Chapter 19: The Surprise Brought By Little Ink
Lin Qianlong thought about it carefully for a full circle—
Both Zhang Tiesheng and Zeng Huanqi were ‘pampered’ and couldn’t endure the hardship of practicing basic skills. Han Xiaoping was the type who would sit if he could lie down, and Du Daihua had some aptitude but complained about the unfairness of the world, spending all his time thinking about social graces.
As for Tian Zhuang, he was long on Lin Qianlong’s blacklist.
He didn’t even dare to let Tian Zhuang talk to patients and sign off on it…
Lin Qianlong sighed and changed the subject, “Xiao Lu, the situation in our department is a bit special, so there’s something I need to make clear to you in advance.”
“In our Emergency Department, the surgical volume is relatively low, so the chief surgeon’s performance bonus will be ten percent less than in a specialty department. The chief surgeon can only get thirty percent, and the remaining ten percent will go into the department’s public performance bonus.”
Actually, according to the hospital’s secondary distribution principle, the chief surgeon gets forty percent of the ‘surgery fee,’ the anesthesiology department and operating room split forty percent, the remaining ten percent goes to the hospital, and ten percent goes into the department’s public performance bonus.
For the chief surgeon in the Emergency Department’s surgery group, they receive ten percent less, meaning twenty percent goes into the public performance bonus.
It’s not just Lu Cheng; Lin Qianlong is also like this, which is how they manage to keep things going. The current performance bonus for the Emergency Department is also subsidized by the hospital’s public performance bonus; otherwise, the Emergency Department really wouldn’t be able to retain staff.
Lu Cheng came from a specialty department and previously had no opportunity to be a chief surgeon. That’s why Lin Qianlong didn’t explain this rule to Lu Cheng.
“Director Lin, I’ll do as I should… I can’t always take advantage of Director Lin and the older brothers,” Lu Cheng replied with a smile.
Currently, there are only four people in the surgery group who can independently perform surgery as chief surgeon.
Lin Qianlong, Zeng Huanqi, and Zhang Tiesheng. Lin Qianlong is mainly responsible for splenectomies, gallbladder removals, and bowel repair. Zeng Huanqi and Zhang Tiesheng are responsible for appendectomies and larger debridement and suturing procedures, which are minor procedures.
Lu Cheng is responsible for tendon suturing.
These are the limited surgical procedures in the Emergency Department.
“It’s good that you understand… In short, if your current surgical volume is sufficient, appendicitis and some major debridements will still be handled by Zhang Tiesheng and Zeng Huanqi. Do you understand what I mean?” Lin Qianlong explained softly.
“Okay!” Lu Cheng nodded without hesitation.
Surgical volume is the foundation for a surgeon’s technical refinement. If Zeng Huanqi and Zhang Tiesheng want to solidify their positions in the Emergency Department and become directors in the future, they naturally need to keep the core procedures in their hands.
“It’s good that you understand… Otherwise, if Professor Chen were to…”
“It would be quite troublesome,” Lin Qianlong said vaguely, his small eyes darting around…
A local strongman doesn’t necessarily fear a dragon from afar. Zeng Huanqi and Zhang Tiesheng have strong connections. Although Chen Song is detached, he won’t be around forever.
If he now suppresses the other two too much to give Lu Cheng surgical opportunities, it would be detrimental to Lu Cheng’s future relationship with Zhang Tiesheng and also detrimental to harmony within the group.
As the director leading the group, he must consider many aspects in detail.
After Director Lin Qianlong left, Lu Cheng also didn’t rest. He first made rounds, discharged the patient from bed 3, and made minor adjustments to the postoperative medical orders for other patients. He also handled dressing changes for those who needed them.
Only then did Lu Cheng call his uncle, Lu Nanyong.
“Uncle, it’s like this, do you know anyone who’s been transferred by 120?”
“Yes, I’m looking for some tendon suturing cases. Professor Chen Song is willing to let me assist…” Lu Cheng explained with a smile.
…
Time flowed like water, and another five days passed in the blink of an eye.
These past five days have been quite fulfilling for Lu Cheng. Under the guidance of Professor Chen Song, he has routinely performed five tendon suturing procedures within his capabilities.
With patients with tendon injuries being discharged sequentially, the number of postoperative patients in the surgery group in the ward even reached 8, setting a new record for the ward.
Of course, Lu Cheng didn’t slack off during other times. When on duty, he strictly followed his duties, pondered patient medical orders, and engaged in detailed “chats” and “communication” with patients. When he discovered any anomalies, he would request consultations from other specialty departments, using his physical examination techniques as much as possible to uncover ‘insignificant’ hidden ailments in patients without any cost.
It’s important to note that Lu Cheng’s ‘physical examination technique’ comes with ‘mastery’.
