Chapter 748

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Protagonist:

Fang Ziye

"The family's signature has been obtained!"

"Originally his daughter absolutely refused to gamble on it." Tang Xiaoping walked in from outside the operating room, holding two surgery consent forms, and as he reported this he noticed quite a few people staring at him.

He immediately realized something and glanced twice toward the anesthesia machine; once the numbers on the anesthesia monitor became clear in his pupils, he silently walked over to the storage table and placed the signed documents down.

The signed documents held in hand were not for creating a lively atmosphere as a joke, but the bottom line of this entire surgery.

The circulating nurse hurried to Tang Xiaoping's side and asked in a low voice: "The family has arrived, has payment been made?"

Tang Xiaoping said in a low voice: "Fifty thousand was prepaid, the rest will go through insurance... the at-fault driver has also been found. The traffic police and police have called over the insurance company's business manager."

After that, neither of them spoke further.

Tang Xiaoping's voice was not quiet; deliberately saying this kind of thing at this moment was also giving everyone a dose of reassurance.

Medical insurance payment reform has happened, but the department operates on a self-financing basis, and the essence of the hospital's establishment quota being a deficit quota has not changed.

All money lost must be made up by the department finding a way.

The former Fang Ziye did not involve himself with financial authority and had no concept of this, but after becoming Ward Director, Head Nurse Huang Xiaowei also often came to lecture him about it, and only then did Fang Ziye truly understand the circulating nurse's words.

Doctors are not saints, they cannot transcend worldly concerns.

……

"Tang Xiaoping, get up here." After hearing Tang Xiaoping's voice fall, Deng Haibo shouted.

Tang Xiaoping properly went out to scrub in.

At this time, the time had already reached 12:40 in the early morning.

The patient's vital signs were temporarily stable, but that did not mean the emergency surgery was over; there were still a great many surgeries left to do.

Fang Ziye roughly scanned the other surgical fields, felt he had no further need to intervene for the time being, and so went to the lower surgical field area——

"Ziye, the dual circulation instruments have been connected."

"Circulate first then hemostasis, or?" Li Nuo raised his head to ask Fang Ziye's opinion while simultaneously reporting what he had done.

Li Nuo was older, formerly a superior, now a peer of Fang Ziye.

On formal occasions he also called Fang Ziye "Ziye," but that did not mean he lacked self-awareness; right now on the operating table, he was simply an apprentice.

He needed to pay the price for his absence during this period when he went to Spine Surgery.

"Circulate first, then explore and remove foreign objects!" After Fang Ziye decided, he turned his head to the circulating nurse: "Adjust parameters, set Circulation Instrument 1 parameters to 3, set Circulation Instrument 2 circulation parameters to 1."

Instrument use must be as foolproof as possible; the more foolproof, the more convenient to use.

If manual adjustment is needed at any time, although the range is wider, controllability is worse.

The circulating nurse's feet were practically smoking from stepping, she acknowledged and couldn't even set off immediately.

Seeing this, Wu Yong coldly interjected: "Who is the Nursing Department's on-duty person in your operating room today?"

"Such a major surgery, and you only dispatched one circulating nurse and two instrument nurses? Tell me her name."

The circulating nurse and instrument nurses were stunned; the circulating nurse immediately said: "I'll call someone right away."

The Medical Affairs Department and Nursing Department are not in a subordinate relationship, but in the hospital's ecological niche, junior doctors are prey before nurses, while before senior doctors and professors, the Nursing Department is there to cooperate with the professor's work.

Generally speaking, professors cannot be replaced, but Nursing Department work is highly replaceable.

If a big professor like Wu Yong really submitted his opinion to the Nursing Department, today's on-duty nurse, even if not removed from the operating room, would still get reprimanded! ~

She conveniently made a phone call.

The call connected, and a voice came from the other end: "Did the patient in Room 13 die? What's the doctors' opinion, give directly to family or send to morgue…"

The circulating nurse hurriedly interrupted: "Teacher Fang, the surgery here is still continuing, need to dispatch another person over."

While simultaneously adjusting the microcirculation instrument's parameters, she waited for the microcirculation instrument to beep, then asked: "Professor Fang, is it good?"

Fang Ziye had no complaints about the circulating nurse; she alone was responsible for surgical collaboration across so many specialties, truly stretched thin — this is an Operating Room Nursing Department management issue.

