Chapter 152

Fang Ziye and Xue Tao passed by the Doctor's Office, and inside it was also bustling with activity.

Director Zhang Mingcan and Old Director Xue Tao were both generous, arranging all kinds of big meals mixed together. There was KFC, there was McDonald's, and there seemed to be a group eating pizza; the people inside were feeding each other and exchanging food, the atmosphere harmonious.

Xue Tao glanced at Fang Ziye, then went into the Doctor's Rest Room first to wash hands side by side, explaining: "Ziye, you wouldn't prefer eating fast food like KFC, would you? If so, I got it wrong?"

"No, Brother Tao, I'm easy, I eat anything, as long as it fills me up." Fang Ziye wasn't joking.

Good food would certainly be better, but KFC definitely doesn't count as good food.

The pre-meal disinfection handwashing need not be as meticulous as before surgery; just casually rub the six-step handwashing method a couple of times and rinse it off, then dry hands with the tissues in the On-call Room.

Fang Ziye and Xue Tao carried six or seven bottles of mineral water out the door together: "Brother Tao, the benefits here are really quite something, huh?"

Speaking of it, the On-call Room at Enshi Central Hospital really had very abundant supplies, unlike Zhongnan Hospital; here the tissues were free and unlimited to a certain extent.

There were also small bottles of mineral water for one yuan a bottle, which could be taken directly to drink. There might also be some other things that he himself hadn't unlocked yet.

Xue Tao smiled, his thick eyebrows relaxing: "Right? When I went to Zhongnan Hospital for further study, I also found it particularly inconvenient; I could only bring my own water cup, otherwise there was nowhere to even get a sip of water."

"But later I found out that the benefits inside Zhongnan Hospital actually aren't in the Doctor's Rest Room, but in the Ward General Rest Room. Guess why?"

Xue Tao didn't bring it up, Fang Ziye only felt it was habit, which was natural.

Put that way, Fang Ziye seemed to discover that Jin Hongzhou's Ward General 'Dog Kennel' On-call Room indeed had abundant supplies, only usually no one dared take them.

Xue Tao asked and answered himself, turning sideways to push open the Director's Office door while saying: "Two reasons. First, Zhongnan Hospital's Ben Yuan staff are the Ward General and above. The second reason is there are too many students, consumption is too high."

"What Ben Yuan and students?" Right as Xue Tao said this, a voice came from inside.

It was Wu Guo Nan arriving; he had been smiling and talking with someone, but his face stiffened, brows furrowing tightly.

His gaze bore into Xue Tao; within his slightly puffy eye sockets, his pupils seemed to release countless pressures, as if warning him: Are you trying to establish some rules for Fang Ziye?

You're Ben Yuan, Fang Ziye is just a student, and you're starting to stir up trouble?

Xue Tao hurriedly explained, knowing the Director had misunderstood.

After a brief explanation cleared it up, Wu Guo Nan smiled and said: "Oh, so that's it. Then it's fine. Doctor Fang, since you've come here, you're practically family of our Ben Yuan. We don't have that many rules here."

Wu Guo Nan then explained and introduced to a middle-aged person beside him: "Director Huang, this is the Doctor from Zhongnan Hospital, Doctor Fang Ziye."

Upon entering the Director's Office, there were quite a few people gathered inside.

Wu Guo Nan and a strange middle-aged man were gathered at one table; additionally there was Wang Zhongxing who hadn't had time to shave his heavy stubble, curly beard like short hair spanning both earlobes, even the hair in front of his ears — unsure if beard or eyebrows — connecting to his hair, looking like a miniature Sha Seng.

He and Huang Yunxiao were hiding on the other side working hard on their rice.

"Hmm, hello Doctor Fang." Doctor Huang raised his head, glanced at Fang Ziye, merely smiled politely and didn't pay much attention, then continued eating his rice.

As if to him, a Doctor was just a person, with a touch of Buddhist-style indifference.

"Hello Teacher Sang Yuerue." Fang Ziye, while distributing the mineral water they'd brought to everyone with Xue Tao, happened to hand them to Director Huang and Director Wu Guo Nan.

Looking at Director Huang up close: slightly plump build, average face shape but neck a bit thick, typical double chin. But he didn't look greasy; estimated to be that special type with a fat neck but nowhere else fat.

