EFB Chapter 103 Director Shan's Questioning
Chapter 103 Director Shan's Questioning
Chapter 103 Director Shan's Questioning
Trauma Surgery, Doctor's Office.
The small window was half-open, and a warm breeze blew in. The leaves of the pothos plant by the window swayed up and down, unnoticed by anyone.
With his hands behind his back, Nie Yunqi, with his thin frame, made his medium-sized white lab coat look like a long robe: "Brother Shan, look at these two films?"
"Can you really tell from this that he's a patient?"
Shan Chenchu is the deputy chief physician in the group. Although his stubble was shaved clean in the morning, new shoots of stubble sprouted again, as if spring had brought new life back.
"Is this a patient's scan?" Shan Chenchu wasn't on duty today, nor was it a surgery day; she was called to the department by Nie Yunqi.
To outsiders, even an associate chief physician is considered a director, and the director himself said there was a fracture!
Surely the patient wouldn't say that Nie Yunqi made him break a bone, would he?
Patients and their families are sometimes not afraid of a more complicated diagnosis, but rather of not being able to get a diagnosis at all.
Nie Yunqi bowed slightly and reported earnestly: "I have carefully compared the ID number and medical record number; it is indeed the same patient."
"Olecranon fracture with displacement and open tendon injury."
"I've already called the hand surgery department. They'll treat it all at once after the local swelling subsides."
"After all, it's not an open fracture."
"There is a fracture now. If we treat the tendon immediately, we are afraid that the fracture will shift and become more serious."
Dan Chenchu nodded, approving of Nie Yunqi's treatment plan, but he was still hesitant: "You mean, it's one of your junior brothers, who is currently working in the emergency department?"
"He just happened to see the X-ray, which is why he suggested that the patient had an olecranon fracture."
"So—he actually determined there was a fracture the moment he saw this X-ray."
"So he's your junior colleague? Why doesn't he come work in our department?"
Nie Yunqi's eyes flashed, and he quickly explained, "Xiao Guo said that we have too few cases of debridement and suturing in our trauma surgery department, so it's not suitable for him to practice."
Shan Chenchu scratched his head: "He only plans to do debridement and suturing? He's not planning to do any more surgeries like fracture repair?"
Shan Chenchu has a bachelor's degree, while he knows that Nie Yunqi has a master's degree from the Provincial People's Hospital and has a very good foundation.
When Nie Yunqi first came to the hospital, we told him to be at ease when performing incisions, debridement, and suturing.
You can start learning fracture surgery directly.
Unlike him, he worked at a class for a year or two after graduation.
When Shan Chenchu first graduated, there was no standardized residency training system.
They can directly take the civil service exam and start working immediately.
Shan Chenchu always felt that simply figuring out wound suturing was the least interesting thing.
It requires no technical skill.
Nie Yunqi's approach is extreme, and now Guo Ziyuan doesn't even come to the trauma surgery department, but instead stays in the emergency department's operating room, which makes it even more extreme.
Nie Yunqi found it difficult to explain to Shan Chenchu: "Xiao Guo has his own plans and arrangements."
Different perceptions.
Buzz!
Shan Chenchu's phone vibrated. He picked it up and saw that it was a letter from Director Chen Xinwen.
The letter was brief: "Nie Yunqi is right. There is a fracture; surgery is scheduled for Wednesday."
Associate Chief Physician Shan Chenchu also reviewed the CT scan and, of course, understood the diagnosis!
Shan Chenchu, holding her phone, asked, "Director Chen, can this X-ray really show a fracture?"
"The olecranon fractures we usually see aren't this subtle, are they?"
"What if I encounter this situation again, and the patient hasn't had a CT scan?"
Chen Xinwen replied, "Then the patient should go home. However, if the joint surfaces don't heal well afterwards, it may lead to secondary traumatic arthritis."
Shan Chenchu, who had followed Director Chen Xinwen for a long time, asked: "Director Chen, are there no other methods or techniques for reviewing films?"
Chen Xinwen: "Isn't a fracture diagnosed according to diagnostic principles?"
What are some basic skills and techniques?
"This situation is not common, so I often suggest that you perform more CT scans on your patients."
"The fact that Nie Yunqi could tell proves that his ability to watch films is quite good."
If your image interpretation skills aren't up to par, use CT scans to compensate.
