July 7th, Tuesday, 11 a.m.
Long County People's Hospital, Emergency Department, Wound Cleaning Room.
Lu Cheng wrapped a gauze around the right forearm of a woman in her forties, helping her stand up from the operating table: "Auntie, I've stitched it up. It's just a minor cut; luckily, it didn't injure any tendons or blood vessels. Be more careful when chopping vegetables next time."
"The kitchen knife is rusty; you should get a tetanus shot."
"You don't need to buy antibiotics from outside for this situation, but you must get a tetanus shot. Not doing so could lead to serious problems."
The woman, the owner of "Big Bowl Rice" opposite Huangcang Middle School, often cuts her hand while chopping vegetables. She's quite chatty: "I definitely need the shot. Old Niu, who runs the noodle shop opposite the vocational school, tried to save money by not getting a tetanus shot and ended up dying!"
"You'd think, as a shop owner, he'd know better than to save money this way."
The woman continued, "Dr. Lu, you graduated from Han City University, right? Your technique is really good; I noticed the stitch looks better than what other doctors usually do."
"Look at my hand."
After graduating, Lu Cheng no longer stayed in Long County; the vocational school the woman mentioned is Lu Cheng's alma mater, Long County Senior High School, though it moved locations more than a decade ago and the original site became a vocational school.
Lu Cheng wasn't sure who the woman referred to as the old boss Niu: "Thank you for your acknowledgment and praise, Auntie. The goal of stitching is simply to treat the wound; as long as it's handled properly, there's no 'better' or 'worse'. "
"After you go home, make sure the wound doesn't get wet, especially when washing vegetables. Be extra careful."
"Avoid wearing waterproof gloves; they don't breathe well and can lead to moisture and infection."
Lu Cheng knew that restaurant owners like Auntie generally run family businesses with no extra help. It's usually hard work, but after an injury, precautions must be taken.
"Sigh... I'll have to hire someone to help, which means wasting money. Our business is small, and earning money isn't easy... Dr. Lu, I'll come back later for my medical records..." Auntie sighed as she walked out.
The costs for wound cleaning and tetanus antitoxin had been prepaid.
After seeing the patient out, Lu Cheng returned to the Wound Cleaning Room, tidied up the wound cleaning kit, and checked his 'earnings statement'!
[Completed one case of suturing skill, guided patient on postoperative care, gained 0.6 Skill Points.]
[Emergency Medicine (Skilled 6/10) (+1)]
'Clinically acquiring skill points is much faster than just reading books!~'
Lu Cheng had roughly estimated the study efficiency of specialized PhD students at Xiangya Second Hospital Emergency Department based on Professor Chen Song's insights.
According to Professor Chen, their department's top PhD graduates should reach a certain competency level upon graduation, requiring mastery in at least three theoretical subjects, four basic surgical skills, two specialist techniques, and three major film reading skills at the 'Proficient' level.
Lu Cheng asked Professor Chen what proficient level meant, and Chen Song said Lu Cheng's suturing skill could be considered proficient.
By extension, that means the specialization level.
It takes about 30 skill points to progress from beginner, through skilled, to specialization, requiring a total of 360 skill points to master 12 skills.
On average, specialized PhD students at Xiangya Second Hospital gain about one skill point every twenty hours.
Lu Cheng, on the other hand, requires around thirty-five hours.
Unlike specialized PhD and Master's students who have teachers closely guiding them, Lu Cheng mostly learns from reading, with no other special guidance.
"Knock, knock, knock!~" As Lu Cheng was deep in thought, Professor Chen Song knocked on the operating room door with an urgent voice:
"Xiao Lu, are you done here? There's a car accident victim with a liver injury needing liver preservation surgery. Join me at the operating table."
"The patient has already been fast-tracked through the CT room and is about to be taken to the operating room."
Lu Cheng sped up gathering his things: "Teacher Chen, I'll write up the surgical notes, be right there."
No matter how busy it gets over there, Lu Cheng must write the surgical operation record; failing to do so would leave a 'time bomb' for himself!
It might not explode, but if it does, it'll bring trouble to Lu Cheng.
"Hurry up, this patient is in critical condition. This time, the General Surgery team in your hospital has become tight-lipped." Chen Song quickly turned away.
Lu Cheng hung his head in silence, hastening to write the surgical operation record...
