The genius doctor starts from the game

Chapter 152 Brick mover!
The road of medical students is very long, and every step is accumulated day by day.
From an ordinary high school student, after four years of long study, and occasionally half a semester of clinical probation,
Then I practiced for another year and a half and graduated successfully. I just touched the threshold of medicine, and many people are still waiting outside the doctor's door.

Even if you are a graduate student, regardless of the differences in special major departments such as internal and external obstetrics and pediatrics, oral cavity, and otolaryngology,

That is, in the same department, there are blind spots in understanding between different sub-specialties. This is something that cannot be avoided. A person’s life is only so long. Even if he spends his whole life, he can only blame one sub-specialty. Studying slowly, there is basically little free time to master and become familiar with the operations and knowledge of other sub-specialties.

Because every subspecialty is deep enough.

Not to mention the scope of orthopedics, neurosurgery, just one head, can be divided into stroke, hemangioma, malignant tumor...

If the department of orthopedics is to be truly subdivided, the current classification of the Second Xiangda Hospital is far from being a true subspecialty.

Microhand surgery, trauma, oncology, bone disease, spine, joints, sports medicine; are these broad categories really enough?
No, it's not enough. If you really want to subdivide it, you can still divide it.

Foot and ankle, orthopedics, chronic injuries, nerve transplantation, sports rehabilitation...

Each one is enough for a doctor to study for a lifetime.
There are not so few diseases in medicine, and each disease is not so simple, and it is not as typical as written in textbooks.

In fact, the more Lu Cheng studied, the more afraid he became, and the more confused he felt.
Although his confusion is much better than that of Pang Lin, he still feels small compared to the vastness of medicine.
Compared with the complexity of human beings, his current thinking is still too simple,
Therefore, Lu Cheng can well understand Pang Lin's current sense of powerlessness,
Lu Cheng also has absolutely no right to blame Pang Lin for not grasping the opportunity, saying: "If you talk like this, you are treating your brother as an outsider. Doesn't it be the first time for anyone or what line of work? If you haven't met before, just meet slowly." , let’s fight together today, and next time you meet, you’ll be fine.”

"For this kind of fracture of the tibial shaft, a circular external fixation bracket can be used, or a triangular bracket formed by two crosses can be used."

"We're going to put on a tripod today."

"You can let go of your hand and help me find the external fixator together."

Lu Cheng said it very euphemistically, he has never had an external fixator before, and he might not even recognize the things that the external fixator needs to use.

Pang Lin just struggled in his heart for a while, then cheered up again, and followed Lu Cheng to study seriously.

He still feels that he is not working hard enough. He usually has a lot of time, so he just stays at home watching live broadcasts and playing games. Learning opportunities and such leisurely study time too.

It doesn't matter if you don't, everyone never knows how to start.

Start to learn, learn slowly, learn one, get one, understand one, and one more.

I, Pang Lin, passed the undergraduate degree in [-], as well as graduate and doctoral students from well-known medical schools across the country. Is there anything else that can bother me?

After straightening his mentality, Chen Yu became more free and easy in an instant. He watched Lu Cheng find a set of external fixation equipment seriously, and remembered them all in his heart.

Bone fixation nail, connecting rod, connecting rod fixing cap.

Lu Cheng only took one bone fixation and fixation cap, and walked back while saying, "Pang Lin, bring seven more here."

"We need to put three fixation nails on the proximal and distal ends of the fracture at the same time, and then form a triangle to put two fixation nails,"

"After connecting with two connecting rods, two stable incomplete triangles are formed, which can achieve the best fixed position."

Pang Lin nodded frequently, and quickly got the two connecting rods and the remaining seven fixing nails and fixing caps.

Lu Cheng had already connected the fixing nails to the electric drill, and he had already used a sharp knife to make the holes that needed to be driven into the nails at the same time, so he said, "Pang Lin, I'll put the upper and lower two first, and then I'll give you the rest." Let's fight!"

"Okay!" Pang Lin took a deep breath and stopped saying thank you.

Now Lu Cheng has become his teacher, not his classmate.

"When placing the fixation nail, we must pay attention to inserting the needle perpendicular to the bone cortex, and choose the position in the front of the tibia, from front to back, so as to avoid hitting nerves and blood vessels, but we must pay attention not to hit the outside of the tibialis anterior muscle. , because this is where the anterior tibial artery takes its shape."

Pang Lin still remembers the basic anatomy very clearly,

Watching Lu Cheng accurately insert the nail into the bone, stop inserting the nail immediately after two breakthroughs, and then use the special handle to completely bury the screw thread of the nail under the skin. The fixed effect.

Pang Lin became a little more active this time: "Brother Xiao Cheng, I can see clearly, it should be fine."

Lu Cheng explained in detail again: "Okay, then you can drive the remaining two nails on the distal end of the tibia first, remember to be in a straight line with the nail I drove, and leave the position of the final fixing cap aside. .And because we want to make two semi-open triangles, the position of the fixed cap should be reserved on the inside of the fixed rod.”

Pang Lin smiled and said, "I still know this."

