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

Chapter 175 A Man Who Can Endure Loneliness!
Zhang Tiesheng had stylish glasses and a refined demeanor, but after listening to Lu Cheng's explanation, he smiled in a somewhat lewd way and whispered, "Want me to take you to try out the product?"

Lu Cheng's eyes flashed: "Brother Zhang, with your wife around, you wouldn't dare to play such a fancy game, would you?"

Zhang Tiesheng, determined to maintain his image as the head of the household, placed his hands folded in front of his stomach and said, "It's perfectly normal for a man to go out and have fun, as long as Xiao Lu is willing to go!"

"Leave it to your brother Zhang, I guarantee he'll find you a few good-looking and skilled women."

Lu Cheng had heard of a type of person who was originally very devoted to love, but once that persona was broken, they would become very promiscuous for a period of time.

Of course, Lu Cheng didn't think Zhang Tiesheng was that kind of person. He was probably just a smooth-talking playboy who only cared about winning arguments: "Brother Zhang, I admit defeat. I can't outlast you."

Zhang Tiesheng, acting as if he were very sensible, said, "Xiao Lu, it's so boring of you to talk like that. I've already made all the preparations and you're saying you're not going."

Lu Cheng yawned.

Zhang Tiesheng looked down at his phone for a while, then held it to his ear for a moment.

Zhang Tiesheng suddenly said, "Xiao Lu, what are you thinking? You have such great skills, but you usually keep them hidden. Can you really hold back?"

This is something Zhang Tiesheng is genuinely curious about.

Based on what his urology colleagues said, Zhang Tiesheng could almost conclude that Lu Cheng was indeed quite capable.

But he certainly didn't become strong just today. However, it seems that Lu Cheng now is not the same as he was a few days ago. He never says anything, never does anything, and just pretends to be ignorant even though he knows the truth.

How can you stand it?
"Brother Zhang, what did you say?" Lu Cheng was feeling a little sleepy and had just yawned, so he didn't quite hear what Zhang Tiesheng said.

Zhang Tiesheng repeated it.

"What's there to be reluctant about?" Lu Cheng replied with a smile.

Zhang Tiesheng then cracked a joke, puncturing the barrier: "So you're really that heartless to just watch someone die?"

During his shift, Zhang Tiesheng encountered so many different kinds of patients that he refused to believe there wasn't a suitable case for Lu Cheng to treat.

"Brother Zhang, you're my older brother, so please don't try to trick me into telling you anything."

“Some things just can’t be done. Even surgery has to be done appropriately and according to fate.” Lu Cheng took another sip of his coffee.

Not knowing if any patients would come that night, Lu Cheng chatted idly with Zhang Tiesheng, feeling quite sleepy with nothing to do.

"What do you mean?" Zhang Tiesheng didn't understand Lu Cheng's words for a moment.

Lu Cheng said casually, "If it's not something our hospital should be doing, then we shouldn't rush into it."

“Showing off in front of others is not suitable for our hospital. We are just a county hospital. If we do it well, people will think it is our duty. If we do it poorly, they will say that we are reckless.”

“A severed limb is alright; after all, it’s just a hand, not a life.”

"No one expects that county hospitals can save patients that even prefecture-level city hospitals can't cure."

"Each hospital has a different positioning."

"Besides, even colleagues find this hard to believe, so why waste time trying to convince the patient's family..."

Du Qiang's cousin today is definitely in mortal danger; it could very well cost him his life.

Without Du Qiang's endorsement, Lu Cheng wouldn't have gone to the trouble of trying to save his life.

Who asked your county hospital to use this kind of blind hemostasis method?

Is there such a thing as blind hemostasis or hemostasis without a field of vision in medicine?

It definitely doesn't exist; there's no record of it in any official document.

If you were to bring it to a top-tier institution like Xiangya Hospital, that would be impressive. The primary responsibility of top-tier hospitals like West China Hospital is to save lives.

You can do something a little unconventional.

