Chapter 146: Seems Not So Hypocritical (Asking for Subscription)

The next patient Xue Tao called in was also an anterior shoulder dislocation, an auntie.

But Fang Ziye still carried out the process in a standard manner.

Busy, but not chaotic.

No matter how familiar he himself was with this surgical operation, he could not finish the reduction before Xue Tao completed the informed consent discussion and signature; this was the bottom-line principle.

The first bottom line Fang Ziye set for himself at the prefecture-level city hospital was not to cause trouble.

One, not cause trouble for others; two, not allow others to cause trouble for him, randomly disrupting his own rhythm.

In clinical practice, informed consent and informed refusal are equally important; Fang Ziye knew this himself, and Old Professor Li Guohua had also recited it many times in front of Fang Ziye.

He kept it in mind.

Physical examination, read films, physical examination, then ask this auntie who came in again what exactly happened...

There are many classifications of shoulder dislocation: anterior dislocation, posterior dislocation, superior dislocation, inferior dislocation, and the extremely rare lateral dislocation; among them, anterior dislocation is the simplest.

And different dislocation types have different degrees of severity; this is the level of professional meticulousness, absolutely impossible for a single treatment method to solve all problems.

Of course, Fang Ziye could determine that this auntie's dislocation type was precisely anterior joint anterior dislocation, the degree of dislocation was mild dislocation, anterior mild dislocation, the probability of causing shoulder joint soft tissue injury was very small.

By the time the auntie had made all preparations, Fang Ziye also saw that her family members over there had already signed their names.

Fang Ziye instructed the auntie to lie down first, then used the traditional external rotation reduction method to effortlessly resolve the dislocation problem.

"Auntie, don't be nervous, it's okay, there will be slight pain."

"Click—!" As Fang Ziye finished speaking, the sound of the dislocation reduction rang out, exceptionally crisp.

At the same time, under Fang Ziye's multi-verbal soothing, the auntie's emotions also gradually calmed down. Only when it was slightly painful did she tense up a bit, immediately feeling the pain go from slight relaxation during traction to absolute relaxation.

Half-believing, half-doubting feeling that the pain had all eased, she asked: "This of mine, is it cured now?"

"Mm, Nai Nai (Auntie), you can stand up, move around, feel if there are any other uncomfortable places." Fang Ziye still called her by the local term of address.

The entire reduction process lasted only about one minute.

And this time was just when Xue Tao finished the diagnosis, went out to find the family to briefly explain the situation, signed and returned, just turned around, and saw Fang Ziye already standing there having completed the reduction.

His heart sank—

Just what kind of Doctor is this? In the department, he was originally a subordinate of the Joint Surgery department!

Currently in joint reduction, besides Director Zhang Mingcan, other people's manual reduction techniques, including Director Hong Du's group, Huang Kai who has more seniority than himself, are all not as good as him.

Just this little strength of his, seemingly in front of Fang Ziye, is a bit not enough to look at.

But this isn't right either; when he himself went to Zhongnan Hospital for further study three years ago, the most formidable among the younger generation there should be Yuan Weihong, right? Yuan Weihong's manual reduction technique strength at that time wasn't this awesome either.

This Fang Ziye...

The concentrated further study sources for Enshi Central Hospital are mostly Zhongnan Hospital and Provincial People's Hospital, after all they are all affiliated with Han City University.

Xue Tao did his further study in Zhongnan Hospital's Trauma Surgery; at that time, he hadn't encountered a person like Fang Ziye, only knew that the Chief Resident of Trauma Surgery, Yuan Weihong, was a tough bull, promoted to Attending Physician during the total residency period.

Xue Tao's nostrils flared slightly, his thick brows knotted into two clumps...

Fang Ziye then said again: "It's okay, Auntie, don't be nervous, you look very nervous, actually there's nothing to it, just a simple mild dislocation, go out and get a forearm sling and that's it, okay?"

"Okay, thank you, Doctor." The auntie, feeling no pain, hurriedly nodded!

Feeling that this speed was a bit fast, and the process was also uneventful.

Able to solve the problem, that is a good doctor.

"Thank you, Doctor." She repeated it to Xue Tao again.

