Surgery Godfather - Chapter 9:
Chapter 9: Chapter 0008: Brother, can you make it?
It was Zhang Lin’s turn for the night shift.
“We’re on night duty tonight. Come early and make sure to eat! We get a lot of emergencies at night.” Zhang Lin instructed, like a grandpa.
Fine! If you say it’s early, then it’s early. Right now, you’re the boss, there’s no choice but to follow you.
The shift started at half-past five in the afternoon.
Yang Ping arrived at four o’clock, had a bowl of Lanzhou noodles with beef and a fried egg. He was full enough, and also brought a bucket of instant noodles just in case.
“Dr. Zhang, you have another new intern?” the nurse on duty greeted him. This guy was leaning on the marble counter of the nurse’s station, casually joking around with the nurses.
Yang Ping looked a bit young, he had been working for several years, but people always thought he had just graduated.
“He’s not an intern, he’s a new doctor. The director asked me to guide him for a while, give him a lesson or two.” Zhang Lin proudly stated, raising his voice a few degrees.
“Dr. Zhang, you are so impressive, now you are guiding other doctors.” The nurse praised.
“Treat time! We’re on duty today!”
“Heytea? How many cups?”
“Four of us, two on duty, and two intern nurses.” The nurse said smiling.
This was an old tradition. When on duty, the duty doctor would treat the nurses to something, so they wouldn’t ring for you every time a patient sneezed.
“Hey! You there, Yang–Doctor Yang! Come here!” Zhang Lin called him over.
Yang Ping walked over, thinking he was introducing him to the pretty nurses. Instead, Zhang Lin said, “Five cups of Heytea, if you can’t drink all of them, make it six.”
I’m not drinking, I’ll just watch you guys enjoy. Yang Ping muttered to himself, hmm, treating is treating, I’m not a stingy person.
Yang Ping quickly took out his phone to order delivery. Glancing at it, the cheapest cup of Heytea was more than ten yuan. He thought it was just a few yuan a cup. No problem, it’s pocket change, not like he was strapped for cash.
Zhang Lin admired his readiness. He usually pushed him around, and Yang Ping never complained. Suddenly, Zhang Lin felt a bit guilty, saying, “Take it easy, there’s no rush with the medical records.”
This was the most normal thing Yang Ping had heard him say. In the last few days, Zhang Lin’s facial expression when he spoke was as if Yang Ping owed him millions, just like a sulky pig liver.
Indeed, these resident doctors are under tremendous pressure, they don’t earn much, and practically spin around the ward twenty-four hours a day, so it’s understandable if they act like crazy people. That’s why Yang Ping didn’t say anything.
“It’s going to be a peaceful night tonight!” An intern nurse sipped her Heytea, happily expressing her hope.
“Shh, shh, shh, don’t jinx it!” Zhang Lin stomped his foot anxiously, pretending to spit on the ground.
There’s a rule among doctors, you can’t be complacent. For instance, you can’t say that none of the surgeries you performed got infected; or that you definitely won’t admit a new patient on your shift; or that the patients you manage won’t complain–
Legend has it that the moment you say something like that, you’ll get a case immediately to prove you wrong.
“How did your teacher train you? He didn’t even teach you the basics?” Zhang Lin glanced indignantly at the experienced nurse.
The senior nurse quickly answered, “Alright, alright, how about we send you a few severed fingers to reattach, will that do?”
Reattaching severed fingers was a tough operation. It was time-consuming, and some doctors dreaded it. If such a patient was admitted during the shift, they would spend the whole night on it.
The few of them chatted idly for a bit.
The telephone at the nursing station rang. Everyone looked at each other. It couldn’t be, could it? The senior nurse picked up the phone, “Hello, this is Orthopedics, an emergency consultation, what kind of patient, severed finger?”
Oh my god! Fire seemed to shoot out of Zhang Lin’s eyes.
The nurse gently put down the phone, spread her hands, and shrugged, “Nothing we can do about it. Did you hear that? Emergency Room, consultation, severed finger!”
“Is that kind of thing even possible?” Zhang Lin held back his rising anger, got up, gently patted the young nurse’s shoulder and said, “I give in to you guys.”
Then he said to Yang Ping, “You stay in the ward, I’ll go down and check. Wait for my news, it could be an open fracture instead of a severed finger.”
Zhang Lin straightened his hair and entered the emergency elevator.
In less than fifteen minutes, Zhang Lin’s call came through.
“It’s a real severed finger, right thumb, cut off by a cutting machine, in two sections. Prepare for emergency surgery.”
The chief was still in the middle of a major operation, for a fall from a height, multiple fractures all over the body, several of them open fractures. Such an operation wouldn’t finish in a few hours. Plus, President Guo had mostly passed the severed finger case.
In the department, three people performed the best in finger reattachment surgeries, Director Han, Director Tian, and Song Zimo. The others who could do it were not as skilled. Director Han and Song Zimo had both gone to a meeting, and only Director Tian was left.
Director Tian was on second-line duty, but there was an emergency at home, he needed to go into the city. He reported to Director Han and notified the chief resident about Old Jin covering his shift. But Old Jin was in surgery. In the meantime, Zhang Lin started debridement, Director Tian would be back soon.
Zhang Lin called Director Tian again. Tian said for this kind of two-segment cases, it would be better to wait for him to do it. He was on his way and the severed finger could be kept in the fridge for a while, it wouldn’t be a big problem.
The junior nurse was about to cry, her innocent eyes seemed to be saying: “It’s not my fault!”
After hanging up the phone, a picture was sent to his WeChat. The thumb was cut into two segments, unspeakably ghastly. The two detached segments were laid out on a white cloth, incredibly jarring to the eye.
