Chapter 216 Becoming a teacher, the fourth fifth-level medical skill
"Thank you! Thank you for letting me feel the warmth of the new department!" Doctor Wu Ziyu thanked Zhou Can repeatedly, with sincere words and sincere eyes. "I also want to thank Dr. Zhou for letting me understand how big the gap is between me and excellent doctors. In the future, I will guard against arrogance and impatience, follow Dr. Zhou's example, and work hard to improve my surgical skills and medical level."
Today, Zhou Can taught her a good lesson.
Her misunderstanding of Zhou Can was cleared up, and her horizons were broadened greatly.
The matter was resolved satisfactorily.
"Not to mention Dr. Wu, even I was extremely shocked after seeing Dr. Zhou's surgical skills. I never thought that a doctor who has been trained for less than two years can have such strong surgical skills. Some of the separations and resections in this operation require surgical skills at least at the deputy director level. It's really amazing!"
Director Mo also praised Zhou Can's surgical skills.
"Maybe I'm brave and my teachers are very caring. They teach me everything they know, so I'm improving fast! Actually, my surgical skills are far from being at the deputy director level. At best, I'm at the attending physician level."
What Zhou Can said is the truth.
Before he practiced the quick knife method, his surgical skills were solid.
Later, the quick knife method was promoted to the entry level. Using the quick knife method to control the separation, incision , and debridement medical skills is equivalent to using internal energy to activate martial arts. Shengsheng raised the level of separation and incision medical skills to a great level.
Although he is only at the level of attending physician, he can demonstrate the strength of deputy director.
This is also what makes the quick knife method fascinating.
Zhou Can was not sure whether 'Steady Knife' and 'Precise Knife Technique' also possessed this ability.
Anyway, he has fallen deeply in love with the magic of the quick knife technique.
Every time I perform surgery, I feel a sense of complete satisfaction.
"You are very capable, but you are humble and modest at all times. The young man has a bright future!" Director Mo was very emotional. He was also very optimistic about Zhou Can's future. "I am relieved that this operation was completed smoothly . To be honest, not only me, but also other chief physicians have not confirmed Dr. Zhou's surgical ability. We are somewhat worried about handing those patients over to you for surgery."
After hearing this, Zhou Can smiled bitterly.
The chief physicians are all mature and steady, with excellent medical ethics.
Zhou Can, a small trainee, took over the surgical patients they were treating. Although it was out of good intentions, the chief physicians were more worried that Zhou Can's surgical skills were not good enough.
In order to be responsible for their patients, although they did not object openly, they appointed Director Mo to go into the operating room to observe Zhou Can's surgical skills.
Now that it is confirmed that Zhou Can's surgical skills are stronger than imagined, Director Mo can explain it well to others.
"Director Mo, I have to accompany Zhou Can . Please keep an eye on the thyroid outpatients. If you encounter difficult and complicated cases, you can gather doctors from the entire department for consultation."
Old Liu warned.
"Don't worry, the Department of Thyroid and Breast Surgery is your department as well as ours. We will all work hard to do our job well. We will never do anything that will ruin our jobs."
Director Mo waved to Mr. Liu and prepared to leave with Wu Ziyu.
"Director Mo, Director Liu, can you let me stay in the surgery room and help with the operation? My surgical skills are far inferior to Dr. Zhou's, but I can help with retractors, suturing, and hemostasis."
Wu Ziyu was somewhat stimulated by seeing Zhou Can's strong surgical skills, and was unwilling to fall behind too much.
Zhou Can's surgery schedule for the next two days is fully booked, including both major and minor surgeries.
She can definitely learn a lot of surgical skills and experience by helping out.
This will be of great benefit to improving her surgical skills.
"I have no objection. It depends on whether Director Liu agrees to it!"
Director Mo did his best to take care of the doctors under him.
"What work has the department assigned to you in the next two days?" Old Liu did not rush to agree.
The department has just been established and there is a lot of things to do.
Manpower is also extremely tight.
Even if you are just a resident, the workload assigned to you is very heavy.
If she is left in the operating room, some of her work will inevitably have to be distributed to others.
"My tasks are to manage the ward, write medical records, and issue medical orders. Don't worry, I won't delay my work. I will coordinate with other colleagues and work overtime at night."
She said hurriedly.
"Okay then. You should not stay in the operating room for more than eight hours. Young man, it's good to work and study hard, but you should also pay attention to rest. You need to get at least six hours of sleep every day."
Old Liu couldn't bear to reject her eager eyes.
Finally chose to agree.
She was Zhou Can's assistant.
Originally, the more difficult tasks such as retractors and hemostasis were all done by Elder Liu. There was no other way, due to the shortage of manpower, the deputy director had to play the role of assistant.
