Path of Medicine With a System

Chapter 146: Trade of requests (Please quit smoking!)

Translator: imperfectluck Editor: Kurisu

Zhang Fan began his work as an independent doctor in the cardiothoracic department. The work here was far less than in most other departments. The department’s nurses had plenty of free time to sit around and chat with each other. Zhang Fan also had a lot of free time, so he just studied his medical textbooks. As a doctor, learning about medicine would take an entire life. It would be vitally important to study whenever one had free time.

Things in this department were quite fair. There would sometimes be busy periods which meant higher income, and there’d be slow periods with less income. The cardiothoracic department was really popular with older nurses because there were fewer patients in this department. Night shifts here would be far easier to deal with. However, doctors were unwilling to join this department.

Zhang Fan received his first cardiothoracic patient later this night at around eight pm. The ambulance brought a male patient in his 60s who suddenly had breathing difficulties and was coughing. The patient was first brought over to the cardiology department.

Ye Jing, Zhang Fan’s previous teaching doctor from the cardiology department, was the first doctor to check on the patient’s condition. She checked the old man’s heart, and found no problems apart from a slightly elevated heartrate. However, when she used her stethoscope to listen to the old man’s chest on the left side, she couldn’t hear any sounds of breathing at all. When she tapped on his chest, she heard tympanic sounds.

“Hurry and immediately call the cardiothoracic department! Have one of their doctors come over to treat this patient!” Ye Jing told a nurse.

There was a regulation in Chasu City Hospital that a doctor already in the hospital absolutely had to arrive within five minutes of being summoned to treat an emergency patient. However, the hospital’s internal medicine and surgery departments were in different buildings. Zhang Fan would need to run all the way there with his stethoscope while passing through several hallways and the hospital grounds. Seeing doctors running at full speed was an incredibly common scene within the hospital. Other doctors and nurses who weren’t in a big hurry would always make way when they saw this.

Ouyang Hong enforced the five-minute rule incredibly strictly after she became the superintendent. Anyone who was late would have their bonuses deducted. When Zhang Fan finally arrived after running all the way, Ye Jing was really surprised to see Zhang Fan as the representative for the cardiothoracic department, but now wasn’t the time for the two to catch up. Back when Ye Jing had her incident with her patient who committed suicide due to financial trouble, Zhang Fan hadn’t said anything negative to her at all. Ye Jing was quite grateful to Zhang Fan for this.

“Doctor Zhang, hurry and come take a look. It’s spontaneous pneumothorax. I already asked the patient; he’s never injured his chest before!”

Zhang Fan smiled at Ye Jing, and then immediately assumed a serious expression. Any emergency patient would typically be in great pain. If the doctor was all smiles while treating the patient, it was common for the patient or their family members to misunderstand and become enraged.

Zhang Fan swiftly performed a checkup for the old man, and noticed that the patient’s breathing difficulties were becoming more severe. “This is bad! He requires immediate surgery. Immediately transfer the patient to the cardiothoracic department for surgery. Bring the patient’s belongings there as well,” Zhang Fan told a cardiology department nurse.

“Okay, hurry over there. Contact me after it’s finished,” Ye Jing said to Zhang Fan.

“Okay, I’m leaving now.” Zhang Fan and the nurse ran together as they pushed the patient’s gurney over towards the surgical department building. As he ran, he phoned the cardiothoracic department director. Although the call was answered, it was the director’s wife who picked up. “He’s completely drunk!”

Zhang Fan instantly hung up the phone, and then called Tang Xiong, an attending physician in the cardiothoracic department. Tang Xiong was from Hunan Province. His ancestor had come here to the border province as part of Zuo Zongtang’s army, fighting against the Russians and settling here later. Tang Xiong didn’t seem like he was originally from southern China at all, and had a really big beard.

“Brother Tang, hurry, there’s an emergency patient with a ruptured pulmonary bulla. He’s already having severe breathing difficulties and requires immediate surgery. Come over immediately!”

Tang Xiong didn’t waste any time with words. Actually, he was about to have sex with his wife and was already naked, yet a phone call came, summoning him to treat an emergency patient, so he had to go. He left as his wife gritted her teeth in anger.

The operating room had already been prepared for Zhang Fan. Back in the time before laparoscopes were invented, having a rupture pulmonary bulla would require a major surgery as it was necessary to open up the patient’s chest! Now that there were laparoscopes, this type of surgery wasn’t as difficult as before, although it still wasn’t an easy one. Tang Xiong had only recently been promoted to attending physician. He was still incapable of performing laparoscopic surgery in the chest.

This was why it was so hard for doctors in the cardiothoracic department. In general surgery, a doctor would be able to master a laparoscopic appendix surgery in one year, and master a laparoscopic gall bladder surgery within three to four years, but in cardiothoracic surgery, opening up the chest would allow you to clearly see the beating heart and all the major arteries and veins in the laparoscopic mirrors. If the surgeon’s hand shook even slightly and accidentally broke any major vein or artery in the chest, that would instantly end the patient’s life, without even a chance to try to save the patient.

