Chapter 204: Green Light All The Way!
After Tian Zhiliang took Lu Cheng to transfer the patient to the Vascular Surgery and Orthopedics departments, he returned to his office and began writing down the patient’s basic information.
“Director Tian, for this kind of surgery, our Emergency Department only handles hemostasis, and the rest is handed over to the specialists?” Lu Cheng asked while watching Tian Zhiliang transcribe the medical record.
The Emergency Department at Xiangzhou People’s Hospital is very different from Long County People’s Hospital!
In comparison, this place is more like a large-scale referral center.
Especially the Emergency Surgery department, apart from debridement and suturing, they don’t perform any surgeries themselves.
Tian Zhiliang chuckled, his tone kind, “Are there different practices at your hospital?”
Lu Cheng nodded, “We perform some surgeries now.”
Although Tian Zhiliang was the Deputy Chief Physician of the Emergency Department at Zhou People’s Hospital, he had heard about the emergency departments in county hospitals. “Then you are quite daring.”
“Our hospital’s consistent practice is to strictly adhere to the departmental division of labor. Our Emergency Department’s role is to handle emergency procedures.”
“We provide basic treatment for the patient’s condition, only addressing critical points.”
“For example, debridement and suturing, tracheal intubation, and tracheotomy. Any other procedures, such as chest tube insertion, are performed by personnel from the Thoracic Surgery Department.”
“It’s also to avoid trouble; our Emergency Department already has enough troubles,” Tian Zhiliang replied honestly.
Lu Cheng responded, “Director Tian, this is also quite good.”
As they spoke, Lu Cheng saw his panel.
【 By effectively performing hemostasis and promptly treating the patient’s active arterial injury, the risk of shock, death, and other complications was reduced to a certain extent, earning 5.3 skill points. 】
For active arterial injury, the most crucial step is not vascular suturing but timely hemostasis to save the patient’s life.
Although Lu Cheng only performed the simplest hemostasis, the skill points gained were comparable to a Level 3 surgery, a significant reward!
Tian Zhiliang was diligently recording the patient’s general information and condition upon admission. The patient had already been taken to the operating room, and the specialist doctors had also arrived.
After the consultation, the patient was automatically transferred to the appropriate specialty department. The Emergency Department’s current task was to complete the basic medical records.
Lu Cheng just watched quietly, not offering any personal advice.
After Tian Zhiliang finished writing the corresponding medical course, he turned and said, “Doctor Lu, our Emergency Department places emphasis on two procedures: incision and hemostasis.”
“These two procedures, though seemingly unrelated, serve the same purpose: to save the patient’s life as much as possible.”
“The content of your practical skills assessment will be these.”
“I’ve finished writing the medical course for this patient’s record. Since you are here for an internship assessment, you will write the admission interview record and the serious illness notification,” Tian Zhiliang assigned tasks to Lu Cheng.
Lu Cheng nodded, “Okay, Director Tian. Should I talk to the patient’s family?”
Tian Zhiliang said, “No need. Print them out and hand them over to the Emergency Operating Room later. The specialist doctors in the Emergency Operating Room will talk to the patient’s family for signing.”
“If the specialist doctors don’t arrive in time and the patient’s condition is very critical, then we will talk to the patient.”
While Tian Zhiliang was speaking, the phone from the on-duty doctor in the Emergency Surgery Clinic rang, “Director Tian, we have a tendon rupture in the surgery clinic.”
“There’s bleeding. Director Tian, can you ask Liang Jianhong to help with temporary bandaging? I still have several other patients here.”
Tian Zhiliang turned and called out, “Liang Jianhong, go to the procedure room and temporarily bandage the patient.”
Liang Jianhong was scheduled in the Emergency Surgery Ward and was primarily responsible for the daily work of patients in the observation ward.
Liang Jianhong immediately stood up, “Okay, Director Tian, I’m going now.”
Tian Zhiliang then explained to Lu Cheng, “Xiao Lu, here, we generally maintain a three-tier on-call system. Both Internal Medicine and Surgery will have a Deputy Senior or a senior Attending Physician covering the Emergency Clinic and the ward together.”
Lu Cheng asked, “Director Tian, then you and Director Zhu must be on duty every day?”
There were three senior physicians in Emergency Surgery in total. Xiao Zhaoxi was a Chief Physician, and Tian Zhiliang and Zhu Yuanzhou were the other two Deputy Chief Physicians in Surgery.
Tian Zhiliang replied, “No, the second-tier duty for Deputy Seniors is rotated among four of us: myself, Zhu Yuanzhou, Director Xiao, and Cao Gui.”
