Path of Medicine With a System
chapter-142

Zhang Fan didn’t need to worry about what was going on outside of the emergency operating room. What he needed to do now was to do a good job on the surgery and save Wang Weiping’s life. However, Zhang Fan felt awkward about issuing commands to the two orthopedic directors. Gao Shijun noticed this, so he said, “Now’s not the time to be polite with us. Let’s start immediately. Right now, the two of us are your subordinate doctors.”

“That’s right! Old Gao is absolutely correct,” Wang Dehua agreed.

“I apologize beforehand then, Directors! Director Gao, wash your hands and disinfect. Director Wang and myself will adjust the patient’s position. I also ask for the cardiology director to be on standby for consultation. It’s possible that her expertise might also be necessary.” Zhang Fan began issuing the commands since both directors were cooperative. To give an analogy, performing surgery actually would be quite similar to fighting a war. First, you would need to determine who was the commanding general. The general would issue orders that the subordinates would then follow. The general needed to have a clear way of thinking, and it was strictly forbidden for the subordinates to carry out their own ideas without approval.

The general’s commands needed to be logical and accurate. Otherwise, the subordinate soldiers would rebel. It was the same for surgeons. Every order needed to be clear and purposeful. This was because several nurses and doctors would be waiting for your command to start the next step.

The two directors disinfected and did medical draping, work typically done by resident doctors. This couldn’t be helped. It was the primary surgeon who had the right to think about how to perform surgery on the patient. The primary surgeon would also need to check the X-rays, CT scans, and MRI scans. The surgical assistants would thus be in charge of the more menial work. Zhang Fan couldn’t afford to worry about such things right now, as he carefully considered what to do as he looked over Wang Weiping’s medical information.

The surgery began. The pelvis was actually a closed and sturdy ring of bone, which consisted of the ilium, ischium, and pubis. Since the pelvis was really sturdy, it wouldn’t fracture easily unless it was subjected to great force.

Wang Weiping’s pelvic fracture was quite severe. His pubis had been completely separated from the pelvis. The tuber sacrale and sacrospinous ligament had been shattered. The sacroiliac joint had been completely dislocated. This displaced portion of the pelvis had moved towards the front of Wang Weiping’s body.

“We must first locate the points of bleeding. There must be a large amount of damage to the blood vessels in the pelvic cavity,” Zhang Fan stated.

He organized how the surgery should be done in a clear and logical manner. Director Gao Shijun and Director Wang Dehua weren’t surprised by this at all. Although this was a serious surgery, it wouldn’t be that difficult for someone like Zhang Fan, who had already shown his amazing skills at performing hip replacement and knee replacement surgeries. The main issue in this surgery was that time was of the essence!

Once the primary surgeon set the strategy, the surgical assistants would have to cooperate to the fullest. For any surgery, the primary surgeon would be like a king. There were some surgeons who had especially bad tempers. They would curse at others or even throw things at others when they were the primary surgeon. Lower-ranking doctors wouldn’t even want to work together with such primary surgeons. Well, there were still plenty of primary surgeons who acted like that regardless. Maybe it was because they had been bullied too much by other primary surgeons, so once they became primary surgeons themselves, they started acting the same way in order to vent!

Zhang Fan chose to make his first incision from the rear. He sliced through the fascia in the gluteus maximus, and then carefully separated the fascia, ensuring that the muscle tissue in the gluteus maximus wasn’t damaged as he did so. Since there was fascia inside the gluteus maximus at intervals of 5-10 millimeters, Zhang Fan had to be especially careful with fascia separation in order to preserve the tissue structure and damage the fascia and muscle as little as possible.

Zhang Fan was extremely careful to preserve the fascia as much as he could during fascia separation so that the patient Wang Weiping could recover as well as possible. He stopped when he located the point where the gluteus maximus was connected to the sacral bone. He then cut off the gluteus maximus’s connection points on the aponeurosis of thoracolumbar fascia, ilium, posterior superior iliac spine, and all the damaged fascia in order.

Cutting off all the gluteus maximus’s connections points was to make it easier to repair the gluteus maximus after the surgery was complete. Zhang Fan maintained a sufficient amount of tendon at the connection points. He then cut off the gluteus maximus at the gluteal crest.