Is this what they do at the county hospital?
Lu Cheng wanted to be a doctor, but he was too noble to ruin his career in order to save someone.

This is not something that can be classified as an out-of-level surgery.

Zhang Tiesheng thought for a while and concluded, "Are you afraid of causing trouble?"

Lu Cheng nodded.

"So why did you choose to make a move again today?" Zhang Tiesheng asked.

"If Director Du has risked his integrity, then even if I fail, I can only accept my bad luck."

Lu Cheng laughed: "Director Du is the head of general surgery, how could he easily risk his reputation?"

"You're right, aren't you?"

Zhang Tiesheng and Lu Cheng hit it off, so Zhang didn't mince words: "Aren't you afraid people will say you're biased and only use your skills to serve those with connections?"

Lu Cheng's statement was simple: if a colleague endorsed him, he would take one of them down with him even if it meant his own death.

Without such a background, Lu Cheng would have simply stood by and watched someone die.

Although Lu Cheng didn't say it explicitly, that was the gist of it.

"Who would care about a small-time doctor like me?"

Lu Cheng continued, "Besides, Brother Zhang, do you think ordinary patients and their families would trust me? If I don't give them enough assurances, will they agree to let me perform the surgery?"

“This kind of critical matter cannot be resolved through conversations and signing documents.”

“I won’t gamble on something that hasn’t appeared in guidelines, textbooks, or literature, even if it has a 90% success rate, because there’s a 10% chance of failure and the patient’s family won’t sue me.”

"I am a nobody and my voice carries little weight; I cannot afford such high costs of trial and error."

"Brother Zhang, I'm going to take a nap, I'm a little sleepy." Lu Cheng changed the subject.

This kind of talk makes a lot of sense, but it's also very sensitive. If someone doesn't understand you, they can easily label you as some kind of paranoid person.

Lu Cheng doesn't flaunt how noble he is, nor does he openly write the words "I'm a scoundrel" on his forehead.

If someone dies at Longxian People's Hospital, it will most likely lead to a medical dispute.

While the hospital may vouch for medical staff who haven't done anything exceptional, given the medical affairs department's track record, they won't protect you if you do something extraordinary.

Given the limited medical resources and capabilities, it's normal and understandable that people die.

But if you recklessly perform surgeries that shouldn't happen, and the patient dies, both the patient and your superiors will ask you, "Why did you do that? Who told you to do that?"
How awesome are you?

Just follow the guidelines and the standard procedures, and you're good to go!
……

After Lu Cheng left, Zhang Tiesheng stroked his chin thoughtfully.

"This Lu Cheng? He used to lick food off the incision site to prepare for surgery, but now he's so cautious?"

"Which one is the more authentic version of him?" Zhang Tiesheng could understand Lu Cheng's expression.

He was just a little confused about Lu Cheng's character traits, since at the beginning, Zhang Tiesheng thought Lu Cheng was just a reckless brute.

However, Zhang Tiesheng soon recalled the events that followed and silently withdrew the label of "reckless man" from his mind.

The pen tip in his right hand wrote the five characters "Those who do not believe will not be treated" on a piece of scrap paper.

Zhang Tiesheng could understand Lu Cheng's choice. He was unwilling to argue with laymen's family members and patients, but he would accept the support of his colleagues from the hospital.

While Lu Cheng may be unable to win an argument and lose his future, it won't be easy for you to get along well at work after betraying him.

The more people Lu Cheng saved, the more difficult it became for someone to betray him.

No one can be sure that their relatives or friends might have a place where Lu Cheng might take action.

Those techniques cannot appear in the surgical records, but they can appear during the surgical procedure, encompassing everything in the practically understandable 'hemostasis' technique.

There's no need to be unconventional; the essential thing is for the patient to survive.

……

Lu Cheng tallied up his earnings.

Adding CT scan reading skills cost 20 skill points. Stopping bleeding and saving lives immediately gained 8.2 skill points.

We lost money, but not by a huge margin, since the level of CT scan interpretation has genuinely improved.