Fang Ziye nodded without speaking, lowered his head and began the pelvic and lower abdominal exploration surgery.

The large steel plate was removed, but that did not mean the surgery had passed the safe period; on the contrary, the surgery had truly just begun.

Before it was only about saving a life; now the patient has not yet left the life-danger period, but the treatment of the disease must also be considered; besides saving the life, the process of the patient's circulation being restored later is also an unknown tribulation.

The circulating nurse's call was hung up; the on-duty nurse surely also knew she had misjudged the condition progression in Operating Room 13.

Since the surgery is still continuing, there is a possibility the patient won't die; then dispatching only one circulating nurse is clearly unsuitable.

As the surgery proceeded in an orderly manner, Vascular Surgery's Liu Faming said: "Operating Room 13 is our Vascular Surgery operating room; the isolation room has interventional monitoring equipment."

"No need to transfer later."

Liu Faming's words made Deng Haibo's gaze flash sharply: "Liu Faming, your new campus side eats this well?"

Generally speaking, interventional operating rooms are separate, with an interventional special zone.

However, that was the operating room allocation from over a decade ago; newly built operating rooms now have found a way to integrate interventional operating rooms with traditional operating rooms.

It's just that the old campus's old operating rooms cannot be demolished and renovated again, so they can only make do with what they have……

Liu Faming lowered his head like an ostrich: "It's the operating room designer's credit; we stepped on luck."

Deng Haibo didn't say much more, just somewhat envied the hardware configuration on the new campus side.

Newly built wards and operating rooms will all have much better hardware facilities than traditional hospitals; this is the general trend of social development, not something Liu Faming and the others deliberately made luxurious.

……

Early morning, 1:31 AM.

Liu Faming used the intraoperative sterile color ultrasound probe to clearly examine the bilateral lower limbs' deep veins, tilted his head and said: "There is deep vein thrombosis formation, the volume is not considered large! ~"

"Professor Fang's speculation is correct; this kind of free-floating thrombus is especially dangerous and requires placing a filter in advance."

Lan Tianluo, the "Chief Resident" who had already rushed to the operating room, also forced himself to rally his spirit at this moment, helping Fang Ziye with a compliment: "My Senior Brother's pair of hands — they've got cheats."

"We never doubted his physical examination results! ~"

The Anesthesiologist said: "Being able to pull a patient in this condition from a blood pressure below 60 up to 85 — if his hands don't have cheats, I wouldn't believe it."

"However, the patient's main circulation flow is too large, the heart's venous return volume is too high, easily causing cardiac burden."

"Transient myocardial ischemia occurs frequently."

Everyone chuckled upon hearing this, having long tacitly accepted the Anesthesiologist's praise of Fang Ziye.

As for the transient ischemia mentioned by the Anesthesiologist, everyone had seen it so often it was no longer surprising.

Blood that should circulate through the whole body refluxes directly from the aorta into the vena cava; if the venous return didn't increase, that would be the strange thing.

Actually, once you get used to it it's fine; patients undergoing high-level limb amputation can survive postoperatively precisely because they've gotten used to it.

Professor Xia Shuanglong from Hepatobiliary Surgery found a moment to interject: "Our surgery department's Professor Fang Ziye — his technique is absolutely beyond doubt."

"What's even rarer is his thinking; he truly brings surgery to life."

"Breaking the whole into parts, then reassembling the parts into a whole."

"Badass! ~" Xia Shuanglong even had the leisure to pull out his right hand and give Fang Ziye a big thumbs-up.

This patient — if not for Fang Ziye's decisive, clean break, directly applying the concept of high-level limb amputation to first discard all organs below the aorta —

the patient would definitely have already entered the Morgue by now.

And such a crazy surgical approach — few people would dare use it on a patient like this.

Fang Ziye smiled faintly: "Thank you for the praise, Professor Xia, but we're only halfway there; the patient still hasn't passed the most dangerous hurdle — how to repair the circulation of the aorta and vena cava anew."

"My opinion is: proceed step by step."

"After the repair is more or less complete, we'll first perform two sets of angiography systems, first search for thrombi — if present, remove them; if absent, monitor."

"Once monitoring is stable, we'll first restore arterial circulation to one lower limb."

"The venous system's flow is relatively gentle and can be connected directly."