While serving as the first assistant, Mr. Liu was nominally the chief surgeon, guiding Zhou Can in the operation.
When it comes to the surgical parts that Zhou Can is not capable of performing now, he needs to do it himself.
Now with an additional resident-level assistant, Mr. Liu can feel a lot more relaxed.
After all, in a thyroid tumor removal operation like the one just now, two trainees and three interns are definitely not capable of doing the job of an assistant.
“Has Dr. Wu ever participated in level 3 surgery?”
"I have participated in it many times, usually as a third assistant. The most I have completed in surgery is stopping bleeding and suturing the skin to close the cavity." She is quite honest.
The vast majority of residents need at least the third year to gradually gain some practical opportunities to perform higher-risk surgeries.
Just like when Zhou Can was in the emergency department, in the beginning, even draining an abscess from a patient would get him excited for a long time.
Surgeons all grow little by little and make it through slowly.
"Well, the next operation is the removal of thrombosed hemorrhoids. You will be Dr. Zhou's assistant!"
Old Liu decided to test her strength first.
She will be given opportunities to undergo surgery later.
The patient was brought in quickly.
The patient was a female in her thirties who walked like a young girl who had just lost her virginity, limping and with a painful expression on her face from time to time.
Hemorrhoids are soft venous masses formed by congestion, dilation and buckling of the hemorrhoidal venous plexus under the rectal mucosa and the skin of the anal canal.
If thrombosed hemorrhoids are not treated in time, it will cause great pain to the patient, making it difficult to sit or lie down, and defecation difficult and painful.
The way this female patient walks has changed, indicating that her condition has progressed to a very serious level.
"Please lie down on the operating table!"
Wu Ziyu took the initiative to arrange the female patient to lie in the side-lying position.
After all, most of the doctors in the operating room are male, and female patients would feel embarrassed.
As a woman, Wu Ziyu can more easily gain the trust of patients and alleviate their embarrassment.
The actual surgeon performing this operation was still Zhou Can.
It's a minor operation and does not require a specialized anesthesiologist.
The surgeon can directly administer local anesthesia to the patient.
"Mr. Liu, would it be better to use caudal anesthesia for her condition?"
Zhou Can has quite a lot of experience in level one and level two general surgery.
In addition, he learned a lot of anesthesia knowledge and skills from Dr. Feng, so he could easily handle the local anesthesia for this kind of minor secondary surgery.
With just a brief understanding of the patient's condition, we can accurately give the most appropriate anesthesia plan.
Hemorrhoid surgery can generally be performed using local anesthesia, sacral anesthesia, and, if necessary, lumbar anesthesia.
"Caudal anesthesia is perfect, let's get started!"
Old Liu gave him an approving look.
Being able to flexibly use the most appropriate anesthesia method shows that Zhou Can’s anesthesia level has made significant progress.
Zhou Can took the anesthetic prepared by the instrument nurse and began to perform caudal anesthesia on the female patient.
This type of anesthesia is more difficult to administer than local anesthesia injected into the muscle.
It requires injecting local anesthetic into the sacral canal cavity through the sacral hiatus to block the sacral nerve. It is a type of epidural anesthesia and is mostly used for rectal, anal and perineal surgeries.
"Dr. Zhou's injection skills are so strong!"
Wu Ziyu watched Zhou Can's operation from the side and couldn't help but marvel at it.
If it were her, let alone an easy success, even if she was given ten chances, it would be considered good if she could succeed once.
She had only seen this type of anesthesia used two or three times.
Because she used to work for Director Mo, most of the surgeries she performed were thyroid surgeries.
Zhou Can just performed caudal anesthesia on the patient, and it looked like he was doing it effortlessly, which further demonstrated Zhou Can's strength.
She secretly made a comparison and found that even if Director Mo operated it personally, it would be difficult for him to be as relaxed as Zhou Can.
"It's nothing. You'll be able to do it easily as you practice more."
Zhou Can smiled nonchalantly.
"Can you teach me a little bit? I've seen other doctors do it two or three times, but none of them do it as well as you do. I've always wanted to learn, but I haven't been able to do it yet."
Seeing that he was easy-going, Wu Ziyu took the opportunity to ask him for advice.
Normally, she would not dare to ask the deputy director or chief physician for advice directly during surgery.
"The most difficult step in implementing caudal anesthesia is puncturing the caudal canal. The patient can be placed in a side-lying or prone position, depending on the patient's condition, to reduce the patient's pain as much as possible. In the side-lying position, the patient's back is arched backward, and the knees are brought close to the abdomen, like a curled shrimp. In the prone position, the patient's hips are supported with a small pillow, the legs are slightly apart, the toes are tilted inward, and the heels are rotated outward to relax the buttocks muscles."
