Chapter 2: Get Stronger With A Little More Contribution
After sending off his uncle Lu Nanyong, Lu Cheng immediately went to the “training room” converted in his home!
As soon as he pushed the door open, the pungent smell of tofu, dried tangerine peel, and pigskin intertwined, causing Lu Cheng to frown instinctively.
【 Overall Level: Resident Physician. 】
【 Basic Theory: Surgery （ Proficient 9/10 ）, Orthopedics （ Proficient 8/10 ）, Hand Surgery Basic Theory （ Proficient 7/10 ）, Trauma Surgery Basic Theory （ Proficient 8/10 ）, Emergency Medicine （ Proficient 5/10 ）… 】
【 Basic Surgical Skills: X-ray Interpretation （ Proficient 8/10 ）, CT Interpretation （ Proficient 8/10 ）, MRI Interpretation （ Proficient 9/10 ）, Surgical Instrument Operation Experience （ Proficient 8/10 ）, Physical Examination （ Mastery 1/20 ）, Auxiliary Examination Reading Skills （ Proficient 9/10 ） 】
【 Basic Surgical Operations: Incision （ Proficient 9/10 ）, Debridement （ Proficient 8/10 ）, Suturing （ Proficient 8/10 ）, Knot Tying （ Proficient 8/10 ）, Puncture （ Proficient 7/10 ）, Hemostasis （ Proficient 4/10 ）. 】
【 Basic Surgical Procedures: Open Reduction and External Fixation for Fractures （ Proficient 1/10 ）, Fracture Manual Reduction （ Proficient 2/10 ）, Open Reduction and Internal Fixation for Fractures （ Proficient 0/10 ）, Closed Reduction of Joint Dislocations （ Proficient 1/10 ）… 】
Lu Cheng looked at his status panel, his smile a little forced.
Basic theory can be learned by reading books, interpretation skills can be improved by reading a large amount of radiological data, and basic surgical medical skills can also be practiced in the “training room.”
However, surgical operations cannot be practiced in a “training room”; learning surgery takes time and effort.
“There are no fracture surgeries in the Emergency Department, and Director Peng of Orthopedics would not allow the Emergency Department to handle fractures and undermine the foundation of Orthopedics, so let’s not worry about it for now.”
“In the Emergency Department, we’ll do simple debridement and suturing if we can.”
Lu Cheng said as he opened the notebook he kept in the training room.
These notebooks were Lu Cheng’s notes from basic skills practice at teaching hospitals, recording the corresponding abilities for different proficiency levels.
【 Suturing, Tofu superficial suturing （ Completed ）, Stretching tourniquet suturing （ Pending breakthrough ）. After completely suturing the tourniquet, tendon suturing can be performed. In Long County People’s Hospital’s Orthopedics department, no one can perfectly and smoothly handle tendon suturing. 】
“Since Director Peng said that tendon injuries do not fall under orthopedics and must be referred from the Emergency Department, I will start by breaking through with the tendon suturing procedure.”
Every step of medical technique improvement is a slow process that requires years of refinement.
Lu Cheng’s basic skills in the department are not bad; his basic skills in debridement and suturing are even comparable to those of the Deputy Chief Physicians in the department, but only comparable, not superior.
【 Remaining Skill Points: 13.1 points. 】
Should he add points?
【 Suturing （ Proficient 10/10 ）, breaking through to the next proficiency tier requires 10 skill points to advance. 】
“Still need to break through? That seems reasonable too.”
With 11.1 skill points remaining, Lu Cheng of course chose to break through.
【 Suturing （ Mastery 0/20 ）, basic suturing skills improved, suturing-related skills passively enhanced. Tendon Suturing （ Beginner 2/5 ）, Flap Transplantation Suturing （ Beginner 4/5 ）. 】
After adding points, Lu Cheng felt a surge of warmth in his hands, which gathered in his palms and then slowly dissipated, with nothing significantly added to his mind.
The suturing method for tendon suturing is not a “secret transmission”; a quick search online yields plenty of theory. In 2023, an era of highly developed information, acquiring theoretical knowledge is not difficult at all.
However, surgical techniques are not just about theoretical knowledge; knowing how to do something in your brain doesn’t mean you can actually do it.
It’s like stir-frying; besides knowing the ingredients, the preparation of the ingredients, the heat control, etc., are all very important. Any slight mistake in each step will affect the final taste.
If surgical procedures could be performed simply by knowing how to do them, then short video platform influencer doctors would have trained millions, or even tens of millions, of top surgeons, and China’s surgical field would be terrifyingly strong!
