Chapter 633: A Bit Arrogant?!~

"Save life first, treat disease later; diagnose first, treat later."

These twelve characters, like an ancient inscription carved in the hall of medicine, radiate a solemn and unshakable brilliance.

They are not flowery rhetoric, but an iron law that every healer must engrave upon their heart!

This twelve-character principle applies in any situation, and at any time point, it must be placed in the position of priority.

Whether it is a pre-arranged elective surgery, or an emergency surgery where every second counts, or even a critical emergency resuscitation, making a clear diagnosis first is always the primary task, and also the most urgent matter.

The more urgent the situation, the more one must calmly follow this principle, like a lighthouse in a storm; only by holding fast to the correct course can one avoid losing one's way in chaos and fear.

Otherwise, all efforts will be in vain, like groping in the dark; no matter how one struggles, one cannot find the correct direction, because the direction of effort deviated from the track from the very beginning.

Over forty thousand Knowledge Points, like a breached flood, poured out and emptied in an instant; Fang Ziye's Physical Examination skill, like a butterfly breaking from its cocoon, finally upgraded to Level 6.

A crisp chime seemed to ring in his mind — the system's upgrade prompt — yet at this moment he had no time to carefully experience the changes brought by the Level 6 skill.

He could only instinctively trust the upgraded "instinct": a keener perception, like the gaze of a falcon, able to discern the truth hidden in the minutest details, and a more precise judgment, like a high-precision instrument's measurement, able to clearly grasp the beating of the pulse of life —

The most critical situations can often be summed up as one type: active arterial rupture bleeding.

This bleeding is like a volcanic eruption; blood gushes out at an astonishing speed, draining the human body of its blood in a short time.

If there are too many bleeding points, dense as a honeycomb, or if the arterial dissection is too severe, like fabric torn open by a sharp blade, causing the blood to be lost entirely in just a few dozen seconds, then even if Jesus and Buddha descended, they would likely be powerless to reverse it.

Time is like quicksand slipping through fingers; once it flows away it can never be retrieved.

Fang Ziye is not Jesus, nor is he Buddha; he has no magic powers, cannot create miracles; he is merely an ordinary person, an ordinary doctor with a pair of hands.

He cannot transcend life and death, but he can choose to do his utmost, to save every life that can possibly be saved.

He extended both hands, not as in movies to stir the blood pool and make the scene even more chaotic, but to "activate" the receptors in his palms, the backs of his hands, even his fingertips.

His two hands, like incomparably precise instruments, possessed perception beyond ordinary people. Relying on these receptors, he had to sense, through the thin medical gloves, the subtle turbulent flow changes in the blood pool, like exploring in a pitch-black abyss, having to rely on perception alone to seek a faint glimmer of light.

He had to use tactile sense to feel the direction of blood flow, to judge the speed of blood loss, to preliminarily locate the bleeding point.

All this sounds slow, like a slow-motion replay in a film; in reality it occurred in only two or three seconds.

Fang Ziye swiftly withdrew his right hand from the blood pool, movement fast as lightning yet incomparably precise, without a shred of hesitation, like a well-trained soldier executing the most critical mission on the battlefield.

His gaze was firm and sharp, as if it could pierce through layers of mist and strike directly at the essence of the problem.

Because it was an emergency resuscitation, all instruments were placed in the most convenient positions; they were neatly arranged on the stainless steel tray, emitting a cold luster under the surgical light, like silent soldiers…

No matter whether the instrument placement is good or bad, it is merely there for people to use.

Fang Ziye did not choose to take over Yao Zhanzhong's Lead Surgeon position; Fang Ziye was merely in the First Assistant position. In a surgery, no matter who is Lead Surgeon, the First Assistant position is crucial; it determines the success or failure of the surgery.

An excellent First Assistant is like the Lead Surgeon's left and right arms; not only must they understand the Lead Surgeon's intent, they must also be able to provide timely help at critical moments. He was composed and calm, without a trace of panic, as if on a battlefield, devoting himself wholeheartedly to the battle.

The Anesthesiologist's hands were practically "steaming"; this was a life-and-death rescue, his pressure was greatest, like walking a tightrope on a cliff, every step requiring utmost care, allowing not the slightest error.

