Surgery Godfather - Chapter 31
Chapter 31: Chapter 0030: Warm-Up Bout
Yang Ping contemplated a lot after meeting with Huang Jiacai.
The prospect of a million-dollar annual salary, which he did not doubt, was becoming more possible especially as his skill in fingertip replantation was about to reach perfection and advance to the master level in the system.
With his skill set, a yearly salary of 500,000 or 600,000 was common in any orthopedic hospital, even if millions weren’t guaranteed.
However, leaving a large third-rate hospital like Sanbo Hospital and missing out on leaders like Director Han who focus on talent would perhaps leave him stuck as an orthopedic surgeon in a small hospital. This was not what Yang Ping wanted.
He believed in achieving greater things, setting higher and further goals. As for financial gain, Yang Ping believed it would come naturally.
After some analysis, Yang Ping was even more firm in his resolve.
The five-section replantation put Sanbo Hospital’s Orthopedics department on the map.
Patients who needed finger replantation were flooding Sanbo Hospital almost every day.
Yang Ping, Tian Yuan, and Song Zimo alternated performing replantation surgeries. Surgeons like Little Five were trained by Song Zimo in microsurgery in the department’s laboratory. Director Han required all doctors above the attending level to train in microsurgery, with the end goal of independently completing replantation surgeries.
Yang Ping checked the task completion progress on the system and it was at 30%.
He felt more at ease, considering the trend. Finishing the task should not be an issue.
Yang Ping only had over nine thousand points left from last time, so he didn’t dare to spend them carelessly.
He learned to be more frugal. He could spend freely when points were plentiful, but he would need to hoard them for emergencies when they were scarce.
Although Yang Ping was a recent hire and an attending physician, his previous performance during surgeries had been spectacular, enough for Director Han to immediately promote him to attending physician.
Director Han had his own plan. Orthopedics had completed its initial phase and was now planning to enter its rapid expansion phase.
Building a team of talents was of the utmost importance. Although he had several outstanding directors under him, they were still prevention-oriented.
Tian Yuan was very good, fully capable of independently handling tasks at the age of thirty-something. Song Zimo was extraordinarily gifted and shone with a bit of cultivation.
However, he felt the lack of talent. Now there was Yang Ping, who completely surpassed Song Zimo judging from a few surgeries.
This gave him a little more confidence. It was time to initiate a rapid expansion strategy.
He decided to help Yang Ping apply for third level surgery permissions, to allow him to progress even faster. He took the application form and knocked on the office door of Professor Zhang Zongshun, the hospital’s expert group.
The old man took off his reading glasses, pointed at the words with his finger, read it once, and said, “A master’s degree, shows promise in limb replantation. It’s not rare. Common surgery.”
He was right, finger replantation was a very common surgery. Any orthopedic hospital could do it every day. All they needed to do was take on tasks, there was no need for perfection.
The expert group was unique to Sanbo. A group of retired domestic experts and professors was hired. Due to their age, they no longer performed surgeries but mainly attended outpatient clinics.
Besides seeing patients, they also had some duties, mostly supervisory. As for assessing surgical permissions, they held that power, and that was when they felt the most important.
“Let’s follow the procedure. Go through all the surgeries on the list. Old Han, without your strong recommendation, we wouldn’t start the procedure for a newcomer without a special educational background. This is a special talent channel. Therefore, his surgical score needs to be more than just passing, it needs to be over eighty on average,” said the old man after putting his glasses back on.
“He made a huge contribution to the hospital last time.” Old Han defended, hoping to speak a few more words to help Yang Ping, at least to reduce the surgical score to lower the difficulty.
The old man looked up, his gaze showing above the rim of his glasses: “That won’t work, it’s two different things. Haven’t we already put him on the special channel?”
These old stubborn men were once figures in their own right, each of them as stubborn as a bull. Old Han couldn’t argue further and had to agree.
