Translator: EndlessFantasy Translation Editor: EndlessFantasy Translation
“I was wondering why our department director follows Ling Ran around all the time.” One of the attending physicians suddenly chuckled, as if he had just discovered an earth-shattering secret.
After he said that, he raised his chin a few times.
However, at that moment, the two other attending physicians had no intention of playing along with him.
“How did he manage to clean the intrahepatic bile duct to this extent?”
“I know right. Everyone does hepatectomy the same way. How did Ling Ran manage to clean the intrahepatic bile duct so much better than other people?”
Both attending physician’s questions pointed towards the same answer.
“I was also thinking about the same question just now.” Zhang Anmin chuckled a few times. He then removed the choledochoscope and started carrying out abdominal closure.
The three other attending physicians stood beside Zhang Anmin and waited for him to continue, but Zhang Anmin did not say anything even after more than ten seconds. One of the attending physicians suddenly came to his senses and said, “Hang on, let me wash my hands and help out.”
After he said that, he exited the operating theater and washed his hands. After he returned, he asked the nurse to put on a surgical gown for him. He then started acting as Zhang Anmin’s first assistant.
In tertiary Grade A hospitals like Yun Hua Hospitals, the medical staff was extremely wasteful when dealing with medical consumables.
As a surgical gown only cost around ten or twenty RMB, doctors often put them on whenever they wanted to, even though those surgical gowns had to be thrown into the trash can after only one use. The staff members were also similarly wasteful when it came to scrubs that had to be sterilized under high temperature after just one use, and surgical tools that had to be sterilized or thrown away after only one use. There were even times when surgical tools were thrown away without ever being used. Slippers were the only thing that was never washed and remained perpetually dirty.
Doctors did not pay much attention to the number of scrubs, surgical gowns, or surgical instruments they burned through in the operating theater. No one would tell them off as long as they did not bring them back home.
Now that Zhang Anmin had an assistant, the abdominal closure took a much shorter time.
The assistant removed the clamps while handing the surgical thread to Zhang Anmin while Zhang Anmin sutured the layers of tissue together one after another. The abdominal closure only took them a few minutes.
It was only then that Zhang Anmin said in a mysterious tone, “I feel that the main reason Doctor Ling is able to clean the intrahepatic bile duct so well is because he is good at choosing the position.”
“Position?”
“Yup. The position is very important,” Zhang Anmin said. “If you guys pay attention, you’ll notice that the position whereby he severed the patient’s liver is where the bile duct stones are concentrated. Besides, it’s very easy for him to remove the stones from there.”
“How does he choose the position, though?”
“It’s probably a form of geometry.” Zhang Anmin did not actually have the answer to that, so he made something up. Of course, this thought had indeed crossed his mind. Zhang Anmin did not know whether his speculation was correct, though.
Since the three other attending physicians did not watch the surgery, they could only imagine things. The more they thought about it, the more they felt that what Zhang Anmin said made sense.
“It’s just like… what is that called again? Oh, constructing an auxiliary line.”
“You still remember the geometry we learned in middle school?”
“We also had to make auxiliary lines when we did solid geometry in high school, right?”
“Going by this line of thought, it’s probably pretty hard for me to choose a good position for hepatectomy. Back in high school, I was super bad at solid geometry, and it was very rare for me to score over ninety marks for it.”
“For me, I was very bad at advanced mathematics. Things like integration and geometry really pulled down my average.”
Even though they had left school for more than ten years, the attending physicians still remembered the mathematics classes they had back in high school and university really well.
They spent a lot of blood, sweat, and tears trying to figure these out when they were in school. Even though they no longer remember the formulas and the exact steps, the pain they had to go through to master these mathematical theories and the sweet feeling of salvation whenever they got to take a break were all still fresh in their minds. Hence, all of them were very willing to talk about it.
After all, for a doctor to be able to establish his position in Yun Hua Hospital, he was definitely an outstanding student back in school. Now that their abilities were considered nothing but ordinary in the hospital, they missed their schooling days even more.
Zhang Anmin did not have much time for idle chatter. He talked for a bit more as he helped Su Jiafu, who was the anesthetist of the surgery, with cleaning up. He then quickly took off his surgical gown and rushed for his next scheduled surgery.
As the three other attending physicians also needed to rush for other surgeries, they had no choice but to part ways even though they really wanted to continue the conversation.
Even though Zhang Anmin tried his best to get to the operating theater as soon as possible, he only managed to become the second assistant.
The first assistant was Ma Yanlin. As Yu Yuan was now a chief resident and had been one for a few months, she was responsible for most of the surgeries in the Emergency Department. This was especially true for the surgeries at night, as chief residents were always the first in line for those. Because of this, Yu Yuan could no longer follow Ling Ran around.
