Translator: EndlessFantasy Translation Editor: EndlessFantasy
The Yiyuan County inpatient building was surrounded by a dozen small flower beds. It was spring, and even Ling Ran felt relaxed as he stared at the colorful plants around him.
Both sides of the inpatient building were surrounded by big trees, which were decades old. Most of them had been planted there since the founding of the country. From the distance, many trees appeared three-stories tall, and their leaves were very dense.
At a corner of the building was a small basketball court. Patients in hospital gowns sat at the stands of the court while the basketball players in the court consisted of young people who looked like students.
Kong Xiangming tried to be friendly with Ling Ran. He started the conversation by introducing their hospital. “Our hospital used to offer Diploma in Medicine, but later it turned into a normal school. This basketball court was built during that time. Our hospital still welcomes students to play basketball over here. This basketball court was closed for some time in the past, but the people were very vocal about it so we decided to reopen the court. Our Inpatient Department even installed a new water dispenser for the kids to drink whenever they come to play basketball.”
It was only then that Ling Ran noticed a water dispenser with a few water tanks at the corner of the basketball court.
Wang Haiyang nodded slowly. “The hospital’s full of Yin energy. Everyone will feel comfortable in the presence of some hot-blooded and energetic boys.”
His Feng Shui explanation made Ling Ran laugh. This also triggered everyone to converse with each other, and they all started to chat as well as laugh together.
The wards of the Department of Orthopedic Surgery were located on the fourth floor of the inpatient building.
Once the doctors walked out of the escalator, they hid their smiles. Wang Haiyang stood in front of the group as the leader, and Kong Xiangming guided them into a single room to meet the patient and his family.
Wang Haiyang had heard about the patient before. He put on a stern look, and he looked dignified. He no longer appeared friendly.
When the patient and his family saw him, they did not say a word. They, too, became solemn.
It was especially so for the patient who had his wound dressed. He did not want to speak, but he still sat up to listen to their conversation.
It was Kong Xiangming who spoke first. “Mister and Missus Cha, let me make one thing clear; it’s something I’ve told you before. Chief Physician Wang’s team rushed all the way here from Yun Hua. They didn’t even have a proper lunch because they hoped to reach here as soon as possible. Now, they’re here to help, so please be patient with us. Please allow us to spend some time on the preoperative diagnosis, analysis, and research. If we can have sufficient preparation, we’ll be able to increase efficiency.”
He had seen too many patients who were impatient. He was worried that the patient would get angry with them, so he added, “Under normal circumstances, if you bring the patient to Yun Hua Hospital or to the provincial hospital, it would be very troublesome and costly. Now, we’ve brought the experts here, and it has lessened your troubles in terms of seeking medical help. It also saves time. However, we can’t just save time for the sake of saving time and cut out the necessary preparations. We need to have a proper discussion. Therefore, don’t be impatient. Let’s get straight down to business, okay?”
The patient and his family nodded after they listened to Kong Xiangming.
In a doctor-patient relationship, patients were always the weaker party, especially patients who were waiting to be treated. For them, regardless of how the informed consent form was written, they still needed to sign it in the end.
Of course, things would be different after the surgery.
Once Kong Xiangming finished explaining matters, Wang Haiyang said, “I read Mister Cha’s MRI scans. From a doctor’s perspective, the success rate of his finger replantation is quite high. But I have to tell you this, even if your finger replantation ends up a success, the finger will not function as good as it used to. The finger’s functionality will be limited…”
Wang Haiyang then mentioned some of the sequelae, including postoperative pain, cold intolerance, and other problems.
The patient and his family began to grow more nervous.
Once Wang Haiyang finished most of what he wanted to say, Kong Xiangming came forward and said, “We invited Chief Physician Wang over because we hope that the surgery will be performed better with fewer complications. Hmm… how should I say this? We have to hope for the best and seek for the best results, but we also have to prepare for the worst since there are risks in the surgery. It is especially so in finger replantation surgeries. The risks are quite high…”
Kong Xiangming looked at Wang Haiyang after he was done with what he needed to say. Once he received his confirmation, he announced the start of the surgery.
The patient was pushed towards the operating theater, while Wang Haiyang and Ling Ran followed Kong Xiangming to change their clothes. Once they were done, the doctors from the Department of Orthopedics Surgery in Yiyuan County Hospital changed into their scrubs as well; they were ready to learn from the surgery.
While they were alone, Wang Haiyang told Ling Ran, “We’ll be less at ease when we perform surgeries as freelance surgeons compared to when we operate in our own hospital. We have to employ surgical plans with lower risk and try our best to conduct the surgery better.”
“I understand.” Ling Ran did not have any experience as a freelance surgeon. Naturally, he would just follow Wang Haiyang’s commands.
The so-called low risk plan referred to the reconnection of multiple blood vessels at the beginning of the finger replantation surgery. The core of finger replantation was blood circulation. If blood circulation could be ensured, the replanted finger would have a chance to survive. Blood was the main supply of energy for the muscles. Without the supply of blood, the muscles would definitely suffer from necrosis.
However, reconnecting multiple blood vessels also meant that the surgeon had to either extend surgery time or save time by cutting down on other aspects. Replantation for a single finger was much easier in this regard, but for multi-finger replantation surgery, the surgeon would also have to consider the time taken to reconnect the other fingers.
However, for Wang Haiyang and Ling Ran, no matter how they decided to reconnect the fingers, it would not pose too much of a problem for them. The selection of a plan basically depended on their preferences and the possibilities of what could happen during surgery. If they did not talk about their skills, luck would then play a major factor in the surgeon’s decision on what plan to use for the surgery.
