Chapter 31 Seemingly Harsh, But Actually Caring
The opportunity is right in front of you, and you must be bold and thick-skinned to have a chance of grabbing it.
"Doctor Xu, can I open the abdomen?"
"no!"
Dr. Xu refused without even thinking about it.
Doctor Lu pulled up a smile, and when he looked at Zhou Can, there was a hint of ridicule in his expression for his ignorance of the immensity of the world.
"Zhou Can, don't be anxious. When the time is right, Dr. Xu will give you a chance to practice." Ye Tingting winked at him and said comforting words.
"Um!"
Zhou Can gave her a grateful smile in return.
This was a secondary surgery, and although laparotomy was not as dangerous as thoracotomy, the risks were equally high. He had expected to be rejected by Dr. Xu.
As for opportunities, you must always be brave enough to fight for them.
Success or failure is not something he can control.
At least I tried my best and I won't have any regrets.
"Stand over there and watch carefully!"
After Dr. Xu rejected his request, he gave him an opportunity to watch and learn from the best angle.
Zhou Can was secretly delighted, as Dr. Xu clearly intended to cultivate him.
"When selecting the surgical site, it is important to avoid possible important blood vessels and nerves. The location of the appendix is not much different between men and women, but the anatomical position of the appendix itself sometimes varies greatly, so it is necessary to determine the surgical site based on the patient's film. Under normal circumstances, the appendix is located in the right lower abdomen, 1/3 of the middle and outer line between the umbilicus and the iliac region, which is called McBurney's point."
Dr. Xu demonstrated while explaining.
"Look, her McBurney point is here. During the operation, the incision will be made along the McBurney point."
This kind of practical experience is very important.
It was summarized by our predecessors after countless operations.
This can ensure that the surgery goes smoothly to the greatest extent possible.
Zhou Can memorized all of them in his mind, and he also put away his reckless thoughts. He calmed down and studied seriously.
After Dr. Xu finished his explanation, he started the operation.
The scalpel seemed to be alive in his hands.
Drop the knife and pull it back.
His eyes are sharp and his movements are accurate, steady and fast.
Skin, subcutaneous fat, anterior rectus sheath, rectus abdominis, posterior rectus sheath, layers of human tissue were cut open by him layer by layer as if by magic.
Zhou Can's eyes widened as he watched.
This level is in no way inferior to Director Liu.
I never thought that the worst emergency department would hide such a powerful expert. And Dr. Xu was only the attending physician.
He couldn't even get to be deputy director.
With such high surgical skills, it is a waste of talent to be assigned as an attending physician in the emergency department.
As these tissue layers were cut, blood began to ooze out rapidly.
Doctor Lu, the assistant, immediately grabbed the electrocoagulation knife to help stop the bleeding.
But I really can’t praise Dr. Lu’s level.
The speed is okay, but accidental injuries or incomplete bleeding may occur from time to time.
He is a very careless person when it comes to doing things.
No wonder he was kicked out of the powerful department.
If you can't correct your careless work habits, you can only do level 1 and level 2 surgeries. You can't even lead level 2 surgeries and can only be an assistant.
As far as stopping bleeding is concerned, Zhou Can is much better than him.
Contempt is despised, Zhou Can is just a resident trainee, so he has no right to criticize a senior resident doctor.
Doctor Xu frowned as he watched, but didn't say much.
I guess there's nothing we can do about it.
The emergency department was already short-staffed, so even though Dr. Lu's skills were poor and his attitude was sloppy, they had to make do with him.
This is the true situation in the emergency department.
But now with two capable generals, Zhou Can and Jin Mingxi, this situation will soon change.
"Remember, after cutting here, only the peritoneal fat layer and the peritoneum are left. Be careful when operating, and don't cut it in one piece just to save time and effort. What's the most important thing in surgery? It's not the amazing technique, but safety. Otherwise, no matter how amazing you are, a small mistake could ruin you forever."
When Dr. Xu said the last sentence, his tone was very special.
It seems to contain deep emotions.
This made Zhou Can have some guesses about Dr. Xu's story.
Doctor Xu was seen holding the scalpel, carving the scalpel slowly and steadily .
The peritoneal fat layer was perfectly cut.
Next is the peritoneal layer.
As soon as it was cut open, pus oozed out.
