System Came When the Doctor was Thirty

After seeing off his uncle Lu Nanyong, Lu Cheng headed straight to the ’Training Room’ his family had modified at home!

As he pushed open the door, the mingling smell of tofu, dried tangerine peel, and pig skin assaulted his nostrils, making Lu Cheng instinctively furrow his brows.

[Overall Level: Inpatient Doctor.]

[Basic Theory: Surgery (Skilled 9/10), Orthopedics (Skilled 8/10), Basic Theory of Hand Surgery (Skilled 7/10), Basic Theory of Trauma Surgery (Skilled 8/10), Emergency Medicine (Skilled 5/10)...]

[Surgical Basic Skills: X-ray Film Reading Skill (Skilled 8/10), CT Film Reading Skill (Skilled 8/10), Magnetic Resonance Imaging Reading Skill (Skilled 9/10), Surgical Instrument Operation Experience (Skilled 8/10), Physical Examination (Specialization 1/20), Auxiliary Examination Reading Skills (Skilled 9/10)]

[Surgical Basic Operations: Incision Skill (Skilled 9/10), Wound Cleaning Skill (Skilled 8/10), Suturing Skill (Skilled 8/10), Knotting Skill (Skilled 8/10), Puncture Skill (Skilled 7/10), Hemostasis Technique (Skilled 4/10).]

[Surgical Basic Techniques: Open Fracture External Fixation Surgery (Skilled 1/10), Fracture Manipulation and Reduction Skill (Skilled 2/10), Fracture Open Reduction Internal Fixation Surgery (Skilled 0/10), Joint Dislocation Manipulation Reduction Technique (Skilled 1/10)...]

Lu Cheng looked at his dashboard, his smile a bit forced.

Basic theory can be learned by reading books, film reading skills can be improved by extensively reading radiological materials, and basic surgical skills can also be practiced in the ’Training Room’.

But surgical operations cannot be practiced in the ’Training Room’; learning surgery is a painstakingly slow process.

”The emergency department doesn’t handle fracture surgeries, and Director Peng of the orthopedics department wouldn’t allow the emergency department to handle fractures, shaking the orthopedics’ foundation, so let’s not worry about it for now.”

”In the emergency department, if simple wound cleaning and suturing can be done, then just do simple wound cleaning and suturing.”

As Lu Cheng spoke, he opened the notebooks he kept in the training room.

These notebooks were filled with notes he accumulated from practicing basic skills at a teaching hospital, documenting the capabilities corresponding to different levels of proficiency.

[Suturing Skill, shallow suturing of tofu (completed), stretching the compression band for suturing (to be surpassed), after successfully suturing the stretched compression band, can suture tendons. In Long County People’s Hospital’s orthopedics department, no one can perfectly and smoothly handle tendon suturing.]

”Since Director Peng says tendon injuries don’t go to orthopedics from the emergency department and must be referred out, I’ll use tendon suturing as a breakthrough point.”

Every step of improvement in medical technology requires years of honing.

Although Lu Cheng’s basic skills aren’t considered poor within his department, and his abilities in wound cleaning, suturing, and such basic skills don’t pale compared to even the deputy chief physicians, they are just on par, not exceptional.

[Remaining Skill Points: 13.1 points.]

Should he try adding points?

[Suturing Skill (Skilled 10/10), needs 10 skill points to break through to the next proficiency level.]

”Breaking through again? Seems reasonable enough.”

With 11.1 skill points left, Lu Cheng naturally chose to break through.

[Suturing Skill (Specialization 0/20), basic skills in suturing improved, suturing skills improved passively. Tendon Suturing Skill (Beginner 2/5), Skin Flap Transplantation and Suturing Skill (Beginner 4/5).]

After adding points, it felt as if a warm current surged randomly in Lu Cheng’s hands, converging in his palms and gradually dissipating, but nothing new appeared in his mind.

The methods for tendon suturing aren’t ”unspoken secrets”; one can find a bunch of theories online. In such an information-rich era in 2023, accessing theory poses no challenge.

Yet, surgical techniques aren’t achieved simply by knowing the theory and understanding how it’s done in the mind.

Just like cooking, apart from knowing the ingredients, handling the food materials and controlling the heat are crucial. Any slip in any step will affect the final taste.

If one could perform surgery just by knowing how to, viral doctors on short video platforms would have long cultivated millions or tens of millions of top surgeons, and Hua Country’s surgery would be terrifyingly strong!