He needed to perform "various operations", like a skilled pilot manipulating various instruments, monitoring the patient's every vital sign, to maintain the patient's fragile vital signs.

Fine beads of sweat oozed on his forehead, but his gaze dared not wander in the slightest.

Fixed on the data on the monitor, every second performing tense calculations and judgments, because these data determined the patient's life or death.

Instinctively urging: "Can't you go faster! ~"

He was anxious! ~

"Click! Click!" The sharp clamping sound of the hemostats was especially piercing in the operating room, like gunfire on a battlefield, making one feel tense and uneasy.

Yao Zhanzhong heard no explanation from Fang Ziye; he only saw him accurately send one hemostat after another into the patient's abdominal cavity.

Movements swift and decisive! Not the slightest hesitation!

Like a skilled carpenter, precisely placing each component into position.

"Why a carpenter?" Yao Zhanzhong's own thoughts began to drift.

He could do what others could not, so it was inconceivable, so his thoughts drifted.

No explanation, and no vision, so the people around did not know what exactly had happened…

Everyone at this moment could only hold their breath and watch quietly, like an audience in a theater watching a splendid performance, not knowing how the plot would unfold.

But there are only two choices: either life, or death.

The Hospital does not actually expect so-called influence-ism, but at this moment they must expect it.

They only knew that the blood pool level, originally balanced with the negative pressure suction's aspiration, was now slowly descending, like the receding tide gradually revealing the reefs on the seabed.

"Hemostasis effective! ~" Lan Tianluo shouted, breaking the silence of the operating room, his voice carrying a hint of pleasant surprise!

"Hemostasis effective." Yao Zhanzhong repeated; he was speaking to the Anesthesiologist, and also replying to him!

"Anesthesiologist, transfuse blood!"

"Where would there be blood reserve at this time? It was used up long ago. We can only wait for the Blood Bank to send it over." The Anesthesiologist shouted back in a bad tone.

He knew he was like a soldier without ammunition, able only to watch helplessly as the enemy closed in, yet powerless to counterattack.

Even a clever housewife cannot cook without rice; without blood it is like an army without soldiers, they can only hold on desperately, doing their utmost to maintain the patient's fragile vital signs, hoping for a miracle to appear.

This Yangyuan never felt it would receive emergency cases!

Today was an accident.

The Yangyuan has no obligation to undertake emergency surgeries; blood for elective surgeries is prepared two or three days in advance.

Fang Ziye's movements were swift and precise, as if a precision instrument, every movement having undergone exact calculation and planning.

His fingers were agile and strong, like a pianist leaping across keys, every movement filled with rhythm and aesthetic beauty…

This aesthetic beauty Fang Ziye himself could not enjoy at all; after a while he only relaxed slightly — he did not completely let down his guard, but continued to calmly observe the changes in the blood pool level…

His eyes, like a falcon's eyes, could capture any minute change, not letting slip any trace of a clue.

As the blood pool descended, the rings of the hemostats, the jaws, gradually emerged; the metal originally stained red with blood slowly turned silvery-white, emitting a cold luster under the surgical light.

Fang Ziye was still waiting; his hand-feel Physical Examination told him the patient still had arterial damage in the retroperitoneum!

If the current blood pool is like a calm sea surface, then the hematoma in the retroperitoneum is a hidden surging undercurrent, liable to erupt at any moment.

And it will inevitably erupt.

Therefore, after clearing the active bleeding within the peritoneal cavity, he still had to open the hematoma behind the peritoneum; he must open it!

The patient had lost too much blood, the peritoneal cavity had already ruptured, only part of the bleeding had been stopped, and it was not thorough; incomplete hemostasis was not enough to pull the patient back from the Ghost Gate.

The Ghost Gate was only three words!

Someone walking in there was a matter of life and death.

Wanting to pull someone back from inside was absolutely not as simple as a few words; details, details...

All miracles must be filled with details to be real; otherwise, they were just fantasy.

He looked left and right, and found that Yao Zhanzhong and the others' eyes were filled with confusion; they looked at the part clamped by his hemostat as if looking at a pile of incomprehensible symbols; obviously, they did not understand the specific situation.

Although they knew the hemostat had clamped a blood vessel, they did not know exactly which blood vessel it was, nor could they understand Fang Ziye's basis for judgment.

