Surgery Godfather

Chapter 51: Chapter 0049: The Arrival of the Strongest Patient

After the examination, the old man was pushed to the trauma orthopedics ward, with Director Xiong personally assisting him at the window to handle the hospitalization procedures.

Upon hearing that Professor Zhang had arrived, the ward was like a storm had come in, causing everyone from interns to lead professors who were still working in the ward to panic.

Everyone immediately stopped what they were doing. The first thing was to quickly make sure the buttons of their white gowns were properly buttoned; anyone missing a button had to rush to the head nurse.

“What have you been doing all this time? Only now realizing you need to sew buttons, like only thinking about fixing your tooth with a chicken leg in your mouth,” Yao Ling reprimanded the postgraduates and standardized trainees. But she was all bark and no bite.

There’s no time to go to the linen room to get this done, nor can they ask a nurse to sew it on. These young women were superb at injections and infusions, but as for sewing clothes and buttons, you better forget it.

Yao Ling herself found a needle and thread box as well as buttons from the department’s storeroom and sat down in the doctor’s office: “Come one by one.”

A few young men lined up to have their buttons sewn, with someone standing guard at the door, ready to alert everyone to any unusual occurrences.

“Hurry, hurry, Elder Man Zhang has fractured his bone, he will be hospitalized soon.” Someone rushed into the duty room to give the news.

A few guys who took advantage of their spare time to play games lost control of their phones when they heard the shouting. They immediately shut down the games, quickly grabbed a book to glance over, pretending to be serious.

“Where is the fracture?” someone asked.

“The greater trochanter of the femur!” responded the one who delivered the news.

Oh – everyone sighed, and they no longer needed to pretend. The books in their hands were put down, definitely not daring to play games anymore.

The rumbling sound of wheels grinding against the ground and the beeping sound of the emergency elevator’s opening door.

Professor Zhang was pushed to the ward on a stretcher, Yao Ling and the top nurse, Cai Qiaojun, personally guarded the entrance, but Cai Qiaojun was noticeably nervous.

Not just the nurses, but the entire hospital, except for Dean Xia and Director Han, who wouldn’t be nervous in front of Professor Zhang?

When Professor Zhang criticizes people, he never uses a swear word, never gets angry or raises his voice. His criticism is clear and logical. He can recall which page of a book, who published which paper, or the latest guidelines; every word and detail is accurate. You’d have no choice but to concede to his point.

Yang Ping was pulling on the injured leg to help everyone transfer him onto the bed. Little Five brought over the skin traction equipment. As emergency surgery was needed, bone traction would no longer be needed. Skin traction could provide some relief for now.

After buckling a wristband onto his wrist and hanging a card indicating a pre-surgery patient on the head of the bed, we immediately began fasting him. We drew his blood, performed an electrocardiogram at the bedside, made sure that there were no recent coughs or other respiratory symptoms, and bypassed a chest x-ray as he had a CT scan during his annual check-up.

Everyone helped Professor Zhang find the most comfortable position, straightened the skin traction ropes, lifted the head of the bed to 45 degrees so he could rest comfortably; he didn’t want to lie flat.

Cai Qiaojun efficiently tied a rubber tourniquet around his arm and began to insert an intravenous catheter into the back of Professor Zhang’s hand.

However, whether due to nerves or because Professor Zhang’s veins were truly difficult to find, she surprisingly didn’t get a blood return on her first attempt.

Despite Cai Qiaojun being an exemplary nurse in orthopedics, and a past award recipient at the city-wide nursing skills competition, she turned pale and visibly faltered with Professor Zhang.

Lying there was Professor Zhang. How could she not be nervous? One could see her sweating from her forehead. Professor Zhang had his right hand placed next to him for the insertion of the needle, slightly turned to his side.

He extended his left hand and said, “Give it to me!”

His tone was very gentle, the gentler he was, the more nervous everyone became. He took the piercing needle for blood drawing, planning to perform the venous puncture himself.