Ling Ran did not really care about who his first assistant was. If his first assistant was skilled, he would be able to operate a little more speedily and pay more attention to the fine details. If his first assistant was not skilled, he merely had to slow down a little and pay attention to everything in the surgery.
If Ling Ran had to state one difference between having an attending physician and having a houseman as his first assistant, he would say that having an attending physician as his first assistant allowed him to go two more surgeries before having to consume another bottle of Energy Serum.
As a wealthy doctor who possessed seven hundred and eighteen bottles of Energy Serums right now, Ling Ran could handle all the accidents his first assistant threw at him.
“Zhang Anmin, get ready. You’ll be holding the choledochoscope.” When Ling Ran saw that Zhang Anmin had arrived, he was more than happy to assign a task to Zhang Anmin and put some pressure on him.
Ling Ran reckoned that Zhang Anmin who had been involved in surgeries related to the gallbladder for the past five or six years probably possessed Specialist Level Choledochoscopy, albeit at the very beginning stages of it. His skills when it came to holding the choledochoscope was probably sufficient when it came to surgeries like hepatectomy.
“Huh?” Zhang Anmin gasped. “I’ll be holding the choledochoscope? Can I?”
Ling Ran furrowed his eyebrows. “Why do you like to ask the same question repeatedly?”
“Do I? Do I ask the same question repeatedly? Huh… I think I do.” Zhang Anmin stood dazed for a moment.
“Don’t ask the same question repeatedly anymore. Try your best not to.” Ling Ran did not really like how wordy Zhang Anmin was, but he did not dwell too much on it.
Zhang Anmin nodded carefully and said in a soft voice, “But if I hold the choledochoscope, I’m afraid that the residual stone rate would be very high.”
He knew his own abilities well. Whenever he held choledochoscopes during hepatectomies, it was hard to even achieve an average residual stone rate of 17%, let alone below 2%.
Ling Ran, though, gave Zhang Anmin a puzzled look. “Who told you that the doctor operating the choledochoscope is a decisive factor when it comes to the residual stone rate?”
“Isn’t it? Shouldn’t it…” Zhang Anmin made the firm decision to shut up, as he did not want to repeat the same question twice.
“There are many factors affecting the residual stone rate. You can look up some research papers and read up on them after this. The choledochoscope is not one of the key factors.” Even though Ling Ran was too lazy to offer an explanation, after thinking about it for a moment, he decided to satisfy Zhang Anmin’s thirst for knowledge. He said, “If there’s anything you don’t understand, you can ask Yu Yuan about it first.”
“Oh, sure.” Zhang Anmin’s mind was in a total mess. What if all four of the attending physicians, including himself, had totally gotten things wrong during their conversation just now?
Ling Ran nodded and carried on with the surgery. As he operated, he suddenly said, “You can also reduce the residual stone rate by using your bare hands.”
As he spoke, he inserted his hands into the liver he had cut open and dug a bile duct stone out of it…
‘He dug a bile duct stone…
‘Dug…’
Zhang Anmin widened his eyes. He suddenly felt that hepatectomy, which he had always regarded as a difficult surgery that could only be performed by skilled surgeons, had become an overplayed pop song.
Zhang Anmin turned to look at Ma Yanlin, but Ma Yanlin acted as if what Ling Ran just did was the most normal thing in the world.
“Hey, do you see Doctor Ling remove bile duct stones with his bare hands all the time?” Zhang Anmin asked Ma Yanlin in a hushed tone.
Ma Yanlin craned his neck to look at Ling Ran’s hand and answered Zhang Anmin with another question, “Isn’t this how it should be done?”
Zhang Anmin was at a loss for words. He thought long and hard for quite some time. “I have read about removing bile duct stones using your bare hands in a research paper. I just didn’t know that you have to dig it out…”
Ma Yanlin hummed flatly in acknowledgment. This was the only type of hepatectomy performed on patients with hepatolithiasis that he had ever witnessed. Hence, he was not in a position to comment.
Zhang Anmin found the whole thing extremely ridiculous. He thought as he gazed at Ma Yanlin. ‘Even a houseman is learning how to dig stones out of livers nowadays? What in the world is going on? Wait, is digging supposed to be a more modern technique of removing bile duct stones?”
Outside the window was a breeze from the west.
Fragrance Yard danced along with the wind, as if it was brandishing a sword. It slowly inched toward a young woman whose gluteus maximus were extremely well-developed.
“Be careful.” The man beside the young woman grabbed her by the hand and pulled her away from Fragrance Yard. He pointed at the goose and flashed a bright smile.