"It's all because your techniques are good." She incidentally, also praised Xue Tao along with him, thinking, Xue Tao is Fang Ziye's teacher after all...

Fang Ziye smiled very happily; he felt that sometimes this knowing smile recognized by patients cannot be compared to the income of large amounts of knowledge points.

Naturally, these two dislocations' manual reductions added up only got 10 knowledge points, far less than half of the previous irreducible anterior hip dislocation.

This doesn't even count as mosquito meat anymore, but a mouthful of small meat, the kind that can slightly recover a mouthful of blood.

Fang Ziye didn't see Xue Tao signal him to stop; he estimated Xue Tao realized that if he himself processed patients at his current speed, he would be faster than Xue Tao.

Although Xue Tao looked at him with scrutinizing eyes, Fang Ziye didn't panic in the slightest.

His manual reduction technique had previously reached Level 3-plus, Chief Resident Jin Hongzhou can prove this, so now adding points to Level 4, Fang Ziye also didn't feel afraid.

It's not like no one can prove it.

Thus, Fang Ziye also wasn't afraid of being sized up and scrutinized; he walked out the door and brought in another patient!

Xue Tao then relatively appreciatively tore open another standard manual reduction consent form, the reduction method directly handwritten, the risks inside purely formatted, no time to revise.

"The risks are just these, you should have heard them before too, if reduction succeeds just put on a plaster cast and go home, if reduction fails then surgical reduction." Xue Tao this time was even more brief, thinking to himself.

With me talking like this, you surely can't still finish the manual reduction right after I just finish the informed consent discussion and signature, right?

Fang Ziye indeed did not, because this patient's dislocation situation was very complex; although it was an elbow joint posterior dislocation, it belonged to a near-irreducible joint dislocation.

Fang Ziye reckoned with his current capability, taking it down was no problem, but in terms of diagnosis, he must deliberate deeply before proceeding.

"Doctor, what about mine?" The patient saw Fang Ziye finish the physical examination, then not move and not speak again, couldn't help feeling slightly panicked inside.

After Xue Tao returned from the discussion, he also saw Fang Ziye pondering; his heart slightly struggling, he stood fixed beside Fang Ziye, thick brows tightly locked, aura like a mountain, seemingly giving Fang Ziye momentum.

"Director Xue, his elbow joint reduction is a bit tricky. My meaning is, still do an MRI first, confirm whether there is ulnar collateral ligament injury, then decide whether to directly perform manual reduction."

"I'm worried, this kind of elbow joint posterolateral dislocation will be accompanied by ligament injury; if there really is ligament injury at that time, it's hard to explain whether it was caused by the manual reduction or by the original injury." Fang Ziye explained to Xue Tao.

Hearing this, Xue Tao panicked big time inside.

Old bro, don't say such overly professional things okay, posterolateral dislocation?

Generally it's either posterior or lateral dislocation, posterolateral?

Xue Tao naturally isn't completely without skill; he carefully percussed the dislocation direction, and indeed it deviated from the typical elbow joint posterior dislocation trend, slightly biased toward the lateral side.

The patient was a youth around thirty years old, features slightly handsome, only expression troubled, said: "Mine still needs examination? I saw they all didn't need examination."

"Why not reduce first?"

He couldn't determine if Fang Ziye was deliberately targeting him.

Xue Tao thought carefully for a moment, then explained: "Old bro, it's like this. Anyway, it's not urgent. Look, we're all young people, so let's just speak directly."

"The degree of your dislocation is still quite significant, so it may cause soft tissue injury. If we're going to reduce it, we have to look at the indications. On the X-ray right now, it's hard to assess whether soft tissue injury exists."

"How about you go down and get an MRI, then come straight back up after it's done?"

Inwardly, he was secretly shocked.

Before, he didn't know where exactly Fang Ziye was excellent and formidable, but now he vaguely guessed it. Fang Ziye's understanding of image reading, and his grasp of diagnosis, were too fucking deep.

Fang Ziye didn't have high-end manipulation techniques; rather, his understanding was more comprehensive and deeper than theirs, and his skill in reading X-rays was also more profound than theirs.