The margin of error allowed in the abdomen would be quite a bit higher. This was why the cardiothoracic department in all hospitals in rural northwestern China hadn’t been developed. There were also very few doctors willing to learn because of the high difficulty and risk involved. Additionally, there were also very few patients. For most people who had heart problems requiring surgery, as long as the patient’s family had an even slightly alright financial condition, they would always go to the provincial hospital, and not even consider the local Class A hospital for heart surgery.

“Brother Zhang, there’s no use even if you call for me. I’m not capable of performing this surgery,” Tang Xiong said when he arrived. He saw that the director wasn’t around, and asked about him, only to learn that the director was completely drunk!

Tang Xiong was stunned. He would have been fine if he hadn’t come, but it would become really troublesome for him now that he arrived if the patient died, as he would have to take responsibility! Although he was now anxious, he hadn’t gotten angry with Zhang Fan.

“I’ll perform the surgery. Can you act as my surgical assistant and hold the laparoscope?” Zhang Fan said as he checked the patient’s X-rays.

Tang Xiong audibly swallowed his saliva as he responded, “No, this isn’t something that can be joked with. Um! Are you really capable of performing ruptured pulmonary bulla laparoscopic surgery?”

“Yes, it’s not a big deal. This patient’s ruptured pulmonary bulla is near the edge. It’s really easy to deal with. All I have to do is enter the lung and separate the bulla from the lung. Who’s the medical equipment supplier for this department?”

Tang Xiong calmed down a bit after Zhang Fan said all this. Since Zhang Fan even knew about medical equipment suppliers, he had to have performed quite a number of surgeries. Also, like every doctor at the hospital, Tang Xiong knew about how the superintendent had chosen Zhang Fan to be the surgeon who saved Vice Director Wang Weiping’s life. He figured that Zhang Fan would be a reliable surgeon.

“I’ll contact the supplier immediately. It won’t affect your surgery. What type of medical equipment would you like to use? Chinese or imported?” Tang Xiong asked since he wouldn’t have the right to decide, as he wasn’t the primary surgeon.

“I’ll use whatever type you guys typically use. You’re more accustomed to things in this department than I am.” Zhang Fan left the decision up to Tang Xiong. What this really meant was that since Tang Xiong was willing to risk his own career by assisting Zhang Fan for the surgery, Zhang Fan would need to give Tang Xiong some benefits via medical equipment kickbacks. Otherwise, it would be impossible for Tang Xiong to be willing to come when summoned next time!

Tang Xiong acted quite swiftly with Zhang Fan saying this as he understood what Zhang Fan was offering him! Tang Xiong voluntarily did all the more menial work like filling out the necessary paperwork and informing the patient about the surgery. “Doctor Zhang, everything is ready!”

“Okay, let’s begin the surgery!” Zhang Fan led the way into the operating room.

Thanks to scientific advancements, surgeries had become more simplified and easier than before. In the past, ruptured pulmonary bulla surgery would require opening up the chest, cutting off the ruptured pulmonary bulla, and then carefully sewing up that portion of the lung. The surgery would take a minimum of five to six hours. But now, there was a device known as a lapro-clip, a clip applier which was capable of delivering absorbable clips for surgical procedures. The surgeon now only needed to use the lapro-clip on the ruptured pulmonary bulla. Clip! Clip! The device sounded nice, and would cause minimal damage to the patient’s body. The lapro-clip also shortened the surgery time by several hours. However, this was all accomplished with the power of money. A single clip would cost 3,000 yuan! It was often that several clips would be necessary.

Tang Xiong held the laparoscope and watched Zhang Fan operate the lapro-clip as the latter began to remove the ruptured pulmonary bulla. Before the surgery began, Tang Xiong hadn’t been very worried, but now that he was looking at the patient’s beating heart and throbbing arteries and veins, he was beginning to break out in a cold sweat due to nervousness.

Tang Xiong secretly peeked at Zhang Fan, who was concentrating on the surgery. Zhang Fan didn’t seem like the reckless type to him. Well, now that the surgery had already begun, it would be impossible to stop it. The laparoscopic mirror was already in the chest cavity! It wasn’t like Tang Xiong was capable of performing this surgery, so all he could do was do his best as the surgical assistant. Yet, if a medical incident occurred here, Tang Xiong would be primarily held responsible despite the fact that Zhang Fan was the primary surgeon. This was all because Tang Xiong was the higher-ranking doctor as an attending physician!

Zhang Fan wasn’t paying attention to what Tang Xiong was doing at all. Zhang Fan was the type who wouldn’t care about anything other than the surgery once it began. Zhang Fan focused on alternating his forceps while removing lung tissue. The old man’s lung was no longer pink. It was more dark red, with all sorts of black and gray spots inside.

