Chapter 274: Whoa! The System knows how to talk!
Translator: imperfectluck Editor: Kurisu
The surgery preparations were finished quite quickly. Currently in the year 2011, China was one of the few countries in the world with enough government assistance to run a national medical insurance program for all its citizens. Although there were still many problems with the Chinese medical system, China was indeed seeing solid progress, development, and improvements. Nowadays, far fewer patients would refuse to pay their medical fees.
Back in earlier days, when village hospitals were still capable of performing caesarean sections and smaller city hospitals were still very good, many people who didn’t have any money would directly leave their ill family member or child in the hospital and then leave! This was the slyness of ordinary citizens. This was a helpless type of slyness because they really didn’t have any money.
The village hospital or small city hospital would then treat the patient, and even feed them! The patient’s family members would then return after the treatment was over, bringing some wheat or flour to pay what they could for the medical fees! This wasn’t an isolated event at all. Such things were incredibly common back then.
But nowadays, in such situations, doctors wouldn’t first consider treating the patients, but rather if somebody would try to sue them afterwards. It would be considered their job if the doctor successfully treated the patient, but what if the doctor didn’t succeed? Doctors had become cowardly about helping patients because of the pressure from medical lawsuits!
As urbanization became more widespread in China, rural communities started shrinking, so village hospitals became just like abandoned temples with almost nobody inside the large buildings. Although medical incidents were really reduced in number at these places, these hospitals were basically relegated to doing nothing more than appendectomies!
Old Yang, the lonely old man who didn’t even count as a temporary worker with his street cleaning job, had numerous metal bars from the split apart wheelbarrow handle stuck in his stomach as he was wheeled into the operating room. He really had a strange appearance like this. As the gurney was pushed into the operating room, the metal bars kept waving around in Old Yang’s abdomen as if they were featherless chicken wings.
Zhang Fan’s expression immediately changed once he entered the operating room. Normally, he always had a smiling expression. He would always greet others with a smile that was rather humble. This was his habit that he picked up from his younger days of being a food seller. Even now, he was unable to change it.
Still, this also had its benefits. Zhang Fan’s smile helped his patients to be highly satisfied with him. “Not only is Doctor Zhang talented as a doctor, he’s also really nice! He’s always smiling, which makes me feel so warm inside!”
However, Zhang Fan’s smile would immediately disappear upon entering the operating room. Although he was wearing a blue one-time-use surgical mask which concealed his mouth, his sharp expression was no longer that of someone who would smile at everyone. Such a Zhang Fan seemed just like a general on the battlefield who wouldn’t stop until his knife had tasted blood!
“Increase the rate of blood transfusion! Administer cardiac stimulant! Correct the acidosis! Open three vein channels! Vasodilation! Potassium supplement!” Zhang Fan was now really amazing. He kept rattling off rapid medical commands. He was the only one speaking in the operating room.
Orthopedic surgery Director Gao and cardiothoracic surgery Director Liu stood by with hands folded, silently waiting for orders from Zhang Fan! The anesthesiologist and nurse swiftly carried out Zhang Fan’s commands.
Anesthesiologists were a special type of doctor in the hospital. Anesthesiologists from earlier times had all been clinical doctors at first. Only later did anesthesiology become its own special medical subcategory.
In hospitals, internal medicine doctors would typically look down on surgeons as the prior would feel that the latter were too coarse and only knew how to cut! Meanwhile, surgeons would look down on anesthesiologists, saying something like “They don’t understand anything other than analgesic sticks!”.
In the operating room, the anesthesiologist and surgeons would have a collaborative relationship. The anesthesiologist wasn’t subordinate to the surgeons, which was why most surgeons would be unable to command the anesthesiologists.
However, Zhang Fan was a special exception in Chasu City Hospital. His medical skills were far too amazing, reaching the point of him beginning to suppress everyone else. Moreover, Zhang Fan wasn’t easy to deal with when he was in the operating room. He had a chilly expression and powerful aura that seemed like he had killing intent!
No anesthesiologist from Chasu City Hospital would dare to go against Zhang Fan’s medical commands. Zhang Fan’s achievements had been far too astonishing. Even the anesthesiology director would be incredibly respectful towards Zhang Fan while in an operating room. The anesthesiology director was respectful of Zhang Fan’s medical skills! This was how the hospital was because skills really mattered here!
