Chapter 177: Big and Small

In the operating theater of the Hand Surgery Department, senior Resident Doctor Hou Kang gave a brief description to Ling Ran and his team, “The patient is a pipeline technician. When he was repairing a piece of equipment, his right thumb was crushed. The patient was originally sent to the local Yiyuan County Hospital. After he was transferred to our hospital, we held a consultation in the department, and we believed that thumb reconstruction is the most suitable for the patient. The patient and his family have agreed on it.”

Once Hou Kang said this, he looked at Ling Ran. Once he saw Ling Ran remaining silent, he then continued, “I think that his right great toe is best for the thumb reconstruction surgery. The patient is receiving debridement in the operating theater now. Doctor Ling, your task is to amputate the right great toe…”

Ling Ran nodded. Surgeries of this scale usually had two or three groups of doctors operating on the patient. It was normal for him to be assigned to perform debridement or amputation.

Ling Ran had never performed a thumb reconstruction surgery before. He would be satisfied just by being able to stand by the operating table.

Wang Haiyang’s thoughts could not be predicted.

If it had to be put in words, thumb reconstruction surgeries were quite rare in Yun Hua Hospital’s Hand Surgery Department. They might only run into one such case once every few months. There were many doctors willing to go to the operating table for such an operation.

However, matters in the hospital had always been complicated, and conflict between doctors only grew more heated, the closer the doctors worked together.

After Wang Haiyang entered the operating theater, he commanded, “Ling Ran, check the operating theater and see if they missed out on anything. If there are any instruments you want to use, have them hurry up and bring it over.”

What he said meant that his acknowledgment towards Ling Ran’s skills was quite high. Several doctors from the Hand Surgery Department looked over.

Ling Ran paid them no heed. He first asked, “Generally, when performing thumb reconstruction, we will usually amputate Morton’s toe, right? Why is this patient different?”

“His feet are tiny.” Wang Haiyang stood in the operating theater while he waited for the draping to be performed. He answered in a very simple and realistic manner.

Ling Ran deliberately stood around for half a minute. When the nurses finished the draping and exposed the surgical field, he saw that the patient did indeed have small feet. His shoe size could not be more than seven, it could even be lesser than six.

His hands, however, were the commonly seen, rough, huge hands belonging to blue-collar workers.

This was also the first time Lu Wenbin ever performed such a surgery. With the advantage of being a junior doctor, he decisively extended his thumb to compare it with the patient’s great toe, then compared it with his Morton’s toe, then with the patient’s hand. He could not help but say, “It’s rare to see people with small feet but big hands.”

“Maybe he wore small-sized shoes since childhood.” Wang Haiyang had seen this many times over. He did not even bother laughing.

A circulating nurse took the opportunity to joke, “He must be the one who wore small-sized shoes often since young. I know the Western equivalent of that; they say something like throwing people under the bus, right?”

“His height is okay. If he is barefooted, he is five feet and nine inches tall. He won’t be too steady on his feet.” The doctor who was debriding the patient hastened to say a couple of words when he had the opportunity.

Hou Kang heard this and became interested. He immediately said to the nurses, “Have you all heard that having big hands and big feet means having a huge d*ck? What does it for someone like this?”

No matter how vulgar it was, those words sounded very professional when it came from a doctor.

Lu Wenbin almost had tears flowing out of his eyes, ‘Damn, this is the operating theater I know. Compared to this, Ling Ran’s operating theaters are too lonely. The chief surgeon does not chat, and there is nothing to talk about among the assistants. The patients all receive laryngeal mask airway anesthesia. They can’t even say a thing. There’s no difference between Ling Ran’s operating theater and a butcher shop.

‘Look at the Hand Surgery Department’s operating theaters. This cheerful atmosphere and all the dirty topics… If doctors can go to heaven, then heaven must be an operating theater with a few cute nurses, a few savvy junior doctors, and a patient under general anesthesia.

“Young Lu, what are you thinking?” Hou Kang’s voice interrupted Lu Wenbin’s imagination.

Lu Wenbin’s habitually revealed a savvy smile. “I think we should focus on the tightness of the underwear.”

Hou Kang was stunned before he was unable to help himself but let out a bark of laughter.

The atmosphere in the operating theater became merrier.

“Ahem.”

Wang Haiyang stood up, and it was as if someone had suddenly pressed the pause button on the operating theater.

Wang Haiyang looked around before he chuckled and said to the crowd, “As doctors, you need to gain more experience, don’t just be an echo of other people’s opinions. Let me start by saying that those with blood type Bs and with large thenars (the root of the thumb protruding from the palm of the hand), will last longer.”

The junior nurses were shocked.

After a few seconds, they began to whisper among themselves.

“This is related to blood types?”

“The thenar is very much related to the size of the hand, right?”

“There’s no way to test now.”

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“Do you mean that there is a way to test it later?”

“You still won’t be able to see the size of his c*ck, but you’re still guessing about it so excitedly?”

“Stupid, at least the size can be quantified. Even though we can’t see it, we can ask from the Department of Urology. How are you supposed to find a specimen that will prove how long he lasts during sex? Are you supposed to measure the time yourself?”

“Geez, that is so gross.”

“But… how did Chief Physician Wang come up with that conclusion?”

…..

Ling Ran had always ignored these talks in operating theaters.