“All right, we’ll follow the procedure. Send the surgery videos to us by every Friday. We old men will meet on Fridays and give a score. Director Han, you seem to have a little bias. There are so many attending physicians in the department. I haven’t seen you apply for third-level permission for all of them. This one hasn’t been here long, right?” The old man was sharp.
“The trauma emergency center was just officially opened, and the volume of orthopedic surgeries has surged. I’m short of competent people.” Old Han said helplessly.
So, after some haggling, this matter was more or less settled, at least they agreed to initiate the procedure. The next step was to perform the surgeries well.
As for how well Yang Ping would do in other surgeries, Old Han hadn’t seen before. Many doctors can only do finger replantation, even a simple fracture might give them trouble; it’s a common occurrence.
That’s fine. This is a good opportunity to see how Yang Ping does in other surgeries. If it’s as outstanding as the finger replantation, we can add more responsibilities on his shoulders; if it’s not up to par, then I need to train him well.
The scalpel was a butcher knife. It depended on whether it could be used directly or needed to be sharpened.
Returning to the office from the administrative building, Song Zimo was waiting for Old Han. Song Zimo handed over the teaching surgeries for the next week for Old Han to review.
“I don’t need to see the teaching surgeries for next week, just report them to me,” Old Han took a sip of his tea.
Song Zimo flipped through the notebook: “Clavicle fracture, performed by Director Tian.”
There were a few teaching surgeries every week, to help young resident physicians and attending physicians learn and master the practical steps of surgery. They were usually done by Director Tian as the chief surgeon, and occasionally Song Zimo would also be the chief surgeon.
In addition to adhering to the national physician training system, Sanbo Hospital also had its own system. Three years of standardized training and five years of specialized training were required to become a beginner specialist doctor.
“Tell Yang Ping that he’s up next week. Are the cases ready?” Director Han asked with concern.
“They’re ready, three cases, all clavicle fractures. Simple fractures, crushed fractures, those requiring vascular and nerve exploration, they’re all typical cases. The patients are young and have no underlying diseases.
Song Zimo, as the secretary of the orthopedics department, was responsible for selecting and confirming these teaching cases.
Clavicle surgery is simple. That’s good, it’s a good opportunity to test the waters. After talking with Song Zimo, Director Han called Yang Ping over and closed the office door.
“Yang, I want to help you get permission for fractures of the limbs and pelvis. Do you think you can handle it? If you can, the hospital will start evaluating you. If you can’t, no worries. You can follow me for a while and I’ll get you up to speed.”
Old Han was being straightforward, and Yang Ping understood that Old Han was helping him get greater surgical permissions from the hospital.
He was moved and said, “Rest assured, I will live up to your expectations.”
“With your confidence, I’m assured. I have submitted the application form, and Old Zhang, the head of the expert group, has agreed. From next week onwards, you will perform the teaching surgeries. They are all scheduled for Thursdays. Next week, you’ll be dealing with clavicle fractures. We have prepared three surgeries, one of which involves the exploration of blood vessels and nerves under the clavicle. It’s somewhat tricky, but don’t worry, I’ll be by your side to assist you if necessary,” Old Han encouraged.
In any profession, having a good teacher is extremely valuable and can save you from taking unnecessary detours. A good teacher not only guides you in the right direction but also supports you in crucial situations.
“There’s a long road ahead, so keep going and remember that your goals are far beyond. Never give up too easily,” the torch-like gaze from Old Han lit up.
Yang Ping nodded, “Yes, thank you Director!”
“Get yourself prepared and review the procedures of clavicle fracture surgery. Although it’s the simplest in orthopedics, it’s not that easy to do well. Every step needs to be accurate. Also remember, your surgery score should average at least 80 points to obtain the surgical rights.”
“Understood!” Yang Ping responded confidently.
Yang Ping felt relieved as he walked out of Director Han’s office, grateful that he had accumulated some points earlier.
In the system, Yang Ping steeled himself and spent 1,000 points to purchase 500 cases of clavicle fracture surgery.
