System Came When the Doctor was Thirty

At ten in the morning, the scorching sun baked the earth, the air shimmered with heatwaves, and the cicadas sang in chorus.

Long County People’s Hospital, Emergency Department, in the doctor’s office.

Lu Cheng was reporting to Associate Professor Chen Song the indications for spleen preservation surgery he had just summarized when the phone rang, interrupting their rhythm.

”Teacher Chen, it’s Zeng Huanqi from the surgical consultation room...” Lu Cheng explained briefly before answering the call, his voice smiling: ”Brother Zeng.”

”A sickle injury, the incision isn’t smooth. Okay, I’m coming right away.” After extracting the key details from the case, Lu Cheng said:

”Teacher Chen, it’s a simple sickle wound. I can handle it, you take a break. I’ll consult you later on.”

Chen Song, hearing it was just a simple sickle wound, lost interest.

He put his hands behind his head, stretched lazily with his feet splayed outward, and gave a slight hum: ”Mm... I’ll come and take a look after you finish.”

Lu Cheng, wearing a mask, rose, keeping the faint smell of disinfectant at bay, and quickly left the doctor’s office heading toward the surgical emergency consultation room.

As Lu Cheng reached the consultation room door, Zeng Huanqi, who was on duty, told the patient: ”Dr. Lu is here, he’ll take you to the debridement room to treat your wound. You can scan the code to pay, or go to the window to pay.”

”Brother Zeng, have you seen the wound? Is it deep?” Lu Cheng’s tone was cautious.

Zeng Huanqi understood Lu Cheng’s implication: ”I only glanced at it briefly, it’s approximately 6 mm deep and 5 cm long, with no tendon damage. You should check carefully when washing in the debridement room.”

”I’ve already discussed with the patient, if tendon damage is found upon further examination, he may need to be referred.”

For tendon damage cases, even the professional doctors in the hospital’s orthopedics department have ended up in lawsuits, and the emergency department doesn’t want to lightly take on such a burden.

The patient, a man in his fifties with graying sideburns and dark skin, smiled revealing yellow teeth: ”I just accidentally cut my hand while cutting grass for the cattle, it shouldn’t be serious enough to require a transfer, right? You doctors do love to scare people.”

Zeng Huanqi adjusted his mask for air: ”Uncle, this isn’t about scaring you. If our hospital can’t handle it, we simply can’t. Who in the technical field would easily admit their skills aren’t enough?”

”Of course, this is just a possibility, the specific situation will be determined after Dr. Lu examines you.”

Lu Cheng took some standard debridement suture consent forms, saying politely: ”Uncle, please follow me this way... would you like to scan the code to pay, or go to the window?”

Paying for consultation is a given, and since this isn’t a ’life-threatening’ emergency, Lu Cheng wouldn’t proceed without payment confirmation.

Once the procedure is done, the fee must be paid!

Either the patient pays or Lu Cheng covers the cost, and earning just a few thousand yuan a month, Lu Cheng can’t afford to bear the loss.

”Scan it.”

”Doctor, could you scan it for me? I’ll enter the password.” The middle-aged patient was injured in his right hand, making it slightly inconvenient to operate.

After the payment was completed, Lu Cheng briefly explained the debridement and suture precautions to the patient, and had him sign his name with a trembling left hand.

After fetching a debridement suture package, Lu Cheng led the patient into the debridement room, instructed him to lie flat and rest his hand on a support to his right, then slowly untied the temporary bandage.

Zeng Huanqi had previously opened the wound, and there was no scabbing, but Lu Cheng still operated meticulously...

Looking at the ceiling, the patient remarked, ”It’s really troublesome to see a doctor nowadays, signing here, signing there. Doctor, aren’t you trying to push all the responsibility onto the patients?”

Lu Cheng shook his head, saying: ”Uncle, this isn’t about pushing responsibility, it’s about respecting the patient’s right to informed consent.”

”These issues have occurred many times, the patient gets stitched up, recovers well, but if there’s no signed consent, the patient sues, and the doctor has to pay compensation, losing four to five months of work without earning a penny.”

”Uncle... your wound isn’t deep, with no tendon damage, so there’s no need for a referral. However, the wound has dirt and rust in it, remember to get a tetanus shot after the procedure.”

”Tetanus bacteria easily hides in rust.”

The uncle frowned, saying, ”Those who sue lack integrity, and authorities lack empathy. If there’s no problem, why should the doctor pay up for nothing? Making the process so cumbersome, it’s us ordinary folks who suffer.”

Lu Cheng chuckled, starting to rinse with saline, gently saying: ”The right to informed consent must be respected, and some patients desire a higher standard of care and opt for better hospitals, which is their freedom.”

”Moreover, seeking medical treatment isn’t like fixing a television fan, it’s much more complicated. Even if problems can be remedied, the patient still suffers considerably.”

”Not even a TV repairman can guarantee that the TV can be fixed and will never malfunction again. Treating patients is hundreds of times more complex than fixing a TV...”

”If any small issue arises and it falls on us doctors, we would all have fled by now.”

Lu Cheng chatted away: ”Alright, now we can proceed with the debridement and suturing. I’ll prepare some local anesthetic for you. The first injection may sting a bit, so please bear with it.”

