Chapter 90: Wang Yanan’s first surgery
Translator: imperfectluck Editor: Kurisu
Wang Yanan was behaving ridiculously subservient to Zhang Fan at work, preparing tea for him, and worrying if he was too cold or too warm, reaching the point where Zhang Fan felt chills running down his spine.
“Just say it, what do you want? I’ll definitely agree to anything I can, but if it’s something I can’t do, you won’t be able to convince me even if you burn incense sticks for me.” Zhang Fan decided to ask directly as he couldn’t take her behavior anymore.
“I treat you well, don’t I? You want Shao Hua to be your girlfriend, so I said so many good things about you in front of her. And yesterday, Shao Hua insisted on leaving, but I forced her to come to the buffet with us. So, you’d better pay me back today!”
“Just what do you need? I’m already so scared. If you want to borrow my car, I really must refuse. I need to be responsible to you and your family! It’s not that I’m unwilling!” Zhang Fan was under the impression that Wang Yanan wanted to borrow his car, but she was quite inept at driving, and Zhang Fan was really afraid that she would crash his car.
“Stop talking about such useless things. I wouldn’t come ask you if I wanted to borrow a car anyways. Yesterday, I took a collarbone fracture patient. So, will you let me be the primary surgeon today or not?” Wang Yanan ran out of patience for pretending to be subservient, and instantly returned to using her typical forceful tone.
“Is that the tone you take when making a request?” Zhang Fan teased her.
“I’m going to call Shao Hua right now! I’m going to tell her that you were doing this and that with a nurse...!” Wang Yanan became angered by Zhang Fan’s teasing. She had prepared for so long already to be the primary surgeon on a surgery, and her nerves were fully tense, unable to handle the teasing.
“Alright, I agree to your being the primary surgeon for this surgery. However, you must let me take a look at the patient’s CT scan first. If the collarbone is shattered too severely, then you should let me take this one, and you can do the next one instead. Where did you obtain this patient from, anyways? It’s not our turn yet to receive new patients.”
“Here’s the CT scan. It’s a really easy surgery with no shattered bones! It’s just an oblique fracture. I can do it!” Wang Yanan pitifully looked at Zhang Fan.
“Okay, yeah, this patient’s bone fracture isn’t severe at all. Let me remind you, the lung is right underneath. It’s very easy to accidentally injure the lung if you aren’t careful. You absolutely must be careful!” Zhang Fan really emphasized this.
“I know. I’ve already assisted you on so many surgeries.” Wang Yanan’s tone became much friendlier. Although she was still feeling impatient, she knew that it was necessary to listen to Zhang Fan. This was how important ranking was in surgery. If a lower-ranking doctor didn’t dare to listen and rebelled, then the higher-ranking doctor could easily take them off the surgery!
The surgical department’s head nurse patrolled the hallways and observed the various operating rooms. This was her personal territory. She guarded it as closely as if she was a mother lion. If anyone was even the slightest bit off in maintaining a sterile environment, she would go over and force them to go over the basics of sterilization.
Zhang Fan stood by the operating table with his arms folded as he observed Wang Yanan’s movements. Her disinfecting, medical draping, and so on were all quite standardized, with no problems at all. According to the CT scan, the patient had a simple fracture, so Wang Yanan cut into the skin along the fracture.
Zhang Fan had medical drapes on hand, and gently held on to the patient’s skin so that he could easily clean up blood at any time and better assist the primary surgeon in making incisions.
The skin around the collarbone would always be quite thin. Wang Yanan soon reached the fractured location. Although the CT scan indicated that the fracture wasn’t severe, things were quite different after opening up the skin. There were extremely tiny bone fragments, alone with bleeding and extravasated blood. Wang Yanan became slightly panicky.
Zhang Fan didn’t say anything. This was a test of Wang Yanan’s own knowledge and understanding of surgery and surgical reconstruction. As the primary surgeon, she should know how to organize everything herself. Wang Yanan drained the extravasated blood, stopped the bleeding, cleaned up the bone fragments, and connected the bone fracture. Although her movements weren’t well-practiced, they were quite good already for her experience level.
This was the difference between being a surgical assistant and the primary surgeon. The surgical assistant would only need to follow the primary surgeon’s actions. The assistant’s main role was to help out and improve the primary surgeon’s vision. Basically, the assistant would act as a second pair of hands for the primary surgeon. The assistant wasn’t required to think, but rather to just follow the primary surgeon’s actions.
Meanwhile, the primary surgeon would need to pay close attention to every part of the surgery. Textbook surgeries would all be quite standardized, but there were far too many patients whose problems could only be generally categorized out there. Every single surgery would always be slightly different. Thus, the surgery would depend on the surgeon’s skill and experience. Being able to find the blood vessels you were looking amongst severe injuries would rely on having a deep understanding of the human body.
