Chapter 170

"Alright, I won't say anything else, but regular follow-up re-examinations are still absolutely necessary. You must come." Fang Ziye instructed the middle-aged man.

"I'll definitely come to you, Doctor Fang. After the follow-up re-examination and seeing the results, I'll go to Minzu University Hospital." He still said indignantly.

These matters were beyond Fang Ziye's control.

Twenty-odd minutes later, after Fang Ziye re-evaluated the middle-aged man's post-reduction X-ray results, he reassuringly explained some precautions to him, wrote the post-discharge medical orders clearly and thoroughly, and let the couple leave.

"Industry Brother, this person really intends to go find trouble with Minzu University Hospital?" Guo Yunlei, who was on duty nearby, asked.

Fang Ziye was currently editing a message to Doctor Wu Xuanqi — precisely the X-ray re-examination results after the closed reduction — while replying to Guo Yunlei: "We are just doctors; as long as we do a good job with the reception work for patients coming to our hospital, our department, that is enough."

"After patients leave our unit, how they choose is their freedom."

"As long as we don't slander, comment on, or lure patients from brother hospitals, we can have a clear conscience."

Between brother hospitals, as long as there is no stepping on others to elevate oneself, normal exchange is reasonable.

Just like now, after Fang Ziye contacted Wu Xuanqi about this patient's re-examination MRI and post-operative outcome, the already-stepped-down Wu Xuanqi was momentarily speechless.

"His luck is really good too; such a rare non-accompanying symptom case, he actually encountered it."

"A moderate injury of posterior shoulder dislocation, without accompanying fracture, rotator cuff injury, or joint capsule rupture — cases like this are certainly extremely rare, there may not even be a reported precedent." What rendered Wu Xuanqi speechless was not the middle-aged man going to find trouble, but that he felt his luck was too good.

Fang Ziye also immediately understood Wu Xuanqi's meaning: "Thank you for your modesty, Senior Brother Wu; otherwise, this case report would have been yours, Senior Brother."

"But my luck is comparatively better; the patient happened to agree to have an MRI done at our hospital, so Junior Brother won't be polite and decline, ha."

A probabilistic case with less than one-in-a-million odds — if not published as a case report, it would truly be an enormous waste.

And the reason Fang Ziye contacted Wu Xuanqi was first to inform Wu Xuanqi that this patient might go over to find trouble.

But more importantly, this patient's confirmed diagnosis and treatment were both conducted at Enshi Central Hospital; at Minzu University Hospital it was only the initial consultation.

According to the rules, the ownership of this medical record should belong to the Central Hospital.

So, Fang Ziye informed Wu Xuanqi in advance that he had set his sights on this case and would write a case report; at that time, don't duplicate it and waste the other party's time — this was also a declaration-of-sovereignty exchange.

"Junior Brother Fang's scientific research nose is really keen; my junior brother here just said a writable interesting case report could be done." Wu Xuanqi said.

"Senior Brother, the nose is keen generally because one has been hungry for too long." Fang Ziye explained.

"Haha, Little Fang, you are quite interesting." Wu Xuanqi actually laughed.

……

After the chat ended, Wu Xuanqi slapped his palm against his chin toward the group in the department: "When you are on duty in the future, pay attention; if there are dislocation or fracture patients transferred from Enshi Central Hospital, you absolutely must not handle them yourselves, call my phone."

Hearing Wu Xuanqi suddenly say this, Song Yi — who followed him around Enshi Central Hospital but had not yet formally enrolled — rolled his eyes a few times and asked: "Senior Brother Wu, do you mean, because Ziye is at the Central Hospital."

"Patients he missed and sent over are either traps or poisoned?"

Song Yi currently, like Fang Ziye, had not yet enrolled; the difference was that after Song Yi completed standardized training and graduation, he directly yo-yo'd from Jingdu to this prefecture-level city hospital in Enshi, also hoping to obtain more operation opportunities.

In the master's school, there is a very capable senior brother currently thriving at Enshi Central Hospital; the Tongji Hospital teachers who value cultivating Song Yi naturally also want Song Yi to understand some basic trauma surgery disease types in advance.

The rare disease type of posterior shoulder dislocation encountered today was jointly received by Song Yi and Wu Xuanqi.