After speaking, Pang Lin picked up the sharp knife and cut the skin steadily with his hands, then used curved forceps to bluntly separate the subcutaneous tissue to the bone surface, and then accurately inserted the fixing nails with the electric drill.

The sound of the nail rubbing against the bone kept ringing, but Pang Lin didn't even shake his hand, and focused on the change of the sound.

After two breakthroughs, he stopped immediately, and then used the handle to feed the pin into the tightest position.

After doing this, he breathed a sigh of relief. In fact, it is not that difficult to put on the external fixation bracket.

With the first nail, the second nail was easy. He carefully looked at the X-ray again, and after confirming the location of the fracture, he took a place about 3cm below the fracture line and broke the skin again...

Six minutes later, Pang Lin finished six nails on the front of the tibia.

Lu Chengcheng said: "Let's put up the fixing cap and the connecting rod first. Fix one side well, and then drive in the remaining two fixing rods from a direction about 45-90 degrees to the side of the connecting rod now. Nails, and then fix the connecting rod."

"Okay!~ This fixed cap looks easy to put on. Let's do it together. This will also save the patient's operation time." Pang Lin said.

Although he is practicing, the first principle is to reduce the patient's operation time.

The most critical part of the upper external fixation bracket is the position selection of these few nails. He has already done it, and there is no need to make the patient suffer more, prolong the operation time and cause more bleeding.

Although the time is longer and the extra tens of milliliters of blood has no effect on the patient, it is unnecessary time.

Lu Cheng was quite relieved when he heard this. He was also a little worried that Pang Lin would completely ignore the operation he was doing now in order to practice. The object of the operation was a patient. real people.

After the two quickly installed all the external fixation brackets, they started debridement again.

The debridement operation was quite simple. The two people basically operated in separate areas at the same time. Although Lu Cheng gave Pang Lin a sweep of his tail in the end, it also saved the operation time again to a certain extent.

It wasn't until the VAC was connected to the negative pressure suction that the patient passed the bed to the push bed and could be sent directly to the department. Then Pang Lin smiled heartily and said, "Brother Xiao Cheng, this feels really good."

"Oh? Are you okay?" Lu Cheng looked at Pang Lin. What he saw in him was the temperament of an ordinary medical student.

The excited and happy expression at this moment can't be concealed at all.

This should be the first operation in which he actively participated in the most critical operation.

And he also noticed that Pang Lin's operational ability and talent are not bad at all, but he usually gets too few opportunities;

Perhaps in the fourth orthopedic ward, he can already cut a simple cyst alone under his own teacher, but compared with the three types of open fracture surgery, the sense of accomplishment is completely incomparable.

Pang Lin's hands are also very steady, basically not shaking much. Such a chief surgeon has a strong psychological quality. After working in the future, he will

Definitely an excellent surgeon too.

If he didn't have the help of cheats, he would only be slightly better than him by a negligible little bit at most, and definitely not by a lot.

Just a slightly better ordinary person.

"Yes, it's no wonder my master always said that only emergency surgery can train people the most. Only after getting the tempering of emergency surgery can we better carry out other elective surgeries. I was skeptical before, but now I am finally Got it."

"But I'm still a little tired." Pang Linhan smiled and wiped the sweat from his brow.

Wang Xiaoyang attaches great importance to clinical teaching.

It was the first time I put on the external fixation bracket. If I was not nervous, I must have pretended it. In fact, my forehead was already covered with fine sweat.

The two were talking, and another person walked in from outside. It was Zheng Liu who had put on the surgical gown and surgical cap. When he saw that the patient was no longer on the stage, he suddenly "excused" in surprise .

"You two can do it, the external fixation bracket and VAC are all finished?"

Talking and looking at the time, it will be done in a little more than an hour.

Lu Chengcheng said: "Pang Lin has a good foundation, and he worked with me separately, which saved a lot of time."

After hearing this, Zheng Liu also looked at Pang Lin, and said, "Is it Teacher Wang's student?"

"It's really great."

"But it's also just right. Two more sets came tonight. I'm still planning to call the assistant class. Now that you two are done, let's move on to the next one."

"I'll do the finger amputation, and you can get a debridement and exploration machine."

"Neural investigation, can it be done?" Zheng Liu asked Lu Cheng.

Lu Cheng frowned when he heard the words, while Pang Lin opened his mouth even more. Today may not be too busy.

Lu Chengcheng asked: "Mr. Zheng, which nerve is it probably? How is the patient's soft tissue?"

Zheng Liu said: "It could be the femoral nerve or the popliteal nerve. Anyway, the patient can't move his feet now."

"Well, I'll go with Pang Lin to have a look. If it's really not possible, I'll call you and you call someone over. I can't guarantee anything about the neurological examination." Lu Cheng quickly replied.

Neural probing, sounds like checking, just a probing, but is it that simple?
But Lu Cheng didn't dare to wrap it up like this.

Hearing what Lu Cheng said, Pang Lin felt weird instead. With Lu Cheng's current strength, should Zheng Liu come to help?

……

After about an hour and a half.

Lu Cheng and Pang Lin walked out of the seventh operating room, and then sat down directly outside the operating room.

