Chapter 206: The impact of betrayal, taking on the responsibility
The patient was brought into the operating room, and the anesthesiologist and nurse were ready.
Zhou Can helped the anesthesiologist to administer anesthesia to the patient.
"This patient is obviously malnourished. Does he need central venous catheterization and parenteral nutritional support?" Zhou Can asked the anesthesiologist for his opinion.
"Can!"
Many anesthesiologists now know Zhou Can and are quite familiar with him.
"In cases like this, dilation treatment can also be performed to allow the patient to take liquid food through the mouth."
He taught Zhou Can some ways to deal with this situation.
After listening humbly, Zhou Can began to perform various intubations on the patient.
He is very diligent in his work, which is one of the reasons why he is loved by many anesthesiologists.
When the anesthesia was almost done, He Hansheng and two residents hurried in. Then, Deputy Director Liu, his intern and two other resident doctors walked into the operating room.
Deputy Director Liu glanced at the wall clock. It was six minutes past nine.
"The operation is about to start, why are there still two people who haven't arrived yet? "
There should be six official doctors in his team.
Without two people, the place immediately seemed much quieter.
"Song Ze has joined Director Yang Qing's team, and resident doctor Hong Zhengbo has joined Director Tang's team and is in charge of the bed. They are embarrassed to tell you in person, so let me tell you."
He Hansheng seemed cautious when talking about this matter. He was very worried that Deputy Director Liu was old, and if it caused high blood pressure or a heart attack, it would be troublesome.
The two doctors he personally trained chose to leave at this critical moment and join other teams, which was a huge blow to Mr. Liu.
Their behavior is no different from betrayal.
However, everyone has the right to choose their own future, so their behavior is not against the rules except that it is somewhat immoral.
After hearing this, there was no expression on Old Liu's face.
After a silence of 20 to 30 seconds, he said, "Now is a very good time to join other teams. Each team needs to strive for more surgeries, and one more person can do a lot more work. If any of you want to leave, you must seize this opportunity. Otherwise, it will be difficult to join a team with a higher ranking in strength under normal circumstances."
The stronger the group, the more stringent the requirements for recruiting new members.
If you don't have the skills, a team like Director Yang Qing, who is ranked very high, will not accept you at all.
"Okay, let's start the operation!"
Deputy Director Liu seemed to be in a very bad mood.
People also look older.
People under sixty years old look like old people in their eighties or nineties.
Walking to the operating table and standing at the main operating position, Deputy Director Liu asked the nurse to help him put on sterile gloves and check the incision sites drawn on the patient's body.
"When you encounter this type of surgical patient, you must check whether the patient has lung infection before the operation. If so, then the operation cannot be performed." Deputy Director Liu shared valuable surgical experience with everyone.
These experiences were gained through lessons learned through blood.
There have been too many accidents among our surgical predecessors.
"In addition to checking for lung infection, we also need to pay attention to the patient's esophagus. Because food is retained in the esophagus, the esophagus is prone to varying degrees of inflammation. So I asked the attending physician to insert a gastric tube into the patient's esophagus once a night three days before the operation to clean the esophagus and inject antibiotic solution after cleaning."
Deputy Director Liu continued to share useful information.
"Three days before the operation, I followed your instructions and inserted a gastric tube to clean the patient's esophagus. I repeated it just now before the anesthesia."
Zhou Can replied.
It is done again before anesthesia to clear the secretions accumulated overnight and leave a gastric tube.
For this type of patients, pills or tablets cannot be used before surgery.
Otherwise it may be dangerous.
"Xiao Zhou's work is still very reassuring."
When Deputy Director Liu looked at Zhou Can, he finally regained a relieved smile.
Zhou Can is the most talented of all the doctors under his command.
He is very down-to-earth, diligent and studious, and makes rapid progress.
"The incision is usually made in the middle of the left upper abdomen, or a little bit to the side of the left upper abdomen, all the way to the xiphoid process."
Deputy Director Liu held the knife and began to cut open the patient's abdominal cavity.
As soon as the knife fell, his body shook.
This scared everyone.
The patient is being operated on, and this is no joke.
The doctor's knife can save lives if it is done well. But if it is done poorly, cuts to the wrong angle, or cuts too deep, it can kill people.
"Director Liu, are you okay?"
Zhou Can and He Hansheng quickly supported him.
The two of them are almost like Deputy Director Liu's right-hand men.
"Maybe I had breakfast too early this morning, and now I feel a little hungry. Han Sheng, are you sure you and Xiao Zhou can complete this operation together?"
Deputy Director Liu looked at the two of them earnestly.
This has never happened before. The reason for Mr. Liu's health problems is definitely not because he ate breakfast too early as he said.
Rather, it was the departure of Song Ze and another resident doctor that deeply hurt Mr. Liu.
When people get older, they can't stand stimulation.
Zhou Can and He Hansheng both knew the truth about this, but neither of them was stupid enough to reveal it.