So, Lu Cheng earned a total of 11.4 skill points from today's surgical shift. That's a high-yield day.

Current skill point balance: 96.1 points.

"Keep this safe, it's my trump card and key weapon in professional matches," Lu Cheng muttered as he walked into the doctors' lounge.

After taking off his white lab coat, he lifted the corner of the blanket and lay down.

"Are you sure? Do you want to go to Shashi together? I heard the crayfish there are pretty good," Lu Cheng said.

Mu Nanshu: "Although I am younger than you, don't lie to me. It's already October, and the season for plump shrimp is long over."

"Crabs are the main attraction this season."

Lu Cheng simply asked directly, "Do you have any other plans? If so, just tell me."

Lu Cheng couldn't understand why Mu Nanshu hadn't agreed to go to Shashi with him.

Mu Nanshu hesitated for a while before sending Lu Cheng a screenshot of the chat.

It came from Xie Yuan'an.

Xie Yuan'an is a hand surgeon at Peking Union Medical College Hospital and a practicing physician. Although she is currently practicing her clinical skills, she is indeed a professional in hand surgery.

Therefore, she had already been subtly asking Mu Nanshu if she needed help with her research project.

Furthermore, Xie Yuan'an made another request: if it was convenient for Mu Nanshu, could she return to Han City for a while to help her organize a paper she had previously submitted?

Her paper was "lettered" by other researchers.

The so-called letter was reported to the editorial department by a colleague, and now she was asked to provide a very detailed explanation.

While Xie Yuan'an was Lu Cheng's first impression of him as a gossip girl, this gossip girl did indeed bring him good luck.

If Lu Cheng hadn't attended the advanced training course at Peking Union Medical College Hospital, he might not have had the opportunity to create his own original tendon suturing technique.

“Since Teacher Xie is in trouble, if you can help, please do so. You two work in the same unit,” Lu Cheng said.

Mu Nanshu: "???"

"You're quite generous, aren't you? I'm still struggling with this, and you've already made the decision for me."

Lu Cheng said, "Mainly because I asked Professor Tong a couple of days ago, and Professor Tong said that the competition schedule for those two days was particularly full."

"On one of those days, Professor Tong would also introduce me to a few people."

Mu Nanshu: "You should have said so earlier. I've been hesitating about it for so long."

"Then I'll go back to Han City for a while. You can go with your teacher Tong to build your network, okay?"

Mu Nanshu cares about and cherishes the time the two of them can spend together.

"Okay." Lu Cheng agreed, then said, "Now it's my turn to do sit-ups... and then I'll go and respond to Professor Tong about visiting the big shot."

Mu Nanshu quickly responded: "You just rejected it outright???"

Lu Cheng explained, "I never intended to get involved with Xiangya Hospital in the first place, so it's best not to get too entangled and cause unnecessary complications."

"I think I'm being quite hypocritical. I never even thought about this from the beginning, but I kept making excuses."

"I was mainly afraid that if I made it too obvious, I would offend Professor Tong and Professor Chen, and they would be unwilling to teach me anything."

"This time we must make things clear."

Hypocrisy isn't a label for adults, but being hypocritical is certainly a calling card for adults; playing along is often necessary. After all, reality isn't a fairy tale.

Mu Nanshu was silent for a moment, then said, "You'll have better opportunities at Peking Union Medical College Hospital, I can guarantee you that!"

"Of course, if you have any other ideas, we can discuss them together."

Mu Nanshu didn't rule out the possibility of a definitive answer...

Lu Cheng said, "Bookworm, to tell you the truth, ever since I heard about the systems at Peking Union Medical College Hospital, I've been afraid that I might be being entrapped."

"What do you mean?" Mu Nanshu asked.

"Didn't you say that at your Peking Union Medical College Hospital, any PhD with overseas experience can stay on as a staff member?" "But they must apply for a National Natural Science Foundation of China general project within a few years, otherwise it's either promotion or dismissal."

"The company will not renew the contract."

"This should be your hospital's consistent way of doing things, that's the atmosphere."