Subconsciously one would consider hyperthyroidism, but Fang Ziye didn't see exophthalmos or such manifestations in him; on the contrary, his whole temperament was quite restrained, possessing the scholarly elegance that Professor Deng Yong had, not at all like the impatient disposition hyperthyroidism should have.

"What specialty does Doctor Fang study?" Seeing Fang Ziye reply, Huang Haitao couldn't help but casually ask.

"Teacher Sang Yuerue, my specialty is Trauma Surgery." Fang Ziye gauged the situation, turning sideways to walk toward another 'dining spot' while leaning to explain.

Even if the Director asks, eating comes first; hungry, you gotta eat.

Naturally, Fang Ziye still took a photo first and sent it to Luo Tingzhu; this behavior was to share, and also to show others.

Huang Haitao understood after reading: "Youth is good, right, Director Wu."

Wu Guo Nan nodded, also knowing; Fang Ziye was probably flirting with someone, who knows. But he hadn't thought in other directions either.

The immediate business was eating; the idle chat during the meal mostly centered on Fang Ziye, but mostly questions like: how old are you, what does your girlfriend do, is she in the same field?

Fang Ziye handled them all with ease, neither shy nor feigning coldness.

When almost everyone's front was a mess, and Wu Guo Nan and Huang Haitao had smoked their Xiao Kuai Le cigarettes down to the end, Wang Zhongxing and Xue Tao lit their own Xiao Kuai Le.

And each gave Wu Guo Nan and Huang Haitao another one.

Smoke instantly swirled inside; Fang Ziye disliked it but didn't show it, just packing up lunch boxes while asking: "Director Huang, I just heard Director Xue say your Manual Reduction is done extremely well; this is something I've never seen at Zhongnan Hospital. Do you think there are any tricks or patterns to it?"

Not knowing, just ask; nothing shameful.

Questions Luo Tingzhu can ask openly, Fang Ziye can ask too; first admit one's shortcomings, the benefit will be even greater, not just substantial.

Huang Haitao didn't hide anything: "This is the content of TCM Bone-Palpation Technique and Bone-Setting Technique. Doctor Fang, you want to learn? Then I'll give you a few sets of books?"

While packing lunch boxes, Fang Ziye's movements stiffened slightly.

He asked back: "Teacher Sang Yuerue, would reading these books require a foundation?"

Fang Ziye knew that in Osteotomy Correction, one of the most critical steps is Manual Reduction. Correction essentially means taking an abnormal form, performing osteotomy, then rotating and reducing it to restore normal form and achieve functional replacement.

Manual Reduction Technique is one of the most critical components; if it's learnable, Fang Ziye doesn't mind learning it, but if it takes ten or eight years of effort, Fang Ziye feels that might be a bit too tough.

"Would need a little, but not much. If it's feasible for you, you can actually convert it into the modern medicine meaning you understand and read it through, counting as understanding."

"But it will be very time-consuming, need to grind slowly. If you need it, you can come to Min Da Hospital and find me; I have a few bound photocopies there."

"People who like reading, I really like." Although Fang Ziye didn't have that very scholarly Confucian air, whether a person likes reading can't be seen at a glance; after a few interactions, you can tell.

On Fang Ziye, Huang Haitao saw intense thirst for knowledge and a steady, heavy depth; this is the temperament accumulated from reading, something ordinary people can't fake even if they pretend.

"Thank you Director Huang, I'll definitely come when I have time. Just these next two days; my face skin is very thick." Fang Ziye helped wipe the table with tissues.

Beside him, Wang Zhongxing and Huang Yunxiao were also doing similar work.

Several Premium title holders naturally couldn't be doing these things.

When Fang Ziye gets books from Yuan Weihong, he's never particularly polite; even if borrowing means returning, he borrows first and talks later. Moreover, since last year when Professor Deng Yong said Fang Ziye could borrow books from him, Fang Ziye really did borrow them; although he hasn't finished reading or returned them, Professor Deng Yong hasn't urged him to return them either; currently Fang Ziye still brought them to Enshi.

It's the full set of Campbell's Operative Orthopaedics, very thick, knowledge scope also very broad, worth careful and thorough reading. Just that it's the full English version, gnawing through it is also very not easy.

Director Huang didn't reply further, just felt Fang Ziye was a bit interesting.

After sitting a while longer, Wu Guo Nan and Huang Haitao started sorting through the in-hospital patients' X-ray Plain Film photos, comparing them meticulously one by one, discussing which were suitable for Manual Reduction and which couldn't be done.

