System Came When the Doctor was Thirty

”Dr. Lu, will the emergency operating room routinely perform tendon suture surgeries in the future?”

”When I sent the surgical schedule to our head nurse, she kept asking about it for a long time. I’ve heard that even the orthopedics department is hesitant to perform such surgeries.” Li Min walked alongside Lu Cheng from the operating room towards the changing room, glancing sideways at Lu Cheng’s profile, her eyes lingering...

In the hospital, doctors who still manage to look handsome despite long hours are rare, and if they have some skills, they can fulfill most people’s true ’fantasies’ about surgeons.

Lu Cheng shook his head, his voice calm: ”Li Min, it’s still not feasible for routine surgeries.”

”More precisely, with my current suturing technique, I can only handle zones 4 of the flexor tendons and zones 4 and 6 of the extensor tendons.”

”If not considering high demands, zones 1 of the flexor tendons and zone 2 of the extensor tendons can also be barely managed.”

”Tendon injuries in other areas?” Lu Cheng shook his head, with a half-smile: ”If you encounter them, run away early…”

”Ah? Different tendon ruptures require different surgeries?” Li Min was incredibly surprised.

Although she studied nursing professionally, when it came to the core knowledge of medicine, she still felt like her brain wasn’t quite enough.

Lu Cheng was previously professionally trained in orthopedics. Although he didn’t accumulate much technique, he read quite a lot, and orthopedics (skilled 8/10), basic theory of hand surgery (skilled 7/10) were not acquired out of thin air, nor were they unfounded.

The reason tendon suturing has many pitfalls is because the division of flexor and extensor tendons in the upper and lower limbs are unique. According to the different divisions and different types of tendons, the preferred and secondary suturing techniques vary.

Just the flexor tendons of the hand are divided into 5 zones, and the extensor tendons into 8 zones. The flexor and extensor tendons of the lower limbs are each divided into five zones, corresponding to different suturing techniques.

The high difficulty of tendon suturing lies primarily in its challenging entry and mastery.

”That’s right, orthopedic tendon surgery involves the most anatomical locations in all surgical fields. I only dare and can choose very narrow tendon ruptures to operate on, not many.”

Lu Cheng then took a deep breath: ”Li Min, thank you for today. Assisting with my first surgery was quite taxing.”

The lead surgeon doesn’t like new circulating and instrument nurses, and likewise, circulating and instrument nurses especially dislike new lead surgeons.

Because of lack of skill, starting the first surgery is bound to take much longer than mature doctors.

”It wasn’t too bad, just over an hour, that’s not particularly long.”

”Dr. Lu, I’m getting off work, and I have a date to go watch a movie with a friend. I’m leaving now.” Li Min stood at the nurse changing room door, standing proudly but speaking in a casual tone.

”See you next time.” Lu Cheng also walked towards the doctor’s changing room.

Dressed in surgical scrubs, Lu Cheng didn’t need to change into his regular clothes and white coat; being an emergency department doctor, surgical scrubs were the most convenient attire.

As the sun gradually set, the rays spilled through the window, casting dappled shadows of branches, which Lu Cheng trampled without mercy. However, after he left, the shadows still lingered there, unaffected by his departure.

”Professor Chen, Xiao Lu is out too. He looks so cheerful, it’s like he’s fallen in love. I wonder if some lady in the operating room has asked him out.” Zhang Tiesheng stood beside Chen Song, speaking politely and cautiously.

”The feeling of the first time was nice, right?” Chen Song’s tone was playful, quick-paced.

”Thanks for your careful guidance and favors, otherwise I wouldn’t dare to easily bring a patient onto the operating table.”

”I should have watched you operate a few times before taking action.” Lu Cheng calmly responded without following Chen Song’s fast pace.

The learning and practice of surgery were theoretically much more complicated than the current steps. Even if Chen Song proved Lu Cheng could operate, he should have supervised a few cases, allowing Lu Cheng to get familiar with the local operation before gradually letting go.

But this was the rhythm of granting surgical privileges at Xiangya Second Hospital. In County Hospital, the teaching process was so ’simple and crude’, that Chen Song couldn’t be bothered with these ’steps’.

Of course, the main factor was Chen Song’s absolute confidence in backing Lu Cheng.

Chen Song had already taken off his work attire, wearing a shirt and trousers that gave him a more casual demeanor than when he wore a white coat: ”Xiao Lu, Dr. Zhang and I are off to dinner, you’ll have to sort out your own dinner.”

”If there’s surgery later, just call Dr. Zhang directly.”

Chen Song’s shift was only from eight to five-thirty, nine and a half hours, which was already ’excessive working hours’.

He was a doctor sent to support rural areas, unlike the County Hospital’s cattle or horse; some surgeries he performed were out of goodwill, not obligation. During his support period, ensuring he had enough rest time was his absolute freedom…

Lu Cheng wasn’t Chen Song—an esteemed professor from a higher-level hospital.

Originally, according to rules, he should have been scheduled like everyone else for emergency room shifts, ward shifts, secondary shifts, as well as day shifts, evening shifts, and night shifts!

That was the duty roster, Professor Chen Song was the one who broke the rules, singling Lu Cheng out to follow his schedule, leaving Lu Cheng with only ward ”day shift”.

If Lu Cheng only worked day shifts, it was considered taking advantage, for Chen Song had the privilege, but could Lu Cheng also enjoy such a special preference, being above others?

Naturally not, so Lu Cheng took on evening shifts, continuing until midnight before returning.

Then rest for a day, and follow Professor Chen Song’s rhythm.

This kind of arrangement was still advantageous for Lu Cheng, since not having night shifts meant no staying up late. However, it was the best solution Lu Cheng could think of.

After seeing the two leave, Lu Cheng returned to the ward to start writing the surgical records for recent surgeries.

This was a ’responsibility’ as a lead surgeon, writing surgical records independently was also a ’distinguished mark’ in County Hospital, representing that your absolute competence had reached a certain level.

…

”Brother Zhuang, this tendon rupture can’t be handled; it’s in extensor tendon zone 7, requiring the sliding Tsuge technique, at least the Modified Tang Method should be known, quickly transfer…” Lu Cheng shook his head, cutting off the patient’s idea of not transferring.

”This one won’t work either. It’s a rupture in the A3 zone of the lower limb flexor tendon, at the transition between the gastrocnemius and soleus, requiring the Pulvertaft Weaving Method or fascia embedding reinforcement!~ You may ask the orthopedic on-call doctor.”

”Patellar tendon rupture at the lower pole-tibial tuberosity, requiring patellar drilling anchoring method or 8-strand Krackow, bone marrow canal fixation; Director Peng in orthopedics can do it, I can’t for now…”

”Hmm, this can be handled; it’s an extensor tendon zone 4 rupture, optimally using the Modified Kessler Suturing Technique.”

Lu Cheng waited for a full three days until July 12th, the evening of his ’rest day’, 9 PM, before encountering a ’surgical technique’ within his range!

Lu Cheng was on single-day ward day shifts, other times being rotated by other doctors. Today’s ward duty doctor was Han Xiaoping, his tone somewhat conflicted: ”Lu Cheng, today you were supposed to rest.”

”It was Director Lin who said you could be called, especially since our department’s business has expanded.”

”Do you want to go into the operating room?” Han Xiaoping’s voice was rather empathetic.