Fang Ziye glanced at the time, then said: "Professor Tang, have someone go explain to the patient's family again — this Artificial Artery Consumable wasn't swapped into the patient; it was used to build a pathway during the life-saving process."

"To avoid any disputes postoperatively — this is truly a single-use consumable."

"I just took a look — the morphology of the patient's aortic rupture is favorable; it can be repaired later, no intimal tear, doesn't require full-length replacement."

"As for the circulation restoration later, my thinking is like this……"

"First restore circulation between the aorta and a single lower limb, buffer the impact of transient blood flow volume, then perform bypass……"

Wu Yong and Deng Haibo had already completed the hemostasis operation; the rest were all specialty repair procedures, and at this moment they were "idling"!

The two idling men glanced at Fang Ziye's direction almost in unison; Deng Haibo blurted out: "It can still be done like this?"

At this moment, Deng Haibo felt that he, a Vascular Surgery professor, was just a babbling child in front of Fang Ziye.

Fang Ziye's Vascular Surgery theory was who knows how many times more transparent than his.

Wu Yong pondered for a while, then smiled: "Deng Haibo, didn't you know long ago that our Professor Fang can not only do this, but also do that?"

"Your character is no good — eat, wipe your mouth, and want to run off."

Wu Yong cracked a joke!

Originally, the Next Director Candidate Wu Yong cultivated was not Deng Haibo, but Professor Wang Linhao from Vascular Surgery.

Deng Haibo found powerful Outside Help himself, developed the technique of using a one-way valve to treat retroperitoneal hematoma, and thus came from behind to take the lead.

Not only did Wang Linhao lose all advantages in front of Deng Haibo; sometimes even he, the Former District Director, when facing Deng Haibo, couldn't fully keep control, and had many things he needed to Consult Deng Haibo about.

"Teacher Wu, you're deliberately badmouthing me — don't love me anymore."

"I've always been extremely respectful toward Professor Fang." Deng Haibo hurriedly expressed his stance.

If before Fang Ziye was his Fortune Star, then now Fang Ziye is his Benefactor.

Fortune Star and Benefactor are different concepts, no?

Back then, Deng Haibo would not Realize that the 'One-Way Valve Technique' Fang Ziye shared with him could establish such high Status in the Jianghu.

"Clang! ~" After Fang Ziye pried the last Steel Fragment out from the patient's tissue, he propped up his upper body.

Then leaned on Lan Tianluo's shoulder to wipe the Sweat from his Forehead.

Yawned, then said: "Tian Luo, Master Nuo, the rest — you two handle it."

"I'll go prepare for the circulation restoration coming up! ~"

"Okay, Hard Work! ~" Li Nuo and Lan Tianluo both hurriedly nodded.

Because what Fang Ziye needs to do, no one can replace — only Fang Ziye can do it personally.

Otherwise, Lan Tianluo and Li Nuo would both be willing to help.

It's just that individual Capability is limited; they can only shoulder a hundred-odd jin body — a three-hundred-jin heavy object really could crush a person to death.

Fang Ziye then temporarily withdrew from the operating table for a while, took several deep breaths, rested briefly, then began preparing for the subsequent circulation repair.

The human body's circulation restoration isn't like diverting water into a paddy field — you can't ignore everything else and just channel the water over; you also have to consider Reperfusion Injury after circulation is restored.

Especially must handle metabolic waste, Blood Pressure, etc. well.

And once it involves the Aorta and Vena Cava, this kind of peril is even higher! ~

Fang Ziye isn't someone who likes thrills; although he also feels that directly reconnecting the Aorta and Vena Cava wouldn't cause too much fluctuation!

Under complete monitoring, even if there are minor Accidents, they can be handled.

But Fang Ziye still plans to use a more gentle, stable method for circulation restoration — step by step, no thrills.

Fang Ziye isn't someone who likes thrills; Fang Ziye prefers that kind of controlled, effortless mastery feeling! ~

For instance, this patient's surgery — if given enough time, say the current Fang Ziye redesigned his rescue and Treatment Plan from scratch, the current plan could be vetoed.

Fang Ziye has already thought of a better plan, but the surgery has already started — there's no chance to turn back.

……

Early morning, 2:30 AM.

Only then did Fang Ziye barely finish the preoperative preparations for restoring circulation.

By this moment, Gastrointestinal Surgery and Hepatobiliary Surgery had already handled the local minor injuries that needed handling about as much as they could.

After all, nearly three hours had passed since everyone arrived at the operating table.