The young woman blushed. She looked like a curled-up spider plant.
Lu Wenbin, who just walked out of the gym, suddenly felt agitated when he saw the loving couple by the fountain. He could not help but quicken his pace. He only felt more relaxed upon entering the operating theater.
“Doctor Lu, do you want to be the first assistant?” As Zhang Anmin was already at his third surgery of the day, he did not mind offering the position to Lu Wenbin.
“Sure thing, I’ll be the first assistant for this surgery, then.” Lu Wenbin did not bother to put on a polite front. He took the position of the first assistant like it was the most natural thing in the world to do.
Zhang Anmin went and stood across Ling Ran. He was feeling a little regretful that he no longer had the strength to serve as the first assistant. He operated the retractor throughout his third surgery of the day.
“Alright. Let’s seize the day and operate on two more patients. But before that, we’re taking a rest first.” As he spoke, Ling Ran turned to look at Zhang Anmin and asked, “When’s the cholecystectomy you’re going to perform scheduled for?”
“The day after tomorrow. It’s scheduled for the day after tomorrow.” For some reason, Zhang Anmin panicked a little. If they had to carry out five surgeries for the day, he had to stand for more than ten hours.
Ling Ran nodded and said, “Email me the exact time for the surgery the day after tomorrow, then. Let’s rest for… thirty minutes while they get the next patient ready.”
After Ling Ran said that, he left the operating theater. Lu Wenbin quickly started performing abdominal closure, and Zhang Anmin helped him with it. They did not take long.
They returned to the waiting room after they were done. Zhang Anmin, who was more than thirty years old, was already feeling tired to the bone.
He took a box of cigarettes from his locker and called out. “Doctor Lu, do you want to go out and smoke?”
Lu Wenbin hesitated for a moment and said, “Let’s go together. Give me a moment.”
Lu Wenbin, too, went to his locker to retrieve a box of cigarettes and exited the waiting room together with Zhang Anmin. He said as he walked, “I don’t really smoke. I’m just a casual smoker.”
“Isn’t that good? I have no way of stopping. I’ve been smoking since I was in school.” They chatted until they reached the balcony, and Zhang Anmin handed one of his cigarettes to Lu Wenbin.
Lu Wenbin did not bother to be polite and took it. He could not help but freeze for a moment when he saw that it was a Double Happiness [1] cigarette, which cost ten RMB a packet. “Wow, Doctor Zhang, you’re so thrifty even though you’re an attending physician. Forget about it. Why don’t you try mine?”
“What’s the point of being an attending physician? The healthcare reform took place a year before I became an attending physician. Hence, I’ve never gotten a taste of riches.” As Zhang Anmin spoke, he took the cigarette Lu Wenbin handed him. The word Chunghwa which was printed on the body of the cigarette sparkled under the sunlight.
Zhang Anmin’s lips twitched a little. “Chunghwa? You sure are a big spender, huh?”
“How is that so? You can buy quite a few packets of these just by carrying out a freelance surgery.” Lu Wenbin buttered up to Zhang Anmin with a smile.
Zhang Anmin flashed a bitter smile. “How am I even qualified to carry out freelance surgeries…?”
As he spoke, Zhang Anmin suddenly realized something. He raised his gaze to look at Lu Wenbin and asked, “You carry out freelance surgeries together with Doctor Ling quite often, right? Do you get paid for that?”
“Yeah,” Lu Wenbin answered in a straightforward manner.
“How much do you get?” Zhang Anmin failed to suppress his curiosity. He genuinely wanted to know the answer.
Lu Wenbin smacked his lips and said. “At least 200 RMB, and I can get around 500 RMB from the high-paying ones. The most I have ever gotten is 1,000 RMB.
“That’s quite a lot, isn’t it? Doctor Ling probably gets to carry out freelance surgeries at least thrice a week. So, you’ll get around 1,000 or 800 RMB a week out of those freelance surgeries.” Zhang Anmin felt slightly better as he calculated Lu Wenbin’s income. That extra money could at most, allow Lu Wenbin to buy a few more packets of these cigarettes.
Lu Wenbin had just lit his cigarette and was about to exhale a puff of smoke. He started laughing when he heard what Zhang Anmin said, which caused him to choke.
“That’s if he only carries out one freelance surgery per trip. They don’t pay freelance surgeons by trip anymore. No one dares to pay Doctor Ling so little nowadays.” Lu Wenbin shook his head as he laughed.
“Not one? Then, how many patients do Doctor Ling usually operate on per trip?”
“What do you think?” Lu Wenbin raised his arm, which had a diameter of fifteen inches. He took a drag of his cigarette and exhaled. He totally looked like a single man who spent all his free time in the gym.
