Chapter 81: The Step-by-Step High Mentioned by the Senior (First Chapter, Requesting Subscriptions)

Zhongnan Hospital, a near-top-tier tertiary teaching hospital, had a particularly well-developed human-resource framework even among its decent orthopedics subspecialties.

Yang Wenzheng was an attending physician who had just become chief resident, junior to his own teacher Yuan Weihong, and on par with Qin Geluo.

However, Fang Ziye, who had served in Yang Wenzheng's group, knew that besides Yang Wenzheng there were Associate Professor Guan Qiquan and Hand Surgery Administrative Director Professor Ni Yaoping.

Attending physician was an intermediate professional title, associate professor was an associate senior title, and above associate senior was the group-leading professor with a senior professional title.

Naturally, in a relatively well-established inheritance framework, the senior-title professor had climbed step by step; while he now taught students, back then he had his own benefactor—what Yang Wenzheng called his teacher-grandfather, Professor Ni Yaoping's teacher, Professor Wen.

Fang Ziye could not look up Professor Wen's name; it was rarely mentioned, but he learned during his time in Hand Surgery that Professor Wen was among the first to engage in limb replantation surgery and was a legendary figure who took the hospital's limb replantation surgery from nothing to something.

One could say that Zhongnan Hospital's Trauma Surgery had always been strong, but Hand Surgery became somewhat strong largely because of this Professor Wen.

It seemed Professor Wen was the fourth or fifth former Administrative Director of Hand Surgery, an absolute elder-level figure in Zhongnan Hospital's Hand Surgery.

Fang Ziye was not deaf and his thinking was not rigid; he naturally knew that Old Brother Yang Wenzheng was referring to this person, now one of the soul figures guarding the Training Room's warehouse in the Training Room.

At the same time, Fang Ziye had actually harbored such a guess for some time before.

For a basic medical skill, going from Level 0 to Level 1 required about 5 progress points, Level 1 to Level 2 required 20 points, and Level 2 to Level 3 required 50 points.

Knowledge points could be directly added to such a progress bar.

But advancing a basic skill from Level 3 to Level 4 required 500 progress points.

As the progress bar rose, the skill improved; actually, taking a skill from nothing to Level 3 required only 75 knowledge points to complete via direct point allocation.

But going from Level 3 to Level 4 suddenly required consuming 500 knowledge points—wasn't that a bit exaggerated?

Fang Ziye did not know whether going from suturing tofu to suturing skin jelly truly required Level 4 suturing; anyway, before completing the point allocation, perfectly suturing skin jelly seemed out of reach.

To strive for regular operation opportunities even after the professors and senior teachers returned, besides expecting suturing, Fang Ziye could not expect anything else.

Associate Professor Xie Jinyuan and his own teacher Yuan Weihong would definitely study high-end surgical techniques so they could routinely carry them out in the department later.

And Attending Physician Qin Geluo would complete parts of high-difficulty surgical techniques, such as the periosteum suturing in bone transport surgery, etc.

And Senior Brother Sun Shaoqing would take away operations like steel plate and screw internal fixation for complex fractures, manual reduction technique, and debridement technique, as practice materials for job hunting.

The rest were just small operations like cutting skin and suturing, but such operations were still very scarce.

Second-year doctoral student Senior Brother Wang Yuanqi and Senior Brother Gu Yi would definitely take quite a lot, and the two doctoral students Yan Zhiming and Luo Tingzhu would also need operations for feeding.

That was not all; Li Yuanpei, a master's student now at the same level as himself, if he lucked out and stayed at the hospital, becoming Professor Deng Yong's doctoral student, then the number of competitors would reach five or six.

Under such circumstances, if his suturing and incision techniques could not be better than others, why would Professor Deng Yong give them to him? He was not Yuan Weihong.

The reason Yuan Weihong was willing to give to him was that he was the first among his students, and stronger than fellow trainee Jie Han.

But under Professor Deng Yong's group there were many students; he could not ignore every one of them unless they were particularly unreliable, and these senior brothers were not unreliable—at most just not outstanding enough—so they definitely would not be discarded.

Among the doctoral senior brothers, first-year Senior Brother Yan Zhiming's suturing was slightly short of suturing skin jelly.