“Look, first 45 degrees, to shorten the puncture path. The puncture needle should pass through layers clearly, skin, subcutaneous tissue, then the vein. Each layer you pass, you should be able to feel it. You just aren’t practiced enough.” Professor Zhang said patiently while operating.

He overturned the needle with his left hand, pushed it lightly, and there it went in, drawing blood in one go.

“After inserting the needle, press and lower the angle of the needle to keep it in line with the direction of the vein. As long as the vein is thicker than the needle, you can insert it. There is no such thing as being nervous. Nervousness comes from lack of proficiency, no matter how nervous you are, you can still answer that one plus one equals two.” Professor Zhang continued talking, while Yao Ling and Cai Qiaojun blushed.

Professor Zhang releases his hand. Cai Qiaojun removed the needle and left the tube inside, then securing it in place, attaching the infusion liquid, and starting the infusion.

In the past, the myth of the old man injecting himself was only hearsay, but now, up close and personal, which nurse would dare to refute his prowess? All they could do was meekly stand by and listen.

Director Han came in carrying his document bag, “Teacher Zhang, I have a plane to catch, please settle in. I’ve also spoken to Tian Yuan. Little Yang, Xiao Song, and Tian Yuan will be present.”

“Alright, I understand. You go about your business. It’s crucial to handle the matters at the institute and not to delay anything.” Professor Zhang was fiddling with the remote control, wanting to watch TV.

Director Han left in a hurry after some small talk.

The head nurse offered to adjust the TV for him, but he declined, “Why are so many people surrounding me? You all carry on with your work. Standard procedures are just fine.”

Upon turning on the TV and channel surfing, he stumbled upon an old movie about the Korean War called ‘Surprise Attack on White Tiger Regiment’.

“You guys go on, there are so many patients. You don’t have to care for me. Get me a male companion nurse. No need for a pre-surgery catheter, it might even be difficult for the Urology department to insert a metal probe successfully. As for my meals post-surgery, there are no dietary restrictions, order anything. You guys can go now. You, stay behind,” he instructed, keeping Yang Ping back with him.

Seeing there was nothing else to be done, the head nurse offered a few comforting words before leaving the ward with everyone else, leaving only Yang Ping behind.

“Sit down. Why are you standing? You haven’t done anything wrong.” The elder man asked Yang Ping to sit.

Yang Ping moved a visitor’s chair over and sat by the bed. Professor Zhang paused the TV, “These old films are interesting to watch. At that time, I was only a teenager. My father was one of the earliest Western-trained orthopedic surgeons. After studying in the United States, he worked at Xiehe Hospital. When the war broke out in 1950, he volunteered to go to the battlefield. In the Battle of Chosin Reservoir, he was injured by a fragment of a shell — even at ninety, the old man still insisted on going to the clinic, sleeping in the office chair there –”

Yang Ping listened quietly, a respect silently forming within. Suddenly Professor Zhang stopped and said, “Bring me the X-rays and CT scans, let’s discuss.”

Yang Ping took out the X-rays and CT scans from the bag by the bed. Professor Zhang put on his reading glasses and under the natural light, he began to explain as he pointed at the scans, “The biggest difference between the upper and lower limbs is that the lower limbs bear weight. Any lower limb fracture requires early weight-bearing activity, and there has to be osseous support, i.e., the more pressure there is, the tighter it becomes. The implants only serve as aids and cannot take over completely. For the most basic transverse fracture of the tibia, the Germans would operate in the morning and the patient would be walking by the afternoon. It was so startling that we dared not speak up. It would take us six to eight weeks to partially bear weight and only after three months would the patient manage completely. Initially, we thought it was a problem with the materials. But later we realized the main issue was not the materials, but the theory of osseous support. Their interlocking intramedullary nails utilized a longitudinal sliding hole, which locked laterally and slid longitudinally, which automatically compressed the fracture ends. Weight bearing actually became a beneficial factor, the more they walked, the faster the fracture healed.”

