Path of Medicine With a System
chapter-188

The spleen was the most easily injured organ in the abdomen. It would also bleed massively if it was damaged. When saving patients with multiple serious injuries, the proper strategy would be to save the patient’s life as the first priority, and to preserve the organs only after. When Zhang Fan reached the abdomen, he already knew that the patient’s spleen and left kidney were unsalvageable.

This was really difficult and cruel! Would you want to be alive but missing a kidney and spleen? This border security military policeman patient was only about 20 years old or so, yet he would be handicapped for the rest of his life, with pain accompanying him forevermore. Right now, all Zhang Fan could do was to try to save the warrior’s life as well as reduce the amount of pain he would feel afterwards.

First, Zhang Fan needed to perform ligation on the splenic artery in order to lessen the bleeding. This would allow the large amount of blood in the spleen to circulate back into the patient’s body, becoming the best form of self-transfusion. In order to do this, Zhang Fan first cut open the gastrocolic ligament and gastrosplenic ligament, and then performed ligation on the blood vessels in the ligaments before entering the lesser omentum cavity and exposing the pancreas.

He came into contact with the palpitating splenic artery on the pancreas, and selected a portion of the splenic artery at the junction of the pancreatic head and tail where he cut into the retroperitoneum and used forceps to carefully separate the splenic artery and ligate it with thick threads. Two threads would be necessary to ligate the splenic artery, and it couldn’t be ligated too tightly. Closing the blood vessel was all that was necessary, and tearing the blood vessel walls had to be avoided. Additionally, the doctor would need to carefully avoid damaging the splenic vein which ran parallel to the splenic artery.

Ye Bo was the only doctor who was even slightly of help to Zhang Fan in this surgery. Tu Xun and Ainur, the other two surgical assistants, were incapable of doing anything other than holding the surgical retractors.

Meanwhile, as Zhang Fan continued his emergency surgery, Zhao Quanping who was performing surgery in the same operating room suddenly shouted, “Hurry! IV drip! Administer Cedilanid! Hurry!” It was obvious from the tone that Zhao Quanping was feeling quite anxious and helpless.

“Director Zhao, it’s no good! The medicine isn’t having any apparent effect!” said the anesthesiologist.

“Electro cardioversion!”

Loud sounds then came from the fibrillator. Zhao Quanping looked at the patient’s screen expectantly as he really wanted this warrior’s heart to start beating again, but in the end, his patient couldn’t be saved! Zhao Quanping could only tightly clench his hands.

“Please send him off!” Zhao Quanping whispered in a soft voice. His patient’s injuries had been far too severe. The border security military policeman’s luck had been too poor. A bullet had damaged his abdomen severely. What was even more cruel was that the bullet hadn’t been immediately fatal. Instead, this warrior had to suffer tremendous pain before finally passing away.

Zhao Quanping finished sewing up the patient’s injuries as a nurse gently wiped away the traces of blood on the patient’s face and helped to straighten the incredibly tattered border security uniform. The patient was then lifted up onto a gurney. A white cloth was then draped over him before he was slowly pushed out of the operating room.

However, this still wasn’t the time to be mourning. There was still another surgery and patient waiting to be saved.

Zhao Quanping calmed himself down and set aside his feeling of defeat as he came over to ask Zhang Fan, “Doctor Zhang, how are things going?”

Zhao Quanping’s meaning was quite obvious. Did Zhang Fan need his help? Zhang Fan wasn’t even a member of the general surgery department, yet his skills were equal to general surgery director Zhao Quanping’s. Asking if Zhang Fan needed his help was a sign that Zhao Quanping respected Zhang Fan as a doctor equal in status to himself.

“There’s far too much bleeding. I just finished ligating the splenic artery. I haven’t dealt with the kidney yet. Please hurry and come help me.” Zhang Fan could get angry and shout at his assistants, but he wouldn’t be able to tell someone who hadn’t been in the surgery that his surgical assistants were incompetent, as that would be going far too overboard and would be considered humiliation!

