Chapter 265: Unintended impact
The surgery began. With Superintendent Ouyang so angry, the general surgery director and urology director both obediently participated in the surgery as Zhang Fan's surgical assistants. Although Superintendent Ouyang hadn't told them specifically to participate in the surgery, both did so in order to avoid her being angry at them.
The proctology director felt really awkward now. It was difficult for him to proceed or leave here. He awkwardly rubbed his hands and glanced at Superintendent Ouyang. Although he was a coward who had easily been frightened by someone else, he was still a department director and Superintendent Ouyang's subordinate, wasn't he?
With a chilly expression, Superintendent Ouyang told him, "Why aren't you going back to work? Why are you still standing here? You want me to issue you a reward?"
"Okay! Okay! Superintendent, I'll go back to performing outpatient services right now." The proctology director wiped away the sweat on his forehead as he left. He was under significant pressure. He had lost everything he had in his divorce from his ex-wife for the sake of being with his younger and prettier new wife. The more he cared about something, the more he didn't dare to do too much!
Superintendent Ouyang then turned around and told the local businessman, "Wait for the news! Greet the secretary-general for me." Superintendent Ouyang then immediately left. She completely ignored the other members of the Hong Kong businessman's party.
The border province businessman had a dark expression. He didn't know anything about medicine, but he did know that the older a doctor was, the more experienced and skilled the doctor would be. Of course he would have a dark expression since Superintendent Ouyang had such a youngster be the primary surgeon. Normal people in such a situation would either think of a method to beg or be absolutely furious.
Although this local businessman's expression was dark, he didn't say a thing. He was thinking of any method that he could use to improve the situation. He was thinking of who he could contact that could pressure Superintendent Ouyang, as well as planning for the worst. What would he do if Chasu City Hospital really did fail to save this Hong Kong businessman's life? How could he protect himself? Maybe this was the difference between the border province businessman and an ordinary person.
Meanwhile, the doctors and nurses in the operating room were all tense. Anesthesiologists would dislike this type of patient the most as in addition to performing anesthesia, they would have to pay attention to the patient's vitals at all times.
The surgery began. Zhang Fan and the two directors began the surgery in an orderly manner. For this type of surgery, as long as the abdominal organs weren't damaged, the surgery really would be quite simple. All that would be needed was to repair the anus. However, since the abdominal organs were also damaged, then the internal bleeding had to be stopped first before the traumatic injury could be dealt with.
Zhang Fan cut open the abdomen and began exploring. For this surgery, speed was absolutely of the essence. The patient was already losing blood to begin with. Now, by cutting into the body, his blood loss would become even more severe, which was why speed was so important. Zhang Fan didn't say anything as he swiftly entered each layer of the body. The two directors were excellent surgical assistants for him. They were both at the level where entering the human body from the abdomen was like an action that was deeply imprinted in them!
Abdominal exploration surgery required the surgeon to be swift, precise, and gentle. There were critical parts of the body that needed to be checked in a specific order in order to prevent missing anything. It was especially important to check certain well-concealed organs.
After opening up the abdomen, what was inside would be used to determine what type of organ had been injured. After cutting open the peritoneum, if there was a large amount of abdominal bleeding, that meant that either parenchyma or a major blood vessel had been damaged. If there were gases or digested food in the abdomen, that meant the gastrointestinal tract had been damaged. If there was any bile-like liquid in the abdomen, that meant there was damage to the biliary system or the duodenum. If there was fecal liquid or a fecal smell, then that would indicate injury to the lower ileum or colon. If there was pee or the smell of pee, then that would mean damage to either the ureter or bladder.
When Zhang Fan opened up the lower abdomen, pee started directly pouring out! Pee mixed with blood directly started to pour out.
Zhang Fan told the medical equipment nurse and anesthesiologist, "Raise the blood pressure! Gauze! Get another one-time-use medical bedsheet!" Since the pressure in the abdomen had suddenly disappeared with the release of this fluid, that would sometimes cause blood pressure to rapidly decrease. Zhang Fan had to be on guard against this.
"This patient is really so unlucky. Not only did he get penetrated right in the anus by the wooden stake, the stake even broke a blood vessel and damaged his bladder. Don't you agree that he's so unlucky?" general surgery Director Zhao Quanping commented to urology Director Li.
The lower-ranking doctors didn't really mind performing surgery together with Zhang Fan. He wasn't the talkative type during surgery, so nobody else would say anything during surgery. However, the higher-ranking doctors would always feel uncomfortable while performing surgery together with him. Not only was Zhang Fan ridiculously fast, he was always incredibly focused and would never say anything unnecessary! Even the doctors who liked to chat during surgery would feel rather awkward about talking because of this.