Huang Haitao was still muttering —

"This one no good. If my Master were here, could try; I think I've seen it, but I can't do it, don't try."

"As for this one, we can reluctantly give it a try..." Huang Haitao's tone was heavy; as he spoke, he shook the cigarette box again. Beside him, Wu Guo Nan opened his own drawer, reaching past one hundred fifty-four packs of Huanghelou Cigarette Cigarette to find a single six-yuan pack of Hongshuangxi Cigarette Cigarette at the very bottom.

Huang Haitao looked at it, yet treated it like a treasure: "You still have this stuff?"

Fang Ziye felt surprised; what could be unavailable about Hongshuangxi Cigarette Cigarette...

Of course, Fang Ziye didn't go pursue the answer to this question either.

Fang Ziye returned to the Deputy Chief Physician Office; after Xue Tao 'gifted' him a workstation, he said with a thoughtful mind: "Tao Ge, you can smoke in here; I'm not that sensitive to the smell of smoke."

Although the harm of secondhand smoke is great, smoking is a form of relaxation for many people; Fang Ziye also couldn't bring himself to forcibly twist Xue Tao's habit just because of himself.

Fang Ziye had previously seen Xue Tao rubbing something in his pocket several times, not knowing what he was going to do, but now he knew.

Xue Tao turned back, let out a hehehe laugh, then lit one up.

After Fang Ziye finished writing and revising all the admission informed consent forms, he printed them out uniformly, planning to go conduct the informed consent talks one by one.

These things have standard formats, but Fang Ziye likes each person to precisely conduct the informed consent talks according to their own understanding; this is a tempering of theory and overall disease cognition.

Through this tempering, Fang Ziye's Orthopedics has now approached Level 3, and Trauma Surgery has already reached proficiency above Level 3; this is without wasting Knowledge Points.

However, by the time he went out, the time was already 1:40 PM.

Fang Ziye's typing speed was relatively faster than the few others like Xue Tao, so at this moment, only he had started going for the informed consent talks.

Who knows if it was a coincidence, but right now Fang Ziye happened to run into Wu Guo Nan and Huang Haitao checking patients at the bedside; moreover, Huang Haitao was palpating the bones one by one, combining it with the plain films to confirm the diagnosis types.

Fang Ziye felt it was a rare opportunity, so he temporarily paused the informed consent talks, followed along at the side, and silently began recording what Huang Haitao said; although some of it he might not quite understand, he could look up the information afterwards.

For Huang Haitao to be valued by Wu Guo Nan and respected by Xue Tao and the others, he definitely has real skill.

Many people in the department say Xue Tao is a pure clinical pragmatist; no matter how good your academics are, if he doesn't acknowledge you and doesn't need you, you're just trash; but if your clinical skill is good enough, then Xue Tao is very willing to get close to you.

Wu Guo Nan and Huang Haitao both noticed Fang Ziye, but only felt Fang Ziye was truly eager to learn, and didn't consider other aspects.

One round walked down, roughly taking half an hour; the time wasn't very long.

However, Huang Haitao then said: "Director Wu, there aren't many either; I feel the reductions I can handle are about eight or so; I pretty much have a bottom line in my heart for these."

"We'll organize it in a bit; you have the people below go do the informed consent talks."

"This informed consent thing, still can't afford to lose it..." Huang Haitao was considerably cautious.

In the end, after a detailed breakdown, Fang Ziye discovered that among the beds he managed, three patients' fractures could be resolved through closed reduction.

They were respectively a tibia-fibula double fracture, a radius fracture type B2.1, and another radius-ulna double fracture.

For these three fracture types, Fang Ziye had all looked at them carefully; if from the perspective of modern medicine, at least according to current Trauma Surgery guidelines and corresponding instability principles, they all require surgical reduction to achieve a relatively good treatment effect.

Wanting to handle them through closed reduction, one can only say the risk is extremely high, and plaster external fixation cannot meet fixation requirements; after reduction, instability and displacement are very likely to occur, leading to re-operation and increasing the patient's suffering.

Of course, since Huang Haitao said so and Director Wu ordered it, Fang Ziye wouldn't nag much either.

Get all the informed consent forms signed, inform the patients that this is just an attempt; if reduction fails or post-reduction assessment still cannot achieve fixation effect, then surgery is still needed; it's just that currently the Director has seen them and we can anticipate closed reduction.