Still, it was a fact that Zhang Fan’s surgical assistants were unable to follow his movements or complement him very well. Zhao Quanping changed into new surgical attire and joined Zhang Fan’s surgery. With him assisting, things became much different. Zhang Fan didn’t need to tell him what to do everywhere like he had to with Kuake City Hospital’s doctors. Zhao Quanping performed excellently with holding the surgical retractors, draining the blood, forceps, ligation, and so on. He and Zhang Fan worked together especially well with tacit cooperation. The speed of the surgery greatly increased as Zhang Fan cut out the spleen, cut out the left kidney, and cleaned the abdomen.

This was all due to the overwhelming might of modern-day weaponry. Just getting brushed by the bullet would cause all touched organs to completely die and rot. There was also severe damage to the patient’s intestine. Zhang Fan was forced to cut off quite a long part thereof.

“Sigh! This patient won’t even be able to enjoy eating a full meal in the future! It’s such a pity!” Zhang Fan couldn’t help but make such a sad comment after he removed the damaged intestine portion.

“At least he’s still alive. The patient that I just operated on had his entire abdomen turned into meat mush. Although it didn’t seem like he had a large injury or much bleeding, everything in his abdomen had completely turned into mush. Sigh! He was so young. I think even my son is only slightly older than he was, yet he was already fighting on the battlefield to protect our country, while my useless son is still playing computer games every day! My son doesn’t even know how to support himself yet!” Zhao Quanping could only exclaim at how things were. He was getting older. As he thought about the warrior who sacrificed himself that he just operated on, he couldn’t help but think of his own son.

In the end, only three of the six emergency military patients were successfully saved. The saved ones included Zhang Fan’s patient, orthopedic director Gao Shijun’s patient, whose leg was injured by a grenade and had to be amputated, and a patient who was shot in the upper part of his chest. The last patient had been quite lucky as the bullet had penetrated through the apex of the lung and into the shoulder blade, shattering the patient’s shoulder severely. Although this patient’s injuries were serious, they weren’t actually fatal.

Zhang Fan felt especially frustrated as he looked at the patients’ injuries which came from guns and grenades. For gun injuries, on the surface the patient would only appear to have a tiny injury the size of a small coin. Internally, however, the size of the damaged area would be bigger than a watermelon. These types of injuries were far too difficult to deal with as there would be severe bleeding, and the organs would start failing rapidly. There were some bullets that had even completely smashed the patients’ organs. Saving three of the six patients had only been possible because all of the best surgical experts of Chasu City Hospital had all been sent here. Otherwise, the result would have been far worse!

Kuake City Hospital had set aside two empty patient rooms to place all of the emergency treatment medical supplies and equipment into. The three warriors who were luckily able to survive their serious injuries wouldn’t be able to leave Kuake City Hospital just yet. They would have to stay here for postoperative care and observation.

Chasu City Hospital’s doctors and nurses were taking charge of these patients. The patients would have someone accompanying them for 24 hours a day.

Chasu City CPC’s leader especially told Superintendent Ouyang, “It’s really precious to have people willing to sacrifice themselves in an era of peace. They’ve already done everything that heroes should. We can’t have our heroes cry after they bleed. I don’t understand the medical profession, but let me stress that you must help them recover no matter the price. Feel free to directly contact me about any difficulties. Chasu City CPC will fully cooperate!”

This had been a sudden incident. The higher-ranking leaders of the military police had yet to arrive, so Chasu City CPC’s leader was in charge here!

Three gurneys covered in white cloth were neatly displayed side-by-side in the large main hall of Kuake City Hospital. The young warriors on these gurneys had now gone to an eternal rest. The doctors had tried their very best, but were unable to take their lives back from the god of death.

The military police captain, who was a man that looked like he was made of iron, started crying as if he was a young child. They were all his soldiers. Just yesterday, they had all been eating a meal and training together in a lively manner, yet three of them were now cold and icy, gone forever.

