Surgery Godfather

Chapter 39: Chapter 0038: Elder Man Zhang’s Instructions

Iceberry ice cream! Uncle Two walked over, his belly protruding, to deliver it personally.

“Wow! How do you guys have this brand? It doesn’t even exist in G City.” Su Yixuan clapped her hands in surprise.

Uncle Two said, “You’ll have to ask him.”

“Me?” What could Yang Ping say?

“Thank you!” Su Yixuan took the ice cream from him.

Yang Ping rubbed the back of his neck, stuttering, his old face flushing red: “I–.”

At the soft whisper of Su Yixuan’s thanks, and the blush that bloomed on her face, Yang Ping was surprised that this man who only knew how to do surgery, knew of her love for Iceberry.

Yang Ping’s mind raced to Manager Huang, that headhunter from the website. It must have been him who orchestrated this. He was really quite unusual, special even. Knowing that there was no way Yang Ping would go to that Orthopedic Hospital, Manager Huang was still persistent, following him doggedly. But why?

Seeing Su Yixuan sitting and eating her ice cream, Yang Ping followed Uncle Two, immediately seizing the opportunity to ask him, “Uncle Two, what’s really going on?”

“Lad, weren’t you the one who asked someone to deliver the ice cream to me? You even instructed me to send up two whenever you dined with this young lady here. Ah, don’t put on an act, I won’t spill your secret. Go on, enjoy your meal. I have business to attend to.” Uncle Two waved his hand, his voice quiet as he explained, his final sentence intentionally louder.

After dinner, it was already past ten, but the customers in the restaurant showed no signs of reducing as the late-night snack time had just begun. Yang Ping dropped Su Yixuan back at the hospital dormitory. He cooled off at the skybridge before returning to his own apartment.

Recalling this week’s teaching surgeries — “horror triad” elbow injuries and distal humerus fractures — Yang Ping entered the system space, scrolling through the holographic screen to see if there were any such solo training packages available.

In the dense list of surgical training, he found these two items. The minimum requirement was to buy 500 simulations and each one required 4,000 points.

Calculating his points, he logged in an account containing 6,000 points, leaving him with 14,000 points.

These two individual items would cost 8,000 points, which was indeed quite pricey.

Looking at other fracture surgery training packages, each calculated for 500 cases, the humerus fracture was 2,000 points, the ulna and radius fracture was 2,000 points, the femur fracture was 3,000 points, and the tibia and fibula fracture was 3,000 points.

The packages like the one for the humerus fracture also include distal humerus fractures. The one for the fracture of the ulna and radius contained the “horror triad”. So it would be more cost-effective to buy these, but possibly fewer cases for the single conditions.

After careful consideration, Yang Ping bought the humerus fracture and the ulna and radius fracture packages. This left him with 10,000 points, allowing more room for emergency situations.

Since it didn’t consume real-world time, Yang Ping completed all the surgical training packages he had just bought inside the system space.

After finishing his shift in the morning, Yang Ping took Little Five on rounds and visited the Trauma ICU. The patient with the ruptured liver and spleen had been extubated and regained consciousness, though the patient’s face was still somewhat pale.

The ICU doctor saw Yang Ping come in, immediately joined him, and reported, “In the morning blood draw, the patient’s hemoglobin was 70g/L. After a massive blood transfusion, the heart rate was somewhat fast at 105 times per minute, and the blood pressure has returned to normal at 98/64mmHg”.

This data was essentially normal. A bit more blood and the hemoglobin would gradually correct itself.

“The blood bank says that blood is currently tight—now that we’re above 70, it’s somewhat difficult to get more blood.” The ICU doctor explained.

Yang Ping said, “Even without a transfusion, it shouldn’t be a big problem. Provide better nutrition in the future, prevent infections, and the hemoglobin should gradually recover, creating a virtuous cycle.”

The patient recognized Yang Ping, and tried to sit up. The ICU doctor held him down: “You can’t get up yet.”

“Doctor, thank you for saving my life.” He extended his hand. Yang Ping shook it, saying, “It’s my duty.”

Really, it was simple for doctors. The greatest fulfillment was saving the lives of patients.

“There shouldn’t be a big problem now.” The ICU doctor also knew Yang Ping was now an integral member of Orthopedics, one of Director Han’s several commanders. He was very polite to Yang Ping, clearly not treating him as an ordinary attending physician. There was a lot more respect in his speech compared to how he treated the regular attending physicians.

After making rounds in the ICU, Yang Ping received a call from Director Han, telling him that Professor Zhang Zongshun wanted to see him in his clinic, as he had something to discuss.

Professor Zhang Zongshun was someone that young doctors avoided. He was eccentric and his demands were strict. If he noticed that you hadn’t buttoned your white gown properly, he would scold you for half an hour.

Yang Ping shuddered at the thought, quickly checking his white gown. Noticing an unbuttoned button, he hastily corrected it before making his way to the outpatient clinic.