But Senior Brother Wang Yuanqi and Luo Tingzhu could already steadily suture skin jelly, and Luo Tingzhu wanted to first train up his suturing, presumably for such considerations.

In a situation of too many monks and too little porridge, what else could one do besides despicably framing others but to improve one's own energy and weight?

Fang Ziye had actually expected that directly pouring his 500 knowledge points in would greatly improve his suturing, ideally breaking through Senior Brother Wang Yuanqi and Luo Tingzhu's blockade, advancing irresistibly, and becoming the second-choice candidate after Senior Brother Sun Shaoqing, who needed to find a job.

But Fang Ziye did not expect it to be this powerful all at once.

Nude rat tail artery anastomosis was a quite high-end suturing material for suturing technique and also a very high-precision suturing technique.

Luo Tingzhu was an eight-year program medical student of this hospital; during his internship stage, he had been brought to the Training Room, where Associate Professor of Hand Surgery Guan Qiquan personally crushed and beat down the interns.

With one hand performing tail artery anastomosis, he whipped a group of arrogant eight-year-program medical newbies into submission.

Fang Ziye originally thought suturing skin jelly with suturing technique would be the end of it, but he did not expect that now, in tail artery anastomosis suturing, he could actually achieve a vascular patency rate as high as ninety-one percent.

Fang Ziye was not a newbie; naturally he knew what this data meant.

Fang Ziye himself was not a professional master's student of Hand Surgery, but he had Hand Surgery master's student classmates; before the third year of master's studies, everyone's pressure was not that great, so they had banquets quite often.

During banquets, while boasting, the professional master's students of Hand Surgery said that Hand Surgery's absolute Blue Ladder was the rat's tail reattachment.

If your tail artery anastomosis vascular patency rate could reach as high as ninety-five percent, Hand Surgery professors could guarantee you a job in Han City; if you could reach as high as ninety-nine percent during your studies, everyone in Hand Surgery would guarantee you a meal to eat in Zhongnan Hospital's Hand Surgery.

Hand Surgery was an industry with very high requirements for suturing technique.

Even an attending physician like Yang Wenzheng was still striving for a ninety-nine percent vascular patency rate; his current suturing level was still a bit short of Fang Ziye's suturing level—

Fang Ziye was a bit happy in his heart.

His ability had improved, and improved by a large margin; he would definitely be very happy.

But there was also a slight bit of annoyance.

He lost out.

The knowledge points were not used to the fullest; if he could evenly allocate these knowledge points to incision technique, debridement technique, suturing technique, etc., he might have three or five skills that could match the pass-out standard of Trauma Surgery's First Training Room, instead of making a big splash in Hand Surgery's Training Room.

After Yang Wenzheng returned, he did not bring Professor Wen over; what time was it now? Past twelve.

The old professor was exerting his remaining heat in the Training Room, not coming to suffer hardship; he definitely could not work day and night. Twelve to two-thirty was their rest time, and now it was close to twelve forty.

The old man had already gone to eat.

However, although Yang Wenzheng did not invite Old Professor Wen over from the Training Room, he called him over by phone.

"Xiao Fang, you're not in a hurry, are you? Professor Wen and our Hand Surgery's Professor Li Qi will be here shortly."

"Wait a moment, I'll go catch you another mouse..." After Yang Wenzheng gave instructions, he immediately brought another mouse cage over to the operating table.

After skillfully completing the mouse's anesthesia, it went limp on the operating table.

And Yang Wenzheng continued to skillfully complete the fixation of the four limbs and the distal fixation of the tail, and then, after slightly symbolically disinfecting, used a round knife to cut open the tail's skin and subcutaneous tissue, fully exposing the tail artery.

Immediately after, under Fang Ziye's curious scrutiny, Yang Wenzheng went click-click-click and directly cut the tail artery into about twenty segments with tissue scissors; after thinking for a moment, he felt this number of segments was about right.

Only then did he tell Fang Ziye: "About twenty segments is enough. If you can suture all these segments back together and the vascular patency rate can still reach above ninety percent, you kid will have struck it rich."

Yang Wenzheng said this very excitedly while using a syringe to draw heparin saline and drip it onto the severed ends of the tail artery to prevent clotting.

