This doctor is already middle-aged, and he's only just started practicing medicine.

Chapter 10 Assisting in Fighting the Boss
Tuesday, July 7th, 11:00 AM.

Longxian People's Hospital, Emergency Department, Wound Cleaning Room.

After bandaging the right forearm of a woman in her forties with gauze, Lu Cheng helped her stand up from the operating table: "Auntie, it's stitched up. You only had a small wound, and the tendons, blood vessels, and nerves weren't damaged. You were lucky! Be more careful next time you chop vegetables."

"The kitchen knife is rusty, so you need to get a tetanus shot."

"You don't need to buy antibiotics outside, but you absolutely must get a tetanus shot. Otherwise, it will be very troublesome if you get tetanus."

The auntie who runs the "Big Bowl Rice" restaurant across from Huangcang Middle School often cuts her hand while chopping vegetables. She's quite talkative: "Of course you have to get a tetanus shot. Old Niu, who runs the noodle shop across from the vocational school, didn't get a tetanus shot to save money, and he ended up dying!"

"You know, he owns a shop and is a business owner, why would he want to save this little bit of money?"

The aunt continued, "Dr. Lu, you used to study at Wuhan University. Your skills are really good. I just saw the sutures on the opening, and they look better than those done by other doctors."

"Look at my hand."

Lu Cheng left Longxian after graduation. The vocational school his aunt mentioned was Lu Cheng's alma mater, Longxian Senior High School, but that was more than ten years ago. Longxian Senior High School has since moved elsewhere, and the original site has become a vocational school.

Lu Cheng didn't know who the aunt was referring to as Boss Lao Niu: "Auntie, thank you for your recognition and praise. The purpose of suturing is simply to treat the wound. As long as it's treated well, that's fine. There's no particular good or bad about it."

"After you get back, make sure the wound doesn't get wet, especially when washing vegetables, be extra careful."

"Don't wear waterproof gloves either, as they are not breathable and can easily become sweaty, leading to infection."

Lu Cheng knew that most restaurant owners like Auntie were husband-and-wife businesses with no one to help out. They could manage on a tight schedule, but they had to be extra careful if they got injured.

"Sigh... I guess I'll have to ask someone for help, which will just waste money. We're just running a small business, and it's not easy for us to make money... Dr. Lu, I'll come back for the medical records later..." The aunt sighed as she left.

The procedures for wound cleaning and suturing, as well as the cost of tetanus antitoxin, were all paid for in advance.

Lu Chengsong returned to the wound cleaning room and continued packing the wound cleaning kit while looking at his 'profit regulations'!
[One suture procedure was completed, and the patient was instructed on postoperative precautions. 0.6 skill points were earned.]

Emergency Medicine (Proficient 6/10) (+1)

'Learning skills through clinical practice is much faster than reading books!'

Based on Professor Chen Song's popular science explanation, Lu Cheng roughly estimated the learning efficiency of the professional doctoral students in the Emergency Department of Xiangya No. 2 Hospital.

According to Professor Chen, the most outstanding doctoral students in their department should have reached a level of proficiency in at least three theories, four basic surgical procedures, two specialized surgical techniques, and three major imaging interpretation skills upon graduation.

Lu Cheng asked Professor Chen what the level of leniency was, and Chen Song said that Lu Cheng's suturing technique could probably be considered leniency.

Following this logic, that should be the level of specialization.

To progress from beginner to proficient to expert in a skill, it takes about 30 skill points. If you need to make compromises among 12 skills, you will need a total of 360 skill points.

Overall, the average learning efficiency of a doctoral student specializing in the emergency department of Xiangya No. 2 Hospital is about one skill point every twenty hours.

For Lu Cheng himself, it would take about thirty-five hours.

The difference is that professional doctoral and professional master's students have professors providing close guidance. Lu Cheng could only rely on his own reading, without any other special instruction.

"Knock knock knock!" As Lu Cheng was deep in thought, Professor Chen Song knocked on the control room door, his voice urgent:
"Xiao Lu, are you done here? We have a car accident victim here with a liver contusion. He needs liver-preserving surgery. Come up to the stage with me."

"The patient has gone directly to the CT room through the green channel and will be taken to the operating room soon."

Lu Cheng quickened his pace in packing his things: "Teacher Chen, I'm going to write a surgical record, I'll be right there."

No matter how busy he was, Lu Cheng had to write down the surgical procedure records. Not writing them down was like leaving himself a 'time bomb'!
It might not explode, but if it does, it will cause Lu Cheng a lot of trouble.

"Hurry up, this patient's life is in danger. Everyone in your hospital's general surgery department has become unusually quiet this time." Chen Song turned around quickly.

Lu Cheng lowered his head in silence, speeding up the writing of the surgical procedure record...