Professor Zhang was a nationally renowned professor of orthopedics. His clinic consisted of an inner and outer suite. The outer suite was a sitting room equipped with a sofa, a coffee table, and a water dispenser – a place for relatives of patients to rest. The inner suite was his proper consulting room, which was rather spacious. It had a diagnostic bed against one wall, curtained off for privacy. Two desks and two computers were pushed together, the screens connected for shared use, with a young graduate student assisting him.

Yang Ping knocked gently and entered the room, greeting the graduate student before finding a corner to stand in where he wouldn’t be in the way.

Old Zhang was in the middle of seeing a patient, his reading glasses held together by tape. The patient lay on the diagnostic bed, wearing a crumpled blue work uniform. As Old Zhang examined the patient’s elbow joint, he mused, “Hmm, only four thousand yuan, huh? Budget’s a bit tight, let me work something out.”

The patient hurriedly explained, “Professor Zhang, I work as a laborer at a construction site. My boss ran off without paying our wages. This money was collected by my coworkers. We’ve been to several hospitals, but they all say that four thousand yuan isn’t even enough to buy the screws, let alone pay for the plate and screws which would cost over twenty thousand.”

“Indeed, a steel plate and screws can amount to over twenty thousand yuan. Now, even the cheaper ones cost upwards of ten thousand yuan and they’re hard to find. Let me see, don’t worry.” After finishing his examination, Old Zhang returned to his desk and scrutinized the X-rays under his viewing light.

After examining the X-rays for a few minutes, Old Zhang said, “Don’t worry, comrade. You need money to eat too. I reckon we can only allocate three thousand yuan for the treatment. I will plan accordingly.”

Assisted by his coworkers, the patient got up. The graduate student helped reapply his cast and secured it with bandages, then hung it over his chest.

“Thank you, Professor. I’ve been to several hospitals. They all just glanced at my X-rays before telling me it’s impossible with four thousand yuan, suggesting I go to a different hospital, then promptly ignored me,” the patient said, tears welling up in his eyes.

Upon noticing Yang Ping had arrived, he beckoned him over. “Come here, come here, take a look!”

Yang Ping immediately walked over, putting on a friendly smile, while Old Zhang added, “This one only has three thousand yuan. If we don’t treat him, he’ll be disabled. Here’s what we’ll do: admit him, and you’ll perform the surgery. Don’t use a steel plate; just proceed with a Kirschner wire. Preoperative examination should only include routine blood, biochemical and serological tests, as well as a kidney function test, and an EKG. He doesn’t have a cough, does he?”

“No, I don’t. I’m in good health. If not for the fracture, I wouldn’t have ever needed to go to the hospital,” the worker promptly replied with confidence.

Old Zhang reflected briefly, “Let’s not take a chest X-ray to save some money. We’ll perform the surgery and discharge him three days afterwards. The cost should be kept around three thousand yuan, we mustn’t go over budget.”

The consumables for fracture surgery, like steel plates, were expensive, costing tens of thousands of yuan, with imported ones being even more pricey. Kirschner wires, on the other hand, were essentially thin steel pins. Affordable and even at a few yuan apiece, this was virtually free. However, the Kirschner wire could only be used for simple fractures, like those of the hands and feet, and wouldn’t work for more complicated fractures.

Goodness, Old Zhang, using a Kirschner wire for this kind of surgery might have worked decades ago when function wasn’t a major concern. But in today’s era, function is key. This kind of fracture can’t be properly fixed with Kirschner wires. If it’s not fixed properly, the patient can’t start exercising early. This kind of distal humerus comminuted fracture is particularly delicate and if it isn’t exercised early, the joint will stiffen in three weeks’ time. He’s really giving me a hard problem to solve.

Without leaving room for Yang Ping to discuss, Old Zhang adjusted his glasses and directed the graduate student to issue an admission notice: “Arrange admission and get the surgery scheduled as soon as possible.”

“That’s all. You may go back to your work,” Old Zhang stated.

That’s it?

“Wait, Old Zhang?” Yang Ping wanted to argue.

Old Zhang waved his hand dismissing Yang Ping’s concerns: “Consider this an assessment for surgical cases.”

He leaned in and whispered, “You don’t have to perform the two surgeries I assigned you last time. Just do this one, and do it properly. If not, I’ll give you a score of thirty!”

That conniving old man, always playing dirty. Everyone was playing him, this was ridiculous! How was he supposed to use a Kirschner wire for this kind of fracture? Professors from Beijing and Shanghai wouldn’t even be able to perform this surgery. He was truly in trouble now. No wonder when Old Han and Song Zimo heard Zhang had chosen him, they adopted an “it’s your problem now” attitude.

Yang Ping refused to leave the consulting room, hoping to catch Old Zhang during a moment of respite to discuss the issue further. However, Old Zhang was busy meticulously instructing the patients on the admission process, cheap food options, and how to protect their belongings from thieves. He then turned his attention to the next patient, paying no heed to Yang Ping.

A young, stylish woman wheeled in a patient suffering from chronic osteomyelitis of the tibia. The patient had undergone treatment at several hospitals and had already had six surgeries.