Path of Medicine With a System
chapter-172

Normally in the medical field, any doctor who was known as an “expert” would have to be 40 years old at minimum. This was why Wang Yongyong’s wife almost collapsed when she saw how young the doctor at Ma Wentao’s hospital was for her husband’s surgery. She was a stay-at-home mom with no job, so everything in the family depended on Wang Yongyong’s income. If something happened to him, the family would be finished.

However, there wasn’t anything that she could do. Wang Yongyong insisted on having the surgery here. His wife couldn’t do anything but worry. Today, Wang Yongyong was the only surgery scheduled at Ma Wentao’s hospital. She sat all by herself under the dim lighting of the corridor outside the operating room, helplessly crying to herself.

Meanwhile, Zhang Fan had his eyes closed as he sat down in a corner of the operating room. It wasn’t that he was sleeping. He was actually constructing a mental image of Wang Yongyong’s knee based on what he had seen in the scans. Li Liang would do all of the other pre-surgery preparations for him even if Zhang Fan wanted to do them.

Wang Yongyong’s knee injury was an old injury. The greatest difficulty about this type of surgery would be dealing with scar tissue and vascular remodeling that might cause unclear connections in the tissue. The knee joint was quite narrow internally, so scar tissue formed here would expand and pressure the knee joint, causing pain. Since the knee joint’s blood supply wasn’t very good, the pain would only get worse and worse.

Disinfection, washing hands, and maintaining a sterile environment were all completed, as these were the basics of all surgeries. The anesthesia began. Zhang Fan adjusted the medical equipment and then began the surgery. This knee surgery would be far more difficult than the surgery he’d performed on Guli’s knee.

Firstly, this was an old injury. Secondly, Wang Yongyong wasn’t that young anymore. Guli had been a teenage girl still in her growth period. Her body would automatically grow new tissue to replace the injured tissue over time. There was less damage to her body due to using arthroscopes, and she had also recovered faster after the surgery since she was younger.

Zhang Fan started the surgery by choosing a muscle tendon which he would need to cut into the shape and length of a ligament by using his scalpel. This was surgical work that required precision. The surgeon would need to patiently take things slowly. Being too hasty would usually result in cutting the tendon too short and wasting it. This job usually couldn’t be done by surgeons who were still unmarried, as they would be more impatient!

Zhang Fan slowly cut at the tendon while holding on to the mirror. In order to help the knee joint become flexible again, this tendon needed to be sturdy enough to get accustomed to torque and be able to absorb at least minor impacts as well as immediately act as a buffer.

The knee joint was a type of hinge joint which was highly scientific, the result of the human body’s evolution. When the knee joint was stretched straight, it would be affected by the knee’s locking mechanism, which limited how much the knee could twist. This function would help the human body to remain stable while standing. Without this locking mechanism, a standing person would twist left and right upon receiving even the lightest impact!

Wang Yongyong had formerly been a professional basketball player, which meant that he moved his knee far more than ordinary people would. His knee had also often suffered more powerful twists and forces than ordinary knees would. The result was that not only was his ligament damaged, even his meniscus was damaged.

Wang Yongyong’s current knee pain was because of patellofemoral joint misalignment. The goal of Zhang Fan’s surgery was to fix this damaged structure which had changed shape due to the old injury.

There was a significant amount of damage, fixing which required an incredibly good understanding of knee joint mechanics as well as sports medicine. This was why sports medicine doctors could be good orthopedic surgeons, but not all orthopedic surgeons would be good sports medicine doctors.

Sports medicine was specialized treatment for a specialized group of patients. Not only would sports medicine doctors need to help their patients recover regular functions, the patients would often expect that they could recover fully and be highly competitive in sports again. This meant that there truly were high requirements for sports medicine doctors.

The truly amazing sports medicine doctors were almost all in America. Sports medicine surgeries’ primary focus was to reduce damage to the body as much as possible, since no matter how wonderful the surgery, it might still be impossible to help a patient to regain 100% functionality like before.

The sports medicine doctor would usually also have to consider the patient’s profession. Only a highly skilled sports medicine doctor would dare to treat a professional athlete with a contract worth 10 million or more dollars. This was because the sports medicine doctor couldn’t only deal with the athlete patient’s pain through the surgery. The doctor would also have to guarantee the athlete’s long-term career, which would be truly difficult.

Zhang Fan began to repair and adjust Wang Yongyong’s knee joint. Due to Wang Yongyong’s weight, Zhang Fan decided to thicken his ligament. Wang Yongyong no longer needed to keep up a professional amount of exercise, but his weight had increased. Also, due to his knee pain over the years, his knee joint had gradually changed shape somewhat.

This surgery would really depend on the doctor’s foundational knowledge of evidence-based medicine. Although China’s medical abilities were rapidly catching up to the west’s, China was still far behind in developing evidence-based medicine.

In all of China, most evidence-based medicine was practiced only part-time. Why was this? Evidence-based medicine would take far too much time and money. Not only that, it wouldn’t have any effects in the short term. Evidence-based medicine required large amounts of time and large numbers of patients to establish scientific case records. The doctor would need to keep checking on a patient’s condition countless times over many years. The doctor might even need to keep checking on the patient until the patient died.