Ling Ran checked through every surgical device and drug, based on Wang Haiyang’s request. Checking whether the items in the operating theater was enough and whether they were suitable was originally the first assistant’s task.

His current identity was equivalent to that of a major first assistant.

Ling Ran was extremely serious in his work. Before the major surgery officially started, he went through all the routinely used devices and drugs. He then checked the microsurgical instruments, looked at the electric surgical drills and endotherm knives, and had the nurses bring out all the varying sizes of Kirschner needles and all varieties of suture threads. Finally, he even checked the electric tourniquet and the recently sterilized microscope cover.

If another doctor were to check the equipment so meticulously, a cranky nurse would start to scold him, but Ling Ran had never encountered cranky nurses before, so, he would not know any better.

Ling Ran glanced at Yu Yuan, who was waiting in a corner. He then intentionally gave another request. “Please prepare a little more heparin saline.”

He needed a second assistant today, and between Yu Yuan and Ma Yanlin, Ling Ran chose Yu Yuan without hesitation. Ma Yanlin was still a houseman of the Hand Surgery Department. He had a risk of losing him if Ling Ran brought him to the Hand Surgery Department’s operating theater. Before this, he had no other choice, but now, since Yu Yuan was here, Ling Ran could tie Ma Yanlin to his side.

“After a while, after we debride the thumb stump, I will make an S-shaped incision. We will avoid the radial arteries, phrenic nerves, and cephalic veins. Ling Ran, you perform a V-shaped incision. Avoid the inactive arteriovenous fistula and nerves, perform an osteotomy, then perform a suture,” Wang Haiyang paused before saying, “This is the first stage. Two groups of people ought to operate separately to complete the work.”

“Okay.”

“Yes.”

The doctors became slightly more serious.

“The second stage is to anastomose the great toe. The cephalic vein will be anastomosed with the vein of the great toe, and the dorsal carpal branch of the radial artery will be anastomosed with the dorsal artery of the foot…” Wang Haiyang gave a detailed description of the procedure. It was the same as the thumb reconstruction; both had many methods to go about the surgery. While the other group was carrying out the debridement, he took the chance to introduce his plan in detail.

In the end, Wang Haiyang said again, “In the second stage, I am the chief surgeon, Ling Ran is the first assistant… Hou Kang the second assistant. Is there a problem?”

“Okay.” Hou Kang had a bit of a hard time answering that question. He had been a resident doctor for several years. He was considered as a senior and yet, was ranked below Ling Ran in the surgery. He was a little embarrassed. However, when he raised his head, he saw that no one seemed to be paying attention to this issue, and Hou Kang was relieved.

Ling Ran said, “I would like to have a look at the MRI scan.”

“It’s ready for you,” Wang Haiyang replied swiftly. Now, everyone knew that Ling Ran understood MRI scans. Being able to understand MRI scans and being able to read them were two different concepts. In the hospital, ordinary resident doctors from the Medical Imaging Department did not dare speak their mind when it came to MRI scans.

This advantage was also one of the reasons why the comments on Ling Ran in the Hand Surgery Department had been so positive. You might only need to take a few months and read thousands of scans to be able to read MRI scans, but it would take much more to understand them.

Occasionally, when the doctors were confronted by problems on MRI scans, Ling Ran, who was very knowledgeable when it came to hand surgeries, could clearly provide more information, and most of the information he provided was what the Medical Imaging Department could not give. The information MRI scans provided on details such as blood vessels, tendons, and other systems were not direct. The Medical Imaging Department would also be selective of what they wanted to scan when they used the machine on the patient. If the doctors were to try to understand the scans seriously, they would find that the requirements for it were extremely high.

Ling Ran, who had the experience of performing three thousand hand dissections, the Master Level MRI Analysis on Four Limbs, and the Perfect Level Finger Replantation Skill, could often make judgments from the information obtained from the scans, and the professionals in the Medical Imaging Department might not even be able to understand what he understood from the scans.

Perhaps it was because he had the former two skills, which then allowed Ling Ran to have the third skill.

“Open it,” Wang Haiyang gestured with his fingers. Then, one of the walls of the operating theater was slowly lifted up to reveal the big screen behind it.

The nurse operated the machine, and the patient’s MRI scans were quickly displayed on the big screen.

Ling Ran was a little surprised. If he were to read the scans on such a big screen, the effects would naturally be superior.

Wang Haiyang smiled and said, “How is it? This is newly equipped in the Hand Surgery Department… What do you say…”

“It’s a divine machine when it comes to scans,” Hou Kang stepped forward and spoke in a solemn tone.

Wang Haiyang nodded in satisfaction and said, “Our Hand Surgery Department is the core department of Yun Hua Hospital. Equipment such as this one costs around one million. Once we say the word, the hospital will immediately install it for us. This is different from the Emergency Department, right. The Emergency Department needs to make a report even when they want to buy a 100,000 RMB instrument. In truth, if you really want it, when the timing is right, it is not impossible for the Hand Surgery Department to buy our very own MRI scanner.”

Ling Ran nodded as he listened to the explanation and read the scans. At the same time, he asked a little curiously, “How did you explain this the Department Director Huo?”

When Huo Congjun was mentioned, Wang Haiyang’s expression turned a little red in rage before he snorted, “I lent him a rehabilitation room for two months.”