System Came When the Doctor was Thirty

At four in the afternoon, the sunlight from the east glass of the doctor’s office had disappeared.

Lu Cheng saw Chen Song walk in from the door of the doctor’s office and greeted him warmly:

”Teacher Chen, would you like something to drink? I’m thinking of ordering a milk tea.”

”Sister Gao already ordered it.”

Sister Gao, whose full name is Gao Hanqiu, is the on-call internal medicine doctor in the ward today.

Long County People’s Hospital has three sets of shifts: the emergency room on-call doctors, the observing ward, debridement room, operating room on-call doctors, and auxiliary shifts.

Auxiliary shifts are easy to understand. They support when the surgical shift doctors cannot handle the emergencies; however, even in the emergency department, this type of auxiliary shift is rarely used...

Chen Song’s words in the morning directly pushed the progress of the Suturing Skill panel, although it didn’t move the progress bar, it definitely improved his skills.

Lu Cheng certainly hoped for more guidance from Chen Song.

Chen Song rubbed his big forehead with force, his flat eyes squinted into two slits, looked around to make sure no one was in the doctor’s office, and then lowered his voice:

”Xiao Lu, what’s going on with the atmosphere in your hospital?”

”Even an appendicitis surgery is being fought over.”

”I was planning to call you, but Zeng Huanqi directly phoned Dr. Zhang. Unbelievable!!” Chen Song gave a thumbs up, his mouth turning downward.

Zeng Huanqi is the on-call doctor in the emergency surgical room today, and Zhang Tiesheng is the ”auxiliary shift” for today!

Lu Cheng wasn’t surprised: ”Teacher Chen, I’ve never done an appendicitis surgery, Brother Zeng knows, so he called Brother Zhang, which is reasonable.”

Chen Song snorted: ”An appendectomy is an inpatient doctor’s surgery, as long as the intern is well guided, it can be done, what’s the fuss about have you done it or not?”

Has Lu Cheng done an appendectomy before? No, he hasn’t!

Can he do it? Absolutely!

”Not having done it is more the reason to learn... I’m really impressed...” It was obvious Chen Song was snubbed by Zeng Huanqi and was feeling quite unhappy.

Lu Cheng directly shifted the topic: ”Teacher Chen, do you want milk tea?”

”What background does this Zeng Huanqi have?” Chen Song asked Lu Cheng after calming down.

Even if one can guess without thinking, unless they are a local bully, they wouldn’t dare provoke a crossing dragon like Chen Song.

Lu Cheng, new to the emergency department, needed to spend some energy familiarizing himself with the environment, had no time for background checks on others, shaking his head: ”Not clear, and not important, Teacher Chen.”

”After all, our County Hospital has a low surgical volume, learning surgery is also a matter of queuing.”

Through Director Lin Qianlong’s different attitudes toward Zeng Huanqi and Zhang Tiesheng, Lu Cheng deduced that their identities were not ordinary.

Surgical skills are the king in the County Hospital’s surgery department, deriving from accumulated surgical volume, a precious ’resource’. Someone like Lu Cheng, new to the emergency department for three days, how could he easily get surgical volume?

On the surface, everyone is courteous, fully aware of the social norms, but when it comes to core ’competency’, no one would be that modest.

Lu Cheng had nowhere to reason; he hadn’t done it yet so he ’wouldn’t’.

The director wouldn’t ask why you ’wouldn’t’; not having learned well is your fault, being weak is an original sin, no other justification!

Likewise, if you can do what others can’t, then you’re the legend!

Chen Song watched the socially polished ”rounded” Lu Cheng, grabbing at his few and short hair, raising the corner of his eyes: ”Then get me a milk tea.”

”I’m rather curious about what the days ahead will be like...”

Chen Song was a bit angry.

Alright, alright, is this how your ecology plays?

Then I really want to see, when Lu Cheng can do surgery you all can’t or does it better than you, what will you become?

Chen Song came ’down to the countryside for support’, wanting to have a ’student’ do an appendicitis surgery but didn’t even have the freedom.