Doctor Lu stood at the assistant's seat, like a dead man, not moving at all.
In this case, the pus must be sucked out immediately.
Zhou Can didn't ask for instructions this time.
There was no time to ask for instructions.
Immediately pick up the suction device and suck out the pus.
"I didn't expect the suppuration to be so serious. Her illness must have lasted for a long time."
Dr. Xu gave Zhou Can an admiring look.
If Zhou Can hadn't reacted quickly, the wound would have been easily contaminated.
"Doctor Lu, you stand over there and make a pinky promise with Jin Mingxi. Xiao Zhou, stand over here and assist."
Doctor Xu saw that Zhou Can's assisting ability and adaptability seemed to be better than Doctor Lu's, so he did not show any mercy to Doctor Lu and directly replaced Zhou Can to the assistant position.
The use of a retractor for appendectomy is not particularly strenuous and the operation time is relatively short.
However, this arrangement was equivalent to promoting Zhou Can to the first assistant, while Dr. Lu, who had more experience and a higher rank, was demoted to the second assistant.
Even with a mask on, one could tell that Dr. Lu looked unhappy.
Zhou Can just does whatever his superiors tell him to do.
After standing in the assistant's seat, he held the electrocoagulation knife in one hand and the suction device in the other.
Be prepared.
The peritoneum was cut open little by little until it became as big as the surgical incision.
At this point, you can already see what's going on inside.
A foul stench hit me in the face.
The abscess was more serious than expected.
The necrotic tissue stuck together like minced meat.
"Make the wound a little bigger."
Zhou Can quickly used electrocoagulation to stop the bleeding at the bleeding point, and then carefully sucked out the pus in the abscess.
It must be sucked clean, otherwise it will easily cause abdominal cavity contamination.
That would be a big trouble.
There is no harm without comparison.
Compared with Dr. Lu's clumsy assistance, Zhou Can's attitude was not only ten times more serious, but his hemostasis skills were also far superior to Dr. Lu's.
"Xiao Zhou, come and look for the appendix."
"good!"
Zhou Can understood that Dr. Xu was focusing on training himself.
It's almost a step-by-step teaching.
He followed the colon, parted the fat on both sides, and searched carefully. He soon found the cecum, which was slightly whiter than the small intestine. But it was not pure white, but grayish white.
Once you find the cecum, you will also find the appendix.
Because they are connected.
Zhou Can used gauze to pad his fingertips, lifted up the cecum, and then successfully found the appendix along the colon band.
"The adhesion seems to be particularly severe."
Zhou Can looked at Dr. Xu.
"It's not hard to separate them if you're careful."
Dr. Xu seemed particularly calm.
He carefully separated the adhesions. The whole process was meticulous, precise, and unhurried, revealing the style of a master.
During the separation, he kept teaching Zhou Can some skills and explaining the key points.
It took nearly half an hour to completely separate the adhesion tissue.
"Now we can remove the necrotic appendix. Remember, whether you are removing the appendix or the appendix, try to do it outside the abdominal cavity to prevent contamination of the abdominal cavity. If conditions do not allow, you can only remove it inside the abdominal cavity, and you must pad gauze around it to properly protect the various layers of abdominal tissue."
The lesions have been separated and laparotomy is sufficient.
The severed ends of the colon were sutured personally by Dr. Xu.
He told Zhou Can and Jin Mingxi all the key points, precautions, and various suturing methods without reservation. As for Dr. Lu, he should have taught him a long time ago.
"Put the intestines back in, clean up the accumulated blood and fluid, and after checking everything is correct, be sure to check the number of surgical instruments and consumables."
There are often irresponsible doctors who forget surgical instruments or gauze inside the patient's body.
This ultimately leads to medical accidents.
These good habits need to be developed from the beginning.
"Xiao Zhou, you come and close the abdomen!"
Dr. Xu was right not to agree to perform an abdominal surgery and remove the appendix.
Because Zhou Can lacked both experience and surgical skills.
After this learning experience, at least next time when Zhou Can is asked to remove the appendix or appendix, he will have a much better chance of success.
Every doctor grows up slowly over time.
The experience value system can accelerate his growth, but it cannot help him achieve success overnight.
Doctor Xu also delegated power to him little by little and trained him slowly.
It seems harsh, but it is actually a kind of care.
