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Chapter 209: No shortcuts in gaining skills

Translator: imperfectluck Editor: Kurisu

Major paths in life would be simple yet also require great concentration. Zhang Fan was extremely addicted to grinding in his System, just as if it was an illegal drug. His attitude towards the System constantly evolved. At first, he was confused. Then, he was worried that the System might disappear at any moment. Zhang Fan then learned some orthopedic surgery knowledge, and activated general surgery courses in his System.

Now, Zhang Fan was focused more and more on improving his overall medical abilities. He was no longer as anxious as before. He now had a girlfriend, home, and car. His life was now stable. He no longer needed to worry about daily life or finances.

Zhang Fan had an ordinary life ever since young. Maybe that was why he didn’t have high requirements for his financial condition. Zhang Fan was more than satisfied with what he already had. All that remained for him was to follow his original dream.

Although Zhang Fan was currently unable to access new courses in his System, he constantly grinded the ones that he already could. The best way to improve one’s medical skills would be to endlessly practice and learn. As the days passed, the accumulation of water droplets would be enough to make a sprout grow into a tall tree.

Shao Hua was also working hard at studying. She was the type who was good at studying to begin with. Zhang Fan was really proud of her!

As humans evolved from crawling on hands and feet to becoming bipedal, the ankle joint was basically an enlarged version of the wrist joint. Without mentioning the complex nerves here, just the bone structure of the ankle joint was already highly complex.

Wang Yongyong’s former teammate decided to go ahead with an ankle surgery in the end. The chronic pain in his ankle was too much for him to bear.

Private hospitals loved performing this type of surgery. First of all, this type of surgery would use very little medical equipment. Additionally, very little medicine would be required during and after the surgery. Apart from paying the doctors, the rest of the surgery fee would be pure profit. The kickbacks at Chinese public hospitals was why nobody performed research or worked on surgeries for smaller body parts.

The ankle joint was far too small. Normally, several incisions would be required for the surgeon to be able to properly see the ankle injury. Not only that, there was far too little room for the surgeon to move around in here. The number one problem with ankle surgery was that the medical equipment would break inside the ankle joint! That was evidence of how difficult ankle joint surgery could be.

Professional athletes would often have better connections than ordinary people would. The more famous the athlete, the better the connections they would have. Wang Yongyong’s former teammate had a detailed investigation done on Ma Wentao’s hospital before deciding to go ahead with the surgery. The moment that he heard that Ma Wentao was actually the son of the leader of the border province, he felt really reassured about going ahead with the surgery.

That was just how people were. Although many people would really look down on young and rich second-generation individuals, they would also unwittingly follow the young and rich second-generation individuals! The teammate never would have decided on the surgery so quickly if the private hospital had been owned by a regular merchant instead. In a way, Ma Wentao’s social status was an advantage!

Zhang Fan didn’t need to worry about pre-surgery checkups, informing the patient’s family about the surgery, or getting the signatures for the necessary paperwork. Ma Wentao’s hospital’s surgical department was running quite smoothly with several doctors to do the work now. Not only were these doctors Ma Wentao’s surgeons, they had also been recruited by Zhang Fan.

Zhang Fan knew in good detail about all these doctors that he recruited, from their moral character to their medical abilities. Currently, Li Liang wanted to learn more about arthroscopies, so Li Liang was assigned to be the surgical assistant for all surgeries that used arthroscopes.

“For this surgery, you absolutely must be careful because the space is so small. It’s easy to accidentally injure the cartilage in the ankle joint. That’s why it’s necessary to be extremely knowledgeable on the tissue structure here.” Zhang Fan taught Li Liang as they made the pre-surgery preparations.

Li Liang had only average talent, but he had the good trait of being willing to work hard. Back at Kuake City Hospital, Li Liang had practiced tying surgical knots so much that he filled the metal railings of the hospital dormitory bed with black knots. Over just one night, he used a total of five boxes of string. He was the type who tried to make up for lack of talent with hard work. This was simply how the medical field was!

The surgery began. Epidural anesthesia would be used for this type of surgery. Zhang Fan properly tied the hemostatic balloon to the leg and began. Normally, Zhang Fan would speak very little while performing surgery, and avoid words as much as he could.

