Chapter 147: Theory and Practice (Asking for Subscriptions)

Man is iron, rice is steel.

Although the patients coming for consultation were all anxious, faced with several white coats wearing fatigue on their faces, no one had the heart to refuse a request like "allow me ten-odd minutes to eat a bite of rice."

Fang Ziye felt he had learned something again, and hurriedly noted it down in the little notebook deep in his heart.

The things learned, the content, and the forms of expression are many; not only professional knowledge, but also styles of conducting oneself and little tricks.

After returning to the office, the five people squeezed together, pooling the dishes each had brought in their boxed meals.

Xue Tao hurriedly used his chopsticks to puncture the packaging bag and started eating, saying unceremoniously while picking up food: "Yuan Hong, you didn't properly introduce him either, letting us all play guessing games, huh?"

Li Yuanhong was at this moment uncovering the dish lids one by one.

He said: "Tao Ge, Fang Ziye, Doctor Fang, Professor Deng and Wei Ge's student, super top student. Among the graduate students currently studying in Zhongnan Hospital Trauma Surgery, whether Doctor or Master's student, he is this one."

While speaking, Li Yuanhong raised his thumb.

Xue Tao nodded, shoveled a mouthful of rice: "No wonder, that's what I thought."

Xue Tao paused for a moment, quickly swallowed a mouthful, and only then did his mouth become nimble: "Doctor Fang is completely different from that kind of pure theory Doctor we know."

After Li Yuanhong piled all the dish lids together, he sat down and said: "Tao Ge, that's definitely not it."

"You don't know, in their hospital's training room, Doctor Fang is the beloved disciple of a group of old professors. Pure cross-generational favoritism."

"Anyway I don't know about others, but even if Wei Ge says in the training room that Doctor Fang is bad here, bad there, he might get scolded. As for what Professor Deng says, I wouldn't dare be sure." After Li Yuanhong finished speaking, he chewed rapidly.

And after swallowing, he sent a voice message to his wife at home: "Come back after eating, wait for me a bit, the department is very busy, I'm temporarily helping out."

"Explain to the two little ones (kids) for me, I miss them."

No one laughed, they just looked in Li Yuanhong's direction, feeling Li Yuanhong was reliable.

Loyal enough, otherwise he wouldn't have chosen to stay in the department at the first moment, but the person has also reached middle age, after all he has his own family and children.

Xue Tao then said: "Yuan Hong, after you finish eating, send Doctor Fang off, we really have no time right now."

"I was just in the small group, heard the newly arrived Director Wu say, Old Director Qiu's wrist twisted a bit during reduction, fortunately it's no problem, but he can't handle patients anymore."

"Today's patient volume is really too much. Ziye, you understand."

Xue Tao did not continue calling Fang Ziye Doctor Fang.

Once familiar, who the hell keeps putting your degree on their lips every time they open their mouth?

The surgical system prefers even purer relationships, won't go "Doctor this, Doctor that" or "PhD this, PhD that."

Unless it's someone newly arrived, not recognized, then they'll be polite for a bit, call them Teacher or something.

Of course, this also relates to identity. If it's an intern or ordinary graduate student, before they've built feelings with people, they should still call them Director or Teacher or Professor and such.

"Tao Ge, you're too polite, I feel like I came at a bad time, instead dragging everyone down."

"I live right across from the hospital, the key is with property management, my aunt's bed is already made up at her place, can be used directly." Fang Ziye also explained a bit, while replying.

In his heart he was calculating today's gains.

A total income of 121.2 Knowledge Points, also counted as letting him win back a big mouthful of blood.

Consumed nearly a thousand Knowledge Points, recovered one-eighth, although a bit of a loss, but after all the skill is his own, and moreover, his current Knowledge Point reserves are close to five hundred again.

Although not enough for the next Level 4 skill, ordinary Level 3 skills can be topped up anytime by adding points.

Fang Ziye's point allocation direction is not random either.

Osteotomy Correction is a major direction for his coming to the prefecture-level city hospital; among them, whether X-ray Reading Technique or reduction, they are all very key operations within Osteotomy Correction.

