Chapter 201: Volunteering in a Crisis (Seeking Subscriptions)

Xue Tao, with his big nose, had a deeper understanding of the people within their department than Fang Ziye did.

After Fang Ziye left the operating room where Cao Zhen was, he found the operating room where the two Senior Attending Physicians, Zhong Xue and Guang Shenqing, were, but the two of them were already cooperating and had opened the case and gone in quite a while ago.

It looked like the hematoma evacuation was almost finished, and both of them were seriously searching for the bleeding point.

It was just that Fang Ziye's sudden entry into the operating room left them puzzled.

Zhong Xue lost his usual goofy demeanor: "Ziye, can't you find the operating room? Do you want me to give Xue Tao a call?"

Normally, Zhong Xue wouldn't know what kind of joke he'd crack, like saying you can't find the door, can't find the hole, that kind of nonsense...

"No, Teacher Zhong, I just came over to take a look!"

"If there's already someone here, I'll go back and help. Tao Ge is afraid there's no one on this side." Fang Ziye casually found a reason.

Fortunately, Zhang Mingcan was the Chief Director, and the group had many people; even though Li Yuanhong went out for further studies, the Senior Attending Physicians still had one more than the other two Chief Directors, so Zhong Xue could temporarily throw his on-duty shift to the pitiful Guo Yunlei to cover.

"Good that you found it." Zhong Xue said this cryptically.

Fang Ziye then silently left.

Since both Guang Shenqing and Zhong Xue were at the table, this patient's hemostasis technique didn't need him to waste more time.

Turning back, he returned to the operating room where Xue Tao was. After scrubbing, gowning, and getting on the table, he discovered that Xue Tao right now, because there was no one to help and the instrument nurse wasn't very knowledgeable either, hadn't even finished the simple hematoma evacuation yet.

However, Xue Tao wasn't anxious at all. Instead, after Fang Ziye approached the operating table, he asked again: "Has that side not opened yet?"

From Fang Ziye going out to coming back, it was only ten-odd minutes; he probably just went to take a glance and then returned the same way.

This was the third time Fang Ziye put on a sterile surgical gown; he felt his hands were full of the strong smell of disinfectant.

However, he still seriously put on the sterile gloves, approached, and said calmly: "Tao Ge, the hemostasis on Cao Zhen's side has been handled. The other operating room has the two Senior Attendings, Zhong Xue and Guang Shenqing, operating, and the hematoma has also been cleared there."

"There's nothing else."

Fang Ziye didn't know Cao Zhen's true strength, but he vaguely remembered that Huang Kai had said Cao Zhen had no problem completing a routine open reduction and internal fixation.

And when Fang Ziye left, he also helped Cao Zhen do the most difficult part of the fracture surgery—the manual reduction—so presumably afterwards, Cao Zhen only needed to complete the temporary K-wire fixation and then put on the plate and screws.

This was a hematoma incision combined with fracture internal fixation; there was no need to pursue a relatively smaller incision intramedullary nail internal fixation and make another cut.

After approaching the operating table, Xue Tao had just finished the preliminary hematoma evacuation and said: "I'll release the vessels first and see where the bleeding point is. I took a look, and there doesn't seem to be any obvious vascular stump."

Fang Ziye scanned the surgical field; the muscle layers inside still had a small amount of clots that hadn't been thoroughly cleaned up, lacking an irrigation step.

But even so, Fang Ziye still captured the course of the anterior tibial artery at a glance.

Roughly matching it with the fracture ends, Fang Ziye picked up the vascular clamp, performed blunt separation on a small tear in the muscle, and fished out a half-continuous artery, saying: "Tao Ge, it should be this one."

This vessel was like a half-burst water pipe; because blood was flowing through it, the stump hadn't oozed blood.

But Xue Tao said dejectedly: "I just clearly explored the anterior tibial artery. Both proximal and distal ends had mobility when pulled, so I thought it wasn't the anterior tibial artery that burst open."

This is a small maneuver of continuous exploration; it's equivalent to saying if you pull the proximal end and the distal end moves along with it, basically the artery's continuity is good.

Pull the distal end, and the proximal end moves along too; same principle.

However, Xue Tao never expected that the vessel Fang Ziye opened up happened to be only half-torn; this level of depth control was a bit too unbelievable.

It could be said to be within theory, but outside operation.