"Don't worry, I have learned cardioplasty from you many times, and with Dr. Zhou's help, I will definitely be able to do this operation well."
He Hansheng comforted Mr. Liu with full confidence.
"Director Liu, please take a rest by the side and help us check and give us some pointers at the critical moment."
Zhou Can also said from the side.
"Okay, okay! I'm really old now, and it's time to retire! My only regret is that I didn't get a senior professional title. This department reform was an opportunity for me, but I didn't expect my health to have problems again. It's time and fate!"
Deputy Director Liu would never say such discouraging words in front of his doctors before.
Seeing the doctor he had worked so hard to train betray him was like a war between princes. After his trusted general betrayed him, he joined the enemy camp. The enemy became stronger, while his own side was in a miserable state.
In addition, as I get older, I feel unwell after being stimulated.
Therefore, he inevitably became pessimistic.
"Don't be discouraged. The competition has just begun, and it's too early to decide who will win. Trees shed their leaves in autumn and quietly accumulate strength in winter. When spring comes, they are still in full bloom. You are not fighting alone. There are so many of us who are following you in this battle."
Zhou Can felt very upset when he saw that Mr. Liu had suffered a severe blow.
He secretly made up his mind that this time he would fight with Old Liu.
In the emergency department, Zhou Can once performed more than a thousand surgeries per month.
What is the concept?
The annual number of surgeries performed at Tuya Hospital is only over 100,000.
If he performs more than a thousand operations every month, he can complete thirteen to fourteen thousand operations a year.
This is a very scary number.
Of course, he performed level one surgeries, which were relatively simple.
Many complex level 3 and 4 major surgeries often require the collaboration of one or more medical teams, which can last up to seven to eight hours, or even more than thirty hours.
The longest complex operation performed at Tuya Hospital so far was thirty-seven hours.
It is a huge test for both doctors and patients.
"Doctor Zhou is right. You still have so many of us fighting with you. You must not give up easily. I also want to take this opportunity to strive for the associate senior professional title!"
He Hansheng echoed.
This department reform is both a crisis and an opportunity.
"My realm is behind! I am not as good as you two youngsters!"
Deputy Director Liu sat down on the chair with a complicated expression.
The operation continued and was carried out by two of his generals.
The chief surgeon or chief physician sometimes does not necessarily need to perform the surgery himself. The same applies to the other doctors who supervise and guide the surgery of the team.
The surgeon is like the chef in a restaurant. He only needs to ensure the safety and quality of the operation, and that is enough.
Otherwise, even if it was like Deputy Director Liu, who was only an associate chief physician, he would perform more than a dozen operations a day. He would do all of them personally, and he would probably die of exhaustion on the operating table before the patient's operation was completed.
"Doctor Zhou, how about you do the laparotomy?"
He Hansheng took the initiative to give Zhou Can some opportunities to practice surgery.
"Thank you, Dr. He, for giving me the opportunity! I will be careful and cautious."
Zhou Can stood at the operating table, took the scalpel, and performed laparotomy on the patient with a focused expression.
The whole process was fast and steady, and he showed the demeanor of a chief physician.
"Very well done! Are you sure you can free the esophagus?"
“You can try it!”
Zhou Can's separation skills are currently at the lower level of the main doctor, and he still needs more than 400 experience points to be promoted to the middle level of the main doctor.
He carefully began to free the esophagus, while others held their breath and watched nervously.
The trachea is brittle and the esophagus is relatively weak.
Free esophageal mobilization is a high-risk surgical procedure.
[Separation skill experience +1.]
[Congratulations on your first successful esophageal separation. Reward: separation experience +100. ]
After Zhou Can successfully freed the esophagus, he received a generous reward.
It feels so good to have your medical experience points increase by more than 100 points in one go.
Only more than 300 points away from being promoted to the mid-level chief physician.
According to this trend, we may not have to wait until the end of the month to rise to above the intermediate level of main treatment.
Because the number of general surgery operations is quite high.
In this trial reform of the department, each team will certainly scramble for surgical patients.
Zhou Can is famous for his fast surgical speed.
Hehe, when the time comes, he will let other groups see the skills of the successor of the Quick Knife.
I heard that Dr. Xu was so famous in the field of surgery that many surgeons could only admire him. They had no intention of confronting him.
Later, if Dr. Xu's knife speed had not been too fast and a medical accident had not occurred, neither the most stable scalpel - Director Hu Kan, nor the top scalpel - Wu Baihe, would have been able to compete with him.
"Very well done! After freeing the esophagus, the triangular ligament of the liver needs to be cut. Look carefully, this is how it is cut."
He Hansheng didn't dare let Zhou Can do it, so he did it himself.
While cutting, he taught Zhou Can and other doctors the specific details and precautions.
Zhou Can secretly memorized the techniques and steps in his mind, so that he could give it a try next time he needed to cut the triangular ligament of the liver.
"Next, turn the liver right side up and cut the peritoneal fold at the cardiac level."
This operation was also not done by Zhou Can, but by He Hansheng himself.