"Do you think it's possible that I'm just one of the 'feed' animals that Professor Zhong Junyun raises?"

"A broad-net policy?"

Mu Nanshu replied: "Survival of the fittest."

"This is the law of survival in reality, it's pretty much the same everywhere. On the contrary, sometimes having a clear standard can help us die more knowingly, can't it?"

Mu Nanshu is no longer that innocent little girl.

“That’s true.” Lu Cheng nodded.

……

October 20th, Tuesday, was Lu Cheng's surgery shift again.

The department's shift schedule is a cycle; Lu Cheng's operating shift is Zhang Tiesheng's emergency room night shift.

"Xiao Lu... this patient has been transferred away like this. I don't know if he can make it through the journey."

Zhang Tiesheng sighed in the emergency room lobby, his gaze passing through the transparent curtain as he looked at the flashing red and blue lights of the ambulance outside the dark, his tone ethereal.

Lu Cheng's expression remained calm: "If the patient's family doesn't trust us, then there's no need to say anything more. Isn't that what you taught me, Brother Zhang?"

This is a closed abdominal injury, and the vital signs are not stable.

Zhang Tiesheng, who was on the night shift in the clinic, immediately called Lu Cheng. They were about to push the patient into the operating room when the family arrived.

I disagree with the risks involved in signing the agreement and strongly request a transfer to another hospital; I have already signed the agreement.

The procedures were swift; the patient was transferred from the emergency room to the ambulance in just three minutes!

The ambulance was dispatched within four minutes.

"If it were you..." Zhang Tiesheng hesitated, but what he meant was that if Lu Cheng's attitude had been clearer just now, perhaps the patient's family would have agreed to let the patient stay for surgery.

During his previous operating shift, Lu Cheng had already been called over by the general surgery department to perform a more complex surgery on a patient with a more complicated condition than this one.

Zhang Tiesheng wasn't on the operating table at the time, but he heard from the people in the operating room that after Director Du Qiang of the general surgery department called Lu Cheng into the operating room, the patient's blood pressure rose from 79 mmHg to 84 mmHg within half an hour, and he was completely out of danger.

This battle made him famous in the operating room.

After that, Lu Cheng only intervened once more, when the patient's family made a very clear statement that they were willing to record video and audio, indicating their agreement to Lu Cheng's rescue efforts and their willingness to entrust the patient to the county hospital for a chance to save him.

For the other patients, Lu Chengdu chose to respect their fate.

This man is truly capable of enduring loneliness.

Lu Cheng said, "Brother Zhang, my coffee has arrived."

A few minutes later, Lu Cheng invited Han Xiaoping, who was on the night shift in the ward, to come to the emergency room to have coffee and chat.

The county hospital's emergency room doesn't have that many patients, so when there's a lull, it's perfectly fine for a few doctors in white coats to get together and chat.

Han Xiaoping, sporting his square hair, said, "Brother Lu is still awesome; he's managed to blacklist Professor Tong."

"Brother Zhang, when was the last time you saw Professor Tong? I seem to remember that Professor Tong hasn't come to the department since the 16th."

Zhang Tiesheng immediately replied, "No, Professor Tong came to check on the patients this morning."

"Han Xiaoping, you'd better not be lazy!"

As one of the few people who knew Lu Cheng's little secret, Zhang Tiesheng not only knew that Tong Yuan'an had been driven to despair by Lu Cheng, but also that Lu Cheng possessed a life-saving emergency medical device, which he had kept secret all along.

Many hospital leaders knew about this, but they didn't publicize it.

Because it's something that can't be publicized, something that even the authorities don't approve of, a county hospital wouldn't dare to publicize.

There must be a number of people who know Lu Cheng's technique, but it is said that this technique cannot be passed down and depends purely on individual talent.

Techniques that cannot be passed down are simply personal practices, so they should not be publicly announced. They can be used internally, but should not be disclosed to the outside world.

Han Xiaoping's face flushed slightly: "Brother Zhang, I didn't slack off. I got up at five o'clock this morning to start practicing my skills."