So, only then could he, using an unconventional closed reduction method that they couldn't quite understand, perform closed reduction on an irreducible hip joint dislocation.

In other words, in places where they themselves hadn't figured things out, Fang Ziye spotted the problem, and through the simple principle of interlocking contact, he first converted the irreducible joint dislocation into an ordinary anterior hip dislocation, and then proceeded with reduction.

It's just that although he figured it out, Xue Tao still felt a bit stunned.

A few years ago, when he went for advanced study, in front of Yuan Weihong, Xue Tao felt he had lived his decades in vain. Back then, Yuan Weihong was already thirty-one, approaching thirty-two.

But now, in front of Fang Ziye, he had this feeling again, yet Fang Ziye was only twenty-seven-plus. What the fuck kind of life is this?

If the young people inside Zhongnan Hospital are all a batch like this, then when will the outstanding talents in their prefecture-level city hospital ever get ahead? Will they never be able to get ahead forever?

This is the struggle in Xue Tao's heart.

When Xue Tao spoke, the weight was completely different. The young man didn't struggle, just asked: "After I get the MRI, can I come over without queuing? Outside?"

"Okay, I'll go say a word." Seeing he was willing to cooperate, Xue Tao hurriedly said.

"Patient friends queuing outside, pay attention. For cases like his, if the diagnosis can't be confirmed midway and they go for supplementary exams, they won't queue later; they'll come straight in. He's already queued once."

"I remember everyone. There won't be any queue-jumping." Xue Tao finished speaking.

Then he said to the young man again: "Go to the nurse station, find a doctor to open a medical order. Just say open an MRI. When it's done, come straight up. Don't wait for results."

"You also know the situation is special. All time wasted is everyone's time."

"We doctors, on the contrary, have no illness or pain. Waiting a bit longer is fine. But you're all uncomfortable, so still, don't struggle anymore, okay?" Xue Tao's words were relatively fair and reasonable.

The young man left quickly.

Xue Tao then put the informed consent form aside, glanced at Fang Ziye a few times, and saw Fang Ziye bring in another patient.

This was also a joint dislocation, but he had no family members, and the dislocated joint was the right shoulder joint.

No way around it. Car accident injury. Many people, when a car accident is about to happen, will grab onto things to avoid serious injury. Habitual violent pulling of the shoulder joint leading to joint dislocation is very common.

The injury type is a bit like it came off an assembly line.

However, after Fang Ziye brought the person in, he didn't get started himself, but asked: "Teacher Xue, how about I do the informed consent, and you reduce both?"

Being in his hospital, it's best not to be too arrogant. Xue Tao symbolically giving one or two closed reduction opportunities was enough. Greed leads to loss.

Back and forth, you do one, I do one. Everyone has a sense of presence. Let Xue Tao show his operation level.

This is at least the first time interacting, a rational choice.

Not to mention strangers' first contact. Even when interacting with a teacher, before feelings develop, you can't overly display your sense of presence, making your teacher feel nothing but frustration.

Excellence without an emotional foundation will make a teacher feel frustration, not gratification.

This is a handling capability Fang Ziye figured out himself through trial and error. It may not be right, but based on his experience, it won't be too wrong.

Xue Tao nodded, feeling Fang Ziye was quite interesting.

He liked interacting with smart people.

Fang Ziye's informed consent wasn't particularly complex, but it was slightly more meticulous. He would mention a few special risk points based on each person's roughly different dislocation types.

For example, the third patient, when cooperation was needed.

"Yours is a hip joint dislocation. The rebound force during hip joint reduction will be larger. As the saying goes, the arm can't twist the thigh. How much muscle strength the leg has, especially someone like you with developed muscles. You should know better than me."

"So during reduction, this one bounce has a certain probability of causing a fracture. Right?"

"So, working out too much, muscles too developed, isn't entirely a good thing either." Fang Ziye's half-praise, half-explanation-of-special-case manner could be said to tend to the patient's emotions very comfortably.

Which fitness enthusiast doesn't like others saying their muscles are strong?