For a bone fracture, do you affix the near end or far end of the fracture first? Surgical textbooks would all have differing opinions. This would be a matter of experience. Newbies would require teaching doctors to slowly impart their experience. Only by accumulating sufficient experience could a new doctor stand on their own at last. This was how to improve clinical medical techniques.
The nurse handling the medical equipment was really bored—this surgery was really slow! This was because Wang Yanan was a new doctor. Obviously, she couldn’t compare in speed to the more experienced doctors. Firstly, she was proceeding carefully with the surgery, and secondly, she lacked confidence in herself.
Wang Yanan kept glancing over at Zhang Fan, wanting to have his reassurance. However, Zhang Fan kept silent for the entire time as she hadn’t made any mistakes. As long as Wang Yanan could succeed in her first surgery, things would become much easier for her afterwards. Her mental state would improve greatly as long as she succeeded without any help whatsoever for her first surgery.
It was now time to affix the metal plate to the bone. This was the part that Zhang Fan was the most worried about. Not being careful here could result in accidentally puncturing the lung. As Wang Yanan bored holes into the bone to affix the metal plate, Zhang Fan placed his osteotomy scalpel underneath the collarbone just in case Wang Yanan was unable to properly control her electric drill. The scalpel would serve to protect the lung from being pierced.
After Wang Yanan finished affixing the metal plate, Zhang Fan touched the bone fracture and found that it had been properly set. He heaved a long sigh of relief. Watching over a surgery for someone inexperienced was far more tiresome than personally performing surgery. His nerves had been constantly tense.
There had been a medical incident in the gynecology department just a few days ago. A rotation doctor had been sewing up a female patient’s stomach after the patient had a caesarean section. However, this patient had been rather chubby, and the rotation doctor didn’t use the proper amount of force. This caused the surgical sewing needle to come loose in the needle holder, and the patient’s muscle contractions caused the layers of fat to also contract. In just an instant, the needle became lost in the fatty lipids.
The doctors immediately contacted the orthopedic surgery departments and used a c-arm x-ray machine for quite a while before discovering the needle. The rotation doctor’s teaching doctor then had to absorb radiation from the x-ray machine for more than half an hour before he managed to successfully remove the needle from the patient’s body. The director of the gynecology department was absolutely furious, scolding the teaching doctor severely in front of all the other gynecology department doctors and nurses. Meanwhile, the rotation doctor wasn’t held responsible at all. The teaching doctor was unable to say a single word back. The mistake of the rotation doctor was the teaching doctor’s responsibility!
“Zhang Fan, did I do alright?” Wang Yanan was incredibly nervous because Zhang Fan hadn’t said anything. She truly did love surgery, and also truly wanted others’ recognition of the fact that she wasn’t here only because of her connections.
“Not bad! Not bad at all! In fact, you did better than I did when I performed my first surgery. You just lack confidence. Go and study your textbooks some more, and memorize all the details about human anatomy. That way, you won’t be as hesitant as you were today.”
“I understand! I’ll do my very best!” Wang Yanan was delighted to receive Zhang Fan’s praise. She now felt that she hadn’t wasted her last half a year’s worth of hard work. Although she was really excited, she knew that she still needed to suppress her emotions as the surgery hadn’t finished yet.
“Little Yi, use your cell phone camera to take a picture of the patient’s collarbone. This is Wang Yanan’s first ever surgery, so we should have a picture to commemorate it.”
Luckily for Wang Yanan, she was wearing a surgical mask and cap right now. Her face instantly flushed red!
“Sheesh, could the teaching doctor and disciple here please do things faster? There’s a tibiofibular fracture patient scheduled for the next surgery in this operating room. Xue Fei has already been here several times to see if we’re done yet. Since this was only a simple collarbone fracture surgery, it was scheduled first, but you’ve taken much longer than even a hip bone fracture surgery!”
Ever since Zhang Fan had rejected Little Yi’s advances, she was somewhat unhappy with him, and would always use sharp words. Typically, it was impossible for her to find any problems with his surgeries, but since Wang Yanan was a newbie doctor, Little Yi started complaining about her slow pace.
“Just hurry and take a picture of the collarbone. If Xue Fei is in a hurry, tell him to come complain to me.” Zhang Fan wanted his disciple to have no regrets about her first surgery ever. Besides, Zhang Fan now had a medical license. He was no longer the same rotation doctor everyone outranked. He would need to stand up for himself when it was necessary. Otherwise, some people would just take advantage of him.