System Came When the Doctor was Thirty

A few days passed in the blink of an eye.

Thursday, July 6th, Lu Cheng followed Chen Song off work and entered into a ”day off”!

At 1 o’clock in the afternoon, his parents had gone to work. After eating a buffet Big Bowl Rice outside the community, Lu Cheng, feeling very full, hurried back and immediately went into the Training Room where the air conditioning had already been turned on.

The hot and humid weather in July was really unbearable. Just by walking home from the gate, Lu Cheng’s short sleeves were completely soaked with sweat.

While pulling at the front of his shirt to let the cool air expel the heat, Lu Cheng opened his notebook: ”In addition to mastering the basics of tendon suturing, it is also necessary to learn the corresponding techniques. The simplest and easiest entry-level technique is the Modified Kessler Suture Technique.”

”Going further up are the Tsuge Suturing Technique and the Modified Tang Method...”

The Suturing Skill is basic. Reaching a certain level means you have mastered the control of distance and force in suturing to a certain degree, allowing detailed handling during sutures.

But simply using the most basic ’simple interrupted’ suture is still insufficient to tackle ”multi-pit” conditions like tendon damage.

According to Professor Chen Song’s analogy, mastering the basics is like inner strength, while the suturing techniques are the applicable moves.

Animals the size of a cat can essentially catch mice, but the ones most skilled and professionally matched for catching mice are still the ’cat’ species.

Lu Cheng then turned a page, looking at the step-by-step training method he sorted from the internet.

[Surface Puncture Positioning (30 minutes/day × 3 days) Motion Breakdown:

Draw two parallel lines on a silicone pad (spacing = tendon diameter)

Vertical needle insertion: needle tip enters 1.5mm from edge at 90°, exits on the other side equidistantly (error ≤0.2mm)

Cross Practice: Complete 10 sets of ”X-shaped cross-needle insertion”, ensuring symmetry on both sides. (Completed)]

Lu Cheng licked his lips, feeling a bit greasy, quickly ran outside to wash his hands and face, then looked into the mirror opposite the sink—

In the mirror, his features were prominent, mature and composed, handsome as Pan An. Lu Cheng thought, if he were a girl, he would definitely marry himself...

Stopping his flights of fancy, Lu Cheng looked again at the checklist on the panel—

[Suturing Skills: Tendon Suturing Skill (Beginner 3/5), Modified Kessler Suture Technique (Beginner 1/5)]

[Current Remaining Skill Points: 16.3]

The improvement rate of technique practice is faster than basic practice, yet it cannot achieve miraculous changes in just a few days. After four days of diligent practice, tendon suturing skill and Modified Kessler Suture Technique only increased by 1 point in skill level.

This progress was made under the guidance of Professor Chen Song; otherwise, it might have been even slower.

After arriving in the emergency department, in 6 days, working three days yielded nearly 15 skill points, which is more than twice as fast as in orthopedics!

It’s unclear whether transitioning from beginner to skilled requires breaking through.

Regardless, let’s just add them first.

In an instant, Lu Cheng’s face turned sour like a bitter melon.

[Suturing Skills: Tendon Suturing Skill (Skilled 0/10) (Skill Points -7), Modified Kessler Suture Technique (Skilled 0/10) (Skill Points -9)]

[Remaining Skill Points: 0.3]

”Oh, to advise someone to study medicine, heaven will strike them with thunder!!!” Lu Cheng cursed...

Then, Lu Cheng looked at the sorted content in his notebook again:

[Tendon Longitudinal Penetration (Chicken Leg Tendon Practical Operation)——

Initial Knot Locking: Key Points - Longitudinal penetration 1cm from the broken end → Tie a triple square knot (with tension to a slight crumple), Common Mistake - Over-tightening causing tendon strangulation (blood supply cutoff)

Core Double Needle Puncture Near End: Key Points - Needle insertion 8mm from the tendon break, angled 45° to exit other side (5mm from the break) → Reverse operation to complete the far end, Common Mistake - Needle angle deviation causing suture exposure

Line Pull Verification: Key Points - Line pull to verify synchronous traction of double lines, ensuring tight matching of cross-section without displacement, Common Mistake: Single line pull causing rotational deformity.

