Chapter 820

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Protagonist:

Fang Ziye

The new campus's training room had not yet been renovated, but Fang Ziye personally funded the establishment of a "Skill Training Room" for the department's students in a nearby civilian house!

The equipment was not as complete as the main campus, and there were old professors holding down the fort in the training room; there were only a few operating tables and a dozen or so sets of operating instruments, and the students still had to wash them themselves after completing operations.

A large ultraviolet disinfection cabinet was placed in the room...

The ceiling lights had been specially corrected. For this, Fang Ziye alone spent nearly one hundred thousand yuan.

But now that he was a director, Fang Ziye's income was not bad either; of course he couldn't be too stingy.

Fang Ziye stood beside an operating table; opposite him stood his beloved disciple Hu Qingyuan, calmly standing there as an assistant.

Placed under Fang Ziye's hand was the tofu that the master's students most wanted to complete suturing on. After Fang Ziye sutured several stitches, he said to Hu Qingyuan: "Scalpel to me!"

"Here, Master! ~" Hu Qingyuan immediately properly and rule-abidingly handed the willow leaf knife into Fang Ziye's hand.

Fang Ziye roughly assessed the depth of the tofu's side, and then without any hesitation sliced straight down horizontally.

The blade steadily *dang-dang* split open the tofu, slicing it open as if planing it flat.

At this moment, there was nothing unusual, but after Fang Ziye flipped over the cut piece of tofu.

A chorus of sharp intakes of breath sounded in the room!

The cross-section of the sutured and joined tofu had suture segments neatly arranged, uniform and even, as if measured by a machine.

It was very obvious that when suturing, Fang Ziye had rigorously calculated the suturing depth of every stitch; the suturing depth of every stitch and the suturing span were all neatly consistent.

Furthermore, during the incision technique, Fang Ziye could also precisely control the incision thickness!

This not only requires steady hands, but also requires mastery of every detail of the incision and suturing techniques, even every data point, to the point of mastery!

Fang Ziye explained while demonstrating: "If I more transparently disassemble for you how to suture tofu well, this is the standard answer."

"The absolute line to master is very obvious: it is not only controlling the spacing of every stitch well, but also the entry point, the needle insertion point, the suturing depth, and the position crossing the cross-section — all must be just right."

"Usually suturing from the surface layer, just explaining it to you like this, you find it very hard to understand!"

"Now I cut it open for you to see; you all can read it, right?"

The first to respond to Fang Ziye was Hu Qingyuan standing opposite; Hu Qingyuan's memory was very good: "Master, our department's master's students' basic requirement to clear the training room is just to suture the tofu well!"

"There's no need to suture it as flatly as you, Master, right?"

Hu Qingyuan was of course very smart, so he knew how to flatter: "If other teachers could achieve what you have, Master, they certainly wouldn't hide it and be unwilling to show us the post-suturing details."

"But for so many years, no teachers have cut open the cross-section to show us; it should be that they all..."

Hu Qingyuan half-concealed his face, aptly concealing the keyword.

They can't do it.

Fang Ziye laughed: "Why do you care whether other teachers would do it or not?"

"I am teaching you!!!!"

"Letting you understand what the different levels of suturing technique actually look like."

"The most entry-level, what you need to control well, is just a few 1cm's!"

"Suture tail length 1cm, suturing spacing 1cm — these are visible to your naked eye!"

"But some things cannot be directly seen by you; they require you to practice, to constantly feel, how to control your suturing depth well — the standard answer is like this."

"Basic suturing has no great tricks, nor practice tricks; it is just control, achieving extreme control. Once you achieve this, it will benefit you for life..."

The kung fu in your hands cannot be borrowed; the basic skill's internal strength also has no great techniques to speak of — it is all solid, solid basic skills, it is internal strength.

A group of little master's students and even doctors all applauded one after another.

Ceng Duoqin's doctor Xie Zhouzhou asked: "Teacher Fang, your current incision technique — compared to one stroke cutting through eight pages of paper, how is it?"

One stroke cutting only eight pages of paper represents control of incision depth.

But Fang Ziye's current incision technique is equivalent to using a scalpel to flat-slice a rectangular prism!