"This patient seems to be really rich. Why not do more fun things with his money? Why does he insist on running into a forest instead? Isn't this just looking for trouble for his anus? He probably won't be able to eat any spicy food for at least half a year!" Director Li commented.
"Southern Chinese people don't like to eat spicy food!" Zhang Fan ended the two older directors' chatting right there. He hated it when others chatted during surgery. He had picked up the habit of being completely silent because of all his practicing surgery by himself in his System.
Before, Zhang Fan wouldn't have the right to care about others chatting during the surgery, but the current Zhang Fan was more than skilled enough to be allowed to care!
When dealing with internal organ damage, the principle was to "first stop the bleeding, then fix the damage." The large amount of blood within the abdomen needed to be swiftly drained. Zhang Fan used his hand to clear the blood clot, and then he examined each parenchyma, one by one. Luckily, men had fewer organs in the pelvic cavity than women did!
After the blood and pee in the pelvic cavity were drained cleanly, Zhang Fan gently flipped over the bladder and located the bleeding vein! He immediately blocked the bleeding with his fingers! His finger finally blocked the blood which had been spurting like a water fountain!
"Hurry! Drain the blood!" Zhang Fan's speed was ridiculously quick. The two directors had still been searching for the point of bleeding, while Zhang Fan had already stopped the bleeding with his fingers.
General surgery Director Zhao swiftly drained the blood while Zhang Fan began the ligation. For this type of ligation, it would be a huge taboo to blindly perform ligation while there was still blood obscuring the vision.
While Director Zhao was preparing gauze for pressure dressing, Zhang Fan already began to apply hemostatic forceps.
"Be careful! Blood vessels!" Director Zhao started panicking. He knew that blindly performing ligation would easily result in damaging perfectly healthy blood vessels because the tissue and blood circulation system were quite abundant in this area. Not only that, large veins would be accompanied side-by-side by large arteries. Basically, the vein would be adjacent to an artery. The distance between them would usually only be a few millimeters.
It was quite common that a healthy blood vessel might accidentally be damaged even when the surgeon had a perfectly clear field of vision. Things would be far more dangerous during blind ligation! The moment that Zhang Fan applied hemostatic forceps, both directors broke out in a cold sweat!
This was because both of them were highly knowledgeable regarding this location. If the hemostatic forceps accidentally damaged an artery, the patient would basically die instantly. It would be unimaginable to try and maintain the patient's blood pressure after damaging a major artery!
With a clipping sound, Zhang Fan affixed the hemostatic forceps, and announced, "Let's drain the blood!"
"You absolutely can't let go right now!" Director Zhao's hands were beginning to tremble. He then immediately told the medical equipment nurse, "Hurry, go bring hemostatic cotton, a large amount of hemostatic cotton!"
Zhang Fan was rather surprised to hear this! "Why do we need hemostatic cotton?"
"You probably broke an artery with the way that you applied the hemostatic forceps! Why do you think we need hemostatic cotton!" Director Zhao was both really angry and anxious! He originally felt that Zhang Fan was really skilled and reliable at performing surgeries. He hadn't expected that Zhang Fan would make such a low-level mistake!
'Sigh! He's still too young!' Director Zhao felt that it was such a pity!
"Haha!" Zhang Fan chuckled and was about to say something, but Director Zhao interrupted him. "You're still laughing? Get off the surgery! Properly self-reflect! Give me the hemostatic forceps!"
Zhang Fan was still holding on to the hemostatic forceps. Director Zhao would have long since grabbed it out of his hands already if it weren't for the fact that the forceps were already affixed to a blood vessel. Director Zhao felt that Zhang Fan was acting ridiculously! This was a surgery! How could Zhang Fan just perform blind ligation before the blood was even completely drained!?
This was actually a difference in skill level, all thanks to Zhang Fan's System! For normal experience gained during surgery, even a surgeon with experience performing more than 500 surgeries on this exact same location still wouldn't dare to perform blind ligation. Yet, Zhang Fan dared to perform blind ligation, even in locations where the blood vessels were even closer together! This was all because he had practiced so much in his System that he had memorized every blood vessel's location!
Not a single other person in the world had the opportunity to practice like he could. Other surgeons would have to wait for patients with the right conditions to practice. Meanwhile, Zhang Fan was capable of practicing any time that he wanted as long as he had the time and was willing to work hard! Of course his experience level would be tremendous!
"There absolutely won't be any bleeding! I definitely accurately pinched the bleeding point without damaging any artery!" Zhang Fan had shown this skill of his in order to stop the bleeding as fast as possible!
"Ridiculous! Get off the surgery!" Director Zhao was truly furious!