Fang Ziye still did not explain, because at this moment, time was life; saying one more sentence meant delaying one more second.

He said in a firm tone: "Knife! ~ Big knife!"

His voice left no room for doubt!

No explanation!

Fang Ziye no longer needed to explain now. He was like a general issuing orders on the battlefield; what he needed was execution, not questions.

He had already passed the age of explaining and requesting.

"The knife is here." The instrument nurse immediately handed over a kidney dish, inside which lay a sharp round knife, also called a willow leaf knife; its blade emitted a cold luster, like a ruthless sharp weapon, yet it was also a life-saving tool in the hands of a healer.

"Group Leader Fang." After understanding Fang Ziye's intention, Yao Zhanzhong wanted to stop him, but hesitated.

Because he knew Fang Ziye must have his reasons for doing this, but he still felt some apprehension in his heart, worried that Fang Ziye's operation would lead to more serious consequences.

He had not yet had time to stop him, but Fang Ziye had no hesitation at all, directly enlarging the rupture of the peritoneal cavity, then enlarging it even more...

His movements were swift, without the slightest hesitation, like an experienced craftsman, precisely controlling every detail.

The retroperitoneal space was a closed space, like a sealed container; once filled with liquid, it would form relatively large pressure, and once the pressure lost balance, it would produce a bursting effect.

This was the most basic physical principle, and also the basis for Fang Ziye to take action in emergency situations.

This time was no exception; after Fang Ziye completely opened the peritoneal cavity, blood spurted out like a high-pressure water gun, at a height of at least twenty-plus centimeters; some bloodstains unsurprisingly splattered directly onto everyone's masks and caps, and a strong smell of blood permeated the air, making people feel uncomfortable.

Fang Ziye was not wearing glasses; he could only tightly close his eyes, temporarily avoiding the splashing blood droplets.

His brow was tightly furrowed; during the intervals of closing his eyes, he began to doubt, began to feel apprehensive, felt a bit conflicted, but he had to end these conflicts as soon as possible.

Feeling the heat of the blood disappear and no longer continue—

Growth is painful; one must endure everything.

No grievance!

No reason why; because others gave you an opportunity, and you yourself still want to grow up, you must bear responsibility.

Professor Li Yongjun's trust absolutely was not for you to simply enjoy!

Fang Ziye!

Start.

Fang Ziye tightly pressed his lips, like a resolute warrior, fearing no challenge. About two seconds later, the blood splashing stopped, like the sky after a rainstorm, everything returned to calm again.

Fang Ziye opened his eyes.

After relieving the balancing pressure outside the blood vessel, one could see the hematoma behind the peritoneum like a wild horse breaking free of its reins, beginning to gallop and leap wildly; blood surged out like a fountain, as if venting the dissatisfaction previously suppressed...

This scene lasted only a few seconds; Fang Ziye's left hand, like grabbing a slippery yellow eel, with the swiftness of thunder too fast to cover one's ears, precisely pinched off the bleeding point that was the culprit.

I also have to hold back my dissatisfaction, and you must shut up for me!

His movements were fast as lightning, precise and powerful, like a leopard pouncing on prey, a fatal blow.

Next, he continued to use the hemostat to clamp the proximal and distal ends of the arterial rupture with "crack crack" sounds, like quickly blocking the enemy's retreat on the battlefield. The metallic collision sound of the hemostat was especially clear in the operating room.

After hemostasis was completed, Fang Ziye then looked at the patient's monitor again, observing those jumping numbers.

Blood pressure 79/52, blood oxygen 93%!

Blood oxygen and blood pressure were not very good, on the verge of shock, but now it was already the best result.

Next, he was already powerless; the remaining work could only be handed over to Yao Zhanzhong and them.

Although Fang Ziye could stay and save this patient one hundred percent, the task Li Yongjun gave him was not to save this one.

Li Yongjun was very greedy!

Rapid assessment ended.

Fang Ziye sighed slightly; although it was only a momentary breather, his eyes still remained calm, without a bit of relaxation.

"Professor Yao, the large-scale bleeding has been stopped; Anesthesiologist, thank you for maintaining vital signs; it is best to keep the patient's blood pressure steadily controlled below the shock line to reduce oozing!" Fang Ziye's tone was calm and powerful.