This was both in order to help maintain a sterile environment as well as because of his personality. However, he had to start talking during this surgery because Zhang Fan was also trying to teach Li Liang, so he had to explain things as he went along.

“For this type of surgery, an anterolateral incision is the most common. It will be located at the external end of the ankle joint line, along the peroneus tertius and extensor digitorum longus. You must remember to be extra careful because this place is also the end point of the superficial peroneal nerve,” Zhang Fan said after he finished inserting the mirror into the ankle joint.

Although Li Liang had studied this topic multiple times before the surgery, he was still dazed when Zhang Fan began to teach him. The textbook explanations were quite basic and simple. Li Liang would have to find higher-level medical textbooks to study from in order to be able to understand Zhang Fan’s teachings!

For ankle arthroscopy, in order to make the surgery more convenient, a joint retractor would usually be used. Zhang Fan slowly cleaned out the old ankle injury with the arthroscope providing vision for him. He performed synovectomy along with clearing out some bone spurs. The difficult part about treating such old injuries was that the recovery process would be highly difficult. In order to completely eliminate the patient’s pain, a lot of adjustments would have to be made within the joint.

Arthroscopic surgeries would be highly difficult because they weren’t very similar in nature. The surgeon would absolutely need to be extremely familiar with the specific part of the body that they were performing surgery on. There was very little space in the ankle joint. Even with the arthroscopic mirror’s support, the surgeon would still need to know what tissue this place was, what district that area was, what tissue was in the surrounding areas, and so on. The surgeon would also need to know the best way to adjust all of the tissue here.

Even higher-level treatment would also require analysis of the patient’s usual walking pattern. The doctor would need to provide as individualized treatment as possible for the best treatment. This was something that China currently sorely lacked. There were just far too many Chinese patients. It could be said that Chinese doctors were incredible at performing all of the basic surgeries thanks to this. However, it would be incredibly difficult for Chinese doctors to make any progress on the more difficult surgeries.

There was a certain story about a doctorate degree medical student from New Zealand coming to study in China on an exchange program. When he arrived, even an ordinary Chinese resident doctor was more skilled than he was at performing basic gall bladder surgery. However, just look at what happened to the two doctors 10 years down the road. The Chinese resident doctor was still performing the same basic gall bladder surgeries, while the New Zealand doctor was starting to research liver transplants! This was the difference caused by different medical systems. In English, the doctor was supposed to mean a qualified practitioner of medicine, someone with good general medical knowledge. Meanwhile, Chinese doctors became similar to assembly line workers instead due to the issue of China having enormous population.

Chinese doctors would often have to repeat the most basic surgeries on a daily basis. How were they supposed to elevate their overall skills like this? At most, the Chinese doctor could easily become an expert in a specific type of basic surgery. However, most Chinese doctors would lack the conditions necessary to research and learn more about the more difficult surgeries. Once the golden period for a surgeon’s learning passed, then the doctor would be nothing more than a surgery-performing assembly line worker.

Zhang Fan slowly repaired the old injury while continuing to explain things to Li Liang. “You absolutely must be careful here. There’s an especially high concentration of nerves, blood vessels, and tendons at this location. You must avoid them during the surgery.” Zhang Fan was being quite verbose today because there truly was a high number of things that a surgeon would need to be careful about during this type of surgery.

Li Liang really wished that he could record this entire surgery and lecture. To be honest, he was only able to learn and understand about 10% of what Zhang Fan was teaching him. Li Liang wasn’t even depressed about this, because he had gotten used to it already. Every time that he assisted on a new type of surgery, he would need to study by himself for a long period of time before he would even be able to make use of what Zhang Fan taught him.

For ankle joint surgeries, there were currently two main prevailing theories. The first theory was that the injury shouldn’t be sewn up after the surgery so that the blood and fluid inside the articular cavity could drain out naturally. The surgical incision would then be allowed to heal naturally. However, Zhang Fan would never do this, as he was supremely confident in his own surgical skills now. He chose the second method: to simply place a drainage strip before suturing the incision.

After the surgery, Zhang Fan applied pressure dressing to the patient’s shin. “Loosen the pressure dressing after two days,” Zhang Fan told Li Liang regarding the postoperative care.

The surgery had been successful. After the surgery finished, Zhang Fan went to Ma Wentao’s office because the latter had something to talk to him about again.