Meanwhile, Zhang Fan was no longer in any hurry. There was nothing more to be worried about for this surgery now that the blood vessel had been ligated. "Director Zhao, I really did stop the bleeding. I absolutely didn't damage an artery!"
"You're refusing to get off the surgery!?" Director Zhao's face was becoming pale with anger! He was so angry because he couldn't stand for any doctor treating the patient's life as a joke!
Since it seemed that no ordinary method would calm down Director Zhao's anger here, Zhang Fan paused for a moment, and then declared, "If an artery broke here today, I'll take full responsibility. Not only that, I'll never perform surgery again in my life!" Zhang Fan stated this quite formally and seriously in a solemn tone!
"Oh!" Director Zhao finally calmed down when he heard this. He knew Zhang Fan's medical skill level quite well. He had never witnessed Zhang Fan behaving rashly before! Director Zhao didn't want to destroy the career of such a promising excellent young doctor.
"What if Doctor Zhang successfully performed ligation without injuring an artery?" commented urology Director Li. He was far calmer because he wasn't involved in the argument. He also had a different personality from Director Zhao.
"Haha, that will depend on Director Zhao, then!" Zhang Fan glanced at Director Zhao and spoke again since someone else was supporting him.
"What do you mean?" Director Zhao's tone was still rather unfriendly, but his expression was already improving a little. His angry glare had also softened a little.
"If I didn't injure a blood vessel today, then you'll have to open up all general surgeries to me in the future, along with explaining the reason to the other doctors for me. Director Zhao will have to personally explain things to them on my behalf!" Zhang Fan exclaimed while taking needle and thread, preparing to begin the sutures!
"Oh!" Director Zhao was truly astonished. He kept staring at the hemostatic forceps. Zhang Fan had already finished cleaning the remaining blood in the area by now!
"Needle and thread!" Zhang Fan ignored Director Zhao and immediately began to suture the blood vessel. A moment later, Zhang Fan removed the hemostatic forceps and used gauze to gently dab the area. The gauze remained completely clean!
Zhang Fan hadn't been intentionally trying to make things difficult for Director Zhao. This was an excuse to calm the latter's anger! Zhang Fan was impressed with doctors like Director Zhao, who really cared about the patient's condition more than friendship between coworkers. It was really impressive how Director Zhao had been willing to get angry at such an outstanding youngster. As the saying went, never look down on hardworking youngsters! Not to mention, Zhang Fan had already shown his skills!
A genius would be given special treatment in any workplace. A genius who made a mistake would also be forgiven more easily. However, this was the medical field!
If the general surgery director wasn't here working on this surgery today, and only the urology Director Li had been assisting Zhang Fan instead, even if Zhang Fan had broken the patient's blood vessel, the urology director wouldn't have gotten angry! He would have even helped to cover things up for Zhang Fan's sake! This was all because Zhang Fan was a genius! Director Li really did have a different personality from Director Zhao!
So, even though Director Zhao had gotten angry at him, Zhang Fan didn't mind at all. He viewed doctors like Director Zhao as his role models. Although Director Zhao wasn't able to control his three vice directors of general surgery, his caring attitude towards patients made him a true doctor!
After Zhang Fan finished swiftly suturing the blood vessel, he prepared to first repair the rectum, since the rectum was more contaminated than other places. Repairing the rectum swiftly would also help to cut off potential infection!
"Metronidazole rinse!" Zhang Fan told the operating room nurse.
"Oh!" Director Zhao felt somewhat awkward, but he didn't regret his anger at all. He gently touched the ligated blood vessel, but didn't need to confirm anything, as there was already no more bleeding!
"Even though you didn't injure an artery today, what you did isn't something amazing at all. You only sped up the ligation process by a few seconds. Why didn't you wait for the blood to be drained so that you could have a clear field of vision for ligation? Of course you understand already the consequences of breaking an artery? Letting the vein bleed for a few more seconds versus breaking an artery. Which is riskier?" Director Zhao was a department director, so of course he would be skilled. Not only did he scold Zhang Fan, he also managed to dissolve the awkward atmosphere!
Zhang Fan truly was unable to explain himself. Was he supposed to say that he was that confident in his own skills? If he really said something like this, Director Zhao would instantly try to kick him off the surgery again. This was performing surgery, not a dance performance!
Urology Director Li spoke up here. "Director Zhang definitely had a guarantee. Don't you see how he wasn't worried even the slightest? This is his skill. It's truly impressive!"
"Hmph!" Director Zhao was unable to say anything more! The surgery now proceeded far more smoothly after the bleeding was stopped. After rinsing with a large amount of metronidazole, the wooden stake could now be gently removed.
The operating room nurse held on to the wooden stake with her gloved hand after it was removed. She stared at it in some astonishment, and commented, "It's so thick!"