Seeing this, Tang Xiaoping said: "Circulating Teacher, arrange the equipment for interventional surgery correspondingly; other teachers temporarily exit the operating room."

A modern operating room without twists, not needing transfer, that can be converted into an interventional operating room anytime, is loved by everyone.

No one likes stimulating tossing about! ~

After another ten minutes or so, two sets of interventional monitoring systems were set up.

There was only one monitoring device, merely two sets of interventional systems; after contrast agent was injected into the circulatory systems respectively, vascular shadows were displayed relatively clearly on the display screen.

The angiography results displayed very quickly, far surpassing the doctors' reading speed.

So, after the results came out, Fang Ziye and the others were still patiently conducting the reading.

Fang Ziye was first responsible for the angiography of his own bilateral lower limbs and kidneys and other positions.

Wu Yong and the others looked toward the intracranial blood supply at the first time, then slowly moved downward.

The process was also very smooth, and no accident occurred! ~

Wu Yong then looked at Fang Ziye, and facing Fang Ziye's calm gaze, said: "Professor Fang, then let's begin."

"Good! ~" All preoperative preparations were done, Fang Ziye no longer hesitated, directly clamping shut the pathway between the patient's large vein and large artery.

Then he cut off a portion of the artificial blood vessel, quickly connecting the cut portion of the artificial blood vessel with the lower segment of the abdominal aorta.

Simultaneously, Professor Deng Haibo also took the opportunity to quickly suture the venous end.

The two did not complete the same operation at the same time; the gap in speed and quality was not very obvious; at this moment they operated simultaneously on the same stage left and right.

Quite a few people instantly knitted their brows.

Very obviously, Deng Haibo, as a Vascular Surgery professor, his strength in the medical attainment of vascular anastomosis was actually beaten by Fang Ziye.

Vascular anastomosis should be one of Professor Deng Haibo's signature skills, yet it is still far behind Fang Ziye.

The simplest: after Fang Ziye completed the arterial whole-process suturing, Professor Deng Haibo's side had only completed three-quarters.

Must not underestimate this one-quarter gap!

This may be a peak that a whole generation, even several generations, cannot break through.

Fang Ziye patiently waited a while longer; the lower limb arteries and veins, he had already handled them all, only waiting for blood supply to reconnect!

Fang Ziye had also already clamped shut the left femoral artery and femoral vein, leaving only the right femoral artery and femoral vein.

Moreover, Fang Ziye feared the blood flow speed changing too fast, the patient couldn't accept it, so he also formed a short-circuit fistula between the femoral artery and femoral vein.

Blood flow speed changing too much, whether from slow to fast or fast to slow, is a strike.

Fang Ziye had already hit the advance amounts properly.

"Restore circulation?" Fang Ziye asked after seeing Deng Haibo finish suturing.

"Restore! ~" Wu Yong nodded.

Opinions consistent, Fang Ziye opened the clamped hemostats for hemostasis; Deng Haibo's side also simultaneously released the double ears of the hemostats.

Blood flow instantly rushed downward! ~

At the same time the two circulations completed fusion, the contrast agent concentration was also constantly being diluted.

Because the blood volumes of the two circulations are not the same, the contrast agent concentrations are inevitably different.

Under the swirling misty shadows, it looked somewhat magnificently beautiful.

However, before everyone could even appreciate all this, the anesthesia machine had already beep-beep-beep-beep-beep alarmed.

Almost instantly, an elevated atrial fibrillation shadow flashed into view.

The anesthesiologist's skill was very deep; just looking at five wave segments, he roared: "Atrial fibrillation! ~"

All this, though abrupt.

Was also the worst result within expectations.

"Pay attention to thrombus! ~"

"Prepare thrombectomy device, prepare thrombolysis." Wu Yong crisp and neat.

Fang Ziye although without expression, without sound, his two eyes dead-stared at the patient's heart.

The large circulation suddenly drilled into the lower limb circulation; circulating blood would form a temporary deficit; the volume and rate of venous return would both change.

This time, atrial over-contraction easily occurs.

Contraction rhythm changes under stimulation, that is atrial fibrillation.

Brief atrial fibrillation is not particularly scary; the anesthesiologist had prepared early; at this moment he had already used Metoprolol.

This is a common drug for intraoperative atrial fibrillation patients; even if ineffective, cardioversion can still be used.