Regarding this point, Fang Ziye's informed consent talk experience is also very rich; previously at Zhongnan Hospital, the most difficult procedure informed consent talks he did had more, more varied, and more chaotic risk clauses, all of which he could clarify and inform one by one.

This point counts as small fry.

And he told each of them they could refuse this operation attempt and go straight to surgical reduction.

However, all three felt that if they could avoid surgery they'd avoid it; if surgery is needed then do it later; they didn't have much subjective initiative or participation, relatively passive.

After finishing the informed consent talks, Fang Ziye rushed to the Operating Room again; Huang Haitao had already completed one reduction, and after the reduction was complete, he confirmed the reduction effect through palpation, then said: "Quickly apply a functional position plaster cast; after fixation is complete, go re-check the X-ray plain film."

"Just maintain this posture." Huang Haitao instructed.

On the other side, Xue Tao, who had handed off his managed beds' informed consent talks to Huang Yunxiao, immediately had the soaked high polymer casting material ready; the moment Huang Haitao finished speaking, he deftly applied the plaster to the suitable position and began wrapping.

Obviously the coordination wasn't just once or twice.

Fang Ziye didn't see Huang Haitao's operation process and wasn't annoyed; there were still seven or eight more to watch afterwards.

However, judging the fracture reduction effect with the naked eye was indeed very amazing; it turns out one really can use closed reduction to handle fractures that originally belonged to surgical indications...

Whether fracture closed reduction is successful actually has a clever similarity with the assessment standard for joint dislocation closed reduction.

Fracture diagnosis lies in: deformity, pain, limited movement, bone crepitus and crepitation.

These are clinically visible manifestations.

Clinically visible manifestations after fracture reduction are: disappearance of deformity, pain relief, and disappearance of bone crepitus — these two points.

There is no free movement; that is the physical examination result after the fracture has completely healed. Just after reduction, you go assess the patient's range of motion and bone crepitus — see if they don't hit you; this is equivalent to letting the patient constantly remain in friction between fracture and reduction, the fundamental source of pain.

At least from the naked eye, Huang Haitao's operation was successful.

Immediately after, Huang Haitao continued with two more; Fang Ziye stood by silently watching the whole time, his gaze and expression full of doubt and uncertainty, his eyes filled with pensiveness and incredulity.

Because if he didn't see wrong, this Huang Haitao's closed reduction technique proficiency might not even be as exquisite as his; because Huang Haitao's control of direction and force might at most be Level 3 max proficiency.

The reason he can be so certain is because Fang Ziye is looking down from a height.

But Huang Haitao could achieve reduction effects that he completely couldn't achieve; what is going on?

Fang Ziye wouldn't dare perform reduction on these patients; these are things that theoretically cannot be reduced.

After doing three closed reductions, Huang Haitao seemed somewhat satisfied with his reduction effects, so he deliberately twisted his waist and looked at Wu Guo Nan: "Director Wu, want to try a hand?"

Wu Guo Nan and Huang Haitao have known each other too long; he shook his head: "Forget it; I've tried and failed countless times; still better to give the opportunity to the young people first; I need to grind a bit more."

Huang Haitao looked at the familiar Xue Tao; Xue Tao and he are also old acquaintances.

Even Wang Zhongxing and Huang Yunxiao have some familiarity with him; although he can't recall Huang Yunxiao's name, he at least knows he's Xiao Huang.

So Huang Haitao looked at Fang Ziye and asked: "Doctor Fang, want to come try? Actually the next fracture's closed reduction is also quite simple; the main thing is to achieve complete traction, sufficient release, and then clamp and oppose the tibial fracture fragments."

"Then with the clamp point greater than the fracture length itself, the passive stretching tension from the muscles being stretched provides supporting force."

"For example, a tree branch; you break it in the middle, but use a hair tie to wrap the two broken ends, and the tree branch can also be very stable." Huang Haitao explained the corresponding principle to Fang Ziye.

Fang Ziye, seemingly thoughtful, then nodded: "Teacher Sang Yuerue, then I'll try."

Xue Tao immediately said upon hearing this: "Director Huang, Xiao Fang's closed reduction technique has skill. Joint dislocation closed reduction, he does exceptionally well."

"Oh?" Huang Haitao was very surprised; his gaze became even more concerned.

(Chapter End)