Meaning, theoretically achievable, but operationally impossible to ever reach.

"Tao Ge, why don't we suture it up first, then restore blood flow and check again. Anyway, it ultimately has to be sutured." Fang Ziye didn't speak in absolutes.

"I'll be the assistant." Xue Tao had already understood in his heart.

This Doctor Fang Ziye just didn't show off; it didn't mean he lacked strength.

Xue Tao had a deep appreciation for how good Fang Ziye's aptitude was after interacting with him for nearly a month.

Just one point: Fang Ziye's osteotomy technique, even Shen Tao from Hubei Provincial People's Hospital who shares his given name but not surname, found extremely admirable.

Fang Ziye's aptitude wasn't just ordinarily good.

Then, the Fang Ziye he had come into contact with—recently, for a month—Fang Ziye certainly didn't just become talented in the last month.

Three years of graduate student life, even in Zhongnan Hospital's training room, were enough for Fang Ziye to practice operations to an extremely profound degree, so Fang Ziye having super-high capability in some minor operations was also understandable.

After all, when Xue Tao was doing further studies before, he had heard that the current Orthopedics Chief Director of Zhongnan Hospital, also the Joint Surgery Chief, Professor Du Xinzhan, in his youth, some minor operations had already surpassed many Attending Physicians and were comparable to Associate Professors.

It was just that the level of surgeries he mastered was low; once he got older, he dominated everywhere, a true tyrant.

Among the many professors at Zhongnan Hospital, he was one of the few who, without relying on research, fought his way to the Chief Director and Professor positions, becoming a professional technical personnel at the current Orthopedics Chief Director level.

And Fang Ziye was even more fierce than him, because Fang Ziye's research also wasn't something ordinary people could compare to.

The two had quite a bit of tacit understanding.

Fang Ziye sutured, Xue Tao cut the thread.

The anterior tibial artery belongs to a medium-sized artery.

When the artery is relatively large, the suturing difficulty actually decreases instead, unless it's a large artery like the aorta, where the suturing difficulty increases again.

Fang Ziye, on the extremely difficult rat tail artery replantation anastomosis, could guarantee no side leakage and an extremely high vascular patency rate; dealing with this kind of ordinary medium artery half-injury was also a piece of cake.

After Xue Tao released the clamped vascular clamp and looked at the surgical field again, there was still no oozing blood, so he relaxed: "Then we can basically declare this surgery finished."

Fang Ziye's manual reduction technique, in handling fractures, was just casually slaughtering everything.

Some fractures couldn't be treated with closed manual reduction and plaster external fixation—not because Fang Ziye couldn't reduce them, but because they couldn't achieve a fixation effect.

Reduction and fixation are the principles of fracture treatment.

So, during open reduction, temporary K-wire fixation would be added.

"Bring the K-wire drill." After Xue Tao finished speaking, he didn't even look at how Fang Ziye reduced it, directly preparing the next step.

And Fang Ziye didn't disappoint Xue Tao; under direct vision, he saw the fracture morphology, and the patient was under anesthesia, so there was no need to consider pain at all.

Just after traction, he maneuvered a few times, and the fracture line closed tightly, becoming barely visible.

The time the instrument nurse handed over the K-wire drill was even slightly slow.

But it didn't hurt the overall situation.

After temporary fixation, Xue Tao, to be cautious, still troubled the circulating nurse a bit, having her push the C-arm over to do an intraoperative fluoroscopy, just to be absolutely sure.

If the fixation and reduction are done well, he can also, together with Fang Ziye, learn from Teacher Deng and Professor Duan's example and tell the "uncles" outside: "You can take this patient away, just guarantee the wound doesn't get wet; on crutches, he can get out of bed and walk tomorrow."

If the fixation and reduction are done well, Xue Tao also has that kind of confidence.

And this time, it was a truly very satisfying surgery.

Wanting to freeload in the hospital and not leave — don't even think about it; although these people are just small fry in the instrument company, they're definitely not important figures.

But as long as they participated, they have to accept the consequences, accept legal sanctions as soon as possible, rather than thinking about delaying time and avoidance.

The subsequent operations had even less difficulty.

After temporary fixation, the steel plate and screws were directly fixed a second time — it could be said to be clamped tight.

Xue Tao even learned from Teacher Deng's example and manipulated the patient's fracture segments a few times — not the slightest sign of loosening!