The two were still discussing that if this patient went to the other two hospitals and they got hot-headed and started reduction, it would likely cause a medical dispute, so Wu Xuanqi formally signed his own name in the medical record book.

Otherwise, under normal circumstances, Wu Xuanqi would not write such formal regular script.

Believe that as long as they are Enshi trauma surgery people, seeing Wu Xuanqi's name would also make them hesitate a bit.

"More or less that meaning, especially you, Song Yi, absolutely must not underestimate him."

"I see this Ziye's proficiency in closed reduction and theoretical learning speed are even a bit faster than yours; don't be negligent." Wu Xuanqi instructed seriously.

With this junior brother Song Yi's arrival, his position as Chief Resident could temporarily rest; in most situations, it was Song Yi filling in for the Follow-up Resident position, receiving and handling some emergency consultations.

"Okay." Song Yi nodded.

His memory of Fang Ziye was also exceptionally deep; at Zhongnan Hospital, Fang Ziye's suture proficiency level had reached an unbelievable degree; now half a year had passed since then.

At that time's professional assessment, there was no closed reduction procedure set; who knows how deep Fang Ziye's skill is?

But encountering this same-age rival Fang Ziye again in Enshi is also quite interesting; at least currently, even in Enshi, there is faintly a bit of the internal-involution atmosphere from the Jingdu days.

Song Yi is even more accustomed to this kind of competitive atmosphere, not wanting to just lie flat directly.

……

"Food's here, Senior Brother Fang." Guo Yunlei is a Second Year Resident; in front of Fang Ziye, he considers himself a Junior Brother.

"Then let's eat. Yunlei, how much for this meal, I'll transfer it to you." Fang Ziye was still organizing the details of the discharge medical records under his charge.

He temporarily didn't want to reach his hand too far; first do a good job with his own group's medical records and medical order management, and didn't really regard himself as a superior managing all Resident Physicians.

Guo Yunlei's eyebrows are sparse, appearance imposing, just lacking a big beard.

And the most distinctive feature is his buttocks are rather plump and firm; during the meal delivery process, he even unconsciously twisted once, looking just a bit flirtatious but not effeminate.

"Senior Brother, you're joking; it's just meal money, not much spent, dig in." Guo Yunlei didn't pursue this matter.

"Let's go Dutch; next time you treat me. Eating and drinking for free just after entering the department isn't right either." Fang Ziye said, transferring thirty yuan to Guo Yunlei.

Seeing Fang Ziye's expression determined, Guo Yunlei returned the money, then opened the lunch box while saying: "Senior Brother, no need for that much, eighteen for one portion."

Fang Ziye then transferred eighteen yuan; seeing Guo Yunlei accept it, he didn't busybody further.

During the meal, Fang Ziye looked at his Knowledge Points again and discovered that this case just now really brought quite a lot of Knowledge Points.

"+12!"

Although 12 Knowledge Points is not much, an ordinary shoulder dislocation closed reduction technique would at most add five or six Knowledge Points; here with him, it doubled.

Obviously, his situation belongs to a very special category.

Current Knowledge Points Balance: 1122.1!

Still better to be more in clinical practice.

Thinking like this, Fang Ziye wanted to first add points to the prerequisite skills for the Osteotomy Correction Technique to a certain level one by one.

The prerequisite skills for Osteotomy Correction Technique are Osteotomy, Closed Reduction Technique, Orthopedics Internal Fixation Instrumentation Operation Experience, Bone Plastic Surgery, Bone Harvesting and Grafting Technique.

After all, at Zhongnan Hospital, the premise for Fang Ziye's special permission to routinely operate in clinical practice was having certain attainment in Osteotomy Correction Technique.

Otherwise, he could only grind seniority.

Fang Ziye naturally had to consider that after returning, he could still remain in the clinical setting with its bountiful Knowledge Points, so as to have more operation opportunities.

"Osteotomy Level 0 1/10."

Alright, the operation of Osteotomy is indeed relatively high-end; if one must argue about surgical grade, there might not be a standalone Osteotomy operation, but generally they are at least sandwiched within Level 3 surgeries.

Add Points——

The result turned into.

Knowledge Points -10.

Osteotomy Level 0 5/10!

Fang Ziye: "..."

No, speak some reason okay, how can it still swallow Knowledge Points, wasn't it agreed to be one-to-one?

