System Came When the Doctor was Thirty

Lin Qianlong thoughtfully considered the situation—

Zhang Tiesheng and Zeng Huanqi are both ’pampered’, unable to endure the hardship required for practicing basic skills. Han Xiaoping, with his narrow-minded thinking, prefers lying down rather than sitting up. Du Daihua has some aptitude but frequently complains about the unfairness of the world, always thinking about managing relationships.

As for Tian Zhuang, he’s long been on Lin Qianlong’s blacklist.

They don’t dare let him talk to patients for discussions or to sign any forms...

Lin Qianlong sighed and changed the topic: ”Xiao Lu, our department’s situation is quite unique, so I need to clarify something with you in advance.”

”In our emergency department, the volume of surgeries is relatively low, so the lead surgeon’s performance pay is 10% less than that in specialized departments. The lead surgeon only gets 30%, and another 10% goes into the department’s public performance fund.”

Actually, according to the hospital’s secondary distribution principle, the lead surgeon gets 40% of the ’surgery fee’, 40% is split between the anesthesiology and surgery departments, 10% goes to the hospital, and 10% goes into the department’s public performance fund.

In the emergency department’s surgical group, the lead surgeon receives 10% less, equating to 20% going to the public performance fund.

It’s not just Lu Cheng; Lin Qianlong as well relies on this to maintain the ’family’. The current performance of the emergency department is still uplifted by the hospital’s public performance fund. Otherwise, the emergency department really couldn’t retain staff.

Lu Cheng came from a specialized department and didn’t have the opportunity to be the lead surgeon before, so Lin Qianlong hadn’t explained this rule to him.

”Director Lin, whatever needs to be done should be done... I can’t always take advantage of you and the other seniors,” Lu Cheng replied with a smile.

Currently, there are only four people in the surgical group who can independently be the lead surgeon.

Lin Qianlong, Zeng Huanqi, Zhang Tiesheng, with Lin Qianlong mainly in charge of splenectomy, cholecystectomy, and bowel repair. Zeng Huanqi and Zhang Tiesheng are responsible for appendectomies and relatively large debridement sutures, these small surgical techniques.

Lu Cheng is responsible for tendon suturing.

These are the few surgical procedures in the emergency department.

”It’s good that you understand... In any case, if your current number of surgeries is sufficient, appendicitis and some major debridements will still be taken by Zhang Tiesheng and Zeng Huanqi, you get what I mean?” Lin Qianlong explained in a low voice.

”Alright!” Lu Cheng nodded without hesitation.

The volume of surgeries is fundamental for a surgeon to hone their skills. If Zeng Huanqi and Zhang Tiesheng want to secure their position in the emergency department and eventually become directors, they need to keep the core techniques firmly within their control.

”It’s good that you understand... Otherwise, if Professor Chen were to...”

”It would be quite troublesome,” Lin Qianlong said somewhat vaguely, his eyes darting.

A strong dragon does not suppress a local snake. The connections of Zeng Huanqi and Zhang Tiesheng are solid, and although Chen Song remains detached, there will always be a time for him to depart.

If he helps Lu Cheng by suppressing the other two too much, forcing surgical opportunities upon Lu Cheng, it wouldn’t be beneficial for Lu Cheng’s future relationship with Zhang Tiesheng, nor would it benefit the group’s harmony.

As the leading director, there are many aspects to consider in detail.

After Director Lin Qianlong left, Lu Cheng didn’t idle, first making his rounds to discharge the patient in bed 3, and made minor adjustments to the postoperative orders of other patients, taking care of necessary medication changes.

Only then did Lu Cheng call his uncle Lu Nanyong.

”Uncle, it’s like this, do you know anyone involved in 120 referrals?”

”Well, I’d like to find some tendon suturing cases, and Professor Chen Song is willing to guide me through them...” Lu Cheng explained with a smile.

...

Time flowed like water, and before long, five more days had passed.

In these five days, Lu Cheng lived quite fulfillingly. Under the guidance of Professor Chen Song, he was able to routinely conduct five tendon suturing surgeries entirely within his ability.

As patients with tendon injuries were discharged in sequence, at one point, the total number of postoperative patients in the surgical group within the ward reached 8, setting a new record in the ward.

Of course, during other times, Lu Cheng didn’t idle. While on duty, he adhered strictly to his schedule, meticulously considering patient orders, engaging in detailed ”conversations” and ”communications” with patients. Upon discovering any anomalies, he would request consultations from other specialists, striving to uncover ’subtle’ hidden conditions in patients through cost-free investigations using his physical examination skills.

