Chinese medicine: When you do things to the extreme

Chapter 100: Young and promising, huh?! (Subscribe)

"Brother Qing, I sent you a location, come over and have lunch together."

"Senior Brother Yu, please treat us." Zhou Yanqing slid open the vibrating phone screen and saw the message from Lin Hua.

"Brother Yu, are you treating us? Why?" Zhou Yanqing asked cautiously.

Zhou Yanqing, who had a limited wallet, did not act like a big shot, but also had to be cautious as to whether this was a reverse treat from his fellow apprentices.

I have been in the spotlight today, but I have to ask other fellow disciples to treat me to a meal, which seems a bit self-righteous.

"Brother Yu's article has been published. I'm so happy."

"IF 10 points." Lin Hua then sent a picture of a thumbs-up.

Impact Factor is abbreviated as IF, which is a data in the Journal Citation Report. It is the total number of citations of papers published in a journal in the previous two years in the report year (JCR year) divided by the total number of papers published in the journal in these two years. This is an internationally accepted journal evaluation indicator.

The impact factor has now become an internationally accepted journal evaluation indicator. It is not only an indicator to measure the usefulness and visibility of a journal, but also an important indicator to measure the academic level of the journal and even the quality of the papers.

The impact factor is a relative statistic.

It is very difficult to publish an article in a journal with an IF of 10 or above.

A paper without quality will never be published.

Generally, associate professors or even professors will be extremely happy for a long time if they can publish an article with an IF score of around 10.

"That's indeed good news, Brother Hua, please congratulate Brother Yu for me! I have already ordered the meal." After carefully reading the message, Zhou Yanqing politely declined the dinner invitation.

Treating guests is relative. No matter what happens in the future, Zhou Yanqing does not have any extra money now. If his family is financially sound, he should not get involved in these things for the time being.

Money is not everything, but money is a good thing.

"OK then."

"Let's get together again next time we have the chance. It's my fault for sending you the message late. Sorry, Brother Qing." Lin Hua replied a little embarrassedly.

However, Zhou Yanqing did not respond with a clear conscience.

I thought to myself that if my family was well-off, I could treat everyone to a meal after this assessment, which would be a way of integrating into the team.

But without the financial strength, you can only enjoy it alone.

……

When practicing in the training room, I always feel that time passes very quickly.

Zhou Yanqing had only practiced the incision less than four hundred times, and four hours had passed in a flash.

Don’t underestimate the four hundred times of practice. It consumed more than thirty plates of plasticine and more than ten pieces of pork, costing a total of more than one hundred dollars.

As Zhou Yanqing was packing up, he glanced at the stuck daily task panel -

"Daily tasks: Complete 20 high-quality incisions in clinical practice. (17/20)"

"Only 17 cases in a month, it's too difficult!" Zhou Yanqing murmured in a low voice.

Although 17 cases are not a lot, Zhou Yanqing knows that this is the result of Professor Tan and Brother Ning Zhu's favoritism.

There are three PhDs and seven Masters in the group.

How could the group perform more than 170 surgeries a month? If we include emergency surgeries, we'd be lucky if we could do 70 or 80.

There are four weeks in a month, eight operating days, and five operations a day. This is the ceiling for the number of elective surgeries.

Emergency surgery can be equal to or even surpass elective surgery, but Ning Zhu cannot save Zhou Yanqing alone at the moment.

Zhou Yanqing is not yet an official student in the group. If you treat Zhou Yanqing too well, he will be jealous.

"Yanqing, aren't you going to practice anymore? It's still early." Zhou Yanqing's action of cleaning the table distracted Yu Yue, who was practicing debridement next door.

"I want to go back and rest early today."

"Brother Yu, I did order and pay for the lunch, so I'm sorry that I couldn't congratulate you in person." Zhou Yanqing said as he packed the fat of the pork belly into a bag, his gloves covered in grease.

"You saved me money and you're saying sorry? That's not nice to hear."

"This time it was Lin Hua who made a mistake. I asked him to inform you earlier. He didn't do his job as a communicator. I punished him at noon." Yu Yue explained with a smile, and then stood on tiptoes to look at the results of Zhou Yanqing's incision.

