Chapter 13: Expanding Business!
“Doctor Lu, will we be routinely performing tendon suturing surgeries in the Emergency Operating Room from now on?”
“When I sent the surgery schedule to our Head Nurse before, she kept asking about it. I heard that Orthopedics is too afraid to perform this kind of surgery.” Wang Limin walked alongside Lu Cheng from the operating room to the changing room, her eyes glancing up at Lu Cheng’s profile, her gaze lingering…
In a hospital, doctors who can look handsome while working long shifts are already rare. If they also have some skill, they can satisfy most people’s true ‘fantasy’ of a surgeon.
Lu Cheng shook his head, his voice calm: “Limin, routinely performing surgeries is still not feasible.”
“More precisely, my current suturing technique can only handle Zone IV of flexor tendons and Zones 4 and 6 of extensor tendons.”
“If we don’t consider high demands, Zone I of flexor tendons and Zone 2 of extensor tendons can also be managed with some difficulty.”
“Tendon injuries elsewhere?” Lu Cheng shook his head, his tone amused: “Run away quickly if you encounter them…”
“Ah? Different tendon ruptures require different surgeries?” Wang Limin was extremely surprised.
Although she had professionally studied nursing, when it truly involved core medical knowledge, she still felt her brain wasn’t quite enough.
Lu Cheng was previously in standardized training for Orthopedics. Although he didn’t accumulate much skill, he still read many books. His proficiency in Orthopedics was not acquired out of thin air, nor was it baseless talk.
The reason tendon suturing has so many pitfalls is that the flexor and extensor tendons of the upper and lower limbs each have unique zones, and depending on the zone and the type of flexor or extensor tendon, the preferred and secondary suturing techniques differ.
The flexor tendons of the hand alone are divided into 5 zones, and the extensor tendons are divided into 8 zones. The flexor and extensor tendons of the lower limbs are each divided into five zones, which also correspond to different suturing techniques.
The fundamental reason why tendon suturing is difficult, and why it is hard to enter and even harder to master, lies here.
“Yes, tendon surgeries in Orthopedics involve the most anatomical locations among all surgical fields. I only dare to, and can only choose to, perform very narrow types of tendon ruptures; I won’t do many.”
Lu Cheng took a deep breath: “Limin, thank you for today. It was quite tiring to be my assistant for my first surgery.”
Just as a chief surgeon dislikes inexperienced circulating and scrub nurses, circulating and scrub nurses also particularly dislike new chief surgeons.
Due to lack of proficiency, this being the first time performing surgery independently, the surgery duration is bound to be much longer than for experienced doctors.
“It was fine, it only took a little over an hour, which isn’t considered long.”
“Doctor Lu, I’m off duty. I have plans to watch a movie with a friend. I’m leaving now.” Wang Limin stood at the door of the nurses’ changing room, hands behind her back, standing proudly but speaking amiably.
“See you next time.” Lu Cheng also headed towards the doctors’ changing room.
Lu Cheng, in his surgical scrubs, did not need to change into his civilian clothes and white coat. As an Emergency Department doctor, surgical scrubs were the most convenient attire.
The sun gradually set, casting dappled shadows of branches through the window. The patterns were orderly but were ruthlessly crushed by Lu Cheng. However, after Lu Cheng passed, the dappled shadows remained, not disappearing because Lu Cheng left.
“Professor Chen, Xiao Lu is out too. He looks so happy, as if he’s in love. I wonder if one of the girls from the operating room is asking him out,” Zhang Tiesheng stood beside Chen Song, speaking politely and cautiously.
“The first time went well, didn’t it?” Chen Song’s tone was playful, and he spoke at a brisk pace.
“Thank you for Professor Chen’s careful guidance and kindness; otherwise, I wouldn’t dare to easily bring a patient onto the operating table.”
“I should have watched you perform a few surgeries before operating myself,” Lu Cheng calmly interjected, not matching Chen Song’s rapid speech.
Theoretically, learning and performing surgery should be a much more involved process than the current procedures. Even though Chen Song had proven Lu Cheng’s capability, he should have supervised a few cases, allowing Lu Cheng to become familiar with the local procedures before gradually letting go.
However, this was the pace of surgical delegation at Xiangya Second Hospital. In a county hospital, even the teaching process is so ‘simple and crude.’ Chen Song was too lazy to go through these ‘procedures’ anymore.
Of course, the main reason was that Chen Song had absolute confidence to back Lu Cheng up.
Chen Song had already taken off his work clothes; in his shirt and slacks, he appeared more amiable than when wearing his white coat. “Xiao Lu, Dr. Zhang and I are leaving to have dinner. You’ll have to sort out your own dinner.”
“If there are any surgeries later, just call Dr. Zhang.”
Chen Song’s on-call shift was only nine and a half hours, from 8 AM to 5:30 PM, which was already considered ‘overtime.’
He was a doctor supporting the rural area, not a workhorse for the county hospital. If he performed some surgeries, it was out of kindness; not performing them was his right. Chen Song had the absolute freedom to ensure sufficient rest time during his support period…
Lu Cheng was not Chen Song; he was a Full Professor from a superior hospital.
Originally, according to the rules, he should have been on the schedule for the Emergency Clinic, ward rounds, and support shifts, as well as day shifts, evening shifts, and night shifts, just like everyone else!
These were the rules for on-call duty, and Professor Chen Song was the one who broke them. He personally assigned Lu Cheng to shadow him for the entire shift, leaving Lu Cheng with only the ward “day shift.”
If Lu Cheng only worked day shifts, he would be getting a free ride. If Chen Song could be special, could Lu Cheng also be so special and superior?
Naturally not, so Lu Cheng took on the evening shift as well, not returning until midnight.
He then rested for a day before resuming Chen Song’s pace.
Even so, Lu Cheng was still getting a free ride, as he didn’t have to stay up all night without a night shift. However, this was the best solution Lu Cheng could think of.
After watching the two of them leave, Lu Cheng hurried back to the ward to start writing the surgical record for the patient he had just operated on.
This was a ‘duty’ as a chief surgeon. Operating independently and writing the surgical record independently were also among the ‘prestigious markers’ in the county hospital, representing that your absolute strength had reached a certain level.
…
“Brother Zhuang, I can’t handle this tendon rupture; this is Zone VII of the extensor tendon, which requires the sliding Tsuge Method, or at least the modified Tang Method. Let’s refer the patient out quickly…” Lu Cheng shook his head, dispelling the patient’s desire not to be referred.
“This one won’t work either. A rupture in Zone A3 of the lower limb flexor tendon is at the musculotendinous junction of the gastrocnemius-soleus muscle, requiring the Pulvertaft weave technique or fascia embedding reinforcement!~ You can ask the on-duty doctor in Orthopedics.”
“A rupture at the inferior pole of the patella – tibial tuberosity insertion requires the patellar drilling and anchoring method, or an 8-strand Krackow stitch, which needs intramedullary fixation. Director Peng of Orthopedics can do this; I can’t do it yet…”
“Yes, this one can be handled. This is a rupture of the extensor tendon in Zone IV, and the optimal choice is the modified Kessler suturing technique.”
Lu Cheng waited for a full three days until the evening of July 12th, a “rest day,” at 9 PM, when he finally found a “surgical procedure” within his capabilities!
Lu Cheng was on the day shift for the ward. Other times were covered by other doctors. Today, the doctor on ward duty was Han Xiaoping, who sounded a bit hesitant: “Lu Cheng, you were supposed to be resting today.”
“Director Lin said I could call you, as our department’s scope of services has expanded.”
“Are you willing to come into the operating room?” Han Xiaoping’s voice was quite humane.