A scalpel is not a kitchen knife; it doesn't have that large a cutting surface; it requires multiple circumferential incisions to work.

"Suturing technique is suturing technique; why do you care about incision technique?"

"Control of incision depth and lateral incision translation are two dimensions; things of different dimensions — how can they be directly compared?"

"However, do you really want to see incision technique?" Fang Ziye had time today, and the students wanted to watch, so he didn't mind showing off a hand.

Xie Zhouzhou nodded.

Hu Qingyuan nodded.

Fang Ziye's students Feng Junfeng and Tian Yao also nodded; both were very much looking forward to this surgical technique ceiling Fang Ziye's incision technique operation.

Fang Ziye then lifted the scalpel in his hand, and after thinking slightly, raised it using the bow-holding posture.

Immediately after, Fang Ziye very, very slowly lowered the scalpel perfectly straight vertically.

Fang Ziye's movements were extremely slow, with no technique to speak of.

Everyone was still in doubt when, after roughly ten seconds, Fang Ziye released his hand.

And then they discovered the scalpel stood perfectly straight on the tofu surface, with no tilt or deviation in any direction.

"Hmm, if you can achieve this on tofu, then in surgical operations you can basically go anywhere." Fang Ziye deliberately acted mysterious.

After speaking, Fang Ziye left.

The scalpel Fang Ziye inserted remained unmoved; everyone else then took photos of it one after another and began to imitate.

Then the room was filled with sighs; "Holy crap" sounds, gasps of astonishment, "holy crap" sounds rose and fell in succession...

This kind of imitation even formed a certain heat, lasting nearly three or four days before it dissipated.

In the end, Xie Zhouzhou and the others, who still hadn't managed to do it, took such photos to ask Professor Ceng Duoqin in the department.

Ceng Duoqin merely glanced at them and laughed, directly announcing in a high-profile manner: "Whoever can achieve this, I guarantee they can stay at the hospital!"

Everyone's mouths curled up in envy!

This promise also spread back to our hospital area.

The temptation of staying at the hospital is far greater than the temptation of pursuing a PhD.

……

June 3rd, Tuesday.

At 7:40 AM, Hu Qingyuan followed Fang Ziye, walking side by side from the ward area toward the outpatient consultation room. Hu Qingyuan asked curiously: "Master, your scalpel technique failed."

"Senior Brother Xie Zhouzhou pressed in less than one more millimeter, and the balance was broken!"

"Why is that?"

"Senior Brother Xie originally thought that the deeper he inserted, the more stability he could maintain!"

Fang Ziye said: "Qingyuan, your science grades were better than mine, your understanding of balance should be more thorough than mine, right?"

"The pinnacle of incision technique is balance!"

Upon hearing this, Hu Qingyuan looked half-understanding, half-confused: "Master, then how can one achieve it?"

Hu Qingyuan emphasized: "I'm not trying to get Professor Zeng to guarantee my hospital retention, I just want to achieve it!"

Hu Qingyuan felt that with his own aptitude, plus the resources in Fang Ziye's team, if he couldn't stay at the hospital, he might as well switch careers early.

In Fang Ziye's team, even a pig could publish a few papers and learn some surgical techniques.

"Then you must prepare for a war of attrition; it requires a very, very long time."

"If it's a specialty technique, there are tricks; even reduction techniques have tricks. Only this kind of basic skill has absolutely no tricks to speak of."

"The basic components of surgery are just incision, debridement, and suturing."

"Specialty procedures are all combinations of tricks and basic skills. Only after forming special tricks are they summarized as specialty procedures!" Fang Ziye said.

Hu Qingyuan had followed Fang Ziye for quite some time, and knew basic skills are the hardest to replicate.

Otherwise, it wouldn't be that until now, no one can replace Fang Ziye's role in spinal cord injury treatment.

"Master, then what surgeries can one learn if incision technique reaches this level?"

"I've been in contact with clinical work for half a year now, it seems I haven't learned any surgeries at all, it's all been learning basic skills." Hu Qingyuan said with some anticipation.

The surgeries Fang Ziye currently performs, even Professor Ceng Duoqin cannot replicate, so Hu Qingyuan has even less chance to get hands-on.

What he can do is just suture skin and such.