“Chief Physician Wang, Doctor Ling, are you used to our equipment?” Kong Xiangming waited for a while before he entered the operating theater. With a smile, he asked them as he pressed his hands together. He seemed to be a little proud of himself.
It was expensive to purchase a complete set of microsurgical instruments, and it was particularly expensive for Kong Xiangming since he chose to buy a dual head microscope, complete with a display screen. The Construction Department’s funds for them, which was in the tens of thousands, was basically spent on the device alone.
The operating theater was also a laminar flow operating theater with air pressure ventilation. Although it was a low-end Class 3 operating theater with a cleanliness level of Class 5 based on the International Standards Organization (ISO), it was more than enough to carry out the finger replantation surgery. If they changed it to an ISO Class 2 operating theater, Yiyuan County Hospital would not be able to afford the maintenance fee.
Wang Haiyang tested the microscope and looked at the display screen, which was positioned above the operating table. He laughed and said, “I like this microscope that you’ve installed.”
“All good doctors like this very much.” Kong Xiangming laughed and looked at Ling Ran, who did not say a single thing. He then said, “Doctor Ling, feel free to let us know if you have any special requests. We’ll try our best to fulfill them.”
“Okay.” Ling Ran smiled faintly. His list of surgical practices and requirements had been delivered to the hospital before he arrived. Kong Xiangming was just being polite.
A moment later, the patient was pushed into the operating theater. After the final confirmation, the anesthetist placed the laryngeal mask over the patient’s face. The patient was anesthetized within a second.
The other doctors from Yiyuan County Hospital’s Department of Orthopedics Surgery entered the operating theater one after another. They stood at the corners to serve as an audience.
Kong Xiangming continued with his meaningless chitchat, and it actually brought a friendly atmosphere to the operating theater.
At that moment, Wang Haiyang became friendly again. Everybody was so comfortable that they talked about the weather, food, surgery, and even the economy.
Ling Ran was the only one not involved in the conversation. He made the circulating nurse show him more MRI scans, and he read them quietly.
He did not like chatting. Perhaps he had been teased too much since he was young, and that gave rise to a sense of rebelliousness in him.
Compared with chatting, reading MRI scans provided him a huge amount of information, and that made Ling Ran happy.
Kong Xiangming just assumed that Ling Ran was too nervous, so he did not comment much on his demeanor. To Kong Xiangming, Ling Ran was only a first assistant, and he was just somebody Wang Haiyang had brought along. As long as he did not perform too badly, he would not ruin the surgery…
The other doctors from the Department of Orthopedic Surgery also thought the same thing. Many people even showed Ling Ran a tolerant smile. The Department of Orthopedic Surgery was a new department in the hospital, but even the youngest resident doctor in the operating theater was equipped with at least three years of experience. When they looked at Ling Ran, they definitely felt some sort of psychological advantage over him because of their age. After all, surgeons needed time to accumulate their experience…
Smiles were still visible on everyone’s faces. When Wang Haiyang performed the incision, the experience Ling Ran accumulated came into play with explosive might.
On the way from Yun Hua to Yiyuan County, Ling Ran did not do anything but spend a long time to read the MRI scans. After they had arrived at Yiyuan County Hospital, he still did nothing but pass the long period by reading the MRI scans.
With his skill in reading scans and the excessive information he obtained from the MRI scans, Ling Ran’s brain was fully filled with all the details of the patient’s severed finger. He could perform much better there than in Yun Hua Hospital’s operating theater.
MRI scans were produced from hydrogen atoms. Cross-sectional data could be reflected in a resonance image made of hundreds or thousands of hydrogen atoms. To a highly-skilled radiologist, who had the ability to analyze scans, MRI scans could be shown in many ways including T1, T2, FLAIR, DWI, and many more. They could show basic information about the patient’s body at the atomic level, which were not visible in X-ray scans.
Technical resources were considerably at a surplus based on current medical technology standards. The only disadvantage was that the doctors could not master quickly-emerging technology. However, every emergence of a new piece of technology indicated that diseases could be diagnosed more accurately.
For example, in a quasi-tertiary grade A hospital like Yiyuan County Hospital, there was not even one high-paid radiologist who could read DWI scans. However, the top hospitals affiliated with Yiyuan County Hospital were fighting to build MRI scanners in their operating theaters.
For Ling Ran, who had in his possession the Perfect Level Finger Replantation Skill, the details of the patient’s severed finger were already constructed in his mind. The surgery was just a process for him.
Once Wang Haiyang, the chief surgeon, made a cut on the muscular layer, Ling Ran performed incisions on everything else; right as he took out the bones, Ling Ran joined them and even prepared a suitable Kirschner needle for Wang Haiyang’s use; after he took out the tendons, Ling Ran debrided them thoroughly in a second and connected them for Wang Haiyang to suture…
Wang Haiyang was so comfortable with the surgery that he felt as if his fingers were dancing. For an old doctor like him, the comfort of being served by Ling Ran in an operation was similar to having someone cloth him, spoon-feed him, massage his legs as he drank tea, and having someone support him while he walked.
He felt like he was being carried around in a marathon; the fascinating view in that 26.21-mile marathon, cheers from thousands of people, the cool breeze, the carefree feeling of swinging his arms when he had nothing to do, the relaxing feeling of being able to grab a bottle as he liked, the eagerness of crossing the finishing line, and the pursuit of glory…
Kong Xiangming and the other six doctors from the Department of Orthopedic Surgery were stunned. They did not expect to see such an amazing spoon-feeding technique in the medical world.
Again, Kong Xiangming stared at Ling Ran, who remained quiet the entire time. He suddenly had an epiphany. ‘This man doesn’t need to kiss anyone’s a**. His spoon-feeding technique in the medical field is the greatest flattering skill ever. I wonder if there’s any surgeon in the world who can resist such flattery.’