Chapter 307: Bo Er Special (Requesting Subscription)

Fang Ziye did indeed see a patient with a mangled right foot in the Emergency Department, only Fang Ziye had thought this was just an ordinary case of mangled extremity.

Mangled extremity has no clear definition in textbooks!

And the diagnostic definition in clinical practice refers to severe limb trauma, with extensive destruction of major blood vessels, nerves, and soft tissues, rendering repair or limb replantation impossible.

Therefore, in current guidelines, the recommended first-choice treatment is amputation, also called limb disarticulation.

Naturally, not every mangled extremity patient Fang Ziye had encountered ended in amputation, but the sole exception was Kai Ye Huang Kai.

In Huang Kai's limb-sparing surgery for mangled extremity, Fang Ziye indeed played no small role; yet even Fang Ziye, having experienced such limb-sparing procedures, still dared not attempt limb-sparing treatment himself.

Back then, Professor Duan Hong and his own teacher Professor Deng Yong had said that for such a 'terminal' disease type as mangled extremity, without the cooperation of several skilled hands, one shouldn't even think about limb-sparing surgery.

After receiving Yuan Weihong's call, Fang Ziye hurriedly tore up the routine 'Surgical Informed Consent Form for Limb Disarticulation' he had prepared, then spent over twenty minutes drafting a new surgical informed consent form.

This mangled extremity patient must have come prepared.

At least one of the three great professors had been informed of his condition beforehand, then contacted the other two professors, and only after confirming everyone was available did they deliberately transfer him to the nearest Zhongnan Hospital.

Fang Ziye just happened to become the Chief Resident receiving him.

If he were closer to Tongji Hospital or Peking Union Medical College Hospital, then this whole matter might have had nothing to do with Fang Ziye at all...

Mangled extremity of the right lower limb, the mangled plane located at the knee joint position.

The risk of hypovolemic shock was not great for now, so there was ample transfer time, and the three professors were currently in the department discussing the subsequent surgical plan for limb-sparing surgery based on his condition.

Fang Ziye skillfully found the patient's family members, and before they could speak, he said: "Sorry, the delay was a bit long."

"But the reason was not that I deliberately delayed or any other reason; it was that after reporting your husband's and your son's situation to my superior and discussing it carefully, I decided to fight for a possibility for him."

After Fang Ziye explained this, cutting off the other party's objections and countless questions, Fang Ziye took the initiative, skillfully spreading out the two informed consent forms, handing one to each person, and said:

"We already talked before; the patient's current condition is mangled extremity, and the definition of mangled extremity is a disease type for which limb-sparing cannot be performed—this is currently the most widespread understanding worldwide."

"Whether it's our country's treatment guidelines suggesting the amputation I recommended to you earlier, even in developed countries like the United States, facing such a disease type, they can only handle it with amputation."

"Of course, guidelines are criteria guiding physicians in general medical practice; in principle, all physicians must conduct standardized diagnosis and treatment according to guidelines."

"But if everything were like that, medicine could not develop; exploratory research is very important—that is, we surgeons try our best to fight for opportunities for patients, right..."

"The success rate cannot be fully guaranteed, but we will definitely strive."

"You see, your husband's current situation—the simplest, most convenient treatment measure, and the handling method currently recognized worldwide—is amputation."

"I can do it, and it can be finished in twenty minutes, reasonable, proper, and compliant, but not in line with human sentiment!"

"If it were for convenience, the three professors and so many medical staff of ours would have no need to fuss this long, right?"

"If you expect one hundred percent limb-sparing success, then I can definitely tell you, that is absolutely impossible; the final result is very likely, and highly likely, that limb-sparing fails and turns into amputation."

"And this process will cost you more money, and at least another twenty thousand yuan or so! That's the minimum."

"If amputation is performed directly..."

As a doctor, when talking and obtaining signatures from patients, informing them of risks is one part. But domestically, informing them of financial risks is an even more important other part.

The domestic medical insurance system, or rather the commercial medical insurance system, may not be as perfect as abroad; therefore, for patients with medical insurance, the portion they must pay out of pocket will be high.

The out-of-pocket amount may be the main factor affecting their treatment choice.

"Doctor Fang, we'll sign."

"Before we were transferred here, the doctors at our county hospital already talked to us. If not for that one-in-a-million chance, we definitely wouldn't have needed to come to Han City for an amputation."

"Bei District People's Hospital can also perform amputation surgery."

"But the director there said that Zhongnan Hospital and Tongji Hospital's great experts have joint collaboration, and can fight for an opportunity for my husband; the ones performing the surgery are all very great experts, right?" The woman speaking was also a middle-aged woman.