But such simple operations naturally cannot satisfy Hu Qingyuan's curiosity!

"What surgeries can pure incision technique do? There are many, such as tendon lengthening, complex tendon release, tumor dissection, malignant tumor cleanup." Fang Ziye said. Fang Ziye also knew Hu Qingyuan's current clinical participation wasn't very high, so he added some "bait"!

Sure enough, upon hearing these procedures, Hu Qingyuan found them all exceptionally high-end and highly difficult.

"If incision technique is learned this well, one can perform such operations???" Hu Qingyuan asked, overjoyed beyond expectation.

His supervisor is Fang Ziye, so Hu Qingyuan knows his learning curve differs from others.

For others, they need to think about what procedures to learn; for himself, he only needs to think about which part of the operations in Master's group he can complete.

The disease types Fang Ziye currently treats, even a single part of the operations taken out, are all super high-difficulty procedures.

For example, complex muscle release, tendon lengthening, tendon-vessel-nerve transposition, nerve grafting surgery.

Which one, placed in a prefecture-level city hospital, isn't unattainably high?

Yet in Fang Ziye's group, these operations are merely components of procedures!!!

Fang Ziye laid the foundation first, and can even forcibly prop up the current Hu Qingyuan to suture two stitches of tendon.

Master's first year, even an exceptionally excellent specialized master's in hand surgery would find it hard to suture tendon, yet Hu Qingyuan has the opportunity.

This is the difference in platform and disease types!

"Definitely possible, but learning it won't be easy." Fang Ziye nodded.

"Just practice slowly, Master, I'm still young." Hu Qingyuan said with anticipation.

Hu Qingyuan knew that ever since he chose Fang Ziye, he would walk a path different from most students.

Not only is his teacher special, but more importantly, he himself is somewhat special.

Same as Master's students, Hu Qingyuan now also feels his two senior brothers seem quite ordinary.

Therefore, the problems Hu Qingyuan considers differ from theirs; they frantically think about how to stay at the hospital, while Hu Qingyuan considers how to inherit Fang Ziye's mantle.

If in the future he can replace Fang Ziye's role, let Fang Ziye rest, and he himself displays prowess in the operating room with peers nationwide carefully observing his procedures, wouldn't that be more fulfilling than live streaming...

Hu Qingyuan immediately said: "Master, today's first patient, can you give me a chance to do the consultation?"

"I've also followed you in outpatient for half a year, the books I should read are pretty much all read."

Hu Qingyuan's memory is excellent; he indeed read all the books he should, and read quite a lot of literature too.

Moreover, after Fang Ziye's organization, Hu Qingyuan feels his theoretical level already has a systematic prototype; next he should temper himself through outpatient.

"Sure, in a bit the first one will be assigned to you!" Fang Ziye said.

When the two reached the outpatient consultation room doorway, there were still people surrounding it, and many who hadn't gotten a number.

Seeing Fang Ziye, they all swarmed over.

This time, Fang Ziye very decisively said: "No extra numbers, today I'm not adding numbers, I have an important task tonight."

"Patients and family members who didn't get a number, please understand, go register for other professors' outpatient, or come again next week."

"Numbers will be released on time at 8 PM tonight..."

"Professor Fang, coming here once wasn't easy, I rushed from Lichuan." A middle-aged man hurriedly explained.

Lichuan is also a county-level city under Enshi, and is Fang Ziye's hometown fellow.

Fang Ziye replied: "That's quite far, but I have important matters today, can't add numbers, hope you can also understand."

"I'm not playing around. I released seventy patient numbers today, twenty more than usual."

"I can't see them all. Sorry."

After saying this, Fang Ziye took Hu Qingyuan toward the consultation room.

"Professor Fang, it's really not easy for me to make one trip..." The patient tried to squeeze forward.

"Don't jump the queue. Professor Fang said no more numbers can be added. Seventy numbers—it looks like a long wait..."

"What's it to you? You just got lucky enough to snag a number, right?" The middle-aged man's tone was aggressive.

"Just don't squeeze me." The person who spoke didn't want to argue.

"Professor Fang..." The middle-aged man still tried to push inside.

The person who spoke was bumped, and then directly sat down on the ground.