“Doctor Zhang, you can begin the surgery. The patient’s vitals can support a surgery!” the anesthesiologist reported to Zhang Fan. The anesthesiologist had to take things very seriously due to the patient’s severe condition. Normally, the anesthesiologist would only say a few words for normal surgeries. “You can begin!” The anesthesiologist would then start writing the anesthesia records rather than being so serious and proper like right now!
“Disinfect!” Zhang Fan wasn’t the type who would waste any words. With his one word, the cardiothoracic director began disinfecting!
Old Yang was really skinny, so his abdominal fat layer was also very light. When Zhang Fan gently opened up Old Yang’s skin with his scalpel, he found that the yellow fat layer was so light that it barely counted as a layer! Zhang Fan didn’t need to use an abdominal retractor for this surgery. Just regular small surgical retractors were enough.
Fat patients, especially patients who were fat and female, would be a nightmare for doctors to perform abdominal surgery on. Surgical incisions required precision and standardization. A surgical incision couldn’t be done just anywhere on the abdomen.
The surgical incision would need to be done by layers, gradually entering into the abdomen, cutting open the skin, satisfactorily stopping the bleeding, and then peeling away the fat layer. The fat layer also contained blood vessels, which meant it was also important to stop the bleeding here. After that would be the muscle layer. If the muscle layer didn’t need to be completely separated, then it would usually be separated with blunt dissection. To explain simply, this meant using the scalpel handle or the fingers to run along the muscle lines and opening up a hole! After that would be the peritoneum.
All of this would be quite similar to slowly peeling an onion one layer at a time. Only an unskilled surgeon would cut all the way to the abdomen in just one go. Not only would that be highly dangerous, it would also leave very negative aftereffects for the patient at the end of the surgery.
Doctors would find it especially difficult to cut open the abdomen for patients who had thick abdominal fat. When opening up the skin, all of the yellow fat might even ruin the surgical incision as the fat would start pouring out as if it was yellow pudding!
That wasn’t even much. The most difficult part would be the thickness of the fat. If the fat had a thickness of five centimeters or more, it would become impossible to use regular surgical retractors. Abdominal retractors would have to be used.
Previously at Chasu City Hospital, there was a rotation doctor in the gynecology and obstetrics department who was working on a caesarean section patient. The rotation doctor had volunteered to do the final suturing. However, the patient’s fat layer had been too thick and slippery. Fat was a lipid, which meant it was also an excellent lubricant.
The rotation doctor wasn’t careful enough and accidentally dropped the needle into the fat layer! In just a short few seconds, as the patient’s muscles contracted, the needle vanished completely into the fat layer! The teaching doctor had been so scared that his face went completely pale at that time! It had taken quite a long while for the teaching doctor to manage to find and remove the needle, even with the assistance of X-ray imaging!
For the surgery on Old Yang, all three surgeons were experts, so the surgery began quite swiftly. But when Zhang Fan opened up the abdomen, cardiothoracic Director Liu almost vomited, even though the latter was such an experienced surgeon. The metal bars which penetrated into Old Yang’s abdomen had directly penetrated into the intestines, making holes in both the small and large intestine.
The human body had evolved in a very scientific manner. The entire digestive system had many doors from start to finish. For instance, there was the cardia at the upper opening of the stomach where the esophagus entered. The cardia was basically a door responsible for preventing stomach acid from entering the esophagus. The opening from the stomach to the small intestine was known as the pylorus. The ileocecal valve was the door between the small intestine and large intestine. All these doors would make it impossible for feces to travel upwards in the digestive system!
The small intestine’s contents would be digested food waiting to have its nutrients absorbed. The large intestine’s contents would simply be feces. Since the patient’s intestines had been penetrated, contents from both intestines had poured out into the abdomen.
Green chives, a difficult vegetable to digest, had filled the abdomen. The feces from the large intestine then tainted all of the chives yellow. It looked as if eggs were on top of the chives in the abdomen! A foul smell wafted over towards the surgeons!
“It seems that this patient must have eaten chives with eggs last night!” Director Liu commented while forcing down his sense of disgust.