"Group Leader Fang, where are you going?" Yao Zhanzhong's gaze stared fixedly at Fang Ziye; he had not yet recovered from that series of dazzling operations just now.

Although he knew Fang Ziye was very powerful, he knew nothing about exactly how he did it; he had originally hoped Fang Ziye could stay and complete the whole surgery.

"I and Tian Luo are going to take a look next door!" Fang Ziye did not explain too much, directly crossing his arms and retreating backward!

He knew they could not stay here anymore; this patient would not have life danger for at least a short time.

If the team led by Yao Zhanzhong was skilled enough, they could completely save the patient.

Currently, there were still many patients needing surgery; time was very urgent; he could not waste all his time here!

This was a kind of irresponsibility, but Fang Ziye's current responsibility was not to be responsible for one or two people!

Li Yongjun called him back from Han City, not to perform one surgery!

Since Professor Li Yongjun had granted him the right to patrol around in the operating room, he absolutely would not let go of this good opportunity to save lives.

In the face of the emergency, all actions obey the commander; he must be like a loyal soldier, guarding this main position of the operating room, protecting every life that needs help.

Lan Tianluo retreated backward while quickly taking off his gloves; his tone carried a hint of anxiety as he suggested: "Senior Brother, changing clothes will waste time; at least change gloves!"

He knew time was life; every second delayed could mean a life falling. His movements were swift and proficient, as if after countless practices.

"Okay! ~" Fang Ziye did not refuse; he knew that to save more people, he could not waste time.

Taking blood-soaked contaminated gloves to the next patient is immoral and risky; the possibility of contamination is too high.

If the surgery in the next operating room wasn't extremely urgent, Fang Ziye originally planned to go to the operating room next door to change into a sterile surgical gown before scrubbing in, but now he no longer had time.

At this moment, Fang Ziye's mind was calm to the extreme, like a precision computer rapidly processing all kinds of data.

If his capability was ordinary, he only needed to perform surgeries on several patients well;

If his capability was somewhat better, he only needed to hold down the patients in one operating room.

But he had confidence in his own capability and was recognized by others, so within the scope of his ability, he hoped to save a few more people; he hoped to make a bit more contribution at this special moment.

At this time, he couldn't concern himself with good prognosis; he had only one goal: save one more if he could, save two more if he could — he had to firmly grasp every single life.

Changing gloves first, then changing the sterile surgical gown — in surgical operations this is an absolute taboo, like abandoning your weapon on the battlefield; but taboos are relative. When there is ample preparation time, one must follow strict sterile principles and treat by specialty.

But in especially emergency situations, even a medical enthusiast can perform CPR on a person in shock; this is the emergency avoidance power granted by law.

In emergency situations, even at an accident scene one can carry out damage-control surgery to save a life; an intern can also pick up a scalpel and operate. The most important thing is, under limited conditions, to strive to do relatively better!

"Is it Group Leader Li? You've come at just the right time." Fang Ziye had just stepped through the door of the adjacent operating room when Lead Surgeon Professor Fang Zhikuan immediately began inviting him without even turning his head; his tone carried a trace of anxiety and a trace of delight.

"Group Leader Li, on the table..." His voice carried fatigue, as if he had already been fighting for a long time.

Fang Ziye swept a glance at the operating table and immediately realized the urgency of the situation; he had no time to change clothes and paid no heed to the blood stains on himself, directly striding forward in a single bound to find an empty spot and stand ready.

His movements were smooth and natural, as if he had already blended into the operating room environment.

While extending both hands wearing clean sterile gloves, he quickly said: "Professor Fang, Professor Li isn't here — it's me!"

"Fang Ziye."

His tone was composed and firm, without any hesitation.

Hearing this, Fang Zhikuan froze for a moment; a flash of incredulity crossed his eyes, as if he couldn't believe his own eyes!

Immediately afterward, it turned into wild joy; his eyes were full of trust and expectation: "Group Leader Fang, it's even better that it's you!"

His tone was excited, as if he had seen a savior.

Hearing Fang Ziye's voice, Miao Haoyu standing to the side hurriedly shifted sideways, making room; his movement was tiny, yet without any hesitation.