Therefore, it doesn't count as superfluous.

On the premise of not affecting this major direction, being able to harvest Knowledge Points through skills is a very comfortable thing.

"Ziye is still very good, truly a youthful talent."

"Ziye is still very young, right? How old this year? Got a girlfriend?" Xue Tao subconsciously fired off three questions in a row.

"Twenty-seven, a little over half a year until twenty-eight, also approaching thirty."

"As for girlfriend, should count as having one!" Fang Ziye explained with a smile, to avoid running into other things.

But Li Yuanhong wasn't acting human: "Overseas, separated by such a distance, our Enshi girls still have a chance to be harmed."

Xue Tao immediately understood, pursing his lips and refusing while hehehe-ing a laugh, after swallowing he sniffed his nose, pulled a tissue and wiped his mouth: "This isn't just long-distance, it's a cross-border relationship, won't last long."

"At least give our Enshi girls a quality resource option, right?" Xue Tao said with a grin.

Needn't take it seriously, but also can't completely not take it seriously.

Fang Ziye just smiled, no need to vie for verbal victory.

And even while eating, several patients' family members came over to peek at the situation inside the office, seeing several white coats gathered together eating boxed meals, they didn't say much more.

This might be thanks to Eastern Han's most basic rule: eating is paramount.

And after finishing the meal, Xue Tao and Li Yuanhong both didn't move, but Wang Zhongxing and Zhang Jinchuan who was on duty today hurriedly wiped their mouths and rushed outside, to further triage and handle patients.

Those applying plaster casts apply plaster casts, dislocations get closed reduction.

Operation is operation, diagnosis is diagnosis, diagnose first, determine what operation to do, then conduct triage.

It sounds a bit like assembly line work, but actually it is so.

If patient volume isn't large, naturally it's one-by-one consultation, diagnosis plus treatment in one go; now with so many squeezed in at once, if you don't save time, waiting patients' wait time might become very long.

If no triage, it might be a minor dislocation, waiting a whole day without a doctor coming to handle it.

After the two went out the door.

Li Yuanhong hurriedly took his leave, but Xue Tao wasn't in a rush; he is a Deputy Chief Physician, the lead sheep of the team doing closed reductions and applying plaster casts in the ward, not necessary for him to personally handle every single thing.

"Ziye, ask a question: before, how did you judge that patient with anterior hip dislocation was irreducible?"

"And also, that patient with posterior and lateral elbow dislocation, why must there be ligament damage, making closed reduction meaningless instead?" Xue Tao was truly curious.

A single flat film, can really see this much content?

Fang Ziye at this moment was scanning the message Luo Tingzhu sent, saying she had already rested; after reading, he dimmed the phone screen; Luo Tingzhu's side right now is late night/early morning, not good to disturb.

What if Luo Tingzhu heard the notification and woke up?

"Tao Ge, this is film reading. I remember when Professor Deng Yong did ward rounds at Zhongnan Hospital, he said that in some joint dislocations, ligament remnants and muscle remnants can occasionally be seen."

Fang Ziye thought for a moment, then replied: "Of course, our department doesn't see that many Joint Surgery patients, so we don't have much film reading experience either, but back when Professor Deng Yong started working, Joint Surgery hadn't split off as a separate specialty yet, so Professor Deng Yong has that recognition experience."

"Professor Deng said, if there's no dislocation, these remnants might be overlooked by us; once dislocation occurs, the joint is necessarily malaligned, and after the joint malaligns, we just happen to be able to see X-ray remnants different from the usual plain films we see."

"It's more conducive to observation and diagnosis."

"Before I didn't really understand it, I just kept those words in mind, and today I happened to notice it."

As Fang Ziye spoke, he learned and imitated the technique Yuan Weihong used when teaching him, moving over to the computer, but the moment he opened the black-screened computer, Fang Ziye was stumped.

Because this wasn't Zhongnan Hospital's internal computer, he couldn't even find where the medical record system was.