Talking more with patients and engaging in communication is beneficial for doctor-patient relationships. A large part of disputes between doctors and patients essentially stems from communication not being in place, and Lu Cheng previously didn’t have the opportunity to perform surgeries, so he spent some time researching these issues.

The uncle laughed and said: ”That’s true, what doctor can guarantee 100% that their treatments are always good?”

”Although we common folks hope for this, doctors are people too after all.”

”But when we get sick, we can only turn to you doctors... Why are there so many illnesses now...?”

Lu Cheng no longer responded. He swiftly prepared the diluted lidocaine local anesthetic, placed it on the sterile sheet, removed the examination gloves, and put on sterile surgical gloves again.

”Uncle, the first needle of local anesthetic will be a bit painful, but once the anesthetic takes effect, it won’t hurt... You need to bear it...” Lu Cheng’s voice was gentle, but his actions were quick and decisive, showing no mercy.

The faster the procedure for local anesthesia, the shorter the period of pain for the patient. The more hesitant and entangled one is, the more prolonged and severe the pain suffered by the patient.

The middle-aged man didn’t even move his eyelids: ”Dr. Lu, where are you from?”

”My hometown is Zhao Market Town. Uncle, the procedure is starting, please don’t speak for now.” Lu Cheng’s operation technique and sequence were very academic, methodical, and honest.

Lu Cheng meticulously used tweezers and gauze to explore the full thickness of the wound, cleaned the dirt and rust thoroughly, and then began to trim the jagged edges.

Debridement isn’t just about removing foreign bodies and necrotic tissue; trimming the incision to facilitate wound recovery is also an important component of the debridement procedure.

Debridement is one of the most basic skills in surgery, a skill Lu Cheng is skilled in and has had considerable exposure to.

Lu Cheng had no hesitation in his incision, his operation was smooth and skilled. When he started suturing, he was even more adept, smoothly threading needles, and tying knots with great proficiency...

What Lu Cheng didn’t notice was that Chen Song, having grown bored and sufficiently rested, was now idling at the entrance of the debridement room, squinting!

”Hmm?” Chen Song made a light, thoughtful sound—a slight squint in his flat eyes leaving only a slit—

Lu Cheng’s right hand holding the needle holder was very steady; each step of the suturing operation applied sufficient force without appearing violent.

The out-needle and in-needle operations were crisp and practiced, the choices of needle entry and exit points were seasoned, and the angle of needle passage was rather tricky. The distance between stitches was distinct and precise. This level was clearly beyond typical basic skill...

Lu Cheng’s movements were agile, and after four or five minutes, he completed the suturing and also finished the outer layer dressing and bandaging: ”Uncle, it’s all stitched up. You’ll need to get a tetanus injection afterward, make sure the wound doesn’t get wet, whether with sweat or water, come for a dressing change every two to three days until the stitches can be removed...”

”You can go to a nearby pharmacy or clinic for dressing changes and stitch removal.”

”If there’s a health station in the village, it can also be used for changes.”

”Oh, okay.” The middle-aged man nodded, paying little attention to whether Lu Cheng’s suturing was good.

If it weren’t for the considerable and unstoppable bleeding, he wouldn’t have come to the hospital, and now that the bleeding has stopped, he considers the issue dealt with.

The simplest folks in Hua Country are very easily satisfied.

”Be sure to get the tetanus shot; the sickle has rust, which is the most likely place for tetanus bacteria to hide, can’t afford to be careless!” Lu Cheng repeatedly emphasized...

”Okay, Dr. Lu.” The middle-aged man nodded.

”After you get the tetanus shot, come back to my place to get your medical record book. I’ll prepare it and then write your surgical operation record. Don’t forget to come get it.” Lu Cheng turned and smiled, explaining in detail.

The patient nodded and left.

After Lu Cheng tidied up the debridement kit on the operating table and was walking out, he found Chen Song staring at him, their eyes locked for over ten seconds, yet Chen Song remained silent.

Lu Cheng politely asked, ”Teacher Chen, was there... no mistake?”

Lu Cheng’s tone was calm, without any other intent.

Lu Cheng previously interned and trained at Han City University Zhongnan Hospital. Although Zhongnan Hospital might not be as technically superior as Xiangya Second Hospital, it’s still one of the well-known teaching hospitals.

There, the somewhat talented Lu Cheng was humbly like ’dust’, even if his skills now returned to Zhongnan Hospital, he would still be just one of the most ordinary group!

Pulling any specialized doctoral peer might not necessarily be weaker than him.

If they pulled a senior resident, Lu Cheng might be standing in place; if they pulled an associate professor or deputy chief physician, Lu Cheng could only admire their skills, hoping one day to reach their level.

If it was a professor’s surgery, Lu Cheng would wish to chop off the professor’s hand to let the hand surgery professor transplant it onto himself.

The medical temple is like a pyramid, the hierarchy is clear, distinctly divided!

Chen Song is an associate professor and deputy chief physician at Xiangya Second Hospital, the king among kings. There are not less than twenty PhDs who were outdone by Chen Song.

”The other day, I misjudged and didn’t observe carefully, and only now do I realize your Suturing Skill has reached such a level...” Chen Song’s keen eye immediately spotted the unusual skill in Lu Cheng’s hands.