The surgery proceeded slowly. The operating room nurse constantly had to wipe sweat off of the three surgeons’ foreheads. None of the three surgeons said a single word. The two surgical assistants were able to nonverbally communicate with their expressions! They were both highly experienced orthopedic surgeons who knew what they needed to do.

Zhang Fan was just as skilled as the directors. The two directors easily understood what he was going to do. However, Zhang Fan had the advantage of being able to practice a tremendous number of surgeries. He was able to proceed incredibly swiftly with the surgery.

It was quite easy to tell Zhang Fan’s expertise. He barely even needed to think or hesitate as he swiftly cut through and separated blood vessels and nerves. Zhang Fan felt as if he could mentally see a 3-D image of every single structure in the human body right before him. The two directors also did their very best in assisting Zhang Fan for the sake of their own respective reputation.

The benefit of such extreme concentration was that the surgery proceeded faster than normal. Zhang Fan discovered the point of bleeding after he entered the pelvic cavity. “The internal iliac artery!” Zhang Fan exclaimed. The two directors also saw the same sight for themselves!

Dealing with arteries in the pelvic cavity was incredibly difficult! It would be impossible to repair arteries here in most cases. However, leaving embolisms here would cause the lower body’s muscles or hip muscles to begin shriveling!

Zhang Fan slightly hesitated here even though he hadn’t slowed down one bit during this surgery before. The two directors were also thinking to themselves what they would have done if they were the primary surgeon for today!

“What’s the blood pressure?” Zhang Fan inquired.

The anesthesiology department director was acting as the anesthesiologist for this surgery. “Doctor Zhang, it’s 85/50 mmHg, heart rate 60.”

“No good!” Zhang Fan had wanted to repair the internal iliac artery, but the patient’s vitals wouldn’t support his doing so. He could only give up on repairing this artery!

“Ligation!” Zhang Fan declared. Repairing this artery wouldn’t work. Gao Shijun and Wang Dehua both understood. Gao Shijun had originally been prepared to try and convince Zhang Fan to give up on repairing this artery, but Zhang Fan had instantly come to the conclusion of ligation by himself. Gao Shijun felt that Zhang Fan was still quite calm in the heat of the moment, a true surgical genius.

Wang Dehua became incredibly envious of Gao Shijun as this surgery went on. He had always competed with Gao Shijun ever since they joined Chasu City Hospital at the same time. They had always been equals, even all the way to their positions as director. Nobody had ever truly won or lost between them. But now, Gao Shijun had raised a demonic disciple whose skills overwhelmingly surpassed all other orthopedic surgeons at the hospital apart from the two directors’ skills.

Wang Dehua was so envious that he would have already cursed out loud if it wasn’t for the fact that he was in the middle of a surgery! He was the ultra-competitive type who had always been proud of his own skills, but now that he was getting old, his rival Gao Shijun finally had something to be prouder about.

Although describing the surgery was quick, the three surgeons had already operated on Wang Weiping for four hours now. They did their best to repair what arteries and veins that they could. In many places, the two directors’ surgical methods would have caused some damage to the blood vessels, but Zhang Fan’s techniques were far too exquisite. He managed to cleverly avoid making any damage at all.

Gao Shijun kept nodding in approval. Although he didn’t say anything, he had such a proud look in his eyes as he looked over at Wang Dehua.

Wang Weiping’s vitals were now stabilized. He was no longer bleeding. Wang Dehua indicated with a gesture for the operating room nurse to wipe his sweat. He then said, “Doctor Zhang, your techniques don’t seem like they’re from the same school as us. Old Gao and I were taught by the same teacher, but your techniques don’t look that similar!” Wang Dehua was unwilling to submit, and wanted to say something because Gao Shijun’s expression really made him dissatisfied.

“Back when I was in orthopedic departments #1 and #2, I often watched the two of you perform surgeries. I would then carefully consider things for myself, so I managed to obtain my own ideas.” Zhang Fan was no longer working so swiftly. Wang Weiping was no longer in any danger.

“The philosophy of our orthopedic department #1 is to bravely create new techniques. Doctor Zhang has done a good job here, but you can’t be too proud, and must set even higher standards for yourself. When you join my department, I’ll set every Tuesday as a day of learning in our department. At that time, everyone can discuss their own ideas and what they’ve learned!” Gao Shijun had a joyous tone.

