fictionpage Chapter 21 The Blow to the Reborn!
Chapter 21 The Blow to the Reborn!
"It's because the teacher doesn't know you well enough and hasn't had enough contact with you."
Dong Anhua lowered his hands and clasped them together on the table: "Please sit down first."
Dong Anhua knew that his teaching method was to have new students first trained by Qin Huai and others, and only after Zeng Tianfang had trained them for a period of time would they be sent to him.
Although Chen Zhuoan's program is eight years long, clinical medicine is an experience-based discipline, and Chen Zhuoan is currently only in his sixth year.
Chen Zhuoan has only been studying clinical medicine for six years at most.
From his perspective, it was still so tender it looked like it could be squeezed for water.
Students in the five-year program only finish their first year of graduate studies in their sixth year.
The college entrance examination scores for the five-year clinical medicine program at Central South University are also not impressive, not much lower than those for the eight-year program…
Chen Zhuoan looked calmly at his teacher, Dong Anhua.
Knowing he hadn't mentored Chen Zhuoan enough, Dong Anhua asked again, "You have a very good memory?!"
The tone was both a question and an affirmation.
"Not bad." Chen Zhuoan chose a more tactful, Chinese-style response.
"How much do you know about the surgeries performed in our department?"
"Is there anything you're particularly interested in, or anything you don't understand?" Dong Anhua asked.
Surgery is a procedure, a set of specific operations.
Even if you've seen it all, memorized it all, and even been able to replicate it all, there will still be many points of doubt.
True surgical mastery requires extensive hands-on practice and continuous understanding to break it down and make it one's own.
Chen Zhuoan thought about it carefully, and replied tactfully again: "I can remember most of it, and I've also looked up some information to understand the underlying details!"
"Yes, that's how you learn medicine: first memorize, then grasp the fundamentals."
Dong Anhua agreed with Chen Zhuoan's view: "Then, in your opinion, what are the key points of pelvic fracture surgery?"
When Chen Zhuoan encountered a specific technical point, he answered without hesitation: "Expose!"
"Exposed?"
Dong Anhua: "Shouldn't it be the continuity and stability of the pelvic ring?"
Chen Zhuoan: "Teacher, it's about exposing, exposing at just the right time."
"Due to the unique anatomical structure and morphology of the bones in the pelvis, fractures are not as disordered as those of long bones."
"Appropriate exposure is the key to restoring the stability and continuity of the pelvic ring."
"If the fracture is not clearly exposed, the pelvic fracture space can easily become trapped."
"Even after the fracture heals, patients may still experience some complications..."
Dong Anhua blinked: "What about the hand flap surgery?"
He initially refuted Chen Zhuoan's point of view. However, Chen Zhuoan provided suitable reasons.
Having a valid reason means that Chen Zhuoan has been in a state of thinking and learning, and has engaged in thinking behavior, so there is no need to discuss right or wrong.
In fact, pelvic fractures are more difficult than skin flap surgery.
However, the flap surgery currently in use for the past 10 years has been very crude.
After skin flap transplantation, patients are often left with large lumps of flesh, which greatly limit both aesthetics and function.
Therefore, Chen Zhuoan needs to extract some key knowledge points about 10 years ago to provide a precise answer.
"For flap surgery, the main considerations at present are the flap's viability and shape design."
"Currently, the best we've done is with perforator flaps, but the fat layer of the flap is very difficult to manage because it's the bed of the perforator artery and its pedicle."
"I'm afraid of being caught in the crossfire."
"Therefore... we can use a more cautious term to describe flap transplantation: palliative soft tissue defect filling."
Although Chen Zhuoan's tone was cautious, Dong Anhua's brows furrowed deeply, and the deep lines on his square face deepened: "Do you even know what 'conciliatory' means?"
"You only use this word?"
Chen Zhuoan calmly replied, "It's a non-radical surgery performed to alleviate the patient's suffering!"
"Teacher, but let's analyze it carefully."
"If a patient has soft tissue defects in the sole of the foot, his main problem is pain and difficulty walking, which causes limping."
"However, after surgery, this kind of patient will have such a large bulge on the sole of their foot." Chen Zhuoan gestured with his hands to form an oval shape the size of a bowl.
"Shoes are hard to buy...and walking is still bumpy."
"Even after surgery, because of the soft tissue protrusions on the soles of the feet, the local pressure is too great, and pressure-induced necrosis can still easily occur again."
"Even if it's not the sole of the foot, but the instep? The patient's shoes are either custom-made or much larger than expected."
"This will still affect their walking..."
If Dong Anhua wants to talk about hand surgery, Chen Zhuoan believes that the most needed change in surgical procedures is the preparation of skin flaps.
We need to gradually abandon the traditional hypertrophic full-thickness flaps and replace them with individualized, precisely designed flaps that will only appear in the future, or even implantation techniques for arteries, skin, and muscle tissue.
In any direction, as long as Chen Zhuoan sets his sights on something, there will be a broad road leading him forward.
Not just osteosarcoma, which Chen Zhuoan specializes in!
In fact, the process of treating osteosarcoma is the longest, but it is also the one that Chen Zhuoan finds particularly important.
Therefore, Chen Zhuoan needs a lot of people.
Just like in his previous life, it would be best to have a large team of three or four people, fifty or sixty in total, to command...
"Judging from your perspective, it is indeed an act of leniency."
"Chen Zhuoan, but you also need to know one thing!"
"Flap transplantation is currently the most advanced surgical technique. It's a solution devised by countless predecessors through painstaking efforts to address skin and soft tissue defects!"
Dong Anhua's tone was serious.
Chen Zhuoan nodded: "Yes, teacher, leniency is not a very bad word."
"Being able to truly solve patients' illnesses and pain is healing and redemption."
"I borrowed it for flap transplantation surgery just to describe it accurately."
"In medicine, 90% of diseases are actually treated with palliative care. This is the essence of the disease, and we have to admit it."
"The human body is born pure, developing from an embryo, and being conceived by parents, which is the most perfect state."
"Once a person is born and lives for a few years, it's impossible for them to return to their most perfect state; that's the fundamental point!"
Dong Anhua released his hands: "Your understanding of medicine is indeed profound."
"That's understandable, considering that video that's been all the rage on the forums these past few days."
"The essence of pneumothorax is that air in the pleural cavity compresses the lung tissue and severely affects the contraction of the respiratory muscles."
"The treatment for pneumothorax involves releasing the gas from the pleural cavity and preventing external gas from entering, relying on a liquid seal plane."
"Putting water directly into a syringe is indeed very suitable for emergency treatment of outpatients with pneumothorax."
"It also facilitates patient transfer and management."
As Dong Anhua spoke, his tone became playful: "The thoracic surgeons even asked me for your services, what do you think?"
Chen Zhuoan thought about it carefully before saying, "If professors from the thoracic surgery department want to collaborate, that's not out of the question!"
Dong Anhua scoffed, "Cooperation? You mean, you provide the ideas, and they provide the work?"
"You expect them to work for you?"
Chen Zhuoan: "The essence of cooperation is a relatively equivalent or relatively unequal exchange."
"They have their own ideas, they do their own research. If they don't have any ideas, they just use their hard work and technical skills to get published papers."
"That's very simple!"
The thoracic surgery team?
It's not impossible!
In his previous life, when Chen Zhuoan was researching sleep apnea syndrome, he also had in-depth contact with thoracic surgery research.
Dong Anhua understood Chen Zhuoan even less...
So Dong Anhua chose to take a hard line: "Your breath smells so bad, do you even have any work to do?"