Great Doctor Ling Ran
Chapter 68 - Someday, With the Scalpel In My Hand
Panda Novel
The following day.
It was the day of the surgery.
Lu Wenbin was the first one to enter the operating theater. He had completed all his tasks from draping to inspection when Ling Ran and Huo Congjun came.
Huo Congjun appeared poised.
Ling Ran appeared elegant.
Lu Wenbin was extremely stressed.
“The patient, Li Xingguo, is twenty-one years old. He has an open wound, and the flexor tendons of his index and middle fingers are ruptured. Both the flexor digitorum profundus and flexor digitorum superficialis of his middle finger are ruptured. It’s rather complicated…” Since Lu Wenbin had read the information beforehand, he explained it to the others.
Ling Ran had read it too, so he pondered as he listened to what Lu Wenbin said. His expression could not be deciphered.
Huo Congjun exhaled. This was the only kind of patient he could find that day.
The location of the wound was known as no man’s land, because the tendons in that area of the hand were too closely-packed. Both the flexor digitorum profundus and flexor digitorum superficialis were bound in narrow tendon sheaths. Adhesion was a serious postoperative problem, and it was not an ideal situation for the recovery of hand function.
Now, the fact that both the flexor digitorum profundus and flexor digitorum superficialis were injured meant that there was more activity in both of them, making the probability of adhesion even higher.
But all these were not a problem for Ling Ran.
For someone who possessed the Master Level M-Tang Technique, treating the flexor digitorum profundus and flexor digitorum superficialis at the same time was only a basic procedure.
Ling Ran checked everything according to sequence and palpated the wound a few times. He then nodded and said, “Let’s get started. Repair of a ruptured flexor tendon in Zone II… Pen.”
The moment Ling Ran stretched out his hand, the focused Wang Jia placed a surgical skin marker pen in his palm. She did it in a way that it was extremely comfortable for Ling Ran to receive the pen. She was most probably specially trained for this.
Wang Jia looked at Ling Ran. She could vaguely see a smile behind Ling Ran’s mask, and it made her extremely happy.
Huo Congjun wanted to be the one making the incision. But he only thought about it; he did not voice his thoughts out in the end.
Higher-ranking doctors often rewarded the lower-ranking doctors by giving them a chance to make an incision. There was no reason for it to be the other way around.
Besides, Huo Congjun could not just help Ling Ran with the incision every single time. In the end, Ling Ran would have to practice making incisions by himself.
When Huo Congjun thought of that, he looked at Lu Wenbin.
Lu Wenbin was the Emergency Department’s resident doctor no matter what. Even though he did his housemanship in another hospital for about two to three years, he was just like a sheep that was let out from the farm to graze. When it was time for the sheep to be milked and sheared, it would have to return to the farm. Moreover, since Lu Wenbin just finished his housemanship, this was the golden period for him to elevate his skills…
Lu Wenbin’s performance in the previous surgery was not bad.
After the surgery, he was also very diligent when it came to the patient’s prognosis.
If Huo Congjun were truly the chief surgeon, and Ling Ran the first assistant, Huo Congjun would most probably choose to let Lu Wenbin make the incision. When he thought about it, no matter how badly Lu Wenbin was at the job, it could not be worse than the incision Ling Ran made during the previous surgery…
There were only three people in front of the operating table. Lu Wenbin immediately noticed that Huo Congjun was looking at him.
Was it a good or bad thing to have the department director pay close attention to you?
Lu Wenbin’s heart beat more rapidly.
The thing he looked forward to the most was for Ling Ran to give up on making the incision and pass the task to him.
If the director had spoken in his favor, he would have the job without question.
Lu Wenbin was not greedy. He was only subconsciously thinking about how Ling Ran was not scrambling to practice his incision skills the day before. Lu Wenbin thought that Ling Ran had either given up on practicing, or he was so bad in this field that he gave up on it because he knew that he was just not good at it.
Thus, it seemed logical for Ling Ran to pass the task of making the incision to someone else.
Lu Wenbin only became slightly calmer after he thought about how the testicle of the middle-aged man involved in the skateboarding accident yesterday came out of his scrotum.
“Pull the skin taut.”
Lu Wenbin only realized that Ling Ran had already drawn the line when he heard Ling Ran’s command.
‘Didn’t he need to hesitate at all? Or did he think about it beforehand?’
Even though Lu Wenbin muttered to himself about it, he quickly got to work and flattened the patient’s slightly curled up hand so that the portion with the line protruded.
Lu Wenbin only realized upon doing this that the position Ling Ran chose was not bad. The act of expanding the surface of an existing wound was a very contradictory choice to begin with. It was not easy to come up with a reasonable scheme every time.
If you were to compare surgery with renovating a house, the patient’s existing wound would be like a load-bearing beam in the middle of the house that you could neither remove nor alter it. You could not even drill a hole in it. And the position of the beam could be different in every house. To renovate the house well, you would have to manage the relationship between the spaces in the house and the load-bearing beam well.
A perfect scheme may not even exist. It would take some effort to even come up with a relatively reasonable scheme.
Ling Ran sunk the scalpel into the patient’s skin.
He held the scalpel like a violin bow. It was a basic technique, which was not garish in any way.
But Ling Ran only took a minute or two to expose his desired surgical field.
Lu Wenbin stared at the incision in astonishment while he helped to adjust the saline-soaked dressing to prevent contamination.
Ling Ran, who still had to make two incisions a few days ago, became a master in making incisions in the blink of an eye?
Based on his experiences from his two-to-three-year experience on clinical rotation in Yun Hua Hospital’s various departments, Ling Ran’s skills in incision right now were exactly the same as higher-ranking doctors in most of the departments.