“Of course, Director Xiao only works half a month’s worth of shifts. We usually rotate among the three of us.”
Lu Cheng worked quickly. The two documents Tian Zhiliang mentioned could be created by establishing templates and then making minor adjustments.
The Emergency Department at Zhou People’s Hospital had been operating for many years, and the templates were very mature, not something Lu Cheng could easily find flaws in and correct.
After Lu Cheng reviewed the two templates and found them satisfactory, he printed them out.
“Director Tian, these are printed. Is there anything else I need to do?” Lu Cheng asked.
“Add medical orders; I’ll do that. You don’t know our department’s medical order templates and are too lazy to find them,” Tian Zhiliang was already on another computer, completing the previous medical orders.
This primarily involved adding routine orders like oxygen administration and blood pressure monitoring, as well as the debridement kit. Debridement and hemostasis were emergency clinical operations and needed to be billed separately.
After the medical orders were reviewed, Tian Zhiliang turned and asked, “Doctor Lu, when you were at Long County People’s Hospital, did you often handle such emergency rescue work?”
“Your hemostasis technique just now was very proficient. Is it true that you are the only one handling these procedures at your hospital?”
Patients with arterial injuries were certainly not unique to Zhou People’s Hospital; county hospitals also encountered them.
However, the mortality risk for patients with such arterial injuries in county hospitals was much higher. A ruptured femoral artery is not something any doctor can quickly and adequately handle.
“We don’t encounter them often, and I’m not the only one who handles them, Director Tian.”
“I handle them when I’m on duty,” Lu Cheng replied.
Arterial injury is considered an ultra-emergency. When Lu Cheng was not on duty, even if he knew about it, he wouldn’t rush to the hospital.
For this type of arterial bleeding, the most critical minutes matter. If hemostasis is effective, they live; if ineffective, miracles are unlikely.
When a patient arrives at the hospital, who is on duty and whether that doctor is skilled in treating active arterial bleeding is purely up to fate.
This is something no one can predict in advance.
Zhang Tiesheng and others could also handle it, just not as skillfully as he could.
“Oh, I thought you were hogging all the credit.”
“Just now, when I heard the message and rushed over, you had already stopped the bleeding. That operation couldn’t have been led by Liang Jianhong,” Tian Zhiliang knew Liang Jianhong’s capabilities well.
Lu Cheng joked, “Director Tian, in such situations, even if my colleagues wanted me to take all the credit, I wouldn’t dare.”
“This is truly like licking food off the edge of a knife.”
……
Lu Cheng followed Tian Zhiliang’s shift the entire day. After Tian Zhiliang finished his day shift, Lu Cheng also went to rest.
Doctors undergoing internship assessments are also human. Once a person’s shift is chosen, there’s no need to create further complications.
Tian Zhiliang is on the night shift tomorrow, which will allow him to observe Lu Cheng’s basic abilities.
Furthermore, tomorrow during the day, the hospital would arrange for someone to take Lu Cheng to the physiology laboratory for a skills assessment.
It would be somewhat inhumane for Lu Cheng to participate in the assessment after staying up all night.
It didn’t really matter; for Lu Cheng, no matter what results he obtained, he would be the only one to make the choice.
Following Tian Zhiliang’s shift was rather uneventful; it was like being an advanced referral assistant.
For patients with kidney stones, refer to Urology.
For acute abdomen, refer to General Surgery.
For fractures, refer to Orthopedics.
For dislocations, refer to Joint Surgery.
The main approach was “referring,” participating but not being responsible, and not providing definitive treatment. Only preliminary diagnosis, not final diagnosis.
Only debridement, no surgery.
……
In the afternoon, at 5:40 PM, after Lu Cheng finished following Tian Zhiliang’s shift, he found it quite boring.
Even when leaving the Emergency Department, Lu Cheng wondered if coming to Zhou People’s Hospital was necessary.
A surgical department without surgical operations sounded somewhat ridiculous.
As soon as Lu Cheng got off work, Mu Leng called him to invite him over for dinner.
Lu Cheng had no other arrangements. After confirming with Tian Zhiliang that he didn’t need to follow Cao Gui’s night shift, Lu Cheng accepted.
When Lu Cheng arrived at Mu Leng’s house, he found that Director Xiao Zhaoxi of the Emergency Surgery Department was also there.
Moreover, Director Xiao Zhaoxi had personally brought wine.