“Get up! You three need to get up! If you’re real men, then get up!” His voice was filled with bitter sobbing.

These warriors of steel would usually bleed without crying. However, that was only because they hadn’t been hurt enough in their hearts. Past memories of fun times together or sweating together during training flashed through all of the warriors’ minds as tears started streaming down all the border security military policemen’s cheeks. These military personnel who typically had such solemn expressions were defending the chaotic border with their blood and sweat, all for the sake of letting people be able to freely and peacefully go out and about on the streets.

It was over, all over now for these three border security members! Uniformed military policemen and uniformed doctors stood by the sides of these three gurneys as they saw off these heroes.

“Brothers! Have a safe trip!” The military policeman captain took off his hat and bowed to the three gurneys. He had cried so much that he had basically lost all his energy. He also really regretted things as he had personally trained these warriors! Normal people wouldn’t be able to understand the pain in his heart. However, there was no medicine in the world that could help one with regret! Sending someone to the battlefield and then having to bury him was something that only military personnel would understand!

The three who survived would receive compensation money for their permanent injuries. However, they would have to bear chronic pain for the rest of their lives, as well as tackle problems with re-entering society, which would be a non-physical pain that they would also need to bear.

Were illegal drugs scary? Indeed. Illegal drugs wouldn’t only fuel the problem of addiction. Far too many evil consequences would accompany illegal drugs, such as AIDS, social instability, and so on.

The absolutely beautiful cities in the border province also had tremendous numbers of people with AIDS! Why was this? It was all brought by the neighboring chaotic countries, through their large amounts of smuggling and sex trafficking. It was also fairly common for those in the neighboring countries to learn how to speak Chinese for easier communication. Once AIDs started spreading, it would spread through all sorts of channels at an astonishing pace. Illegal drugs and AIDS thus became dark clouds looming over this beautiful paradise.

Superintendent Zou woke up and stopped pretending to be unconscious after this incident was all over. However, he was finished! Right after the surgeries for the emergency military patients finished, Kuake City CPC’s leader gave the order that Superintendent Zou was fired from his position as leader of Kuake City Hospital. In his place, Shi Lei was promoted to being the new superintendent. Shi Lei, the former orthopedic surgeon, was now in a fully political and administrative position, completely saying goodbye to having to rely on his medical skills.

The directors of Chasu City Hospital’s ICU, respiratory department, general surgery department, and orthopedic surgery department each left behind one doctor from their respective departments who would be in charge of continuing to look after the three lucky survivors. The other doctors all hurriedly returned to Chasu City because they would still need to go to work as usual the next morning. No matter who died, it wouldn’t stop the sun from rising the next day or other patients from needing their help.

Zhang Fan and Zhao Quanping happened to ride in the same military policeman’s car on the way back. Silence reigned for a long time in the car before Zhao Quanping gently broke the silence. “What will their parents do?”

“Sigh!” Zhang Fan could only listlessly look outside the car window. Such violent injuries were truly too shocking to behold. Zhang Fan had grown up knowing only peace. He had been truly astonished by the extent of the border security military policemen’s injuries.

He and Zhao Quanping could only chat about this a little in the car now, because before everyone got on the military police cars to go back to Chasu City, Superintendent Ouyang had given everyone the command that they weren’t to tell anyone else about this incident. This was out of worry that ordinary citizens would panic if they learned that a major shoot-out had occurred so close to them.

Life returned to its ordinary calmness. Zhang Fan began to work hard at studying English. Although he had tested for Level 4 English during college before, he had yet to ever touch English again since his final examination. He really had forgotten most of his English, so he would need to start over from the beginning again.

On the weekend, general surgery director Professor Li of Dee University Affiliated Hospital brought his medical team and patient to Chasu City Hospital as promised. Chasu City Hospital’s doors, buildings, and hallways were completely covered in advertising, making full use of Dee University Affiliated Hospital’s reputation as a provincial hospital in order to improve Chasu City Hospital’s standing.

