Great Doctor Ling Ran Chapter 173
"Alright, Lu Wenbin, you can go rest. Young Ma will be the first assistant, and Yu Yuan will be the second assistant." Ling Ran waited until his assistants were done chatting before he allocated tasks for them again.
Lu Wenbin was so tired that he was going to die of fatigue. The moment he heard that he could rest, he quickly asked, "For how long?"
He knew that it was impossible for Ling Ran to let him rest all day, or else Ma Yanlin would be the one dying from exhaustion.
"You can come after you wake up." Ling Ran did not set a fixed time. He had consumed two bottles of Energy Serum and worked consecutively for more than forty hours. He planned to take a rest after working for a few more hours because he did not want to drink a third Energy Serum.
It was already inappropriate enough for doctors to test out medicine on themselves, but even those who did so were found to be unsettled if they administered a high dosage for themselves.
Meanwhile, Lu Wenbin followed Ling Ran's orders and left after taking off his gloves. To put it in movie terms, he was worried that changes would take place if he lingered around any longer.
As Lu Wenbin left, Ma Yanlin glanced at him with envy. Meanwhile, he put down a pair of forceps and took the seat that was previously occupied by Lu Wenbin. He looked into the lenses and observed for a few seconds before he extended his hand and said, "CIRCLE forceps."
Ma Yanlin's voice was slightly loud, and he deliberately placed a huge emphasis on the word "circle."
The circulating nurse placed a pair of holding forceps into Ma Yanlin's palm and said, "You meant ring forceps, right? You're confusing me to the point that I'm getting dizzy.
Ma Yanlin chuckled and looked at Ling Ran. However, Ling Ran did not raise his head at all. Ma Yanlin could not help but felt a little disappointed He wanted to go home, too.
Meanwhile, Yu Yuan changed into her scrubs with the assistance of the nurse. Since she was only four feet and nine inches in height, even the smallest-sized scrub seemed a bit long on her. However, her bearing and countenance were extremely earnest.
She extended her hands in front of her chest and stepped on the stepping stool to go beside Ling Ran. She then lowered her head to look at the part he was suturing.
"It's a contusion." Yu Yuan immediately recognized the patient's condition and said, "If there are serious damages to the soft tissues, a successful replantation would be very hard. Even if the patient recovers, it would be very hard for him to recover finger functionality."
"The patient and his family strongly requested for the finger to be replanted," Ling Ran answered and asked, "Have you been in the Orthopedics Department before?"
Contusions were the most commonly seen condition in the Orthopedics Department.
Yu Yuan adjusted her large plastic spectacles and said, "I read up on it when learning about conditions often encountered in the Emergency Department. However, I was mostly focused on foot contusions at that time because it was a more common condition."
"Oh, how much do you know about contusions?" Ling Ran asked casually. After all, to understand his new assistant, it was unavoidable for him to question her in the manner of a senior doctor.
In reality, 70% of the reason why senior doctors asked junior doctors questions was because they wanted to entertain themselves. However, 10% was because they needed to understand their assistant's situation so that they could utilize their assistants fully.
Even though Yu Yuan was already a pretty qualified resident doctor, she still thought carefully about Ling Ran's question, and said, "I don't know much, either. Usually, foot contusions occur due to traffic, industrial, or construction-related accidents. Hence, when we treat the patient, we must gain a detailed understanding of how the accident occured. From there, we'll be able to understand the mechanism of the injury.
"At the same time, we have to pay attention to the patient's condition, specifically, the area of the injured foot. We must first palpate the pulse of the main artery in the back of the feet and the shin. Initial treatment includes debridement and drainage, micromanometry, depressurization of the fascial compartments, and administration of antibiotics to prevent infection.
"Additionally, we must shut or cover the wounded area. There are scholars who believe that internal fixation can effectively recover the anatomical structure of the feet. Mubarak et al. divides the foot into four anatomic components... A pressure of four megapascals is the critical value since any pressure higher than that would result in irreversible necrosis of the muscles and nerves, and also secondary fibrosis"
"About this, can you stop for a moment" Ma Yanlin really could not take it anymore and cut Yu Yuan off. He then said, "I know that this isn't really polite, but if this continues, I'm going to fall asleep"
Ma Yanlin tried his best to keep his eyes open. He felt like they were about to droop shut the next moment.
As a young man born in a small town in the Yangtze River Delta, Ma Yanlin had always been a sweet talker. However, he could not care less right now, because he was afraid that if he waited a little longer to speak, he would be hypnotized to sleep.
Yu Yuan stopped nonchalantly and said with a smile, "I don't actually know much. That was pretty much it."
"That would be enough," Ling Ran commented. Even though his finger replantation skills were at Perfect Level, when it came to knowledge regarding contusions, he was not as well-versed as Yu Yuan.
Most importantly, Yu Yuan presented her points in a logical and detailed manner without prior preparation. It meant she was indeed knowledgeable.