Zhou Can very competently taught her the anesthesia knowledge and skills he had mastered.
"Before puncture, first touch the tip of the coccyx, which is here." He pointed to the tip of the patient's coccyx. "Then about 3 to 4 centimeters along the midline toward the head, you can feel a V-shaped or U-shaped depression. On both sides of it is a bean-sized bony protrusion of the sacral angle, which is the sacral foramen. Find this foramen and puncture, and it will basically be done."
An anesthesia operation seemed very simple to Zhou Can, but when he was explaining it, he realized how hard it was to be a teacher.
I actually told her a lot.
Thinking back to the senior doctors who had taught him and who had patiently explained to him the surgical techniques, precautions and specific steps, he couldn't help but feel a deep sense of gratitude.
If you are not a teacher, you don’t know the hard work of a teacher.
If you are not a parent, it is difficult to understand how difficult it is for parents.
"I have basically learned how to find the sacral foramen. Can you tell me more about the specific puncture? I'm a little stupid, so please don't bother me." She said a little embarrassedly.
Seeing her eager eyes for knowledge, it was so similar to when Zhou Can consulted his superior doctor.
"You are very smart. All doctors are similar to you when they learn practical operations. It took me a long time to learn this anesthesia operation from a teacher."
Zhou Can told her a white lie.
When Dr. Xu first taught him this operation, he learned it in just one try.
"First, make a skin mound in the center of the sacral hiatus, and then vertically penetrate the skin and the sacrococcygeal ligament covering the sacral hiatus. When penetrating the ligament, there is a feeling of falling into the air as the resistance suddenly disappears. At this time, insert the needle at a 30-degree angle to the skin to enter the sacral canal cavity."
Zhou Can gestured again.
However, the patient was not punctured again.
Otherwise, the patient would curse.
"Thank you for teaching me so patiently."
She took careful notes, no doubt preparing to study them carefully when she returned.
After successful anesthesia, the operation officially began.
The female patient was not in a coma or anything like that; she was awake.
She originally felt somewhat uneasy about such a young doctor performing surgery on her, but after listening to Zhou Can's teaching to Wu Ziyu, she changed her mind.
Since he can take apprentices, his medical skills must be good.
He is also a master.
She waited patiently for Zhou Can to perform surgery on her.
"Has Dr. Wu ever performed this type of surgery?"
"No! This is just the first time I've seen it!"
She shook her head shyly.
"Watch each of my surgical steps carefully. Make radial incisions at the site of the blood clot first."
Zhou Can explained while performing surgery on the patient.
"After cutting open the skin, you can see purple-red blood clots. Here, these are them."
Zhou Can pointed it out to her.
"Use your thumb and index finger to squeeze out all the blood clots from the bottom of the clot toward the incision. Be careful not to be too forceful or too gentle, otherwise the blood clots will not be squeezed out or not squeezed out completely, and good treatment effects will not be achieved. Fill the wound with vaseline gauze or a small cotton ball dipped in hemostatic powder and benzocaine powder."
Zhou Can performed the operation very quickly.
As soon as the words were spoken, the operation was basically completed.
"Remember, don't suture the wound, just let it heal gradually."
There are many wounds that cannot be sutured.
Hemorrhoidal wounds are one of them.
Some novice surgeons have made jokes in the past. Some doctors who have only learned a little have even opened clinics and, due to lack of guidance and supervision from senior doctors, have even made some medical mistakes.
This operation is relatively easy and it is completed here.
Old Liu stood by without saying a word.
Just as he watched Zhou Can teaching Wu Ziyu how to perform surgery, a hint of relief appeared in Old Liu's eyes.
When a doctor's skills improve to a certain level, especially when he is older, he will particularly want to pass on his medical skills and teach them to more people.
Watching Zhou Can teach Wu Ziyu, this is the performance passed down from generation to generation.
So Mr. Liu would feel particularly gratified.
After this female patient was pushed out, a new surgical patient was soon pushed in.
Zhou Can continued to be the absolute main force, performing surgeries on patients . Wu Ziyu served as his first assistant in some minor surgeries. When encountering a high-risk and difficult secondary surgery, she could only serve as the second assistant.
Mr. Liu will personally assist Zhou Can.
When Zhou Can performed his fourth operation of the day, his hemostasis skills were finally promoted to level five as he wished.
[Hemostasis, level 5, current experience value 1/100000, junior level of deputy director.]
This is his fourth level five surgery.
At this rate, by the end of the three-year training period, perhaps most medical skills can be upgraded to deputy director level.
That's awesome.
Basically, I can perform all level 3 surgeries independently, and can even start to challenge the core surgical parts of level 4 surgeries.