Compression band isn’t a direct translation of a Japanese jargon; it’s a tool used by nurses for venous blood draws, with good elasticity.

Stretching the compression band, as the name implies, involves placing the compression band in a stretched state, cutting it short, and then using a suture to sew it up, achieving suture continuity and no tears in the compression band, and thus reaching proficient suturing skills.

This is a beginner practice material that parallels tendon suturing and serves as an entry-level material. If one wants to practice higher tendon suturing skills, one would need to buy real animal materials like pig tendons for practice.

Tendon suturing is an entry-level hand surgery operation; starting is not easy, mastering it is even harder.

More than eighty percent of surgeons can’t perform tendon suturing, and saying hand surgery is boasting isn’t unfounded…

Lu Cheng had watched practice videos of suturing the stretched compression band online; using nails to keep the compression band in a passive stretched state, then cutting it with scissors, causing the band to retract upon breaking.

He meticulously recalled the standard steps for tendon intermittent suturing and began performing simple interrupted suturing.

Simple interrupted suturing is the most basic suturing technique, attainable by interns.

However, performing it well is no easy task.

Even to start practicing suturing stretched compression bands like Lu Cheng requires layer upon layer of practice to have the ambition to aim for it, otherwise, it’s a waste of materials.

For example, the most basic is suturing human-like rubber, banana skin, orange peel, half-layer suturing of orange peel, orange pulp peel suturing, deep tofu suturing, shallow tofu suturing.

Most surgeons probably give up at the half-layer suturing of orange peel…

Specialties that don’t require high-level suturing techniques don’t bother with flashy suturing, as long as the skin is approximated well without infection, it suffices.

Lu Cheng picked up the needle holder, feeling the ears of the needle holder scrape against the calluses on his right ring and middle fingers, causing slight discomfort, but he quickly accustomed to it.

Approximately twenty minutes later.

Lu Cheng examined his three sutured compression bands, put down the needle holder, took off his examination gloves, and scrutinized them carefully…

”One of them is actually torn!~ It seems reaching this level doesn’t guarantee a 100% success rate in suturing.”

”But once I’m skilled, I should also be able to suture common tendon injuries!~”

”The speed of improvement from adding points is unbelievably fast, countless times faster than silently practicing suturing on my own.”

”These skill points can be accumulated in half a month, even in orthopedics where operational opportunities are extremely scarce. If I got more practicals in the emergency department?” Lu Cheng could not fathom how fast he could improve.

Or rather, Lu Cheng could not imagine how insignificant his natural aptitude was compared to this ’extra aid’!!

”It seems many top teaching hospital hand surgery departments consider tendon suturing the clinical operation standard for PhD graduations, unsure if that’s true.”

”But none of this has much to do with me, getting to sleep early and going to work in the emergency department early tomorrow is more practical!~”

”Practicing with the dashboard for nearly half a month; the progress bar hasn’t moved at all. Reading books also hasn’t helped, perhaps progress is just too slow, or each increment requires a massive accumulation of knowledge…”

”Possibly, a 0.1 progress wouldn’t show on the dashboard.” Lu Cheng’s voice was low.

Lu Cheng is a science student, capable of logical analysis.

Entry-level N/5, skilled N/10. By the time professional PhD graduates, who have essentially studied medicine for eleven years, if including breakthroughs, it needs around 30 points of progress.

On average, that’s just three points a year; the occasional practicing over half a month hardly advances it a bit…

Learning techniques is exceedingly arduous.

Taking a few deep breaths, he began clearing the operating table, masks, and sutures, cleaning them, and placing them in a small sterilization cabinet.

Returning to his room, Lu Cheng was restless, unable to fall asleep.

At thirty, in many industries, one might consider retiring.

But in the field of medicine, he was still young and inexperienced.

He always held one thought in his mind, hand surgery-focused PhD graduates were generally around twenty-nine years old when they graduated, their average level at graduation being ’tendon suturing’.

Suturing Skill is the surgical skill hand surgeons are most proficient in…

Even before the ’dashboard’, he was merely ’a step away’ from tendon suturing; this was still without any guidance from a mentor or teaching from a professor to enhance efficiency…

Fate, timing, all play roles…

Lu Cheng looked out the window, the hot wind swayed the branches, mottled moonlight streamed into the room, fracturing the night and shaking Lu Cheng’s unstable mood further.

Yet it didn’t deter Lu Cheng from going to work the next morning.