This kind of informed consent mode and method was something Fang Ziye learned from a classmate in Urology. That classmate, when encountering a patient who took drugs, then hit a bed corner and broke skin, in the emergency department, during informed consent, used it exactly like this. It was an interesting case that classmate shared with Fang Ziye during his Orthopedics rotation.

Fang Ziye naturally didn't collect material for future conversation, but indeed, he learned a subtle communication style.

"Your time is long, you've worn the skin bald. This is your unique characteristic. There's no way around it. Only you have this risk!"

Aiyo, put like that, that guy almost spread-eagled to let that classmate take a good look, standing tall and proud while being sutured, not a temper in sight...

Men will fight for this breath of pride until death.

If you say he can't do it, he might be unhappy. If you say he can, especially the same sex, even if it's three seconds, he'll hold out for thirty seconds.

The patient lay happily on the operating table, asking: "Director Xue, is my fracture risk big, and unique to me? Others don't have it?"

"About right." Xue Tao felt a chill inwardly, and nodded heavily.

"Then it's fine. No way around it. Muscles trained up, can't soften them. I accept it."

"Come, I'll sign." The patient, lying down, wrote his name with a bold stroke.

Immediately after, Fang Ziye and Xue Tao, the two of them, started closed reduction. Because it was hip joint dislocation closed reduction, an assistant was needed.

Old bro also said: "Want me to exert some strength too? My leg might be a bit... not good for traction."

However, before he could finish, he saw the truly powerfully built Zhang Jinchuan, called in by a phone call from Xue Tao.

One look, and the patient himself was a bit embarrassed. He sniffed his nose, head lowered, chin almost poking his chest, glancing from time to time at Zhang Jinchuan's build, eyes rolling non-stop.

After Zhang Jinchuan came in, with the combined effort of three people, in two or three minutes, they completed a closed reduction.

The patient felt pain, but didn't even hum once.

Upholding the principle that although I'm not as big as you, I'm still a tough guy, highlighting one thing: endurance.

After everything was operated on, when the patient stood up, he even pinched Zhang Jinchuan's arm.

"Brother, how did you train this?"

"Swinging a sledgehammer, lifting legs, closed reduction like this." Zhang Jinchuan didn't hide anything at all.

"Farewell~" the patient cupped his hands and left, limping.

Damn it, I really got a lesson.

This is real hard skill, not muscles trained with instruments in a gym.

And by the time it got here, the patients with shoulder dislocations queuing outside gradually decreased.

……

After another half hour or so, the patients for closed reduction queuing at the doorway were cleared out by several people.

After seeing the last patient out of the Operating Room, Xue Tao patted his own hands and said, "Let's go eat first. At this consultation frequency, I feel there might be another wave in the evening."

"But after eating, Doctor Fang, you go rest first."

"Today really embarrassed me, still letting you take a shift in advance." Xue Tao's tone was formal, no longer treating Fang Ziye as a gilding person.

With Fang Ziye's strength, if he still needed gilding, then the word gilding person, he himself would be unworthy. Fang Ziye is truly someone who came to temper himself, restoring the essence of this plan to come below for counterpart exchange learning.

"Brother Tao, you're too polite, I didn't help much either. Teacher also instructed me not to cause trouble."

"As long as you didn't cause trouble." After getting familiar with Xue Tao, Fang Ziye discovered that Xue Tao, though he looks thick-browed, big-nosed, and big-eyed, is actually cold on the outside, warm on the inside.

To acquaintances, to capable people, he has no airs at all.

But if someone comes to show off, to put on airs, he won't give a damn about you.

"Look, this is the word after humble, called hypocritical."

Xue Tao laughed and scolded: "The most annoying are hypocritical people like this."

"But Doctor Fang's hypocrisy doesn't seem that hypocritical either." Xue Tao admitted Fang Ziye's strength, even a bit shocked, so he added another sentence.

Several people, chatting and laughing, walked towards the Doctor's Office.

Outside, although a few more patients came, seeing the White Coats, they asked how it would be handled now.

Xue Tao then said: "Really sorry, can you give us ten minutes to eat a meal? You do it first, we really have no strength left?"

"Just ten minutes." Xue Tao's tone was very good, cupping his hands, making the other party unable to refuse.

(Chapter End)