In one go, he performed all kinds of clavicle fracture surgeries within the system, from failing to crafting a perfect surgery each time.
On Thursday, after the shift handover and ward rounds, the young resident doctors and attending physicians converged in the orthopedic operating room which doubled up for teaching predicaments.
Everyone arrived early and sat in the adjacent teaching room waiting. Interns were not scheduled to attend, as they were yet to form a broad concept of specialized surgeries. Watching at this stage would be unproductive since they couldn’t comprehend fully. However, some interns still managed to make time to be there.
On the beach chair was Little Five, acting as the assistant. They washed their hands routinely, disinfected the area, and put on their surgical gowns.
Su Yixuan was assigned as the instrument nurse for Yang Ping because her familiarity with the surgeries would enhance their coordination.
After preoperative verification, the surgery began!
As for how a surgeon, bestowed for his flawless finger replantation, performs other surgeries, many were curious. Some even hoped to see him falter, just for the sake of rebalancing their own mindset.
Song Zimo had been eager to observe him for a long time. Of course, not for the joy of watching him falter, but out of curiosity about the quality of his surgeries other than the finger replantations.
Scalpel!
There was no need to utter that. All he had to do was reach out his hand.
And it would delicately fall into his palm.
He began with a vertical cut, then tilted it forty-five degrees, and finally straightened it to retract the blade.
A neat incision was made, following the grain of the skin, a one-off cut known as the cleaver incision! The cut was deep enough to open the skin without overdoing it and reaching the deep fascia.
The supraclavicular nerve was avoided!
Using skin hooks to part the cut skin, Little Five used both hands to carefully hold the hooks, both above and below the incision.
“Be gentle!” Yang Ping reminded Little Five.
Heeding the warning, Little Five instantly reduced the force in his hands.
Electrosurgical pencil!
As the electrosurgical pencil sliced through the deep fascia and the neck’s broad muscle, there was smoke, but it was all sucked away by the aspirator in his left hand. Barely any smell of the burning flesh was allowed to disperse.
Before pinpoint bleeding could form, the electrosurgical pencil eradicated them one by one, like in a game of ‘whack-a-mole’.
They advanced layer by layer. The gauze was nearly bloodless, with only faint spots here and there.
After cutting open the periosteum in one move with the electrosurgical pencil, there was a gentle peeling under the periosteum, and the limited bone surface showcased itself.
Without uttering a word, the reduction clamp was already handed over. This was Su Yixuan’s first time assisting Yang Ping in a surgery other than the finger replantation. But the two of them felt as if they had rehearsed countless times beforehand, acting in tacit understanding without uttering a word.
Could it be that such harmony could be naturally fostered?
With two point reduction clamps, the two fractured ends were secured. A gentle pull aligned the fracture, relying on the inherent stability of the fracture itself.
Another reduction clamp swiftly clamped onto the fracture end. A 1.5 millimeter Kirshner wire was drilled in perpendicularly to the fracture line, stopping once it had pierced through.
With robust temporary fixation, the reduction clamp was removed.
The steel plate template was attached, pre-bent, and molded, then according to the template, the steel plate was shaped.
Six holes in the steel plate perfectly attached to the clavicle, hole-drilling, depth-measuring, screw threading, each step was clear, no omissions, no rushes, steadily advancing.
Six screws were inserted.
Flush!
Layer by layer suturing, with absorbable sutures inside.
Finally, the skin was sutured with thin nylon thread, a ‘continuous intradermal suture,’ also known as ‘cosmetic suture.’
Just six minutes. Just six minutes from incision to suturing.
Song Zimo’s interest was piqued, but his curiosity had not lessened. Instead, it grew. He wondered how Yang Ping would perform in other types of surgeries. This curiosity had taken root deep within him, turning into an obsession.
Although it was a simple surgery, it was executed to perfection, just like from a textbook.
Old Han’s face bore a smile; the lad hadn’t let him down.
This surgery was but a minor testing of the waters, and it seemed his performance was commendable!