Li Jingjin saw so many such advertisements on the way that his expression darkened. He felt that Superintendent Ouyang was taking way too much advantage of the situation without caring about giving face to Dee University Affiliated Hospital. However, there was nothing he could do about this, as he was the one who wanted to come and learn here.

Things were slightly better in the hospital’s conference room as the medical equipment supplier merchants were in charge of arranging things here. Everything for the conference was arranged rather extravagantly. All of the bottled water was imported. A 200 yuan shopping mall gift card was prepared for every single doctor attending this academic conference. The medical equipment supplier merchant in charge of hosting this conference was a young and highly skilled person. No other explanation would be necessary.

The medical equipment supplier merchant had truly been willing to spend a lot of money on these potential customers. Many doctors had arrived for this academic conference to view the liver tumor removal surgery. Several hundred people all sat down in the large conference room at Chasu City Hospital.

Cameras and microphones were adjusted as Superintendent Ouyang personally hosted and began the conference. “Fellow experts and doctors, I welcome you all to Chasu City Hospital. I represent everyone who works here at Chasu City Hospital in warmly welcoming you here today. Today, a doctor at our hospital is fortunate enough to work in a surgery together with a professor from Dee University Affiliated Hospital. Everyone, please give them your advice and criticism after you observe the surgery.” Superintendent Ouyang was feeling quite proud. Of course she would be very happy! The previous superintendent Huang Yun had worked in surgery for all his life, yet he had never been able to accomplish anything grand for the hospital. Meanwhile, just look at her, and that was despite being on the job for less than a year so far!

Inside the operating room, pre-surgery preparations were still being made. Professor Li’s doctorate degree students would be in charge of doing this work. Professor Li joked with Zhang Fan, saying, “When I return to Raptor City, I think I’ll be scolded. Your Superintendent Ouyang is really too amazing.”

What could Zhang Fan even say about this? He found himself unable to reply. However, the Chasu City Hospital anesthesiology director responded first. “Would the superintendent of DUA Hospital even be willing to scold you? I heard that you were invited to Beijing for a surgery a few days ago. Here in the border province, you’re this in general surgery.” The anesthesiology director gave Professor Li a big thumbs-up.

“Hey! This is embarrassing. Do you know what surgery I went to perform in Beijing?” Professor Li had an awkward expression.

“What was it?” Zhang Fan was also curious. He had wanted to help with the pre-surgery preparations, but Li Jingjin wouldn’t let him.

“A leader in the border province with rather special status somehow managed to get hepatic hydatid tapeworms. I was the one who personally diagnosed him. I recommended to him at the time that he should have surgery performed, and he said he would consider it. One week later, Old Chen from Zhongyong Hospital in Beijing called me, telling me that there was a tapeworm surgery that I should fly over to perform. Although we’re just a border province hospital, honestly, we’re probably the best in the whole world, not just China, at performing tapeworm surgeries.”

The anesthesiology director nodded, and asked, “And then?”

“And then things were so awkward! I hurriedly flew over to Beijing, and hey! Wasn’t that a familiar face? I would be operating on the same leader that I had diagnosed and made a recommendation to. He felt really awkward as well since we saw each other again thousands of kilometers away in Beijing. Sigh!”

As they chatted while waiting for the pre-surgery preparations to be completed, the two doctorate degree students that had come along with Professor Li became rather unhappy. The two of them barely ever had to do such menial tasks at Dee University Affiliated Hospital anymore. Yet, they now had to do work normally done by a resident doctor here at a smaller city hospital. What seemed the silliest to them was that the primary surgeon was a young doctor who appeared to be even younger than they were.

These two doctorate degree students had already worked hard at the provincial hospital, a higher-level medical field, for seven or eight years already. They really didn’t believe that a regular young doctor in a smaller city in the border province would be able to accomplish such a difficult surgery. That would go completely against all of the hard work they had to put in over more than a decade already.