He warned rudely: "Don't leave, my butt hurts so much! ~ I already told you not to squeeze, my legs and feet were already inconvenient."

He picked up his mobile phone and started calling the police: "..."

"..."

Hu Qingyuan very enthusiastically led the first outpatient clinic patient into the ward, smiling as he stepped forward to ask: "Sister, hello, where are you uncomfortable?"

"This hand of mine used to be very numb, and there was red swelling before..." The middle-aged woman raised her left upper limb.

At her elbow joint, pigmentation could still be seen.

An ordinary person's elbow joint has a certain radial deviation angle, but her radial deviation angle was obviously a bit excessive.

Based on the medical history, Hu Qingyuan immediately considered infection: "Were you hospitalized before? What treatment did you receive? How long has the condition lasted roughly?"

"I was hospitalized, stayed at the local hospital for a long time. The doctors at the local hospital said it was an infection, but injections and such had no effect."

"Some doctors said it was gout, some said it was non-specific inflammation, and some said it was rheumatoid arthritis."

"But after blood tests, no special etiology was found."

"This situation continued intermittently for nearly two years..." The patient sighed deeply.

"Did the blood test indicate infection? Did they say what bacterial infection it was?" Hu Qingyuan had a rough idea in his mind.

Gout and rheumatoid arthritis both have obvious specific indicators; if there weren't any, it was more likely to be considered infection.

"It seemed okay, it was just red swelling, the doctor didn't say anything special."

Seeing that only Hu Qingyuan was asking, the patient looked toward Fang Ziye: "Professor Fang, what is the cause of my condition?"

Fang Ziye was drinking water: "Aren't we examining you? I don't have X-ray eyes. Your condition should be a relatively rare disease type."

Fang Ziye had roughly guessed in his mind, so he gave Hu Qingyuan a hint.

How smart was Hu Qingyuan? He immediately understood Fang Ziye's hint and started searching in the direction of rare diseases!

"Sister, was this hand injured before?" Hu Qingyuan asked.

If there had been trauma, it might be traumatic arthritis.

The middle-aged woman shook her head: "No injury. My job's physical strength intensity isn't high either."

Then it wasn't post-traumatic stubborn elbow joint deformity.

"Do you have pain in other joints?" Hu Qingyuan thought of cystinosis among rare diseases again.

His memory was very profound. After locating rare elbow joint diseases, he could pursue them one by one.

Cystinosis, due to a lysosomal cystine transport defect, causes cystine crystals to deposit in bone, joint, and other tissues. It can cause systemic bone and joint lesions!

The middle-aged woman also shook her head: "Only this joint hurts, no other joints hurt. Doctors asked before and said rheumatism affects multiple joints."

Hu Qingyuan temporarily ruled out cystinosis: "Do you have other diseases? For example, diabetes?"

Charcot joint (Charcot joint), mostly secondary to diabetic peripheral neuropathy, causes repeated microtrauma due to loss of joint sensation, eventually leading to joint destruction, deformity, and functional impairment. Common in lower limbs; Charcot joint of the elbow joint is very rare.

"My blood sugar has always been normal. I just had a physical examination last month! ~ Fasting 4.2, postprandial also normal, under 6."

Postprandial blood glucose under 6 means no impaired glucose tolerance.

Hu Qingyuan glanced at his Master, his eyeballs darting around, thinking silently in his heart: Master, it seems like none of them fit!

Is it that I know too few rare diseases?

Hu Qingyuan immediately acted like a coward: "Master, I've finished asking. I'll go do a physical examination for the patient first."

He knew it was time to hand over the diagnostic authority.

His luck was very bad. This rare disease was too rare; for him, it was slightly too overstepping his specialty.

Hearing this, Fang Ziye said: "Then do the physical examination first."

While conducting the physical examination, Fang Ziye asked again: "Are your left hand and both feet numb now?"

The middle-aged woman thought for a moment, shook her head: "Not numb anymore. I was numb before."

Hearing this, Fang Ziye immediately understood: "Hu Qingyuan, test the patient's pain and touch sensation."

"This patient is still considered to have Charcot joint disease. But not caused by diabetes; more likely caused by spinal disease." (Chapter End)