He raised his chin, looked Zhou Yanqing up and down, and stopped at a special part: "Yanqing, your incision technique is so popular, but your suturing technique is so popular. Do you have any special obsession with suturing?"

Harming others without benefiting oneself, this is exactly what Yu Yue is like at this moment.

In order to find a balance, they directly framed Zhou Yanqing with "psychological" problems.

"Brother Yu, I can sue you for defamation." Zhou Yanqing straightened his chest to show that he was full of masculinity.

Zhou Yanqing then rolled up the pig skin and put it into another bag. This pig skin can also be used as a material for practicing sutures, and can be taken home and frozen for use next time.

"Brother Yu, I've finished cleaning up here. I'll be leaving now."

Zhou Yanqing put the equipment back on the tray and held the plate. The bag of pork waste was bulging and the small bag of pig skin was in the other corner of the tray.

What's left on the workbench is a mass of recyclable plasticine...

Yu Yue watched this scene but did not say anything. He just kept it in mind and would ask the teacher to apply for some discounts or privileges for Zhou Yanqing when the time comes.

When the superiors were practicing the operation, the mouse's severed tail could be reattached free of charge, and Zhou Yanqing could pay for other skills at his own expense, but for suturing, he should not waste time and energy on basic practice materials.

It can be seen that Zhou Yanqing is very frugal and knows how to live.

……

At 5:30 in the afternoon, when Zhou Yanqing walked out of the residential area where he rented, he saw a man with a bald forehead. He was riding a small electric scooter, wearing a rainproof and windproof jacket, and holding a helmet in his hand, spinning it on the index finger of his right hand.

"Brother Liu, you can just give me the location. You came to pick me up specially. I feel a little cold on my back!" Zhou Yanqing said as he jogged a few steps and stepped into the car.

"Where we live is really convenient. Anyway, the speed of my electric scooter is constant and not restricted by the evening rush hour." Liu Qingshan said with his feet on the ground.

"Have a seat, and we're off."

After Zhou Yanqing put on the helmet, the windproof suit was quite comfortable and he only felt a cool breeze on his neck.

"Yanqing, let me tell you, you should get an electric car as soon as possible, it doesn't matter if it's first-hand or second-hand."

"If you're not travelling far, don't even think about driving to and from get off work, given the traffic conditions around our hospital." Liu Qingshan began to explain to Zhou Yanqing.

While Liu Qingshan was talking, Zhou Yanqing had already seen the long traffic jam in front of the hospital entrance. The red brake lights on the rear of the cars were quite dazzling.

"Brother Liu, if it weren't for the ban on noise, your eardrums would probably be damaged by now, right?" Zhou Yanqing asked with a smile.

The traffic volume near Xiangya Hospital during the same period was estimated to be at least five times that at the entrance of Hengda Affiliated Hospital.

"It's like this, most people who drive in Shashi are uncultured."

“Not using turn signals, cutting in line, and changing lanes on solid lines are common.”

"Those who park their cars on the side of the road to block the road, and those who park their cars on the right-turn lane to get on or off, I tell you, it's the traffic police who are not doing their job and the fines are too light!"

"Take Shanghai for example. I feel that if people from Shashi want to drive there, they will have to pay at least a few thousand dollars in tuition fees before they can take the traffic rules seriously." Liu Qingshan has much more knowledge than Zhou Yanqing and is also very talkative.

Zhou Yanqing has never driven a car and doesn't even have a driver's license.

Zhou Yanqing comes from a small mountain village. His parents do not have much knowledge and do not support Zhou Yanqing to learn to drive after the college entrance examination. They just hope that Zhou Yanqing can have a relaxing summer vacation.

The driver's license is something you can learn when you need it later...

Then Zhou Yanqing kept delaying it for many years.

During his master's degree, his master Gong Yi asked him if he could drive. Gong Yi shook his head, and then Gong Yi served as Zhou Yanqing's driver many times.

But it's too late to regret now.

In fact, Zhou Yanqing also knew that the reason his parents didn’t let him take the driving test at first was that they felt a little reluctant about the registration fee.

When the two arrived at Professor Tan Zhongyu's community, it was already five forty-seven.

After Liu Qingshan sent a message to Professor Tan Zhongyu, he arrived at the underground parking lot with ease.