Seeing the scene, Lu Cheng raised his eyebrows and began greeting them: “Uncle Mu, Auntie, Director Xiao. Shudai.”
Mu Nanshu had come with Lu Cheng for this internship assessment, but Mu Nanshu had only hitched a ride and was not staying at the hotel outside with Lu Cheng; she had gone directly to Mu Leng’s place.
“Xiao Lu, you’re here. Come in and sit. Dinner is ready; the last two dishes will be out soon,” Yan Sangyue said kindly.
Mu Leng was chatting with Xiao Zhaoxi, “Xiao Lu, you’ve arrived just in time. Come quickly and pour some wine for your director.”
Lu Cheng changed into slippers, washed his hands at the sink, and then approached the dining table: “Director Xiao, I have a practical skills assessment tomorrow, so I won’t be drinking.”
Xiao Zhaoxi said with a gruff tone, “You brat, were your methods a bit too harsh? You got rid of the other two people in this second round of examination.”
“You know you have a skills assessment now? It’s not interesting or stressful to be assessed alone, is it?”
Xiao Zhaoxi believed that Lu Cheng had used his connections and employed underhanded tactics to eliminate the other two competitors.
Thanks to these two competitors for helping meet the ‘examination standard’!
Mu Leng’s expression faltered slightly: “Director Xiao, are you saying that only Lu Cheng went to your department today?”
“Yeah? You don’t know yet?” Xiao Zhaoxi looked at Mu Leng thoughtfully.
Mu Leng glanced at Lu Cheng and shook his head, “I didn’t know about this matter.”
Xiao Zhaoxi said with a chuckle, “Then our Xiao Lu is even more interesting, keeping even you, his father-in-law, in the dark.”
Lu Cheng didn’t offer further explanation, just stated according to the rules: “Director Xiao, I don’t know why the other two gave up either.”
“His mindset is quite good, not arrogant or impatient,” Xiao Zhaoxi liked Lu Cheng’s personality, finding him not ostentatious.
Some people would surely brag about how amazing they were and how they had tricked others.
Mu Leng changed the subject, “Director Xiao, Lu Cheng’s technique is quite good, right? At least it’s not embarrassing?”
Xiao Zhaoxi shook his head, “There’s no embarrassment. Even the Deputy Chief Physicians in our department are inexplicably wary of him.”
“They were complaining to me at noon…”
“After all, he’s a young man who won awards in provincial competitions. We old timers are definitely doomed,” Xiao Zhaoxi’s praise was very formal and serious.
It was evident that Tian Zhiliang’s words had left a deep impression on him and made him somewhat wary.
The competition was for individual operations, whereas Lu Cheng’s observation of Tian Zhiliang’s shift focused on comprehensive ability.
Lu Cheng was not the type of doctor who only relied on award certificates but a clinician with genuine substance.
Mu Leng quickly said, “Director Xiao, if you say that, I’ll take it that you think Lu Cheng is passable?”
“You can interpret it that way.”
Xiao Zhaoxi saw that Lu Cheng had indeed emptied his wine glass, “You really aren’t drinking?”
“Director Xiao, perhaps next time. I’m still in an internship assessment, and if there’s any lingering smell of alcohol tomorrow, it wouldn’t be good.”
“I hope you can understand.” One is responsible for their own affairs.
During formal work, drinking would lead to endless trouble. He was still in a ‘selection examination,’ and drinking while working during an internship assessment could lead to immediate disqualification.
Building a good relationship with Xiao Zhaoxi could lead to many opportunities.
Xiao Zhaoxi nodded, “Calm enough. This is excellent clinical quality; one doesn’t easily get lost in surface appearances.”
However, Xiao Zhaoxi’s tone shifted, “But, you must drink this wine today, Xiao Lu, whether you want to or not, because I need to ask you for a favor.”
After speaking, Xiao Zhaoxi began pouring wine for Lu Cheng himself.
Hearing this, Lu Cheng was filled with confusion, “Director Xiao?”
Xiao Zhaoxi directly asked, “Xiao Lu, did you know someone from the inspection team last time?”
“Your Uncle Xiao needs your help with a small matter.”
Upon hearing this, Lu Cheng’s mind immediately became calm, “Director Xiao, I think you’ve misunderstood.”
“We’re not strangers. Your Uncle Xiao really needs your help with something. We don’t need to be so formal.”
“The situation is like this: I… I took a little bit, but not much.”
“I donated all this money, but I didn’t keep proper records…”
Xiao Zhaoxi said, “Mu Leng and Xiao Mu are not outsiders, so I’ll be frank. What I mean is, if Xiao Lu, you really know someone in higher positions.”
