Chapter 294

"Master!" Fang Ziye unhurriedly peeled off the rubber gloves in his hands, folded them inside out, tucked them together, and tossed them into the yellow trash bin, calling out as he did so.

He knew Yuan Weihong's mood wasn't great right now, so he hurried to explain: "Master, these joint dislocations and fractures are all relatively simple cases, not the kind with suspected additional injuries."

Fang Ziye had to explain to Yuan Weihong — last time, Yuan Weihong had already warned him.

Other people's words could be ignored, but if Master Yuan Weihong misunderstood him as being two-faced, that would cause huge problems.

A single person, without the Master's School's assistance and patronage, who falls out with or creates a misunderstanding with their own Supervisor — their future basically won't go far, unless the Supervisor is truly excessive.

Yuan Weihong took a deep breath, and only after calming down did he say: "Tell me the truth — how many patients did you actually see this morning?"

Medicine is no child's play!

Even the Emergency Department at Peking Union Medical College Hospital wouldn't dare claim an assembly-line approach.

The only assembly-line work in a hospital is laboratory tests and auxiliary examinations!

Real clinical consultation is one-on-one, seeing a case through from start to finish before moving to the next.

But when it came to Fang Ziye, good fellow —

They lined up together for closed reduction!

You think you're hosting a reduction party?

Hearing this, Fang Ziye hurriedly confessed honestly: "Master, I only saw five patients total — one joint dislocation, three fracture patients, and among those three fractures, one had both a fracture and a joint dislocation!"

"Of the other two fracture patients, one is very likely a closed fracture but has combined chest and abdominal injuries, currently with no absolute indication for emergency surgery — only needs a minor local debridement."

"The other two fractures — one simple fracture patient, I performed reduction and plaster external fixation, should need hospitalization for continued treatment; as for the other fracture..."

Fang Ziye explained in great detail.

Fang Ziye had no choice — patients arrived sequentially, not queued up simultaneously; he couldn't batch-check every patient's vital signs and such in a short time!

Meaning, he had to steal time between seeing the previous patient to go check the next one! To prevent the next patient from having an absolute emergency surgery indication.

After confirming the next patient had no life-threatening danger. Fang Ziye then went back to check the previous patient's test results; by this time he'd also just about finished examining them, and Fang Ziye could assess based on results whether closed reduction was feasible!

Or offer other therapeutic options and opinions.

At the same time he had to receive new emergency patients, so under these circumstances, he'd temporarily set aside patients already diagnosed and with treatment plans already calculated in his mind.

Prioritize the task of new arrivals — unknown whether they had life-threatening danger or latent diseases — moving them to the front.

Screen for life-threatening danger first, then handle symptoms — that's definitely fine.

Pile up like this, and doesn't it naturally turn into the current queuing phenomenon?

However, Yuan Weihong came precisely for this, so after hearing enough, he interrupted: "Wait a minute."

"You said one patient you want to admit — hey, let me ask you this. Fang Ziye, when have you ever seen our hospital admit a simple fracture patient just to occupy a bed?"

"The department has an empty bed for him? You want him to occupy a department bed — is your face bigger or your reputation bigger, Fang Ziye?"

Listening to Fang Ziye's explanation, Yuan Weihong felt a bit of a headache!

Not to mention, after solo consultation, what must be noted is the First-Consultation Responsibility System — this is a medical system principle; actually, whether emergency patient or any patient, once they enter the hospital, you must be responsible to the end.

Like Fang Ziye — sees halfway, sends patient away, then continues seeing, uniformly arranging reductions — that's somewhat irresponsible.

Fang Ziye's current queuing method is unscientific — he simply cannot simultaneously consult this many patients, and moreover, for such patients, you still can't process their hospitalization procedures.

No such procedure exists, and there's no spare bed for a minor fracture.

Hearing this, Fang Ziye's tone stalled: "Uh! ~"

Immediately after, Fang Ziye thought of something: "Before, Jin Hongzhou, and when Nuo Ge was Chief Resident, didn't they also admit patients to the wards?"

Hearing this, Yuan Weihong immediately said: "That was because they couldn't treat them well or the emergency couldn't handle them, and under extremely dangerous circumstances, they needed to be admitted so the professors could finish the treatment!"

"The one you just admitted — I glanced at it and know: one, no bone defect; two, no lower limb defect!"

"Three, no shock symptoms seen — where would you admit him to?"

Hearing this, Fang Ziye looked up in confusion: "Then what do I do?"

Fang Ziye was bewildered at that moment.

"Han City has more than just Zhongnan Hospital; Han City's trauma surgery emergency care isn't limited to Zhongnan Hospital alone."

"No bed, not fatal, non-absolute emergency — can be discretionarily transferred to other hospitals."

