I Am Diagnosed as a Medical Titan

Chapter 150: Chapter 126: An Unbridgeable Chasm

The examiner looked Jiang He up and down.

’This student is in a cast and not walking very fast. Factoring out the time it took him to walk, how long was he actually in Zone A? A minute? A minute and a half?’

’Whatever. My job is just to proctor the exam. I shouldn’t overthink it.’

The examiner said, ”Your assessment is for a case of traumatic shock with total collapse of peripheral veins. Requirement: Complete a great saphenous vein cutdown and cannulation within three minutes to establish a viable IV channel.”

In the emergency rooms of ’08, intraosseous infusion (IO) was not yet widely adopted.

When faced with a patient in severe shock with collapsed peripheral blood vessels, a great saphenous vein cutdown was a fundamental skill for any frontline emergency doctor.

But because it required incising the skin and isolating a blood vessel, the hands-on procedure was an extreme test of a doctor’s anatomical proficiency.

”You may begin when you’re ready. The timer starts the moment you pick up your first instrument.”

Jiang He hobbled to the right side of the operating table on his single crutch, shifting his weight to his left leg.

He picked up an iodine-soaked cotton swab and sterilized the area above the mannequin’s medial malleolus in a circular motion.

He tossed the swab and used his left hand to lay out a sterile drape.

”The patient is in severe shock and a deep coma, unresponsive to pain. To save their life, I will skip local anesthesia and proceed directly with the incision.”

After stating the step routinely skipped in clinical practice, Jiang He smoothly picked up the scalpel with his right hand.

He made a transverse incision in the skin above the medial malleolus with the tip of the blade.

The incision was two centimeters long.

He picked up two curved hemostats and performed alternating blunt dissection through the subcutaneous tissue.

With just two motions, a white, tubular structure was exposed in the operative field.

The examiner watched from the side, a brow slightly raised.

’He found the vessel way too fast.’

’A typical student would be overly cautious during dissection, afraid of severing the vein. But Jiang He’s movements were like... uh, coming home?’

Jiang He used the hemostat to lift the great saphenous vein.

With his left hand, he passed two ligature threads underneath the vein.

He ligated the distal end.

Then, he picked up a pair of ophthalmic scissors and made a small V-shaped incision on the anterior wall of the vein.

With his right hand, he picked up an IV cannula and slid it flatly into the vessel through the incision.

Blood return was visible.

He withdrew the stylet.

With his left hand, he quickly tied off the proximal ligature.

He secured the cannula.

He connected the infusion set.

”Cannulation complete. Channel established.” Jiang He let go and took half a step back.

The examiner glanced down at the stopwatch in his hand.

Forty-eight seconds.

Moreover, the incision was clean, the dissection was neat, and the ligature was secure.

Even a senior attending from the emergency department at Affiliated Hospital No. 1 with ten years of experience couldn’t match this level of skill.

The examiner was silent for a long time.

He suddenly felt a bit crushed.

’This kid’s a student, and he’s already this damn good. What does that make all my years of hard work? Huh?’

But on second thought, for a student to become this good, he must have endured a hundred, even a thousand times more hardship than the average person.

Thus, his bitterness turned into admiration.

The examiner ticked the boxes next to ”Anatomical Localization,” ”Incision and Dissection,” and ”Cannula Securement” on his form.

”Full marks.” He nodded slightly. ”Exit and turn left. Proceed to Zone C.”

”Thank you, sir.”

Jiang He picked up his crutch, turned, and pushed the door open to leave.

The examiner looked at the score on the form, walked over to a nearby computer, and entered Jiang He’s results into the system.

This competition utilized a fully integrated, real-time scoring system.

As soon as a score was entered, it would sync directly to the central screen in the main hall.

...

「Meanwhile.」

Academician Zheng was getting a little annoyed; his view from the center was so poor he couldn’t see Jiang He’s procedure clearly.

Gong Nian quickly escorted him to the VIP observation room at the back.

He then explained the expensive new scoring system they had implemented.

”Gentlemen, if you’ll please look here,” Gong Nian began, ”the chart on the large screen updates each student’s progress in real time. Zone A is clinical reasoning, Zone B is emergency practical skills, Zone C is radiological diagnostics, and Zone D is prognosis and treatment planning. A red light means the student is currently being tested, while a green light indicates they’ve passed and displays their score.”

Gong Nian pointed to the screen. ”This real-time, rolling score-release method ensures maximum fairness and avoids any post-competition disputes over score tallying.”

Minister Lin was quite pleased, nodding. ”It’s certainly efficient. Only one person should be out of Zone A by now, right?”

”Correct. Jiang He. He should be in the middle of a tough battle in Zone B right now.”

The words had barely left his mouth when the very top of the large screen updated.

[Southern Medical University Team, Jiang He. Zone B Practical Skills, Score: 100. Time: 48 seconds. Status: Has entered Zone C.]

The observation room fell silent for a moment.

Lin Zhenhua turned to Gong Nian. ”A tough battle?”

Gong Nian: ”Er, haha, it seems... it wasn’t much of a battle after all.”

Academician Zheng asked, ”What exactly was the test in Zone B?”

Gong Nian reported truthfully, ”A great saphenous vein cutdown and cannulation.”

After hearing this, Zheng Liyan remarked with a sigh, ”Forty-eight seconds for a cutdown and cannulation? It looks like he got in a lot of practice with Yang Xu at Affiliated Hospital No. 1.”

Lin Zhenhua also nodded.

It came back to the same old saying—a genius might be able to publish many papers, but when it comes to practical skills, this level of proficiency is impossible without countless hours of relentless training.

Not just talented, but also diligent and motivated.

This Jiang He! What a talent!

...

「Zone C, Radiological Diagnostics Room.」

The room was dimly lit, making it easier to see the film viewers on the wall.

An imaging film was clipped to each viewer.

When Jiang He entered, there was only one examiner inside, responsible for recording his answers.

”Zone C assessment.” The examiner pointed at the films on the wall. ”Five images. You have two minutes to state the primary diagnosis and key radiological features for each.”

This kind of film-reading test was no challenge for Jiang He at all.

It was no exaggeration to say that the number of films he had read in real-life practice was hundreds of times greater than the number of ”films” Li Wei had ever watched on his media player.

He hobbled on his crutch to the first film viewer.

”Anteroposterior chest X-ray. Significant mediastinal widening. Primary diagnosis: suspected aortic dissection. Recommend an immediate follow-up chest CTA.”