"Hahaha!" The urology director and the anesthesiologist both laughed out loud at this. "Yes, it's pretty thick!"
"Annoying!" The operating room nurse's face reddened. She realized that she had said a double entendre.
"Zhang Fan, how about you come over to the general surgery department? I can give you full authority to pick any type of general surgery that you like!" Director Zhao tried for the second time to recruit Zhang Fan! After Zhang Fan showed off his skills this time, Director Zhao contemplated his skills and was truly astonished! Incredibly astonished! Zhang Fan was far too skilled!
"Haha, I doubt that Director Gao would let him go so easily," Director Li said rather tauntingly.
"Does it have anything to do with you? Why do you think you get to have a say!"
"Haha, you're not even embarrassed in your old age!"
Since the surgery was really successful, the two directors were now much more relaxed with their tones. Still, Director Zhao really was still rather afraid of the potential consequences. Zhang Fan's blind ligation had been far too scary. Had he been off even slightly to the left or the right, or if his hand had shaken just a little, he would have broken the internal iliac artery! Director Zhao glanced over at Zhang Fan, feeling so many different conflicting emotions in his heart!
Zhang Fan finished repairing the rectum. He examined the abdominal walls and didn't find any tearing. He then continued with the surgery. At this time, he needed to switch his gloves since the rectum had been a contaminated area, while the bladder was relatively clean.
The bladder was quite easy to sew. The bladder was rather stretchable, just like a basketball bladder. Zhang Fan first sewed the inner layer, followed by the outer layer. There wasn't even much to pay attention to regarding sewing the bladder. There wasn't any blood vessel or nerve that the surgeon would need to be careful about. The most important point was simply that there couldn't be any leak after the sewing was finished!
The last part of the surgery was to repair the anus! This was quite troublesome. Although the wooden stake was round rather than being a polygon, it had still torn the anus! Zhang Fan had to sew things up slowly. He sewed up the sphincter muscles!
"Dear Directors, which department should this patient be assigned to?"
"Place him in the general surgery department!" answered Director Zhao.
Zhang Fan had actually originally wanted to place the patient in the urology department as the urology department would have fewer patients. However, urology Director Li didn't want to take the patient, because he was afraid of his ex-girlfriend, Superintendent Ouyang!
The surgery was now finished. As Zhang Fan was the primary surgeon, he had to take the wooden stake and go talk to the patient's retinue. Outside the operating room, the Hong Kong businessman's personal assistant, bodyguards, and the border province businessman were all waiting for the surgery's results. They were all ignoring each other!
The local businessman had been really anxious before the surgery began. He tried calling everyone he could think of who might be able to pressure Superintendent Ouyang. He ended up calling Li Xiao!
Li Xiao heard his worries, and immediately asked, "The primary surgeon is Doctor Zhang, Zhang Fan?"
"Yes. I've found out quite clearly that he's just a young doctor who joined Chasu City Hospital less than two years ago! Please save me, President Li! Hurry and help me think of something! Otherwise, I'm dead for sure!"
"Relax, it won't be a problem at all. You can just wait assuredly!" Li Xiao was no longer worrying at all once she heard that Zhang Fan was the primary surgeon. She had a good relationship with this local businessman, so she had originally intended to go to the hospital, but she sat back down again in her home after hearing that Zhang Fan would be performing this surgery.
"What is it?" the local businessman also could tell that something was up.
"Superintendent Ouyang really is giving face to the secretary-general. That young doctor is the most skilled doctor in their hospital! The most skilled doctor! Understand?"
"Someone like him!? He's still so young!" The local businessman didn't believe this at all!
"That's right! He really is their most skilled doctor! Be polite to him when you meet him! He's really amazing!"
Even after the local businessman hung up, he still didn't really believe this. He found it far too inconceivable that someone so young would be Chasu City Hospital's best doctor. The local businessman did know at least the very basics about how the medical field, after all.
Thus, he decided to call Professor Chang, the professor who had lost a severe amount of face when he acted really rude at Chasu City Hospital!
"Professor Chang, do you know about Chasu City?"
Professor Chang had long since moved far away to inland China in order to escape his humiliation. He trembled all over when he suddenly heard Chasu City being mentioned!
"Yes, what about it?"
"Do you know Doctor Zhang, Zhang Fan?"
"That little brat! Did he say something about himself being incredible and my skills being terrible!? I was just overconfident, do you understand!? I was merely overconfident!!" Professor Chang was so angry that he even started frothing at the mouth! He felt that he had already ran so far away to inland China, yet Zhang Fan was still trying to humiliate him!
Professor Chang had accidentally taken an unintended impact!