

Going to a battlefield filled with smoke and fire?

Ji Xiang's palms were sweating.

Although it was only Empathy, Ji Xiang still couldn't help but feel nervous.

The System NPC stubbed out the cigarette; Ji Xiang took the butt, threw it into the toilet to flush it away, and followed the System NPC outside the Operating Room.

Light and shadow flickered; Ji Xiang did not open his eyes immediately, but instead sniffed hard.

There was no smell of gunpowder smoke, nor did he hear the deafening sound of cannons; instead, he smelled the faint scent of a hospital.

Disinfectant, sweat, and noisy human voices were mixed together.

Sounds and smells could actually be mixed together; this was a particularly strange feeling, yet Ji Xiang firmly believed it was real.

"Himself" was lying on the bed, from the perspective of an onlooker.

Ji Xiang had nothing to do this time, so he read the memories of "himself" at the first opportunity.

It turned out that his own grandfather was in the terminal stage of Lung Cancer, with no possibility of treatment, and was waiting for death.

"Himself" was a Doctor, taking turns with other family members to look after his grandfather.

But ever since his grandfather was hospitalized, "himself" knew very well that he wouldn't live much longer, so he had been suffering from insomnia and anxiety recently, and hadn't slept for several days.

Taking a break to rest, he lay on the bed but felt no sleepiness at all, and could only let his mind wander.

Sigh.

Ji Xiang sighed helplessly.

Joys and sorrows, partings and reunions—these are the norms of the human world; there is no helping it.

It was just that "his" grandfather was in the terminal stage of Lung Cancer, which shouldn't involve surgery.

Strange.

While searching through the memories, Ji Xiang was often interrupted by the recollections of "himself."

When "himself" was young, he lived with his grandfather, and his memories were full of the warmth of childhood.

There were elm seeds, and... Sha Paozi.

His grandfather would take a hunting rifle and bring "himself" out to hunt, and the prey was Sha Paozi.

That thing was truly stupid; Ji Xiang felt particularly helpless about the stupidity of the roe deer.

It seemed that his own family's Sha Paozi was much smarter.

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

People definitely couldn't be kept; "himself" could only stay in the department day and night, accompanying the Old Man through his final days.

Although exhausted, "himself" couldn't feel it at all, lying silently on the bed, not sleeping, just staring at the sky.

"Brother Ji! Grandfather says he can't catch his breath, take a look."

The Nurse pushed the door open and said hurriedly.

"Himself" jumped up immediately.

"Bang!" His head hit the upper bunk; "himself" didn't care about the pain, shuffled in slippers, and ran to the ward.

The Old Man's face was withered, sitting upright to breathe; every time he inhaled, the supraclavicular fossa, suprasternal notch, and intercostal spaces all sank in simultaneously—a very typical Three depressions sign.

"Grandfather," Ji Xiang whispered.

The Old Man sat on the bed and waved his hand gently.

The simple movement made his breathing even more difficult, especially the depression in the supraclavicular fossa, which was deep enough to hold a bowl of water.

Ji Xiang hurriedly took out a stethoscope.

The Old Man had right Lung Cancer with systemic metastasis, and originally there were faint breath sounds on the right side.

But when auscultating, there were no breath sounds at all on the right side!

Ji Xiang immediately performed percussion and determined it was Pneumothorax accompanied by a large amount of Pleural Effusion.

And it must have appeared suddenly, because none of this had happened earlier in the morning.

What should be done next?

"Prepare for Closed Thoracic Drainage!" "himself" said loudly.

The Nurse went to prepare the items immediately.

Ji Xiang remembered one time during Empathy when he had Closed Thoracic Drainage performed on him, and the Doctor almost "shoved" him into the wall.

It hurt like hell!

But that was a young person, whose local tension after trauma caused muscles and pleura to be taut.

If it were an elderly person, there shouldn't be such a large reaction.

And...

Ji Xiang hoped the Nurse would bring in a Chest Tube that was one of the High-value Consumables.

Heaven followed human wishes; the Nurse indeed brought in a pile of things, among which was a High-value Consumables Chest Tube.

This kind of Chest Tube was thinner than a regular one and had a steel core in the middle, making it easier to insert into the chest cavity.

Even if there were taut pleura or muscles, the situation of the Patient being shoved into the wall wouldn't happen.

"Himself" was a thoracic surgeon; it stood to reason that a minor procedure like Closed Thoracic Drainage should be without any difficulty.

Could it be...

Ji Xiang suddenly recalled the content of this Empathy.

Could it be that he couldn't even perform such a minor procedure?