When patients encounter appendicitis, cholecystitis, cholangitis, or other similar conditions, the general surgery department of the hospital is always full of patients.

However, when it comes to complex cases, everyone tries to avoid them. If Professor Chen Song isn't there, the patient will most likely only get a quick look from a general surgeon and then be immediately referred.

As for whether the patient will die on the way to the transfer, there's nothing that can be done about it.

The liver cannot be completely removed to save a life like the spleen or gallbladder. The county hospital cannot handle this kind of liver rupture. Pushing the patient into the operating room means certain death. Who would dare to admit the patient into the department?

Chen Song said that this type of disease should be treated discreetly, and no one dared to utter a single word of dissent.

After finishing writing the surgical procedure record, Lu Cheng quickly walked to the nurses' station, handed the medical record to the auntie 'boss', and then quickly turned back to remind her, "Auntie, please remember not to get the wound wet! Otherwise, it's very easy to get infected."

"For other precautions, please refer to the medical advice I wrote for you... Remember to change the medication..."

The aunt was getting a tetanus shot when she saw Lu Cheng in such a hurry and asked in confusion, "Why did Dr. Lu run away?"

"A very complicated emergency has arrived, and Dr. Lu is going into the operating room."

"Fortunately, Professor Chen Song from Xiangya No. 2 Hospital came to our hospital during this period, otherwise this patient would have had to risk his life to be transferred to the state people's hospital." The nurse patiently explained, and then asked, "The medication has been drawn... Did Dr. Lu prescribe any other medications for you?"

“No… Dr. Lu said I don’t need any special medication. Do I need to take any other medication?” the aunt replied.

The nurse instructed, "If there's no medication, you can go home later. Don't take anything Dr. Lu didn't prescribe."

If it were another doctor on duty, they would probably prescribe some pain relievers and swelling reducers as appropriate, but Lu Cheng doesn't seem to do that like the others.

……

When Lu Cheng arrived at the operating room, the deputy chief physician of general surgery had already entered. The patient didn't wait for Lu Cheng to arrive before starting the operation; Chen Song had already opened up the abdominal wall.

He spoke politely and cautiously: "Professor Chen, this patient has lost a significant amount of blood."

"A frontal impact to the upper right abdomen, with a liver rupture and an AAST score of level four, indicating destructive rupture of the liver parenchyma, necessitates immediate anatomical segmentectomy." Chen Song's voice was crisp and unquestionable.

Immediately afterwards, Chen Song turned to Lu Cheng and said, "Little Lu, this surgery is very difficult. During the operation, you must listen to instructions the whole time and do not attempt to do anything on your own."

Lu Cheng dared not, but he knew Chen Song was giving him a chance to go on stage, so he immediately replied, "Okay, Teacher Chen, I'll go wash my hands and go on stage right away..."

After that, throughout the entire surgery, Lu Cheng and the associate chief physician of general surgery were both in a state of being 'punished by standing'.

Although Chen Song explained a lot of professional knowledge, such as the anatomy of the liver's Glisson sheath, the liver parenchyma clamping technique, the Pringle method for blood control, the Heaney method for hemihepatic blood flow occlusion, and the Takasaki method for hepatic segmental blood flow occlusion, neither Lu Cheng nor Chen Song knew these professional terms.

Associate Professor Chen Song single-handedly carried out the entire critical surgery. After more than four hours of hard work, he finally completed the entire liver segment resection procedure.

Then, wiping the sweat from Lu Cheng's forehead on his back, he looked back at him carefully and said, "Xiao Lu, place the drainage tube and close the abdominal wall incision."

"I'll step off the stage and rest for a bit."

Liang Qiao, the associate chief physician of general surgery, immediately forced a smile: "Professor Chen, thank you for your hard work. You can leave the rest to me and Xiao Lu..."

Lu Cheng could only obediently follow Professor Chen Song's instructions to complete the follow-up tasks, and received a small reward for his assistance.

[Assisted in completing suture ligation hemostasis, reducing intraoperative bleeding and decreasing the patient's chance of shock to some extent, earning 0.6 skill points]

[Assisted in completing local debridement, removing necrotic tissue, reducing postoperative complications, and earning 0.6 skill points.]

[Assist in suturing, drainage, knot tying, puncture... and gain 1.3 skill points!]

[Current skill points remaining: 2.8]

Assisting in fighting a boss, with absolutely no presence, and yet you still get 1.9 skill points? Compared to three days of solo wound cleaning and suturing, Lu Chengdu felt he had gotten a great deal from Professor Chen Song.

Lu Cheng felt like he had returned to the year he was at Zhongnan Hospital, where he could only watch surgeries and didn't even dare to think about participating.

(End of this chapter)