Fang Ziye definitely understood Yang Wenzheng's meaning; he moved his left foot back half a step: "Brother Zheng, I, my doctoral supervisor is Professor Deng Yong."

Fang Ziye wanted to remind Yang Wenzheng.

But Yang Wenzheng shook his head and said: "That doesn't matter. Whether you're from Trauma Surgery or Joint Surgery, as long as you can do the vascular anastomosis for our Hand Surgery's finger replantation, you can come to our Hand Surgery."

"Orthopedics is one big family, not separate households. When looking for a job, as long as you find work, that's enough. You're still young now; you don't understand these things."

"Our hospital's Hand Surgery platform is much better than Trauma Surgery..." Yang Wenzheng winked at Fang Ziye.

The implied meaning was that he earned more.

Fang Ziye still didn't reply, hands behind his back, eyeballs rolling, as if thinking about something.

Yang Wenzheng continued: "Xiao Fang, you've trained so hard in suturing technique, and practiced it to such a deep level, you can't tell me you don't have this intention, can you?"

"If you don't come to Hand Surgery, why suffer so much in suturing technique and waste so many materials?"

"Look, suturing technique: in the Training Room, you first suture rubber skin, then orange peel, tofu, skin jelly, plastic box fragments floating on the water surface, blood vessel models simulated underwater, then tension suturing with rubber band tension vessels, and only then did you reach this step."

"Right? You know yourself how much hardship you've endured." Yang Wenzheng wore an expression of "I knew what you were thinking all along."

Fang Ziye's foot retreated another half step, cautiously replying: "Brother Zheng, after skin jelly suturing, are there still so many suturing practice materials?"

This kind of thing couldn't be agreed to recklessly.

Not practiced meant not practiced; if Fang Ziye boasted that he had practiced, it would be hard to explain. After all, everyone in the Training Room knew what had been practiced.

The materials Fang Ziye practiced with were actually at most skin jelly suturing; where would there be floating plastic box fragments, blood vessel models, rubber band tension vessels, and such?

Fang Ziye's counter-question left Yang Wenzheng completely stumped; the syringe in his hand and his whole body stiffened: "You haven't practiced?"

Fang Ziye shook his head slightly.

Yang Wenzheng's breathing became even more labored. Originally, Yang Wenzheng only thought Fang Ziye was secretly practicing to reach Hand Surgery's absolute Blue Ladder, persisting tirelessly even if unknown.

Then waiting to soar to the sky in Hand Surgery, be recognized, and naturally become a Hand Surgery Doctor, then smoothly become a Hand Surgery physician.

But Fang Ziye's gaze and expression at this moment seemed to confirm that his guesses were all wishful thinking.

"None of this matters; let's wait until Professor Wen and Professor Li Qi arrive to discuss." Yang Wenzheng said no more nonsense.

In the entire Hand Surgery subspecialty, now there are not many high-end operation Lead Surgeons who are particularly proficient in suturing blood vessels; at most, only a few Professors and Associate Professors can undertake such tasks alone.

As for some Attending Physicians, even Zhu Quanlin, an Attending Physician with more seniority than Yang Wenzheng, depends on performance and is not particularly steady.

This means that once the Department encounters an emergency of a severed limb or severed finger, the Associate Professor must personally go out, and even occasionally, a Professor like Ni Yaoping must personally take the field.

The Professors have long hoped for someone who could take the lead and take over Limb Replantation Surgery, so they could honestly perform more high-end and cutting-edge techniques such as flap design, nerve transposition, nerve grafting, and vessel grafting.

But so far, such a young person has not appeared yet.

When Guan Qiquan was previously an Attending Physician, he routinely performed Limb Replantation Surgery, but now he has already been promoted to Associate Professor and surely hopes to contact more high-end disease types, unwilling to continue shining and heating up on Limb Replantation Surgery, hoping a junior brother can take over.

One fifty-five.

Associate Professor Li Qi, who was doing emergency surgery retention at the Hospital, handed the surgery over to the Attending Physician in his group to operate, and directly ran to the Training Room.

