Chapter 445: Ganglion Cyst, Recruiting a Deputy General
The female patient didn't know what Zhou Can was trying to do. Out of trust in the doctor, she cooperated without saying a word.
However, a trace of pain still appeared on her face from time to time.
After pressing for more than ten seconds, Zhou Can suddenly increased his strength.
“Ouch!”
The female patient screamed in pain.
Zhou Can also let go of her hand at the right time.
"Look at the bag in your hand again!"
Hearing this, she raised her arms and looked down.
"Ah...where's that bag?"
An expression of extreme surprise appeared on her face, and she stared at her arm in disbelief with her eyes wide open.
"This is too amazing!" Luo Shishen also stared at the scene in front of him with wide eyes.
"Could it be a ganglion cyst? This disease often occurs on the back of the wrist, popliteal fossa and other parts of the body. It is a benign tumor. Surgery can be chosen for treatment."
Yang Zhi's insights clearly far surpassed Luo Shishen's.
He revealed the origin of the disease in one breath.
"Doctor, do I still need surgery?" The female patient was surprised and delighted, and rubbed the place where the bag was in disbelief.
"Your ganglion cyst should be one of the most friendly ones. Based on my personal experience in diagnosis and treatment, it should not require surgery. I'll prescribe some medicine for you to take and apply on it."
Zhou Can said to her.
"Really? That's great! I'm really scared of surgery. When I came in just now, I was thinking that if I was left with a few ugly scars on the back of my hand, I wouldn't be able to wear short sleeves and skirts in the summer."
She seemed very happy to hear that she didn't need to undergo surgery.
"Just now when I was waiting in line outside, I heard other patients say that there is a young doctor named Zhou in the emergency department who has very good medical skills. Seeing is believing, and I now completely believe it. I know without asking that the doctor Zhou must be you."
Zhou Can felt very comfortable with the flattery from the female patient.
"The sea of medicine is endless, and I am far from being an expert in medicine. At best, I have seen more diseases. Your disease is usually a benign lesion caused by soft tissue injury. It is medically defined as a benign tumor that grows near joints, tendons, and ligaments. So, even though it has been pressed down for you now, it may grow again if you don't take good care of it."
Zhou Can explained the precautions to the patient while prescribing medicine for her.
Then, with the female patient thanking her profusely, she asked Ma Xiaolan to send the person away.
The female patient said that the long wait was worth it. It is estimated that she will spontaneously promote the emergency department of Tuya Hospital for a long time.
Especially when her relatives or friends need surgery, she will definitely recommend Dr. Zhou from the Emergency Department of Tuya Hospital first.
Ma Xiaolan soon brought in the second patient, a male patient in his thirties who needed to have the dead bones in his facial bones removed.
According to the lateral X-ray of the patient's left mandible, it can be found that the lesion is confined to a certain range with clear boundaries, and a large number of dead bones of varying sizes are formed in the bone necrosis area.
This operation requires careful avoidance of blood vessels and nerves around the lesion, and removal of the bad bone and the entire tissue involved in the lesion.
The technical difficulty is high and the risk is relatively high, so this is a high-level secondary operation.
For senior surgical residents, this level of surgery is already extremely challenging. Without extensive surgical experience, it is difficult to complete it easily. Generally, only attending physicians dare to perform this type of surgery alone.
Zhou Can is already capable of performing level 3 ultra-high difficulty surgeries on his own. In his eyes, this level of surgery is a piece of cake.
"Doctor Yang, if you were asked to perform the surgery, where would you choose to make the incision?"
He began his assessment of Dr. Yang again.
It was really strange that a junior resident doctor was assessing a surgeon at the attending level.
But the party being assessed is happy to accept the assessment as a matter of course.
"This type of surgery is not part of the surgical program of my department, so I am not very professional. However, for the safety and convenience of the operation, I will choose to make an incision inside the mouth."
Yang Zhi failed the assessment of the first case.
This time, he used all his skills.
"Great minds think alike! I am also going to make a small transverse incision in the patient's intraoral vestibule groove, right here."
Zhou Can was obviously satisfied with his answer this time.
"Mr. Luo, remember this. When you encounter this type of surgery, if the patient has symptoms of systemic failure, you must first correct the symptoms of systemic failure and incise and drain the lesion. Do not perform surgery rashly, otherwise it is very easy to cause serious postoperative complications, leading to rapid progression of systemic failure and unpredictable consequences."
He patiently taught Luo Shishen relevant surgical knowledge.
Luo Shishen took out a small notebook and started recording quickly.
A good memory is not as good as a bad pen.
Medical students should take more notes and not be lazy, because there is too much knowledge to learn. If you don't take notes, even if you remember it at the time, it will be very easy to forget it later.