Mainly must pay attention to the duration of atrial fibrillation, whether thrombus appears.

If thrombus once appears, must also pray it doesn't enter the carotid artery.

Because the patient did not have a carotid artery filter placed in advance.

Everyone only considered the possibility of atrial fibrillation; impossible to make all preparations for atrial fibrillation sequelae perfectly complete.

Such expense is too great; for the patient, for the doctors, both are an extra burden.

Time slowly passed on; breaths in the operating room had already stiffened.

The shadowless lamp had already been turned off; the angiography display instrument displayed the patient's atrial contraction rhythm; blood in the atria and ventricles became turbulent flow.

The cardiac monitor's beep-beep-beep sound also rang non-stop.

At this moment, everyone was very nervous.

The monitor's alarm was unmistakably the death-knell shrieks of the little imps come to collect.

The atrial fibrillation persisted.

Roughly thirty seconds passed!

The anesthesiologist said: "How about we prepare for cardioversion! ~"

"Wait a bit more! ~" Fang Ziye stared at the angiography screen.

"No thrombus found so far; the patient's heart is adapting to the new blood-volume rhythm."

"Thirty-one, thirty-two, thirty-three……"

The surgical timer panel had been reset by the circulating nurse the moment the atrial fibrillation occurred; now the time ticked slow and steady, pausing for no one.

"A thrombus has detached from the deep veins of the lower limb." Wu Yong knew Fang Ziye's attention was fixed on the heart, so he gave the reminder.

Fang Ziye answered: "There's a femoral venous filter, no need to worry! ~"

"The renal artery has a small ooze; the bleeding volume is decreasing — consider it a transient shock." Deng Haibo reported the situation and gave his own judgment.

Fang Ziye glanced toward the renal artery's location.

"Forty-five, forty-six, forty-seven……"

"Heart rate is already one hundred thirty." The anesthesiologist reported again.

Fang Ziye said: "No rush! ~"

"Wait."

The anesthesiologist spoke no further.

The circulating nurse lifted her right foot, not daring to set it down normally, and slowly lowered her stride, like a cat's paw padding the ground.

The instrument nurse's right hand gripped the curved hook, pressing the glove into wrinkles; her slim neck stood rigid, eyelids trembling……

This was the scene everyone had envisioned, yet when it appeared, everyone was still tense.

This patient was already ill-fated; when he entered the OR, the surgical department and the anesthesiologist had declared his "death"!

Then, after barely a glimmer of hope appeared, now he might be taken away again?

What was the meaning of everyone struggling from past nine until now?

Atrial fibrillation kills.

It really kills!

One minute, two minutes, three minutes.

Five minutes passed.

The anesthesiologist gave another 5 mg of medication.

"Five minutes later, if the atrial fibrillation hasn't recovered, consider cardioversion! ~" He was no longer asking Fang Ziye's opinion, but issuing a unilateral order.

During surgery, how to operate is Fang Ziye and the others' business, but how to monitor vital signs is his business.

Right now, Fang Ziye thought carefully for a moment, then said: "Tian Luo, connect the other lower limb's circulation into the circuit as well."

Lan Tianluo heard this and instinctively asked: "But?"

"Connect! ~" Fang Ziye couldn't explain much.

There was no time for this explanation.

Lan Tianluo chose to trust Fang Ziye, released the hemostats on the left femoral artery and femoral vein, and the vessels refilled.

Simultaneously, the patient's full-body vascular imaging finally appeared on the display screen.

It could be seen that right now the patient's internal circulation was still quite beautiful!

Although there was a small amount of turbulent flow at the suture sites, this bit of turbulence did not affect blood flow in the slightest.

No bleeding, circulation intact.

"The atrial fibrillation is still ongoing, it's been seven minutes already." The circulating nurse really couldn't hold back and reported.

No one replied.

The anesthesiologist had already quietly instructed his assistant to push the cardioversion device.

Immediately, the sound of rolling wheels sliding pierced through the OR, blending with the alarm.

Fang Ziye said: "Currently, the patient's hemodynamics are stable, the atrial rhythm is acceptable, no need for cardioversion."

The anesthesiologist was a bit embarrassed: "But?"

"In major cardiac surgery the heart can be stopped; a bit of atrial fibrillation is fine." Fang Ziye insisted.