Xue Tao stirred at those words, immediately dragging a stool to Fang Ziye's side: "Our hospital's film reading system is separate, especially the outpatient system, it's not connected to the film reading system; only the inpatient medical record system and the film reading system are connected."

"This system isn't easy to use……"

Xue Tao watched Fang Ziye hurriedly recording the Orthopedics Department's film reading system account and password in his phone's memo, and his mood instantly tightened.

Someone this excellent, still this hardworking, do the rest of us even get to live?

But this is Fang Ziye's habit, Xue Tao couldn't say much more.

After pulling up the plain film of that anterior hip dislocation patient, Xue Tao then yielded his position.

Fang Ziye used the mouse to enlarge the page: "Tao Ge, I don't know if what I'm saying is right, I definitely don't have the professors' systematic understanding, I can only give my own understanding."

"This dislocation is certain, and it's a typical anterior dislocation; whether by film reading or through the patient's special deformity signs, it can be confirmed."

"However, if we observe carefully, we'll discover that on the lateral side of this anterior dislocation, that is, at this point of the acetabulum, there's a faintly visible cord-like shadow."

As Fang Ziye spoke, he continued zooming in: "In my guess, this should be the position of the ligamentum teres."

"So I'm guessing, maybe this ligamentum teres created something like a rubber band's elastic resistance, obstructing our reduction; its tension, part of the stress is directed inward."

"And, the femoral head has an anteversion angle, so the plane we see definitely has part of the femoral head and the acetabulum here in an impaction state; if we only do simple traction on the lower limb, it's definitely not enough."

"Moreover, since it's not a posterior dislocation, under normal circumstances we wouldn't think to move the thigh toward our operating side, but precisely because of this, it caused an irreducible dislocation."

"Naturally, the reason I'm so certain is because I feel that Tao Ge you've reduced so many times and still couldn't reduce it, there must be something tricky; Tao Ge you're all experienced doctors. Similar reductions, you haven't done a thousand, but several hundred at least."

"In this situation, still not reduced, we have to find the impaction point."

When Fang Ziye deduced this, it was also to some extent taking care of Xue Tao and the others' emotions.

Immediately after, Fang Ziye said: "Since that's the case, we first have to solve the longitudinal impaction point, then separate the joint through traction."

Fang Ziye demonstrated simultaneously, his right fingers hooking, first hooking the back of his left hand, pulling down; then unless the fingers deform, there will definitely be impaction.

But Fang Ziye immediately moved his right hand a distance toward himself, then in the process of slowly retracting, more or less simply restored the reduction trajectory.

The theory Fang Ziye spoke wasn't profound, yet not simple either.

At least not tedious, not the mystifying kind.

Xue Tao felt amazement: "Like this, you can really see it on X-ray? Really seen a ghost."

To a certain extent, Xue Tao once had a kind of disgust toward academic superiority.

He was more willing to believe capability outweighs degree, actual operation outweighs theoretical knowledge. After all, especially medicine, all theory ultimately returns to clinical practice.

Only, after Xue Tao went for advanced training, he gradually changed this thinking.

After all he went to Zhongnan Hospital for advanced training, and in many people there, he knew that medicine, at least the orthopedics field he's familiar with, isn't that there are many operations that can't be explained theoretically; if you think there are, then it's definitely your skills not being refined enough, understanding not enough, cognition insufficient.

Professor Deng Yong, and Associate Professor Xie Jinyuan and others — at that time Xie Jinyuan wasn't an associate professor yet — they could all use relatively plain and understandable ways to articulate the corresponding theory.

Not unfathomably deep; actually once explained clearly, they're just some simple things, but before they're explained clearly, if you completely need to comprehend them yourself, then it's hard.

Open the door, and you can see the scenery outside the door; otherwise it's all just imagination.

But, after Xue Tao returned from advanced training, a divine academic PhD came to the department; he was originally quite happy, humbly consulting, later felt he himself was quite a joke.

"Tao Ge, first glance, definitely can't see it; I feel I don't have that level, but if after trial and error, I'll consider in this direction." Fang Ziye didn't pretend either.