“The mirror is slightly too high. Be careful of the nearby artery as you lower it slightly. Yes, that’s good!” Zhang Fan directed Tang Xiong to provide him with better vision.

Zhang Fan finished with tissue separation and began the clipping. Tang Xiong was far more reassured regarding the surgery by now. Zhang Fan’s movements were extremely well-practiced. His tissue separation movements had been soft, gentle, accurate, and incredibly swift. In comparison, cardiothoracic Director Liu would always take his time while often scolding his surgical assistants!

Zhang Fan began the clipping. Clip! Clip! Clip! Clip! He used four clips in total, meaning a medical equipment fee of 12,000 yuan. Tang Xiong broke out into an incredibly big smile. If it wasn’t for the fact that he was wearing a surgical mask, it would be possible to even see his molars!

After the clipping was over, Zhang Fan gently cut off the ruptured pulmonary bulla, and said to the nurse, “Specimen bag.” He then placed the cut off tissue into the specimen bag. After that, he told Tang Xiong, “Doctor Tang, this patient will count as yours. I’ll leave the pathological examination to you.”

“How could I possibly accept that? You were the one who accepted and treated him, so he should be recorded as your patient! Otherwise, I’ll refuse to help you in the future!” Tang Xiong was quite adamant. He was someone who wanted face. He had already received quite a lot of money via medical equipment kickbacks on this patient, so he wouldn’t feel right about officially taking the patient away. This was why he was so insistent.

“Alright then, Brother Tang. Sorry to trouble you today. You should hurry home now. Your wife is probably waiting for you!” Zhang Fan was just making small talk to be polite, but Tang Xiong’s face reddened as he and his wife had just been about to have sex before he was summoned here!

“Okay, okay, okay! I’ll go home right now. Sorry to trouble you with the rest of the work!” Tang Xiong replied while hurriedly changing out of his surgical garb. “Sigh! I’m going to have to deal with an angry tiger when I go home. My back really hurts! I need to make some time to have a Chinese medicine doctor treat my back!”

Zhang Fan began to write the medical report and deal with the rest of the work. This old man was a local from Chasu City. He had several children, who somehow managed to find out Zhang Fan’s connection to Shao Hua and contact Shao Hua’s father.

Shao Hua’s father had been a farm employee for his entire life. It was quite rare for anyone to come to him with a request. This time, the farm’s government secretary brought the patient’s family to his home to make a request of him. Shao Hua’s father gained so much face that it seemed as if his expression had become blindingly radiant. The farm’s government secretary, one of the highest-ranking people at the farm, personally came over to make a request. Shao Hua’s father barely even heard the request before instantly agreeing!

Shao Hua’s mother was so angry that she was trembling, but she couldn’t say anything with so many people around. Once the secretary and the patient’s family left, she scolded her husband. “Why are you just going around promising things to other people? What do you mean, it’ll be no problem? Why are you making trouble for Zhang Fan? How will Zhang Fan look at you and our Hua?”

“I don’t think it should be a big deal. I’ll try asking him. We can forget about it if it’s no good.” Shao Hua’s father instantly cooled down from his moment of passion. That was right, his daughter’s happiness was more important than anything. He didn’t want to do anything that would make things difficult for his daughter.

Later that night at dinner, Shao Hua’s father was having a really difficult time making his request. That was because he had been recently bullying Zhang Fan quite badly in Chinese chess. It was quite often that Zhang Fan had no pieces but his king remaining against a powerful army!

When dinner was almost over, Shao Hua’s mother stepped on Shao Hua’s father’s foot under the table.

“Um, Zhang Fan, is it simple for doctors like you to pay some extra attention to a patient and tell the nurses to arrange a room with few others for him? Or would it be troublesome?”

Zhang Fan instantly understood that Shao Hua’s father had a request to make of him—after all, Shao Hua’s father normally never asked Zhang Fan anything about his work at the hospital. Zhang Fan thought it over for only a moment before replying, “It’s not that difficult. What’s the matter, Sir?”

“The friend of a coworker of mine is one of your patients in the hospital. He wants to ask you to take special care of his friend and to also talk to the nurses. My coworker’s friend is getting old. The patient’s children are also worried about him.”

“Sure, no problem!” Zhang Fan stated. “However, I also have a request for you that I wanted to talk to you about.”

Shao Hua’s mother and father both paused in surprise. He really knew how to find a good timing! They were prepared for an instant refusal, but not an exchange of requests!

Shao Hua glanced at Zhang Fan. Although she believed that he wasn’t the type to be greedy and only do favors for the sake of other favors, she really was surprised by him today. Shao Hua bit down on her chopsticks as she waited for what Zhang Fan would say next. She didn’t stop him, because she trusted him.