System Came When the Doctor was Thirty

The sun was setting; though the sunlight no longer reached the emergency department, the incandescent lamps still illuminated the general ward brightly.

Zeng Huanqi, with his legs crossed, replied, ”Mm, okay, Director Lin, I’m right here in the department! ~ Xiao Lu himself said his manual repositioning technique was quite good.”

”Moreover, he has taken and organized photos of both the pre-operative and post-operative X-ray examination results. His surgical records are very detailed, and the documentation is meticulous.”

”Yes, the documents for the conversation and signatures are also preserved.”

”I also called the medical department. In our hospital, the authority for manual repositioning is routinely given to orthopedic and emergency department doctors. Lu Cheng had this authorization in his surgical permissions chart the year he joined.”

”Alright, I got it, Director Lin.”

...

At nine in the evening, the night was deep, and the cicadas outside the window were still chirping intermittently.

Xiang Kuihua logged into the emergency system on his computer, and there were many types of cases.

However, Xiang Kuihua’s mouse hovered over the patient data of a mid-shaft fibula fracture.

Lu Cheng’s diagnosis was very thorough.

Lower limb trauma.

Mid-shaft fibula fracture (AO Type A1.2).

Treatment suggestions: 1. The fracture has displacement and meets surgical indications. It’s recommended for the patient to undergo surgical treatment or manual repositioning of the fracture. After informing the patient of the detailed risks of surgery and manual repositioning, the patient opted for manual repositioning.

2. Perform external fixation with plaster. Full rest for one month post-operation.

3. Administer Celecoxib 200mg once daily for pain relief and Maizhiling 300mg twice daily for swelling reduction.

4. A recheck is advised one month post-operation to determine the next step of treatment based on the results.

5. Return if uncomfortable.

”A displaced fracture, a fracture with surgical indications, why did you choose manual repositioning? Lu Cheng, do you intentionally want to go against me?” Xiang Kuihua’s mouth tightened...

After some thought, Xiang Kuihua felt that continuing like this might cause problems, so he found Tang Zhongqi’s number in the contact list and called.

”Director Tang, it’s me, Xiang Kuihua from orthopedics. I need to report something to you...”

...

At ten in the evening, Lu Cheng rubbed his eyes and closed the surgery textbook by Huang Jiasu. After bookmarking the reading page, he stretched lazily in the doctors’ lounge!

I have to say, the feeling of reading while taking breaks is really nice.

The breaks help Lu Cheng absorb a lot of key points unexpectedly, and upon rereading, he discovers many details in the textbook, gaining new insights.

Medical students all know that every time you read any textbook, you get new understandings and insights. Reading this way, not for exams but for new experiences, is truly enjoyable.

After closing the book, Lu Cheng put on his white coat, preparing for a ward round, ready to go home after his shift ended at midnight.

However, just as Lu Cheng fastened two buttons, the phone rang.

Lu Cheng stepped aside a few steps, picked up the phone from the lounge table, and smiled as he recognized the caller: ”Hello, Director Tang, this is Lu Cheng from the emergency department.”

The caller was Tang Zhongqi from the medical department, the deputy director of the office in charge of physician registration and surgical permissions at the hospital.

”Dr. Lu, I heard you’re doing manual repositioning for fractures in the emergency department. Isn’t that against regulations?”

”Don’t do it; fractures are a designated specialty of orthopedics.” Tang Zhongqi’s rich voice was unquestionable.

”Director Tang, there must be a mistake. In our hospital, are there any specially designated specialties besides this? Wasn’t it about giving more work to those who can at meetings?”

”In principle, as long as other specialties don’t handle it, and you have the confidence, you can apply for permission from the medical department, can’t you?” Lu Cheng replied calmly, his memory clear.

The patient volume at the County Hospital is not high, and there are not so many specialized departments.

General surgery spans many specialties such as breast and thyroid surgery, vascular surgery, and hepatobiliary surgery.

Tang Zhongqi seemed to think Lu Cheng was naive.

Tang Zhongqi, being in the office, naturally knew the usual rules: ”Dr. Lu, there’s really no need; you’re undermining orthopedics.”

Tang Zhongqi didn’t dare counter Lu Cheng’s point because he wasn’t sure if Lu Cheng was recording: ”Our hospital doesn’t have many fracture patients. If there’s a surgical indication, you shouldn’t do manual repositioning.”

Lu Cheng smiled and replied: ”Director Tang, we regularly consult orthopedics for cases with absolute surgical indications in the emergency department.”

”With optional indications or after a detailed evaluation and finding indications for manual repositioning, we perform it only after fully considering informed consent and the patient’s request.”

”In the emergency department, we have always been very rigorous about recognizing and identifying patient conditions.”

Tang Zhongqi said: ”Then, what do you expect the orthopedic people to do with your actions? Are you deliberately causing trouble?”

Lu Cheng said: ”Director Tang, how am I causing trouble?”

”It’s simple; orthopedics could set up a clinic in the emergency department if they wanted, or they could perform manual repositioning for patients.”

”Manual repositioning isn’t exclusive to our emergency department’s surgical permissions...!”

Tang Zhongqi said: ”Dr. Lu, your actions are not conducive to harmony among colleagues in the hospital. If you absolutely won’t heed advice, I can only suspend your permission to perform manual repositioning.”

Upon hearing this, Lu Cheng was silent for a moment before replying: ”Director Tang, you are the leader. Suspending my permission to perform manual repositioning is within your rights, but I need to see an announcement!”

”I need to know the specific reasons for the suspension of my surgical permissions by the medical department, whether on the internal network or the official website!”

Tang Zhongqi’s voice rose a notch: ”Lu Cheng? You should be a smart person. Don’t you understand how to go with the flow? Must you make things so tense?”

Lu Cheng replied: ”Director Tang, I do my job conscientiously, seriously fulfilling my role as an emergency department doctor. How is it that I’m being unreasonable?”

”How is it that I’m making things tense?”

”Manual repositioning is a traditional specialty feature of the Traditional Chinese Medicine Hospital. If they can do it, why can’t we at Renmin Hospital?”

”My stance is clear, Director Tang. If you want to suspend my surgical permissions, I must see the document and reasons, and I will follow up daily!”

”Anyone who dares to privately and unjustly suspend my permissions without reason is acting against regulations!”

Obviously, Tang Zhongqi had already taken a biased stance, but Lu Cheng had no guilt. He wasn’t targeting anyone, nor was he insulting Tang Zhongqi.

As long as Tang Zhongqi didn’t create trouble himself, there would be no issues with this matter.

If Tang Zhongqi really did take action behind the scenes due to Xiang Kuihua’s words, Lu Cheng would not mind confronting him about it.

”I told you to stop your clinical duties based on the comprehensive considerations of the medical department,”

”What announcement? I’m informing you directly, and that’s enough.”

”Anyway, I’ve warned you; you currently don’t have permission to perform this surgery, so don’t cause unnecessary trouble!” Tang Zhongqi sternly reprimanded.

Lu Cheng asked in return: ”Director Tang? Who is the authorized person to cancel my surgical permissions?”

”Lu Cheng? Are you refusing to listen?” Tang Zhongqi was a bit annoyed that he couldn’t suppress Lu Cheng.

Lu Cheng hung up the phone with a smile: ”I’m going to the medical department to inquire now; probably the head on duty will handle it...”

”Lu Cheng!” Tang Zhongqi called out again, realizing he was just shouting into emptiness.

Lu Cheng, since he was not on ward duty or clinic duty, could freely head towards the medical department.