"Self" opened the incision pack, and the Nurse nimbly filled the Chest Bottle with external Saline and opened a bottle of Ropivacaine.

A 5ml Syringe was used to draw the anesthetic, which was then diluted with Saline in preparation for local Anesthesia.

Although Ji Xiang was not in Thoracic Surgery, he understood the most basic principles.

In a case like the Old Man's, there was no need for an Ultrasound for localization; one could simply insert the Chest Tube between the 6th and 7th ribs at the mid-axillary line.

After "Self" finished drawing the anesthetic and appeared completely normal, Ji Xiang observed calmly.

Local disinfection was performed, a fenestrated drape was laid out, and the 5ml Syringe was picked up, followed by pushing out the air.

The movements were skillful and steady; calling them "flowing clouds and water" might be an exaggeration, but they were absolutely impeccable.

Ji Xiang watched "Self's" movements with focused Spirit; the moment the needle tip, held by a sterile glove, touched the skin, "Self" suddenly froze.

Uh...

Ji Xiang could feel that "Self's" mind was a blank slate, and the hand began to tremble; never mind using a scalpel, even the simplest Anesthesia could not be performed.

At this moment, Ji Xiang really wanted to seize control of the body and begin the Anesthesia and Closed Thoracic Drainage.

Such a simple minor surgery!

Yet "Self" was just so useless; the hand was trembling severely, even the Muscle Memory was gone, the body felt weak and sore, and stars began to dance before the eyes.

"Self" steadied their mind and took a deep breath.

As fresh air was inhaled, "Self" seemed to feel a bit more spirited.

Another attempt.

The moment the needle tip touched Grandpa's skin, "Self" lost courage again.

The Muscle Memory mentioned by the system NPC had completely vanished, and "Self" was like a novice who didn't know how to perform surgery, staring blankly while holding the Syringe.

"Brother Ji?"

The young Nurse asked in a low voice, looking somewhat surprised.

Ji Xiang could already feel that "Self's" back was covered in cold sweat, which instantly soaked the White Uniform.

How could one be so useless!

Ji Xiang was scolding "Self," and even more so, scolding himself.

To not even dare to perform a simple procedure—how could one be this useless?

Recalling his own strange behavior in the operating room, Ji Xiang felt a bit of understanding, but he was not satisfied.

The situation he faced was far less severe than the one before him; it was merely some accumulation from the Empathy, yet he couldn't even perform the surgery—truly useless.

And here, facing the grandfather who had raised him from childhood, he didn't dare to make the move...

That didn't seem right either.

The Old Man sat upright, struggling to breathe; every second was painful for him.

Acting early to resolve it, letting the Old Man catch his breath sooner—that was what should be done.

But "Self" just couldn't bring himself to do it.

Ji Xiang watched "Self" trembling and felt anxious, urgently wanting to take over.

A few seconds later, "Self" placed the Syringe into the incision pack, removed the sterile gloves, and without explaining anything to the family, cursed under his breath, turned around, and left the ward.

"Is that Lang Ge? It's me, Xiao Ji."

After leaving the room, "Self" began to make a phone call.

"Are you free? My grandfather needs a Closed Thoracic Drainage, and I can't... I can't bring myself to do it."

"Then thank you, Lang Ge."

After "Self" finished talking to Shen Lang, his legs felt weak, and he slid down the wall to sit on the floor.

Patients and Family Members in the hallway looked at "Self" with strange gazes.

They didn't understand, but Ji Xiang did.

This time was different from the usual Empathy.

Previously, the feelings were experienced in the virtual world and then applied to reality.

But this time, it was Ji Xiang in reality "forgetting" how to perform the surgery and coming to the virtual world to seek an answer.

"Self" just sat on the floor like that, head in hands.

Although his eyes were closed, stars were dancing before them, and a buzzing sound rang in his ears.

"Self" knew very well that performing the surgery early would mean less suffering for the Old Man, but he couldn't do it.

Ji Xiang sighed; it was indeed like this.

Comparing reality with the system's Empathy, he seemed to have grasped a thread of understanding.

"Xiao Ji, I'm here."

Shen Lang appeared before him; he didn't smile, but instead turned to change his clothes and then trotted over.

"Did you take an X-ray?"

"No, confirmed by physical examination."

"Alright, I'll go take a look; let's get the tube in first."

Shen Lang didn't hesitate; he went straight inside and began the physical examination.

Everything was already prepared; Shen Lang administered the Anesthesia, incised the skin, performed Blunt Dissection of the subcutaneous tissue, and gradually reached the pleura.

Puncturing the pleura, bloody pleural effusion flowed out directly.