"This patient, external iliac..." Professor Fang Zhikuan had only spoken halfway when he realized he hadn't precisely stated the exact location; Fang Ziye had already sent a hemostat clamping it in!

His movements were fast as lightning and incomparably precise, as if he had long known where the bleeding point was.

He had originally, after opening the right external iliac artery, found the rupture site somewhat difficult to pinpoint, and could only have Miao Haoyu temporarily cover it, pressing the proximal skin of the external iliac artery with his hand to temporarily stop the bleeding; he was thinking of a way to expose the bleeding point, then handle the bleeding together with Gu Yi.

But he hadn't expected that Fang Ziye, from who knows where, found a gap and directly clamped the external iliac artery with a hemostat — movement fast, accurate, ruthless.

With a "Click!" he then swiftly clamped the vascular clamp on the distal vessel of the external iliac artery rupture point, and only then began lifting the surrounding soft tissue.

One could clearly see the external iliac artery was not the segment before the bifurcation, but had a relatively regular opening; bright red blood was still gushing out nonstop.

A femoral artery rupture can drain an adult male's blood dry in under two minutes, and the external iliac artery's diameter is even larger than the femoral artery's; if the bright blood were allowed to flow unchecked like this, the patient could only go negotiate with Ox-Head and Horse-Face about when to die.

This patient had a crush injury to the right lower abdomen; besides damage to the right external iliac artery, there were soft tissue and some small artery injuries, such as the right ureteric artery, etc.

But during emergency rescue, handling massive hemorrhage must be the first-priority priority.

So, Professor Fang Zhikuan and them earlier simply had no time to deal with these trivial minor issues.

Fang Ziye took over, and after handling the external iliac artery bleeding, he and Lan Tianluo quickly finished dealing with the bleeding of those trivial minor vessels as well.

He quickly scanned once and decisively said: "Professor Fang, suture the external iliac artery as fast as possible, debride early, finish the surgery."

His tone was calm and powerful, full of confidence.

"Good!" Fang Zhikuan nodded.

"I'm leaving."

Fang Ziye stepped back two paces; he looked at his own sterile surgical gown, already covered in speckled blood stains; he couldn't worry about too much now, could only find a place to change clothes as fast as possible.

Clothes too dirty won't do. He swiftly took off the sterile surgical gown and gloves and asked: "Professor Fang, just how many people were injured this time?"

His tone was calm, but his eyes carried a trace of worry.

Fang Zhikuan heard the question clearly, but he didn't answer, only sighed: "Group Leader Fang, let's not discuss this kind of thing; we'll read the news when the time comes."

He knew discussing these had no meaning; the things that should be done still had to be done.

Whether the authorities would release the true casualty numbers — even if the news releases fewer, it won't decrease their workload; they can only do their utmost to treat.

Fang Ziye also felt it was so; he estimated the Fang family and Professor Fang also hadn't come into contact with this level of thing; better to just do the work first.

"Senior Brother, should I stay here?" Lan Tianluo hesitated a bit; he knew he wasn't as all-capable as Fang Ziye. The only thing he could do was anchor himself in one operating room and, through his own operations, help do a few more surgeries.

Because he clearly understood he still hadn't grown up enough, couldn't shoulder heavy responsibility; he could only do things within his ability — for example, go do some closed reductions, go outside and do some small trauma debridement, etc.

"You come with me! Be my assistant." Fang Ziye refused Lan Tianluo's proposal; he gave no explanation, because he knew a good assistant can let him unleash his full strength more than a good professor can.

It's not that he needs a person with especially superb technique as an assistant; what's more important is that he can understand your intent and coordinate with you seamlessly.

Like just now, the speed at which Lan Tianluo passed him instruments was the fastest; he could even roughly guess his own operating style.

If he had to ask the instrument nurse on the table, or ask other assistants for those instruments, it would only waste time. At this special time node, time is what's most valuable.

The third operating room — Fang Ziye and Lan Tianluo entered and immediately came out again; inside were Nie Mingxian and Wu Xuanqi holding the fort; although the wound was large, the two coordinated seamlessly, and with the patient not in absolute shock, bringing the person back should be no problem.

They quickly arrived at the fourth operating room.

The lead surgeon on the table was Hepatobiliary Surgery Professor Lin Qiaoshan; he too was full of anxiety at this moment; he turned his head and thought it was Li Yongjun who had come.