“Have you been practicing making incisions lately?” Huo Congjun looked even more shocked. This was the only reasonable explanation he could think of.
“Yes.” Ling Ran nodded. He did try a few times.
Huo Congjun was speechless.
He thought that he had seen a lot. Little did he know that it was still not enough.
If someone had told him prior to this day that a person could become a master in making incisions after practicing diligently for only three days, he would have definitely sprouted a lot of curses at the individual.
Or did Ling Ran purposely perform below par the previous time he made an incision?
It sounded pretty reasonable when Huo Congjun first thought of it. But from what he could remember, Ling Ran’s movements were all over the place the last time he made an incision, and it did not look like he was performing below par on purpose.
“Retract the skin,” Ling Ran gave Lu Wenbin a simple command.
Lu Wenbin who had been using the retractor for years naturally picked up the skin retractor and expanded the newly-made incision.
The two tendons were clearly exposed.
Even though it was vital to have your movements smooth and neat when making incisions, the most important thing in making incisions was still to facilitate the expansion of surgical fields.
In this respect, Ling Ran’s incision was considered to be very well done.
At least, Lu Wenbin could not find any fault in it. It was also impossible for him to make such a good incision.
Lu Wenbin could only feel a tightness in his chest as he remembered how he thought of Ling Ran as arrogant yesterday. Little did he know that Ling Ran had all the rights to be arrogant.
Even though no one knew what Lu Wenbin was thinking about the day before, he felt strangely guilty. He let out a hollow laugh and said, “At this speed, laymen will think that you’re using a hack.”
Ling Ran smiled a little.
“Why does other people’s opinion matter?” Huo Congjun had recovered from his initial shock, and was happily cracking a smile. It was so big it looked like his face was being cut open.
What did the hospital need? What did the department need? What did the department director need?
Did they not need someone like Ling Ran?
The medical journey was a long one. While doctors who took three years to practice suturing, three years to practice making incisions, three years to learn how to perform appendectomies, became associate chief physicians at forty-five, and finally became chief physicians at fifty-five were the backbone of the hospital, they were only like junior officers and company-grade officers in the army. Even though the hospital valued and needed the regiments formed by junior officers and company-grade officers, they did not need any particular junior officer.
The only type of doctor the hospital always sought for was doctors who could lead, or rather, the so-called pioneers.
They were either one of the best in the regiment, standing head and shoulders above the rest, genii who were tutored by legends, or little darlings who descended from the sky.
An example was Wu Mengchao. He was the ace of the hepatobiliary surgical field in China. Even though he only finished his undergraduate degree at an age of twenty-seven, he presented his research paper at the National Conference of Hepatobiliary Surgery and came up with the five-lobe six-segment as well as the five-lobe four-segment theory of the liver. He made a breakthrough and completed the first caudate lobectomy of the liver at the age of forty-one. While ordinary doctors were still battering their brains to become associate chief physicians, he became a renowned hepatobiliary surgical expert in the country and was hailed as the “father of Chinese hepatobiliary surgery”. Any hospital with such a pioneer could achieve great success even with their eyes closed. Of course, Wu Mengchao’s teacher was also extremely impressive. He was Qiu Fazu who was hailed as the “father of modern Chinese surgery”. All the doctors in China studied his book in medical school.
“Oh yeah, Ling Ran, I heard that you always buy pig feet with your own money to practice your surgical skills?” Huo Congjun suddenly asked.
“I’ve bought some.” Ling Ran was wearing a pair of surgical magnifying glasses. He did not slow down at all as he talked.
“You’re still an intern now. This won’t do. An allowance of a few hundred RMB a month isn’t even enough for you to buy all those pig feet, right?” Huo Congjun said seriously, “You shouldn’t have to pay for practice materials out of your own pocket. Even though the Emergency Department can’t afford to build a simulation training space right now, we should act according to circumstances and provide an environment where our doctors can elevate their skills. Don’t you think so?”
Even though Huo Congjun was talking to Ling Ran, he turned and looked at Su Jiafu who was sitting in a round chair.
Su Jiafu the anesthetist stood up very slowly and said, “Yes.”
“It doesn’t sound nice on paper if you apply for reimbursement to buy pig feet, and it won’t be easy either. Why don’t we do this? Since you don’t have a medical practitioner’s qualification cert yet, even though you act as the chief surgeon in these surgeries, my name or Lu Wenbin’s name will be in the official records. I’ll transfer the surgery fees to you after they’re banked into my account. Please don’t decline them. You deserve to be paid for your work.”
Ling Ran had no plans of declining the surgery fees at all. He answered in acknowledgment and started to perform the surgery in a focused manner.
Lu Wenbin was filled with so much envy that he did not even have the strength to retract the patient’s skin.
In the hospital, if a chief physician was recorded as the chief surgeon, even if he did not show up during the surgery, the surgery fee would still have to be paid to him as a rule. This was only a small amount of money before the healthcare reform. However, surgery fees became rather sizable after that.
This was especially true for the chief surgeons’ pay, which was more than twice the amount of the assistant, the nurse, and the anesthetist’s pay combined. With that amount of money, Ling Ran could buy as many pig’s feet as he wanted. Moreover, the money was forcibly given to Ling Ran by the department director.
Lu Wenbin lowered his head and made up his mind. ‘I’m definitely learning the M-Tang technique!’
Soon, all sorts of dishes made using pig trotters appeared in his mind: sauced trotters, stewed trotters, grilled trotters, braised trotters, spicy trotters, steamed trotters, steamed trotters with chopped pepper, red rice vinesse trotters, beer trotters, honey trotters, and trotters cooked with corn, oxtail, and bamboo shoots…
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