If you let a child run as soon as he learns to walk, you are harming him, because he won't be able to run far before he falls badly.
After Zhou Can sewed up the patient's abdomen, he earned another 20 experience points.
The patient received ten stitches in total.
His suturing skills are becoming more and more proficient.
Suturing on a patient and suturing on pig skin or white mice are two completely different concepts.
First, the feel is different.
Human skin is more delicate and appears more delicate when sutured.
In addition, when practicing with pig skin, there is no psychological pressure. When suturing a patient, you will naturally feel nervous and have a lot of psychological pressure. Your mental strength is also highly concentrated throughout the process.
To be precise, this was the fourth time he had sutured a patient.
Compared with the first time, there has been obvious progress in all aspects.
Although he couldn't be as calm as Dr. Xu, at least he wasn't as nervous as the first time. When he closed the patient's abdomen just now, he was relatively calm.
This kind of improvement in state of mind is definitely not something that the experience value system can give.
It can only be improved through surgical experience.
"You sew well. In the future, any work like suturing the epidermis or closing the abdominal cavity can be assigned to you. I guess Doctor Lu and Doctor Jin have already looked down upon this kind of work, right?"
Even a fool could see that Dr. Xu was deliberately cultivating Zhou Can.
"It's good to let Zhou Can exercise more." Jin Mingxi expressed.
"I really don't look down on skin stitching and cavity closing. I hope Dr. Xu can let me perform a level-two operation someday!" Dr. Lu said with a smile.
"When will you change your careless habit of doing things? Then come and make this request to me again!" Dr. Xu said to him mercilessly.
Dr. Lu smiled awkwardly and stopped talking.
The old lady's operation was very successful. After waking up from anesthesia, she was pushed out of the operating room by the nurse.
…
The emergency operating room has a steady stream of patients being sent in, and they are always well fed.
For Zhou Can, it is simply a paradise for upgrading his medical skills.
Unfortunately, many surgeries cannot be performed.
Either Dr. Xu will take charge, or the patient can only be advised to transfer to a specialist for surgery.
Zhou Can was busy until midnight, when the doctor who was supposed to take over the shift arrived and he left work.
When he walked out of the hospital, Zhou Can felt like his body was almost falling apart.
Being a doctor is really tiring.
But today's harvest is unimaginable.
Not only did he achieve his goal of staying in the hospital as a resident trainee, but he also quickly integrated into the big family of the emergency department and has been initially recognized by Director Lou and Doctor Xu.
As long as you don’t commit suicide, your future development will definitely be bright.
Dr. Xu has obviously begun to focus on training him now.
Even Jin Mingxi didn't receive this treatment.
In addition, he gained a lot of experience points in the four medical skills of suturing, hemostasis, ligation, and injection. He gained the least experience points in incision, only 2 points.
For slightly risky dissections, Dr. Xu was afraid of accidents, so he usually performed the operation himself and did not dare to let Zhou Can do it.
At most, when cutting, he would explain to Zhou Can in detail the key points and precautions of each step.
After all, it takes a long time to train a medical talent.
It will not be achieved in a day or two.
Zhou Can also made adjustments to his studies based on the current situation.
After get off work, you can buy more mice and rabbits to practice dissection at home. Although the experience points gained by practicing dissection on small animals are 5 times less than that gained by practicing on human bodies.
But there's no risk.
Moreover, he could practice whenever he wanted, and practice at home every day. Even if he only gained 20 to 30 points of incision experience a day, after practicing for two or three months, his incision skills could be upgraded to the level of a major doctor.
Having no time to check his phone all day, he fished it out and checked it.
There are quite a lot of unread messages.
The classmates in Class 512 were in an uproar.
Almost all classmates and teachers sent messages in the group to congratulate him and Yang Chan for successfully obtaining the qualification for regular training.
Yang Chan has already replied in the group.
It's nothing more than thanking the teacher for his cultivation, thanking classmates for their blessings and so on.
Zhou Can didn't reply in the group for a long time, and some students were fed up.
Start with rhythm.
No matter how successful he is now, why would he care about his teachers and classmates?
What's even more outrageous is that some people say that he is now the top scorer in the regular training examination of Tuya Hospital, and he doesn't even take his teachers seriously. I'm afraid he has long forgotten his teachers' kindness.
Zhou Can glanced through the messages in the class group and was speechless for a while.