"It has already reached the best possible state."

"Suture! ~"

"Circulating Teacher, you go to the doorway and communicate with Officer Zhao at the door — whether this patient goes straight to the ward or he takes him to the detention center or whatever..." As the surgery was about to end, Xue Tao turned his head and said to the circulating nurse with full confidence.

"Got it." The circulating nurse immediately nodded and jogged out the door.

At the same time, the anesthesiologist stood up and asked: "Can we wake the anesthesia now? If the surgery is ending soon, I'll start waking him up."

"Okay, Teacher, it should be just ten-odd minutes; you assess the anesthesia depth and extubation time." Xue Tao said.

The patient needs to be transferred out, so the anesthesia definitely has to be woken.

Hearing this, the anesthesiologist said: "No problem; you guys say this surgery is fast, I didn't even intubate him, he'll wake up in a bit."

……

Fang Ziye and Xue Tao's suturing speed was very fast. Very quickly, all operations including suturing and bandaging were completed.

After the patient woke up, he basically had no chance to resist at all and was directly escorted to the operating room doorway by Xue Tao personally, then handed over to Officer Zhao outside.

Looking at the plaster cast and gauze on the patient's feet, it was indeed confirmed he had undergone surgery, so he asked: "Director Xue, are you sure, this surgery just ended and he can be transferred out?"

"Postoperative, no additional handling needed?"

He's not a doctor, he fundamentally doesn't understand; he feels after surgery, one always has to be hospitalized for observation for a period of time.

"The detention center has a medical office, right? As long as they can do ordinary infusions and dressing changes, there's no problem." Xue Tao replied firmly.

Hearing this, the patient's family member said: "Hey, you're a doctor, how can you talk like that? What if there's an infection?"

"Didn't you just say it's a 'what if'? In his situation, postoperative antibiotics won't be needed for long, at most just one or two doses."

"Wherever it's used is the same; our hospital's surgeons actually aren't as good at medication as the doctors inside the detention center; mainly we provide surgical technique." Xue Tao said to the patient's family member.

"You can't do this, you guys, this?"

"Surgery done, straight into detention center — isn't that inhumane?"

"The detention center's medical office has beds, you can also visit, it won't affect anything..." Officer Zhao, seeing the usually cautious Xue Tao speak like this now, also understood Xue Tao's meaning.

He unhesitatingly took the patient and transferred him away.

The detention center differs from prison; prison has a hospital, the detention center only has a medical office; although there are beds, the medical equipment inside is actually very crude.

So, if Pang Hong had to be transferred at the first time before, he could only go to the hospital, because Pang Hong's injuries were more severe, and it was an open fracture, and the delay was also long.

Otherwise, you bring back a corpse or an infected person — what meaning is there in entering the detention center?

But this patient, since he fundamentally wasn't an open fracture, can go into the detention center.

Unless special necessity, suspects won't be let wander outside!

Xue Tao personally went over to complete the handover.

Although the patient's family was making a scene outside, right now, the police were already waiting outside for the person — how could they allow them to get close.

Because even if the patient's family cursed loudly, even brought the patient's child for moral kidnapping, but moral kidnapping in front of violated law has no substantive meaning.

……

Fang Ziye didn't follow Xue Tao over, mainly because Fang Ziye's current identity is a student, while Xue Tao is a physician of this hospital and moreover a Deputy Director physician — position and representativeness are completely different.

So, after Fang Ziye completed the suturing, he finally had time and came to the operating room where Huang Kai was.

Inside the operating room, a crowd gathered; there were quite a few onlookers, but most were sitting against the wall.

These people's ages weren't small — all in their forties approaching fifty; they should be directors of various departments, at least Deputy Directors, and both internal medicine and surgery were represented.

For example, the ICU director was discussing Huang Kai's vital signs right now with Anesthesiology Director Huang Jiaoshan and Professor Feng from Peking Union Medical College Hospital's Anesthesiology Department.

"Currently vital signs are safe, should be temporarily no risk, but still have to watch the surgery's progress; I see Vascular Surgery and General Surgery don't seem to be progressing smoothly." Professor Feng said.

On the operating table, it was surrounded by people — at least a dozen-plus — absolutely no field of view for anyone to observe.