“These aren’t eggs at all. Eggs aren’t so pasty. This is probably actually fecal matter that’s sticking to the chives!” Director Gao was also feeling rather comfortable!
There was a way to decrease the sense of disgust, although there was no scientific basis for it. That would be to do your best to describe and talk about the disgusting thing in front of you, which would help to prevent you from vomiting. General surgeons were highly skilled at doing this!
The stinky, fermenting smell resembled stale moldy tofu that had been rotten for many years already. The operating room nurse immediately had to run out of the operating room. She kept dry heaving as if she was a pregnant woman. The operating room head nurse arrived to replace her less than three minutes later!
“Sigh! You guys are so disgusting. It was already so stinky, but you had to talk about chives, fried chives, chives and eggs, and so on. Our nurse Little Chen directly vomited outside!” There was no helping it. The operating room head nurse had to come replace the nurse Little Chen.
“Haha, she’s still too young. As expected of the head nurse, you’re not reacting at all.” Director Liu felt slightly awkward.
“I currently have rhinitis, so I can’t smell anything~! I can’t smell a thing!” The head nurse was feeling for the first time ever like her rhinitis was a good thing for her.
Rinse! Constant rinsing! This surgery was highly difficult. Every single tear in the intestine needed to be sewed up one by one. Not only were Director Gao and Director Liu disgusted, Zhang Fan was having a hard time as well! The smell of the patient’s feces was far too intense. The smell of operating room disinfectant wasn’t able to suppress the fecal smell at all.
The two directors constantly talked about disgusting things in order to help themselves suppress the urge to vomit. Meanwhile, Zhang Fan couldn’t do anything at all. He couldn’t join them, as he didn’t want to let things get to the point where the medical equipment nurse and anesthesiologist also vomited. When Zhang Fan opened up the abdomen and smelled the stench coming right at him, he had furiously squeezed his right hand’s back with his left hand with such force that his right hand got bruised!
Still, the sensation of disgust lasted only for about a minute or so for everyone. Human tolerance was quite strong. After tolerating the disgusting smell for a while, it would feel slightly better. At this time, even if the fecal chives were splashed onto the surgeons’ faces, they probably wouldn’t be disgusted anymore!
“Head nurse, metronidazole in saline solution rinse! 1,000 mL for now,” Zhang Fan told the head nurse.
He rinsed, constantly rinsed. The greenish-yellow fecal matter was finally all rinsed away. “Change gloves!”
After Zhang Fan changed his gloves, he poured the saline solution into the abdomen and covered the intestines. He then told the head nurse, “Let’s insert nitrogen, head nurse.”
“You only know how to bully me!” the head nurse intentionally spoke in a flirtatious manner to Zhang Fan.
“It’s not like Doctor Zhang is injecting nitrogen into you! This doesn’t count as bullying!” Director Liu began to crack some slightly perverted jokes.
“Old fart!” The head nurse rolled her eyes at Director Liu. The directors would only dare to crack such a joke with the head nurse since they were of similar age. The directors would still need to save face with the younger nurses.
There were far too many holes in the patient’s intestines. Zhang Fan had to inspect which places had holes as if he was filling up a balloon!
How would he do this? That was rather simple! He would insert an air pump, similar to ones used for pumping air into car tires, into the patient’s anus and then slowly inject air into the intestines.
There wouldn’t be too many negative aftereffects with this treatment method. The only thing was that the patient would often fart after this type of surgery. Someone with more severe aftereffects would constantly fart as if firecrackers were going off. Also, some patients would constantly hiccup after the surgery. The hiccups would have a fecal smell to them!
“Stop!” Zhang Fan saw a bubbling location, and then swiftly began to sew it up.
“Start!
“Stop!”
This process kept repeating until Zhang Fan no longer found any bubbles in the intestines.
“Alright, head nurse, this part is finished now,” Zhang Fan told the head nurse after he was absolutely certain that he had repaired every hole in the patient’s intestines.
“Sigh, this is so pitiful. His intestines are filled with holes!” Director Liu commented sympathetically.
“This one’s still better than the teenaged girl next door. The iron bars weren’t that thick. Director Zhao is probably having an even harder time. Tree branches are worse than metal bars!” the head nurse commented.
The head nurse instantly caused the atmosphere in the operating room to become more depressing. She also realized her own mistake as she hurriedly wiped the surgeons’ sweat with some gauze.