Lu Cheng didn’t know Chen Song’s thoughts, proactively took out his phone: ”Teacher Chen, what would you like to drink?”

”Let me see what’s the most expensive...” Chen Song started sliding up and down.

It shouldn’t be too cheap for Lu Cheng.

”No problem.” Lu Cheng didn’t think much of it, after all, it’s just a milk tea treat.

After Chen Song ordered the milk tea, Lu Cheng continued the topic from the morning, concluding: ”Teacher Chen, you see here, through the abdominal CT, we can observe that the patient’s splenic laceration has a depth of 3.1 cm, and the hematoma in the splenic parenchyma is approximately 7.3 cm!”

”According to the hematoma diameter grading, it should be AAST spleen injury grade 2, but according to depth grading, it’s a standard AAST 3 grade.”

”It’s an indication for combined surgery to preserve the spleen.”

Upon hearing this, Chen Song raised his eyebrows, his tone startled: ”You can determine specific depth and hematoma diameter from a CT?”

CT film reading skill has traces to follow.

Lu Cheng can spare time to look up AAST scores, knowing the scoring criteria of AAST.

He knows spleen rupture grade 2 criteria: subcapsular hematoma greater than 10% surface area, parenchymal hematoma diameter 10 cm; parenchymal laceration depth 1-3 cm, length 10 cm...

But if Lu Cheng can, specifically on the abdominal CT, understand the patient’s splenic laceration depth is 3.1 cm, hematoma diameter is 7.3 cm, that’s beyond the shallow film reading skill, which can’t be ’guessed’ and memorized.

CT film reading skill also has distinctions in expertise.

Lu Cheng, without any doubt, directly started pulling lines on the film reading system, and then adjusted the coordinates ruler.

”Yes, Teacher Chen, these are quite clear.” Lu Cheng on the film reading system, standardly pulled the spleen laceration depth and hematoma diameter.

Chen Song’s level is not ordinary, his film reading level is also not ordinary, knowing how each person’s film reading capacity gradient varies.

The simplest CT film reading is actually finding different anatomical structures, identifying splenic laceration, splenic hematoma, roughly at an inpatient doctor level.

Further, if one can locate the anatomical structure of the spleen, knowing whether it’s the anterior, posterior, left, right, surface, or inner layer rupture, that’s roughly a specialized PhD level.

Being able to identify specific injury locations, and precisely measure injury diameter and depth, even for an emergency department specialized PhD, requires quite a talented individual to master, not everyone can.

In emergency department doctors, diagnostic techniques are paramount! Film reading skill is one crucial component of diagnostic techniques.

Chen Song listened, interest rising, asked again: ”Then take a closer look at this patient’s CT, can you find anything the radiologist hasn’t reported?”

Evaluating a person’s skill level should be multi-dimensional.

Upon hearing this, Lu Cheng wasn’t surprised, rather expertly pulled the CT layer up, quickly locating a small cyst on the liver’s posterior lobe: ”Teacher Chen, are you referring to this?”

”This cyst has a diameter of about 4 mm, the capsule is intact, no calcified foci, basically not malignant, such a small cyst doesn’t have surgical indications.”

Chen Song instantly understood, slightly surprised, glanced at Lu Cheng, reverting to his local dialect: ”Are you just an undergraduate? ’Bluffing is son’?”

”Huh?” Lu Cheng listened, full of confusion.

”You haven’t done post-graduate?” Chen Song asked.

Lu Cheng realized, nodded: ”Teacher Chen, I didn’t have that opportunity. Previously, I was training at Han City University Zhongnan Hospital.”

Chen Song certainly knew Han City’s Zhongnan Hospital, his pupils shining: ”Xiao Lu, how old are you this year?”

”Two more months to thirty.” Lu Cheng said.

Chen Song resolutely sighed: ”What a pity... a bit old, if a little younger... how good it would be...”

Lu Cheng instead laughed clearly: ”Teacher Chen, if I were a few years younger, you probably wouldn’t notice me more.”

Despite being a bit older, Lu Cheng understood he had learned a few more years.

This society, is organized in reality.

...