BXBX NOVEL Chapter 32: The Small Appendix, The Great Spirit
That day, after handing over her shift, Head Nurse Tian Xianglan suddenly said, “The end of the month is approaching, and our emergency department’s performance is likely going to be at the bottom again. Everyone, please make sure to follow up on patients’ hospitalization fees during this time. Many have incurred debts upon admission and have not yet paid. Our department definitely won’t meet its targets, but we can’t let the hospital leadership call us out again, right?
Also… doctors, please conserve your medical supplies. They’re money, you know. And those masks, can you not use a new one every day, like your home has a mine? And those swabs, don’t just throw them out before they are fully used. Besides, add some alcohol and they can still be used!… It’s all money after all.”
“Lastly, there’s the issue with outpatient fees. From now on, one appointment for one patient. You can’t have one appointment for dozens of patients. The hospital is now implementing a policy of one identity card for one patient. Also, remember to charge for suture packs and dressing packs. This place isn’t a welfare institution, everyone… I won’t mention names, but everyone please be attentive…”
Mm, the head nurse, as always, remarked that one doesn’t know the cost of fuel and rice until they run a household.
As the steward of the department and in charge of the family’s finances, Tian Xianglan also had a significant responsibility.
It may seem like the emergency department is the largest in the hospital, but… it is also the poorest.
The emergency department’s shift system is quite unique, varying from one hospital to another.
The daytime work is more tedious—writing medical records, rounding, treating patients, debridement, dressing changes. These activities had become a habit of life for a surgeon, as natural as getting up in the morning and washing one’s face and brushing one’s teeth. Not handling a scalpel or gauze for a day felt like something was missing.
Wang Qian came back from honeymoon, and his vacation in Hawaii had made the burly young man lose several pounds.
Chen Cang exclaimed with a sigh that apparently, a honeymoon could be a real workout.
Chen Bingsheng looked at Chen Cang and said, “Today I have two appendectomy surgeries, and An Yanjun has one. I have talked to him, and asked you to do it, so give it your all.”
Chen Gang’s eyes lit up, and he said with a smile, “Alright, boss! Thanks a lot.”
Having surgeries to perform was a joyful affair for a surgeon.
How many surgeons entered a hospital and didn’t get to perform a single surgery for days or even weeks, and even if they did, they were just passing instruments; so opportunities were very important.
Chen Bingsheng gave Chen Cang opportunities, even “borrowing” An Yanjun’s surgeries for him.
Chen Bingsheng rolled his eyes: “Cut the flattery, just practice hard. Strive to perfect the appendectomy during this period, and when they come for the inspection, you’ll handle the appendectomies. There will surely be no problems!”
Chen Cang nodded, smiling and asked, “Can you really make something special out of an appendectomy?”
Chen Bingsheng sneered: “You think appendectomy is simple?”
Chen Cang curiously asked, “Is it difficult?”
Chen Bingsheng couldn’t help but shake his head: “A simple appendectomy is very easy; that’s true. But what if the patient has various complications, or if the situation inside the abdominal cavity is less than ideal? How far can you go then?”
“Here at our Provincial Second Hospital, we mostly encounter routine cases. When I was studying at Shanghai Sixth Hospital, I witnessed dozens, even hundreds of difficult appendectomy cases.”
“Routine appendectomy is suitable for cases where the appendix mesentery is relatively easy to separate and the inflammation at the base of the appendix is mild. But what do you do when there’s abnormal swelling at the base, necrosis, perforation, or severe adhesions of the appendix, making it impossible to free?”
Several consecutive questions baffled Chen Cang.
Because he had never even considered these issues.
Chen Bingsheng sighed: “There are so many problems in clinical practice; you can’t let your guard down. What’s the difference between us surgeons and those who slaughter pigs? The goal of pig slaughterers is just to kill the pig—if one stab doesn’t do it, they’ll stab again. But we’re different; we’re here to save lives.”
“Why do you think medical training requires five years of undergraduate study, three years of postgraduate, and still not be enough, with residency needed after graduation? It’s because you have no idea how patients are going to fall ill!”
Chen Cang was taken aback…
Choose how to fall ill???
Chen Bingsheng sighed: “This disease, like people, comes in all shapes and sizes. It doesn’t follow the script of your textbooks, saying how appendicitis should be like this or that. Any disease can change based on the individual differences of the patient.”
“One person might get over a cold without any issue, while another might recover even without medication. One person, one constitution—similarly, one disease, one constitution.”
“I’m telling you all this not for any reason other than to encourage you to settle down, to seriously study the science, to learn the skills thoroughly. Not to mention anything else, if you can actually get good at performing appendectomies this year, I will be very grateful!”
Chen Cang couldn’t help but ask, “Boss, how would you define having done a good job with an appendectomy? I see that your and Director Li’s appendectomies are quite similar. In fact, Director Li isn’t even as fast as you.”
Chen Bingsheng couldn’t help but smile, looking at Chen Cang: “What do you think is the difference between an average doctor and a famous doctor?”
Chen Cang: “Skill level? Technique? Detail? Or perhaps…”
Chen Bingsheng interrupted: “Do you know what a car’s airbag is for?”
Chen Cang had an epiphany!
Chen Bingsheng: “An airbag doesn’t make the car look more beautiful, nor does it make it faster. However, only when you encounter a problem does the airbag show its true worth.”
“Masters and ordinary people don’t seem very different in normal times; there might be some differences in detail, but you wouldn’t notice. However, when you find yourself in a special situation, the gap between you and a master will become glaringly obvious. Director Li is that kind of person!”
“This is to tell you, whenever you have time, think more, ponder more, read more. A surgical doctor is first a general physician and then a surgeon. Got it? You’ve just started with surgeries, you haven’t even mastered an appendectomy. These days, conventional appendectomies are rare, and laparoscopic surgeries are the norm. You need to step up the pace and catch up.”
Chen Cang nodded, smiling: “Alright, boss!”
In the past two years, Chen Cang mainly dealt with some basic clinical operations such as suturing, debriding, and resuscitating, but he had rarely touched surgery itself.
Now Chen Bingsheng was essentially opening this big door for Chen Cang completely.