“I just called Director Tian, he said to arrange for surgery first. He is on his way.” Zhang Lin said, “You go straight to the operating room, draw blood, conduct electrocardiograms, the preoperative examination has been done in the emergency room. I am doing the consultation and signing off, I will go to the operating room right after.”
These emergency surgeries were usually expedited and didn’t require prior hospitalization. To save time, preoperative preparations were done in the emergency room, consultation and consent were completed, then they were directly taken to the operating room for surgery, and admitted to the ward after the surgery.
Yang Ping instructs the nurse to call for the on-call staff to watch over the ward. He then checks on the critically ill patients to ensure they aren’t in immediate danger. Riding the emergency elevator, he rushes to the operating room, swaps his shoes, and puts on surgical scrubs, a mask, and a cap.
The operating room is fully lit with President Guo and Old Jin hard at work. Caesarean sections in Obstetrics and Gynecology, Appendicitis in General Surgery, Traumatic Pneumothorax in Thoracic Surgery, Craniotomy in Neurosurgery — a frog-like cry, a baby is born from a Caesarean section.
The automatic doors open and despite the patient not having arrived yet, Yang Ping waits in the operating room, where the circulating nurse is already preparing the materials.
About ten or so minutes later, the patient is wheeled in by the nurse and Zhang Lin enters in his scrub suit.
The small refrigerator containing the severed finger sits on a medical cart. Upon opening it, Yang Ping notices that the severed edge is uneven.
“Is Director Tian here yet? Has he not arrived?” The circulating nurse shows anxiety as he asks Zhang Lin, his voice a bit hostile.
Zhang Lin feels slighted by the nurse’s tone and responds curtly, “Tend to it first!”
Senior doctors aren’t on the first line of duty but rather the second. In case of an emergency, the doctors below disinfect and lay sheets, slowly laying down the groundwork. This is standard procedure.
Yang Ping assists in extending the hand, Zhang Lin wears gloves, and begins washing the hand’s wound and the severed finger. Saline, hydrogen peroxide, saline, and antiseptic solution, all rinsed twice in this sequence.
“Hold the hand steady! I’m going to go wash up,” commands Zhang Lin to Yang Ping.
The scrub nurse has already washed her hands and put on her clothes, the sterile operating set all laid out, with every tool being arranged on the table by a pair of dexterous hands. Soon, the tools are split into different zones, with the most commonly used ones in the most easily accessible spots.
After Zhang Lin has washed his hands, disinfected them, and covered the table with the scrub nurse, he anticipates Yang Ping helping on the operating table and instructs him to wash his hands and suit up.
Despite both men being prepared and suited up inside the operating room, Director Tian has yet to arrive.
Debridement, we can start with the debridement.
Zhang Lin visibly loses confidence, the composure he feigned at the start now broken.
Rinse – debride – rinse again!
One-millimeter Kirschner wire, drill!
With the quiet hum of the miniature drill, the two broken ends of the bone are fixed together with intersecting Kirschner wires.
The microscope is wheeled over and adjusted, its eyepiece coming into view. After adjusting the focus and pupil distance, the vision field finally becomes clear.
The patient’s hand must be secured to avoid any disruptions during the surgery. With all the prep work done, the only things left are the critical steps – identifying the blood vessels and performing vascular anastomosis.
Zhang Lin can only perform simple procedures under a microscope, but when it comes to vascular anastomosis, he’s not able. So he dares not continue. This isn’t a joke; his limited microscopic skills would result in poorly connected blood vessels, which won’t allow blood flow.
Zhang Lin picks up the microscope forceps and scissors, attempting to locate the blood vessels, but his hands are shaking severely.
“Brother, can you do this?” Yang Ping asks gently.
Zhang Lin, originally intent on proving himself in front of Yang Ping, abandons the forceps and scissors as soon as his hands disobey him, he replies, “Wait for Director Tian.”
“It’s been over an hour, why isn’t he here yet!” The circulating nurse whispers to Zhang Lin.
“Hurry him up!” Zhang Lin lowers his voice in response.
The patient was given brachial plexus anesthesia, not general anesthesia; only one arm is numb. They have to be discreet and avoid the patient overhearing their telephone conversations to prevent unnecessary worry.
The circulating nurse darts out again to make a call. A few minutes later, she returns, her spirit deflated, nods her head, and whispers, “He’s in a traffic jam in the city area; even if the road clears right now, it will still take an hour.”
The circulating nurse asks, “What do we do now?”
“We wait. We wait right here on the platform. He should be arriving shortly!” Zhang Lin replies.
“Anesthesiologist, put the patient to sleep.” Zhang Lin instructs.
“Ding-dong, Task: save the team from the crisis, complete one finger reattachment, reward: 1600 points.”
These words appear in the upper right corner of Yang Ping’s vision, stay for a moment, and then disappear.
Now that the novice’s period is over, there’s no newbie gift package and the reward points have started.
Through several tasks, Yang Ping understands a little about the system’s temperament. Real-world events can trigger system tasks. Completing tasks will earn rewards such as points, which can then be used in the system to swap for surgical training, thereby enhancing skill levels.
Sounds about right, Yang Ping thinks. He had just obtained the system not too long ago and isn’t very familiar with it. He needs to probe it more in the future to fully utilize it.
While Zhang Lin is whispering to the nurse, Yang Ping suggests, “If we go on waiting, it might delay the patient’s situation. Can I do it?”
“Have you ever done a finger reattachment before?”
Yang Ping answers casually: “I have done it before!”
“A lot?”
“Not a lot, just a few hundred times!”
Wow! I haven’t even seen a few hundred of those surgeries, and you’ve done it a few hundred times and you’re saying it’s not a lot?
“Give it a try!” shrugs Zhang Lin.
Under the microscope, one blood vessel is already groomed clean and is undergoing anastomosis.
The operation is carried out systematically…