But uniquely, the head area where Anesthesiology is located is an absolute no-man's-land; only Anesthesiology people can guard here — they are the guardians of the patient's intraoperative life.

No matter how cramped the position, without anesthesia's care, who dares to do surgery?

If vital signs aren't good, even if the surgery is done perfectly, it has no meaning.

So, Fang Ziye still didn't see Huang Kai; he only saw, overhead, two cold, blindingly bright shadowless lamps, being told by the lead surgeon on the table to the people below to move this way and that!

After hearing the Anesthesiology professor say Huang Kai's vital signs were currently fine, Fang Ziye also slowly moved toward the direction of the lower limbs, because that side is Orthopedics' domain.

You do General Surgery surgery, you can't stand at the foot to do it.

After getting closer, he could hear some people on the table holding their breath, as if operating on some critical step!

Roughly half a minute later.

Fang Ziye heard a familiar stop shout: "Stop!!!"

"No good! ~"

"Master, Professor Duan, still no good; my control of force right now is only maintained at the level of technique borrowing force, still hasn't reached Old Doctor Chen's stage of minute control."

"This pelvic rotation probably needs Old Doctor Chen to be invited." Wu Xuanqi finished, panting heavily, both feet trembling slightly — obviously just now he had exerted full force, consumption too great, a bit tired.

Hong Du Lao Zhuren didn't take the operating position on the table, but wearing clothes, he reached the foot of the table's sterile area; hearing this, he replied in a deep voice: "Old Doctor Chen said he's going to clean house; this matter after all involves his son."

"Under such circumstances, making him come save someone rather than handle his own son's problem — indeed a bit forcing someone to do the impossible."

"If it can't be handled well, then how about we listen to Professor Duan's suggestion and just directly cut the internal pudendal artery and the vesical artery."

"Even if postoperative function of the perineum and bladder function are lost, it's still better than the person dying." Hong Du finished speaking and looked towards Duan Hong and Teacher Deng's direction.

Immediately after, Fang Ziye heard his own Master's voice again.

"Right now, the broken ends' edges of this pelvic fracture have already severed two arteries, but formed a local interlock; at this time it's not something that brute-force reduction will solve."

"Excessive force can very easily lead to secondary fractures in other areas or damage to other arteries."

"This is the most difficult barrier to handle in the ultra-complex pelvic osteotomy reconstruction surgery."

"But if there's really no solution, we can only follow our conventional approach; whatever needs cutting gets cut."

"To save the life……"

At this moment, Tongji Hospital's Professor Duan Hong, who was also Wu Xuanqi's teacher, looked towards Deng Yong and asked with slight puzzlement: "Teacher Deng, didn't you say you had a certain new breakthrough in manual reduction technique? Isn't it this direction?"

"What I did was redefine the classification of fractures; it's not that the manual reduction operation itself was raised to a new height. One is cognitive theory, the other is reality operation — fine force control."

"How can those be the same?" Deng Yong heard this and his forehead darkened slightly.

No way; his own student, the pot dumped on him — no matter how heavy, no matter how black, as long as it doesn't affect reputation but instead certifies his excellence, he can only carry it.

No matter how heavy, he has to bear the burden.

"I thought you could do it?" Duan Hong's tone wasn't sarcastic, but rather felt a bit regretful.

"Can we still find someone else?" Duan Hong asked his student Wu Xuanqi.

"Actually there is one more person, but he definitely won't be easier to get than Old Professor Chen. He is Old Doctor Chen's son; actually Old Doctor Chen's son, when in his thirties, his medical attainment in Traditional Chinese Medicine already matched Old Doctor Chen in his fifties."

"But Young Teacher Chen likes to walk the entrepreneurship path; besides the two teachers, maybe I……"

"Forget it, stop talking." Wu Xuanqi no longer continued boasting about himself, giving those on stage any more hope.

"Then we can only cut." Duan Hong hurriedly paved a way back for his student.

And right at this moment, Fang Ziye in the crowd listened to the gist, both hands placed tightly in front of his abdomen, looked very seriously at his own manual reduction progress bar, and the knowledge points that, just now earned, had increased by another 1200 points.

Recalling what Wu Xuanqi said, he then said: "Professor Duan, Master, how about I give it a try?"

"At most it wastes one minute, won't affect the overall surgical schedule." Fang Ziye spoke up, self-recommending.

(Chapter End)