Professor Tan drives an Audi, but Zhou Yanqing doesn't know exactly what model it is.

Zhou Yanqing, who didn't even have a driver's license, studied during his undergraduate studies. During his master's degree, he focused on doing experiments and completing his residency tasks, and rarely checked his phone.

After Liu Qingshan sat in the driver's seat, he happily fastened his seat belt.

Said: "Teacher Tan, your car feels really good."

Tan Zhongyu waved his hand and said, "Drive quickly. We will arrive at eight o'clock and try to be back by twelve o'clock."

"The original appointment was for tomorrow, but I have other special plans tomorrow, so I moved it up."

Seeing Zhou Yanqing silent, Tan Zhongyu tilted his head and asked, "It's such a happy day today, but you still want to act cool?"

"No, Master, I just don't know what to talk to you about." Zhou Yanqing quickly broke the ice.

"If you don't know what to talk about, let's just chat casually. Today's operation is a soft tissue defect flap transplant. Do you dare to do it yourself?" asked Tan Zhongyu.

Zhou Yanqing's whole body immediately tensed up: "Master, let's wait for a while. I haven't read any books related to skin flap transplantation yet."

For flap transplantation, Zhou Yanqing was previously involved in flap incision and flap suture.

But how to remove the flap, how deep to take it, and what nutrient blood vessels to preserve?
I'm sorry, this is something that the superiors should consider. Junior doctors like Zhou Yanqing can only perform partial operations of the overall surgery.

If you don’t know how to do it, then you definitely won’t dare to do it.

"If you don't know, I can teach you. Everyone has gone through this."

"Your master still has the ability to recite on the spot." Tan Zhongyu patted Zhou Yanqing on the shoulder to comfort him.

Chief Dr. Liu Qingshan was very sensible and sat quietly in the driving seat, keeping the speed steady all the way.

……

After getting off the car, Zhou Yanqing was introduced to an unfamiliar director and attending physician.

Of course, this unfamiliar director and unfamiliar attending physician also greeted Zhou Yanqing, the unfamiliar "master", in an unfamiliar way.

Like a follower, he walked into the elevator, entered the operating room locker room, and then entered the operating room.

Director Jiang smiled and said, "Professor Tan, the patient was very happy when he heard that you were going to perform the surgery on him personally."

"I've been asked at least ten times this week, Professor Tan, whether you will come on time. I said I will definitely be on time, just control the infection first."

"Now that I think about it, this patient probably knows a little bit about the I Ching and can tell fortunes. It seems that he knew the surgery time would be changed." After washing his hands and disinfecting them, Tan Zhongyu twisted a green sterile surgical gown and shook it gently. Then he put on his sleeves and asked the circulating nurse to help him tie his tie. He said, "Director Jiang, didn't he expect that he would get infected?"

Director Jiang's eyelids froze, and he spoke in a gentle tone while wearing sterile gloves: "Professor Tan, I am a firm materialist."

Then he saw Dr. Liu Qingshan standing awkwardly next to him, so he quickly changed the subject: "Professor Tan, isn't Dr. Liu going to the stage?"

"Today I brought a new assistant, Dr. Zhou Yanqing! Liu Qingshan, let him take a rest first." Tan Zhongyu also began to put on gloves.

Zhou Yanqing in the next room raised his arms, hung up his sterile surgical gown, and waited for the visiting nurse to visit him.

There won't be many circulating nurses for one operation, and two circulating nurses are considered high-level staff. Naturally, they are the first to put on sterile surgical gowns for important figures like Professor Tan Zhongyu and Director Chen.

However, Liu Qingshan soon noticed this and quickly helped to replace the circulating nurse's "job".

Director Chen took a look at Zhou Yanqing, and the impression left in his mind was that this handsome guy was a little cute and had a very good appearance.

"Doctor Zhou should be Professor Tan's favorite disciple, right?" Director Chen asked.

A student who can be taught by a professor is undoubtedly a favorite disciple.

Consultation surgeries in rural areas, to a certain extent, reflect the comprehensive capabilities of the surgeon and the team.

If you don’t have the strength, you will definitely not be able to show it off.

"That depends on whether our Xiao Zhou gives face to me, Old Tan." Tan Zhongyu sighed.

Director Chen was stunned when he heard this.