Gao Shijun and Wang Dehua had competed for their entire careers without a clear winner, but now, Gao Shijun had the advantage with such a disciple. He really wanted to show off and anger Wang Dehua a little.

Wang Dehua thought to himself, ‘Ridiculous! If people really could learn their own personal surgical techniques just by watching a few surgeries, there would be no need for experienced doctors like myself, and I could simply retire!’ He rolled his eyes and glared at Gao Shijun before saying, “Don’t be so proud just yet. At this rate, I figure that Doctor Zhang will be leaving Chasu City Hospital sooner or later!”

‘Hmph, you can be proud for now, but let’s see how you’re going to show off after Zhang Fan leaves!’ Wang Dehua felt much better after having such a thought.

“No matter where he goes, his teacher will still be me, Gao Shijun, not someone surnamed Wang. In the future, whenever people mention Zhang Fan, they’ll also mention me. I did accomplish something!”

Gao Shijun and Wang Dehua kept verbally sparring each other, which made Zhang Fan rather annoyed. He felt that the two directors were just like women with how much they argued with each other. Zhang Fan didn’t understand how lucky it was to have such a professional rival! The rivals would spur each other on to constantly improve. If Gao Shijun and Wang Dehua hadn’t met each other, it was a definite that neither of them would have been as skilled as they were today.

“The bone isn’t severely shattered. Let’s begin fixation!” Zhang Fan wasn’t able to take it anymore, so he stopped the two from arguing! He was the primary surgeon today and had this right.

The surgery was successful in the end, and Wang Weiping’s vitals had stabilized. This made the tense atmosphere in the operating room instantly ease up.

The anesthesiology director made a joke, saying, “You two old farts, hurry and do as many surgeries as you can now. The future will belong to Doctor Zhang. This generation doesn’t belong to us anymore!” The anesthesiology director had joined Chasu City Hospital at the same time as the two orthopedic directors!

The two directors both sighed when they heard this. They exchanged glances and both noticed that the other was starting to grow some strands of white hair.

“Yeah, it’s no longer our time!” Gao Shijun said softly to himself.

It was impossible for anyone to avoid growing old and dying, surgeons included. Surgeons would only have a few decades of golden time to perform surgeries. Once that time passed, they would gradually start losing their ability as vision, stamina, and other such traits became worse with age.

The operating room’s head nurse had been the primary nurse on duty for this surgery. She already knew about Zhang Fan’s status due to having assisted in many of his surgeries before. She lightly wiped away some sweat on Zhang Fan’s head, and said, “Doctor Zhang, how much time do you estimate is left before you’re completely finished? It’s already past lunchtime. The superintendent told me to ask you what you guys would like to eat. The hospital will pay for your meal today. We nurses also get to benefit because of you!”

“Haha, anything is fine with me. You’ll have to ask the leaders. I’m just a low-ranking grunt. I’ll eat whatever you guys eat.” In the operating room, apart from Zhang Fan and an assisting nurse, all of the others were leaders of their departments!

The assisting nurse secretly laughed, but she didn’t dare to joke around with the leaders like this. Although the head nurse seemed like a nice woman, she could be quite vicious when dealing with subordinates.

“Hand-grabbed mutton? Or maybe steak?” said the anesthesiology director.

“Okay! Since our boss is being so generous to us today, let’s have some steak! It’s a rare opportunity for the superintendent to treat us. Besides, Superintendent Ouyang is beginning to show more and more obvious favoritism for her old department, the internal medicine, by giving them more resources. Our bonuses are also beginning to decrease. We should have a talk with the superintendent soon,” Wang Dehua said to Gao Shijun.

“Yeah, we really must talk with her. Our subordinate doctors are filled with complaints!”

This wasn’t something that Zhang Fan needed to worry about. In fact, he hadn’t even heard their discussion, as he was fully concentrating on finishing the surgery!

Fixation! Sutures! Ligation! The surgery was completed! The anesthesiology director and nurses took the patient to ICU. Zhang Fan stretched his sore legs, and then turned around, only to see that both Gao Shijun and Wang Dehua were already sitting down, resting against the wall, without regards to their status!

They had gotten old!