System Came When the Doctor was Thirty

Emergency Department, observation ward doctor’s office, sunlight slanted into a corner.

Professor Chen Song casually pulled up a chair to sit down, picked up his coffee, and spoke casually, ”Xiao Lu, I heard from Director Lin that you also just joined the emergency department? How old are you this year? How did your previous department let you go?”

Lu Cheng smiled, ”Teacher Chen, I’ll be thirty in two months!~”

”I don’t really have any skills, what director would be reluctant to let me go?”

Chen Song shook his head; his slim stature and scholarly appearance made him look refined. After sipping his coffee slowly, he said, ”That’s not right; you’re only thirty, still very young.”

”At your age, you should focus on mastering basic skills first, otherwise when you truly dive into the field of surgery in the future, it’ll be hard to find time to solidify your basics.”

”Your level of basic skills largely determines the highest point you can reach in the surgical profession in the future.”

”I checked your basic skills the other day, very solid indeed. Not far behind some of the PhDs in our department.”

”How did your previous director miss all of that? Are they blind to such things?” Chen Song’s expression was extremely relaxed; after all, this wasn’t Xiangya Second Hospital, under the scrutiny of professors, his tone was exceptionally casual.

Lu Cheng also took a small sip of his coffee, imitating Chen Song, ”Teacher Chen, this is a county hospital after all, what we need are doctors who are good at techniques, doctors who can treat and save patients.”

”With my skills, I can’t perform any surgeries, so of course I’m of no use.” Lu Cheng refrained from complaining to Chen Song; Chen Song was not his uncle.

It’s easy to get blacklisted when you rashly complain about previous leaders in front of Chen Song.

”Nonsense!~” Chen Song rolled his eyes, ”Surgery is something that must be learned; if your basic skills are good, you’ll quickly grasp specialized surgeries, and when surgical techniques involve local operations, you’ll be more adept.”

”Did you not have many opportunities to perform surgeries in the past?”

Despite his scholarly appearance, Chen Song’s gaze was sharp, and his words were incisive, ”Before I came, I heard someone say that the waters in county hospitals might be deeper than those in city-level hospitals.”

Lu Cheng’s expression was cautious; unsure of Chen Song’s intention, he replied carefully, ”Teacher Chen, here we still focus on specific surgical techniques.”

The hospital where Lu Cheng previously trained was also rigorous about basic skills and theory, but Long County People’s Hospital didn’t care about those.

When it comes to surgery, it’s about two points: can you diagnose? Can you treat?

Why you can diagnose, why you can treat, why you can’t—all irrelevant; no one’s going to spend time listening to your roundabout explanations. Getting real work done is what matters.

Chen Song put down his coffee cup, rubbing his thumb and forefinger together repetitively, ”Such simple and violent outcome-based reasoning certainly has its merits, as it can better reveal a person’s ability to treat; however, in practice, it’s like killing the goose that lays the golden eggs.”

”What department were you in before?” Chen Song didn’t press further; he was just a visiting doctor, subscribing to the philosophy of adapting to local customs.

He could remain lofty as much as he liked, but he couldn’t change the larger environment, only a small environment centered around himself.

”I was in orthopedics, Teacher Chen.” Lu Cheng replied.

Chen Song specified, ”Orthopedics, then you’ll be handling emergency cases like fractures, joint dislocations, limb injuries, tendon ruptures.”

”Which of these cases have you come across?”

Lu Cheng carefully answered one by one, ”In the department, the most common surgery encountered is fractures. Fractures here are treated surgically by the orthopedics specialty department. We in the emergency department cannot perform such surgeries.”

”As for limb injuries, we have an agreement with orthopedics: wounds under 5 cm are handled by the emergency department, while those over 5 cm are dealt with by orthopedics.”

”In joint dislocations, we only perform the most typical dislocation manual reductions, and tendon ruptures is something Director Peng advised the department against doing.”

Chen Song chuckled, ”You’ve stumbled upon quite a few pitfalls, haven’t you?”

Lu Cheng nodded, feeling a bit ashamed, ”There are two patients who are still complaining.”

Chen Song was not surprised, ”Tendon suturing is hard to learn and master; even the basics are challenging! Perfecting it is even more difficult; I’ve stumbled upon these pitfalls several times in the past!”

”Fortunately, our hospital has a specialized hand surgery department; they can step in when needed.”