Fang Ziye's eating motion immediately paused.

But thinking carefully, Fang Ziye suddenly understood again.

The operation difficulty of Suturing Technique and the operation difficulty of Osteotomy are completely incomparable; if both consumed the same Knowledge Points, it might not be able to demonstrate the high-end nature of this Osteotomy operation.

Forget it, add them.

Fang Ziye consumed 60 Knowledge Points before raising the skill to Osteotomy Level 2 0/50!

To reach Level 3 for Osteotomy would require at least one hundred Knowledge Points; Fang Ziye didn't touch it for now.

Instead he continued trying the point-addition consumption of several other skills.

Then Fang Ziye discovered that Bone Plastic Surgery and Bone Harvesting and Grafting Technique actually had Knowledge Point consumption ratios that weren't exaggerated, just a 1:1 ratio.

This made Fang Ziye slightly baffled; why was this?

But after thinking for a while, Fang Ziye couldn't get a definite answer; he could only say that perhaps the operation difficulty of Osteotomy is a bit greater than Bone Plastic Surgery and Bone Harvesting and Grafting Technique.

After this round of operations, merely adding points to three Level 2 skills consumed over a hundred Knowledge Points.

And because the application time for Osteotomy Correction is next year, Fang Ziye, well, planned to wait until next year to add points to this final skill.

Currently, as long as Osteotomy is added to a certain degree, it will be enough to deal with the money-earning skill competition at that time.

Fang Ziye truly wished he possessed ten thousand or even a hundred thousand Knowledge Points, to achieve complete point-addition freedom.

Then, just like the novels previously recommended to him, when he returned to Zhongnan Hospital, he would punch Teacher Deng Yong, kick Teacher Li Guohua, blow a breath and Yuan Weihong would ascend on the spot and be specially appointed as a Changjiang Scholar, then point a single finger and Teacher Deng Yong would immediately be arranged to become an Academician...

Beautiful dreams are all good, it's just that Guo Yunlei saw Fang Ziye's slightly smug smile and felt a bit creeped out.

"Senior Brother? Is the taste not right?" Guo Yunlei asked when he saw Fang Ziye hadn't moved his chopsticks for nearly half a minute.

Fang Ziye, whose soul had wandered beyond the heavens, withdrew his "Divine Sense": "No, I was thinking about some things."

"Oh, I thought the dishes I ordered didn't suit your taste." Guo Yunlei flattered with an accompanying smile, proper and well-behaved.

"Definitely not, I'm not picky." Fang Ziye hurriedly shoveled rice.

With Knowledge Points, one can have many things; he must continue to obtain the Knowledge Points from managing patients and grinding medical orders in the clinic, and embark on a proper, sustainable Knowledge Point gain track.

Best would be to early on add points to Basic Cell Experiment and Animal Experiment up to Level 5.

And then let his Teachers give the Teacher a fair account.

Yuan Weihong doesn't need Fang Ziye to vent anger for him or anything, but Fang Ziye can slam the relevant workload in front of Yuan Weihong.

Whether an apology is needed is Yuan Weihong's choice; whether you can make others take the initiative to apologize is your strength issue.

Suppose Yuan Weihong has already become an Outstanding Youth or Distinguished Youth now; then even if his own Teachers dare not apologize, at the very least they would sleep uneasily every night, because once the scandal breaks, as long as Yuan Weihong hints at something, what awaits them is an abyss ten thousand zhang deep.

"Senior Brother, Kai Ye said he is in charge of this year's Orthopedics pre-competition training for the skill competition. He told me, if Senior Brother you also want to compete, and still think highly of him, you can contact him privately." Halfway through the meal, Guo Yunlei mentioned this.

"Huh? Kai Ye really said that?" Fang Ziye was a bit incredulous.

Huang Kai is the Top Pillar of the younger generation in the Department; him being this polite, isn't that a bit inappropriate.

"Yes, really, it was Kai Ye this morning who found me and said this; at that time Senior Brother you were still on ward rounds." Guo Yunlei spoke while observing Fang Ziye's expression.

His heart was exceptionally envious.

Fang Ziye, although a Doctor, is not that Doctor in the Department; regardless of specialty or theory, in just a few days since entering the Department, he gained recognition, not to mention.