Luo Tingzhu is from Anesthesiology; although Fang Ziye isn't an anesthesia specialist, he had heard Luo Tingzhu mention the most critical key.

For emergency and anesthesia, the most important thing is hemodynamics!

"After ten minutes, cardioversion must be performed first." The anesthesiologist still insisted on his opinion.

This time it was Fang Ziye's turn to fall silent.

He was only a surgeon; during surgery, heart rate and circulation follow the anesthesia department's advice!

"Thrombus formed! ~" Wu Yong said.

Fang Ziye saw it too; the other reason he didn't reply was that he saw, under the sustained atrial fibrillation, impurities "deposited" in the turbulent flow and formed a thrombus.

Yet Fang Ziye still didn't move.

He had a certain doubt in his heart.

This patient's recirculation process went very smoothly, circulation recovered step by step; by all logic, he shouldn't have so many abnormalities.

Could it be another "atrial fibrillation" beyond conventional theory?

Just like Chen Song?

"Beep beep beep beep……" The OR phone rang.

The circulating nurse was right at the side; she answered in just one second: "Operating Room 13."

"There's an available ECMO now. Do you still need it in the OR?"

The circulating nurse immediately looked toward the surgical field; this decision wasn't hers to make, and the moment she connected the call she put it on speakerphone.

"Bring it up!" Fang Ziye replied on his own initiative.

Anesthesiology matters are decided by the anesthesiologist, but surgical matters — for now I can still make the call. After all, Wu Yong authorized me, and he hasn't taken it back yet.

As he answered, Fang Ziye even found himself glancing suspiciously at his own side, wondering if Ox-Head and Horse-Face were standing there mocking him.

The human body ought to follow reason.

Yet it exceeded theoretical understanding!

Just as Fang Ziye hesitated, suddenly —

The anesthesia machine's alarm sounded again; visibly, the patient's heart rate sped up a burst, then rapidly slowed.

At the same time, it could be seen that a thrombus had penetrated the patient's left anterior descending coronary artery!

Seeing this, Professor Wu Yong immediately thought to deal with the LAD thrombus.

However, the move from Fang Ziye that Wu Yong expected did not appear.

Professor Wu Yong had no time to think further; he could only act himself.

On the anesthesiologist's side, seeing the patient go into A-fib, he muttered a low "Holy crap." Though he addressed no one, everyone could tell who he was cursing.

It had to be Fang Ziye, the one who wouldn't listen to advice.

Lan Tianluo's gaze kept shifting back and forth between Fang Ziye and the display screen —

But at this moment, Fang Ziye's eyes suddenly narrowed: "Dealing with the thrombus — it came at just the right time."

When myocardial infarction occurs in the anterior wall or is accompanied by heart failure and hypotension, it may cause tachycardia, because myocardial ischemia and hypoxia weaken contractility, increasing cardiac load.

But that is the normal situation.

This patient, after a sudden increase in circulating blood volume, no longer had hypotension; therefore, under such conditions, myocardial ischemia would not produce a tachycardic response — instead it would cause the heart rate rhythm to drop.

The response to myocardial ischemia is extremely fast.

Sure enough, just seconds after the embolus formed, the patient's transiently accelerated heart rate dropped again, falling from 130 to around 100, and still dropping.

If you looked closely, the patient's atrial fibrillation had already disappeared, replaced by an ischemic focus in the anterior wall of the heart.

"Professor Wu, give it to me!" Fang Ziye asked Wu Yong for the operating device.

Although Wu Yong was advancing the guidewire, under fluoroscopy the guidewire was still in the thoracic aorta!

Wu Yong trusted Fang Ziye and handed over the operating device.

Once Fang Ziye got the operating device, it was as if he was helping the catheter's distal tip find home — smoothly, familiarly, from the thoracic aorta to the aortic arch, back to the left atrial orifice.

The left and right coronary arteries originate from here.

Fang Ziye merely turned the catheter tip slightly, and the catheter slipped into the left coronary artery, then reached the thrombus in the LAD.

Thrombectomy might not be that easy to use right now; it requires placing a thrombectomy catheter. Fang Ziye directly had Professor Wu Yong deploy a stent to prop the thrombus open.

After blood flow was restored, the heart's rate fluctuated for a short while.

But only for that short while; it soon returned to normal rhythm.

Another twenty seconds passed, and the anesthesiologist's stern voice sounded again, flatly: "The patient's sinus rhythm has recovered."