It’s worth noting that Lu Cheng’s ’Physical Examination Skill’ is equipped with ’specialization.’

Previously, when Lu Cheng had neither surgeries nor patients, he would treat the patients under his management as examples to dismantle. Consequently, over time, his skill naturally reached the ’specialization’ level.

During duty, he thoroughly investigated pharmaceutical applications, meticulously compiling and organizing the basic principles of commonly used postoperative medications such as antibiotics, painkillers, and anticoagulants through AI.

He then presented this compilation to Professor Chen Song, earnestly seeking guidance on the distinctions between these medications, inquiring whether their side effects were relatively minor, and questioning whether adjustments should be made. Would such adjustments reduce complications for patients?

For example, previously, after a consultation with a digestive physician, it was recommended to use the classic ’Omeprazole’ for gastric protection. However, after consulting the relevant materials, Lu Cheng found the application of Pantoprazole to be more extensive and more suitable for elderly patients, so he made the adjustment, earning 0.2 skill points...

Seeing Lu Cheng being so meticulous, Professor Chen Song couldn’t help but feel a bit impatient, affectionately calling him ’Little Nagger’!

’Little Nagger’ wasn’t only used by Professor Chen Song; even the seniors in the department, nurses, and patients occasionally referred to Lu Cheng as the ’Little Nagger Doctor.’

Lu Cheng naturally didn’t mind this ’nickname.’

Detailed physical examinations, meticulous patient conversations for history-taking, and careful medication administration uncover ’hidden’ diseases in patients, improve prognosis, and earn skill points.

Being labeled as ’nagger’ for such thoroughness, Lu Cheng took pride in his methodology...

When not on duty, Lu Cheng either diligently read and meticulously organized various suturing techniques into stepwise practice routines or purchased materials for practice.

Although progress was slow, it wasn’t without advancements.

Perhaps the culmination of past work paid off, as the basic theory of hand surgery improved from [skilled 7/10] to [skilled 8/10], and Lu Cheng’s naturally unallocated knotting skill also progressed a point in skill level to [skilled 9/10].

Of course, these minor improvements paled compared to the significance of skill points—

[Independently completed a professional tendon suturing operation, alleviating patient pain, securing better functional health for the patient, earning 1.1 skill points...]

[Professionally guided the patient’s postoperative rehabilitation and medication adjustment, reducing the patient’s complication risk, earning 0.2 skill points...]

[Independently completed a professional tendon suturing operation... earning 1.6 skill points...]

[...]

On average, a standard tendon suture combined with postoperative guidance earns about 1.4 skill points.

Through independent operations on six surgeries, Lu Cheng accumulated 8.5 skill points, while postoperative guidance and medication adjustments for patients with ’tendon injuries’ ’consulted’ by Professor Chen Song earned Lu Cheng an additional 0.3 skill points.

Medications adjusted for the other four general emergency department patients resulted in a modest increase of 0.6 skill points for Lu Cheng, cumulatively.

[Current remaining skill points: 14.8 (+13.9)]

The remaining skill points were attained from minor activities during Lu Cheng’s duty, such as changing dressings, debridement, and suturing.

The accumulation of skill points was indeed quite ’tedious.’

[Suturing Skills: Tendon Suturing Skill (skilled 2/10), Modified Kessler Suture Technique (skilled 3/10), Tsuge Suturing Technique (including sliding type) (entry-level 2/5)]

With the difficulty of mastering the techniques, even after nearly a week of diligent practice, Lu Cheng had only managed to advance his Tsuge Suturing Technique to (entry-level 2/5). Unable to endure the tortoise-paced progress, Lu Cheng decided to accelerate his training.

[Suturing Skill (specialization 2/20) (Skill Points -2), Tendon Suturing Skill (skilled 5/10), Tsuge Suturing Technique (including sliding type) (skilled 1/10) (Skill Points -9)]

[Current remaining skill points: 0.8]

The accumulated skill points of a week were spent almost entirely.

However, Lu Cheng successfully exchanged them for a video demonstrating the Tsuge Suturing Technique on a pig’s trotter, which he sent to Professor Chen Song.

This time, Professor Chen didn’t instantly reply. Nearly an hour later, he exclaimed with excitement: ”Oh wow...you’re not dragging your feet when learning technology, are you? Did you leave it on overnight?”

”Did you manage to discover the essence of the Tsuge Suturing Technique again?”

”Are you cheating?”

The atmosphere was set, and Lu Cheng responded: ”Teacher Chen, it’s just a small trick, if there’s any cheating it’s because you’ve got my back...”

”Let’s go, time for a drink!~” Having read Lu Cheng’s message, Chen Song immediately felt refreshed.