Since China’s society was still focused mainly on money right now, very few people would be willing to abandon their chance at earning more money and work in this field that required selflessness. Evidence-based medicine wouldn’t have any short-term benefits, but it was actually incredibly important for treating patients with chronic illnesses.

For instance, Wang Yongyong’s surgery. Should the surgeon thicken or reduce the ligament? Which method would help him to recover more function in his knee? In order to establish a strong system of evidence-based medicine, the national government would need to support its development. A single doctor or single hospital trying to do evidence-based medicine would be nothing more than a drop in the bucket.

Any second-highest level certification orthopedic surgeon at any Class A hospital would be able to successfully perform knee surgery on Wang Yongyong and help him no longer feel any pain. However, ordinary orthopedic surgeons would be unable to help his knee recover to the point where he could actively get involved in sports again.

Zhang Fan thus had a tremendous advantage because of his System. The medical treatment of the future highly valued evidence-based medicine. Zhang Fan’s System already contained countless highly successful examples of surgery with only the best results and methods for him to study from.

Zhang Fan went quite slowly in performing this surgery. There was a difference between knowing how to do this surgery and knowing how to do it well. It would even be impossible to do it knowing how if you didn’t have a tremendous amount of practice.

Zhang Fan had grinded surgeries in his System for two years already, yet there were still many surgery types that he wasn’t that familiar with. This was because the medical field was truly complex.

Surgical assistant Li Liang only watched Zhang Fan’s electrotome slowly cutting away without understanding what the latter was doing. The knee joint was far too complex. It was beyond Li Liang’s level. If Gao Shijun had been Zhang Fan’s surgical assistant today instead, he definitely would have started discussing with Zhang Fan why he was doing the cuts he was.

When it came to repairing ligaments, the medical field still currently had controversy and debate whether or not using suture augmentation for the posterior cruciate ligament was beneficial or not for the patient. However, the future had already proved that suture augmentation was definitely superior. This was Zhang Fan’s advantage. He had the medical knowledge of countless geniuses from the future due to his System!

Although Zhang Fan performed the surgery slowly, the surgery was really successful. Li Liang finished the last amount of work with stopping the bleeding, pressure dressing, and plastering a cast. “Brother Zhang, this surgery was far too complex. I didn’t understand a single thing you did today. I only saw you cutting and cutting, sewing and sewing, but really didn’t understand at all.”

“Yeah! For this surgery, you must first create a mental image of the knee joint’s structure, and then understand the patient’s typical habits on how he applies pressure to his knee. It really is rather difficult. Take things slowly! Don’t be in a hurry.” There really was no good way for Zhang Fan to explain things. Others didn’t have the System that he did, so they would only be able to slowly learn over time through their own hard work.

Normally, if a 20-year-old intern doctor like Li Liang worked really hard and got hired by a large Class A hospital, he would be able to perform this type of surgery at around 35 years old. Although he wouldn’t be able to achieve Zhang Fan’s current skill level even then, he would be able to help the patient recover normal functionality in the knee. However, for a doctor to achieve Zhang Fan’s current skill level in the year 2010, only the doctors at the very best hospitals in China would be able to accomplish the same feat of helping the knee to regain full functionality for heavy involvement in sports. Only the doctors that the top hospitals spent plenty of resources on developing would have this skill level. Additionally, the doctor would need to be at minimum 50 years old in order to have the experience necessary to reach this skill level. That was how powerful Zhang Fan’s System was!

The medical field was just that cruel. Any surgeon would be getting old by the time that his skills were so excellently developed. Although geniuses in other fields could easily establish themselves as experts at the age of around 30, that would be impossible in the medical field. A 30-year-old doctor would still only be starting out.

Doctors at major hospitals who were so fatigued that they slept on the floor of an operating room after surgery weren’t just doing it for show. They were actually quite pitiful and deserved sympathy, but others not in their profession wouldn’t know.

The public relations photos that hospitals would display about their doctors were only the tip of the iceberg. Currently, China’s medical system had plenty of problems, lots of corruption, lots of wrongdoing, and so on. But, was that something that the doctors could do anything about? You shouldn’t deny how hardworking and studious the doctors were because of factors that the doctors couldn’t change. They truly had it hard.

Was the outbreak of SARS infection in China scary? Those not in the medical field only knew that getting infected would be fatal. However, the doctors who went to go treat the SARS outbreak knew that they were at high risk of dying just by going to treat the outbreak. So many doctors wrote their wills and then courageously entered the quarantined districts. Were they afraid of the SARS? Only idiots wouldn’t be afraid of SARS.

After the SARS outbreak was finished, the doctors who entered the quarantined districts to treat the outbreak were rewarded by having 10 bonus points added to their children’s college entrance examinations. These 10 points were highly precious! These points had been obtained using the doctors’ lives.

Not a single doctor back then had quit the doctor profession, saying that they wouldn’t go! Not a single one! Who would be willing to risk death, if not the doctors? It wouldn’t be easy for anyone in such a special profession. Many things would be unknown to those not in the field.