Chapter 34: 34 – Illegal Operation?

During a multisystem trauma, it was difficult to discern the correct order of operation and priority. Was it to save the heart life, the liver, kidneys, brain, or lungs? All of which were vital to human life and no acute trauma cases were exactly the same. The standards for handling trauma patients were also different nationally due to the vast territory within China.

"How is he?" Doctor Hao asked Li Yun after he had cleared out the blood from the patient's airway.

Li Yun placed both hands over the patient's jaw and listened in on the airway. The patient's breathing was stronger and the chest was moving regularly. "Airway is clear."

Doctor Hao nodded, "we'll operate now."

With the patients stabilized, everyone prepared for surgery. Doctor Hao noticed a good amount of residents had arrived to the scene.

"You, what's the proper protocol for a patient with multiple trauma!?" Dr. Hao asked the resident standing nearby with a bandaging kit.

"MARCH! Sir! Massive hemorrhage, airway, respiration, circulation, and hypothermia," the resident replied who was likely a military graduate.

"F***!" Dr. Hao swore. "We aren't on the battlefield!"

Dr. Hao didn't think the resident would answer MARCH, but it was obvious from the type of residents Chief Gao and Zhang liked to hire. Most medical students would say ABCDE; airway with cervical spine control, breathing, circulation, disability arising from neurological damage, and exposure. An inexperienced doctor may forget ABCDE under immense stress, or they forget that the priorities were based on the time constraint of each situation. It was difficult for some residents to stabilize the breathing first when their first instinct was to control the bleeding.

The nurses and technician finished the prep work and Dr. Hao entered the operating room after consulting with the other specialists. Li Yun followed along to assist with surgery.

As Li Yun assisted, he waited for instructions on crucial steps, but followed his own path of things to ensure the patient's survival. He didn't need Doctor Hao to tell him to use the suction when it was obvious that the excess blood was blocking the surgical field or that a forcep was needed to stop the bleeding.

The initial operation was completed after an hour in the OR. Doctor Hao examined the CT scans, making sure they didn't miss anything. The only thing they could do was send the patient into the ICU.

"So, how many surgeries have you performed?" asked Doctor Hao.

"As first assistant?" asked Li Yun. "This is my first time."

"I'll be damned, did you operate illegally before coming here?"

Li Yun stared awkwardly at Doctor Hao. He may have been a delinquent, but he had always considered himself an upright citizen that followed the law. He wasn't moonlighting as a triad surgeon.

After performing several surgeries with Li Yun, Doctor Hao had a high evaluation of his skill level. It was as good or even better than the attending doctors. Trauma surgeries were complex, and required a lot of experience in various surgical specialties. One of the most important skills a surgeon could acquire during surgery was not dexterity or even a stable hand, but a stable mind. Without a stable mind, the most dexterous person could still make mistakes.

Li Yun was unusually level headed and calm. Although he wasn't able to make quick assessments, he was able to perform everything that Doctor Hao had instructed. After a few weeks, Li Yun could perform assessments without needing Doctor Hao's instructions.

As the ER turned chaotic during the night, Doctor Hao would sign his name and leave Li Yun to lead the surgical operation with two other residents as he took care of other emergency cases. Was that the usual protocol? No, but Doctor Hao wasn't the type to care much about rules and regulations.

"Doctor Hao, you know that this is against our policy," Doctor Gao warned in his closed private office.

"Yeah, whatever, like you're the one to talk," said Doctor Hao. "I know you gave the kid permission to perform your surgeries."

"Yes, but at least I was in the same room, I can't say that about you. What if the residents and nurses start talking?"

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"The residents won't talk, they are getting more opportunities to perform surgery, and do you honestly think they will talk about Dr. Li?"

Doctor Gao nodded. The residents were either scared of Li Yun or treated him like their boss. Heck, some of the doctors were afraid of him. "Even if they don't say anything, the residents rotating from other departments will."

"And what can they do?" Doctor Hao raised both his hands, showing his bravado. "Complain to their chiefs? I want to see them try."

"You're not worried that they will cut your pay for not supervising a surgery?"

"Eh? I'm in the same building, and I am watching from a video monitor, who said I wasn't supervising? Are you going to tell me you're still stuck in the 20th century?"

Doctor Gao paused for a moment. "Oh hot damn, you're right, there's nothing in the guideline that states you have to be in the same room, he just has to be supervised. You're brilliant Doctor Hao!"

"Oh ho ho ho! Thank you!" Sometimes, being a triad's surgeon back in the day really helped in hospital politics.

Sitting in the back of the office, Doctor Lim rolled her eyes in annoyance just watching the two of them. However, she had to admit that Li Yun had abilities beyond his age.

Everyone in the ER trusted Li Yun, whether it was in surgery or handling difficult patients. It had also led to many rumors.

"What did you hear about me?" asked Li Yun during a lunch break.

Although Yang Kang was annoyingly talkative, he wasn't the vicious type. His gossip was a form of entertainment.

"You would not believe this, but some of the nurses and residents think you're a fortune teller," Yang Kang replied.

Li Yun laughed. "Really? I wish I had that ability."

"But seriously, I sometimes believe them," Yang Kang chimed in. "Like, how do you know I'm from Changsha and that I like banana splits? I don't remember telling anyone about it."

"That's not even a difficult guess. Anyone with eyes can guess based on the type of food you bring in. And your eyes light up whenever the cafeteria has a banana split."

"How about the time the patient attacked me?" asked Lui Jing. "A nurse said you never left the resident quarter, so you couldn't have known about it. There wasn't any visible marking, so how did you know?"

"When I asked you to get up, your first reaction was to cover your head," said Li Yun. "Something must have hit your head for that type of reaction. Since the ER is chaotic, I assumed it was likely a patient. You had signs of a concussion, so I recommended that you get checked."

"What about the elderly lady with depression?" Mi Xuan asked curiously. "She came in again and apologized to me. How did you help her with depression so quickly? You barely talked to her."

"Face reading," Li Yun replied.

Everyone looked curiously at Li Yun, they all thought face reading was a form of fortune-telling.

"Think of it more as an observational skill," Li Yun explained. "Face reading can give you a general idea of a person's condition. In Ms. Ching's case, her previous physical and medical history confirmed the diagnosis. Since there were no physical signs of illness or complications, there was a high probability that this was a mental issue. She came in for the sole purpose of getting attention."

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