When it comes to appendicitis, cholecystitis, cholangitis, the General Surgery doctors flock to them.
But faced with complex conditions, they're all keen to avoid them.
If Professor Chen Song weren't present, the likely outcome would be the patient getting a cursory glance from a General Surgery doctor before immediately getting a referral.
Whether the patient dies en route, that's beyond control.
The liver can't be entirely removed like the spleen or gallbladder to save a life; the County Hospital can't handle this liver rupture. Pushing the patient to the operating room spells certain death; no one dares admit them.
With such cases, when Chen Song says he'll manage, no one dares utter a complaint.
Once Lu Cheng finished writing the surgical operation record, he swiftly headed to the nurse's station, handing the medical record to Auntie 'the owner', and quickly turned back, still reminding: "Auntie, make sure the wound doesn't get wet! Or it will be prone to infection."
"For other precautions, you can read the medical directive I wrote for you... Remember to change the dressing..."
Auntie was getting her tetanus shot and saw Lu Cheng's hurry, somewhat puzzled: "Why is Dr. Lu running?"
"A complicated emergency case came in; Dr. Lu needs to go into the operating room."
"Fortunately, Professor Chen Song from Xiangya Second Hospital is here temporarily; otherwise, this patient would have to risk being transferred to State People's Hospital." The nurse patiently explained, then continued: "The medication is done... Did Dr. Lu prescribe you any other medication?"
"No... Dr. Lu said no special medication is required. Should I take anything else?" Auntie replied.
The nurse informed: "If there's no medicine prescribed, you can leave soon. Whatever Dr. Lu didn't prescribe means don't take it."
If a different doctor were on duty, they'd likely prescribe some pain relief or anti-inflammatory medication, but Lu Cheng didn't follow suit.
...
When Lu Cheng arrived at the operating room, the Deputy Chief Physician of General Surgery was already inside. The surgery didn't wait for Lu Cheng to start; Professor Chen had already opened up the abdominal wall.
His tone was courteous yet careful: "Professor Chen, the patient's bleeding is substantial."
"The direct impact on the right upper abdomen resulted in a liver rupture with an AAST score of grade four, necessitating immediate anatomical liver segment resection." Chen Song's tone was firm and undeniable.
Immediately, Chen Song turned to Lu Cheng: "Xiao Lu, this operation is challenging, follow directions throughout the procedure and don't act rashly."
Lu Cheng dared not, but he knew Chen Song was giving him a chance to assist, promptly responding: "Alright, Teacher Chen, I'll wash my hands and scrub in immediately..."
Then, throughout the operation, Lu Cheng and the General Surgery Deputy Chief Physician were both in a 'standing by' state.
Though Chen Song explained a lot of professional knowledge, like liver Glisson sheath anatomy, liver parenchymal clamping technique, the Pringle maneuver for blood control, hemihepatic blood flow blockade (Heaney method), and segmental hepatic blood flow blockade (Takasaki method), Lu Cheng was unfamiliar with these specialties.
Professor Chen Song single-handedly managed the critical parts of the surgery. After a full four-hour battle, Professor Chen Song completed the liver segment resection operation.
Afterward, with Lu Cheng sweating from exertion, he glanced back: "Xiao Lu, place the drainage tube and close the abdominal wall incision."
"I'll step down to rest for a bit."
Deputy Chief Physician Liang Qiao from General Surgery immediately put on a smile: "Professor Chen, you've worked hard, leave the rest to me and Xiao Lu..."
Lu Cheng obediently followed Professor Chen's orders for the follow-up, earning some assistance rewards—
[Assisted in hemostasis suturing technique, reducing patient intraoperative bleeding, slightly reducing the risk of patient shock, gained 0.6 Skill Points]
[Assisted in local debridement skill, clearing patient's necrotic tissue, reducing postoperative complications, gained 0.6 Skill Points.]
[Assisted in suturing skill, drainage skill, knotting skill, puncture skill... gained 1.3 Skill Points!]
[Current skill points remaining: 2.8]
Assisting with a boss, feeling completely insignificant, yet gaining 1.9 skill points? Equivalent to spending three days doing wound cleaning and suturing, Lu Cheng felt he got a great advantage from Professor Chen Song.
Lu Cheng felt like he was back in Zhongnan Hospital, just observing surgeries, with no thought of participating.