Even a Deputy Director Physician like Huang Kai, when facing Fang Ziye, would speak more implicitly.

This kind of jianghu status is what Guo Yunlei dreams of but cannot obtain.

"Then that's a good thing, I've never participated in a competition before; whenever you gather, let me know then."

"We started in March, but we don't have a Training Room like large hospitals, only a Functional Training Room; Director Zhang got it from the hospital, temporarily borrowing it for a period." Guo Yunlei explained.

Basically every hospital has its own Clinical Skills Training Room; it's just that the Skill Training Rooms in prefecture-level city hospitals are not as large in scale and formal as the Training Rooms in Zhongnan Hospital.

And the Training Rooms in Zhongnan Hospital, especially the Orthopedics Training Room, benchmark against the domestic top tier; in equipment and Old Professor allocation, they are not inferior to other University Affiliated Hospitals.

In the afternoon there were no more emergency patients coming in.

There were two fractures, both fibula distal fractures and patella superior pole small avulsion fractures, only requiring plaster cast fixation.

Such operations didn't need Fang Ziye to personally step forward; after instructing Guo Yunlei, Guo Yunlei went off eagerly to apply plaster casts.

Taking advantage of this time, Fang Ziye cleared through the medical orders of the twenty-odd patients in the Group.

Several issues can be summarized: first, inside Enshi Central Hospital, postoperative medication is not very focused on.

The principled structure, such as anti-inflammatory, analgesia, prophylactic anticoagulation and other major directions, won't be wrong.

But in the management of duration continuity, besides anti-inflammatory antibiotics being stopped timely, there exist relatively large problems in the use of analgesia, detumescence, and prophylactic anticoagulation drugs.

For example, patients operated on Saturday are still using Nadroparin Calcium for prophylactic anticoagulation today.

Actually, for such patients, one to two days post-op, after they can get out of bed and move, they can switch to oral anticoagulants.

Analgesics are the same.

In Zhongnan Hospital, for those large trauma patients, postoperative IV analgesics are used for at most three to five days, then switched to oral Celecoxib for analgesia; but here, on postoperative day four, just a routine small fracture, they are still using IV analgesics.

Fang Ziye did not directly correct, but only handled the patients under his charge according to the principles he previously summarized from reviewing literature, marked the corresponding medical orders, and planned to discuss with Wu Guo Nan and Xue Tao and others then, before suggesting corrections.

Suggestions are what one should do oneself; corrective handling is their own choice.

Fang Ziye would never treat himself as a new official's three fires, burning whatever — completely unnecessary.

But if it were at Zhongnan Hospital, his two fellow trainees or Teacher Deng's fellow trainees using medication like this, Fang Ziye would give them a knock/warning.

Around four forty in the afternoon.

Director Wu Guo Nan as well as Deputy Directors Shen Tao and Xue Tao and others returned to the ward one after another.

Several people on the way back were still discussing today's surgical progress, saying that except for one fracture patient's closed reduction, which took about six reductions to reduce, the others were all very smooth.

Several people returned, planning to look once more at today's postoperative patients; this is Doctor Shen Tao's habit after finishing surgery.

Seeing this, Fang Ziye also followed along to do ward rounds first.

The first-time postoperative ward round mainly asks about the patient's anesthesia recovery situation and the affected area's pain assessment, to avoid the extremely small probability of anesthesia accidents and poor surgical quality situations.

After finishing ward rounds, Fang Ziye then told Xue Tao and Wu Guo Nan the summary suggestions he made today in the department regarding group internal patients' medication.

But when Fang Ziye spoke like this, Shen Tao's gaze toward Fang Ziye became thoughtful, as if his eyes contained something.

But what Shen Tao didn't expect was that Deputy Chief Physician Xue Tao, after listening, immediately said: "Change, definitely change."

"Doctor Fang, your suggestion, that is definitely the most scientific." While speaking, Xue Tao's thick eyebrows squeezed together, his tone even faintly carrying a few points of fawning politeness.

Shen Tao's heart also secretly stiffened; he thought to himself, this little Fang's status in the group and department is not ordinary, able to have this much weight in such a short time since coming to the department.

No wonder Yuan Weihong picked up the North Sea One Leaf nickname again, playing the arrogant one.

(Chapter End)