Although her attire was somewhat disheveled, she still appeared refined; she seemed to be at least a white-collar worker.

Her husband should also have a formal job, but while riding an electric vehicle home from work, he had "intimate" contact with a bus tire, ending in mangled extremity of the right lower limb, with no other ambiguity.

"Mm, yes. The lineup for your husband's surgery this time is indeed quite strong."

"Professor Duan, Professor Qi, and our hospital's Professor Deng are among the top professors in trauma surgery in Hubei Province; their theoretical level and operational level are both at their peak."

"Perhaps older professors with better theoretical levels than them lack stamina; those with better stamina than them cannot match them in theory and operation."

"These three professors appearing together—I'm seeing it for the first time, and even my teacher has only heard of it." Fang Ziye did not deliberately add weight to the three professors.

Because they were already impressive enough, needing no words for extra embellishment.

"I'll sign and pay; the rest is covered by medical insurance."

"Doctor, can you use relatively better..." The woman replied very firmly.

The bus's insurance was relatively sufficient.

The grandmother beside the middle-aged woman, namely the patient's mother, said not a word at this moment, and didn't even look at the informed consent form; who knew if she was illiterate or something else.

"Fine, you need to make up the cost issue; we'll take a look before surgery."

"But you should know, what our doctors actually most want to be responsible for is technical issues—spending more time designing and planning the surgical procedure to be performed—rather than tracking your surgery costs."

"Sign right here."

"This power of attorney—your husband must sign his own name personally. The ID number and other information can be signed by you on his behalf." Fang Ziye was calm and unhurried.

Under any circumstances, the signature on a power of attorney must be the patient's own expression of intent.

If they can sign, they sign; if they can press a fingerprint, they press a fingerprint.

If the patient is already in comatose shock upon arrival at the hospital, then there's no way.

All of the above has lessons of blood and tears before...

After obtaining the corresponding signature procedures, Fang Ziye reported the situation to Yuan Weihong.

On Yuan Weihong's side, he had long ago canceled the pre-defense team and, in the shortest time, assembled a super luxurious assistant lineup.

Yuan Weihong led, with General Qin Geluo, and behind them senior doctoral students Luo Tingzhu, Wang Yuanqi, and Gu Yi; even Yuan Weihong included Dong Wenqiang, a doctoral student who was academic-type but had strong operational ability, in the reserve lineup.

Plus the trauma surgery department's only 'Precious Junior Sister' Luo Tingzhu—this luxurious assistant lineup was quickly assembled.

The specific surgical procedure and sequence, Fang Ziye could not know; anyway, after he reported upward, the feedback from Yuan Weihong was to hurry and send the patient to the operating room, and not to the emergency operating room, but to open an operating room in the Surgical Building as the emergency operating room.

This was the energy of Professor Deng Yong, a Full Professor, personally leading the team to carry out emergency surgery.

Even the on-duty nurses and anesthesiologists in the surgical operating room dared not be the slightest bit negligent, let alone curse and complain.

But if it were a Chief Resident like Fang Ziye occasionally performing emergency surgery in the Emergency Operating Room, he would encounter grumbling and complaints.

Even his teacher Yuan Weihong dared at most call acquaintances to perform emergency surgery in the Surgical Building Operating Room; if he called the regular on-duty anesthesiologists and nurses, they would definitely dis him.

But that was before.

The gap between senior and non-senior titles could be made up for with just one Outstanding Youth Fund.

Everything was ready.

After Fang Ziye entered the Trauma Surgery Operating Room, he immediately arranged and organized the Senior Brothers to begin disinfection and draping together.

Due to the patient's anesthesia, under the interference of Teacher Deng, they invited the most formidable professor in anesthesiology; even with both neuraxial anesthesia and nerve tissue anesthesia administered simultaneously, all procedures were completed in less than twenty minutes.

Disinfection and draping for a Mangled Extremity would be more complicated than for ordinary trauma, but the overall principle was largely the same.

Soon Teacher Deng brought Professor Duan Hong and Professor Qi Qiaowen, both fully equipped, walking in.

With professors from outside the hospital present, Yuan Weihong and the other Assistants hurried to stand against the wall, keeping the vertical distance between the onlookers and the operating table at the centimeter level.

Professor Duan Hong's face was covered by a mask, and his casual hairstyle was hidden under a cap, but his fleshy neck still stood out between the mask and surgical gown, looking like a goiter.

He looked especially easygoing, exuding an approachable air.