“I’ve sent all the videos to Brother Lu. You can ask him if you don’t believe me.”

Han Xiaoping's voice also carried a hint of playfulness.

You, Zhang Tiesheng, always say that I, Han Xiaoping, am lying down. Don't you have any idea why I'm lying down?
What should I do if I don't lie down before Lu Cheng comes to the emergency department?
The surgeries in the department are basically monopolized by you, Zeng Huanqi, and Director Lin. We can only act as assistants.

You're just an assistant, you don't teach anything. You expect me to watch your surgeries and learn from your assistant?
Lu Cheng nodded: "Brother Zhang, Brother Han is working very hard. Recently, he often gets up at four or five o'clock to practice his skills."

Zhang Tiesheng felt a slight sense of crisis and touched his pectoral muscles with his right hand: "Um?"

"It's all because of you, Xiao Lu, that we've ruined the atmosphere in our department. We weren't nearly as competitive as we are now back then."

Although Zhang Tiesheng said that, he hasn't fallen behind in his practice lately.

It could even be said that Zhang Tiesheng's current suturing skills are second only to Lu Cheng in the entire department.

Previously, Tian Zhuang, Lin Qianlong, Zeng Huanqi, and others who had higher levels of basic suturing skills than him had all been silently surpassed by Zhang Tiesheng.

With his basic qualifications, if Zhang Tiesheng were ten years younger, Lu Cheng even suspected that Zhang Tiesheng could now perform all the tendon sutures on the upper limbs.

Of course, Zhang Tiesheng was not in a hurry to perform tendon suture surgery in the department.

According to Zhang Tiesheng, Lu Cheng is still alive, and Lu Cheng has set an example for others, so Zhang Tiesheng wouldn't be so foolish as to try to take Lu Cheng's exclusive surgery.

Tian Zhuang and his team didn't have their own surgeries to begin with; they just did tendon sutures, and Zhang Tiesheng couldn't very well take that away from them.

After all, when Zhang Tiesheng was on duty, he could still perform surgeries such as appendectomy and cholecystectomy.

Han Xiaoping nodded in agreement: "Brother Lu has ruined our atmosphere, especially Fifth Brother Tian Zhuang. I heard him say that he sometimes only sleeps four or five hours a day."

"Brother Lu, is Tian Zhuang now basically able to handle all the tendons in the upper limbs?"

Lu Cheng nodded: "Apart from weaving and sewing, Tian Zhuang did a pretty good job with other tendon suturing."

"However, it will take some time before you can master the flexor tendon suturing in Zone 2."

"For flexor tendon ruptures in Zone 2, strict entry and exit procedures are essential. No trial work is allowed until the standard is met."

"Peng Kun, an orthopedic surgeon, died during this surgery."

Lu Cheng emphasized this point specifically for Zhang Tiesheng.

While it will take longer for Zhang Tiesheng to continue honing his basic suturing skills, it will make him more adept in clinical practice in the future.

In fact, Zhang Tiesheng is a ruthless person. In less than a month, his suturing skills improved quite quickly.

This proves that although Zhang Tiesheng appeared carefree in the department, he had put in a lot of effort in private, and may have even devoted most of his time to technical practice.

Just as Lu Cheng was about to reply, the ear-piercing sound of a cart's wheels came from outside.

"Doctor, doctor!~"

"Help!"

"Doctor," the middle-aged woman called out in the lobby.

Lu Cheng and the others immediately stood up and ran quickly out of the consultation room.

At a glance, Lu Cheng and his companions saw the man on the trolley, his abdomen covered in blood, his face ashen, being guided by emergency room nurses and other family members into the resuscitation room...

"Dr. Lu and the others have arrived," the nurse said to the middle-aged woman when she saw Lu Cheng and his group.

"What happened?" Lu Cheng asked the middle-aged woman while asking Han Xiaoping to help straighten the patient's trolley.

“My husband was walking home at night when he fell. He got stuck on something, and I couldn’t pull him up by myself.”