The operation began quickly.
"When the mandibular bone is damaged over a large area, a conventional submandibular incision should be performed instead of dogmatism and intraoral incision. Some female patients, in particular, who love beauty, will actively request to leave as few scars as possible, but we cannot agree to that. The first principle of our surgery for patients is safety. Only after ensuring safety can we consider aesthetics."
While performing surgery, Zhou Can also taught relevant surgical contraindications and knowledge.
He also accumulated these things bit by bit, constantly understood them through practice, and with the instruction of his teachers and his own reading, he has achieved his current strength.
When he mentioned the word dead bone, he deliberately used the word bad bone instead, which is also a common word usage rule in the operating room.
Try not to say words like death, cancer, or the end.
Not only is it unlucky, but it can also easily cause patients to panic if they hear it.
After incising the mucoperiosteum, the mucoperiosteal flap is turned over to expose the dead bone.
This surgical approach is only suitable for small pieces of dead bone.
If the lesion is large, a conventional incision approach is required to expose the dead bone.
After the dead bone is exposed, loosen it along its edge.
Soon, with Zhou Can's skillful techniques, the dead bone was successfully removed.
Don’t think that the operation is completed at this point, it is still a long way to go.
"After removing the bad bone, you should also thoroughly scrape the granulation tissue at the edge and the small bad bone fragments around it. You must clean the lesion as cleanly as possible to avoid a second surgery."
Zhou Can's surgery was very quick.
After finishing the scraping, he took the iodine-form gauze drainage strip that Qiao Yu had already prepared and filled it into the bone cavity.
"Doctor Yang, can you sew it up?"
The difficulty of intraoral suturing is definitely higher than that of facial suturing, and the suturing requirements are also higher.
Zhou Can was also a man of great skill and courage, and he directly handed over the remaining suturing task to Yang Zhi.
According to his thinking, Yang Zhi has been working in the operating room for six years after all. If he doesn't even have this kind of suturing ability, it means he is just slacking off.
In addition to practicing suturing on patients, you can also practice at home using pig skin and cloth.
It may sound a bit cruel to say it.
Some novice doctors who are in the critical period of advancement will deliberately make incisions on some experimental animals, such as mice and rabbits, and then suture them in order to test their suturing skills.
Although it was done under anesthesia, if the medical protection organization knew about this, they would inevitably complain.
Practice makes perfect.
It is allowed to conduct some medical experiments on animals.
Experiments on primates and monkeys are also supported by the law, as long as the purchase channels are legal.
Another point is that some doctors have seen wounds heal very quickly after suturing them on mice or rabbits, and then they confidently began to practice on patients, but the results were not satisfactory.
This is because humans do not have the same healing abilities as these experimental animals.
Some patients have underlying diseases or poor physical conditions, such as old age, poor blood circulation, slow metabolism, and limited nutritional supplements, which can easily cause slow healing of wounds after sutures.
Therefore, it is really not easy for human medical technology to develop to this day.
It is not what some people imagine, that can be achieved by experimenting on animals. Instead, it is the result of countless clinical experiences and gradual improvements that have led to the current mature medical system.
After Yang Zhi took over the patient, he began to suture.
Zhou Can did not rush to call the next patient in, but stood by and watched Yang Zhi operate.
After Yang Zhi finished suturing, Zhou Can nodded with satisfaction.
He wrote medical advice to the patient and then asked Ma Xiaolan to send him out.
"Doctor Yang's basic surgical skills are quite solid!"
Zhou Can praised.
Tight sutures should be performed inside the mouth. Intraoral operations are somewhat limited, so the requirements for suturing techniques are naturally higher .
As a result, Yang Zhi completed the task very well.
"You're too kind! But when I have nothing to do, I practice some basic surgical skills."
What this means is that he is not only excellent in suturing, but also in other basic surgical skills.
At this time, Dr. Xu came in.
"Teacher, this is Yang Zhi, the anorectal and colorectal surgery surgeon I mentioned to you. He just performed intraoral suture on the patient, and it was excellent." Zhou Can's surgical team was going to expand with new members, and he must have discussed this with Dr. Xu in advance.
Doctor Xu's gaze was very oppressive. When he stared at Yang Zhi, Yang Zhi felt goosebumps all over.
However, he always wanted to join Zhou Can's surgical team.
Especially after watching Zhou Can treat two patients in a row, he was deeply impressed by his strong surgical skills and yearned for him.
He firmly believed that if he worked with such an outstanding young doctor, the outcome would definitely not be bad.
"Does Director Mi agree with your plan to come to the emergency department?"
Dr. Xu stared at Yang Zhi and asked.
