Chapter 19: Technique

“Doctor Ling, don’t use up all your strength, there may be more ambulances arriving later,” the young Nurse Wang Jia reminded Ling Ran as she carried out preoperative preparations.

Today was the busiest day in the Emergency Department beginning from the moment Ling Ran arrived at Yun Hua Hospital. ‘And to think that there will still be ambulances coming…’ Ling Ran smiled, showing his teeth. “That’s good.”

His mission was basically one where, for every ten patients he treated, he would acquire one Basic Treasure Chest. A moment ago, he had still been worried that there would be an insufficient number of patients, and that his mission would go to waste. It would naturally be even better for Ling Ran if more ambulances arrived.

Wang Jia did not expect to see such a response from Ling Ran. After experiencing a short moment of surprise, she could not help but think, ‘As expected, Doctor Ling is different from those men who put on airs.’

A low-income resident doctor, who looked so common that no one could even remember his name, cast a glance at the treatment room. It was now filled with patients in every corner. He then said, “If more patients come, we’ll be overwhelmed with work as well.”

“Emergency Medical Care will not be sending patients our way for the time being. But that will also depend on the situation.” Doctor Zhou, who was at least remembered by his family name even though he was rather ugly, gave a brief introduction on the situation in an attempt to make himself stand out. “The normal patients will definitely not be sent over here. However, those in critical condition will be sent here if they are close to us. The patients will also be assigned here if their families request for them to be sent here. And then there are the patients who’ll just come to our doorstep on their own.”

“Most of the patients will request to be dispatched to our Yun Hua Hospital, I assume.” The resident doctor who came over to help pursed his lips a little. Yun Hua Hospital was one of several tertiary grade A general hospitals in Yun Hua City, even ordinary people would specifically come here for its outpatient services, and it would be even more so for emergency cases.

“Judging by the current situation, if we can transfer them over to the other departments, then we should just do it. Even if we’re very busy, we still have to grit our teeth and persevere. We can’t just ask the patients to be transferred to another hospital after they’re sent here, right?” Doctor Zhou was already past the age where he would get sentimental. He only said, “You’ll get to know about it after you stay here a little longer. For a big hospital like ours, we’ll always have to work past the hospital’s capacity for patients. Just wait until you have the experience, then you’ll learn how to allocate your energy as well as set your priorities.”

The resident doctor grimaced in pain at the thought, but agreed.

However, Ling Ran suddenly asked, “In that case, if I’ve already treated the patients who are assigned to us, is it acceptable for me to help the others as well?”

Doctor Zhou was shocked for a moment. He had never considered that question before. Was it not better to rest after completing your own tasks?

‘Doctors work themselves to the bone every single day. As a doctor yourself, don’t you want to rest?’

With the intention of encouraging the intern, and to not expose the craftiness of a middle-aged man in front of the intern and young nurse, Doctor Zhou said, “No one will stop you if you want to help the others in their job.”

The resident doctor next to him seemed to be inspired by Ling Ran. His spirits were lifted and he said, “Then we’ll have to work faster.”

“You just follow me obediently,” Doctor Zhou shattered the resident doctor’s dream with just one sentence.

Doctor Zhou may have seemed like a good man with average medical skills, but he had already been in the hospital for around a decade, and he was a good judge of character.

He agreed to let Ling Ran act without supervision because Ling Ran had proven that he possessed the ability to perform ordinary sutures independently.

This was a very crucial step. It was something that many resident doctors could never achieve in a year, like the plain and ugly resident doctor who had his dream shattered. Doctor Zhou would definitely worry himself if he had allowed that resident doctor to perform debridement independently.

The fact that Ling Ran was able to perform debridement independently without causing others to worry meant that he could help as well as share their occupational burdens, and not bring about new complications.

The plain and ugly resident doctor was the opposite of Ling Ran. He still needed Doctor Zhou to guide and supervise him. Sometimes, he would even require step-by-step guidance. In Doctor Zhou’s eyes, it really was easier to perform the surgeries himself than to teach others how to do it.

It would take less time, and the results would also be better. He would also not have to deal with the patient’s dissatisfaction, much less recite the numerous clauses in the Standard Precautions for Patients.

However, from Doctor Zhou’s viewpoint, judging by the injuries of the six patients assigned to them, Ling Ran’s workload would already be heavy enough if he had to treat those patients. Ling Ran might probably end up needing others to assist him.

After all, the injuries were caused by an explosion. There was probably more than one wound on many of the patients. There would also be all sorts of contaminants covering the wounds.

After Doctor Zhou wore his gloves, he attended to the patient with the most serious injuries—the patient with the lacerated brow.

He proceeded to disinfect the wound and perform debridement on the patient. He used ether to wipe away the grime around the wound, and then replaced the gauze that covered the wound. Immediately after that, he dipped a soft brush into the disinfectant before he used it to thoroughly clean the skin. He also rinsed the wound clean with distilled water, washed it, and used antiseptic gauze to dry it up.

Doctor Zhou was already highly skilled in this process, but he still had to spend more than ten minutes just to get everything done.

When he lifted his head again, he was surprised to see that Ling Ran was done treating the patient on the bed next to his. That patient had many small wounds scattered all over one of his legs.

“Come over here and perform the suturing,” Doctor Zhou called Ling Ran over to his side immediately while he went to the neighboring bed to check on Ling Ran’s suturing.