Zhou Yanqing quickly called out "Master" in a polite manner.

To be honest, Zhou Yanqing didn't have a very good impression of the trip to Huashan.

The assessment was inexplicable, the notification letter was inexplicable, and I felt inexplicably that I had lost something.

It may be that I have not accumulated enough experience, my vision is limited, my identity is not prominent, and I cannot see through the high-end model of Huashan Hospital.

If you can't get in, don't force your way in.

If you are not in the same circle and do not have enough accumulation, even if you squeeze in, you will only find yourself standing in the corner and feeling uncomfortable.

Tan Zhongyu gave a series of reactions to today’s events.

Not to mention that Zhou Yanqing felt a little flattered, but at least he felt like he was being cared for.

In fact, Zhou Yanqing's inner balance had already shifted.

Just a little.

At the same time, Professor Tan Zhongyu treated Zhou Yanqing with courtesy, while Huashan Hospital felt that Zhou Yanqing was dispensable.

……

"Professor Tan, isn't this calling me Master?" Director Chen was a little confused.

Tan Zhongyu said with a smile: "Yes, yes, yes, let's go, let's go for the surgery."

"Let's take another look at the wound. After that, I'll design the skin flap, and then Yanqing, you can take it and sew it."

As he spoke, Tan Zhongyu led Zhou Yanqing closer to the operating table.

Director Chen and another deputy director's assistant were stunned when they heard this.

Then he slightly accelerated and ran towards the operating table: "Professor Tan, the reason why this patient chose our hospital for hospitalization and did not transfer to Shashi is because he is a relative of a doctor in our hospital, so he trusts our hospital to invite the most professional experts."

The patient is now under general anesthesia, otherwise Director Chen would not dare to say a word.

Upon hearing this, Tan Zhongyu glanced at Director Chen and said calmly, "Director Chen, don't worry, I know what's going on."

Director Chen's eyes flickered quickly for a while, and his eyes moved back and forth between Tan Zhongyu and Zhou Yanqing. Then he lowered his head slightly and did not respond to Tan Zhongyu's words.

Obviously he was dissatisfied with Tan Zhongyu's arrogance!
If someone of Zhou Yanqing's age was to be operated on, why did you invite Tan Zhongyu from Xiangya Hospital? Why not just find someone at random in the department to perform the operation? !

Just give the face that should be given, and don't say things that shouldn't be said.

Seeing this, Tan Zhongyu also understood Director Chen's thoughts, and after tilting his head slightly, he suggested: "How about this, Director Chen, I will remove the skin flap and let Doctor Zhou sew it?"

"Is that okay?"

Authorizing subordinates to perform surgery also requires good timing.

This is Ning City, not Sha City.

What they value is Tan Zhongyu's skills, not the fact that Tan Zhongyu is here to bring a student to perform surgery.

Director Chen said in a friendly tone: "Professor Tan, Dr. Zhou is your favorite student. I believe his skills are proven. I believe in your vision, Professor Tan."

The topic could have ended here, but Zhou Yanqing interrupted: "Master, I want to do an incision for the skin flap."

"I just want to experience the feeling of holding a knife in clinical practice."

"Let Director Chen and Brother Liu do the suturing later. I'm afraid I don't have enough experience."

To retreat in order to advance is the strategy.

Completing the flap suture can certainly increase the number of suture practice times, but one more suture is far less effective than making a cut yourself to speed up the progress of daily tasks.

Don't employ people you doubt, and don't doubt people you employ. Zhou Yanqing was too lazy to cause trouble for his teacher.

If something went wrong with the patient after the operation and he sutured it himself, Director Chen would definitely cause trouble for Professor Tan and bring his own factors to the table.

But if I just make a skin flap to extract the incision, then Director Chen will never use me as a trick!

"Okay, as you say!~" Tan Zhongyu looked at Zhou Yanqing with a doting tone.

……

Next, Zhou Yanqing carefully observed Professor Tan Zhongyu's flap design.

In fact, the flap design is based on the shape of the soft tissue defect.

There are many types.

The skin flap to be taken now is called an arbitrary skin flap, and it is a distal skin flap among arbitrary skin flaps.