Shen Lang pressed the incision with Gauze and inserted the Chest Tube with the steel core.

"Self" was still staring blankly; the Nurse was quick-handed and sharp-eyed, clamping the Chest Tube before Shen Lang could even speak, and began connecting it to the tubing of the Chest Bottle.

Then, the Nurse squatted on the floor, opened the clamped Chest Tube, and the bloody pleural effusion and air were drawn out with a "whoosh, whoosh, whoosh."

"Lang Ge, how much should I drain?" the Nurse asked.

"Start with 500, then come back in half an hour for 400. The Old Man is weak, so take it slow," Shen Lang said. "Your Brother Ji is already spent, so you help keep an eye on things."

"You got it," the Nurse replied efficiently.

The atmosphere in the department is really good, Ji Xiang thought with emotion.

Shen Lang's procedure took about a minute from start to finish, yet for such a simple operation, "he" couldn't bring "himself" to do it at all.

"Keep a close watch, come back and check every few minutes," Shen Lang nagged again before pulling "him" away.

"Xiao Ji, smoke a cigarette and calm your nerves. Look at your back, it's soaked in sweat." Shen Lang didn't mock "him," but comforted "him" instead, "It's fine, everyone finds it hard to make the first move."

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

"What are you saying?" Shen Lang lit a cigarette, shoved it into "his" mouth, and then lit one for himself to smoke.

"You think everyone is like the Director! That guy is a real animal."

"Huh?"

Ji Xiang was stunned to hear Shen Lang describe Zhou Jiaoshou like that.

An animal! Shen Lang actually described Zhou Jiaoshou that way.

"Back when the Boss had an Aortic Dissection, he had already signed the waiver to give up. Senior Brother rushed back from abroad just to see the Boss one last time; no one dared to say a word against it. But right after the milk was pushed and the Boss fell asleep, Cong Wen disconnected the Insulin Pump and pushed the Boss straight into the operating room."

Listening to Shen Lang describe the past, Ji Xiang felt a sense of yearning.

He could roughly perceive the relationship between Zhou Jiaoshou and the Boss—like teacher and father—it wasn't as distant as the current situation appeared.

Yet Zhou Jiaoshou had acted with such efficiency and decisiveness.

"Senior Brother and Second Senior Brother were both stunned, damn it; no one dared to step up, their hands were shaking. In the end, Cong Wen and I assisted, using an interventional approach to place a large stent inside. It was a 3D-printed stent, the first attempt in the country."

"I thought later, people like Senior Brother and Second Senior Brother are the normal ones. But Cong Wen... look at the Boss now, he's still in good health, he's lived so many extra years."

Shen Lang kept rambling, and Ji Xiang was fascinated.

"That's why I say Cong Wen is a damn animal!"

"Lang Ge, don't talk about the Director like that."

"I'm praising him." Shen Lang curled his lip and laughed, "Only a man who dares to act in that situation is a real man."

"Uh..."

"Let me ask you, what is a person with a strong heart like?" Shen Lang asked.

Ji Xiang pondered; "he" didn't answer either, but looked at Shen Lang, waiting for him to give the answer.

"A Psychiatrist on Twitter gave a pretty reasonable reply—people who don't empathize with others are the ones with strong hearts."

Ji Xiang was suddenly stunned.

This guy Shen Lang seemed to have given the ultimate answer, but his answer contradicted the Empathy System.

What exactly is going on?

Originally, Ji Xiang thought he was just experiencing a "trial," but he never expected Shen Lang to give an answer that exceeded his expectations.

This answer even completely overturned the empathy of the System Operating Room.

"Is that so, Lang Ge?"

"Of course. Otherwise, look at Lao Zhao from Gynecology; he's always able to empathize, so he can't even work as a Doctor. But he's very capable; he's already the director of the Medical Records Room now."

"Cong Wen said it would be better if Lao Zhao had lower empathy."

"He has a high level of skill, is meticulous, and his surgeries are super excellent."

"What a pity."

Shen Lang bit on his cigarette, speaking vaguely like a hoodlum.

Ji Xiang fell into deep thought.

Although he was observing from the perspective of a bystander this time and had no chance to chat with Shen Lang, it didn't stop Ji Xiang from thinking.

What Shen Lang said made sense.

But in the end, should one empathize, or is empathy unnecessary? Ji Xiang thought about this question for a long time.

Empathy allows one to think about problems from the Patient's perspective.

Yet at certain moments, empathy makes one vulnerable, to the point of "forgetting" surgical skills.

Because he couldn't ask questions, Ji Xiang wrote this matter down, preparing to ask the system NPC when he returned.

(End of this chapter)