It's much clearer at a glance.
Instead of demanding that a doctor improve their ability to read images online, there are already more efficient and accurate alternatives in clinical practice.
CT scan!
It only costs a few hundred more dollars.
Chen Xinwen is a senior director who hasn't worked in the emergency room for a long time, so he finds it hard to understand how "difficult" patients are these days.
When he first became a doctor and started working in the emergency room, the doctors in the hospital were very authoritative and their word was law.
There weren't as many medical disputes back then.
Shan Chenchu: "Director Chen, Xiao Nie said that this was discovered by one of his junior colleagues, who is currently working in the emergency department."
"I happened to run into him, so I sent him a message!"
Chen Xinwen: "Nie Yunqi's junior apprentice? What's he doing here at our hospital?"
Shan Chenchu: "I heard from Xiao Nie that it was to practice my skills."
"It wasn't surgery, just procedures like cleaning and suturing!"
"I think it's a bit of a mess."
Chen Xinwen: "Oh."
Shan Chenchu was still very enthusiastic: "Director Chen, but I think that Nie Yunqi has good aptitude, but he has already fallen behind by a lot."
"What about his junior colleague? Should we let him come to our department to learn surgery sooner?"
Chen Xinwen's tone was somewhat impatient: "Who are you? What gives you the right to give advice? What gives you the right to comment on Nie Yunqi and his junior brother?"
"Just based on what you think?"
Shan Chenchu: "Director Chen, I just don't want to waste another good prospect."
"Didn't you often say that if Nie Yunqi had gotten involved in fracture surgery earlier, he could probably have undergone intramedullary nailing by now?"
Chen Xinwen countered, "Will you, Shan Chenchu, be the one to perform the pelvic defect surgery later?"
Upon seeing these words, Shan Chenchu's face instantly showed fear and unease.
Shan Chenchu: "Director Chen, you're joking. If you don't even dare to perform the surgery, how could I dare to?"
"I can't do it."
Chen Xinwen: "Then why are you using your limited, narrow-minded perspective to tell others how they should behave?"
"What you think you can never do in your life is already routine at the Provincial People's Hospital."
Why would you doubt someone else's teaching method?
Shan Chenchu continued to question, "Director Chen, is performing bone defect surgery simply a matter of practicing basic skills?"
Chen Xinwen: "If it's a serious injury, why don't you just have it amputated?"
"You're coming here for limb-sparing surgery because of an arterial embolism?"
"Alright, stop with the nonsense. You're not qualified to tell others what to do."
"I used to think the same way you do, that operating techniques and methods were everything."
"But you'll only realize that once you truly understand surgery."
"Never mind, I won't say anymore," Chen Xinwen said, trying to change the subject.
Shan Chenchu: "Medicine is a practical discipline, not a theoretical one!"
Chen Xinwen then lost his temper: "Then let me ask you, how do you treat diabetic foot? You're skilled, you're good at the operation, so why don't you treat me?!"
"I'll listen to you."
"Shan Chenchu, will you cure him?"
Shan Chenchu: "Isn't this a surgery we often perform at our hospital?"
Chen Xinwen: "Which of the surgeries we frequently perform in our hospital is a procedure that only you, Shan Chenchu, could perform?"
"We are just tools who learn other people's surgical techniques, apply these techniques to patients, treat patients' difficulties, and earn some money to support our families."
"Shan Chenchu, do you think that just because you won a provincial-level operational award, you can look down on everyone?"
"You even dare to question Nie Yunqi's teacher??"
After reading the message, Shan Chenchu glanced at Nie Yunqi, her gaze complex and conflicted.
He replied, "But, Director Chen, it's such a pity about Nie Yunqi."
"If he doesn't waste his time, he'll only become more outstanding than me in the future!"
Chen Xinwen: "But at least Xiao Nie was cannon fodder. You don't even have the right to be cannon fodder. That's the reality."
"Okay, I'm not arguing with you anymore. Just rest and do your shift. Don't bother me with these trivial things."
"I have only one question for you."
Why couldn't you see the fracture today?
"You just happen to know how to perform surgery."
"This patient is doomed to have met you!"
Nie Yunqi only dared to look at Chen Xinwen respectfully.
Nie Yunqi was an attending physician, but he was only a junior attending physician. Compared to a deputy chief physician like Shan Chenchu, he was still a nobody.
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