Any skin flap is determined by the characteristics of its blood supply, that is, there are no axial blood vessels in the skin flap, only the dermal vascular network, the subdermal vascular network, and sometimes the subcutaneous vascular network, but no arterial axial blood vessels.

At this time, the design should pay special attention to length and width, and peel off the layers of the plane.

However, during the operation, Tan Zhongyu did not teach Zhou Yanqing how to design the flap pattern. He just circled the flap opening pattern for Zhou Yanqing with a sterile marking pen after measuring.

"Come on, Yanqing, cut according to this. The first cut should be made within the subcutaneous fascia layer." said Tan Zhongyu.

Zhou Yanqing had already picked up the knife and cut it according to the standard markings made by Professor Tan Zhongyu.

Zhou Yanqing's incision skills were average, better than those of his peers, but still slightly inferior to those of veteran doctors in prefecture-level city hospitals.

But even so, Director Chen could see that Zhou Yanqing's technique of controlling the knife was quite sophisticated.

"Doctor Zhou's basic skills are quite good. Where is Doctor Zhou from?" The layman watches the excitement while the expert watches the details. Zhou Yanqing was noticed by Director Chen just after cutting the skin.

Hearing this, Liu Qingshan, who was standing with his hands behind his back, stood at attention and looked at Director Chen.

Tan Zhongyu glanced at Director Chen, but did not bother to explain. Instead, he took the knife from Zhou Yanqing and began to peel off the skin flap, carefully searching for the nutrient blood vessels...

While serving as an assistant, Zhou Yanqing replied, "I am from Heng City."

"There are two brothers from Heng City who come to work in our orthopedics department. Compared with the recruitment of Hengda Affiliated Hospital No. 1 and Hengda Affiliated Hospital No. 2, our hospital is much more friendly to the public."

"Doctor Zhou, if you are interested." Director Chen said.

Tan Zhongyu interrupted: "Director Chen, Doctor Zhou is from our hospital!~"

Director Chen was slightly startled when he heard this, and looked up and down at Zhou Yanqing: "Dr. Zhou, have you graduated with a doctorate?"

Then he apologized: "I'm sorry, I'm really short-sighted and didn't see it."

"I haven't graduated yet, and I haven't even started my PhD program yet, but that doesn't matter." Tan Zhongyu replied, and stretched out his hand and said, "Give me another pair of tweezers."

Many people in the operating room were shocked by Tan Zhongyu and did not react for a while.

He claims to be from Xiangya University before he even graduates with a PhD. Does that mean Zhou Yanqing is a relative of his?

Professor Tan, you can’t be so sure, right?

Could it be that the relationship is connected to the sky?
After Tan Zhongyu received the forceps and returned to the surgical field, Director Chen continued to scan Zhou Yanqing's body many times.

"What a promising young man!" Director Chen laughed.

To be honest, the core basic skills of hand surgery that Zhou Yanqing just demonstrated, incision technique, doesn't seem like he's a super genius, right?

Director Chen's tone was a little sarcastic.

Tan Zhongyu tilted his head and said "eh", but didn't explain.

……

The atmosphere during the following operation was one of silence.

The patient had undergone multiple surgeries before this one. After the last surgery, he underwent debridement and suture, and continuous drainage with a VAC negative pressure suction device on his right upper limb.

The debridement of the affected area has been completed by the associate chief physician of our hospital!

The next operation is to suture the vascular stumps at the soft tissue defect and the nutrient blood vessel stumps of the transplanted skin flap.

This time the skin defect was not a critical functional area, so there was no need for nerve suture.

The next focus of the operation is to suture the nutrient pedicled blood vessels.

After Professor Tan Zhongyu sutured the two larger blood vessels himself, he looked at Director Chen and said, "Director Chen, do you think the remaining small blood vessels should be sutured?"

"Professor Tan, when we suture skin flaps, we usually don't suture tiny blood vessels like this," Director Chen replied.

After the main vascular pedicle is sutured, the remaining capillaries may be smaller in diameter than the arteries in the uninhabited area.

"Yanqing, you give it a try. It won't affect the overall surgical effect anyway." Tan Zhongyu gave up the main operating position and said.

Upon hearing this, Director Chen looked at Tan Zhongyu, then at Zhou Yanqing, and said nothing.

Just his brows wrinkled slightly.

(End of this chapter)