Emergency surgery is generally arranged from 1-10 operating rooms.

This is already the fourth emergency operation performed by the two of them.

The first one was an open fracture, the other one was an exploration of the common peroneal nerve, the other one was debridement of the buttocks, and the one just finished was a tendon suturing of a hand trauma.

With high-intensity operation for a long time, although the operation time has been reduced, the workload will not be reduced at all.

Especially the tendon suturing of the last one was operated by Lu Cheng throughout the whole process. The number of sutures was at least 100 stitches in total, which was a test for the eyes and hands.

Now Lu Chengcheng still feels a little twitching pain in his index finger and little finger.

Pang Lin sat for a while, then got up again and said, "Brother Xiao Cheng, sit down for a while, I'll go buy some drinks, we need to replenish some energy."

Lu Cheng said: "I'll go and you can rest for a while."

What Lu Cheng actually thought in his heart was that I am the one who gets the salary, and what you get is the subsidy, which is [-] a month. If you want to buy drinks, I am the one to buy them.

But the words are irritating.

Pang Lin said: "What are you talking about? Brother Xiaocheng, you have always been the main force. I am a soy saucer, so I should run errands, and today's harvest is really too big. It is not too much to buy a bottle or two of drinks, and Brother treats you to a few meals, there is no pressure."

"To put it bluntly, there are so many students in our year, and you and I are the only ones in Hunan Province. This is fate."

After speaking, Pang Lin walked away.

At this moment, the itinerant nurse from the six operating rooms also came out to get consumables. Seeing Lu Cheng sitting at the door, she asked with wide eyes, "Are you finished again?"

Lu Cheng raised his head and grinned: "Yes, sister Yuan."

The itinerant nurse was also Tian Yuanyuan who was on duty today. When Jiang Ting, who was on duty in the operating room before, was not around, she helped connect the suction device and electric knife, so Lu Cheng knew her, and she also knew Lu Cheng.

She immediately covered her forehead: "Which god are you? Can you show some respect to emergency surgery?"

"To do three sets in two and a half hours, we are almost driven to death by you on tour."

"Ah? Who? Who did three emergency services in two and a half hours?" When Tian Yuanyuan said this, a man in green and blue hat just came out of the operating room.

Tian Yuanyuan said unabashedly: "This perverted orthopedic general is hospitalized. Their orthopedics department has occupied two operating rooms today. The other one has only had two severed fingers connected until now. He has finished all three."

"It's not a minor operation, it's an open fracture."

"A nerve exploration machine explored all the way from the femoral nerve to the superficial peroneal nerve."

"And the one that just ended was about suturing the tendons of four fingers. It took 46 minutes."

As Tian Yuanyuan said, she also complained: "We went to get sutures and took a total of 23."

The man in green clothes and blue hat was shocked when he heard that there were 23 sutures, and asked: "Is it real or fake?"

23 needles, even if it is sewing, it may take more than an hour to sew, but Lu Cheng completed the sewing and all operations in two and a half hours.

Tian Yuanyuan exaggerated: "How could it be fake? If you don't believe me, ask Tingting, she was almost tortured to death by him."

Lu Cheng also apologized a little apologetically: "Isn't it because I want everyone to get off work early, sister Yuanyuan, don't criticize me."

Tian Yuanyuan felt embarrassed when Lu Cheng said this, and said sincerely: "Am I scolding you? I am praising you, sincerely."

"If you weren't so strong, we might not be able to survive tonight. At least until the early morning."

After listening to Tian Yuanyuan's words, the green-clothed and blue-hat couldn't help giving a thumbs-up and said, "Brother, you are cruel enough to be a human being!"

"It simply doesn't give us emergency workers a way to survive. Three Category III surgeries in two and a half hours!"

"It's really cruel."

"How about drinking? Do you smoke?"

"Do you want a betel nut?"

Lu Chengcheng said: "Smoking and betel nuts are not used anymore. I was afraid of doing them before. I can use a little wine in the future."

Now that Lu Cheng thought of these three things, he felt disgusted.

He hurriedly said: "Then what are you waiting for, let's go,"

"It's okay if you can drink, but if you don't smoke, you will lose something,"

"Betel nuts and cigarettes bring boundless joy. Mixing cigarettes and wine makes you happier. Betel nuts and wine make you have everything in your dreams."

Lu Chengdao: "What do you call teacher?"

Lu Cheng is the boss of the class. When he meets the boss of another department, he must be right if he calls out to the teacher.

"Urology, Zhou Ziyu."

"What chicken feather teacher, when did your orthopedic department learn such a way of burying people? Everyone is a hard-working person in mining. You can just call me Tzuyu. Are you the new chief hospitalist?"

"The surgical system has never seen you before." Zhou Ziyu is very good at talking.

"My name is Lu Cheng. I'm the new head attendant. I may be quite angry. I encountered four emergency rooms when I first started. I usually have nothing to do." Lu Cheng followed Zhou Ziyu down to the locker room.

Zhou Ziyu stopped holding the betel nut, looked at Lu Cheng seriously, and then continued: "That's ruthless! Little brother, you are not a human being!"

(End of this chapter)