The doctorate degree students had spent five years as undergrads, three years as master’s degree students, and two years as doctorate degree students. As for Zhang Fan? He appeared so young that he likely only had an undergraduate degree at most. Yet, Zhang Fan was sitting there and chatting with their professor as an equal. Not only that, it seemed like their professor was trying to get into Zhang Fan’s good graces! Didn’t this seem like they had studied so hard over a decade for nothing?

Only the elites of the elites would be able to come with their teacher to perform such a critically important surgery. Although there were also plenty of doctorate degree medical students out there, there were many of them who wouldn’t even be able to recognize all of the medical equipment.

Although the two doctorate degree students were dissatisfied, their teacher was right there. No matter how dissatisfied they were, they wouldn’t express it. They decided to simply watch the surgery. For doctorate degree students who were still in their studies, their teacher’s words would be the law.

The surgery began. Zhang Fan took the primary surgeon position after anesthesia was finished. Zhang Fan truly was becoming more and more amazing. Here in a Class A hospital, even the operating room head nurse would rush over to help him put on surgical garb, which was quite something. Normally, even the department directors wouldn’t receive such treatment from the head nurse.

“Doctor Zhang, what type of incision will you begin with today?” Professor Li inquired. Zhang Fan was too much the silent type who wouldn’t say anything to you unless he was asked. This made Professor Li slightly sad as he had been a professor for many years already. He really was a bit embarrassed to have to raise questions with a doctor who was much younger than he was!

Actually, this was all because of Zhang Fan’s personality. He felt that he was still just a low-ranking doctor, so it would be quite awkward to try and teach a professor about a surgery. That was all there was to it. There was no salvaging Zhang Fan!

“Let’s use a standard incision. Professor Li, shall we begin the surgery?” Zhang Fan asked.

“Begin, begin!” This was a really awkward conversation where both felt awkward.

“Turn on the microphones and cameras! Connect to the conference room!” Chasu City Hospital’s technical department personnel started displaying what was happening in the operating room to all the doctors waiting in the conference room.

“Alright, the surgery is beginning now. Everyone, please take good care of our doctor!” Superintendent Ouyang put down her microphone and sat down on her seat.

When the video feed began, many doctors watching the surgery in progress made audible sounds of surprise. They had thought originally that perhaps the general surgery director of Chasu City Hospital would be performing this surgery. Yet, it turned out to be a doctor that they didn’t recognize. This doctor appeared to be very obviously young, which made the other doctors incredibly astonished. These surprised doctors were mostly all doctors from other hospitals in Chasu City.

The doctors from smaller cities within Chasu City’s jurisdiction were also really surprised, because they never expected that the Doctor Zhang they invited so often because he would always share the surgery fees with them was actually capable of such a high-level surgery. Some of them couldn’t help but say out loud, “Zhang Fan! Doctor Zhang!” Plenty of doctors in the area recognized him as Zhang Fan had already become relatively well-known in the area around Chasu City.

In just one short year, Zhang Fan had made a name for himself in the smaller cities around Chasu City. Although this was also thanks to his System’s assistance, he wouldn’t have been able to gain so much reputation for himself without his willingness to grind as well as sacrificing a part of the profits he made to share with others.

Because of the doctors who recognized him spreading the information, soon all the doctors present at the conference learned that the primary surgeon for today was named Zhang Fan!

The surgery had begun. Zhang Fan’s movements were incredibly swift. He was already highly familiar with this type of surgery due to having practiced it many times in his System. Professor Li had also mimicked Zhang Fan’s movements during the previous large liver tumor removal surgery many times by himself at night after work already. This was because Professor Li was the genius type who constantly strived to improve further. How could a genius rise to reach the peak of a specific medical field? It would be impossible to do this with talent alone, as hard work and the desire to improve would also be necessary!