He is a senior and amazing attending physician, and his abilities are really strong.
"Pause, I will explain to you the next surgical steps. This is a critical step that is very difficult to perform." Deputy Director Liu stood up and began to explain in detail to several junior doctors.
"Put your finger into the mediastinum through the esophageal hiatus, free the esophagus, and wrap a gauze around the cardia to pull it downwards, pulling the cardia and the lower end of the esophagus into the abdominal cavity..."
Deputy Director Liu did not do it himself, but every time he explained a step, he would signal He Hansheng to do it.
Zhou Can had never performed this kind of operation before and had little experience, so he could only learn and watch from the side.
Lend a hand when necessary.
The entire operation, whether it was the longitudinal incision of the anterior wall of the muscular layer of the esophageal cardia from outside the mucosa, or the subsequent shaping and various sutures, all broadened Zhou Can's horizons.
The complexity of this operation is beyond imagination.
No wonder few doctors are willing to do it now.
Towards the end, when suturing the abdominal wall, Zhou Can did not compete with the two residents.
Instead, he took the initiative to step aside.
He was already very familiar with suturing the abdominal cavity, so there was no need to watch the resident doctor close the cavity. There was nothing to learn.
He Hansheng stood by and watched as it was his duty.
Zhou Can took advantage of this opportunity to quickly take notes on the surgical steps and key points so that he could review them later.
After more than forty minutes, the clumsy resident finally succeeded in closing the abdominal cavity.
"The operation was a complete success. Thank you all for your hard work. You can organize your surgical notes. It is past lunch time now. I have ordered food. After everyone finishes eating, you can take a break. Then we will have the second operation around 3 pm."
The operation took quite a long time, almost five hours.
Fortunately, the operation was successful.
This is also something that makes everyone feel gratified.
From the moment a doctor sees a patient, he or she has to put in a lot of effort, including communicating with the patient's family, as well as managing the entire perioperative period and performing difficult surgeries.
Finally the patient recovered and was discharged from the hospital, which was the happiest moment for the doctors.
At around 2:50 in the afternoon, Zhou Can and the intern in charge of the patient sent the patient to operating room No. 4.
Endoscopic surgery is usually performed in this operating room.
As soon as I turned the corner of the corridor, I saw a large group of doctors walking towards me. All of them were wearing dark green surgical gowns. Some even had masks hanging on their chins.
Judging from the situation, he must have just had surgery.
The leading doctor was of medium height, wore glasses, appeared to be in his forties or fifties, and had a very calm demeanor.
This person is Director Yang Qing, who ranks very high among the many chief physicians in the general surgery department who can perform surgery.
It must be said that not every chief surgeon is good at performing surgery.
There are actually very few chief physicians who can perform surgery well.
Theoretically speaking, the strength of a surgical team is not just the strength of the chief surgeon.
The chief surgeon plays the role of a leader.
Director Yang Qing's surgical team consists of many experts and talents.
Du Leng is also in the surgical team and holds a relatively high position.
A doctorate from a prestigious overseas university is really popular. He is now just a new surgeon, and his status is at best the same as that of a lesser attending physician.
Now he has been promoted to the rank of associate chief physician. It seems that he is highly valued in Yang Qing's team.
"Um?"
Zhou Can's gaze stayed on Du Leng's face for only about a second, and soon fell on a younger male doctor walking behind the surgical team.
That person was none other than Song Ze, who had just betrayed Deputy Director Liu.
Compared with Du Leng's life of luxury, Song Ze's status is far inferior.
I could only travel with a few residents.
And he was walking at the tail end of the residency.
I really don’t know what’s the point of him joining Yang Qing’s team?
When he was under Deputy Director Liu, he was the third-in-command before Zhou Can came.
Now he has joined Director Yang Qing, but he is not even as good as the resident doctor.
The status is only slightly higher than regular training.
How sad.
When Song Ze saw Zhou Can, he lowered his head guiltily.
People always feel guilty when they do something wrong.
Director Yang Qing glanced at the patient Zhou Can brought with him and looked away indifferently.
Not to mention Zhou Can, a trainee, Yang Qing didn't even take Deputy Director Liu seriously.
They really have the strength and confidence.
The two sides passed each other.
On Zhou Can's side, there was only him, a trainee, and an intern, and he seemed to be alone and powerless.
On the other side, there were several chief physicians and deputy chief physicians.
Not to mention attending physicians and resident doctors.
It can be said that the army is strong, the generals are numerous, and the food is abundant.
The gap in strength between the two sides is really huge.
Zhou Can took the patient and the intern and took the initiative to step aside to let the other party pass first.
Humility is not only a kind of broad-mindedness, but sometimes it also reflects calmness and confidence.
When Du Leng passed by Zhou Can, a sneer of disdain appeared on his face. It came from the bottom of his heart.
Because the gap between the two teams is too obvious.
Song Ze's betrayal and joining of Yang Qing's team made Du Leng feel like he had been injected with chicken blood, and he believed that victory was in his grasp.