"If they insist on treatment at our hospital, they'd likely need to go through the routine Outpatient Clinic process — nobody taught you this, right?"

"So you didn't ask either?"

"You know everything anyway..." Yuan Weihong seemed to have found an opening, and began a crazy flood of output — all the phrasing people online use to complain about large hospitals' emergency consulting physicians.

The purpose is only one: no inpatient beds, surgery here means waiting — go to the slightly worse hospital next door, don't waste our hospital's beds.

Many people think this is the hospital picking patients because they didn't pay enough.

In reality, it's picking disease types.

"Master, then what about the ones I handled today?" Fang Ziye wasn't persuaded, but could only concede.

Yuan Weihong coming to negotiate with him still left room for jokes.

If it were really Professor Deng Yong coming to question him — Yuan Weihong's words about whether Fang Ziye really intends to arrange our group's patient source to admit disease types —

Then Fang Ziye would have absolutely no way to reply.

"Fine then? Since they're all handled, the post-reduction X-rays must be properly evaluated — responsible to the end." Yuan Weihong sighed, not pursuing accountability, just giving Fang Ziye a warning knock.

"Then what about that patient who might need admission?" Fang Ziye asked Yuan Weihong how to resolve it.

Yuan Weihong patted Fang Ziye's shoulder and said: "Watch me."

Fang Ziye nodded, then watched as Yuan Weihong approached that middle-aged man from Sichuan Province — the one Fang Ziye had said had surgical indications.

Barely three minutes passed before cursing and grumbling drifted over: "How can you still be like this?"

"Clearly agreed on surgery."

"It is surgery — surgery is treatment, but to schedule surgery at our hospital, for your kind of surgery, you might wait half a month."

"And in half a month's wait, your fracture might already have healed with deformity. No choice — some emergencies aren't what you understand as emergencies." Yuan Weihong explained.

"Look over there, those people — as soon as they show up, our Orthopedics Department admits them straight to the Ward. There's no way around it."

"Right?"

"If we admitted every kind of Emergency, our Hospital's Orthopedics Department would've exploded with patient volume long ago. The real Emergencies might not even be able to squeeze in." Yuan Weihong appealed to reason and emotion.

"Then what do I do now? You guys……"

"Go next door? Which next door?" After Yuan Weihong gave him a hint, he asked again.

"Any of them works — you choose yourself. I can't give you a hint or a direct recommendation, otherwise you'll think I'm steering you to a specific hospital and then I'd be earning a referral fee for sending you there."

"I don't do that kind of unscrupulous thing. Aside from our Hospital, you can go to any other hospital, as long as you contact them in advance and secure a bed and they're willing to accept you. But I suggest you still don't contact Tongji and those few other major hospitals……"

"Really can't you guys arrange Surgery for me?" The middle-aged man from Sichuan still wouldn't give up.

"Son of a bitch!" Yuan Weihong must have traveled the rivers and lakes quite broadly, so he even knew a sentence or two of Sichuan dialect.

Once those words came out, the other party found him credible, sighed, and rolled his Wheelchair off to the side.

"Let's go, let's take a look at the Reduction situation." Yuan Weihong no longer struggled; after giving Fang Ziye a preoperative demonstration, he still wanted to back him up as steadily as possible.

This student of his — once he fell in love, he completely forgot he had a Master. Before taking over as Chief Resident, he didn't ask a single important question.

Actually everyone thought the postoperative recheck result review was just a Procedure!

But that's not true — observing whether the post-Reduction condition is truly proper is the real measure of a person's skill level.

Fang Ziye and Yuan Weihong entered the Consultation Room again; inside, people were discussing in a hubbub.

"Today really broadened our horizons. Before we only heard that once you come to the Hospital you need a pile of examinations, then Hospitalization. Didn't expect we'd actually get to see an immediate Reduction like in short videos — no injections, no medicine, no Surgery scene like that."

"Right, maybe we've all been too one-sided, thinking only Old Chinese Doctors do Closed Reduction. Everyone thought Western medicine just does Surgery."

"……"

While they were discussing, seeing Fang Ziye and Yuan Weihong come in, the person near the Doorway greeted Fang Ziye: "Doctor Fang, do we still need to go for a recheck on this one?"

"Yes, they all need a recheck first — that way the assessed results will be more reassuring." Fang Ziye's gaze was sincere, his tone relatively gentle.

After all, in a bit we still have to make it so you're not Hospitalized at our Hospital, so we need to preemptively build a good relationship.

Recheck, assess the recheck results — though important, the process isn't Complex.

The main ways to evaluate post-Reduction effect are these few.

First, see if Symptoms are relieved.

Second, see if Deformity has Disappeared.