"I didn't dare to tell Director Mi about this directly. I just said twice in a tactful way that I was going to leave the Department of Anorectal Surgery. Director Mi urged me to persevere twice, but to be honest, I didn't see any hope there. Although there are fewer doctors in the department and the competition is much less, that is not the job I want. My family conditions also don't allow me to struggle on the line of food and clothing. I want to accumulate experience continuously, and one day be promoted to associate senior, and then have a stable income."
Yang Zhi was frank and spoke frankly about the actual situation.
After listening to me, Dr. Xu asked again, "Do you work to make more money?"
"Having a high income is part of my pursuit, but not all. I hope to improve my medical skills, and I firmly believe that if my skills improve and I work hard, my income will not be much different."
His thoughts should be what most doctors think.
It's nonsense to say that work is not for making money.
We are all human beings, with wives, children and parents to support. Is it possible to do this for fun without making money?
This is unrealistic.
"You are a very honest young man, not bad! Xiao Zhou, continue the operation!"
Dr. Xu finished questioning Yang Zhi.
During their first conversation, Yang Zhi's performance should have satisfied Dr. Xu.
He also secretly breathed a sigh of relief.
Dr. Xu is Zhou Can's teacher. If Dr. Xu does not agree to his joining, this matter will most likely fail.
The third patient was quickly brought into the operating room. Zhou Can did not dare to let Yang Zhi take the knife for the operation, but he was asked to help with suturing, hemostasis, and retractors.
…
We worked until after eleven o'clock in the evening, and all the patients completed the operation successfully.
Zhou Can already had some understanding of Yang Zhi's surgical abilities, as well as his personality and work attitude.
Overall it's pretty good.
His surgical skills are absolutely above standard, and his work attitude is down-to-earth, meticulous and responsible.
Communication is also very worry-free.
To put it bluntly, this person doesn't play any tricks during the conversation and just says what he thinks.
Like Dr. Lu who was sent to prison by Zhou Can before, sometimes one sentence may hide three intentions. Communicating with such people is actually a very laborious thing.
Another point is that Yang Zhi has a strong desire to learn and a positive attitude towards learning.
Whenever he encounters something he doesn't understand, he writes it down in a notebook he carries with him. You can see that this notebook has many pages filled in, which shows that he has always had this study habit.
"Doctor Zhou, Doctor Xu, I'll be leaving first. If you need help and you think I'm still capable, you can give me a call."
Yang Zhi said goodbye to them.
"I've already ordered some midnight snacks. Don't worry, eat first before you leave! At least bring some with you for the journey."
Zhou Can said with a smile.
Yang Zhi passed the assessment. I need to discuss the details with Dr. Xu, because it involves transferring people from other departments, and some things are very complicated.
It is true that Director Mi is an honest man, but this kind of person also tends to be stubborn.
If you try to steal his girlfriend, it will easily cause disputes.
If you want to do things beautifully, you must pay attention to the methods and ways of doing things.
"You guys eat, my wife and kids are waiting for me at home, bye!" Yang Zhi was embarrassed to eat with them, as it was the first time they had interacted with each other.
"Take some for the journey! When I ordered supper, I included you in the order. If we can't finish the extra food, it will be wasted."
Zhou Can quickly picked up one and stuffed it into his hand.
"Don't be polite, Doctor Yang! In our team, Doctor Zhou has always been so generous, and we have always been happy." Ma Xiaolan also interrupted and helped ease Yang Zhi's embarrassment.
"Okay! Thank you then!"
Yang Zhi accepted it.
"What's your phone number? I'll write it down so I can contact you easily."
Zhou Can took the initiative to ask for his phone number, which made Yang Zhi immediately show a hint of joy.
He is not stupid. He would only ask him to leave his mobile phone number if he has a good impression of him and is willing to recruit him into the surgical team.
Immediately report the number to Zhou Can.
For things like this, he could only wait for Zhou Can to contact him.
If he hadn't been contacted, this matter would have been a failure.
After Yang Zhi left, Zhou Can talked with Dr. Xu while having supper.
"Teacher, what do you think of Dr. Yang? I am quite satisfied with him. Luo Shishen will soon finish his internship and go for regular training, and my team also needs a new helper."
Zhou Can expressed his opinion first in order to give Dr. Xu a reference.
Although Dr. Xu is asked to help make decisions on recruiting, Zhou Can's opinion will definitely be the main one.
Dr. Xu just helps him to check.
"You can recruit him and give him a try. As for the old man Mi from the general surgery department, we need to ask Director Lou to come out and say hello to him so as not to cause any misunderstanding. I will find a chance to talk to Director Lou tomorrow, and I will tell you the result when the time comes."
Dr. Xu is also very optimistic about Yang Zhi.
In the past two months, Zhou Can has actually been looking for a medical assistant, but has never found a suitable one.