After obtaining Level 4 X-ray Reading Technique, Fang Ziye improved by at least several levels compared to Level 3 film reading technique.

Fang Ziye roughly knows what different proficiency performances of X-ray Reading Technique Level 3 are — that is, what differences there are in the layers you're able to see.

And such layers are not merely front-back left-right relationships; it's that you yourself can, through film reading technique and basic anatomy understanding, restore these things, imprint them in your mind.

Level 3 film reading technique can only give you the ability to see many fine anatomies on X-ray, but cannot restore layers.

Current Fang Ziye can at least do 5-layer stratification of structures on X-ray, front-back left-right, five layers each, counting up should be around ten layers; this is Level 4 X-ray Reading Technique's capability and level.

Who exactly this level can benchmark against, Fang Ziye can't judge well, but estimates his own teacher Yuan Weihong's current level is just a bit higher than his own; this counts as fairly precise.

Yuan Weihong is his master; he's thirty-four-plus this year, approaching thirty-five, talent originally very high, having this capability isn't exaggerated.

Of course, Level 4 film reading technique isn't Chinese cabbage, not everyone can have it; perhaps Associate Professor Xie Jinyuan has it, but Attending Qin Geluo and Chief Resident Jin Hongzhou like that, probably don't have it; still very formidable.

"Precise, well-founded, theory and actual operation combined is real skill. Admire." Xue Tao said very sincerely, not sucking up, but envy.

He now increasingly understands a sentence his master said when he was a grad student.

When you reach the point where you feel you need to explain the reasons for your own operations, but you feel you can't explain them, then you'll know reading is useful.

Current Xue Tao still continues reading literature, but instead for some basic theories, gradually blurs and doesn't value them; the literature he reads is mostly operational principles.

Equivalent to unstable foundation; now even if he wants to go back and make up for it, afraid his set thinking patterns and logic habits won't allow him to change.

"Envy, but can't envy it into being." Xue Tao looked at Fang Ziye, with an indescribable envy, and respect.

Fang Ziye relaxed his straightened posture slightly, returned a smile: "Tao Ge, I envy your experience too."

"Experience, you walk forward, it naturally accumulates, but the theory, cognition, and knowledge reserve you currently possess, are what others cannot turn back for."

"Forget it, not saying more; I'll slowly learn, slowly make up for it myself."

"Ziye, you go rest first." Xue Tao stood up, then walked out.

At middle age, one must do things; can't be like Fang Ziye at his age, pointing the way through purely rich theory.

The pressure on him in the department is to do surgeries, to prepare him for leading a group later; not like Fang Ziye who can systematically, comprehensively, all-around make up for his shortcomings.

Leveraging his own strengths is the only choice he can make.

The age for plugging gaps, no longer belongs to him; he missed that age, one miss is a lifetime……

Fang Ziye watched Xue Tao's back view, thoughtful.

Rising in one motion, he hurried back to the Rest Room first, returned the White Coat, then pushed the Suitcase and walked out of the Department.

No longer struggling, no longer conspicuous.

If there is a need, if it is necessary, the people here will definitely send him a WeChat or make a Phone Call; he has already obtained a certain extent of presence, so there is no longer any need to keep seeking presence.

There are many people in the Department, but there is also no need to keep recognizing all of them.

On the contrary, being able to have a relatively deep Conversation with Deputy Director Xue Tao makes him even more able to be determined about Fang Ziye's original Choice.

If he himself had just graduated with a Master's and come here, perhaps in the short term he could obtain a certain amount of economic compensation, obtain a certain social status, realize a certain life value.

But when he truly reaches the point of confusion, would he become confused like Xue Tao?

Fang Ziye doesn't know, but fortunately he hasn't missed it.

Theory and practice are equally important; this is a principle Fang Ziye heard from his teacher, and also needs to slowly comprehend himself.

But he still has Opportunity; Fang Ziye left smiling, and no longer feels the future is confused.

Opportunity, to a certain extent, is more than Effort and Choice.

(Chapter End)