Third, see if active and Passive movement after Joint Dislocation Reduction have recovered.

Fourth, see on the plain film whether the Joint is already in place, whether there's soft tissue Interlock or False Reduction — if none of those, it proves a High Quality Reduction.

Fifth, see if there are any Complications during the Reduction process, such as Fractures and the like.

Yuan Weihong read the films; Fang Ziye handled the post-Reduction Physical Examination, checking active and passive movement……

Yuan Weihong's Image Reading skill — he himself believed it was higher than Fang Ziye's! At least Yuan Weihong felt that way.

Therefore, Yuan Weihong could see that the patients Fang Ziye had treated — not only had Deformity Disappeared and mobility recovered, but this batch of four Reduced patients.

Not a single patient had 'additional symptoms'!

What are 'additional symptoms'? They're the Complications that are almost certain to exist after Reduction.

Generally speaking, during Reduction, slight tears of soft tissue inside the Joint Cavity, oozing blood, or edema signals from impact tend to appear — these are what beginners at Closed Reduction of Joint Dislocation most easily produce.

Although these Symptoms are harmless, they'll recover after rest.

And these Symptoms — like oozing blood — if an Orthopedics physician's skill isn't up to par, they fundamentally can't even see them.

But Yuan Weihong himself could see them, because this was the greatest confidence stemming from his own strength after his Image Reading improved.

But?

Yuan Weihong looked for twenty-odd seconds, didn't find those rookie mistakes — which only proved that in the entire diagnosis and treatment process, Fang Ziye not only did Closed Reduction well, but also assessed the indications for Closed Reduction extremely accurately.

Suspected additional symptoms, or obvious additional symptoms — those all belong to relative indications for Closed Reduction, requiring you to carefully consider before choosing whether to do Closed Reduction; they're also relative indications for Surgical Reduction, sitting at the critical point.

All of this represents Fang Ziye's Reduction level and Basic Skills.

Yuan Weihong didn't find them, so the "go all out" intention he'd prepared in his heart to teach and explain to Fang Ziye got reined in!

Yuan Weihong glanced at Fang Ziye several times.

Fang Ziye's side had more or less finished the Physical Examination.

"Master, should be no problem, right?" Seeing Yuan Weihong not speak, Fang Ziye also didn't dare just send the patients away.

With Master present, disposal authority doesn't fully belong to oneself.

"Let's go." Yuan Weihong had prepared a lot of talking points in his heart; this time none of them got used, so he could only be a spectator the whole way.

One by one by one.

Fang Ziye more or less finished reviewing all four patients' recheck results, and even learned from Yuan Weihong's example to send the other patient who might need Hospitalization and Antibiotics off to the Emergency Department or another Community Hospital.

Only then did he walk back to the Consultation Room.

He looked at Yuan Weihong's face full of complex emotions and said: "Master, the preoperative and postoperative check films of the previous few patients can also be pulled up in the Film Reading System — Master, let me seriously learn from you a bit?"

Yuan Weihong stood up shrugging his shoulders, stretching a Lazy Stretch, and said irritably: "Alright, you've shown off to a sufficient degree — don't keep showing off. You think I'm checking your Homework?"

Fang Ziye laughed at once: "Master, that's not what I meant."

"Oh, so you want to check my Homework then?" Yuan Weihong bulged his eyes, feigning anger.

"Master, I'd dare even less." Fang Ziye's head shook like a rattle-drum.

"I feel you're not that you don't dare — you've been doing exactly this all along. Just now when I was reading films, during the process of watching you, you kept watching me — what do you mean? You're afraid your Master won't understand what he's seeing?" Yuan Weihong asked.

Fang Ziye was Thoughtful, couldn't answer correctly right away.

And seeing Fang Ziye's hesitation, Yuan Weihong instantly lost his composure: "You really dare think that. Let me tell you, your Master I!"

"I really didn't see it all that clearly." Yuan Weihong deflated at once.

Fang Ziye's mindset also became much more relaxed.

"However, I still must warn you: absolutely do not make things hard on yourself."

"Did you hear that?"

Fang Ziye nodded. He looked around left and right, then discovered Fellow Trainee Jie Han, who at this moment was pacing at the doorway, simply not daring to enter.

One also didn't know whether it was that he didn't want to see Yuan Weihong reprimand Fang Ziye, or didn't want to see Yuan Weihong make a fool of himself in front of Fang Ziye.

Children grown are not kept; the student's wings have hardened, and the Master's School's cage is also not enough to contain him.

Jie Han had long since grown accustomed to it.

Senior Brother finishes posturing, then Fellow Trainee postures, then Master comes to find him to posture — he can only quietly watch to see who is most capable of posturing...

(Chapter End)