A tourniquet is not a direct translation of a Japanese slang term; it is a tool used by nurses for venipuncture and is quite elastic.
Stretching a tourniquet, as the name suggests, means placing the tourniquet in a stretched state, cutting it short, and then suturing it with suture thread. If the suture does not break and the tourniquet is not torn, then the suturing skill has been achieved.
This is a basic practice material analogous to tendon suturing, and it is also beginner material. If one wants to practice higher-level tendon suturing techniques, they need to purchase actual animal materials like pig trotters tendons for practice.
Tendon suturing is an introductory procedure in hand surgery; it is not easy to get started, and mastering it is even more difficult.
The fact that at least eighty percent of surgeons cannot perform tendon suturing is not an exaggeration by the Hand Surgery department…
Lu Cheng had watched videos online of practicing suturing stretched tourniquets, where a nail is used to keep the tourniquet in a passive stretched state, then cut with scissors, causing the tourniquet to retract.
Afterwards, Lu Cheng meticulously reviewed the standard interrupted suturing steps for tendons and began performing simple interrupted suturing.
Simple interrupted suturing is the most basic suturing technique, a medical skill that interns can master.
However, suturing it well is not easy.
Even to begin practicing suturing stretched tourniquets like Lu Cheng, one needs to go through layers of practice before having the ambition to attempt it; otherwise, it’s just a waste of consumables.
For example, the most beginner materials include rubber artificial skin, banana peels, orange peels, half-layer suturing of orange peels, suturing the pulp side of orange peels, and deep and superficial suturing of tofu.
Perhaps the vast majority of surgeons give up at the half-layer suturing of orange peels…
Specialty departments that do not require high-precision suturing techniques are too lazy to bother with fancy suturing techniques; as long as the skin can be approximated without infection, it’s done.
Lu Cheng picked up the needle holder, the double jaws of which scraped against the calluses on his ring and middle fingers, causing him slight discomfort, but Lu Cheng quickly accustomed himself to it.
Approximately twenty minutes later.
Lu Cheng looked at the three tourniquets he had sutured, put down the needle holder, took off his examination gloves, and examined them carefully…
“One of them even broke! It seems that reaching this level doesn’t guarantee a 100% success rate for suturing.”
“However, once I become proficient, I should be able to suture common tendon injuries too!~”
“The rate of improvement with these skill points is too fast, infinitely faster than my own private practice of suturing.”
“These skill points can be accumulated in half a month, and this is in Orthopedics where there are very few opportunities for practice. If I got more opportunities in the Emergency Department?” Lu Cheng didn’t dare to imagine how fast his improvement would be.
Or rather, Lu Cheng didn’t dare to imagine how humble his aptitude was in the face of a ‘cheat’!
“It seems that many top teaching hospitals in Hand Surgery consider tendon suturing as the clinical operation standard for doctoral graduation. I don’t know if it’s true.”
“But these don’t matter much to me. Sleeping early and going to the Emergency Department to work tomorrow is the proper thing to do!~”
“I’ve been practicing with the panel for nearly half a month, and the progress bar hasn’t budged. Reading books doesn’t seem to help either; it’s probably too slow, or each increase in the progress bar requires a large amount of knowledge accumulation…”
“Perhaps 0.1 progress points are not displayed on the panel,” Lu Cheng said in a low voice.
Lu Cheng was a science student and could analyze it.
Beginner N/5, Proficient N/10. A professional doctoral graduate, who has studied medicine for about eleven years, would require about 30 points of progress to break through.
An average of three points per year. It would be strange to move the needle at all with half a month of cursory, occasional practice…
Learning techniques is very difficult.
After taking a few deep breaths, he began to clean up the operating table, mask, and suture, and then placed them into a small disinfection cabinet.
Back in his room, Lu Cheng tossed and turned, unable to sleep.
At thirty, in many professions, one can already retire.
However, in the field of medicine, one is still young and immature.
He always had a thought: the average age of graduation for a professional doctoral student in Hand Surgery is twenty-nine, and their average level upon graduation is ‘tendon suturing’.
Suturing is the most mastered medical skill of a hand surgeon…
Therefore, even before he had the ‘panel’, he was only ‘one step away’ from tendon suturing, and this was achieved with improved efficiency without a mentor or professor’s guidance…
People, fate, and time…
Lu Cheng looked out the window. The hot wind rustled the branches, and the dappled moonlight streamed into the room, shattering the darkness and shaking Lu Cheng’s heart.
But it didn’t stop Lu Cheng from going to work when daybreak arrived.