”It’s tricky, especially now that the relationship between doctors and patients has become increasingly tense... The best advice is not to involve oneself lightly...”

Lu Cheng nodded; his theoretical level was not low, knowing full well the many pitfalls of tendon suturing.

For instance, some classic tendon suturing techniques are unsuitable for certain tendon ruptures, which is why scholars worldwide eagerly pursue innovations and improvements in hand surgery tendon suturing techniques.

Chen Song continued, ”But Xiao Lu, I think your suturing skills are quite good. With a bit more practice, you might get the hang of the ’relative contraindications’ for suturing tendons at special positions, which you can then explore.”

”Have you read any books on hand surgery?”

Lu Cheng answered, ”I’ve read some; when there weren’t any surgeries, there was nothing else to do but read and practice basic skills.”

”It’s good that you’ve read some books; since you’re an orthopedic doctor, let’s see if we can get a few tendon rupture cases today and give you a little appetizer.”

”If you gather patients with tendon ruptures in the emergency department, will people secretly complain?” Chen Song laughed and asked.

The hospital’s role is to treat and save lives, yet the salaries of doctors and nurses are tied to patient volume, and every department in the county hospital has many empty beds.

For the emergency department to grab the ’disease categories’ from a specialty would be like stealing from a large group.

Long County People’s Hospital isn’t Xiangya Second Hospital; Xiangya Second Hospital’s wards are packed, appointments never end, and the specialties would prefer the emergency department take some of the load.

Chen Song wasn’t the first one from Xiangya Second Hospital to visit Long County People’s Hospital, and not even the first in the emergency department.

Where there’s smoke, there’s fire; as rumors spread, the parties you vent about may hear corresponding information.

Chen Song was quite cautious about this.

Lu Cheng decisively shook his head, ”Impossible, Teacher Chen. Director Peng of orthopedics has publicly stated during shift changes that the department will no longer perform tendon suturing and hand surgeries; if anyone wants to do them, they should apply to the medical department and take responsibility themselves.”

”Tendon rupture patients, except for Achilles tendon ruptures, are referred out.”

Lu Cheng sighed softly, ”Our county’s patients usually can only be referred to Xiangzhou People’s Hospital or the Enzhou Central Hospital next door in E Province!”

”Having to travel so far just for tendon ruptures is actually quite bothersome.”

Xiang Province Xiangzhou and E Province Enzhou Tujia and Miao Autonomous Prefecture are neighboring.

To Lu Cheng, patients from the county hospital going out for consultation is inevitable, but tendon injuries should be a technique the orthopedics department could handle; for such minor conditions to be referred out, the people of Long County are indeed pitiable.

However, it’s not a situation Lu Cheng can change; the hospital and department simply don’t perform such surgeries, so how could Lu Cheng conjure up skills from nowhere?

Relying on online learning?

Online learning as a surgical doctor is the least reliable.

”Do you want to learn?” Chen Song’s gaze wandered over Lu Cheng, his calm tone imbued with admiration.

Lu Cheng’s face smiled so much it seemed he had undergone cosmetic surgery several times, ”As long as you’re willing to teach, Teacher Chen, I’m willing to learn, not limited to orthopedics.”

”Teacher Chen, I’m no longer an orthopedic doctor now; I’m an emergency surgeon.”

Chen Song laughed heartily, ”You’ve got good awareness... ”

After finishing, Chen Song looked around, lowered his voice, ”Surgical techniques must be well learned, not just understanding the surgical process, but also the fundamentals of the disease.”

”For example, for the splenectomy today, if I were handling it, I would opt for spleen preservation instead of splenectomy.”

”As you’re willing to learn other surgeries, while there’s nothing much now, you can ponder the specific diagnosis of that patient and consider the core reasons for performing spleen preservation surgery.”

Chen Song began his casual teaching, not with generalizations, but with concrete evidence.

Lu Cheng paused, swallowing with his Adam’s apple rolling...

Did Chen Song come right out and subtly say Director Lin at the emergency department is technically incompetent? Was he always so direct?

Knowing the ecosystem of the county hospital, Chen Song picked up his coffee and got up, his explanation drifting away, ”Different surgeons have different ideas and philosophies; as long as issues are resolved, it’s not about right or wrong, just good or better...”

The slanted sunlight was blocked by Chen Song’s back, casting a golden hue on his back with a faint halo.