While Zhang Fan’s movements were really swift, Professor Li was right there, matching him in speed. The two doctorate degree students were indeed highly skilled as well. As surgical assistants, they provided nearly perfect vision with the surgical retractors. They were so skilled as surgical assistants that they were almost as good as Zhang Fan’s System’s perfect AI-controlled surgical assistants for simulated surgery practice.

Since this was an educational surgery which was being recorded and observed by many other doctors, there was almost no communication between those in the room. The entire process was silent. For doctors of their level, there was no need for communication. Zhang Fan didn’t even need to tell the others what they should be doing.

Zhang Fan slowed down once he entered the patient’s abdomen. He couldn’t be hasty here in the abdomen. As expert general surgeons would often say, “Slow is quick”. Zhang Fan slowly began to perform ligation to stop the bleeding.

The head nurse of the operating room even acted as Zhang Fan’s personal nurse! In the conference room, when the surgery reached the patient’s abdomen and all the doctors saw the tremendous tumor on the screen, they couldn’t help but exclaim. The patient’s tumor really was too large, and was located in the exact center of the liver. Not only would none of the doctors present be capable of performing such a surgery, they would all agree that this would be a classical example of a surgery case that could be written into any surgery textbook as “impossible to accomplish”!

But then, their worldview was about to be overturned. This was the deficiency of doctors here in the remote border province. The classical ideas that they worshiped might be outdated, but they wouldn’t even realize it!

“It will be really difficult for the patient to even be able to live through this surgery, honestly! This Professor Li is acting quite ridiculously,” the general surgery director of another hospital in Chasu City remarked to another general surgery director.

“I don’t think it’s that ridiculous. Do you really think that Superintendent Ouyang would make this into such a big deal unless she had a great guarantee of success? I don’t know about the success rate of this surgery, but I do know that she’s an amazing character. There definitely won’t be any problem,” the other general surgery director responded.

Zhang Fan slowly peeled away the tissue and slowly stopped the bleeding. The scary part of a tumor was that it would have unclear connections with the tissue. In order to surgically remove a tumor which had a one-centimeter radius, the surgeon would need to cut out at minimum a five-centimeter radius of tissue around the tumor or more.

Zhang Fan was someone who only had average talent and intelligence if not for his System. But now, he was finally at the peak of surgical skill in Chasu City. This surgery would be his way of proving himself.

Back when he had just graduated, he felt nothing but helplessness. He had even been jealous of others who had been born with better parents than him. He had to ride a bike everywhere in search of a job. Finally, his hard work over the past two years after receiving his System had paid off. Right here, right now for this surgery, Zhang Fan was by far at the extreme forefront of all others in his age group as he concentrated fully on this surgery.

The heavens would favor the hardworking. As long as you were willing to work hard enough, even if you started in a mud ditch or rainstorm, you would be able to crawl out sooner or later and see the rainbow. No need to wait! No need to rely on others! If the person you relied on suddenly collapsed, then you would collapse as well. Only personal strength would be true strength.

The two doctorate degree students assisting in the surgery were having some slight difficulty breathing. They knew who had invented this surgical technique, and how highly technical and difficult this surgical technique would be.

Today, right here and now in Chasu City Hospital, a minor resident doctor gave them a lesson that they would never forget. What was precision surgery? What was the most accurate type of liver tumor removal surgery? Professor Li experienced this better than anyone else. Last time, he had only observed Zhang Fan’s surgery from the side. This time, he was directly working as Zhang Fan’s assistant. Was this type of surgery difficult? It really was! It would likely take Professor Li another 10 or more times of working as an assistant on this type of surgery before he could master it enough to independently perform it by himself.

This was because the tumor was far too large, and located in the exact center of the liver. Just one small accident would easily cause liver failure or lead to unsuccessful removal of the tumor by not having removed enough of the cancerous tissue. For such a surgery, there would be no second chances if you failed. If you failed, either the patient would die, or the cancerous tumor tissue would spread too much to be able to safely remove it!

Zhang Fan finally spoke slowly after he made the final cut.