Unlike Professor Duan Hong, the other Professor Qi Qiaowen was tall and thin with a broad frame, sharp eyes, and carried a stern aura.

"Gloves, size seven and a half." Qi Qiaowen, standing at 1.85 meters, though not broad in build, his frame and stern tone made everyone's hearts tremble slightly.

Even top professors, in a strange operating room, with a stern hum, could carry an aura that intimidated everyone.

Yuan Weihong subconsciously tightened his gluteus maximus and gluteus medius, his posture at attention even more standard, to avoid embarrassing his hospital and appearing to lack rules.

Fang Ziye confirmed the assistant positions; Yuan Weihong and the others were all designated assistant positions.

Three professors, one leg, one designated Chief Resident assistant, and no other positions remained.

Before Teacher Deng made introductions, Fang Ziye dared not ignore the rules and call out to people.

The current focus was emergency surgery limb preservation, not human relations.

After confirming the tourniquet and other items were in place, everyone took their positions.

Duan Hong and Deng Yong stood very well-matched as a pair of teammates at the knee joint.

That left only Professor Qi Qiaowen and Fang Ziye as a pair.

After this, it seemed there was still an empty spot on the other side of the operating table, and Teacher Deng said: "Yuan Weihong, you come up and make up the numbers, follow Professor Qi to learn debridement of the foot and ankle."

Hearing Teacher Deng say this, Qi Qiaowen slightly turned his head, glancing in the direction where Yuan Weihong stood, and under a very stern expression, actually squeezed out a joke: "The Yage that Dong Dongsheng spoke of?"

Hearing this, it was not easy to understand.

The three characters of Yuan Weihong contained neither the surname Ye nor the character Ye; where did this Yage come from?

But if connected with Yuan Weihong's official nickname North Sea One Leaf, it could be understood.

Yuan Weihong did not dare be presumptuous in front of Teacher Deng; stepping out of the sensing door of the operating room to wash his hands, he still turned back politely: "Teacher Qi, my name is Xiao Yuan; you can also call me Xiao Wei, or Xiao Ye."

Amid politeness, there was still an arrogant air.

If Professor Qi Qiaowen understood the meme, he would know Yuan Weihong was courting him, and such words, he had not used for many years...

If it were not that this big shot was indeed quite big, he would not have let Xiao Wei's meme reappear in the martial world...

"Xiao Wei...?" Professor Duan Hong repeated beside him, incidentally bringing along a once very famous musical score.

Yuan Weihong had already slipped away, and Deng Yong blushed: "Professor Duan, Professor Qi, Xiao Yuan has always lacked manners; please don't take it to heart."

"Still the usual rules: Professor Qi is responsible for debridement, I am responsible for exploring blood vessels and nerves, Professor Duan is responsible for blood supply..."

Hearing this, Professor Duan Hong raised his voice: "Does Teacher Deng not have much contact with the professors of Hand Surgery?"

Listening to this voice, it seemed like revenge.

Hearing this, Teacher Deng first sighed, then looked in the direction where Fang Ziye was: "Yes, it used to be fine; last year we had an argument."

"Claiming that our Trauma Surgery students are extremely talented in Hand Surgery—isn't that talking nonsense?"

Hearing this, Fang Ziye abruptly raised his head, realizing that perhaps when he had gone to the Training Room of Hand Surgery to show off back then, the outcome had not been as carefree as he had understood.

But Teacher Deng did not mention these things by half a word.

Compared with his teacher Yuan Weihong, his methods and frequency of expressing emotion were too low-profile, but he had actually not been absent at all...

"Do you know the Debridement Technique? This is a basic skill of Trauma Surgery." Professor Qi Qiaowen directly began working, asking Fang Ziye in a steady tone.

"A little, Teacher Qi." Fang Ziye glanced at his Debridement Technique: 【Debridement Technique Level 3 234/500】, the level and proficiency were not low.

Hearing this, Professor Qi Qiaowen immediately became interested and immediately said: "Oh, a little? A little, then let's do it together."

Next door!

Teacher Deng hurriedly explained: "Professor Qi, Xiao Fang is younger than Xiao Yuan and has not yet officially started working; he might not have understood your meaning."

Professor Qi Qiaowen slightly tilted his head and made a not very funny cold joke: "Can a Second-Year Doctor not understand the meaning?"

Yuan Weihong and Fang Ziye were called the Two-Link Specials, and Fang Ziye had once been called Fang Xiao Te.

But later, because Fang Ziye's identity was truly outrageous, to describe Fang Ziye running too fast, they made a homophone of Second-Year Doctor Special...

(Chapter End)