"You son of a bitch are a talent, daring to gamble like this." He said this to Fang Ziye.

"Phew—" Everyone let out a long breath.

Fang Ziye replied: "Anesthesia Teacher, this isn't a gamble!"

The anesthesiologist didn't answer; in his view, Fang Ziye was gambling, and just got lucky.

Surgeons only care about results, not process; you don't even have to explain the principles in depth.

Especially for theory so closely tied to principles — never speak of it; ordinary people won't learn it, and can't be bothered to learn.

After all this, the patient's entire rescue process finally came to a conclusion.

At this moment, the OR phone rang again.

The circulating nurse answered and asked: "The ECMO has arrived at the OR doorway. Do you still want us to get it?"

Wu Yong shook his head: "Forget it. Tell them we don't need it here. The new campus's ECMO machines are few; leave them for those who need them more."

The circulating nurse relayed that truthfully over the phone, and the call was quickly hung up.

Seeing this, Fang Ziye checked the monitor showing patent bilateral lower limb perfusion, then nodded: "Professor Wu, Professor Deng. Orthopedics has no trauma, no fractures."

"Pelvic hematoma, arterial and venous injuries — we've handled them all."

"The rest I don't care about. It's past three o'clock." Fang Ziye said.

Seizing the moment before anyone else could speak, Lan Tianluo very sensibly got in first with a PUA line: "Senior Brother, go rest. You operated all day yesterday, have to get up later for surgery, and still have to run to the main campus."

Hearing Lan Tianluo's words, Tang Xiaoping's face twitched as if cracking; he immediately looked at Fang Ziye, his expression complex.

He wasn't from Trauma Surgery, so naturally he didn't know Fang Ziye's daily schedule inside out.

But if the schedule really was like that, these past few days of calling Fang Ziye so much — he really deserved to die!

"Fine, then wait until the surgery ends before leaving." Fang Ziye instructed.

With the previous lesson learned, Fang Ziye now dared not just pack up and leave.

He had to see the patient step down — come off the operating table.

In front of Lan Tianluo, if anyone dared dismantle Orthopedics' sutured vessels, they'd truly be asking for trouble.

That person would almost certainly be done in this line; from the old generation to the new, Orthopedics would spare no effort to nail him down.

Wu Yong and Deng Haibo also began scrubbing out.

Professor Xia Shuanglong of Hepatobiliary Surgery also stepped down from the operating table.

The four walked out together at a leisurely pace.

Xia Shuanglong said: "Professor Fang, I truly didn't expect this patient still had a chance to pull through."

"Before?"

"Offense taken." Xia Shuanglong apologized to Fang Ziye first.

Fang Ziye also explained: "Teacher Xia, a misunderstanding born of not understanding isn't really a misunderstanding. I should apologize for bringing you no small amount of trouble as well."

"But that's just how I am — if I don't do it, I don't do it. Since I've come all this way, if I can do it, I'll try my best to do it well."

Fang Ziye looked at Xia Shuanglong, his gaze complex.

It could be seen that Xia Shuanglong's skill level was extremely high. This patient — if he wanted to operate, there was a certain probability he could save him.

But Xia Shuanglong did not do so, and even after completing the hemostasis himself, he still did not make that choice.

This should not be a beating from society, but a beating from worldly convention.

A beating from society is: you have the capability, but you have no opportunity, you can't move up.

A beating from worldly convention is: you've clearly already done your utmost, but others, for their own purposes, still cling to you and bite, and once they bite down, they never let go!

Such a thing, once encountered even once, the heart turns cold.

There are no longer the four words "do one's utmost."

Xia Shuanglong's eyelid twitched: "Still hope Professor Fang's childlike heart can be preserved a while longer. I'm already rotten through and through."

Having spoken, Xia Shuanglong walked forward.

After Xia Shuanglong went ahead, Deng Haibo explained to Fang Ziye: "Professor Xia fought a lawsuit lasting five years a few years back. He lost in the end on humanitarian grounds."

Hearing this, Fang Ziye nodded: "People teaching people — they may not learn."

"But I'm an exception! Professor Deng, next time please still give Professor Tang a heads-up."

Deng Haibo and Wu Yong exchanged a glance. Wu Yong sighed first: "The child's grown up, can't be controlled anymore."

"Tang Xiaoping hasn't suffered a beating like that. We can't persuade him either."