In the past, when Lu Cheng had no surgeries and no patients, the most he could do was dissect the patients under his care as case studies. Therefore, with the accumulation of time, it naturally reached the ‘mastery’ level.
When on duty, regarding medication, he also strived for thoroughness and delved into the roots. He organized and collected the basic principles of commonly used postoperative medications such as antibiotics, analgesics, and anticoagulants through AI, compiling them into a table.
He then sent it to Professor Chen Song, diligently asking about the differences between these drugs, and inquiring which drugs had relatively fewer side effects and whether they should be modified. If modified, could the patient’s complications be reduced?
For example, with the elderly gentleman previously, after consultation with the internal medicine doctor, they suggested using the classic ‘omeprazole’ for stomach protection. However, after querying relevant information, Lu Cheng discovered that pantoprazole had a wider range of applications and was more suitable for elderly patients, so he made a modification, earning 0.2 skill points…
Seeing Lu Cheng like this, Professor Chen Song became a bit impatient and affectionately called Lu Cheng ‘Xiao Mojī’ (Little Dawdler)!
‘Xiao Mojī’ wasn’t just called by Professor Chen Song; the older brothers in the department, nurses, and patients would also occasionally call Lu Cheng ‘Doctor Mojī’.
Lu Cheng, of course, didn’t care about this ‘nickname’.
Meticulous physical examinations, detailed conversations to gather medical history, and careful medication management could not only uncover patients’ ‘hidden’ illnesses but also lead to better prognoses and earn skill points.
Being called ‘Mojī’ was fine; Lu Cheng continued to be this ‘Mojī’…
When not on duty, Lu Cheng was either diligently reading and organizing step-by-step practice routines for various suturing techniques, or buying materials for practice.
Although the speed was slow, it wasn’t without progress.
It’s unclear if the previous accumulations have paid off together, but the basic theory for hand surgery has improved from ‘Proficient 7/10’ to ‘Proficient 8/10’. The knot-tying technique, which Lu Cheng hasn’t actively upgraded, has also naturally increased its proficiency by a bit, reaching ‘Proficient 9/10’.
Of course, these minor improvements are like a drop in the bucket compared to skill points.
Successfully completing a professional tendon suturing procedure independently, alleviating the patient’s pain, and achieving better functional recovery for the patient, earning 1.1 skill points…
Providing professional guidance for the patient’s postoperative recovery and medication adjustments, reducing the incidence of patient complications, earning 0.2 skill points…
Successfully completing a professional tendon suturing procedure independently… earning 1.6 skill points…
…
On average, a standard tendon suturing plus postoperative guidance can earn 1.4 skill points.
The 6 surgeries performed independently by Lu Cheng earned a total of 8.5 skill points. Postoperative guidance and medication adjustments for the ‘tendon injury’ patients that Professor Chen Song ‘consulted’ on brought Lu Cheng an additional 0.3 skill points.
The postoperative medication for the remaining 4 general surgery emergency patients only brought Lu Cheng 0.6 skill points in total.
Current remaining skill points: 14.8（+13.9）】
The remaining skill points are from the fragmented operations such as dressing changes, debridement, and suturing that Lu Cheng performed during his shifts.
The gains from skill points are also quite ‘Mojī’ (slow and meticulous).
Suturing Skills: Tendon Suturing Technique （Proficient 2/10）, Modified Kessler Suturing Technique （Proficient 3/10）, Tsuge Suturing Technique （including sliding type）（Beginner 2/5）】
Techniques are difficult to practice. After nearly a week of diligent practice, Lu Cheng has only managed to advance the Tsuge Suturing Technique to ‘Beginner 2/5’. Unable to bear this snail-like pace, Lu Cheng prepared to speed it up.
Suturing Technique （Mastery 2/20）（Skill Points -2）, Tendon Suturing Technique （Proficient 5/10）, Tsuge Suturing Technique （including sliding type）（Proficient 1/10）（Skill Points -9）】
Current remaining skill points: 0.8】
The skill points accumulated over a week were all used up.
However, Lu Cheng successfully exchanged them for a video of the Tsuge Suturing Technique on pig trotters and sent it to Professor Chen Song.
This time, Chen Song didn’t reply immediately. It took nearly an hour before he shouted in surprise, “Whoa… You’re not dawdling when learning techniques, are you? Did you cheat?”
“Have you figured out the Tsuge Suturing Technique again?”
“Are you using a cheat code?”
With the atmosphere set, Lu Cheng replied, “Teacher Chen, a little cheat isn’t cheating. If there’s a cheat, it’s you who’s carrying me…”
“Let’s go for a drink!” After reading Lu Cheng’s message, Chen Song instantly felt refreshed.