And Professor Wen was already on the way, calling to say that once Li Qi arrived, he should first arrange for students to operate; he only needed to look at the 'Step by Step High' results.

Li Qi asked: "Professor Wen, who is Step by Step High?"

"Step by Step High is Fang Ziye, Fang Ziye is Step by Step High; why do you care so much?"

"I'm riding a bike; don't call anymore. Hurry up and do the operation first." Professor Wen urged over the phone.

Everything was called off, and Fang Ziye could only be forced into business.

With the previous two suturing levels, Fang Ziye couldn't deliberately suture messily to lower his suturing level; that would be disrespectful to the mice used as practice material, and disrespectful to Superior Physicians like Yang Wenzheng.

When Fang Ziye was suturing the fifth blood vessel rupture, Old Professor Wen Dongfang arrived at the Training Room and closed the door; at this moment wearing a mask and cap, he tore open sterile Examination Gloves and approached the Operating Table.

The Operating Table was exactly square, unlike an Operating Room where one can stand in every direction; he stood at the only empty direction.

After looking for two moments, Professor Wen Dongfang couldn't help but guide: "Too little force; blood vessels aren't as fragile as you imagine. Increase your current force by thirty percent; then when you suture and tie knots, it will be more convenient."

Fang Ziye glanced at Professor Wen Dongfang, didn't reply, but ultimately increased a bit of force.

His control of force now was more at ease than before.

However, Old Professor Wen Dongfang's eyes seemed like fiery golden eyes.

After Fang Ziye completed another suture stitch, Old Professor Wen Dongfang said again: "Too much force; reduce a bit, reduce another ten percent of your previous force; definitely make the blood vessel broken ends fit just right, without forming eversion or inversion, only then can avoid vortex and turbulent flow formation, and increase blood vessel patency rate."

"Once turbulent flow or vortex forms, it will increase thrombus formation risk. Similarly, it will also affect blood vessel patency rate. Generally, many hospitals require ninety percent patency rate, all because during suturing, force control is poor, forming partial inversion or eversion, thus forming turbulent flow and vortex."

Too professional; Professor Wen Dongfang's guidance was too professional.

Fang Ziye benefited immensely; after understanding the operation principle and force size control, Fang Ziye reduced the pulling force during suturing a bit.

After Professor Wen Dongfang watched Fang Ziye finish suturing two more stitches, he said again: "Yes, just like that; feel this hand feel, especially when tying knots, the pulling tension between suture thread and blood vessel wall; this touch is your absolute standard for controlling force in the future."

"No matter what tissue you suture, once you find this touch, when you adjust suturing force in the future, you will be at ease."

"Continue suturing, don't hesitate or look back..."

Professor Wen Dongfang was not teaching through enjoyment, but teaching through examination; examining while teaching.

Thus time slowly passed; after a full twenty-plus minutes, Fang Ziye completed the severed tail artery anastomosis that Yang Wenzheng had incised into over ten segments.

After suturing was finished, Yang Wenzheng was about to open the hemostat for hemostasis, while looking at Fang Ziye and asking: "Are you more nervous or more expectant?"

Associate Professor Li Qi and Professor Wen Dongfang each gave Yang Wenzheng a sideways glance; Professor Wen Dongfang asked in a stern tone: "Why so much talk? Hurry up and release the hemostat, observe blood vessel patency rate. What are you selling a secret for?"

The Senior spoke; Yang Wenzheng didn't dare be negligent and directly released the vascular clamp.

After the Vascular Flowmeter beeped several times, flashing green numbers, it was still only ninety-one percent!

But even so, Associate Professor Li Qi, while taking off Gloves on one side, patted Fang Ziye's shoulder: "A good seedling, very high talent. Teacher Wen, you said it."

Wen Dongfang then asked: "Whose student are you in our Hand Surgery Department? Ni Yaoping's, or Zhou Ziyu's? Or which little physician's?"

Wen Dongfang subconsciously thought that the Step by Step High they thought of was a Hand Surgery student.

Exploding like yesterday definitely won't do; slowly update, the Author is more used to writing big chapters. Can write more smoothly and delicately.

Of course, won't pad the text; some foreshadowing, if simply written out, would be dry; can only add some plot to mix it in.

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(Chapter End)