But seeing clearly it was Fang Ziye, he first seemed to want to speak but stopped, hesitated a few seconds, then asked: "Professor Fang, do you know how to stop bleeding at the liver hilum and the large vein?"

His tone was anxious, eyes full of hope.

Fang Ziye had just changed gloves and gown, so at this moment he was relatively clean; he directly approached the operating table, seeing Lin Qiaoshan already using his hand to cover the massive bleeding surface, and asked: "Professor Lin, what's the situation?"

"Liver rupture, inferior vena cava injury, liver hilum injury — a complete mess." Lin Qiaoshan's tone was full of helplessness,

"Right now we can only..." He didn't finish, because the situation before them had indeed reached a point difficult to control.

The inferior vena cava is responsible for venous return; it is the largest venous trunk in the body; once injured, the consequences are unthinkable, even directly life-threatening.

Fang Ziye wasn't humble, because he knew at this time humility had no meaning; seeing Professor Lin Qiaoshan had already covered the major bleeding surface with his hand, what he needed to do was actually relatively delicate hemostasis work.

He was composed and calm, without hesitation!

"Tian Luo, go to the opposite side." Fang Ziye said, then explained: "Professor Lin, this is my fellow trainee. The two of us working together will have better tacit understanding."

Lin Qiaoshan saw Lan Tianluo already standing at the Second Assistant's position; he was just about to explain the patient's condition.

But he had just opened his mouth when he discovered Fang Ziye was like a beast, not listening to his explanation at all, as if he couldn't understand human speech, and directly started operating with violence; his movements were too fast, fast enough to make one dizzy.

The opening in the inferior vena cava was not small, but Fang Ziye quickly performed a temporary suture of the inferior vena cava. Don't look at how fast Fang Ziye sutured, but the quality of his suturing was not low at all; even after releasing the hemostat, the inferior vena cava did not continue to leak outward.

Just this temporary suture for hemostasis alone was enough for many people to learn for many years. And this was merely Fang Ziye's most basic, most solid basic skills.

However, emergency over protocol, the surgery had already reached this step, and Professor Lin Qiaoshan would not dwell on why Fang Ziye could reach this extent; he only knew that Fang Ziye could do it.

So, he quickly joined the surgery himself, bringing up all his ideas one by one.

"Group Leader Fang, if you can……"

"Group Leader Fang, if you can still……"

"If……"

Ten minutes later, Lin Qiaoshan opened his mouth wide, his whole person numb: "Group Leader Fang, you really can do all of this?"

His tone was full of shock and admiration; this ability had far surpassed the level of an ordinary doctor.

Fang Ziye calmly stepped back: "It's all thanks to Professor Lin's guidance!" He did not take credit and become proud, because he knew that the reason he could do it was because he had mastered basic skills and the ability to turn ideas into reality.

Fang Ziye's understanding of other surgical specialties was only based on basic anatomy, understanding some common surgical injuries and common surgical operations.

As for the operation details of 'major' trauma in hepatobiliary surgery, Fang Ziye had no idle time to learn them.

He only knew where the arteries and veins inside the liver were distributed, where there were nerves and blood vessels, and the operating patterns of these blood vessels and nerves, etc.

Fang Ziye mastered the treatment principles of blood vessels and nerves, not the rescue process for portal vein injury; the specific steps of these rescues were all explained by Lin Qiaoshan.

However, after Lin Qiaoshan performed operation decomposition on the rescue procedure based on his theory and knowledge accumulation, Fang Ziye was one attempt, one success; his execution ability was quite excellent.

"Group Leader Fang's skills are really good, I truly……" Lin Qiaoshan hadn't finished speaking when he discovered Fang Ziye had already stepped on the foot pedal sensor air valve door of the operating room and left; he left very decisively, and also very quickly.

"Is Professor Fang a bit proud?" Deputy Director Physician Dai Zhongyin, at Lin Qiaoshan's side, muttered a sentence, and there was still a trace of unwillingness in his eyes.

"Emergency over protocol, does Professor Fang want to be like usual, where we exchange pleasantries for seventy or eighty or ninety minutes?" Lin Qiaoshan himself did not feel anything was improper, so he directly gave Deputy Director Dai a warning.

……

(Chapter End)