Fang Ziye looked at Wu Yong, then at Deng Haibo. Deng Haibo wore an innocent expression.

Only then did he realize Tang Xiaoping was also a man of genuine temperament.

"Then I can only refuse unilaterally. Truth is, Professor Deng, today's patient was terribly difficult to handle."

"More exhausting than me doing three surgeries in a row in our department! ~" Fang Ziye shook his head.

He originally hadn't wanted to come.

If not for Wang Qiang's phone call, Fang Ziye definitely wouldn't have come.

Only, Fang Ziye hadn't expected Tang Xiaoping would swallow his pride and call again.

"Naturally. Trauma with no reference system whatsoever — who knows how many have died."

"Wanting to set up a stage in such a short time to fight ox-demons and snake-spirits — how could it not be exhausting?"

"Professor Fang, us surgeons — when we exercise our skill, it consumes both physical strength and mental strength."

Deng Haibo gave a thumbs-up: "Awesome! ~"

"Nothing more to say."

"Bold yet meticulous." Deng Haibo seemed to have read Fang Ziye through.

Wu Yong yawned repeatedly: "It's not early. Everyone go rest."

"Professor Fang, you've been tired this long. If you have surgery tomorrow, you probably won't sleep well either."

"Thanks for your hard work."

Fang Ziye smiled: "Professor Wu, you've worked hard too. It's not just me. I'm still young, should be able to hold up."

The few of them didn't exchange further pleasantries. After going down to the changing room, they changed clothes and each went their separate ways.

Fang Ziye didn't go home. He groped his way up to the department, burrowed into the single bed in the Director's Office, set his alarm clock, and lay down.

When Fang Ziye woke, it was already 7:20.

Fang Ziye hadn't fully woken, but time waits for no one.

Fang Ziye put on his clothes and went out, discovering Lan Tianluo's office door wasn't even latched tight. Lan Tianluo was inside, snoring like thunder.

Fang Ziye didn't go in to disturb him. Fortunately, Hu Qingyuan was very sensible and ordered breakfast for Fang Ziye.

While eating, Fang Ziye sorted through his Knowledge Points once more.

Current Knowledge Points Balance: 345212.3!

Three hundred forty thousand Knowledge Points — really not a lot! ~

Still a long way from the next Level 7 Skill.

"Level 5 Skills are especially practical. Level 6 Skills are invincible. Level 7 Skills are profound and mysterious, with infinite subtleties."

"Still can't be negligent." Fang Ziye's heart set this as the baseline.

Today's early-morning patient — if I hadn't participated, certain death.

But even with me, if I hadn't handled it well, he still might have died.

Level 6 Skills may be invincible, but only invincible compared to others. Invincible compared to seniors? No. And it doesn't mean I can handle every disease type.

To have a chance at handling every disease type encountered — only Level 7 offers that chance.

Above Level 7, there is no Level 8. It's the realm of profound mystery and infinite subtlety — limited by overall cognitive level, yet transcending it.

"Director Fang, there are two surgeries today. You need to operate."

"Le Yuan and Huang Xiaoxiao's. Both scheduled for the morning." Ceng Duoqin pushed open the Doctor's Rest Room door.

Hearing this, Fang Ziye's gaze flashed. He nodded: "I know, Teacher Zeng."

Both patients are bone tumors. Puncture results are already out. They requested Fang Ziye as Lead Surgeon, and Fang Ziye agreed.

Naturally won't go back on his word.

"But Teacher Zeng, these two surgeries need quick turnover. I still have to go back to the Main Hospital Area for surgery. Must rush over before 11." Fang Ziye said helplessly.

Ceng Duoqin also knew the "major event" in Trauma Surgery: "Then I'll arrange for the patients to be sent down now. We'll hand over shift and go straight to the OR."

"Let someone else handle the Ward Round."

An Attending Physician's Ward Round, in principle once a week is enough.

"Thank you for your understanding, Teacher Zeng." Fang Ziye gave a slight Cupped Hands...

Actually, doing Bone Tumor Surgery isn't a loss either; after finishing a single case, the Income/Benefit can reach three to four thousand Knowledge Points.

Comparable to Fang Ziye's Whole Day's Income/Benefit.

Knowledge Points are one's own Kung Fu Combat Power; wanting to fight Weird things, Ghosts, and Demons, one's current Kung Fu is slightly Not Enough... (Chapter End)