Yang Ping listened attentively, and Professor Zhang continued.

“This bone fragment has to be pulled out, these few must be anatomically reduced, and this fragment needs steel wires and cables. Nowadays, once a surgery needs steel wires, it’s considered backward. Without the use of steel wires, it’s considered advanced. But surgery isn’t about following trends, there needs to be your own thought process. Medicine needs to advance, but new things aren’t necessarily the best, they need to be tested over time. The last distal humerus comminuted fracture you did used steel wire and a pin, and it was done very well. You must’ve put a lot of thought into the process of anatomical reduction and fixation.”

“I think the sequence of anatomical reduction and fixation in a fracture is a profound process, it’s not simple at all. Much like building a house, it’s not just stacking bricks, there should be a complete theory behind it,” said Yang Ping, expressing his feelings.

“Hmm, to be able to realize this is very good. I too have been considering this issue. Many things seem simple on the surface, but upon further study, you’ll discover they are incredibly profound and complex. Just like a Rubik’s cube, on the surface, it seems to be all about twisting and turning, but the strategy of restoring it, how to arrange the order, is a big topic.” Professor Zhang put down the scan.

Yang Ping kept the scans, and Professor Zhang said: “A surgeon, especially an orthopedic surgeon, should possess an important ability—spatial imagination. They should be able to construct a three-dimensional anatomy in their minds, and this construction must be precise and specific. Just like a chess player can play with their eyes closed, we surgeons should be able to perform surgery in our minds. Close your eyes and be able to recall the entire surgery process in your mind. Pass me the paper!”

Yang Ping pushed the mobile table over, setting it on the bed and in front of Professor Zhang, locking it in place. He then retrieved paper and a pen from the bedside drawer.

The old man began to draw on the paper with the pen, and in less than three minutes, an image of a hip joint appeared on the paper. He completely drew out his own fracture. Then, he drew another picture on a separate paper, showing what it would look like after anatomical reduction and fixation. The picture was so realistic and detailed, portraying a strong sense of three dimensions, that it left a strong visual impact.

“Back in our day, mastering the art of drawing was necessary. Nowadays, it’s hard to find a doctor who can draw. If you need, I have some sketch manuscripts, you can take a look.” Professor Zhang put down his pen.

Yang Ping was stunned. No wonder everyone in the hospital feared him. It wasn’t because he liked to scold people, but because everyone indeed could not meet his expectations. The two pictures on the table were of such high quality that they could be compared with the works of Western realist painters. They were incredibly lifelike and breathtaking. Also, these weren’t just 2D but 3D drawings. With just a black pen, he managed to perfectly depict the sense of three dimensions. This level of skill could easily earn him a spot as a street performer drawing 3D images.

“Surprised? If it was in color, you would think there were joint models and steel plates and screws on the paper. Simple line combinations can achieve such results, why can’t medicine? After self-learning modern 3D painting and combining it with medical illustration, I acquired such 3D painting skills.” Professor Zhang laughed.

Yang Ping was highly interested in Professor Zhang’s drawing. He previously had no concept of it. He put away the two pieces of paper, “Can I keep these two drawings?”

“They were drawn for you in the first place, take them and study the surgical process. I’m a bit thirsty, and the mixture in this IV drip doesn’t seem quite right.” Professor Zhang chimed in.

Yang Ping quickly poured a glass of water. There were cotton swabs on the bedside table. He soaked a cotton swab and helped moisten Professor Zhang’s lips.

“During the surgery later, get someone to arrange a tablet that’s connected to the operating room’s video system. I want to watch the entire process myself.” Professor Zhang reminded.

Yang Ping responded, “I’ll have someone prepare it now.”

“You go prepare. I need to rest now. I’ve performed surgeries on others all my life, now it’s my turn.”

“Remember, I want to be walking by tomorrow.”

As Yang Ping was about to leave the room, Professor Zhang reminded him once again.

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