He was worried that Ling Ran would make mistakes because he was trying to be quick. Making mistakes while rushing to complete surgeries was something commonly seen among young doctors.

However, when Doctor Zhou checked the entire suture, he became more and more shocked.

The patient had been injured by flying shrapnel, and he had more than ten wounds all over one of his legs. Some were deep and some were not, some were big and some were small. In response to that, Ling Ran had also used different suturing techniques on the wounds.

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There was a simple interrupted suture with multiple knots tied on one side, and there was also a simple continuous stitch where a long thread was used to continuously stitch up the wound before a knot was tied at the end of it. There was also a cross mattress suture in the shape of an ‘X’ as a result of cross-stitching found on the largest and deepest wound.

Doctor Zhou could even see an interlocking suture below the knee.

That kind of suture was unfamiliar territory to the doctors in the Emergency Department, even though it was often used in operating theaters. That was because simple continuous sutures had to first be used on the wound before the doctor could interlock the thread. Not only was the difficulty of performing this suture much higher, the time and energy spent on it was also greater.

Although the interlocking suture technique was very suitable for handling thin skin and parts of the body that moved around a lot, doctors would usually just tell the patients to not move around to solve the problem.

If he had not been in the Emergency Department right then, perhaps Doctor Zhou would have thought that he was currently looking at someone giving a lecture on sutures.

In fact, Ling Ran’s sutures were even better than those seen in lectures about sutures, because the sutures Ling Ran chose to perform were all appropriate for each wound. No one could pick any faults from it.

The interlocking suture was performed on the wounds located below the knee. The cross mattress suture was performed on the wounds in high-tension areas. The simple interrupted suture was performed on the wounds that were longer. The simple continuous stitch was performed on superficial wounds. It saved time and reduced the patient’s pain as well.

It seemed that Ling Ran had mastered a large variety of sutures, and his decisions on which suture to use were correct as well. Doctor Zhou could not help but sigh while a well of emotion filled his heart. ‘This man is truly blessed and protected by his ancestors.’

The patient seemed a little worried as he asked, “Doctor, is there any problem with my stitches?”

“No problem. The stitches are pretty good.” Doctor Zhou paused for a moment and said, “Give me a moment. Let us take some photos of these so that we can use them as educational material for the interns.”

After he said these words, the patient instantly felt relieved. Doctor Zhou quickly called for Nurse Wang, who was standing beside him, to take a few photos.

After they were done, Doctor Zhou turned his head around again. By then, Ling Ran was also done stitching up the patient with the lacerated brow.

The thread that Ling Ran used for the stitches was the surgical catgut[1] which can be absorbed. And because of this, it was also known as the absorbable suture.

The tensile strength of such sutures was weaker. So the doctors of the Emergency Department were not fond of using it, especially the older doctors. They adhered to the principal of saving lives, and were only concerned with whether the thread would break. They were not concerned about the scar being too big.

Additionally, thinner threads meant that they would need to stitch more rounds, leading to them wasting time for no reason.

However, Ling Ran did not have those ideologies weighing him down. He just used whatever he deemed appropriate.

Doctor Zhou could only laugh bitterly after he saw this. Then he said, “The private hospital outside would charge the patient over a thousand or two thousand because you used 0.39 inches of absorbable thread.”

Ling Ran raised his eyebrows a little and asked, “So… did I just increase the revenue for our hospital?”

“You didn’t notify the patient earlier, right?”

Ling Ran shook his head.

“Just charge it based on the rate of normal threads. Let’s prevent the issue from becoming more complicated.” Once Doctor Zhou finished saying this, he continued, “I’ll just inform Department Director Huo verbally later.”

The patient with the lacerated brow was a young lad. He heard the conversation between the two of them and quickly thanked them. Then, he also expressed contempt for the high fees charged by private hospitals. However, it remained unclear to all of them if the young lad actually felt contempt towards the ‘revenue-generating theory’ which Ling Ran had spoken of.

Doctor Zhou laughed cheerfully and said, “You’re lucky you met Doctor Ling. If it were the other doctors, they would probably not be so capable in performing such fine stitches on your fractured brow. As the saying goes, ‘one minute of performance on stage, ten years of hard work off stage’.”

“In that case, I won’t have a scar after this?” The young lad felt a little embarrassed after he asked the question, so he added, “I don’t have a girlfriend yet, you see.”

“You won’t have a scar,” Nurse Wang Jia assured the young lad of the results of Ling Ran’s suture.

Ling Ran lifted his head and added a few words, “But that won’t really help you much in finding a girlfriend.”

“Doctor Ling, you don’t have to say it out loud…” Wang Jia covered her mouth as she laughed. She also shook her waist and gave Ling Ran a gentle bump with her hip.

The young lad who was lying on the patient bed felt as though he was hit by an impact stronger than the explosion…

Ling Ran then specifically reminded the young lad, “Remember to keep your face free of expressions. Be cautious, or the thread may break off.”

“You’re very attentive with your patients, Doctor Ling.” Two young nurse interns slowed down as they passed by Ling Ran’s side. They also let out a few soft little chuckles that resembled bells.

Translator’s Note:

[1] Surgical catgut: A type of cord that is prepared from the natural fibers found in the walls of animal intestines.