"I called for backup, and they managed to drag him up here. He was covered in blood..."

"Is there anything down there?" Lu Cheng asked.

“Someone chopped firewood, and a broken piece of wood pierced right into my stomach. My husband turned over by himself, otherwise we wouldn’t have dared to move.”

"Doctor, please save him, I beg you..." the middle-aged woman pleaded.

After he finished speaking, another middle-aged man who was helping to set up the bed asked, "Doctor, how is my brother's condition?"

Zhang Tiesheng immediately interrupted, "Don't speak, we are currently evaluating..."

"Blood pressure 75/50, blood oxygen 89, body temperature 37.9!" The nurse quickly measured the basic vital signs.

“There’s no time for a CT scan. Call the blood bank.” Zhang Tiesheng looked at Lu Cheng.

Lu Cheng then looked at the middle-aged woman: "Your husband is in very dangerous condition right now, and he may very well die."

"You now have two options: first, you can be transferred to a higher-level hospital; second, you can go into the operating room and see if you can be saved."

The middle-aged woman immediately lost her composure, trembled, and froze.

"What's your decision?" Lu Cheng raised his voice.

The middle-aged woman remained silent. Another middle-aged man, possibly the patient's brother, asked, "What are the chances of them snatching it?"

“The situation is very urgent, and the chances of success are slim. But even if he is transferred to a higher-level hospital, he is unlikely to survive there.”

After Lu Cheng finished answering, he shouted to the nurse, "Prepare for endotracheal intubation immediately! Call the operating room and start the surgery right away."

The patient's blood oxygen saturation was very low, and simply administering oxygen was no longer effective.

Only with endotracheal intubation and timely laparotomy to stop the bleeding could the patient's vital signs be salvaged.

"Doctor, what exactly happened to my brother?" the middle-aged man asked.

"External injury, bleeding, shock. These are obvious, but we don't have X-ray vision to assess them at a glance."

After answering, Lu Cheng continued to instruct another nurse, "Prepare cotton pads and gauze! Pack the wound temporarily to stop the bleeding."

Han Xiaoping made a preliminary assessment of the patient's condition: "The patient is in a coma and in shock. His lips are pale, and the color of his fingers and thumb is very poor."

"The pupils are slightly dilated, and the light reflex is sensitive and symmetrical."

After listening to the chest briefly, Zhang Tiesheng said, "There is no solid sound in the lungs."

"Speak up and make a decision quickly," Lu Cheng urged the family members again.

"His condition can't be treated in the emergency room."

"The gauze and cotton pads have arrived."

"The endotracheal intubation is ready." Two nurses arrived at the bedside almost simultaneously.

Zhang Tiesheng took Han Xiaoping to have the tube inserted and gave the doctor's orders: "Prepare adrenaline, prepare norepinephrine intravenous infusion, and establish bilateral intravenous access..."

"Doctor...Doctor..." Just then, a voice calling for help came from outside.

"Dr. Zhang is in the emergency room, please wait a moment," the triage nurse said.

"It hurts so much!" a patient outside cried out. "Where's the doctor?"

Zhang Tiesheng and Lu Cheng ignored them. Lu Cheng continued to look at the patient's family: "Say something! Every minute we delay, the chances of him being saved decrease."

With so many people talking at once, the middle-aged woman was completely bewildered. She finally came to her senses, her voice tumbling out in a jumbled and anxious tone:
"Doctor, you must save my husband..."

"Surgery is the only hope; without surgery, you will die 100%."

“The risks of referral are also very high. What do you choose?” Lu Cheng glared fiercely, guiding the other party to give a direct answer.

"Surgery, we need surgery! You must save my husband, doctor, please!" the middle-aged woman pleaded.

"Han Xiaoping, take some people to talk and sign the papers, and call Director Lin to request a consultation from the general surgery department."

"Let's get the patient to the operating room first!"

"This patient has an active hemorrhagic injury to the abdomen and is already in shock!" Lu Cheng gave a speculative diagnosis.

(End of this chapter)