Su Jiafu, who was half-asleep, also woke up from the noise. Since all the cases were prepared for Su Jiafu, he could not sleep even though Lu Wenbin and Ma Yanlin could take turns to do so. At most, he would be able to sleep for half an hour or an hour when Ling Ran energized his brain and carried out an M-Tang technique surgery.
Su Jiafu could not sleep in his room. Ling Ran often took the opportunity to massage Su Jiafu for a minute or two so that he get to enjoy a deeper sleep. For the sake of this pleasure, Su Jiafu always slept in the operating theater.
After this continued for over thirty hours, Su Jiafu's consciousness was almost messed up. However, anesthetists do this all the time, and it was possible for them to endure it, by hook or by crook.
Unlike Ma Yanlin, Su Jiafu's eyes opened because of Yu Yuan's voice. After wiping his face, he took the opportunity to fill up some reports while he observed some figures.
The temperature of the operating theater was always set at 73 degrees Fahrenheit. It was comfortable and cool. There were mini speakers on all four corners of the room, and soft, indistinct music could be heard.
Because Ling Ran did not like to chat, it was unavoidable for the nurses to entertain themselves by maximizing the opportunity to the fullest and listen to music. However, they always made sure that the volume was low to keep from disturbing the chief surgeon while he worked.
Ling Ran never interfered with all this. He had always been a very focused person. When participating in all kinds of psychological tests, the figures of his results were always exceptionally high. In real life, ever since he was little, he never cared about whether his family clinic was noisy at all while he did his homework. He could mind his own business even in the middle of a bustling market.
Ling Ran was even more at ease in the operating theater.
"Have you done any finger replantations before?" Ling Ran asked.
As expected, Yu Yuan said that she had not. She was a colorectal specialist who worked in the Emergency Department. How could she have participated in a finger replantation surgery before this?
Ling Ran nodded and said, "Then, get a pair of forceps and come open up the operating field."
He gave Yu Yuan an easy task to start off with.
The moment the forceps were placed onto Yu Yuan's palm, she craned her waist to retract the patient's skin. The dual-power microscope was already occupied. Yu Yuan could either wear a head-mounted microscope or work solely by using her naked eye. For a second assistant, that completely depended on their personal preferences.
Yu Yuan was still not very familiar with surgical magnifying glasses. She lowered her head a little to retract the patient's skin and looked at Ling Ran in a bored manner as he worked.
"You are looking for the vein, right?" Yu Yuan suddenly said.
Ling Ran was astonished. "You can tell?"
"I guessed it when I saw you peeling the intravenous layer in reverse," Yu Yuan answered so simply that Ma Yanlin was baffled.
"You knew that without reading up on it beforehand?" Ma Yanlin was in slight disbelief. It felt like she had known the question earlier and was here for a performance.
Yu Yuan nodded calmly and said, "I saw Doctor Ling loosen the tourniquet just now. It meant that he was done suturing the arteries. Naturally, he would be looking for the veins now."
"Theoretically, it's like that" Ma Yanlin chuckled a few times and felt extremely unconfident. 'Is this how someone who has published in a Tier 1 journal acts? That's unbelievably impressive! My position is in danger Tomorrow, I'll have to ask my grandmother to send some dried fish over'
"Drench the operating field." Ling Ran stopped moving for a moment, raised his head, and turned his neck.
The circulating nurse immediately brought over the heparin saline she had prepared beforehand. It was just a basin filled with stroke-physiological saline solution that contained heparin, and it was specially used to moisten the operating field. This was because the suturing of blood vessels took quite long, and to prevent the blood vessels from drying up due to long exposure, it had to be drenched often with heparin saline.
The nurse passed the basin over a shelf to Yu Yuan, who was serving as second assistant. Yu Yuan carefully took it, aimed for the operating field, and poured out the heparin saline.
"Carefully, don't spill any on the screen," Ma Yalin quickly reminded her.
Yu Yuan exclaimed in acknowledgement and quickly turned the basin towards another direction. However, she moved the basin too much, and half of the heparin saline spilled on the floor. The splash woke Su Jiafu up.
"Can't you even pour the liquid accurately?" Su Jiafu was quite angry. It was not easy for him to get some rest during the surgery, and he had ended up being woken up a few times.
Yu Yuan anxiously apologized, and she had a remorseful expression.
"Get a new basin of heparin saline and drench the operating field later." Ling Ran was not insistent on drenching the operating field now. He lowered his head and started suturing the vein.
Ling Ran finished suturing one vein after a few minutes. He reminded her, "Moisten the operating field again."
Yu Yuan immediately took the basin from the young nurse. She tilted it slightly and accurately poured a thin line of saline solution onto the operating field.
"Faster." Ling Ran furrowed his eyebrows.
"Okay." Yu Yuan tilted the basin a little more.
Yu Yuan poured the entire basin of heparin saline and flooded the operating field. Everyone in the operating theater stared at Yu Yuan dazedly.
Ma Yanlin really wanted to laugh. 'Turns out she's bad with her hands.'