“Could you help me make a connection and explain this matter.”
Lu Cheng’s expression grew increasingly serious, “Director Xiao, I cannot do this. I don’t know anyone.”
“You must have misunderstood.”
Xiao Zhaoxi directly pointed out, his tone slightly cold, “Didn’t you come to our hospital last time and perform a splenectomy?”
“Are you trying to play ‘hiding the lamp under a bushel’ with me?”
“Xiao Lu, I’m truly desperate. Otherwise, I wouldn’t lower myself to beg you here,” Xiao Zhaoxi’s tone was sincere, his face twitching slightly.
Lu Cheng replied without hesitation, “Director Xiao, you’ve misunderstood. I only received instructions from my superiors to come and assist, to lend a hand.”
“I don’t know who performed the surgery, and no one contacted me. I can’t help you.”
Anyone could guess that helping with such a matter was impossible.
“You’re not giving me face?” Xiao Zhaoxi’s gaze was almost chilling.
“Mu Leng, your kid here doesn’t give me any face at all.”
Mu Leng didn’t understand Xiao Zhaoxi’s specific intentions and was completely bewildered by the current situation, “Director Xiao, is there some misunderstanding here?”
“Xiao Lu is just a regular doctor. How could he know the person you want to meet?”
Xiao Zhaoxi said, “He does know. Ask him yourself.”
Lu Cheng shook his head, “I don’t know, Director Xiao.”
“Being hypocritical is pointless!” Xiao Zhaoxi leaned back, creating at least a two-person distance between himself and Lu Cheng.
Lu Cheng still said, “Director Xiao, what I’m saying is the truth. If you don’t believe me, there’s nothing I can do, but what I’m saying is the honest truth.”
“The last time I came to Jishi City, I just followed my leader’s arrangements and assisted with surgery. I know nothing else.”
“After the surgery, I went to the laboratory with Professor Chen from Xiangya Second Hospital.”
“I also had dinner with Professor Chen. I even asked Uncle Mu which restaurant was good.”
Mu Leng confirmed, “That’s right. Xiao Lu told me the same thing back then.”
“Old Xiao? Did you make a mistake?” Mu Leng tried to mediate.
Xiao Zhaoxi was quite surprised, “They didn’t contact you?”
Lu Cheng nodded, “Yes, Director Xiao!”
Xiao Zhaoxi then squinted his eyes and said, “Not servile, not arrogant, has his own principles, his own ideas, firm in his decisions. He also has his own sense of right and wrong.”
“Mu Leng, how about we really discuss this? You’re breaking up a good couple. Give her to me for my niece; my niece and Lu Cheng are a perfect match.”
As Xiao Zhaoxi spoke, Mu Nanshu happened to walk out. Her hand, holding a plate, trembled slightly. She widened her innocent eyes and looked at Xiao Zhaoxi. Although she didn’t put the plate down heavily, her questioning gaze was undeniable.
What was this person talking about?
Xiao Zhaoxi immediately said, “Niece, I misspoke. Mu Leng, I really didn’t mean anything else.”
After apologizing to Mu Nanshu, Xiao Zhaoxi said to Lu Cheng, “Xiao Lu, what you’ve told me today, you must memorize it by heart. No matter who asks, you must say the same thing.”
“Do you understand?”
“I was just rehearsing with you. The people who might come looking for you might be even more disgusting than my approach just now.”
Lu Cheng still nodded cautiously, unsure if Xiao Zhaoxi was acting or continuing the previous conversation.
Regarding the other Director Xiao, Lu Cheng hadn’t had time to explain in detail to Mu Nanshu, precisely because that “Director Xiao’s” identity was sensitive.
The atmosphere became awkward for a moment.
However, Xiao Zhaoxi was good at livening up the mood. He called out, “Don’t just stand there. Yan Sangyue, Xiao Mu, you’ve been busy all afternoon. Why aren’t you sitting down? I’m going to start eating!”
“Don’t ask me why I did that just now; just watch Xiao Lu’s reaction.”
Lu Cheng, not wanting the previous awkwardness to linger for the entire meal, said, “Uncle Mu, Aunt Yan, Shudai, please sit down and eat. Director Xiao was just joking with me.”
Lu Cheng’s opening was an indirect acknowledgment of some matters.
These were matters that Xiao Zhaoxi had indirectly elicited, but Lu Cheng had not openly admitted them.
And everyone knew that Lu Cheng found it difficult to admit them openly.