Zhang Fan started closing up the abdomen now that he was finished with cleaning the abdomen. “Doctor Wang, help me close the abdomen,” Zhang Fan told Doctor Wang, an attending physician from the cardiothoracic department who was also assisting in this surgery.
“Alright.”
Normally, Zhang Fan wouldn’t let others take any part of his surgery. However, today was different. He wanted to finish this surgery as quickly as possible because he wanted to also help out with the even more difficult surgery on the teenaged girl in the adjacent operating room.
No matter what the patient or their family members were like, none of that was important. Once a doctor put on their white doctor’s coat, they would need to shut off their emotions and act only professionally. No matter who the patient was, no matter if they were rich or poor, no matter if they were young or old, the doctor would have to do their very best for them.
The patient was placing tremendous trust in the doctor by leaving their life in the doctor’s hands. Please value this type of trust! In this generation where money was considered so important, such trust was truly precious!
Zhang Fan intended on leaving this surgery early if the patient’s chest’s condition wasn’t too severe.
Doctor Wang sewed all around the abdomen incision, while Zhang Fan, Director Gao, and Director Liu prepared to open up the patient’s chest.
Meanwhile, Director Zhao next door was truly having a difficult time. He felt his head going numb all over. When he opened up the teenaged girl’s abdomen, what was inside wasn’t as disgusting as in Zhang Fan’s patient. This was because the girl hadn’t eaten any dinner last night. She had only drunk some beer. She also normally ate very little because she wanted to diet and be skinny, so her intestines were rather clean inside.
Director Zhao’s head was going numb because the girl’s intestines were in incredibly terrible condition. Why had the head nurse commented that tree branches were worse than metal bars? This was because metal bars were narrow and straight. Even if metal bars penetrated the body, they would only cause some small holes.
Meanwhile, tree branches were far more troublesome to deal with. Many portions of the girl’s intestines had been completely destroyed by the tree branches. Bleeding was already the least of her worries.
The most troublesome thing right now was that her intestines were dying! Large portions of her intestines were dying. Her intestines were beginning to turn blue. This color change was evidence that the intestines were no longer able to receive blood flow.
“Little Li, go next door and see what step Zhang Fan and the others are at in their surgery.” Director Zhao didn’t dare to take action here, so he told his operating room nurse to go check next door. This was because if he took standard surgical procedures with this girl’s surgery, then it would be almost impossible to preserve much of her intestines. If Director Zhao performed standard surgery on her for her condition, then it would become a classical example of a perfect surgery that still left the patient dead!
Director Zhao didn’t care about face or his status right now! He wanted Zhang Fan’s help for the sake of the patient’s life!
“Head nurse, Director Zhao told me to ask what step of the surgery Zhang Fan and the others are at,” the nurse Little Li asked the operating room head nurse in Zhang Fan’s operating room.
“What’s the matter next door?” Zhang Fan immediately responded before the head nurse could even answer.
“There’s incredibly severe damage in the intestines. Director Zhao wanted me to come over and ask about things.”
Zhang Fan became even more worried than he originally was. This wasn’t because Zhang Fan was arrogant. He was the type who would do anything that he knew he was capable of. Luckily for him, the heavens had sent him his System. Moreover, this was also about human life. He wanted to save as many people as he possibly could. This was because he was a doctor! Any true doctor would want to do this, whether or not they had a System like Zhang Fan did.
After opening up Old Yang’s chest, it turned out that he had been truly lucky. Only his rib bones had been shattered severely, while his heart and lungs were perfectly fine! This was good fortune among great misfortune!
“Directors, I’ll be leaving this surgery for the one next door!” Zhang Fan stopped working on this surgery as he said this to Director Gao and Director Li.
“You should hurry! Director Zhao has probably met with great trouble!” Director Gao told him.
Zhang Fan didn’t waste any time as he immediately left. Right after exiting the operating room, he took off his surgical attire. This had been a clean-contaminated surgery, which meant that he needed to wash his hands and change into new surgical attire for the sake of maintaining a sterile environment. Right when Zhang Fan took off his gloves and put his hands on his clothes, his System, which had never said even a single word to Zhang Fan before, suddenly spoke!