Training Indicator: Complete 10 alignments within 20 minutes, Standard → Alignment tensile strength ≥15N (tested with a spring scale)]

Chicken legs were bought, 6-0 sutures were purchased as wholesale defective goods!

The silicone training pad (with simulated sheath, blue/white dual-color) was made from rubber tubes and dyed using dye.

”All is ready, let’s get started!!~” Lu Cheng set up his phone’s shooting position, then pressed the record button.

There are many advantages to recording one’s operation, one being self-review to spot omissions, another sending it to the teacher for error correction.

After all, when suturing, the needle hand’s wobble needs to be less than

Medical technology has to be learned this way.

Of course, while practicing, Lu Cheng added a little bit of ’cheat’ power for assistance.

Having thoroughly memorized the operation technique, he had no other worries while practicing.

One chicken leg, two chicken legs, three chicken legs...

After about two hours, a total of eight chicken legs had been handled by Lu Cheng.

These chicken legs were all placed in front of Lu Cheng, who began to carefully inspect them one by one.

Two minutes later, Lu Cheng, somewhat despairingly, removed his inspection gloves, covering his forehead.

With a skilled level of Modified Kessler Suturing, there’s still a 38% failure rate, what’s the point of this!

Of course, this also has context: chicken leg flexor tendon diameter is 3-4mm (close to human Zone II flexor tendon), one of the most challenging tendon practice materials for suturing.

”Sigh!~” Unable to vent his despair, Lu Cheng could only heave a sigh.

If it weren’t for the high difficulty of tendon suturing, Director Peng at the hospital wouldn’t have explicitly ordered to give up.

Lu Cheng continued to take notes, analyzing the reasons for operational mistakes, treating them as an error correction log.

”Failure Case 1: Gap between sections ＞3mm.

Root Cause Analysis: Insufficient tension at the end knot; Correction Plan: Pull both sutures slightly until the tendon turns slightly white after knotting.”

”Failure Case 2: Tendon surface suture exposed;

Root Cause Analysis: Needle insertion depth too shallow; Correction Plan to practice ’buried suture method’: Press the insertion point skin 0.5mm with forceps.”

”Failure Case 3: Pull test end separation;

Root Cause Analysis: Longitudinal suture not parallel within the tendon; Correction Plan: Use microshears to open tendon and verify suture path.”

”Successful Case: …”

Once everything was recorded, Lu Cheng photographed it, and then separately edited the process and detail video of these chicken leg sutures.

He then sent it to Chen Song, politely saying: ”Teacher Chen, this is my failed operation practice case for today. If you have time, could you help me review the reasons for the errors?”

The training materials in the training room can fail, but clinical practice cannot.

In exams, one can make mistakes at most leading to point deductions, but a failed surgery would result in very serious consequences.

By this time it was already past four, and Professor Chen Song was sitting in the ”municipal residence” arranged by the County Hospital, slowly sipping tea as he watched the sunset.

He picked up the teacup and put it down repeatedly, as well as his phone, so forth about four or five times...

Finally, with his heart tightening, Chen Song started replying, evasively: ”Xiao Lu, why don’t you consider pursuing a graduate degree.”

”Although you’re older, you’re still not ’too old’!”

Chen Song is an associate professor, deputy chief physician, senior researcher at Xiangya Second Hospital, and a doctoral supervisor planning to be promoted to chief physician and professor (senior title)!

Lu Cheng’s study attitude is just excellent!

His talent is also outstanding. In just a few days, he’s already gotten the Modified Kessler Suture Technique looking promising, and crucially, even when asking questions, he dissects them in detail with substance.

Polite and sensible, streetwise and tactful, speaking and doing things smoothly, what reason could he find not to love such a student?

In five minutes, Chen Song saw the chat window with Lu Cheng continually flash ’the other party is typing...’, disappearing, ’the other party is typing’.

It eventually boiled down to one sentence: ”Teacher Chen, I’ve already completed my residency training, and I can’t pursue a professionally-oriented master’s. At my age, it’s also too late to attempt a research master’s.”

”Sigh...” Chen Song replied with one word and six dots.

What Lu Cheng thought of, he naturally couldn’t not think of either.